• Title/Summary/Keyword: Psychiatric diagnosis

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Importance of CADASIL research in Jeju: a review and update on epidemiology, diagnosis, and clinical spectrum (제주도에서 CADASIL 연구의 중요성: 역학, 진단 및 임상양상에 대한 고찰)

  • Choi, Jay Chol;Lee, Jung Seok;Kim, Kitae
    • Journal of Medicine and Life Science
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    • v.17 no.3
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    • pp.65-73
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    • 2020
  • Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a single-gene disease of the cerebral small blood vessels caused by mutations in the NOTCH3 gene on chromosome 19. Although CADASIL was known as a rare disease, recent research has suggested that the NOTCH variants could be found frequently even in the general population. The main clinical features included recurrent stroke, migraine, psychiatric symptoms, and progressive cognitive decline. On brain magnetic resonance imaging, patients with CADASIL showed multifocal white matter hyperintensity lesions, lacunar infarcts, microbleeds, and brain atrophy. Among them, lacunar infarcts and brain atrophy are important in predicting the clinical outcomes of patients with CADASIL. In the Jeju National University Hospital, we have diagnosed 213 CADASIL patients from 2004 to 2020. Most NOTCH3 mutations were located in exon 11 (94.4%), and p.Arg544Cys was the most common mutation. The mean age at diagnosis was 61.0±12.8 years. The most common presenting symptoms were ischemic stroke (24.4%), followed by cognitive impairment(15.0%), headache (8.9%), and dizziness(8.0%). Although the exact prevalence of CADASIL in Jeju is still unknown, the disease prevalence could be as high as 1% of the population considering the prevalence reported in Taiwan. Therefore, it is necessary to discover efficient biomarkers and genetic tests that can accurately screen and diagnose patients suspected of having CADASIL in this region. Ultimately, it is urgent to explore the exact pathogenesis of the disease to identify leading substances of treatment potential, and for this, multi-disciplinary research through active support from the Jeju provincial government as well as the national government is essential.

Comparative Analysis of decreased Mental state Patients after Overdose with Sedative-hypnotics (진정수면제 음독 후 의식저하로 내원한 환자의 급성중독 비교)

  • Oh, Seung Jae;Cho, Soo Hyung;Ryu, So Yeon
    • Journal of The Korean Society of Clinical Toxicology
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    • v.20 no.1
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    • pp.8-14
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    • 2022
  • Purpose: This study was undertaken to investigate how sedative-hypnotics affect the occurrence and severity of the patient's symptoms. In addition, we conducted a study to determine the type of patients who reacted severely and required hospitalization; patients were accordingly classified as hospitalized patients and patients discharged from the emergency room. Methods: From January 2017 to December 2019, we investigated the demographics, drug information, history, laboratory tests, and severity of patients who visited our emergency department and were diagnosed with benzodiazepine, zolpidem, and doxylamine succinate overdose. We further compared details of hospitalized patients and discharged patients. Results: Subjects who had overdosed and visited the ED included 120 for benzodiazepine, 147 for zolpidem, and 27 for doxylamine succinate. Comparisons between the three groups revealed differences in their early diagnosis, psychiatric history, and sleep disturbance. Differences between groups were also determined for mental state, poisoning history, treatment received in the intensive care unit, and intubation and ventilator support. In cases of benzodiazepine overdose, we obtained a high hospitalization rate (40.0%), admission to the intensive care unit (24.2%), and intubation rate (18.3%). Comparisons between hospitalized patients and discharged groups showed differences in transferred patients, early diagnosis, and mental state. Conclusion: Patients poisoned by sedative-hypnotics are increasing every year. In cases of benzodiazepine and zolpidem, the hospitalization rates were high, and benzodiazepine overdose resulted in hospitalization, intensive care unit admission, and pneumonia in a majority of cases. Therefore, active treatment and quick decisions in the emergency room are greatly required.

A Study on Nursing Diagnoses, Interventions, Outcomes Frequently Used and Linkage to NANDA-NOC-NIC in Major Nursing Departments (간호 대상자별 다빈도 간호진단, 간호중재, 간호결과 및 연계 체계조사)

  • Kim, Jong-Kyung
    • Journal of Korean Academy of Nursing Administration
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    • v.16 no.2
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    • pp.121-142
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    • 2010
  • Purpose: The purpose of this study was to identify NANDA, NIC, and NOC frequently used and their linkages in major nursing departments for development of the nursing process and nursing management system. Methods: This study was a descriptive study. Data were collected from 123 nurses who worked in medical, surgical, pediatric, gynecologic, and psychiatric department. The questionnaire was based on the NANDA, NOC, NIC, and NANDA-NOC-NIC linkage system. This research was analyzed by an EXCEL program and SPSS $Pc^{+}15.0$. Results: Nursing diagnoses frequently used were 'anxiety', 'disturbed sleep pattern', 'activity intolerance', 'social isolation', 'nausea', 'ineffective airway clearance', 'chronic pain', nursing outcomes frequently used were 'thermoregulation', 'bowel elimination', 'pain control', 'vital sign status', 'pain level', and nursing interventions frequently used were 'nausea management', 'airway suctioning', 'bowel elimination management', 'diarrhea management', 'medication management'. NANDA-NOC-NIC linkages in major nursing departments were recognized, and these results were similar to the results of other researches. Conclusion: The results of this study will be provided as a guideline to apply to the nursing process and development of the nursing process system with the NANDA-NOC-NIC linkage in major nursing department.

Current Status of Health Screening in Korea (한국의 건강검진 현황)

  • Jo, Han-Ik
    • Journal of Korea Association of Health Promotion
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    • v.2 no.3
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    • pp.73-96
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    • 2004
  • Along with a development of medical technology, a variety of tests, such as laboratory tests, x-ray and endoscopies are being used in health screening tests. As the tests determine the quality of health screening, test items and methods should be carefully selected. This study was to get hold of the test items of major health screening programs in Korea Most of the health screening programmes focused upon detection of risk factors and diagnosis of life - style related diseases (diabetes, hypertension, cardiovascular diseases, hypercholesterolemia, overweight, drinking, smoking, cerebrovascular diseases, osteoporosis) ,cancers (stomach, cervix, lung, breast, liver, colon, prostate, ovary, pancreas, thyroid, esophagus) , infectious diseases (hepatitis, tuberculosis, sexually-transmitted diseases, parasites) , chronic obstructive respiratory diseases, chronic renal diseases (bacteriuria hematuria, proteinuria) , anemia, glaucoma, hearing loss, Alzheimer disease, stress, early psychiatric diseases. The health screening tests were basic physical examination, basic laboratory tests (CBC, urinalysis, liver function tests, lipid tests, glucose, HbAlc, uric acid, electrolytes, serological tests (HBsAg, HBs-Ab, HCV-Ab, HIV-Ab, VDRL) EKG, x-ray (chest PA, CT) , endoscopy (gastroscopy, colonoscopy) , sonography(abdomen, thyroid, pelvis, breast) ,cytology (cervix) , bone density, tumor markets (NMP22, alpha-FP, CEA, CA-19-9, CA12S, PSA) and eye tests. Advanced technologies, like CT, PET, MRI, MRT/Angio, molecular testings) were widely used in hospital health screening programmes .In summary, a variety of tests were utilized in health screening in Korea. Those tests were utilized by stages or according to sex and age in most of health screening programmes, however a few program used tests to excess disregarding health screening subjects.

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Development of the Children's Separation Rating Scale Its Clinical and Research Use (아동분리반응척도의 개발 : 임상 및 연구응용)

  • Kim, Wun-Jung;Hahn, Sung-Up
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.148-160
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    • 1990
  • This paper reports on the development of the Children's Separtion Rating Scale(CSRS), its initial reliability and validity, and clinical/research utility with psychiatrically hospitalized children. The CSRS appears to be a reliable and valid instrument, and useful in distinguishing children's separation reaction from their general psychopathology. It may be also useful in aiding clinicians in differential diagnosis. This study points to the need for further understanding of children's psychiatric hospitalization in relation to their separation reaction and its possible untoward effects. Findings of this pilot study support the notion that inpatient treatment programs should address the developmental needs and abilities of the various age groups and the particular deficits reflected in their psychopathology.

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The Use of Virtual Reality in Psychiatry: A Review

  • Kim, Suji;Kim, Eunjoo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.31 no.1
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    • pp.26-32
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    • 2020
  • With the advancement in modern information technology, virtual reality (VR) is being increasingly used for the diagnosis, assessment, and treatment of mental disorders. Recently, a VR-based cognitive behavioral therapy for social phobia has been recognized as a new medical technology in South Korea. This might lead to an increase in the use of VR in the field of psychiatry. The present review provides an overview of the status of VR therapies in various psychiatric conditions such as anxiety disorder, post-traumatic stress disorder, psychosis, addiction, and eating disorder. Besides, it summarizes the role of VR therapy in the management of disorders associated with child and adolescence psychiatry as well as various other clinical applications. Additionally, we discuss the merits and limitations of VR therapy, which might serve as a useful reference for researchers. In the current environment wherein novel medical models consisting of a combination of digital devices and medicine are being developed; understanding new technologies such as VR could open new doors to mental health treatments.

Living Experiences of Indian Adult Cancer Survivors - a Brief Report

  • Mohanti, Bidhu Kalyan;Kaur, Jaspreet
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.507-512
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    • 2015
  • Background: This pilot study looked into the physical, social, psychological and economic issues of Indian adult cancer survivors. Materials and Methods: Assumed cancer free patients, after cancer directed therapy (CDT), were assessed on the basis of a questionnaire developed by the investigators. The mental status of the survivors was elicited by modified MINI international neuro-psychiatric interview. This cross sectional assessment was conducted as a direct interaction with each patient for 30 to 45 minutes at a cancer hospital in 2012. Results: Thirty one adult cancer survivors participated in this study. Median age was 53 years with a median follow up duration of 21.8 months (Range 2.3-194.1 months). The majority (68%) did not receive financial support for treatment. Median interval after CDT to start of activity of daily living was 1.5 months (range: 0-24 months). Fatigue and loss of appetite were reported by 52% and 29% respectively. The cancer diagnosis and its treatment adversely impacted the financial condition in 42% of patients. Nineteen percent each showed social anxiety and post-traumatic stress disorder and another 13% patients reported depression. Conclusions: This prospective assessment highlights survivorship issues and the need to address those issues particularly in the context of developing countries where resources and manpower are limited.

The Korean Practice Parameter for the Treatment of Pervasive Developmental Disorders : Clinical Manifestation, Epidemiology, Course, Causes, and Comorbidity (전반적 발달장애의 한국형 치료 권고안 : 임상양상, 역학, 경과, 원인, 동반질환)

  • Yoo, Han-Ik;Cho, In-Hee;Yoo, Hee-Jeong;Koo, Young-Jin;Chung, Un-Sun;Ahn, Joung-Sook;Ahn, Dong-Hyun;Son, Jung-Woo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.18 no.2
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    • pp.88-96
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    • 2007
  • Pervasive developmental disorders are characterized by lifelong impairments in fundamental social and/or communication skills and by the presence of seemingly purposeless and repetitive behaviors, interests, or activities. A number of possible biological etiologies, including genetic, structural and functional brain abnormalities, have been identified in patients with pervasive developmental disorders. In addition, clinicians should take the possibility of comorbid psychiatric conditions into consideration when making the differential diagnosis of pervasive developmental disorders.

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Pediatric Crohn's Disease presenting as Severe Constipation and Abdominal Distension (심한 변비와 복부팽만으로 발견된 소아 크론병 1예)

  • Sung, Myong-Soon;Kang, Seok-Jeong;Choi, Kwang-Hae
    • Journal of Yeungnam Medical Science
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    • v.25 no.2
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    • pp.139-144
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    • 2008
  • Crohn's disease is a chronic inflammatory bowel disease that mainly affects children and young adults. Its cause remains unknown. The incidence of pediatric Crohn's disease is increasing, so it is important for clinicians to be aware of the presentation of this disease in the pediatric population. The majority of patients complain of abdominal pain (72%), with only 25% presenting with the 'classical triad' of abdominal pain, weight loss, and diarrhea. Many children with Crohn's disease present in a 'non-classical' manner, with vague complaints such as lethargy or anorexia, which may be associated with only mild abdominal discomfort. Other symptoms include fever, nausea, vomiting, growth retardation, malnutrition, delayed puberty, psychiatric symptoms, arthropathy, and erythema nodosum. Severe constipation and abdominal distension are uncommon symptoms at diagnosis. We report a case of pediatric Crohn's disease, which was diagnosed after the patient presented with severe constipation and abdominal distension.

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Cognitive Behavioral Therapy in Childhood Tic Disorder : A Case of Report (틱 장애 아동의 인지행동치료 증례: 5회기 습관뒤집기 훈련과 호흡훈련을 중심으로)

  • Song, Jung-Rim;Hong, Jong-Woo;Doh, Jin-Ah;Kim, Hyun-Woo;Lim, Myung-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.22 no.1
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    • pp.38-43
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    • 2011
  • Chronic tic disorder or Tourette syndrome is known to be a chronic neuro-behavioral disease for which cognitive behavioral therapy (CBT) strategies have recently been introduced. Here, we report the effectiveness of CBT in a case of childhood chronic tic disorder, which is very common in clinical settings. The DSM-IV clinical diagnosis was applied by a child psychiatrist. The Yale Global Tic Severity Scale, Kovac's children's depression inventory, Spielberger State-Trait Anxiety Inventory, Abbreviated Conners' Rating Scales, and the Dupaul ADHD Rating Scales were used. This case involved a pharmacological treatment-refractory patient over the previous year. Thus, psychiatric consultation was undertaken. Subsequently, we administered five sessions of CBT for four weeks, consisting of symptom evaluation and planning, habit reversal training, and ventilation training. Following four weeks of CBT administration, there were improvements in the scores of the Yale Global Tic Severity Scale and the Clinical Global Improvement scale. Our observations indicate that CBT may be effective in the treatment of childhood tic disorder.