• Korean Journal of Psychosomatic Medicine
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• v.19 no.1
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• pp.28-33
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• 2011

Objective: This study aimed to investigate the pattern of psychiatric consultation-liaison in a new general hospital over a 5-year period. Method: Retrospective chart review was conducted for psychiatric consultations performed from May 2004 to December 2008 in a new general hospital in Hwasun, Korea. Results: A total of 1,852 patients who were referred to the Department of Psychiatry for consultation were included in the analysis. The main reasons for psychiatric consultation were changes in mental status(20.5%), depression(16.8%), insomnia(12.8%), and anxiety(7.9%). Psychiatric consultations were conducted with diagnoses of delirium(39.7%), depressive disorder(28.2%), adjustment disorder(7.9%), and anxiety disorder(4.1%). Patients with delirium were significantly older than were those with other psychiatric diagnoses(p<0.001). Delirium was more common in male patients than in female patients(47.1% vs. 29.9%, respectively), and depression was more common in female patients than in male patients(48.3% vs. 33.9%, respectively)(p<0.001). Delirium was more common in patients who underwent surgical operation than those who did not(p=0.010). Conclusion: Delirium was the most common diagnosis for psychiatric consultation followed by depression in a university hospital. Delirium was more prevalent in men than in women, while depression was more common in women.

• Korean Journal of Psychosomatic Medicine
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• v.6 no.1
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• pp.46-58
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• 1998

Objectives : This study was performed to evaluate the status of psychiatric consultation at a newly opened university hospital, to explore problems related to psychiatric consultation and to contribute for future consultation to be more systematic and more efficient. Methods: The subjects of this study were 284 patients hospitalized at Inha University Hospital between September 1, 1996 and August 31, 1997, who were referred for psychiatric consultation during hospitalization. This study was evaluated demographical characteristics of referred patients, resons for referral, recommendations by psychiatric consultant, clinical diagnoses, psychiatric diagnoses, relationship between referral time and hospitalization following the day of consultation and consultation referral types based upon psychiatrists' reports and patients' medical charts. Results : Most common patients referred to consultation were females aged 20s who visited at the department of internal medicine and related to the risk of suicidal attempts. Mood disorder was the most frequent psychiatric diagnosis, and the most common recommendations were to use psychopharmacological treatment along with outpatient visits. The 30% of subjects were referred to consultation within a day after hospitalization. In the case of consultation referral timing within two days and after three days, there was significant difference between early consultation and shorter hospitalization following the day of consultation. Most frequent type of consultation(29.6%) was categorized as IIIa type(physical complication type as a "Mending" request type). Conclusion : In review of consultation referral timing and consultation referral type of the subjects, who were referred for psychiatric consultation for one year at a newly opened University Hospital, referrals were found to be made within two days after their admission to hospital(50.7%), which was observed to be early request. We found that there was significant association between early consultation and shorter hospitalization following the day of consultation. The physical complication type(29.6%) which belongs to "Mending" request type was found to be the most frequent consultation referral type. This result indicates that more systematic psychiatric consultation is needed for the future.

• Korean Journal of Psychosomatic Medicine
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• v.21 no.2
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• pp.114-121
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• 2013

Objectives: The aim of this study was to know differences of characteristics between presenile and senile patients who were consulted to the department of psychiatry during medical-surgical admission. Methods: The demographic and clinical data obtained from the medical records of psychiatric consultation in the presenile inpatients with age 50 to 64 years(N=162) and those of the senile inpatients with age over 65 years(N=171) were reviewed and compared. Results: 1) The most common chief complaints for psychiatric consultation in presenile patients were somatic symptoms, anxiety and sleep disturbance in order, while cognitive decline, clouded consciousness and depressed mood were most common in senile patients with statistical significance. 2) The most frequent psychiatric diagnoses after consultation in presenile patients were delirium, mood disorder and substance use disorder in order, while delirium, mood disorder and major neurocognitive disorder were most frequent in senile patients with statistical significance. 3) There were no significant difference in numbers of physical illnesses, while numbers of therapeutic drugs for them were more in senile patients. Conclusions : Our study found significant differences between presenile and senile patients on psychiatric symptoms and diagnoses in geropsychiatric consultation. Therefore, more subdivided age-specific approach seems to be needed for the geropsychiatric consultation activities.

• Korean Journal of Psychosomatic Medicine
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• v.13 no.2
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• pp.75-84
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• 2005

Objectives : This study was conducted to look over the current status of psychiatric consultation in a general hospital. Methods : We analyzed 664 medical records : 317 in 2002 and 347 in 1997, and compared the records of 1997 and 2002. Results 1) The average age of the patients increased from 45.9 years(1997) to 53.2 years of age (2002). Dividing the referred patients into 3 age-brackets as below 40, between 40 and 60, and above 60, the number of patients in the age group above 60 was significantly increased, more prominently in women. 2) Overall consultation rate was 2.29% in 2002 and 2.2% in 1997 .44.2% and 57.1% of the whole referrals were from the department of internal medicine in each year, and the department of rehabilitation medicine was leading in consultation rate in both years. 3) 'Mood disorders' and 'Substance related disorders' were the most frequent diagnoses in 2002 and 1997 respectively. 4) Use of psychotropic drugs was the most frequent recommendations of psychiatric consultation, in both years, and the most frequently prescribed drugs were anti-anxiety drugs in both years. The use of SSRI and atypical anti-psychotics were increased, while the use of typical anti-psychotics was decreased significantly in 2002. Conclusion : In 2002, compared with 1997, the average age of the patients was increased, and the consultation of the patients with the diagnosis of 'mood disorders' and 'cognitive disorders' was done more frequently than in 1997. The recommendation to use psychotropic drugs was well accepted, but the concern to diagnostic procedure was relatively low.

• Korean Journal of Psychosomatic Medicine
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• v.1 no.1
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• pp.75-80
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• 1993

To understand and evaluate the patients who were referred for psychiatric consultation from medical departments, the authors reviewed the concept of disease, psychological reaction to disease, problems on psychiatric diagnosis and evaluation which were encountered at the medical ward. In addition, we reviewed what psychiatrists should do during consultation.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.130-137
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• 2019

Objectives : When a patient who attempts suicide visits the emergency room, it is important that the departments of emergency medicine, internal medicine, and psychiatry communicate with each other and prioritize treatment. This study was conducted to verify the effectiveness of the multidisciplinary emergency consultation system (ECS) for drug intoxicated patients. Methods : We retrospectively analyzed the data from medical records prior to the ECS, from July 2017 to May 2018, and after the ECS, from July 2018 to May 2019, to verify the effectiveness of the system. Results : After the ECS, admission to open wards was significantly higher than to the intensive care units (χ²=8.567, p=0.014). In addition, the proportion of consultations to the department of psychiatry among patients admitted to other departments tended to increase (χ²=4.202, p=0.053), and the time required for consultation response decreased (Z=-2.031, p=0.042). As a result of the consultation, the proportion of the patients who had been transferred to the department of psychiatry was increased (χ²=4.692, p=0.043), and the time spent to transfer tended to decrease (Z=-1.941, p=0.052). Conclusions : After implementing the ECS for drug intoxicated patients, unnecessary intensive care unit admissions, consultation response time, and the time spent to transfer were reduced, and the rate of consultation referrals and transfer rates increased. This means that the multidisciplinary consultation system rapidly provided essential medical services to patients at lower medical costs.

• Anxiety and mood
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• v.13 no.2
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• pp.108-114
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• 2017

Objective : A pilot project entitled '50s mental health screening project' was conducted in Seoul. As a part of this project, we conducted surveys to obtain the opinions of psychiatrists regarding mental health screenings. Methods : A questionnaire was mailed to members registered with the Korean Neuropsychiatric Association, which enquired about the '50s mental health screening project'. Results: A majority (90.9%) of the subjects agreed on the purpose and implementation of the project. However, there were fewer individuals that actually showed the intent to participate (65.8%). The mean age of the group with the intention to participate was higher compared to the group with no intention to participate. The factors that negatively affected the intent to participate included prejudice and discrimination against psychiatry (3.795), low health insurance reimbursement (3.784), and inconvenience of reporting to public health centers (3.664). The most appropriate method that scored the highest for screening mental health was face-to-face consultation with a psychiatrist (3.889). Most of the participants agreed on the method of a self-reported survey along with an interview of psychiatrist (84.9%). Conclusion : Subjects were concerned about prejudice and discrimination against psychiatry, low health insurance reimbursement, and inconvenience of reporting to public health centers. These problems need to be supplemented. Face-to-face consultation with a psychiatrist may be considered an appropriate method for future mental health screening.

• Korean Journal of Psychosomatic Medicine
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• v.19 no.1
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• pp.15-19
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• 2011

Alcohol is so-called "a magic bullet" affecting on the various organs and central and peripheral nervous systems and causes mental illness as well as physiological and psychological dependence. Also, alcohol problem is related with serious social problems including family violence, suicide, loss of job and crimes. Because alcohol use disorder is a common cause of consultation and liaison in general hospital, we could consider alcohol use disorder of one of psychosomatic disorder. Thus, I reviewed the prevalence, rate of consultation, and general consultant and treatment issues in treating patients with substance use disorder in a psychosomatic medicine.

• Korean Journal of Biological Psychiatry
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• v.6 no.1
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• pp.49-66
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• 1999

Polypharmacotherapy, both psychotropic and nonpsychotropic, is widespread in various situations including psychiatric hospitals and general hospitals. As the clinical practice of using more than one drug at a time increase, the clinician is faced with ever-increasing number of potential drug interactions. Although many interactions have little clinical significances, some may interfere with treatment or even be life-threatening. The objective of this review is evaluation for drug-drug interactions often encountered in psychiatric consultation. Drug interactions can be grouped into two principal subdivisions : pharmacokinetic and pharmacodynamic. These subgroups serve to focus attention on possible sites of interaction as a drug moves from the site of administration and absorption to its site of action. Pharmacokinetic processes are those that include transport to and from the receptor site and consist of absorption, distribution on body tissue, plasma protein binding, metabolism, and excretion. Pharmacodynamic interactions occur at biologically active sites. In psychiatric consultation, these two subdivisions of drug interactions between psychotropic drugs and other drugs are likely to happen. We gathered informations of the drugs used in physically ill patients who are consulted to psychiatric department in Korea University Hospital. And we reviewed the related literatures about the drug-drug interactions between psychotropic drugs and other drugs.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.20 no.3
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• pp.158-164
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• 2009

Trichotillomania is a neuropsychiatric disorder characterized by repetitive pulling out of one's hair. We present a trichotillomania case study illustrating the effectiveness of habit reversal training, which has recently been found, in western countries, to be a very effective cognitive behavioral treatment. The refractory patient in our study had previously received 1 year of drug treatment and psychiatric consultation for the disorder. We administered 10 habit reversal training sessions, which was followed by an obvious improvement in the patient's trichotillomania symptoms. Our observations indicate that habit reversal training might be effective in the treatment of trichotillomania.