• Title/Summary/Keyword: Consultation psychiatry

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PSYCHIATRIC CONSULTATION IN A CHILDREN'S HOSPITAL (소아병원에서의 정신과 자문)

  • Lee, Young-Sik;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.108-116
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    • 1990
  • Child Psychiatric consultations on 92 patients hospitalized at the Seoul National Childrens Hospistal were analyzed retrospectively. The main referral sources were Pedictrics(77.2%), Neurosurgery(8.91%) and Orthopedics(3.96%) Consultation rate was 0.81% for the Hospital, 1.41% for Department of Pediatrics, 3.54% for Neurosurgery and 0.3% for the other department were made for the differential diagnosis raher than for the treatment or intervention. The diagnosis of referred patients were somatoform disorder(25%), organic mental disorder(18.5%), developmental disorder(14.1), conduct disorder(6.5%), anxiety disorder(6.5%).

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Clinical Characteristics of Misdiagnosed Delirium (오진된 섬망 환자의 임상적 특징)

  • Oh, Eugene;Baek, Sue-Hyun;Kim, Min-Hyuk;Min, Seongho;Park, Ki-Chang;Ahn, Jung-Sook
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.2
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    • pp.87-92
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    • 2014
  • Objectives : Delirium of hospitalized patients is common and it is significantly associated with increased mortality rate. Misdiagnosis rates of delirium are reported in a range of 36.7 to 63% in clinical setting. We aimed to identify the clinical features and symptomatic characteristics associated with misdiagnosis of delirium. Methods : Subjects were 256 inpatients who were referred for psychiatric consultation and diagnosed with delirium by a psychiatrist at a university hospital between January 1 and June 30, 2012. Clinical data were obtained with retrospective chart review. Patients were divided into misdiagnosed group and correct diagnosed group, after reviewing the reason which were described in the consultation request form. Results : Sixty nine(27%) subjects of the 256 patients were referred for other reasons(mood, substance, anxiety, dementia etc.) than "delirium/confusion" by clinician(misdiagnosed group). In misdiagnosed group, use of antipsychotics was more common. There were no differences between the two groups in age, gender, and department of referring clinician. Fluctuation score of DRS-R-98 was higher in the correct diagnosed group. Conclusions : In this study, the risk of misdiagnosis was higher when the patients have taken antipsychotics or less symptom fluctuation. Careful clinical attention is needed for diagnosis for delirium in these patients.

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OBSTETRICIAN'S VIEW OF TEENAGE PREGNANCY:PRESENT STATUS, PREVENTION AND PSYCHIATRIC CONSULTATION (산과 의사가 인지한 10대 임신의 현황, 예방, 정신과 자문)

  • Kim, Eun-Young;Kim, Boong-Nyun;Hong, Kang-E;Lee, Young-Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.117-128
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    • 2002
  • Objectives:For the purpose of obtaining the more vivid present status and prevention program of teenage pregnancy, this survey was done by Obstetricians, as study subject, who manage the pregnant teenager in real clinical situation. Methods:Structured survey form about teenage pregnancy was sent to 2,800 obstetricians. That form contained frequency, characteristics, decision making processes, and psychiatric aspects of the teenage pregnancy. 349 obstetricians replied that survey form and we analysed these datas. Results:(1) The trend of teenage pregnancy was mildly increased. (2) The most common cases were unwanted pregnancy by continuing sexual relationship with boyfriends rather than by forced, accidental sexual relationship with multiple partners. (3) The most common reason of labor was loss the time of artificial abotion. (4) Problems of pregnant girls' were conduct behaviors and poor informations about contraception rather than sexual abuse or mental retardation. (5) Most obstetricians percepted the necessity of psychiatric consultation, however psychiatric consultation was rare due to parents refusal and abscense of available psychiatric facility. (6) For the prevention of teenage pregnancy, the most important thing was practical education about contraception. Conclusions:Based on the result of this study, further study using structured interview schedule with pregnant girl is needed for the detecting risk factor of teenage pregnancy and effective systematic approach to pregnant girl.

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Nonpsychiatric Physicians' Attitudes toward Psychiatry (타과 의사들의 정신과에 대한 태도)

  • Koh, Kyung-Bong;Lee, Hee-Sang
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.1
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    • pp.13-21
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    • 1998
  • The purpose of the study was to examine nonpsychiatric physicians' attitudes toward psychiatry. 129 physicians responded to the questionnaire regarding attitudes toward psychiatry. A majority were favorable about psychiatric education, psychiatric consultation, psychoanalysis, students' choice of psychiatry as a career, and psychiatrists. Staff were more positive toward psychiatry than residents, and senior staff were more positive about psychiatry than junior staff. Overall, however, no significant differences were found in attitudes toward psychiatry between nonsurgical physicians and surgeons, although staff or residents in nonsurgical departments were more favorable about some aspects of psychiatry than staff or residents in surgical departments. The physicians with more interest in psychiatry as a career in the past were more likely to to be positive about psychiatry as a comprehensive science and a rapidly expanding field of medicine. Physicians with older age were more likely to be positive about status and efficacy of psychiatry, role and functioning of psychiatrists than those with. younger age. The results suggest that previous interest in psychiatry, age and clinical experience favorably influenced physicians' attitude toward psychiatry. In addition, development of models for psychiatric education will be needed to enhance physicians' attitude toward psychiatry.

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A Case of Tardive Tremor as A Varient of Classic Tardive Dyskinesia (지연성 진전 1례)

  • Yi, Jang Ho;Yoon, Doh Joon
    • Korean Journal of Biological Psychiatry
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    • v.2 no.1
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    • pp.140-143
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    • 1995
  • Tardive dyskinesia(TD), typically appearing as an undesirable side effect of a long term antipsychotic drug treatment has gained increased attention in recent times due to the discovery of many TD variants. This is a single case study of a patient who has undergone more than 8 years of high dosage antipsychotic treatment. After altering the type and dosage of antipsychotic medication 3 months prior to visit, the patient showed relatively abrupt onset symptoms of severe tremor and dystonia. These symptoms, appearing in clear consciousess, got better to a certain degree after 48 hours, worsened for 12 hours, and then improved again. Subsequently there was no continuing movement disorder. Several tests and consultation were carried out. However except for the medication factor, no other possible causes for such disabling symptoms were found. This clinical condition was thought to be akin to tardive tremor, a variant of TD. Furthermore, the course was atypical.

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Habit Reversal Training in Tic Disorder (틱 장애에서 습관뒤집기 훈련의 임상효과)

  • Hong, Jong-Woo;Doh, Jin-Ah;Kim, Hyun-Woo;Lim, Myung-Ho
    • Anxiety and mood
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    • v.6 no.1
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    • pp.24-30
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    • 2010
  • Objectives : Tic disorder is known to be a chronic neuro-behavioral disease, cognitive behavioral treatment (CBT) strategies, like habit reversal training (HRT), are introducing recently. We report the effectiveness of HRT in Tourette disorder, which are very common in clinical settings. Methods : The DSM-IV clinical diagnosis applied by child psychiatrist. YGTSS, Kovac's children's depression inventory, Spielberger State-Trait Anxiety Inventory, Abbreviated Conners' Rating Scales, Dupaul ADHD Rating Scales are used. Ultimately, totally 10 children were evaluated. Subject group are consist of 6 boys and 4 girls, and the mean age was $10.90{\pm}1.73$ years old. This study is treatment-refractory 10 patients (from 9-14 years old) though 1 years drug treatment and psychiatric consultation were taken. We administered 5 times of HRT for 4 weeks. Results and Conclusion : There were improvement of scores in Yale Global Tic Severity Scale, Clinical Global Improvement. Our observations indicate that HRT might be effective in the treatment of Tourette disorder.

Mental Health Service Use by the North Korean Defectors (북한이탈주민의 정신건강서비스 이용 실태)

  • Kim, Da Eun;An, Ji Hyun;Lee, Kyoung Eun;Moon, Carolyn Seungyoun;Jun, Jin Yong;Chang, Hye In;Hong, Jin Pyo
    • Anxiety and mood
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    • v.14 no.1
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    • pp.28-35
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    • 2018
  • Objective : The purpose of this study was to assess the use of mental health services by North Korean defectors. The study sought to understand the determinants of use with socio-demographical characteristics and the barriers of using mental health service. Methods : Data were collected from a sample of the 300 North Korean defectors who have settled in South Korea within the last three years, aged 18 years and older. Face-to-face interviews and a survey using the North Korean version of the Composite International Diagnostic Interview were conducted. Results : 21.0% of respondents reported the use of mental health services. Among them, 16.0% reported the use of mental health specialty, 2.0% reported the use of general medical services, and 3.0% reported the use of others. Of the respondents who had one or more psychiatric disorders, 28.8% used mental health services. The highest rate of use of mental health services was by respondents who are aged over 50 years old, had less than 10 years of education, and were unemployed. Of those who suffered from a psychiatric disorder but did not seek for consultation, 74.4% said that they could handle the problem by themselves, and 74.6% asserted that they had no psychiatric disorder. Conclusion : North Korean defectors in South Korea used mental health services more than the general South Korean population. It would be crucial to provide appropriate mental health services based on the needs of North Korean.

The association between adverse childhood experiences and self-harm among South Korean children and adolescents: a cross-sectional study

  • Scott Seung W. Choi;Jeong-Kyu Sakong;Hyo Ju Woo;Sang-Kyu Lee;Boung Chul Lee;Hyung-Jun Yoon;Jong-Chul Yang;Min Sohn
    • Child Health Nursing Research
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    • v.29 no.4
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    • pp.271-279
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    • 2023
  • Purpose: Adolescent self-harm is a public health problem. Research suggests a link between adverse childhood experiences (ACEs) and self-destructive behaviors. Few studies, however, have examined the effects of ACEs on self-harm among Asian adolescents. This study explored the association between lifetime ACEs and a history of self-harm among Korean children and adolescents in elementary, middle, and high schools. Methods: A cross-sectional, retrospective medical record review was conducted on a dataset of a national psychiatrist advisory service for school counselors who participated in the Wee Doctor Service from January 1 to December 31, 2020. The data were analyzed using multiple logistic regression to predict self-harm. Results: Student cases (n=171) were referred to psychiatrists by school counselors for remote consultation. Multiple logistic regression analyses revealed that the odds of self-harm were higher among high school students (adjusted odds ratio [aOR]=4.97; 95% confidence interval [CI]=1.94-12.76), those with two or more ACEs (aOR=3.27; 95% CI=1.43-7.47), and those with depression (aOR=3.06; 95% CI=1.32-7.10). Conclusion: The study's findings provide compelling evidence that exposure to ACEs can increase vulnerability to self-harm among Korean students. Students with a history of ACEs and depression, as well as high school students, require increased attention during counseling. School counselors can benefit from incorporating screening assessment tools that include questions related to ACEs and depression. Establishing a systematic referral system to connect students with experts can enhance the likelihood of identifying self-harm tendencies and offering the essential support to prevent self-harm.

Causal Attributions, Social Support and Psychological Morbidity in Patients Undergoing Thyroid Surgery

  • Yildirim, Nazmiye Kocaman;Ozcinar, Beyza;Dogan, Selim;Aksakal, Nihat;Sahbaz, Nuri Alper;Tutal, Firat;Torun, Bahar Canday;Ozkan, Mine;Erbil, Yesim
    • Journal of Endocrine Surgery
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    • v.18 no.4
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    • pp.219-227
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    • 2018
  • Purpose: The primary objective of the present study was to investigate the course of anxiety and depression in thyroidectomy. The second objective was to investigate the association between somatic symptoms and psychological symptoms, and the final objective was to identify the sociodemographic, clinical, and psychosocial factors that affect psychiatric morbidity. Methods: This prospective study, 101 patients who were admitted to the Endocrine Surgery Clinic of the Department of General Surgery, Istanbul Faculty of Medicine, University of Istanbul, with thyroid pathology were included in the study. Data were collected before surgery, and in the early, and late periods after surgery. Data were collected using a semi-structured interview form, a visual analogue scale, and the Hospital Anxiety and Depression Scale. Results: The average scores of anxiety and depression before surgery were statistically significantly higher compared with the early and late periods after surgery (P<0.001). Psychological morbidity was identified about 10% of patients before surgery and remained after thyroidectomy. A poor positive correlation founded between somatic symptoms and psychological condition in period surgery (P<0.05). Various sociodemographic features and psychosocial parameters affected anxiety and depression level (P<0.05). Conclusion: Anxiety and depression level in thyroid diseases decreased after thyroidectomy. These patients may express psychologic distress through somatic symptoms. Screening of psychological morbidity is suggested in patients planned thyroid surgery, especially in women, low-educated, inadequate social support, attributed to psychological causes.

Review of Psychiatric Adolescent Inpatient with Dermatologic Consultations (청소년 정신과 입원 환자들의 피부과 자문 의뢰에 관한 행태 분석 및 고찰)

  • Kwon, Hyunjung;Jo, Hyunyoung;Kim, Youngil;Park, Kyungduck;Chung, Hyun;Park, Joonsoo
    • Korean Journal of Psychosomatic Medicine
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    • v.23 no.1
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    • pp.20-25
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    • 2015
  • Objective:To review the patterns of the dermatologic consultations of psychiatric adolescent inpatient and to explore the relationship between the dermatologic disorders and psychiatric disorders. Methods:We retrospectively studied the data from 22 cases referred by psychiatric adolescent for a dermatologic consultation over 10 years in Daegu Catholic University Medical Center and compared with the data from 108 cases referred by the other department adolescent patients. Results:The mean age of patients was 15.9. The male to female ratio was 1:1.44. The most common psychiatric and dermatologic disorder was major depressive disorder and acne, respectively. The most frequent reason for consultation was to ask for dermatologic disease or condition(54.5%) followed by to perform cosmetic procedure of patients need(40.9%) and to perform dermatologic test(4.6%). Conclusions:More than just a cosmetic disfigurement, dermatologic disorders are associated with a variety of psychopathologic problems that can affect the patient. Increased understanding of biopsychosocial approaches and liaison among psychiatrists and dermatologists could be beneficial.