• Korean Journal of Biological Psychiatry
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• v.18 no.3
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• pp.163-167
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• 2011

Complex regional pain syndrome (CRPS) is a disease that causes chronic spontaneous pain and hyperesthesia of one or more parts of legs and arms, which is accompanied with problems of the automatic nervous system or the motor nervous system. However, up to date, it is unclear what causes the syndrome and how to diagnose and treat it. Although several treatments including medication and sympathetic nerve block are performed against CRPS, the therapeutic effect of the treatments is limited. The electroconvulsive thera-py (ECT), of which the mechanism is not clarified, is a treatment used for treatment-resistant depression. ECT is also reported to be effective against pain. Therefore, we performed the ECT for a 24-year-old female patient who has been diagnosed as CRPS. Her pain had not been much improved by medications and interventional procedures. At admission to a psychiatric ward for ECT, she com-plained of over 8 points of pain on visual analogue scale and the constrained movement around the painful part. Eight ECTs-three times a week-were performed for three weeks in hospital and then the ECT once a week was performed after her leaving the hospital. During the ECTs, pain had been reduced and the range of movement in the constrained parts had increased. Further systematic re-search is needed to confirm the effect of electroconvulsive therapy against CRPS.

• Korean Journal of Psychosomatic Medicine
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• v.2 no.1
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• pp.22-33
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• 1994

The author presented several points of experienced materials obtained from the joint meetings of consultation-liaison Psychiatric division with oncologic department in Kyung Hee University Hospital. The joint meetings which have been held regularly every other week were very helpful not only for the psychiatrist but also for the cancer department stags to manage the cancer patients actively. The joint meetings have been progressed into more cohesive and active communication as time goes by. Most of the subjects discussed in the meeting was focused on the psychological and behavioral problems of the cancer patients. Besides, the difficulties arising from the chemotherapy were discussed. Probably the most difficult task for the treatment team was to provide complete information while respecting the patient's right to deny their situation The liaison psychiatrist usually gave comments to the charge doctor and/or nusing staff how to evaluate the patient's behavior and what would be the influential factors in developing the doctor-patient relationship. It was found that many cancer patients and their family members had their own peculiar illness behavior and disease concept which led patients to take non-medical or moreover, anti-therapeutic care. The family members were found to play an influential role in the choice of treatment method and progression of the disease. Another role of the liaison psychiatrist in the oncology ward was to encourage the treatment team members. In the practical point of view, it was not easy for the liaison psychiatrist to have time regularly for the cancer patients to encourage the liaison activities. And it seems to be fundamental that the consultation fee for the liaison psychiatrist should be set up at the resonable level.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.4
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• pp.251-257
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• 2015

Objectives : We compared the clinical presentations of manic and depressive episodes and the treatment response among children and adolescents with bipolar disorder (BD) types I and II and BD not otherwise specified (NOS). Methods : The sample consisted of 66 patients, aged between 6 and 18 years, who were admitted for BD to a 20-bed child and adolescent psychiatric ward in a university hospital located in Seoul, Korea. Results : Patients with BD type I were more likely to have lower intelligence quotients and exhibit violent behaviors during manic episodes than patients with BD type II or BD NOS and to show better treatment responses during manic episodes than patients with BD NOS. Patients with BD NOS were more likely to have an irritable mood rather than a euphoric mood during the manic phase than patients with BD type I or II and to exhibit violent behaviors during the depressive phase and chronic course than patients with BD type II. Conclusion : Pediatric BD patients are heterogeneous with respect to their clinical characteristics. Implications for the usefulness of the current diagnostic subtype categories should be investigated in future studies.

• Korean Journal of Biological Psychiatry
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• v.20 no.4
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• pp.179-186
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• 2013

Objectives This study is designed to compare the clinical characteristics of patients with early onset schizophrenia to those of adult onset schizophrenia patients in first episode. Methods Authors reviewed medical records of 16 early-onset schizophrenia patients and 22 adult-onset schizophrenia patients who had been admitted in the psychiatric ward and diagnosed as schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders, fourth Edition (DSM-IV) at Eulji University Hospital during 2004-2008. Socio-demographic data and clinical characteristics such as duration between onset and active phase, number of significant positive and negative symptoms, positive and negative symptom scores of Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity (CGI-S) scores, duration from onset to admission, duration of admission, and equivalent dose of antipsychotics were reviewed. These clinical characteristics of early-onset group were compared to those of adult-onset group. Correlation between age of onset and other clinical characteristics was also analyzed. Results Early-onset group showed more insidious onset pattern and had longer duration of hospitalization than adult-onset group. Early onset group also exhibited more negative symptoms, higher negative symptom scores, and higher CGI-S scores than adult-onset group after treatment. However, there were no significant differences in family history of psychosis, positive symptom frequency at discharge and equivalent dose of antipsychotics between two groups. Conclusions This study revealed that patients with early-onset schizophrenia exhibited more insidious onset, more negative symptoms, and more severe symptoms than those with adult-onset schizophrenia after treatment.

• Journal of Korean Academy of Nursing
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• v.11 no.1
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• pp.7-17
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• 1981

The purpose of this study is to investigate the relationship between family attitude about mental illness and their general characteristics. The subjects for this study were a sample of 120 families selected from psychiatric ward of one university hospital, which is one national hospital in Seoul. Data was collected from July 1th to August 10th in 3980 used by Opinion about Mental Illness Scale (O.M.I.). The materials were analized by S.P.S.S. program. The findings of the study were as follows: A. Families' attitude toward mental illness shown ay this study was more negative compared to those of Korea1 nursing professorss, nurses and nursing students. B. Variables which influence families' attitude about mental illness: 1. There is no significant between general characteristics and authoritarianism. (p＞ 0.05) 2. Benevolence (Factor B) was found to be significantly related to such variables as religion, eucation levels, existence of mental patient in their an intimate friends. (P < 0.01) Families' attitude about benevolence was mere positive in families who have not relegion or having christion beliefs: haying the higher education levels; not having a mental patient in their an intimate friends. 3. Mental health ideology (Factor C) was found to be significantly related to variable experience of mental illness. (P < 0.01). families' attitude about mental health ideology was more positive in families who had experience of mental illness. 4. Social Restrictiveness (Factor D) was found to be significantly related to variable relationship between families and patients(P<0.01). An intimate friend's attitude about mental health Ideology was mon positive than that of parent and couple. 5. Interpersonal Etiology (Factor E) was found to be significantly related to variable religion (P < 0.05). Families' attitude about interpersonal etiology was more positive in families who have relegion.

• Women's Health Nursing
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• v.23 no.1
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• pp.21-32
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• 2017

Purpose: The purpose of this study was to investigate the experience and perception of sexual harassment during the clinical practice among nursing students and to identify the relationship between these variables and self-esteem. Methods: Participants included 191 senior nursing students who voluntarily participated. Sexual harassment experiences and perceptions were measured using the tools developed by the researcher. Self-esteem was measured using self-esteem inventory developed by Rogenberg. Results: 50.8% of the participants experienced sexual harassment. Physical harassment was the most common, followed by verbal, visual and gender-role related sexual harassment. 'Blocking the way' and 'Brushing one's body on purpose' were the most common behaviors. The perception of sexual harassment severity was 3.35 out of 5 points. There were negative correlation between sexual harassment experience and self-esteem (r=-.17, p=.013). The subjects who experienced sexual harassment showed lower self-esteem score than those who did not (t=-2.10, p=.037). The main offender was a male patient in 40s, and the psychiatric ward was the most vulnerable to sexual harassment. Conclusion: Results showed that sexual harassment in clinical practice among nursing students were serious. It is necessary to develop an educational program to prepare them for sexual harassment in clinical practice.

• Korean Journal of Schizophrenia Research
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• v.22 no.2
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• pp.51-55
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• 2019

Objectives: Late-onset schizophrenia (LOS, age at first onset ≥40 years) is characterized by including predominance of women, better premorbid social adjustment and lower severity of positive/negative symptoms. However, few studies have been conducted on LOS, especially in Asian countries. This study aimed to examine the clinical features of LOS in comparison with early-onset schizophrenia (EOS). Methods: By retrospectively reviewing medical records, we assessed demographic data and clinical features of 76 LOS (20 males) and 357 EOS (144 males) who admitted to the psychiatric ward of a general hospital. Results: The mean ages of onset were 47.3±5.1 (LOS) and 25.7±6.5 (EOS) years. There were significantly more women in LOS (73.7%) than EOS (59.6%). Significantly more LOS patients had a marital (88.2% vs. 25.8%) and employment history (28.9% vs. 13.1%) than EOS. Patients with LOS had fewer negative (14.3±9.0 vs. 19.9±9.3), general psychopathology score (36.9±11.1 vs. 42.3±13.9) than EOS patients. Conclusion: In line with previous studies, this study demonstrated that LOS patients have better premorbid social adjustment. Our finding also replicates previous findings that LOS patients differ from EOS in predominance of women and relative lack of negative symptoms. These results suggest that LOS may be a distinct subtype of schizophrenia.

• Korean Journal of Social Welfare
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• v.55
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• pp.231-254
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• 2003

The main premise of this study is that the assurance on human rights of the mentally ill is contradictory to 'the greatest happiness of the greatest number' or 'therapeutic benefits'. Accordingly this study aims to find out the conceptual framework of assurance and restriction on human rights of the mentally ill. Using qualitative method, this study conducted the in-depth interview with 10 general public, 9 professionals, 6 mentally ill regarding the several issues of human rights included long-term hospitalization, restriction on driver's licence, involuntary hospitalization, restriction on communication in psychiatric ward. Research results are as follows ; two sets of dimensions are inferred from the analysis of interview transcript. First dimension is the focus of justification, ranging from the emphasis on positive consequences influenced to 'the greatest numbers'(the utilitarian thought) to the emphasis on assurance of rights without any conditions(the deontological thought). Second dimension is the locus of decision, raging from the formal system included the professionals and the government agency to the informal system included the families and the mentally ill. And there are differences in attitudes toward assurance and restriction on rights of the mentally ill among general public, professionals, and the mentally ill. In detail, general public regarded that 'involuntary hospitalization' and 'restriction on driver's license' which are apt to be directly harmful to people must be justified by consequence-centered and decided by the formal system, while 'long-term hospitalization' which is less harmful to people could be justified by right-centered and decided by the formal-system. And they thought that 'restriction of communication' could be justified by right-centered and decided by the informal system. Based on the findings, this study would conclude that practical guidelines for the promotion of human rights of the mentally ill must be developed.

• Quality Improvement in Health Care
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• v.9 no.2
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• pp.116-133
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• 2002

Background : It is very common in Korea to take care of non-acute patients in an acute setting, due to the lack of long-term facilities. Long term hospitalization increase medical expenses and decreases the bed utilization, which can affect the urgent and emergent admissions, and eventually jeopardize the hospital financially. In this study, strategies for effective transfers to the lower levels of care, and to decrease the length of stay were presented by surveying and analyzing the patient's knowledge of the transfer needs, and the willingness to transfer those whose hospital length of stay was more than 30days. Method : The survey is subject to a group of 251 patients who have been hospitalized over 30 days in a general hospital in Seoul. Excluding those that were in the Intensive Care Unit and psychiatric ward, 214 in-patients were used as participants. They were surveyed from April 9, 2002 to April 17, 2002. One hundred and thirty seven out of 214 were responded which made the response rate 64%. Data were analyzed by SAS and SPSS. Result : Multi-variable Logistic Regression Analysis showed a significant effect in medical expenses, knowledge of referral system and the information of the receiving hospital. The financial burden in medical expenses made the patient 10.7 times more willing to be transferred, knowledge of the referral system made them 5 times more willing to be transferred, and the information of receiving hospital makes 6.5 times more willing to be transferred. Reasons for willing to be transferred to a lower level of care were the phase of physical therapy, the distance from home, the attending physician's advice and being unable to be treated as an out patient. Reasons for refusing to be transferred were the following. The attending physician's competency, not being ready to be discharged, not trusting the receiving hospital's competency due to the lack of information, or never hearing about the referring system by the attending physician. Conclusion : Based on this, strategies for the effective transfer to the lower levels of care were suggested. It is desirable for the attending physician to be actively involved by making an effort to explain the transfer need, and referring to the Healthcare Coordinating Center, which can help the patient make the right decision. Nationwide networking for the referral system is the another key factor that may need to be suggested as an alternative to decrease the medical expenses. Collaborating with the Home Health Agency for the early discharge planning and the Social Service Department for financial aid are also needed. It is recommended that the hospital should expedite the transfer process by prioritizing the cost and the information as medical expenses, knowledge of referring system and the information of the receiving hospital, are the most important factors to the willingness to transfer to a lower level of care.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.7
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• pp.393-405
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• 2019

This study is descriptive survey research to find out factors which violence experience, violence coping and social support affect. This study aims at reducing burnout of psychiatry nurses and founding problem-oriented violence handling standardized intervention. The subjects were 204 nurses who have worked for more than a year in a hospital. The data collection period was conducted with structured survey from July 1, 2018 to August 31, 2018. Collected data was analysed with average, standard deviation, t-test, ANOVA, Pearson's Correlation confident, Multiple Regression and this data will go to by SPSS. The results of the study were as follows. 92.2% of psychiatry nurses are experiencing verbal violence, 92.2% are experiencing physical threat and 75.5% are experiencing physical violence. Relations between violence experience and violence coping(r=0.15. p<.027), violence experience and burnout(r=0.16, p<.017) were positive correlation. Relation between violence coping and social support(r=0.30, p<.001) was positive correlation, and social support and burnout(r=-0.28, p<.001) was negative correlated. Also we found out that nursing job satisfaction, social support and physical violence experience affect burnout. Which shows model's explanatory power was 33.3%. Therefore preventive discipline which can reduce violence experience of psychiatry nurses, founding systems to reinforce social support and creating circumstance where nursing job satisfaction can increase will help reduce burnout and serve better nursing.