• Korean Journal of Psychosomatic Medicine
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• v.7 no.2
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• pp.252-255
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• 1999

Numbers of patients who have chronic pain seem to be increasing even in the psychiatric practice. One report in Korea showed more than 40% of psychiatric patients who visited out-patient clinic were suffered from chronic pain and one third of those patients were needed treatment for the on-going pain. For evaluating and treating those patients the charateristics of illness behavior should be understood. Abnormal Illness behavior was found as one of the most influential factors which led symptoms complicated and chronified. This symposium was planned to illustrate how to manage the patients whose pain are associated with arthropathy and connective tissue diseases, neuropathic pain and headache more effectively and efficiently. So, It is hoped to get fruitful knowledges for the management of chronic pain in the scope of consultation-liaison psychiatry.

• Korean Journal of Psychosomatic Medicine
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• v.16 no.2
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• pp.75-80
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• 2008

Delirium independently contributes to poor outcomes including prolonged hospital stays and increased risk of mortality. The reported prevalence of delirium in variety of medical and surgical hospital settings is from 15% to 70% ; delirium is, therefore, one of major reason for consultation that is required for psychosomatic interventions. This article reviews the psychosomatic interventions to treat delirium including 1) identification of risk factors and precipitating causes ; 2) non-pharmacological interventions, such as modifying treatment environment and educating patient's family and care-giver ; and 3) pharmacological approaches to control the various symptoms that are frequently presenting with delirium.

• 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.

• Korean Journal of Psychosomatic Medicine
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• v.22 no.1
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• pp.13-22
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• 2014

Objectives : Breast cancer has been the most prevalent female cancer in South Korea since 2001. Early detection of this disease is the most effective strategy for reducing mortality. The objective of this study was to identify factors which could predict advanced stage at diagnosis of breast cancer. Methods : Participants who were initially diagnosed with breast cancer and referred to the Stress Clinic of the Breast Cancer Center at Kyungpook National University Hospital were included. Through a semi-structured interview, the authors investigated psychosocial variables such as the extent of marital and family functioning and emotional-economic family burden as well as sociodemographic and health behavior-, health characteristic- and cancer-related variables. Results : Data were collected from 219 participants. One hundred and twenty(54.8%) subjects were diagnosed with advanced-stage breast cancer. Variables that were significantly different between the advanced-stage and early-stage groups included : monthly breast self examination(p<0.000), annual mammographic screening(p<0.000), mode of tumor detection(p<0.000), nature of the first symptoms(p<0.000), time to treatment after diagnosis(p<0.000), overloaded economic and family burden(p=0.018), marital functioning(p<0.000) and family functioning(p<0.00). Logistic regression analysis indicated that irregular annual mammography screening(OR=7.431 ; 95% CI 2.407-22.944) or a lack of screening(OR=25.299 ; 95% CI 7.855-81.482) and a dysfunctional marital relationship(OR=4.772 ; 95% CI 2.244-10.145) were significantly associated with advanced stage at diagnosis of breast cancer. Conclusions : We reconfirmed screening behavior to be a risk factor for delayed diagnosis of breast cancer. Our findings also emphasized the importance of psychosocial factors such as marital functioning in early detection of breast cancer. Psychiatric consultation in the area of martial functioning could be beneficial for increasing early detection in breast cancer.

• Korean Journal of Psychosomatic Medicine
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• v.5 no.2
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• pp.151-157
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• 1997

The relationship of stress and psychopathology with subjective or objective tinnitus intensity was investigated in 43 patients with tinnitus. Global assessment of recent stress scale, Beck depression inventory and symptom checklist-90-revision were used to measure stress perception and psychopathology. Subjective tinnitus intensity was assessed by subjective tinnitus severity inventory, whereas objective tinnitus intensity was assessed by tinnitogram. Scores of perceived stress related to interpersonal relationship and sickness or min had significantly positive correlation with subjective tinnitus intensity. In psychopathology, scores of somatization, interpersonal sensitivity, depression, anxiety, phobia, paranoid ideation, psychoticism had significantly positive correlation with subjective tinnitus intensity. However, stress perception and psychopathology did not significantly correlate with objective tinnitus intensity. These findings suggest that tinnitus may be associated with stress perception and multiple psychopathology including anxiety and depression. Thus, it is emphasized that Psychosocial intervention as well as effective consultation-liasion activity is needed for evaluation and treatment of patients with tinnitus.

• The Journal of the Korea Contents Association
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• v.11 no.11
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• pp.221-230
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• 2011

The purpose of this study was to determine whether parenting stress is related to anxiety in children with ADHD. The data were provided by 112 children between the ages of 7 and 9. Forty nine children with a diagnosis of ADHD were recruited through 3 departments of child psychiatry and 63 normal children were recruited from elementary schools from the same city. The Korean version of Parenting Stress Index-Short Form was used to assess parenting stress and the Korean version of the State Trait Anxiety Inventory for Children was used to assess the level of anxiety. The results show that children with ADHD have significantly higher levels of anxiety and parenting stress than normal children. However, no significant differences in parenting stress and anxiety were found across gender, age, and the type of ADHD. Significant correlation was found between trait anxiety and parental distress and between state anxiety and difficult child. Parenting stress didn't significantly influence on anxiety in children with ADHD. Occupational therapist need to consider that the anxiety level of children with ADHD is different from normal children. It is needed for interventions for children with anxiety symptoms and also consultation and intervention for parents with parenting stress.

• Journal of The Korean Society of Clinical Toxicology
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• v.15 no.2
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• pp.140-147
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• 2017

Purpose: This study was conducted to analyze the features of poisoning in individuals aged 0-18 years to understand the characteristics of potential victims and eventually prevent poisoning. Methods: We retrospectively analyzed poisoned children and adolescents (0-18 years) who visited the emergency department of one tertiary hospital from January 2003 through December 2013. We collected data including their age, sex, reason for poisoning, components and dose of poison, results of treatment, and psychiatric diagnosis. Results: During the study period, there were 436 cases of poisoning (male 47.2% (n=206); female 52.8% (n=230)). Subjects were classified into four groups (0-1 years, 2-5 years, 6-12 years, 13-18 years). The most common cause of poisoning in all age groups was accidental poisoning (72.9%), but intentional poisoning increased as age increased (p<0.001). Moreover, females were more often subject to intentional poisoning than males (p<0.001). The most common poisoning material was drugs (41.7%). Among intentional poisoning patients, 62.7% patients had consulted a psychiatrist, and their most common diagnosis was adjustment disorder (44.6%). Conclusion: The most common cause of poisoning in individuals aged 0-18 years was accidental poisoning, while intentional poisoning was most common among adolescents. Guardians should take care to prevent accidental poisoning, while psychiatric consultation and national moderation will be needed to prevent intentional poisoning.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.1
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• pp.26-33
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• 2021

Objectives : This study was designed to investigate datas related to panic attack and treatment in emergency room of panic disorder patients who visited emergency room for panic attack. Methods : A retrospective analysis of medical records was conducted on 92 patients with panic disorder who visited Chungju Konkuk university hospital emergency department due to panic attack and had bodily symptoms from 1st January 2010 to 31th December 2019. In addition to demographic characteristics and comorbid disorders, triggering stressors and alcohol consumption were corrected as pre-panic attack datas, bodily symptoms at the time of panic attack were corrected as datas during attack, electrocardiogram trial, consultation with psychiatrist, admission and information of used psychotropic drugs were corrected as post-attack data. Depending on size of data, Chi-square test or Fisher's exact test was used. Collected data was analyzed using R 4.03. Results : Cardiovascular disease was accompanied by 5.4% and depressive disorder was the most common coexisting mental disorder. Among triggering stressors, economic problem/work-related stress was significantly higher in men than women (𝛘²=4.322, p<0.005). The most common physical symptom during attack was circulatory (65.2%), followed by respiratory (57.6%), numbness-paralysis (33.7%), dizziness (19.6%), gastro-intestinal (14.1%) and autonomic symptom (12.0%). Electrocardiogram was taken at higher rate when patients complained circulatory symptom (𝛘²=8.46, p<0.005). The psychotropic drug most commonly used in emergency room was lorazepam, used in 92.1%. Conclusions : The most common bodily symptom during panic attack was circulatory symptom and the most common triggering stressor in men was economic problem/work-related stress. The most commonly used psychotropic for panic attack was lorazepam.

• Journal of Yeungnam Medical Science
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• v.8 no.2
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• pp.24-34
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• 1991

Delayed emergence of speech or language are frequent causes for concern about development during early childhood. Dealy in evaluation and proper management until school entry in more likely to result in frustration, anxiety and school failure. Many language disturbances and their attendant behavior disorders respond to intensive language therapy. Authors analyzed the medical recoreds of 52 children with delayed language development evaluated during 30 months from January 1986 through June 1988. The results were as follows : 1. The majority of cases were evaluated at the age of 2-2.9 year old(16 cases, 30.8%) and 3-3.9 year old(11 cases, 21.2%) 2. Male to female ratio was 3 : 1 3. The most common cause was mental retardation(53.8%), followed by developmental language disorder(23.1%) and autism(13.5%) 4. The most common associated condition was dysarticulation(17.3%), followed by strabismus(9.6%) and seizures(7.7%) 5. Special education was recommended in cases of 23(44.2%), speech therapy in 12 cases(23.1%) and consultation to child psychiatry in 7 cases (13.5%). Making diagnosis of underlying disorders is not simple because assessment of intelligence in young children is difficult and only a few tests are standardized. More detailed study on children with delayed language development and development of psychometric tests for the handicapped children are necessary, especially in Korea.

• 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.