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A Study of the Depressive Symptoms and the Quality of Life in Patients with Breast Cancer in a University Hospital (일 대학병원 유방암 환자의 우울증상과 삶의 질)

  • Jang, Seung-Ho;Lee, Dae-Bo;Choi, Un Jong;Lee, Kwang-Man;Lee, Sang-Yeol
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.1
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    • pp.11-17
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    • 2013
  • Objectives : This study was designed to investigate the prevalence of depressive symptoms in patients with breast cancer and to identify demographic variables and clinical characteristics impact on depressive symptoms and health related quality of life in patients with breast cancer in a university hospital. Methods : Fourty-one patients with breast cancer were selected, who had visited the department of General surgery of the Wonkwang University hospital with a diagnosis of breast cancer regularly during the period November, 2010-May, 2011. All of subjects were evaluated for the depression, anxiety and the health related quality of life with Beck Depression Inventory(BDI), anxiety subscale of Personality Assessment Inventory(PAI) and Short-Form 36 Health Survey-Korean version(SF-36-K). Patients were divided into depressive symptoms and non-depressive symptoms group according to the BDI score. We compared SF-36-K between two groups, and analized multiple regression with depression and health related quality of life as criterion variables and demographic and clinical characteristics. Results : The prevalence of depression in patients with breast cancer in a University hospital was 36.4%. Compared to the non-depression, depressed patients with breast cancer appeared significantly lower mean scores on six subscales in SF-36-K : Physical function(p<.01), Role-physical(p<.001), General health(p<.05), Social function(p<.001), Role-emotional(p<.001) and Mental health(p<.001). But there was no significant difference between two groups in Vitality and Bodily pain. Anxiety, level of education and presence of enforcement of chemotherapy(63.6%) were significant explanation variables for depressive symptoms. And type of surgery and age(55.8%) were significant explanation variables for health related quality of life. Conclusions : The prevalence of depressive symptoms in patients with breast cancer in a University hospital was 36%. The depressive symptoms had not only negative impact on the health related quality of life but also important explanation variable for health related quality of life. These results suggest that depressive symptoms in patients with breast cancer should be evaluated and treated for improving patient's health related quality of life.

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THE CLINICAL FEATURES OF THREE SUB-DIAGNOSED GROUPS OF TIC DISORDERS AND FACTORS RELATED WITH ILLNESS SEVERITY (틱 장애의 진단분류에 따른 임상특징과 질환 심각도와 연관된 변인들)

  • Jung, Hee-Yeon;Hwang, Jeong-Min;Chung, Sun-Ju
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.1
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    • pp.115-124
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    • 2001
  • Objective:The purpose of this study was to compare the clinical features of children with three subdiagnoses of tic disorder(transient tic disorder(TTD), chronic tic disorder(CTD) and Tourette’s disorder (TD)) and to exam the factors related with illness severity of them. Method:Subjects were 69 children who met DSM-IV criteria for tic disorder and 43 control children. All subjects were investigated demographic and clinical factors related to tic. The severity of tic was assessed with the Yale Global Tic Severity Scale(YGTSS) in tic disorder children. The Child Behavior Checklist(CBCL) was accomplished by parents of all subjects. Results:Children with TTD had not only shorter duration of tic symtoms but also milder tic severity and impairment than those with CTD and TD. They also had significantly lower scores on most CBCL subscales than children with CTD and TD, while they were similar with controls in all the CBCL subcale scores except aggressive behavior. Children with CTD and those with TD were similar to each other in clinical variables except number of tic symptom and scores on CBCL social problem subscale. The interference and intensity of motor tic symptoms and duration of tic symptoms were significant predictors of global impairment score on YGTSS, while the presence of comorbid ADHD was a preictor of the total behavior problem score of CBCL. Conclusion:These findings indicate that duration of tic symptoms and the presence of comorbid ADHD as well as the severity of tic symptoms strongly associated with the illness severity of children with tic disorder. These results also suggest that those clinical factors may be more important for assessing the severity of illness and determining the treatment strategy than the sub-diagnosis itself in children with tic disorder.

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SURVEY OF SELF-CONCEPT AND DEPRESSION-ANXIETY OF THE ELEMENTARY SCHOOL BOYS WITH LEARNING DISABILITIES (학습장애를 가진 초등학교 남학생의 자아상 개념과 우울-불안 특성 조사)

  • Kim, Bong-Soo;Seong, Deock-Kyu;Jung, Yeong;Yoo, Hee-Jung;Cho, Soo-Churl;Shin, Sung-Woong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.1
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    • pp.125-137
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    • 2001
  • We investigated the self-concept, subjective depression, and state-trait anxiety of the school boys with learning disabilities(abbr. LD, n=86) and compared them with normal boys(n=52) using Piers-Harris Self-Concept Inventory, Child Depression Inventory(abbr. CDI), and State-Trait Anxiety Inventory(abbr. STAI). With regard to Piers-Harris Self-Concept Inventory total scores, there was no significant difference between two groups, but normal boys showed higher scores in intellectual and school status, physical appearance, and happiness-satisfaction subscales than patients with LD. The male patients with LD showed significantly higher ratings in CDI total scores, and CDI subscales - ineffectiveness, anhedonia, negative self-esteem than normal children. The patients with LD reported significantly higher state anxiety, but not trait anxiety. Correlation analyses revealed that self-concept decreased over time, and depression-anxiety increased across grades in the patients with LD, but not in normal children. Especially, negative mood, anhedonia, negative self-esteem subscales of CDI, and state-trait anxiety showed significant positive correlation with grades. In both groups, CDI scores were inversely correlated with Piers-Harris Self-Concept and positively with State-Trait anxiety. In conclusion, self-concept problems which were related with school achievement and self-esteem were more abundant in the patients with LD than normal children, self-image problem, depression and anxiety increased across grades. According to regression analysis, age, behavior subscale, intellectual-school status, anxiety, popularity, happiness-satisfaction, CDI-ineffectiveness, interpersonal problem, negative self-esteem, and state anxiety could explain the self-concept in the patients with LD, not in normal children. So, the self-concept of the patients with LD were found to be related to the school achievement and stress when comparing with peers. In conclusion, elementary school boys with LD showed lower self-concept, higher depression and anxiety, and these differences increased across grades. Since the patients with LD have concomitant depression and anxiety disorders, it is important that comorbidity with emotional problems should be explored and managed properly.

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COMPUTER GAME PLAYING PATTERNS, PARENTAL REARING PATTERNS AND INDIVIDUAL PSYCHOPATHOLOGY IN ADOLESCENTS (청소년의 컴퓨터게임 이용실태, 부모양육방식, 개인의 정신병리)

  • Ryu, Jeoung-Whan;Kim, Young-Mi;Jeong, Hong-Kyung;Jo, A-Ra;Lee, Jung-Ho;Choi, Young-Min;Lee, Gi-Chul;Jeon, Seong-Ill
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.27-41
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    • 2000
  • Objects:This study was designed for studying of current Korean adolescents computer game playing habits and exploring associations with parental rearing patterns and individual psychopathology. Methods:One hundred twenty four adolescents(age 13-15) who reside in urban area completed self-report questionnaires containing Questionnaires designed by authors, Symptom Checklist-90-Revision of Korean Version(SCL-90-R) and Parental Bonding Instrument(PBI). Results:1) Computer game playing appears to be one of the social and leisure phenomena in these days. Although Adolescents spend a lot of times on computer game, Many of them perceive not problematic. 2) Compared with females, Male play computer games more regularly, more longer, spent more times in gamebang. 3) There was positive relationship between anxiety subscale in SCL-90-R and detrimental effects of computer game. 4) There was positive relationship between game frequency and maternal overprotection. 5) The main reasons for playing are 'for an avoidance of stressful life events', academic burden was the most troublesome issues in korean adolescents. 6) Many adolescents use gamebang as a social place, but they thought that gamebang is not good places to have a good time. Conclusion:This papers shows that computer game playing is a popular social leisure activity in Korean adolescents. And, Most of korean adolescents reported that they are suffered from pressure of academic achievements. They use computer game mainly by means of relieving academic pressures. In a heavy game users who have many conflicts with parents, teacher and who has frequent truancy and social withdrawal show significant anxiety. Maternal overprotection was observed in heavy game users. Authors recommended that clinicians should be careful in examining heavy computer game behaviors. Both underlying affective states and environmental influences, including family situations should be vicariously examined.

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DEVELOPMENT OF KOREAN FORM OF CHILDREN'S YALE-BROWN OBSESSIVE-COMPULSIVE SCALE(CY-BOCS):A RELIABILITY AND VALIDITY STUDY (한국판 아동용 예일-브라운 강박 척도 ; 신뢰도와 타당도 연구)

  • Lee, Jeoung-Seop;Kang, Yun-Hyong;Cho, Seong-Jin;Suh, Dong-Hyuck;Hong, Kang-E;Chung, Sung-Ju
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.60-69
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    • 2000
  • Objective:This study was carried out to evaluate the reliability and validity of the Korean form of the Children's Yale-Brown Obsessive Compulsive Scale(CY-BOCS). Method:Forty-two children with obsessive-compulsive disorder(OCD)(31 boys and 11 girls, aged 7 to 18 years) were assessed with CY-BOCS. Interrater agreement was assessed by two raters in subsample(n=20). discriminant and convergent validity were assessed by comparing CY-BOCS scores to Clinical Global Impression-OCD(CGI-OCD), Leyton Obsessional Inventory-Child Version (LOI-CV), State-Trait Anxiety Inventory for Children(STAI-C), and Child Depression Inventory(CDI). Results:Internal consistency was high, measuring 0.86 for the 10 items and total score. The intraclass correlations for the CY-BOCS total, obsession, and compulsion scores were 0.94, 0.94, 0.84, suggesting excellent interrater agreement for subscale and total scores. The CY-BOCS total score showed highest correlation with CGI-OCD(r=0.88), and significant correlation with LOI-CV(r=0.51), Trait Anxiety score(r=0.43), and CDI scores(r=0.49), but it was not correlated with State-Anxiety score(r=0.25). Conclusion:The results of this study indicate that the Korean form of CY-BOCS is a reliable and valid scale for rating obsessive-compulsive symptom severity.

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Health-related Quality of Life Measurement with St. George's Respiratory Questionnaire in Post-tuberculous Destroyed Lung (결핵후 폐손상에서 한국어판 St. George's Respiratory Questionnaire를 이용한 건강 관련 삶의 질 평가)

  • Lee, Byoung Hoon;Kim, Young Sam;Lee, Ki Deok;Lee, Jae Hyung;Kim, Sang-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.3
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    • pp.183-190
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    • 2008
  • Background: The control of active pulmonary tuberculosis is still an issue in community medicine. But there are also considerable needs for supportive management of symptomatic patients with post-tuberculous destroyed lung. Few studies have evaluated clinical characteristics and health-related quality of life in patients with post-tuberculous destroyed lung. Methods: We evaluated lung function, exercise tolerance, HRCT and health-related quality of life measurements using the Korean version of St. George's Respiratory Questionnaire (SGRQ) in 22 patients with parenchymal damage to more than a half of one lung due to pulmonary tuberculosis. Results: In the pulmonary function test, mixed defects and obstructive defects were observed in 10 (45.0%) and 9 (40.9%) of patients, respectively. In the cardiopulmonary exercise test, the mean $VO_2max%$ predicted ($39.0%{\pm}10.9%$) and $O_2$ pulse% predicted ($61.3%{\pm}13.6%$) were markedly decreased. In the SGRQ, the impact score (mean $27.8{\pm}18.5$) was significantly lower than the symptom score (mean $53.9{\pm}20.9$) or activity score (mean $50.8{\pm}27.3$) (p<0.05, p<0.01). Cronbach's alpha coefficient value for reliability was more than 0.7 for each subscale and total score. The total score showed a significant negative correlation with $FEV_1%$ predicted (r=-0.46, p<0.05) and $SaO_2$ (r=-0.60, p<0.05). On HRCT, a median of 9 (range 5~15) bronchopulmonary segments were destroyed by less than half, which significantly correlated with SGRQ total score (r=-0.52, p=0.02). Conclusion: The reliability and validity of the Korean version of the SGRQ was acceptable for the measurement of health-related quality of life in patients with post-tuberculous destroyed lung.

The Effects of Monoamine Oxidase A CA Repeat Polymorphism on Behavioral Trait and Clinical Characteristics in Korean Male Alcoholics (단가아민 산화제 A CA 반복 유전자 다형성이 한국 알코올의존 남자환자의 행동특성과 임상양상에 미치는 영향)

  • Lee, Jung-Sik;Yang, Byung-Hwan;Lee, Kyung-Mee;Kim, Hong-Kwan;Kim, Yong-In;Chai, Young-Gyu
    • Korean Journal of Biological Psychiatry
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    • v.7 no.1
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    • pp.64-73
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    • 2000
  • There are several candidate genes in genetic study of alcoholism. Among them, allelic associations have been reported between MAOA CA repeat polymorphism and alcohol dependence, recently. And also, several studies have been investigated genotype-phenotype relationships between MAOA CA repeat polymorphism and clinical manifestations. The authors tried to identify differences in allelic frequency of MAOA CA repeat polymorphism between alcohol dependence and controls, and in behavioral trait and clinical characteristics according to MAOA CA repeat polymorphism. We also tried to investigate genotype-phenotype relationships between MAOA CA repeat polymorphism and behavioral trait such as aggression. We examined 49 male patients with alcohol dependence(DSM-IV) who had been admitted in Yong-In Mental Hospital from June 1st 1998 to October 31th 1998. We performed semistructured interview for demographic and clinical characteristics. Self-report questionnaire for BDHI(Buss-Durkey Hostility Inventory) was given to all subject at least 4weeks later after admission. Using polymerase chain reaction and polyacrylamide gel electrophoresis, MAOA CA repeat polymorphism were observed in 52 male controls and 49 male patients with alcohol dependence. We devided alcoholic patients into two groups according to allelic length of MAOA CA repeat polymorphism ; alcoholics with short alleles(${\leq}$119bp, N=20) and alcoholics with long alleles(${\geq}$123bp, N=29). T-test, ${\chi}^2$-test and Fisher exact probability test were used for statistical analysis. There were no significant differences in frequency of each allele and short and long alleles of MAOA CA repeat polymorphism between alcoholics and controls. But there were significant differences in clinical symptoms and behavioral trait between alcoholics with short and long alleles. In clinical symptoms, alcoholics with long alleles used alcohol more frequently during one month before admission, had much more maximum amount of beer drinking and reported withdrawal seizure more frequently than with short alleles. In contrary, alcoholics with short alleles expressed depressed mood and guilty feeling more frequently and wanted complete abstinence as a treatment goal more frequently than with long alleles. In behavioral trait, alcoholics with long alleles had higher total aggression score and showed much more self-assertive attitude(subscale of expression of aggression) than with short alleles. Allelic length of MAOA CA repeat polymorphism was correlated with self-assertive attitude and accounted for 9% of the variance of self-assertive attitude. And also, predictable variables of allelic length of MAOA CA repeat polymorphism were drinking frequency and self-assertive attitude. Our findings suggest that MAOA CA repeat polymorphism may provide some behavior modifying role especially in self-assertive attitude and indirect symptom modifying role in Korean male alcoholics.

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The Validity and Reliability of 'Computerized Neurocognitive Function Test' in the Elementary School Child (학령기 정상아동에서 '전산화 신경인지기능검사'의 타당도 및 신뢰도 분석)

  • Lee, Jong-Bum;Kim, Jin-Sung;Seo, Wan-Seok;Shin, Hyoun-Jin;Bai, Dai-Seg;Lee, Hye-Lin
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.2
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    • pp.97-117
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    • 2003
  • Objective: This study is to examine the validity and reliability of Computerized Neurocognitive Function Test among normal children in elementary school. Methods: K-ABC, K-PIC, and Computerized Neurocognitive Function Test were performed to the 120 body of normal children(10 of each male and female) from June, 2002 to January, 2003. Those children had over the average of intelligence and passed the rule out criteria. To verify test-retest reliability for those 30 children who were randomly selected, Computerized Neurocognitive Function Test was carried out again 4 weeks later. Results: As a results of correlation analysis for validity test, four of continues performance tests matched with those on adults. In the memory tests, results presented the same as previous research with a difference between forward test and backward test in short-term memory. In higher cognitive function tests, tests were consist of those with different purpose respectively. After performing factor analysis on 43 variables out of 12 tests, 10 factors were raised and the total percent of variance was 75.5%. The reasons were such as: 'sustained attention, information processing speed, vigilance, verbal learning, allocation of attention and concept formation, flexibility, concept formation, visual learning, short-term memory, and selective attention' in order. In correlation with K-ABC to prepare explanatory criteria, selectively significant correlation(p<.0.5-001) was found in subscale of K-ABC. In the test-retest reliability test, the results reflecting practice effect were found and prominent especially in higher cognitive function tests. However, split-half reliability(r=0.548-0.7726, p<.05) and internal consistency(0.628-0.878, p<.05) of each examined group were significantly high. Conclusion: The performance of Computerized Neurocognitive Function Test in normal children represented differ developmental character than that in adult. And basal information for preparing the explanatory criteria could be acquired by searching for the relation with standardized intelligence test which contains neuropsycological background.

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Cognitive and Psychological Characteristics of Psychiatric Patients with Military Service Eligibility Issues (군 복무 적합성 판정을 위해 내원한 환자들의 인지적 및 심리적 특성)

  • Nam, Jisoo;Choi, Junho;Kim, Eunkyeong
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.119-129
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    • 2019
  • Objectives : The purpose of this study was to examine cognitive and psychological characteristics of patients who visited psychiatric outpatient clinic with military service suitability issues. Methods : Since January, 2017 to September, 2018, patients were recruited from the department of psychiatry of university hospital. Participants were diagnosed using DSM-5 criteria by board certified psychiatrists. And each of participants tested with K-WAIS-IV, K-SCL-95 by clinical psychologist. The data were analyzed using SPSS 18.0. Results : The results indicated 24.6% of the patients have significantly low level of intellectual functioning. and 10.8% of the patients have borderline level of intellectual functioning, and 26.3% of them were below average. The results of psychological characteristics showed patients have cautious and potentially dangerous level of depression, anxiety, agoraphobia, and suicidal idea. And PTSD subscale's mean score was above problematic level. Next, we divided patients into two groups based on question of whether the patient is eligible to serve in the military service or not arises from recruitment process or army training center. But two group didn't differ significantly. And for further analyses, we also divided patients into two groups based on if they got single psychiatric diagnosis or more than one psychiatric diagnosis. Conclusions : The results indicated that group which has coexisting psychiatric disorders were more depressed, had higher level of anger and aggression, and had more serious levels of suicidal ideas than single psychiatric diagnosis group. The implications and limitations were discussed along with some suggestions for the future studies.

The Effects of Cooperative Learning to Study the Unit 'Metabolism' in High School: Application of STAD Model (고등학교 생물 '물질대사' 단원에서 협동학습의 효과: STAD 모형의 적용)

  • Chung, Young-Lan;Lee, Hye-Won
    • Journal of The Korean Association For Science Education
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    • v.23 no.1
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    • pp.35-46
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    • 2003
  • Problem solving ability, having been thought as one of the most important goals of science education is also a primary task for the current education. Indeed, the students' problem solving ability has shown almost no actual progress, despite our long accumulated science education. Under this circumstances, cooperative learning, a way to grow students' positive inter-dependence and problem solving ability in the basis of their active participation and discussion, was proposed as an effective teaching method. But, results have not consistently shown the advantage of cooperative learning over traditional learning for promoting academic achievement in science. Studies have consistently shown greater effectiveness on affective aspects. But, relatively few have focused on biology in Korea. The purpose of this study was to examine the effects of cooperative learning on the achievement and attitude of high school biology students. The pretest-posttest control group design was applied. The sample consisted of 50 11th-grade female students in experimental group(cooperative learning Student Team Achievement Division model) and 50 students in control group(traditional learning). Students in both groups recieved identical content instruction on the unit 'II. Methabolism'. These groups were treated for 13 hours during 5 weeks. Achievement data were collected using a 24-item multiple-choice test(content validity= .85). Science attitude was measured by an instrument which adapted by Kim In Hee(1994). The instrument(Cronbach $\alpha$=.89) included 40 items in four subscales: attitude toward science, social meaning of science, attitude toward science class, and scientific attitude. An analysis of covariance (ANCOVA) was used as the data analysis procedure. For the achievement data, no significant difference exists between the cooperative and traditional groups (p> .05). But, cooperative learning was effective in low-ability students(p < .05). For the science learning attitude data, cooperative learning was more effective than the traditional one(p< .05). Students in the cooperative group acheived better than those in traditional one especially in the subscale of attitude toward science class. There was no meaningful difference of the two methods in both high and average ability students, while cooperative learning was more effective than the traditional one in low ability students(p<.05).