• Title/Summary/Keyword: Severity of illness

Search Result 178, Processing Time 0.025 seconds

Neurocognitive Dysfunction in Patients with Obsessive-Compulsive Disorder in Association of Duration of Untreated Illness : A Preliminary Study (강박장애의 치료받지 않은 유병기간에 따른 신경인지기능 이상 : 예비연구)

  • Oh, Sang Hoon;Kim, Sung Nyun;Han, Jaewook;Lee, Junhee;Lee, Tae Young;Shin, Min-Sup;Kwon, Jun Soo
    • Korean Journal of Biological Psychiatry
    • /
    • v.24 no.2
    • /
    • pp.75-81
    • /
    • 2017
  • Objectives Obsessive-compulsive disorder (OCD) is a chronic and disabling psychiatric disorder. The duration of untreated illness (DUI) has been suggested as one of the predictors of clinical course and outcome in various psychiatric disorders. There is increasing evidence that cognitive dysfunction is associated with the prognosis of OCD. The aim of this study was to investigate the influence of DUI on the neurocognitive functions in patients with OCD. Methods Sixty-two patients with a DSM-IV diagnosis of OCD from the outpatient clinic were included in this study. We defined the short DUI if the DUI was 2-year or less and the long DUI if it was longer than 2-year. Neurocognitive functions were assessed by visuospatial memory function test and 4 subsets of K-WAIS such as vocabulary, arithmetic, block design and picture arrangement. Differences in neurocognitive functions as well as clinical variables between OCD patients with short DUI and those with long DUI were investigated. Correlation analyses were also performed to determine the correlation between DUI and neurocognitive functions. Results Compared with the short DUI group, the long DUI group performed worse in the block design test, which measures executive function. The long DUI group also had a higher level of compulsive symptom severity than the short DUI group. However, the DUI was not correlated with neurocognitive functions. Conclusions Findings in this preliminary study suggest that the long DUI in patients with OCD is associated with more severe executive dysfunction. Studies with larger samples and longitudinal design are needed to further confirm the prognostic role of the DUI in OCD.

Anger-Related Characteristics and Childhood Adversity in Somatic Symptom Disorder (신체증상장애와 관련된 분노정서특질과 아동기 역경 경험)

  • Kang, Sung-Hyuk;Park, Chun Il;Kim, Hae Won;Kim, Se Joo;Kang, Jee In
    • Anxiety and mood
    • /
    • v.16 no.2
    • /
    • pp.49-56
    • /
    • 2020
  • Objective : The present study aims to investigate differences in anger-related features in patients with somatic symptom disorder (SSD) compared to healthy controls, and to examine whether anger trait and anger regulation strategy are associated with clinical characteristics in patients with SSD. In addition, we examined the relationship between childhood adversity and SSD. Methods : 26 patients with SSD and 28 healthy controls were included. Anger-related features were assessed with State-Trait Anger Expression Inventory (STAXI). Clinical somatic symptoms were assessed using the somatization subscale of the Symptom Checklist-90-Revised and the Somatosensory Amplification Scale. Childhood adversity was assessed by the Childhood Traumatic Events Scale. Multivariate analysis of covariance was performed. Results : Disease status of SSD had a significant overall effect on anger-related features (Wilks λ=0.725, F(5, 44)=3.332, p=0.012). Patients with SSD showed a significantly high Trait-Anger (p=0.017) and they had a high score in both Anger-Out (p=0.013) and Anger-In (p=0.001) of anger expression styles. In particular, a directed inward style of anger expression was significantly associated with somatization symptom severity (p=0.003). Regarding childhood adversity, more childhood extreme illness was experienced by the SSD group than the control group (p=0.012). Within the SSD group, childhood extreme illness was associated with higher Trait-Anger (p=0.027) and Anger-Out (p=0.001). Conclusion : The present findings suggest that trait anger, anger expression styles, and childhood adversity of extreme illness may be involved in SSD. Further studies are needed to explore the role of anger-related features and its relationship with childhood adversity in the pathophysiology of SSD.

Characteristics of Early Maladaptive Schemas in Patients with Panic Disorder (공황장애 환자의 초기부적응 심리도식의 특성)

  • Woo, Na Young;Lee, Byung Wook;Lee, Hong Seock;Jung, Myung Hoon;Yi, Jung Seo
    • Anxiety and mood
    • /
    • v.7 no.2
    • /
    • pp.85-91
    • /
    • 2011
  • Objective : This study aimed to investigate the characteristics of the early maladaptive schemas in patients with panic disorder. Methods : Patients (n=35) included people who had met the DSM-IV-TR criteria for panic disorder. The normal control group (n=35) were those people who had no psychiatric disorder and had never experienced panic attack. The early maladaptive schemas and the severity of depression and anxiety were assessed by the Young Schema Questionnaire Short-form (YSQ-SF), the Beck Depression Inventory (BDI), and the Spielberger State-Trait Anxiety Inventory (STAI). Results : The scores on the STAI-S, STAI-T, and BDI were significantly higher in the patient group. Compared to the control group, the scores of vulnerability to harm and illness, and abandonment/instability schemas were significantly higher in the patient group. In the patient group, defectiveness/shame and subjugation schemas were found to predict BDI, dependent/incompetence, abandonment/instability schemas were found to predict STAI-S, and vulnerability to harm and illness, and abandonment/instability schemas were found to predict STAI-T. In normal controls, failure and insufficient self-control/self-discipline, failure, and emotion inhibition schemas were found to predict BDI, STAI-T, and STAI-S. Conclusions : Vulnerability to harm and illness and abandonment/instability schemas may be characteristic schema in patients with panic disorder.

A Study on the Related Factors of the Wellbeing of Family Caregivers in Elderly with Stroke (뇌졸중 노인을 돌보는 주 가족간호자의 안녕감 예측 요인)

  • Park, Yeon-Hwan;Yu, Su-Jeong;Kim, Shin-Mi;Lee, Yun-Jung
    • Journal of Korean Academy of Nursing
    • /
    • v.36 no.2
    • /
    • pp.373-380
    • /
    • 2006
  • Purpose: The purpose of this study was to identify the factors related to the wellbeing of the family caregivers of the elderly with a stroke. Methods: The subjects of this study were 199 elderly treated in four oriental hospitals in Korea, and their primary family caregivers. The data was collected by interviewsand a self reported Questionnaire, during the period from October, 2003 to April, 2004. Results: The results of this study were as follows. The mean score of wellbeing of family caregivers was 60.6412.63. The factors related to wellbeing of family caregivers were sex, age, education, depression, illness severity, ADL, paralysis, and speech disability in elderly characteristics. Among family caregivers characteristics, education, relation, and burden were significantly related. In situational variables, family income and the previous relationship between the elderly and family caregivers were related to wellbeing. Stepwise multiple regression analysis revealed that the most powerful predictor of wellbeing was the burden of family caregivers. A combination of the depression of elderly and age of family caregivers accounted for 50.3% of the variance of wellbeing. Conclusions: On developing the nursing intervention for improving wellbeing of family caregivers, many factors should be considered, especially caregiver burden, and elderly depression.

$^{67}Gallium$ Scan Findings in Miliary Tuberculosis (속립성 결핵의 $^{67}Gallium$ Scan 소견)

  • Lee, Myeong-Seob;Kim, Eung-Jo;Hong, In-Soo;Sung, Ki-Jun;Park, Hyun-Ju
    • The Korean Journal of Nuclear Medicine
    • /
    • v.26 no.1
    • /
    • pp.111-115
    • /
    • 1992
  • Miliary Tuberculosis is an illness produced by acute dissemination of tubercle bacilli via the blood stream. In chest roentgenogram, a diffuse "miliary" infiltrates are usually seen, but normal or suspicious ground glass pattern also can be seen in early manifestation. Ten patients of miliary tuberculosis who underwent whole-body $^{67}Ga-citrate$ scintigraphy were evaluated retrospectively to study usefulness of Ga-scan for early diagnosis of miliary Tbc and evaluation of disease activity. All of ten patients demonstrated significantly diffuse bilateral pulmonary uptakes on 48 hours image. All of three patients of ground-glass pattern in chest roentgemogram also demonstrated increased uptakes. In the statistical analysis, the severity of chest roentgenographic findings showed positive correlation with the activity on Ga?scan. These results suggest that Gallium scan is useful for diagnosis of early miliary tuberculosis and for evaluation of disease activity on follow-up examination of miliary tuberculosis of lung.

  • PDF

Regionalization of neonatal care and neonatal transport system (신생아 괸리의 지역화 및 전원시스템)

  • Sin, Jong Beom
    • Clinical and Experimental Pediatrics
    • /
    • v.50 no.1
    • /
    • pp.1-6
    • /
    • 2007
  • In the United States, The concept of designation for hospital facilities that care for newborn infants according to the level of complexity of care provided was first proposed in 1976. The extent of perinatal health care regionalization varies widely from one area to the other. facilities that provide hospital care for newborn are classified into three categories on the basis of functional capabilities; level I-primary or basic care, level II-secondary or specialty care, level III-tertially or subspecialty care. These facilities should be organized within a regionalized system of perinatal care. The transport system of newborn infants should be organized for referral of high risk newborn to centers with the personnel and resources needed for their degree of risk and severity of illness. In Korea, The korean society of neonatology was established and articulated in the 1994. During the past decade, the number of neonatologist has increased and neonatal intensive care units have proliferated in Korea. However, no standard definitions exist for the graded levels of complexity of care that neonatal intensive care units provide and no uniform guideline or recommendation for regionalization and referral system of high risk neonate have been established. With the rapid changing neonatal care system in Korea, the optimal neonatal care demands regionalization of care in utilization of manpower resources and in efficient use of advanced technology and facility.

Radiological Accident and Acute Radiation Syndrome (방사선 사고와 급성 방사선 증후군)

  • Roh, Hyung-Keun
    • Journal of The Korean Society of Clinical Toxicology
    • /
    • v.9 no.2
    • /
    • pp.39-48
    • /
    • 2011
  • In mass casualty situation due to radiological accidents, it is important to start aggressive management with rapid triage decisions. External contamination needs immediate decontamination and internal contamination should be treated with special expertise and equipment to prevent the rapid uptake of radionuclides by target organs. Acute radiation syndrome shows a sequence of events that varies with the severity of the exposure. More severe exposures generally lead to more rapid onset of symptoms and severe clinical findings. After the massive exposure, various systems of the body reflect their severe damages that can lead to death within hours or up to several months. The disease progression has classically been divided into four stages: prodromal, latent, manifest illness, and recovery or death. Three characteristic clusters of symptoms including the hematopoietic syndrome, the gastrointestinal syndrome and the cerebrovascular syndrome are all associated with the acute radiation syndrome. The standard medical management of the patients with a potentially survivable radiation exposure includes good medical, surgical and supportive measures. Specific treatment with cytokines and bone marrow transplantation should be considered. The management of internal contamination is much the same as the treatment of poisoning. The standard decontamination should be applied to reduce uptake, and the chelating agents can be administered to enhance the clearance of radioisotopes. Radioactive iodine ($^{131}I$) as one of the nuclear fission products can increase the incidence of thyroid cancer in children. Potential benefit of potassium iodide prophylaxis is greater especially in neonates, infants and small children.

  • PDF

Reliability and Validity Tests of Patient Classification System Based on Nursing Intensity (간호강도에 의한 환자분류도구의 신뢰도 및 타당도 검증)

  • Park, Jung-Ho;Kim, Eun-Hye
    • Journal of Korean Academy of Nursing Administration
    • /
    • v.13 no.1
    • /
    • pp.5-16
    • /
    • 2007
  • Purpose: This study is to verify the validity and reliability of classified items and criteria of the patient classification system(PCS) based on Park's definition of nursing intensity. Methods: An expert group of 8 persons verified the content validity of the tools. The 1817 inpatients at a tertiary hospital in Seoul, Korea were classified into 4 groups according to two tools for verifying concurrent validity and interraters' reliability. These verifications were performed from September to October, 2004. Results: Nursing domains of the tools have been divided into 12 items: hygiene, nutrition, elimination, exercise & activity, education & counseling, emotional support, communication & consciousness, treatment & examination, medication, measurement & observation, coordination of multidisciplinary team, admission & discharge & transfer management. Content validity was verified by the content validity index(above 0.75 in all 12 areas). Interraters' reliability was no significant difference in the results of the patient classification between the two raters(A group 93.75%. B group 88.24%). Concurrent validity was also verified by the agreement of two tools(73.7%). Conclusion: These results showed that the reliability and validity of the PCS based on the nursing intensity were verified. These will use an data for nursing productivity in the future.

  • PDF

Factors Influencing Stress Appraisal of Cancer Patients' Primary Caregivers (암환자의 일차간호제공가족의 스트레스 인지평가 영향 요인 분석)

  • Shin, Gye-Young;Kim, Mae-Ja
    • Korean Journal of Adult Nursing
    • /
    • v.14 no.1
    • /
    • pp.125-134
    • /
    • 2002
  • Purpose: The objectives for this study were to identify the factors that correlate with appraisal of illness and to explore what variables are predictive of cancer patients primary caregivers' cognitive appraisal for stress. Method: The subjects were selected by convenient sampling and 130 caregivers who completed a questionnaire. Measures used in this study included the Family Inventory of Resources for Management, Social Support Index, Family Crisis Oriented Personal Evaluation Scales and Family Coping Coherence Index. Pearson correlation was used to identify the relationship among factors and multiple regression was used to determine the individual and cumulative effect of potential predictors on the caregivers' appraisal. Results: Patient's level of activity, severity of the disease, quality of relation between patient and caregiver, caregiver's subjective health status, economic status, family resources and coping were significantly correlated. Among the variables, coping, family resources, economic status and quality of relation between caregiver and patient predicted 49.2 percent of the variance in appraisal of caregivers' stress condition. Conclusion: These findings suggest that coping mechanisms and family resources are important for positive appraisal. Nurses should provide adequate nursing care for the primary caregiver about professional care information and supportive counseling.

  • PDF

A Case Report of Tic Disorder Children Treated by Kuibiondam-tang Gami (귀비온담탕가미방(歸脾溫膽湯加味方)의 틱장애 환아 20례에 대한 치료효과)

  • Kang, Kyung Ha;Park, Eun Jung
    • The Journal of Pediatrics of Korean Medicine
    • /
    • v.28 no.4
    • /
    • pp.118-124
    • /
    • 2014
  • Objectives The purpose of this study is to report 20 cases of tic disorder children who were treated by Kuibiondam-tang Gami. Methods We treated the tic disorder children with herbal medicine, Kuibiondam-tang Gami. Then we evaluated tic disorder by Yale Global Tic Severity Scale (YGTSS) and observed the progress of tic disorder. Results 20 children (male 17, female 3 / transient tic disorder 6, chronic motor or vocal tic disorder 13, Tourette's disorder 1) were studied, the average age of children was $8.45{\pm}2.08$ years, the average duration of illness was $16.55{\pm}13.63$ month and the mean of treatment was $13.20{\pm}9.29$ week. After the treatment, mean of YGTSS was reduced $36.35{\pm}9.84$ to $9.35{\pm}1.03$ and total effective rate was 95%. Conclusions Kuibiondam-tang Gami is effective for reducing tic symptom and improving general conditions in children.