• Title/Summary/Keyword: 증상 심각도

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Comparisons of HRV Parameters Among Anxiety Disorder, Depressive Disorder and Trauma·Stressor Related Disorder (불안장애, 우울장애, 외상 및 스트레스 관련 장애의 심박변이지표 비교 연구)

  • Kim, Ji-eun;Park, Do-won;Han, Ji-yeon;Lee, Jung Hyun
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.81-88
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    • 2020
  • Objectives : This study aimed to compare autonomic nervous system (ANS) dysregulation and differential relationships with clinical severities between anxiety disorder, depressive disorder, and trauma·stressor related disorder using heart rate variability (HRV) parameters. Methods : We conducted a retrospective chart review of outpatients from 2017 to 2018 in Stress Clinic of National Center for Mental Health. Total 473 patients were included; 166 anxiety disorder; 184 depressive disorder ; 123 trauma·stressor related disorder. Parameters of 5-min analysis of HRV were compared in three groups. Additionally, we investigated the differential association of each parameters with Clinical Global Impression-Severity Scale (CGI-S) across each group. Results : No significant differences were found in all HRV parameters between the three groups. However, significant group interactions by CGI-S were found in standard deviation of all RR intervals (SDNN) and the square root of the mean squared differences of successive normal-to-normal intervals (RMSSD) (SDNN, p=0.017 ; RMSSD, p=0.034). A negative relationship between CGI-S and SDNN, RMSSD has been found in anxiety disorder and depressive disorder. However, a positive relationship between CGI-S and SDNN, RMSSD has been found in trauma·stressor related disorder. Conclusions : Despite of no significant differences of each HRV parameter, our findings suggested the differential associations of HRV parameters with clinical severity among anxiety disorder, depressive disorder and trauma·stressor related disorder. In trauma·stressor related disorder, the clinical severity and degree of ANS dysregulation may differ, so more aggressive treatment is suggested.

A Pediatric Case of Dengue Fever with Extreme Hyperglycemia Developed in a Family Who Returned from India (인도에서 귀국한 가족에서 발생한 심한 고혈당 동반 소아 뎅기열 1례)

  • Kim, Joon Young;Kim, Han Wool
    • Pediatric Infection and Vaccine
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    • v.27 no.2
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    • pp.140-146
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    • 2020
  • Dengue fever (DF) is endemic throughout tropical and subtropical regions; however, it is not endemic in Korea. Imported infectious diseases should be suspected when encountering returned travelers with non-specific symptoms such as fever, rash, and headache. Persistent vomiting, abdominal pain, hemorrhagic tendency, hepatic enzyme abnormalities, and proteinuria are risk factors for the development of severe DF in a patient with DF. Severe hyperglycemia is also known to be related to poor prognosis in acute illness, and with certain underlying diseases that present with hyperglycemia, such as diabetes, it is related to the progression of severe DF. We report a DF case with severe hyperglycemia in an adolescent returning from India. Pediatric DF cases reported in Korea were also reviewed.

Gender Differences in Symptoms of Posttraumatic Stress Disorder (외상 후 스트레스 장애 환자에서 성별에 따른 증상 차이)

  • Kim, Yoo-Ra;Woo, Young-Sup;Ko, Hyo-Jin;Jung, Young-Eun;Seo, Ho-Jun;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.4 no.2
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    • pp.121-126
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    • 2008
  • Objective : The present study investigated gender differences in the symptoms of posttraumatic stress disorder (PTSD) among Korean PTSD patients from a multicenter sample. Methods : Data were collected from 18 psychiatric units of training hospitals nationwide. All the patients were interviewed by attending psychiatrists using a structured format for PTSD by DSM-IV diagnoses. Additionally the Davidson Trauma Scale was used to evaluate all self-reported symptomatology. Results : Forty-three patients with PTSD, 23 female and 20 male patients, were enrolled in this study. There were significant differences in the frequency and severity of avoidance symptoms, and severity of re-experience symptoms. The female patients reported a higher level of re-experience and avoidance symptoms than the male patients. Conclusion : The results of the present study were found to be consistent with previous studies on gender differences. Women were more susceptible to PTSD symptoms than men, especially exaggerated re-experience and chronic avoidance. Since all patients groups were enrolled from the hospital, this findings needs to be reexamined using community samples.

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Implementation of oral patient management system using smartphone and embedded imaging module (스마트폰과 임베디드 촬영 모듈을 활용한 구강 환자 관리 시스템 구현)

  • Lee, Hyoun-sup;Youn, Joo-sang;Kim, Jin-deog
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.22 no.4
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    • pp.581-586
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    • 2018
  • A common characteristic of many patients whose illness is getting worse is that they miss the treatment red flag. When high subjective symptoms appear or there is no strong pain, this problem arises because it is reluctant to visit the hospital. Gingivitis causes bleeding from the gums in the early and mid-term, and shows mild symptoms of tooth collapse. When treatment is done at this point, it shows a very high effect. However, when you miss the timing of treatment you will have a situation where you can't eat food by causing serious problems in the health of the gums and oral cavity. In this paper, the patient's periodontal image is photographed with a smartphone and transmitted in real time. This is done by the doctor in charge. Then, we propose a design of a patient management system that provides information on the current situation to the patient so as not to miss the timing of treatment.

A SURVEY OF THE PSYCHOSIS AMONG SCHOOL VIOLENCE VICTIMS (학교폭력 피해자의 정신병 실태 조사)

  • Kwon, Seok-Woo;Shin, Min-Sup;Cho, Soo-Churl;Shin, Sung-Woong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.124-143
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    • 2000
  • Objectives:The primary purpose of this study is to understand the psychopathology of the victims of school violence in terms of early psychosis. By doing this, the early detection of psychosis among the victims is possible, and early detection may lead to early intervention. Methods:Two-thousand and nine-hundred seventy two students from 16 middle schools in Seoul were asked to fill out questionnaire comprised of popularity and intellectual and school status of Piers-Harris Children's Self Concept Inventory, Symptom Check List-90-Revised, and Ostracism Scale. The subjects whose scores upon Ostracism Scale were higher than average by two standard deviation were labeled as ‘Repelled and Isolated group', and subjects whose scores on popularity were significantly lower than average and whose scores on psychoticism of SCL-90-R were higher than average were defined as 'tentative early psychosis group'. Odds ratios were calculated from the numbers of subjects with and without high psychoticism scores and high ostracism scores. On the subjects of 'tentative early psychotic group', we examined every clinical characteristic and conducted correlation analysis and regression analysis in order to find out the risk factors and to construct theoretical model that explains the psychoticism scores. Results:The results were as follows:1) Total 157(5.3%) subjects were rated significantly higher on ostracism scale, and among them, 47 subjects(29.9%) were rated significantly higher than average on psychoticism scale, while only 50 subjects among 2,135 students who were rated within normal range showed significantly higher score on psychoticism scale. Odds ratio for psychotic group of isolated group were 17.82 and it was statistically significant. 2) Forty-seven subjects(31 boys, 16 girls) who were rated as they were unpopular and rejected from peers had significantly higher psychoticism scores. They were not significantly different from simply high psychoticism subjects in anxiety, social anhedonia scale, magical thinking, obsessivecompulsive symptoms, phobic anxiety, psychoticism, somatization, but showed higher ostracism scores and paranoid tendencies. Among school violence victims, who rated themselves unpopular and showed higher psychoticism scores, the psychoticism scores were mainly explained by anxiety, depression, hostility, interpersonal sensitivity, obsessive-compulsive symptoms, paranoid tendency, somatization scales($r^2=0.93$). Conclusion:Thus, it can be concluded that the subjects with higher ostracism score have the substantially high risk for psychosis development. By these results, we propose that school violence victims with anxiety, depression, hostility, interpersonal sensitivity, obsessive-compulsive symptoms, paranoid tendency, somatization should be tested individually considering school adjustment, attentional deficit, concept formation problems.

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A Study on the Ship's Performance of T.S. HANBADA(II) - The Evaluation of Boarding Comfort with Vertical Acceleration - (실습선 한바다호의 운항성능에 관한 연구(II) - 상하가속도를 이용한 승선감 평가 -)

  • Jung, Chang-Hyun;Lee, Yun-Sok
    • Journal of Navigation and Port Research
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    • v.32 no.5
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    • pp.333-339
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    • 2008
  • When a vessel is underway in a heavy weather, passengers and crew suffer from seasickness caused by ship motions such as pitch, heave or roll, or all combined Sickness induces drowsiness, dizziness, headache, stomachache etc, in extreme conditions, they are met with a serious trouble which is physiologically unrecoverable. It results in weakening of spiritual activities or making errors from decrease of motivation, dropping off skills, poor recognition and poor judgement. In this paper, it was examined the international standards concerning the occurrence of sickness and the execution of works, also evaluated the boarding comfort by conducting several times of questionnaire on cadets boarding on the training ship HANBADA As a result, it was confirmed that the main factor of occurring the sickness was the vertical acceleration and the level was more than 0.2g. Also, it was presented the way how to reduce the sickness by changing the speed and/or course in relation to the encounter period.

Persistent Accelerated Idioventricular Rhythm in a Shih Tzu with Central Neuropathy (중추신경 장애를 가진 시추 종의 개에서 지속적인 가속성 심실고유 율동)

  • Han, Suk-Hee;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.27 no.4
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    • pp.440-444
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    • 2010
  • A 7-year-old neutered male Shih Tzu dog weighing 5.2 kg was presented because of severe neurological signs (paddling, unconsciousness, blindness, seizure). ECG revealed accelerated idioventricular rhythm (AIVR) with ~140 bpm ventricular rate. Based on magnetic resonance imaging (MRI) study and cerebrospinal fluid (CSF) analysis, the neurological condition was tentatively diagnosed as disseminated granulomatous meningoencephalomyelitis (GME). The neurological signs were managed with steroids, anticonvulsive drugs, diuretics and antibiotics with 20% mannitol infusion. The rhythm disturbance (AIVR) was managed with oral medication of mexiletine. Because the heart rhythms were unstable without anti-arrhythmic therapy in spite of improvement of clinical signs after emergency treatment for neurological problems, the anti-arrhythmic therapy was maintained till the neurological signs were abolished.

The clinical effects of Rabeprazole sodium (Pariet$\circledR$) in the treatment of Laryngopharyngeal Reflux (인후두역류질환 ( Laryngopharyngeal Reflux Disease. LPRD )에서 Rabeprazole Sodium (Pariet$\circledR$)의 임상효과)

  • 최홍식;김한수;최현승
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 2002.12a
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    • pp.9-9
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    • 2002
  • 이비인후과 영역에 있어서 위산 역류에 의한 질환의 진단은 쉽지 않고 분명하지 않은 점이 많지만, 병변의 영향은 광범위하며, 실제로 역류에 의한 증상을 가지고 내원하는 환자도 증가하는 추세이다. 인후두역류질환의 치료는 크게 생활습관의 변경, 약물복용, 항역류수술로 나눌 수 있으며, 사용약제는 크게 두 부류로 나누는데, 제산제, H2 수용체 차단제, PPI(Proton Pump Inhibitor) 제제와 같은 산억제 약물군과 Prokinetic 약물군이다. Rabeprazole sodium(Pariet(R))은 PPI 제제에 해당하는 약제로 기존의 omeprazole, lansoprazole, pantoprazole과는 달리 대사 과정 중 CYP2C19에 대한 의존도가 낮아, 개체 간 차이가 적고 빠르고 일정하게 산분비 억제 효과를 나타내는 것으로 알려져 있은 약물이다. 2001년 5월부터 2002년 4월까지 32개 병원에서 Pariet(R) 를 복용한 2166명의 환자를 대상으로 분석하였다. 복용기간에 따라 4군(1군;1-14일, 2군;15-28일, 3군;29-56일, 4군:57일 이상)으로 나누었으며, 8가지 증상(Heart burn, Regurgitation, Chronic cough, Hoarseness, Globus sensation, Chronic throat clearing, Sore throat, Dysphagia)에 대한 호전 여부 및 후두내시경상 개선 정도, 의사에 의한 유용도 평가, 부작용 발생 여부에 대해 연구하였다. 증상개선율 50%이상을 치료 반응군으로 했을때 전체 2166명중 1627명(75.1%)에서 증상의 호전을 보았으며, 이는 복용기간이 길수록 증가하였다. 후두 내시경상 개선 정도는 현저한 개선이 32.9%, 중등도 개선이 38.7%로 대부분 환자에서 객관적인 병변의 호전을 보였으며, 유용도 평가에서는 매우 유용이 37.6%, 유용이 50.3%로 치료효과에 대한 만족도도 높은 것을 알수 있었다. PPI 제제의 부작용으로 보고되고 있는 두통, 오심, 설사, 복통. 변비, 어지럼증. 피곤 중. 소수의 환자가 두통을 호소하였으나, 그다지 심각한 정도는 아니었다. 인후두역류증 치료제로서 Pariet(R) 는 비교적 안전하고 효과가 높은 약물임이 임상 연구 결과 밝혀졌기에 보고하는 바이다.

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A Study on Trauma Experiences among Korean Adults based on Conditional probability of PTSD symptoms (PTSD 증상의 조건비율에 근거한 한국 성인의 트라우마 경험에 관한 연구)

  • Kim, Ji-Yun;Lee, Dong-Hun;Kim, Si-Hyeong
    • Korean Journal of Culture and Social Issue
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    • v.24 no.3
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    • pp.365-383
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    • 2018
  • In this study, to search for events that cause high levels of PTSD symptoms, traumatic events are classified into 'criterion events' that meet DSM-IV-TR criteria and 'life stresssful events', conditional probability of PTSD was confirmed. From a sample of 1,000 adults residing in South Korea, 998 statistically relevant samples were extracted. Criterion events include cases of 'sexual harassment before age 16', 'sightings of other accidents', 'rape before 16', 'domestic violence before 16', 'disaster', 'traffic accidents', 'other accidents'. Life stressful events appeared to be 'legal arrest or detention(person and family)', 'parental separation or divorce', 'failure or despair causing serious stress', 'extreme conflict with family or frequent quarrels'. Among the demographic characteristics, age, marital status, religion were found to affect PTSD symptoms. The implications and limitations of these results are discussed.

Association between Type D Personality and the Somatic Symptom Complaints in Depressive Patients (우울증 환자에서 D형 인격과 신체 증상 호소와의 관련성)

  • Park, Wu-Ri;Jeong, Seong-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.1
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    • pp.18-26
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    • 2013
  • Objectives : Type D personality was originally introduced to study the role of personality in predicting outcomes of heart disease. However, researches showed that other medical conditions are also affected by this personality. The purpose of this study was to evaluate the relationship between type D personality and somatic symptom complaints in depressive patients. Methods : Eighty-two individuals diagnosed with depressive disorder were included. Type D personality was measured with DS14. Patient Health Questionnaire(PHQ) 9 and 15 were used to measure depression severity and somatization tendencies. For alexithymia, TAS-20 was used. Student T-test and linear regression analysis were performed. The best regression model was determined by stepwise variable selection. Results : More than half of the subjects(56%) complained at least medium degree somatic symptoms according to PHQ-15 criteria. Two-thirds of the subjects were classified as Type D personality(63.4%). The mean PHQ-15 score of the Type D individuals was significantly higher than the remaining subjects(PHQ-15 mean=12.7, $p=8.2{\times}10^{-7}$). The best regression model included age, PHQ-9 score and NA subscale score as predictor variables. Among these, only the coefficients of age($p=1.5{\times}10^{-3}$) and NA score($p=1.5{\times}10^{-7}$) were found to be statistically significant. Conclusions : The result showed that Type D personality was one of the strong predictors of somatic complaints among depressive individuals. The finding that negative affectivity rather than social inhibition was more closely associated with somatization tendencies does not fully agree with the traditional explanation that inability to express negative emotion predispose the individuals to somatic symptoms. The finding that alexithymia was not shown to be a significant predictors also substantiated this discrepancy. However, it might be possible that the high correlation between NA and SI subscore(r=0.65) and between NA and TAS-20 score(r=0.44) hid the additional effects of social inhibition and alexithymia. Further research with a larger sample would be needed to investigate the effects of the latter two components over and above the effect of negative affectivity on the somatic complaints in depressive patients.

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