Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.7
no.2
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pp.258-266
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1996
Self-injurious behaviors are commoly founded in the case of the developmentally impaired, such as mental retardation and autistic disorder. These behaviors are primary serious sources of distress for both child and their parents, another obstacle to overcome within the family and society. The author has a case that a child, had never before shown self-injurious behaviors. He abruptly started to injury his face and heel. The beginnings of these harmful behaviors are associated with symptoms of physical illness, such as fever, chills and general aches. The self-injured wounds were very severe. After the patient was treated with haloperidol and improved his physical conditions, self-injurious behaviors disappeared. The author reports the child's clinical process, characteristics of self-injurious behaviors, and discuss the treatment factors, along with a literature review.
Objectives : Severe mental illness is a major risk factor for suicide. This study aimed to identify characteristics of patients who died by suicide among subjects who had been received service from a community mental health center. Methods : We searched individuals who had committed suicide in Gwangju Bukgu Community Mental Health Center since 2006. Sociodemographic and clinical data were gathered from medical records and their case managers and they were compared with those of general members in the center. Characteristics of schizophrenia patients who died by suicide were particularly summarized. Results : Twelve person committed suicide between 2006 and 2016. The characteristics of those who died by suicide were male (67%), diagnosis of schizophrenia (75%), aged below 50 (83%), unemployed (92%), past history of psychiatric hospitalization (100%), recent admission within 3 months (67%), past history of suicidal attempt (78%), family history of schizophrenia (58%), poor adherence to medication (58%), and use of daily rehabilitation program (42%). Ten out of twelve (83%) showed warning sign for suicide. All identified method of suicide in patients with schizophrenia was jumping from high building. Many patients with schizophrenia, who committed suicide, suffered from comorbid depressive symptoms (67%) and auditory hallucination (78%). Conclusion : Case managers should pay attention to and carefully manage individuals who showed suicidal warning, particularly with risk factors for suicide, such as unemployment, admission state or recent discharge from psychiatric hospital, poor adherence to medication, family history of schizophrenia, and a history of suicidal attempt.
Schaffer, Clara;Hart, Andrew;Watfa, William;Raffoul, Wassim;Summa, Pietro Giovanni di
Archives of Plastic Surgery
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v.46
no.6
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pp.589-593
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2019
Post-traumatic defects of the distal third of the leg often require skipping a few steps of the well-established reconstructive ladder, due to the limited local reliable reconstructive options. In rare cases, the reconstructive plan and flap choice may encounter challenges when the patient has psychiatric illness affecting compliance with postoperative care. We describe a case of a patient with severe intellectual disability and an open fracture of the distal lower limb. After fracture management and debridement of devitalized tissues, the resultant soft tissue defect was covered with a free gracilis flap. On postoperative day 7, the patient ripped out the newly transplanted flap. The flap was too traumatized for salvage, so a contralateral free gracilis muscle flap was used. The patient showed good aesthetic and functional outcomes at a 1-year follow-up. When planning the postoperative management of patients with psychiatric illness, less complex and more robust procedures may be preferred over a long and complex surgical reconstruction requiring good compliance with postoperative care. The medical team should be aware of the risk of postoperative collapse, focus on the prevention of pain, and be wary of drug interactions. Whenever necessary, free tissue transfer should be performed despite potential compliance issues.
Journal of The Korean Society of Integrative Medicine
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v.10
no.2
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pp.49-59
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2022
Purpose : The purpose of this study is to directly understand the health condition of residents of mental health sanatoriums nationwide, which has been difficult to ascertain in surveys conducted to date. The study presents specific measures for improving the health of these residents. Methods : A "physical examination questionnaire for residents of mental health sanatoriums" was developed to check the basic physical condition of residents, and 20 out of 59 mental health sanatoriums nationwide were randomly selected. Medical personnel visited the sanatoriums, interviewing and examining the residents in person. A total of 396 health surveys were completed. Results : Many of the residents were underweight but had abdominal obesity. It was confirmed that chronic diseases among the residents were not diagnosed early or were not properly managed. Among the subjective symptoms complained of by the residents, musculoskeletal symptoms were the most common. Oral examinations revealed a serious level of oral health problems among the residents, including dental caries and missing teeth. Basic physical examinations found health problems that required additional examination or medical treatment. Blood pressure abnormalities made up the highest percentage of the health problems. Conclusion : Regular health surveys are needed to determine the health condition of residents of mental health sanatoriums. Access to and quality of primary medical services within the sanatoriums need to be dramatically improved. A delivery system for severe diseases and emergency medical care in the sanatoriums should also be specifically presented. The residents should be notified upon admission and during their stay that they have the right to the enjoyment of the highest attainable standard of mental and physical health. The issue of health rights should be addressed within a larger framework of reorganizing management plans for people in the community - not only residents - with chronic mental illness.
The objective of this study was to examine the association between personal, housing, program, and service characteristics and quality of life among persons with severe mental illness living in supported housing. A cross sectional survey of a random sample of 237 clients residing in supported housing in Philadelphia was used to assess the association between personal and environmental characteristics, and quality of life. Data were collected from structured interviews, administrative data, the 2000 U.S. Census data file and the Philadelphia police crime database. Multiple regression analyses were used to identify personal and environment characteristics that are associated with quality of life. Clients with diagnoses of schizophrenia, those with lower levels of psychiatric symptoms, those with higher levels of physical health status, and those with higher levels of perceived supportiveness with staff had higher levels of quality of life. Findings of this study suggested that clients' clinical characteristics and consumer staff relationships can be important variables for understanding quality of life among supported housing residents. Factors associated with quality of life identified in this study may help service providers design and plan services to promote quality of life and stable independent living in the community of supported housing residents.
Due to the deepening of COVID-19, high-intensity social distancing has been prolonged and many social problems have been cured. In particular, physical and psychological isolation occurred due to the non-face-to-face system and a lot of damage occurred. The various social problems caused by Corona acted as severe stress for all those affected by Corona 19, and eventually acted as a factor threatening mental health such as depression. While the number of people suffering from mental illness is increasing, the actual use of mental health services is low. Therefore, it is necessary to establish a system for people suffering from mental health problems. Therefore, in this study, depression detection and emergency detection models were constructed based on sensor information using smartphones from depressed subjects and general subjects. For the detection of depression and emergencies, VAE, DAGMM, ECOD, COPOD, and LGBM algorithms were used. As a result of the study, the depression detection model had an F1 score of 0.93 and the emergency situation detection model had an F1 score of 0.99. direction.
Purpose: This study was aimed at understanding the nature of the suffering of families with patients in mental health nursing homes and hoped to contribute to the rehabilitation process of those with a chronic mental disorder. Method: Research methodology was based upon Parse's human becoming research methodology. Results: a) Despite the despair the family feels by the violence caused by their now-institutionalized relative, they also realize anew the importance of their role as protectors b) Although they fear social stigmatization they also try to be supportive, out of guilt feelings; c) They regret their severe rearing style and wish to be more sympathetic, d) They find courage and hope through family therapy, which leads to a better understanding of the illness, e) With hopes of rehabilitation, the family members feel happy and go through an emotional release, by sharing the pain with each other. Conclusion: Families of nursing home residents share a focus on the process of human-health-universe. This is a positive,'human-becoming' process with which, based on past feelings of despair, fear, resignation, and pain, one can render meaning into his or her experiences in the present in the pursuit of love, conquest, hope, liberty and success.
The life of Antonin Artaud exactly reproduces a very cruel drama. He lived in constant anguish and suffered from severe mental pain. This research will trace his thoughts in his writings while he was a prisoner of language. Artaud was a poet filled with anxiety about language, things, being, and thought. Whenever he tried to explain the mystery of being by means of mundane language, he experienced psychological agony. His poetic thoughts began to break down, because of his identity loss. Nevertheless, he was destined to grasp the world through language. Artaud had suffered from mental illness during his youth. His mental illness was associated with his difficulty in creating poetry. In this research, the letter, Correspondance avec Jacques $Rivi{\grave{e}}re$, is analyzed. The poet refers to "the collapse of the spirit's core, and the erosion of the fundamental thought that slips away" to convey his linguistic incompetence. Hereafter, he constantly demonstrated anxious mental symptoms. Even though he became mentally deranged, he maintained his consciousness, as is apparent in his writings. Also, his spiritual belief is reflected in his mental uneasiness. While he was traveling through the Tarahumaras area in Mexico, he was obsessed with its primitive belief in the Peyote rituals, and he immersed himself in performing them. His unchristian belief was the product of his mystical personality. Until his last breath, he did not give up writing. Artaud's mental derangement does not mean lunacy, but if one insists in calling it so, that is a metaphor. His derangement comes from his refusal to accept his limitations and from his aspiring to regard his body in the same light as his intellectual perceptions. His intellect could manifest more easily when his mind was elevated to the extreme. Artaud's lunacy is no different from that of a profound philosopher. The lives of poets who suffer from mental derangement are more poetic than the lives of those who do not. Artaud's atypical emotions provide a way of to measure our own limitations, helplessness, and resignation. His scream is nonsegmental but different from that of a mental patient. That difference is why people are interested in his works and wish to delve into his writings.
Choe, Michael Sung Pil;Ahn, Jae Yun;Kang, In Gu;Lee, Mi Jin
Journal of The Korean Society of Clinical Toxicology
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v.12
no.1
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pp.14-21
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2014
Purpose: The objective of this study was to develop a new scoring tool that is comprehensively applicable and predicts fatality within 24 h of intoxication. Methods: This was a cohort study conducted in two emergency medical centers from 2011 to 2012. We identified factors associated with severe/fatality. Through a discriminant analysis, we devised the aBIG (age, Base deficit, Infection, and Glasgow coma scale) score. To compare the ability of aBIG to predict intoxication severity with that of previous scoring systems such as APACHE II, MODS, SAPS IIe, and SOFA, we determined the receiver operating characteristic curves of each variable in predicting severe-to-fatal toxicity. Results: Compared with the mild/moderate toxicity group (n=211), the severe/fatal group (n=143) had higher incidences of metabolic acidosis, infection, serious mental change, QTc prolongation and hepato-renal failure. Age, base deficit, infection-WBC count, and Glasgow Coma Scale were independently associated with severe/fatal poisoning. These variables were combined into the poisoning "aBIG" score [$0.28{\times}$Age group+$0.38{\times}WBC$ count/$10^3+0.52{\times}$Base deficit+$0.64{\times}$(15-GCS)], which were each calculated to have an area under the curve of 0.904 (95% confidence interval: 0.868-0.933). The aBIG poisoning score had an equivalent level of severity predictability as APACHE II and a superior than MODS, SOFA, and SAPS IIe. Conclusion: We developed a simplified scoring system using the four variables of age, base deficit, infected leukocytosis, and GCS. The poisoning aBIG score was a simple method that could be performed rapidly on admission to evaluate severity of illness and predict fatal severity in patients with acute intoxications.
Astrocytes play a critical role in normal brain functions and maintaining the brain microenvironment, and defects in astrocytogenesis during neurodevelopment could give rise to severe mental illness and psychiatric disorders. During neuro-embryogenesis, astrocytogenesis involves astrocytic differentiation of neural precursor cells (NPCs) induced by signals from ciliary neurotrophic factor (CNTF) or pituitary adenylate cyclase-activating peptide (PACAP). However, in contrast to the CNTF signaling pathway, the exact mechanism underlying astrocytic differentiation induced by PACAP is unknown. In the present study, we aimed to verify a signaling pathway specific to PACAP-induced astrocytogenesis, using exchange protein directly activated by cAMP2 (Epac2)-knockout mice. We found that PACAP could trigger astrocytic differentiation of NPCs via Epac2 activation and an increase in the intracellular calcium concentration via a calcium ion influx. Taken together, we concluded that astrocytogenesis stimulated by PACAP occurs through a novel signaling pathway independent from CNTF-JAK/STAT signaling, that is the well-known pathway of astrocytogenesis.
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