The culpability of a person, as determined by due process of law, for any of his actions that are defined as criminal. Determination of such responsibility is a legal function, not a psychiatric one, although a psychiatrist may be called upon to present evidence to the court in order to aid the judge or jury in reaching a decision as to responsibility. Determination of responsibility varies with the laws of the state in which the accused is being tried, but in general all states base their laws on three famous judicial decisions concerning criminal responsibility. 1. the M'Naghten(McNaughton) rule(a. to establish such a defense the accused, at the time the act was committed, must be shown to have been laboring under such defect of reason as not to know the nature and quality of the act he was doing, b. if he did know it, he did or know that what he was doing was wrong). 2. the irresistible impulse test. 3. the Durham decision. Under the Durham test, however, the psychiatrist may give any relevant testmony concerning the mental illness at issue. The psychological and behavioral appearance of a person, in clinical psychiatry this term is commonly used to refer to the results of the mental examination of a patient. The written report of the mental status usually contains specific references to the following areas: I. Attitude and General Behavior (1)General health and appearance. (2)General habits of dress. (3)Personal habits. (4)General mood. (5)Use of leisure time. (6)Degree of sociability. (7)Speech. II. Attitude and Behavior during interview (1)Co-operativeness. (2)Poise. (3)Facial expression. (4)Motor activity. (5)Mental activity. (6)Emotional reactions. (7)Trend of thought. III. Sensorium, mental grasp, and capacity (1)Orientation. (2)Memory and retention. (3)Estimate of intelligence. (4)Abstraction ability. (5)Tests of absurdity, interpretation of proverbs. (6)Judgment.
Background : Various type of psychological and stressful events in life have been reported to have much effect in the onset, progress and exacerbation of psychosomatic disorders such as hypertension, bronchial asthma, peptic ulcer, tension headache, alopecia areata, and atopic dermatitis. However, the nature of the association between stress and psychosomatic disorders remains unclear. Objective : The purpose of this study is to determine the relation of stress and the progress of dermatologic disorder. Method : We examined 30 patients with atopic dermatitis and 30 control subjects with tinea pedis and onychomycosis who visited to Dept. of Dermatology, Chung-Ang University Hospital. To evaluate the stress, we used 'Scale of Life Events' and 'Multidemensional Coping Scale'. Result : 1) The score of life events stress in atopic dermatitis group was significantly higher than that of control group. 2) In the result of coping strategies, the atopic dermatitis group was significantly higher than control group at the active forgetting, positive comparison, and emotional pacification, while in control group religious seeking and accomodation tended to be higher with no statistical significance. Conclusion : These findings suggest that psychosocial stress may play a role in life pattern of atopic dermatitis. But further studies are needed to clarity the exact relationship between stress and psychosomatic disorder.
Jiu Qi(九氣) was shown at Ju Tong Lun(擧痛論) in Shao Wen(素問) Huang Ti Nei Ching(黃帝內經), and is nine important factors that affect the function of human body. Jiu Qi concludes endogenous, exogenous, non-endo-exogenous factors. I do the bibliographical study on the Jiu Qi, the results were as follows; 1. The Qi of Jiu Qi has two opposite meanings. one is genuine vital energy(正氣), and the other is the factors causing abnormal state in vital energy. Jiu Qi is nine factors concluding coldness-heat(exogenous factors). six emotional factors(endogenous factor), overworking(non -endo-exogenous factor). 2. Anger may lead to abnormal rising of vital energy. Anger causes Qi of the liver to go perversely upward, and perverted flow of exuberant Qi of the liver lead to dysfunction of the spleen, so resulted in hematemesis, diarrhea, indigestion. 3. Joy can promote the harmony of vital energy and blood, so do the circulation of nutrient and defensive energy in physiological state. But an excessive joy may lead to the sluggishness of vital energy. 4. The lung keeps the pathway of air unconstructed, disseminates vital energy, cleanses the inspired air and keeps vital energy flowing downward. Sorrow affects on the function of the lung and the heart, so could result in obstruction of the circulation of nutrient and defensive energy. An excessive sorrow after stagnation may lead to the consumption of vital energy. 5. Fear makes vital energy and essence of the kidney sink to inward and downside, makes Yang-Qi can't go upward, so causes obstruction of triple wanner. An excessive fear can obstructs the ascending of Yang-Qi, so may lead to the abnormal falling of vital energy. 6. Coldness makes the sweat pore be contracted, so obstructs the circulation of triple warmer, causes sluggishness of defensive energy or Qi of the internal organ. 7. Heat makes the sweat pore be open, much amount of sweat is excreted with Yang-Qi, defensive energy, vital energy. Heat may consume vital energy. 8. Sudden fright affects on spirits of the heart and liver, causes disorder of the mental faculties and separation of blood and vital energy. Fright may lead to disorder of Qi. 9. Overwork concludes overfatigue and exhaustion caused by intemperance in sexual life. Overwork renders vital energy consumed, and hence results in lassitude and listlessness. 10. Thinking affects on the function of the heart and the spleen. Over thinking may lead to depression of vital energy. Through the bibliographical study on Jiu Qi, I got smallest amount of it, and this must be more investigated correlating with clinical study.
Choi, Miji;Kim, Yeni;Ban, Ji-Jeong;Hwang, Samuel Suk-Hyun;Kim, Bung-Nyun;Yang, Young-Hui
Journal of the Korean Academy of Child and Adolescent Psychiatry
/
v.28
no.4
/
pp.220-227
/
2017
Objectives: The purpose of this study was to examine the reliability and validity of the Korean version of the Behavior Problems Inventory (BPI-01) among children and adolescents aged between 3 and 18. Methods: The control group consisting of one hundred children and adolescents was recruited from schools and the patient group consisting of forty one children and adolescents with autism spectrum disorder were recruited from a hospital. We compared the measurements of both groups. To assess the concurrent validity of the BPI-01, we compared the problem behavior index of the Korean Scale of Independent Behavior-Revised (K-SIB-R) and, to assess the discriminant validity, we compared the Korean version of the Child Behavior Checklist (K-CBCL). The Cronbach's alpha of the BPI-01 was measured to assess its reliability. Correlation analyses between the BPI-01 and the other scale were carried out to examine the former's concurrent and discriminant validity. Results: The patient group showed a significantly higher score for all three subscales of the BPI than the control group. The Cronbach's alpha was 0.92 for the total severity score of the BPI and ranged between 0.67-0.89 for each subscale in the patient group. All subscales of the BPI-01's, i.e., self injurious behavior, stereotyped behavior and aggressive/destructive behavior, were significantly correlated with the corresponding subscales of the K-SIB-R. The BPI-01 generally did not demonstrate any significant correlation with emotional items such as anxiety/depression in the K-CBCL. Especially, the BPI-01's stereotyped behavior subscale showed little correlation with externalizing behaviors such as social problems and aggressive behaviors. Conclusion: This study found that the Korean version of BPI-01 is a reliable and valid behavior rating instrument for problem behavior in developmental disabilities among children and adolescents.
A Cerebrovascular accident(CVA), or Stroke is a medical emergency that occurred when the blood supply to the brain is interrupted or blocked. The stroke causes physical function disorder due to hemiparalysis and emotional disorder. Also the stroke patients experience helplessness, powerlessness, sense of alienation and loss of hope. These feelings make the rehabilitation difficult because they lose the will of life. The purpose of this study is to identify the correlation between perceived social support and hope of stroke survivors. The subjects for this study were 100 out-patients with stroke in one general hospital and oriental medicine hospital located in Mokpo. The data were analysed by frequency, t-test, ANOVA. Duncan test, Pearson's correlation, using the SPSS WIN 9.0 program. Data were collected from July 11 to September 9, 2000, using a structured questionnaire. The instruments used for this study : The social support scale developed by Park, Ji-won(1985) and the hope scale developed by Miller(1988). The results were as follows. 1. It was found that the higher the degree of perceived social support, the higher the degree of hope(r=.726, p=.000). Therefore hypothesis was supported. 2. The mean score of perceived social support was 77.8(SD=21.0) with a score range from 27.0 to 104.0. 3. The mean score of perceived hope was 117.0(SD=25.7) with a score range from 57.0 to 160.0. 4. The level of social support depending on general characteristics were significantly different in variables such as marital status(t=3.131, p=.010). degree of income satisfaction(F=16.027, p=.000). 5. The level of hope depending on general characteristics were significantly different in variables such as marital status(t=2.681, p=.040). current job(t=-2.055, p=.043) degree of income, satisfaction(F=11.363, p=.000). For these subjects, there was a significant relationship between social support and hope. The stroke survivors need social support to inspire their hope. Nurses should plan interventions to enhance social support for patients with stroke. The above results may be used as the basic data to seek more efficient way of elevating nursing practice and rehabilitation for the patients with stroke.
1. Background and Purpose: We intended to make the standards of CVA management of Sasang Constitutional Medicine and be helpful to understand the constitutional symptoms through a clinical study of CVA. 2. Methods: We studied 157 CVA inpatients(79 men and 78 women) who were in constitutional clinic of Dongguk Pundang Oriental Hospital during 1 year from March 1997 to February 1998. We investigated and analysed the characteristics, past histories, symptoms and progresses of patients. 3. Results: The results of constitutional analysis showed 88 Taeumin(56.1%), 48 Soyangin(30.6%) and 21 Soeumin(13.4%). The frequency of strokes was much the same between male and female and the greater part of cases were 50-70 of age. The CVA cases were classified into 119 cerebral infarction(75.8%), 11 cerebral hemorrhage(7.0%), 1 subarachnoid hemorrhage(0.6%) and 26 trasient ischemic attack. From the standards of symptom management, there were abnormality of a coated tongue(63.1%) in most cases, sleeping disorders(48.4%), excremental disorders(44.7%) and urinary disorders(36.9%) on admission. With regard to the rate of improvement in the standards of CVA management, excremental disorders improved 87.1% and emotional disorder 81.0%, swallowing disorder 78.7% and so on.
The purpose of the study is to investigate the predisposing factors of posttraumatic stress disorder (PTSD) in fire fighters in Korea and to suggest the program development and solution to the critical incident stress management (CISM) in the future. PTSD is characterized by invasion, withdrawal, negative change of cognition and mood, and hypersensitivity. Trauma memory includes explicit memory and implicit memory. The explicit memory is conscious, cognitive, and descriptive and is controlled by hippocampus. The data of explicit memory have inhibitive and narrative language structure. The implicit memory is inconscious, emotional, and remembered by the body. The implicit memory is controlled by amygdala and has inexpressive language structure. The deletion of implicit memory is the key point to trauma treatment. Critical incident stress management (CISM) is the approach for the solution of PTSD. In conclusion, the essential goal of CISM is the psychological cessation of PTSD. This study tried to suggest the education program development of PTSD.
Objective : The purpose of this study was to establish a school-based mental health intervention. The success of which was indexed by its effects on the social anxiety symptoms of the enrolled adolescents. Methods : This program for promoting mental health among adolescents in the community was adopted by three middle schools that volunteered to participate in the project. The program included screening for emotional problems related to social anxiety, depression, suicide, and post-traumatic stress disorder. Case management was provided for groups considered high-risk for depression, suicide, or post-traumatic stress disorder; cognitive-behavior therapy was provided for those at high-risk of developing social anxiety. Additionally, educational programs for the prevention of suicide, a "loving life" module, and mental health promotional campaigns were also included. In total, 1,100 middle school students completed self-report questionnaires. Twenty-five students in the high-risk group for social anxiety participated in a cognitive-behavior therapy program, comprising eight sessions, and conducted by two clinical psychologists. Results : Following the suicide prevention education program, suicide awareness among students increased and coping strategies were improved. In addition, the loving life program was associated with positive self-perceptions by many students. Furthermore, social anxiety symptoms showed a statistically significant difference after the cognitive-behavior therapy program. After the therapy, not only did social anxiety symptoms improve, depressive symptoms and suicidal ideation decreased significantly, while self-esteem and psychological resilience significantly increased. Conclusion : A school-based mental health intervention was successfully implemented in three middle schools and improved the mental health of the participating students. Therefore, this intervention could be widely implemented to promote positive mental health among middle school students.
Introduction: Stroke refers to a sudden brain disease that results in disorders in the anatomy of the brain. The cause is a sudden circulatory disorder of the cerebrovascular system that creates a consciousness disorder and hemiplegia. Despite aggressive treatment after the onset, stroke is a social problem because the patient has difficulty in recovering from sequelae that can include limb movement disorders, language disorders, and emotional disorders. In this study, we describe the effect of traditional Korean medicine treatment on the sequelae in a subacute cerebral infarction patient admitted to a Korean medical hospital. Case presentation: A 67-year-old male patient was diagnosed with cerebral infarction circa 2005, and his condition had not improved. Around March 15, 2018, he experienced the sudden onset of a cerebral infarction in his daily life. This was confirmed by a brain MRI, and he was hospitalized at other hospitals, but he showed no improvement. We conducted a manual muscle test (MMT) to evaluate the patient's exercise and strength. His gait level was measured to evaluate his degree of walking. He was treated with Bojungikgi-tang and acupuncture twice a day. After 34 days of inpatient treatment, the patient's exercise strength improved from Grade 2+~Grade 3 to Grade 3+ determined by the MMT, and his walking ability improved from Gait Level 3 to Gait Level 4. Conclusion: The findings of this study indicate that acupuncture and herbal medicine treatment can help treat patients with hemiplegia due to cerebral infarction.
Objective : Patients with mild ischemic stroke experience various sequela and residual symptoms, such as anxious behavior and deficits in movement. Few approaches have been proved to be effective and safe therapeutic approaches for patients with mild ischemic stroke by acute stroke. Sildenafil (SIL), a phosphodiesterase-5 inhibitor (PDE5i), is a known remedy for neurodegenerative disorders and vascular dementia through its angiogenesis and neurogenesis effects. In this study, we investigated the efficacy of PDE5i in the emotional and behavioral abnormalities in rats with mild ischemic stroke. Methods : We divided the rats into four groups as follows (n=20, respectively) : group 1, naïve; group 2, middle cerebral artery occlusion (MCAo30); group 3, MCAo30+SIL-pre; and group 4, MCAo30+SIL-post. In the case of drug administration groups, single dose of PDE5i (sildenafil citrate, 20 mg/kg) was given at 30-minute before and after reperfusion of MCAo in rats. After surgery, we investigated and confirmed the therapeutic effect of sildenafil on histology, immunofluorescence, behavioral assays and neural oscillations. Results : Sildenafil alleviated a neuronal loss and reduced the infarction volume. And results of behavior task and immunofluorescence shown possibility that anti-inflammation process and improve motor deficits sildenafil treatment after mild ischemic stroke. Furthermore, sildenafil treatment attenuated the alteration of theta-frequency rhythm in the CA1 region of the hippocampus, a known neural oscillatory marker for anxiety disorder in rodents, induced by mild ischemic stroke. Conclusion : PDE5i as effective therapeutic agents for anxiety and movement disorders and provide robust preclinical evidence to support the development and use of PDE5i for the treatment of mild ischemic stroke residual disorders.
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