• Title/Summary/Keyword: Psychiatric syndrome

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Neuropsychiatric Aspect of Traumatic Brain Injury (두부외상의 신경정신과적 관점)

  • Kim, Young Chul
    • Korean Journal of Biological Psychiatry
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    • v.2 no.2
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    • pp.157-168
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    • 1995
  • The neuropsychiatric sequelae of traumatic brain unjury(TBI) are effects on complex aspect of behavior, cognition and emotional expression. They include psychiatric disorders such as depression, psychosis, personality change, dementia, and postconcussion syndrome. The damage is done not only to the cortex of the brain but also to subcortical and axial structures. The diffuse degeneration of cerebral white mailer is axonal damage that is caused by mechanical forces shearing the neuronal fiber at the moment of impact(diffuse axonal injury, DAI). The DAI and the changed receptor-agonist mechanism ore the most important mechanisms in genesis of neuropsychiatric sequalae by mild TBI. The most important instrument for diagnosis of neuropsychiatric sequalae of TBI is a physician or psychiatrist with experience and knowledge. The most effective therapeutic tool is a professional who understands the nature of the problem.

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A Case of Woman with Histrionic Personality who Suffered from Chronic Gastrointestinal Dysfunction (만성 위장장애를 호소하는 히스테리성 성격의 여자)

  • Song, Ji-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.1 no.1
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    • pp.101-108
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    • 1993
  • A case of a 38 year-old woman with histrionic personality who had chronic epigastric pain, dyspepsia and alternating bowel habit for more than 10 years was presented in detail on its course of two times of admission and follow-up. The diagnosis was thought as psychophy-siological disorder or gastrointestinal motility disorder of undefined etiology rather than hypo-chondriasis or Briquet's syndrome. She was characterized by sustained illness behavior and combined several physical illnesses. i.e. tuberculosis. anemia and hepatic stone. These physical diseases led to a blurring of psychological and physical boundaries regarding symptom formation. The points on consultation from medical part to psychiatric department were discussed and the supposed causal mechanisms in non-organic functional gastrointestinal disturbances were also reviewed. Physical and psychological modalities for the treatment and the abnormal illness behavior were mainly emphasized in this case.

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Attention Deficit Hyperactivity Disorder and Sleep Problems (주의력결핍 과잉행동장애와 수면 문제)

  • Park, Eun-Jin
    • Sleep Medicine and Psychophysiology
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    • v.18 no.1
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    • pp.10-16
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    • 2011
  • There has been a growing interest in sleep problems associated with attention deficit hyperactivity disorder (ADHD). In this paper, we reviewed the current literature on the underlying sleep problems associated with ADHD. Sleep problems are very common in children with ADHD. Patients with ADHD may have sleep difficulties including difficulty falling asleep, frequent night awakening, increased tiredness upon waking. Children with ADHD are associated to restless legs syndrome, periodic limb movement and sleep-disordered breathing. Screening for other psychiatric comorbidities and the side effects of medications, such as psychostimulants, is also necessary when considering sleep problems in ADHD. Sleep problems can cause a negative impact on the quality of life and emotional well-being both of children with ADHD and their parents. Many evidences suggest that assessment of sleep difficulties should be included in evaluating the patient of ADHD.

Two Cases of Obesity Treatment Using Liraglutide 3 mg with Intensive Behavioral Changes in Morbidly Obese Patients with Major Depressive Disorder (주요우울증을 동반한 고도비만 환자에 대한 행동요법을 병행한 리라글루티드 치료의 2예)

  • Ko, Hae-Jin
    • Archives of Obesity and Metabolism
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    • v.1 no.1
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    • pp.39-42
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    • 2022
  • Obesity is a chronic disease associated with severe complications. A major complication of obesity is depression, which can worsen obesity and vice versa. In addition, most antidepressants or antipsychotics cause weight gain, and the relationship between obesity and depression is clinically critical. However, treatment of obese patients with major depressive disorder is complicated. Bariatric physicians should provide appropriate behavioral interventions alongside pharmacological treatment, considering psychiatric symptoms, drug side effects, and drug interactions. Two successful cases of moderate-to-severe obese patients with major depressive disorder who had been treated for obesity using behavioral intervention therapy along with liraglutide will be discussed. This report highlights the safety and efficacy of liraglutide treatment of obesity in patients with depression who take antidepressants and antipsychotics.

COVID-19 and Sleep (코로나바이러스감염증-19와 수면)

  • Jaegong, Cyn
    • Sleep Medicine and Psychophysiology
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    • v.29 no.2
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    • pp.29-34
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    • 2022
  • Coronavirus disease 2019 (COVID-19), which was a global pandemic caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), is still a serious public health problem. COVID-19 causes various symptoms not only in the respiratory system but also in various parts of the body and has a significant effect on sleep. Insomnia and poor sleep quality were observed at high rates in patients with COVID-19 as well as in the uninfected general population. Obstructive sleep apnea is also considered a risk factor in patients with severe COVID-19. Virus-induced central nervous system damage is likely to be the cause of many sleep disorders in COVID-19, but psychosocial influences also seem to have played a significant role. Sleep problems persisted at high rates for a considerable period after the infection phase was over. More attention and research on the effect of COVID-19 on sleep is needed in the future.

Adverse Effect of Newer Antidepressant : Nausea and Vomiting, Weight Gain, Sexual Dysfunction - Mechanisms, Epidemiology, and Pharmacological Management - (새로운 항우울제의 부작용: 오심 및 구토, 체중증가, 성 기능장애 - 발병기전, 역학, 약물학적 처치를 중심으로 -)

  • Lee, Kyung-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.2
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    • pp.81-92
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    • 2013
  • Newer antidepressants are commonly used in clinical practice to treat psychiatric disorder and psychosomatic disorder including chronic pain syndrome, fibromyalgia, headache. However there are many unexpected adverse effects of these drugs such as nausea and vomiting, weight gain, sexual dysfunction. These are 3 most well-recognized common adverse effects of newer antidepressant and are most common causes of treatment failure. I reviewed mechanisms, epidemiology, and pharmacological management of these adverse effects of newer antidepressants. In this paper, newer antidepressants include selective serotonin reuptake inhibitor(fluoxetine, fluvoxamine, citalopram, escitalopram, sertraline, paroxetine), serotonin norepinephrine reuptake inhibitor(venlafaxine, duloxetine), norepinephrine and dopamine reuptake inhibitor(bupropion), noradrenergic and specific serotonergic antidepressant(mirtazapine), and reversible inhibitor of MAO-A(moclobemide). I suggest that psychiatrists and clinicians in the psychosomatic field should know mechanisms, epidemiology, and management of these common and well-recognized adverse effects of newer antidepressants. Therefore it will be helpful to recognize easily and treat well for patients with psychiatric disorder and psychosomatic disorder using newer antidepressants.

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Patterns of wrist cutting: A retrospective analysis of 115 suicide attempts

  • Cho, Jakwang;Choi, Youngwoong
    • Archives of Plastic Surgery
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    • v.47 no.3
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    • pp.250-255
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    • 2020
  • Background Rosenthal et al. classified female, habitual, non-suicidal wrist cutters as a group and introduced the concept of wrist-cutting syndrome. We investigated the characteristics of wrist-cutting patients at our institution in comparison with results reported previously. Methods We conducted a retrospective study involving 115 patients who had cut their wrists and been examined at the emergency department of a single hospital in Seoul, Korea, between March 2014 and August 2018. Results There were more women (73 patients; 63.5%) than men (42 patients; 36.5%), and the women (mean age, 34.42 years) were significantly younger than the men (mean age, 50.07 years). The patients who had cut their wrists repeatedly were mainly women (22 of 26 patients; 84.6%); however, men caused more severe damage than women. Substance use before a suicide attempt did not significantly increase the severity of wrist cutting. Our institution planned and implemented a suicide prevention intervention program to improve the continuity of outpatient care. The number of patients who continued psychiatric treatment increased significantly after program completion. Conclusions We confirmed that most patients were young women who were not suicidal in the true sense because their wounds were not severe. Our study showed a protective role of the barrier tendons (flexor carpi radialis, palmaris longus, flexor carpi ulnaris), and we suggest careful repair of the barrier tendons to protect neurovascular structures against subsequent cutting events. We found that it was possible to improve the continuity of patient counseling by managing patients through a psychiatric treatment program.

Literatures Review in Hwabyung Research (홧병 연구에 관한 고찰)

  • Park, Young-Sook;Chae, Sun-Ok
    • Research in Community and Public Health Nursing
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    • v.12 no.3
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    • pp.705-715
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    • 2001
  • This study examined 19 papers published from 1977 to 2000 based on the objective frame evaluation. This purpose of this study was to examine the trend of Hwabyung research and to serve as a guide for the future 'Hwabyung' study. The results of studies were as follow. In the design of research, clinical studies are definitely dominant. As for the fields of research, the concept of Hwabyung was studied more frequently than the others. As for the authorship. psychiatrists prevailed but nursing professionals are on the increase. Research subject in clinical and survey study, patient was definitely dominant and the place of study was almost always a hospital (75%), data collection was higher on interview (58.3%). Hwabyung was considered unique culture bounded syndrome related to Korean culture. Frequent etiologic factor of Hwabyung were a husband's extra-marital affair, conflicts between houses wives and mothers-in-laws, and financial loss and suffering. From the incidence of Hwabyung, a greater number of patients with Hwabyung were middle aged women in the low economic and educational classes, and these were connected with the culture and the family system. The symptoms of Hwabyung included psychological and physical symptom, neurological disorder and disease behavior. Defense mechanisms and coping strategies for Hwabyung were somatization, suppression, orality, withdrawal, isolation, regression, help-seeking, complaining, and wreaking anger. Treatment of Hwabyung were medication, effort by herself, communication with families, consultation with psychologist, acupuncture, negative therapy, moxa, and Qi-kong. Psychiatric therapy, behavior therapy, nursing intervention on multi-interdisciplinary approach and psychiatric nursing approach were recommended for the nursing care of a Hwabyung patient.

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Quality of Life of Antipsychotic-Induced Hyperprolactinemia in Patients with Schizophrenia (항정신병약물로 유발된 고프로락틴혈증을 가진 조현병 환자의 삶의 질)

  • Woo, Seonjin;Jin, Bo-Hyun;Won, Seunghee
    • Journal of the Korean society of biological therapies in psychiatry
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    • v.24 no.3
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    • pp.218-229
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    • 2018
  • Objectives : Antipsychotic-induced hyperprolactinemia causes physical symptoms, such as amenorrhea, galactorrhea, gynecomastia, sexual dysfunction, and bone density loss, as well as psychiatric symptoms, such as depression and cognitive impairments. This study aimed to clarify the associations among hyperprolactinemia caused by antipsychotics in patients with schizophrenia, psychiatric pathology, and psychosocial factors. Methods : Ninety-nine patients with schizophrenia in the psychiatry department of a university hospital were registered between 2015 and 2017. All participants were assessed using structured questionnaires to elucidate psychopathology, social function, quality of life, and hyperprolactinemia-related side effects. The standard levels for hyperprolactinemia were 24ng/mL for women and 20ng/mL for men. Results : The average prolactin levels were $73.45{\pm}49.37ng/mL$ in patients with hyperprolactinemia and $9.16{\pm}6.42ng/mL$ in those without hyperprolactinemia. The average prolactin level in women was significantly higher than that in men(p=0.04). Risperidone was most commonly administered in patients with hyperprolactinemia(58.1%, p<0.01), while aripiprazole was most commonly administered in those without hyperprolactinemia(44.7%, p<0.01). Patients with hyperprolactinemia had significantly higher Positive and Negative Syndrome Scale(p=0.03) and Patient Health Questionnaire-9(p=0.05) scores and had significantly lower Social and Occupational Functioning Assessment Scale(p=0.04) and Strauss-Carpenter Levels of Functioning Scale(p=0.03) scores than patients without hyperprolactinemia. There were no significant differences in side effects or quality of life between the two groups. Conclusion : These findings demonstrate that hyperprolactinemia confers negative effects on depression and social function, but does not directly affect the quality of life. These results suggest that patients with schizophrenia who take antipsychotics that increase prolactin or cause side effects of hyperprolactinemia need to be assessed and receive interventions for depression.

Anti-LGI1 Antibody Encephalitis (양극성장애로 오인된 LGI1 자가면역성뇌염)

  • Kim, Eun Soo;Lee, HeeJun;Jeon, Sang Won;Cho, Sung Joon
    • Korean Journal of Biological Psychiatry
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    • v.27 no.2
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    • pp.112-116
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    • 2020
  • Leucine rich glioma inactivated (LGI1) encephalitis is an uncommon neurological disorder rarely encountered in clinical practice. However, it is a potentially fatal autoimmune syndrome that can decrease the level of consciousness, possibly progressing to coma. Additionally, unless diagnosed and promptly treated, it can cause permanent cognitive impairment. Since LGI1 encephalitis can initially present with psychiatric symptoms, there can be delays in reaching a proper diagnosis. This report describes a case of a 47-year-old woman with LGI1 antibodies-associated limbic encephalitis who initially presented with psychosis. Her blood tests were normal and no MRI and EEG abnormalities were found. Cerebrospinal fluid analysis was negative for other possible infectious causes. Three months after admission, she was found to be LGI1 antibody positive. LGI1 encephalitis should be suspected in patients with symptoms such as memory loss, confusion, seizures, and psychiatric symptoms. Prompt diagnosis and treatment of LGI1 encephalitis are warranted because prognosis becomes worse when such actions are delayed.