• Korean Journal of Biological Psychiatry
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• v.14 no.4
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• pp.241-248
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• 2007

Objectives : Schizophrenia is equally distributed in both sexes. However, later-onset, milder psychopathology, and better outcome are associated with the females. This reason is thought to be partly due to the estrogen system. Recently, it was suggested that estrogen receptor 1(ESR1) gene polymorphisms might affect the expression of ESR1 and were associated with several psychiatric disorders. Thus, we investigated the association between two single nucleotide polymorphisms(SNPs) in the ESR1 gene and Korean schizophrenic patients in this study. Methods : Genotype, allele, and haplotype frequencies of the two SNPs(rs 2234693 and rs 2228480) were analyzed between 218 Korean controls and 158 Korean schizophrenic patients. Also, age of onset and negative symptom scale scores according to genotypes were analyzed in the patients with schizophrenia. Results : There was a significant difference in allele frequencies of rs 2234693 between the schizophrenic patients and the controls(p=0.03). Genotype distributions(p=0.03) and allele frequencies(p=0.01) of rs 2234693 were significantly different between the female schizophrenic patients and the female controls. The frequency of TC-CC genotypes compared with TT genotype in the female schizophrenic patients was significantly higher than that in the female controls(OR=2.36). The mean age of onset in the schizophrenic patients with TC-CC genotypes was significantly lower than that in the patients with TT genotype. The frequency of rs 2234693C- rs 2228480G haplotype in the female schizophrenic patients was relatively higher than that in the female controls. Conclusions : These results of our study support the possibility that the ESR1 gene polymorphisms might be involved in the susceptibility of females to schizophrenia and play a role in sex difference of schizophrenia.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.1
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• pp.42-48
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• 2018

Purpose: On November 15, 2012, sales of OTC (Over-The-Counter) drugs began at convenience stores, which changed the accessibility of some drugs. As a result, the exposure and access patterns of these drugs could have changed. In this study, we reviewed the changes in the characteristics of drug poisoning patients because of the reposition of nonprescription drugs according to the revised Pharmaceutical Affairs Act. Methods: A retrospective study was conducted to evaluate changes in characteristics of drug poisoning patients between 2008 and 2016. A registry was developed by an emergency medical center in a local tertiary teaching hospital, and patients who visited the center were enrolled in this registry. We compared two periods, from 2008 to 2012 (Pre OTC) and from 2013 to 2016 (Post OTC), for type of intoxicant, time from poisoning to visiting the emergency center, intention, psychiatric history, previous suicidal attempt, alcohol status, and emergency room outcomes. The primary outcome was the number of patients who took acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Secondary outcomes were ICU admission rate, mortality rate, and number of patients who visited the ER when the pharmacy was closed after taking acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Results: Among 1,564 patients, 945 and 619 patients visited the emergency room during pre and post OTC periods. The number of patients with acetaminophen and NSAIDs poisoning decreased from 9.2% to 6.1% (p=0.016). The ICU admission rate and mortality rate in the emergency room did not show significant results in the relevant patient groups, and so was the number of patients visiting ER when the pharmacy was closed taking acetaminophen and NSAIDs. Conclusion: Despite the sales of nonprescription drugs at convenience stores, the number of acetaminophen and NSAIDs poisoning patients decreased.

• Korean Journal of Psychosomatic Medicine
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• v.12 no.1
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• pp.56-65
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• 2004

Objectives: The aim of this study was to investigate the quality of life of caretaking family members who have a patient with psychiatric disorders. The results will be served as a basic data of ameliorating the quality of life of caregivers. Methods: 78 caretaking family members who have a patient with schizophrenia and 54 caretaking family members who have a patient with alcohol dependence, a total of 132 persons completed the questionnaire, and analyzed. The Korean version of the SmithKline Beecham Quality of Life Scale and the Family Burden Scale were applied. Results: There was no statistically significant correlation between burden and sex, age, income, and duration of living with patients before onset. The male caregiver showed higher quality of life than that of female. It showed statistically significant correlation between age and factor physical well-being and factor activity. 41% of variance of quality of life of caregivers were explained by the stress response, burden, and overall merits of the field of psychiatry, and the tension had the most explanatory power. Conclusion: The chronic illness may give a burden on caregivers, and that decrease the quality of life of caregivers. The longer duration of illness of patients, the lower quality of life of caregivers on competence factor. Therefore, the authors recommend the therapeutic modality must be offered to the caregivers who may experience the stress and burden.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.2
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• pp.183-198
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• 1997

Objects：This study was carried out to develop the Korean form of Moral Development Inventory for Adolescents designed to assess the principled morality in adolescents. And the auther also intended to find the demographic variables that influence the moral development. Methods：The Korean form inventory was applied to 507 middle and high school adolescents, and retest was done in 42 second year middle school adolescents with 3 weeks interval. Together this inventory, short form of Rest moral development which had been proved its reliability and validity, were administered to the all subjects for concurrent validity. And then the author examined whether this inventory discriminates between conduct disorder patients, psychiatric controls and normal controls in the level of moral development. Results：Test-retest reliability and internal consistency were very satisfactory. Concurrent validity with this inventory was also high level. And conduct disorder patients were scored significant lower than psychiatric and normal controls in the level of principled morality. The mean PM scores did not show significant difference according to the variables such as sex, birth order and religion. But there was significant difference according to the educational level of mother and places. Conclusions：These results indicate that the Korean form of Moral Development Inventory is a reliable and valid rating inventory to assess the moral development level in Korean adolescents.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.5 no.1
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• pp.162-171
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• 1994

Objects : This study was carried out to develop the Korean form of Leyton Obsessional Inventory-Child Version(LOI-CV) designed to assess the obsessive compulsive symptoms in children and adolescents. The LOI-CV was modified into a paper-and-pencil form in order to administer it to group. Methods : We applied the Korean form LOI-CV to 127 elementary, middle and high school children, and retest it to 82 children with 3 weeks interval. Together with LOI-CV, Korean form of SCL-90-R which had been proved its reliability and validity, were administered to the all subjects for examining of concurrent validity. And then we examined whether this scale discriminates between obsessive patients, psychiatric controls and normal controls in the level of obsessive symptoms. Results : Test-retest reliability, internal consistency were very satisfactory. Concurrent validity with SCL-90-R was moderate level. And obsessive patients was scored significantly higher than psychiatric and normal controls in the level of obsessive symptoms. In factor analysis, items are clustered to 5 factors. In the global obsessive symptom, obsessive scores of female elimentary school students were higher than that of male students. Conclusions : These results indicate that the Korean form of LOI-CV is reliable and valid self-rating scale to assess the obsessive-compulsive symptoms in Korean children and adolescents. Author suggests that future research is needed for Korean version standardization study in normal and clinic-refered population.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.10 no.2
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• pp.178-185
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• 1999

Objective：This study was designed to examine the validity of the Ego Impairment Index(EII) in adolescent psychiatric patients(depression, depressive-conduct disorder, schizophrenia), and to explore the validity of the depressive-conduct disorder as a diagnostic entity. Method：19 depressives, 13 depressive-conduct disordered, and 10 schizophrenics with the age from 12 to 18 were selected based on DSM-IV and ICD-10 criteria, and their responses of the Rorschach and MMPI were analyzed. The EII was empirically developed by Perry and Viglione(1991) in order to assess the degree of ego impairment, and was derived from the Rorschach test. Results：It was founded that a single factor, ego impairment, was derived from the principal component analysis and explained 57.18% of total variances. The degree of ego impairment was grater in schizophrenics than in the other two groups, but there were no difference between depressives and depressive-conducts. Conclusions：These results offered support for the use EII as an empirical means of assessing the degree of ego impairment in adolescent patients. And these results suggest that depressive-conduct disorder group is more similar to the depressive group, implying that depressive-conduct disorder might correspond to so called masked depression. The clinical implication and limitation of present study were discussed.

• Health Policy and Management
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• v.29 no.2
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• pp.105-111
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• 2019

On December 31, 2018, an incident occurred where a doctor was attacked and killed by a patient carrying a lethal weapon in the outpatients' clinic of the psychiatric department of a tertiary general hospital. The suspect was diagnosed with bipolar affective disorder (manic depressive disorder) and has been hospitalized and cared for in the psychiatric ward of this hospital. This incident illustrates the necessity of more active cures and therapeutic intervention for mental patients with intellectual developmental disorders who require treatment considering the fact that a radical outcome has been caused by such a patient. However, on the other hand, there is also a need for an approach and analysis from the perspective of crime prevention for all medical departments. The reason for this is that even a tertiary general hospital equipped with the largest human resources, medical devices, facilities, and so forth, is susceptible to violence. As for illegal actions perpetrated against health and medical service personnel in medical institutions, such as verbal abuse, assault, injury, etc. there have neither been understanding shown for the current extent of damage in detail, nor discussions of active institutional improvement related to the seriousness of the act. It can be said that violence in the field of medical treatment is a realm requiring serious discussion and appropriate remedial actions. This is because when such incidents take place, if a patient who is supposed to get treatment from the damaged health care provider is in an urgent situation or on the waiting list of serious cases, he or she could suffer serious damage caused by deprivation of treatment opportunity, or secondary damage might be caused to the patient and/or a guardian who can hardly have an opportunity to take action. Accordingly, in this review, we would like to help create the necessary conditions for both health and medical service personnel and patients/guardians, respectively, to provide and receive medical treatment in a more secure environment. Therefore, objective assessment of the institution and issues relating to this aforementioned incident and general cases of violence occurring in medical institutions, and by suggesting legal and institutional improvements and solutions.

• Journal of Korean Neurosurgical Society
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• v.64 no.1
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• pp.125-135
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• 2021

Objective : This study aimed to validate the Korean version of the Repeatable Battery for the Assessment of Neuropsychological Status Update (K-RBANS). Methods : We performed a retrospective analysis of 283 psychiatric and neurosurgery patients. To investigate the convergent validity of the K-RBANS, correlation analyses were performed for other intelligence and neuropsychological test results. Confirmatory factor analysis was used to test a series of alternative plausible models of the K-RBANS. To analyze the various capabilities of the K-RBANS, we compared the area under the receiver operating characteristic (ROC) curves (AUC). Results : Significant correlations were observed, confirming the convergent validity of the K-RBANS among the Total Scale Index (TSI) and indices of the K-RBANS and indices of intelligence (r=0.47-0.81; p<0.001) and other neuropsychological tests at moderate and above significance (r=0.41-0.63; p<0.001). Additionally, the results testing the construct validity of the K-RBANS showed that the second-order factor structure model (model 2, similar to an original factor structure of RBANS), which includes a first-order factor comprising five index scores (immediate memory, visuospatial capacity, language, attention, delayed memory) and one higher-order factor (TSI), was statistically acceptable. The comparative fit index (CFI) (CFI, 0.949) values and the goodness of fit index (GFI) (GFI, 0.942) values higher than 0.90 indicated an excellent fit. The root mean squared error of approximation (RMSEA) (RMSEA, 0.082) was considered an acceptable fit. Additionally, the factor structure of model 2 was found to be better and more valid than the other model in χ2 values (Δχ2=7.69, p<0.05). In the ROC analysis, the AUCs of the TSI and five indices were 0.716-0.837, and the AUC of TSI (AUC, 0.837; 95% confidence interval, 0.760-0.896) was higher than the AUCs of the other indices. The sensitivity and specificity of TSI were 77.66% and 78.12%, respectively. Conclusion : The overall results of this study suggest that the K-RBANS may be used as a valid tool for the brief screening of neuropsychological patients in Korea.

• 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.

• Korean Journal of Psychosomatic Medicine
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• v.9 no.1
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• pp.58-65
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• 2001

Objectives : It is well known that pharmacologic and behavioral therapies of panic disorder show remarkable acute treatment outcome, however the course of panic disorder in clinical settings is often chronic and relapsing. The purpose of this study is to investigate the treatment outcome of panic disorder and the factors related to good treatment outcome by prospective follow-up study after 6 month in clinical settings. Methods : Twenty nine patients were diagnosed to have panic disorder by SCID(Structured Clinical Interview for DSM-III-R), among the patients who had visited the psychiatric out-patients clinic of the Asan Medical Center for the first time. We determined the initial clinical and demoraphic features of each patient and reevaluated them after 6 months, investigating the treatment outcome by anxiety, phobia, impairment scales. We looked into the rate of the patients who showed good treatment outcome and determined the factors that had relation with good treatment outcome among demographic and clinical features. Results : Nineteen out of 29 patients could be followed after 6 months. Among them, 10 patients 52.6%) on the impairment scale and phobia scale each, and 8 patients(42.1 %) on the anxiety scale showed good treatment outcome. 8 patients(42.1 %) showed good treatment outcome on the all three scales. High score in initial phobia scale had significant relation with good treatment outcome. Short duration of illness did not have significant relation with good treatment outcome however there was a trend(p=0.07). Conclusion : About half(42.1 %) of the panic disorder patients showed good treatment outcome on all three scales. Severe initial phobic symptom and short duration of illness were expected to have relation with good treatment outcome.