Numbers of patients who have chronic pain seem to be increasing even in the psychiatric practice. One report in Korea showed more than 40% of psychiatric patients who visited out-patient clinic were suffered from chronic pain and one third of those patients were needed treatment for the on-going pain. For evaluating and treating those patients the charateristics of illness behavior should be understood. Abnormal Illness behavior was found as one of the most influential factors which led symptoms complicated and chronified. This symposium was planned to illustrate how to manage the patients whose pain are associated with arthropathy and connective tissue diseases, neuropathic pain and headache more effectively and efficiently. So, It is hoped to get fruitful knowledges for the management of chronic pain in the scope of consultation-liaison psychiatry.
Objective: This study examined the use of mental health helping systems among college students in Korea. A behavioral model of health service utilization was applied to examine factors influencing different types of helping systems. Methods: A total of 454 college students from four universities participated in the survey. A self-administered questionnaire measuring help-seeking behaviors including formal health and mental health services, informal helping system, peer group, and family support was used. Results: Respondents frequently turn to family members and peer group when in need, and age, sex, mental Health status, and attitude and knowledge on mental illness were significant factors affecting help-seeking behaviors of Korean students. While older students and those with more severe symptoms were more likely to seek help from formal resources, students with more severe symptoms were less likely to seek help from informal resources. Male students and those with negative attitude toward mental illness were less likely to ask peer groups for help. Conclusions: Study results indicate that informal resources and peer groups can be significant sources of social support for individuals in their late adolescence and young adulthood, however, their role as gateways to professional help is limited. Student counseling centers should take on a more active role in reaching out; implications for developing peer leaders as counselors and self-help groups are discussed.
Purpose: This study was done to investigate community attitudes towards people with mental illness and to mental health services. Methods: From August to October of 2006, 474 citizens of Siheung city were asked to give demographic data and their personal attitude toward mental illness and mental health services. Results: The residents of Siheung community showed slightly negative attitudes, with a mean opinion about mental illness score of $93.38{\pm}17.29$. According to the study, health professionals and citizens showed a positive attitude to the establishment of day care centers and residential facilities (62.2% and 55.4% respectively). Civil servants showed negative attitudes (40.4%). There were significant differences in attitudes according to gender, age, education level, occupation, religion, and income. Positive attitudes were found for health professionals and negative attitudes for civil servants. Conclusion: The results of this study indicate a need to provide public information and education for civil servants, and for those who have negative attitudes, in particular, men, people in the younger age group, who have lower education levels, who are Buddhists, monthly renters, who have a monthly income below 1 million won, who have no children and no experience with people who have a mental illness.
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.
Journal of the Korean Academy of Child and Adolescent Psychiatry
/
v.8
no.1
/
pp.34-42
/
1997
Enuresis is repeated involuntary or intentional voiding of urine into bed or clothes over age 5. Though it would be a self-remitting disorder, it could be serious problem in emotional and socio-adaptational aspects. The author reviewed the enuretic patients of Child & Adolescence psychiatric section in Chungnam National University Hospital during past 3 years. 46(4.9%) of 936 patients were diagnosed as enuresis in DSM-Ⅳ. The author evaluated their comorbidity by the data of diagnostic review made in two psychiatrists, and emotional aspects(self-concept, anxiety, depression) through the self-rating scales (Piers-Harris children’ self concept scales, RCMAS, state-trait anxiety inventory for children, child’s depresson inventory). Thirty(65.2%) of the 46 enuretic patients had additional diagnoses such as attention deficit hyperactive disorder, mental retardation, encopresis, oppositional defiant disorder, depression, anxiety disorder, autism, somatoform disorder, tic disorder, obsessive-compulsive disorder, sleep disorder, etc. Sixteen enuretic patients had at least one comorbid disorder. Eleven patients had two, and three patients had more than three. Fourteen of 46 enuretic patients were evaluated through self-rating scales of self-concept, anxiety and depression. But we couldn’t obtain meaningful results. Maybe it was due to the small sample size(N=14) and the influence of the comorbid disorders. Finally, it was an impressive evidence that there exist many comorbid disorders in enuresis(esp. attention deifict/hyperactive disorder). In emotional aspects, the author thought that further evaluation should be needed for more meaningful results.
The main purpose of this study was to investigate attitudes toward mental illness and the mentally ill of psychiatric nurses in Korea and to identify the relationships between the nurses' attitudes and demographic variables. Subjects in this study were 122 psychiatricnurses and 111non-psychiatric nurses in active service at 12 hospitals in Seoul. The insrtument used for measuring attitudes was a questionaire developed by Cohen and Struening (1962) referred to as the“Opinions about Mental illness(OMI) Scale”made up to 51 Likert-type items. The findings of this study indicated hatnurses showed negative attitudetoward mental illness and the mentally ill: Very high on social restrictiveness (factor D), low on Mental Health Ideology (factor C), and Interpersonal Etiology (factor E). Since the high score on Factor A, B and the low score on Factor B, C, E reflect a negative altitudes toward mental illness, this study population related extremely negative attitudes compared to any other surveys. And of the demographic variables that related to their attitudes the education degree and the kind of the hospital in active service showed very significant differences. On the basis of the investigation the findings indicated the followings; 1) Althohg attitudes toward mental illness and the mentally ill of psychiatric nurses were not significant differences from non-psychatric nurses, there was a trend that attitudes of psychaitric nurses did show more negative responses rather than those of non-psychiatric nurses. 2) Demographic variables that relate to their attitudes on the OMI scale were the education degree of the respondent and the kind of their hospital in active service. 3) About attitudes toward mental illness and the mentally ill baccalaureate nursesshowed more positive attitudes in Factor A (Authoritarianism), Factor C (Mental Health Ideology) and Factor D (Social Restrictiveness) than diploma program murses. 4) Nurses in active Service in the private hospital revealed more positive attitudes(A,B,C,D) except Factor (E) than those in the national or public hospital. 5) The ages, duration of work, wanted or unwantedG roup of psychiatric ward and satisfactory level of psychiatric nursing service were non-significant.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.7
no.1
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pp.92-109
/
1996
The objectives of the present study were to provide comprehensive assessment of the impact of epilepsy on the psychological well-being of children with epilepsy and to identify the neurological factors associated with the psychopathology. The participant patients were recruited from the population of children and adolescent aged 7 to 16 attending the OPD of department of pediatric neurology in Seoul National University Hospital in Korea. We exclude mental retardation, pervasive developmental disorder and brain organic pathology. As control group, formal students were chosen and their sex, age, achievement, socioeconomic status were matched to patients. The first author interviewed the children and their family members and obtained the developmental history and family information. We used the following 10 scales for assessing psychological and behavioral problems in patients and their family member. The scales were standardized and their validity and reliability were confirmed before. Parent rating scales : Yale children's inventory, Disruptive behavior disorder scale, Parent's attitude to epilepsy questionnaire, Family environment scale, Symptom check-list-90 revision, Children behavior check-list. Children's self rating scales : Children's depression inventory, Spielberger's state-trait anxiety anxiety, Piers-Harris self-concept inventory and Self-administered Dependency questionnaire for Mother. The result showed the risk factors associated depression were early onset, complex partial seizure, lateralized temporal focal abnormality on EEG, Drug polypharmacy, high seizure frequency and sick factors associated anxiety were old age of patient, lateralized temporal focal abnormality EEG, Drug polypharmacy, high seizure frequency. Also the result of this present study indicated that risk factors associated oppositional defiant disorder, conduct disorder and attention deficit hyperactivity disorder were young age, male, early onset, lateral temporal EEG abnormality and high seizure frequency. According to these results, common risk factors associated psychological and behavioral problems were lateralized EEG temporal abnormality, high seizure frequency in neurological factors.
This descriptive-comparative study attempted to examine the differences according to the year in college of 288 junior college nursing students attitudes about mental illness. The instrument used for this study was the OㆍMㆍI (Opinion about Mental Illness) scale developed by Cohen and Struening. Data collection was done from the 27th to the 30th of September, 1988 by means of a questionnaire. Data were analyzed by computer, using the t-test and Analysis of Variance. The finding of this study are as follows : 1. Hypothesis I: “There will be a difference in attitudes toward mental illness according to the year in college 1"There will be a difference in the attitude about authoritarianism-according to the year in college" was rejected(F=.5675, P=.5676). 2 "There will be a difference in the attitude about benevolence-according to the year in college." was accepted(F=.5376, P=.5848). 3. "There will be a difference in the attitude about mental hygiene ideology-according to." was accepted (F=17.3497, P=.0000). 4. "There will be a difference in the attitude about social restrictiveness-according to" was rejected (F=1.7416, P=.1771), 5."There will be a difference in the attitude about interpersonal etiology-according to" was accepted (F=10.8597, P=.0000). 2. Hypothesis II : "There will bed difference in attitudes toward mental illness." according to whether or not the student have had clinical practice in the psychiatric ward. 1.There will be a difference in the attitudes about authoritarianism - according to "whether or not the student's have had clinical practice in the psychiatric ward was rejected(t=.59, p=.555). 2. "Whether they have had clinical practice at the psychiatric ward or not, There will be difference in the attitudes about benevolence." was rejected (t=1.34, p=.182). 3."Whether they have had clinical practice at the psychiatric ward or not, there will be difference of the mental hygiene ideology attitude." was accepted (t=2.72, p=.008). \circled4 “Whether they have had clinical practice at the psychiatric ward or not, there will be difference of the social restrictiveness - attitude." was rejected (t=-.59, p=.557). 5. "Whether they have had clinical practice at the psychiatric ward or not, there will be difference of to interpersonal etiology-attitude." was accepted(t=3.55, p=.001). In conclusion, it was found that the higher the year in College, the more positive the attitudes are about mental hygiene ideology and interpersonal etiology. This study suggests that more positive attifudes about psychiatric illness can be induced by a more effective educational experience. The main limitation of this study was that the sociocultural background of Korea is not considered in the OㆍMㆍI scale.
The earliest memories and dreams have been investigated in many aspects; biological, psychological, statistical, and psychotherapeutic, in psychiatric field. The approach methods to these psychic contents are innumerable according to the schools, the collector's attitudes to these materials, the collecting methods and the variable factors of the reporter. In this study the author attempted to compare the distribution of the aggression and dependency themes in these psychic contents among groups of different sexes and clinical diagnoses. In this purpose the author devised new scales, the Aggression and the Dependency Scales for the earliest memories and dreams which are composed of 12-theme classes, according to 3 aspects of the ego attitudes and 4 degrees of the intensity of drives. The scales were tested on a series of the earliest memories and dreams from 100 male medical students by two raters. The interrater reliabilities, measured by kappa method, were all significant at better than the .001 level. The author collected the reports of the earliest memories and dreams from 293 schizophrenics (161 males and 132 females) and 301 neurotics (164 males and 137 females) who were either outpatients or inpatients of 5 general hospitals and 2 private neurospychiatric clinics and from 310 controls (169 males and 141 females) who were either students, housewives or employees in Taegu area during the periods from March to August, 1980 and from April to August, 1983. The author compared the contents of the earliest memories and dreams from these 3 clinical groups on the newly devised scales and the results could be summarized as follows: In general, the contents of the earliest memories showed more differences among diagnostically different groups, while the contents of dreams showed more differences among sexually different groups. The dependency themes were more frequent than the aggression thems in all groups. The aggression themes were more frequent in dreams than in the earliest memories. Of the earliest memory themes, the distribution of the aggression themes was different among clinical groups, i.e., most frequent in schizophrenics, next in neurotics, and least in controls. The distribution of the dependency themes was in reverse order. Attitudes of being attacked were more frequent in schizophrenics. Observing attitudes of dependency need were more frequent in neurotics while gratifying attitudes were more frequent in controls. Highest degrees of aggression and delpendency were more frequent in neurotics. In the distribution of the dream themes, there were some differences among male and female schizophrenics. Aggression themes, especially active and the highest degree of aggression, were more frequent in male sclizophrenics, while dependency themes, especially frustrated themes, were more frequent in female schizophrenics. Among 3 clinical groups, observing attitudes of dependency need were more frequent in female groups, while gratifying attitudes were more frequent in male groups.
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