• Title/Summary/Keyword: Psychiatric diagnosis

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Psychiatric Consultation for 5 Years in a University Hospital (일 대학병원에서 5년간 시행된 정신과 자문의뢰 분석)

  • Kim, Sung-Wan;Kim, Seon-Young;Kim, Sung-Jin;Kim, Jae-Min;Shin, Il-Seon;Yoon, Jin-Sang
    • Korean Journal of Psychosomatic Medicine
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    • v.19 no.1
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    • pp.28-33
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    • 2011
  • Objective: This study aimed to investigate the pattern of psychiatric consultation-liaison in a new general hospital over a 5-year period. Method: Retrospective chart review was conducted for psychiatric consultations performed from May 2004 to December 2008 in a new general hospital in Hwasun, Korea. Results: A total of 1,852 patients who were referred to the Department of Psychiatry for consultation were included in the analysis. The main reasons for psychiatric consultation were changes in mental status(20.5%), depression(16.8%), insomnia(12.8%), and anxiety(7.9%). Psychiatric consultations were conducted with diagnoses of delirium(39.7%), depressive disorder(28.2%), adjustment disorder(7.9%), and anxiety disorder(4.1%). Patients with delirium were significantly older than were those with other psychiatric diagnoses(p<0.001). Delirium was more common in male patients than in female patients(47.1% vs. 29.9%, respectively), and depression was more common in female patients than in male patients(48.3% vs. 33.9%, respectively)(p<0.001). Delirium was more common in patients who underwent surgical operation than those who did not(p=0.010). Conclusion: Delirium was the most common diagnosis for psychiatric consultation followed by depression in a university hospital. Delirium was more prevalent in men than in women, while depression was more common in women.

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Medical Care Utilization Status and Associated Factors with Extended Hospitalization of Psychiatric Patients in Korea (우리나라 정신질환자의 의료이용 현황과 장기입원 관련 요인)

  • Suh, Soo-Kyung;Kim, Yoon;Park, Jong-Ik;Lee, Myung-Soo;Jang, Hong-Suk;Lee, Sun-Young;Lee, Jin-Seok
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.6
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    • pp.416-423
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    • 2009
  • Objectives : This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization. Methods : Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. Results : The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. Conclusions : The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.

A Review of Clinical Studies for Journal of Oriental Neuropsychiatry - since 2001 to 2010 - (동의신경정신과학회지에 게재된 임상연구논문 동향분석 - 2001년부터 2010년까지 -)

  • Heo, Eun-Jung;Jeon, Won-Kyung;Kim, Wu-Young;Han, Chang-Hyun
    • Journal of Oriental Neuropsychiatry
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    • v.22 no.3
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    • pp.115-125
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    • 2011
  • Objectives : This study was aimed to review the trend of clinical studies in Journal of Oriental Neuropsychiatry since 2001 to 2010. Methods : We collected 260 clinical studies and analyzed them for publish year, sorts of disease or symptoms, pattern identification diagnosis, and classification of clinical studies. Among them, we selected 46 clinical experimental studies and these studies were further analyzed for publish year, research institution, sort of disease or symptoms, sorts of treatments, number of subject, and pattern identification diagnosis. Results : The number of clinical studies in Journal of Oriental Neuropsychiatry have increased since the year of 2001. There were 62 kinds of diseases and symptoms and Hwa-Byung had the highest number of studies followed by depression, headache, insomnia and so on. The clinical experimental studies, which took up 17% of the clinical studies, have increased since 2001 and was varied with year. There were 13 reserch institutions for clinical experimental studies and they studied about stress, dementia, Hwa-Byung, and so on. Most of studies researched treatment about acupuncture, herb medicine, and meditation treatment for persons under 144. There are only 22% of studies using pattern identification diagnosis. Conclusions : For the development of oriental medicine for psychiatric disease, we need more qualifying clinical studies like RCT. We hope more researchers for psychiatry disease of oriental medicine will be interested in the publication of clinical studies and this will serve to produce advance of oriental medicine as evidence based medecine.

Diagnosis and Treatment of Restless Leg Syndrome and Periodic Limb Movement of Sleep (하지불편 증후군과 주기성 사지운동장애의 진단과 치료)

  • Ham, Byung-Joo
    • Sleep Medicine and Psychophysiology
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    • v.10 no.1
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    • pp.26-31
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    • 2003
  • Restless leg syndrome (RLS) and periodic limb movement of sleep (PLMS), often concurrent, come under diagnosed disorders of sleep and treatable condition. RLS symptoms are evoked in the limbs at rest and increase in the evening and during the night. PLMS is characterized by periodic episodes of repetitive limb movements caused by muscle contractions during sleep. RLS is often associated with a sleep complaint and PLMS. Both RLS and PLMS represent one of the most commonly encountered sleep disorders in a primary care setting. The circadian rhythm and the presence of PLMS cause sleep disturbances in RLS. The emphasis on pathophysiology includes consideration of central nervous system localization, neurotransmitter, and the role of iron metabolism. Dopaminergic agents are considered the treatment of choice for RLS and PLMS. With proper diagnosis and effective treatment patients' ability to fall asleep and maintain sleep improves, and their sense of well being increases.

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Changes in Psychotropic Prescription Patterns in Patients Admitted to an Open Psychiatric Ward : Eleven-Year Comparison in a University Hospital in Gyeonggi-Do (정신건강의학과 개방병동 입원 환자의 진단군별 약물 처방 경향 변화 : 경기도 소재 일 대학병원에서의 11년 비교 연구)

  • Byun, Seonjeong;Kim, Euitae;Yoo, Hee Jeong;Ha, Tae Hyon;Yoon, In-Young;Kim, Ki Woong
    • Korean Journal of Biological Psychiatry
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    • v.22 no.4
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    • pp.195-204
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    • 2015
  • Objectives This study investigated the patterns of psychotropic medications prescribed to patients admitted to an open psychiatric ward. Methods We reviewed 4282 medical records of patients who were discharged from an open psychiatric ward from May 2003 through April 2014. Data were collected on each patient's age, sex, length of hospital stay, number of past admissions, discharge diagnosis, and kinds and dosages of psychotropic medications at discharge. Results Among the 1384 male and 2898 female patients, 3.56 psychotropic medications were prescribed on average, with the number increasing across years, from 3.30 in 2003-2008 to 3.76 in 2009-2014. Prescription rates of antipsychotics, anxiolytics, and hypnotics significantly increased in patients with depressive disorders, bipolar disorders, anxiety disorders, delirium, dementia, and amnestic and other cognitive disorders. Only lithium prescription rates decreased significantly. Prescriptions for two or more anxiolytics and antipsychotics increased during the survey years, while antidepressant polypharmacy rates decreased. Conclusions Recently, there has been a significant increase in the number of psychotropic medications prescribed, including antipsychotics, anxiolytics, and hypnotics. Caution should be exercised when prescribing medications to avoid cost increases and the risk of side effects, with uncertain gains in the quality of care.

Psychiatric Evaluation of Maladaptive Male Conscripts in a Division of the Republic of Korean Army : Focus on Green Camp Participants (한국 육군 일개 사단에서 군 복무 부적응자들의 정신의학적 평가 : 그린캠프 참가자들을 중심으로)

  • Kim, Ju-Hyun;Kang, Suk-Hoon;Ye, Byoung-Seok;Hwang, Hyun-Kuk;Suh, Jae-Won;Chai, Gong-Ju;Lee, Hwan-Bae;Kim, Chan-Hyung
    • Anxiety and mood
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    • v.6 no.2
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    • pp.131-136
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    • 2010
  • Objectives : In this study, we aimed to elucidate the demographic and psychological characteristics of maladaptive soldiers in the Republic of Korean Army. Methods : Study participants included 110 male conscripts who had participated in the Green camp, which was a form of group psychosocial treatment program for maladaptive soldiers. All participants were interviewed and diagnosed by a psychiatrist, and classified into two groups according to whether they left or rejoined the army. We analyzed the differences between these two groups in terms of demographic features, psychiatric diagnosis and the Minnesota Multiphasic Personality Inventory (MMPI) subscores. Results : Compared with soldiers who rejoined their units, those who left military service exhibited significantly lower educational level (p=0.041) and a higher rate in psychiatric treatment prior to enlistment (p=0.011). Among the 106 subjects, 63 (59.4%) and 23 (21.7%) were diagnosed with personality disorder and adjustment disorder, respectively. Further, those who left military service were diagnosed more frequently with mood disorder (p=0.001) and schizophrenia (p=0.014) than those who rejoined their units. Additionally, the MMPI scores of soldiers who left military service were significantly higher on the psychasthenia (p=0.028) and schizophrenia (p=0.039) scales than those of soldiers who rejoined their units. Conclusion : Most of the maladaptive soldiers were diagnosed with mental disorders. The results of this study suggest that systematic, consistent psychiatric evaluation and intervention for maladaptive male conscripts is crucial in the Republic of Korean army.

Relationship among Dysfunctional Attitudes, Stress Coping Strategies and Depressive Symptoms in Psychiatric Patients (정신질환자들의 역기능적 태도, 스트레스 대처 방식 및 우울증상 간의 관계)

  • Park, Chan-Moo;Seo, Kyung-Ran;Rhee, Min-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.1
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    • pp.31-42
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    • 1997
  • This study was aimed to investigate dysfunctional attitudes, stress coping strategies and depressive symptoms in psychiatric patients. The subjects of this study consisted of 210 patients(138 schizophrenic patients, 29 depression patients, 43 alcohol dependence patients) according to DSM-IV criteria. Futhermore, the instruments were K-BDI(Beck Depression Inventory-Korean version), DAS(Dysfunctional Attitude Scale) and multidimensional coping strategy scale. The results were the following. 1) There were statistically significant correlations between depressive symptoms and dysfunctional attitudes in psychiatric patients. 2) In terms of coping strategies, there were positive correlations between depressive symptoms and focus on and venting emotions, accommodation, active forgetting, self-criticism, positive comparison, fatalism, passive withdrawal. Whereas, there was significant negative correlation between depressive symptom and active coping. 3) In terms of coping strategies, there were significant correlations between dysfunctional attitudes and focus on and venting emotions, active forgetting, self-criticism, positive comparison, fatalism, passive withdrawal. 4) Depression groups reported significantly higher BDI scores than schizophrenia groups. 5) In depression groups, DAS scores were significantly higher than those in schizophrenia groups. 6) In terms of coping strategies according to diagnosis, there were significant differences in venting emotions, active forgetting and self-criticism. As for venting emotions, alcoholic groups were scored significantly higher than schizophrenic groups. As for active forgetting, depression groups were scored significantly higher than schizophrenic groups. In self-criticism, depression groups and alcohol dependence groups reported significantly higher scores than schizophrenic groups.

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Comparison of Prescription Patterns and Clinical Features according to Clinical Departments in Sedative-hypnotic Intoxication (진정수면제 중독 환자의 처방과에 따른 처방 및 임상양상 비교)

  • Kim, Do Min;Park, Won Bin;Lim, Yong Su;Kim, Jin Joo;Jang, Jae Ho;Jang, Jee Yong;Yang, Hyuk Jun;Lee, Geun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.12 no.2
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    • pp.54-62
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    • 2014
  • Purpose: The purpose of this study was to compare prescription patterns and clinical features according to clinical departments in sedative-hypnotic intoxication. Methods: This was a retrospective study of histories, substances of poisoning, acquisition routes, clinical courses, and outcomes of patients treated for acute intoxication in a single emergency medical center from January, 2011 to December, 2013. Results: A total of 769 patients were treated for acute intoxication, 281 patients ingested sedative hypnotics during the study period. Among 281 patients, 155 patients were prescribed by psychiatric department and 80 patients were prescribed by non-psychiatric department. Benzodiazepines were more likely to be prescribed by psychiatrists, and zolpidem was preferred by non-psychiatrists (p<0.001). Non-psychiatrists were more likely to prescribe short acting benzodiazepines than psychiatrists (p<0.001). However, there was no statistically significant difference in the clinical outcomes, including prevalence of admission to ICU, ventilator care, and length of stay in ICU. In patients prescribed by non-psychiatrists, there were more patients prescribed without psychiatric diagnosis and diagnosed as major depression disorder after hospitalization. Conclusion: To promote rational prescribing of sedative hypnotics, proper psychiatric evaluation should be performed before prescribing, and educational programs including the contents of interactions and side effects of sedative hypnotics are needed.

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Cognitive and Psychological Characteristics of Psychiatric Patients with Military Service Eligibility Issues (군 복무 적합성 판정을 위해 내원한 환자들의 인지적 및 심리적 특성)

  • Nam, Jisoo;Choi, Junho;Kim, Eunkyeong
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.119-129
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    • 2019
  • Objectives : The purpose of this study was to examine cognitive and psychological characteristics of patients who visited psychiatric outpatient clinic with military service suitability issues. Methods : Since January, 2017 to September, 2018, patients were recruited from the department of psychiatry of university hospital. Participants were diagnosed using DSM-5 criteria by board certified psychiatrists. And each of participants tested with K-WAIS-IV, K-SCL-95 by clinical psychologist. The data were analyzed using SPSS 18.0. Results : The results indicated 24.6% of the patients have significantly low level of intellectual functioning. and 10.8% of the patients have borderline level of intellectual functioning, and 26.3% of them were below average. The results of psychological characteristics showed patients have cautious and potentially dangerous level of depression, anxiety, agoraphobia, and suicidal idea. And PTSD subscale's mean score was above problematic level. Next, we divided patients into two groups based on question of whether the patient is eligible to serve in the military service or not arises from recruitment process or army training center. But two group didn't differ significantly. And for further analyses, we also divided patients into two groups based on if they got single psychiatric diagnosis or more than one psychiatric diagnosis. Conclusions : The results indicated that group which has coexisting psychiatric disorders were more depressed, had higher level of anger and aggression, and had more serious levels of suicidal ideas than single psychiatric diagnosis group. The implications and limitations were discussed along with some suggestions for the future studies.

Posttraumatic Stress Disorder of Patients Referred to Psychiatry after Motor Vehicle Accidents (자동차사고 후 정신과로 의뢰된 환자의 외상후 스트레스장애)

  • Yun, Kyu-Wol
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.174-183
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    • 1999
  • Objective : This study was designed to evaluate the incidence and characteristics of posttraumatic stress disorder(PTSD) after motor vehicle accidents(MVA) in 44 consecutive MVA victims referred to psychiatry for the diagnosis, treatment and psychiatric assessment. Method : The diagnosis of posttraumatic stress disorder was made on the basis of DSM-IV criteria, and posttraumatic stress symptoms were assessed by the Clinician-Administered PTSD Scale(CAPS). Correlation between the extent of physical injury and the severity of PTSD symptoms using the Abbreviated Injury Scale(AIS) was analyzed and the frequency of psychiatric comorbidity of PTSD was invested. Result : Twenty-two(45.5%) MVA victims met DSM-IV criteria for PTSD, while thirteen(29.5%) showed a subsyndromal form of it. AIS scores significantly related with the development of posttraumatic stress symptoms(r=0.565, p=0.0001). PTSD group showed high percentages of each of the 17 symptoms(criterion B, C, D), while subsyndromal PTSD group showed relatively high percentages of criterion Band D. The most frequent symptom was 'distressing dreams' of criterion B in both group. A high percentages(56%) of the MVA-PTSD group also met the criteria for current major depression. Conclusions : These findings suggest that there is apparently a high likelihood of developing all or part of the PTSD syndrome after motor vehicle accidents. So it does appear that for those MVA victims who seek medical attention and eventually need psychiatric referral, diagnostic possibility of PTSD should be taken into account in treatment planning and early intervention.

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