• Title/Summary/Keyword: Severe anxiety

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Impact of Comorbid Obsessive Compulsive Symptoms on Quality of Life in Stable Patients with Chronic Schizophrenia (안정화된 만성 조현병 환자에서 강박장애 증상이 삶의 질에 미치는 영향)

  • Moon, Jung Yoon;Kang, Sukhoon;Seok, Jung-Ho;Kim, Chan-Hyoung;Kim, Tae Yong;Choi, Jin Hee;So, Hyong Seok
    • Anxiety and mood
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    • v.13 no.2
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    • pp.141-147
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    • 2017
  • Objective : This study aimed to evaluate the relationship between comorbid obsessive compulsive disorder (OCD) and quality of life in stable patients with schizophrenia. Methods : We interviewed 162 symptom-stable inpatients who have been on a constant dose of antipsychotics for at least 3 months prior and diagnosed as chronic schizophrenia. Subsequently, patients were classified according to the existence of OCD as evaluated using the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). Further, all clinical and demographic data were collected and evaluated. To investigate potential interrelationships, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Korea-Positive and Negative Symptom Scale (K-PANSS), Korean Modification of the Scale to Measure Subjective Well-Being under Neuroleptic Treatment (KmSWN) and Korean Version Quality of Life Scale (K-QOLS) were performed. Independent t-test and Chi-square test were used to compare groups and regression analysis was done to assess the relationship between the Y-BOCS and quality of life. Results : Schizophrenia patients with OCD showed significantly earlier onset of schizophrenia, more severe psychiatric symptoms and lower quality of life, compared to those without comorbid OCD. OCD might be associated with lower quality of life in schizophrenia. Conclusion : Schizophrenia patients with OCD showed lower quality of life than those without OCD. In the treatment for schizophrenia, evaluation of OCD might be needed to improve their quality of life and social function.

Hyperventilation During Local Anesthesia in Acute Odontogenic Infectious Lesion - Report of two cases - (급성 치성감염 병소에서 국소마취 중 유발된 과환기 -증례 보고-)

  • Yoo, Jae-Ha;Kim, Hyun-Sil;Baek, Sung-Hum;Yoo, Tae-Min;Lee, Ji-Woong;Chung, Won-Gyun
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.2 no.2 s.3
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    • pp.107-113
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    • 2002
  • Hyperventilation is defined as ventilation in excess of that required to maintain normal blood $PaO_2$ and $PaCO_2$. It is produced by several distinct causes: anxiety, respiratory alkalosis, increased blood catecholamine levels, and a decrease in the level of the ionized calcium in the blood. The dental fears about acute pain, needle, drill and dental surgery lead to the severe anxiety and increased blood catecholamine level. Therefore, the most dental patient should be cared gently as the stress reduction protocol. In spite of the gentle care, two cases of hyperventilation were occurred during local anesthesia for incision and drainage of acute odontogenic infectious lesions. We suggest that the dental patients with acute odontogenic infection must be attention for the manifestation of hyperventilation, especially in the medically compromised conditions.

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A Comparison of the Depressive Predisposition between Obese and Non-Obese Elderly (노년기 비만군과 정상 체중군 간의 우울 성향 비교)

  • Mune, June-Sik;Lee, Yong-Ho;Chun, Sae-Il;Suh, Ho-Suk
    • Anxiety and mood
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    • v.3 no.2
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    • pp.128-133
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    • 2007
  • Objective : Obesity has been considered to be associated with numerous physical, mental and psychological diseases. Depression, which is a major psychological factor affecting occurrence and treatment of obesity, can be a cause of obesity as well as can be triggered by obesity. This study aimed to find out the need of positive consideration to the existence of depressive mood in the management of obesity. Methods : A total of 101 subjects were enrolled among those who were 60 years old and over at one local clinic. Obese group (n=49) was defined as BMI${\geqq}$25 and normal weight group (n=52) as 20$5.2{\pm}2.5$) was significantly higher than that of the normal weight group ($3.8{\pm}1.7$)(p<0.05). In male subjects, there was no significant difference in the mean GDSSF-K score between both groups, but in female subjects, the mean GDSSF-K score of the obese group, $6.4{\pm}2.6$ was significantly higher than that of the normal weight group ($4.0{\pm}1.8$)(p<0.05). Conclusion : The elderly obese group showed higher depressive scale score than elderly normal weight group, especially in female elderly. Since the elderly obese female group had a depressive predisposition, comprehensive management including mental and psychological approach is required in obesity control programs.

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Weight Control History according to Risk of Eating Disorder (일부 대학생의 식사 장애 위험 정도에 따른 체중 조절 방법)

  • Nam Hee-Jung;Kim Young-Soon
    • The Korean Journal of Food And Nutrition
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    • v.19 no.2
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    • pp.111-125
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    • 2006
  • This quantitative study was conducted to examine the relationship between weight control behaviors and disordered eating patterns in some university students. This study used a cross-sectional study design. A total of 347 students from three universities participated in this study (88 male and 259 female) Eating disorders were assessed using the Eating Attitudes Test (EAT-26); a score of =20 identifies individuals who likely have an eating disorder, including anorexia nervosa and bulimia nervosa. A score for healthy dietary behaviors was obtained by self-assessment on a healthy diet scale (20-item questionnaire), and the severity of any state-trait anxiety was calculated by the state-trait anxiety inventory (40-item questionnaire). In the analyzed results, the percentage of participants with experience of weight control was 58% in male and 73% in female. The subjects with a high risk of an eating disorder (score of =20 of EAT-26) were 44.3% ($mean{\pm}S.D;\;18.9{\pm}13.4$) of the males, and 57.9% ($mean{\pm}S.D;\;23.2{\pm}11.6$) of the females. Higher Body Mass Index (BMI) was significantly related with an increased risk for an eating disorder in females, but not in males. In the group who had attempted weight control of all types, there was a severe risk of an eating disorder. Increased eating disorder risk was significantly related with weight control behaviors such as a higher number of attempts at weight control, having used medication, having experienced side effects, and having experienced disease for both sexes. Therefore, the results of this paper showed that detrimental behaviors of weight control are connected to an increased risk of eating disorders. Consequently, education regarding the correct, behaviors of weight control is necessary to prevent eating disorders in adolescents.

Understanding of Posttraumatic Embitterment Disorder (PTED) (외상후 울분장애의 이해)

  • Ko, Han-Suk;Han, Chang-Su;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.10 no.1
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    • pp.3-10
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    • 2014
  • Reactive disorder is a group of diagnosis with a definitely known etiology and whose etiological factor is essential to the diagnosis. In DSM system, such reactive disorders are listed as adjustment disorder, acute stress disorder, brief psychotic disorder with marked stressor and posttraumatic stress disorder (PTSD). However, a growing number of individuals is suffering from a prolonged feeling of embitterment after exceptional negative life events and this condition could be diagnosed neither PTSD nor adjustment disorder nor depressive disorder in the context of DSM-IV diagnostic system. This clinical condition can be described as 'posttraumatic embitterment disorder' (PTED). PTED is a reactive disorder triggered by exceptional, though normal negative life events such as conflict in the workplace, unemployment, death of a relative, divorce, severe illness, or experience of loss or separation. The common feature of such events is that they are experienced as unjust, as a personal insult, accompanied by psychological violation of basic beliefs and values. The central psychopathological response pattern in PTED is a prolonged feeling of embitterment. In particular, the core emotion of embitterment can lead to the rejection of treatment. Therefore, "wisdom therapy" as a new treatment approach specifically designed for PTED has been developed. It is assumed that many patients suffering from PTED are often misunderstood and misdiagnosed. This review would help to introduce PTED into the clinical field in psychiatry.

Reliability and validity of the Korean version of the Dental Fear Survey

  • Kim, Ah-Hyeon;Shim, Youn-Soo;Park, So-Young;Kim, Hee-Won;An, So-Youn
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.2
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    • pp.85-92
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    • 2015
  • Background: Many people experience varying levels of discomfort when confronted with the prospect of dental treatment. Dental treatment can be a traumatic experience, especially for children and adolescents with dental anxiety. In this age group, dental fear causes a significant problem in dental management and has been related to severe dental caries and dental pain. The Dental Fear Survey (DFS) is the most widely used measure of dental fear. This study was undertaken to develop the Korean version of the DFS (K-DFS) and test its reliability and validity. Methods: The K-DFS, which uses projective techniques to measure children's and adolescents' dental fear, was developed. The DFS was translated into Korean and participants were selected via convenience sampling. Reliability and validity were tested using data from a sample of 813 middle school students in Gyeonggi Province, selected from the Self questionnaire survey. The K-DFS was administered twice to 102 adolescents aged 12-15 years. Results: The K-DFS had high internal consistency reliability (99.1%) but low test-retest reliability. Conclusions: The results indicate that the Korean versions of the DFS have good internal consistency reliabilities and test-retest validities. However, we need to further examine the test-retest reliability of the K-DFS and replicate the current study in different samples covering various age groups.

Effects of Vicarious Trauma on Mental Health in Firefighters (소방 공무원에서 간접 외상이 정신 건강에 미치는 영향)

  • Baik, Jun-Hyuck;Jung, Young-Eun;Chae, Jung-Mi;Myong, Jun-Pyo;Yim, Hyeon-Woo;Cha, Jeong-Ho
    • Anxiety and mood
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    • v.6 no.1
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    • pp.65-70
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    • 2010
  • Objectives : Indirect contact with trauma may occur when a person empathically listens to detailed descriptions, exposing the person to intense emotional pain from trauma victims. Although less severe than direct trauma, indirectly traumatized persons may experience the same fear, rage, and despair as direct trauma victims. This phenomenon has been variously termed vicarious trauma, traumatic countertransference, burnout, compassion fatigue, and secondary traumatic stress. Using a psychiatric symptoms questionnaires, this study investigated the effects of indirect exposure to co-worker's trauma on the mental health of firefighters who had not directly experienced traumatic events in the previous year. Methods : We administered self-report questionnaires, such as the Impact of Event Scale-Revised (IESR) and Alcohol Use Disorder Identification Test (AUDIT), to firefighters working at two fire stations in a metropolitan city. We analyzed 188 of 232 collected surveys, after excluding falsely entered data (28 cases) and questionnaires by directly-traumatized victims (16 cases). Results : Alcohol consumption and posttraumatic stress disorder (PTSD) symptoms, as determined by the AUDIT and IES-R, were significantly higher in the indirectly-traumatized group. The ratio of high-risk members scoring higher than 23 in IES-R was larger in the indirectly traumatized group, although this was not statistically significant. Conclusion : Alcohol consumption was significantly higher in the indirectly traumatized group. This group also included more members at high risk for PTSD. Further research, with a larger group of indirectly traumatized firefighters and ongoing investigation of PTSD development and other psychiatric symptoms, is needed.

Comorbid Obsessive Compulsive Disorder and Social Function in Stable Patients with Chronic Schizophrenia (안정화된 만성 정신분열병 환자에서 강박장애 동반과 사회적 기능)

  • Kang, Suk-Hoon;Seok, Jung-Ho;Kim, Chan-Hyung;Kim, Yoon-Joong;Kim, Hyoung-Ju;Choi, Jong-Hyuck
    • Anxiety and mood
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    • v.7 no.1
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    • pp.40-47
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    • 2011
  • Objective : This study aimed to investigate the prevalence of obsessive-compulsive disorder (OCD) in schizophrenia, and the relationship among OCD, severity of psychopathology, and social function in stable patients with chronic schizophrenia. Methods : We interviewed 138 symptom-stable inpatients who had been on a constant dose of antipsychotics for at least 1 month prior and diagnosed as chronic schizophrenia. Subsequently, patients were classified according to the existence of OCD as investigated using the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Further, all clinical and demographic data was investigated. To investigate potential interrelationships, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Korea-Positive and Negative Symptom Scale (K-PANSS), and the Korean Personal and Social Performance (K-PSP) were used. An independent ttest and Chi-square test were used to compare groups and a Pearson's correlation coefficient was used to assess the relationship between the Y-BOCS and other clinical rating scales. Results : The prevalence of OCD in schizophrenia patients was 18.1%. Patients with schizophrenia and OCD exhibited significantly earlier onset of schizophrenia, more severe psychiatric symptoms, and lower personal and social performance ability as compared to those without OCD. There was no significant relationship among Y-BOCS, K-PANSS, and K-PSP. Conclusion : We found that comorbid OCD was relatively more frequent in patients with schizophrenia. An investigation involving larger samples of schizophrenia patients with OCD with respect to social function and thus, the effect on quality of life is required.

The Study of the Subjective Symptoms according to Frontal Lobe Damage and Change in Neurocognitive Function in Traumatic Head Injury Patients (두부외상 환자에서 전두엽 손상과 신경인지기능 변화에 따른 주관적인 증상 연구)

  • Kim, Jun-Won;Han, Doug-Hyun;Kee, Baik-Seok;Park, Doo-Byung
    • Anxiety and mood
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    • v.8 no.1
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    • pp.31-40
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    • 2012
  • Objective : The purpose of this study was to analyze the correlation between symptom severity and neurocognitive factors in traumatic head injury patients. In addition, the effect of frontal lobe damage on these parameters was examined. Methods : We selected 18 patients who had brain damage for the moderate to severe traumatic brain injury (MSTBI) group, and 17 patients who met the diagnostic criteria for post-traumatic stress disorder (PTSD) without the finding of brain damage for the comparison group. For the evaluation of neurocognitive function, K-WAIS, Rey-Kim Memory Test, K-FENT, WCST, and MMPI-2 were used. Results : The results of the comparison (using the malingering scale) revealed that the values of PDS and PK, which express the severity of symptoms, and the values of the validity scale F, F (B), and F (P) were significantly higher in the overly-expressed group. F (B) in overly-expressed group and PK, Pt, and Sc in the properly-expressed group had significant correlation with the severity of symptoms. F (B), S, and Stroop error inhibition in PTSD, and PK, Pt, Sc, and MQ in MSTBI had significant correlation with the severity of symptoms. The results of the comparison based on the finding of frontal lobe damage revealed that PDS, EIQ, and MQ ware significantly higher in the group without brain damage. Conclusions : It was revealed that each neurocognitive factor was correlated with the severity of symptoms. There was a decrease in complaints or symptoms reported by the frontal lobe injury group, and this is believed to be due to degenerative change in the personality and emotional functioning of these patients following frontal lobe damage.

Case Series Reporting 7 Somatic Symptom Disorder Cases Diagnosed as Greater Yin Disease by Shanghanlun Provisions (『상한론(傷寒論)』 태음병(太陰病)으로 진단된 신체증상장애 환자 7례 증례 보고)

  • Yun, Hyo-joong;Ha, Hyun-yee;Doo, In-sun;Lee, Sung-in;Lee, Sung-Jun
    • 대한상한금궤의학회지
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    • v.13 no.1
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    • pp.45-59
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    • 2021
  • Objectives: This study was conducted to confirm the reproducibility of the diagnosis of greater yin disease (太陰病) and the efficacy of herbal treatment using Gyejigajakyak-tang or Gyejigadaehwang-tang in somatic symptom disorder (SSD). We also further refined the characteristics of greater yin disease in SSD. Methods: We analyzed the demographic and treatment data of seven patients with SSD from four Korean medical clinics. The reliability of diagnosis and the efficacy of the treatments were evaluated by the Beck Anxiety Inventory (BAI), a numerical rating scale (NRS), and the patients' statements. Finally, we analyzed patients according to the diagnostic points of Shanghanlun provision 273. Results: Seven SSD patients took Gyejigajakyak-tang or Gyejigadaehwang-tang. The mean age of the patients was 52.1±15.8 years old, and the herbal medication period was 82.2±38.2 days. At the first visit, the patients showed hypochondriasis, obvious stress, and a severe BAI score (40.4±10.9). The NRS significantly decreased from 8.9±1.6 to 0.7±0.7 after the treatments. There were no side effects reported. As a result of analyzing these 7 cases, hypochondriasis, obvious stress, and anxiety were identified, which had been previously suggested as 自痛, 因爾, and 結硬. Conclusions: We confirmed the reproducibility of greater yin disease in 7 SSD cases from 4 medical institutions. These results imply that there could be a considerable relation between SSD and greater yin disease as defined by the Shanghanlun provisions.