• 대한임상독성학회지
• /
• 제17권2호
• /
• pp.118-125
• /
• 2019

Purpose: Non-benzodiazepine hypnotic drugs (including zolpidem) are associated with an increased risk of suicide and suicidal ideation. Considering the wide usage of zolpidem, this drug should be considered a possible etiology for stupor or coma in any patient exposed to this drug. However, there are no reports on zolpidem blood levels in emergency department patients in Korea. We therefore reviewed the analyzed data of a toxicology laboratory at one university affiliated hospital. Methods: The sex, age, chief symptoms, suspiciousness of poisoning, and presumption of poison were analyzed from January 2018 to June 2019. The detection frequency and level of zolpidem in the patient blood were compared to the mental changes presented, which is the main consequence of zolpidem. Results: A total of 229 toxicological analyses, requested to a toxicological laboratory at one university affiliated hospital, were reviewed. Among 229 patients, the mean age was 54.3±20.7 years old with 113 women and 116 men. 8.7% of patients have psychiatric illness and 39.7% were poisoned intentionally. The chief symptoms detected were: mental change 55.0%, gastrointestinal 14.4%, cardiovascular 10.5%, focal neurological 7.4%, respiratory 3.5%, none 8.7%, and unknown 0.4%. A request for detailed reports revealed that causative poisons were specified only in 20.1% cases. Zolpidem was detected in 22.3% cases (51/229), with median blood level 1.26 mg/L (interquartile 0.1, 5.06 mg/L) and urine 0.90 mg/L (interquartile 0.11, 5.6 mg/L). Furthermore, zolpidem was more frequently detected in toxicology analysis of patients where mental change was the primary symptom, as compared to other symptoms (32.5% vs. 9.7%, p<0.01). Conclusion: This study reported the blood level of zolpidem in suspected poisoning patients admitted to the emergency department.

• 한국조경학회지
• /
• 제43권1호
• /
• pp.82-95
• /
• 2015

본 연구는 정신질환자에 대한 청각적 요소의 심리적, 생리적 영향을 분석하여 정신병원 치유정원의 음경관 조성을 위한가이드라인을 얻는데목적이있다. 피실험자는전라북도에소재한정신병원의입원환자중주치의의추천을받은경증의 정신분열증 환자 27명을 대상으로 했으며, 조사는 2011년 10월에 이루어졌다. 조사는 피실험자에게 물소리, 새소리, 풍경소리 및 음악소리 등의 단일음과 이들의 일부로 구성된 4개의 복합음을 각각 들려주고, 뇌파 및 심리적 효과를 측정하였다. 물소리는 기분 좋고 활기를 불어넣을 수 있는 이미지로, 새소리는 듣기 좋고 유쾌한 소리로 인식되어 정신병원의 치유정원을 설계할 때에는 반드시 소리의 활력성을 고려해야 할 것이다. 물소리는 선호도도 높고, 심리적 활력성에 미치는 영향도 여타의 단일음 보다 탁월하다. 마음의 평정심에는 음악소리가 큰 영향을 미치며, 물소리는 심리적 활력성과 평정심에 모두 영향을 미치고 있다. 심리적 영향에 대한 단일음과 복합음을 비교하면 활력성에는 물소리, 평정심에는 음악소리와 같이 단일음이 복합음보다 영향력이 크다. 복합음에 대한 선호도는 물소리와 새소리로 구성된 복합음이 상대적으로 높고, 대체적으로 물소리가 포함된 복합음이 선호되었다. 단일음에 대한 생리적 반응을 분석한 결과, 마음의 평정심을 유도하기 위해서는 물소리나 새소리의 자연음보다는 인공음인 음악소리가 더 효과적이다. 생리적 반응에 있어서 평정심을 고취시키기 위하여 복합음을 도입할 경우에는 음악소리와 새소리 또는 음악소리와 물소리를 조합시키는 것이 바람직하지만, 복합음보다 단일음인 음악소리가 가장 효과적이다. 심리적 반응 및 생리적 반응을 종합적으로 분석하면 마음을 가장 평온하게 하는 것은 음악소리와 물소리이며, 가장 큰 활력을 불어 넣는 것은 물소리이다.

• 정신신체의학
• /
• 제10권1호
• /
• pp.8-17
• /
• 2002

연구목적: 본 조혈모세포 이식술의 광범위한 사용 및 시술 후 생존율의 증가와 함께 조혈모세포 이식환자의 심리적 적응에 대한 관심이 증가하였다. 이에 본 연구에서는 조혈모세포 이식환자의 스트레스 대처방식과 발현될 수 있는 정신과적 증상에 대해 알아보고자 하였다. 방법: 동종 조혈모세포 이식을 전후하여 환자들의 심리적 스트레스 증상을 평가하였으며 스트레스 대처방식에 심리적 변인의 차이에 대해 알아보았다. 29명의 조혈모세포 이식 환자가 본 연구에 참여하여 조혈모세포 이식 직전과 직후에 평가를 시행하였으며, 30명의 정상 대조군이 본 연구에 참여하였다. 평가방법으로는, 면담을 통한 정신상태검사와 여러 가지 표준화된 설문지(스트레스 대처방식 척도, 스트레스 지각 척도, Short-Form 36 Health Survey)를 사용하였다. 결과: 환자군에서 정상 대조군에 비해 우울(p<0.001) 이나 불안(p=0.011) 의 정도가 유의하게 높았으나, 환자군의 조혈모세포 이식 전후에 우울과 불안은 차이가 없었다 또한 소극적인 대처방식을 사용하는 환자군에서 우울(p=0.046) 이나 불안(p<0.001)의 정도가 유의하게 높았다. 결론: 본 연구를 통해 조혈모세포 이삭 환자들이 정상 대조군에 비하여 심한 우울과 불안 증상을 경험하고 있으며, 비적응적인 수동적 대처방식을 사용함으로써 이런 부정적 감정 경험의 정도가 심해짐을 알 수 있었다. 이는 조혈모세포 이식을 받는 환자의 스트레스 대처방석에 대한 적절한 평가와 정신과적 개입의 필요성을 시사한다고 하겠다.

• 동의신경정신과학회지
• /
• 제27권3호
• /
• pp.147-155
• /
• 2016

Objectives: Schizophrenia is a serious disease that influences not only the patients themselves but also their family and the society. In this case, we employed art therapy and Korean traditional medicine for treating a schizophrenia patient.Methods: The patient was diagnosed with schizophrenia, and the main complaints were hallucination, visual hallucination and catatonic behavior. We treated the patient with art therapy and Korean traditional medicine including acupuncture, moxa and herbal medicine. We used the Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale (PANSS) for assessment.Results: After treatment, clinical symptoms were improved and the BPRS and PANSS scores were decreased, especially the scores for anxiety, depression and poor rapport.Conclusions: Combined treatment with art therapy and Korean traditional medicine can be effective for treating chronic schizophrenia.

• 대한간호학회지
• /
• 제28권4호
• /
• pp.881-892
• /
• 1998

This study attempts to identify attitudes of community leaders toward mental illness in order to obtain useful information concerning the planning of community mental health services. The community sample consists of 50 community leaders including, civil servants, doctors, herb doctors, school nurses, counselors, village leaders, pharmacists, and pastors. Individuals were asked to give demographic data, their personal attitudes toward mental illness' etiology & prognosis, and toward neighbors who are psychiatric patients. The interview with open questions was used to collect data. According to the study community leaders 82% believed that mental illness could be treated, 66% believed that mental illness was caused by genetic factors and environmental stress, and 76% had negative impressions about mentally ill people such as fear, seclusion, asylum, also crime. Only 28% of mentally ill people were accepted as neighbors in community. 52% of community leaders rejected opening of mental hospital, and thought that the Chunchon community needed facilities such as group homes, or day care centers (30%), however, 34% of the leaders they didn't recognize community mental health. These findings suggest that mental health professionals need to pay special attention to change the attitude of Chunchon community leaders and mental health institutions need to a develop mental health education program for community leaders.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제18권2호
• /
• pp.88-96
• /
• 2007

Pervasive developmental disorders are characterized by lifelong impairments in fundamental social and/or communication skills and by the presence of seemingly purposeless and repetitive behaviors, interests, or activities. A number of possible biological etiologies, including genetic, structural and functional brain abnormalities, have been identified in patients with pervasive developmental disorders. In addition, clinicians should take the possibility of comorbid psychiatric conditions into consideration when making the differential diagnosis of pervasive developmental disorders.

• 대한간호학회지
• /
• 제27권3호
• /
• pp.520-530
• /
• 1997

Antineoplastic agents may exhibit effects not only in patients therapeutically exposed, but also in health workers who prepare and administer these drugs. This study was done to clarify whether nurses who handle anticancer drugs show signs of drug absorption. The experimental group was 14 nurses handling anticancer drugs at three medical wards of a hospital in J city ; the control group was 12 psychiatric nurses at the same hospital. The test materials were the nurses' 24hr urine specimens, which were concentrated by XAD-2 column chromatograpy. Tester strains were TA98(±S9mix), TA100(±S9 mix), TA1535(±S9 mix) and TA1537(±S9 mix) : the salmonella mammalian microsomal test (Ames test) was used for the urinary mutagenicity assay. The results are summarized as follow : 1. In qualitative analysis of the results, both experimental group and control group showed 15.4% urine toxicity. 2. The experimental group revealed significantly higher urinary mutagenicity both in the activation method test and non-activation method test of the tester strains TA98, TA100 and TA1535. In the case of TA1537, the two groups showed no difference in the non-activation method test, but the activation method revealed a difference. 3. In urinary mutagenicity of the experimental group by ward career, there was a significant difference between the group with more than 20 months experience and the group with less than 20 months on the tester strains TA98, TA100, and TA1537. No Significant difference was found between two groups by the tester strain TA1535.

• 생물정신의학
• /
• 제11권1호
• /
• pp.61-63
• /
• 2004

We describe the case of a 73 year-old female patient, YSG, who initially presented with a manic episode without any previous psychiatric history and was later diagnosed as having a meningioma in the left frontal lobe. YSG's symptoms were characterized by hyperactivity, insomnia, aggressive behavior with an auditory hallucination. She showed no abnormal signs on a complete neurologic examination. A gadolinium-enhanced MRI study showed a huge, extra-axial mass with homogenous enhancement in the left high convexity of the frontal lobe. Her manic symptoms subsided after administration of risperidone 1mg and valproic acid 500mg daily, for three weeks without surgical resection of the tumor. These findings suggest that YSG's mania might have resulted from the left-sided frontal tumor, and that her symptoms were treated rapidly by small doses of risperidone combined with valproic acid. Medical staff who care for manic patients should be aware of this possibility of a organic lesion without evidence of neurologic disease.

• 생물정신의학
• /
• 제23권3호
• /
• pp.116-121
• /
• 2016

Objectives Experience of early childhood abuse elevates the risk of developing schizophrenia in later period of life, incidence of psychiatric comorbidity, symptomatic severity and complexity. In this context, we hypothesized that the pattern of psychotropic medication used would reflect this; those with childhood trauma will received more types and higher doses of psychotropic medication. Methods From our database of 102 outpatients diagnosed with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) schizophrenia, we analyzed experiences of childhood trauma measured by the Childhood Trauma Questionnaire-Short Form and types and dose of prescribed psychotropic medication. Results We found significant positive correlations between child sexual abuse and the number of psychotropic medications (p = 0.029) and between child emotional neglect and the number of psychotropic medications other than antipsychotics (p = 0.045). Conclusions This preliminary study suggests that the pattern of psychotropic use may be affected by types of childhood trauma. Further studies will have to shed light on mediating factors such as symptoms or comorbid conditions that lead to prescription of certain psychotropic class.

• Journal of Yeungnam Medical Science
• /
• 제25권2호
• /
• pp.139-144
• /
• 2008

Crohn's disease is a chronic inflammatory bowel disease that mainly affects children and young adults. Its cause remains unknown. The incidence of pediatric Crohn's disease is increasing, so it is important for clinicians to be aware of the presentation of this disease in the pediatric population. The majority of patients complain of abdominal pain (72%), with only 25% presenting with the 'classical triad' of abdominal pain, weight loss, and diarrhea. Many children with Crohn's disease present in a 'non-classical' manner, with vague complaints such as lethargy or anorexia, which may be associated with only mild abdominal discomfort. Other symptoms include fever, nausea, vomiting, growth retardation, malnutrition, delayed puberty, psychiatric symptoms, arthropathy, and erythema nodosum. Severe constipation and abdominal distension are uncommon symptoms at diagnosis. We report a case of pediatric Crohn's disease, which was diagnosed after the patient presented with severe constipation and abdominal distension.