• 제목/요약/키워드: Mood disorder

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안정화된 만성 조현병 환자에서 강박장애 증상이 삶의 질에 미치는 영향 (Impact of Comorbid Obsessive Compulsive Symptoms on Quality of Life in Stable Patients with Chronic Schizophrenia)

  • 문정윤;강석훈;석정호;김찬형;김태용;최진희;소형석
    • 대한불안의학회지
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    • 제13권2호
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    • pp.141-147
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    • 2017
  • Objective : This study aimed to evaluate the relationship between comorbid obsessive compulsive disorder (OCD) and quality of life in stable patients with schizophrenia. Methods : We interviewed 162 symptom-stable inpatients who have been on a constant dose of antipsychotics for at least 3 months prior and diagnosed as chronic schizophrenia. Subsequently, patients were classified according to the existence of OCD as evaluated using the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). Further, all clinical and demographic data were collected and evaluated. To investigate potential interrelationships, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Korea-Positive and Negative Symptom Scale (K-PANSS), Korean Modification of the Scale to Measure Subjective Well-Being under Neuroleptic Treatment (KmSWN) and Korean Version Quality of Life Scale (K-QOLS) were performed. Independent t-test and Chi-square test were used to compare groups and regression analysis was done to assess the relationship between the Y-BOCS and quality of life. Results : Schizophrenia patients with OCD showed significantly earlier onset of schizophrenia, more severe psychiatric symptoms and lower quality of life, compared to those without comorbid OCD. OCD might be associated with lower quality of life in schizophrenia. Conclusion : Schizophrenia patients with OCD showed lower quality of life than those without OCD. In the treatment for schizophrenia, evaluation of OCD might be needed to improve their quality of life and social function.

한글판 우울증 선별도구(Patient Health Questionnaire-9, PHQ-9)의 신뢰도와 타당도 (Reliability and Validity of the Korean Version of the Patient Health Questionnaire-9 (PHQ-9))

  • 박승진;최혜라;최지혜;김건우;홍진표
    • 대한불안의학회지
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    • 제6권2호
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    • pp.119-124
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    • 2010
  • Objective : The reliability and validity of the Korean version of the Patient Health Questionnaire-9 (PHQ- 9) was examined in Korean patients with depressive symptoms. Methods : Eighty six outpatients diagnosed as major depressive disorder or depressive episode of bipolar I disorder according to the DSM-IV criteria were assessed with the PHQ-9, Hamilton Depression Rating Scale (HDRS), the Quick Inventory of Depressive Symptomatology Self Report (QIDS-SR), and the Center for Epidemiologic Studies Depression Scale (CES-D). Results : The Cronbach's alpha coefficient from the PHQ-9 was 0.81. And the correlations of each item with the total score were statistically significant (r=0.28-0.70, p<0.01). The test-retest correlation coefficient (r=0.89, p<0.01) was relatively high and correlations of the PHQ-9 with the HDRS, QIDS-SR and CES-D were 0.70, 0.81, and 0.81 respectively. Conclusion : These results demonstrated that the Korean version of PHQ-9 could be a reliable and valid tool for the screening and assessment of depressive patients. The Korean version of PHQ-9 will be a useful tool for screening depressive symptoms in Korea.

경찰공무원에서 외상후스트레스장애와 기질 및 성격 특성의 관계 (Relationship between Temperament and Character Dimensions and Post-Traumatic Stress Disorder in Police Officers)

  • 이정현;김옥주;남윤영;신정하;이희봉;김지애;심민영
    • 대한불안의학회지
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    • 제11권1호
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    • pp.61-68
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    • 2015
  • Objective : Police officers are exposed to job-related traumatic events and have a high prevalence of post-traumatic stress disorder (PTSD). This study examined the relationship between PTSD symptoms and dimensions of temperament and character in police officers. Method : Thirty-six police officers participating in a psychological support program were enrolled. All subjects were asked to complete a demographic questionnaire, the Impact of Event Scale-Revised (IES-R), the Temperament and Character Inventory (TCI) and other self-reported symptoms scales. Results : Among all participants (age $40.8{\pm}10.2$, men 94.4%), the rate of 'post-traumatic stress symptoms group' was 47.2%. After controlling for confounding factors, lower self-directedness scores were significantly associated with higher PTSD symptoms (${\beta}=0.6$, p=0.03) in multiple regression analysis. Conclusion : Character traits, especially self-directedness, were associated with the severity of PTSD symptoms severity. These findings may provide useful information regarding personality factors related to PTSD in police officers.

한의학 정신요법 집단치료로 호전된 감별 불능 신체형장애 여환 1례 (Oriental Medicine Based Psychotherapy for Somatoform Disorder;A Case Report)

  • 변순임;김상호;박소정;김지영;김종우;정선용;황의완;김지혁
    • 동의신경정신과학회지
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    • 제17권3호
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    • pp.97-106
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    • 2006
  • Oriental Medicine Based Psychotherapy is consisted of 8 sessions which are available for various kinds of patients(mood disorders, somatoform disorders, anxiety disorders, Hwabyung, adjustment disorders etc.). Through 8 sessions, patients were educated on the relationship of mind and body which is the basic concept of oriental medicine and also received several training such as Progressive Muscle Relaxation, Autogenic Training, Breathing Training, Meditation, Qi-training. After these several training they get to think of their problems and inner conflict with people and get some insight about themselves and others, it can help handling their problems. This case report is about the patient with lots of somatic complains through the whole body, who got better after treatment by oriental medicine based psychotherapy added on herbal medicine and acupuncture.

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일 도시 감정노동자의 직무스트레스와 우울증의 연관성 (The Relationship Between Job Stress and Depressive Disorder Among Emotional Laborers in a City)

  • 장준호;이유정;이상준;양종철;박태원;박종일;정상근
    • 대한불안의학회지
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    • 제16권1호
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    • pp.24-31
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    • 2020
  • Objective : The purpose of our study was to investigate the relationship between job stress and depressive disorder among emotional laborers in a city. Methods : A total of 677 emotional laborers living in Jeonju-city participated in this study. The participants completed survey questions regarding demographic characteristics, job stress (using the Korean Occupational Stress Scale-24, KOSS-24), and depression (the Patient Health Questionnaire-9, PHQ-9). Logistic regression was performed to estimate the association between job stress and depression. Results : Our results indicated that 34.9% of the participants had a high risk of total job stress and 21.7% of participants had depression. In the multivariate logistic regression analysis, female sex (OR=1.66, 95% CI=1.01-2.72) and total job stress (OR=3.84, 95% CI=2.57-5.75) were significantly associated with depression after adjusting for confounding factors. Among the subscales of job stress, job demand (OR=3.06, 95% CI=1.99-4.72) and occupational climate (OR=1.88, 95% CI=1.19-2.97) were significantly associated with depression. But insufficient job control, interpersonal conflict, job insecurity, the organizational system and lack of rewards were not. Conclusion : Among the emotional laborers, job stress, particularly job demand and occupational climate, were major contributing factors associated with depression. Early screening and preventive strategies focusing on job stress could reduce the impact of depression in emotional laborers.

한국판 성인용 웩슬러 지능검사 4판(K-WAIS-IV)으로 살펴본 병무용 진단서 대상 주요우울장애 환자의 특성 : 후향적 연구 (Clinical Characteristics of Patients with Major Depressive Disorder on Military Service and Conscription Issues Using K-WAIS-IV : A Retrospective Study)

  • 김지영;박은희
    • 대한불안의학회지
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    • 제16권1호
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    • pp.32-40
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    • 2020
  • Objective : The purpose of this study was to investigate the cognitive performance of major depressive disorder (MDD) in military service/conscription personnel who visited the psychiatric clinic for a medical certificate to consider the situation from the perspective of Korea's unique compulsory military system. We used the Korean Wechsler Adult Intelligence Scale-IV (K-WAIS-IV) as the test for verifying the suitable level of cognitive functioning for military service and as the embedded measure with reflecting suboptimal effort. Methods : The study was conducted on 56 (28 males, age 19-34) in/out-patients admitted to the psychiatry department and diagnosed with MDD (DSM-IV). All participants completed a structured clinical interview (MINI-Plus), as well as self-report questionnaires related to demographics and severity of clinical symptoms. K-WAIS-IV was administered to each subject to assess cognitive characteristics. Results : Military group showed significantly lower processing speed index (PSI) score including subtests of symbol search (SS) and coding (CD) score, compared to the control group. There was no other significant differences in the Full Scale IQ (FSIQ), Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI) scores including sub-tests comprised of the above indices, and Reliable Digit Span (RDS), Enhanced-RDS-Revised (E-RDS-R) between the study and control groups. Conclusion : This study was the first effort to verify the characteristics of Korea's military group with MDD and suggest the applicability of PSI and processing speed of K-WAIS-IV as an embedded performance index to test sub-optimal effort or low motivation beyond the purpose of testing cognitive deficits.

한국판 전투 노출 척도의 신뢰도와 타당도 (Reliability and Validity of the Korean Version of the Combat Exposure Scale)

  • 김동수;정혜경;최진희;소형석;김해정;고창민;김태용;정문용
    • 대한불안의학회지
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    • 제8권2호
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    • pp.106-112
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    • 2012
  • Objective : In posttraumatic stress disorder (PTSD), it is essential to evaluate the severity of trauma with a reliable instrument. The combat exposure scale (CES) is one of the most widely used measures for the combat-related trauma. The present study was conducted to test the reliability and validity of the Korean version of CES (CES-K). Methods : One hundred and forty-five male Korean veterans of the Vietnam War participated in this study. CES-K, the structured clinical interview for DSM-III-R (SCID), clinician administered PTSD scale (CAPS), and the Korean version life events checklist (LEC-K) were administered. Results : Cronbach's coefficient of CES-K was .85, and the test-retest reliability was .94. The mean [standard deviation (SD)] scores of CES-K were 20.4 (9.0) in the PTSD group and 12.0 (8.6) in the non-PTSD group (p<.001). CES-K showed a significant correlation with LEC-K (r=.31, p<.001) and CAPS (r=.52, p<.001). Only one factor was revealed by the factor analysis. Conclusion : CES-K showed good reliability and validity for assessing the severity of combat exposure. Further, it demonstrated comparable psychometric properties to the previous study. It is expected that CES-K will be a useful tool for evaluating the severity of combat exposure in Korea.

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

  • 김다은;안지현;이경은;문승연;전진용;장혜인;홍진표
    • 대한불안의학회지
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    • 제14권1호
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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.

장기요양환자에서 환자 특징 및 기능상태와 환자돌봄 시간과의 관련성 (A Relationship of Care Time with Functional Status and Patients Characteristics among Patients in Long-term Care Hospitals)

  • 이지전;김정인;유승흠;유형식;이상욱
    • Journal of Preventive Medicine and Public Health
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    • 제37권3호
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    • pp.282-291
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    • 2004
  • Objectives : The aim of this study was to investigate the functional status variables related to the care time of health professionals for patients in long-term care facilities. Methods : The functional stati of 1001 patients in 8 long-term care hospitals were examined by the Resident Assessment Instrument for Long-term Care Facility Version 2.0. The care time of health professionals for patients was calculated using data from a self-reported task survey by nurses, auxiliary nurses, private aides, doctors, physiotherapists and social workers. Results : The average care time per diem was 240.6 minutes. The care time by doctors, nurses and private aides were 11.0, 71.0 and 139.5 minutes, respectively. The lower the function of activities of daily living (ADL) and the greater the symptoms of extensive services, special care and clinical complexity, the more care time was served. On the contrary, the greater the symptoms of nursing rehabilitation, depression, cognitive disorder, behavior problem and psychiatry/mood disorder, the less care time was served. Age and gender were not significantly related to the care time. Conclusions : Developing a case mix classification system for elderly long term care patients may be helpful for both of patients and health care providers. The ADL, extensive services, special care and clinical complexity of variables should be considered in the development of a case mix system for the long term care of patients in Korea.

북한이탈 청소년의 외상후 스트레스가 정신건강에 미치는 영향 (Influence of Posttraumatic Stress on the Mental Health among Adolescents of North Korean Refugees)

  • 손용훈;이주실;박민철;이상열
    • 대한불안의학회지
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    • 제6권1호
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    • pp.37-44
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    • 2010
  • Objectives : This study investigated the influence of traumatic experience on the ego identity, self-esteem, and general psychopathology of adolescent North Korean refugees. Methods : The participants were 146 adolescents North Korean refugees who attended H High School for North Korean refugees. We divided the subjects into two groups according to the severity of their traumatic experience : the more-traumatic-experience group and the less-traumatic-experience group. Each group performed self-report assessments including an assessment to reveal demographic characteristics, the Traumatic Experiences Scale for North Korean Defectors, the Scale for Ego identity, the Scale for Self-esteem and the Symptom Check-90-Revision (SCL-90-R). Statistical analysis of t-test and multiple regression utilized SPSS 12.0 for Window for comparison between more-traumatic-experience group and less-traumatic-experience group. Results : The prevalence of posttraumatic stress disorder among adolescents North Korean refugees was 37%. The factor with the greatest influence on ego identity was length of time living in South Korea, while, for self-esteem the most influential factor was perception of health. The more-traumatic-experience group had lower self-esteem scores on some subscales of the Scale for Ego identity. They had higher scores on all SCL-90-R subscales than the less-traumatic-experience group. Conclusion : Adolescent North Korean refugees experienced high rates of posttraumatic stress disorder. The more traumatic-experience-group had lower self esteem and poorer ego identity and mental health than the less-traumatic-experience group.