• Title/Summary/Keyword: Psychiatric

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Prognostic Factors in Postpsychotic Depressive Disorder of Schizophrenia (정신분열증의 정신증 후 우울장애의 예측인자)

  • Kim, Jin-Sung;Lee, Jong-Bum;Seo, Wan-Seok;Koo, Bon-Hoon;Bae, Dae-Seok;Kim, Yi-Youg;Kim, Jung-Youp
    • Journal of Yeungnam Medical Science
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    • v.22 no.2
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    • pp.150-165
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    • 2005
  • Purpose: This study was conducted to investigate the prognostic factors of postpsychotic depressive symptoms in patients with schizophrenia. Materials and Methods: Eighty patients were selected based on the diagnostic criteria from the DSM-IV, PANSS and ESRS. For all patients information was collected on demographic and clinical characteristics. The subjective depressive symptoms and the objective depressive symptoms, as well as patients insight regarding psychosis were evaluated. The subjective depressive symptoms were evaluated by BDI and ZDS; the objective depressive symptoms were evaluated by HDRS and CDSS, and patient insight into the psychosis was evaluated by KISP. Results: The comparisons using demographic and clinical characteristics showed that HDRS and CDSS had significant difference with regard to gender and suicide attempts; the BDI was associated with difference in education level and age of onset. The patients with scores above cuff-off score for each scale were 20(25.0%) for the BDI, 16(20.0%) for the ZDS, 18(22.5%) for the CDSS and 6(7.5%) for the HDRS. The results of the stepwise multiple regression analysis showed that the scores for the KISP, education levels, gender and suicide attempts were the main prognostic factors in patients with the psychotic depressive disorder of schizophrenia. Conclusion: The main prognostic factors in psychotic depressive disorder of schizophrenia included: insight into psychosis, suicidal attempts. Insight into the psychosis was the most reliable prognostic factor but this characteristic had a negative relationship to the with depressive symptoms.

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A Study of Effects of Psychosocial Factors and Quality of Life on Functional Dyspepsia in Firefighters (소방관에서 기능성 소화불량에 대한 심리사회적 요인의 영향 및 삶의 질에 관한 연구)

  • Jang, Seung-Ho;Ryu, Han-Seung;Choi, Suck-Chei;Lee, Hye-Jin;Lee, Sang-Yeol
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.66-73
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    • 2016
  • Objectives : The purpose of this study was to investigate the characteristics of psychosocial factors related to functional dyspepsia(FD) and their effects on quality of life(QOL) in firefighters. Methods : This study examined data collected from 1,217 firefighters. We measured psychological symptoms by Patient Health Questionnaire-9(PHQ-9), Generalized Anxiety Disorder questionnaire(GAD-7), Korean Occupational Stress Scale(KOSS), Ways of Coping checklist(WCCL), Rosenberg's Self-Esteem Scale(RSES) and World Health Organization Quality of Life Scale abbreviated version(WHOQOL-BREF). Chi-square test, independent t-test, Pearson's correlation test, logistic regression analysis, and hierarchical regression analysis were used as statistical analysis methods. Results : For the group with FD, the male participants showed significantly higher frequency(p=0.006) compared to the female participants. The group with FD had higher scores for depressive symptoms(p<.001), anxiety (p<.001), and occupational stress(p<.001), and did lower scores for self-esteem(p=.008), quality of life(p<.001) than those without FD. The FD risk was higher in the following KOSS subcategories: job demand(OR 1.94, 95% CI : 1.29-2.93), lack of reward(OR 2.47, 95% CI : 1.61-3.81), and occupational climate(OR 1.51, 95% CI : 1.01-2.24). In the hierarchical regression analysis, QOL was best predicted by depressive symptoms, self-esteem, and occupational stress. Three predictive variables above accounts for 42.0% variance explained of total variance. Conclusions : The psychosocial factors showed significant effects on FD, and predictive variables for QOL were identified based on regression analysis. The results suggest that the psychiatric approach should be accompanied with medical approach in future FD assessment.

Disappearance of Hysteria(Conversion Disorder) and the Evolutionary Brain Discord Reaction Theory (히스테리아(전환장애)의 소실과 진화적 뇌신경 부조화 반응 가설)

  • Song, Ji Young
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.28-42
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    • 2016
  • Objectives : The author tried to find out reasons why and how hysteria(and conversion disorder) patient numbers, which were so prevalent even a few decades ago, have decreased and the phenotype of symptoms have changed. Methods : The number of visiting patients diagnosed with conversion disorder and their phenotype of symptoms were investigated through chart reviews in a psychiatric department of a University hospital for the last 12 years. Additionally, the characteristics of conversion disorder patients visiting the emergency room for last 2 years were also reviewed. Those results were compared with previous research results even if it seemed to be an indirect comparisons. The research relied on Briquet P. and Charcot JM's established factors of the vicissitudes of hysteria(and conversion disorder) which has been the framework for more than one hundred and fifty years since hysteria has been investigated. Results : The author found decreased numbers and changes of the phenotype of the hysteria patients(and conversion disorder) over the last several decades. The decreased numbers and changes of the symptoms of those seemed to be partly due to several issues. These issues include the development of the diagnostic techniques to identify organic causes of hysteria, repeated changes to the symptom descriptions and diagnostic classification, changes of the brain nervous functions in response to negative emotions, and the influence of human evolution. Conclusions : The author proposed that the evolutionary brain discord reaction theory explains the causes of disappearance of and changes to symptoms of hysteria(conversion disorder). Most patients with hysteria(conversion disorder) have been diagnosed in the neurological department. For providing more appropriate treatment and minimizing physical disabilities to those patients, psychiatrists should have a major role in cooperating not only with primary care physicians but with neurologists. The term 'hysteria' which had been used long ago should be revived and used as a term to describe diseases such as somatic symptom disorder, functional neurological symptoms, somatization, and somatoform disorders, all of which represent almost the same vague concept as hysteria.

Development of the Korean version of Postconcussional Syndrome Questionnaire (한글판 뇌진탕후증후군 척도의 개발)

  • Yoon, Mi-Ri;Ko, Young-Hoon;Han, Chang-Su;Joe, Sook-Haeng;Jeon, Sang-Won;Han, Chang-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.23 no.1
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    • pp.26-35
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    • 2015
  • Objectives:The purpose of this study was to evaluate reliability and validity of the Korean version of the Postconcussional Syndrome Questionnaire(KPCSQ) which was originally developed in 1992 by Lees-Haley. Methods:Patients with traumatic brain injury were recruited from April 2009 to December 2011 from the Korean University Ansan Hospital. We selected patients that met the ICD-10 diagnostic criteria of postconcussional syndrome and organic mental disorder including organic mood disorder, organic emotionally labile disorder, organic anxiety disorder and organic personality disorder. The KPCSQ, Trait and State Anxiety Inventory(STAI-I, II), and Center for Epidemiologic Studies Depression Scale(CESD) were administered to all subjects. Factor analysis of the items were performed and test-retest correlation were evaluated. Internal consistency of the KPCSQ and its subscales was assessed with Cronbach's alpha. External validity of the KPCSQ were examined by correlation coefficient with the STAI-I, II, and CESD. Results:The Cronbach's alpha coefficient of the total PCSQ was 0.956. The test-retest reliability coefficient was 0.845. The PCSQ showed significant correlation with STAI-I, II and CESD. The factor analysis of the PCSQ yielded 4 factors model. Factor 1 represented 'affective and cognitive symptoms', factor 2 represented 'somatic symptoms', factor 3 represented 'infrequent symptoms' and factor 4 represented 'exaggeration or inattentive response'. There was no significant difference between the PCS group and the organic mental disorder group in the score on each measure. The scores on KPCSQ and its subscales in the subjects that had scored 5 or more in 'exaggeration or inattentive response' are significantly higher than those in the subjects had scored 4 in 'exaggeration or inattentive response'. Conclusions:This study suggests that the Korean version of PCSQ is a valid and reliable tool for assessing psychiatric symptomatology of patients with traumatic brain injury. Further investigations with greater numbers of subjects are necessary to assess the clinical usefulness of the KPCSQ.

Gender Differences of Direct and Relational Aggression in Children and Adolescents (국내 초등학생 및 중학생의 성별에 따른 직접적 공격성과 관계적 공격성의 차이)

  • Jeong, Da-un;Kim, Ji-Woong;Hong, Hyun-ju;Kim, Seung-Jun;Lee, Na-Hyun;Yang, Ji-sun;Ahn, Song-ii;Im, Woo-Young;Jhung, Kyungun
    • Korean Journal of Psychosomatic Medicine
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    • v.23 no.2
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    • pp.86-92
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    • 2015
  • Objectives : The aim of this study was to investigate the gender differences of direct aggression and relational aggression in Korean elementary and middle school students. Methods : Parents of 946 elementary school students(age $9.54{\pm}1.72$ years, 485 boys, 461 girls) completed the Child Behavior Checklist(CBCL). Six-hundred-and-three middle school students(age $13.98{\pm}0.93$ years, 301 boys, 302 girls) completed the Youth Self-Report(YSR). Independent t-test, chi-square test, and Fisher's exact test were used. Results : Boys had significantly higher direct aggression scores than girls in elementary school students(p<0.001). There was no significance gender difference of relational aggression in elementary school students(p=0.235). In middle school students, boys had significantly higher direct aggression than girls(p=0.017), and girls had significantly higher relational aggression compared to the boys(p<0.001). Conclusions : Our results suggest the presence of gender differences in manifestation of aggression subtypes in Korean elementary and middle school students. These gender differences should be taken into account in prevention and intervention approaches of aggression in children and adolescents.

Changes in prevalence of obesity according to gender in Korea adults: Using a population-based Korea National Health Check-up Database, 2011-2013 (우리나라 성인의 성별에 따른 비만유병률의 변화 : 국민건강보험 건강검진(2011-2013) 자료 이용)

  • Choi, Oh-Jong;Cho, Sung-Il
    • Korean Public Health Research
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    • v.44 no.4
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    • pp.87-97
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    • 2018
  • Background: Recently, the prevalence of obesity (body mass index [BMI] ${\geq}25kg/m^2$) has been increasing rapidly worldwide over a short period. In Korea, the prevalence of obesity has also increased rapidly due to the rapid socio-economic development and lifestyle changes, with differing patterns according to gender. This study aimed to compare the change in obesity prevalence according to gender among the adult population in Korea using representative data, the National Health Check-up Database (NHCD), to follow-up individuals who had undergone checkups during both years in Korea (2011~2013). Methods: To analyze the changes in obesity prevalence in the recent two years, data regarding men and women who had undergone health check-ups in both two years (2011, 2013) were extracted. The final study population comprised 144,934 persons: 83,604 (58%) males and 61,330 (42%) females. Chi-square test within a univariate analysis, and the level of factor difference was verified with t-test, one-way ANOVA and multiple comparison. Results: In 2011, one out of three participants was obese (BMI ${\geq}25kg/m^2$; male, 37.7%; female, 27.3%) and more than half of the subjects were overweight (BMI ${\geq}23kg/m^2$; male, 65.6%; female, 50.4%) requiring obesity management. For the two years, the BMI of the participants significantly increased (p < .0001) and the prevalence of obesity increased among both males and females. The prevalence of obesity was higher among both genders with a longer duration of smoking, more smoking, family history of hypertension, and family history of diabetes. However, residence, income level, drinking status, psychiatric disorder, disability status and severity of disability were the opposite gender. Conclusion: In the analysis of data, the prevalence of obesity among both men and women was increasing. The degree of change in the prevalence of obesity among men and women was different in each variable. Thus, it will need to consider gender in developing health policies for obesity mediation and to provide integrated healthcare and management for those people.

The Characteristics and Types of Psychiatric Consultation for Insomnia Symptom in Hospitalized Patients (불면증으로 의뢰된 입원환자의 임상적 특징 및 협진 유형 분석)

  • Jeon, Hansol;Ryu, Seung-Ho;Ha, Jee Hyun;Jeon, Hong Jun;Park, Doo-Heum
    • Sleep Medicine and Psychophysiology
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    • v.25 no.2
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    • pp.68-73
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    • 2018
  • Objectives: The purpose of this study was to explore insomniac demographic characteristics and the type of consultation provided to hospitalized patients asked to the Department of Psychiatry for insomnia and to compare patient insomnia characteristics by consultation type. Methods: We performed a retrospective chart review of 4,966 patients who were hospitalized from August 1, 2005 to December 31, 2011 that received consultation in the Department of Psychiatry. Among them, 236 patients were referred for insomnia. We compared the differences in demographic characteristics and types of consultation between the insomnia patient group and other patient group. We also compared the difference between demographic characteristics and type of consultation by dividing total subjects into 'with reconsultation' and 'without reconsultation' groups. Results: Our results came from the analysis of 9,689 consecutive consultation requests. There were 4,966 patients that participated in the study over 6 years and 6 months. The overall consultation rate was 3.3% of all admissions and insomnia patients comprised 4.8% of those. The ratio of re-consultation for insomnia was 27.5%. There was no significant difference in mean age between the insomnia 'with reconsultation group' and the insomnia 'without reconsultation group', but the 'with reconsultation' group had significantly more male patients and medical patients than the 'without re-consultation' group. For insomnia patients, consultation types were in the order of Mending request (51.3%), Paralle request (36.6%), Complementary request (9.0%) and this composition differed from that of total admission patients. Conclusion: Hospitalized patients referred for insomnia showed a higher proportion of male patients, lower rates of re-consultation compared with other patients, and most of these were for secondary insomnia. Each doctor should be aware of the possibility of inpatient insomnia, conduct positive assessments and referrals as necessary, and psychiatrists who might be asked for consultation need to prepare an active intervention with initial diagnosis and treatment, as well as recommendations for the timing of reconsultation.

Plasma Levels of Cytokines in Patients with Postpartum Depression (산후우울증 환자에서 혈장 Cytokine의 농도변화에 대한 전향적 연구)

  • Lee, Younjung;Kim, Yong-Ku;Kim, Kye-Hyun;Lee, Bun-Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.177-184
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    • 2020
  • Objectives : Postpartum depression is known to occur in 10-15% of mothers. The concentration of cytokine varies depending on stress, depression, pregnancy and general medical conditions. We hypothesized that the concentration of cytokines may be related to reproduction and childbirth, and that women with postpartum depression would show alterations in cytokines levels. Methods : A total of 104 pregnant women were selected as subjects, and 60 non-pregnant women were selected as normal controls. Symptoms of depression were evaluated in the pregnant study subjects using the diagnostic criteria outlined in the Edinburgh Postnatal Depression Scale (EPDS). The pregnant subjects were divided into three groups perinatal non-depression controls (n=61), postpartum depression-recovery (n=18), and postpartum depression (n=25). Results : The plasma concentration of TGF-β1, IGF-1 was higher in the pregnant group than in non-pregnant controls (TGF-β1 ; p<0.01, IGF-1 ; p=0.026). At 24 weeks of pregnancy and 6 weeks of delivery, there were no significant differences in the plasma concentration of TGF-β1, IGF-1, β-NGF, IL-2, IL-4, IL-6, IFN-γ, TNF-α between the three groups. There was no statistically significant difference in all three groups during the course of depression in pregnant women. Conclusions : This study found significant difference in plasma cytokines concentrations between non-pregnant controls and perinatal non-depression controls.

Job Characteristics and Status of Community Occupational Therapist : Focus on OTs in Public Health Centers (지역사회 작업치료사의 업무 특성 및 실태 조사 : 보건소 근무 작업치료사를 중심으로)

  • Min, Kyoung-chul;Kim, Eun-hee;Woo, Hee-soon
    • The Journal of Korean society of community based occupational therapy
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    • v.10 no.3
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    • pp.37-52
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    • 2020
  • Objective : This study was conducted to identify occupational therapists working in public health centers, the characteristics and actual conditions of occupational therapists in the community, and use them as basic data on occupational therapists in the community as of 2020. Methods : 77 questionnaires were replied by e-mail from OTs work at nationwide health public centers. Job characteristics and status were analysed by descriptive statistics and check correlation between job satisfaction and other factors. Results : Most survey respondents were female(77.9%) and 20-30(96.1%).. Some occupational therapists worked for dementia related team(72.7%) and others worked for like visiting care, health care, and rehabilitation center etc. Rate of experiences of public health center was 1-2 years(67.5%), the most common type of contract was flexible part-time worker(61%) and work intensity(94.8%) and satisfaction of work was very high(85.7%). The highest difficulty of their job was budget administrative work(26.7%) and of non-work difficulty was inequality under contracts(27.2%). They usually participated at dementia shelter, visiting OT, group OT. Difficulty of their job was high in budget administration, dementia shelters, and visiting work treatments. Goals of treatment were high in improvement of cognitive ability and, family support. Frequency of treatment was high in improvement of cognitive therapy, family support, and evaluation. Occupational therapy targets for health centers were dementia, the general elderly, and adult brain lesions, including those for ordinary people, psychiatric disorders and children. It was found that the primary occupations for evaluation were nurses (35.7%) and occupational therapists (33.7%), and that MMSE-DS, SGDS, and SMCQ were used a lot. Conclusion : This study could identify the job characteristics and status of community OTs. We hope that this result could be basic data for building expertise and role for community OTs in changing situations like community cares.

A Study on the Characteristics and Consultation Request Type of Inpatients Referred for Depressive Symptoms (우울 증상으로 의뢰된 입원환자의 임상적 특징 및 자문 의뢰 형태에 관한 연구)

  • Yoon, Nara;Ryu, Seung-Ho;Ha, Jee Hyun;Jeon, Hong Jun;Park, Doo-Heum
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.1
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    • pp.34-41
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    • 2021
  • Objectives : The purpose of this study is to investigate the characteristics of depressive patients who admitted to general hospital. We examined the clinical characteristics of patients who were referred to the Department of Psychiatry as depressive symptoms, according to the type of consultation request, and comparing 'with re-consultation' and 'without re-consultation' groups. Methods : We performed a retrospective chart review of 4,966 inpatients who were referred to the Department of Psychiatry from August 2005 to December 2011. Results : For about 6 years, among the inpatients referred for psychiatric consultation, a total of 647 patients were referred for depressive symptoms, accounting for 13.82% of the total consultations. The average age of depressive patients was 58.6 years, which was higher than the average of 56.4 years of overall patients. Among the depressive patients, 275 patients were included in 'with re-consultation' group and there was no statistically significant difference when comparing 'with re-consultation' group and 'without re-consultation' group. However, there was a difference in the tendency of the two groups in the type of consultation request. 'With re-consultation' group was in the order of frequency of consultation type 3-2-1, whereas the 'without re-consultation' group was in the order of frequency of consultation type 2-3-1. Conclusions : The group of inpatients who were referred for depressive symptoms in general hospital showed the largest proportion of the group of patients referred to the Department of Psychiatry. 'With re-consultation' group had a higher rate of re-consultation due to the occurrence of new symptoms after hospitalization compared to 'without re-consultation' group. Therefore, doctors in each department and psychiatrists should pay attention to the depressive symptoms of inpatients and actively discuss treatment plans to improve the quality of medical services, identify risk factors, and make efforts to intervene early if necessary.