• Korea Journal of Hospital Management
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• v.6 no.3
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• pp.130-147
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• 2001

This study is about major symptoms of elderly and medical services for elderly in long-tenn care facilities. The subject of this study was 298 patients over 00 years old staying in two geriatric hospitals and two nursing homes. The symptoms and medical services were level of patient classification from RUG(Resource Utilization Group)-III which is applied for both Medicare and Medicaid for skilled nursing facilities reimbursement system in US and designed for measuring patient characteristics and medical staff time. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). In this study, the symptoms and services were compared by facility type and they were categorized by level and compared by CMI. Major findings are as follows; 1. There were more elderly who have cognitive function problems in nursing homes than patients in geriatric hospitals. There were more patients with behavioral problems in geriatric hospitals than residents in nursing homes. These results were both statistically significant. 2. The patients in geriatric hospitals received significantly more nursing rehabilitation services, rehabilitation services and extensive services than residents in nursing homes. Other hands, special care services were provided significantly more to residents in nursing homes than elderly in geriatric hospitals. 3. ADL and depression variables had higher CMI when the symptoms were heavier condition. The CMI were not matched with levels of cognitive function problems and behavioral problems. 4. The CMI matched well significantly with levels of nursing rehabilitation services, special care services, and clinically complex services provided for the patient in geriatric hospitals and only nursing rehabilitation services in nursing homes. The CMI for rehabilitation services level and extensive services had regular trends. From the result of this study, the resource utilization level and services provided for elderly in each long-term care facilities were figured out. For the further study, it needs to have more concern about RUG-ill which classification variables were just analyzed.

• Women's Health Nursing
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• v.5 no.2
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• pp.247-261
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• 1999

The purpose of this study was to figure out related factors to the self-reported climacteric symptoms and the relationship among the health promoting behaviors, climacteric symptoms and degree of Sanhujori, the Korean traditional postpartal care. A cross-sectional survey design was employed in this study. The subjects were 108 middle-aged women who were non-hystrectomized and ranged in age from 40 to 60 years. They were selected in seoul and Kyoung-ki province, Korea, Data were collected from Oct.25 Nov. 10, 1997 by a structured questionnaire. The instruments used for this study were the revised health Promotion Lifestyle(HPLP) developed by Walker, Sechrist & Pender, and revised Climacteric Symptoms Scale developed by Chi, Sung Ai. the data were analyzed by the SPSS/$PC^+$ program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows ; 1. The mean score of health promoting behaviors was low($2.42{\pm}0.35$). There were statistically significant differences in the score of health promoting behaviors according to the educational background, family income, marital satisfaction, whether or not taking a restorative food and degree of Sanhujori, especially the period (t=-2.07, F=2.60~7.57, p<0.05). 2. The mean score of score self-reported climacteric symptoms was 1.69%;99% of middle-aged women had symptoms. There were statically significant differences in the score of middle -aged women's self-reported climacteric symptoms according to the age, number of children, educational background, occupation, family income, marital satisfaction, whether or not receiving hormon replacement therapy (HRT) or consultation by a professional, perceived health status and self evaluation of Sanhujori(t=-2.04~3.69, F=2.87~11.63, p<0.05). 3. women's degree of Sanhujori was a positive correlation with health promoting behaviors(r=0.34, p=0.00) and negative correlation with the degree of self-reported climacteric symptoms(r=-0.19,p=0.03). 4. The influencing factors to the climacteric symptoms were self actualization, interpersonal support, and perceived health status among the health promoting behaviors with 57% of variance($R^2$=0.57). 5. The middle-aged women's type of coping pattern for the climacteric symptoms was classified as active behavioral coping, spiritual & psychological coping, and negative coping. In conclusion, to intervene the middle aged women's climacteric symptoms and develop nursing strategies for their health, health promoting behavior, especially ; self actualization, interpersonal support, and perceived health status should be considered. And, as the primary prevention strategy for women's health during the period of childbearing and also middle age, especially for the climacteric symptoms, Sanhujori should be reconsidered.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.10 no.2
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• pp.212-219
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• 1999

Objective：This study is designed to get clinical guidelines for management of children with TBI by examining neuropsychiatric sequelae of TBI, determining whether the severity of TBI, type of treatment, and enviornmental factors are related to those sequelae, and defining the adequacy of public psychological tests as evaluating tools for them. Method：This is chart review of 47 children, aged 5 to 14 years, referred to a psychiatric outpatient clinic for neuropsychiatric evaluation at least 6 months after TBI. Data on the initial GCS score, associated injury, treatment type, and duration of hospital stay are obtained from medical records. EEG, MRI, intelligent test, and several psychological tests are administrated at the point of assessment. Results：1) Cognitive symptoms outnumber externalizing behavioral, emotional, and somatic symptoms, with no significant differences of frequencies of those 4 categorical symptoms between mild injury group and moderate to severe group. 2) Children treated with non-surgical method(p<0.01) complain more cognitive symptoms than the others. 3) Behavioral symptoms are related to younger age(p<0.05), and to anticonvulsant medication(p<0.05). 4) Children with associated injury complain emotional symptoms more frequently(p<0.05). 5) More somatic symptoms are presented by children with no medication(p<0.05), and with higher I.Q(p<0.05). 6) Low I.Q is correlated to low GCS score (p<0.05). Cognitive impairment is confirmed in 25 in 42 children complaining cognitive symptoms though I.Q test and BGT, whose hospital stay is longer than the others(p<0.05). 7) emotional disturbance is confirmed in 22 in 25 children showing emotional problems through psychological tests, who complain cognitive symptoms more frequently(p<0.05). Conclusion：This findings suggest that even mild TBI children need to be followed-up and treated as complaining neuropsychiatric symptoms over 6 months after injury, and shorter hospital stay is recommended for cognitive and emotional status of children, and for better evaluation of neuropsychiatric sequelae of TBI, more specific tests should be included in neuropsychological test tools.

• 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.

• Korean Journal of Psychosomatic Medicine
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• v.31 no.2
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• pp.108-117
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• 2023

Objectives : Somatic symptom disorder (SSD) is characterized by the manifestation of a variety of physical symptoms, but little is known about differences in autonomic nervous system activity according to symptom severity, especially within patient groups. In this study, we examined differences in heart rate variability (HRV) across symptom severity in a group of SSD patients to analyze a representative marker of autonomic nervous system changes by symptoms severity. Methods : Medical records were retrospectively reviewed for patients who were diagnosed with SSD based on DSM-5 from September 18, 2020 to October 29, 2021. We applied inverse probability of treatment weighting (IPTW) methods to generate more homogeneous comparisons in HRV parameters by correcting for selection biases due to sociodemographic and clinical characteristic differences between groups. Results : There were statistically significant correlations between the somatic symptom severity and LF (nu), HF (nu), LF/HF, as well as SD1/SD2 and Alpha1/Alpha2. After IPTW estimation, the mild to moderate group was corrected to 27 (53.0%) and the severe group to 24 (47.0%), and homogeneity was achieved as the differences in demographic and clinical characteristics were not significant. The analysis of inverse probability weighted regression adjustment model showed that the severe group was associated with significantly lower RMSSD (β=-0.70, p=0.003) and pNN20 (β=-1.04, p=0.019) in the time domain and higher LF (nu) (β=0.29, p<0.001), lower HF (nu) (β=-0.29, p<0.001), higher LF/HF (β=1.41, p=0.001), and in the nonlinear domain, significant differences were tested for SampEn15 (β=-0.35, p=0.014), SD1/SD2 (β=-0.68, p<0.001), and Alpha1/Alpha2 (ß=0.43, p=0.001). Conclusions : These results suggest that differences in HRV parameters by SSD severity were showed in the time, frequency and nonlinear domains, specific parameters demonstrating significantly higher sympathetic nerve activity and reduced ability of the parasympathetic nervous system in SSD patients with severe symptoms.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.16 no.1
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• pp.106-116
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• 2005

Summary : This study was designed to identify the difference in temperament, parent-adolescent's goodness of fit and behavioral problems between early-adolescent high risk group which can be divided into subgroups (ADHD-I and ADHD-HI/C) and normal group. Method : Subjects of this study were students of a Boy's Middle School and their parents. ADHD high risk group was determined by using three rating scales of ADHD behavioral symptoms : 1. Korean-ADHD Rating Scale, 2. Abbreviated Conners Parents Rating Scale, 3. Conners-Wells' Adolescent Self-Report Scale. Final research was based on the subjects including 25 people in ADHD-I high risk group, 70 ADHD-HI/C high risk group, 70 in normal group. Revised Dimensions of Temperament (DOTS-R) was used for students to assess their temperament, while DOTS-R : Ethnology for parents to access environmental demands. Goodness of fit between parent and adolescent was figured out by results of the two scales. Korean Youth Self Report (K-YSR) was used to examine behavioral problems. Results : When it comes to temperament of adolescents, ADHD-HI/C high risk group was found to be associated with higher scores on general activity level. In contextual parent demand to adolescent, ADHD-HI/C parents showed higher level of demands in general activity than other groups, and lower expectation of positive mood than ADHD-I parents. In parent-adolescent's goodness/poorness of fit, the research found out that ADHD-I and ADHD-HI/C had lower level of fit on pesitive/negative mood than normal group and indicated that ADHD behavioral symptoms connected with poorness of fit in emotional relationship between adolescents and their parents. In behavioral problems, ADHD-HI/C high risk group had severe externalizing and internalizing problems distinctly. It had more severe in externalizing problems than ADHD-I, while there were no differences in internalizing problems between the two subgroups. Conclusion The two ADHD subgroups in high risk adolescents had differences on temperamental activity level and on goodness of fit about positive mood. In addition, they had different patterns in externalizing/internalizing problems.

• Korean Journal of Schizophrenia Research
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• v.22 no.2
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• pp.21-33
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• 2019

Objectives: The current study covers a secondary revision of the guidelines for the pharmacotherapy of schizophrenia issued by the Korean Medication Algorithm for Schizophrenia (KMAP-SCZ) 2001, specifically for co-existing symptoms and antipsychotics-related side-effects in schizophrenia patients. Methods: An expert consensus regarding the strategies of pharmacotherapy for positive symptoms of schizophrenia, co-existing symptoms of schizophrenia, and side-effect of antipsychotics in patients with schizophrenia was retrieved by responses obtained using a 30-item questionnaire. Results: For the co-existing symptoms, agitation could be treated with oral or intramuscular injection of benzodiazepine or antipsychotics; depressive symptoms with atypical antipsychotics and adjunctive use of antidepressant; obsessive-compulsive symptoms with selective serotonin reuptake inhibitors and antipsychotics other than clozapine and olanzapine; negative symptoms with atypical antipsychotics or antidepressants; higher risk of suicide with clozapine; comorbid substance abuse with use of naltrexone or bupropion/varenicline, respectively. For the antipsychotics-related side effects, anticholinergics (extrapyramidal symptom), propranolol and benzodiazepine (akathisia), topiramate or metformin (weight gain), change of antipsychotics to aripiprazole (hyperprolactinemia and prolonged QTc) or clozapine (tardive dyskinesia) could be used. Conclusion: Updated pharmacotherapy strategies for co-existing symptoms and antipsychotics-related side effects in schizophrenia patients as presented in KMAP-SCZ 2019 could help effective clinical decision making of psychiatrists as a preferable option.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.1 no.1
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• pp.65-76
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• 1990

Behavioral characteristics of Attention Deficit Hyperactivity Disorder (ADHD) are aften observed in normal children. As a result, it is at times difficult to distinguish behavior disorder of clinical significance and normal developmental phenomenon. In addition, symptoms of ADHD can vary greatly depending on situations and social context, creating considerable difficulties in assessment. Therefore it is important to obtain information from various sources and in diverse situations. It is also desirable to quantify the severity of the problems whenever possible and determine their clinical significance by comparing the data to developmental norms. Specifically, various assessment methods such as interview with parent and child, behavior rating scales, behavioral observation and psychological testing were reviewed with discussion on merits and limitatious of each. It was emphasized that systematic and comprehensive assessment utilizing appropriate methods is necessary for accurate diagnosis and treatment evaluation of ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.24 no.3
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• pp.132-140
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• 2013

Objectives : This study aims to investigate the effectiveness of an internet-based anger management program for school-aged children. Methods : Forty-eight elementary school students took part in an anger management training program; subsequently, participants, their parents, and their teachers answered questionnaires assessing the participants' anger, aggressiveness, and other emotional/behavioral problems, pre- and post-training. Results : At the post-training self-assessment, the participants showed significant reductions in their "anger-out" tendencies and physical aggressiveness. In addition, the effects of the program on "anger-out" tendencies, aggressiveness, anger and peer relational problem were found to be more significant in participants who reported depressive symptoms. Teachers rated the participants' peer-relational problems as having decreased after the training. Conclusion : The proposed internet-based anger management program had a significant effect on the school-aged children's abilities to control their anger.

• Journal of Oriental Neuropsychiatry
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• v.20 no.2
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• pp.187-196
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• 2009

Objectives : This study was performed to report the effect of oriental treatments for panic disorder with functional gastrointestinal disturbance. Methods : In this case, a 30 year-old female patient has been suffered by panic disorder with functional gastrointestinal disturbance for 10 years. This case can be caused by KanKiUlKyul(肝氣鬱結), KanKiBeomYi(肝氣犯胃) and KanKiSeungBi(肝氣乘脾). We treated the patient with Herbal medication, Cognitive-behavioral therapy and Relaxation therapy. The effects of treatment were measured by GSRS(Gastrointestinal Symptom Rating Scale), BPI(Brief Pain Inventory) and VAS(Visual Analog Scale) Results : As a result of oriental treatments, the symptoms of Panic Disorder with Functional Gastrointestinal Disturbance was improved. Conclusions : These results suggest that oriental treatments have an effect on Panic Disorder with Functional Gastrointestinal Disturbance.