• Title/Summary/Keyword: Psychiatric patients

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Effectiveness of Nursing Interviews on Initial Contacts with In- patients (입원시 정보수집을 위한 간호면담 방법의 효과에 대한 연구)

  • 이평숙
    • Journal of Korean Academy of Nursing
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    • v.7 no.1
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    • pp.88-98
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    • 1977
  • This study was designed to identify a more effective method of nursing interview in gathering informations by comparing the two, the structured and unstructured methods. May through October, 1976, 40patients on psychiatric wards of Korea University Hospital and National Mental Hospital, Seoul, were sampled and interviewed on their admission/within one week of admission. Both methods were used simultaneously by different interviewers ; 48 hour interval were kept between the two approaches of interview. Contents of informations gathered were grouped according to the criteria developed by the researcher, frequency, percentile score and the means were scored, and the two methods were compared; the amount of information gathered, number of questions used, time spent and the general response towards the methodologies. Results of the study are summarized as follows ; 1. 1. 5 times as many informations were gathered through the structured interview. (1366 ; 849) 2. 68.32% of informations gathered through the unstructured interview and 42.46% of the structured interview revealed to be overlapping; through structured interview, more unique informations (57.54%) were gathered. 3. The average of 33.25 minutes were consumed for the structured interview while 95, 50 minutes for the unstructured. Much higher time consumption is revealed in the unstructured. 4. Majority of patients showed positive response towards both approaches of interview (90% each), however, interviewers responded to experience of certain degree of tension (stress) in the unstructured method (35%) 5. The average of 0.88 question were used to gather one information in the structured while 1.87questions for the unstructctured were used. 6. The average of 0.97 minutes were consumed to gather one information in the structured while 4.50minutes for the unstructured. 7. The average of 1.11 minutes were consumed for one question for the structured while 2.41 minutes for the unstructured. The results of the study revealed that the structured interview were more effective in gathering informations; a larger quantity of informations were gathered in shorter time. Recommendations for further in investigations are as follows ; 1. Comparative analysis of informations gathered through the two methods by experienced professional nurse- interviewers is recommended. 2. Comparative analysis of the quality of informations is recommended. 3. Comparative analysis of the interviewing process (interactions) in relation to the characteristics of patients'health problems is recommended.

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Clinical Study on Personality Characteristics of the Alcoholic Patients -with MMPI & Sasang Constitution(四象體質)- (알콜리즘 환자(患者)의 인격특성(人格特性)에 관(關)한 임상적(臨床的) 고찰(考察) -MMPI와 사상체질(四象體質)을 중심(中心)으로-)

  • Kim Jong-U;Kim Ji-Hyeok;Hwang Ui-Wan
    • Journal of Oriental Neuropsychiatry
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    • v.3 no.2
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    • pp.65-85
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    • 1992
  • To study the personality characteristics of alcoholic patients, they were screned with the MAST(Michigan Alcoholism Screening Test) and administered with the MMPI (Minnesota Multiphasic Personality Inventory) in the Dept. of Neuropsychiatry, Oriental Medical Hospital in Kyung Hee Univ. form March 1991 to June 1991. Patients admitted for alcoholism were examined and analyzed using the above tests and then studied by Sasang Constitutional approach. Results were as follows; 1. In the MAST score, the cases of obvious alcohol dependence was 53.3% and overall mean score was 28.1 point. 2. In the MMPI scale, the mean of the T-scores for 2(D)-4(Pd) profile was high, but it was not statistically significant. 3. The results obtained by multivariate cluster analysis of MMPI T-scores can be divided into 3 subgroups; 1) 9% showed the psychiatric tendency of F-6(Pa)-9(Ma)profile, 2) 44.2% showed no significant profile, 3)46.5% showed the neurotic tendency of 1(Hs)-2(D)-3(Hy)-4(Pd) profile. 4. Since 44.2% showed no significant profile on the MMPI, much more alcoholic patients were caused not by personality factors but by social tolerance, and also by increasing apportunities of drinking in Korean society. 5. When analyzed with Sasang Constituional approach, 1) for the Soyangin (少陽人): 6(Pa) scale was particularly high, 1(Hs) and 3(Hy) scales were low compared to others, 2) for the Taiumin(太陰人): 1(Hs)-2(D)-3(Hy)-4(Pd) neurotic profile was high, the K-scale and 4(Pd)scale were high compared to the Soyangin, 3) for the Soumin(少陰人): 1(Hs)-2(D)-3(Hy)-4(Pd) neurotic profile and 7(Pt) scale were also high.

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Neurophysiological and Neuroimaging Characteristics of Depression and Anxiety (우울과 불안의 뇌 기능 - EEG, ERP, Functional Neuroimaging, HRV 소견을 중심으로 -)

  • Choo, Jung-Suk;Lee, Seung-Hwan;Chung, Young-Cho
    • Anxiety and mood
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    • v.4 no.1
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    • pp.3-10
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    • 2008
  • The purpose of this review was to investigate the neurophysiological and neuroimaging characteristics of patients with depression and anxiety reported in previous studies. A literature search was conducted using Medline and psychiatric textbooks. "Electroencephalography (EEG)", "Event Related Potentials (ERP)", "functional neuroimaging", "heart rate variability (HRV)" and "depression or anxiety" were used as key words. A physiological finding indicated that there was a higher degree of relativity with regards to prefrontal dysfunction in patients with depression. Right prefrontal lobe hyperactivity and left prefrontal hypoactivity were consistently observed, and abnormalities were observed in other regions (ACC, hippocampus, amygdala, etc.). Therefore, dysfunctions in these areas are related to depressive symptoms. In patients with anxiety disorder, each emotional condition showed specific activation patterns in different brain regions, such as the prefrontal cortex, occipital lobe, temporal lobe, hippocampus, and limbic system, including the amygdala. However, in the majority of patients with anxiety disorder, the degree of activation was higher in the right hemisphere than in the left hemisphere. The current data supports that there is a difference in brain dysfunction characteristics between depression and anxiety and that the different activations of various brain regions would play a significant role in the pathophysiology of depression and anxiety disorder.

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Importance of CADASIL research in Jeju: a review and update on epidemiology, diagnosis, and clinical spectrum (제주도에서 CADASIL 연구의 중요성: 역학, 진단 및 임상양상에 대한 고찰)

  • Choi, Jay Chol;Lee, Jung Seok;Kim, Kitae
    • Journal of Medicine and Life Science
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    • v.17 no.3
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    • pp.65-73
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    • 2020
  • Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a single-gene disease of the cerebral small blood vessels caused by mutations in the NOTCH3 gene on chromosome 19. Although CADASIL was known as a rare disease, recent research has suggested that the NOTCH variants could be found frequently even in the general population. The main clinical features included recurrent stroke, migraine, psychiatric symptoms, and progressive cognitive decline. On brain magnetic resonance imaging, patients with CADASIL showed multifocal white matter hyperintensity lesions, lacunar infarcts, microbleeds, and brain atrophy. Among them, lacunar infarcts and brain atrophy are important in predicting the clinical outcomes of patients with CADASIL. In the Jeju National University Hospital, we have diagnosed 213 CADASIL patients from 2004 to 2020. Most NOTCH3 mutations were located in exon 11 (94.4%), and p.Arg544Cys was the most common mutation. The mean age at diagnosis was 61.0±12.8 years. The most common presenting symptoms were ischemic stroke (24.4%), followed by cognitive impairment(15.0%), headache (8.9%), and dizziness(8.0%). Although the exact prevalence of CADASIL in Jeju is still unknown, the disease prevalence could be as high as 1% of the population considering the prevalence reported in Taiwan. Therefore, it is necessary to discover efficient biomarkers and genetic tests that can accurately screen and diagnose patients suspected of having CADASIL in this region. Ultimately, it is urgent to explore the exact pathogenesis of the disease to identify leading substances of treatment potential, and for this, multi-disciplinary research through active support from the Jeju provincial government as well as the national government is essential.

Characteristics of Early Maladaptive Schemas in Individuals with Schizophrenia: A Comparative Study Relative to Major Depressive Disorder (주요우울장애와의 비교를 통한 조현병 환자의 초기 부적응적 스키마 특성)

  • Jang, Tae Yang;Lee, Seung Jae
    • Korean Journal of Schizophrenia Research
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    • v.23 no.1
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    • pp.29-37
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    • 2020
  • Objectives: This study aimed to investigate the characteristics of early maladaptive schemas and their associations with clinical symptoms in patients with schizophrenia. Methods: Forty-eight patients with schizophrenia, 49 patients with major depressive disorder, and 50 healthy controls completed the Young Schema Questionnaire and symptom measures including the Brief Psychiatric Rating Scale-Expanded (BPRS-E). Results: The schizophrenia group had significantly higher scores than the healthy controls and lower scores than the depression group in most schemas. Compared with healthy controls, the schizophrenia group exhibited higher scores in 10 schemas, i.e., mistrust, social isolation, failure, dependence, vulnerability to harm, enmeshment, insufficient self-control, subjugation, emotional inhibition, and negativity schemas (all p<0.001). Moreover, vulnerability to harm, enmeshment, subjugation, and negativity schemas were correlated with total scores of the BPRS-E (0.37≤r≤0.43, all p<0.05). Regarding the five BPRS domains, emotional deprivation schema showed significant relationships with negative (r=0.50, p=0.005) and disorganization (r=0.39, p=0.033) symptoms, while no schemas showed correlations with positive symptoms. Conclusion: These results suggest that most schemas in patients with schizophrenia pertain to impaired autonomy and performance as well as disconnection and rejection domains and may improve our understanding and the treatment of schizophrenia from a perspective of schema therapy focused on these domains.

Genetic Association Study of the Common Genetic Variation of Early Growth Response 3 Gene With Bipolar Disorder in Korean Population (Early Growth Response 3 유전자와 양극성 장애 간 유전연합 연구)

  • Jang, Moonyoung;Ahn, Yong Min;Kim, Yong Sik;Kim, Se Hyun
    • Korean Journal of Biological Psychiatry
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    • v.29 no.2
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    • pp.33-39
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    • 2022
  • Objectives The early growth response 3 (EGR3) gene located in chromosome 8p21.3 is one of the susceptibility loci in many psychiatric disorders. EGR3 gene plays critical roles in signal transduction in the brain, which is involved in neuronal plasticity, neuronal development, learning, memory, and circadian rhythms. Recent studies have suggested EGR3 as a potential susceptibility gene for bipolar disorder (BPD). However, this requires further replication with an independent sample set. Methods To investigate the genetic role of EGR3 in Korean patients, we genotyped six single-nucleotide polymorphisms (SNPs) in the chromosome region of EGR3 in 1076 Korean BPD patients and 773 healthy control subjects. Results Among the six examined SNPs of EGR3 (rs17088531, rs1996147, rs3750192, rs35201266, rs7009708, rs1008949), SNP rs35201266, rs7009708, rs1008949 showed a significant association with BPD (p = 0.0041 for rs35201266 and BPD2, p = 0.0074 for rs1008949 and BPD, p = 0.0052 for rs1008949 and BPD1), which withstand multiple testing correction. In addition, the 'G-C-C-C' and 'G-C-G-C' haplotypes of EGR3 were overrepresented in the patients with BPD (p = 0.0055, < 0.0001, respectively) and the 'G-T-G-C' haplotype of EGR3 was underrepresented in patients with BPD (p = 0.0040). Conclusions In summary, our study supports the association of EGR3 with BPD in Korean population sample, and EGR3 could be suggested as a compelling susceptibility gene in BPD.

Prevalence and Risk Factors of Post-Stroke Depression (뇌졸중후우울증의 유병율 및 예측인자)

  • Kang, Hee-Ju;Bae, Kyung-Yeol;Kim, Sung-Wan;Kim, Jae-Min;Shin, Il-Seon;Kim, Joon-Tae;Park, Man-Seok;Cho, Ki-Hyun;Yoon, Jin-Sang
    • Mood & Emotion
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    • v.9 no.2
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    • pp.57-63
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    • 2011
  • Objectives : This study aimed to investigate the prevalence and risk factors of depression within two weeks after stroke. Methods : A total of 362 stroke patients were recruited. Depression (major and minor depressive disorders) was diagnosed by applying DSM-IV criteria. Data on socio-demographic characteristics (age, gender, education, marital state, living state, religion, occupation, income, life event, and social support), stroke severity (NIHSS), disability (BI), stroke hemisphere and location, vascular risk and disease, and previous history of stroke and depression were obtained. Results : Depression was present in 90 (24.9%) patients: major depression 29 (8%) and minor depression 61 (16.9%) patients. In the univariate analyses, depression was associated with older age, higher number of stressful life event, poorer social support, severe disability, anterior stroke location, previous history of stroke and depression. In the multivariate analyses, depression was independently associated with higher number of stressful life events and poorer social support. Conclusion : Depression was common and was determined by premorbid levels of stress and social support in stroke patients at acute stage. More intensive psychiatric care and intervention is needed for the high risk group.

Association Between Psychiatric Medications and Urinary Incontinence (정신과 약물과 요실금의 연관성)

  • Jaejong Lee;SeungYun Lee;Hyeran Ko;Su Im Jin;Young Kyung Moon;Kayoung Song
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.63-71
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    • 2023
  • Urinary incontinence (UI), affecting 3%-11% of males and 25%-45% of females globally, is expected to rise with an aging population. It significantly impacts mental health, causing depression, stress, and reduced quality of life. UI can exacerbate psychiatric conditions, affecting treatment compliance and effectiveness. It is categorized into transient and chronic types. Transient UI, often reversible, is caused by factors summarized in the acronym DIAPPERS: Delirium, Infection, Atrophic urethritis/vaginitis, Psychological disorders, Pharmaceuticals, Excess urine output, Restricted mobility, Stool impaction. Chronic UI includes stress, urge, mixed, overflow, functional, and persistent incontinence. Drug-induced UI, a transient form, is frequently seen in psychiatric treatment. Antipsychotics, antidepressants, and other psychiatric medications can cause UI through various mechanisms like affecting bladder muscle tone, altering nerve reflexes, and inducing other conditions like diabetes or epilepsy. Specific drugs like lithium and valproic acid have also been linked to UI, though mechanisms are not always clear. Managing UI in psychiatric patients requires careful monitoring of urinary symptoms and judicious medication management. If a drug is identified as the cause, options include discontinuing, reducing, or adjusting the dosage. In cases where medication continuation is necessary, additional treatments like desmopressin, oxybutynin, trihexyphenidyl, or amitriptyline may be considered.

The Characteristics of Depression in Cancer Patients on Chemotherapy (항암제 투여 환자의 우울 양상)

  • Joo, Yeol;Seo, Wan-Seok;Kim, Jin-Sung;Lee, Jong-Bum;Cheung, Seung-Douk;Song, Shin-Ho;Bai, Dai-Seog;Lee, Kyung-Hee;Hyun, Myung-Soo
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.2
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    • pp.154-165
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    • 2002
  • Objectives : The purpose of this study was to identify characteristics of depression in cancer patients treated with chemotherapy. Methods : Subjects were 37 cancer inpatients of oncology in Yeungnam university hospital. BDI and ZDS were done and HDS was performed through semistructured interview. Results: 1) There were no significant differences of depression scale score according to sex, education, religion, marital status. 2) The mean scores of BDI, ZDS and HDS in 37 cancer patients were 18.27${\pm}$7.73, 36.51${\pm}$10.82, 15.14${\pm}$6.60, respectively. 3) HDS, ZDS scores were significantly higher in other cancer group receiving high dose chemotherapy. 4) Item score for depressed mood, diurnal variation(p<0.001), dissatisfaction(p<0.01), physical anxiety, decreased libido, sleep disturbance(p<0.05) were significantly higher in other cancer group than others. 5) Eight patients were diagnosed as having major depressive disorder, 11 as adjustment disorder, and 18 patients had no axis I diagnosis. 6) In major depressive disorder group, the score of the depressed mood item in ZDS was high (p<0.05). HDS item score for depressed mood, work difficulty, anxiey(p<0.001), psychomotor retardation(p<0.01) were significantly higher in major depressive disorder group. 7) In patients with adjustment disorder, ZDS item score of constipation(p<0.001), fatigue, anorexia (p<0.01), emptiness, sleep disturbance, dissatisfaction, weight loss(p<0.01) were high. HDS item score of hypochondriasis(p<0.01), agitation(p<0.01), fatigue, decreased libido(p<0.05) were significantly higher in adjustment disorder group. Conclusion : Some psychiatric disorders, such as adjustment disorder and major depressive disorder were common in the cancer patients in chemotherapy. Psychiatric intervention will increase compliance of cancer treatment and improve the quality of life. This study suggests that it would be important to consider the nature of somatic symptoms in diagnosing depression in cancer patients.

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Clinical Characteristics of Panic Disorder with Comorbid Major Depressive Disorder (주요우울장애를 동반한 공황장애 환자군의 임상적 특징)

  • Lee, Sun-Woo;Lee, Kang Soo;Lee, Sang-Hyuk
    • Korean Journal of Biological Psychiatry
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    • v.25 no.3
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    • pp.45-52
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    • 2018
  • Objectives The objective of this study was to investigate the differences in sociodemographic and clinical characteristics, temperaments, and quality of life between panic disorder (PD) patients with and without major depressive disorder (PD+MDD and PD-MDD patients, respectively). Methods We compared 411 PD-MDD and 219 PD+MDD patients. All patients who were drug-free for at least 1 month were assessed at initial outpatient visits before the administration of medication. The following instruments were used for assessment: the NEO Personality Inventory-Neuroticism (NEO-N) ; the Temperament and Character Inventory-Harm Avoidance (TCI-HA) ; the State-Trait Anxiety Inventory (STAI) ; the Intolerance of Uncertainty Scale-Short (IUS); the Anxiety Sensitivity Index-Revised (ASI-R); the Beck Depression Inventory (BDI) ; the Beck Anxiety Inventory (BAI); the Penn State Worry Questionnaire (PSWQ) ; the Generalized Anxiety Disorder for 7 item (GAD-7) ; the Albany Panic and Phobia Questionnaire (APPQ) ; the Panic Disorder Severity Scale (PDSS) ; the Early Trauma Inventory Self Report-Short Form (ETISR-SF) ; the Scale for Suicidal Ideation (SSI) ; the World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF) ; the Sheehan Disability Scale (SDS) ; and the Short Form health survey (SF-36). Results Compared to the PD-MDD patients, the PD+MDD patients were younger and more likely to be unmarried. They showed higher rates of unemployment, lower levels of education and income, younger age of onset, more previous suicide attempts, a greater incidence of agoraphobia, and more previous treatments. The PD+MDD patients showed significantly higher scores on the NEO-N, the TCI-HA, the STAI, the IUS, the ASI-R, the BDI, the BAI, the PSWQ, the GAD-7, the APPQ, the PDSS, the ETISR-SF, and the SSI. In addition, the PD+MDD patients showed significantly lower quality of life than did the PD-MDD patients. In contrast with previous studies, we observed no significant differences between the two groups in terms of gender, duration until treatment, and psychiatric comorbidities. Conclusions This study showed that the PD+MDD patients have more early trauma experiences, higher levels of anxiety-related temperaments, more severe panic and depressive symptoms, and lower quality of life than the PD-MDD patients.

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