• 정신신체의학
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• 제4권2호
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• pp.163-169
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• 1996

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.

• 대한간호학회지
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• 제46권4호
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• pp.583-597
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• 2016

Purpose: The study was done to evaluate the effects a Stress Management Program (SMP) on stress, problem solving skills, and quality of life for hospitalized patients with Schizophrenia. Methods: A mixed method design was used: a combination of a repeated-measure design with a non-equivalent control group and qualitative data collection. The participants were 40 patients with schizophrenia admitted in three psychiatric hospitals. The experimental group (n=20) received the SMP twice a week for a total of 8 weeks. Results: Study results revealed that the SMP was effective for stress (F=321.02, p<.001), problem solving ability (F=246.28, p<.001), and quality of life (F=63.35, p<.001) for hospitalized persons with schizophrenia. Conclusion: The results suggest that a SMP can be an effective strategy to reduce patients' hospitalization stress, and improve problem solving skills and quality of life. Therefore, it is recommended that mental health nurses use this stress management program in clinical practice to assist adaptation to hospitalization for persons with schizophrenia.

• 대한간호
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• 제32권3호
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• pp.68-87
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• 1993

This study was designed to investigate the family burden, family home care needs and to identify the relationship between family burden and home care needs for families of psychiatric in-patients. The subjects for this study were 104 family members of psychiatric in-patients at two private hospitals and one municipal hospital. The data were collected during the period from February 1. 1993 to March 30. 1993. The questionnaire developed by Montgomery to measure the family burden was used as modified by the research team for this study. The questionnaire was developed by Garrad to measure the home care need was also used as modifed by the research team. The data was analyzed using descriptive statistics, t-test, ANOV A and Pearson Correlation Coeffcient. with the SPSS program. The Result of this study can be summarized as follows ; 1. For perceived family burden, the meanscore as measured by the guestionnaire was 70.6 of a possible to total of 110. 2. For home care need. the meanscore as measured by the questionnaire was 44.8 fo a possible total of 66. 3. The results showed a higher score for cases from the municipal hospital for family burden and a higher score for cases at the private hospitals for home care need. 4. Ther was a statistically significantly higher score on family burden for female family member (T =-2.77. P<.05) and for bereaved family members. (F=2.862. p<.05) 5. There was a statistically significantly higher score (F= 10.3535, P<.001) for family burden when the hospitalization period was between 7~ 12 months and a statistically significantly higher score (F =7.679.P<.001) for home care need when the hospitalization period was over 37 months. 6. Ther was a significant correlation between family burden and home care need. (r=.4002, P<.05) The conclusion that can be drawn from this study is that addressing home care needs would contribute to reduce family burden.

• 대한임상독성학회지
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• 제14권1호
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• pp.47-53
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• 2016

Purpose: Intentional poisoning is a major public health issue in many parts of the world. This study was conducted to provide details regarding the epidemiology of intentional poisoning in a metropolitan emergency department and to identify the changing patterns and epidemiology of poisoning. Methods: A retrospective study was conducted to evaluate intentional poisoning of patients who visited the emergency department in a tertiary teaching hospital between 2001 and 2015. All intentional poisoning-related emergency department visits over three five year periods (2001-2005 (P1), 2006-2010 (P2) and 2011-2015 (P3)) were reviewed to investigate trends in intentional poisoning patients. Information regarding patient sex, age, time from episode to admission, psychiatric history, type of intoxicants, alcohol co-ingestion, gastric lavage, charcoal administration, any previous suicide attempts, need for hospitalization and death before discharge was reviewed. Results: A total of 1269 patients were enrolled in this study. The number of patients admitted during each period was P1=515, P2=439 and P3=315. Comparison of the three groups revealed significant differences according to age (p<0.001), psychiatric history (p<0.001), alcohol co-ingestion (p=0.013), gastric lavage (p<0.001), charcoal administration (p<0.001), need for hospitalization (p=0.044), repeated attempt (p<0.001) and type of intoxicants (p<0.001). Conclusion: The average age of intentional poisoning patients has increased. While the use of sedatives and multiple drugs increased, the use of pesticides and the antihistamine decreased.

• 대한임상독성학회지
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• 제12권2호
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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.

• 한국융합학회논문지
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• 제9권4호
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• pp.397-408
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• 2018

본 연구의 목적은 심층면담을 통해 조현병환자의 입원스트레스 경험을 규명하고 입원스트레스를 중재 할 수 있는 기초 자료를 마련하고자 한다. 연구방법은 두 지역의 3개 정신과 병원 폐쇄 병동에 입원중인 조현병환자 15명을 대상으로 심층 면담을 시행하여 면담 내용을 질적 내용분석하였다. 연구 대상자는 15명으로 평균 나이는 40세였다. 현재 입원 기간은 평균 2년이었다. 연구기간은 2015년 10월 21일부터 11월 10일까지이다. 연구결과 입원스트레스 내용은 5개의 상위범주와 17개의 하위범주 및 58개의 의미 있는 내용이 도출되었다. 5개의 상위범주는 '가족에 대한 그리움과 죄책감', '미흡한 치료적 환경으로 인한 불편함', '환자의 권리를 존중받지 못함', '퇴원 후 삶에 대한 불안', '사회적인 편견과 자기낙인감'이었다. 본 연구 결과는 조현병환자의 입원스트레스를 중재 할 수 있는 기초자료를 마련한 것에 의의가 있다. 후속연구에서는 같은 환경에 입원중인 조울증, 알코올 중독 등 다른 정신질환을 가진 대상자의 입원스트레스를 파악하여 비교 분석해보는 연구를 제언한다.

• 대한임상독성학회지
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• 제20권1호
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• pp.8-14
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• 2022

Purpose: This study was undertaken to investigate how sedative-hypnotics affect the occurrence and severity of the patient's symptoms. In addition, we conducted a study to determine the type of patients who reacted severely and required hospitalization; patients were accordingly classified as hospitalized patients and patients discharged from the emergency room. Methods: From January 2017 to December 2019, we investigated the demographics, drug information, history, laboratory tests, and severity of patients who visited our emergency department and were diagnosed with benzodiazepine, zolpidem, and doxylamine succinate overdose. We further compared details of hospitalized patients and discharged patients. Results: Subjects who had overdosed and visited the ED included 120 for benzodiazepine, 147 for zolpidem, and 27 for doxylamine succinate. Comparisons between the three groups revealed differences in their early diagnosis, psychiatric history, and sleep disturbance. Differences between groups were also determined for mental state, poisoning history, treatment received in the intensive care unit, and intubation and ventilator support. In cases of benzodiazepine overdose, we obtained a high hospitalization rate (40.0%), admission to the intensive care unit (24.2%), and intubation rate (18.3%). Comparisons between hospitalized patients and discharged groups showed differences in transferred patients, early diagnosis, and mental state. Conclusion: Patients poisoned by sedative-hypnotics are increasing every year. In cases of benzodiazepine and zolpidem, the hospitalization rates were high, and benzodiazepine overdose resulted in hospitalization, intensive care unit admission, and pneumonia in a majority of cases. Therefore, active treatment and quick decisions in the emergency room are greatly required.

• 동의신경정신과학회지
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• 제33권1호
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• pp.113-122
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• 2022

Objectives: To report the effect of Korean medicine on a patient with insomnia from severe hot flashes. Methods: The patient suffered from extreme hot flashes for months. Symptoms were so severe that the patient attempted suicide. After starting psychiatric medication, symptoms persisted and hospitalization began. During hospitalization, herbal medicine, acupuncture, and psychotherapy were conducted. For evaluating therapeutical effect, Digital Infrared Thermal Imaging was performed twice during the treatment process. It was divided into major facial area and back area. The facial area was divided into two small units to measure the difference in temperature between two points. The back area was measured in the same way. Results: The temperature difference between the two points decreased over time and the patient's subjective symptoms reduced. Conclusions: Korean medicine therapy can improve symptoms of patients with insomnia accompanied by hot flashes.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제8권1호
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• pp.70-82
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• 1997

본 연구는 비행청소년의 사회심리적 특성을 파악하고 비행을 직접적으로 유발시키는 요소를 알아보고자 실시되었다. 청소년 병동에 입원한 환자 중 정신증 진단을 제외한 210명을 비행의 정도에 따라 경찰체포후 훈방된군(60명), 재판 판결을 받은군(35명), 이러한 사실이 없는 정서적으로 혼란된 비교군(105명)으로 나누어 인지-학습, 감정상태, 자살사고, 성격특성, 가족구조, 생활사건 영역에 관한 표준화된 검사를 실시하고 그 결과를 비교분석하였다. 공유진단을 파악하고자 이중 무작위로 60명은 구조화된 면담을 실시하였다. 연구결과 비행청소년은 비교군에 비해 1) 입양, 성생활의 문란, 가출, 정신과 입원력이 높았으며, 2) 언어성 지능지수 및 학습능력이 떨어지고, 3) 성격구조상 충동적이고 사회순응도가 낮으며, 강압적이며, 4) 가족단위의 여가활동이 적고, 낮은 종교 도덕관을 가진 가족의 특성을 보였으며, 5) 부정적 생활 경험이 많았고, 6) 품행자애, 반항장애, 주의력 결핍 과잉행동장애 진단율이 높았다. 우울, 불안, 자살사고는 3군중 훈방된군에서 가장 낮게 나왔다. 따라서 비행청소년을 다룰 때 비행에 관여하는 인지학습측면, 충동적인 성격구조, 가족구조, 부정적 생활경험, 파탄적 행동장애 측면에 관한 보다 집중적인 대처방안이 강구되어져야 하겠다.

• 한국사회복지학
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• 제55권
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• pp.231-254
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• 2003

본 연구는 장애의 특성상 인권보장이 '다수의 안전'이나 '치료적 이득'과 갈등이 있을 수밖에 없는 정신장애인의 인권 보장과 제한을 일반적으로 어떻게 이해하는지를 알아보고자 하는 것이다. 따라서 일반인 10명, 전문가 9명, 정신장애인 6명을 대상으로 각 권리(존엄성 존중, 차별대우 받지 않을 권리, 자발적 입원보장, 자유로운 환경보장)별로 문제영역(장기입원, 운전면허취득제한, 강제입원, 통신의 자유제한)을 구체화하여 면담하였다. 면담내용을 질적 분석한 결과 조사대상자들이 권리보장과 제한을 이해하는 두 가지 차원을 발견하였다. 첫 번째 차원은 권리보장과 제한을 다수에 미치는 긍정적 결과를 중심으로 정당화하느냐 아니면 인권존중의 보편적 원리를 내세워 권리중심으로 정당화하느냐 하는 것이다. 두 번째 차원은 권리보장과 제한의 판단주체를 공식적 체계에 두느냐 아니면 비공식적 체계에 두느냐 하는 것이다.