• Title/Summary/Keyword: 정신 및 행동장애 환자

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Quality of Life and Related Factors in Caregivers of Attention Deficit Hyperactivity Disorder Patients (주의력결핍 과잉행동장애 환아 보호자의 삶의 질과 관련요인)

  • Jeong, Jong-Hyun;Hong, Seung-Chul;Han, Jin-Hee;Lee, Sung-Pil
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.2
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    • pp.102-111
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    • 2005
  • Objective : The purpose of this study was to investigate the quality of life and it's related factors in caregivers of attention deficit hyperactivity disorder patients. Methods : The subjects were 38 attention deficit hyperactivity disorder patients' caregivers(mean age : $37.5{\pm}6.5$, 38 women). Patients were diagnosed with DSM-IV-TR ADHD criteria. Korean version of WHOQOL-BREF(World Health Organization Quality of Life assessment instrument Abbreviated Version) was used for assessment. Results : 1) No significant differences were found in the score of WHOQOL-BREF, overall QOL, physical health domain, psychological domain, social relationships domain and environmental domain between caregiver and control group. 2) The score of Activity of daily living facet$(3.0{\pm}0.7\;vs.\;3.6{\pm}0.7)(p=0.008)$ and self-esteem facet $(2.8{\pm}0.7\;vs.\;3.3{\pm}0.7)(p=0.049)$ were significantly decreased in caregivers of ADHD. 3) Total score of WHOQOL-BREF(r=0.437, p=0.007) and physical health domain(r=0.370, p=0.024) were correlated with caregiver's educational age. 4) In the psychological domain, the score of self-esteem facet(r=-0.337, p=0.039) and thinking, learning, memory & concentration facet(r=-.341, p=0.036) were decreased with caregiver's age. 5) The score of environmental domain were significantly increased with caregiver's educational age (r=0.482, p=0.003), but decreased with patient's age(r=0.328, p=0.044). Conclusion : Although the quality of life in caregivers of ADHD patient had not significantly decreased than control, the quality of lift were positively correlated with educational age of caregives, and negatively correlated with chronological age of caregivers and children. Above results suggest that physicians should consider integrated approaches for caregiver's subjective quality of life in the management of ADHD.

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Ingestion of Gouda Cheese Ameliorates the Chronic Unpredictable Mild Stress in Mice (마우스 모델에서 Gouda Cheese 섭취에 따른 만성 스트레스 개선 효과)

  • Kang, Min Kyoung;Yun, Bohyun;Oh, Sangnam
    • 축산식품과학과 산업
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    • v.9 no.2
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    • pp.58-65
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    • 2020
  • 우울증은 동기, 의욕, 관심, 주의력, 정신기능 및 식욕의 감소를 특징으로 하는 일종의 기분 장애이다. 우울증은 유전적, 내분비 및 환경적 스트레스를 포함한 다양한 원인에 의해 발생하지만 가벼운 우울증은 식이요법으로 개선되는 것으로 보고되었다. 따라서 우울증 환자를 치료하기 위해서는 기능성 및 영양 보충제를 포함한 다양한 식품 공급원이 필요하다. 치즈에는 숙주 건강에 유익한 영향을 미치는 생리 활성 펩타이드가 포함되어 있다. 특히 저지(Jersey) 우유는 홀스타인(Holstein) 우유보다 고형분 함량이 높은 것으로 보고되었다. 이 연구는 저지(Jersey) 와 홀스타인(Holstein) 우유의 가우다 치즈(Gouda cheese)가 만성 스트레스(CUMS, chronic unpredictable mild stress)에 미치는 영향을 조사했다. 치즈를 먹인 만성 스트레스 마우스 모델의 개선적 변화는 젖소 종에 관계없이 통계적으로 유의미하게 효과적으로 나타났다. 흥미롭게도 PCR을 통한 분변 미생물 균총 분석에서 저지 치즈를 섭취함으로써 Bacteroidetes가 증가하고 Firmicutes가 유의적으로 감소하는 것으로 나타났다. 종합하면, 본 연구는 치즈 섭취가 스트레스 개선 작용이 있음을 제시하며, 특히 장내 미생물 균총의 유익한 방향으로의 변화가 관찰되는데, 치즈의 생리활성물질 혹은 장내미생물 균총의 대사물질들이 이러한 행동·정신학적 개선 작용과의 연관성이 있음을 시사한다.

DENTAL TREATMENTS OF THE CHILD WITH LOWE SYNDROME : A CASE REPORT (Lowe syndrome 환아의 치과적 치료 : 증례보고)

  • Ju, Chan-Hee;Kim, Seon-Mi;Choi, Nam-Ki
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.2
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    • pp.161-165
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    • 2012
  • Lowe syndrome, also known as oculocerebrorenal syndrome, is a rare genetic disorder involving eyes, kidney, brain and musculoskeletal system, and occurs predominantly in males. The patient with Lowe syndrome is characterized with congenital cataracts, glaucoma, prominent forehead, thin and sparse hair, mental and growth retardation, muscular hypotonia, renal dysfunction, and metabolic bone disease. We have experienced a 10-year-old boy with Lowe syndrome who had poor oral hygiene and trouble for teeth brushing. To manage his behavior and systemic metabolic disorder, sedation was performed during dental care. Excessive calculus formation in this patient is caused by both medication and lack of ability to maintain oral hygiene. The dental management of those patients has to be focused on prevention due to difficulties in dental treatment and dangers of general anesthesia for the Lowe syndrome.

The Study For Clinical Measurement of Pain (통증(痛症)의 임상적평가법(臨床的評價法)에 관한 고찰(考察))

  • Shin, Seung-Uoo;Chung, Seok-Hee;Lee, Jong-Soo;Shin, Hyun-Dae;Kim, Sung-Soo
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.2
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    • pp.25-46
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    • 2000
  • Pain can be evaluated by experimental methods and clinical methods, but due to subjective characteristics of pain, clinical methods are generally used. The clinical pain measurement tools are divided into unidimensional and multidimensional assessment tools. The former include Visual Analogue Scale, Verbal Rating Scale, Numerical Rating Scale, Pain Faces Scale, and Poker Chip Tool and the latter include McGill Pain Questionnaire, MMPI, Pain Behavior Scale, Pain disability index, and Pain Rating Scale. Unidimensional pain scales mainly measure the intensity of pain on the basis of the patient's self report and their simple construction and ease of use enable the invesgator to assess acute pain. Multidimensional pain scales are used to evaluate subjective, psychological and behavioral aspects of pain and because of its comprehensive and confidential properties they are applied to chronic pain. Patient's linguistic and cognitive abilities are major factors to restrain accurate assessment of pain. Although behavioral patterns and vital sign are inferior to self-report in the measurement of pain, they can be useful indexes in those situations. When deciding on a pain-assessment tool, the investigator must determine which aspect of pain he or she wishes to evaluate on the characteristics of the group of patients, their backgrounds, and their communication skills. Making the proper choice will facilitate the acquisition of meaningful data and the formulation of valid conclusions.

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A Clinical and Polysomnographic Study of Parkinson's Disease Patients with Sleep Benefit (수면이득이 있는 파킨슨병 환자의 임상특징 및 수면다원검사에 대한 연구)

  • Chun, Dong-Yeol;Yang, Chang-Kook;Kim, Jae-Woo;Yoo, Seung-Yoon;Hahn, Hong-Moo
    • Sleep Medicine and Psychophysiology
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    • v.7 no.2
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    • pp.102-108
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    • 2000
  • Objectives: Parkinson's disease (PD) patients may experience fluent mobility upon awakening from a night's sleep, which is called sleep benefit (SB). Although SB is a phenomenon closely associated with sleep, sleep features of PD are not well characterized. The objectives of this study were, first, to investigate if there are any clinical characteristic features between patients with SB and without SB (NSB), and second, to examine if SB patients are associated with any specific sleep variables compared with NSB patients. Methods: Thirty-three PD patients (14 men and 19 women) participated in this study. All subjects were interviewed to examine whether or not they had SB and overnight polysomnography was performed at the sleep center. Various clinical variables were collected through medical record review. Results: The 331 PD patients were divided into 16 SB group (48.5%) and 17 NSB group (51.5%). SB patients were younger (p<0.02), had higher sleep efficiency (p<0.05), and showed shortened sleep latency (p<0.02) as compared with NSB patients. However, no difference was found between SB and NSB with respect to gender, duration or stage of PD, antiparkinsonian medications prescribed, and predominant motor symptoms. SB did not clearly relate to a specific sleep stage and other sleep variables except sleep efficiency and sleep latency. Although primary snoring was more prevalent in SB patients (p<0.05), other sleep disorders were seen with equal frequency in SB and NSB groups. Conclusion: Our results suggest that good sleep efficiency, shortened sleep latency, and age may have an effect on morning motor function (i.e., SB) in Parkinson's disease.

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Validation of the Korean version of Center for Epidemiologic Studies Depression Scale-Revised(K-CESD-R) (한국판 역학연구 우울척도 개정판(K-CESD-R)의 표준화 연구)

  • Lee, San;Oh, Seung-Taek;Ryu, So Yeon;Jun, Jin Yong;Lee, Kounseok;Lee, Eun;Park, Jin Young;Yi, Sang-Wook;Choi, Won-Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.83-93
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    • 2016
  • Objectives : The Center for Epidemiologic Studies Depression scale-Revised is a recently revised scale which has been reported as a valid tool for the assessment of depressive symptoms. It encompasses cardinal symptoms of depression described in the Diagnostic and Statistical Manual of Mental disorders, fourth edition. In this study, we assessed the reliability, validity and psychometric properties of the Korean version of the CESD-R(K-CESD-R). Methods : Forty-eight patients diagnosed as major depressive disorder, dysthymia, depressive disorder NOS according to the DSM-IV criteria using Mini International Neuropsychiatric Interview and 48 healthy controls were enrolled in this study. They were assessed with K-CESD-R, K-MADRS, PHQ-9, KQIDS-SR, STAI to check cross-validation. Statistical analyses were performed using calculation of Cronbach's alpha, Pearson correlation coefficient, Principal Component Analysis, ROC curve and optimal cut-off value. Results : The Cronbach's alpha of K-CESD-R was 0.98. The total score of K-CESD-R revealed significantly high correlations with those of K-MADRS, PHQ-9, KQIDS-SR(r=0.910, 0.966 and 0.920, p<0.001, respectively). Factor analysis showed two factors account for 76.29% of total variance. We suggested the optimal cut-off value of K-CESD-R as 13 according to analysis of the ROC curve which value sensitivity and specificity both equally. Conclusions : These Results showed that the K-CESD-R could be a reliable and valid scale to assess depressive symptoms. The K-CESD-R is expected as a useful and effective tool for screening and measuring depressive symptoms not only in outpatient clinic but also epidemiologic studies.

A Case of Ring Chromosome 20 with Mental Retardation and Epilepsy (정신 지체와 간질을 동반한 20 환(Ring) 염색체 증후군 1례)

  • Jung, Yeon Kyung;Lee, Gyeong Hoon
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.108-111
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    • 2005
  • Ring chromosome 20 mosaicism [r(20)] is a rare chromosomal anomaly associated with minor dysmorphism, mental retardation, autistic behavior, and intractable epilepsy. The proposed mechanism of ring formation is breakage of both short and long arms of a chromosome with subsequent end-to-end fusion. We encountered an 18-month-old boy who presented with developmental delay and mental retardation with seizure episodes, but showed normal brain magnetic resonance imaging. Chromosome study from peripheral blood showed 46,XY, r(20)(p13q13.3) karyotype. The authors report a case of ring chromosome 20 with mental retardation and epilepsy, with a review of the literature.

Somatic Symptoms after Psychological Trauma (심리외상 이후의 신체증상)

  • Park, Joo Eon;Ahn, Hyun-Nie;Kim, Won-Hyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.43-53
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    • 2016
  • Objectives : Somatic symptoms after the exposure of psychological trauma frequently developed. However, the somatic symptoms are not covered under the diagnostic criteria of posttraumatic stress disorder(PTSD) in detail, although they are often associated with social and occupational functioning and patient-doctor relationships. The aim of this article is to highlight the potential mechanisms, the common manifestations, and the treatment of the somatic symptoms. Methods : This article studied the somatic symptoms searched using academic search engines like PubMed, Scopus, Google Scholar, KoreaMed and KISS from the earliest available date of indexing to March 31, 2016. Results : The mechanism of somatic symptoms after the exposure was described as psychological and physiological aspects. Psychological mechanism consisted of psychodynamic theory, cognitive behavioral theory, and others. Physiological mechanism involved changes in neuroendocrine and immune system, autonomic nervous system and central nervous system. Somatization associated with psychological trauma manifested various health conditions on head and neck, chest, abdominal, musculoskeletal, and dermatological and immune system. Few studies described the standardization of treatment for the somatic symptoms. Conclusions : Clinicians and disaster behavioral health providers should think of the accompanying somatic symptoms during intervention of psychological trauma and PTSD. Further studies are needed on the somatic symptoms seen in psychological trauma and PTSD.

Comparison of Health Care Utilization and Morbidity of Children With and Without Disabilities in Korea (장애아동과 비장애아동의 의료이용 및 질병특성 비교)

  • Kim, Eu-Gene;Kim, Kyung-Mee;Yoo, Dong-Chul
    • The Journal of the Korea Contents Association
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    • v.17 no.7
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    • pp.696-706
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    • 2017
  • This study is to examine health care utilization and morbidity of disabled and non-disabled children in Korea to evaluate the health disparities. We used medical claim data of 2010 from the National Health Insurance Service-National Sample Cohort data. As a result of the analysis, the disabled children are not in good health condition because they have more frequency of medical service use, hospitalization rate, and more number of diseases and spent more on medical expenses than non-disabled children. Patterns of the most frequent disease differ from significantly between disable and non-disabled. Disabled children had a higher prevalence of selected birth defects and selected health conditions associated with physical disability and a lower prevalence of selected infection disease than children without disability. In conclusion, Health policy changes that would extend the access to health service for children with disabilities characterized by frequent medical care, hospitalization, excessive medical expenditure and complex diseases.

NEW ANTIDEPRESSANTS IN CHILD AND ADOLESCENT PSYCHIATRY (소아청소년정신과영역의 새로운 항우울제)

  • Lee, Soo-Jung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.12-25
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    • 2003
  • Objectives:As increasing number of new antidepressants have been being introduced in clinical practice, pharmacological understanding has been broadened. These changes mandate new information and theories to be incorporated into the treatment process of children with depressive disorders. In light of newly coming knowledge, this review intended to recapitulate the characteristics of new antidepressants and to consider the pivotal issues to develope guidelines for the treatment of depression in childhood and adolescence. Methods:Searching the Pub-Med online database for the articles with the key words of 'new', 'antidepressants' and 'children' ninety-seven headings of review articles were obtained. The author selected the articles of pertinent subjects in terms of either treatment guideline or psychopharmacology of new antidepressants. When required, articles about the clinical effectiveness of individual antidepressants were separatedly searched. In addition, the safety information of new antidepressants was acquired by browsing the official sites of the United States Food and Drugs Administration and Department of Health and Human Services. Results:1) For the clinical course, treatment phase, and treatment outcome, the reviews or treatment guidelines adopted the information from adult treatment guidelines. 2) Systematic and critical reviews unambiguously concluded that selective serotonin reuptake inhibitors(SSRIs) excelled tricyclic antidepressants( TCAs) for both efficacy and side effect profiles, and were recommend for the first-line choice for the treatment of children with depressive disorders. 3) New antidepressants generally lacked treatment experiences and randomized controlled clinical trials. 4) SSRIs and other new antidepressants, when used together, might result in pharmacokinetic and/or pharmacodynamic drug-to-drug interaction. 5) The difference of the clinical effectiveness of antidepressants between children and adults should be addressed from developmental aspects, which required further evidence. Conclusion:Treatment guidelines for the pharmacological treatment of childhood and adolescence depression could be constructed on the basis of clinical trial findings and practical experiences. Treatment guidelines are to best serve as the frame of reference for a clinician to make reasonable decisions for a particular therapeutic situation. In order to fulfill this role, guidelines should be updated as soon as new research data become available.

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