• Title/Summary/Keyword: Post-traumatic stress disorders

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One year of treating patients with open fractures of the lower extremity in a new military trauma center in Korea: a case series

  • Ji Wool Ko;Giho Moon;Jin Geun Kwon;Kyoung Eun Kim;Hankaram Jeon;Kyungwon Lee
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.376-384
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    • 2023
  • Purpose: The Armed Forces Trauma Center of Korea was established in April 2022. This study was conducted to report our 1-year experience of treating soldiers with open fractures of the lower extremity. Methods: In this case series, we reviewed the medical records of 51 Korean soldiers with open fractures of the lower extremity between April 2022 and March 2023 at a trauma center. We analyzed patients with Gustilo-Anderson type II and III fractures and reported the duration of transportation, injury mechanisms, injured sites, and associated injuries. We also presented laboratory findings, surgery types, intensive care unit stays, hospital stays, rehabilitation results, and reasons for psychiatric consultation. Additionally, we described patients' mode of transport. Results: This study enrolled nine male patients who were between 21 and 26 years old. Six patients had type II and three had type III fractures. Transport from the accident scene to the emergency room ranged from 75 to 455 minutes, and from the emergency room to the operating room ranged from 35 to 200 minutes. Injury mechanisms included gunshot wounds, landmine explosions, grenade explosions, and entrapment by ship mooring ropes. One case had serious associated injuries (inhalation burn, open facial bone fractures, and hemopneumothorax). No cases with serious blood loss or coagulopathies were found, but most cases had a significant elevation of creatinine kinase. Two patients underwent vascular reconstruction, whereas four patients received flap surgery. After rehabilitation, six patients could walk, one patient could move their joints actively, and two patients performed active assistive movement. Eight patients were referred to the psychiatry department due to suicidal attempts and posttraumatic stress disorder. Conclusions: This study provides insights into how to improve treatment for patients with military trauma, as well as medical services such as the transport system, by revising treatment protocols and systematizing treatment.

Comorbid Conditions in Persons Exposed to Ionizing Radiation and Veterans of the Soviet-Afghan War: A Cohort Study in Kazakhstan

  • Saule Sarkulova;Roza Tatayeva;Dinara Urazalina;Ekaterina Ossadchaya;Venera Rakhmetova
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.1
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    • pp.55-64
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    • 2024
  • Objectives: This study investigated the prevalence and characteristics of comorbid conditions in patients exposed to ionizing radiation and those who were involved in the Soviet-Afghan war. Methods: This study analyzed the frequency and spectrum of morbidity and comorbidity in patients over a long-term period (30-35 years) following exposure to ionizing radiation at the Semipalatinsk nuclear test site or the Chornobyl nuclear power plant, and among participants of the Soviet-Afghan war. A cohort study, both prospective and retrospective, was conducted on 675 patients who underwent comprehensive examinations. Results: Numerical data were analyzed using the Statistica 6 program. The results are presented as the mean±standard deviation, median, and interquartile range (25-75th percentiles). The statistical significance of between-group differences was assessed using the Student t-test and Pearson chi-square test. A p-value of less than 0.05 was considered statistically significant. We found a high prevalence of cardiovascular diseases, including hypertension (55.0%) and cardiac ischemia (32.9%); these rates exceeded the average for this age group in the general population. Conclusions: The cumulative impact of causal occupational, environmental, and ultra-high stress factors in the combat zone in participants of the Soviet-Afghan war, along with common conventional factors, contributed to the formation of a specific comorbidity structure. This necessitates a rational approach to identifying early predictors of cardiovascular events and central nervous system disorders, as well as pathognomonic clinical symptoms in this patient cohort. It also underscores the importance of selecting suitable methods and strategies for implementing treatment and prevention measures.

Reliability and Validity of Korean Version of Depression and Somatic Symptom Scale(DSSS) (한국판 우울과 신체 증상 평가 척도(Depression and Somatic Symptom Scale, DSSS)의 신뢰도와 타당도)

  • Kim, Kun-Woo;Hong, Jin-Pyo;Park, Seung-Jin;Choi, Ji-Hye;Choi, Hye-Ra
    • Anxiety and mood
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    • v.7 no.1
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    • pp.9-15
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    • 2011
  • Objectives : We examined the reliability and validity of the Korean version of the Depression and Somatic Symptom Scale (DSSS) in Korean patients with depressive symptoms. Methods : Participants were 55 outpatients diagnosed with major depressive disorder, a depressive episode of bipolar I disorder, somatoform disorder, panic disorder, generalized anxiety disorder, or post-traumatic stress disorder according to the DSM-IV criteria. We assessed them using the Korean versions of the DSSS, Hamilton Depression Rating Scale (HDRS), and Quick Inventory of Depressive Symptomatology Self Report (QIDS-SR). Results : The Korean version DSSS had a Cronbach's alpha of 0.90. Moreover, each item's correlation with the total score was statistically significant (r=0.24-0.71, p<0.01). The test-retest correlation coefficient (r=0.83, p<0.01) was relatively high, and the DSSS correlations with the HDRS and QIDS-SR were 0.77 and 0.74, respectively. Conclusion : These results demonstrate that the Korean version of the DSSS could be a reliable and valid tool for screening and assessing depressive patients. The Korean version of the DSSS will be a useful tool for screening both depressive and somatic symptoms in Korea.

Analysis of Public and Researcher Interests in Suicide and Related Illnesses, and Acupuncture and Acupressure: Utilizing Google Trends and Major Electronic Database (자살 및 관련 질환과 침치료 및 혈위지압에 대한 대중과 연구자의 관심도 분석: Google Trends와 주요 전자 데이터베이스를 이용하여)

  • Sung-Hyun Kang;Jung-Gyung Lee;Chan-Young Kwon
    • Journal of Oriental Neuropsychiatry
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    • v.34 no.3
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    • pp.235-245
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    • 2023
  • Objectives: The aim of this study was to analyze public and researcher interests in suicide and related illnesses and acupuncture and acupressure treatment using Google Trends and some electronic databases. Methods: Search results for keywords "suicide," "acupuncture," "acupressure," and several illnesses related to suicide were analyzed in Google Trends from January 2004 to June 2023. Illnesses included anxiety, depression (including major depressive disorder), schizophrenia, bipolar disorder, post- traumatic stress disorder (PTSD), eating disorder (including anorexia nervosa and bulimia nervosa), substance use disorder, autism spectrum disorder, personality disorder (including borderline person- ality disorder), and chronic pain. Search results were extracted using relative search volume (RSV) scores between 0 and 100. Search terms were also searched in online databases, including PubMed, CNKI, and OASIS, to estimate the number of related studies, and descriptive analysis was conducted. Results: Google Trends analysis showed a strong positive correlation between the RSVs of "suicide and depression," "acupuncture and chronic pain," and "acupressure and PTSD." The electronic database search results produced numerous studies published on "suicide and depression," "acupuncture and depression," and "acupressure and anxiety." High interest in "suicide and depression," "acupuncture and chronic pain," and "acupressure and anxiety" was seen among the public and researchers. Interest in "suicide and chronic pain," "acupuncture and eating disorder," and "acupressure and PTSD" was higher in the public than among researchers, while "anxiety and suicide" and "anxiety and acu- puncture" showed opposite trends. Conclusions: The results of this research enable an understanding of public and researcher interest in suicide, acupuncture, acupressure, and suicide-related illnesses. The results also provide a basis for fu- ture research and examining public health implications in Korean medicine.

Longitudinal Change in Health Status after the Sewol Ferry Accident among Bereaved Parents (세월호 참사 후 희생자 부모의 건강상태 변화)

  • Yang, Sang Eun;Tae, Hye Jin;Hwang, Jihyun;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.14 no.1
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    • pp.44-52
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    • 2018
  • Objective : The present study had examined the psychiatric symptoms and physical health consequences for the bereaved parents of the high school students who died in the 2014 Sewol ferry accident. Methods : Forty bereaved parents participated in the study. The authors administered self-report questionnaires about the parents' health behaviors and psychiatric symptoms. The authors also conducted laboratory tests to assess the parents' physical health at 18 and 30 months after the accident. Univariate descriptive statistics were performed to report the prevalence and severity of psychiatric symptoms and health-related behaviors. Paired t-test and Mcnemar test were performed to compare the 18-and 30-month findings. Correlation analysis between psychiatric symptoms and laboratory findings were performed to find a relationship between the two variables. Results : At 30 months after the accident, most of the bereaved parents still appeared to suffer from complicated grief (97.5%), post traumatic stress disorder (80%), insomnia (77.5%) and severe depression (62.5%) based on the scores on the Inventory of Complicated Grief (ICG), the PTSD Check List-5 (PCL-5), the Insomnia Severity Index (ISI) and the Patient Health Questionnaire-9 (PHQ-9). One quarter of the bereaved parents reported high-risk drinking, and 47.5% reported increased drinking amount and frequency after the accident. In objective laboratory results, 55% of the bereaved parents were obese as defined by body mass index ${\geq}25$. The parents' mean low-density lipoprotein shows a significant increase over time (118.5 mg/dL at 18 months. vs. 132.5 mg/dL at 30 months. paired t-test t=-4.061, $$p{\leq_-}0.001$$). Total cholesterol and low-density lipoprotein at 30 months after the accident were in clinically borderline high range. In correlation analysis, triglyceride was positively correlated with ISI. Conclusion : The loss of children in the Sewol ferry accident, a disaster caused by human error, continued to have considerable impact on the victims' parents' mental and physical health 18 and 30 months after the accident. A longitudinal study following the parents' physical health would be necessary to investigate the long-term effects of this traumatic experience on physical health.

An autoethnography on the Development and counseling Experience of Non-face-to-face Mental Health Mobile Service Platform of Mental Health Social Welfare expert (정신건강사회복지 전문가의 비대면 정신건강 모바일 서비스 플랫폼 개발 및 상담 경험에 관한 자문화기술지)

  • Lee, Sol-Ji
    • Journal of Internet of Things and Convergence
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    • v.8 no.5
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    • pp.63-70
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    • 2022
  • This study is a study that collects and analyzes data through An autoethnographyon as one of method of qualitative research, through which researcher have experienced firsthand in the process of developmenting and counseling there a new concept professional mental health mobile service platform as a mental health social welfare expert. The results of this study are as follows.First, there are people in Korea who are directly exposed to mental health issues and need to receive professional medical services, but there are also quite a few members of the public who have a desire for general mental health services, although the level of therapeutic intervention is not required. Second, considering the characteristics of modern society and especially in the pandemic situation of infectious diseases such as COVID-19, more and more people are preferring various mental health service platforms using mobile devices. Third, all generations complain of mental health issues such as family problems, stress, interpersonal relationships, and occupations, and other mental health problems such as self-harm and suicide accidents are frequently mentioned in connection with mental disorders such as depression, anxiety disorder, addiction, and post-traumatic stress disorder. Fourth, youngth s were exposed to various mental health-related issues, and above all, they were complaining of serious mental health problems such as self-harm and suicide accidents. Fifth, in delivering professional mental health services, mental health experts with the ability also to provide professional services online through mobile devices are needed as well offline. Finally, based on the results of this study, policy and practical suggestions related to the provision of mental health services in the future, and directions for follow-up studies were suggested.

Validation of the Korean Version of the Trauma Symptom Checklist-40 among Psychiatric Outpatients (정신건강의학과 외래환자 대상 한국판 외상 증상 체크리스트(Trauma Symptom Checklist-40)의 타당도 연구)

  • Park, Jin;Kim, Daeho;Kim, Eunkyung;Kim, Seokhyun;Yun, Mirim
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.1
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    • pp.35-43
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    • 2018
  • Objectives : Effects of multiple trauma are complex and extend beyond core PTSD symptoms. However, few psychological instruments for trauma assessment address this issue of symptom complexity. The Trauma Symptom Checklist-40 (TSC-40) is a self-report scale that assesses wide range of symptoms associated with childhood or adult traumatic experience. The purpose of the present study was to evaluate the validity of the Korean Version of the TSC-40 in a sample of psychiatric outpatients. Methods : Data of 367 treatment-seeking patients with DSM-IV diagnoses were obtained from an outpatient department of psychiatric unit at a university hospital. The diagnoses were anxiety disorder, posttraumatic stress disorder, depressive disorder, adjustment disorder and others. Included in the psychometric data were the TSC-40, the Life events checklist, the Impact of Event Scale-Revised, the Zung's Self-report Depression Scale, and the Zung's Self-report Anxiety Scale. Cronbach's ${\alpha}$ for internal consistency were calculated. Convergent and concurrent validity was approached with correlation between the TSC-40 and other scales (PTSD, anxiety and depression). Results : Exploratory factor analysis of the Korean Version of TSC-40 extracted seven-factor structure accounted for 59.55% of total variance that was contextually similar to a six-factor structure and five-factor structure of the original English version. The Korean Version of TSC-40 demonstrated a high level of internal consistency. (Cronbach's ${\alpha}=0.94$) and good concurrent and convergent validity with another PTSD scale and anxiety and depression scales. Conclusions : Excellent construct validity of The Korean Version of TSC-40 was proved in this study. And subtle difference in the factor structure may reflect the cultural issues and the sample characteristics such as heterogeneous clinical population (including non-trauma related disorders) and outpatient status. Overall, this study demonstrated that the Korean version of TSC-40 is psychometrically sound and can be used for Korean clinical population.

A Study on Satisfaction level with Herbal Public Health Services and its Improvement Plans (한방공중보건서비스 만족도와 개선방안)

  • Lee, Jae-Won;Koo, Jin-Suk;Seo, Bu-Il
    • Korean Journal of Oriental Medicine
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    • v.18 no.2
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    • pp.65-89
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    • 2012
  • Objective : In order to investigate and improve public Korean medical health service satisfaction level, this study was designed. Method : A questionnaire has been conducted on 212 patients who received treatments at six public health centers in the northern part of Gyeongbuk during 15 days between Sep. 24 and Oct. 8, 2011. Result : 1. An Investigation on the usage of herbal clinics in public health centers reveals that 63.7% have received three times or more medical treatments previously and 61.8% have had their illness treated at other medical institutions. In regard to illness 32.1% have had arthritis or muscle aches. 50.9% have taken insurance medication after having had treatments at the public health centers. 66% have assessed acupuncture and moxa cautery the most satisfying. 2. To a question regarding whether herbal health treatment costs higher than that of physician's, the highest response at 31.6% is 'No'. And to a question regarding whether herbal medicines administered at public health centers have more side effects than that of physician's, the highest response at 39.6% is 'No'. 3. To a question regarding whether herbal treatment of public health centers has little effect against acute disease, 48.1% of responses are 'Fair'. To a question regarding whether herbal treatments, when compared with physician's treatments, boost better recovery of patients, 48.1% of responses are 'Fair'. To a question regarding whether herbal medicine is unscientific, when compared with that of western medicine, 38.2% of responses are 'Fair', To a question regarding whether herbal medicine has faster effect on disease than western medicine, 41.0% of responses are 'Fair'. To a question regarding whether herbal medicine is more effective on disease prevention and promotion of health than disease treatment, 38.2% of responses are 'Fair'. And to a question regarding whether the lack of various types of physical therapy devices in herbal medicine, when compared with western medicine causes inconvenience in herbal treatment, 42.0% of responses are 'Fair'. Those responses take up highest portion at each questionnaire. 4. A comparative study between herbal treatments and physician's treatments has also been conducted. To questions regarding which one of the two considering types of disease is the better, responses are the latter accounted for 43.9% against 'Cancer', the latter accounted for 45.3% against 'Endocrine disorders', the former accounted for 30.7% against 'Psychiatric disorders', the latter accounted for 38.2% gainst 'Otolaryngological(ENT) disease', the former accounted for 47.6% against 'Post traumatic stress disorder', and the former accounted for 52.4% against 'Muscle-skeletal disease'. 5. An investigation on frequency of patients' visits via (p<0.05) of subjects show a statistically significant difference. 6. First, an investigation on frequency of reasons of medical treatments reveal that age, occupation, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects taking insurance medicines after herbal health treatments reveal that monthly income (p<0.05) of subject shows a statistically significant difference. 7. First, an investigation on frequency of a claim that herbal treatments of public health center does not have great effect on acute disease reveals that age, education, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of analysis that herbal treatments has faster effect on disease compared with western treatments reveals that education level, religion, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. 8. When herbal clinics of public health centers and general herbal medicine institutions are compared, a survey on additional treatments that herbal clinics need the most reveals that education level, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects who want various forms of herbal medicines reveals that occupation and insurance type (p<0.05) of subjects show a statistically significant difference. Conclusion : In order to improve efficiency of treatments and enhance patient's satisfaction level, this study suggests measures such as providing a differentiated acupuncture treatments as a whole, streamlining an reception procedure, adopting more elaborated computer system for a patient to get proper medical attention, standardizing a treatment duration in order for a maximum result, keeping regular office hours, and optimizing a consultation time for a patient.