• 제목/요약/키워드: Psychiatric patients

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Nocturnal Eating Behavior Associated with Zolpidem (Zolpidem과 연관된 야간 식이 행동 증례)

  • Kim, Ji-Min;Paik, Kyoung-Won;Shin, Hong-Beom;Kim, Soo-In;Yun, Kyu-Wol;Lim, Weon-Jeong
    • Sleep Medicine and Psychophysiology
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    • v.12 no.2
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    • pp.144-147
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    • 2005
  • Objective: The authors would like to find the relationship between zolpidem and nocturnal eating episodes in diverse psychiatric patients. Method: We evaluated case series of 6 patients who showed nocturnal eating episodes after takine zolpidem. Results: We have experienced 6 cases who showed nocturnal eating behavior after taking zolpidem. They included 3 patients with schizoprenia, a patient with major depressive disorder, a patient with PTSD and a patient with bipolra I disorder. With reducing or discontiuation of zolpidem, their nocturanl eating resolved. Conclusion: This finding strongly suggests the relationship between zolpidem and the nocturnal eating episode. Physicians should be aware that zolpidem might induce nocturnal eating behaviors.

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The opportunities of virtual reality in the rehabilitation of children with attention deficit hyperactivity disorder: a literature review

  • Bashiri, Azadeh;Ghazisaeedi, Marjan;Shahmoradi, Leila
    • Clinical and Experimental Pediatrics
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    • v.60 no.11
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    • pp.337-343
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    • 2017
  • Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in childhood. This disorder, in addition to its main symptoms, creates significant difficulties in education, social performance, and personal relationships. Given the importance of rehabilitation for these patients to combat the above issues, the use of virtual reality (VR) technology is helpful. The aim of this study was to highlight the opportunities for VR in the rehabilitation of children with ADHD. This narrative review was conducted by searching for articles in scientific databases and e-Journals, using keywords including VR, children, and ADHD. Various studies have shown that VR capabilities in the rehabilitation of children with ADHD include providing flexibility in accordance with the patients' requirements; removing distractions and creating an effective and safe environment away from real-life dangers; saving time and money; increasing patients' incentives based on their interests; providing suitable tools to perform different behavioral tests and increase ecological validity; facilitating better understanding of individuals' cognitive deficits and improving them; helping therapists with accurate diagnosis, assessment, and rehabilitation; and improving working memory, executive function, and cognitive processes such as attention in these children. Rehabilitation of children with ADHD is based on behavior and physical patterns and is thus suitable for VR interventions. This technology, by simulating and providing a virtual environment for diagnosis, training, monitoring, assessment and treatment, is effective in providing optimal rehabilitation of children with ADHD.

Relationship between the Distribution of Comorbidity and Length of Stay and Medical Cost for Planning Integrated Community Care Services among Inpatients at a Seoul Municipal Hospital (지역사회 통합 케어서비스 방안 마련을 위한 시립병원 입원환자의 동반질환 분포와 재원일수 및 진료비와의 관련성)

  • Kim, Jae-Hyun;Noh, Jin-Won;Lee, Yunhwan;So, Yekyeong;Hong, Hyeonseok
    • Health Policy and Management
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    • v.29 no.4
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    • pp.445-453
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    • 2019
  • Background: This study is to investigate the association between the distribution of multimorbidity and length of stay and medical expenses among inpatients in a municipal hospital to achieve an integrated care setting. Methods: We used the exploratory factor analysis and the generalized estimating equation model to analyze the data from patients living in the northeast region of Seoul, who were hospitalized from January 2017 to December 2017 in a municipal hospital. Results: As a result of the factor analysis, seven types of multiple chronic diseases were classified. Among the elderly patients admitted to municipal hospitals, the burden of medical expenses was mainly influenced by the length of stay (B=310,719, p-value <0.0001), not the type of disease (all not significant). Length of stay were mainly due to psychiatric illness (factor 1: B=4.323, p-value <0.0001) related to the brain and metabolic diseases (factor 2: B=2.364, p-value=0.003). Conclusion: This study showed that the medical expenses of the elderly patients were largely due to prolonged hospitalization, not multimorbidity. Therefore, it is necessary to develop an integrated care paradigm strategy cope with the multimorbidity of the elderly in the community and to alleviate the socio-economic burden.

The Distributional Changes in the First-Visit Psychiatric Child and Adolescent Outpatients at a University Hospital over a Ten-Year Period (지난 10년간 일 대학병원 정신건강의학과 소아청소년 초진환자 분포의 변화)

  • Kim, Hyo-Jin;Jung, Sung-Won;Jung, Chul-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.26 no.3
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    • pp.165-175
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    • 2015
  • Objectives : The purpose of this study was to investigate changes in child and adolescent outpatients at a university hospital in Daegu from 2004 to 2013. Methods : The subjects were first-visit patients under 18 years old, who visited Dongsan Medical Center, Keimyung University, from January 1, 2004 to December 31, 2013. Computerized medical records of 2,738 patients (male 1,906, female 832) were reviewed. Results : The ratio of male to female was 2.3 : 1 in the period of study. The most prevalent age category was 7-9 years. The mean age was $10.12{\pm}4.68$ years ($9.84{\pm}4.59$ years in males, $10.76{\pm}4.81$ years in females). The ratio of child and adolescent patients to total outpatients was 27.0%. The most common diagnostic category was the attention-deficit hyperactivity disorder (ADHD) group, followed by the mental retardation (MR) group. In males, the ADHD, MR, communication disorder groups were more prevalent, but in females, the MR, ADHD, depressive disorder groups were more prevalent. Conclusion : The female to male ratio and total mean age were on the rise. The ADHD group was the most prevalent and the depressive disorder group was also on the rise in this period.

Mediating Role of Anxiety and Depression in the Relationship between Posttraumatic Stress Symptoms and Illness Intrusiveness

  • Kim, Nam Hee;Kim, Seok Hyeon;Hyun, So Yeon;Kang, Dae Ryong;Oh, Min Jung;Kim, Daeho
    • Journal of Korean Medical Science
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    • v.33 no.45
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    • pp.284.1-284.12
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    • 2018
  • Background: Posttraumatic stress symptoms (PTSS) in patients with psychological trauma lead to poor health-related quality of life. Understanding of the relationships among PTSS, anxiety, depression, and illness intrusiveness will guide the development of efficient approaches to enhance subjective well-being in patients with psychological trauma. This study investigated whether anxiety and depression mediate the relationship between PTSS and illness intrusiveness in the hope of providing more comprehensive and effective trauma treatment. Methods: Psychiatric outpatients who visited the trauma clinic of a university hospital (n = 260) participated in this study. Assessments were conducted for PTSS, anxiety, depression, and illness intrusiveness. Structural equation modeling and path analysis were performed to analyze the mediating effects of anxiety and depression on the relationship between PTSS and illness intrusiveness. Results: PTSS had both direct and indirect exacerbating effects on illness intrusiveness. Anxiety exhibited the largest direct exacerbating effect on illness intrusiveness. The indirect effects of PTSS on illness intrusiveness through anxiety alone and through a depression-to-anxiety pathway were significant, but the indirect effect through depression alone was not. Conclusion: The findings demonstrate that anxiety, both independently and as part of an interrelated pathway with depression, partially mediates the relationship between PTSS and illness intrusiveness. Appropriate interventions and a comprehensive approach to alleviate anxiety and depression could mitigate the negative effects of PTSS on illness intrusiveness in patients with psychological trauma.

Development and Efficacy of Psychiatric Nursing Simulation Practical Training program Using Standardized Patients (표준화 환자를 활용한 정신시뮬레이션 실습프로그램 개발 및 효과)

  • Kim, Namsuk;Kim, Soo-Jin;Song, Ji-Hyeun
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.4
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    • pp.67-74
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    • 2022
  • The purpose of this study was to develop and apply a mental simulation practice program using standardized patients for nursing students and to verify the effectiveness. This study is a single-group pre- and post-design study, and a structured questionnaire was provided to 186 nursing students at a university in J for data collection. The collected data were analyzed using SPSS/WIN 27.0 program. As a result of the study, the mental simulation practice education program using standardized patients showed the subjects' communication ability (t=-2.575, p=001), learner self-efficacy (t=-2.228, p=.026) and problem-solving ability (t=-2.298, p=.017) was found to be effective. As a result of this study, it is necessary to develop and apply a simulation practice education program that creates an environment similar to the actual situation and applies various cases using the necessary resources to improve the field adaptation ability of nursing students.

Differences in Social and Clinical Characteristics between Readmission and Dehospitalization in Long-Term Inpatients with Schizophrenia (장기 재원 조현병 환자에서 재입원 혹은 탈원에 따른 사회적 및 임상적 특징 차이)

  • Kim, Min-Sun;Park, Sunyoung;Choi, Jin-sook
    • Korean Journal of Schizophrenia Research
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    • v.23 no.1
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    • pp.38-44
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    • 2020
  • Objectives: Dehospitalization of long-term inpatients with schizophrenia can be difficult because of complex factors such as chronic symptoms and low family and social support. The aim of this study was to identify factors related to dehospitalization and readmission of long-term inpatients with schizophrenia. Methods: This retrospective study reviewed the medical records of patients discharged from a psychiatric hospital in Yongin, South Korea, from February 1, 2016, to July 31, 2017. Patients who were hospitalized for over 3 months were divided into two groups: readmission (n=47) and dehospitalization (n=55). Differences in sociodemographic and clinical factors were analyzed between the two groups. Results: Regarding sociodemographic characteristics, female sex, familylessness, discharge to nursing homes, and discharge after symptom improvement were more prevalent in the dehospitalization group, whereas male sex, having a sibling as next of kin, and discharge because of other problems were more prevalent in the readmission group. Among clinical characteristics, hospital stay was longer in the readmission group. Conclusion: In this study, patients without a family showed a tendency to not be readmitted when they were discharged to nursing homes after symptom improvement. Expansion of social welfare support may encourage dehospitalization of long-term inpatients with schizophrenia.

The Comorbidity of Anxiety Disorder in Depressed Patients : A CRESCEND(Clinical Research Center for Depression in Korea) Cohort Study (우울증 환자에서 불안장애의 동반이환 : 우울증 임상연구센터 코호트연구)

  • Sakong, Jeong-Kyu;Lee, Do-Yun;Suh, Ho-Suk;Sung, Hyung-Mo;Kim, Jung-Bum;Jung, Young-Eun;Lee, Min-Soo;Kim, Jae-Min;Jo, Sunjin
    • Mood & Emotion
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    • v.9 no.1
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    • pp.30-36
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    • 2011
  • Purpose : Anxiety disorder and depressive disorder are often comorbid with each other, and the comorbidity is associated with poorer psychiatric outcome, resistance to treatment, increased risk for suicide, greater chance for recurrence. We aimed to investigate the comorbidity of anxiety disorder in Korea. Method : Subjects were total of 867 depressed patients recruited CRESCEND-K multicenter trial. We used SCID (Structured Clinical Interview for DSM - IV) to find comorbidity of anxiety disorders in depressed patient. Results : Of 867 patients, total 8.2% had anxiety disorder. Proportion of anxiety disorder Not Otherwise Specified was 3.5%, panic disorder was 1.7%, generalized anxiety disorder was 1.1%, post traumatic stress disorder was 0.9%, obsessive compulsive disorder was 0.6%, social phobia was 0.4%. Conclusion : In this study, anxiety disorder in depression were measured at a low comorbidity rate in compare to previous studies. Selection bias, use of antidepressants at registration, severity of depression symptoms, and point of SICD administration seems to have affected these results. It is probable that comorbidity evaluation would be more precise if shorter, structured interviews such as M. I.N.I.-Plus were used during first clinical interview for depression diagnosis.

A Study on the Perception of the Importance and Performance of Patient Education of the Clinical Nurses (종합병원 간호사가 인식하는 환자교육 중요도와 수행도의 관계연구)

  • Yoo, Eun-Kyung;Suh, Moon-Ja
    • The Journal of Korean Academic Society of Nursing Education
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    • v.6 no.2
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    • pp.287-302
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    • 2000
  • The purpose of the study are to examine the perception of the importance and performance of patient education of the clinical nurse and find out the interfering factors in practicing patient education. The data were collected from convenient sample of 256 clinical nurses working in the nursing units of adult patients except the psychiatric unit, obstetric unit, dental surgical unit and intensive care unit of one University Hospital in Seoul from September 29 to October 2, 1998. Three measurement tools of self-report- questionnaires developed by researcher used. For the content validity of the questionnaires, two sessions of panel discussion and a pilot test were done and finally factor analysis was done with Varimax method. Analysis of data was done with SAS program using frequency, percentage, means, standard deviation, Pearson's Correlation Coefficients, t-test and ANOVA. The obtained results were as follows : 1. The surveyed nurses perceived the importance of patient education at higher level with mean score of 4.08 among 5 point than their perception of practice( mean score : 3.42). 2. There was positive significant correlation(r=.29, p=0.0001)between nurses' perception of the importance of patient education and it's practice 3. Among the teaching contents for patients, 'information of diagnostic procedure and operation' and 'orientation of hospitalization' were perceived most important. And 'preparation for discharge' and 'understanding of disease and health promotion' were perceived least important 4. Among the teaching contents for patients, 'orientation of hospitalization' and 'information of diagnostic procedure and operation' were perceived highly performable. And 'understanding of disease and health promotion' and 'preparation for discharge' were perceived least performable. 5. Three types of interfering factors were identified as patient-factor, situational factor, nurse-factor. The mean degree of impediment with the interfering factors was at average level(3.09 among 5). The patient and situational factors of impediments were more interfering than nurse- factor for teaching patients. 6. In older age(p<.05), married state (p<.05), higher educational status (p<.01), higher clinical experience (p<.01) and higher position(p<.01), the score of perceived importance of patients education was more high. 7. In older age(p<.01), higher clinical experience(p<.001) and surgical unit (p<.01), the score of perceived performance of patients education was more high. In conclusion, in order to activate patient education practice in the clinical setting, the continuing education for patients education should be more emphasized and the effective teaching methods and materials should be developed to help patient teaching. And an organizational support such as budgeting for patient education and reimbursement system should be administrated.

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Factors Affecting the Duration of Untreated Psychosis in Community-Dwelling Patients with Schizophrenia Spectrum Disorder (지역사회 거주 조현병 범주 장애 환자의 정신증 미치료 기간 관련 요인)

  • Kim, Mina;Kim, Jae-Kyeong;Jhon, Min;Kim, Ju-Wan;Lee, Ju-Yeon;Kim, Jae-Min;Shin, IL-Seon;Yoon, Jin-Sang;Lee, Myung-Soo;Kim, Sung-Wan
    • Korean Journal of Schizophrenia Research
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    • v.23 no.1
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    • pp.1-7
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    • 2020
  • Objectives: This study aimed to identify factors affecting the duration of untreated psychosis (DUP) in patients with schizophrenia spectrum disorder. Methods: Six-hundred patients with schizophrenia spectrum disorder were recruited from mental health welfare centers in Gwangju Metropolitan City and Gyeonggi-do. Subjects were categorized into two groups according to median DUP. Demographic and clinical characteristics were compared between the two groups. Results: The mean DUP was 80.8 weeks, and the median DUP was 15.9 weeks. Patients with Medicaid, higher age, and longer duration of the schizophrenia prodrome were more likely to have a longer DUP. The DUP was shorter in patients who were consulted by family/relatives prior to treatment. Patients visiting university hospitals were more likely to have a shorter DUP compared with those visiting psychiatric clinics or small-sized mental hospitals, i.e., with less than 100 beds. A multivariate regression analysis showed that the duration of the prodrome was a factor that significantly affected DUP. Conclusion: The vulnerable group of patients with schizophrenia with a long DUP should be monitored closely. Moreover, it is necessary to develop a strategy to identify patients who have an insidious course of psychosis to reduce the DUP.