Objective : Bipolar disorder is known to have strong genetic background and cellular immune activation. Based on the hypothesis that abnormalities of normal inhibitory control of T cell immunity can contribute to the pathophysiology of bipolar disorder, we investigated the relationship between the first exon at position +49(A/G) polymorphism of cytotoxic T lymphocyte antigen 4(CTLA4) gene and bipolar disorder. Method : Among the Korean patients diagnosed as bipolar disorder according to DSM-IV, 90 patients without serious medical illness, neurologic illness, hormonal disorder, or concomitant mental illness were selected. The normal control group consisted of 149 age-and sex-matched subjects without current or past history of autoimmune diseases or mental disorder. DNA was extracted from whole blood and the exon 1 region of CTLA-4 gene was amplified by polymerase chain reaction. Gene typing was performed using single strand conformation polymorphism. Results : There were no significant differences in genotype frequencies of G/G, G/A, and A/A between the patients with bipolar disorder and the control group(48.9% vs 46.3%, 44.4% vs 39.6%, and 6.7% vs 14.1%, respectively). There were no significant differences in allelic frequencies of G and A between the patients with bipolar disorder and the control group(71.1% vs 66.1%, and 28.9% vs 33.9%, respectively). Conclusion : This study did not show the association of exon 1 polymorphism of CTLA-4 gene with bipolar disorder.
Objectives This study is conducted to estimate the cost paid by the public suffering from disease possibly caused by chemical and to examine the effect on public health. Methods Cost-benefit analysis is an important factor in analysis and decision-making and is an important policy decision tool in many countries. Cost-of-illness (COI), a kind of scale-based analysis method, estimates the potential value lost as a result of illness as a monetary unit and calculates the cost in terms of direct, indirect and psychological costs. This study estimates direct medical costs, transportation fees for hospitalization and outpatient treatment, and nursing fees through a number of patients suffering from disease caused by chemicals in order to analyze COI, taking into account the cost of productivity loss as an indirect cost. Results The total yearly cost of the diseases studied in 2012 is calculated as 77 million Korean won (KRW) per person. The direct and indirect costs being 52 million KRW and 23 million KRW, respectively. Within the total cost of illness, mental and behavioral disability costs amounted to 16 million KRW, relevant blood immunological parameters costs were 7.4 million KRW, and disease of the nervous system costs were 6.7 million KRW. Conclusions This study reports on a survey conducted by experts regarding diseases possibly caused by chemicals and estimates the cost for the general public. The results can be used to formulate a basic report for a social-economic evaluation of the permitted use of chemicals and limits of usage.
An explanatory design was employed to identify the relationship of physical, emotional & social readjustment and social support of post hospitalized stroke patients and their caregivers. A convenient sample of 254 patients who given follow-up care at the outpatient department after discharge and 225 caregivers were recruited. Mental Status Questionnaire (MSQ), Social Support Inventory Stroke Survivors (SSISS), Illness intrusiveness(II), Instument Activity of Daily Living(IADL), Center of Epidemilogic Studies-Depression(CES-D), social activity and caregiver burden were used for measurement in this study. Results showed patient's physical level measured by IADL and psychological level measured by depression were high. But social activity was low. Cognitive function, depression & social activity were not significantly different by the posthospitalized period, but IADL was. The source of professional support was mostly the physician at the outpatient department. The family support was found significantly related to patient's depression & social activity and caregiver's subjective burden. Professional support was found significantly related to patient's IADL & depression. Illness intrusiveness as a mediating variable was a sig nificantly predicting power on patient's IADL & depression. The path analysis was used to identify the variables to predict the physical, emotional, and social status of patients. As a result, patient's age, cognitive function, illness intursiveness and professional support significantly predicted the level of IADL ; patient's cognitive function, illness intrusiveness and family support significantly predicted the level of depression ; and patient's age and family support significantly predicted the level of social activity of posthospitalized stroke patients. Based upon these results, the rehabilitation programs to reduce the illness intrusiveness and improve cognitive funtion were recommended for the readjustment of the stroke patients. This model of the readjustment of the posthospitalized stroke patients is recommended as the framework for care of the stroke patients.
Purpose: As the daily life experiences of community-dwelling people with mental disabilities are closely correlated to mental health recovery, this study aimed to analyze their daily life experiences in depth to determine their significance. Method: Participants included eight community-dwelling people with mental disabilities. A total of 12 in-depth interviews were conducted once or twice per participant. The collected data were analyzed using the phenomenological analysis method described by Giorgi. Results: The daily life experiences of community-dwelling people with mental disabilities were categorized into the following four components: "encountering shocking reality in the outside world", "life tied down by the mental illness", "happiness and gratefulness encountered in daily life", and "wishing for a change and self-sustaining life". Conclusion: This study found that the recovery and welfare of community-dwelling people with mental disabilities were promoted and that these patients made necessary efforts to become a member of the local community. These findings could be used as a reference for establishing social welfare policies which enable people with mental disabilities to participate as functioning members of the community that facilitate the prevention of relapse, to promote their integration into the community. Furthermore, the present results will contribute to the development of nursing intervention programs to promote recovery and prevent relapse, to ultimately establish a mental health management system.
Objectives: The suicide rate in Korea is increasing every year, and is the highest among the Organization for Economic Cooperation and Development countries. Psychiatric patients in particular have a higher risk of suicide than other patients. This study was performed to evaluate determinants of mental health care utilization among individuals at high risk for suicide. Methods: Korea Health Panel data from 2009 to 2011 were used. Subjects were individuals at high risk of suicide who had suicidal ideation, a past history of psychiatric illness, or had utilized outpatient services for a psychiatric disorder associated with suicidal ideation within the past year. The chi-square test and hierarchical logistic regression were used to identify significant determinants of mental health care utilization. Results: The total number of subjects with complete data on the variables in our model was 989. Individuals suffering from three or more chronic diseases used mental health care more frequently. Mental health care utilization was higher in subjects who had middle or high levels of educational attainment, were receiving Medical Aid, or had a large family size. Conclusions: It is important to control risk factors in high-risk groups as part of suicide prevention strategies. The clinical approach, which includes community-based intervention, entails the management of reduction of suicidal risk. Our study identified demographic characteristics that have a significant impact on mental health care utilization and should be considered in the development of suicide prevention strategies. Further studies should examine the effect of mental health care utilization on reducing suicidal ideation.
Journal of the Korea Society of Computer and Information
/
v.26
no.12
/
pp.195-200
/
2021
Seafarers play an important role in shipping and logistics. However, seafarers are relatively vulnerable to mental illness because they have to board ships for a considerable period of time and work in isolation. In particular, in the pandemic situation caused by COVID-19, the crew change is delayed due to the closure of many ports around the world, increasing the mental burden on seafarers. The mental health management of the crew is important because these mental problems can lead to major accidents of lives and ships. This paper identified the necessity of mental health management of seafarers through a survey and identified problems with the currently operated mental health management program and curriculum. Especially, this study proposed VR-based programs to help crews receive mentally counseling treatment in a timely manner and to reduce the mental burden on them by preventing sensitive personal information exposure. Through this, it is expected to contribute to the stable development of the logistics industry by establishing a safe seafarers working environment.
The aim of this paper is to expound upon the concept of mental health and disease in Plato. In ancient Greece, philosophy was to care for the health of the soul and to pursue the happiness of the life, while medicine was to care for the health of the body. It is the role of philosophy that defines what the mental disease is, rather than the realm of medicine, and the practical function of philosophy is the life of caring for our souls. In order to take care of the soul, it is important to diagnose what the mental disease is and where it comes from. In ancient Greek, medicine disease was initially regarded as a divine punishment and healing as, quite literally, a gift from the gods. Plato, however, insists that mental illness is not just brain problem but a human whole problem, (2) it is caused by imbalance and discord, and (3) ignorance is also a mental disease, (4) and furthermore, injustice and vice are mental diseases as well. Therefore Plato argues that the aim of philosophy is to practice a virtue as the mental health and further to achieve political justice to maintain the health of the soul.
Objectives : Severe mental illness is a major risk factor for suicide. This study aimed to identify characteristics of patients who died by suicide among subjects who had been received service from a community mental health center. Methods : We searched individuals who had committed suicide in Gwangju Bukgu Community Mental Health Center since 2006. Sociodemographic and clinical data were gathered from medical records and their case managers and they were compared with those of general members in the center. Characteristics of schizophrenia patients who died by suicide were particularly summarized. Results : Twelve person committed suicide between 2006 and 2016. The characteristics of those who died by suicide were male (67%), diagnosis of schizophrenia (75%), aged below 50 (83%), unemployed (92%), past history of psychiatric hospitalization (100%), recent admission within 3 months (67%), past history of suicidal attempt (78%), family history of schizophrenia (58%), poor adherence to medication (58%), and use of daily rehabilitation program (42%). Ten out of twelve (83%) showed warning sign for suicide. All identified method of suicide in patients with schizophrenia was jumping from high building. Many patients with schizophrenia, who committed suicide, suffered from comorbid depressive symptoms (67%) and auditory hallucination (78%). Conclusion : Case managers should pay attention to and carefully manage individuals who showed suicidal warning, particularly with risk factors for suicide, such as unemployment, admission state or recent discharge from psychiatric hospital, poor adherence to medication, family history of schizophrenia, and a history of suicidal attempt.
This study examined the relationships among the case management implementation factors, client satisfaction and quality of life among the persons with mental illness. The survey and interviews were conducted to the 18 community-based mental health service agencies which were implementing case management, and the 381 mentally ill persons who were living in the community and were receiving services from the agencies. The path analysis and the hierarchical linear modeling were used to examine the association among the independent, mediator, and dependent variables. The major finding of this study were that the caseload had the direct relationship with the quality of life. The case management team approach had the direct relationship with the client satisfaction. The suggestions were made that more focus should be on the maintenance of the appropriate caseload, the increase of the number of the case manager, and the team approach.
Objectives : This study aimed to suggest distinct signs of Greater yin disease (tàiyīnbìng, 太陰病) by researching the etymology of three terms: zi-tong (自痛), jie-ying (結硬), and yin-er (因爾), which are exclusive found only in Greater yin disease (太陰病) in Gangpyeong-shanghanlun, but not in other categories. Methods : We studied the etymologies of the three terms that are unique in Greater yin disease, then found some pathological signs that are related with them through the four mental illness cases, which include somatization, obsessive-compulsive behavior, delusion, and panic disorder. Results : Based on the definitions of each term, we diagnosed the four patients who had mental illnesses as having Greater yin disease, and we observed meaningful improvements after administering herbal medication. After Gyejigajakyak-tang administration, the Insomnia Severity Index (ISI) score decreased from 18 to 7 and the Beck's Anxiety Index (BAI) score decreased from 36 to 18 in the first case, the ISI score decreased from 27 to 16 and the BAI score decreased from 50 to 33 in the second case, and the ISI score decreased from 23 to 4 and the BAI score decreased from 34 to 5 in the third case. In the last case, the ISI and BAI scores were 16 and 22, respectively, at the first visit, and it was found that the scores had changed to 6 and 22, respectively, at the last visit. Conclusions : We found that the unique terms in Greater yin disease, including zi-tong (自痛), jie-ying (結硬), and yin-er (因爾), can be interpreted as groundless arbitrary assumption, resting strong tension, and psychological projection based on the etymological hypothesis. Therefore, we suggest these as specific signs of Greater yin disease.
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