• Title/Summary/Keyword: Schizoaffective disorder

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Effects of the Illness Management and Recovery Program on Recovery, Knowledge of Mental Illness, and Hope of Inpatients with Mental Illness (회복지향질병관리 프로그램이 입원한 정신과 환자의 회복 및 정신질환 지식과 희망에 미치는 영향)

  • Shin, Eun-Sik;Lee, Hyun-Bok;Jeon, Mi-Sook;Kim, Sun-Hee;Yoon, Bo-Hyun;Sea, Young-Hwa;Park, Su-Hee
    • The Journal of the Korea Contents Association
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    • v.17 no.7
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    • pp.579-591
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    • 2017
  • The Illness Management and Recovery(IMR) Program was designed to improve self-management and recovery of people with mental illness. The purpose of this study was to identify the effects of the Korean version of the IMR program on recovery, knowledge against mental illness, hope among inpatients with severe mental illness. 92 participants diagnosed with schizophrenia, bipolar disorder and schizoaffective disorder were assigned to either an IMR group(n=51) or the control group(n=41) without randomization. Data collection had been conducted from June 2015 to December 2016. Mental Health Recovery Scale, Knowledge Scale, and Hope Scale was administered to participants before and after the intervention. Participants in the IMR program showed significant improvement in progress toward their recovery and knowledge about their mental illness compared with those receiving treatment as usual. However, changes in hope were not significant in both groups. This is the first evaluation of the effects of the Korean version of the IMR program. Our findings support potential benefits of implementing the Korean version of the IMR program.

Study of the Positive and Negative Caregiving Experiences in the family members who care for the psychiatric mentally ill relatives (정신장애인 가족의 긍정적, 부정적 돌봄의 경험에 관한 연구)

  • Lee, Kwang-Ok;Kim, Hee-Jung
    • Research in Community and Public Health Nursing
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    • v.10 no.2
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    • pp.435-454
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    • 1999
  • The caregiving experiences of 100 family menbers of outpatients with schizophrenia and schizoaffective disorders were investigated for the presence of positive(positive family-patient relationship. patient' contribution to the family) and negative caregiving experience(objective and subjective burden) and their predictors. This study attempts to make the analysis of caregiving experience more useful by expanding the focus to incoporate these positive aspects of the experience of family caregiver. Objective burden consists of two elements: 'disruption of family life', 'care'(amount of caregiving related to activity of daily living). Subjective burden is defined as emotional reactions to the care giving and it comprised of 6 emotional subdimensions such as 'stigma', 'grief'. 'worry', 'pity', 'fear', 'despair'. Also we investigate the severity of patients' disturbing behaviors into two categories, positive and negative disturbing behaviors and patient' contribution to the family as a predictors of positive and negative caregiving experiences. This study use Pearson's correlation coefficient, Hierardhical regressions in the SAS Program. The results are as follows: 1. Respondents reported moderate level of objective burden 'disruption of family life' (mean = 2.48, range = 1-4), and 'care' (mean=2.54, range = 1-4), and slightly high level of total subjective burden(mean = 2.19, range = 1-4). Mean scores for the measure of the severity of behavioral disturbance indicated that the caregiver experienced negative disturbing behaviors around almost 'somtimes'(mean=2.28, range = 1-4), and positive disturbing behaviors 'almost not frequent'(mean=2.78. range=1-4). So they reported that they perceived patient's negative disturbing behaviors more than positive disturbing behaviors. Mean scores for the measure of the patient' contributions (mean = 1.99. range = 1-4) indicated that caregivers experienced these contributions a little. It means that there should be a positive aspect of possibilities of patient' family roles that can be developed in the daily life. Mean scores for the measure of the positive family-patient relationship indicated that caregivers experienced moderate level of positive family-patient relationship(mean=2.52, range = 1-4). 2. Hierardhical regression analysis 1) Hierardhical regression of 'disruption of family life' showed that the interaction between positive disturbing behaviors and patient' contributions (B = .20. p = .022) and caregiver's educational level(B=.06. p=.000) were 'significant and Hierardhical regression of 'care' showed that 'negative disturbing behaviors'(B= .35. p= .007). 'patient' contributions'(B= .28, p= .019). 'family income'(B=-.l1. p=.096) were significant. 2) Hierardhical regression of 'total subjective burden', 'stigma', 'grief', 'worry', 'pity'. 'fear', 'dispair' showed that 'positive disturbing behaviors'(B=.51. p=.000). 'negative disturbing behaviors' (B = .17, p = .026), 'caregiver's educational level'(B = .03. p=.036), 'family income'(B=.08. p=.041) were significant predictors of 'total subjective burden': 'positive disturbing behaviors'(B=.32. p=.066). 'negative disturbing behaviors'(B=.24, p=.096) 'durations of illness'(B= .03. p= .079) were significant predictors of 'stigma' 'negative disturbing behaviors'(B=.28. p=.005). 'patient sex'(B=-.32. p=.022). 'positive disturbing behaviors'(B=.28. p=.020), 'patient age'(B=.02. p=.010), 'caregiver age'(B=-01, p= .002) were significant predictors of 'grief' 'negative disturbing behaviors'(B= .28, p= .005). 'patient sex'(B= -.32. p=.039), 'caregiver age'(B=-.02, p= .023). 'caregiver's educational level'(B= .04, p = .044) were significant predictors of 'worry' 'patient sex'(B=-.46. p=.005). 'negative disturbing behaviors'(B= .28. p=.018), 'caregiver age'(B=-.01, p=.037) were significant predictors of 'pity' 'positive disturbing behaviors'(B=.83. p=.000). 'patient' contributions' (B = .22, p =.017). 'family income'(B=.09. p=.65) were significant predictors of 'fear' 'positive disturbing behaviors'(B=.49, p=.001). 'negative disturbing behaviors'(B= .24. p=.057) 'patient sex'(B=-.4l, p=.017), 'family income'(B=.14, p=.047) were significant predictors of 'dispair'. 3) Hierardhical regression of 'positive relationship' showed that 'patient contributions'(B=.32, p=.000). 'negative disturbing behaviors'(B= .24, p= .005), 'patient sex'(B=-.23, p=.036).

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Vocational Rehabilitation for Improvement of Life Care in Patients with Schizophrenia : A Systematic Review (조현병 환자의 라이프케어 증진을 위한 직업재활 : 체계적 고찰)

  • Kim, Ok-Gyeong;Paek, Hyun-Hee
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.5
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    • pp.229-243
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    • 2020
  • This study selected a total of 19 studies using databases of PubMed, SAGE Journal, and Wiley Online Library from 2000 to 2019 to find out about vocational rehabilitation of patients with schizophrenia in the area of overseas occupational therapy. First, the quality level of the study was all Level I. Second, the diagnosis for participants of the studies other than schizophrenia had the most schizoaffective disorder. Third, by types of interventions, 11 papers, the largest, were about social skills and cognitive rehabilitation training plus supported employment, followed by 4 about supported employment and 3 about social skills and cognitive rehabilitation training, 1 about other vocational approaches. Regarding studies showing effects in the employment rate by interventions type following three types of employment, as the most effective of studies, they were social skills and cognitive rehabilitation training plus support employment in competitive employment, social skills and cognitive rehabilitation training in non-competitive employment, and support employment in paid employment. Fifth, looking at the studies trend in the last 5 years, the most studies were social skills and cognitive rehabilitation training plus supported employment. Since this study classified the types and effects of vocational rehabilitation for patients with schizophrenia based on previous overseas studies, it is hoped that this study will be provided as basic data for understanding vocational rehabilitation of schizophrenic patients and applying them in domestic clinical settings.

The Effect of Risperidone on Serum Prolactin Concentrations (Risperidone이 혈청 Prolactin 농도에 미치는 영향)

  • Cheon, Jin-Sook;Cho, Woong;Oh, Byoung-Hoon
    • Korean Journal of Biological Psychiatry
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    • v.5 no.2
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    • pp.253-262
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    • 1998
  • Objectives : Risperidone, an atypical antipsychitics which blocks both dopaminergic and serotonergic receptors, have a good response to the negative symptoms as well as positive symptoms, and improve cognitive dysfunction of schizophrenic patients. Furthermore, it has few extrapyramidal side effects and tardive dyskinesia. Although it had been reported that the atypical antipsychotics have less effect on prolactin(PRL) than the classical antipsychotics, we could experience PRL-associated symptoms such as amenorrhea, galactorrhea and hyperprolactinemia in practice. Therefore, we tried to identify the sex differences of risperidone-induced hyperprolactinemia, to evaluate factors affecting PRL levels, and to know the association between cognitive disorders and PRL. Methods : The baseline levels of PRL and TSH prior to risperidone administration were measured by enzyme immunoassay method for 50 patients(25 ma-les and 25 females) admitted with schizophrenia, schizoaffective disorder or schizophreniform disorder according to the DSM-IV classification, and the measurements of PRL were repeated on the 2nd and the 4th wks of risperidone administration. Concomitantly, the severity of psychotic symptoms using CGI, BPRS and PANSS, and the cognitive dysfunction using PANSS-CF were assessed prior to, on the 2nd and the 4th wks of risperidone administration. The PRL and TSH levels of 54 healthy controls(29 males and 25 females) who had no medical, neurological and psychiatric illnesses were also evaluated. Furthermore, the correlation with the psychiatric diagnosis, education, age, sex, duration of illnesses, risperidone dosage, duration of risperdone administration, TSH concentration, cognitive function, severity of psychotic symptoms were also identified. Results : 1) The baseline PRL levels of female schizophrenics($74.3{\pm}49.6ng/ml$) were significantly(p<0.005) higher than those of males($36.3{\pm}24.6ng/ml$), which were significantly(p<0.0001 respectively) higher than those of controls(females $16.9{\pm}6.1ng/ml$, males $13.3{\pm}4.9ng/ml$). The PRL levels measured on the 2nd wks(females $133.7{\pm}47.8ng/ml$, males $56.9{\pm}23.6ng/ml$) and on the 4th wks(females $146.1{\pm}45.9ng/ml$, males $70.0{\pm}31.5ng/ml$) after risperidone administration were significantly(p<0.0001 respectively) higher in females. The mean dosages of risperidone on the 2nd wks were $3.8{\pm}1.7mg$(2-6mg) for the females and $4.0{\pm}1.6mg$(2-6mg) for the males, and on the 4th wks were $4.5{\pm}2.1mg$(2-8mg) for the females and $5.4{\pm}2.2mg$(2-8mg) for the males. 2) The rise of PRL levels were positively correlated with increased risperidone dosage in males(${\gamma}$=0.307 on the 2nd wks and ${\gamma}$=0.280 on the 4th wks), while they were not correlated with dosages in females. For the females, the PRL levels were negatively correlated(${\gamma}$=-0.320) with decrease of TSH concentration. The baseline PRL levels were not correlated with age, education, duration of illnesses, psychopathology, cognitive disorders in both males and females, while it was negatively correlated with TSH levels only in females(${\gamma}$=-0.320). 3) The cognitive dysfunction was not correlated with PRL levels in males, while PANSS-CF scores were negatively correlated with PRL levels(${\gamma}$=-0.220 on the 2nd wks and ${\gamma}$=-0.366 on the 4th wks) in females. The psychopathology was positively correlated with cognitive dysfunction in both males and females. Therefore, the risperidone-induced cognitive improvement seemed to be correlated with improvement of psychopathology in both males and females, and with increase in PRL levels only in females. Conclusions : The fact that the serum PRL levels of schizophrenics were higher than those of controls, especially in females suggested that it could be related with risperidone dosage in males and with primary pathological process in females. The risperidone-associated cognitive improvement seemed to be related with general improvement of psychopathology as well as the rise of PRL levels especially in females. The facts that the effect of risperidoneinduced hyperprolactinemia and the cognitive function were more in females suggested that somewhat different mechanisms could be exerted on them.

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