• Anxiety and mood
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• v.2 no.2
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• pp.101-107
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• 2006

Object : Since autonomic nerve system dysfunction was known as the mechanism of panic disorder, many researchers used heart rate variability (HRV) as means of measuring autonomic nerve function of patients with panic disorder. We aimed to examine the effect of paroxetine medication for 3 months on symptom improvement and change of heart rate variability of the patients with panic disorder. Methods : The subjects were patients with panic disorder who visited the psychiatric outpatient clinic of Samsung Medical Center in Seoul. We included panic disorder patients who were aged from 20 to 50 and in normal BMI range (from 18 to 30) to minimize the effect of age and weight on HRV data. We excluded the patients with EKG abnormalities, hypertension or other major psychiatric disorders. They took 20-40 mg paroxetine medication a day for 3 months. Alprazolam was used only during the first month to control the acute panic symptoms and was tapered off after that. We measured the acute panic inventory (API), Hamilton rating scale for anxiety and depression (HAM-A & HAM-D), Spielberger state-trait anxiety inventory (STAIS, STAIT), and Beck depression inventory (BDI) in order to assess clinical improvement of the patients. And we measured time and frequency domain HRV in the resting, standing and cognitive stress states to assess the change of HRV. All measurements were done before and after paroxetine treatment. Result : After paroxetine medication, patients showed significant improvement in all psychiatric scales. In time domain of HRV, standard deviations of all R-R intervals (SDNN) were significantly increased in all states. In frequency domain of HRV, the ratio of high frequency to total power (HF/TP) in the standing state was significantly increased. Conclusion : After 3 months paroxetine medication, panic disorder patients showed significant clinical improvement and change in HRV data such as SDNN in all states and HF/TP ratio in the standing state. This result suggests that paroxetine medication is effective for the improvement of autonomic nerve system dysfunction in panic disorder patients.

• Anxiety and mood
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• v.15 no.2
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• pp.61-67
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• 2019

Objective : This study aimed to investigate the general process from the symptom onset to the psychiatric treatment in Korean panic patients and the effect of improved public awareness on it. Methods : This study has a retrospective design. The subjects were the new patients with panic disorder who visited the psychiatric outpatient clinic in twelve university-affiliated hospitals all across Korea. The medical chart was reviewed retrospectively and the data were collected including chief complaints of symptoms, recent stressors, the time to visit the psychiatric outpatient clinic, and visit of other departments and diagnostic approaches for their symptoms. Results : A total of 814 participants were included in the study. The most common department other than psychiatry the panic patients visited were cardiology (28.3%), general internal medicine (16.0%) and neurology (11.4%). The most frequently used diagnostic tests were a echocardiography (17.9%), 24-hour Holter monitoring (11.2%), and brain MRI (8.2%). Only 37.3% of participants visited psychiatric clinic directly. About 80% of participants visited psychiatric department within 1 year after their first panic symptoms and it took $13.8{\pm}13.7weeks$ on average. Comparing before and after 2012, the number of participants increased who visit directly the psychiatric clinic without visiting other departments (p=0.002) and without visiting emergency room (p<0.001). Conclusions : Our results suggest that a substantial number of patients visit departments other than psychiatry when they experience first panic symptoms. However, most patients begin psychiatric treatment within 1 year after their first symptoms and the number of patient are increasing who visit psychiatric department directly without visiting other departments.

• Journal of The Korea Institute of Healthcare Architecture
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• v.29 no.1
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• pp.53-62
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• 2023

Purpose: Recently, the number of severely mentally ill patients has been increasing rapidly in Korea, but there are no design guidelines for spatial planning of Korea's acute psychiatric wards. The study aims to clarify the areas and required rooms in Korea's acute psychiatric wards which are important in establishing the design guidelines for Korea's acute psychiatric wards. Methods: This study proposed a structural framework based on the results of investigating and analyzing the acute psychiatric ward guidelines in the UK, Australia, and the U.S. and the areas and the required rooms of the wards stipulated in the basic data for establishing acute psychiatric ward design guidelines in Korea. The design guidelines for overseas acute psychiatric wards are 'Adult Acute Mental Health' in the UK, 'Adult Acute Mental Health Inpatient Unit' in the Australia, and 'Specific Requirements for Mental Health Hospitals' in the United States. Results: As a result of investigating and analyzing the design guidelines for overseas acute psychiatric wards, the areas of wards applicable to acute wards in domestic psychiatric wards were access, patient, treatment, support, and employee areas. In addition, the required rooms for each area were defined around major considerations such as visibility, convenience, comfort, security, safety, patient observation, barrier-free design, and privacy protection. Implications: The results of the study will be presented as a structural framework and basic data for establishing design guidelines for Korea's acute psychiatric wards, which is still absent.

• Sleep Medicine and Psychophysiology
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• v.4 no.1
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• pp.120-128
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• 1997

Clinical neuropsychological tests were developed originally for the diagnosis of neurological and neuro-surgical diseases. Recently, these tests are being introduced to psychiatric patients. Authors had the experience to use these tests in pychiatric outpatient clinic. Results were as follows. There was a significantly increase in language and attentional function in residual schizophrenia compared to normal control. In chronic neurosis, as visuospatial function was reduced, language and attentional functions were enhanced. With these results, authors suggest that application of neuropsychological tests in psychiatric patients may be very helpful in classifying the subgroups of disease, in selecting the modality of treatment, and in expecting prognosis.

• Journal of The Korea Institute of Healthcare Architecture
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• v.3 no.4
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• pp.7-16
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• 1997

Mental hospital has been expanding its function to psychiatric treatment in the meaning of therapy. Therefore systematic research on thr mental hospital is urgent. This study aims to prepare the basic data which are needed on planning and designing the mental hospital with emphasis on the wards, which take the largest area ratio and play a principal role to psychiatric patients. The process of study is to 1) to survey facility of Mental hospital in Korea, 2) to analize charactor and behavior of psychiatric patients 3) to suggest element of ideal ward in general hospital.

• Korean Journal of Psychosomatic Medicine
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• v.21 no.2
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• pp.114-121
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• 2013

Objectives: The aim of this study was to know differences of characteristics between presenile and senile patients who were consulted to the department of psychiatry during medical-surgical admission. Methods: The demographic and clinical data obtained from the medical records of psychiatric consultation in the presenile inpatients with age 50 to 64 years(N=162) and those of the senile inpatients with age over 65 years(N=171) were reviewed and compared. Results: 1) The most common chief complaints for psychiatric consultation in presenile patients were somatic symptoms, anxiety and sleep disturbance in order, while cognitive decline, clouded consciousness and depressed mood were most common in senile patients with statistical significance. 2) The most frequent psychiatric diagnoses after consultation in presenile patients were delirium, mood disorder and substance use disorder in order, while delirium, mood disorder and major neurocognitive disorder were most frequent in senile patients with statistical significance. 3) There were no significant difference in numbers of physical illnesses, while numbers of therapeutic drugs for them were more in senile patients. Conclusions : Our study found significant differences between presenile and senile patients on psychiatric symptoms and diagnoses in geropsychiatric consultation. Therefore, more subdivided age-specific approach seems to be needed for the geropsychiatric consultation activities.

• Journal of Korean Academy of Nursing
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• v.5 no.1
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• pp.59-69
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• 1975

Author studied on various psychiatric nursing problems applying with the test of questionnaire to the 376 nurses who are attending at 13 general hospitals and one mental hospital in Korea from Apr. 1, 1974 to July 30. 1974. The results obtained were ai follows: 1. 13.095 of nonpsychiatric registered nurses wanted the psychiatric service for their most attractive assignment and this was the 3rd in order next to the general surgical and operating room. Among the psychiatric nurses, the popularity toward psychiatric ward was 31. 0% and they were 26.0%at the private general hospitals and 6, 0% in national public hospitals. 2, The feelings or attitudes of disgust and apprehension on nursing care of the patients at-flirted with infectious diseases were the highest responses (38.5%) and these 1.ends were also appeared in 6.9% of psychiatric nurses. 3. 85.5% of nonpsychiatric registered nurses have had received course lectures on psychiatric nursing and nursing care training on the psychiatric ward at their school of nursing. 38.0% of psychiatric nurses had received post graduate psychiatric nursing and they were higher in national public hospitals (27.0% ) than in private general hospitals (11.0%). 4. The responses of satisfaction and security on their employment were almost similar patterns between nonpsychiatric registered nurses and psychiatric nurses. But among the psychiatric nurses. they were more satisfied at private general hospitals (33.0%) than that of national public hospitals (10.0%). 5. Almost the half of the nurses (50.8%) were employed by the hospitals without considering their past educational or clinical experience or career. Among the psychiatric nurses, who were employed by hospitals without considering their past experience or career were 35.0% in national public hospitals and 12.0% in private hospitals. On the contrary, the nurses who were employed by their wishes fore more higher (26.0%) in private general hospitals than national public hospitals (2.0%). 6. The nurses who thought their employment was fit for their aptitude were 48.6% in nonpsychiatric registered nurses and 51.0% in psychiatric nurses. Among the psychiatric nurses, this response was higher in private general hospitals (34.0%) than the national public hospitals (17.0%). 7. Responses on wort loadings of nurses showed almost same patterns between nonpsychiatric registered nurses and psychiatric nurses. But. among the psychiatric nurses who felt much heavier than the nurses of other part were 24.0% in national public hospitals and 8.0% in private general hospitals. 8. 92.6% of nurses felt that the psychiatric nurses should have post graduate training in psychiatric nursing prior to their assignment. 9. 96.0% of nurses agreed to the risk coverage on the payment for the nurses assigned to the psychiatric ward and the ward for infection diseases.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1580-1591
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• 2000

This study was conducted to assess the amount of nursing services for psychiatric inpatients and to estimate psychiatric nursing costs by using the RBRVS. Full details of medical services, including physician and nursing services, for psychiatric inpatients were surveyed and data of general characteristics of hospitals and patients were also collected. The cost of nursing activities was estimated by the multiple conversion factor which was drawn from the Korean RBRVS Development Project to the RBRVS score of each nursing activities, which was drawn from the results of Korean Nurses Association (KNA)'s projects about nursing RBRVS development and cost of nursing activities. The data about 89 inpatients from 3 general hospitals with psychiatric departments were analyzed. The total cost of nursing activities for each patient per admission day was from KRW 22,185 to KRW 27,954 by hospital, and KRW 25,220 in average. The percent of nursing cost to the total cost of medical services was from 36% to 48% by characteristics of patients and 41.4% in average. The cost of nursing activities estimated in this study was between the existing NHI fee schedule and the one suggested by KNA. It is considered as appropriate and acceptable level compared to the total amount of medical services. In the process of KNA's activities to get nursing fee in NHI fee schedule, results of additional studies to estimate the cost of nursing activities balanced with total cost of medical services in every departments should be found and utilized.

• The Korean Journal of Pain
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• v.31 no.2
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• pp.116-124
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• 2018

Background: We aimed to investigate the prevalence of unrecognized depression in patients with chronic pain, but with no history of psychiatric diseases. Methods: Patients with chronic pain who did not have a history of psychiatric disease were selected for this study. The Beck Depression Index (BDI) was used to evaluate depression. Participants' socio-demographic characteristics and pain-related characteristics were also recorded. Results: The study included 94 consecutive patients with chronic pain (28 men and 66 women). Based on the BDI scores, 33/94 (35.1%) patients with chronic pain had comorbid depression. The prevalence of depression was significantly higher in our cohort than it was in the general population (P < 0.001). The standardized incidence ratio, adjusted for age and sex, was 2.77 in men and 2.60 in women. Patients who were unmarried (odds ratio [OR] = 3.714, P = 0.044), and who had subjective sleep disturbance (OR = 8.885, P < 0.001), were more likely to have moderate to severe depression. Patients with high education levels (OR = 0.244, P = 0.016), and who were economically active (OR = 0.284, P = 0.023), were less likely to have moderate to severe depression. Conclusions: Our results indicate that unrecognized depression in patients with chronic pain is common. Therefore, pain physicians should actively seek to identify these problems rather than relying on the patient to volunteer such information.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.1
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• pp.33-45
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• 2017

Objectives : The purpose of this study was to examine psychological characteristics of patients who visited psychiatric clinic for medical certificate for military service using MMPI-2-RF. We compared target group with general psychiatric patients with same age range. Methods : A total of 165 male patients for medical certificate and 154 general psychiatric patients were collected from the Department of Psychiatry of three university hospitals. There were significant differences of age and educational level between two groups. We used independent t-test, ANCOVA, ${\chi}^2$ test to examine differences between two groups. Results : Medical certificate group scored higher on the validity scales, the Higher-Order(H-O) scales, the Restructured Clinical(RC) Scales, the Specific Problems(SP) Scales, and the Personality Psychopathology Five (PSY-5) Scales. Especially, EID, RC7, HLP, SFD, SAV, SHY, DSF, and INTR-r showed significant differences between two groups on all three statistical tests. Conclusions : The present study showed that psychiatric patients who received psychological evaluation for military service have significantly higher emotional distress, helplessness, lower self-confidence, and lower quality of interpersonal relationships. And the difference of validity scales between two groups could be related with psychological burden of compulsory military service in the study sample which causes elevation on scales of infrequent responses. MMPI-2-RF would be helpful instrument to assess these emotional and psychological characteristics.