• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.111-118
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• 2019

Objectives : The purpose of this study was to investigate the clinical characteristics of antipsychotic medication prescription for the symptom control in patients with delirium. Methods : One hundred and eighty-five patients referred to consultation-liaison psychiatric services for delirium due to general medical condition were included in this study. All subjects were divided into two groups (antipsychotics users vs. antipsychotics nonusers), and comparison analyses on their clinical characteristics were performed. Results : One hundred and twenty nine patients (66.5%) used antipsychotics for their delirium, and 56 patients (30.3%) did not use antipsychotics. The history of psychotropic medication was more frequently observed in antipsychotic users (5.4% vs. 18.6%, χ²=5.498, p=0.022). Especially, the history of benzodiazepine use was significantly high in antipsychotics users. The total score and sub-items of delirium rating scale-severity items except for the psychomotor retardation item showed higher scores in antipsychotic users than in nonusers (all p<0.05). The total score of the delirium rating scale-diagnosis items was higher in antipsychotic users than in the nonusers (p=0.010). Conclusions : Delirium patients with more severe delirium symptoms and with more history of benzodiazepine use were treated with antipsychotics more frequently than those without. These findings imply that benzodiazepine may not only exacerbate delirium but be associated with aggression or psychomotor agitation that need immediate intervention. Clinicians may need to pay attention not only these external symptoms but also to hypoactive symptoms that may lead to misdiagnosis and undertreatment.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.77-85
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• 2021

Breast cancer is the most prevalent oncological disease among women. Various psychosocial distress is common at the diagnosis, treatment, and posttreatment phase of breast cancer. For the treatment of breast cancer, not only medical treatment but also psychosomatic integrative care will be needed. Patients with breast cancer may lead to increased vulnerability to stress, adjustment disorder, anxiety disorder, and depressive disorder, and these psychiatric diseases and conditions are associated with recurrence or exacerbation of breast cancer. Psychosocial treatment of anxiety and depression could increase the quality of life of patients and decrease the recurrence and progression of breast cancer. In this article, we reviewed 5 clinical breast cancer survivorship guidelines focused on psychosomatic integrative care including psychosocial treatment and alternative treatment for psychosocial distress. Because 5 treatment guidelines were using various definitions of evidence, we confirmed evidence of various psychosocial treatments for patients with breast cancer based on the definition of evidence by the US Preventive Service Task Force (USPSTF) guideline. We also reviewed the effect size of psychosocial treatment for anxiety, depression, mood, and quality of life in patients with breast cancer. This article discusses the barrier to the delivery of psychosomatic integrative care and suggests integrative care planning for breast cancer. Multi-disciplinary teams, patient's needs assessment, information technology support, patient and caregiver engagement, planned periodic monitoring of psychosocial distress by a psychosomatic specialist or consultation-liaison psychiatrist are recommended as key features of a psychosomatic integrated care plan.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.2
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• pp.139-149
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• 2003

Objectives：To review the history of the development and current status of Korean Child and Adolescent Psychiatry and to propose the future tasks at this 20th anniversary of Korean Academy of Child and Adolescent Psychiatry. Methods：Records and publications of Korean Academy, personal communications with senior members of the Academy, the author's recollections and memoirs. Results：Korean Child Psychiatry started with opening Child Psychiatry Clinic at Seoul National University Hospital in 1979 and establishing Division of Child and Adolescent Psychiatry at the same hospital in 1980. A Child Psychiatry Study Group was formed in 1983 and it transformed into Korean Academy of Child and Adolescent Psychiatry in 1986. In the past 20 years, Korean child and adolescent psychiatry made an impressive progress and contributed significantly to the development of Korean medicine as well as to the establishment of child mental health service. There are 77 board-certified and 48 board-eligible child psychiatrists, and 18 child psychiatry fellows are in training as of 2003. Main forces of this successful introduction of child psychiatry are 1) 7 child psychiatry training centers at major university hospitals, 2) publication of Korean Journal of Child and Adolescent Psychiatry in 1990, 3) the establishment child psychiatry board certification system in 1996. Korean child psychiatry has extended its role in the international child psychiatry and took leadership in establishing Asian Society of Child and Adolescent Psychiatry and Allied Professions(ASCAPAP). Conclusion：Korean child psychiatry has achieved a remarkable progress for the past 20 years and is currently producing 15 or more child psychiatry each year. However, there are needs of more active involvements in adolescent problems, more active consultation-liaison services at general hospitals as well as community mental health institutions. More school consultation and preventive educational services are desired. There is a urgent need of carrying out more empirical studies with strong scientific rigor. Korean Academy should pay attention and provide assistance to the development of child psychiatry service in other countries in Asia.