• 생물정신의학
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• 제10권1호
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• pp.80-84
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• 2003

Objective : Bipolar disorder is known to have strong genetic background and cellular immune activation. Based on the hypothesis that abnormalities of normal inhibitory control of T cell immunity can contribute to the pathophysiology of bipolar disorder, we investigated the relationship between the first exon at position +49(A/G) polymorphism of cytotoxic T lymphocyte antigen 4(CTLA4) gene and bipolar disorder. Method : Among the Korean patients diagnosed as bipolar disorder according to DSM-IV, 90 patients without serious medical illness, neurologic illness, hormonal disorder, or concomitant mental illness were selected. The normal control group consisted of 149 age-and sex-matched subjects without current or past history of autoimmune diseases or mental disorder. DNA was extracted from whole blood and the exon 1 region of CTLA-4 gene was amplified by polymerase chain reaction. Gene typing was performed using single strand conformation polymorphism. Results : There were no significant differences in genotype frequencies of G/G, G/A, and A/A between the patients with bipolar disorder and the control group(48.9% vs 46.3%, 44.4% vs 39.6%, and 6.7% vs 14.1%, respectively). There were no significant differences in allelic frequencies of G and A between the patients with bipolar disorder and the control group(71.1% vs 66.1%, and 28.9% vs 33.9%, respectively). Conclusion : This study did not show the association of exon 1 polymorphism of CTLA-4 gene with bipolar disorder.

• Environmental Analysis Health and Toxicology
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• 제30권sup호
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• pp.6.1-6.4
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• 2015

Objectives This study is conducted to estimate the cost paid by the public suffering from disease possibly caused by chemical and to examine the effect on public health. Methods Cost-benefit analysis is an important factor in analysis and decision-making and is an important policy decision tool in many countries. Cost-of-illness (COI), a kind of scale-based analysis method, estimates the potential value lost as a result of illness as a monetary unit and calculates the cost in terms of direct, indirect and psychological costs. This study estimates direct medical costs, transportation fees for hospitalization and outpatient treatment, and nursing fees through a number of patients suffering from disease caused by chemicals in order to analyze COI, taking into account the cost of productivity loss as an indirect cost. Results The total yearly cost of the diseases studied in 2012 is calculated as 77 million Korean won (KRW) per person. The direct and indirect costs being 52 million KRW and 23 million KRW, respectively. Within the total cost of illness, mental and behavioral disability costs amounted to 16 million KRW, relevant blood immunological parameters costs were 7.4 million KRW, and disease of the nervous system costs were 6.7 million KRW. Conclusions This study reports on a survey conducted by experts regarding diseases possibly caused by chemicals and estimates the cost for the general public. The results can be used to formulate a basic report for a social-economic evaluation of the permitted use of chemicals and limits of usage.

• 대한간호학회지
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• 제29권3호
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• pp.639-655
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• 1999

An explanatory design was employed to identify the relationship of physical, emotional & social readjustment and social support of post hospitalized stroke patients and their caregivers. A convenient sample of 254 patients who given follow-up care at the outpatient department after discharge and 225 caregivers were recruited. Mental Status Questionnaire (MSQ), Social Support Inventory Stroke Survivors (SSISS), Illness intrusiveness(II), Instument Activity of Daily Living(IADL), Center of Epidemilogic Studies-Depression(CES-D), social activity and caregiver burden were used for measurement in this study. Results showed patient's physical level measured by IADL and psychological level measured by depression were high. But social activity was low. Cognitive function, depression & social activity were not significantly different by the posthospitalized period, but IADL was. The source of professional support was mostly the physician at the outpatient department. The family support was found significantly related to patient's depression & social activity and caregiver's subjective burden. Professional support was found significantly related to patient's IADL & depression. Illness intrusiveness as a mediating variable was a sig nificantly predicting power on patient's IADL & depression. The path analysis was used to identify the variables to predict the physical, emotional, and social status of patients. As a result, patient's age, cognitive function, illness intursiveness and professional support significantly predicted the level of IADL ; patient's cognitive function, illness intrusiveness and family support significantly predicted the level of depression ; and patient's age and family support significantly predicted the level of social activity of posthospitalized stroke patients. Based upon these results, the rehabilitation programs to reduce the illness intrusiveness and improve cognitive funtion were recommended for the readjustment of the stroke patients. This model of the readjustment of the posthospitalized stroke patients is recommended as the framework for care of the stroke patients.

• 지역사회간호학회지
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• 제31권3호
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• pp.244-255
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• 2020

Purpose: As the daily life experiences of community-dwelling people with mental disabilities are closely correlated to mental health recovery, this study aimed to analyze their daily life experiences in depth to determine their significance. Method: Participants included eight community-dwelling people with mental disabilities. A total of 12 in-depth interviews were conducted once or twice per participant. The collected data were analyzed using the phenomenological analysis method described by Giorgi. Results: The daily life experiences of community-dwelling people with mental disabilities were categorized into the following four components: "encountering shocking reality in the outside world", "life tied down by the mental illness", "happiness and gratefulness encountered in daily life", and "wishing for a change and self-sustaining life". Conclusion: This study found that the recovery and welfare of community-dwelling people with mental disabilities were promoted and that these patients made necessary efforts to become a member of the local community. These findings could be used as a reference for establishing social welfare policies which enable people with mental disabilities to participate as functioning members of the community that facilitate the prevention of relapse, to promote their integration into the community. Furthermore, the present results will contribute to the development of nursing intervention programs to promote recovery and prevent relapse, to ultimately establish a mental health management system.

• Journal of Preventive Medicine and Public Health
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• 제49권1호
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• pp.69-78
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• 2016

Objectives: The suicide rate in Korea is increasing every year, and is the highest among the Organization for Economic Cooperation and Development countries. Psychiatric patients in particular have a higher risk of suicide than other patients. This study was performed to evaluate determinants of mental health care utilization among individuals at high risk for suicide. Methods: Korea Health Panel data from 2009 to 2011 were used. Subjects were individuals at high risk of suicide who had suicidal ideation, a past history of psychiatric illness, or had utilized outpatient services for a psychiatric disorder associated with suicidal ideation within the past year. The chi-square test and hierarchical logistic regression were used to identify significant determinants of mental health care utilization. Results: The total number of subjects with complete data on the variables in our model was 989. Individuals suffering from three or more chronic diseases used mental health care more frequently. Mental health care utilization was higher in subjects who had middle or high levels of educational attainment, were receiving Medical Aid, or had a large family size. Conclusions: It is important to control risk factors in high-risk groups as part of suicide prevention strategies. The clinical approach, which includes community-based intervention, entails the management of reduction of suicidal risk. Our study identified demographic characteristics that have a significant impact on mental health care utilization and should be considered in the development of suicide prevention strategies. Further studies should examine the effect of mental health care utilization on reducing suicidal ideation.

• 한국컴퓨터정보학회논문지
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• 제26권12호
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• pp.195-200
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• 2021

선원은 해운물류에 중요한 역할을 담당한다. 하지만 선원직은 상당기간동안 선박에 승선해야하며 고립되어 근무를 하기 때문에 정신질환에 상대적으로 취약하다. 특히, COVID-19로 인한 팬데믹 상황에서 세계 곳곳의 항만 폐쇄로 선원교대가 지연되고 있어 선원들에게 정신적인 부담이 가중되고 있다. 이러한 선원들의 정신적인 문제는 인명 및 선박의 대형 사고로 이어질 수 있기 때문에 선원들의 정신건강관리가 중요하다. 본 논문은 설문조사를 통하여 선원들의 정신건강관리에 대한 필요성을 확인하고 현재 운영되고 있는 정신건강관리 프로그램과 교육과정에 대한 문제점을 식별하였다. 또한 식별된 문제점에 대하여 VR기술 기반의 개선방안을 제시하여 선원들이 적기에 정신질환에 대한 상담치료를 받을 수 있도록 도우며 민감한 개인정보 노출을 방지하여 선원들의 정신적인 부담을 줄일 수 있도록 제안하였다. 이를 통하여 안전한 선원근무 환경을 구축하여 원활한 물류산업 발전에 기여할 수 있을 것으로 기대된다.

• 철학연구
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• 제121호
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• pp.1-24
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• 2018

본 논문의 목적은 영혼의 질병과 치유와 관련된 고대 논변들을 통해 플라톤이 말하는 정신의 질병과 건강은 무엇인지 알아보는 것이다. 고대 그리스에서 의학은 몸의 건강을 돌보는 것이었다면, 철학은 영혼의 건강을 돌보며 삶을 변화시키는 것이었다. 따라서 정신적 질병의 개념을 규정하는 것은 의학의 영역이기보다 철학의 영역이며, 철학의 실천적 기능은 우리의 영혼을 돌보는 삶이다. 그리고 영혼을 돌보기 위해서는 영혼의 질병은 무엇이며 어디서부터 오는지에 관한 진단이 우선시 된다. 플라톤은 정신적 질병을 (1) 국부적인 뇌의 문제가 아니라 인격의 총체적 문제이며, (2) 이는 불균형과 부조화에 기이하는 것으로, (3) 무지 또한 정신적 질병이라 할 수 있다고 말한다. (4) 더 나아가 그는 부정의와 악덕 역시 정신적 질병이라고 진단하며, 정신적 질병의 문제를 개인을 넘어서 국가의 문제로 확대시킨다. 결과적으로 플라톤은 철학의 목적을 영혼의 건강을 유지하기 위해 덕을 가지고 공동체 속에서 정치적 정의를 이루어 나가는 것이라고 주장한다.

• 대한조현병학회지
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• 제20권2호
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• pp.55-60
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• 2017

Objectives : Severe mental illness is a major risk factor for suicide. This study aimed to identify characteristics of patients who died by suicide among subjects who had been received service from a community mental health center. Methods : We searched individuals who had committed suicide in Gwangju Bukgu Community Mental Health Center since 2006. Sociodemographic and clinical data were gathered from medical records and their case managers and they were compared with those of general members in the center. Characteristics of schizophrenia patients who died by suicide were particularly summarized. Results : Twelve person committed suicide between 2006 and 2016. The characteristics of those who died by suicide were male (67%), diagnosis of schizophrenia (75%), aged below 50 (83%), unemployed (92%), past history of psychiatric hospitalization (100%), recent admission within 3 months (67%), past history of suicidal attempt (78%), family history of schizophrenia (58%), poor adherence to medication (58%), and use of daily rehabilitation program (42%). Ten out of twelve (83%) showed warning sign for suicide. All identified method of suicide in patients with schizophrenia was jumping from high building. Many patients with schizophrenia, who committed suicide, suffered from comorbid depressive symptoms (67%) and auditory hallucination (78%). Conclusion : Case managers should pay attention to and carefully manage individuals who showed suicidal warning, particularly with risk factors for suicide, such as unemployment, admission state or recent discharge from psychiatric hospital, poor adherence to medication, family history of schizophrenia, and a history of suicidal attempt.

• 한국사회복지학
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• 제61권3호
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• pp.103-127
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• 2009

사례관리의 수행요소가 지역거주 정신장애인의 삶의 질에 미치는 영향이 소비자 만족도에 의해 어떻게 매개되는지를 분석하였다. 분석대상은 지역사회정신보건서비스 기관 중 사례관리를 수행하는 18개 기관과, 이 기관의 서비스를 이용하는 381명의 정신장애인이다. 설문조사를 실시하였으며, 클라이언트 수준과 기관 수준의 자료를 동시에 고려하는 위계적 선형모형(HLM: Hierarchical Lineral Model)을 적용하여 검증하였다. 주요한 연구 결과는 실무자의 담당 사례량이 삶의 질에 직접적 영향을 주었다. 사례관리팀 접근은 소비자 만족도에 직접적 영향을 미친 반면, 소비자 만족도를 매개하여 삶의 질에 이르는 간접적 영향은 미미하였다. 적절한 사례량의 확보 및 사례관리자 확대, 팀접근의 유용성에 대한 실천적 함의를 제안하였다.

• 대한상한금궤의학회지
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• 제12권1호
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• pp.23-48
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• 2020

Objectives : This study aimed to suggest distinct signs of Greater yin disease (tàiyīnbìng, 太陰病) by researching the etymology of three terms: zi-tong (自痛), jie-ying (結硬), and yin-er (因爾), which are exclusive found only in Greater yin disease (太陰病) in Gangpyeong-shanghanlun, but not in other categories. Methods : We studied the etymologies of the three terms that are unique in Greater yin disease, then found some pathological signs that are related with them through the four mental illness cases, which include somatization, obsessive-compulsive behavior, delusion, and panic disorder. Results : Based on the definitions of each term, we diagnosed the four patients who had mental illnesses as having Greater yin disease, and we observed meaningful improvements after administering herbal medication. After Gyejigajakyak-tang administration, the Insomnia Severity Index (ISI) score decreased from 18 to 7 and the Beck's Anxiety Index (BAI) score decreased from 36 to 18 in the first case, the ISI score decreased from 27 to 16 and the BAI score decreased from 50 to 33 in the second case, and the ISI score decreased from 23 to 4 and the BAI score decreased from 34 to 5 in the third case. In the last case, the ISI and BAI scores were 16 and 22, respectively, at the first visit, and it was found that the scores had changed to 6 and 22, respectively, at the last visit. Conclusions : We found that the unique terms in Greater yin disease, including zi-tong (自痛), jie-ying (結硬), and yin-er (因爾), can be interpreted as groundless arbitrary assumption, resting strong tension, and psychological projection based on the etymological hypothesis. Therefore, we suggest these as specific signs of Greater yin disease.