• Title/Summary/Keyword: Psychiatric patients

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Patterns of the Diagnosis Prevalence of Psychiatric Disorders in the Population Aged 0-18 Years Based on the Nationwide Insurance Sample Data

  • Lee, Seung Yup;Bahn, Geon Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.31 no.4
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    • pp.214-224
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    • 2020
  • Objectives: This study aimed to examine the trend in diagnostic prevalence of psychiatric disorders in children and adolescents. Methods: Individuals aged 0-18 years were included in the study based on the National Health Insurance Claims Data. To investigate the trends in diagnosis and diagnostic prevalence of psychiatric disorders reflecting the decrease in the birth rate, data were analyzed from 2010 as a reference year to 2015. Results: The number of patients diagnosed with psychiatric disorder decreased annually, from 23,412 on 2010 to 18,821 on 2015. The most common disorder was hyperkinetic disorder in male and depressive episode in female. Although there was no significant change in overall diagnostic prevalence rate of psychiatric disorders, age groups <10 years and some disorders had significant changes in prevalence rate. This study classified the diagnostic prevalence by age into two unique patterns: group in which the diagnosis rate increases with age and group in which the diagnosis rate peaks at a certain age and then decreases. Conclusion: Diagnostic prevalence of psychiatric disorders was different according to age and sex. These patterns should be reflected in the formulation of policies related to mental health and in medical practice for pediatric patients. It is urgent to identify how these patterns change in young adults.

Lower Serum Cholesterol Level is Associated with More Serious Injury in Psychiatric Patients with Suicide Attempt (자살을 시도한 정신과 환자에서 낮은 혈청 콜레스테롤 농도와 심각한 자살 수행과의 연관성)

  • Kim, Yong Ku;Lee, Heon Jeong;Kim, Ji Yeon;Choi, So Hyun;Lee, Min Soo
    • Korean Journal of Biological Psychiatry
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    • v.6 no.2
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    • pp.227-234
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    • 1999
  • An association of low total cholesterol in blood with psychiatric diseases and suicidal behavior has been suggested. As part of an attempt to further explore this relationship, we examine first, whether serum cholesterol levels in psychiatric patients with suicidal attempt would be lower than in non-suicidal psychiatric inpatients or normal controls, second, whether such significant difference of cholesterol levels would be present when the diagnostic groups are analyzed separately, third, whether low cholesterol level would be associated with a history of serious suicidal attempts, and finally, whether low cholesterol level in suicide attempters is a state or a trait marker. We determined the serum cholesterol levels in 231 patients admitted to an emergency room following an suicidal attempt, in the same numbers of age-, sex- and diagnosis- matched non-suicidal psychiatric controls, and in the same numbers of age-, sex matched normal controls. The seriousness of an attempt was divided into 5 grades according to the degree of the resulting medical injury. Total cholesterol levels in suicide attempters were significantly lower compared with both psychiatric and normal controls, when sex, age, and nutritional status (i.e., body mass index) were controlled for. This significant relationship was observed in major depressive disorders and personality disorders, but not in schizophrenia and bipolar type I disorders. The severity of suicide by a lowering of blood cholesterol was related to the magnitude of the cholesterol reduction. After treatment of their psychiatric ailments, the cholesterol levels in suicide attempters were significantly increased. This result suggests that low cholesterol level in psychiatric patients might be a potential biological marker of suicide risk. It is hypothesized that low cholesterol levels is associated with the suicide by modifying the serotonin metabolism, the production of interleukin-2 and melatonin metabolism in psychiatric patients.

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An Investigation of Psychological Factors in Patients with Functional Dyspepsia (기능성 소화불량증 환자의 심리특성에 관한 연구)

  • Kim, Jin-Sung;Bai, Dai-Seog;Lee, Kwang-Heun;Suh, Jeong-Ill
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.244-254
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    • 1999
  • Objectives: This study investigated the psychological characteristics of patients with functional dyspepsia. Methods: The subjects included ninety patients with functional dyspepsia and sixty four psychiatric out-patients. We administered Minnesota Multiphasic Personality Inventory(MMPI) and Illness Behavior Questionnaire(IBQ). Results: There were no significant differences between the patients with functional dyspepsia and the psychiatric out-patients by MMPI. Two groups both showed a higher distribution in hypochondriasis, depression, hysteria subscales than in any other subscales. The patients with functional dyspepsia showed lower scores in disease conviction and affective disturbance subscales in IBQ than the psychiatric out-patients. The distribution of scores of the other IBQ subscales were similar between the patients with functional dyspepsia and the psychiatric out-patients. The patients with functional dyspepsia were divided into three groups for the Multivariate cluster analysis: normal, similar to psychiatric out-patient, and severe neurotic. The severe neurotic group showed higher scores in hypochondriasis, depression, hysteria, psychathenia, and schizophrenia subscales in MMPI and showed significant different scores in affective disturbance, disease conviction, psychological and somatic concerns, affective disturbance, denial, and irritability subscales in IBQ. Conclusion: If patients with functional dyspepsia show severe neurotic behavior, such as those in, they would need appropriate psychiatric intervention.

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Prevalence and Risk Factors of Polydipsia and Water Intoxication in Psychiatric Inpatients (정신과 입원 환자에서의 다음증 및 물중독 유병률 및 위험인자에 관한 연구)

  • Cho, Ae-Hwa;Cho, Yeon-Soo;Roh, Jaewoo
    • Korean Journal of Biological Psychiatry
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    • v.16 no.4
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    • pp.246-255
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    • 2009
  • Objectives : The aims of this study are to estimate the prevalence of polydipsia and water intoxication and to identify risk factors of polydipsia and water intoxication in psychiatric inpatient. Methods : 1,108 Psychiatric inpatients at 2 mental hospitals in Yongin city were studied from September, 2008 to January, 2009. We diagnosed 'polydipsia' using staff reports(fluid intake>3L/day) or by specific gravity of urine(SPGU<1.008) and diagnosed 'at risk for water intoxication' using normalized diurnal weight gain (NDWG>4%). We attempted to identify clinical characteristics of patients by reviewing their medical records. Results : Two hundred forty seven patients(22.3%) were polydipsic. Sixty eight patients(6.1%) were at risk for water intoxication. The factors associated with polydipsia were lithium, smoking, younger age and increased smoking amounts. The factors associated with risk for water intoxication were valproic acid and polydipsia. Conclusion : Polydipsia and water intoxication in psychiatric inpatients are not rare conditions. Therefore, clinicians' attention should be paid to these conditions.

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Psychiatric Consultation for 5 Years in a University Hospital (일 대학병원에서 5년간 시행된 정신과 자문의뢰 분석)

  • Kim, Sung-Wan;Kim, Seon-Young;Kim, Sung-Jin;Kim, Jae-Min;Shin, Il-Seon;Yoon, Jin-Sang
    • Korean Journal of Psychosomatic Medicine
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    • v.19 no.1
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    • pp.28-33
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    • 2011
  • Objective: This study aimed to investigate the pattern of psychiatric consultation-liaison in a new general hospital over a 5-year period. Method: Retrospective chart review was conducted for psychiatric consultations performed from May 2004 to December 2008 in a new general hospital in Hwasun, Korea. Results: A total of 1,852 patients who were referred to the Department of Psychiatry for consultation were included in the analysis. The main reasons for psychiatric consultation were changes in mental status(20.5%), depression(16.8%), insomnia(12.8%), and anxiety(7.9%). Psychiatric consultations were conducted with diagnoses of delirium(39.7%), depressive disorder(28.2%), adjustment disorder(7.9%), and anxiety disorder(4.1%). Patients with delirium were significantly older than were those with other psychiatric diagnoses(p<0.001). Delirium was more common in male patients than in female patients(47.1% vs. 29.9%, respectively), and depression was more common in female patients than in male patients(48.3% vs. 33.9%, respectively)(p<0.001). Delirium was more common in patients who underwent surgical operation than those who did not(p=0.010). Conclusion: Delirium was the most common diagnosis for psychiatric consultation followed by depression in a university hospital. Delirium was more prevalent in men than in women, while depression was more common in women.

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Medical Care Utilization Status and Associated Factors with Extended Hospitalization of Psychiatric Patients in Korea (우리나라 정신질환자의 의료이용 현황과 장기입원 관련 요인)

  • Suh, Soo-Kyung;Kim, Yoon;Park, Jong-Ik;Lee, Myung-Soo;Jang, Hong-Suk;Lee, Sun-Young;Lee, Jin-Seok
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.6
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    • pp.416-423
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    • 2009
  • Objectives : This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization. Methods : Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. Results : The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. Conclusions : The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.

Effects of Psychiatric Nursing Practicum using Simulated Patients on Self-Directed Learning Readiness, Learning Self-Efficacy, Satisfaction of Learning (모의환자를 활용한 정신간호 시뮬레이션 교육이 자기주도적 학습, 학습 자기효능감, 교육만족도에 미치는 효과)

  • Kim, Soon-Ok;Kim, Hyun-Sook
    • The Journal of the Korea Contents Association
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    • v.14 no.2
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    • pp.396-408
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    • 2014
  • The purpose of this study is to examine the effect of the psychiatric nursing simulation practicum, which was developed for the therapeutic relationship forming and communication, psychiatric nursing assessment training utilizing simulated patients, on self-directed learning, learning self-efficacy and learning satisfaction. As a one group pre-test and post-test design, this test conducted 8 hours of intervention on 119 senior nursing students as study subjects. As a result, self-directed learning and learning self-efficacy were seen to be significantly improved after the program compared to before the program, and these variables displayed a moderate-level static correlation with learning satisfaction. These results can be deemed representative of the fact that, concerning psychiatric nursing practicum, a simulation teaching using simulated patients is effective. The results of this study are expected to contribute to improving field-centered psychiatric nursing practicum and the quality of psychiatric clinical work.

Validation of the Edmonson Psychiatric Fall Risk Assessment Tool for Psychiatric Inpatients: A Retrospective Study (정신건강의학과 입원 환자를 위한 낙상 위험 사정도구 (Edmonson Psychiatric Fall Risk Assessment Tool)의 타당도 평가: 후향적 연구)

  • Kim, Kyung Young;Son, Young Sun;Lee, You Ji;Kim, Ji Eun;Kim, Mi Kyung;YI, Young Hee
    • Journal of Korean Clinical Nursing Research
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    • v.28 no.3
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    • pp.270-276
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    • 2022
  • Purpose: The purpose of this study was to validate the Edmonson psychiatric fall risk assessment tool (EPFRAT) for psychiatric inpatients. Methods: Data from retrospective study were collected from 670 adult inpatients in two departments of mental health medicine of a tertiary general hospital by reviewing their electronic medical records. There were 41 patients who experienced falls and 629 patients who did not experience falls during the period from January to December 2019. Data were analyzed by sensitivity, specificity, positive predictive value, negative predictive value, and a receiver-operating characteristic curve (ROC) for validity assessment using the IBM SPSS/WIN 26.0 program. Results: Factors affecting falls were the participant's age, guardian's residence, high-risk determination at the time of admission, and comorbidity. At the 85 points where the point of sum of the sensitivity and specificity was largest, the sensitivity, specificity, positive predictive value, and negative predictive value of EPFRAT were 92.7%, 79.7%, 22.9%, and 99.4%, respectively. The area under the ROC to assess the overall validity of the tool was .92 (95% CI 0.89~0.94). Conclusion: The EPFRAT was proved to be valid and reasonable for predicting falls in psychiatric inpatients. Based on the results of this study, it could be used for the assessment of high-risk patients for falls in psychiatric units.