• Clinical and Experimental Pediatrics
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• 제52권10호
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• pp.1167-1170
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• 2009

털위석은 위장관에 털이 축적되어 생기며, 발모광이나 다른 정신적인 문제나 신경학적인 문제가 있는 환자들에게서 주로 발생한다. 털위석은 복통, 식욕부진, 구토 같은 위장관 폐쇄의 증상들로 나타난다. 국내외에서 위석의 보고는 식물위석에 대한 것이 대부분이며, 털위석이 소아에게서 보고된 경우는 많지 않다. 9세 여아가 복부 불쾌감과 복부 종괴로 내원하였다. 환아는 5년 전부터 머리카락을 주어먹는 버릇이 있었고 부모로부터 오빠에 대한 차별적인 대우를 받는다고 생각하였으며 학교에서 성적은 뒤처지는 편이지만 그 외 특별한 병력은 없었다. 복부 컴퓨터단층촬영술을 시행하여 위 안에 거대한 털위석을 확인하였으며, 위절개술을 시행하여 털위석을 제거하였다. 그 후 정신과적인 상담과 치료를 권유하였으나 보호자의 거부로 중단되었다. 이에 저자들은 정신적인 문제가 수반된 환아가 복부 증상으로 내원시 털위석의 유무에 대한 접근과 진단의 중요성을 강조하는 바이다.

• 대한간호학회지
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• 제7권1호
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• pp.55-62
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• 1977

Varieties of literatures were reviewed in regard to the fundamental concept of day hospital, historical trends, the recipient of its care, facilities and personnel, therapeutic programmes and the follow-up care plans. Through the research the advantages of day hospital were highlighted in order to provide the reference for those who consider planning such health care institution. Since the introduction of the concept of day hospital and its implementation in 1930, many psychiatric patients world over are treated and cared. Patients with specific health problems ; alcoholism, acute or serious psychiatric disease, tendencies of humidor suicidal attempts, and with serious physical problems were excluded from the general recipient. Day hospital were annexed to the psychiatric hospitals in most in instances ; facilities, personnel, except nursing personnel, were shared. All therapeutic care were planned in daley, weekly programmes, and were focussed on socialization. The follow-up care were provided for those participating post- therapy club activities which were planned and introduced ahead. Many advantages of day-hospital care in contrast to the traditional hospitalization care were found: 1. The abrupt discontinuity of his family and other social role is prevented. 2. Therapeutic progress is faster. 3. Lessened economic burden to the family. 4. Behavioral regression is lessened and the lessened fear of hospitalization. 5. Less injury to the patients, self- respect, through lessened anxiety of hospitalization. 6. Incidents of secondary crisis believed to be existing in long term cases are decreased. 7. Therapeutic care implemented in freer atmosphere, better Patient-personnel relationships are created. 8. Varieties of group activities are Induced which enable faster recovery. 9. Patients could engage himself with social activities including getting job on part-time basis. 10. Rehabilitation of patient could be implemented.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제24권3호
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• pp.141-150
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• 2013

Objectives : The objective of this report is to identify the utilization of hospital school service during hospitalization among patients in their childhood and adolescence with psychiatric disorders. Methods : We retrospectively reviewed the medical record of child and adolescent psychiatric who were hospitalized during March 2009 through October 2012. We compared the one-year successful schooling and outpatient follow up rate between users and nonusers of the inpatient hospital school service. The hospital schooling experiences of the users were investigated upon follow-up visits to the outpatient clinic. Results : Sixty-three students received hospital school service during hospitalization among total 122 child and adolescent inpatients. Hospital school participants showed a significantly higher school reentry rate (61.9%) than non-participants (40.7%). However, there was no difference on follow up rate between the two groups. More than 60% of the 22 interviewed participants expressed an above-average level of satisfaction about hospital school service. Conclusion : Many patients with mental illness experience difficulty in receiving school education during treatment. That induces deterioration in disease, academic failure, poor social skills, low self-esteem, economic difficulties, and future job opportunities. The results of this study emphasize the importance of hospital school service and offer useful guidance for hospital school operation.

• 임상간호연구
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• 제28권3호
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• pp.270-276
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• 2022

Purpose: The purpose of this study was to validate the Edmonson psychiatric fall risk assessment tool (EPFRAT) for psychiatric inpatients. Methods: Data from retrospective study were collected from 670 adult inpatients in two departments of mental health medicine of a tertiary general hospital by reviewing their electronic medical records. There were 41 patients who experienced falls and 629 patients who did not experience falls during the period from January to December 2019. Data were analyzed by sensitivity, specificity, positive predictive value, negative predictive value, and a receiver-operating characteristic curve (ROC) for validity assessment using the IBM SPSS/WIN 26.0 program. Results: Factors affecting falls were the participant's age, guardian's residence, high-risk determination at the time of admission, and comorbidity. At the 85 points where the point of sum of the sensitivity and specificity was largest, the sensitivity, specificity, positive predictive value, and negative predictive value of EPFRAT were 92.7%, 79.7%, 22.9%, and 99.4%, respectively. The area under the ROC to assess the overall validity of the tool was .92 (95% CI 0.89~0.94). Conclusion: The EPFRAT was proved to be valid and reasonable for predicting falls in psychiatric inpatients. Based on the results of this study, it could be used for the assessment of high-risk patients for falls in psychiatric units.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제34권4호
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• pp.275-282
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• 2023

Objectives: This study aimed to identify the psychiatric comorbidity status of adult patients diagnosed with attention-deficit hyperactivity disorder (ADHD) and determine the impact of comorbidities on neuropsychological outcomes in ADHD. Methods: The study participants were 124 adult patients with ADHD. Clinical psychiatric assessments were performed by two board-certified psychiatrists in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. All participants were assessed using the Mini-International Neuropsychiatric Interview Plus version 5.0.0 to evaluate comorbidities. After screening, neuropsychological outcomes were assessed using the Comprehensive Attention Test (CAT) and the Korean version of the Wechsler Adult Intelligence Scale, Fourth Edition (K-WAIS-IV). Results: Mood disorders (38.7%) were the most common comorbidity of ADHD, followed by anxiety (18.5%) and substance use disorders (13.7%). The ADHD with comorbidities group showed worse results on the Perceptual Organization Index and Working Memory Index sections of the K-WAIS than the ADHD-alone group (p=0.015 and p=0.024, respectively). In addition, the presence of comorbidities was associated with worse performance on simple visual commission errors in the CAT tests (p=0.024). Conclusion: These findings suggest that psychiatric comorbidities are associated with poor neuropsychological outcomes in adult patients with ADHD, highlighting the need to identify comorbidities in these patients.

• 정신신체의학
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• 제4권1호
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• pp.79-84
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• 1996

We have studied 16 patients diagnosed of social phobia among the hospitalized patients for 1 year, from September 1994 to August 1995, to evaluate whether serial phobic symptoms are the prodromal symptoms of the other psychiatric disorder or concomitant disorder. The results were as follows; 1) In the subject of this study, the mean age of onset of social phobic symptoms was 17.3, and the mean age of inital hospital visit was 27.4. 2) The proportion of offensive type was higher than the simple type : 7 cases of the subjects classified as simple type, 9 cases as offensive type. 3) According to the type of social phobia, they developed different type of psychiatric disorder. Majority of patients with simple type had final diagnosis of mood disorder. Patients with offensive type had schizophrenia spectrum disorder, such as schizophrenia, delusional disorder, and schizophrenia, personality disorder. 4) Social phobic symptoms have taken various courses according to the final diagnosis. In the patients who developed major depression and delusional disorder, social phobic symptoms have not been changed during the course. Patients with the final diagnosis of schizophrenia and schizotypal personality disorder have showed various social phobic symptoms. In the patients with the final diagnosis of bipolar disorder, their social phobic symptoms disappeared with improvement of depression.

• 생물정신의학
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• 제23권1호
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• pp.12-17
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• 2016

Neuroinflammation is one of important allostatic loads contributory to the various psychiatric illness. It is mediated mainly by glial cells, which produce both proinflammatory and antiinflammatory cytokines, and the balance of them determines the inflammatory process in the central nervous system. S100 calcium-binding protein B, which is used as an inflammatory marker is also released by glial cells. In the molecular level, oxidative stress contributes to the neuroinflammation. Their disturbances have been revealed in the psychiatric illness and related with the dysregulation of the glutamatergic and monoaminergic systems. There is a possibility to use them as disease markers. The approach for inflammation using antiinflammatory drugs and antioxidants could be connected to the development of disease-modifying treatments. Also, a searching examination about specific subtypes who are vulnerable to inflammation in the patients is required to confirm their efficacy clearly.

• 동의신경정신과학회지
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• 제14권2호
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• pp.155-167
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• 2003

Objective : The aims of this study were to show the clinical aspects and to investigate psychiatric traits by SCL-90-R in patients who visited Oriental Medicine Hospital Emergency Room. Method : We studied twenty patients who visited Daejeon University Oriental Medicine Hospital from May, 2003 to September, 2003. Results : 1. The ratio of male to female patients was 1:3 and age distribution was most frequent in 30s&40s. 2. The most frequent cause of illness was stress in occupation and overwork. The greater part of patients came to hospital in 12hours after an attack. 3. In chief problem, somatic symptoms such as headache, dizziness, numbness and chest discomfort were most frequent. In diagnosis, somatization disorder was most frequent. 4. After treatment, most of symptoms were improved. 5. Psychiatric traits by SCL-90-R correlated with somatization and anxiety.

• 정신간호학회지
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• 제27권4호
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• pp.380-393
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• 2018

Purpose: The purpose of this study was to explore psychiatric nurses' decision making in the use of seclusion and restraint (SR). Methods: Data were collected using focus group interviews. Two focus group interviews were held with a total of 10 psychiatric nurse participants. All interviews were recorded and transcribed, and data were analyzed using qualitative content analysis. Results: Eleven categories emerged from three main themes. All the themes describe factors that participants took into account when deciding whether to implement SR: 1) Personal factors area: 'Personal attributes of nurses,' 'Attitude of nurses regarding SR,' 'Nurses' physical and emotional states,' 'Negative experiences of nurses related to SR'; 2) Relational factors area: 'The level of cooperation between nurses and doctors,' 'Role models created by seniors and colleagues,' 'The level of support by nursing assistants,' 'Therapeutic relations with patients'; and 3) Environmental factors area: 'Poor nursing work environment,' 'Atmosphere of ward regarding SR,' and 'Social atmosphere to raise alarm about SR.' Conclusion: These findings should be considered in the evaluation of the use of SR in psychiatric hospital settings and appropriate strategies used to help minimize the use of restraint.

• 대한간호학회지
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• 제47권1호
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• pp.49-59
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• 2017

Purpose: The purpose of this study was to identify non-psychiatric nurses' difficulties in caring for patients with mental illness. Methods: Data were collected from eighteen general medical-surgical nurses working at a university hospital in Seoul, Korea. This study involved two focus group discussions and three in-depth individual interviews. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis. Results: General medical-surgical nurses experienced difficulties in 3 categories, 9 subcategories, 27 codes. The three categories were 'nurse' related factors, 'patient' related factors, 'resource' related factors. The nine categories were 'unpreparedness', 'nursing barriers due to stigma', 'undervaluing and avoidance of psychiatric nursing', 'eroding into the trap of a vicious cycle', 'facing unapproachable patients', 'dealing with unhelpful family members', 'burdening already overburdened staff', 'obstructive environment', and 'isolation of staff with heavy responsibilities'. Conclusion: The results of this study indicate the need to develop psychiatric mental health education programs for non-psychiatric nurses. Education about psychiatric mental health and support from institutions for non-psychiatric nurses can reduce their negative attitude toward psychiatric patients and difficulties in caring for psychiatric patients.