• 제목/요약/키워드: Psychotic disorder

검색결과 58건 처리시간 0.022초

항정신 약물을 복용하는 시설거주 정신과 환자의 변비 완화를 위한 경락마사지 효과 (The Effects of Abdominal Meridian Massage on Constipation in Institutionalized Psychiatric Patients Taking Antipsychotic Drugs)

  • 김인자;조유나
    • 성인간호학회지
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    • 제19권5호
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    • pp.127-137
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    • 2007
  • Purpose: It was investigated if abdominal meridian massage has effects on constipation in institutionalized psychiatric patients taking antipsychotic drugs. Methods: According to the constipation screening tests, 22 patients were selected as subjects. One group pre and post repeated measurement design was used. Constipation was operationalized as perceived constipation, frequency of defecation, frequency of bowel sound, and number of medicine taken to relieve constipation. Abdominal meridian massage was given for two weeks, 10-15 minutes each time and 10 times in total. Results: Perceived constipation, frequency of bowel sound, and number of medicine taken were significantly improved after massage. Except for number of medicine taken, the effects on perceived constipation and frequency of bowel sound were found to be persistent 2 weeks after massage. Conclusion: Based upon these results, abdominal meridian massage was recommended as independent nursing intervention for the relief of constipation in psychiatric patients who taking anti-psychotic drugs. Further studies to investigate the maximal duration time of effects and whether the effects of intermittent application of this method is more beneficial than the continuous application of this method are necessary.

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공황장애와 도파민 D2 수용체 TaqI A 다형성의 관련 (Association between Panic Disorder and Dopamine D2 Receptor TaqI A Polymorphism)

  • 임세원;김범조;오강섭;이민수
    • 대한불안의학회지
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    • 제2권1호
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    • pp.45-49
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    • 2006
  • Puropse : Disturbances of dopaminergic system might be related to the possible mechanism of panic disorder. This study was aimed to examine the association of DRD2 Taq 1 polymorphism and panic disorder. Methods : One hundred and fourteen patients with panic disorder (62 male (54.4%), mean age $40.96{\pm}0.11$ years) and 200 comparison subjects (114 male (57.0%), mean age $35.57{\pm}8.81$ years)were tested for DRD2 TaqI A polymorphism. We excluded panic patients with comorbid alcohol related disorders, bipolar disorders, and any kinds of psychotic disorders because there have been some reports about association of these disease and DRD2 TaqI A polymorphism. Results : There was significant difference in the frequency of the genotype in DRD2 polymorphism between patients and controls (${\chi}^2$=6.09, df=2, p=0.048). The A1+ allele (A1A1 and A1A2) frequency analysis also showed significant association (${\chi}^2$=4.08, df=1, p=0.043). In addition, we observed a more strong and specific association between panic disorder and the A1+ allele of the DRD2 TaqI polymorphism for men (${\chi}^2$=4.71, df=1, p=0.03), but not for women (${\chi}^2$=0.45, df=1, p=0.50). Conclusion : These results in our Korean sample suggest that the DRD2 TaqI A polymorphism may be associated with panic disorder. Furthermore, we found sex-specific association of DRD2 A1 allele with panic disorder.

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청소년기의 경계선 인격장애 (BORDERLINE PERSONALITY DISOREDER IN ADOLESCENTS)

  • 장경준;정제연
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제6권1호
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    • pp.34-42
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    • 1995
  • 청소년기의 경계선 인격장애는 충동조절의 결여, 타인에 대한 평가절하와 자신보다는 대상에 대하여 만족감을 얻으려는 욕구, 분리 방어기제를 특징으로 하는 인격장애로서 성인의 경계선 인격장애와 비슷한 양상으로 나타난다. 청소년기의 경계선 인격장애의 주요한 증상은 우울, 불안, 정체성 위기와 이러한 정체성 위기로 인한 반사회적인 행동을 흔히 볼 수 있다. 따라서 이들 증상들과 정상 청소년들이 보일 수 있는 질풍노도의 양상과 구별이 힘든 경우가 있다. 경계선 인격장애에서는 대상관계의 불안정, 정동의 불안정, 분리 등 미숙한 방어기제로 인해서 심한 스트레스하에서 정신병적 삽화가 나타날 수 있으며, 이로인해 정신분열증, 정동장애, 분열형 인격장애, 편집형 인격장애등과 감별진단이 필요하다. 청소년기 경계선 인격장애의 원인으로는 정신역동적 요소, 유전적 요인을 포함한 생물학적 요소, 가족역동적인 요소등을 복합적으로 고려해야 한다. 치료는 개인정신치료, 그룹치료, 가족치료, 약물치료 등이 있다. 소아 청소년기 경계선 인격장애가 성인기 경계선 인격장애로 될 것인가에 대해서는 논란이 되고 있다.

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다면적 인성검사에 의한 대학신입생의 정신건강평가 (A Study on MMPI in College Freshmen)

  • 이중훈;박병탁;이종범;정성덕
    • Journal of Yeungnam Medical Science
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    • 제5권2호
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    • pp.141-150
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    • 1988
  • 1988년 1월부터 동년 2월까지 영남대학교 신입생중 본조사에 응한 3792명(남학생 : 2586명, 여학생 : 1206명)을 대상으로 Zung의 자가평가 불안척도와 자가평가 우울척도, Derogatis등이 고안한 SCL-R중 정신증척도등의 고득점자 392명(10.3%)에서 2차 조사에 응답한 신입생은 156명(69.9%), 여대생은 47명(30.1%)이었다. 이들에게 실시한 MMPI의 결과는 Lachar의 분류법을 이용하였다. 1) MMPI 결과 신경증적경향 24명(15.4%), 정신병적경향 20명(12.8%), 행동장애경향 7명(4.5%)으로 이는 전체 사례수의 약 1.4%이었다. 2) MMPI의 세부조사 결과 정서장애 8명, 불안장애 6명, 정신분열증 9명, 인격장애 3명 등으로 이들 26명은 총 신입생의 0.7%이었다. 3) 사회정신의학적 요인분석에서 자기집 가족 분위기에서 불만인 경우, 부모상호간의 친숙정도에서 불만인 경우, 나와 아버지 사이의 갈등정도에서 심각한 경우, 나와 어머니 사이의 갈등정도에서 심각한 경우 등에서 공통적으로 정신분열증 척도가 높았다. 4) 건강상태가 허약할 경우, 정신과 입원한 경험이 있는 경우, 최근 3년동안의 신체적 질환이 있는 경우 등에서 건강과 관계된 성적은 섬기증척도가 공통적으로 높았다.

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두부외상 환자의 신경정신의학적 평가(I) : 외상후 기질성정신장애 환자에서 뇌의 구조적 및 기능적 검사소견의 비교 (Neuropsychiatric Evaluation of Head-Injured Patients(I) : Comparison of Structural and Functional Brain Studies in Post-Traumatic Organic Mental Disorder)

  • 이장호;장환일
    • 생물정신의학
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    • 제3권1호
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    • pp.57-65
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    • 1996
  • The Evaluation of patients complaining of psychiatric symptoms following head injury is much affected by the results of various tests. The objecive of this paper is to investigate the effectiveness of each lest by comparing the structual and fuctional brain studies. The subjects were 93 organic menial disorder in and out patients at the Dept. of Neuropsychiatry of the Kyung Hee University Hospital. After carrying out MRI, CT, SPECT, EEG, the results of each were analysed for the sesitivity and ability to detect focal lesion. The degree of inter-test correlations of lest results were also investigated. Furthermore, the characteristic features of psychological tests were studied and the relationship between each of above mentioned tests and psychological test was examined. As for the test sensitivity to diagnosis, the SPECT was the most superior followed by MRI, CT, EEG in thai order. In the case of abnormality, SPECT ranked 1st in detection of focal lesion, followed by MRI, CT in that order. In the inter-test result correlation, the correlation of SPECT-MRI was statistically significant. When mare than moderate abnormality EEG finding was reported, it correlated significantly with that of MRI findings. In the MMPI, the average scores on F, Hs, D, Hy, Pa, Pt, Sc subscales were above 60. Abnormal SPECT group scored significantly high on the F, Pd, Pa, Sc, Ma scales and therefore in comparison ot the SPECT normal group, displayed more psychotic features. In K-WAIS, the mean full scale IQ was down to 77. 23(Verbal IQ : 78.76, Performance IQ : 77.44) but there was no characterogic significant relationship between the lowered to and abnormal SPECT, MRI, CT and EEG results. In conclusion, 1) The SPECT was mast superior in sensitivity and detection of focal lesions. In comparision with other tests, the results of SPECT correlated well with MRI had thus is thought to be very usefull testing method in the evaluation of organic mental disorder patients. 2) The MRI had relatively high sensitivity, ability to detect focal lesion and superior correlation with other test. 3) Although EEG fared less an sensitivity in comparison to other tests, the results of above moderate abnormal grade group and that of MRI correlated significantly. 4) In the MMPI highly scored in F, Hs, D, Hy, Pa, Pt, Sc subscales and abnormal SPECT patients were shown to display more sever psychotic features. There was no significant character relationship between the lowered IQ(in K-WAIS) and abnormal findings on MRI, CT, SPECT, EEG.

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양극성 장애의 약물치료 가이드라인 비교 (Comparative Review of Pharmacological Treatment Guidelines for Bipolar Disorder)

  • 진서연;김효영;김예슬;허채원;권보영;최보윤;이보배;이지예;권채은;문영도;;박지현
    • 한국임상약학회지
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    • 제33권3호
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    • pp.153-167
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    • 2023
  • Objective: Bipolar disorder displays a spectrum of manifestations, including manic, hypomanic, depressive, mixed, psychotic, and atypical episodes, contributing to its chronic nature and association with heightened suicide risk. Creating effective pharmacotherapy guidelines is crucial for managing bipolar disorder and reducing its prevalence. Treatment algorithms grounded in science have improved symptom management, but variations in recommended medications arise from research differences, healthcare policies, and cultural nuances globally. Methods: This study compares Korea's bipolar disorder treatment algorithm with guidelines from the UK, Australia, and an international association. The aim is to uncover disparities in key recommended medications and their underlying factors. Differences in CYP450 genotypes affecting drug metabolism contribute to distinct recommended medications. Variances also stem from diverse guideline development approaches-expert consensus versus metaanalysis results-forming the primary differences between Korea and other countries. Results: Discrepancies remain in international guidelines relying on meta-analyses due to timing and utilized studies. Drug approval speeds further impact medication selection. However, limited high-quality research results are the main cause of guideline variations, hampering consistent treatment conclusions. Conclusion: Korea's unique Delphi-based treatment algorithm stands out. To improve evidence-based recommendations, large-scale studies assessing bipolar disorder treatments for the Korean population are necessary. This foundation will ensure future recommendations are rooted in scientific evidence.

조기 발병한 정신증적 장애에서 자기공명영상을 이용한 측뇌실에 대한 구조적인 예비연구 (THE PRELIMINARY STUDY OF THE QUANTITATIVE MORPHOLOGIC ANALYSIS USING MRI OF THE LATERAL VENTRICLE IN EARLY-ONSET PSYCHOTIC DISORDER)

  • 이윤희;강민희;김철응;배재남;홍강의;이정섭
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제12권2호
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    • pp.256-262
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    • 2001
  • 연구 목적:측뇌실의 확장은 성인기의 정신분열병에서 잘 확립된 소견이지만, 조기에 발병한 정신증적 장애에서는 아직 논란이 있다. 본 연구에서는 자기공명영상을 이용한 후향적인 방법을 통하여 지금까지 비교적 연구가 많이 시행되지 않았던 조기발병한 정신분열병·양극성 장애 환아들을 대상으로 측뇌실의 구조적인 이상을 연구하여, 이러한 뇌의 구조적 이상이 병의 초기부터 시작되어 정상과는 다른 경과로 진행되는 것인가를 알아보고자 하였다 방 법:정신분열병과 양극성 장애의 DSM-III-R 진단 기준에 부합하는 14명의 환아(평균 연령 14.0세, 표준편차 2.1)와 26명의 두통 대조군에서 뇌자기공명 영상상을 후향적으로 모집하였다. 분석을 위하여 측뇌실이 가장 잘 보이는 축 영상(axial image)를 선택하였다. 뇌자기공명영상상은 평판형 스캐너로 읽어들여서 NIH IMAGE 프로그램을 통하여 분석하였다. 결 과:환자군에서는 측뇌실 크기, 측뇌실확장지수가 연령의 증가에 따라 함께 증가하는 상관관계를 나타내었으나, 대조군에서는 연령과 측뇌실 크기, 측뇌실확장지수 등이 유의한 상관관계를 보이지 않았다. 환자군에서는 정상군에서 보이는 좌우 측뇌실 비대칭성이 소실된 결과를 보였다. 그리고 통계적으로 유의한 정도는 아니었으나 환자군이 대조군에 비해 측뇌실과 측뇌실확장지수가 큰 경향을 보였다. 결 론:정신증적 환자에서의 뇌의 구조적 이상은 병의 비교적 초기 경과에서부터 시작되며, 정상과는 다소 다른 경과를 취하며 진행한다는 것을 시사하는 결과라 할 수 있다.

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호스피스.완화의료에서의 사별 돌봄 (Bereavement Care in Hospice and Palliative Care)

  • 김창곤
    • Journal of Hospice and Palliative Care
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    • 제10권3호
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    • pp.120-127
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    • 2007
  • Bereavement is the state of loss resulting from death. Grief is the emotional response associated with loss, intense and acute sorrow resulting from loss. Complicated grief represent a pathological outcome involving social, physical, emotional, cognitive, spiritual morbidity. The common psychiatric disorders associated complicated grief or abnormal grief responses include clinical depression, anxiety disorders, alcohol abuse or other substance abuse, and dependence, psychotic disorders, and post-traumatic stress disorder (PTSD). Grief tasks involve a series of stage or phases following an important loss that gradually permit adjustment and recovery. Three phases of grief involve phase 1 (walking the edges), phase 2 (entering the depths), and phase 3 (reconnecting the world). For intervention to be effective they need to be individually tailored to abnormal grief reaction or unresolved grief reaction. Clear understandings of complicated grief, abnormal responses, factors increasing risk after bereavement will often enable us to prevent psychiatric disorders in bereaved patients.

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정신사회적 치료와 한방요법을 병행한 정신분열병 환자의 증례고찰 (A Case of Combination Therapy of Psychosocial Treatment and Oriental Medical Treatment On Schizophrenia)

  • 최보윤;정인철;이상룡;하수영
    • 동의신경정신과학회지
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    • 제15권1호
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    • pp.247-254
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    • 2004
  • Schizophrenia is a frequent psychotic disorder. Recently many studies raised biochemical theory as a cause of schizophrenia. But in this case, we used psychosocial treatment and oriental medical treatment, without antipsychotic drugs for 4 months, obtained good results. Practicing psychosocial treatment, we were able to remove anxiety and fear of the patient. In addition positive symptoms, for example auditory hallucination and delusion, were improved. Schizophrenia conforms to JEONKWANG(癲狂) in oriental medicine. We concluded this case to JEONJUNG(癲證) due to QIULDAMHWA(氣鬱痰火). So we used herbal medication and acupuncture according to oriental medical theory and these efforts helped the care of disease.

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치료저항성 조현병: 정의와 임상양상 (Treatment-Resistant Schizophrenia: Terminology and Clinical Features)

  • 이건석
    • 대한조현병학회지
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    • 제23권2호
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    • pp.45-50
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    • 2020
  • Schizophrenia is one of serious mental illnesses and is often described as a heterogeneous disorder. Approximately one-third of schizophrenia cases are treatment-resistant schizophrenia (TRS). The aim of this study was to review the definitions and clinical features of TRS. Though it was found that the criteria for TRS were considerably diverse, the Treatment Response and Resistance in Psychosis (TRRIP) consensus criteria were recently introduced. According to the TRRIP criteria, TRS should be suspected if symptoms persist alongside psychotic symptoms despite sufficient treatment for ≥12 weeks, or two or more symptoms persist significantly for ≥6 weeks. The clinical characteristics of TRS includes an earlier age of onset, more severe and familial form, possibly more rural residence, unlikely association with male sex, and an increase in cognitive deficits.