• Title/Summary/Keyword: comorbidity

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A Influencing Factors in Korea Adults Stroke (한국인의 뇌졸중에 영향을 미치는 요인)

  • Shin, Seung-Ok;Roh, Eun-Kyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.12
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    • pp.6227-6236
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    • 2013
  • This study examined the health behavior and comorbidity based on a community health survey of stroke patients in 2010. The subjects were 4,449 adults over the age of 19 years, who were diagnosed by doctors and completed a community health questionnaire. The subjects demographic characteristics, health behavior and comorbidity were analyzed. Significant differences in age, education, smoking and alcohol consumption were observed. The influencing factors for comorbidity according to gender included myocardial infarction, diabetes and depression. According to the characteristics of comorbidity of the life cycle, hypertension, myocardial infarction and depression. The influencing factors related to the 19-44 year age group included Ex-smokers, 45-64 year old ex-smokers, diabetes, hyperlipidemia, atopic dermatitis, and the 75 year and over group with diabetes, hyperlipidemia, tuberculosis, and atopic dermatitis. This study suggests that health education and a health policy approach based on the relevance between stroke and comorbidity, and the health behavior according to the life cycle and gender are needed.

Development of Mortality Model of Severity-Adjustment Method of AMI Patients (급성심근경색증 환자 중증도 보정 사망 모형 개발)

  • Lim, Ji-Hye;Nam, Mun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.6
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    • pp.2672-2679
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    • 2012
  • The study was done to provide basic data of medical quality evaluation after developing the comorbidity disease mortality measurement modeled on the severity-adjustment method of AMI. This study analyzed 699,701 cases of Hospital Discharge Injury Data of 2005 and 2008, provided by the Korea Centers for Disease Control and Prevention. We used logistic regression to compare the risk-adjustment model of the Charlson Comorbidity Index with the predictability and compatibility of our severity score model that is newly developed for calibration. The models severity method included age, sex, hospitalization path, PCI presence, CABG, and 12 variables of the comorbidity disease. Predictability of the newly developed severity models, which has statistical C level of 0.796(95%CI=0.771-0.821) is higher than Charlson Comorbidity Index. This proves that there are differences of mortality, prevalence rate by method of mortality model calibration. In the future, this study outcome should be utilized more to achieve an improvement of medical quality evaluation, and also models will be developed that are considered for clinical significance and statistical compatibility.

Difference in Psychiatric Comorbidity of Panic Disorder According to Age of Onset (공황장애의 발병연령에 따른 정신과적 공존질환의 차이)

  • Kim, Eun-Jee;Lim, Se-Won;Oh, Kang-Seob
    • Korean Journal of Biological Psychiatry
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    • v.16 no.1
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    • pp.37-45
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    • 2009
  • Objectives : It is reported that panic disorder is frequently comorbid with other psychiatric illnesses. The aim of this study was to investigate differences of psychiatric comorbidity according to age of onset of panic disorder. Methods : Three hundred-two patients participated in the study. All the patients were evaluated by clinical instruments for the assessment the presence of other comorbid psychiatric disorders and various clinical features; Korean version of Mini International Neuropsychiatric Interview, Self-report questionnaires(Beck Anxiety Inventory, Beck Depression Inventory, Anxiety Sensitivity Index and State-Trait Anxiety Inventory) and clinical rating scale (Hamilton Anxiety Scale, Hamilton Depression Scale and Global Assessment of Functional score). Chi-square test was used to determine the difference between early onset and late onset panic disorder. Results : Forty percent of panic patients were found to have at least one comorbid psychiatric diagnosis. There were no differences among the groups divided by number of comorbidity in sex, agoraphobia comorbidity, duration of panic disorder, except onset age of panic disorder. Early onset group had more comorbidy with social phobia, agoraphobia, PTSD. We also found that Early onset panic disorder patients were more likely to experience derealization, nausea, parethesia than late onset panic disorder patients. Conclusion : The results of our study are in keeping with previous data from other parts of the world. Our finding suggest that earier onset of panic disorder related to more psychiatric comorbidity.

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Compared Effectiveness of 10-Session Social Skill Training for Korean Early Elementary School Children in Two Groups Diagnosed as Pure ADHD and ADHD with Comorbidity (초등학교 저학년 대상 ADHD 단독군, 동반 질환을 가진 ADHD군에서의 10회기 사회기술 훈련의 효과 비교)

  • Lee, So Hee;Chung, Un Sun;Hwang, Sun Yung;Jeong, Jae Hoon;Kim, Eun Ji;Woo, Jeong Min;Jo, Hyun Young
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.26 no.4
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    • pp.258-265
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    • 2015
  • Objectives : Children with attention-deficit hyperactivity disorder (ADHD) have problems in social interactions. We compared the effect of 10-session social skill training (SST) among two groups, children with pure ADHD, and those with ADHD with comorbidity. Methods : Consecutive 10-session SST was conducted for 34 children from 2006 to 2012. There were 22 children with pure ADHD (male 20, female 2), and 12 children suffering from ADHD with comorbidity (male 11, female 1). All children took medication as prescribed by their doctors before the start of SST. The Child Behavior Checklist (CBCL), the Korean Personality Inventory for Children (K-PIC), the Conner's Rating Scale, the ADHD Rating Scale, and the Home Situation Questionnaire were completed by mothers before and after the SST. All children completed the Child Depression Inventory, the Stat-Trait Anxiety Inventory for Children, the Self-Concept Scale and the ADHD Diagnostic System before and after the SST. Results : Only children with pure ADHD showed improvement in anxiety and self-concept in scales rated by children. In the CBCL rated by parents, the pure ADHD group and the ADHD with comorbidity showed improvement in both externalizing and internalizing subscales. In the K-PIC rated by parents, the pure ADHD group showed improvement in most outcomes and ADHD with comorbidity showed positive change in verbal development. Conclusion : These results suggest that SST has significant positive effects on both the pure ADHD and ADHD with comorbidity group. Further research is needed in order to target diverse comorbidity groups with ADHD to improve the effectiveness of the SST.

Mortality of Stroke Patients Based on Charlson Comorbidity Index (뇌졸중 환자의 Charlson Comorbidity Index에 따른 사망률 분석)

  • Kim, Ka-Hee;Lim, Ji-Hye
    • The Journal of the Korea Contents Association
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    • v.16 no.3
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    • pp.22-32
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    • 2016
  • As the number of aged population rapidly goes up, the cases of stroke and the related medical expenses continuously increase. The purpose of this study is to investigate the mortality of stroke patients based on CCI(Charlson Comorbidity Index) by utilizing the Korea National Hospital Discharge Injury Survey, analyzing the factors associated with the mortality of stroke patients. We analyzed 21,494 cases which are classified as the death of strokes aged over 20 years by using the Korea National Hospital Discharge Injury Survey between the year 2005 and 2010. In order to find out the mortality based on CCI and status of comorbidity, we used the technical statistics. We performed a logistic regression analysis to examine the reasons for the mortality of the strokes. We found that the independent variables for the influence of the mortality of strokes include age, type of insurance, residence urban size, size of hospital beds, the location of hospital, admission route, physical therapy, brain surgery, type of stroke, and CCI. This indicates that the effective monitoring on the age, types of stroke, comorbidity is needed. In addition to this, more medical support toward medicaid patients are needed, too. We believe that these results will be used positively for the evaluation of the stroke patients, providing the basic materials for the further research on the establishment of the health-related policy.

Efficacy and Tolerability of Osmotic Release Oral System-Methylphenidate in Children with Attention-Deficit Hyperactivity Disorder According to Comorbid Psychiatric Disorders (주의력결핍 과잉행동장애 아동에서 공존질환에 따른 OROS-Methylphenidate의 효과와 안전성)

  • Yoon, Hyung-Jun;Yook, Ki-Hwan;Jon, Duk-In;Seok, Jeong-Ho;Hong, Na-Rei;Cho, Sung-Shick;Hong, Hyun-Ju
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.19 no.3
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    • pp.147-155
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    • 2008
  • Objectives: The purpose of this study was to evaluate the efficacy and tolerability of osmotic release oral system-methylphenidate (OROS-MPH) in children with attention-deficit hyperactivity disorder (ADHD) and comorbid psychiatric disorders. Methods: This was an 8-week open label study of OROS-MPH monotherapy. The subjects were 113 children with ADHD aged 6-12 years. Outcome measures were the Korean version of the parent ADHD Rating Scale (K-ARS), Korean version of the Conners Parent Rating Scale (K-CPRS), Clinical Global Impression-Severity and Clinical Global Impression-Improvement. Side effects were monitored using Barkley's Side Effect Rating Scale. We compared the change-over-time in the mean scores of the outcome measure according to the comorbidity of disruptive behavior disorder, depressive disorder, anxiety disorder, and tic disorder. Results: The mean K-ARS and K-CPRS scores were significantly decreased, regardless of the comorbidity. The mean doses of OROS-MPH and dropout rate did not differ significantly according to comorbidity. The OROS-MPH was well tolerated, regardless of the comorbidity. However, children with tic disorder reported a higher frequency of tics or nervous movements between the $2^{nd}\;and\;8^{th}$ week than those without tic disorder. Conclusion: The OROS-MPH is effective for decreasing the symptoms of ADHD, and it is well tolerated, even by patients with comorbid psychiatric disorders.

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A Review on the Pain and Depression Comorbidity Animal Models (통증과 우울증의 병합 동물모델에 대한 최신 연구 동향 분석)

  • Song, Ji-Hye;Kook, Hye-Jung;Park, Byung-Jin;Kim, Song-Yi;Park, Ji-Yeun
    • Korean Journal of Acupuncture
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    • v.38 no.2
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    • pp.75-99
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    • 2021
  • Objectives : The purpose of this study is to analyze animal behavioral changes and related neurobiological mechanisms in recent studies using animal models with pain and depression. Methods : We conducted database search in Pubmed, NDSL, and EMBASE up to January 2021. Included studies were classified as depression-like behavior observed in pain model, pain-like behavior observed in depression model, and pain and depression comorbidity model. The results of pain- and depression-like behaviors, the changes of neurobiological mechanisms, and the treatment methods such as drugs, natural substance-derived chemicals, or acupuncture were analyzed. Results : We included 124 studies (81 studies in depression-like behavior observed in pain model, 19 studies in pain-like behavior observed in depression model, and 24 studies in pain and depression comorbidity model). Pain and depression comorbidity animal models were induced using various methods by drugs or surgery. Von frey test, a method for evaluating mechanical allodynia was the most commonly used for measuring pain-like behavior and the forced swimming test was the most commonly used for measuring depression-likes behavior. The changes of neurobiological factors, such as decrease of 5-hydroxytryptamine and increase of oxidative stress and pro-inflammation cytokines were generally changed in the frontal cortex, hippocampus, thalamus, and spinal cord in all types of models. For treating pain and depression-like behaviors, various types of drugs such as antidepressant, tranquilizer, analgesic, and natural substance-derived chemicals were used. Acupuncture treatment was used in 4 studies. Conclusions : In the future, more diverse studies on the combined model of pain and depression need to be conducted. In addition, it is necessary to establish a mechanistic basis for the development of various treatments by identifying the common mechanisms of pain and depression.

Severity of Comorbidities among Suicidal Attempters Classified by the Forms of Psychiatric Follow-up (자살시도자의 정신건강의학과 치료 연계 형태에 따른 동반질병 심각도의 차이)

  • Lee, Hyeok;Oh, Seung-Taek;Kim, Min-Kyeong;Lee, Seon-Koo;Seok, Jeong-Ho;Choi, Won-Jung;Lee, Byung Ook
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.74-82
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    • 2016
  • Objectives : Suicide attempters have impaired decision making and are at high risk of reattempt. Therefore it is important to refer them to psychiatric treatment. Especially, People with medical comorbidity are at higher risk of suicidal attempt and mortality. The aim of this study was to investigate the characteristics of suicidal attempters and to analyze the influence of the medical comorbidity on decision to receive psychiatric treatment after visit to an emergency department. Methods : One hundred and thirty two patients, who visited the emergency room of a general hospital in Gyeonggi-do between January, 2012 and December, 2012 were enrolled as the subjects of this study. After reviewing each subject's medical records retrospectively, demographic and clinical factors were analyzed. Results : Regardless of the engagement type, either via admission or outpatient clinic, the determinant factors of psychiatric treatment engagement were psychiatric diagnosis, employment status, previous psychiatric treatment history, and previous attempt history. Comparison of severity of medical comorbidity(Charlson Comorbidity Index) showed that suicide attempters who received psychiatric treatment via admission or refused the treatment tended to have higher level of medical comorbidity than who received psychiatric treatment via outpatient department. Conclusions : Our findings showed that medical comorbidity of suicide attempters affected the decision to accept psychiatric treatment. All psychiatrists should evaluate the presence and the severity of medical comorbidity of the suicide attempters and consider implementing more intervention for the medically ill attempters who are willing to discharge against advice.

Diagnosis and Comorbidity of Chronic Ankle Instability (만성 족관절 불안정성의 진단 및 동반 질환)

  • Ha, Dongjun;Kim, Duckhee;Gwak, Heuichul
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.2
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    • pp.49-54
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    • 2018
  • Ankle sprains are among the most common injuries sustained during athletic activities and daily life. Acute ankle sprain is usually managed conservatively with functional rehabilitation but the failure of conservative treatment leads to the development of chronic ankle instability. The development of repetitive ankle sprains and persistent symptoms after injury has been termed chronic ankle instability. Acute ankle sprains and chronic ankle instability require a careful evaluation to detect other comorbidities, such as subtalar instability, osteochondral defect, peroneal tendinopathy, tarsal coalition, os trigonum, flexor hallucis longus tendinitis, calcaneus anterior process fracture, and neural injuries. For the successful treatment of acute ankle sprains and chronic ankle instability, the treatment of comorbidity lesions should be performed first.