• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제21권2호
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• pp.45-53
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• 2015

Purpose: This study is to derive the behavioral characteristics of the users appear in the outpatient department of psychiatry. Methods: By referencing John Zeisel's Tools for environment-behavior research, observation of user behavior and expert interviews as a method of the study has been carried out. Results: The results of this study are as follows. First, adjacent placement among children, youth and regular the outpatient department of psychiatry is necessary and easy access to internal medicine department and family medicine department is required in order to allow cooperated treatments. Secondly, depending on the characteristics of the outpatient department of psychiatry treatment, adjustment of space requirement or the change of kinds of necessary space is required. Third, considering the psychological and behavioral characteristics of mental illness and guardians, various search for the environment that can support this. Implications: This study is a basic research for space improvement and evaluation of the outpatient department of psychiatry, and need to be followed by further study using various perspectives and methods.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제21권1호
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• pp.17-26
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• 2015

Purpose : This study examined the social and environmental change in the outpatient department of psychiatry, were analyzed disease characteristics and using characteristics of the mental illness. Thus, this aims to provide a material that can be used for efficient spatial composition of psychiatry. Methods : This study was conducted through a literature review, observation surveys, interviews. Results : Psychiatry is aware of the need to respond to the current needs of ambulatory space, there are concerns that the spatial configuration for your needs. In accordance with the results of studies conducted are as follows: 1) Specialty care programs and space needs based on segmentation and specialization of the disease 2) Considered in conjunction with the layout of essential space and other departments 3) Spatial composition and furnishings for characteristic of psychiatry 4) Spatial configuration taking into account the patient's characteristic. Implications : This study looked at the change of social change and the environment related to psychiatry. Grasp the present state of spatial composition in psychiatry. And the use characteristics of patients and guardians were investigated. Meanwhile, studies of psychiatric outpatient department is still lacking. As a result, its significance is to analyze the spatial composition requirements.

• 우울조울병
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• 제9권2호
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• pp.126-132
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• 2011

Background and Objectives : This study aims to identify sociodemographic and disease-related variables which predicts continuity of outpatient treatment after discharge among bipolar patients. Materials and Method : The medical records of patients who discharged with the diagnosis of bipolar disorder from Department of Psychiatry, St. Mary's hospital from 2005 to 2009 were reviewed. Data on sociodemographic and disease-related variables were analyzed. Results : It showed older age, higher rate of male and higher rate of being married in 1-year follow-up group than in non-follow-up group. And it showed longer duration of index hospitalization, higher rate of previous psychiatric outpatient treatment within 3 months before index hospitalization, higher rate of involuntary admission in 1-year follow-up group than in non-follow-up group. The univariate logistic regression analysis revealed that older age, being male, previous psychiatric treatment and longer duration of index hospitalization were significantly related to an increased likelihood of 1-year follow-up visits. Conclusion : Age, sex, history of previous psychiatric treatment, and duration of hospitalization seems to have influence on continuity of outpatient treatment after discharge.

• 보건행정학회지
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• 제27권4호
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• pp.315-323
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• 2017

Background: This study was purposed to analyze the effect of spatial accessibility to the psychiatry department in general hospital on the outpatient visit of mental patients. Methods: Data was provided from the Statistics Korea and Statistical Geographic Information Service, National Health Insurance Service, Health Insurance Review and Assessment Service, and Korea Transport Institute in 2015. The study regions were 103 administrative regions such as Si and Gu. The 103 regions had at least one general hospitals with a psychiatry department. The number of outpatient visit of mental patients in regions was used as the dependent variable. Spatial accessibility to mental general hospital was used as the independent variable. Control variables included such as demographic, economic, and health medical factors. This study used network analysis and multi-variate regression analysis. Network analysis by ArcGIS ver. 10.0 (ESRI, Redlands, CA, USA) was used to evaluate the average travel time and travel distance in Korea. Multi-variate regression analysis was conducted by SAS ver. 9.4 (SAS Institute Inc., Cary, NC, USA). Results: Travel distance and time had significant effects on the number of outpatient visits in mental patients in general hospital. Average travel time and travel distance had negative effects on the number of visits. Variables such as (number of total population, percentage of aged population over 65, and number of mental general hospital) had significant effects on the number of visit in mental patients. Conclusion: Health policy makers will need to consider the spatial accessibility to the mental healthcare organization in conducting regional health planning.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제24권3호
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• pp.141-150
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• 2013

Objectives : The objective of this report is to identify the utilization of hospital school service during hospitalization among patients in their childhood and adolescence with psychiatric disorders. Methods : We retrospectively reviewed the medical record of child and adolescent psychiatric who were hospitalized during March 2009 through October 2012. We compared the one-year successful schooling and outpatient follow up rate between users and nonusers of the inpatient hospital school service. The hospital schooling experiences of the users were investigated upon follow-up visits to the outpatient clinic. Results : Sixty-three students received hospital school service during hospitalization among total 122 child and adolescent inpatients. Hospital school participants showed a significantly higher school reentry rate (61.9%) than non-participants (40.7%). However, there was no difference on follow up rate between the two groups. More than 60% of the 22 interviewed participants expressed an above-average level of satisfaction about hospital school service. Conclusion : Many patients with mental illness experience difficulty in receiving school education during treatment. That induces deterioration in disease, academic failure, poor social skills, low self-esteem, economic difficulties, and future job opportunities. The results of this study emphasize the importance of hospital school service and offer useful guidance for hospital school operation.

• 정신신체의학
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• 제25권1호
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• pp.46-55
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• 2017

연구목적 외래치료명령제는 정신질환을 앓고 있는 사람이 특정한 외래치료 프로그램에 참여하도록 법에 의해 명령을 내리는 사회적 강제 제도이다. 본 연구에서는 외래치료명령제 및 정신질환자들의 치료 순응도에 영향을 미치는 요인들에 관해 알아보고자 하였다 방법 정신건강의학과 전문의 60명을 대상으로 2016년 10월에서 11월까지 외래치료명령제 및 치료 순응도에 관한 설문조사를 실시하였다. 설문지 각 문항은 문헌조사를 통하여 초안을 작성하고 3명의 정신건강의학과 전문의 및 1명의 법학전문대학원 교수의 의견 조회 과정을 거쳐서 최종적으로 확정하였다. 설문에 응답한 대상자들의 답변을 기술 통계를 이용하여 분석하였으며, 외래치료명령제의 실효성 점수에 대해서는 중앙값과 최고치, 최저치를 알아보았다. 결과 60명의 정신건강의학과 전문의 중에서 45명(75.0%)이 외래치료명령제를 알고 있었지만, 지난 12개월 중에 이를 이용한 전문의는 2명(4.0%)이었고, 주관적 실효성 점수는 40점/100점으로 그 실효성은 매우 낮게 나타났다. 또한 재입원 환자 중 외래 치료를 지속적으로 받았던 환자의 비율은 37.7%, 외래치료를 임의 중단한 환자 비율은 53.1%로 임의 중단 환자가 차지하는 비율이 더 높았다. 퇴원 환자 중에서는 약 2/3가량이 지속적인 치료를 받고 있었다. 임의로 치료를 중단한 환자의 관리방법으로 '아무런 조치를 취하지 않는다'(n=27)와 '파악하지 않음'(n=15)가 대부분이었지만 '정신건강증진센터 연락한다'는 의견은 2명으로 매우 저조하였다. 또한 임의 중단 환자에 대한 효율적인 조치로서는 '정신건강증진센터에 연계해야한다'는 의견이 가장 많았다(n=30). 결론 현재 시행되는 외래치료명령제는 실효성이 낮고, 외래치료 환자의 치료순응도 또한 매우 저조하였다. 따라서 이에 대한 효과적인 개입을 위해 제도적, 행정적 개선이 필요하며, 향후 정신건강증진센터의 역할이 중요할 것으로 판단된다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제23권4호
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• pp.181-187
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• 2012

Objectives:The objective of this study was to examine the perinatal and developmental risk factors of attention-deficit hyperactivity disorder (ADHD) diagnosed with a structured interview among Korean children. Methods:The current study included 924 children (6-15 years) recruited from schools in five Korean cities or a child psychiatry outpatient clinic of Seoul National University Children's Hospital. The parents of the children completed the structured diagnostic interview for attention-deficit hyperactivity disorder, as well as questionnaires on perinatal and developmental risk factors. Results:Preterm delivery, severe maternal stress during pregnancy, change in primary care taker during the first three years, postpartum depression, and delayed first sentence showed a significant association with ADHD diagnosis. Conclusion:These findings suggest that perinatal and developmental factors contribute to development of ADHD in Korean children. Conduct of future research using a prospective design is needed in order to identify the causal relationship between observed risk factors and development of ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제19권2호
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• pp.112-119
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• 2008

Objectives : This study was conducted to examine whether there are qualitative differences in attention problem among children with various psychiatric disorders, including attention-deficit hyperactivity disorder (ADHD), depressive disorder, anxiety disorder, and tic disorder using clinical ADHD diagnostic system (ADS) T-scores. Methods : The subjects were 794 outpatient children aged from 5 to 15 years, including 540 children with ADHD, 95 children with depressive disorder, 86 children with anxiety disorder, and 73 children with tic disorder. Clinical T-scores on the ADS were calculated using the mean and standard deviations of four ADS variables for the ADHD group. Results : All four groups had T-scores on the ADS in the abnormal range. However, when comparing the clinical T-scores, the children with depressive and anxiety disorders performed better than the children with ADHD. We also found that although the four groups seemed to be similar in terms of clinical T-scores for omission and commission errors, there were significant differences in clinical T-scores for reaction time and the standard deviation of response time (RT) between the ADHD and other groups. Conclusions : We concluded that inattention and impulsivity might not be specific only to ADHD and that the clinical T-scores of RT and standard deviation of RT on the ADS could be used to discriminate between ADHD and other clinical groups.

• 생물정신의학
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• 제13권1호
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• pp.26-31
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• 2006

Object : To evaluate how the therapeutic factors affect post-discharge course of patients with schizophrenia, we analyzed relationship between each therapeutic factor and outcome of inpatients with schizophrenia in Hanyang University Hospital. Methods : This study is a retrospective report. Subjects were schizophrenic inpatients who were discharged from Hanyang University Hospital from January 1, 2003 through December 31, 2004. We obtained demographic and clinical data from review of inpatient and outpatient charts. Results : We analyzed the records of 104 patients with schizophrenia(44 males and 60 females). Patients who had longer first admission days have fewer number of readmission. There were no significant correlation between psychiatric rehabilitation and course of schizophrenia. Courses, such as duration of outpatient department follow-up and number and duration of rehospitalization, did not differ according to the existence of extrapyramidal symptoms or types of antipsychotics prescribed. Conclusion : Among the therapeutic factors, longer duration of the first admission only affected better post-discharge course of patients with schizophrenia.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제20권2호
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• pp.61-67
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• 2009

Objectives: The purpose of this study was to examine the performance and electrophysiological characteristics of drug-naive children with attention-deficit/hyperactivity disorder(ADHD) during the Go/NoGo task. Methods: Twenty-three boys with ADHD and 18 age-matched normal boys were recruited at a child psychiatric outpatient clinic in Seoul. All subjects were assessed by the Kiddie Schedules for Affective Disorders and Schizophrenia Present and Lifetime version. The investigator also assessed all subjects using the ADHD Rating Scale-IV(ADHDRS). Event-related potentials were recorded from 8 scalp electrodes during the visual Go/NoGo task. Results: Children with ADHD showed a larger mean of standard deviation of response time during the Go/NoGo task than normal children. The temporal N200 and P300 amplitudes were larger in children with ADHD relative to controls. The parietal N200 and P300 latencies were more prolonged in children with ADHD compared to normal controls. Conclusion: These results suggest that psychotropic-naive children with ADHD may have more variable performance ability, more difficulty in discriminating visual stimuli, and slower information processing speed than their normal age-matched counterparts.