• Title/Summary/Keyword: Psychiatric syndrome

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Fibromyalgia: practical considerations for oral health care providers

  • Jeon, Younghoon
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.5
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    • pp.263-269
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    • 2020
  • Fibromyalgia is a syndrome characterized by chronic pain in the skeletal system accompanied by stiffness, sleep disturbance, fatigue, and psychiatric problems, such as anxiety and depression. Fibromyalgia commonly affects orofacial health, presenting with a variety of oral manifestations, including temporomandibular disorder, xerostomia, glossodynia, and dysgeusia. Therefore, oral healthcare providers need to be aware of this clinical entity to effectively manage oral symptoms and provide proper oral self-care modification and education on the nature of fibromyalgia. This review focuses on the epidemiology, pathophysiology, clinical manifestation, diagnosis, orofacial concerns, and treatment of fibromyalgia.

Sleep Disorder and Socioeconomic Burden (수면질환과 사회경제적 비용)

  • Kang, Eun-Ho
    • Sleep Medicine and Psychophysiology
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    • v.18 no.2
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    • pp.72-75
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    • 2011
  • Sleep disorders such as insomnia, obstructive sleep apnea (OSA), and restless legs syndrome (RLS) are very common disorders and may cause significant burden in terms of individual as well as societal aspects. Sleep insufficiency from such sleep disorders may cause deleterious effects on daily work life and may be associated with other major medical or psychiatric disorders including cardiovascular disease, diabetes mellitus, depression, and anxiety disorder. Various motor or occupational accident may result from the sleep problems. In addition, recent researches provide the method to evaluate the lost productivity time in terms of absenteeism and presenteeism. Moreover, several studies on cost-effectiveness of treatment of sleep disorders show that it is cost-effective.

Prognosis and Clinical Outcome of Alcohol Withdrawal Syndrome in Trauma Patients (외상 환자에서 알코올 금단 증후군의 발생이 예후에 미치는 영향)

  • Oh, Dong Gil;Cho, Min Soo;Bae, Keum Seok;Kang, Sung Joon
    • Journal of Trauma and Injury
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    • v.21 no.2
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    • pp.115-119
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    • 2008
  • Purpose: Abrupt abstinence from alcohol in cause of chronic alcohol addiction can trigger alcohol withdrawal syndrome. The authors studied the effect of post-operative alcohol withdrawal syndrome in patients who require intensive care due to trauma. Methods: For the study group, we selected 70 patients who had undergone emergency surgery from May 2003 to March 2007 due to trauma and who had been treated with prophylactic thiamine. Data was collected retrospectively. We excluded those who extended their hospital stay for other than traumatic causes, those who died within 3 days of surgery after trauma, those who transferred to other institutions, and those who received a psychiatric diagnosis. Patient groups were determined by the existence or the non-existence of withdrawal syndrome. Age, sex, injury mechanism, mortality, complications, durations of hospital stay and intensive care, use of mechanical ventilator, and sedative use were investigated. A Chi-square test and The Mann-Whitney method were used for statistical analysis in this study. Results: Twenty-four (24) patients from the 58 who had an ISS of 16 or more showed alcohol withdrawal syndrome, and men were shown to be affected with the syndrome significantly more than women. Although ISS was higher in the group with alcohol withdrawal syndrome, statistically, the difference was not significant (P<0.08). The total hospital stay in the patient group with alcohol withdrawal syndrome was on average 10 days longer. However, the difference was not significant (P<0.054). The duration of intensive care in the patient group with alcohol withdrawal syndrome was significantly longer (P<0.029). The patients with alcohol withdrawal syndrome showed no significant difference in the duration of mechanical ventilator use (P<0.783), or in the duration of sedative use (P<0.284). Respiratory distress, pneumonia, upper airway infection, sepsis, acute renal failure, and mortality in the alcohol withdrawal syndrome group were investigated, but no statistically significant difference were noted. Conclusion: We found that the duration of intensive care in chronic alcohol abusers was longer due to the development of alcohol withdrawal syndrome. We also discovered that, when the patients overcame the symptoms of alcohol withdrawal syndrome after intensive care, no difference was found in the frequency of developing complications, the morbidity, and the mortality. Therefore, we conclude that intensive care in trauma patients who are chronic alcohol abusers decreases the incidence of complications found in patients with post-operative alcohol withdrawal syndrome and does not adversely impact the prognoses for those patients.

Childhood Trauma, Metabolic Syndrome, and Physical Health among Outpatients with Schizophrenia (조현병 외래 환자의 아동기 외상과 대사증후군 및 신체 건강과의 관계)

  • Jung, Tae Hwa;Kim, Dae Ho
    • Korean Journal of Biological Psychiatry
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    • v.24 no.4
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    • pp.196-203
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    • 2017
  • Objectives Childhood trauma increases substantial risks for later developing not only mental health issues including psychotic illnesses such as schizophrenia but also physical illness. In this study, possible associations of childhood trauma with metabolic syndrome and physical heath indices were tested among outpatients with schizophrenia. Methods A final sample of 46 adult outpatients with schizophrenia was recruited from an outpatient psychiatric unit of Hanyang University Guri Hospital. Participants completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), laboratory tests and physical measurement including Body Mass Index (BMI) and Waist to hip ratio (WHR). The Clinical Global Impression (CGI) scale and the Global Assessment of Functioning scale (GAF) were also administered. Results We did not find significant correlations between total scores of childhood trauma and any of these variables, but physical neglect was negatively associated with BMI (r = -0.329, p = 0.026) and waist circumference (r = -0.304, p = 0.040). Conclusions In this preliminary study, we noted that subtypes of childhood trauma could contribute to physical health status separately. Clinicians need to consider the possibility that childhood trauma may affect physical health as well as psychological aspect of schizophrenic illness.

Three Cases of Typical Clinical Characteristics and Overview of Neuroleptic Malignant Syndrome (항정신병약물성 악성증후군에 관한 3증례 및 개관)

  • Lee, Kyung-Kyu;Kim, Hyun-Woo
    • Korean Journal of Biological Psychiatry
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    • v.4 no.1
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    • pp.136-145
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    • 1997
  • We are report on three cases of typical clinical characterstics and treatment response in neuroleptic maligant syndrome(NMS), and reviewed the literatures of NMS. NMS was first recognized as a life-threatening complication of dopamine receptor antagonists, and defined as a catatonic-like states associated with fever, obtundation, muscle rigidity, and unstable vital sign in patients taking neuroleptic agents. Concepts of NMS have changed because medications other than classic neuroleptic drugs have been implicated as triggering agents and syndromes identical to NMS have been observed in other conditions. The important neurochemical features are probably functional dopamine deficiency and ensuing hyperactivity of excitatory amino acid neurotransmission in the basal ganglia and hypothalamus. Recognition of NMS and early discontinuation of neuroleptics are the most important step in its management. Supportive care includes management of hyperthermia and fluid replacement. Controversial therapeutic measures include the application of dopamine receptor agonists, excitatory amino acid antagonists, or dantrolene. Psychiatric patients with a history on NMS and psychotic relapse necessitating antipsycotics do not commonly redevelop NMS.

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Behavioral Problems in Patients with Prader-Willi Syndrome

  • Park, Sung Won
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.5 no.1
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    • pp.29-33
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    • 2021
  • Prader-Willi Syndrome (PWS) is a neurodevelopmental genomic imprinting disorder involving a lack of gene expression from the paternal chromosome 15q11-q13 region. This is typically due to paternal 15q11-q13 deletions (in approximately 60% of cases), maternal uniparental disomy 15, or when both 15s are from the mother (about 35% of cases). An imprinting center controls the expression of imprinted genes in the chromosome 15q11-q13 region. PWS is a neurodevelopmental disorder characterized by mental retardation and distinct physical, behavioral, and psychiatric features. Characteristic behavioral disturbances in PWS include excessive interest in food, skin picking, difficulty with a change in routine, temper tantrums, obsessive and compulsive behaviors, and mood fluctuations. Individuals with PWS typically have intellectual disabilities (borderline to mild/moderate mental retardation) and exhibit a higher overall level of behavior disturbances compared to individuals with similar intellectual disabilities. This condition severely limits social adaptations and quality of life. Different factors have been linked to the intensity and form of these behavioral disturbances, but there is no consensus regarding the cause. Consequently, there is still controversy surrounding management strategies and there is a need for new data. PWS is a multisystem disorder. Family members, caregivers, physicians, dieticians, and speech-language pathologists all play an important role in the management and treatment of symptoms in an individual with PWS. Here we analyze behavioral problems in children and adults with PWS by age and review appropriate management and treatment strategies for these symptoms.

Psychosocial Factors Influence the Functional Gastrointestinal Disorder among Psychiatric Patients (정신질환자들에 동반된 기능성 위장질환에 영향을 미치는 정신사회적 요인에 관한 연구)

  • Kang, Deung-Hyun;Jang, Seung-Ho;Ryu, Han-Seung;Choi, Suck-Chei;Rho, Seung-Ho;Paik, Young-Suk;Lee, Hye-Jin;Lee, Sang-Yeol
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.1
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    • pp.1-8
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    • 2018
  • Objectives : This study aimed to investigate the psychosocial characteristics of functional gastrointestinal disorder (FGID) in patients with psychiatric disorders. Methods : This study was conducted with 144 outpatients visiting the psychiatric clinic at a university hospital. FGIDs were screened according to the Rome III questionnaire-Korean version. Demographic factors were investigated, and psychosocial factors were evaluated using the Hospital Anxiety Depression Scale, Patient Health Questionnaire-15, Childhood Trauma Questionnaire-Korean, and State-Trait Anger Expression Inventory. Chisquared test and student's t-test were used as statistical analysis methods. Results : There were differences in education level between two groups divided according to FGID status (${\chi}^2=10.139$, p=0.017). Comparing the psychiatric disorder by FGID group, irritable bowel syndrome (IBS) group showed significant differences (${\chi}^2=11.408$, p=0.022). According to FGID status, IBS group showed significant differences for anxiety (t=-3.106, p=0.002), depressive symptom (t=-2.105, p=0.037), somatic symptom (t=-3.565, p<0.001), trait anger (t=-3.683, p<0.001), anger-in (t=-2.463, p=0.015), and anger-out (t=-2.355, p=0.020). Functional dyspepsia group showed significant differences for anxiety (t=-4.893, p<0.001), depressive symptom (t=-3.459, p<0.001), somatic symptom (t=-7.906, p<0.001), trait-anger (t=-4.148, p<0.001), state-anger (t=-2.181, p=0.031), anger-in (t=-2.684, p=0.008), and anger-out (t=-3.005, p=0.003). Nonerosive reflux disease group showed significant differences for anxiety (t=-4.286, p<0.001), depressive symptom (t=-3.402, p<0.001), somatic symptom (t=-7.162, p<0.001), trait anger (t=-2.994, p=0.003), state anger (t=-2.259, p=0.025), anger-in (t=-2.772, p=0.006), and anger-out (t=-2.958, p=0.004). Conclusions : Patients with psychiatric disorders had a high prevalence of FGID, and various psychosocial factors contributed to such differences. Therefore, the psychiatric approach can offer better understandings and treatments to patients with FGID.

Relationship Between Neurologic Soft Signs and Some Clinical Variables in Patients with Schizophrenia (정신분열증환자의 연성 신경학적 증상과 임상변인과의 관련성)

  • Chae, Jeong-Ho;Habm, Woong;Lee, Chung-Kyoon
    • Korean Journal of Biological Psychiatry
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    • v.2 no.1
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    • pp.115-122
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    • 1995
  • This study was performed to know the relationship between neurologic soft signs (NSS) and clinical variables such as psychopathology. history of illness, and premorbid social adjustment in patients with schizophrenia. The authors evaluated NSS in 31 patients with schizophrenia using the structured tool for measuring neurologic abnormalities, Neurological Evaluation Scale- Korean Version(NES-K). Relationships between NSS and clinical variables such as duration of illness, intensity of precipitating stressors, duration of outpatient treatment, schooling, peer relationship, total duration of unemployment, total days of psychiatric admission, age, total days of being medicated, age at the first psychiatric admission, frequency of admissions, content of treatment, social adjustment, and severity of symptoms were analyzed. Differences between paranoid and non-paranoid schizophrenics were examined. In addition, Differences between patients with schizophrenia who have predominant positive symptoms and who have predominant negative symptoms were examined too. Total scores of NES-K were correlated with lower schooling (${\gamma}$=0.44, p<0.01). Scores of motor coordination subcategory were correlated with poor peer relationship(${\gamma}$=0.67, p<0.001). Other clinical variables were not correlated with any scores of NES-K. Paranoid and non-paranoid schizophrenics were not different in scores of NES-K. Also positive and negative schizophrenics were not different in scores of NES-K. Most clinical variables except schooling and peer relationship were not related with NSS. This results indicated that the meaning of these signs was not fully be understood. Introduction of the new classification concepts such as deficit or non-deficit syndrome will be helpful to elucidate the meaning of NSS in patients with schizophrenia.

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Characteristics of Women Who Have Had Cosmetic Breast Implants That Could Be Associated with Increased Suicide Risk: A Systematic Review, Proposing a Suicide Prevention Model

  • Manoloudakis, Nikolaos;Labiris, Georgios;Karakitsou, Nefeli;Kim, Jong B.;Sheena, Yezen;Niakas, Dimitrios
    • Archives of Plastic Surgery
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    • v.42 no.2
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    • pp.131-142
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    • 2015
  • Literature indicates an increased risk of suicide among women who have had cosmetic breast implants. An explanatory model for this association has not been established. Some studies conclude that women with cosmetic breast implants demonstrate some characteristics that are associated with increased suicide risk while others support that the breast augmentation protects from suicide. A systematic review including data collection from January 1961 up to February 2014 was conducted. The results were incorporated to pre-existing suicide risk models of the general population. A modified suicide risk model was created for the female cosmetic augmentation mammaplasty candidate. A 2-3 times increased suicide risk among women that undergo cosmetic breast augmentation has been identified. Breast augmentation patients show some characteristics that are associated with increased suicide risk. The majority of women reported high postoperative satisfaction. Recent research indicates that the Autoimmune syndrome induced by adjuvants and fibromyalgia syndrome are associated with silicone implantation. A thorough surgical, medical and psycho-social (psychiatric, family, reproductive, and occupational) history should be included in the preoperative assessment of women seeking to undergo cosmetic breast augmentation. Breast augmentation surgery can stimulate a systematic stress response and increase the risk of suicide. Each risk factor of suicide has poor predictive value when considered independently and can result in prediction errors. A clinical management model has been proposed considering the overlapping risk factors of women that undergo cosmetic breast augmentation with suicide.

Study of Pathologic Mechanism Related Chiljeong-Based on a Literature Review of Donguibogam (동의보감(東醫寶鑑)에 나타난 칠정(七情)의 대한 연구-병기(病機)를 중심으로)

  • Lee, Go-Eun;Lyu, Yeoung-Su;Kang, Hyung-Won
    • Journal of Oriental Neuropsychiatry
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    • v.25 no.1
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    • pp.85-108
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    • 2014
  • Objectives: Chiljeong means the basic emotions containing joy, anger, anxiety, depression, fear and fright in Korean traditional medicine. Chiljeong was considered as a cause diseases or syndrome. The pathology of Chiljeong described the action of the gi and the principle of eumyangohaeng. When we treat the psychiatric symptoms in Korean traditional medicine, we need to understand the pathologic mechanism of Chiljeong. Methods: We extract the sentences regarding Chiljeong, Oji, Chilgi and Gugi along with the related words in Donguibogam. We analyze the selected sentences and classify the pathologic mechanism according to the general and seven emotions. Results: We found that several parts were related to Chiljeong, except the Sinmun, including the psychiatric symptoms in Donguibogam. Conclusions: The most frequently mentioned affected areas of basic Jangbu are Sim and Gan. The pathologic mechanism of general emotion was categorized by sentences into 4 groups, Giul, Dameum, Hwa and Heo.