• Title/Summary/Keyword: 정신과 장애

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Attention and Psychiatric Disorders (주의력과 정신장애)

  • Ha, Kyoo-Seob;Kang, Ung Gu;Kim, Jong-Hoon
    • Korean Journal of Biological Psychiatry
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    • v.4 no.1
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    • pp.19-23
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    • 1997
  • Attention is a phenomenon hard to define, but can be conceptualized as a mental function ranging from sustaining readiness to perceive stimuli to understanding the nature and value and selecting stimuli that are most relevant to the given situation. Manifestations of attention include vigilance, and focused, directed, selective, divided, and sustained attentions. While basic attentional tone is controlled by the interaction among reticular activating system, thalamus and prefrontal cortex, direction and selection of attention is controlled by neural circuits of prefrontal, posterior parietal, and limbic cortex. It is expected that understanding of attention and its neural control could provide answers to the relationship between pathophysiology and clinical symptoms of some major psychiatric disorders. More efforts are required to develop tools to assess more detailed and various aspects of attention in Korea.

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Psychotherapeutic Experience on a Patient with Somatoform Pain Disorder (신체형 동통장애 환자의 정신치료 경험)

  • Kim, Hyun-Woo;Lee, Hyun-Je
    • Korean Journal of Psychosomatic Medicine
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    • v.2 no.1
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    • pp.107-112
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    • 1994
  • The authors tried to look into the process of the individual psychotherapeutic experience of a 18-year-old male diagnosed as somatoform pain disorder or chronic pain syndrome. The patient had showed strong resistance to acceptance of his psychological problems. Some issues such as indications of psychotherapy for chronic pain, changing the mode of the treatment some problems around changing the therapist secondary gain and parents' attitude were discussed considering their relatedness to the outcome. The psychotherapy had lasted about 2 years and the result was estimated as fair.

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Psychobiological Approach for Post-Traumatic Stress Disorder (외상후 스트레스 장애의 정신생물학적 접근)

  • Park, Ki-Chang
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.1
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    • pp.124-137
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    • 1996
  • As the society becomes more industrialized and modernized, we have more chances to experience a serious traumatic event. Post-traumatic stress disorder (PTSD) has 3 major categories of symptoms such as memory disturbance, hyperarousal and avoidance or numbness. I reviewed the psychobiological evidences in 3 main categories of symptoms and the biological treatment after a brief review of the epidemiology, psychosocial etiology and diagnosis of PTSD. The memory disturbance of PTSD might be developed by the potentiation of the memory pathway mediated by norepinephrine. PTSD induces HPA axis abnormality, it might also develop hippocampal dysfunction, which might contribute to the memory disturbance. The kindling effect develops desensitization, which might develop reexperiencing of the traumatic events and hyperarousal state. Chronic aroused state of locus ceruleus with resultant chronic maladaptive state of norepinephrine system, might develop hyperarousal state. Social avoidance and physical numbing state in PTSD might be caused by serotnin or opiate system. Stress induced analgesia might be developed by opiate reliesed against the acute stress. The biologic research results would help the selective treatment of PTSD.

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Epigenetics and Psychiatric Disorders (Epigenetics와 정신장애)

  • Oh, Daeyoung;Yang, Byung-Hwan;Lee, Yu-Sang
    • Korean Journal of Biological Psychiatry
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    • v.15 no.4
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    • pp.243-253
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    • 2008
  • In the post-genomic era, the mechanisms controlling activation of genes are thought to be more important. Gene-environment interactions are crucial in both development and treatment of psychiatric disorders as they are complex genetic disorders. Epigenetics is defined as a change of gene expression that occurs without a change of DNA sequence and can be heritable by certain mechanisms. Epigenetic changes play essential roles in control of gene activation. DNA methylation, chromatin remodeling and RNAi act as key mechanisms for epigenetic modifications of genes. Here, we review the basic mechanisms of epigenetics and discuss their potential involvement of human diseases, including psychiatric disorders.

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Stimulants Medication of Attention-Deficit Hyperactivity Disorder (주의력결핍 과잉행동장애에서 정신자극제를 이용한 약물치료)

  • Yang, Young-Hui;Yoo, Hee-Jeong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.19 no.2
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    • pp.61-71
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    • 2008
  • Attention-deficit hyperactivity disorder (ADHD) is characterized by inattention, hyperactivity, impulsiveness and problems in other higher cognitive processes such as executive function deficits. Currently, there are many treatment modalities, of which pharmacotherapy is the most strongly supported by scientific and clinical evidence. Stimulants, which are first choice in the pharmacological treatment of ADHD, block dopamine reuptake by binding the dopamine transporter and so increasing the concentration of dopamine in synaptic clefts. Stimulants are effective in improving core ADHD symptoms, as well as the nonspecific symptoms, such as aggressiveness and oppositional behavior. Frequently reported short-term adverse effects are decreased appetite, sleep disturbance, headache, dizziness and irritability. Although questions have been raised about the long-term side effects of stimulants, including growth suppression, cardiovascular events, and abuse potential, there is no clear evidence to support these concerns.

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Empowerment Effects of the Chronic Mental Ill's Volunteer Program (정신장애인 자원봉사 프로그램의 임파워먼트 효과)

  • Choi, Myung-Min
    • Korean Journal of Social Welfare
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    • v.56 no.3
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    • pp.89-112
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    • 2004
  • The purpose of this study is to systemize volunteer program for the people with chronic mental health problems to participate in helping the community as service providers not receivers, and then to examine empowerment effects of this volunteer program. The distinctive feature of this program was to volunteer the mental ill to help other people. Therefore, this volunteer program had specially strengthened preliminary stage which make not only the mental ill be ready to work but also the community to use them as volunteer, and to invite general citizen of the community as co-volunteers. The result showed this program empowered the mental disorders to have more positive self-concept. It revealed that co-volunteer's attitude toward the mental disorders was changed positively through this program, also. These results told us not only the chronic mental ill could be volunteers helping others using their abilities, but also this activity would make their self-image better and citizen's perception toward mental disorder less prejudiced. The volunteer program presented in this paper was expected to be useful for their empowerment and social integration.

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PROGNOSIS OF TREATED INPATIENTS WITH CONDUCT DISORDERS USING A STRUCTURED TELEPHONE FOLLOW-UP INTERVIEW (구조화 전화추적 면담을 이용한 품행장애 입원 치료 환자의 예후)

  • Chae, Jeong-Ho;Moon, Seok-Woo;Lee, Eun-Hoi;Hahm, Woong;Bang, Yang-Weon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.2
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    • pp.231-239
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    • 2000
  • Objectives:The major goal of this study was to investigate the treatment outcome of psychiatric treatment in inpatients with conduct disorder and to elucidate factors affecting its prognosis. Methods:We reviewed the medical records of 300 inpatients with conduct disorder who had been treated with a specialized adolescent treatment program. Follow-up structured telephone interview had been performed in 96 patients. Results:1) At the point of follow-up, 90% of the patients were improved in behavioral patterns, 2% of the patients were worse, and 8% of the patients were unchanged. 2) Intrafamilial relationship was improved in 70% of the patients, worse in 2%, and unchanged in 28%. 3) Fifty-seven percent of families thought to be helped by psychiatric inpatient treatment, 6% replied to be harmed, and 37% thought not to be helpful. 4) Comparing the good prognosis group who were all better in behavioral patterns, intrafamilial relationship, and efficacy of treatment with the rest of subjects, the good prognosis group was significantly younger and had more history of problems in familial structure. Conclusion:Although the present study had some meterological limits, the promising positive results in the outcome of inpatients with conduct disorder encourages further more sophisticated investigations in this problematic psychiatric conditions.

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A Clinical Study on Softening E.C.T. & Comparison of Propofol and Pentothal as Anaesthetic Agents on Seizure Duration (연성 전기 경련 요법의 임상적 고찰과 마취제 pentothal과 propofol에 따른 경련기간의 비교에 관한 연구)

  • Song, Hun-Il;Min, Kyung-Joon;Choi, Ihn-Geun;Yoo, Tae-Hyuk
    • Korean Journal of Biological Psychiatry
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    • v.4 no.2
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    • pp.259-264
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    • 1997
  • The authors performed this preliminary study to investigate the effect of softening E.C.T. and propofol was compared to pentothal for induction of anaesthesia for E.C.T. on seizure duration. The results were follows ; 1) E.C.T. was performed in 60 psychiatric inpatients who were admitted during the study period. Of them 51.7% were diagnosed as schizophrenia, 21.6% as major depressive disorder, 16.7% as bipolar I disorder, manic and 10% of others. 2) Mean number of E.C.T. was 12.2 times a patient. 3) The most common target symptoms were persecutory delusion in schizophrenia, psychomotor retardation or agitation in major depressive disorder, and violent aggressive behavior in bipolar I disorder, manic. 4) Pre-ECT medication usually used were atropine $0.0093mgkg^{-1}$, pentothal $2.76mgkg^{-1}$ or propofol $1.42mgkg^{-1}$. 5) The duration of seizure, as measured clinically, was reduced with propofol(20.5 sec) in comparison with pentothal (35.7 sec)(p<0.001). This suggests the possibility that additional treatments may be needed for the same clinical effect in psychiatric illness when propofol is used as the induction agent.

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Relating Factors on Mental Health Status (Depression, Cognitive Impairment and Dementia) among the Admitted from Long-term Care Insurance (노인장기요양보험 인정자의 정신적 건강상태(우울, 인지기능장애 및 치매) 및 그의 관련요인)

  • Song, Young-Su;Kim, Tae-Baek;Bae, Nam-Kyou;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.2
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    • pp.247-260
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    • 2018
  • This study examined the mental health status (depression, cognitive impairment and dementia) and its association with the related factors in the elderly people who were admitted from long-term care insurance. The study subjects were 1,488 people (male 740, female 748) aged over 70 years of age who had been recognized for long-term care insurance services in the years 2011~2014 from the National Health Insurance Corporation. The data collected from the National Health Insurance Corporation set forth a lifestyle questionnaire, itemized health screening tests, and long-term care as recognition data for research purposes. As a result, depression, cognitive impairment, and dementia of subjects increased significantly with age. As a multiple logistic regression result, the risk ratios of depression, cognitive impairment, and dementia, which indicated the mental health status, were significantly higher in women than in men, in the lower body weight group than in the overweight group, in the smoking group than in the non-smoking group, and in the drinking group than in the non-drinking group. These results suggest that the mental health status (depression, cognitive impairment, and dementia) of subjects decreased with increasing age, particularly the group with poor health related behaviors, such as smoking, drinking, and regular exercise, indicating that the mental health condition is lower than in the good group.

Characteristics of Premenstrual Changes in Patients with Affective Disorder (정서장애 환자의 월경전기변화 특성)

  • Ko, Young-Hoon;Joe, Sook-Haeng;Suh, Kwang-Yun
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.103-115
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    • 1999
  • Objectives : A large of studies have found an association between premenstrual syndrome and affective disorder, in particular, depression. Some studies have reported that women with depressive disorders may experience menstrual cycle-associated changes in the severity of their symptoms. This study was designed to compare the characteristics of premenstrual changes between control group and affective patient group, and to assess possible risk factors for premenstrual changes in patients. Methods : Eighty normal controls and eighty outpatients given maintenance therapy with fixed dose for at least more than four weeks were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and functional impairment. In addition, to compare the characteristics of premenstrual changes, 16 items based on DSM-IV criteria A for premenstrual dysphoric disorder were rated on the following scale : 0(no change), 1(mild), 2(moderate), 3(severe). Moderate or severe change in each item was considered as premenstrual change and the subjects who reported more than one premenstrual change were defined as premenstrual change group. Results : The results were as follows : 1) The percentage of premenstrual change group was 32.6% in patient group and 50% in control group. 2) Frequently reported premenstrual changes were as follows in control group : breast tenderness; anger ; affective liability ; lethargy, easy fatigability, or marked lack of energy ; abdominal pain or discomfort. In patients, the mood or behavioral changes were frequently reported. The changes were as follows : lethargy, easy fatigability, or marked lack of energy ; change in appetite; affective liability ; sense of difficulty in concentrating : hypersomnia or insomnia. 3) In the premenstrual change group, the patients with only mood or behavioral changes were significantly more than those with only physical changes or both changes. 4) The severity of functional impairment was significantly correlated with the frequency of mood or behavioral changes in patients. 5) There were no significant differences in menstrual characteristics between patients with premenstrual changes and patients without them except the severity of dysmenorrhea. And the severity of dysmenorrhea was correlated with the frequency of premenstrual change. Conclusion : The proportion of patients with affective disorder, who reported moderate-to-severe premenstrual changes, experiencing mood or behavioral changes larger than those experiencing physical changes during premenstrual period. It is possible that some patients with affective disorder, who reported premenstrual mood or behavioral changes, suffer from coexisting premenstrual syndrome with affective disorder or premenstrual exacerbation of affective disorder. Since the more premenstrual changes, the severer functional impairment, the patients reporting mood or behavioral disturbance in premenstrual period should be carefully evaluated, and appropriate therapeutic stategies might be considered.

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