• Title/Summary/Keyword: comorbidity

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PREVALENCE OF DISRUPTIVE BEHAVIOR DISORDERS (파탄적 행동장애의 유병율에 대한 연구)

  • Cho, Soo-Churl;Shin, Yun-O
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.5 no.1
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    • pp.141-149
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    • 1994
  • The prevalence rates of disruptive behavior disorders(attention deficit hyperactive disorder, conduct disorder and oppositional defiant disorder, ADHD, CD and ODD respectively) were studied in 780 elementary school children from 4th to 6th grades. The results are summarized as follows : 1) The prevalences rates of ADHD were in boys 10.3%(45/436), 4.1%(14/344) in girls and the overall prevalence rate was 7.6%(59/780). 2) The prevalence rates of CD were 5.0%(22/436) in boys, 2.3%(8/344) in girls and the overall prevalence rate was 3.8%(30/780). 3) The prevalence rates of ODD were 5.7%(25/436) in boys, 2.3%(8/344) in girls and the overall prevalence rate was 4.2%(33/780). 4) These three disorders were significantly more common in boys than in girls. 5) There were no significant differences in the prevalence rates of ADHD, CD and ODD by grades or urban-rural status. 6) The comorbidity of ADHD was also explored, 3.5% (2/59) of ADHD also had CD, 13.6% (8/59) had both CD and ODD. 7) The mild forms of these three disorders were about two times more common than typical forms.

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Medical Characteristics of the Elderly Pedestrian Inpatient in Traffic Accident (노인 보행자 운수사고 입원환자의 의료적 특성연구)

  • Park, Hye-Seon;Kim, Sang-Mi
    • Journal of Digital Convergence
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    • v.17 no.12
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    • pp.345-352
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    • 2019
  • This study aims to analyze the factors affecting the length of stay in elderly pediatric inpatients in traffic accidents. We used Korean National Hospital Discharge In-depth Injury data on the discharged from 2012 to 2016. Statistically significant factors affecting the length of stay are admission route, Charlson Comorbidity Index(CCI), injury parts, operation, results, hospital area, and beds for hospitals. The length of stay was shorter in the case of the admission route of the outpatient department than the emergency room, the results were not improved or death rather than improved, and the bed size was 500-999 beds or over 1000 beds rather than 100-299 beds. However, the length of stay was longer in the case of CCI score was 1-2 or over 3 rather than 0, injury parts were other parts rather than head/neck, when the operation was yes, and when the hospital area was a province, metropolitan rather than Seoul. This study intends to understand the medical characteristics of inpatient to prevent pedestrian traffic accidents in accordance with the population aging. Based on this finding, we wish to be used as the basic data for the establishment of policies to effectively manage traffic safety and medical resources in consideration of the characteristics of the elderly people.

THERAPEUTIC APPROACHES FOR TREATMENT RESISTANT OBSESSIVE-COMPULSIVE DISORDER IN CHILDREN AND ADOLESCENTS (소아청소년기 치료저항성 강박장애의 치료적 접근)

  • Suh, Hyun-Ju;Kim, Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.64-80
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    • 2003
  • Although obsessive-compulsive disorder(OCD) affects children, adolescents, and adults whether its juvenile(dhild and adolescent) and adult forms are different subtype of a disorder remains unknown. But there are increasing findings that suggest that juvenile OCD may be unique subtype of the disorder. One proposed subtype is the childhood OCD associated with high comorbidity of tic disorder and increased familial loading for OCD or tic disorder. The other proposed subtype is the childhood OCD and/or tic disorder occuring in association with streptococcal infection(PANDAS). These two subtypes of OCD are unlikely to respond to SSRI due to possible different pathphysiological mechanism. So this paper reviews the characteristics of OCD and therapeutic approaches for treatment resistant OCD in childhood and adolescence. Considering the likely heterogeneity of OCD, the possibility that juvenild OCD may be a variant of the disorder can have important clinical and scientific implications because it may further our understanding of this disorder, its etiology, and perhaps its treatment.

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Personality Trait in Panic Disorder Patient and Its Clinical Significance (공황장애 환자의 성격특성과 임상적 의의)

  • Chae, Young-Lae;Lee, Chung-Tai;Kim, Bo-Yeon;Lee, Sung-Pil;Hong, Seung-Chul;Kim, Chong-Woo;Keh, Yoon-Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.3 no.2
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    • pp.139-146
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    • 1995
  • Forty patients meeting DSM-III-H criteria for panic disorder and 51 normal controls were assessed with the Personality Diagnostic Questionnaire-Revised(PDQ-R), a self-rating scale designed to assess Axis II personality disorders and traits. Results replicated previous findings of a preponderance of dependent, avoidant, and histrionic features. But our result showed other features such as paranoid, schizotypal, borderline, and antisocial traits also. Patients were divided into two groups according to the severity of their personality traits(high or low). These groups were compared in various panic symptomatology and SCL-90-R. None of the specific symptom dimensions in panic disorder, i.e. panic, anxiety, agoraphobia, social impairment, or chronicity was different between groups. Rather, high personality trait groups were found to have significantly more symptomatology in SCR-90-R than low personality groups. Result indicated that patients exhibiting a greater number of personality traits were also significantly more symptomatic. The results suggested a possible link beteween panic disorder and personality disorder. And, general factors such as depression, social or interpersonal sensitivity might provide a much better explanation of personality disorders in panic patients.

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Does performing high- or low-risk coronary artery bypass graft surgery bias the assessment of risk-adjusted mortality rates of hospitals? (관상동맥우회로술의 위험 수준이 병원내사망률 평가 결과에 미친 영향 분석)

  • Lee, Kwang-Soo;Lee, Sang-Il;Lee, Jung-Soo
    • Health Policy and Management
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    • v.17 no.3
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    • pp.87-105
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    • 2007
  • The purpose of this study was to analyze whether nonemergency, isolated coronary artery bypass graft (CABG) surgery for high- or low-risk patients biases the assessment of the risk-adjusted mortality rates of hospitals. This study used 2002 National Health Insurance claims data for tertiary hospitals in Korea. The study sample consisted of 1,959 patients from 23 tertiary hospitals. The risk-adjustment model used the patients' biological, admission, and comorbidity data identified in the claims. The subjects were classified into high- and low-risk groups based on predicted surgical risk. The crude mortality rates and risk-adjusted mortality rates for low-risk, high-risk, and all patients in a hospital were compared based on the rank and the four intervals defined by quartile. Also, the crude mortality rates of the three groups were compared with their 95% confidence intervals of predicted mortality rates. The C-statistic (0.83) and Hosmer-Lemeshow test ($X^2$=11.47, p=0.18) indicated that the risk-adjustment model performed well. Presenting crude mortality rates with their 95% confidence intervals of predicted rates showed higher agreements among the three groups than using the rank or intervals of mortality rates defined by quartile in the hospital performance assessment. The crude mortality rates for the low-risk patients in 21 of the 23 hospitals were located on the same side of their 95% confidence intervals compared to that for all patients. High-risk patients and all patients differed at only one hospital. In conclusion, the impact of risk selection by hospital on the assessment results was the smallest when comparing the crude inpatient mortality rates of CABG patients with the 95% confidence intervals of predicted mortality rates. Given the increasing importance of quality improvements in Korean health policy, it will be necessary to use the appropriate method of releasing the hospital performance data to the public to minimize any unwanted impact such as risk-based hospital selection.

Prevalence and Correlates of Physical Activity and Sitting Time in Cancer Survivors: 2009-2013 Korea National Health and Nutrition Examination Survey

  • Kim, Byung Hoon;Lee, Hyo
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.12
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    • pp.5295-5302
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    • 2016
  • Objectives: A physically active lifestyle is important for cancer survivors. Therefore, this study was conducted to 1) provide population-based estimates of the prevalence of physical activity and sitting time, and 2) their correlates in Korean cancer survivors. Materials and Methods: This study analyzed a cancer survivor subsample (N=1,482) from 2008-2013 Korea National Health and Nutrition Examination Survey (KNHANES), data selected with a complex sampling design. Overall and subgroup-specific prevalences of physical activity and sitting time were estimated. Correlates of moderate- to vigorous-intensity physical activity ( MVPA) and sitting time were tested using age-group-specific hierarchical multiple regression models. Results: Overall adherence rate to physical activity guidelines was 34.9% (95% CI=31.5-38.4). Age-group-specific adherence rates were 41.1% (95% CI=36.3-45.9) in adults (30-64 years old), and 25.3% (95% CI=21.0-25.3) in older adults (65 years or older). Adults spent 213.33 minutes (95% CI=172.4-254.3) per week on MVPA and 55.3 minutes (95% CI=36.4-64.6) on sitting time per day. In adults, sitting time was significantly associated with employed status (B=28.0, p=0.046), smoking (B=-47.4, p=0.020), and number of comorbidity conditions (B=-13, p=.037). MVPA was significantly associated with marital status (B=134.9, p<0.001), employment status (B=98.12, p=.046), and years since cancer diagnosis (B=104.7, p=0.015). Older adults spent 162.2 minutes (95% CI=119.5-204.8) per week on MVPA and 63.0 minutes (95% CI=45.0-89.5) on sitting time per day. Their significant correlates were sex (B= -45.2, p=0.014), smoking (B=-70.14, p<0.001), and years since cancer diagnosis (B=37.0, p=0.024). Age (B=5.8, p=0.042) and marital status (B=83.8, p=0.033) were also significantly associated with MVPA in older adults. Conclusion: A majority of Korean cancer survivors do not sufficiently participate in physical activity. In general, older, unhealthier, non-working, and being unmarried were risk factors for physical inactivity. While this study informs public health policy makers and practitioners about physical activity intervention demand for cancer survivors, future investigations should address psychosocial mediators to better inform intervention programs.

A Trend in Pharmacotherapy for Inpatients with Posttraumatic Stress Disorder at a Single University Hospital (일 대학병원에서 외상 후 스트레스장애 입원환자의 약물 치료 경향)

  • Min, Jung-Ah;Jung, Young-Eun;Seo, Ho-Jun;Bahk, Won-Myong;Jun, Tae-Youn;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.4 no.1
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    • pp.42-48
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    • 2008
  • Objective : Due to a better understanding of the pathophysiology of posttraumatic stress disorder (PTSD) and the relative limitations in the treatment of patients with PTSD, a variety of medications and treatment algorithms for PTSD have been investigated. This study was conducted to investigate the trends in the pharmacotherapy used in the treatment of inpatients with PTSD at a single university hospital in Korea. Methods : Data from 75 patients diagnosed with PTSD according to the DSM-IV criteria from January 1998 to December 2007 were collected. Demographic data and clinical data, including medications prescribed, were investigated. Results : Thirty-three of the 75 subjects included in this study were male, and 42 were female. Considering psychiatric comorbidity, depressive disorder, cognitive disorder, psychotic disorder and anxiety disorder were reported in order. Approximately 97% of the subjects were treated with antidepressants, including paroxetine in 54.7%, and 24% of the subjects were treated with two different kinds of antidepressants. In addition, atypical antipsychotics were prescribed in 33.3% of patients, mood stabilizers in 17.3%, and anxiolytics in 94.7% of the subjects. Conclusion : In our study, various kinds of antidepressants were prescribed for most patients with PTSD. Antipsychotics and mood stabilizers were added to the treatment regimens of some subjects, and anxiolytics were added to the treatment regimens of most subjects. Despite its many limitations, this study shows the prescription pattern and trends in PTSD treatment in Korea. We hope that these preliminary data would be helpful for the development and integration of a practical guideline for the treatment of PTSD in Korea.

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Discordance between Physician and the General Public Perceptions of Prognostic Disclosure to Children with Serious Illness: a Korean Nationwide Study

  • Kim, Min Sun;Lee, Jihye;Sim, Jin-Ah;Kwon, Jung Hye;Kang, Eun Joo;Kim, Yu Jung;Lee, Junglim;Song, Eun-Kee;Kang, Jung Hun;Nam, Eun Mi;Kim, Si-Young;Yun, Hwan-Jung;Jung, Kyung Hae;Park, June Dong;Yun, Young Ho
    • Journal of Korean Medical Science
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    • v.33 no.49
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    • pp.327.1-327.10
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    • 2018
  • Background: It is difficult to decide whether to inform the child of the incurable illness. We investigated attitudes of the general population and physicians toward prognosis disclosure to children and associated factors in Korea. Methods: Physicians working in one of 13 university hospitals or the National Cancer Center and members of the general public responded to the questionnaire. The questionnaire consisted of the age appropriate for informing children about the prognosis and the reason why children should not be informed. This survey was conducted as part of research to identify perceptions of physicians and general public on the end-of-life care in Korea. Results: A total of 928 physicians and 1,241 members of the general public in Korea completed the questionnaire. Whereas 92.7% of physicians said that children should be informed of their incurable illness, only 50.7% of the general population agreed. Physicians were also more likely to think that younger children should know about their poor prognosis compared with the general population. Physicians who opposed incurable illness disclosure suggested that children might not understand the situation, whereas the general public was primarily concerned that disclosure would exacerbate the disease. Physicians who were women or religious were more likely to want to inform children of their poor prognosis. In the general population, gender, education, comorbidity, and caregiver experience were related to attitude toward poor prognosis disclosure to children. Conclusion: Our findings indicate that physicians and the general public in Korea differ in their perceptions about informing children of poor prognosis.

Study of Anti-inflammatory Activity of 7 Herbal Prescription Effective for Sleep Disorders and Atopic Dermatitis (수면 장애 및 아토피피부염에 효과적인 7 가지 한약 처방의 항염증 활성 연구)

  • Choi, Min-Jin;Nguyen, Ly Thi Huong;Jeong, Jeonghwa;Park, Minyoung;Yoon, Joohee;Lee, Byung-Wook;Yang, In-Jun;Shin, Heung-Mook
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.35 no.2
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    • pp.56-63
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    • 2021
  • This study was conducted to find a candidate prescription with anti-inflammatory efficacy of 7 herbal prescriptions known to be effective in atopic dermatitis and sleep disorders in Korean medicine. The anti-inflammatory of the 7 herbal prescriptions extracts were evaluated by ELISA assay and Western blot assay. 7 herbal prescriptions, Seongyutang(SU), Danseontoetang(DST), Sotosajahwan(ST), Jisiljagyagsan(JJ), Seokchangpo(SCP), Wiryeongseon(WLS), Gogojohwan(GGJ) 30 % EtoH extract was used for in vitro experiments. In TNF-α + IFN-γ(TI) stimulated HaCaT cells, all 7 herbal prescriptions reduced TARC and MDC production, and JJ strongly reduced TARC and MDC production at 100 ㎍/ml concentration. SCP strongly reduced MDC production at 10 ㎍/ml and 100 ㎍/ml concentration. In addition, in substance P(SP)/CRH stimulated HMC-1 cells, JJ strongly inhibited VEGF production at both 10 and 100 ㎍/ml concentrations. In LPS/CRH stimulated Raw264.7 cells, all 7 herbal prescriptions significantly inhibited TNF-α. PMA + Ionomycin(PI)/CRH stimulated EL4 cells, SU significantly reduced IL-4 production at both concentrations of 10 and 100 ㎍/ml. WLS significantly reduced IL-17 production at both concentrations of 10 and 100㎍/ml. This suggests that 7 herbal prescriptions have anti-inflammatory effects by reducing inflammatory cytokines in keratinocytes, mast cells and macrophages caused by inflammation. Therefore, it is expected that 7 herbal prescriptions that are effective for sleep disorders and atopic dermatitis can be used as therapeutic materials for sleep disorders and diseases associated with atopic dermatitis.

A Study on the Effect of Osteoporosis Knowledge, Osteoporosis Preventive Behaviors and Self-Efficacy of Middle Aged Women on Health-Related Quality of Life (중년기 여성의 골다공증 지식 및 예방행위, 자기효능감이 건강관련 삶의 질에 미치는 영향)

  • Jeong, Yun Ju;Kim, Yun Ah;Kwon, Young Chae
    • The Journal of the Convergence on Culture Technology
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    • v.7 no.2
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    • pp.107-116
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    • 2021
  • Purpose : To examine the relationship among osteoporosis knowledge, osteoporosis preventive behaviors, self-efficacy and health-related quality of life of middle aged women and to find out factors which influence health-related quality of life. Methods : For study subjects, female patients aged 40 to 64 and hospitalized at the surgical wards of two general hospitals in G city were conveniently sampled. The data have been collected from January 11 to March 10, 2018. Data were analyzed by descriptive statistics, t-test, ANOVA, Scheffe's test, Pearson's correlation coefficient, and multiple regression. Results : The average score of osteoporosis knowledge was 12.50±3.47, the average score of osteoporosis preventive behaviors was 44.96±8.16 and the average score of osteoporosis self-efficacy was 40.38±8.07. The factors influencing EQ-5D Index in health-related quality of life were comorbidity, osteoporosis preventive behaviors, osteoporosis knowledge and average monthly income, which could account for health-related quality of life at 18.0%. The factors influencing EQ-5D VAS were osteoporosis preventive behaviors, self-efficacy, osteoporosis knowledge and age of menarche, which could account for health-related : Higher osteoporosis knowledge, osteoporosis preventive behaviors and self-efficacy, the better the subjects health-related quality of life. Therefore, as a way to promote health-related quality of life of middle aged women, the constant development and the application of a program which may promote osteoporosis knowledge, osteoporosis preventive behaviors and self-efficacy are needed.