• Title/Summary/Keyword: Psychiatric hospitalization

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A Study on the Influences of Stressful Events and Coping Behavior on Mental Health (스트레스 사건과 적응행동이 정신건강에 미치는 경향에 대한 연구)

  • 이평숙;임현빈
    • Journal of Korean Academy of Nursing
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    • v.10 no.1
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    • pp.57-64
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    • 1980
  • The purpose of the study was to find out the relationship between experienced stressful events and its coping behavior within mentally wellness and illness, and to define the effective coping method under the stressful situation. By doing so, during the period of April, 1978- to March, 1979 the objects of this study were 100 persons who were under the psychiatric facilities in their first hospitalization, and who were registered in psychiatric out patient department in the form general hospitals located at Seoul selected as a experimental group. As a control group 100 persons who never experienced psychiatric treatment who were not under the current medical treatment, and who were tarring appropriate social roles in their community were selected, and in both groups utilized questimaires for Social Readjustment Pating Scale and Coping Scale. This study was tested by X$^2$ examinationand by F-ratio(analysis of variance). Results were as follows : Hypothesis 1. The actually experienced life events were expected to be higher in the experimental group than in the control group, but they did not show the significant difference between the groups.( p >0.05) Thus hypothesis 1 was rejected. Hypothesis : 2. The stress scores were expected to be higher in the experimental group than in the control group, and also did show the significant difference between the groups ( p< 0.05). Therefore hypothesis 2 was supported. Hypothesis 3. The non-effective coping behavior were expected to be higher in the experimental group than in the control group, and also did show the significant difference between the two groups(p < 0.001). Also hypothesis 3 was supported. Hypothesis 4 . The higher stress score groups (above 250 LCU ) were expected to utilize non.effective coping method more frequently than in the lower stress score groups (below 249 LCU ), and not only they showed high in utilizing non-effective coping method but also showed high in utililzing effective coping method. Thus hyphothesis 4 was partially supported. (p < 0.001) The following are drawn out based on the result of this study that the stress scores were higher, and more utilized non-effective coping method in the emotionally disturbances than in the emtionally healthies.

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The Investigation Regarding the Psychiatric Consultation of the Inpatient from General Hospital (일 종합병원 입원 환자의 정신과 자문 의뢰의 최근 3년간의 특성에 대한 연구)

  • Lee, Soo-Jin;Lee, Joong-Kwaun;Wang, Kwuan-Shu;Kim, Jung-Gee;Cho, Dong-Hwan;Kim, Hyun-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.1
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    • pp.49-59
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    • 2005
  • Objectives: This clinical study investigates the status of psychiatric consultation from 2001 to 2003 at Maryknoll General Hospital, located in Busan to evaluate the characteristic patterns of current psychiatric consultation and to contribute for further data of consultation study. Methods : The subjects of this study were hospitalized at Maryknoll General Hospital from 1 January, 2001 to 31 December, 2003, who were referred for psychiatric consultation during hospitalization. This study was analysed demographic data, reason for referral, psychiatric diagnosis by patient's chart and psychiatrist's report retrospectively. Results : 1) The psychiatric consultation rates was 1.72%. 2) There was 47.8% in referral among the age group over 60 years, especially the age group over 70 years was 20.3%. 3) The most frequent referral source was department of internal medicine(72.5%). 4) The frequency of psychiatric consultation was the highest at March and the lowest at December. 5) The reasons of psychiatric consultation, according to frequency, were affective change, somatic symptom without abnormal finding. And drug intoxication. alcohol problem were increased. 6) Somatoform disorder was the most common psychiatric diagnosis followed by depressive disorder, organic mental disorder. The diagnosis of somatoform disorder, depressive disorder, alcohol dependence were increased, but anxiety disorder, organic mental disorder were decreased. 7) Pharmacotherapy was the most recommendation, and diagnostic procedure and psychotherapy were increased. Conclusion : In review of consultation referral subjects, the referral rate was 1.72%. The consultation referral of the old(over 60 years) was 42.8%, and annually increased. The most frequent request source was from department of internal medicine. The reasons of consultation referral was the most due to affect change. The recommendation of pharmacotherapy was the most numerous. and psychotherapy was increased annually. Further studies warranted on geriatric psychiatric consultation, pattern change of consultation.

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Influences of mental health characteristics and admission experiences on perceived coercion (정신장애 특성과 입원과정의 경험들이 지각된 강요에 미치는 영향)

  • Seo, Mi Kyung;Kim, Seung-Hyun;Rhee, MinKyu;Choi, Yong-Sung;Kim, Sung-Hyun;Lee, Moon-Soo;Lee, Heon-Jeong;Kwon, Young-Joon;Kim, Bong-Jo
    • Korean Journal of Health Psychology
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    • v.16 no.1
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    • pp.1-14
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    • 2011
  • Coercive treatment in mental health has undergone an immense period of philosophical and clinical debate and yet it remains as a highly important issue in which ideology and practice contradict each other. this study focused on the perceived coercion of the persons with mental disorder and analyzed how the characteristics of mental disorder(psychiatric symptoms, psycho-social functions, insight, and the degree of awareness on the need for treatment) and experiences in the process of hospitalization (legal status, coercive measures, and procedural justice) can predict perceived coercion. The participants of this study were 302 patients that has been hospitalized in the psychiatric ward within the period of 4 weeks. 195 participants(64.6%) were male and 106(35.1%) participants were female. MAES, BPRS, GAF, Insight, Legal Status, Coercive Measures, and Need for Treatment were measured. Regression analysis was used to analyze how much perceived coercion can be predicted by characteristics of mental disorder such as the patients' BPRS, GAF, insight, and need for treatment. As a result it showed that among the characteristics of mental disorder insight and awareness of the need for treatment were the main predictors and the characteristics of experiences during hospitalization such as procedural justice, coercive measures, and legal status all displayed significant predictability. As well as implications of results in a practical method of intervention to reduce perceived coercion, the paper discussed issues for limitations and future consideration.

Characteristics of Patients who Died by Suicide in a Community Mental Health Center (정신건강센터 등록 회원 자살사망자 특성)

  • Nah, Gihoi;Choi, Seunggi;Kim, Honey;Lee, Ju-Yeon;Kim, Jae-Min;Shin, Il-Seon;Yoon, Jin-Sang;Kim, Sung-Wan
    • Korean Journal of Schizophrenia Research
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    • v.20 no.2
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    • pp.55-60
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    • 2017
  • Objectives : Severe mental illness is a major risk factor for suicide. This study aimed to identify characteristics of patients who died by suicide among subjects who had been received service from a community mental health center. Methods : We searched individuals who had committed suicide in Gwangju Bukgu Community Mental Health Center since 2006. Sociodemographic and clinical data were gathered from medical records and their case managers and they were compared with those of general members in the center. Characteristics of schizophrenia patients who died by suicide were particularly summarized. Results : Twelve person committed suicide between 2006 and 2016. The characteristics of those who died by suicide were male (67%), diagnosis of schizophrenia (75%), aged below 50 (83%), unemployed (92%), past history of psychiatric hospitalization (100%), recent admission within 3 months (67%), past history of suicidal attempt (78%), family history of schizophrenia (58%), poor adherence to medication (58%), and use of daily rehabilitation program (42%). Ten out of twelve (83%) showed warning sign for suicide. All identified method of suicide in patients with schizophrenia was jumping from high building. Many patients with schizophrenia, who committed suicide, suffered from comorbid depressive symptoms (67%) and auditory hallucination (78%). Conclusion : Case managers should pay attention to and carefully manage individuals who showed suicidal warning, particularly with risk factors for suicide, such as unemployment, admission state or recent discharge from psychiatric hospital, poor adherence to medication, family history of schizophrenia, and a history of suicidal attempt.

The Effects of COVID-19 on the Self-Harm in Children and Adolescents Observed in a University Hospital (대학병원에서 관찰한 코로나19가 소아청소년 자해에 미치는 영향)

  • Oh, Sae-Bom;Kim, Seung-Jun;Kim, Ji-Woong;Oh, Hong-Seok;Im, Woo-Young;Lee, Na-Hyun
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.128-135
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    • 2021
  • Objectives : The aim of the present study is to investigate the impact of COVID-19 on the incidence and severity of childhood and adolescent self-harm. Methods : Medical records were retrospectively reviewed for patients under the age of 18 who visited the emergency room of Konyang University Hospital to compare the rate of self-harm attempts and the demographic, clinical, and self-harm-related of self-harm attempters aspects before and after the COVID-19 outbreak. Results : During 11 months after the COVID-19 outbreak, the proportion of the number of children and adolescents patients with self-harm and their episodes increased significantly compared to that during 11 months before the COVID-19 outbreak (𝛘2=14.397, p<0.001; 𝛘2=24.156, p<0.001). Between about the year before and after the outbreak of COVID-19, there was a significant difference in the prior self-harm history and psychiatric history among children and adolescents who visited the emergency room and the ratio of hospitalization to other departments than department of psychiatry (p<0.05; p<0.05; p<0.05). Conclusions : In the COVID-19 situation, the proportion of children and adolescents who visited the emergency room due to self-harm and admission to other departments are increasing. And it has been shown that the incidence of self-harm has significantly increased in children and adolescents with a history of prior self-harm and psychiatric past history. These findings underscore the need for the psychiatric evaluation and intervention of self-harm related high-risk groups among children and adolescents in pandemic situations.

A Study on the Rank of Stressful Events Related to the Experience of Hospitalization (입원환자가 경험한 입원스트레스 순위에 관한 연구)

  • 이소우;하양숙;박은숙
    • Journal of Korean Academy of Nursing
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    • v.15 no.1
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    • pp.17-29
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    • 1985
  • This study was to explore on the rank of stressful events related to the experience of hospitalization. 180 hospitalized patients on surgical and medical wards were asked to rate 49 stress-producing events associated with the experience of hospitalization. Two university hospitals was used as the setting for this study. Because the nature of the events in the stress scale pertain mainly to general short term hospitalizations, patients in the rehabilitation and psychiatric units of the hospital were not included. Prior to the beginning of the study, three times meeting were held with 12 head nurses and 3 investigators for discussing with the ethics subject related to the study. The pretest was done to determine whether items to use were pertinent or not. According to the result of the pretest, Volicer's Hospital Stress Rating Scale was selected as a study tool for this study. Data collection was used an interview and a card-sorting method. The interviewing was done by two authors and three graduate nursing students. A total 125 completed the card-sorting procedure. The stressful items were ordered from most to least stressful within the categories. Additional information such as: age, sex, marital status, and diagnosis was obtained from the kardex file. The ordered list of items, with mean values, as scored by the total of 125 respondents was significantly accepted at 1% level by Friedman test. (X²=1448.339) The event,“knowing you have a serious illness.”was rated highest stressful and (M=41.54) “Being awakened in the night by the nurse”least stressful. (M=14.73) Highly rated items were orderly “Thinking you might have cancer”“Thinking you might lose a kidney or some other organ”“Not being told what your diagnosis is. “Not knowing for sure what illness you have,”five lowerly rated items were orderly “Having to eat at different times than you usually do”“net being able to call family or friends on the phone”“Not having friends visit you,”“Having strangers sleep in the same room with you.”Futher analysis of the data was done to ascertain tao degree of similarity of judgment between different groups in the sample as to how events should be rated. The sample was divided into two groups according to the demographic characteristics and the degree of seriousness of illness. The rank order correlation was calculated for the two sets of ranks as a measure of consensus between the two groups. The correlations ranged from .85∼.99 all indicating a high degree of consensus.

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The Role of Tc-99m HMPAO Brain Perfusion SPECT in the Psychiatric Disability Evaluation of Patients with Chronic Traumatic Brain Injury (만성 외상성 뇌 손상 환자의 정신의학적 후유 장애 평가에서 Tc-99m HMPAO 뇌혈류 SPECT의 역할)

  • So, Young;Lee, Kang-Wook;Lee, Sun-Woo;Ghi, Ick-Sung;Song, Chang-June
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.4
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    • pp.232-243
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    • 2002
  • Purpose: We studied whether brain perfusion SPECT is useful in the psychiatric disability evaluation of patients with chronic traumatic brain injury (TBI). Materials and Methods: Sixty-nine patients (M:F=58:11, age $39{\pm}14$ years) who underwent Tc-99m HMPAO brain SPECT, brain MRI and neuropsychological (NP) tests during hospitalization in psychiatric wards for the psychiatric disability evaluation were included; the severity of injury was mild in 31, moderate in 17 and severe in 21. SPECT, MRI, NP tests were peformed $6{\sim}61$ months (mean 23 months) post-injury. Diagnostic accuracy of SPECT and MRI to show hypoperfusion or abnormal signal intensity in patients with cognitive impairment represented by NP test results were compared. Results: Forty-two patients were considered to have cognitive impairment on NP tests and 27 not. Brain SPECT showed 71% sensitivity and 85% specificity, while brain MRI showed 62% sensitivity and 93% specificity (p>0.05, McNemar test). SPECT found more cortical lesions and MRI was superior in detecting white matter lesions. Sensitivity and specificity of 31 mild TBI patients were 45%, 90% for SPECT and 27%, 100% for MRI (p>0.05, McNemar test). Among 41 patients with normal brain MRI, SPECT showed 63% sensitivity (50% for mild TBI) and 88% specificity (85% for malingerers). Conclusion: Brain SPECT has a supplementary role to neuropsychological tests in the psychiatric disability evaluation of chronic TBI patients by detecting more cortical lesions than MRI.

Development of the Children's Separation Rating Scale Its Clinical and Research Use (아동분리반응척도의 개발 : 임상 및 연구응용)

  • Kim, Wun-Jung;Hahn, Sung-Up
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.148-160
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    • 1990
  • This paper reports on the development of the Children's Separtion Rating Scale(CSRS), its initial reliability and validity, and clinical/research utility with psychiatrically hospitalized children. The CSRS appears to be a reliable and valid instrument, and useful in distinguishing children's separation reaction from their general psychopathology. It may be also useful in aiding clinicians in differential diagnosis. This study points to the need for further understanding of children's psychiatric hospitalization in relation to their separation reaction and its possible untoward effects. Findings of this pilot study support the notion that inpatient treatment programs should address the developmental needs and abilities of the various age groups and the particular deficits reflected in their psychopathology.

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Primary Polydipsia in Children: Two Case Reports

  • Hwang, Nu Ri;Kim, Min Sun;Kim, Soon Chul;Lee, Dae-Yeol
    • Childhood Kidney Diseases
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    • v.22 no.2
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    • pp.67-70
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    • 2018
  • Primary polydipsia (PP) is marked by an increase in thirst, and most often presents in patients with psychiatric illnesses. Although uncommon in children, we experienced cases of PP in a 15-month-old boy and a 5-year-old girl. Both were admitted to the hospital with symptoms of polydipsia and polyuria that appeared 1-3 months before admission. Brain magnetic resonance imaging in both patients was normal. A water restriction test was performed after hospitalization and showed normal results. The symptoms improved after the parents were instructed to implement water-intake restriction for 2 weeks. Our report provides useful information for the treatment of PP in children.

A Research of School Refusal on Adolescent with Psychiatric Disorders (정신병리를 가진 청소년의 등교거부 사례보고)

  • Heo, Eun-Jung;Lee, Sang-Eon;Lyu, Heui-Yeong
    • Journal of Oriental Neuropsychiatry
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    • v.21 no.4
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    • pp.219-231
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    • 2010
  • Objectives : School refusal is usually considered as individual's behavioral problem. These days. however. the adolescents' school refusal needs some kind of medical approaches because it is related to mental disorder of the adolescents. Due to too much pressure and stress from the competition between classmates and from good performance in school. the number of adolescents who refuse to go to school is increasing. Despite this circumstance. school refusal is neither regarded as a single independent disorder nor endorsed as an officially classified disease. which makes difficult to conduct research on this issue and to establish standardized treatment for it. In addition. there is a lack of research on this topic. especially in oriental medicine. so there is no a case report or study on school refusal. This study is trying to comment on school refusal from the perspective of oriental medicine. Methods : We tried to examine the effect of oriental medicine treatment for school refusal with four adolescent cases. The patients commonly have at least more than one mental disorder (including depression disorder. anxiety disorder. and anorexia nervosa). have some problem with the relationship with their family. in particular with mother. do not have father or not be loved by their father. and have irregular eating habits. Thus. we diagnosed them as qi transforming into fire (氣鬱化矢) spleen-stomach deficiency cold (脾胃虛寒) and heart blood deficiency (心血虛) due to stress from the family issues and unhealthy eating habits. The patients received supportive therapy. family therapy. etc among many oriental mental treatments and their progress had been observed through hospitalization and outpatient treatment. Results : All four cases were reported positive progress on their symptoms and started coming back to school. We also examined whether they were well fitting into the school while they received outpatient treatment. and the results show that all four patients continue to settle down in normal school life. Conclusions : This study closely reviewed the mental disorder of school refusal cases and showed that the Oriental medical treatment was effective in helping the patients come back to school. More future research is required to better treatment for school refusal cases in oriental medicine.