• Title/Summary/Keyword: 정신신체장애

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Covariance Structure Analysis of the Influence of Social Support, Physical and Mental Health Status on Quality of Life among the Elderly at Care Facilities (요양시설 노인의 사회적지지, 신체적 및 정신적 건강수준이 삶의 질에 미치는 영향에 대한 공분산구조분석)

  • Lim, Young-A;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.8
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    • pp.210-220
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    • 2017
  • This study investigated the effect of social support (MOS-SSS), and physical (ADL, IADL) and mental (CES-D, MMSE-K) function on the quality of life (WHOQOL- BREF) among the elderly at care facilities. The survey respondents were 524 elderly aged 65 and older living in 15 care facilities located in D city. Data were collected through a personal interview conducted by interviewers who visited each care facility from November 2015 to January 2016. As a result, the quality of life was significantly lower in the elderly group with lower social support, with dysfunction in ADL and IADL than in the normal range group, with depression and cognitive impairment group than in the normal range group. The quality of life had a significant positive correlation with social support, ADL, IADL and cognitive impairment, but a significant negative correlation with depression. According to the results of covariance structure analysis, physical function had a greater impact on the quality of life than mental function or social support. Lower quality of life was associated with lower physical and mental function and lower social support. Therefore, concrete measures need to be devised to enhance physical function in order to improve the quality of life among the elderly in care facilities.

Relationship between Severity of Physical Trauma and Subsequent the Severity of PTSD Symptoms in Traffic Accident Related PTSD Patients (교통사고 관련 외상후 스트레스 장애 환자에서 신체적 외상의 정도와 외상후 스트레스 장애 증상의 심각도 사이의 관계)

  • Lee, Ji-Youn;Na, Chul;Cho, Ju-Yeon
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.1
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    • pp.28-34
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    • 1998
  • Objective: This study was designed to evaluate the etiological factors of the PTSD(post traumatic stress disorder) by examining the relationship between severity of physical trauma and subsequent the severity of PTSD symptom in traffic accident related PTSD patients. Method: Subjects were 21 psychiatric inpatients with history of traffic accident related PTSD(DSM-IV criteria), the purpose of evaluation of mental disability and no evidence of organic brain leisons. The severity of physical trauma was assessed by McBride number of nonpsychiatric department and the presence / absence of loss of conciousness. The severity of PTSD symptom was assessed by Hovens' self rating inventory for PTSD. And then we evaluated the correlation between these two factors. And we also evaluated relationship between severity of PTSD symtom and clinical variables. Results : There were no significant relationship between McBride number of nonpsychiatric department severity and symptomatic severity(r= 0.17, p<0.05), the presence / absence of loss of conciousness and symptomatic severity(p>0.05). And significant relationship between symptomatic severity and clinical varibles such as sex, education level, marital status(p<0.05). Conclusions : These data did not support data of previous studies that traumatic severity was correlated with symptom severity but, suggested that other variables affecting the severity of PTSD symptom is more important indirectly. And that the 'trauma' in PTSD is psychological meaning rather than physical meaning is also suggested.

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Stress Perception of Patients with Extrinsic Type of Bronchial Asthma (외인성 기관지천식환자들의 스트레스지각)

  • Koh, Kyung-Bong;Hong, Chein-Soo
    • Korean Journal of Psychosomatic Medicine
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    • v.1 no.1
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    • pp.45-51
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    • 1993
  • Stress perception was investigated in 53 outpatients with extrinsic type of bronchial asthma, using GARS scale and other questionnaires. 40% of the patients were found to be psychosomatic. The patients were more likely to consider their physical symptoms as severe than the allergist Severity of symptoms rated by the allergist had significantly positive correlation with scores of stress perception related to changes in relationship. However, no significant correlation was found between severity of symptoms rated by patients and scores of stress perception. Psychosomatic group was significantly higher in scores of stress perception related to illness and injury, financial burden, and change or no change in routine than non-psychosomatic group. Female. older age, higher education. presence of religion. and presence of psychological stressors at onset and/or aggravation of the illness were found to increase stress perception. These findings indicate ant extrinsic asthmatics an less likely to perceive psychological stress than physical symptoms, and that they are less vulnerable to psychological stressors than patients with other diseases.

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Network Analysis of Depressive and Anxiety Symptom in Young Adult of an Urban City (일 도시 청년 인구의 불안 우울 공존 증상 네트워크 분석)

  • Jong wan Park;Hyochul Lee;Jae Eun Hong;Seok Bum Lee;Jung Jae Lee;Kyoung Min Kim;Hyu Seok Jeong;Dohyun Kim
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.118-124
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    • 2023
  • Objectives : Depressive disorder and anxiety disorder frequently co-occur, even at sub-threshold level. This study aims to identify network structure of co-morbid depression and anxiety at symptom level in nonclinical population and to reveal the central symptoms and bridge symptoms of the co-morbidity. Methods : This study was based on 2022 Asan Youth Mental Health Screening. Patient health questionnaire (PHQ-9) and Generalized anxiety disorder scale (GAD-7) were used to assess depressive and anxiety symptoms of 810 young adult participants from community sample. Network structure of co-morbid depressive and anxiety symptoms was estimated by Isingfit model. Results : Depressed mood, Restlessness and Nervousness were the most central symptoms in the network. Bridge symptoms between anxiety and depression were Restlessness and Irritability. Conclusions : This study revealed key central symptoms and bridge symptoms of co-morbid depression and anxiety in nonclinical population and provided potential insight for treatment targets to reduce co-morbidity.

A Case of Rapid Cycling Secondary Bipolar Disorder Following Rt. Hemisphere Cerebral Infarction in a Patient with Preceeded Left Hemisphere Poststroke Depression (좌반구 뇌졸중후 우울증 환자에서 우반구 뇌경색이 수반된 급속 순환형 이차성 양극성장애 1례)

  • Chang, Ho-Kyun;Yi, Ho-Taek;Paik, Ju-Hee;Lee, Sang-Yeon
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.1
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    • pp.79-84
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    • 1998
  • Authors report a case of poststroke bipolar disorder that occurs much less frequently than poststroke depression(PSD). A MRI study performed to identify the etiology of a secondary manic episode in a patient with preceded PSD after left basal ganglia infarction revealed newly developed right basal ganglia infarction associated with poststroke bipolar disorder. It is interesting to note that (1) the temporal relationship was found between the occurrence of PSD after left hemisphere stroke and the occurrence of poststroke bipolar disorder following right hemisphere stroke, and that (2) the occurrence of PSD and the occurrence of poststroke bipolar disorder are associated with lesion location respectively. It has been reported that bipolar disorders were associated with subcortical lesions of the right hemisphere, whereas right-cortical lesions led to unipolar mania and that risk factors for mania included a family history of psychiatric disorders and mild subcortical atrophy. In this case, MR image shows subcortical lesions of the right hemisphere and mild subcortical atrophy. The investigation of the relationships among stroke lesion locations and potstroke mood disorders and risk factors for poststroke bipolar disorder may contribute to understanding the neurobiology of primary mood disorder. A clinical implication is that the risk of secondary bipolar disorder after cerebral infarction should be highlighted.

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Effect of Duloxetine in Functional Gastrointestinal Disorder : In the Perspective of 'Brain-Gut Axis' (기능성 위장관 장애에서 Duloxetine의 효과 : '뇌-장관 축' 모델을 중심으로)

  • Lee, Sang-Shin;Park, Si-Sung
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.2
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    • pp.135-138
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    • 2012
  • The pathophysiology of functional gastrointestinal disorder(FGID) is not completely understood, but the importance of the 'Brain-Gut Axis(BGA)' model in FGID is being increasingly recognized. The BGA model is a bidirectional, hard-wired and homeostatic relationship between the central nervous system(CNS) and the enteric nervous system(ENS) via neural, neurohormonal and neuroimmunological pathways. In addition, the BGA model would provide a rationale for the use of psychotropics on FGID. The authors experienced two cases in which duloxetine, a serotonin-norepinephrine reuptake inhibitor, was effective in relieving FGID symptoms as well as psychiatric symptoms such as depression and hypochondriacal anxiety. Therefore we discuss the vignettes from the perspective of BGA theory. Duloxetine showed efficacy in these two patients by reducing visceral hypersensivity (bottom-up regulation) and by relieving depression and anxiety(top-down regulation).

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Comparison of Emotional and Psychological Characteristics between Suicide Attempters and Non-Attempters in Depressed Patients : Using MMPI-2 Profiles (우울장애 환자의 자살 시도 여부에 따른 심리적 특성의 차이 : MMPI-2 프로파일을 중심으로)

  • Lee, Seul-Ah;Kim, Keun-Hyang;Suh, Shin-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.1
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    • pp.40-49
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    • 2012
  • Objectives : To examine emotional and psychological characteristics associated with suicide attempts in depressed patients. Methods : A sample of 37 inpatients diagnosed with major depressive disorder or depressive disorder NOS was divided into two groups : lifetime suicide attempters(N=15 ; 40.54%), non-attempters(N=22 ; 59.46%). Beck Depression Scale(BDI), Beck Anxiety Scale(BAI), Hamilton Depression Rating Scale(HDRS), Hamilton Anxiety Rating Scale(HARS), and MMPI-2 were used to evaluate symptoms severity and psychological characteristics. Results : Suicide attempters scored higher on the BDI though there were no group differences on the HDRS and on the both anxiety scales. Also they showed higher scores on the F, Fb, Pa, RC1, DEP, HEA, PK, AAS among MMPI-2 subscales. Our findings suggest that suicide attempters among depressed patients undergo more severe subjective distress and difficulties in adjustment than non-attempters. Also they were more hostile to others and showed lower trust. Lastly, they showed more somatic complaints and substance related problems. Conclusion : The present study showed that suicide attempters among depressed patients have distinct emotional and psychological characteristics. MMPI-2 would be helpful to assess suicidal risk of depressed patients.

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Assessment and Treatment of Depression in the Medically III (신체질환 환자들에서 우울증의 평가 및 치료)

  • Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.2
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    • pp.111-132
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    • 2001
  • Depression in the medically ill is a common clinical problem that primary physicians and psychiatric consultants encounter. Treatment of such patients begins with a careful evaluation of the patient's medical and psychiatric conditions. The assessment of depression in the medical patients requires a multidimensional approach. Psychological instruments are also used as a method of assessment in these patients. First of all, what the therapists have to do is to find and remove organic causes. Psychosoical treatment includes dealing with the patient's resistance and despondency relevant to physical diseases. For biological treatment, it is important to select appropriate antidepressants. Therapists should be familiar with the side effects of the antidepressants as well as the patient's primary depressive symptoms, pharmacokinetics and pharmacodynamics of the available agents. In addition, special attention should be paid to the potential for drug-illness and drug-drug interactions. Tricyclic antidepressants can be still effectively used for patients with pain disorder, although a variety of new antidepressants such as selective serotonin reuptake inhibitors (SSRI), bupropion and venlafaxine could have more benefits in depression of the medically ill. However, electroconvulsive therapy can be recommended for refractory cases of depression in patients with medical illness.

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MMPI PROFILE TYPES OF MOTHERS WITH PSYCHIATRIC DISORDERED CHILDREN (정신 장애 아동들의 어머니의 MMPI 유형 분석)

  • Shin, Min-Sup;Oh, Kyung-Ja;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.3 no.1
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    • pp.97-105
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    • 1992
  • Present study investigated the relationship between children's psychiatric disorders and their mothers' psychological problems. Ninety-one psychiatric outpatients from a children's hospital were classified into three diagnostic groups - internalizing symptom group(n=35), externalizing symptom group(n=35), and developmental disorder group(n=21) - based on their psychiatric problems. A normal control group was formed by matching on the age and education of mothers. Mothers' MMPI profiles which were classified into five types - normal, depression, anxiety disorder, somatization disorder, and personality disorder - were examined in relation with children's diagnoses. The profiles of the mothers in the normal control group were mostly normal, while depressive profiles were dominant among those of the clinical groups regardless of the children's diagnoses. Therefore, the data implied association between children's psychiatric problems and their mothers' psychological problems. A possibility of negative reciprocal interactions between children and their mothers was discussed. It was also suggested that further research need to examine the specific effects of children's psychiatric problems on the psychological adjustment of their mothers, as well as the effects of parental psychiatric problems on the adjustment of their offsprings.

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Effects of Traumatic Events on Posttraumatic Stress Disorder(PTSD), Burnout, Physical Symptoms, and Social and Occupational Functions in Korean Fire fighters (소방공무원의 외상후 스트레스장애가 정신신체적 증상에 미치는 상관관계)

  • Choi, Hea-kyung;Kim, Jee-hee
    • Proceedings of the Korea Contents Association Conference
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    • 2010.05a
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    • pp.213-215
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    • 2010
  • 본 연구의 목적은 소방대원들의 외상사건 경험이 외상후 스트레스장애 증상, 정서적 탈진, 신체증상, 사회 및 직업기능에 미치는 영향을 파악하기 위해 이들 간의 관계를 설명하는 가설적 모형을 구축하고 검증하므로써 소방공무원의 근무여건 개선 및 외상후 스트레스 관리방안 마련을 위한 기초자료를 제공하고자 하였다. 전국의 소방공무원 2,167명을 대상으로 2008년 1월20일부터 2008년 2월 15일까지 이메일을 통한 설문조사를 실시하였으며, 연구 도구는 일반적 특성 및 근무특성 설문, 외상사건경험 설문, 사건충격척도(IES-R-K), 정서적 탈진척도(MBI), 신체증상 측정도구, 사회 및 직업기능척도(SOFAS)를 사용하였다.

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