• 제목/요약/키워드: Psychiatric patients

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정신질환자들의 역기능적 태도, 스트레스 대처 방식 및 우울증상 간의 관계 (Relationship among Dysfunctional Attitudes, Stress Coping Strategies and Depressive Symptoms in Psychiatric Patients)

  • 박찬무;서경란;이민규
    • 정신신체의학
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    • 제5권1호
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    • pp.31-42
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    • 1997
  • This study was aimed to investigate dysfunctional attitudes, stress coping strategies and depressive symptoms in psychiatric patients. The subjects of this study consisted of 210 patients(138 schizophrenic patients, 29 depression patients, 43 alcohol dependence patients) according to DSM-IV criteria. Futhermore, the instruments were K-BDI(Beck Depression Inventory-Korean version), DAS(Dysfunctional Attitude Scale) and multidimensional coping strategy scale. The results were the following. 1) There were statistically significant correlations between depressive symptoms and dysfunctional attitudes in psychiatric patients. 2) In terms of coping strategies, there were positive correlations between depressive symptoms and focus on and venting emotions, accommodation, active forgetting, self-criticism, positive comparison, fatalism, passive withdrawal. Whereas, there was significant negative correlation between depressive symptom and active coping. 3) In terms of coping strategies, there were significant correlations between dysfunctional attitudes and focus on and venting emotions, active forgetting, self-criticism, positive comparison, fatalism, passive withdrawal. 4) Depression groups reported significantly higher BDI scores than schizophrenia groups. 5) In depression groups, DAS scores were significantly higher than those in schizophrenia groups. 6) In terms of coping strategies according to diagnosis, there were significant differences in venting emotions, active forgetting and self-criticism. As for venting emotions, alcoholic groups were scored significantly higher than schizophrenic groups. As for active forgetting, depression groups were scored significantly higher than schizophrenic groups. In self-criticism, depression groups and alcohol dependence groups reported significantly higher scores than schizophrenic groups.

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정신과에 의뢰된 내과계 환자들에 대한 치료적 접근 - 정신사회적 측면 - (Therapeutic Approaches to the Patients Who were Referred for Psychiatric Consultation from Medical Departments - Psychosocial Aspects in Consultation-liaison Psychiatry -)

  • 박종철
    • 정신신체의학
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    • 제1권1호
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    • pp.98-100
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    • 1993
  • To become an effective and successful consultation-liasion psychiatrist the psychiatrist should consider two aspects of consultation before he/she meets his/her patients. First the psychiatrist should understand the internal need and psychological state of patients who visited their physician before being refered to a psychiatrist So psychiatrists should be careful in the evaluation of the patient's intention whether they are willing to accept the psychiatric treatment approach or not Second the psychiatrist should understand the situation and the physician's internal need in the consultation. Psychiatrists should recognize whether there are any factors which interfere with the mutual understanding and cooperation between physicians and psychiatrist.

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정신과 환자의 치료적 활동에 관한 문헌적 고찰 (Literary Review of Therapeutic Activity of Psychiatric Patients)

  • 이소우
    • 대한간호학회지
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    • 제2권1호
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    • pp.175-188
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    • 1971
  • More and Tore emphasis is put on moral treatment in the care of psychiatric patients. Methods employed for moral treatment rake use of therapeutic activity for the mentally ill patient. In some psychiatric hospitals all of the therapeutic activities are categorized as occupational therapy, while in others these activities are departmentally categorized -recreational, musical, occupational and bibliotherapy. All of these constitute separate departmental therapies. By research, it is known at this time, that the above activities have been of great help in personality integration, reeducation and early recovery of patients, as well as in their social adjustment after discharge. The goal of these therapeutic activities incorporate the goals set by healthier interpersonal relationship and psychotherapy. Put the therapeutic activities require a prolonged time of therapy for effectiveness, economic support, special trained personnel, careful planning, guidance and proper evaluation. Therefore this treatment is a very complicated one. But it may be the most profitable therapy for certain patients. One true fact about this treatment is, that simple recreation, occupation, music, reading, etc., make the patients life in the ward more interesting and have a good effect on the interpersonal relationship between patients. Thus it has been proved that this kind of treatment demands the active and full participation of the personnel and the full support of the hospital administration.

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영과잉포아송회귀분석을 활용한 안정병동에 입원한 정신질환자의 공격행동 예측요인 (Predictors for Aggressive Behavior of Patients with Mental Illness in a Closed Psychiatric Ward using Zero-Inflated Poisson Regression: A Retrospective Study)

  • 김정호;신성희
    • 동서간호학연구지
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    • 제28권2호
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    • pp.160-169
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    • 2022
  • Purpose: This study was conducted to identify predictors related to aggressive behavior of patients with mental illness admitted to a closed psychiatric ward. Methods: This study adopted a retrospective design which analyzed the hospital medical records of 363 patients with mental illness admitted to the psychiatric closed ward of a university hospital in Seoul, Korea. The collected data were analyzed using SPSS IBM 20.0 and STATA 12.0 SE. ZIP (Zero-Inflated Poisson) and count data analysis were used for the factor influencing the occurrence and frequency of aggressive behavior. Results: The results of ZIP model showed that the factors influencing non-probability of aggressive behavior were anxiety, non-adherence, and frustration. In addition, the factors influencing frequency of aggressive behavior were bipolar disorder and personality disorder trait. Conclusion: We found that bipolar disorder, frustration, and non-adherence are more likely to increase the likelihood of aggressive behavior in patients with mental illness. In particular, patients diagnosed with bipolar disorder were 1.95 times more likely to engage in repetitive aggressive behavior compared to those without a diagnose. However, since the results were different form previous studies, further studies on the traits of anxiety and personality disorders are needed.

건강보험과 의료급여 환자간의 정신요법 진료량 차이 비교 - 정신병원 입원환자를 대상으로 - (Comparing Difference of Volume of Psychiatric Treatments between the Patient with Health Insurance and Those with Medical Assistance - For Inpatients of Korean Psychiatric Hospitals -)

  • 이대희;박은철;남정모;이상규;이동한;유승흠
    • Journal of Preventive Medicine and Public Health
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    • 제36권1호
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    • pp.33-38
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    • 2003
  • Objectives : To assess the difference in the volume of psychiatric treatments provided to health insurance inpatients, compared with those on medical assistance(the medical aid program) Korean psychiatric hospitals, and to determine factors which affect the volume of the services. Methods : 21 psychiatrists, from 3 Korean psychiatric hospitals recorded the frequencies psychiatric treatments provided to inpatients in one week (February 18-24, 2002). The records of 329 patients were analyzed through t-tests, and random effectmixed model analyses to define the difference between the two groups, and to find other factors affecting the volume of service. Results : A significant difference in the volume of psychiatric treatments provided was observed between the health insurance and medical assistance groups. The variation in the volume of service between hospitals was prominent, and other factors (gender, agegroup, length of stay and mental disorder)were also found to be significant. The patients on medical assistance received only 70% of the psychiatric treatments of those on health insurance. Conclusions : More effort is required to improve the methods of payment to increase the level of fee scheduling for medical assistance. Further studies on the mechanisms causing these differences in the volume of service are required.

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

  • 박한나;전성숙;변은경
    • 동서간호학연구지
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    • 제20권2호
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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.

내외과계 환자의 정신과 약물치료에서 약물-약물 상호작용 - 고려대학교 부속병원의 자문조정의 경험을 통하여 - (Drug-drug Interactions between Psychotropic Agents and Other Drugs in Physically Ill Patients - Experience of Consultation-liason in Korea University Hospital -)

  • 이민수;이헌정
    • 생물정신의학
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    • 제6권1호
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    • pp.49-66
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    • 1999
  • Polypharmacotherapy, both psychotropic and nonpsychotropic, is widespread in various situations including psychiatric hospitals and general hospitals. As the clinical practice of using more than one drug at a time increase, the clinician is faced with ever-increasing number of potential drug interactions. Although many interactions have little clinical significances, some may interfere with treatment or even be life-threatening. The objective of this review is evaluation for drug-drug interactions often encountered in psychiatric consultation. Drug interactions can be grouped into two principal subdivisions : pharmacokinetic and pharmacodynamic. These subgroups serve to focus attention on possible sites of interaction as a drug moves from the site of administration and absorption to its site of action. Pharmacokinetic processes are those that include transport to and from the receptor site and consist of absorption, distribution on body tissue, plasma protein binding, metabolism, and excretion. Pharmacodynamic interactions occur at biologically active sites. In psychiatric consultation, these two subdivisions of drug interactions between psychotropic drugs and other drugs are likely to happen. We gathered informations of the drugs used in physically ill patients who are consulted to psychiatric department in Korea University Hospital. And we reviewed the related literatures about the drug-drug interactions between psychotropic drugs and other drugs.

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종합병원 소아정신과에 자문의뢰된 환아에 대한 임상적 고찰 (A CLINICAL STUDY OF CHILD AND ADOLESCENT PSYCHIATRIC CONSULTATION IN A GENERAL HOSPITAL)

  • 김영랑;홍성도;이상신;임성후;박정환
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제16권1호
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    • pp.72-78
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    • 2005
  • 목 적 : 종합병원에서의 소아청소년을 대상으로 한 정신과 자문의 임상적 특징을 알아보고자 하였다. 방 법 : 4년 동안 한 종합병원에서 소아정신과에 의뢰된 302명의 환자의 병원기록을 조사 분석하였다. 결 과 : 학령기 아동과 청소년의 소아정신과 자문비율은 $2.15\%$였다. 중, 고등학생에서는 여자에서 더 많이 자문이 의뢰되었으나 학령전기 아동에서는 남자에서 더 많이 의뢰되었다. 자문의 $50\%$가 내과와 소아과로부터 의뢰되었다. 자문의뢰의 주된 이유는 정신과적 평가$(31.1\%)$, 우울$(11.6\%)$, 그리고 불안$(11.3\%)$이었다. 가장 자주 행해진 치료 목적의 정신과적 처치는 정신과적 교육과 지지적 정신치료였다$(21.2\%)$. 결 론 : 정신과 자문 의뢰의 임상적 양상은 성인과 소아청소년 사이에 차이가 있다. 소아 및 청소년을 위한 자문서비스를 강화시키기 위하여 더 많은 연구가 필요하다.

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정신질환자를 위한 대사증후군 통합건강관리 프로그램 개발 및 평가 (Development and Evaluation of an Integrated Health Management Program for Psychiatric Patients with Metabolic Syndrome)

  • 곽윤복;김지영
    • 대한간호학회지
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    • 제52권3호
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    • pp.261-277
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    • 2022
  • Purpose: This study developed an integrated health management program for metabolic syndrome in psychiatric patients and examined its effects on self-efficacy, healthy lifestyle, physiological indicators, knowledge of metabolic syndrome, attitudes toward healthy behavior, and social support. Methods: A non-equivalent control group pretest posttest design was used. The participants were 65 psychiatric patients with metabolic syndrome in psychiatric rehabilitation centers, with 33 in the experimental group and 32 in the control group. The experimental group participants engaged in daily mobile application and walking exercises three times a week for more than 40 minutes over 8 weeks, while those in the control group were provided education booklets. The outcomes were measured using self-report questionnaires, anthropometrics, and blood analyses. Intervention effects were analyzed using the independent t-test, Mann-Whitney U test, ANCOVA, and Ranked ANCOVA. Results: The experimental group showed a significant increase in self-efficacy (F = 8.85, p = .004, ηp2 = .13) and knowledge of metabolic syndrome (t = 2.60, p = .012, d = 0.60) compared to the control group. Additionally, the experimental group demonstrated a significant decrease in waist circumference (Z = - 2.34, p = .009, d = 0.58) and body mass index (Z = - 1.91, p = .028, d = 0.47) compared to the control group. Conclusion: The integrated health management program for psychiatric patients with metabolic syndrome is effective in improving self-efficacy and knowledge of metabolic syndrome and decreasing physiological indicators such as waist circumference and body mass index.

Beyond Attention-Deficit Hyperactivity Disorder: Exploring Psychiatric Comorbidities and Their Neuropsychological Consequences in Adults

  • Hyun Jae Roh;Geon Ho Bahn;Seung Yup Lee;Yoo-Sook Joung;Bongseog Kim;Eui-Jung Kim;Soyoung Irene Lee;Minha Hong;Doug Hyun Han;Young Sik Lee;Hanik K Yoo;Soo-Young Bhang
    • 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.