• Title/Summary/Keyword: 정신신체 증상

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Relationship between Physical Illness and Depression in North Korean Defectors (북한이탈주민의 신체질환과 우울증상의 연관성에 관한 연구)

  • Kim, Seog-Ju;Kim, Hyo-Hyun;Kim, Jung-Eun;Cho, Seong-Jin;Lee, Yu-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.19 no.1
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    • pp.20-27
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    • 2011
  • Objectives: The present study aims to investigate the effects of physical illness on depression in North Korean Defectors. Methods: One hundred forty-four North Korean Defectors(20 males, 124 females) and 376 South Koreans 133 males, 243 females) in Incheon Metropolitan areas participated the present study. Face-to-face interview was conducted for demographic information including presence of physical illnesses. To investigate depressive symptoms, all participants were required to complete the Center for Epidemiologic Studies-Depression scale (CES-D). Results: After controlling gender, age, marital status, educational year, employment status and physical illness, North Korean Defectors showed higher CES-D score than South Koreans(${\beta}$=0.449, p<0.001). Within North Korean Defectors, the presence of physical illnesses independently was related to higher CES-D score(${\beta}$=0.243, p<0.001). However, within South Koreans, the presence of physical illnesses did not significantly predict CES-D score. North Korean Defectors with physical illness have higher CES-D score than North Korean Defectors without physical illness($26.8{\pm}13.8$ versus $19.7{\pm}12.7$). However, there was no significant differences of CES-D score between South Koreans with physical illness and South Koreans without physical illness($10.3{\pm}9.8$ versus $9.3{\pm}8.8$). Conclusion: Compared to South Koreans, North Korean Defector showed higher depressive symptoms independently from gender, age, education, employment, marriage. In addition, only North Korean Defectors showed the relationship between depression and physical illness. Our study suggests that depression should be assessed when North Korean Defectors have physical illness.

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남성 갱년기

  • KOREA ASSOCIATION OF HEALTH PROMOTION
    • 건강소식
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    • v.30 no.12 s.337
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    • pp.6-11
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    • 2006
  • 남성도 갱년기를 겪는다. 중년 여성의 전유물로 여겨졌던 갱년기가 남성에게도 나타나는 것이다. 40세 이후 남성의 신체기능 저하는 최근까지 자연적인 노화현상으로 치부됐다. 그러나 평균수명의 연장과 의학의 발달 등으로 건강한 노년 생활에 대한 욕구가 커지면서 남성의 갱년기 증상이 발견되기 시작했다. 특히 20대에 최고조로 증가하는 남성 호르몬(테스토스테론)이 점차 줄어들다가 40~55세 사이에 급격히 감소하면서 여러 가지 신체적, 정신적, 심리적 변화가 나타난다. 남성호르몬 감소의 첫 번째 징후는 부부관계에 관심이 없어지고, 좀 더 진행되면 만성피로를 느끼고 얼굴이 달아오르거나 식은 땀을 흘리며 손발이 저리기도 하다. 그리고 감정이 잘 조절되지 않아 사소한 일에도 짜증을 내게 되는데, 남성 호르몬 부족 때문에 나타나는 이러한 증상들을‘남성 갱년기’라 한다. 이번 호에서는 서울아산병원 비뇨기과 안태영 교수와 성의학클리닉 연구소 강동우 전문의의 도움으로 남성 갱년기에 관해 자세히 알아본다.

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The Relationship between Epileptic Focus and Psychiatric Symptoms of the Refractory Epileptic Patients (난치성 간질환자의 간질초점 위치와 정신증상과의 관련성)

  • Han, Wou-Sang;Kim, Jong-Hoon;Lee, Sang-Kun;Cho, Doo-Young;Kwon, Jun-Soo;Ha, Kyoo-Seob
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.1
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    • pp.64-70
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    • 1996
  • The prevalence rate of psychiatric symptoms of the refractory epileptic patients was evaluated according to the location of the epileptic focus. The subjects were 91 patients admitted to Epilepsy Monitoring Unit of Seoul National University Hospital. The psychiatric symptoms were assessed by Korean version of Symptom Checklist-90-R(SCL-90-R). The locus of epileptic focus was assessed by clinical features, 2-hour interictal EEG, long-term video-EEG monitoring, brain MRI, interictal and ictal brain SPECT, and interictal brain PET The subjects were divided into three groups according to the epileptic focus, non-temporal(N=29), left temporal (N=26), and right temporal(N=32). There were no statistical differences in demographic and seizure-related variables among groups. The number of patients with $T-score {\geq} 65$ at any subscale of the SCL-90-R were compared by $X^2-test$ among groups. The mean T-scores of each subscale of the SCL-90-R were compared by oneway-ANOVA among groups. The prevalence rate of psychiatric symptoms of the refractory epileptic patients was 38.5%. There was no statistical difference in the prevalence rate of psychiatric symptoms among groups. However, the patients with non-temporal or right temporal epileptic foci showed statistically significant higher mean T-scores of interpersonal sensitivity, depression, hostility, and phobic subscales than the patients with left temporal epileptic foci. These results suggest that the epileptic focus plays an important role in the production of interictal psychiatric symptoms of the refractory epileptics.

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Relationship among Dysfunctional Attitudes, Stress Coping Strategies and Depressive Symptoms in Psychiatric Patients (정신질환자들의 역기능적 태도, 스트레스 대처 방식 및 우울증상 간의 관계)

  • Park, Chan-Moo;Seo, Kyung-Ran;Rhee, Min-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.1
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    • pp.31-42
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    • 1997
  • This study was aimed to investigate dysfunctional attitudes, stress coping strategies and depressive symptoms in psychiatric patients. The subjects of this study consisted of 210 patients(138 schizophrenic patients, 29 depression patients, 43 alcohol dependence patients) according to DSM-IV criteria. Futhermore, the instruments were K-BDI(Beck Depression Inventory-Korean version), DAS(Dysfunctional Attitude Scale) and multidimensional coping strategy scale. The results were the following. 1) There were statistically significant correlations between depressive symptoms and dysfunctional attitudes in psychiatric patients. 2) In terms of coping strategies, there were positive correlations between depressive symptoms and focus on and venting emotions, accommodation, active forgetting, self-criticism, positive comparison, fatalism, passive withdrawal. Whereas, there was significant negative correlation between depressive symptom and active coping. 3) In terms of coping strategies, there were significant correlations between dysfunctional attitudes and focus on and venting emotions, active forgetting, self-criticism, positive comparison, fatalism, passive withdrawal. 4) Depression groups reported significantly higher BDI scores than schizophrenia groups. 5) In depression groups, DAS scores were significantly higher than those in schizophrenia groups. 6) In terms of coping strategies according to diagnosis, there were significant differences in venting emotions, active forgetting and self-criticism. As for venting emotions, alcoholic groups were scored significantly higher than schizophrenic groups. As for active forgetting, depression groups were scored significantly higher than schizophrenic groups. In self-criticism, depression groups and alcohol dependence groups reported significantly higher scores than schizophrenic groups.

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Disappearance of Hysteria(Conversion Disorder) and the Evolutionary Brain Discord Reaction Theory (히스테리아(전환장애)의 소실과 진화적 뇌신경 부조화 반응 가설)

  • Song, Ji Young
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.28-42
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    • 2016
  • Objectives : The author tried to find out reasons why and how hysteria(and conversion disorder) patient numbers, which were so prevalent even a few decades ago, have decreased and the phenotype of symptoms have changed. Methods : The number of visiting patients diagnosed with conversion disorder and their phenotype of symptoms were investigated through chart reviews in a psychiatric department of a University hospital for the last 12 years. Additionally, the characteristics of conversion disorder patients visiting the emergency room for last 2 years were also reviewed. Those results were compared with previous research results even if it seemed to be an indirect comparisons. The research relied on Briquet P. and Charcot JM's established factors of the vicissitudes of hysteria(and conversion disorder) which has been the framework for more than one hundred and fifty years since hysteria has been investigated. Results : The author found decreased numbers and changes of the phenotype of the hysteria patients(and conversion disorder) over the last several decades. The decreased numbers and changes of the symptoms of those seemed to be partly due to several issues. These issues include the development of the diagnostic techniques to identify organic causes of hysteria, repeated changes to the symptom descriptions and diagnostic classification, changes of the brain nervous functions in response to negative emotions, and the influence of human evolution. Conclusions : The author proposed that the evolutionary brain discord reaction theory explains the causes of disappearance of and changes to symptoms of hysteria(conversion disorder). Most patients with hysteria(conversion disorder) have been diagnosed in the neurological department. For providing more appropriate treatment and minimizing physical disabilities to those patients, psychiatrists should have a major role in cooperating not only with primary care physicians but with neurologists. The term 'hysteria' which had been used long ago should be revived and used as a term to describe diseases such as somatic symptom disorder, functional neurological symptoms, somatization, and somatoform disorders, all of which represent almost the same vague concept as hysteria.

Clinical Characteristics of Misdiagnosed Delirium (오진된 섬망 환자의 임상적 특징)

  • Oh, Eugene;Baek, Sue-Hyun;Kim, Min-Hyuk;Min, Seongho;Park, Ki-Chang;Ahn, Jung-Sook
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.2
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    • pp.87-92
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    • 2014
  • Objectives : Delirium of hospitalized patients is common and it is significantly associated with increased mortality rate. Misdiagnosis rates of delirium are reported in a range of 36.7 to 63% in clinical setting. We aimed to identify the clinical features and symptomatic characteristics associated with misdiagnosis of delirium. Methods : Subjects were 256 inpatients who were referred for psychiatric consultation and diagnosed with delirium by a psychiatrist at a university hospital between January 1 and June 30, 2012. Clinical data were obtained with retrospective chart review. Patients were divided into misdiagnosed group and correct diagnosed group, after reviewing the reason which were described in the consultation request form. Results : Sixty nine(27%) subjects of the 256 patients were referred for other reasons(mood, substance, anxiety, dementia etc.) than "delirium/confusion" by clinician(misdiagnosed group). In misdiagnosed group, use of antipsychotics was more common. There were no differences between the two groups in age, gender, and department of referring clinician. Fluctuation score of DRS-R-98 was higher in the correct diagnosed group. Conclusions : In this study, the risk of misdiagnosis was higher when the patients have taken antipsychotics or less symptom fluctuation. Careful clinical attention is needed for diagnosis for delirium in these patients.

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Current State and Limit of Mobile-Based Mental Health Intervention Using Information & Communication Technology (정보통신기술(Information & Communication Technology)을활용한 모바일 기반 정신건강개입의 현황과 한계)

  • Lee, Sang Min;Kim, Seung-Jun;Im, Woo-Young;Paik, Jong-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.61-65
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    • 2016
  • Currently, a variety of Information and Communication Technology(ICT) is being broadly utilized for mental health. Especially, mobile application is one of the effective ICT, and several applications have been developed after the spread of smartphones. The mobile-based mental health has several strengths, such as better treatment accessibility and easier check-ups of symptoms or daily activities by real-time monitoring. Better follow-ups of treatment course, more customized feedback and better transportability enable patients to be more adherent. However, there are some limitations of mobile technology about the mental health, such as technical troubles of electric errors, data safety problems and personal information extrusion. Therefore, full considerations should be given during the development and provision of the technology. Most of all, mental health specialists should actively participate in the development process by incorporation of evidence-based experiences and assurance of good clinical qualities.

Validation of the Korean Version of the Trauma Symptom Checklist-40 among Psychiatric Outpatients (정신건강의학과 외래환자 대상 한국판 외상 증상 체크리스트(Trauma Symptom Checklist-40)의 타당도 연구)

  • Park, Jin;Kim, Daeho;Kim, Eunkyung;Kim, Seokhyun;Yun, Mirim
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.1
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    • pp.35-43
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    • 2018
  • Objectives : Effects of multiple trauma are complex and extend beyond core PTSD symptoms. However, few psychological instruments for trauma assessment address this issue of symptom complexity. The Trauma Symptom Checklist-40 (TSC-40) is a self-report scale that assesses wide range of symptoms associated with childhood or adult traumatic experience. The purpose of the present study was to evaluate the validity of the Korean Version of the TSC-40 in a sample of psychiatric outpatients. Methods : Data of 367 treatment-seeking patients with DSM-IV diagnoses were obtained from an outpatient department of psychiatric unit at a university hospital. The diagnoses were anxiety disorder, posttraumatic stress disorder, depressive disorder, adjustment disorder and others. Included in the psychometric data were the TSC-40, the Life events checklist, the Impact of Event Scale-Revised, the Zung's Self-report Depression Scale, and the Zung's Self-report Anxiety Scale. Cronbach's ${\alpha}$ for internal consistency were calculated. Convergent and concurrent validity was approached with correlation between the TSC-40 and other scales (PTSD, anxiety and depression). Results : Exploratory factor analysis of the Korean Version of TSC-40 extracted seven-factor structure accounted for 59.55% of total variance that was contextually similar to a six-factor structure and five-factor structure of the original English version. The Korean Version of TSC-40 demonstrated a high level of internal consistency. (Cronbach's ${\alpha}=0.94$) and good concurrent and convergent validity with another PTSD scale and anxiety and depression scales. Conclusions : Excellent construct validity of The Korean Version of TSC-40 was proved in this study. And subtle difference in the factor structure may reflect the cultural issues and the sample characteristics such as heterogeneous clinical population (including non-trauma related disorders) and outpatient status. Overall, this study demonstrated that the Korean version of TSC-40 is psychometrically sound and can be used for Korean clinical population.

Effects of Group Tai Chi Exercise Prograam on Body Mass Index(BMI), Positive and Negative Psychiatric Symptoms in Patient with Schizophrenia (타이치 운동프로그램이 정신분열병 환자의 신체질량지수와 양성 및 음성 정신 증상에 미치는 효과)

  • Kwon, Yun-Hee;Kwag, Oh-Gye
    • The Korean Journal of Rehabilitation Nursing
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    • v.14 no.2
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    • pp.129-135
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    • 2011
  • Purpose: This study was done to examine the effects of Tai Chi exercise program on BMI, positive and negative psychiatric symptoms in patient with schizophrenia. Methods: The participants were patient with schizophrenia in S psychiatric hospital in D city. Twenty five patients were assigned to experimental group, and 26 patients were assigned to control group. Data were collected from May 9, to July 8, 2011. The Tai Chi exercise program was conducted with a duration of 60 minutes, 2 times a week for 8 weeks (a total 8 times). Measures were BMI, positive and negative psychiatric symptoms. Data were analyzed using descriptive statistics, chi-square test and t-test with SPSS/WIN 19.0 version. Result: The experimental group received Tai Chi exercise program had a significant changes in BMI, positive and negative psychiatric symptoms. Conclusion: The results of this study indicate that Tai Chi exercise program is an effective intervention program to improve the BMI, positive and negative psychiatric symptoms of patients with schizophrenia.

The Investigation Regarding the Psychiatric Consultation of the Inpatient from General Hospital (일 종합병원 입원 환자의 정신과 자문 의뢰의 최근 3년간의 특성에 대한 연구)

  • Lee, Soo-Jin;Lee, Joong-Kwaun;Wang, Kwuan-Shu;Kim, Jung-Gee;Cho, Dong-Hwan;Kim, Hyun-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.1
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    • pp.49-59
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    • 2005
  • Objectives: This clinical study investigates the status of psychiatric consultation from 2001 to 2003 at Maryknoll General Hospital, located in Busan to evaluate the characteristic patterns of current psychiatric consultation and to contribute for further data of consultation study. Methods : The subjects of this study were hospitalized at Maryknoll General Hospital from 1 January, 2001 to 31 December, 2003, who were referred for psychiatric consultation during hospitalization. This study was analysed demographic data, reason for referral, psychiatric diagnosis by patient's chart and psychiatrist's report retrospectively. Results : 1) The psychiatric consultation rates was 1.72%. 2) There was 47.8% in referral among the age group over 60 years, especially the age group over 70 years was 20.3%. 3) The most frequent referral source was department of internal medicine(72.5%). 4) The frequency of psychiatric consultation was the highest at March and the lowest at December. 5) The reasons of psychiatric consultation, according to frequency, were affective change, somatic symptom without abnormal finding. And drug intoxication. alcohol problem were increased. 6) Somatoform disorder was the most common psychiatric diagnosis followed by depressive disorder, organic mental disorder. The diagnosis of somatoform disorder, depressive disorder, alcohol dependence were increased, but anxiety disorder, organic mental disorder were decreased. 7) Pharmacotherapy was the most recommendation, and diagnostic procedure and psychotherapy were increased. Conclusion : In review of consultation referral subjects, the referral rate was 1.72%. The consultation referral of the old(over 60 years) was 42.8%, and annually increased. The most frequent request source was from department of internal medicine. The reasons of consultation referral was the most due to affect change. The recommendation of pharmacotherapy was the most numerous. and psychotherapy was increased annually. Further studies warranted on geriatric psychiatric consultation, pattern change of consultation.

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