• Title/Summary/Keyword: Psychosomatic Medicine

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Significant Variables Affecting Follow-up after Psychiatric Consultation in General Medical Units (정신과 자문이 의뢰된 내과 환자들의 추적치료 결정요인)

  • Lee, Sang-Kyu;Kim, Do-Hoon;Son, Bong-Ki
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.2
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    • pp.176-187
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    • 1998
  • This study was performed to identify the significant variables affecting Follow-up after psychiatric consultation in General medical units and the trends of psychiatric consultation at the Hallym University hospital in Chunchon. Subjects of this study were 107 patients from April 1, 1998 to August 31, 1998, who were referred for psychiatric consultation during hospitalization. The results were as follows ; 1) Referral rate of General medical units was 7.5% and ordered Gastroenterology, Cardiology, nephrology, Other part. 2) The rate of total follow-up was 58% and the rate of No-follow-up was 42%. 3) In the cases of referral timing over admission 8th days, the days hospitalized after consultation performed were lengthened, significantly. 4) Common reasons for no follow-up of consultation were 'early- discharge' and 'patient's unwillingness to psychiatric reconsult. 5) Significant variables affecting follow-up were 'treatment recommendation', 'concordance with psychiatric drug recommendation', 'concordance with laboratory recommendation', 'total days hospitalized', 'Days hospitalization after consult was performed' and 'referral reason'.

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Weight Gain of the Psychiatric Female Hospitalized Patients (정신과 여자 입원 환자의 체중 증가)

  • Seo, Dong-Hyang;Park, Ki-Chang;Shin, Jong-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.2
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    • pp.120-125
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    • 1998
  • Objectives : The purposes of present study were to identify weight increment in female psychiatric patients during hospitalization and to evaluate the relationship between weight gain and daily calorie intake, daily activity and other variables of disease itself. Methods : 20 patients were studied. Body weight were measured once a week, and daily activity(total amounts of walking/day) and total amount of daily calorie intake were measured twice a week. We examined psychiatric and medical illness history, eating disorders' history and family history of eating disorders and obesity. Results: Mean body weight and Body Mass Index(BMI) at admission are 49.40kg and 19.59kg/$m^2$. Mean weight increment during hospital stays of mean 65 days is 4.90kg. Mean amounts of daily calorie intake and daily activity(daily walks) were increased during hospital stays, but not statistically significant. The degree of weight increment is higher in longer hospital stay group, but not statistically significant. Mean body weight at admission of mood disorder group is higher than that of schizophrenia group, but not statistically significant. Conclusion : This results suggested that weight increment in female psychiatric hospitalized patients is present. However, it is not resulted by amount of calorie intake and daily activity level.

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Behavioral Response and Immune Alterations by Electric Footshock in Mice (생쥐에서 전기자극 스트레스에 의한 행동반응과 면역 기능 변화)

  • Kim, Jung-Bum;Park, Won-Kyun;Song, Dae-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.1
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    • pp.44-53
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    • 1996
  • The present experiment was designed to investigate the effects of behavioral, response to immune function in response to electric footshock in mice. Mice were subjected to electric footshock for 3 days(two sessions a day, 11 times of shock for about 31 minutes a session). The humoral immune response was measured using mice immunized with rat RBC. The cell-mediated immune responses were evaluated by contact hypersensitivity to 2, 4-dinitrofluorobenzene(DNFB) and by phytohemagglutin(PHA)-stimulated splenocytes proliferation assay. In stressed group, electric footshock suppressed significantly anti-rat RBC antibody production(p<0.05), but enhanced significantly $T_{48}$ relative to $T_{24}$ in contact hypersenstivry (P<.01) and T-cell proliferation response(P<.05) by PHA stimulation elative to control group. T-cell proliferation response by PHA stimulation was significantly correlated to the movement than the sensitivity and coping behavior in the mouse, in response to the electric footshock. These data supper the importance of behavioral response in stress-induced changes of immune functions.

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A Case of Nephrogenic Diabetes Insipidus with Delirium and Hypernatremia due to Lithium Medication (Lithium 투약도중 과나트륨혈증과 섬망을 동반한 신장성 뇨붕증 환자 1례)

  • Chung, Hyo-Kyung;Lee, Young-Ho;Chung, Young-Cho
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.1
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    • pp.91-97
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    • 1996
  • Lithium is a widely used important drug in the treatment of manic-depressive illness and its prevention of relapse. However, this drug has a Low therapeutic index, therefore, it has many attendant side effects. The most prevalent renal effect of lithium is impairment of concentrating ability and this defect appeared into overt polyuria. A renal lesion is confined to the collecting tubule and 12-20% of patients taking lithium suffer from nephrogenic diabetes insipidus. This nephrogenic diabetes insipidus causes the states of extracellular fluid depletion, hypernatremia and precipitates lithium intoxication. In such situation, symptoms of nephrogenic diabetes insipidus and lithium intoxication are very similar, so we should be very cautious to discriminate them. We herein report a patient characterized by a prolonged stuporous state, hypernatremia and severe nephrogenic diabetes insipidus during lithium therapy.

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Analyzing etiologic factors of Cases : Understanding Sanghanlun record of anger and sleeping disorder (황련아교탕(黃連阿膠湯)으로 호전된 3례의 병인(病因) 분석 : 분노와 수면장애에 대한 『상한론(傷寒論)』 기록의 이해)

  • Kim, Jin-A;Jo, Gang-Mun;Lee, Sung-Jun
    • 대한상한금궤의학회지
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    • v.7 no.1
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    • pp.87-106
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    • 2015
  • Objective : We analyzed 3 clinical cases to estimate the possibility of shanghanlun as a completed clinical text which has its own diagnostic system. Methods : We collected 3 cases treated by huang lian e jiao tang conducted by a practiced shanghanlun doctor and defined the conceptional meaning of each provisions by analyzing the application of them in each case. Results : Shanghanlun provisions dualized with Je Gang(提綱) and Jo Mun(條文) is the record of preceding factors which describe the phenomenon initiating the diseases. Conclusions : Rudimentarily a factor can bring about many outcomes, so if shanghanlun is structured record of the factors which can make a human sick from many diseases, it can be used as the completed clinical text only with those 113 prescriptions. Factors that shanghanlun recorded seem somewhat different from western conventional medicine because the field of each factors are very varied from biological phenomenon to psychological phenomenon. However it is not that weird because psychosomatic medicine in western conventional medicine also point out the factors come from mental, society and behavior.

A Study on the Relationship among Perceived Stress, Vulnerability Variables, and Somatization Tendency in University Entrants (대학교 신입생들에서 지각된 스트레스 및 취약성 변인과 신체화 경향의 관계에 관한 연구)

  • Kim, Hack-Ryul;Cho, Jun-Ho;Cho, Yong-Rae
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.1
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    • pp.63-72
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    • 1997
  • For the purpose of examining the relationship between perceived stress, vulnerability variables, and somatization tendency, the self-report questionnaires of perceived stress, styles of stress coping(passive and active copings), self-perception, gender, and somatization tendency were administered to university entrants(n=2,024). The results were as follows: 1) Perceived stress, styles of stress coping(passive and active copings), self-perception, and gender accounted for 15.56% of the total variance in somatization tendency. As a result of comparing the relative contributions of all predictor variables to somatization tendency, the highest was perceived stress, and the next in order were passive coping style, self-perception, and gender, whereas direct effect of active coping style was not significant. 2) The two-way and three-way interaction effects of perceived stress X vulnerability variables were not significant. 3) The two-way and three-way interaction effects of gender X psychosocial variables were not significant. To conclude, perceived stress and vulnerability variables independently contribute to somatization tendency in university entrants, and furthermore it is suggested that vulnerability variables as well as perceived stress must be considered to account for somatization tendency.

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Clinical Case Report of a Patient with Hyperventilation Syndrome Developed after Traffic Accident (교통사고 후 발생한 과호흡증후군에 대한 증례 보고)

  • Lee, Chong-Woo;Lee, Sang-Gyu;Jung, Soon-Kwan;Yeom, Seung-Ryong;Han, Myeng-Gum;Yun, Sang-Hak;Kwon, Young-Dal
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.4
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    • pp.1063-1067
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    • 2006
  • The purpose of this study was to investigate the clinical application of oriental medical treatment to a patient with hypeventilation syndrome developed after traffic accident. Hypeventilation syndrome is a kind of psychosomatic disorder. Typical complaints are tachypnea, palpitation, paresthesia, muscle spasm and tetany. We treated the patient with herbal medication, physical therapy, acupuncture and moxibustion therapy, etc. In acute hyperventilation attack, we used bloodletting therapy(+宣, shihhsuan), cupping therapy(B40, B57), emergency treatment with paper bag rebreathing and herbal medication in order to tranquilize. After 2 months of oriental medical treatment, we obtained good improvement in patient's state. This results suggest that oriental medical treatment has the positive effects on a patient with hyperventilation syndrome.

A Comparison of Illness Behavior among Patients with Somatoform Disorders, Depressive Disorders and Psychosomatic Disorders (신체형장애, 우울장애 및 정신신체장애 환자들간의 질병행동의 비교)

  • Koh, Kyung-Bong;Ki, Sun-Wan
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.2
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    • pp.185-194
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    • 1997
  • A comparison was made regarding illness behavior among patients with somatoform disorders, depressive disorders and psychosomatic disorders. The subjects consisted of out-patients with somatoform disorders(N=52), depressive disorders(N=52) and psychosomatic disorders(N=51). illness behavior was assessed by illness Behavior Assessment Schedule and the questionnaire about help-seeking behavior. The patients with somatoform disorders and psychosomatic disorders more often affirmed the presence of somatic disease, were more likely to have phobia of disease, had more preoccupation with ideas of disease and more frequently shopped around oriental clinics than the patients with depressive disorders. The patients with somatoform disorders more often attributed its cause to physical factors, less often attributed the origin of affective disturbance to psychological causes, showed Less depression and irritability, and were less likely to accept psychiatric treatment recommended by other physicians than depressive patients. The patients with somatoform disorders were more likely to report having been told that they suffered from a mild illness than those with psychosomatic disorders. The patients with somatoform disorders with psychological problems tended to inhibit expression of their emotion. Female patients with somatoform disorders more often affirmed the presence of psychological disorder and attributed its cause to psychological factors than male ones. These results suggest that in illness behavior, patients with somatoform disorders are different from depressive patients, whereas the former patients are similar to psychosomatic patients except the discrepancy between therapists and patients regarding evaluation of their symptoms. Thus, it is emphasized that first, therapists need to approach patients with somatoform disorders somatically with understanding of their underlying need to deny psychological problems, followed by either psychological or biopsychosocial approach.

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Facing Stress Through Mindfulness and Its Clinical Use (마인드풀니스를 통한 스트레스 대처와 임상적 활용)

  • Kim, Kyung-Seung
    • Korean Journal of Psychosomatic Medicine
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    • v.16 no.1
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    • pp.5-16
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    • 2008
  • Several treatment programs putting mindfulness to practical use are being utilized in the various clinical settings as well as educational fields since 1980's. In this article, I studied several books and journals related with mindfulness and tried to show that mindfulness may have its neural circuits in the brain and can be utilized in the form of MBSR, MBCT, ACT, DBT not only to reduce stress and the symptoms of various psychosomatic conditions but to be applied to psychiatric illness such as, anxiety disorders, depressive disorders, and eating disorders, predicting its usefulness as a new psycho-social treatment.

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Suicide of The Psychiatric Patients during Social Adjustment Period (적응과정에서의 정신과 환자의 자살)

  • Nam, Jung-Hyun;Kwak, Sang-Kon
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.2
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    • pp.163-169
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    • 1996
  • The authors examined for risk factors for suicide among psychiatric patients who had committed suicide through the analysis of demographic, clinical and psychological characteristics of the patients. The total number of suicides committed during social adjustment period was 9. Male and female ratio was 5:4 and the highest incidence occurred in the age group of 21-29 years. Of the 9 cases, schizophrenia accounted for two-third of the suicides. Among the committed suicides, 4 were in hospitalization and rest were postdischarge state. We found that 4 of 5(80%) suicides occurred in the first year after discharge, and that three fifth(60%) occurred within three months of discharge. In this result, most of suicides occurred immediately or soon after discharge and some during inpatient care. The major precipitating factors the patients showed before committing suicide were realistic and psychological problems. Consquently, they become dejected, experience feelings of hopelessness, go on to a depressed mood, and, in that case, have suicidal ideas that are eventually acted on. We believe that the ability to recognize risk factors for suicide and develop appropriate interventions is key to suicide prevention.

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