• Title/Summary/Keyword: Psychiatric characteristics

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The Clinical and Prognostic Significance of Command Hallucinations in Schizophrenic Patients (정신분열병 환자에서 명령환각의 임상적 및 예후적 의의)

  • Yun, Kyu-Wol
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.1
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    • pp.82-88
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    • 1997
  • Background : Patients with command hallucinations are commonly assumed to be at high risk for dangerous behavior. However the issue of whether command hallucinations hold any clinical relevance in schizophrenic patients has not been established. Method : The author analyzed the clinical and research records of schizophrenic patients with auditory hallucinations who participated in outpatient research follow-up for 9 months after discharge. Patients with auditory hallucinations were classified as experiencing or not experiencing command hallucinations based on clinical psychiatric assessment. Results : Of 63 patients with auditory hallucinations, 29(46%) reported the command hallucinations and these hallucinations often were violent in content(44.8%). Patients with command hallucinations were not significantly different from patients without command hallucinations on sociodemographic and clinical characteristics, and clinical or prognostic course variables, but patients with command hallucinations had significantly more short hospitalizations(less than one month) than patients without command hallucinations. 3 of the patients with command hallucinations who committed suicide during the follow up periods were died. Conclusion : Command hallucinations may be frequent, and in most cases they have minimal influence on the outcome of schizophrenia, but if the patients with command hallucinations have a history of suicide attempts before admission, the possibility of suicide attempts by command hallucinations should be considered.

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New Approaches to Xerostomia with Salivary Flow Rate Based on Machine Learning Algorithm

  • Yeon-Hee Lee;Q-Schick Auh;Hee-Kyung Park
    • Journal of Korean Dental Science
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    • v.16 no.1
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    • pp.47-62
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    • 2023
  • Purpose: We aimed to investigate the objective cutoff values of unstimulated flow rates (UFR) and stimulated salivary flow rates (SFR) in patients with xerostomia and to present an optimal machine learning model with a classification and regression tree (CART) for all ages. Materials and Methods: A total of 829 patients with oral diseases were enrolled (591 females; mean age, 59.29±16.40 years; 8~95 years old), 199 patients with xerostomia and 630 patients without xerostomia. Salivary and clinical characteristics were collected and analyzed. Result: Patients with xerostomia had significantly lower levels of UFR (0.29±0.22 vs. 0.41±0.24 ml/min) and SFR (1.12±0.55 vs. 1.39±0.94 ml/min) (P<0.001), respectively, compared to those with non-xerostomia. The presence of xerostomia had a significantly negative correlation with UFR (r=-0.603, P=0.002) and SFR (r=-0.301, P=0.017). In the diagnosis of xerostomia based on the CART algorithm, the presence of stomatitis, candidiasis, halitosis, psychiatric disorder, and hyperlipidemia were significant predictors for xerostomia, and the cutoff ranges for xerostomia for UFR and SFR were 0.03~0.18 ml/min and 0.85~1.6 ml/min, respectively. Conclusion: Xerostomia was correlated with decreases in UFR and SFR, and their cutoff values varied depending on the patient's underlying oral and systemic conditions.

Association of the Comprehensive Attention Test and the Korean Wechsler Intelligence Scale for Children-Fourth Edition in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder

  • Min-Su Jang;Sang-Keun Chung;Jong-Chul Yang;Jong-Il Park;Joo-Han Kwon;Tae-Won Park
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.34 no.3
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    • pp.181-187
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    • 2023
  • Objectives: This study aimed to investigate the correlation between the Comprehensive Attention Test, Korean-Wechsler Intelligence Scale for Children-Fourth Edition, and Attention-Deficit/Hyperactivity Disorder (ADHD) Rating Scale-IV scores in children and adolescents with ADHD. Methods: Fifty-five children and adolescents diagnosed with ADHD and not taking psychiatric medications were included in this retrospective study. A correlation analysis was performed. Results: Although simple visual and auditory selective attention have diagnostic value in traditional continuous performance tests, this study revealed that inhibition-sustained attention and interference-selective attention are also effective in evaluating ADHD. Furthermore, the correlation between the attention and intelligence test scores varied depending on the use of visual or auditory stimuli. Conclusion: The findings of this study contribute to clarifying our understanding of the cognitive characteristics of children and adolescents with ADHD and can be used in future research.

A Prediction Model for Psychiatric Counseling for Depression among Subjects with Depressive Symptoms (우울증 대상자의 정신 상담 경험 여부 예측 모형)

  • Han, Myeunghee
    • Journal of Korean Public Health Nursing
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    • v.37 no.1
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    • pp.125-135
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    • 2023
  • Purpose: The number of patients suffering from depression is rapidly increasing worldwide, and by 2030, it is expected to pose a severe social and economic burden. Reports suggest that approximately 30% of subjects with symptoms of depression do not attempt treatment. Therefore, predicting the characteristics of subjects with depressive symptoms who have not even attempted counseling treatment is essential to increase the participation rate for such treatment. This study intends to predict the participation rates for psychological counseling treatment for depression among subjects with depressive symptoms. Methods: This study used data from the 2021 Korea Community Health Survey (KCHS). Data analysis was carried out using a decision tree to design a model that predicted participation in psychological counseling for depression. Results: The results showed that subjects aged 65 to 74 had difficulty understanding the explanations of medical staff even though they did not have cognitive impairment. Only 11.1% of this group received psychological counseling, which was the lowest rate among the various age groups. Among the subjects, 62.4% of those aged 19-44 or 45-64, who had suicidal thoughts and attempted suicide, received psychological counseling and this was the highest rate among the age groups surveyed. Conclusion: The identification of people showing depressive symptoms is crucial for encouraging them to undertake treatment. Also, proper depression-oriented medical services should be developed and implemented for people with depressive symptoms who exhibit a blind spot towards attempting treatment.

Prescribing Pattern of Clozapine and Clinical Factors associated with Discontinuation of Clozapine (클로자핀 처방 패턴 및 클로자핀 중단과 관련된 임상 요인)

  • Kang, Shi Hyun;Lee, Hey Won
    • Korean Journal of Schizophrenia Research
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    • v.22 no.1
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    • pp.1-7
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    • 2019
  • Objectives: Clozapine is the drug of choice in treatment-resistant schizophrenia. However, its use is often delayed and a significant proportion of clozapine treated patients fails to respond and experience potentially dangerous side-effects. The aim of this retrospective study was to describe the clinical characteristics of patients started on clozapine and the rate and reason of discontinuation of clozapine. Methods: Medical records of 83 patients started on clozapine during the period of 2012-2016 were reviewed. Results: Clozapine started on patients in chronic phase; the mean age of start was 38.1 years old and the mean number of psychiatric admission was 6.5. A majority (80.7%) of the patients had been subjected to antipsychotic polypharmacy prior to clozapine and most (61.5%) of them were being treated with polypharmacy including clozapine. Overall, 39 (47.0%) subjects had continued clozapine whereas 15 (18.1%) discontinued it; 29 (34.9%) were lost to follow-up. The most common reason for discontinuation was side-effects (n=13) including six life-threatening cases, most of which occurred within 6 months of its start. Conclusion: This study demonstrated that there is some evidence of delays to clozapine use, high rates of polypharmacy and significant rate of discontinuation during the early phase of clozapine treatment.

A Case of a Depressed Patient With Progressive Supranuclear Palsy (우울증으로 내원한 진행성 핵상 마비 환자 1례)

  • Seoyun Han;Jhin Goo Chang;Su Young Lee
    • Anxiety and mood
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    • v.19 no.2
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    • pp.56-60
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    • 2023
  • Progressive supranuclear palsy (PSP) is rare atypical Parkinsonism accompanied by various psycho-behavioural problems. In this case report, we describe the diagnostic and treatment progress of a 65-year-old PSP patient who visited the psychiatric clinic with a depressed mood and lumbar pain resulting in a suicide attempt. Over the course of 30 months of treatment, typical characteristics of PSP, such as postural instability, dyskinesia, cognitive dysfunction and supranuclear gaze palsy, became prominent, and magnetic resonance imaging and the F-18 FP-CIT positron emission tomography revealed midbrain atrophy and reduced dopamine uptake in the basal ganglia. When treating elderly patients with depression, parkinsonism symptoms such as gait disturbances, frequent falls, tremors, and rigidity should be closely examined.

Relationship of Level of Stress, Life Style, Subjective Symptoms and Clinical Diagnosis in Clients taken Multiphasic Screening Program (종합검진 수검자의 스트레스 수준과 생활습관, 자각증상 및 임상적 진단의 관련성)

  • Park, Jun-Han;Chun, Jin-Ho;Kang, Jang-Mi;Son, Byung-Chul;Kim, Dae-Hwan;Lee, Chang-Hee;Jeong, Kui-Won;Urm, Sang-Hwa
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.4 s.63
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    • pp.728-739
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    • 1998
  • To improve wellness and quality of life by recognizing the health efforts of stress, the author estimated the relationships between stress, subjective symptoms and clinical diagnosis through a questionnaire and a battery of specified laboratory tests; electrocardiography, blood pressure, cholesterol, aspartate aminotransferase(AST), alanine aminotransferase(ALT), gamma glutamyl transferase$(\gamma-GTP)$, fasting blood sugar, gastro-endoscopy or UGI, abdominal sonography, etc. The data was gathered from 337 clients who were undergoing multiphasic screening program at a University Hospital from January to March 1998. The mean age of subjects was $46.5{\pm}11.2$ years and the mean of body mass index was $24.0{\pm}3.7kg/m^2$. The mean vol of stress was $18.5{\pm}6.0$ expressed as the score out of 40. By general characteristics and lift style among male, mean level of stress was significantly higher in case of lower socioeconomic status, habitual drug use, longer daily working time(>10 hours), no regular exercise, drinkers, irregular meal, skip-ping breakfast(p<0.05). In case of female, that was significantly higher in case of lower education, lowe. socioeconomic status, longer daily working time(>10 hours), no regular exercise, drinkers, smokers, irregular meal, skipping breakfast(p<0.05). Significant correlations were observed between stress and subjective symptoms in all kinds of organ system (p<0.01). Correlation coefficients of stress among male were relatively high with neuro-psychiatric symptom$(\gamma=0.476)$ and cardio-vascular symptom$(\gamma=0.361)$ in order, and correlation coefficients of stress among female was highest with neuro-psychiatric symptom$(\gamma=0.371)$. The prevalence of the diagnosis through the battery of laboratory tests was high in upper gastrointestinal disorders and hypercholesterolemia in order in both sex group. Among male the mean score of stress was significantly high in ulcerative peptic disorder of upper gastrointestine and hepatopathy in order (p<0.05) . Among female that was significantly high in diabetes mellitus. In summary, it is likely that there are associations between stress, subjective symptoms and clinical diagnosis. To promote wellness and quality of life it would be of value that periodic stress evaluation program and stress management including apropriate control of smoking and drinking, regular exercise and meal.

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Analysis of Clinical Characteristics by Gender in Children and Adolescents with Intentional Poisoning at Emergency Department (의도적 음독으로 응급실에 내원한 소아 청소년 환자들의 성별에 따른 특성 분석)

  • Kim, Yun Jae;So, Byung Hak;Kim, Hyung Min;Jeong, Won Jung;Cha, Kyeong Man;Kim, Seong Wook
    • Journal of The Korean Society of Clinical Toxicology
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    • v.12 no.2
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    • pp.63-69
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    • 2014
  • Purpose: The aim of this study is to investigate the difference between male and female in some clinically meaningful aspects and to prevent intentional poisoning in children and adolescents. Methods: Retrograde medical records review of patients who visited the emergency department of two secondary hospitals for drug ingestion from March 2010 through March 2013 was performed. Unintentional ingestion or ingestion by others was excluded. Results: A total of 138 cases were reported, male 25.4% (n=35), female 74.6% (n=103). The reason for poisoning was intentional in 132 cases (95.7%) and misuse in six cases (4.3%). In female patients, non-prescription drugs was the most common cause of intentional poisoning (68.9%). Male patients tend to use life substances for intentional poisoning more frequently (20.0%) than female (3.9%). Seven male patients and 12 female patients had previous psychiatric history and 34.3% of male and 41.7% of female were consulted to the psychiatric department. Conclusion: Female adolescents are more likely to ingest drugs intentionally for suicide attempt than males of comparable ages. The drugs they ingested were, in many cases, obtained with ease from the drug store nearby and, remarkably, most of the drugs they obtained in that way were acetaminophen-containing. This suggests that some guidelines or control in the pharmacy that restrict children or adolescents from obtaining potentially or possibly life-threatening drugs might be necessary. In addition, education regarding drugs is thought to be necessary in school for teenagers as they tend to misuse them with incorrect acknowledgement.

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A Delphi Study for Constructing a Suicide Prevention Protocol for Male Baby Boomers (베이비붐세대 남성의 자살 예방 프로토콜 구성을 위한 델파이 연구)

  • Kim, Hee-SooK;Shin, Eun-Jeong;Kim, Gab-Yeon
    • Journal of Internet of Things and Convergence
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    • v.7 no.1
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    • pp.43-54
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    • 2021
  • Purpose: The purpose of this study was to construct a protocol for the prevention of suicide in male baby boomers. Methods: In order to construct the protocol, a three-step expert consensus process was carried out. The first step was to compose questions based on various research data. For this purpose, two professors of psychiatric mental health nursing and two advanced practitioner nurse of psychiatric mental health in the composition. The second step was to conduct the first Delphi survey on expert panelists. The survey period was from October 13, 2015 to November 1, 2015. The third stage, the second Delphi investigation was conducted from November 10 to December 4, 2015. Results: As a result of the survey, a total of 7 areas of protocol configuration items were derived. The derived items include the characteristics of male baby boomers, suicidal signs, suicide risk factors, suicide protection factors, suicide measurement tools, related organizations, and mental health promotion programs. Conclusion: This study can be used as a guideline when intervening suicide prevention of male baby boomers in community mental health centers.

Clinical Diagnosis and Emotional Behavioral Characteristics Study of Children in a Special Education Class in Korean Elementary School (초등학교 특수학급아동의 임상적 진단 및 감정 행동특성 연구)

  • Lim Myung-Ho;Kang Jin-Kyung;Lee Joo-Hyun;Kim Hyun-Woo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.17 no.2
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    • pp.114-123
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    • 2006
  • Objectives : The special class has been made, bringing rapid increase quantitatively. The authors carried out the child psychiatric interview and evaluation for 9 special-classed children in Asan city to find out clinical diagnosis and emotional/behavioral characteristics. Methods : The child psychiatrists evaluated special class children by DSM-IV and K-SADS-PL. Tools for the evaluation were Child Behavior Checklist- Korean version, Korean Personality Inventory for Children, Children's Depression Inventory, Abbreviated Conners Parent-Teacher Rating Scale-Revised, State-Trait Anxiety Inventory for Children, Vineland Social Maturity Scale, Wechsler Intelligence Scale for Children-III, and Childhood Autism Rating Scale. Results : Ultimately 53 children, consisting of 35 boys(67.9%) and 18 girls(32.1%), participated, and the average age was $10.5{\pm}1.3$ years old. Their measure of Vineland Social Maturity Scale was $78.7{\pm}20.0$, Childhood Autism Rating Scales was $25.4{\pm}9.0$, Child Depression Inventory was $22.2{\pm}5.2$, State-Trait Anxiety Inventory for Children was $35.2{\pm}8.2/36.5{\pm}6.2$, and Abbreviated Conners Parent-Teacher Rating Scale was $11.0{\pm}4.6$. In the clinical diagnosis evaluation, the prevalence rate of learning disorder was decreased compared to early research, ADHD had been newly appeared and depression disorder and anxiety disorder had been increased. Conclusion : This result suggests that a lot of children in a special class have complex emotional and behavioral problems in addition to educational problems.

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