• Title/Summary/Keyword: 정신사회재활

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Change of Prescribing Pattern after Clozapine Discontinuation: A Retrospective Chart Review (클로자핀 중단 이후 처방 패턴의 변화: 후향적 의무기록 분석)

  • Kang, Shi Hyun
    • Korean Journal of Schizophrenia Research
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    • v.24 no.1
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    • pp.36-43
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    • 2021
  • Objectives: Despite the high discontinuation rate of clozapine in refractory schizophrenia, there is limited evidence regarding the suggested treatment after clozapine discontinuation. Methods: The medical records of 37 patients who discontinued clozapine were retrospectively reviewed. The prescription patterns of antipsychotics, mood stabilizers, and antidepressants were compared at three points before and after clozapine treatment and at the most recent visit. Results: After clozapine discontinuation, 75.6% of the subjects were receiving antipsychotic polypharmacy, and 32.4% were taking more than 3 antipsychotics. The frequently used antipsychotics were olanzapine (21.5%), quetiapine (21.5%), and paliperidone (12.7%). The rates of augmentation with mood stabilizers and antidepressants were 43.2% and 29.7%, respectively. Furthermore, valproate was the most commonly used mood stabilizer (87.5%). Conclusion: Antipsychotic polypharmacy and augmentation are inevitable in schizophrenia patients for whom clozapine has been discontinued. Further research is required to improve the outcomes of polypharmacy and augmentation in schizophrenia patients.

A Study on Families' Coping with the Mentally III (정신장애인 가족의 대처에 관한 연구)

  • Seo, Mi-Kyoung
    • Korean Journal of Social Welfare
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    • v.37
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    • pp.217-239
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    • 1999
  • The main premise of this study is that a successful treatment and rehabilitation of the mentally ill depends on an active. coping of their family members, who are the primary care-takers of the patients, even if families are confronting many difficulties because of caring their patients. Accordingly, this study aims to find out which factors are related to families active coping with the mentally ill. This study is conducted the survey with 191 family members of the mentally ills in order to discover: 1) what kinds of relations do exist between sociodemographic factors of the respondents, care-burden toward the mentally ill, and social supports, and the active coping, and 2) in what extent do these related factors affect on the active coping. The major findings of the study are: 1) gender and educational background of the respondents are positively related to the active coping; 2) regarding care-burden felt by the respondents, there is statistically significant positive relationship between - the respondents' burden due to a lack of social and institutional support and their active coping; 3) considering the relationship with social support, there is highly positive relationship between decision. emotional. material supports and the active coping; 4) using a multiple regression, respondents' sociodemographic background, care-burden, social support affect significantly on the active coping by 26.2% of explanatory power; and 5) using a step-wise multiple regression, the most powerful influenced factors on active coping are emotional support, burden due to a lack of social and institutional support, and educational background of the respondents. In conclusion, this study recommends clinicians to use an educational and support model for the families. All these efforts will contribute to enhance active coping of the families with the mentally ill.

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Effects of Horticultural Therapy on the Improvement of the Self-Esteem and Sociality of Mentally Retarded Persons (원예치료프로그램의 적용이 정신지체장애인의 자기주장 및 사회성 향상에 미치는 영향)

  • 박민희;차영주;유영원;부희옥;이숙영
    • Korean Journal of Plant Resources
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    • v.17 no.3
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    • pp.339-351
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    • 2004
  • This study was conducted to evaluate the effect of phased horticultural therapy(HT) program on the experience of psychologic therapy and the development of job and social integration in the mentally handicapped persons. In this study, the mentally handicapped persons participated in HT program were chosen in disabled person's welfare institute of Jeonnam. HT program was performed twice a week with 1 hour activity for 4 months. As a results, the mentally handicapped persons participated in HT program showed high interest of horticulture and improvement of self-respect and the high satisfactory degree of HT program. Therefore, the mentally handicapped persons were showed the experience of both physical and mental therapy, improvement of self-esteem scale and sociality in HT program. Also, the application of HT program with continuously interest will be showed high improvement of physical, psychological and sentimental. In the course of this HT program progress, horticultural therapist and social welfare officer were showed the limitation of role. Therefore the leaders of group for successful HT program be required the comprehensive plan of more efficient HT program and induced technique of continuously up-phased improvements in HT program progress.

Type of Service Setting and Drinking Behavior in Persons with Major Mental Illnesses (정신보건서비스 환경에 따른 이용자들의 음주 행태)

  • Lee, Sun-Hae
    • Korean Journal of Social Welfare
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    • v.50
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    • pp.265-288
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    • 2002
  • The use of alcohol is recognized as having negative consequences on clinical and psychosocial outcomes in service users with major mental illnesses. This necessitates an introduction of intervention measures in domestic mental health service in Korea. Since research basis on which such measures are developed lacks, this paper aims at exploring drinking patterns of Korean service users and suggesting directions and strategies for intervention. The data came from 151 service users recruited at 14 service settings in Seoul Metropolitan area. The quantitative part of the data includes their recent drinking experiences in terms of patterns and severity; the qualitative part includes information on the drinking context. The data were compared among three types of service settings, each of which differs in physical availability of alcohol by their users. Each group revealed distinctive features in drinking patterns, the author thus suggested directions and strategies of intervention specific to type of service setting.

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A Study on Life Experience by Persons with Mental illness - Focusing on the Experience after the Onslaught of Mental Illness - (정신장애인의 생애경험에 관한 연구 - 정신질환발병 이후의 경험을 중심으로 -)

  • Park, Eun-Ju
    • Korean Journal of Social Welfare
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    • v.63 no.1
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    • pp.5-28
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    • 2011
  • This study, based on the research on the history of life, aimed to recompose and analyze into what life progressive structure the life experience by the mentally ill, after the onslaught of the disease, developed in a bid to understand the risk progress in the mentally ill's life, and to determine what contributed to the current stabilized recovery and adjustment. Five mentally ill persons participated in the study, and Sch$\ddot{u}$tze's narrative interview was used to gather data. The gathered data were analyzed according to Sch$\ddot{u}$tze's process structure of life. The interviewees' life experiences were chronologically organized as understood, and significant stories were recomposed that not only brought about changes but also helped overcome their disabilities in the process of treatment and rehabilitation after the onslaught of the disease. As a result, their experiences were recomposed into the stage of onslaught of the mental illness and confusion, and into the stage of intensive treatment and rehabilitation. The former was categorized into suppression by the disease, repetition and endurance of the painful life, and separation from their family and frustration. The latter was categorized into the rediscovery of self through social role change, others who helped realize the life potential, the expansion of mental health services in the community, obstacle to the integration of communities, re-integration of family relationships, re-analysis of experience of the disease through the examination of the life prior to onslaught of the disease, and expectation for the future. Also, these themes were comparatively examined so as to examine the crisis progress in the mentally ill's life after the onslaught of the disease, as well as the life transfer process through positive rehabilitation. Lastly, on the basis of these results, important areas of mental health services for the mentally ill were discussed.

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The Comparative Analysis of Overseas and Domestic cases of School-based Mental Health Project: Focusing on Singapore, the U.S., and Australia (학교중심 정신건강사업의 해외(싱가포르, 미국, 호주)와 한국의 비교분석)

  • Lee, Ju-Yong;Lee, Eun-Jin;Baik, Hyung-Ui
    • Journal of Digital Convergence
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    • v.20 no.5
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    • pp.789-802
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    • 2022
  • The purpose of this study is to present implications for effective operation of domestic school-based mental health services by comparing those in Singapore the United States, Australia. Based on reviewing the public data and previous article, researchers conducted a comparative study on the background, history, goal, and managing process of overseas and domestic organizations. The result of comparison in overseas cases suggests that the foundation of school-based mental health project was laid with the national health plan and detailed frame work for implementation. It was also discussed that domestic school-based mental health project is still in introduction stage, while foreign services were delivered efficiently through the leading agency and the cooperation between government ministries and institutions were active. It suggests that cooperation between government ministries, preparation of an effective operating system, and various approaches for students, guardians and teachers are need for domestic school-based mental health project.

Neurocognitive Function Assessment of Traumatic Brain Injury (외상후 뇌손상의 신경인지기능 평가)

  • Oh, Byoung Hoon
    • Korean Journal of Biological Psychiatry
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    • v.2 no.2
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    • pp.177-185
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    • 1995
  • 외상후 뇌손상은 대표적이며, 가장 중요한 신경정신계 질환의 하나이다. 더욱이 외상후 뇌손상 환자들은 각종의 사고 및 산업재해 등으로 인해 그 수가 급증하고 있으며, 특히 인지기능의 장애로 인한 다양한 기질성 정신장애로 고통을 겪게 된다. 따라서 외상후 뇌손상은 손상의 시점에서부터 정확하고 올바른 평가는 물론 손상후의 경과 및 치료대책의 수립에 있어서 체계적이며 종합적인 신경인지기능의 평가는 필수적이다. 왜냐하면 신경인지기능평가는 뇌의 손상부위와 이와 관련된 기능장애 및 행동의 변화에 대한 객관적인 자료를 제시해 주기 때문이다. 신경인지기능 평가의 영역은 지각, 운동기능은 물론 주요인지기능인 기억, 언어, 실행 및 감정조절능력에 이르기까지 다양하며, 외상후 뇌손상환자들은 손상부위 및 정도에 따라 신경인지기능의 장애를 초래하게 된다. 대표적인 신경인지기능평가 도구로는 KWIS, Halstead-Reitan, Luria-Nebraska batteries, 특히 전두엽기능검사인 Wisconsin Card Sorting Test (WCST)를 비롯하여, 현재는 PC/S Vienna Test System 및 Stim등의 각종 전산화 인지기능검사가 개발되어 임상에서 활발히 사용되고 있다. 즉 외상후 뇌손상환자를 위한 신경인지기능평가의 목적은 뇌손상과 관련된 신경인지기능장애를 정확히 평가하여, 환자 개개인에 적합한 인지재활치료 계획을 수립하는데 있다. 물론 여기에는 신경정신상태검사(neuropsychiatric mental status examination)를 통하여 외상 후 뇌손상의 경과 및 예후에 결정적인 영향을 미칠 수 있는 나이, 의식소실 및 외상후 기억 손상 시간의 정확한 측정은 물론 심리 사회 문화적인 상태와 두부외상전 환자의 지적수준 및 사회 적용기능이 함께 평가되어야 할 것이다.

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Korean Guidelines for the Treatment of Panic Disorder 2018 : Psychosocial Treatment Strategies (2018 한국형 공황장애 치료지침서 : 정신사회적 치료전략)

  • Gim, Minsook;Kim, Min-Kyoung;Lee, Jae-Hon;Kim, Won;Moon, Eunsoo;Seo, Ho-Jun;Koo, Bon-Hoon;Yang, Jong-Chul;Lee, Kang Soo;Lee, Sang-Hyuk;Kim, Chan-Hyung;Yu, Bum-Hee;Suh, Ho-Suk
    • Anxiety and mood
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    • v.15 no.1
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    • pp.13-19
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    • 2019
  • Objective : The purpose of this study was to investigate consensus relative to treatment strategies for psychosocial treatment in panic disorder, that represents one subject addressed by the Korean guidelines for treatment of panic disorder 2018. Methods : The executive committee developed questionnaires relative to treatment strategies for patients with panic disorder based on guidelines, algorithms, and clinical trials previously published in foreign countries and Korea. Seventy-two (61.0%) of 112 experts on a committee reviewing panic disorder responded to the questionnaires. We classified the consensus of expert opinions into three categories (first-line, second-line, and third-line treatment strategies), and identified treatment of choice using the Chi-square test and 95% confidence intervals. Results : For psychosocial treatment of panic disorder, individual and group cognitive behavior therapy (CBT) were recommended treatments of choice, and mindfulness based cognitive therapy (MBCT) was recommended as first line strategy. There was statistically significant consensus among experts regarding usefulness of each component of CBT and MBCT, for treatment of patients with panic disorder. Conclusion : Results, that reflect recent studies and clinical experiences, may provide the guideline for psychosocial treatment strategies for panic disorder.

Comparison of Demographic Characteristics, Health and Quality of Life between General Adults and Adults Living with Dementia Patients : The 2016 Community Health Survey (치매 환자와 함께 거주하는 성인과 일반 성인 사이의 인구사회학적 특성, 건강 및 삶의 질 비교 : 2016년 지역사회건강조사 원시자료를 이용하여)

  • Moon, Jong-Hoon;Kim, Ye-Soon
    • Journal of Society of Occupational Therapy for the Aged and Dementia
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    • v.12 no.2
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    • pp.57-65
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    • 2018
  • Objective : The purpose of this study was to compare the demographic characteristics, health and quality of life between general adults and adults living with dementia. Method : The data were collected using raw data of the 2016 community health survey and compared between 2,592 adults living with dementia patients and 225,840 general adults. health were assessed for sleep time, stress level, depression, and subjective health status, and quality of life was measured by EQ-5D. Result : In comparison of demographic characteristics, age and family number of adults living with dementia patients were significantly higher than general adults (p<.001), income and eduation levels were low (p<.001), and marital status was higher rate of living with spouse (p<.05). In comparison of health status, adults living with dementia patients were significantly longer in sleep time than the general adults (p<.001), and stress level was higher (p<.001), the percentage of experience of depression was higher (p<.001), and the subjective health status was worse (p<.001). Adults living with dementia patients were significantly lower in quality of life total score and all sub-domain than general adults (p<.001). Conclusion : Based on the results of this study, it is necessary to seek ways to improve the health and quality of life of dementia patients' families.

The Effect of Disability Acceptance Mediated with Policy Trust on the Life Satisfaction: Group Comparison of Disability Type (장애수용이 정책신뢰도를 매개로 삶의 만족에 미치는 영향: 장애유형별 집단 비교)

  • Choi, Youn Jeong
    • 재활복지
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    • v.22 no.3
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    • pp.145-168
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    • 2018
  • The purpose of this study is to analyze the effect of disability acceptance mediated with policy trust on the life satisfaction and group difference of disability type. For this purpose, the raw data(2nd wave, 2st survey) of Panel Survey of Employment for the Disabled(PSED) conducted by the Korea Employment for the Disabled were used. Among the respondents, the data of 2,378 of the external physical disabled and 571 of mental disabled were analyzed. For the analysis, the structural equation model was used to verify the effect of mediation and group difference. The result of the study were as follows. First, disability acceptance of the disabled people effect on the life satisfaction by policy trust, and this was verified with partial mediated model. Second, In both groups, the external physical disabled and metal health disabled, disability acceptance and policy trust were the predictors of life satisfaction. Third, the difference in path coefficients between the two groups of external physical disabled and mental disabled was identified. Based on the results of this study, action plans were discussed to improve the life satisfaction of the disabled.