• Title/Summary/Keyword: Psychiatric history

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Influences of Injury Severity and Age on Severe Anxiety in Posttraumatic Stress Disorder Patients with no Previous History of Psychiatric Disorders (정신건강의학과 치료 과거력이 없는 외상후 스트레스 장애 환자에서 나이와 손상 심각도가 중증 불안에 미치는 영향)

  • Park, Woon Yeong;Park, Sang Hag;Kim, Sang Hoon;Kim, Seung Gon;Park, Jung In;Choo, Il Han
    • Anxiety and mood
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    • v.9 no.1
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    • pp.54-60
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    • 2013
  • Objectives : Posttraumatic stress disorder (PTSD) is classified as an anxiety disorder. PTSD occurrence is known to be increased in middle-aged and older people, female, and individuals with a previous history of psychiatric disorders, lower education levels, low socioeconomic status, and severely injured patients. Anxiety symptoms are also related to later development of PTSD. In this study, we investigate the influences of injury severity and sociodemographic factors on severe anxiety in PTSD patients with no previous history of psychiatric disorders. Methods : Forty-one PTSD patients without previous history of psychiatric disorders were recruited from the psychiatric clinic at Chosun University Hospital. Subjects underwent psychiatric and physical examinations including the Injury Severity Score (ISS), Beck Anxiety Inventory (BAI), and Korean-Wechsler Adult Intelligence Scale (K-WAIS). We defined severe anxiety as a BAI scores of 30 or more. Logistic regression analyses and multi-step model selection were applied to identify predictive factors for severe anxiety. Results : In univariate analysis, age, ISS, and socioeconomic status were found to be significant factors. Through multivariate logistic regression analyses and a stepwise model selection, we found the combination of age and ISS to be the best-fitted model for affecting severe anxiety in PTSD patients without a previous history of psychiatric disorders. Conclusion : Our findings suggest that the combination of age and ISS could develop severe anxiety in PTSD patients with no previous history of psychiatric disorders.

Weight Gain of the Psychiatric Female Hospitalized Patients (정신과 여자 입원 환자의 체중 증가)

  • Seo, Dong-Hyang;Park, Ki-Chang;Shin, Jong-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.2
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    • pp.120-125
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    • 1998
  • Objectives : The purposes of present study were to identify weight increment in female psychiatric patients during hospitalization and to evaluate the relationship between weight gain and daily calorie intake, daily activity and other variables of disease itself. Methods : 20 patients were studied. Body weight were measured once a week, and daily activity(total amounts of walking/day) and total amount of daily calorie intake were measured twice a week. We examined psychiatric and medical illness history, eating disorders' history and family history of eating disorders and obesity. Results: Mean body weight and Body Mass Index(BMI) at admission are 49.40kg and 19.59kg/$m^2$. Mean weight increment during hospital stays of mean 65 days is 4.90kg. Mean amounts of daily calorie intake and daily activity(daily walks) were increased during hospital stays, but not statistically significant. The degree of weight increment is higher in longer hospital stay group, but not statistically significant. Mean body weight at admission of mood disorder group is higher than that of schizophrenia group, but not statistically significant. Conclusion : This results suggested that weight increment in female psychiatric hospitalized patients is present. However, it is not resulted by amount of calorie intake and daily activity level.

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Therapeutic Approaches to the Patients who were Referred for Psychiatric Consultation from Medical Departments - Internist's View about Management of Medical Patients with Psychiatric Problems - (정신과에 의뢰된 내과계 환자들에 대한 치료적 접근 - 내과의사로서의 입장 -)

  • Lee, Sang-In
    • Korean Journal of Psychosomatic Medicine
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    • v.1 no.1
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    • pp.81-91
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    • 1993
  • The consulting internist will encounter patients with psychiatric symptoms and those who take psychotropic medications in many settings. The internist must loam to feel comfortable interacting with patients who display psychiatric symptoms. while maintaining an open and unprejudiced attitude toward their evaluation. The proper delineation of psychiatric disorders from normal emotional reactions resets on a careful history, a mental status evaluation. and a knowledge of psychiatric syndromes. Many physicians tend erroneously to view behavioral changes only in a psychological framework Abrupt changes in behavior, personality, mood. or ability to function should be evaluated for possible organic causes. Then, the internists should take their consultation to psychiatrists and freely discuss psychologic problems of the patients.

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The Psychiatric Treatment Link Characteristics of Suicide Attempters Visiting Emergency Room (응급실 내원 자살시도자의 정신과 진료 연계 관련 특성)

  • Park, Han Na;Jun, Seong-Sook;Byun, Eun Kyung
    • Journal of East-West Nursing Research
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    • v.20 no.2
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    • pp.93-102
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    • 2014
  • Purpose: This study aimed to investigate the characteristics of patients attempting suicide and to analyze treatment determination factors for patients with mental illness who go to an emergency center for treatment. Methods: Data collected from 117 suicide attempters who visited Busan Regional Emergency Medical Center were analyzed using frequency, percentage, ${\chi}^2$-test with SPSS/WIN 15.0. Results: Only 31 cases consulted with the psychiatric department; the other attempters' refused to consult (26.5%). Among the 31 attempters who consulted, 23 cases (74.2%) were suffering from depression. The most common reason (38.6%) suicidal attempters gave to refuse psychiatric treatment was "I'm not mad. I don't need the psychiatric treatment". Treatment determination factors for mental illness were religion (p<.001), past history (p=.017), financial satisfaction (p=.048), previous history of suicidal attempts (p=.006), sleep disturbance (p<.001), expression of suicide (p=.010), and type of leaving the emergency room (p=.020, p<.001). Conclusion: Results suggest that people frequently misunderstand psychiatric treatment which leads to their refusal to accept psychiatric treatment. Therefore hospitals need to develop standard guidelines and procedures for suicidal attempters with the collaboration of emergency and psychiatry departments. In addition, medical teams need to provide attempters appropriate information and encourage them to actively seek psychiatric treatment.

Association Between Suicidal Attempt and Internet Addiction in Korean Psychiatric Patients: A Case-Control Study (한국 정신질환자에서의 자살시도와 인터넷 중독 간의 연관성에 관한 환자-대조군 연구)

  • 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.

Nonpsychiatric Physicians' Attitudes Toward Psychiatric Consultation (정신과자문에 대한 타과 의사들의 태도)

  • Lee, Hee-Sang;Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.2 no.1
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    • pp.98-106
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    • 1994
  • The authors investigated 131 nonpsychiatric physicians' attitudes toward psychiatric consultation, using questionnaires. A comparison was made as regards psychiatric consultation from nonpsychiatric physicians over position(staffs vs. residents) and department(medical vs. surgical). These findings are as follows ; 1) 51.9 percent of nonpsychiatric physicians estimated that less than 30 percent of their patientshadpgychiatricproblems. 2) The percentage of the patients referred for psychiatric consultation were 30 or less than 30 percent 3) Staffs tried to refer their patients to psychiatric department for psychiatric consultation more frequently than residents. 4) Medical physicians tried to refer their patients to psychiatric department for psychiatric consultation more frequently than surgeons. 5) Psychiatric consultation was estimated to be most frequently requested for overt psychiatric symptoms(23.0%) and past history of psychiatric treatment(20.8%). 6) The most frequent causes of not referring to department of psychiatry were found to be the patients' rejection(46.8%) and non-psychiatric physicians' dissatisfaction with the results of consultation (22.2%). 7) Medical physicians tended to explain the reasons for psychiatric consultation more adequately than surgeons. 8) Residents more specifically wrote the reasons for psychiatric consultation on the chart than staffs. The results suggest that staffs are more active in psychiatric consultation than residents, whereas medical physicians are more active than surgeons. Thus, education should be more emphasized for surgeons and residents, especially for the latter for effective consultation-liaison activity. On the other hand, psychiatrists should try to improve nonpsychiatric physicians' dissatisfactions with the results of psychiatric consultations, which will positively change their attitudes toward psychiatric consultation.

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Limitation of Psychiatric Intervention for Suicidal Drug Intoxication Patients in Emergency Room (응급실에 내원한 약물음독의 자살 시도자에서 정신건강의학과 진료 참여의 제한점)

  • 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.

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An Exploration of Essentials of Psychiatric and Mental Health Nursing (정신건강간호의 실체규명을 위한 업무경험 탐색)

  • Oh, In Ohg;Nam, Kyoung A
    • Journal of Korean Academy of Psychiatric and Mental Health Nursing
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    • v.27 no.4
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    • pp.415-426
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    • 2018
  • Purpose: This study aimed to explore the essentials of psychiatric and mental health nursing by identifying the care experience of the psychiatric nurses. Methods: Eleven psychiatric nurses were recruited across five geographical areas in the Korea. Data were collected using semi-structured interviews from two focus groups, which were analyzed with an inductive content analysis. Results: Participants constructed two categories including 'nursing tasks for the client' and 'nursing tasks for the organization'. Subcategories of nursing tasks for the client are 'staying alert on crisis prevention', 'leading them to be real with eager and persistent will', 'nursing beyond role boundaries', 'tuning the needs of clients' family', 'taking journey with clients' personal life history', and 'doing invisible but recognizable nursing'. Subcategories of nursing tasks for the organization are 'working as a responsible team member', 'integrating team competencies at the center of team', and 'balancing protection and control'. Conclusion: Psychiatric nurses played professional and holistic care roles for the clients, and managerial roles for the organizations. This study provides essential data for defining psychiatric nursing and estimating the appropriate ratio of psychiatric nursing staffing.

A Basic Study on Effects of Psychological Symptom Analysis in a Movie on Understanding of Psychiatric Disease - Focusing on Students at a Korean Medical University (영화 속 정신증상 분석이 정신질환 이해에 미치는 영향에 대한 초보적 고찰 - 일개 한의과대학 대학생을 대상으로)

  • Kim, Kyung-Soo;Bae, Jin-soo;Jeong, Seo-yun;Jeong, Hyeonu;Kim, Kyeong-ok
    • Journal of Oriental Neuropsychiatry
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    • v.32 no.4
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    • pp.329-335
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    • 2021
  • Objectives: The purpose of this study was to determine how analyzing movies, including mental symptoms, according to a certain method, might affect the understanding of psychiatric disorders. Methods: Forty-four oriental medicine students who had completed Korean medicine neuropsychiatric science were required to submit reports on episode analysis, psychiatric personal history investigation, diagnostic criteria, and the connection between Korean medicine and psychiatric diseases after watching a movie, including psychiatric symptoms. After submitting the report, a questionnaire related to understanding before and after watching the movie was asked to be filled out. Demographic survey, frequency analysis, and response sample t-test were performed based on 42 questionnaires. Results: Results of analyzing the questionnaire were as follows. 1. The average number of movies watched was three. 2. Psychiatric disorders and psychiatric symptoms, diagnostic criteria, psychiatric personal investigation, and understanding of the connection between Korean medicine and psychiatric diseases all increased statistically significantly. 3. A separate process might be needed to improve the understanding of psychiatric personal strength investigation and oriental medicine connection. Conclusions: Movie analysis, including individual mental symptoms, could improve students' understanding of psychiatric disorders in psychiatric symptoms, diagnostic criteria, and psychiatric personal investigation, but some students might need feedback.

Factors for Completing Case Management of Suicide Attempters: A Coihort Follow-Up Study Based on Data From Case Management of Emergency Room-Based Suicide Attempters (자살시도 환자의 지속적 관리 완수 요인: 응급실 기반 자살시도자 사후관리 사업 자료를 기반으로 한 코호트 추적 연구)

  • Ryou, Jae Hyun;Heo, Yoon Kyung;Kim, Da Seul;Kim, Sun Mi;Han, Doug Hyun;Min, Kyoung Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.176-183
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    • 2021
  • Objectives : The purpose of this study was to find out how demographic factors, suicide attempt patterns, psychiatric history and management of suicide attempters affect the completion of emergency department (ED) based case management program. Methods : Among the patients who attempted suicide and visited the emergency department of Chung-Ang University Hospital from June 1, 2018 to May 31, 2021, 661 patients who agreed to case management were studied. After being discharged from the emergency department, subjects were registered for an eight-week follow-up service program. Hierarchical logistic regression analysis was conducted with demographic factors, suicide attempt patterns, psychiatric history and management as independent variables, and completion of case management program as dependent variables. Results : Suicide attempt pattern had the most significant influence on the completion of case management program, followed by demographic factors, psychiatric history and management. Those who completed the case management program were significantly more likely to have suicide plans in the future, more authentic in suicide attempts, and had higher proportion of past suicide attempts than those who did not complete the program. Conclusions : To ensure that the subjects complete the follow-up project program and get connected to community services, an individualized approach with consideration of suicide attempt patterns, demographic factors, and psychiatric history is needed.