Objectives : Depression disturbs the individual life from the loss of productivity to suicide. Furthermore the whole society is also influenced by depression in social and economic areas. Many scientific treatment methods are known to be effective in depression. But in reality more than half of patients with depression prefer self help treatment rather than medically based treatment. For the patients with mild depression and primary physicians, it is reasonable to provide the evidence based self care including self help or alternative treatment. This study is supported by the Korean Health 21 R&D Project for the Depression Center to establish the Korean treatment guideline for depression. Methods : The members of Depression Center including the authors attended the workshops where the methods of evidence based medicine such as literature search, quality evaluation of the articles, making the level of evidence were educated. The professional librarians helped the authors for get the searched articles. Among the total of 354 abstracts of systemic review and 300 abstracts of random controlled trials, 3 systemic reviews and 2 random controlled trials were the main structure of evaluation. Result : Among the 37 self care methods known to be effective for depression, 11 kinds of methods were worth of evaluation. The first step for the self care of mild depression is to use St. John's wort, exercise, bibliotherapy, and light therapy in depression during winter season. Acupuncture, negative ion therapy, massage, relaxation technique are known to be efective with evidence. Music therapy, hypnotherapy, and aromatherapy are known to be effective but until now the evidences is insufficient and further evaluations are needed. Conclusion : Among 11 listed self-care methods, several methods need more evidence especially in Korean situation. Exercise is the most recommendable evidence based self care method in Korea nowadays. St. John's wort is effective with evidence, but it is not the OTC drug in Korea, so it is not recommendable now. For the bibliotherapy, there is no book such as "Feeling Good" in Korea. Only the introductory book about depression is available. Publishing the self help book based upon cognitive behavioral approach or psychodynamic approach is needed. Light therapy is practiced in a few clinics, but not self-help style. Exposure to the sunlight is recommended in the level of commen sense. These self care methods are for the mild patient. Moderate to severe patients with depression should seek the professional treatment.
An, Yong Ho;Park, Hyun Jung;Shim, Hyun Soo;Choe, Yun Seok;Han, Jeong Jun;Kim, Jin Su;Lee, Hye Jung;Shim, Insop
Journal of Physiology & Pathology in Korean Medicine
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v.28
no.3
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pp.337-345
/
2014
The present study examined the effects of soybean-derived phosphatidylserine (SB-PS) on the learning and memory function and the neural activity in rats with trimethyltin (TMT)-induced memory deficits. The cognitive improving efficacy of SB-PS on the amnesic rats, which was induced by TMT, was investigated by assessing the Morris water maze test and by performing cholineacetyl transferase (ChAT), acetylcholinesterase (AChE) and cAMP responsive element binding protein (CREB) immunohistochemistry. A positron emission tomography (PET) scanning the rat brain was by performed administer 18F-Fluorodeoxy-glucose (18F-FDG). The rats with TMT injection showed impaired learning and memory of the tasks and treatment with SB-PS produced a significant improvement of the escape latency to find the platform in the Morris water maze at the 2nd day compared to that of the MCT group. In the retention test, the SB-PS group showed increased time spent around the platform compared to that of the MCT group. Consistent with the behavioral data, SB-PS 50 group significantly alleviated the loss of acetyl cholinergic neurons in the hippocampus compared to that of the MCT group. Treatment with SB-PS significantly increased the CREB positive neurons in the hippocampus as compared to that of the MCT group. In addition, SB-PS groups increased the glucose uptake in the hippocampus and SB-PS 50 group increased the glucose uptake in the frontal lobe, as compared to that of the MCT group. These results suggest that SB-PS may be useful for improving the cognitive function via regulation of cholinergic marker enzyme activity and neural activity.
Choi, Yeonsun;Lee, Mi hyun;Choi, Jae-Won;Kim, Soohyun;Kim, Jichul;Lee, Yu Jin
Sleep Medicine and Psychophysiology
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v.23
no.2
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pp.77-83
/
2016
Objectives: The present study investigated current practices of insomnia treatment among Korean doctors in clinical settings. Methods: A total of 100 doctors participated in the present study and filled out a series of survey questions regarding their treatment of insomnia patients. Results: The results revealed that the primary type of insomnia treatment was pharmacological and that the most popular medication was zolpidem. The majority of doctors reported that they also utilized non-pharmacological treatments such as sleep hygiene education and cognitive-behavioral therapy. However, these treatments tended to result in low satisfaction. In addition, the doctors perceived that patients largely preferred pharmacological treatments to non-pharmacological ones and did not have sufficient knowledge of non-pharmacological treatments. Conclusion: Many doctors believed that non-pharmacological treatments for insomnia were important, but reported that they were difficult to implement in practice. The results of this study suggest that improved medical conditions for non-pharmacological treatments and education of physicians are necessary to appropriately treat insomnia.
Journal of The Korean Dental Society of Anesthesiology
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v.8
no.1
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pp.22-28
/
2008
Background: Cerebral palsy (CP) is non-progressive disorder of motion and posture. In CP patient, there are difficulties in dental treatment because of uncontrolled movement of limb and head, and conjoined disabilities such as cognitive impairment, sensory loss, seizures, communication and behavioral disturbances. It is reported that CP patients have high incidence in caries and a higher prevalence of periodontal disease. But, despite the need for oro-dental care, these patients often are unlikely to receive adequate treatment without sedation or general anesthesia because of uncontrolled movements of the trunk or head. Methods: We reviewed the 58 cases of 56 patients with CP who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 19 (2-54) years. The number of male patient was 40 and that of female was 18. They all had severe spastic cerebral palsy and 22 had sever mental retardation, 15 epilepsy, 8 organic brain disorder, 1 blindness, 2 deafness and cleft palate. For anesthesia induction, 14 cases was needed physical restriction who had sever mental retardation and cooperation difficulty, but 44 cases showed good or moderate cooperation. Drugs used for anesthesia induction were thiopental (37 cases), sevoflurane (14 cases), ketamine (3 cases ) and propofol (4 cases). All patients except one were done nasotracheal intubation for airway management and 4 cases were needed difficult airway management and 1 patient already had tracheostomy tube. Mean total anesthetic time was $174{\pm}56$ min and staying time at PACU was $88{\pm}39$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.
Objectives: Sleep disturbance is a very rapidly growing disease with aging. The purpose of this study was to investigate the prevalence of sleep disturbances and its predictive factors in a three-year cohort study of people aged 60 years and over in Korea. Methods: In 2012 and 2014, we obtained data from a survey of the Korean Social Life, Health, and Aging Project. We asked participants if they had been diagnosed with stroke, myocardial infarction, angina pectoris, arthritis, pulmonary tuberculosis, asthma, cataract, glaucoma, hepatitis B, urinary incontinence, prostate hypertrophy, cancer, osteoporosis, hypertension, diabetes, hyperlipidemia, or metabolic syndrome. Cognitive function was assessed using the Mini-Mental State Examination for dementia screening in 2012, and depression was assessed using the Center for Epidemiologic Studies Depression Scale in 2012 and 2014. In 2015, a structured clinical interview for Axis I psychiatric disorders was administered to 235 people, and sleep disturbance was assessed using the Pittsburgh Sleep Quality Index. The perceived stress scale and the State-trait Anger Expression Inventory were also administered. Logistic regression analysis was used to predict sleep disturbance by gender, age, education, depression score, number of coexisting diseases in 2012 and 2014, current anger score, and perceived stress score. Results: Twenty-seven percent of the participants had sleep disturbances. Logistic regression analysis showed that the number of medical diseases three years ago, the depression score one year ago, and the current perceived stress significantly predicted sleep disturbances. Conclusion: Comorbid medical disease three years previous and depressive symptoms evaluated one year previous were predictive of current sleep disturbances. Further studies are needed to determine whether treatment of medical disease and depressive symptoms can improve sleep disturbances.
Aim : The purpose of this study was to investigate the hypothesis that treatment with self-checking behavior management program was valuable in the management of temporomandibular disorders compared with a existing method treatment group. Methods : All participants who are diagnosed with temporomandibular disorders were treated with medication and physical therapy. They came into the clinic at intervals of two weeks, three times. The signs and symptoms were assessed investigating Pain NRS(Numerical Rating Scale), MCO(Maximum comfortable opening), Noise NRS, LOM(Limitation of Mouth opening) NRS at every visit. Experimental group received instructions repeatedly by using self evaluation questionnaire. Control group was educated once at the beginning of treatment. The difference Pain NRS, MCO, Noise NRS, LOM NRS between first and second visits, first and third visits were estimated.. Result :Experimental group showed greater improvement on MCO difference after stopping medication(p=0.001). This improvements were prominent in the male(p=0.001) and the first or second decade of the patients(p=0.004). Conclusion : The present study showed that there was better result when educating repeatedly with using self evaluation questionnaire than educating once at the beginning of the treatment.
Natural products have been used to treat many neurological illnesses such as Alzheimer's disease. In the present study, the effects of the water extract of smoke-dried skipjack tuna (WSST), which is used as a traditional seasoning in Japan, as well as its fractions on acetylcholinesterase (AChE) inhibition in vitro and on memory in scopolamine-induced amnesia mice in vivo were evaluated. Bio-Rad P-2 gel permeation chromatography revealed the presence of 7 peaks and AChE significantly inhibited peak 3 and 5. When in vivo behavioral studies were conducted, a passive avoidance test revealed that treatment with 50 and 100 mg/kg WSST as well as with fraction 3 and 5 improved the loss in memory retention induced by scopolamine. These results suggest that skipjack tuna extract and its fractions improve memory deficits and that these substances are suitable for use in healthy foods designed to improve memory deficits induced by aging and Alzheimer's disease.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.25
no.1
/
pp.6-13
/
2014
Objectives : The aim of this study is to assess the career paths and practice patterns of child and adolescent psychiatrists in South Korea. Methods : A survey on demographic data, work environment, opinion on fellowship training program, and current practice patterns was conducted in 76/223 (34.0%) of all child and adolescent psychiatrists (N=223) were from 1980 to 2008. The survey data from the responders were analyzed. Results : More than half of those surveyed were women. The mean age of survey participants was 40.8 years; most were married, and lived in the Seoul National Capital Area. In general, the responders were very satisfied with their work. They worked in private practice, public sector, group practice, and as consultants. Up to 87% of the patients treated were children and adolescents. The most common treatment modalities were medication and parent psychoeducation. Social skills training and play therapy were applied mainly for children aged 4 to 12 years old. Cognitive behavioral therapy and counseling were preferred in adolescents. Conclusion : The current study used a database approach in order to define current practice patterns. These data may be helpful in consideration of future training programs, workforce issues in child and adolescent psychiatry in South Korea, and also in collaboration with other mental health providers.
Journal of the Korean Academy of Child and Adolescent Psychiatry
/
v.13
no.1
/
pp.47-66
/
2002
Sexual abuse is emerging as one of the major form of child abuse. In the late 1990s, official reports of sexual abuse began to mushroom at a much more rapid rate than reports of other forms of abuse in Korea. In addition, sexual abuse can cause the most serious emotional-cognitive-behavioral sequelae to victims. Although child & adolescent psychiatrists meet many sexual abuse victims who are referred from many types of child protective services, the psychiatrists may not be likely to give them sufficient and appropriate treatment and guideline for victims and their parents. In this article, the historical concepts, pathophysiological processes, shortterm & longterm sequelae of sexual abuse are reviewed and summarized. And I summarize the intervention and outcome studies for sexual abuse victims. In the close future, the active participation of psychiatrists who help the child and adolescents will be expected in the development of nationwide preventive and therapeutic projects for victims and families of sexual abuse.
Kim, Jin-Hyung;Sue, Joo-Hee;Lee, Go-Eun;Kim, Nam-Kwen;Choi, Sung-Youl;Lyu, Yeoung-Su;Kang, Hyung-Won
Journal of Oriental Neuropsychiatry
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v.26
no.1
/
pp.49-61
/
2015
Post traumatic stress disorder (PTSD) is an anxiety disorder that usually occurs after suffering from a psychological trauma that can not threatening events, which is one of the individual's subjective pain and their families and the larger society due to the chronic disease burden results. Treatment with a medication, as well as cognitive behavioral therapy (CBT), exposure therapy, prolonged exposure therapy (PE), eye-movement desensitizing, and reprocessing (EMDR) are preferentially performed, including psychotherapy. Korean medical psychotherapy consists of a wide range of manual therapy, but it does not have systematically screening limits. This study was developed by Korean medical psychotherapy program for PTSD, and it was carried out as a preliminary clinical trial for validity. The Korean medical psychotherapy program for PTSD consists of four stages as follows: building chapter of safety, flow and send, accept, and integration. Based on this preliminary clinical study of PTSD, seven patients were treated for 2 hours per week for 5 weeks. We report the meaningful results gained by observing the changes in IES-RK points, questionnaire on five-faceted mindfulness, quality of life, anxiety, depression, insomnia, hwabyung scale, HRV, and EEG, before and after the Korean medical psychotherapy program.
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