Lee, Joo Hwan;Yang, Seung Jun;Eun, Seung Wan;Jin, Sang Chan;Choi, Woo Ik;Jung, Sung Won
Journal of The Korean Society of Clinical Toxicology
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v.14
no.1
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pp.37-46
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2016
Purpose: This study was designed to determine the factors hindering psychiatric intervention for suicide attempters in the emergency room (ER). Methods: Participants were 299 patients aged 18 years or older admitted to the ER for suicidal drug overdose between July 2012 and June 2014. Patients were divided into two groups according to whether they had received psychiatric treatment in the ER. Medical histories and follow-up treatments were determined by examining patients' medical records and through phone surveys, and were then compared using ${\chi}^2$-test and Fisher's exact test. In addition, the rate of satisfaction of the treatment group and the reasons for their dissatisfaction were also determined. Results: The treatment and non-treatment groups comprised 135 (45%) and 164 patients (55%), respectively. Factors influencing participation in psychiatric intervention were previous history of suicide attempts (p=0.004), history of psychiatric disorder (p<0.001), time of day (p=0.039), and day of the week (p=0.040) of arrival in the ER. Whether or not the patient received follow-up psychiatric treatment was not significantly relevant (p=0.300). Of the 82 patients who participated in the treatment satisfaction survey, 50.2% reported being unsatisfied, mainly because of unfriendly medical personnel (36.6%), discomfort regarding other people's perceptions (24.4%), and cursory care (14.6%). Conclusion: To raise the participation rate of psychiatric consult, cooperation with psychiatry at night and on weekends is required, and incorporation of patients without previous history of suicidal attempt or other psychiatric disorder is important. Resolution of complaints toward psychiatric consult in suicide attempt survivors is also required.
Preoperative and postoperative psychiatric evaluation were done for 51 patients who were undergoing open-heart surgery. The incidence of postoperative psychopathological complications following open-heart surgery was 27.5%. This rate is comparable to that of previous studies. Neurotic reactions occurred in eight patients, delirium in five, and acute psychotic reaction in one. Of those variables which were previously suggested to influence the high incidence, the demographic factors and the severity of preoperative illness were correlated with postoperative psychopathologic dysfunctions. No somatic variable associated with intraoperative or postoperative procedures has been proven to correlate. By preoperative psychiatric evaluations, the patients could be divided into three groups: the Anxiety group, the Denial group, and the Adjusted group. The most important psychological finding was that in patients who demonstrated a high degree of preoperative anxiety or who could not express preoperative anxiety, postoperative psychological complications developed more frequently. With these findings, the preoperative psychiatric interview was recommended for prevention and reduction of postoperative psychiatric complications.
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.
The authors examined for risk factors for suicide among psychiatric patients who had committed suicide through the analysis of demographic, clinical and psychological characteristics of the patients. The total number of suicides committed during social adjustment period was 9. Male and female ratio was 5:4 and the highest incidence occurred in the age group of 21-29 years. Of the 9 cases, schizophrenia accounted for two-third of the suicides. Among the committed suicides, 4 were in hospitalization and rest were postdischarge state. We found that 4 of 5(80%) suicides occurred in the first year after discharge, and that three fifth(60%) occurred within three months of discharge. In this result, most of suicides occurred immediately or soon after discharge and some during inpatient care. The major precipitating factors the patients showed before committing suicide were realistic and psychological problems. Consquently, they become dejected, experience feelings of hopelessness, go on to a depressed mood, and, in that case, have suicidal ideas that are eventually acted on. We believe that the ability to recognize risk factors for suicide and develop appropriate interventions is key to suicide prevention.
Purpose: The purpose of this study was to examine the effects of a Combined Exercise Program on Obesity and Metabolic Syndrome Factors for Chronic Psychiatric Inpatients. Methods: Thirty two subjects participated in this program who were admitted into a national mental hospital of C city. All measurements were done at baseline, 4 week, 8 week, and 12 week during the program. The effectiveness of the program was evaluated according to the change of body mass index, body fat, waist circumference, total cholesterol, high density lipoprotein cholesterol, triglyceride, and fasting blood sugar. Collected data was analyzed by frequency, percentage, and repeated measures ANOVA with SPSS WIN 19.0. Results: There were statistically significant differences in the body mass index (p=.002), body fat (p<.001), waist circumference (p<.001), triglyceride (p=.020), and fasting blood sugar (p=.008). However, there were no statistically significant differences in the total cholesterol, or high density lipoprotein cholesterol. Conclusion: The results of this study showed that a combined exercise program has positive effect on obesity and metabolic syndrome factor. Thus, a Combined Exercise program is recommended as an intervention to improve obesity and metabolic syndrome factors for chronic psychiatric inpatients.
Sun, Tai hui;Song, Seung Il;Kweon, Kukju;Chee, Hyun Seung;Choi, Kwang-Yeon
Anxiety and mood
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v.17
no.2
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pp.78-83
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2021
Objective : Current study investigated the association between internet addiction and suicidal attempts in psychiatric patients. Methods : Patients who visited emergency department or psychiatry outpatient unit of Chungnam National University Hospital from January 2020 to July 2021 were included in this study. Total of 192 participants, 96 suicidal attempt cases and 96 psychiatric control patients without history of suicidal attempt were matched by gender and baseline diagnosis. Depression and internet addiction were assessed by using Patient Health Questionnaire-9 (PHQ-9) and Young's Internet Addiction Test (IAT). Independent t-tests, and logistic regression analyses were conducted. Results : IAT scores were significantly higher in suicidal attempt case group (41.09±18.196 years) compared to psychiatric control patients without history of suicidal attempt (36.63±17.016 years) (p=0.040). Internet addiction (adjusted Odds Ratio [aOR]=2.049, 95% Confidence Interval [CI]=1.004-4.539, p=0.0493) was an independent risk factor for suicidal attempt in psychiatric patients after controlling age, gender, and sociodemographic factors, such as marital status, education level and employment status. Conclusion : This is the first study to investigate the relationship between internet addiction and suicidal attempt in psychiatric patients in Korea. Internet addiction is significantly associated with suicidal attempt in psychiatric patients, after adjusting sociodemographic variables. This study provides evidence to future studies to further investigate on causality of internet addiction and suicidality in psychiatric patients.
Objects : Cancer patients receiving radiotherapy have many psychological problems. Those problems depend on clinical factors of cancer and the characteristics of patients. This study was designed to estimate the morbidity of psychiatric disorder and to investigate the relationship between psychiatric disorders and clinical variables. Methods : The subjects were 47 patients who had been treated by radiotherapy. Psychiatric disorder was diagnosed according to DSM-IV. The authors assessed the relation between psychiatric disorder and demographic features, clinical features of cancer such as site, duration, frequency of recurrence of cancer, and patients' awareness of disease and expectation of outcome of radiotherapy. Results : 21 patients(44.7%) had a psychiatric disorder. The most common psychiatric disorder were adjustment disorder(66.7%), and the next major depressive disorder(23.8%). There was a significant positive relationship between psychiatric disorder and recurrence of cancer, patients' expectation of poor outcome after radiotherapy. Psychiatric morbidity was significantly low in those who had no evidence of recurrence and who considered radiation treatment as curative. However, site and duration of cancer, patients' awareness about serious illness were not related with psychiatric disorder. Conclusion : Psychiatric disorders are common among cancer patients on radiotherapy. Further clinical attention and effective treatment of psychiatric complication in cancer patients are needed not only for reducing symptoms but for better adjustment.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.26
no.2
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pp.112-119
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2015
Objectives : The purpose of this study was to examine the prenatal, perinatal and developmental risk factors of attention-deficit hyperactivity disorder (ADHD), compared to unaffected siblings (SIB), and typically developing children (TC). Methods : Subjects with ADHD, their SIB, and TC were recruited from the child psychiatry outpatient clinic of the Asan Medical Center Children's Hospital. The parents of the children completed questionnaires on perinatal and developmental risk factors. Results : Fifty-eight subjects with ADHD (41 boys, $7.7{\pm}1.3years$), 21 SIB (8 boys, $8.2{\pm}1.8years$), and 22 TC (8 boys, $8.5{\pm}2.1years$) were included. The ADHD group showed higher rates of maternal stress during pregnancy than the SIB group (p=.002), and the ADHD group showed higher rates of familial psychiatric history than the TC (odds ratio, 8.76 ; 95% confidence interval, 1.69 to 45.45). Conclusion : These findings suggest that among perinatal and developmental factors, maternal stress during pregnancy contribute to the development of ADHD. Future prospective studies will be needed in order to determine the causal relationship between perinatal risk factors and development of ADHD.
Background: Breast cancer is the most common type of cancer among women in Turkey and around the world. Treatment adversely affects women's physical, psychological, and social conditions. The purpose of this study was to identify the experiences of Turkish women with breast cancer and the facilitating coping factors when they receive chemotherapy. Methods: A phenomenological approach was used to explain the experiences and facilitating factors of breast cancer patients during the treatment period. Data were collected through individual semi-structured interviews. The sample comprised 11 women with breast cancer receiving treatment. Results: At the end of the interviews conducted with women with breast cancer, two main themes were identified: adjustment and facilitating coping factors. The adjustment main theme had two sub-themes: strains and coping. Women with breast cancer suffer physical and psychological strains as well as stress related to social and health systems. While coping with these situations, they receive social support, turn to spirituality and make new senses of their lives. The facilitating coping factors main theme had four sub-themes: social support, disease-related factors, treatment-related factors and relationships with nurses. It has been determined that women receiving good social support, having undergone preventive breast surgery and/or getting attention and affection from nurses can cope with breast cancer more easily. Conclusions: Women with breast cancer have difficulty in all areas of their lives in the course of the disease and during the treatment process. Therefore, nurses should provide holistic care, teaching patients how to cope with the new situation and supporting them spiritually. Since family support is very important in Turkish culture, patients' relatives should be informed and supported at every stage of the treatment.
The purpose of this study was to investigate factors affecting suicidal ideation in psychiatric inpatients. A total of 186 psychiatric inpatients participated in the study. Data were analyzed by frequencies, t-test, ANOVA, Pearson correlation coefficient, and hierarchical multiple regression with SPSS WIN 18.0. Suicidal ideation showed significant differences according to marital status, diagnosis, and previous suicide attempt history. There were significant correlations among depression, self-esteem, spirituality and suicidal ideation. Depression and spirituality were identified as predictors affecting suicidal ideation. The regression model explained 52.4% of suicidal ideation. As a result, intervention program for decreasing depression and improving spirituality is essential to decrease suicidal ideation in psychiatric inpatients.
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