• Korean Journal of Psychosomatic Medicine
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• v.23 no.2
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• pp.121-128
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• 2015

Objectives : This study developed and validated the Perceived Stigma of Delirium Scale(PSDS), which is designed to measure perceived stigma associated with delirium in patients suffering from that disorder. Methods : Based on a literature review of scales assessing stigma, a preliminary scale comprising seven items was developed. After recovering from delirium, 128 patients completed the PSDS and the Distress Thermometer (DT). Factor analysis was used to examine construct validity, and internal consistency and test-retest reliability were examined to ensure reliability. Concurrent validity was assessed using the correlation between the total scores on the PSDS and the DT. Results : Factor analysis yielded a single-factor structure from the seven candidate items. One item was excluded due to low factor loading. The internal consistency was computed and Cronbach's ${\alpha}$ was 0.85 for the total score. The overall test-retest reliability was 0.71, with items ranging from 0.58 to 0.83. The total score on the PSDS was significantly correlated with the DT score. Conclusions : The PSDS may be a reliable, valid instrument for evaluating perceived stigma in patients who have recovered from delirium. Further study of the perceived stigma by delirium patients is required to assess the implications of the PSDS for clinical practice and research.

• Journal of Hospice and Palliative Care
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• v.24 no.3
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• pp.135-143
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• 2021

End-of-life patients experience physical, mental, social, and existential distress. While medical personnel provide medication and care to alleviate patients' distress, listening to and interacting with patients remains essential for understanding their psychological condition. The most important tool, though difficult to implement in practice, is end-of-life discussion (EOLD). EOLD has been shown to have positive effects on end-of-life treatment choices, achievement of patients' life goals, improvements in the quality of life of patients and their families, and the prevention of depression and complicated grief among bereaved family members. EOLD is not often undertaken in clinical practice, however, due to hesitancy among medical personnel and patients for various reasons. In order to conduct an EOLD, the patient's judgment, psychiatric illnesses such as delirium and depression, and psychological issues such as the side effects of psychotropic drugs, denial, and collusion must be evaluated. Open and honest conversation, treatment goal setting, the doctor's familiarity with the patient's background, and attentiveness when providing information are important elements for any dialogue. Meaning-centered psychotherapy was developed to alleviate the existential distress of cancer patients, and its application may promote EOLD. The future development of meaning-centered psychotherapy in practice and in research is expected to further promote EOLD.

• Journal of Oriental Neuropsychiatry
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• v.15 no.1
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• pp.9-25
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• 2004

Behavioral characteristics of Attention Deficit Hyperactivity Disorder(ADHD) is one of the most common mental disorders among children.child psyachiatry. Inattention, Hyperactivity that is done by hyperkinesis or minimal brain dysfunction is major sypmton in ADHD, But etiology and pathological facor of ADHD is very much or unkown.. We brought to about a Study on the Oriental - medical pathologic Understanding about Inattention, Hyperactivity symptom in ADHD within Don yui bo gam Book are as follows. 1. Oriental medical pathologic concepts about Inattention, Hyperactivity are continuous with process of Yang Qi(陽氣), an unbalance of qi(氣) and shen ming(神明), excess of seven emotions(七情), pathology of Huo(火). 2. Immanent factors in inattention, Hyperactivity are improper diet, overtiredness and seven emotions, are continuous with pathological process of the heart, liver, gall bladder, spleen, stomach, kidneys. 3. In oriental medicine, considered as a child's qi of shao yang, dynamic physiological feature, excess and want of yin and yang, organs and bowels, immanently imbalance in growth rather than a child's mental disorder 4. Inattention, looseness in ADHD-PI type are continuous with forgetfulness, improper overtiredness, shortage of qi, the interior heat syndrome due to yin deficiency within Don yui bo gam Book 5. Hyperactivity, impulsive actions in ADHD-C type are continuous with sudden palpitation, severe palpitation, delirium, fidgeting due to deficiency, fidgetiness, hyperactivity of huo due to yin deficiency, fever, febrile disease with accumulation of blood.

• Sleep Medicine and Psychophysiology
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• v.8 no.1
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• pp.37-44
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• 2001

Background: Sleep disorders are prevalent in the general population and in medical practice. Three diagnostic classifications for sleep disorders have been developed recently: The International Classification of Sleep Disorders (ICSD), The Diagnostic and Statistical Manual, 4th edition (DSM-IV) and The International Classification of Diseases, 10th edition (ICD-10). Few data have yet been published regarding how the diagnostic systems are related to each other. To address these issues, we evaluated the frequency of sleep disorder diagnoses by DSM-IV and ICSD and compared the DSM-IV with the ICSD diagnoses. Method: Two interviewers assessed 284 inpatients who had been referred for sleep problems in general units of Anam Hospital, holding an unstructured clinical interview with each patient and assigning clinical diagnoses using ICSD and DSM-IV classifications. Results: The most frequent DSM-IV primary diagnoses were "insomnia related to another mental disorder (61.1% of cases)" and "delirium due to general medical condition (26.8%)". "Sleep disorder associated with neurologic disorder (38.4% of cases)" was the most frequent ICSD primary diagnosis, followed by "sleep disorder associated with mental disorder (33.1%)". In comparing the DSM-IV diagnoses with the ICSD diagnoses, sleep disorder unrelated with general medical condition or another mental disorder in DSM-IV categories corresponded with these in ICSD categories. But DSM-IV "primary insomnia" fell into two major categories of ICSD, "psychophysiologic insomni" and "inadequate sleep hygiene". Of 269 subjects, 62 diagnosed with DSM-IV sleep disorder related to general medical condition or another mental disorder disagreed with ICSD diagnoses, which were sleep disorders not associated with general medical condition or mental disorder, i. e., "inadequate sleep hygiene", "environmental sleep disorder", "adjustment sleep disorder" and "insufficient sleep disorder". Conclusion: In this study, we found not only a similar pattern between DSM-IV and ICSD diagnoses but also disagreements, which should not be overlooked by clinicians and resulted from various degrees of understanding of the pathophysiology of the sleep disorders among clinicians. Non-diagnosis or mis-diagnosis leas to inappropriate treatment, therefore the clinicians' understanding of the classification and pathophysiology of sleep disorders is important.

• The Journal of Internal Korean Medicine
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• v.43 no.6
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• pp.1274-1288
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• 2022

Objectives: The study investigated the effect of Korean medicine treatment on a hemiplegic patient with conscious and cognitive disorders due to hemorrhagic transformation after interventional reperfusion therapy of anterior circulation infarction. Case presentation: The patient was treated with acupuncture, moxibustion, cupping, and herbal medicine in combination with Western medicine and physical therapy. The effects on clinical symptoms were evaluated using the Manual Muscle Test (MMT), Glasgow Coma Scale (GCS), Korean Mini-Mental State Examination (K-MMSE), Korean Nursing Delirium Screening Scale (Korean Nu-DESC), and Modified Bathel Index (MBI). After the treatment, the MMT grade increased from Gr.0-1 to Gr.0-3, the GCS score increased from 10 to 15, the K-MMSE score increased from 8 to 15, the Korean Nu-DESC score decreased from 3 to 1, night delirium disappeared, and the MBI score increased from 13 to 26. Conclusions: Complex Korean medicine treatments were effective for improving the clinical symptoms of hemorrhagic transformation after interventional reperfusion therapy for anterior circulation infarction in a patient with hemiplegia and conscious and cognitive disorders. However, further studies are needed.

• The Journal of Internal Korean Medicine
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• v.22 no.4
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• pp.743-747
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• 2001

Hepatic encephalopathy is caused by disorders affecting the liver. The exact cause of the disorder is unknown. It occurs changes in mental state, consciousness, behavior, personality and changes in mood include forgetfulness, confusion, disorientation, delirium, dementia, decreased alertness, daytime sleepiness, decreased responsiveness, progressive stupor, coma. As 3 admission patients into oriental hospital of daejeon university include 2 cases of cerebral infarction, 1 case of liver cirrhosis, we found those are all hepatic encephalopathy. But until the diagnosis is made, we have many mistakes to find correct. Among the mistackes, specialy mixed thing is to compare hepatic encephalopathy and cerebral infarction. So, we report these cases with a brief review of related literatures.