• Archives of Plastic Surgery
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• 제47권5호
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• pp.382-391
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• 2020

Facial palsy has a broad clinical presentation and the effects on psychosocial interaction and facial functions can be devastating. Pediatric facial palsy, in particular, introduces unique familial and technical considerations as anatomy, future growth potential, and patient participation influence treatment planning. Though some etiologies of pediatric facial palsy are self-limiting, congenital and long-standing facial palsies pose difficult challenges that require a combination of surgical, adjunctive, and rehabilitative techniques to achieve facial reanimation. Given the spectrum of ages and symptom severity, as well as the various surgical options available for facial palsy, a tailored approach needs to be developed for each child to restore facial balance and function. Here, we review the etiologies, workup, and treatment of pediatric facial palsy and present our novel algorithmic approach to treatment.

• 정신신체의학
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• 제6권2호
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• pp.210-220
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• 1998

The relationships between emotion, stress and gastro-intestinal dysfunction were briefly reviewed. Until now, several kinds of theories on about pathophysiology, such as motility dysfunction, changes of pain perception on the lumen, dysregulations on the central nervous system associated with psychosocial factors were reported. However, none of those factors could'nt give any clues for the causes of the functional bowel disorders. For understanding the meaning of the symptoms and for the treatment approach, clinicians should give attention to the comprehensive point of view, i.e., not only biological but also psychological aspects of the patients with non-organic bowel dysfunctions. Giving warm and kind explanations to the patient about symptom formation and progression and understanding the patient's illness behaviors, and good and strong doctor-patient relationship is essentials for the treatment.

• The Journal of Korean Physical Therapy
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• 제3권1호
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• pp.189-201
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• 1991

Hospice, a concept of care for dying patients, focuses on providing comfort measures rather than aggressively searching for a cure. Hospice addresses symptom control from a wholistic view under the direction of an interdisciplinary team. Physical therapy fits with many of the tenets of hospice, such as the interdisciplinary team, inclusion of the patient and family as the care unit, provision of treatment in various in and out patient settings, and attention to the comfort of the patient. Physical therapy educators must recognize the need for medical ethics, psychosocial and medicolegal issues to be incorporated throughout the curriculum.

• 정신신체의학
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• 제5권2호
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• pp.151-157
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• 1997

본 연구는 이명환자들에서 스트레스지각 및 정신병리와 주관적 및 객관적 이명의 정도간의 관계를 알아보기 위해 시행되었다. 연구대상은 이비인후과외래에 내원한 43명의 이명환자들로 구성되었다. 스트레스지 각 및 정신병리를 평가하기 위해서 Global Assessment of Recent Stress Scale, Beck Depression Inventory 및 Symptom Checklist-90-Revision을 이용하였다 한편 주관적 이명의 정도는 이명의 심한 정도를 평가할 수 있는 Subjective Tinnitus Severity Inventory로, 객관적 이명의 정도는 이명강도검사(tinnitogram)를 사용하여 측정하였다. 대인관계와 질병 및 상해와 관련된 스트레스지각점수는 각각 주관적 이명의 정도와 유의한 양상관성을 보였다. 또한 신체화 강박증, 대인예민, 우울, 불안, 공포, 편집증, 정신증척도점수는 주관적 이명의 정도와 유의한 양상관성을 보였다. 반면 스트레스지각 및 정신병리는 객관적 이명강도와 유의한 상관성을 보이지 않았다. 이 결과는 이명이 스트레스 및 다양한 정신병리와 연관되어 있음을 시사한다. 따라서 이런 환자들에 대한 평가 및 치료에 있어서 정신사회적 개입은 물론 이비인후과의사 및 일차 진료의 들과의 효과적인 자문조정활동의 필요성이 강조된다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제10권1호
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• pp.34-42
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• 1999

본 연구는 정서 행동적 문제를 자주 동반하는 것으로 알려진 아토피피부염 소아 청소년에 대해, 정신과적 문제의 정도와 병변 심각도에 영향을 미칠 수 있는 심리 사회적요인을 알아보고자 하였다. 서울대학교병원 아토피 크리닉을 방문한 아토피피부염 환자 70명(평균 나이 9.9세, 범위：$4{\sim}15$세)과 그 어머니를 대상으로 병력조사설문지, CBCL, MBRI, CDI, STAI을 주어 완성하도록 한 후, 정신과적 면담을 시행하였다, 환자의 피부 병변에 대해 SCORAD index를 이용하여 침범부위, 병변의 경중도, 주관적 증상으로 나누어 평가하였다. 16명(22.9%)이 임상적으로 유의한 정서 행동적 문제가 있을 것으로 예측되었으며 이들은 우울, 특성 불안, 어머니의 통제적 태도, 부정적평가 척도에서 다른 아토피 군보다 점수가 높았다. 병변의 경중도는 특성불안이나 우울정도와, 주관적 증상은 우울, 특성불안, 가족영향, 사회능력, 내재화 및 외현화 문제, 성문제, 아이에 대한 부정적 평가와 관련이 있었다. 아토피피부염을 가진 소아 청소년은 정신과적 문제의 고위험군이며 이러한 정신과적 문제는 양육태도와 함께 피부증상의 주관적 지각에 영향을 미칠 가능성이 높다고 할 수 있다. 향후 이에 대한 정신과적 개입이 필요할 것으로 생각된다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제7권2호
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• pp.203-212
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• 1996

주의력결핍 과잉행동장애아(ADHD)와 품행장애나 반항성장애와 같은 외면성 증후를 공존질환으로 갖는 주의력결핍 과잉행동장애아(ADHD + CD/ODD)간에 사회경제적지위, 부모 학력수준, 생활 스트레스 사건, 친인척의 정신병력을 내용으로 하는 가족 배경과 부모의 결혼 만족도, 양육자 스트레스, 양육태도 등의 심리사회적 변인에 차이가 있는지 검증하였다. 연구결과, ADHD+CD/ODD집단이 위의 가족배경에서 가장 열악한 수준을 보이고 있었고, 부모의 결혼적응도에서도 ADHD+CD/ODD 집단이 가장 낮았으며, 양육자 스트레스에서는 ADHD+CD/ODD>ADHD>통제집단 순으로 높았으며 부모가 지각한 양육태도에서 임상집단의 어머니들이 증오적, 거부적 의존성을 포함하는 양육태도를 가지고 있었으며, 아동이 지각한 부모의 양육태도에서는 임상집단의 부모가 아동에게 더 거부적이고 지배적이고, 모순적인 양육태도를 지닌 경향성을 알 수 있었다.

• 대한예방한의학회지
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• 제8권1호
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• pp.19-32
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• 2004

This study was conducted to evaluated musculoskeletal subjective symptoms and the degree of stress of industrial workers to present fundamental materials of preventive oriental medicine for improving their health and quality of life. During the medical examination with oriental medicine method, presence of subjective symptoms of musculoskeletal pain, Psychosocial Well-being Index(PWI) and life style were checked by using questionnaire method in 474 industrial workers. The collected data were analyzed with crosstabs, ANOVA and T-test. The results were as follows; 1. In general differences according to musculoskeletal subjective symptoms, education level of high school graduation had significantly higher distribution than that of below middle school or above university graduation in the pain present group. 2. In the musculoskeletal subjective symptoms and the degree of stress, all of Factor1, Factor2. Factor3, Factor4. and PWI had higher score in pain present group than in pain free group and the difference was statistically significant. 3. According to degree of stress and general character of subjects, single and education level of high school graduation had high score in Factor2, Factor3 and PWI. Factor1 and Factor3 was high in income group of low 1.49 million won. Factor2, Factor4, and PWI was high significantly in income group of 1.50 - 2.99 million won. In job type, manufacturing worker group had significantly high score in Factor3. 4. In degree of stress and life style difference, there was significant difference in PWI score in the field of alcohol chinking, smoking, exercise, obesity except sleeping hours. In the present study. as a result, it is found out that musculoskeletal subjective symptoms present group had higher score in psychosocial stress across the fields than symptom-free group and it is recommended that continuous studies on the relationship of job-related musculoskeletal disorders and psychosocial stress should be performed for improvement and prevention of mental and physical health of industrial worke

• 우울조울병
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• 제16권3호
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• pp.158-162
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• 2018

Objectives : The purpose of this study was to examine psychosocial factors related to burnout of social welfare officers working in Jeonnam Province. Methods : A total of 395 social welfare officers (male 99, female 296) working in 22 areas of Jeollanam-do province, were subjects of this study. We examined socio-demographic factors, using a self-reporting questionnaire. Subjects were asked to complete the Maslach Burnout Inventory-General Survey (MBI-GS), Center for Epidemiological Studies Depression Scale (CES-D), Perceived Stress Scale (PSS), and the Generalized Self-Efficacy Scale (GSS), to assess psychosocial factors affecting to burnout of social welfare officers. Results : Among 395 subjects, 221 (55.9%) reported recent experiences of burnout. There was no significant difference in age between two groups, divided by burnout. Sex (p<0.001), rank (p=0.003), working period (p=0.034), depression (p<0.001) revealed differences between the burnout group and control group. Scores of PSS (p<0.001) were higher, while the scores of GSS (p<0.001) were lower in the burnout group, than control group. Multivariate logistic regression analysis revealed that female (OR 2.840, 95%CI 1.466-5.504, p=0.002), depressive high-risk group (OR 6.824, 95%CI 2.893-16.096, p<0.001) PSS (OR 1.247, 95%CI 1.153-1.349, p<0.001) and GSS (OR 0.950, 95%CI 0.930-0.971, p<0.001), were significantly associated with burnout. Conclusion : We found that some factors, were associated with experienced burnout in social welfare officers. Depressive symptoms were the strongest associative factor, for burnout in public servants in charge of social welfare. Sex, stress and self-efficacy also correlated with burnout, and especially self-efficacy was a protecting factor.

• 생물정신의학
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• 제5권2호
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• pp.263-277
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• 1998

Conventional high-dose antipsychotics tend to result in more side effects, negative symptoms and dysphoria, and at the same time lower the cognitive function which is already impaired in most schizophrenics. Florid psychotic symptoms, negative symptoms and cognitive impairment greatly impede psychosocial performance and eventual reintegration into society. The reduction of symptom and the improvement of cognitive funtions and social skills are therefore central to the psychiatric rehabilitation process. The purpose of this study was to evaluate the dose-reduction effects of antipsychotics on chronic schizophrenics prescribed conventional high-dose antipsychotics more than 1,500mg equivalent of chlorpromazine. Fifty-one chronic schizophrenics who maintained high-dose antipsychotics for more than three months were randomly assigned to two groups : 20 patients comprised the dose-maintaining group and 31 patients made the dose-reduction group. Over a sixteen weekperiod Positive and Negative Syndrome Scale(PANSS), Extrapyramidal Symptom(EPS), Nurses' Observation Scale for Inpatient Evaluation(NOSIE-30), Continuous Performance Test(CPT), Quality of Life(QOL), and haloperidol/reduced haloperidol blood levels were determined at the base line and after 2, 4, 6, 8, 12, 16 weeks to evaluate the dose reduction effects of high-dose antipsychotics. The results were as follows : 1) Dose-reduction is highly effective in reducing positive and negative symptoms, and general psychopathology. Effects were most prominent at 8, 12, 16 weeks. Among the dose reduction group, positive symptoms in positive symptom group and negative symptoms in negative symptom group were more reduced. 2 Extrapyramidal symptoms showed no significant difference between two groups. But the EPS was reduced time after time within two groups. 3) Hit rates of Continuous Performance Test, which indicate attentional capacity, increased significantly after dose reduction. 4) Haloperidol and reduced haloperidol blood levels decreased until the 4th week, after which they were constant. 5) Total scores of Nurses' Observation Scale for Inpatient Evaluation were unchanged between the two groups. But among the indices, social interest and personal neatness were improved in the dose-reduction group and retardation was aggrevated in the dose-maintaining group. 6) Total quality of life scores were unchanged between two groups. But in the dose maintaining group, satisfaction scores of attention, autonomy, and interpersonal relationship decreased progressively. These findings suggest that the dose reduction of antipsychotics for chronic schizophrenics on programs of high-dose antipsychotics were effective. Dose reduction should therefore be implemanted to spread the rehabilitation and improve quality of life for chronic schizophrenics.

• 정신신체의학
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• 제29권2호
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• pp.95-101
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• 2021

신체증상장애를 포함하여 다양하게 신체증상을 호소하는 환자는 여러 영역의 임상현장에서 자주 접할 수 있는 정신질환이지만 분류 및 개념이 명확하지 않음으로써 정확한 진단과 치료가 이뤄지지 못하는 경우가 많다. 치료는 환자에게서 원인을 찾거나 정신사회적 원인을 강조하면서 지나치게 인지행동치료를 포함한 정신치료에만 초점을 맞추기보다는 환자의 고통을 줄일 수 있는 대증요법을 시행하여야 한다. 정신사회적 원인론에 대한 과도한 강조는 신체증상장애 환자들에게 도움이 되지 않을 뿐만이 아니라 이 질환의 약물치료에 대한 이해 및 연구를 더욱 어렵게 할 뿐이다. 신체증상장애의 약물치료에 관한 연구는 개념과 경계의 불명확성, 그리고 기능성 신체증후군과의 중첩 등으로 인해 제대로 된 연구가 어렵다. 몇몇 체계적 연구들의 결과를 살펴보면 정신약물은 단기간에서는 효과적인 것으로 나타났다. 대부분의 항우울제가 신체증상을 호소하는 환자들에게 효과가 있으며, 선택적 세로토닌 재흡수 차단제는 신체추형장애 및 건강염려증에서 그리고 세로토닌 노르아드레날린 재흡수 차단제는 통증이 주된 증상인 환자들에게서 다른 항우울제보다 더 효과적이다. 정신건강의학과 의사들은 신체증상을 호소하는 환자들에게 적용할 수 있는 인지행동치료를 포함한 다양한 정신치료적 기법뿐만이 아니라 약물치료에서 정신약물 및 비정신약물의 사용을 잘 알고 사용함으로써 이 환자들을 도울 수 있을 것이다.