• 대한의사협회지
• /
• 제61권12호
• /
• pp.758-764
• /
• 2018

Dementia is a clinical syndrome characterized by a cluster of symptoms and signs that manifest as difficulties in cognitive functions such as memory, psychological and psychiatric changes, and impairments in activities of daily living. As a result of worldwide trends of population aging, dementia has had a huge impact on public health in almost all countries. Disease modification therapies for dementia have not yet been developed. However, pharmacotherapy is essential in patients with dementia to combat delays in their cognitive and functional decline. In this article, we review the current pharmacotherapy for dementia. Three acetylcholinesterase inhibitors-donepezil, rivastigmine, galantamine-and memantine are the only medications that have been approved for the treatment of dementia. We present the indications, dose recommendations, side effects, and criteria for National Health Insurance coverage in Korea of these medications for dementia treatment. Although the Ministry of Food and Drug Safety in Korea has not approved any medications for managing the behavioral and psychological symptoms of dementia, some antipsychotics and antidepressants have been studied and used clinically for those purposes. Clinicians may consider vitamin E, Ginkgo biloba extract, choline alfoscerate, or omega-3 fatty acids as additional treatment options. Non-steroid anti-inflammatory drugs, estrogen hormone therapy, and statins are not generally recommended for dementia treatment. We believe that our findings will aid clinicians in the treatment of patients with cognitive decline.

• 대한간호학회지
• /
• 제39권2호
• /
• pp.157-165
• /
• 2009

Purpose: The purpose of this study was to analyze the effects of a cognitive-behavioral nursing intervention on anxiety and depression of patients with breast cancer undergoing radiotherapy. Methods: A nonequivalent control group design was used for the study. The research participants were patients with breast cancer (N=71; experimental group=35, comparison group=36) who received radiotherapy at P university hospital. The experimental group received a 6-week cognitivebehavioral nursing intervention (2 hr/week), which included nursing counseling, education about treatment choices for breast cancer and possible side effects and management strategies during radiotherapy, and rehabilitation exercise. Results: Following the intervention, the experimental group showed significantly lower levels of anxiety (Experimental group=$34.60{\pm}6.35$, Comparison group=$44.63{\pm}9.93$, t=3.552, p<.001) and depression (Experimental group=$10.20{\pm}6.61$, Comparison group=$17.81{\pm}10.85$, t=3.542, p<.001) than the comparison group. Conclusion: The findings from this study showed that cognitive-behavioral counseling applied by nurses is very effective to reduce anxiety and depression among patients with breast cancer. Therefore, providing nursing counseling to broader spectrum of patients with cancer should be considered. Further research would warrant future clinical application of nursing counseling.

• Clinical and Experimental Pediatrics
• /
• 제59권10호
• /
• pp.414-420
• /
• 2016

Purpose: We investigated behavioral problems, attention problems, and cognitive function in children and adolescents born small for gestational age (SGA). Methods: Forty-six SGA children born at term and 46 appropriate for gestational age (AGA) children born at term were compared. Psychiatric symptoms were examined with reference to the Korean-Child Behavior Checklist, Korean-Youth Self Report, and Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS). Cognitive function was estimated using the Wechsler Intelligence Scale. Sociodemographic data were recorded from interviews. Results: SGA children had high scores on delinquent behavior, aggressive behavior, and the externalizing scale, and they also showed a propensity for anxiety and depression. The SGA group had a higher mean ADHD-RS score than the AGA group ($10.52{\pm}8.10$ vs.$9.93{\pm}7.23$), but the difference was not significant. The SGA group had a significantly lower verbal intelligence quotient (IQ) than the AGA group, but the mean scores of both groups were within normal limits. Conclusion: This study indicates marked behavioral problems, such as delinquency, aggressiveness, and anxiety and depression, as well as low verbal IQ in the SGA group than in the AGA group. Even in cases in which these symptoms are not severe, early detection and proper treatment can help these children adapt to society.

• Journal of Oral Medicine and Pain
• /
• 제46권3호
• /
• pp.84-87
• /
• 2021

Morsicatio buccarum is a condition caused by chronic cheek biting. It means frictional hyperkeratosis by repetitive cheek biting, which may be associated with obsessive compulsion. Clinically it presents as rough, shaggy, whitish, often peeling surface. We report a 9-year-old female patient who complained oral ulceration on both buccal mucosa. The initial diagnosis was oral candidiasis because of whitish plaques which were peeled off. Topical antifungal agent was ineffective and the symptom did not disappear. By incisional biopsy, she was diagnosed with morsicatio buccarum. A soft oral appliance was placed in the patient's oral cavity. Although morsicatio buccarum improved significantly when the appliance was used, the oral lesion had a tendency to recur, when the patient stopped using the appliance. In case of recurrence, cognitive behavioral therapy for obsessive-compulsive disorder is needed for the fundamental treatment.

• Journal of Korean Biological Nursing Science
• /
• 제7권2호
• /
• pp.49-57
• /
• 2005

There have been many trials of clinical efficacy of multi component and single component treatments for irritable bowel syndrome(IBS). We reviewed effects of non phamacological treatments in the IBS. Though the efficacy of multi-component approaches was unclear, several results suggest that cognitive behavioral therapy was effective in improving gastrointestinal symptoms of IBS. As a single component, cognitive therapy and relaxation with or without biofeedback could improve the symptoms and psychological health of IBS patients. Yoga, meditation, self-help information and hypnotherapy could be applicable to IBS.

• 성인간호학회지
• /
• 제16권4호
• /
• pp.556-565
• /
• 2004

Purpose: According to Lazarus & Folkman (1984), appraising a stressor as a threat is associated with negative psychological and physical adjustment, whereas appraising a stressor as a challenge is positive psychological and physical adjustment. This study examined how cognitive appraisal of PTCA(heart disease threat and treatment appraisal) related to the cardiac risk reduction behaviors(smoking cessation, low salt and low cholesterol diet, regular exercise and stress management) 6 weeks following discharge. Method: Data were collected from 50 subjects with successful primary PTCA. Result: Heart disease threat was negative related to treatment appraisal (r=-0.240, p=0.046). Psychological well-being was negative related to heart disease threat (r=-0.317, p=0.012) and positive related to treatment appraisal(r=0.402, p=0.002). The cardiac risk reduction behaviors score was negative related to heart disease threat(r= -0.296, p=0.018) and positive related to treatment appraisal(r=-0.291, p=0.020). Conclusion: More negative appraisal was related to lower the cardiac risk reduction behaviors score. But more positive appraisal was related to higher the cardiac risk reduction behaviors score. So, there is a need to develop the cognitive-behavioral intevention that increase the coping strategy to replace with positive appraisal.

• 수면정신생리
• /
• 제25권2호
• /
• pp.74-81
• /
• 2018

목 적 : 한국 사회의 고령화와 동반되어 노인 인구의 불면증은 증가되는 추세이나 이로 인해 초래되는 개인 및 사회경제적 손실에 비해 적절한 치료를 받는 환자의 수는 많지 않다. 불면증 인지행동치료가 부작용을 최소화할 수 있는 일차적인 치료로서 추천되고 있으나, 시간 및 경제적 제약, 인지적인 자원이 필요한 부담으로 인해 치료에 대한 접근성이 제한된 실정이다. 불면증 단기 치료 프로그램은 이러한 부담을 최소화할 수 있는 대안이 될 수 있을 것이다. 본 연구의 목적은 지역사회 거주 노인을 대상으로 불면증 단기 치료 프로그램의 효과를 검증하는 것이다. 방 법 : 2016년 5월부터 2018년 1월까지 서울 소재 3개의 노인 종합복지관을 방문한 65세 이상의 불면증을 호소하는 노인들 47명을 대상으로 3주에 걸쳐 불면증 단기 치료 프로그램을 시행하였다. 프로그램의 전, 후의 수면의 질을 측정하는 피츠버그 수면의 질 지수(Pittsburgh sleep quality index, PSQI), 수면 위생 척도, 정서 관련 평가를 실시하였으며 치료 기간 중 매일 수면 일지를 작성하도록 지시하였다. 임상적 효과는 치료 전후의 총 수면 시간, 수면 잠재기, 수면 후 각성 시간 및 수면 효율로 평가하였다. 치료 전, 후의 변화를 비교하기 위해 비모수검정 방법인 윌콕슨 부호 순위 검증(Wilcoxon's signed-ranks test)을 이용하여 분석을 시행하였다. 결 과 : 불면증 단기 치료 프로그램을 시행한 뒤, 치료 전보다 대상자들의 PSQI 총점이 감소하였으며 PSQI 로 측정한 주관적 수면의 질이 유의하게 호전되었다. 치료 전후에 시행한 수면 일지를 비교한 결과에서도 개운함 및 수면 후 각성 시간에 대해서 유의한 수준의 호전을 보였다. 결 론 : 개발된 불면증 단기 치료 프로그램은 지역 사회 노인의 불면증에 대해 긍정적인 치료 효과를 보이는 것으로 나타났다 기존의 불면증 인지행동치료에 비해 시간적, 인지적 자원 부담이 적음을 고려하였을 때 불면증 단기 치료 프로그램은 지역 사회 내에서 노인 불면증 치료에 대한 접근성을 확대하는 데 사용할 수 있을 것이다.

• 대한조현병학회지
• /
• 제19권1호
• /
• pp.10-16
• /
• 2016

Objectives : This article aims to describe the development of smartphone application for the case management of patients with schizophrenia. Methods : Gwangju Bukgu-Community Mental Health Center developed and launched a smartphone application (HYM) for cognitive-behavioral case management and symptom monitoring. The development of the application involved psychiatrists, nurses, social workers, psychologists, and software technicians from a software development company (Goosl Corp.). Results : The HYM application for clients includes six main modules including Thought record, Symptom record, Daily life record, Official notices, Communication, and Scales. The key module is the 'Thought Record' for self-directed cognitive-behavioral treatment (CBT). When the client writes and sends the self-CBT sheet to the case manager, the latter receives a notification and can provide feedback in real time. 'Communication' and 'Official notices' are useful for promoting communication between case managers and clients with schizophrenia. Ratings in 'Symptom record', 'Daily life record', and 'Scales' modules are stored in graphic or table form representing changes in them and shared with case managers. Conclusion : The interactive function of this application is the key characteristics that distinguishes it from other mobile self-treatment tools. This smartphone application may contribute to the development of a youth- and customer-friendly case management system for individuals with early psychosis.

• 생물정신의학
• /
• 제16권1호
• /
• pp.15-24
• /
• 2009

Objectives : The purpose of this study is to examine the efficacy and side effects of quetiapine and haloperidol for the treatment of symptoms of delirium. Methods : One hundred and seven patients with delirium were recruited and randomly assigned to receive a flexible-dose regimen of quetiapine or haloperidol over 7days and seventy-seven patients completed the study(quetiapine group N=40, haloperidol group N=37). The severity of delirium was assessed by using Memorial Delirium Assessment Scale(MDAS) scores, the psychiatric and behavioral symptoms were assessed by Neurobehavioral Rating Scale(NRS) scores, and the cognitive status was measured by Mini-mental state examination Korean version(MMSE-K) scores. The side effects were measured by Drug Induced Extrapyramidal Symptoms Scale(DIEPSS) scores. Results : MDAS scores significantly improved in both treatment groups. NRS scores also significantly improved in both treatment group, but the group-by-time effect approached significance, likely caused by the greater decrease in scores of the quetiapine group. MMSE-K scores significantly improved only in the quetiapine group. Side effects associated with treatment were not significant in either treatment groups. Conclusion : This study suggests that quetiapine is as efficacious as haloperidol in the treatment of delirium. In particular, quetiapine seems to improve psychiatric and behavioral problems of delirium and was more effective than haloperidol in cognitive improvement.

• 대한불안의학회지
• /
• 제4권1호
• /
• pp.28-33
• /
• 2008

Objective : A working group of psychiatrists from the Korean Academy of Anxiety Disorders was established to determine the appropriate medication algorithm for treating patients with panic disorder. In this article, we discussed the consensus among psychiatrists regarding the use of cognitive behavior therapy (CBT) in the development of a treatment algorithm for panic disorder in Korea. Methods : Based on the guidelines or algorithms published by the American Psychiatric Association, National Institute for Clinical Excellence, and Canadian Psychiatric Association, we constructed questionnaires regarding the core components and contents of CBT for patients with panic disorder. Fifty-four experts in panic disorder completed the questionnaires. Results : There was statistically significant consensus among the experts in the belief that cognitive reconstruction and psychological education are the core components of CBT for the treatment of patients with panic disorder. However, there was some inconsistency between the opinions of some experts regarding the content and frequency of CBT and the results of studies published outside of Korea. Conclusions : CBT, especially the psychological education and cognitive reconstruction components, should be considered when treating patients with panic disorder. However, further consideration needs to be put into the design of a more detailed treatment guideline for the use of CBT in the treatment of patients with panic disorder.