• 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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.2 no.1
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• pp.43-48
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• 1991

The College entrance examination stress syndrome is a kind of anxiety disorder. The underlying cause of this disorder is not a test anxiety itself. One's hidden inner and familial conflicts are more likely attributed to this disorder. Patient's the most common complaints are various psychosomatic symptoms but in severe cases underlying psychopathology may be activated and progress to major psychosis. In a broad sense adolescent's delinguent behavior, drug abuse, school drop-out and sucide are closely related to this syndrome. In clinical management of these patients, considering the special situation of impending examination, the therapist must access to central conflict theme in a short time without severe resistance. The authors classified this syndrome into 5 clinical subtypes ; 'the anxious group', 'the exhaustion group', 'the despair group', 'the emptyness group' and 'the boredome group'. Typical case of each subtype and it's management methods were presented briefly.

• Journal of the Korea Convergence Society
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• v.11 no.7
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• pp.319-328
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• 2020

The purpose of this study is to assess the relationships of alcohol consumption patterns to mental distress and self-rated health. Data of 19,856 adult drinkers over 19 years of age and older from the Korea National Health and Nutrition Examination Survey were evaluated by multivariate logistic regression analysis. Risks of experiencing perceived high stress, depressive symptoms and suicidal thoughts were higher in alcohol use disorder group in male, whereas the risks were higher in both alcohol use disorder and hazardous drinking groups in female, reflecting higher susceptibility to mental distress. In both male and female, former drinkers presented poor self-rated health compared with low-risk drinkers, although no difference was found in the prevalence of mental distress. Specialized mental health management measures for female drinkers are required, and former drinkers are suggested to be assessed separately from never or low-risk drinkers for their physical and mental health status.

• Korean Journal of Psychosomatic Medicine
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• v.23 no.1
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• pp.66-69
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• 2015

In addition to classical triad such as gait disturbance, urinary incontinence and dementia, parkinsonian extrapyramidal motor signs and neuropsychiatric symptoms can be observed in patients with normal pressure hydrocephalus (NPH). In our case, a 46 year old female patient showed extrapyramidal symptoms such as bradykinesia, rigidity and neuropsychiatric symptoms such as agitation, anxiety, restlessness and regressed behavior beside two(gait disturbance & urinary incontinence) symptoms of three classical triad. It was difficult to diagnose this patient as NPH from the beginning because of her relatively young age and previous psychiatric mediation history for controlling advanced anxiety and affective disorder. Antiparkinsonian agents and discontinuation of psychiatric medications did not work for this patient. Patient's brain computed tomographic finding showed enlarged ventricles. We suspected NPH and did empirical drainage of 30mL CSF. Finally, patient's pyramidal and neuropsychiatric symptoms as well as two of three classical triad of NPH were improved dramatically within several days. It is important to consider NPH as one of the differential diagnosis in patient with parkinsonian symptoms and various neuropsychiatric symptoms who did not respond to usual clinical management especially in case of ventricular enlargement in neuroimaging because of its treatable property by CSF shunt operation.

• Korean Journal of Psychosomatic Medicine
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• v.31 no.1
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• pp.1-9
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• 2023

Patients with neurocognitive disorder show behavioral psychological symptoms such as agitation, aggression, depression, and wandering, as well as cognitive decline, which puts a considerable burden on patients and their families. For the treatment of behavioral psychological symptoms, patient-centered, non-pharmacological treatment should be used as a first line approach. This paper describes non-pharmacological interventions to manage and treat behavioral psychological symptoms in patients with neurocognitive disorder. In order to control behavioral psychological symptoms such as agitation, depression, apathy, insomnia, and wandering, it is important to identify and evaluate factors such as environmental changes and drugs, and then solve such problems. Non-pharmacological interventions include reassurance, encourage, distraction, and environmental change. It is necessary to understand behavior from a patient's point of view and to approach the patient's needs and abilities appropriately. Reminiscence therapy, music therapy, aroma therapy, multisensory stimulation therapy, exercise therapy, light therapy, massage therapy, cognitive intervention therapy, and pet therapy are used as non-pharmacological interventions, and these approaches are known to improve symptoms such as depression, apathy, agitation, aggression, anxiety, wandering, and insomnia. However, the quality of the evidence base for non-pharmacological approaches is generally lower than for pharmacological treatments. Therefore, more extensive and accurate effectiveness verification studies are needed in the future.

• Korean Journal of Psychosomatic Medicine
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• v.5 no.2
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• pp.176-184
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• 1997

Abnormal illness behavior in patients with somatoform disorders were known formed by their traditional disease concepts and somatization-prone socio-cultural factors. The authors evaluated the characteristics of abnormal illness behavior in patients with somatoform disorders(who had somatization) by using abnormal illness behavior questionnaire. Methods : 29 somatoform disorders(SD) and 57 disease controls were compared by clinical characteristics, severity of pain, state anxiety(by Spielberger's State & Trait Anxiety Inventory), depression(by Beck's Depression Inventory) and level of psychosocial stess(by DSM-III-R). The illness behavior was measured by illness Behavior Questionnaire(IBQ). Results SD group had longer period of somatic symptoms with less severity in pain. The degree of anxiety and depression were higher in SB compared with controls. However, the degree of psychosocial stress was almost same between both groups. In IBQ, SD showed higher scores in general hypochondriasis, disease conviction, and affective disturbance subscales compared to control group. Conclusion: High disease conviction and hypochondriacal nature revealed by IBQ seemed to be a role in making somatization by way of somatic focusing and hypervigilance. And those tended to lead patients visit hospital frequently and report various somatic complaints. Evaluating abnormal illness behavior in somatoform disorders would be not only helpful in understanding the natures of somatoform disorders but also useful differentiating SD with other psychiatric conditions.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.5
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• pp.268-277
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• 2017

This study was performed to determine the level of physical health(ADL, IADL) and mental health (cognitive impairment, dementia) among centenarians and to find the related factors. The study subjects were 268 centenarians who received medical check-ups from the National Health Insurance Corporation during 2011-2014. From the results, the factors that significantly influenced the ADL of the study subjects were gender, residential area, IADL, cognitive impairment and dementia. ADL and cognitive impairment were selected as the influencing factors of IADL, smoking status, ADL and IADL were selected as the influencing factors of cognitive impairment, and gender and ADL were selected as the influencing factors of dementia. These results suggested that the levels of physical and mental health of the centenarians were significantly affected by socio-demographic characteristics and health-related variables. Especially, the levels of physical and mental health were decreased with the poor group of health-related variables such as smoking, alcohol drinking and regular exercise.

• Korean Journal of Psychosomatic Medicine
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• v.12 no.1
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• pp.66-75
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• 2004

Objectives: This study was intended to see the relationship between psychiatric consequences and injury severity following traffic accidents. Methods: We surveyed the 134 patients who were hospitalized from 1994 to 2003 at Chosun University Hospital for psychiatic disability evaluation following traffic accident. We reevaluate demographic factors from admission note. Psychiatric symptoms from mental status exam in medical records. Psychological tests(MMPI, BAI, BDI, K-WAIS) were done. Then we calculate the injury severity score and McBride's rate of disability due to diagnosis from emergency care hospital records. Their relationships were evaluated by statistical methods which were t-test and Pearson correlation analysis using SPSS-10. Results: When physical injury was not severe, suicidal attempt was more frequent and depression, hysteria, psychasthenia, psychopathic deviation subscales were high in MMPI. But when physical injury was severe, they have diffficulty in concentration, impaired orientation, and changed in IQ score. There was no relationship between physical injury severity and faking bad scales(F, Ds-r). Conclusion: We must not assume when physical injury was not severe, the severe sympomts are just faking for their benefit.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.1
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• pp.81-88
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• 2020

Objectives : This study aimed to compare autonomic nervous system (ANS) dysregulation and differential relationships with clinical severities between anxiety disorder, depressive disorder, and trauma·stressor related disorder using heart rate variability (HRV) parameters. Methods : We conducted a retrospective chart review of outpatients from 2017 to 2018 in Stress Clinic of National Center for Mental Health. Total 473 patients were included; 166 anxiety disorder; 184 depressive disorder ; 123 trauma·stressor related disorder. Parameters of 5-min analysis of HRV were compared in three groups. Additionally, we investigated the differential association of each parameters with Clinical Global Impression-Severity Scale (CGI-S) across each group. Results : No significant differences were found in all HRV parameters between the three groups. However, significant group interactions by CGI-S were found in standard deviation of all RR intervals (SDNN) and the square root of the mean squared differences of successive normal-to-normal intervals (RMSSD) (SDNN, p=0.017 ; RMSSD, p=0.034). A negative relationship between CGI-S and SDNN, RMSSD has been found in anxiety disorder and depressive disorder. However, a positive relationship between CGI-S and SDNN, RMSSD has been found in trauma·stressor related disorder. Conclusions : Despite of no significant differences of each HRV parameter, our findings suggested the differential associations of HRV parameters with clinical severity among anxiety disorder, depressive disorder and trauma·stressor related disorder. In trauma·stressor related disorder, the clinical severity and degree of ANS dysregulation may differ, so more aggressive treatment is suggested.

• Korean Journal of Psychosomatic Medicine
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• v.19 no.1
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• pp.28-33
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• 2011

Objective: This study aimed to investigate the pattern of psychiatric consultation-liaison in a new general hospital over a 5-year period. Method: Retrospective chart review was conducted for psychiatric consultations performed from May 2004 to December 2008 in a new general hospital in Hwasun, Korea. Results: A total of 1,852 patients who were referred to the Department of Psychiatry for consultation were included in the analysis. The main reasons for psychiatric consultation were changes in mental status(20.5%), depression(16.8%), insomnia(12.8%), and anxiety(7.9%). Psychiatric consultations were conducted with diagnoses of delirium(39.7%), depressive disorder(28.2%), adjustment disorder(7.9%), and anxiety disorder(4.1%). Patients with delirium were significantly older than were those with other psychiatric diagnoses(p<0.001). Delirium was more common in male patients than in female patients(47.1% vs. 29.9%, respectively), and depression was more common in female patients than in male patients(48.3% vs. 33.9%, respectively)(p<0.001). Delirium was more common in patients who underwent surgical operation than those who did not(p=0.010). Conclusion: Delirium was the most common diagnosis for psychiatric consultation followed by depression in a university hospital. Delirium was more prevalent in men than in women, while depression was more common in women.