• 대한불안의학회지
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• 제9권2호
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• pp.106-112
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• 2013

Objective : Several reports have found abnormal levels of androgen in post-traumatic stress disorder (PTSD) patients. This abnormality in androgen is hypothesized to due to chronic psychological stress effects on the hypothalamic-pituitary-gonadal (HPG) system. The present study was conducted to estimate serum testosterone levels in PTSD patients in comparison with normal subjects. Methods : Seventy-five male Korean veterans of the Vietnam War volunteered for the study, of which eleven were excluded because of incomplete psychological assessment. To measure basal serum testosterone, blood samples were collected between 8.00 and 9.30 a.m. The clinician administered PTSD scale (CAPS), the structured clinical interview for DSM-IV (SCID), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Rating Scale for Depression (HAM-D), Mini International Neuropsychiatric Interview Plus (Korean version of MINI-Plus), CES-K (Korean version of combat exposure scale). Results : The serum testosterone level of PTSD patients ($5.4{\pm}2.5ng/mL$) was higher than that of a control group ($3.1{\pm}1.7ng/mL$, p<0.001). Testosterone levels were significantly correlated with CAPS (r=.38, p<.01), HAM-A (r=.35, p<.01) and HAM-D (r=.28, p<.01) in all subjects. Conclusion : The results of the present study suggest that chronic psychological stress affects the HPG system.

• 대한불안의학회지
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• 제14권2호
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• pp.80-87
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• 2018

Objective : The purpose of this study was to investigate prevalence and clinical characteristics of Post-traumatic Stress Disorder (PTSD) in North Korean defectors (NKD). Methods : The study population consisted of 300 NKDs registered in the multi-regional adaptation center (Hana Center), within three years of settling in South Korea. We conducted in-person interviews and a survey with each subject, based on the North Korean version of the WHO-Composite International Diagnostic Interview (NK-CIDI) and various clinical scales. Results : Lifetime prevalence of PTSD in NKDs was 15.3%, approximately nine times higher than South Koreans (1.7%). Although experiencing broader type of traumas with higher rate than South Koreans, NKDs revealed lower odds of PTSD in most type of trauma (p<0.05). Conclusion : NKDs are at higher risk of experiencing different types of trauma than the general population in South Korea, and it is further validated that prevalence of PTSD is also higher. Careful evaluation for comorbid psychiatric symptoms and type of traumas prior to PTSD treatment for NKDs is necessary to facilitate more appropriate intervention for each subject, according to personal experience.

• 한국간호교육학회지
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• 제26권1호
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• pp.47-55
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• 2020

Purpose: The aim of this study was to examine the validity and reliability of the Korean version of the PTSD scale (K-PTSD) for measuring attitudes and knowledge of PTSD. Methods: A cross-sectional study design was used. The K-PTSD scale consisted of 8 items for attitudes, 8 items for general knowledge of PTSD, and 3 items for knowledge of PTSD treatment; 211 nursing students and paramedic students participated. Content validity, item analysis, and factor analysis were used to examine the construct validity. Criterion validity was tested by using educational experience with PTSD as a criterion. Cronbach's α was used to identify internal consistency reliability in the attitude scale. Results: Construct validity of the K-PTSD was verified by exploratory factor analysis, with factor loadings for attitude ranging from .59 to .84. Criterion validity in comparing knowledge of PTSD (t=2.02, p=.044) and PTSD treatment (t=3.19, p=.022) showed a significant difference according to PTSD educational experience. Cronbach's α for the attitude scale was .79 and .59. Conclusion: The findings suggest that the K-PTSD is a valid and reliable tool that can measure attitudes and knowledge of PTSD among nursing and paramedic students. However, further study is needed to retest the verification of this scale with more diverse participants.

• Journal of Hospice and Palliative Care
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• 제18권1호
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• pp.35-41
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• 2015

목적: 본 연구는 항암치료 단계 유방암 환자의 PTSD, 대처방식, 사회적 지지의 관계를 파악하여 암환자의 PTSD에 관한 효과적인 간호중재의 기초자료를 제시하기 위함이다. 방법: J시 소재 G지역암센터 외과 외래를 방문한 만 30세 이상이며, 항암치료단계인 유방암 환자134명을 대상으로 조사하였다. 수집된 자료는 SPSS WIN 18.0프로그램을 이용하여 서술통계, ANOVA, Pearson correlation coefficients 등을 실시하였다. 결과: 항암치료 단계 유방암 환자의 외상 후 스트레스 장애는 26.9%가 PTSD 고위험군, 17.9%가 PTSD 위험군에 속하는 것으로 나타났다. 대상자의 PTSD 그룹(고위험군, 위험군, 정상)의 대처방식(적극적 대처, 소극적 대처), 사회적 지지의 상관관계는 PTSD 고위험군인 경우 적극적 대처와 소극적 대처가 유의미한 정적 상관관계를 가지는 것으로 나타났으며, PTSD 고위험군에서 사회적 지지와 적극적 대처는 유의미한 정적 상관관계를 가지고 있는 것으로 나타났다. 결론: 항암치료 단계 유방암 환자 중 26.9%가 PTSD 증상을 보이는 것으로 나타났으며, PTSD 고위험군에서 사회적 지지가 증가할수록 적극적 대처가 증가하는 것으로 나타났다. 암은 평생 자기관리가 필요한 질병임을 고려할 때 높은 사회적 지지는 자신의 건강관리 능력을 증진시킬 수 있는 계기가 될 수 있을 것이며, 더 나아가 PTSD 고위험군에게 있어 높은 사회적 지지는 환자의 스트레스를 줄이고 삶의 질을 높이는데 효과적인 역할을 할 것이라 여겨진다.

• 한국간호교육학회지
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• 제26권4호
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• pp.393-401
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• 2020

Purpose: This study aimed to identify attitude and knowledge level on post-traumatic stress disorder (PTSD) among nursing and paramedic students. Methods: A questionnaire survey was conducted from December 1st to 20th in 2019. A total of 210 students participated from two universities in Korea. Data were analyzed using descriptive statistics, t-tests and one-way analysis of variance. Results: Students were positive about the government's spending on PTSD treatment (91.4%), and professional training (92.4%). PTSD patients were considered to be more dangerous (68.1%) and violent (42.4%) than the general population. There were no significant differences in attitude and general knowledge on PTSD between nursing and paramedic students. However, general knowledge on PTSD differed according to education experience on PTSD (t=2.04, p=.043). Knowledge scores for PTSD treatment differed significantly according to the academic major (t=2.02, p=.044), and education experience on PTSD (t=2.87, p=.005). Conclusions: The results of this study indicate nursing and paramedic students lack knowledge on PTSD. Therefore, developing curriculum regarding PTSD-related contents in undergraduate and continuing education in both departments is needed to provide better quality health care to people with PTSD.

• 중환자간호학회지
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• 제13권3호
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• pp.62-74
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• 2020

Purpose : This study aimed to investigate the prevalence and risk factors of mental health problems in patients discharged from the intensive care unit (ICU). Methods : This was a secondary analysis study using data from a multicenter prospective cohort of post-ICU patients. We analyzed data of 311 patients enrolled in the primary cohort study who responded to the mental health questionnaire three months after the discharge. Anxiety and depression were measured on the Hospital Anxiety-Depression Scale, and post-traumatic stress disorder (PTSD) was measured on the Posttraumatic Diagnostic Scale. Results : The prevalence of anxiety, depression, and PTSD in patients at three months after ICU discharge were 25.7%, 17.4%, and 18.0%, respectively, and 7.7% of them experienced all three problems. Unemployment (OR=1.99, p=.033) and unplanned ICU admission (OR=2.28, p=.017) were risk factors for depression, while women gender (OR=2.34, p=.009), comorbid diseases (OR=2.88, p=.004), non-surgical ICUs (trauma ICU: OR=7.31, p=.002, medical ICU: OR=3.72, p=.007, neurological ICU: OR=2.95, p=.019) and delirium (OR=2.89, p=.009) were risk factors for PTSD. Conclusion : ICU nurses should proactively monitor risk factors for post-ICU mental health problems. In particular, guidelines on the detection and management of delirium in critically ill patients should be observed.

• 동의신경정신과학회지
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• 제30권3호
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• pp.251-263
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• 2019

Objectives: The purpose of this study was to review the clinical research trends in the treatment of post traumatic stress disorder (PTSD) in Korean medicine (KM). Methods: We searched MEDLINE, CENTRAL, EMBASE, Google Scholar and five Korean databases through May 2019, for studies on KM to treat PTSD. Clinical research that conducted KM treatment of PTSD patients were included. Two researchers independently conducted study selection and data extraction process. Results: Totally, eight studies were included in this review. Types of traumatic events that patients experienced included physical violence/threatening, traffic accidents, sexual violence and personal tragic events. KM interventions performed included acupuncture, moxibustion, herbal medicine, physical therapy, and KM-based psychotherapy. Treatment duration varied from two days to more than five months. Follow-up began at least one week to three months after the end of treatments. It was reported that the major psychological and/or somatic symptoms of PTSD, such as anxiety, depression, insomnia, and musculoskeletal pain, subjectively improved, as well as other objective outcomes: Impact Event Scale-Revised Korean version (IES-R-K), Beck's Depression Inventory (BDI), State-Trait Anxiety Inventory, Hwabyung Symptoms/characters, Electroencephalography (EEG) change, etc. Statistical studies were conducted in three studies only. Outcomes such as Visual Analogue Scale (VAS), BDI, and IES-R-K showed statistically significant improvement after KM treatments. There was no study reporting adverse events during or after the interventions. Conclusions: According to this review, diverse types of KM treatments have been used among PTSD patients in eight studies. The KM treatments effectively improved psychological and somatic symptoms of PTSD patients. However, the lack of high quality research as well as the lack of standardization of KM treatments for PTSD are limitations. Further methodologically robust clinical trials should be performed, and the standardization of KM treatments for PTSD should be sought.

• Journal of Preventive Medicine and Public Health
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• 제52권6호
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• pp.345-354
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• 2019

Objectives: It is well-known that post-traumatic stress disorder (PTSD) among firefighters contributes to their job-related stress. However, the relationship between burnout and PTSD in firefighters has rarely been studied. This study therefore explored the association between burnout and its related factors, such as trauma and violence, and PTSD symptoms among firefighters in Korea. Methods: A total of 535 firefighters participated in the Firefighter Research on Enhancement of Safety & Health study at 3 university hospitals from 2016 to 2017. The 535 participants received a baseline health examination, including questionnaires assessing their mental health. A Web-based survey was also conducted to collect data on job-related stress, history of exposure to violence, burnout, and trauma experience. The associations among burnout, its related factors, and PTSD symptoms were investigated using structural equation modeling. Results: Job demands (${\beta}=0.411$, p<0.001) and effort-reward balance (${\beta}=-0.290$, p<0.001) were significantly related to burnout. Burnout (${\beta}=0.237$, p<0.001) and violence (${\beta}=0.123$, p=0.014) were significantly related to PTSD risk. Trauma (${\beta}=0.131$, p=0.001) was significantly related to burnout; however, trauma was not directly associated with PTSD scores (${\beta}=0.085$, p=0.081). Conclusions: Our results show that burnout and psychological, sexual, and physical violence at the hands of clients directly affected participants' PTSD symptoms. Burnout mediated the relationship between trauma experience and PTSD.

• 정신신체의학
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• 제28권2호
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• pp.155-160
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• 2020

연구목적 본 연구는 외상후 스트레스장애(Posttraumatic Stress Disorder, PTSD)를 비롯한 정신질환자의 기질과 성격의 변화 양상을 확인하고 한다 방 법 PTSD 환자 33명과 비PTSD 환자 69명을 대상으로 Temperament and Character Inventory (TCI)를 1, 2차에 걸쳐 측정하였고, 그 결과값에 대해 반복측정 ANOVA와 단순 주효과분석을 시행하였다. 결 과 비PTSD 집단에서는 1차와 2차 검사 결과의 차이가 나타나지 않았다. 반면, PTSD 집단에서는 위험회피, 사회적 민감성, 자율성, 연대감에서 유의미한 차이가 있었다. 또한 위험회피, 사회적 민감성, 자율성, 연대감에서 시간과 그룹 간의 상호작용과 시간에 따른 주효과가 유의하게 나타났다. 결 론 본 연구는 외상적 사건이 자율성, 연대감과 같은 성격적 특성은 물론, 위험회피와 사회적 민감성과 같은 기질적 특성의 변화에 영향을 미칠 수 있음을 확인하였다는 점에서 의의가 있다.

• 대한불안의학회지
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• 제5권2호
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• pp.80-88
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• 2009

Disorder of Extreme Stress, Not Otherwise Specified (DESNOS) is the proposed diagnosis that meets the severe, complex, and prolonged psychological sequela of victims with chronic traumatization (e.g., family violence, incest, and childhood sexual or physical abuse). The hallmarks of DESNOS are a multiplicity of symptoms (e.g., somatization, dissociation, and depression), pathological changes in relationships, identity disturbances, and a propensity to experience repeated harm and injury at the hands of oneself and others. DESNOS can be directly assessed by Structured Interview of Disorder of Extreme Stress (SIDES) and Self- Report Inventory of Disorder of Extreme Stress (SIDES-SR). The treatment of DESNOS should be phaseoriented and involve movement back and forth among three basic stages : 1) stabilization ; 2) trauma processing ; 3) reintegration.