• Title/Summary/Keyword: 정신장애

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Automatic Nerve Activity to Physiologic Response in Adult With Psychiatric Disorder: A Systemic Review (성인 정신장애의 청각자극에 따른 생리학적 반응 측정에 대한 체계적 고찰)

  • Jung, Hye-Rim;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.9 no.1
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    • pp.45-52
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    • 2011
  • Objective : The aim of this study was to provide the method to measure physiologic response using equipments and auditory stimulation, and the physiologic response features of adult psychiatric disorders through a systemic review. Methods : The systemic review was executed using PubMed. The key words for search were "auditory stimulation, auditory startle, electromyograph, skin conductance, heart rate, psychiatric disorder, anxiety disorder, schizophrenia, depression". 8 studies were used for data analysis, and all of levels of evidence were level II. The substances of the review were subject(population), auditory stimulation, measure equipments and physiologic response features of psychiatric disorder. Results : 1. The subjects for the studies were anxiety disorder(4) and schizophrenia(4). 2. Auditory stimulation was used in 8 studies and visual stimulation with auditory stimulation was used in 2 studies to induce physiologic response. 3. Every study used electromyograph, and skin conductance was used in 2 studies and heart rate was used in 2 studies with electromyograph to measure physiologic response. 4. The subjects for the studies, schizophrenia and anxiety disorder(PTSD, OCD) have different physiologic response features with the normal control group. Conclusion : All studies used simple tones as an auditory stimulation and electromyograph to measure physiologic response. Psychiatric disorders indicated larger response, shorter and delayed habituation. The objective and systematic study using physiologic measure to investigate the sensory feature of psychologic disorders.

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Network Identification of Major Risk Factor Associated with Delirium by Bayesian Network (베이지안 네트워크를 활용한 정신장애 질병 섬망(delirium)의 주요 요인 네트워크 규명)

  • Lee, Jea-Young;Choi, Young-Jin
    • The Korean Journal of Applied Statistics
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    • v.24 no.2
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    • pp.323-333
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    • 2011
  • We analyzed using logistic to find factors with a mental disorder because logistic is the most efficient way assess risk factors. In this paper, we applied data mining techniques that are logistic, neural network, c5.0, cart and Bayesian network to delirium data. The Bayesian network method was chosen as the best model. When delirium data were applied to the Bayesian network, we determined the risk factors associated with delirium as well as identified the network between the risk factors.

Difference of Somatic Symptoms between Anxiety Disorder and Major Depressive Disorder and Their Domainal Association with Suicidal Idealization, Plan and Attempts (불안 장애와 주요우울장애에서 나타나는 신체 증상과 증상군에 따른 자살 사고, 계획, 행동과의 관계 고찰)

  • Ahn, Jun Seok;Kim, Eun young;Cho, Maeng Je;Hong, Jin Pyo;Hahm, Bong-Jin;Chung, In-Won;Ahn, Joon-Ho;Jeon, Hong Jin;Seong, Su Jeong;Lee, Dong-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.2
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    • pp.174-183
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    • 2016
  • Objectives : The aim of this study is to evaluate difference of somatic symptoms of anxiety disorder and major depressive disorder and domainal association with suicidal idealization, plan, and attempts. Methods : A total of 359 adults diagnosed with major depressive disorder and anxiety disorder of last one year participated. Participants interviewed with certain sections of Korean version of Composite International Diagnostic interview of CIDI. Sections of interests includes questionnaires regarding somatic symptoms and suicidal idea, plan and attempts of last one year. Results : Chest pain shows more prevalence in major depressive disorder. Symptoms of Headache and loose stool are more prevalent in anxiety disorder. Difficulty in equilibrium and fainting spells are more common somatic complaints of co-diagnosis states of anxiety disorder and major depressive disorder. Comparing 3 domains of pain symptoms, gastrointestinal symptoms and pseudo-neurological symptoms, pain symptom domains, gastrointestinal symptoms domain shows significant statistic difference between diagnosis. Average somatic symptom numbers of each symptom domains increase through suicidal idealization, plan and attempt, accordingly. Conclusions : Our finding shows some of somatic symptoms are more prevalent at certain diagnosis. Since increasing numbers of somatic complaints of each symptom domains goes with the suicidal idealization to suicidal attempts, proper psychiatric evaluation and consultations are crucial for patients with numerous somatic complaints in non-psychiatric clinical settings.

A Modified Attribution-Affection Model of Public Discrimination against Persons with Mental Illness -Model comparisons among schizophrenia, depression and alcoholism- (정신장애인의 사회적 거리감에 대한 수정된 귀인정서모형 적용 - 정신장애 유형별 모형비교 -)

  • Park, Keun Woo;Seo, Mi Kyoung
    • Korean Journal of Social Welfare
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    • v.64 no.4
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    • pp.209-231
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    • 2012
  • Recently, the many anti- stigma program use the 'mental illness is an illness like any other biogenetic illness' approach. This is based on Weiner's attribution affection theory. However, mental illness is difficult to be applied with attribution affection premise because attributing no blame for mental problem(biogenetic cause) leads to fear and dangerousness. We proposed a modified attribution affection model that explains the relations between biogenetic causal belief and social distance. Our model assumed that attributing personal responsibility for each mental problem leads to anger and social distance. And attributing no blame for mental problem(biogenetic causal belief) reinforces perception of dangerousness and social distance. This study presented typical vignettes of schizophrenia, depression and alcoholism according to the diagnosis criteria of DSM-IV to 768 university students randomly. Path analysis was used to test modified attribution affection model. The major findings are, First our original model modified partially for fit index. So final model assumed that i) The more respondents believed personal responsibility, the more anger, the more anger reaction corresponded closely with more social distance. ii) biogenetic causal beliefs leads to a worsening of dangerousness and perception of dangerousness leads to a increasing of social distance. Second, multi-group analysis was conducted to verify how a modified attribution affection model would be applicable to three groups. The result is that there is no difference among three groups. Finding from this research suggest to change anti-stigma program that use medical model.

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NEW DRUG THERAPY IN CHILD AND ADOLESCENT PSYCHIATRY-NEW LONG-ACTING PSYCHOSTIMULANTS (소아청소년 정신과 영역에서의 새로운 약물치료:새로운 장기작용형 중추신경자극제)

  • Choi, Sung-Ku
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.3-11
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    • 2003
  • Attention-deficit/Hyperactivity disorder(ADHD) is the most common psychiatric disorder of childhood and among the most prevalent chronic health conditions affecting school-aged children. Children with ADHD experience significant functional problems, such as school difficulties, academic underachievement, troublesome interpersonal relationships with family members and peers, and low self-esteem. The most widely used pharmacological treatments for ADHD are psychostimulants, such as methylphenidate and amphetamine salts. These medications provide clinical efficacy by increasing the availability of catecholamines, primarily dopamine, in the frontal lobe of the brain. immediate-release(IR) formulations of sychostimulants were among the most effective psychotrophic medications in the psychopharmacological treatment. However, there are some limitations of IR formulations:the short half-life and duration of efficacy, which result in the need for multiple daily dosing and the poor compliance. These limitations have led to the development of once-daily, extended-release(ER) formulations of methylphenidate and amphetamine salts. However, these ER formulations may not be as immediately helpful to ADHD children due to delayed onset of action and the acute tolerance which is the failure to sustain the efficacy with the same concentration of drug as the initial stage of medication. OROS-methylphenidate(Concerta$^{\circledR}$) given once a day produces an ascending-pattern plasma drug level generated by the osmotically released, timed drug-delivery system. These new formulations of the psychostimulants have been shown to be a useful alternative to old stimulant medications through the evidence by the clinical trials.

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GENETIC CONTROL MECHANISM AND MOLECULAR BASIS OF NEURODEVELOPMENT (유전인자 조절기전과 신경발달의 분자 생물학적 특성)

  • Joung, Yoo-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.5-14
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    • 2005
  • There has been an enormous progress in understanding of how genes contribute to both normal and abnormal development. Also many laboratory works are exploring the intricacies of how to develop in the human central nervous system. Understanding the mechanisms of cortical development gives essential insight into the pathogenesis of many genetic and acqured developmental psychiatric disorders, including autism, schizophrenia, and teaming disorder. Genes have been implicated in an ever-increasing number of disorders. Advance in genetics have begun to clarify the molecular basis of not only single-gene disorders, but also more complex phenotypes.

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Premenstrual Dysphoric Disorder : A Clinical Review (월경전 불쾌기분 장애에 대한 임상적 고찰)

  • Hwang, Gul
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.1
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    • pp.14-21
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    • 2007
  • Premenstural dysphoric disorder(PMDD) imposing 4-5% of women is possibly caused by an enhanced responsiveness to the changes of sex steroid hormones and the decrease of serotonin, melatonin and GABA. The common clinical features between PMDD and depression, seasonal affective disorder, panic disorder and anorexia nervosa suggest a relatedness between PMDD and each of them. The diagnostic criteria of DSM-IV-Tr for PMDD requires psychological symptoms, that commonly include irritability, anger, depression, mood swing, affect lability, tension, anxiety, fatigue and food craving. As of today, the best pharmacological treatment for PMDD is the selective serotonin reuptake inhibiter, and leuprolide, danazol, estradiol, spironolactone and bromocriptine are possible alternatives. Nonpharmacological treatments for patients with mild to moderate symptom severity are diet, exercise, light therapy, psychotherapy and keeping a diary.

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The Comparison of ICSD and DSM-Ⅳ Diagnoses in Patients Referred for Sleep Disorders (정신과에 의뢰된 환자 중 수면장애에 대한 ICSD와 DSM-Ⅳ 진단 비교)

  • Lee, Bun-Hee;Kim, Leen;Suh, Kwang-Yoon
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.37-44
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    • 2001
  • Background: Sleep disorders are prevalent in the general population and in medical practice. Three diagnostic classifications for sleep disorders have been developed recently: The International Classification of Sleep Disorders (ICSD), The Diagnostic and Statistical Manual, 4th edition (DSM-IV) and The International Classification of Diseases, 10th edition (ICD-10). Few data have yet been published regarding how the diagnostic systems are related to each other. To address these issues, we evaluated the frequency of sleep disorder diagnoses by DSM-IV and ICSD and compared the DSM-IV with the ICSD diagnoses. Method: Two interviewers assessed 284 inpatients who had been referred for sleep problems in general units of Anam Hospital, holding an unstructured clinical interview with each patient and assigning clinical diagnoses using ICSD and DSM-IV classifications. Results: The most frequent DSM-IV primary diagnoses were "insomnia related to another mental disorder (61.1% of cases)" and "delirium due to general medical condition (26.8%)". "Sleep disorder associated with neurologic disorder (38.4% of cases)" was the most frequent ICSD primary diagnosis, followed by "sleep disorder associated with mental disorder (33.1%)". In comparing the DSM-IV diagnoses with the ICSD diagnoses, sleep disorder unrelated with general medical condition or another mental disorder in DSM-IV categories corresponded with these in ICSD categories. But DSM-IV "primary insomnia" fell into two major categories of ICSD, "psychophysiologic insomni" and "inadequate sleep hygiene". Of 269 subjects, 62 diagnosed with DSM-IV sleep disorder related to general medical condition or another mental disorder disagreed with ICSD diagnoses, which were sleep disorders not associated with general medical condition or mental disorder, i. e., "inadequate sleep hygiene", "environmental sleep disorder", "adjustment sleep disorder" and "insufficient sleep disorder". Conclusion: In this study, we found not only a similar pattern between DSM-IV and ICSD diagnoses but also disagreements, which should not be overlooked by clinicians and resulted from various degrees of understanding of the pathophysiology of the sleep disorders among clinicians. Non-diagnosis or mis-diagnosis leas to inappropriate treatment, therefore the clinicians' understanding of the classification and pathophysiology of sleep disorders is important.

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A Study on the Responsibility Judgment and Mental Disorder of Criminal Psychology (책임능력판단에 관한 범죄심리학적 이론과 정신장애 항변 연구)

  • Rim, Sang-Gon
    • Korean Security Journal
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    • no.10
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    • pp.293-322
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    • 2005
  • The culpability of a person, as determined by due process of law, for any of his actions that are defined as criminal. Determination of such responsibility is a legal function, not a psychiatric one, although a psychiatrist may be called upon to present evidence to the court in order to aid the judge or jury in reaching a decision as to responsibility. Determination of responsibility varies with the laws of the state in which the accused is being tried, but in general all states base their laws on three famous judicial decisions concerning criminal responsibility. 1. the M'Naghten(McNaughton) rule(a. to establish such a defense the accused, at the time the act was committed, must be shown to have been laboring under such defect of reason as not to know the nature and quality of the act he was doing, b. if he did know it, he did or know that what he was doing was wrong). 2. the irresistible impulse test. 3. the Durham decision. Under the Durham test, however, the psychiatrist may give any relevant testmony concerning the mental illness at issue. The psychological and behavioral appearance of a person, in clinical psychiatry this term is commonly used to refer to the results of the mental examination of a patient. The written report of the mental status usually contains specific references to the following areas: I. Attitude and General Behavior (1)General health and appearance. (2)General habits of dress. (3)Personal habits. (4)General mood. (5)Use of leisure time. (6)Degree of sociability. (7)Speech. II. Attitude and Behavior during interview (1)Co-operativeness. (2)Poise. (3)Facial expression. (4)Motor activity. (5)Mental activity. (6)Emotional reactions. (7)Trend of thought. III. Sensorium, mental grasp, and capacity (1)Orientation. (2)Memory and retention. (3)Estimate of intelligence. (4)Abstraction ability. (5)Tests of absurdity, interpretation of proverbs. (6)Judgment.

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