• 정신신체의학
• /
• 제16권1호
• /
• pp.25-30
• /
• 2008

최근 노인인구의 급속한 증가로 인하여 정신과에서 노인에 대한 자문의 중요성이 확대되고 있다. 따라서 임상에서의 노인에 대한 정신과 자문의 특징과 지침에 대한 이해가 필요하다. 타과적 질환을 갖는 노인에 대한 정신과적 자문은 다른 연령층과는 다른 특성을 갖는다. 노화에 따른 장기 기능의 변화와 약동학 및 약력학의 변화에 대한 숙지가 노인에 대한 정신약물학적 접근에 매우 필수적이다. 타 연령층에 비해 노인에 대한 정신과적 자문은 상대적으로 적은 것으로 조사되었으나 실제 정신과적 자문이 노인질환의 재원기간이나 기타 사망률 등을 낮출 수 있음을 고려할 때, 노인에 대한 자문을 저해하는 요인들을 분석하고 교정하는 것이 매우 필요하다.

• 한국학교ㆍ지역보건교육학회지
• /
• 제14권1호
• /
• pp.37-47
• /
• 2013

Objectives: A descriptive correlational study was designed to examine the relationship of anger to psychosomatic symptoms. In addition, this study investigated the mediating effect of parental attachment in relation to anger and other variable. Methods: Data were collected from 112 subjects in grade 4 or 6, and descriptive statistics, Pearson correlation coefficient, and hierachical multiple regression were used with SPSS/PC 18.0 program to analyze the data. Results: There was a significantly positive effects between state-trait anger and psychosomatic symptoms. Father attachment negatively correlated state-trait anger and psychosomatic symptoms. Also, mother attachment negatively correlated state anger and psychosomatic symptoms. However, maternal attachment was not significantly associated with trait anger. Parental attachment had a significant mediating effect in relation to state-trait anger and psychosomatic symptoms. Conclusions: For the effective management of multi-cultural children's psychosomatic symptoms, programs including parental attachment increasing strategies should be established. These programs can increase parental attachment security which is mediator role between anger and psychosomatic symptoms.

• 정신신체의학
• /
• 제21권2호
• /
• pp.81-92
• /
• 2013

새로운 항우울제가 개발되고 임상에서 정신과적 질환뿐만이 아니라 만성통증증후군, 섬유근통증증후군, 두통 등의 많은 정신신체질환 그리고 신체질환자의 적응장애 및 우울증 등의 자문조정정신의학 영역에서도 다양하게 자주 사용되고 있다. 다양한 정신의학적 질환을 치료하기 위해 처방하는 새로운 항우울제의 사용 시 치료중단의 가장 큰 원인은 약물부작용이다. 이 논문은 현재 우리나라에서 널리 사용되고 있는 새로운 항우울제 사용 시 나타나는 부작용들 중 정신신체의학과 자문조정정신의학영역에서 관심을 가져야 할 매우 빈번하게 나타나는 세 가지 부작용인 오심과 구토, 체중증가, 성기능장애에 대한 발생기전, 발생빈도, 그리고 약물학적 처치를 위주로 한 해결방안을 알아보았다. 저자는 이 논문을 통하여 정신건강의학과 의사만이 아니라 정신신체의학 영역에 관심을 가지거나 자문조정정신의학과 연계되는 타과 영역의 의사들이 새로운 항우울제를 사용할 때 빈번하게 나타나서 삶의 질을 떨어뜨리고 치료중단을 일으킬 수 있는 이 약물들의 부작용을 잘 인지함으로써 이를 조기에 발견하고 적절히 해결하여 환자 치료에 도움을 주고자 하였다.

• 정신신체의학
• /
• 제3권1호
• /
• pp.58-63
• /
• 1995

The author introduced 12 session short term dynamic psychotherapy for the intervention of stress related disorders. An examplary case was introduced to suggest the clinal usefulness of time limitted short term dynamic psychotherapy for stress related disorders. It was suggested that the term "stress" should be limitted to certain natural and man-made catastrophies and disasters whose consequences rep quire a total reorganization of the person. Common defensive manuvers and psychological responses in the stress disorders were also reviewed.

• 정신신체의학
• /
• 제4권1호
• /
• pp.85-90
• /
• 1996

Cognitive-behavioral approach to two cases with chronic headache was presented. Cognitive-behavioral interventions focus on indirectly altering symptom-related physiological activity by changing the way patients cope with headache-eliciting stressors. This treatment focuses directly on the patients' cognitive and behavioral changes. Cognitive-behavioral treatment can be divided into three phases Education, self-monitoring, and problem-solving or coping-skills training. Literature reviews on the follow-up evaluation of therapeutic effectiveness revealed that cognitive-behavioral treatment is effective in the management of chronic headache.

• 정신신체의학
• /
• 제3권1호
• /
• pp.91-97
• /
• 1995

Pain is a complex symptom consisting of a sensation underlying potenial disease and associated emotional state. Acute pain is a reflex biological response to injury, in contrast, chronic pain consists of pain of a mininum of 6 months duration and associates with physical, emotional past experience, economic resources of the patient, family and society. Moreover, chronic pain is characterized by physiological affective and behavioral responses that are quite different than those of acute pain. The different type of stimuli exciting pain receptor are mechanical, thermal and chemical stimli and chronic pain are concerned with three of all stimli. The major three components of pain central(Analgesia) system in the brain and spinal cord are 'periaqueductal gray area of the mesencephalon', 'the raphe magnus nucleus' and 'pain inhibitory complex located in the dorsal horns of the spinal cord'. But unfortunately, the central biochemical mechanisms of chronic pain are not clearly defined. To proper management of chronic pain, comprehensive urderstanding as a psychosomatic aspect and multidisciplinary therapeuti-team approach must be emphasized.

• 대한치과기공학회지
• /
• 제35권2호
• /
• pp.157-171
• /
• 2013

Purpose: This study aims to present a database for the development of a healthcare management program based on the survey and analysis of self reported psychosomatic symptoms among the current dental technology students. Methods: Subjects of our study are 480 dental technology major students enrolled in a third year college located Gyeonggi, Chungcheong, and Gangwon province. Using a random sampling, we conducted a self-report survey from August 30, 2011 to October 28, 2011 and 418 reports were collected as feedback and we put an analysis on them. Results: 1. The average physical self symptom was 20.49, which is higher than the average mental self symptom(18.54). Of the subcategories of psychosomatic self symptom, we observed multiple subjective symptoms as the highest one(37.77), and aggression as the lowest(13.77). 2. As to gender, both physical and mental self symptom were statistically significant with the scale score of(p<.001). The scale score of subcategories is as follows; multiple subjective symptoms(I, p<.001), eye and skin(B, p<.001), digestive(C, p<.001), impulsiveness(H, p<.001), lie scale(L, p<.001), mental instability(J, p<.001), depression(K, p<.001), aggression(F, p<.001), irregularity of life(G, p<.001), mouth and anal(D, p<.05), nervousness(E, p<.05). 3. As for obesity, statistical significance was shown with the scale scores of physical self symptom(p<.001), multiple subjective symptoms(I, p<.001), digestive(C, p<.001), aggression(F, p<.001), depression(K, p<.01), irregularity of life(G, p<.01), respiratory(A, p<.05), eye and skin(B, p<.05), impulsiveness(H, p<.05), mental instability(J, p<.05). The scale scores in the environmental quality and life satisfaction were shown as follows; depression(K, p<.001), lie scale(L, p<.01), and irregularity of life(G, p<.05). 4. We employed multiple regression analysis to take account of general factors affecting psychosomatic self symptoms, and drew that the explanatory power of the model was proved with the scales of physical self symptom(4.1%) and mental self-symptom(3.6%). Obesity was a factor that affects physical self symptom with the scale score of(p<.01), and environmental quality and life satisfaction(p<.01) and obesity(p<.05) affect mental self symptom. Conclusion: In this analysis we observed obesity of dental technology students can influence their psychosomatic self symptoms. In this sense, it would be reasonable to develop a healthcare management and education programs that help the students maintain a healthy weight and promote their health.

• 정신신체의학
• /
• 제16권1호
• /
• pp.17-24
• /
• 2008

소아청소년에서의 정신신체의학은 자문조정 정신의학이라고도 불리며 신체적 질환이 있는 소아청소년에서의 정신건강 서비스를 제공하는 것으로, 정신과에서는 정신사회학적 질병모델에 익숙한 반면 타과 의료진의 경우 생의학적 질병모델에 입각하여 접근하기 때문에 원활한 의사소통을 통한 타과 의료진과의 협업 체계 구축이 중요하다. 신체질환이 있는 소아청소년의 정신과적 문제에 대해서는 개별 질환에 초점을 맞추고 의학적 심리적 정신과적 인자들의 상호작용과 그 영향을 밝히는 범주적 접근법과 질병에 걸렸다는 사실로 인하여 스트레스를 경험하는 아동 자체에 대한 접근에 주안점을 두는 비범주적 접근법으로 나눌 수 있다. 이러한 신체질환이 있는 소아청소년의 치료에 그들의 발달단계에 맞는 고유한 치료기법의 적용이 필요하다. 비약물학적인 치료의 경우 경험적으로 입증된 치료(empirically supportive therapy)들을 구분하려는 시도도 이루어지고 있다.

• 정신신체의학
• /
• 제4권2호
• /
• pp.245-253
• /
• 1996

In spite of its prominent effects on reduction of panic attacks and preveniton of relapse, cognitive-behavioral therapy(CBT) for panic disorder is seldomly utilized and studied in this country. for the past year, authors have modified CBT program for panic disorder that was based on PCT(panic control program) designed by Dr. Barlow and Dr. Craske. Our program is composed of informational component, somatic management skills, cognitive restructuring, interoceptive exposure and in vivo exposure. One patient has significantly improved by this program and satisfied with the treatment result. The aim of this article is to present our experience of treating a panic patient with CBT.

• 정신신체의학
• /
• 제3권1호
• /
• pp.72-80
• /
• 1995

Because the origins of stress are various, complex, and often indirectly-causing, reactions to stress are also various according to it's psychopathologies and mechanisms. For a proper management of stress, first of all accurate evaluation and diagnosis must be done. Then, treatment against the stress also can be considered, if necessary. In case of extreme stress, psychotropic drugs such as short-term anxiolytics or antidepressants can be used according to it's specific target symtoms. But long-term treatment of stress must be directed by increasing the individual's usual coping strategy or decreasing the externally causing stresses. Reactions to stress and drug interactions. which are not the whole of the biologic treatment strategy, are very important As a results, in our discussions, we ought to describe the issues by focusing the interactions between the drug and it's reaction to stress rather than the reaction to stress or drug itself and aimed at helping the proper treatment against the stress.