• Title/Summary/Keyword: 정신의학

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The Relationship between Suicide Attempts and Serum Lipids in Patients Admitted with Depression (우울감을 주호소로 입원한 환자의 자살 시도와 혈청 지질과의 연관성)

  • Park, Sun Hong;Kim, Seung-Jun;Kim, Ji-Woong;Oh, Hong-Seok;Lee, Sang Min;Jun, Jin Yong;Im, Woo Young
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.164-171
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    • 2018
  • Objectives : Depression is a common mental illness and a major cause of suicide. Although serum lipids have been associated with depression and suicide, there has been much debate. In this study, we investigated the relationship between depression, suicide, and serum lipids in patients admitted with depressed mood. Methods : A total of 134 subjects were divided into 86 non-suicide patients and 48 suicide attempters. The serum lipid levels and sub-scores of the Korean Symptom Checklist-95 (KSCL95) were compared. We also investigated the relationship between serum lipids and sub-scores of KSCL95 and investigated whether serum lipids were risk factors for suicide attempts. Results : There was no difference in serum lipids between the two groups. Among the sub-items of KSCL95, obsession was higher in non-suicide group. Triglyceride showed positive correlations with anxiety, phobic anxiety, agoraphobia, schizophrenia, and self-regulation problem. High triglyceride was a risk factor for suicide attempts. Conclusions : Triglyceride is associated with depression, anxiety, and self - regulation, and high serum triglyceride levels may be a risk factor for suicide attempts.

Treatment-Resistant Schizophrenia : Pathophysiology and Treatment (치료 저항성 조현병의 이해와 치료)

  • Kim, Euitae
    • Journal of Korean Neuropsychiatric Association
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    • v.57 no.3
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    • pp.230-234
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    • 2018
  • A large proportion of patients with schizophrenia show a poor response to first-line antipsychotic drugs, which is termed treatment-resistant schizophrenia. Previous studies found that a different neurobiology might underlie treatment-resistant schizophrenia, which necessitates the development of different therapeutic approaches for treating treatment-resistant schizophrenia. This study reviewed previous studies on the pathophysiology of treatment-resistant schizophrenia and the pharmacological intervention, and forthcoming investigations of treatment-resistant schizophrenia are suggested.

Cognitive Processing Therapy as a First-line Treatment for Post-Traumatic Stress Disorder (인지처리치료: 외상후 스트레스 장애의 일차 치료)

  • Jin-Hee, Choi;Hyung-Seok, So;Soonjo, Hwang;Ji-Woo, Suk;Hayun, Choi;Seung-Hoon, Lee;EunYoung, Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.2
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    • pp.80-98
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    • 2022
  • Posttraumatic stress disorder (PTSD) is well known to have a limited response to drug treatment. Many recently published clinical care guidelines recommend trauma-focused psychotherapies such as cognitive processing therapy (CPT) and prolonged exposure therapy (PE) as first-line treatment and medication such as serotonin reuptake inhibitors and venlafaxine as second-line treatment. Current review introduces the session composition and contents of CPT and presents various CPT studies that show therapeutic effect for civilian and veterans/military with PTSD. In order for clinicians to help effectively patients with PTSD, it is necessary to learn and actively use evidence-based trauma-focused psychotherapies including CPT and PE.

The Effects of COVID-19 on the Self-Harm in Children and Adolescents Observed in a University Hospital (대학병원에서 관찰한 코로나19가 소아청소년 자해에 미치는 영향)

  • Oh, Sae-Bom;Kim, Seung-Jun;Kim, Ji-Woong;Oh, Hong-Seok;Im, Woo-Young;Lee, Na-Hyun
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.128-135
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    • 2021
  • Objectives : The aim of the present study is to investigate the impact of COVID-19 on the incidence and severity of childhood and adolescent self-harm. Methods : Medical records were retrospectively reviewed for patients under the age of 18 who visited the emergency room of Konyang University Hospital to compare the rate of self-harm attempts and the demographic, clinical, and self-harm-related of self-harm attempters aspects before and after the COVID-19 outbreak. Results : During 11 months after the COVID-19 outbreak, the proportion of the number of children and adolescents patients with self-harm and their episodes increased significantly compared to that during 11 months before the COVID-19 outbreak (𝛘2=14.397, p<0.001; 𝛘2=24.156, p<0.001). Between about the year before and after the outbreak of COVID-19, there was a significant difference in the prior self-harm history and psychiatric history among children and adolescents who visited the emergency room and the ratio of hospitalization to other departments than department of psychiatry (p<0.05; p<0.05; p<0.05). Conclusions : In the COVID-19 situation, the proportion of children and adolescents who visited the emergency room due to self-harm and admission to other departments are increasing. And it has been shown that the incidence of self-harm has significantly increased in children and adolescents with a history of prior self-harm and psychiatric past history. These findings underscore the need for the psychiatric evaluation and intervention of self-harm related high-risk groups among children and adolescents in pandemic situations.

The Basic principle of treatment according to the symptom (病證藥理) in Sasang Constitutional Medicine (사상인병증약리(四象人病證藥理)의 성립과정(成立過程)과 그 운영정신(運營精神)에 대한 고찰(考察))

  • Song, Il-Byung
    • Journal of Sasang Constitutional Medicine
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    • v.8 no.1
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    • pp.1-15
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    • 1996
  • The Sasang Constitutional Medicine seeks the psychosomatic balance, and the Basic principle of treatment according to the symptom(病證藥理) in Sasang Constitutional Medicine could be summarize as follows. 1. The pursuit of Shape-Image Medicine (形象醫學) and the Symptoms of shape - Symptoms of disease (形置病證). It established emotion, symptoms of constitution, and symptoms of constitutional disease on the base of Shape-Image Medicine (形象醫學) which means qi (氣) is inside and shape is outside (氣裡形表). 2. The inductive medicine and positive medicine. It systematized the Symptoms of shape - Symptoms of disease (形證病證) on the base of the medical practice of the ancients and Lee Jae-Ma (李濟馬)'s own experience inductively, and it present show to control the psychosomatic balance practically. 3. The pathology centering on human. Oriental medicine is based on Yin-Yang (陰陽) and Five elements (五行) and the harmony of nature and human (天人相應) of Taoism, but Sasang Constitutional Medicine is based on emotional and ethical pathology of Confucianism (儒學). 4. The treatment according to the symptom (病證藥理) in Sasang Constitutional Medicine centering on clear qi (正氣). The promotion and demotion (補瀉) which is based on clear qi (正氣) and evil qi (邪氣) is a basic principle in Oriental medicine, but In Sasang Constitutional Medicine it is attached importance to control of clear qi and classify obedience symptom and disobedience symptom (順 逆症) as the type to oppose disease. 5. The treatment according to the psychomatic symptoms. It takes importances to control of one-sided emotion as well as the treatment of psychical symptoms, and also to remedy disease as keeping under control one's mind. 6. The preventive medicine and the medicine to develop one's health. It is in pursuit of social health to develop personality through clear qi (正氣) in real life, to prevent disease, and to spread the sickness control of individual person. Sasang Constitutional Medicine pursuits the psychosomatic balance through 'Balance', 'Control', 'Self regulating Control' of the 'Golden Mean (中庸)' with the treatment according to the symptom (病證藥理) in Sasang Constitutional Medicine.

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Impact of COVID-19-Related Stress and Depression in Public Sector Workers (코로나 19 관련 공공근로자에서의 우울증상 및 스트레스 반응)

  • Park, Jinsol;Cho, Hye-mi;Ko, Min-soo;Chi, Su-hyuk;Han, Changsu;Yi, Hyun-suk;Lee, Moon-Soo
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.136-143
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    • 2021
  • Objectives : The coronavirus disease 2019 (COVID-19) outbreak is a global medical crisis imposing particular burden on public sector employees. The aim of this study was to investigate the psychiatric distress among public sector workers amid the COVID-19 pandemic. Methods : We conducted a cross-sectional study with 531 public sector workers in Gwangmyung city who completed Korean versions of the Perceived Stress Scale (PSS), Patient Health Questionnaire-9 (PHQ-9), and Impact of Event Scale-Revised-Korean (IES-R-K). Results : The results revealed more than moderate levels of stress (85.2%), depressive symptoms (22.2%), and posttraumatic stress symptoms (38.8%). PSS total score was significantly correlated with PHQ-9, IES-R-K total scores as well as IES-R-K subscale scores. Total scores on the PSS, PHQ-9, and IES-R-K were all inversely correlated with age. Conclusions : COVID-19-related workers experience considerable stress and depressive symptoms, with self-rated stress correlating significantly with depression scores. Age may serve as a protective factor against occupational stress and burnout. These findings highlight the need for adequate psychiatric screening and intervention for public sector workers.

The Association Between Childhood Interpersonal Trauma and Psychiatric Symptom Complexity, and the Mediating Impact of Dissociation (아동기 대인관계 외상, 정신 증상의 복잡성 및 해리의 매개 효과)

  • Kim, Yaeseul;Kim, Seok Hyeon;Kim, Daeho;Kim, Eun Kyoung;Kim, Jiyeong;Choi, Nayeon
    • Anxiety and mood
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    • v.18 no.2
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    • pp.72-79
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    • 2022
  • Objective : Any traumatic event can be a risk factor, for subsequent mental disorder. However, childhood trauma, especially in interpersonal nature, is associated with later development of complex symptom patterns. This study examined the role of dissociation as a mediator between childhood trauma and symptom complexity. Methods : A pooled data of 369 psychiatric outpatients at a university-affiliated hospital was analyzed for descriptive statistics, group differences, and bivariate correlation analysis to verify a structural model. The questionnaires included the Symptom Checklist-90-Revised, the Trauma History Screen, the Dissociative Experiences Scale-Taxon, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. Results : When other trauma variables were controlled, childhood interpersonal trauma had significant correlation with symptom complexity (r=0.155, p=0.003). Among the paths analyzed, that of childhood interpersonal trauma and dissociation showed the greatest impact on symptom complexity (b=9.34, t=5.75, p<0.001). Based on the significance of the indirect impact, the results suggest a complete mediation impact of dissociation on symptom complexity. Conclusion : This study validated that childhood interpersonal trauma impacts symptom complexity, through the sequential mediating impact of dissociation. Thus, clinicians should understand childhood interpersonal trauma, dissociation, and symptom patterns in a complex and interacting mode, and develop effective pertinent treatment strategies.

A Study on the Characteristics and Consultation Request Type of Inpatients Referred for Depressive Symptoms (우울 증상으로 의뢰된 입원환자의 임상적 특징 및 자문 의뢰 형태에 관한 연구)

  • Yoon, Nara;Ryu, Seung-Ho;Ha, Jee Hyun;Jeon, Hong Jun;Park, Doo-Heum
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.1
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    • pp.34-41
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    • 2021
  • Objectives : The purpose of this study is to investigate the characteristics of depressive patients who admitted to general hospital. We examined the clinical characteristics of patients who were referred to the Department of Psychiatry as depressive symptoms, according to the type of consultation request, and comparing 'with re-consultation' and 'without re-consultation' groups. Methods : We performed a retrospective chart review of 4,966 inpatients who were referred to the Department of Psychiatry from August 2005 to December 2011. Results : For about 6 years, among the inpatients referred for psychiatric consultation, a total of 647 patients were referred for depressive symptoms, accounting for 13.82% of the total consultations. The average age of depressive patients was 58.6 years, which was higher than the average of 56.4 years of overall patients. Among the depressive patients, 275 patients were included in 'with re-consultation' group and there was no statistically significant difference when comparing 'with re-consultation' group and 'without re-consultation' group. However, there was a difference in the tendency of the two groups in the type of consultation request. 'With re-consultation' group was in the order of frequency of consultation type 3-2-1, whereas the 'without re-consultation' group was in the order of frequency of consultation type 2-3-1. Conclusions : The group of inpatients who were referred for depressive symptoms in general hospital showed the largest proportion of the group of patients referred to the Department of Psychiatry. 'With re-consultation' group had a higher rate of re-consultation due to the occurrence of new symptoms after hospitalization compared to 'without re-consultation' group. Therefore, doctors in each department and psychiatrists should pay attention to the depressive symptoms of inpatients and actively discuss treatment plans to improve the quality of medical services, identify risk factors, and make efforts to intervene early if necessary.

From the Onset of Panic Symptoms to Getting to a Psychiatric Treatment : The Change by Improved Public Awareness of Panic Disorder in Korea (증상의 발현부터 치료의 시작까지 : 한국인의 공황장애 인식도 변화가 치료적 접근에 미친 영향)

  • Choi, Yong-Won;Seo, Ho-Jun;Han, Sang-Woo;Hong, Jin-Pyo;Lee, Kyoung-Uk;Kim, Se-Joo;Lim, Se-Won;Lee, Sang-Hyuk;Yang, Jong-Chul;Lee, Seung-Jae;Park, Seon-Cheol;Gim, Min-Sook;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.15 no.2
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    • pp.61-67
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    • 2019
  • Objective : This study aimed to investigate the general process from the symptom onset to the psychiatric treatment in Korean panic patients and the effect of improved public awareness on it. Methods : This study has a retrospective design. The subjects were the new patients with panic disorder who visited the psychiatric outpatient clinic in twelve university-affiliated hospitals all across Korea. The medical chart was reviewed retrospectively and the data were collected including chief complaints of symptoms, recent stressors, the time to visit the psychiatric outpatient clinic, and visit of other departments and diagnostic approaches for their symptoms. Results : A total of 814 participants were included in the study. The most common department other than psychiatry the panic patients visited were cardiology (28.3%), general internal medicine (16.0%) and neurology (11.4%). The most frequently used diagnostic tests were a echocardiography (17.9%), 24-hour Holter monitoring (11.2%), and brain MRI (8.2%). Only 37.3% of participants visited psychiatric clinic directly. About 80% of participants visited psychiatric department within 1 year after their first panic symptoms and it took $13.8{\pm}13.7weeks$ on average. Comparing before and after 2012, the number of participants increased who visit directly the psychiatric clinic without visiting other departments (p=0.002) and without visiting emergency room (p<0.001). Conclusions : Our results suggest that a substantial number of patients visit departments other than psychiatry when they experience first panic symptoms. However, most patients begin psychiatric treatment within 1 year after their first symptoms and the number of patient are increasing who visit psychiatric department directly without visiting other departments.

The Therapeutic Effect of Mindfulness-Based Interventions on Depressive Symptoms in Patients With Major Depressive Disorder: A Meta-Analysis (주요우울장애 환자의 우울증상에 대한 마음챙김 기반의 치료적 개입의 효과에 관한 메타분석)

  • Hannui Park;Seyeon Hong;Euihyeon Na;Myoung-Nam Lim;Kanguk Lee
    • Korean Journal of Biological Psychiatry
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    • v.31 no.1
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    • pp.7-14
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    • 2024
  • Objectives We conducted a meta-analysis of randomized controlled trials to investigate the therapeutic effects of mindfulness-based interventions on depressive symptoms in patients with major depressive disorder. Methods In February 2021, we searched Embase, MEDLINE, Cochrane Library, PsycINFO, CINAHL, and AMED. Under the guidance of the corresponding author, two evaluators independently reviewed and selected articles based on predetermined selection criteria. Results Based on the selection criteria, we systematically screened and included a total of 12 randomized controlled trials comprising 720 cases for the final analysis. Utilizing a random-effects model for data analysis, we determined the Hedges' g value to be 0.787, indicating a medium-sized effect according to Cohen's interpretation. The 95% confidence interval for the effect size ranged from 0.414 to 1.160 (p-value < 0.0001). Conclusions This study reveals the potential effectiveness of mindfulness-based interventions in treating depressive symptoms among patients with major depressive disorder.