• Title/Summary/Keyword: 정신과 장애

Search Result 1,859, Processing Time 0.024 seconds

The Development of a Mental Disorder Recovery Scale (정신장애인의 회복측정도구 개발)

  • Lee, Jeong-Sook;Lee, Sun-Young
    • Journal of Digital Convergence
    • /
    • v.11 no.12
    • /
    • pp.639-647
    • /
    • 2013
  • This paper is a methodological research aimed at developing a mental disorder recovery scale (MDRS) and testing its validity and reliability. After three sessions of factor analysis, a total of three factors using an Eigen value of 1.0 or more were drawn. The explanatory power was found to be 58.1%. All the items met the criteria for communality and factor loading with no item removed, and, ultimately, 25 items were selected. Criterion-related validity test showed that Pearson's correlation coefficient was significant at .71 (p<.01) with significant correlation with each factor (p<.01). The reliability test showed that Cronbach's ${\alpha}$ coefficient was .95 and that Cronbach's ${\alpha}$ coefficient for each factor ranged from .87 to .93. MDRS, which was developed in this study and possessing 3 factors and 25 items, had both its validity and reliability confirmed; therefore, the developed scale would be useful to evaluate the recovery of individuals with mental disorder.

PSYCHOPHARMACOLOGY OF ADHD WITH COMORBID DISORDERS (주의력결핍 과잉행동장애와 공존질환의 약물치료)

  • Cho, In-Hee
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • v.14 no.1
    • /
    • pp.36-52
    • /
    • 2003
  • Attention deficit/hyperactivity disorder is one of the most comminly treated conditions in the child psychiatric units and results in substantial impairment in peer, family and academoc functioning. For 70% to 80% of children with a diagnosis of ADHD, stimulant tratment results in successful improvement of the core ADHD symptoms. However, children with ADHD have high level of comorbidity and may respond differently from children with ADHD without comorbidity. Therefore they may need specific treatment plan. We reviewed efficacy and safety of prescribed medication for treating children with ADHD, the relationship between ADHD and the comorbid conditions and treatment algorithm projects of ADHD with/without comorbid conditions performed Korean and American child psychiatrists. Our main objective is to increase the uniformity of treatment and improve the clinical outcomes of children with comorbid ADHD.

  • PDF

The Effect of Low-Frequency Repetitive Transcranial Magnetic Stimulation on Treatment-Resistant Tourette's Syndrome among Children and Adolescents : An Open-Label Study (치료저항성 뚜렛장애를 가진 소아청소년에서 저빈도 반복적 경두개자기자극술의 효과 : 오픈 라벨 연구)

  • Lee, Young-Ji;Chae, Jin Hyuk;Seo, Wan Seok
    • Journal of the Korean society of biological therapies in psychiatry
    • /
    • v.24 no.3
    • /
    • pp.239-246
    • /
    • 2018
  • 목 적 : 본 연구의 목적은 치료저항성 뚜렛장애를 가진 소아 청소년들에 대해서 보조운동영역을 표적으로 한 저빈도 반복적 경두개자기자극술의 효과를 평가하는 것이다. 방 법 : 이 연구는 미국정신의학회 진단기준 및 통계편람, 제 4판을 기준으로 뚜렛장애로 진단받은 10명의 소아 청소년(평균연령 $12.56{\pm}1.04$세)을 대상으로 하였다. 모든 참가자들은 1년 이상 지속적으로 충분한 용량의 약물치료를 받았음에도 불구하고 한국판 예일 틱 증상 평가척도(YGTSS) 20점 이상, 임상인상척도(CGI-TS) 4점 이상을 받았다. 참가자들은 보조운동영역을 표적으로 1 Hz 반복적 경두개자기자극 치료를 매일 20분간 받았으며, 총 20회 치료를 받았다. YGTSS, CGI-TS 및 이상반응 체크리스트는 연구 시작 전과 연구 시작 후 4, 8, 12주에 시행되었다. 결 과 : 틱 증상은 연구 12주차까지 호전된 상태로 지속되었으며, YGTSS와 CGI-TS가 통계적으로 유의하게 감소하였다. 특히 음성 틱 점수의 감소가 운동 틱 점수의 변화보다 전체 YGTSS 점수의 감소에 큰 역할을 한 것으로 나타났다. 그리고 전체 10명의 참가자 중 9명이 심각한 부작용 없이 연구를 끝까지 완료하였다. 결 론 : 본 연구는 보조운동영역을 표적으로 한 저빈도 반복적 경두개자기자극술이 치료 저항성 뚜렛장애를 가진 소아 청소년들에게 효과적이고 안전한 치료도구가 될 수 있음을 시사한다. 이러한 반복적 경두개자기자극술의 치료효과를 확정하기 위해서는 보다 많은 환자를 대상으로 한 잘 통제된 연구가 필요할 것이다.

Pharmacotherapy for Patients Complaining With Somatic Symptoms (신체증상을 호소하는 환자의 약물치료)

  • Lee, Kyung-Kyu
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.29 no.2
    • /
    • pp.95-101
    • /
    • 2021
  • Patients complaining with somatic symptoms are very common in clinical practice, and are often consulted to medical department. But it is difficult to treat well. The treatment of somatic symptom disorder is multi-modal as none of the methods on their own provide a satisfactory outcome. The treatment of somatic symptoms disorders is complicated by lack of boundary, conceptual clarity, and overemphasis on psychosocial causation and effectiveness of psychological treatments. In clinical practice all classes of psychotropics are used to treat somatic symptoms disorder. Drugs such as tricyclic antidepressants, serotonin reuptake inibitors(SSRI), serotonin and noradrenalin reuptake inhibitors (SNRI), atypical antipsychotics are studied. The evidence indicates that these drugs are effective in somatic symptom disorders. All classes of antidepressants seem to be effective against somatic symptom disorders. SSRIs are more effective against hypochondriasis and body dysmorphic disorder, and SNRIs appear to be more effective than other antidepressants when pain is predominant. The author suggest that psychiatrists should know how to treat patients complaining with somatic symptoms by using not only psychotherapeutic approach but also pharmacological treatment. It will be helpful to reduce suffering and increase quality of life of these patients.

A Qualitative Study on the Mental Crisis Occurence and Self-Help Support Process of People with Mental Disabilities - Focused on the Experience of Participating in Self-Study and Mutual Help of Bethel's House (정신장애인의 정신적 위기 발생과 자조적 지원과정에 관한 질적 연구 - 베델의 집 당사자연구 참여경험을 중심으로 -)

  • Lee, Yong-Pyo;Chung, Yu-Seok;Bae, Jin-Young
    • The Journal of the Korea Contents Association
    • /
    • v.21 no.7
    • /
    • pp.304-316
    • /
    • 2021
  • The purpose of this study is to analyze the records of 8 people with mental disabilities who had participated in Research and Mutual Help of Bethel's House and to investigate the occurrence of mental crisis and process of self-help by using the grounded theory method. As a result of axial coding, the central phenomenon of crisis experience of the people with mental disabilities was derived as 'being overwhelmed by hardships in the life related to their symptoms'. In the self-help process of overcoming the crisis, Action-interaction strategies were derived as 'talking about the hardships', 'researching and practicing with peers', 'participating in various groups', etc. through the intervening conditions such as 'understanding patterns and meanings of hardships led by the person' and 'finding ways to overcome the hardships with the person'. These strategies were analyzed as a process in which the person with mental disabilities leads his/her life reassuming control over his/her crisis. The result of this study shows that it is necessary to expand the political crisis concept in the support system for the mental crisis of people with mental disabilities, and the self-help approach in which the persons participate autonomously can be useful.

Factors affecting the rehabilitation center exit and reentry among homeless persons with mental illness. (정신장애노숙인의 재활시설 퇴소 및 재입소 영향요인에 관한 연구)

  • Min, So-Young;Lee, Byung-Suk
    • Korean Journal of Social Welfare Studies
    • /
    • v.42 no.1
    • /
    • pp.219-242
    • /
    • 2011
  • This study examined the factors associated with exit from and reentry into the rehabilitation center among homeless persons with mental illness. Shelter use of a total of 203 study population was monitored between 2004 and 2008. Cox's proportional hazard model was employed to analyze the factors influencing the rate of the first exit from and the first reentry into the rehabilitation center. Also, competing risk analysis was conducted to examine the factors differently associated with the type of the first exit from the rehabilitation center: a positive exit and a negative exit. This study found that homeless persons with mental illness were less likely to experience the negative exit while their resident registration status not being abolished on the first entry into the rehabilitation center, having more frequent hospitalizations during the rehabilitation center stay, being connected to the family members, having more participations into the basic rehabilitation, mental rehabilitation, and vocational rehabilitation programs during the rehabilitation center stay. Age, the number of hospitalization and of the participations into the mental rehabilitation programs during the rehabilitation center stay were associated with the rate of the first reentry into the rehabilitation center.

고위험 공무직군의 직무스트레스 연구동향 및 과제: 경찰관, 소방관을 중심으로

  • Byeon, Sang-Hae;Yu, Sang-Hyeon
    • 한국벤처창업학회:학술대회논문집
    • /
    • 2018.04a
    • /
    • pp.143-147
    • /
    • 2018
  • 직무스트레스를 이해하기 위해 많은 선행연구가 있어왔다. 특히 고위험 공무직군의 직무스트레스는 다양한 정신건강에 영향을 미쳐오고 있는 만큼 연구된 내용을 이해할 필요가 있다. 선행연구내용을 경찰관과 소방관을 중심으로 분류하고 적용된 직무스트레스 모델과 척도를 분석하였다. 분석된 논문에서 직무스트레스가 영향을 주고 있는 정신장애를 확인하고, 직무스트레스와 정신장애 간의 영향을 조절할 수 있는 조절변인들을 확인하였다. 직무스트레스 모델과 척도는 JCQ, ERI, NIOSH 모델을 바탕으로, 척도는 KOSS(52%)가 가장 많았다. 또한 직무스트레스가 영향을 주는 요인들로는 직무태도(62%)로 가장 많았으며, 우울(19%)로 나타났다. 직무스트레스를 조절하는 변인으로 직무만족(20%), 사회적지지(19%), 직무특성(15%)로 나타났다. 논의에서는 연구의 한계와 직무스트레스가 영향을 주는 정신장애와 조절변인들을 분석하는 것을 통해서 이후 연구에 나아갈 방향을 제시하였다.

  • PDF

CHILDHOOD TRAUMA:PSYCHIATRIC OVERVIEW (아동기 외상의 정신과적 개관)

  • Han, Sung-Hee
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • v.13 no.1
    • /
    • pp.3-14
    • /
    • 2002
  • Childhood psychic trauma appears to be a crucial factor in the development of serious disorders both in childhood and in adulthood. Traumatized children show strong tendency to revisualize or re-feel a traumatic events. Play and behavioral reenactments are frequent manifestations of both the single blow and the long-standing traumas in childhood. Those children who suffer the results of single, intense terror appear to exhibit detailed memory, retrospective reworkings and misperceptions. In long-standing or repetitive trauma, children would show psychic numbing, self-hypnosis, dissociation and rage. Child's brain is undergoing critical and sensitive periods of differentiation. During this time, developing central nervous system is exquisitely sensitive to stress. Stressor-activated neurotransmitters and hormones can play major roles in neurogenesis, migration, synaptogenesis, and neurochemical differentiation. Internal opiate system operates in some trauma and causes the victim to fail to respond, to avoid, to shut off feelings. Evidence is also accumulating in traumatology that dysfuntion of locus coeruleus and ventral tegmental neucleus system leads to catecholamine receptors hypersensitivity. This change result in hypervigilance, increased startle, affective lability, and increased autonomic nervous system hyperreactivity. Another site of action of trauma on the brain is hypothalamic-pituitary-adrenal axis. Individuals with PTSD do not have enough cortisol to halt the alarm reaction. When children are exposed to long-standing extreme events, massive attempts to protect the psyche and to preserve the self are put into gear. These developmental traumas mobilize various kinds of defense mechanisms. Massive denial, dissociation, self anesthesia, identification with aggressor and aggression turned against the self often lead to profound character changes in the youngsters.

  • PDF

The review of the 2016 amended Korean Mental Health promotion Act from the Perspective of Human Rights and Inclusion of Persons with Mental Disabilities (정신장애인의 인권과 지역사회통합의 관점에서 본 2016년 정신건강증진법의 평가와 과제)

  • Park, Inhwan
    • The Korean Society of Law and Medicine
    • /
    • v.17 no.1
    • /
    • pp.209-279
    • /
    • 2016
  • The Korean Mental Health Act was amended 2016 overall. This paper examines and evaluates the old Korean Mental Health Act since 1995 and the new Korean Mental Health Promotion Act 2016 from the Perspective of Human Rights and Inclusion of Persons with Psychosocial Disabilities. The persons with mental disabilities was separated and ruled out from society by the enactment of the Mental Health Act in 1995 and five times amendment. That has been justified and institutionally supported by medical viewpoint. The medical approach which reconsider the persons with mental disabilities as patients conceal that the aims of the involuntary admission in Mental Hospital are protection of society and the relief of the family member's duty of support for person with mental disabilities. This is institutionally supported in the 1995 Korean Mental Health Act by involuntary admission through the consent of family members as protectors. According to the old Act, the family members as protectors are authorized to consent to involuntary admission of persons with mental disabilities. Also, the psychiatrist that diagnoses the person with mental disabilities and evaluates the need for treatment by admission is not impartial in this decision. Family members as protectors may want to lighten their burden of support for the person with mental disabilities in their home by admitting them into a mental hospital, and the psychiatrist in the mental hospital can be improperly influenced by demand of hospital management. Additionally, Article 24 of the Korean Mental Health Act for the Involuntary Admission by the Consent of Family Members as Protector might violate personal liberty, as guaranteed in the Korean Constitution. The Mental Health Promotion Law was amended to reduce the scope of the persons with mental illness which are subject to forced hospitalization and to demand that a second diagnosis is made by another psychiatrist and screening by the committee concerning the legitimacy of admission in the process of the involuntary admission by the consent of family members as a method of protection. The amended Mental Health Promotion Law will contribute to reducing the number of the involuntary admissions and the inclusion of persons with mental disabilities. But if persons with mental disabilities are not providing some kind of service to the community, the amended Mental Health Promotion Law does not work for Inclusion of them.

  • PDF

T.O.V.A. PROFILES OF CLINICALLY REFERRED CHILDREN WITH SYMPTOMS OF INATTENTION (주의산만을 주소로 소아정신과를 내원한 아동의 인지적 특성 - T.O.V.A. 양상을 중심으로 -)

  • Lee, Soo-Jin;Lee, Hye-Ran;Ko, Ryo-Won;Shin, Yee-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • v.11 no.2
    • /
    • pp.290-296
    • /
    • 2000
  • Objective:This study aims to investigate the cognitive characteristics of clinically referred children with symptoms of inattention, cach as having ADHD, tic disorder, and emotional disorder. Methods:65 boys(38 with ADHD, 17 with Tic disorder, and 10 with Emotional disorder) were individually assessed using the KEDI-WISC(FIQ, VIQ, PIQ) and T.O.V.A.(errors of omission, errors of commission, reaction time, variability, anticipatory response, multiple response), and the results of those tests were analyzed. Results:There was significant difference among three diagnostic groups of the VIQ of KEDIWISC and the reaction time of T.O.V.A. after the correction of the effect of age difference. Conclusion:The findings suggest that the reaction time of T.O.V.A. might be the useful variable to differentiate the ADHD from other psychiatric disorders and the effect of age and IQ difference should be considered carefully to diagnose in clinical setting.

  • PDF