• Title/Summary/Keyword: Psychiatric disorders

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Practice Guideline of Use of Benzodiazepines in Psychiatric Field (정신과 영역에서 벤조다이아제핀계 약물의 사용과 문제점)

  • Oh Kang-Seob
    • Anxiety and mood
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    • v.1 no.1
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    • pp.37-42
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    • 2005
  • Benzodiazepines are widely used for a variety of conditions in psychiatric field. In this article, the author reviewed the indications, the effects on anxiety and sleep disorders, the side effects, the drug-drug interactions, and the tapering strategies. Benzodiazepines were relatively safe and useful for the treatment of anxiety and sleep disorders. However, used clinically, benzodiazepines can induce many adverse effects (e. g. over-sedation, cognitive impairments, paradoxical effects, dependence and withdrawal symptoms, and so on). Currently available informations about their effects on the developing fetus is controversial. For this reason, pregnant women and nursing mother should be cautioned against the use of benzodiazepines. Drug-drug interactions have to be considered in combination treatments. For the tapering issues, gradual tapering was important to prevent the withdrawal symptoms. Especially, the tapering schedules have to be individualized for the each long-term benzodiapzepine users.

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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.

Long-term Results of Stereotactic Psychosurgery (뇌정위적 정신수술의 장기 추적 결과)

  • Son, Byung-Chul;Kim, Moon-Chan;Lee, Chul;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.29 no.4
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    • pp.514-520
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    • 2000
  • Objective : Stereotactic psychosurgery is known as one of effective means of treating in some medically intractable psychiatric illness. However, it is unfamiliar and it's long-term clinical result has not reported in our country. The authors evaluated its long-term results of pscychosurgery and discussed its neuroanatomical basis. Methods : Since 1993, eight patients underwent stereotactic psychosurgery for medically intractable psychiatric illnesses. All were referred from psychiatrist of these disorders, one was aggressive behavior, five were obsessive-compulsive disorders(OCD), and two were depression with anxiety disorders. Bilateral amygdalotomy and subcaudate tractotomy were done for aggressive behavior, and limbic leukotomy was done for OCD and depression with anxiety. The results of OCD were evaluated with with YBOCS(Yale-Brown obsessive compulsive scale) and VAS (visual analogue scale), CGI(clinical global impairment) in OCD, and OAS(overt aggression scale), MMS, WAIS were checked for the evaluation of aggressive behavior. Hamilton depression scale(HAMD) was used for evaluation of depression. Ventriculography was used in the first five patients and MR-guided stereotaxy was used in recent three cases for localization of target. The lesions were made with radiofrequency lesion generator. Results : With long-term follow up(mean 45 months) in five OCDs, mean YBOCS declined from 34 to 3(n=5). All returned to previous social life. In OAS scores of aggressive behavior during six-year follow up, scores declined from 8 to 2 with clinical improvement. In two patients with depression with anxiety, HAMD declined from 28.5 to 16.5(n=2). There was no operative mortality and no significant morbidity except one case of mild transient urinary incontinence. Conclusion : With these long-term results, authors assumed that stereotactic psychosurgery could be one of safe and effective mtherapeutic methods in several medically intractable psychiatric illness.

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Comorbid Psychiatric Symptom Associated With Oppositional Defiant Symptom in Community School-Age Children

  • Yong Hun Kim;Duk-Soo Moon;Na Ri Kang
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.34 no.3
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    • pp.169-174
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    • 2023
  • Objectives: Oppositional defiant disorder (ODD) is often comorbid with other psychiatric disorders in childhood. This study aimed to investigate comorbid psychiatric symptoms and associated factors in elementary school children with symptoms of ODD. Methods: The participants consisted of 205 mother-offspring pairs. Psychiatric symptoms were measured using the Diagnostic Predictive Scales and Korean Child Behavior Checklist. Psychiatric comorbid symptoms were compared between children with ODD symptom and those without ODD symptom. Multivariate logistic regression analysis was used to estimate the odds ratio of psychiatric symptom on ODD. Results: ODD group had a significant association with internalizing and externalizing problem (p=0.001, p<0.001, respectively). ODD group were more comorbid with anxiety disorder, depressive disorder, attention-deficit/hyperactivity disorder, and conduct disorder. Among psychiatric disorder, generalized anxiety disorder (GAD) (adjusted odds ratio [AOR]=18.620, p<0.001) and conduct disorder (AOR=9.529, p=0.014) were associated with ODD symptom. Conclusion: These findings suggest that children with ODD symptom had significantly higher rates of comorbid psychiatric symptoms. And GAD and conduct disorder are related to ODD symptom.

Automatic Nerve Activity to Physiologic Response in Adult With Psychiatric Disorder: A Systemic Review (성인 정신장애의 청각자극에 따른 생리학적 반응 측정에 대한 체계적 고찰)

  • Jung, Hye-Rim;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.9 no.1
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    • pp.45-52
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    • 2011
  • Objective : The aim of this study was to provide the method to measure physiologic response using equipments and auditory stimulation, and the physiologic response features of adult psychiatric disorders through a systemic review. Methods : The systemic review was executed using PubMed. The key words for search were "auditory stimulation, auditory startle, electromyograph, skin conductance, heart rate, psychiatric disorder, anxiety disorder, schizophrenia, depression". 8 studies were used for data analysis, and all of levels of evidence were level II. The substances of the review were subject(population), auditory stimulation, measure equipments and physiologic response features of psychiatric disorder. Results : 1. The subjects for the studies were anxiety disorder(4) and schizophrenia(4). 2. Auditory stimulation was used in 8 studies and visual stimulation with auditory stimulation was used in 2 studies to induce physiologic response. 3. Every study used electromyograph, and skin conductance was used in 2 studies and heart rate was used in 2 studies with electromyograph to measure physiologic response. 4. The subjects for the studies, schizophrenia and anxiety disorder(PTSD, OCD) have different physiologic response features with the normal control group. Conclusion : All studies used simple tones as an auditory stimulation and electromyograph to measure physiologic response. Psychiatric disorders indicated larger response, shorter and delayed habituation. The objective and systematic study using physiologic measure to investigate the sensory feature of psychologic disorders.

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Hypnotherapy in Cases with Psychosomatic Disorders (정신신체장애의 최면치료)

  • Choe, Byeong-Moo
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.2
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    • pp.176-180
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    • 2002
  • Hypnosis as a traditional healing method, in its recent development, has generated a multitude of techniques. These serve as practical tools which can be combined with other therapy techniques for the treatment of a variety of psychiatric and medical conditions. The empirical evidence for the effectiveness of hypnosis is considerable and proves its clinical impact in various areas of application. This case review describes the integration of hypnotherapeutic methods into the continuum of psychiatric encounters in a general practice. Guidelines for the application of hypnosis in approaching and treating each patients with headache, sexual dysfunction and bronchial asthma were illustrated. As hypotheses mechanism of effectiveness in psychosomatic disorders has been formulated. Training in hypnotherapy provides the psychiatrist with skills needed to address psychophysiological disorders. Emphasis is placed on the necessity and opportunity for research on the efficacy and specific technique of hypnosis in the psychosomatic disorders.

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Mega cisterna magna in bipolar mood disorder: a case report

  • Yazici, Esra;Kose, Sefanur;Gunduz, Yasemin;Kurt, Elif Merve;Yazici, Ahmet Bulent
    • Journal of Yeungnam Medical Science
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    • v.39 no.1
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    • pp.58-61
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    • 2022
  • Mega cisterna magna (MCM), one of the members of the Dandy-Walker complex, is a developmental malformation of the posterior fossa that is larger than 10 mm but morphologically does not affect the vermis and cerebellar hemispheres. Reports of psychiatric disorders associated with this anomaly are rare. We present the case of a patient with MCM who presented with a psychotic manic attack and was diagnosed with bipolar disorder. A 28-year-old female, single housewife, university graduate, presented with irritability, decreased sleep and appetite, distraction, and agitation. The patient also had a delusion of reference. In the clinical follow-up, an increase in energy and an increase in the amount of speech were observed. Her neurological examination was normal, and cranial magnetic resonance imaging revealed an MCM. The relationship and clinical significance of MCM with psychosis and mood disorders have not yet been fully elucidated. It is not known whether this association is accidental or based on etiological commonality. The purpose of this case report is to review the relationship between the cerebellum and psychiatric symptoms and to contribute to the literature.

COMORBIDITY OF CHILD AND ADOLESCENT INPATIENTS (소아정신과 입원환자의 공존질병(Comorbidity))

  • Shin, Yun-O;Cho, Soo-Churl;Hong, Kang-E;Kim, Ja-Sung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.4 no.1
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    • pp.91-97
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    • 1993
  • The objective of this paper was to determine the degree of diagnostic overlap. In a pilot study of 56 inpatients(mean age 12) with DSM-III-R axis I and/or II disorders, the degree of psychiatric comorbidity was examined. 64.3% had two or more diagnoses. The samples were divided into the following 9 groups 1) attention deficit hyperactivity disorder 2) conduct disorder 3) oppositional defiant disorder 4) schizophrenia 5) mood disorders 6) tie disorders 7) elimination disorders 8) mental retardation 9) personality disorders Substantial overlap(especially tic disorders, elimination disorders, disruptive behavior disorders) occured among inpatients Patients had about 2 DSM-III-R axis I & II diagnoses. Additional research with increased sample size is necessary to clarify its relationship with other psychiatric diagnoses.

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Measuring Symptom Exaggeration in Posttraumatic Stress Disorder using the MMPI-2 and the Personality Assessment Inventory Symptom Validity Scales (MMPI-2와 Personality Assessment Inventory 타당도 척도를 이용한 외상후 스트레스 장애 환자의 증상과장 평가)

  • Kong, Sung-Whoi;Chae, Jeong-Ho;Lee, Jong-Hun;Hahn, Sang-Woo;Park, Eun-Jin;Choi, Kyeong-Sook
    • Anxiety and mood
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    • v.8 no.1
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    • pp.22-30
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    • 2012
  • Objective : We investigated whether Posttraumatic stress disorder patients have a higher tendency to exaggerate the extent of their psychological symptoms compared to other psychiatric patients. Methods : Medical records of patients, who had received psychiatric treatment at four university hospitals in Korea between January 2009 and December 2010, were retrospectively reviewed. We compared a group of 37 patients diagnosed with PTSD, and another group of 41 patients diagnosed with neurotic, stress-related and somatoform disorders according to the ICD-10. To compare the extent of malingering in the two groups, we compared the validity scales of MMPI-2 and Personality Assessment Inventory. We determined the number of participants in both groups feigning their responses by using various cutoff scores of the validity indicators. Results : The PTSD group showed significantly higher scores on the F (p=0.001), F (B)(p=0.000), F (P)(p=0.030), F-K (p=0.003) scale of the MMPI-2 compared to the other group of psychiatric patients. The PTSD group had a significantly higher NIM score (p=0.001) but a lower PIM score (p=0.020) of the PAI compared to the other group of psychiatric patients. Using the cutoff scores, the PTSD group showed a significantly higher number of patients who feigned responses compared to the other group ($Fb{\geq}75$ (p=0.010), $F-K{\geq}1$ (p=0.005), $F-K{\geq}10$ (p=0.011) from the MMPI-2, and $NIM{\geq}80$ (p=0.001) from the PAI). Conclusion : These results suggest that PTSD patients have a tendency to exaggerate their symptom. This group of patients overreported the severity of their condition during standardized personality assessment that included the MMPI-2 or PAI compared to patients diagnosed with other psychiatric disorders. Additional research is required to determine the factors influencing symptom exaggeration in PTSD.

Attentional Dysfunction in Major Psychiatric Disorders (주요 정신장애에서의 주의력 장애)

  • Ha, Kyoo-Seob
    • Sleep Medicine and Psychophysiology
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    • v.5 no.2
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    • pp.155-169
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    • 1998
  • Attentional dysfunction is considered as one of the core deficits in schizophrenic process. The findings, pathophysiological mechanisms, and their clinical implications of clinical and experimental neurocognitive tests for the attentional impairment in schizophrenics are reviewed. The influences of psychopathology, antipsychotic treatment, and chronic institutionalization are also included in the review. In contrast, there are only a few evidences that attentional dysfunction would be a core deficit of depressive, manic, and anxiety disorders. Some recent findings of attentional impairment in these disorders are reviewed.

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