• 동의신경정신과학회지
• /
• 제17권2호
• /
• pp.227-235
• /
• 2006

Delirium is a acute syndrome of disorientation caused by dysfunction of brain tissue and has a many varied symptom. The characteristic symptoms of delirium are conscious disturbance with disorientation and dys-mnesia and emotional disturbance. We experienced a 77 year-old male who had a hallucination and disorientation as well as delirium caused by antipsychotic medication, and whose condition was improved through discontinuing medication and traditional Korean medical treatment. We had given herb medication, acupuncture treatment and decreased medication to this patient, and observed. The patient's delirium symptom ad improved through oriental medical treatment and decreasing medication. It was able to improve a delirium caused by not specified origin and side effect of drug abuse through oriental medical treatment and decreasing medication.

• 동의신경정신과학회지
• /
• 제26권4호
• /
• pp.349-356
• /
• 2015

Objectives: Schizophrenia is difficult to treat effectively and the antipsychotics used have many side effects. However, few studies have focused on the combined treatment of Korean and Western medicine as an alternative. In this study, we reported an inpatient with chronic schizophrenia who was treated by a combination of Korean and Western medicine. Methods: We experienced a case of a diagnosed schizophrenia patient as whose chief complaint was avolition, diminished emotional expression and hallucination. The patient was treated with Western medicine and Korean traditional treatment including acupuncture, moxa and herbal medicine. The Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale (PANSS) were used for assessment. Results: After treatment, symptoms involving avolition, diminished emotional expression and hallucination were improved; furthermore, the scores of the BPRS and the PANSS were decreased by approximately 50%, respectively. In addition, there were no notable side effects. Conclusions: The combined treatment of Korean and Western medicine can be an effective and well-tolerated treatment modality for patients with chronic schizophrenia.

• 대한간호학회지
• /
• 제39권1호
• /
• pp.62-71
• /
• 2009

Purpose: The purpose of this study was to explore the effects of listening to music in inpatients diagnosed with schizophrenia, on their auditory hallucinations, and positive and negative symptoms. Methods: A quasi-experimental research design with $2{\times}2$ cross-over trial and convenience sample was used. Eleven patients (Group AB) listened to music followed by a wash out period and then a usual care period, and 12 patients (Group BA) had a usual care period followed by a wash out period and then listened to music. For one week those who were in the experimental period listened to individualized music using an MP3 player whenever they heard hallucinations. Results: There was a statistically significant decrease in the frequency of auditory hallucinations after listening to the music. There was a decrease in the mean scores for positive symptoms, negative symptoms, and general psychopathology after listening to music, but only negative symptoms showed a statistically significant decrease. The treatment effects on scores for positive symptoms, negative symptoms, and general psychopathology were greater in Group BA than Group AB. Conclusion: These findings suggest that listening to music may be useful for managing auditory hallucinations in schizophrenia inpatients.

• 생물정신의학
• /
• 제7권2호
• /
• pp.174-179
• /
• 2000

연구목적 : 환청이 자기감시체계의 이상이라고 주장하는 일부 학자들은 청각적 언어상상과 관련된 뇌 활성화 소견을 이용하여 환청의 병리기전을 밝히고자 하였다. 그런데 대부분의 환청의 내용은 부정적 감정을 동반하는 내용이다. 이런 점에서 저자들은 부정적 감정이 청각적 언어상상에 의해 유발된 대뇌 피질 활성에 어떤 식으로 영향을 미치는지 알아보고, 이를 통해 부정적 감정이 환청발생에 미칠 수 있는 영향을 이해해 보고자 하였다. 방법 : 정상인과 정신분열병 환자를 대상으로 부정적 내용의 청각적 언어상상 과제와 부정적 내용의 청각적 언어상상 과제를 수행토록 하였다. 이 두 가지 과제를 수행하면서 정량화뇌파검사를 시행하였고, 이때의 대뇌피질 활성의 차이를 paired t-test를 이용하여 분석하였다. 그리고 이러한 차이가 정신분열병 환자와 정상인에서 각기 어떤 식으로 달리 나타나는가 비교하였다. 결과 : 정상인의 경우 중립적 감정일 때에 비해 부정적 감정의 청각적 언어상상시, 좌측 측두엽 부위(TCP1)에서 beta주파수대의 뇌파 진폭이 증가하였고, 대뇌 우반구의 몇몇 부위(FP2, F4, C4, CP2, P4)에서 theta주파수대의 뇌파 진폭이 감소하였다. 그러나 정신분열병 환자의 경우, 두 가지 과제를 수행하는 동안 모든 주파수대에서 뇌파 진폭의 차이가 관찰되지 않았다. 결론 : 본 연구 결과는 좌측 측두엽의 더 많은 활성이 요구되는 부정적 내용의 청각적 언어상상을 하게 될 때, 정신분열병 환자에서는 적절한 활성화가 이루어지지 못하는 것을 지지하는 소견으로 생각된다. 그리고 이에 따른 자기감시체계의 활성의 저하가 환청과 밀접하게 관련될 수 있는 것으로 시사된다.

• 수면정신생리
• /
• 제12권2호
• /
• pp.133-138
• /
• 2005

목 적：본 연구에서는 성남 용인 소재 고등학생 대상으로 기면병의 특징적인 증상인 주간졸림증, 탈력발작, 수면마비, 입면시 환각의 비율을 조사하고 성별차이에 대한 연관성을 알아보고자 하였다. 방 법：성남 용인 지역의 35개 대상 고등학교 중 26개 학교가 연구에 협조하여 20,407명 대상으로 하였다. 전체 학생들에게 한국어로 번안한 Ullanlinna 기면병 척도를 측정하였고, 14점 이상인 학생들에게 기면병의 증상에 대해서 전화 인터뷰를 시행하였다. 기면병 증상의 비율과, 성별에 따른 심한 정도의 차이, 수면마비와 입면시 환각의 상관관계에 대해서 비교, 분석하였다. 결 과：Ullanlinna 기면병 설문지에 응답한 학생은 20,407명 중 20,343명이었으며 이 가운데 14점 이상 학생은 4,535명(22.2%)였다. Ullanlinna 기면병 설문지에 응답한 20,343명의 남녀 사이에 기면병 척도 평균점수는 유의한 차이가 있었고, 탈력발작과 주간졸림증의 평균점수도 남녀간의 차이가 있었다. Ullanlinna 기면병 설문지에서 14점 이상인 학생 4,535명 가운데 전화 인터뷰에 응답한 학생은 3,234명이었으며 수면발작, 주간 졸림증, 유사 탈력발작, 수면마비, 입면시 환각이 남자보다 여자에서 높은 비율을 보였다. 하지만 심한 수면발작과 유사 탈력발작의 빈도에 있어서는 남녀간의 차이가 없었다. 수면마비와 입면시 환각은 흔히 동반되는 증상이었으며 두 변수 사이에 상관관계가 관찰되었다. 수면마비가 일어나는 시기는 잠자기 전, 잠자는 동안, 잠에서 깨어난 후 중에 잠자는 동안에서 가장 많이 일어난다고 보고하였다. 결 론：기면병의 특징적인 증상인 주간졸림증, 탈력발작, 수면마비, 입면시 환각에서 남자보다 여자에서 높은 비율을 나타냈다. 이러한 성별 차이는 여학생이 남학생보다 신체 증상에 좀 더 민감하다는 것과 연관하여 설명할 수 있을 것이다.

• 정신신체의학
• /
• 제24권2호
• /
• pp.200-207
• /
• 2016

연구목적 알츠하이머병은 대표적인 증상인 인지 기능의 저하 외에도 다양한 행동심리증상(Behavioral Psychological Symptoms of Dementia, BPSD)을 흔히 동반하며, 이는 간병인들로 하여금 부양 부담을 야기한다. 본 연구에서는 한국의 치매 환자들과 그들의 간병인들을 대상으로 행동심리증상의 각 항목들과 간병인의 부양 부담에 대한 상관관계를 알아보고자 한다. 방 법 80명의 치매 환자들을 대상으로 행동심리증상을 한국형 신경정신행동검사(Korean neuropsychiatric inventory, K-NPI)를 통해서 평가하였고, 부양자들의 부양부담은 한국판 Zarit Burden Interview(ZBI)를 이용하여 평가하였다. 결 과 K-NPI의 망상, 환각, 초조/공격성, 우울/낙담, 불안, 탈억제, 과민/불안정 빈도와 간병인 부양부담의 평가척도인 ZBI 사이에 통계적으로 유의한 상관이 있었으며, K-NPI의 환각, 초조/공격성, 불안, 탈억제, 이상운동증상, 수면/야간행동의 심각도와 ZBI 척도 간에 유의한 상관이 있었다. K-NPI의 빈도${\times}$심각도 영역에서는 망상, 환각, 초조/공격성, 우울/낙담, 불안, 탈억제, 이상운동증상, 수면/야간행동과 ZBI가 유의한 상관관계를 보였다. 또한 인지기능척도(MMSE-KC, CDR, GDS)와 ZBI 척도 사이에 유의한 상관이 있었으며, 일상생활수행능력(Barthel-ADL, K-ADL)과 ZBI 척도 사이에도 유의한 상관관계를 보였다. 결 론 알츠하이머병 환자의 BPSD와 간병인의 부양부담과 상관관계가 있었다. 또한 간병인의 부양부담은 인지기능 및 일상생활수행능력과도 상관이 있었다. BPSD를 조기에 발견하고 적절하게 치료함으로써 치매 환자의 삶뿐만 아니라 보호자의 삶의 질도 개선시킬 수 있을 것이다.

• 대한약학회:학술대회논문집
• /
• 대한약학회 2003년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.1
• /
• pp.170.1-170.1
• /
• 2003

Carisoprodol(CSP), commonly prescribed as a skeletal muscle relaxant, is increasingly abused among young people for a recreational purpose in Korea. CSP may induce hallucination if it were ingested with large amounts, futhermore a carisoprodol overdose is considered fatal. Recently, we encountered overdoses of carisoprodol in 6 suicide cases. (omitted)

• 호스피스학술지
• /
• 제2권1호
• /
• pp.75-86
• /
• 2002

Prupose: The purpose of this study was to identify signs and symptoms of hospice patients during their dying processes. Method: The subjects of this study were 76 patients who received hospice care services in 2 different hospice care programs in Seoul area. Data was obtained from January, 1999 to June, 2001 by hospice nurse's observation, interviews with patient's primary caregiver and hospice volunteers, patient's self report, nursing records and questionnaires which had been developed by selecting from various references and refining them based on the result of preliminay studies. The collected data were analyzed with the SPSS PC+ program and content analysis. Results: Mean lengths of hospice patient's dying process were 3.6 days. Physical signs and symptoms of hospice patients during their dying processes were 'increased sleep'(89.5%), 'decreased oral intake of food'(88.2%) and 'liquids'(86.8%), 'change of respiration'(82.9%), 'decreased urine output'(80.3%), 'cold extremities'(69.7%), 'death rattle'(67.1%), 'cyanosis'(57.9%), 'restlessness'(55.3%), etc. And psychological, spiritual and social signs and symptoms were 'decreased interpersonal relationships'(61.8%), 'panorama of memories from childhood'(60.5%), 'experiences as like hallucination'(56.5%), 'saying bye with family'(69.7%), 'forgiveness', 'make a will', etc. Experiences as like hallucination were seemed not as dream but reality were shown by 43 dying patients. They had experienced to see and to talk with their deceased mother(18.6%) and/or relatives(30.2%), angels(20.9%), heaven(11.6%), old house in which they had lived, someone from the world beyond with black clothes, etc. Conclusion: The above results indicate that death of hospice patients is ongoing process with dying signs and symptoms during several days contains not only in physical aspects but also among psychological, spiritual and social aspects including family dynamics.

• 대한한의학회지
• /
• 제34권1호
• /
• pp.179-191
• /
• 2013

Kleine-Levin syndrome is a rare disorder characterized by recurrent episodes of hypersomnia, hyperphagia, hypersexuality and delusion and hallucination with spontaneous recovery. A 17-year-old female suddenly showed hypersomnia, severe fatigue, and compulsive hyperphagia. She was diagnosed with suspected Kleine-Levin Syndrome. The precipitating factor was an upper respiratory tract infection that the patient had undergone 2 weeks prior. Past psychiatric history included somnambulism and ADHD; her symptoms of ADHD included attention deficit, impulsiveness, hyperactivity, and irritability. This was her third episode. Her hypersomnia was longer in duration but lower in frequency compared with usual KLS. Her low LF/HF ratio in heart rate variability measurement showed high parasympathetic nerve activity. A MMPI report showed some psychological problem. The patient was diagnosed of gastric fever by pattern identification. Her hypersomnia episode improved 6 weeks after onset. This is the first reported case of suspected Kleine-Levin Syndrome in the field of Oriental Medicine in Korea.

• The Korean Journal of Pain
• /
• 제12권2호
• /
• pp.250-252
• /
• 1999

A 77-year-old male patient was admitted to the hospital with acute appendicitis and underwent emergency appendectomy under inhalation anesthesia without any complications. After the operation, the patient was placed on epidural analgesia with the mixture of fentanyl-bupivacaine and scopolamine patch for nausea and vomiting. The patient experienced central anticholinergic syndrome (CAS) with hallucination, confusion, somnolence, dysarthria and delirium at 20 hours after patch placement and recovered from all symptoms of CAS in 24 hours after the removal of the patch. The CAS occurs when central cholinergic sites are occupied by specific drugs and also as a result of an insufficient release of acetylcholine. The diagnosis of CAS is often determined by a process of exclusion and not actually made until a positive therapeutic response to physostigmine, a centrally active anticholiesterase agent, has taken place. Treatment of CAS includes prompt removal of the patch, cleansing of the area, and physostigmine administration. The scopolamine patch should be used with extreme caution in elderly patient.