• Title/Summary/Keyword: 주요 정신장애

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Neuropsychological Mechanism of Perceptual Disorder (지각 장애의 신경 심리학적 기전)

  • Lee, Sung-Hoon;Park, Yun-Zo;Kim, Dong-Wha;Park, Hae-Jung;Kim, Ji-Woong
    • Sleep Medicine and Psychophysiology
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    • v.6 no.2
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    • pp.143-148
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    • 1999
  • Objectives: We studied correlations between neuropsychological tests and perceptual disorder in patients with head trauma and psychiatric patients in order to explore the functional localization of brain in perceptual disorders. Methods: Halstead Reitan Neuropsychological Test Battery, Korean Wechsler Intelligent Scale, and Minnesota Multiphasic Peronality Inventory(MMPI) were administered to one hundred ninteen patients consisting of sixty nine psychiatric patients and fifty patients with brain damage. We tested the correlation between results of neuropsychological tests and peceptual disorder scale PDS) made from nine items related with perceptual disorder in MMPI. T-tests between twenty one higher scorers and seventeen lower scorers of PDS were also performed in the psychiatric group. Results: In brain damage group, significant correlations were found in tests related with function of frontal lobe such as category tests, trail making tests, tactual performance test, and fingertip number writing test, and significant correlations were also noted in the tests related with function of right hemisphere such as tactual performance test, performance, picture completion, picture arrangement and block design. Tests related with subcortical function such as digit symbol test, arithmetic and digit span were signigicantly correlated, too. In psychiatric group, there were significant differences of PDS in the tests related with function of right hemisphere such as picture completion, block design, and right laterality index, and in the tests related with function of left hemisphere such as comprehension, vocabulary, and similarities. Conclusion: Perceptual disorder seems to be related with functions of frontal lobe, right hemisphere, and subcortex in both groups. In a psychiatric group, left hemisphere may be also partially related with perceptual disorder.

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Permanency Plan for Adults with Mental Illness : Focused on Mental Health System of New Zealand (성인정신장애인의 평생계획모형 : 뉴질랜드 정신보건서비스를 중심으로)

  • Seo, Mi-Kyung
    • Korean Journal of Social Welfare
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    • v.58 no.2
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    • pp.33-56
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    • 2006
  • Primary care takers, especially older parents, who live with and care for an adult child with mental illness struggle with the dilemma of who will provide for their child's social and emotional needs and physical care requirements when they can no longer care so. Therefore, 'Permanency plan(financial, residential, legal plan)' is very important for social integration and normalization of mental illness adults. This study aims to introduce the mental health systems in New Zealand and to investigate the permanency plan strategies(benefit, supplements, and the laws) of the government and community support services of NGOs through the interviews with team leaders of representative NGO, Te Korowai Aroha. Permanency plan strategies of New Zealand Government and NGOs are as follows. 1) Financial plans for adults with mental illness include main benefit(invalid benefit), various allowances(family allowance and disability allowance), and wage subsidies for employment. 2) The Government provide accommodation supplement and re-establishment grant for residential plan. And NGOs have supported accommodation program to provide support and accommodation that are important for social integration. 3) Adult mental illness is provided the support of welfare guardian and property manager under the Protection of Personal and Property Rights Act. According the results, this study concluded that social services for the mental illness which secure supported accommodation and benefits is strongly needed. At the same time, mental health delivery system is needed to make distinction between social services and clinical services.

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Alexithymia in Major Depressive Disorder and Subclinical Depression (주요 우울장애와 준임상적 우울증에서의 감정표현불능증)

  • Kim, Seog-Ju;Yu, Seung-Hee;Kim, Seong-Youn;Kim, Dong-Wook;Cho, In-Hee;Cho, Seong-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.2
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    • pp.100-106
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    • 2007
  • Objectives : The objective of the present study was to investigate alexithymia in major depressive disorder(MDD) and subclinical depression(SCD). Methods : Three hundred eighty-six community-dwelling adults(238 females and 148 males, age 19-79; mean age $43.0{\pm}13.9$) were recruited. Structured clinical Interview for DSM-IV(SCID) was conducted for the diagnosis of MDD or other Axis I psychiatric disorders. The Center for Epidemiological Studies for Depression Scale(CES-D) and the Totonto Alexithymia Scale(TAS) were administered to assess depressive symptom and alexithymia, respectively. Among subjects without MDD, those who had minor depressive disorder on the SCID or high scores(i.e. over 16) on the CES-D were defined as subjects with SCD. TAS total score and factor I, II, III scores of TAS in MDD, SCD, and non-depressive controls were compared. Results : Among 386 subjects, 38 subjects(9.8%) were diagnosed as MDD by DSM-IV criteria, while 57 subjects(14.8%) were classified into SCD group. There were significant differences between 3 groups(MDD, SCD and non-depressive controls) in total score($F_{2,383}=14.0$, p<0.01), factor I(difficulty in identifying feeling)($F_{2,383}=23.4$, p<0.01) and factor II(difficulty in describing feeling)($F_{2,383}=7.8$, p<0.01), but not factor III(external oriented thinking)($F_{2,383}=1.8$, p=0.16) of TAS. In post-hoc analysis, both MDD subjects and SCD subjects had higher scores in TAS total, factor I and factor II, compared to non-depressive controls(all p<0.01). In contrast, there were no significant differences between MDD subjects and SCD subjects in any TAS factor. Conclusion : In this study, both MDD subjects and SCD subjects were more alexithymic than non-depressive control subjects. These findings suggest that SCD, as well as MDD, is also related to alexithymia.

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Pharmacotherapy for Patients Complaining With Somatic Symptoms (신체증상을 호소하는 환자의 약물치료)

  • Lee, Kyung-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.95-101
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    • 2021
  • Patients complaining with somatic symptoms are very common in clinical practice, and are often consulted to medical department. But it is difficult to treat well. The treatment of somatic symptom disorder is multi-modal as none of the methods on their own provide a satisfactory outcome. The treatment of somatic symptoms disorders is complicated by lack of boundary, conceptual clarity, and overemphasis on psychosocial causation and effectiveness of psychological treatments. In clinical practice all classes of psychotropics are used to treat somatic symptoms disorder. Drugs such as tricyclic antidepressants, serotonin reuptake inibitors(SSRI), serotonin and noradrenalin reuptake inhibitors (SNRI), atypical antipsychotics are studied. The evidence indicates that these drugs are effective in somatic symptom disorders. All classes of antidepressants seem to be effective against somatic symptom disorders. SSRIs are more effective against hypochondriasis and body dysmorphic disorder, and SNRIs appear to be more effective than other antidepressants when pain is predominant. The author suggest that psychiatrists should know how to treat patients complaining with somatic symptoms by using not only psychotherapeutic approach but also pharmacological treatment. It will be helpful to reduce suffering and increase quality of life of these patients.

Network Analysis of Depressive and Anxiety Symptom in Young Adult of an Urban City (일 도시 청년 인구의 불안 우울 공존 증상 네트워크 분석)

  • Jong wan Park;Hyochul Lee;Jae Eun Hong;Seok Bum Lee;Jung Jae Lee;Kyoung Min Kim;Hyu Seok Jeong;Dohyun Kim
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.118-124
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    • 2023
  • Objectives : Depressive disorder and anxiety disorder frequently co-occur, even at sub-threshold level. This study aims to identify network structure of co-morbid depression and anxiety at symptom level in nonclinical population and to reveal the central symptoms and bridge symptoms of the co-morbidity. Methods : This study was based on 2022 Asan Youth Mental Health Screening. Patient health questionnaire (PHQ-9) and Generalized anxiety disorder scale (GAD-7) were used to assess depressive and anxiety symptoms of 810 young adult participants from community sample. Network structure of co-morbid depressive and anxiety symptoms was estimated by Isingfit model. Results : Depressed mood, Restlessness and Nervousness were the most central symptoms in the network. Bridge symptoms between anxiety and depression were Restlessness and Irritability. Conclusions : This study revealed key central symptoms and bridge symptoms of co-morbid depression and anxiety in nonclinical population and provided potential insight for treatment targets to reduce co-morbidity.

Current Update on Transcranial Direct Current Stimulation as Treatment for Major Depressive Disorder (주요우울장애의 치료로서 경두개 직류자극술(Transcranial Direct Current Stimulation)의 현재)

  • Lee, Seung-Hoon;Kim, Yong-Ku
    • Korean Journal of Biological Psychiatry
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    • v.25 no.4
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    • pp.89-100
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    • 2018
  • Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation method that delivers 1-2 mA of current to the scalp. Several clinical studies have been conducted to confirm the therapeutic effect of major depressive disorder (MDD) patients with tDCS. Some studies have shown tDCS's antidepressant effect, while the others showed conflicting results in antidepressant effects. Our aim of this review is to understand the biological bases of tDCS's antidepressant effect and review the results of studies on tDCS's antidepressant effect. For the review and search process of MDD treatment using tDCS, the US National Library of Medicine search engine PubMed was used. In this review, we discuss the biological mechanism of tDCS's antidepressant effect and the existing published literature including meta-analysis, systematic review, control trial, open studies, and case reports of antidepressant effects and cognitive function improvement in patients with MDD are reviewed. We also discuss the appropriate tDCS protocol for MDD patients, factors predictive of response to tDCS treatment, the disadvantages of tDCS in MDD treatment, and side effects.

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Drug Treatment in Psychosomatic Disease (정신 신체의학에서 최신 치료 약물)

  • Song, Ji-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.2
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    • pp.133-142
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    • 2001
  • For treating various conditions of the psychosomatic disease, not only psychotropic drugs but also drugs used in internal medicine or other than psychiatric fields would be applied. So psychiatrists who are interested in psychosomatic medicine should make expanded knowledges of those medicine. And modalities of drug treatment should be modified according to the characteristics of illness behavior and disease concept which the patient have. Some drugs used in complementary medicine could be applied to the psychosomatic illness. For example, herbs and/or aromas which have some effects without serious adverse reactions could be used carefully to the patient. And the mode of action and efficacies of them should be evaluated by doctors.

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A CASE-ANALYSIS OF THE PSYCHIATRIC SEQUELAE IN ADOLESCENTS VICTIMIZED BY SCHOOL VIOLENCE (학교폭력 피해 청소년의 정신의학적 후유증에 관한 사례 연구)

  • Yook, Ki-Hwan;Lee, Ho-Bun;Noh, Kyung S.;Song, Dong-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.2
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    • pp.232-241
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    • 1997
  • The psychological problems following the experiences of school-violence could be more important than the physical problems. Victims could suffer from fear, depression, anger, lowered self-esteem, suicidal thought, and personality changes. To study the risk factors for school violence and the psychiatric problems after the experiences to school-violence provide us important informations to prevent and solve the problems of school violence. We examined clinical characteristics and psychosocial backgrounds of 13 adolescents who visited the psychiatric clinic after exposures to school violence from September, 1996 to May, 1997. The clinical data included intensity, motivations, durations, and methods of violence, psychiatric symptoms following exposure, findings of psychological test, and treatment course. The socioeconomic data included developmental characteristics of subjects, family characteristics, school life, and peer relationships. Of the 13 adolescents who experienced exposure to violence, 8 have experienced chronic psychiatric disturbances, 5 experienced transient psychiatric symptoms such as anxiety, depression, suicidal attempt who eventually returned to home and school life. Of the 8 adolescents who experienced chronic psychiatric disturbances, 4 experienced PTSD and depression lasting 3-6 months more, otherwise 4 showed converted features, such as aggressive behavioral disorder or perpetrator by strong compensatory effects after psychological shock. The subjects who have experienced chronic psychiatric disturbance have clinical characteristics such as physical or emotional abuse, physical illness or handicap, defects of ego functionings, and lack of family support. In summary, victims by school-violence manifested serious psychiatric disturbances, and they had clinically significant risk factors and some of them became perpetrators of school-violence.

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A Reliability and Validity Study of the Korean versions of the Eating Disorder Examination Questionnaire version 6.0 (EDE-Q version 6.0) and the Clinical Impairment Assessment Questionnaire (CIA) (한국판 섭식장애검사-자기보고형 6.0 (EDE-Q version 6.0) 및 한국판 임상손상평가(CIA)의 신뢰도와 타당도 연구)

  • Bang, Eun Byul;Han, Cho Long;Kim, Yu Ri;Kim, Mirihae;Lee, Young Ho;Heo, Si Young;Kim, Youl-Ri
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.152-163
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    • 2018
  • Objectives : The Eating Disorder Examination Questionnaire, version 6.0 (EDE-Q version 6.0) and the Clinical Impairment Assessment Questionnaire (CIA) measure attitudes and behavioral features of eating disorders and impairments secondary to eating disorders, respectively. The aims of this study were to examine the reliability and the validity of the Korean versions of the EDE-Q version 6.0 and the CIA. Methods : Four hundred nineteen participants (370 female university students and 49 women with eating disorders) completed the EDE-Q version 6.0, the CIA, the Body Shape Questionnaire (BSQ) and the Weight Concern Scale (WCS). Results : Excellent internal consistencies were obtained for the EDE-Q version 6.0 (Cronbach's ${\alpha}=0.92$) and the CIA (Cronbach's ${\alpha}=0.91$). Exploratory factor analysis of CIA extracted the 3 factors of personal, social, and cognitive impairments, as the original CIA had. The EDE-Q version 6.0 and the CIA were well correlated with the BSQ and the WCS, in respect to their contextually concordant variables. Patients with eating disorders had higher scores both in the EDE-Q 6.0 and the CIA than university women had, supporting good discriminant validity. Conclusions : The EDE-Q version 6.0 and the Korean versions of the CIA had adequate reliability and validity. These data will help clinicians and researchers to use the EDE-Q and the CIA in diagnosis, prevention and intervention of eating disorders in Korea.

COMPARISON OF CARIES EXPERIENCE BETWEEN THE MENIALLY RETARDED AND THE NORMAL (정신지체장애인과 정상인의 우식경험도 비교 조사 연구)

  • Maeng, Jun-Nam;Lee, Kwang-Hee;Kim, Dae-Eop;Bae, Sang-Man
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.2
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    • pp.202-207
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    • 2000
  • The purpose of study was to compare the caries experience between the mentally retarded(MR) and the normal(N) children and adolescents and to survey the dental visit frequency. preventive dental care, and tooth-brushing behavior of the mentally retarded. Two hundred and fifty MR and two hundred and ten N subjects were selected for the study. 1. The number of teeth which had experienced caries was 3.28 in MR and 4.66 in N. The number of decayed teeth was 2.24 in MR and 1.50 in N. The number of filled teeth was 0.71 in MR and 3.06 in N Filled teeth rate was 19.78% in MR and 58.89% in N The differences between MR and N were all significant(P<0.01). 2. Dental visit frequency of MR was 1.15 per year, and the 51.2% of MR did not visit the dental clinic for the last one year. 38.0% of MR had received the preventive dental care. 3. Toothbrushing frequency per day was 2.16 and the toothbrushing time for 78.3% of MR was less than two minutes. 51.2% of MR brushed their teeth by themselves, 13.3% did with the help of the carers, and 35.5% totally depended on the carers. In conclusion, MR experienced less dental caries than N, had more untreated caries than N, and had need for regular preventive dental care.

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