• Title/Summary/Keyword: 정신과 장애

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Developing the Self-Reporting Scale of Community Integration for the Person with Psychiatiric Disabilities (정신장애인의 자기보고식 지역사회통합 척도 개발)

  • Choi, Youn Jeong
    • 재활복지
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    • v.16 no.3
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    • pp.165-192
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    • 2012
  • This study aims to develop a valid self-report scale for the community integration of persons with psychiatric disabilities. To this end, conducted were in-depth interviews with individuals with psychiatric disabilities, consultation with experts, and a survey. First, literature review and the in-depth interview with individuals with psychiatric disabilities were collected questionnaires regarding the community integration of persons with psychiatric disabilities. Second, preliminary research 1 focused on the selection and modification of the items collected in the first research. Final 44 items were selected by the verification of the importance and content-validity of items under the advices of professionals. Lastly, preliminaty research 2 applied cross-validation method to the data from 524 cases in order to verify the factor structure and concept-validity of the items. The result of exploratory factor analysis shows that 5 factor structures are the most appropriate, and the confirmatory factor analysis suggests that the Self-reporting Scale of Community Integration for the person with psychiatric disabilities consists of 27 questionnaires which compose 5sub-concepts such as'psychological integration','physical integration', 'social support', 'social integration', 'independence/self-actualization'. Moreover, this scale was significantly related to the 'Life Satisfaction scale for the person with psychiatric disabilities'. This proved concurrent validity of the scale.

The Therapeutic Implications of Alexithymia in Patients with Eating Disorders (식이장애 환자에서 나타나는 감정표현불능증의 치료적 함의)

  • Kim, Seung-Jun
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.54-60
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    • 2016
  • Alexithymia is characterized by difficulties identifying and describing feelings, impoverished fantasy life, and concrete and poorly introspective thinking. Alexithymic patients have been reported to show a stable deficit with regard to processing and regulating emotions. Eating disorders are characterized by a persistent disturbance of eating or eating-related behavior that significantly impairs physical health or psychosocial functioning. Like alexithymic patients, patients with eating disorders show the impaired capacity to process and regulate emotions. There is a robust body of literature showing patients with eating disorders are more alexithymic than healthy controls. Specifically, patients with eating disorders experience difficulties identifying and describing emotions. Childhood maltreatment can increase the risk for depression and alexithymia, which can in turn lead to disordered eating symptoms. Also, higher levels of alexithymia are correlated with a less favorable clinical outcome in patients with eating disorder. Therefore, treatments to help processing and regulating emotions of eating disorder patients with pronounced alexithymic traits may seem to lead to a higher possibility of recovery.

A Development and Validation Study of the Web-based Korean Version of the Eating Disorder Diagnostic Scale DSM-5 (웹 기반 한국판 섭식장애진단척도 DSM-5의 개발 및 타당화 연구)

  • Lee, Hye Rin;Kwag, Kyung Hwa;Lee, You Kyung;Han, Soo Wan;Kim, Youl-Ri
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.185-193
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    • 2020
  • Objectives : The aim of this study was to develop and to verify the Korean version of the Eating Disorder Diagnosis Scale DSM-5 (K-EDDS) as a web-based diagnostic system, which enables rapid diagnosis of patients for early intervention. Methods : A total of 119 persons participated in the study, including patients with eating disorders (n=38) and college students (n=81). Along with the paper-and-pencil SCOFF, all participants completed the web-based K-EDDS, the Eating Disorder Examination-Questionaire (EDE-Q), and the Clinical Impairment Assessment Questionnaire (CIA). The semi-structured interview using the Eating Disorder Examination Interview (EDE) was conducted for participants with two or more SCOFF scores. Within two weeks, the web-based K-EDDS, the EDE-Q, and the CIA were re-tested. Results : In the exploratory factor analysis, four factors were extracted : body dissatisfaction, binge behaviors, binge frequency and compensatory behaviors. The four subscales of the web-based K-EDDS had significant correlation with each of the four subscales of the EDE-Q. The internal consistency of the web-based K-EDDS was highly satisfactory (Cronbach's alpha=0.93). The diagnostic agreement between the web-based K-EDDS and the EDE was excellent (96.83%), and the web-based K-EDDS's test-retest diagnostic agreement was fairly good (92.86%). The web-based K-EDDS and the CIA also showed significant differences between patients and general population, supporting discriminant validity. Conclusions : This study suggested that the web-based K-EDDS is a valid tool for assisting diagnosis of eating disorders based on DSM-5 in clinical and research fields.

The Differences of Serum Homocysteine Levels in Mild Cognitive Impairment and Dementia of Alzheimer's Type with or without Depressive Symptoms (경도인지장애, 알쯔하이머형 치매 환자에서 우울증상 유무에 따른 혈중 호모시스테인의 차이)

  • Hwangbo, Ram;Kim, Hyun;Lee, Kang Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.1
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    • pp.40-45
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    • 2014
  • Objectives : Mild cognitive impairment(MCI) and dementia of Alzheimer's type(AD) are characterized by progressive decline of cognitive abilities and a wide range of neuropsychiatric symptoms like depression. Among various diagnostic tools of AD, many studies showed that elevated levels of serum total homocysteine are associated with increased risk of developing Alzheimer's disease, depression and other neuropsychiatric disorders. We investigated whether elevated homocysteine concentrations are associated with depressive symptoms in MCI and AD. Methods : A total of 86 patients diagnosed with MCI or AD participated. Total serum homocysteine levels in fasting blood samples were measured. We examined cognitive symptoms by MMSE-KC, Global Deterioration Scale(GDS), Clinical dementia rating(CDR) and depressive symptoms by Korean version of Geriatric Depression Scale(K-GDS). Results : The total serum homocysteine levels were significantly higher in MCI with depression than in MCI without depression. There was no significant difference in the mean homocysteine levels between AD patients with depression and AD patients without depression. The total homocysteine levels showed a negative correlation with MMSE-KC and a positive correlation with CDR, GDS. Conclusions : These findings suggest that elevated homocysteine level is a risk factor for the decline of cognitive function and depression. We found a significant relationship between elevated serum homocysteine level and depressive symptoms in MCI. But our study had several limitations, thus more research is needed to confirm this finding.

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BORDERLINE DISORDER OF CHILDHOOD : 8 CASES (아동기 경계선 장애 : 8증례)

  • Hong, Kang-E;Lee, Jeong-Seop;Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.6 no.1
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    • pp.3-17
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    • 1995
  • The so-called borderline children are characterised by disturbances in the sense of reality and interpersonal relationships, lack of control, fluctuation of functioning, uneven development and excessive anxiety. But the concept of borderline disorder of childhood is very difficult to define and diagnose in current classification system. The present study adapted the consensus symptoms in borderline children by Bemporad and Vera eight cases aged 7-11 were examined in 37 variables. Results are as follows 1) All subjects are boys and girl hardly be diagnosis n current diagnostic system and have many concurrent diagnoses. Common chief complaints in the sense of reality. 2) In KEDI-WISC test, the borderline children showed average intelligence, but performance IQ tends to be higher than verbal IQ. In Rorscharch test, they showed high thought disorder index, emotional instabilities and aggressive impulses. The results of TOVA suggested attentional deficit in half of the subjects. The organicity is not prominent. 3) Many of the borderline children were unwanted baby. Although primary care takers of all the subjects were their mothers there were moderate problems in caring attitude of their children and marital relationship with their husband. Sccioeconomic status was generally below middle class. Most of all subjects have delayed language development, but have overcome subsequently. Many subjects were rejected by peers because of their aggression. 4) The first visit of the subjects was about 6 years of age. Average duration of treatment was 2 years. All of them were treated in the outpatient basis except one. The effect of pharmacotherapy was doubtful and the necessity of long term play therapy was suggested. Although there were many limitations of method in present study, it was suggested that further research is needed for diagnostic criteria, epidemiology and treatment.

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Clinical Characteristics of Night Eating Syndrome in Outpatients with Bipolar Disorder (양극성 장애 외래환자에서 야간식이증후군의 임상적 특성)

  • Jung, Haran;Yoon, Bo-Hyun;Sea, Young-Hwa;Song, Je-Heon;Park, Suhee;Koo, Bonki;Kim, Kyung-Min;Nam, Seok-Hyun
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.2
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    • pp.112-120
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    • 2014
  • Objectives : The aim of this study is to evaluate the clinical characteristics of night eating syndrome(NES) in bipolar disorder outpatients. Methods : The 14 items of self-reported night eating questionnaire(NEQ) was administered to 84 bipolar patients in psychiatric outpatient clinic. We examined demographic and clinical characteristics, body mass index(BMI), subjective measures of mood, sleep, binge eating & weight-related quality of life using Beck's Depression Inventory (BDI), Pittsburgh Sleep Quality Index(PSQI), Binge Eating Scale(BES) and Korean version of Obesity-Related Quality of Life Scale(KOQoL), respectively. Results : The prevalence of night eating syndrome in bipolar outpatients was 14.3%(12 of 84). Comparisons between NES group and non-NES group revealed no significant differences in demographic characteristics, BMI and clinical status except economic status and comorbid medical illnesses. However, compared to non-NES, patients with NES was more likely to have binge eating pattern and poorer weight-related quality of life. Conclusions : This study is to be the first to describe the clinical correlates of night eaters in bipolar outpatients. Although there were few significant correlates of NES in bipolar outpatients, relatively high prevalence of NES suggest that clinicians should be aware to assess the patients with bipolar disorder on NES, regardless of obesity status of patients.

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THE TREATMENT RESULTS OF A DAY TREATMENT PROGRAM FOR CHILDREN WITH DEVELOPMENTAL DISORDERS (발달 장애 아동에게 시행된 주간 치료실 프로그램의 치료 결과에 대한 고찰)

  • Kwak, Young-Sook;Kang, Gyung-Mi;Lee, Hae-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.100-109
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    • 2000
  • Objective:This was conduced to evaluate the effect of early intervention to promote the development of children with developmental disorders. Methods:49 children(31 in PDD group and 18 in DLD group) participated in a one year day treatment program conduced from 1996 to 1999. They were performed PEP, CARS, and SMS. They were grouped by diagnosis, comorbidity, chronological age and CARS score at the beginning of the program and the treatment effect was compared. Results:The children who participated in the day treatment program showed significant increase in their PEP, SMS score, and decrease trend in their CARS score. When children were grouped by diagnosis, comorbidity, chronological age, and severity in CARS score we did not find out significant difference between groups. Conclusion:Our data suggest that the day treatment program which emphasis on development is effective in treating children with developmental disorders.

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Complementarity between SDQ-SR and MMPI-A in Assessing Adolescents with Internalizing Disorder : A Preliminary Study (내재화장애 청소년의 평가에서 자기보고용 강점난점척도와 MMPI-A의 상호보완성 : 예비연구)

  • Shin, Kyo Jung;Ahn, Joung Sook;Lim, Jee Young;Lee, Jin Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.1
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    • pp.9-18
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    • 2018
  • Objectives : The aims of this study were to investigate the psychopathology in adolescents with internalizing disorder using the self-report version of Strengths and Difficulties Questionnaire (SDQ-SR) and the Minnesota Multiphasic Personality Inventory for adolescents (MMPI-A), and to explore the complementarity between these two inventories for diagnostic assessment. Methods : Ninety-one patients aged 13-17 were divided into two groups by clinical diagnosis, 44 with internalizing disorder and 47 comparison group with other disorders. The data of SDQ-SR and MMPI-A completed by them were analyzed for the ability to predict internalizing disorder. Results : The logistic regression analysis revealed that diagnostic predictability increased by 2.27 times with every 1 point of SDQ-SR emotional symptom score increment. Comparison of ROC curves for internalizing disorders showed that the SE and SP of SDQ-SR emotional symptom with score over 4 was 88.94 and 78.72, respectively. For A-anx of MMPI-A with score over 56, SE and SP was 77.27 and 74.47, respectively. However, combination of these scales could not enhance the predictability of diagnostic classification more than that of SDQ-SR emotional symptom alone. Conclusions : Emotional symptom scale of SDQ-SR and A-anx, A-aln, A and INTR of MMPI-A should be important subscales for diagnosing the internalizing disorder of adolescents, however, which needs to be examined further with a larger sample size including normal control group.

CLINICAL CHARACTERISTICS OF CHILD AND ADOLESCENT PSYCHIATRIC INPATIENTS WITH MOOD DISORDER (입원한 기분장애 소아청소년의 임상특성 - 주요 우울증과 양극성장애의 우울삽화 비교를 중심으로 -)

  • Cho, Su-Chul;Paik, Ki-Chung;Lee, Kyung-Kyu;Kim, Hyun-Woo;Hong, Kang-E;Lim, Myung-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.2
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    • pp.209-220
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    • 2000
  • The purpose of this study is to find out the characteristics of depressive episode about major depression and bipolar disorder in child and adolescent. The subjects of this study were 34 major depression patients and 17 bipolar disorder patients hospitalized at child and adolescent psychiatry in OO university children's hospital from 1st March 1993 to 31st October 1999. The method of this study is to review socio-demographic characteristics, diagnostic classification, chief problems and symptoms at admission, frequency of symptoms, maternal pregnancy problem history, childhood developmental history, coexisting psychiatric disorders, family psychopathology and family history and therapeutic response through their chart. 1) The ratio of male was higher than that of female in major depressive disorder while they are similar in manic episode, bipolar disorder. 2) Average onset age of bipolar disorder was 14 years 1 month and it was 12 years 8 months in the case of major depression As a result, average onset age of major depression is lower than that of bipolar disorder. 3) The patients complained of vegetative symptoms than somatic symptoms in both bipolar disorder and depressive disorder. Also, the cases of major depression developed more suicide idea symptom while the case of bipolar disorder developed more aggressive symptoms. In the respect of psychotic symptoms, delusion was more frequently shown in major depression, but halucination was more often shown in bipolar disorder. 4) Anxiety disorder coexisted most frequently in two groups. And there coexisted symptoms such as somartoform disorder, mental retardation and personality disorder in both cases. 5) The influence of family loading was remarkable in both cases. Above all, the development of major depression had to do with child abuse history and inappropriate care of family. It is apparent that there are distinctive differences between major depression and bipolar disorder in child and adolescent through the study, just as in adult cases. Therefore the differences of clinical characteristics between two disorders is founded in coexisting disorders and clinical symptoms including onset age, somatic symptoms and vegetative symptoms.

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An Exploratory Analyses on Factors related to Mental Health Confidence among Individuals in Long-term Care Facilities: Focusing on the Differences by the Length of Hospitalization (정신요양시설 입소 정신장애인의 정신건강자신감 관련요인에 대한 탐색적 연구: 입소기간에 따른 차이를 중심으로)

  • Jeon, Hae Sook
    • The Journal of the Korea Contents Association
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    • v.16 no.3
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    • pp.563-574
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    • 2016
  • This study aimed to examine the predictors of mental health confidence(MHC) among individuals in psychiatric long-term care facilities(PLCF). It further examined whether the predictors and underlying mechanisms differed by the length of hospitalization. Sample consisted of 1,742 individuals residing in PLCF who participated in the Survey on PLCF. Structural equational modeling was used to examine the predictors of MHC. Multi-group Structural Equation Modeling(SEM) was used to examine whether the predictors and mechanisms differed by the length of hospitalization between those of 10 years or less (n=962) and 10 years and more (n=780). Major findings were as follows. (1) Education, duration of mental illness, and psychiatric symptoms were significantly related to MHC. (2) Duration of mental illness presented significant indirect effects on MHC via its effects on perceived stigma. (3) The predictors and underlying mechanisms differed by the length of hospitalization. Based on the findings, implications and limitations of the research were discussed.