• 제목/요약/키워드: neurotic patient

검색결과 9건 처리시간 0.029초

칠정구기증환자 63례에 대한 임상적 고찰 (63 cases report of neurosis patient)

  • 이동원;김은정
    • 동의신경정신과학회지
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    • 제15권1호
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    • pp.127-141
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    • 2004
  • This is 63 cases report of neurotic patient which have gone to Dep. of Neuropsychiatry of Dongshin University sunchun oriental hospital from October, 2002 to October, 2003. Objective : To find out distributional characteristics of neurotic patient Result : 1. The distribution of sex is Female and of age is thirty, fourty is large. 2. The distribution of a history of case is chronic patient is large. 3. The distributional ratio of psychosomatic : musculoskeletal : gastrointestine symptom of chief complain was 48.7: 25.3: 14.9. 4. The distribution of yanghyulansin ondam: soganhaewul gudam : bohyulansin description was 41.3: 15.9: 9.5. Conclusion : This 63 cases report is relatively small cases about analysis and comparison of neurotic patient. So, it's needed to abundant study of this, afterwards.

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원형탈모증 환자의 정서상태와 성격특성에 관한 임상적 연구 (Clinical Study of Emotional State and Personality Characteristics in Patients with Alopecia Aerata)

  • 이경규;백기청
    • 정신신체의학
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    • 제5권2호
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    • pp.158-167
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    • 1997
  • Objectives: This study was aimed to investigate the emotional state and personality characteristics of alopecia aerata patient and to determine whether these characteristics are similar with those of neurotic patient. Methods : 20 alopecia aerata patients, 20 neurotic patients, and 20 normal healthy controls were studied. Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI) and Korean standardized edition of Catell's 16 Personality factors Questionnaire(16PF) were used for assessment. Results: 1) Total score of BDI was higher in neurosis group than alopecia aerata group and normal control group(p<0.05). Inspire of statistical non-significance, total score of in alopecia aerata group was higher than normal control group. 2) Total scores of state anxiety and trait anxiety in alopecia aerata and neurosis group were significantly higher than normal control group(p<0.001). 3) In first-stratum source traits of 16PF, normal control group was significantly higher than alopecia aerata group and neurosis group in B-factor(intelligence) and C-factor(ego-strength)(p<0.05). Alopecia aerata group and neurosis group were significantly higher than normal control group in O-factor(guilt-proneness) and $Q_4-factor(tension,\;anxiety)$(p<0.001). 4) In second-stratum source traits of 16PF, alopecia aerata group and neurosis group were significantly higher than normal control group in ANX-factor(anxiety)(p<0.05). Conclusions : These results suggest that emotional state and personality characterstics of patients with alopecia aerata are a distinguishable different to compare with normal control, and are very similar with those of neurotic patients. The authors propose that psychiatric management in patient with alopecia aerata will be more benificial.

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서울지하철 범죄 실태에 대한 범죄심리학적 연구 (Study on the Realities in Seoul Subway Crimes: Criminal Psychology)

  • 임상곤
    • 시큐리티연구
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    • 제7호
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    • pp.233-285
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    • 2004
  • ‘Defined legally as a violation of law' (Sutherland, E. H. Principles of Criminology, Lippincott, Chicago, 1939) Crime within the group is essentially and primarily antisocial in that the criminal who is welfare of his group acts instead against it and breaks the principles of social solidarity not merely by not doing what these principles prescribe, but by doing something exactly opposites. Any program set up to attack crime and delinquent behavior at their sources. A program of his nature needs the constant and comprehensive collaboration of psychiatrists, social works, educations, lawmakers, and public officials, since crime is a social problem and it should be treated as such. Some crime preventives which should be mentioned are as follows, (1) The insurance that every child will be decently born and that his home life be socially and economically adequate; without socially mature parents the chid is handicapped at the start; thus parental education, integrated with the public school system, should be developed now. (2) A more meaningful educational program which would emphasize ideals of citizenship, moral integrity, and respect for the law and the police. (3) A periodic check made for potential delinquents throughout the public schools and treatment provided if possible; and if not, proper segregation in institutions. (4) Careful attention paid to press, movies, and radio so that crime may no longer appear to be glamorous. This can be done by women's clubs, civic bodies, and other educational groups exerting pressure on the movie syndicates and broadcasting companies to free their productions of the tawdry and lurid characteristics of crime and criminals. Aggression associated with the phallic stage of development, The child ordinarily comprehends sexual intercourse as an aggressive and sadistic act on the part of the male, and specifically on the part of the penis. Evidence that the penis is phantasied as a weapon of violence and destruction come from unconscious productions of normal adults. Limerick, for instance, often refer to the penis as square, or too large, etc., so that intercourse is dangerous and painful for the partner, This may wall be a projection of the male's own fear of coitus. A certain portion of the death-instinct always remains within the person; it is called 'primal sadism' and according to Freud is identical with masochism. 'After the chief part of it(the death instinct) has been directed outwards towards objects, there remains as a residuum within the organism the true erotogenic masochism, which on the one hand becomes a component of the libido and on the other still has the subject itself for a object.' Criminalism, compulsive-neurotic frequent repetition of criminal acts in a compulsive manner. Like most symptoms of the compulsive-neurotic, such antisocial act are closely rated to feelings of hostility and aggression, often against the father. Because these acts are symptomatic, they afford only temporary relief and are therefore repeated. One patient with compulsive-neurotic criminalism was apprehended after breaking into hardware store and stealing money. He later confessed to many similar incidents over the preceding two years. At the same time it was apparent that he stole only for the sake of stealing. He did not need the money he thus obtained and had no special plans for using it.

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기능성 소화불량증 환자의 심리특성에 관한 연구 (An Investigation of Psychological Factors in Patients with Functional Dyspepsia)

  • 김진성;배대석;이광헌;서정일
    • Journal of Yeungnam Medical Science
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    • 제16권2호
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    • pp.244-254
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    • 1999
  • 1998년 1월 1일부터 12월 31일까지 영남대학교와 동국대학교 의과대학 부속병원을 내원한 기능성 소화불량증 환자 90명의 심리적 특성을 알아보기 위하여, 정신과 외래 환자 64명을 대조군으로 하여 다면적 인성검사와 질병행동 설문지 조사를 실시하였으며, 그 결과는 다음과 같다. 다면적 인성검사를 통한 비교에서, 기능성 소화불량증 환자군과 정신과 외래환자군 사이에 유의한 차이가 없이 유사한 성적분포를 보였다. 양군에서 건강염려증, 우울증, 히스테리 척도에서 상대적으로 높은 점수를 보였다. 질병행동 설문지를 통한 비교에서 기능성 소화불량증 환자군이 정신과 외래환자군보다 질병집착심과 정서적 혼란 소척도에서 성적이 낮게 나왔으며, 다른 소척도들은 비슷한 성적분포를 보였다. 다면적 인성검사 성적을 이용하여 기능성 소화불량증 환자를 중다변인 군집분석한 결과, 정신과 외래의 신경증환자와 같은 집단<집단 1>, 정상인과 같은 집단<집단 2>, 신경증적 경향이 심한 집단<집단 3>으로 나눌 수 있었다. 분류된 집단들 간의 다면적 인성검사 성적 비교에서, 신경증적 경향이 심한 집단<집단 3>은, 건강염려증, 우울증, 히스테리, 강박증, 정신분열증 등의 소척도 점수가 높게 나왔다(P<.05). 신경증적인 경향이 심한 집단<집단 3>의 질병행동 설문지 결과를 보면 다른 집단들과 정서적 억압척도를 제외한 모든 척도 즉, 건강염려증, 질병집착심, 심리적 대 신체적 관심, 정서적 혼란, 부정, 자극과민성 등의 척도에서 유의하게 차이가 있는 것으로 나타났다(P<.05). <집단 3>처럼 심한 신경증적인 질병행동을 보이는 군은 정신의학적 접근이 도움을 줄 수 있는 집단이다.

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암 환자의 침치료 금기증에 대한 고찰 (Review of Contraindications for Oncology Acupuncture)

  • 방선휘;유화승;이연월;조종관
    • 대한암한의학회지
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    • 제16권2호
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    • pp.9-17
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    • 2011
  • Objectives : Contradictions for Oncology acupuncture were searched and reviewed to establish fundamentals for the appropriate contraindication guideline. Methods : In order to search contraindications for oncology acupuncture, domestic journals, books and online database of Pubmed were searched using the terms, cancer, tumor, acupuncture, safety, contraindications and guideline were below. Results : We found 7 papers and 1 book by the above methods. We reviewed and suggested the contraindications. Contraindications for oncology acupuncture are neutropenia (absolute neutrophil count : ANC less than $500/mm^3$), thrombocytopenia (platelets less than $50,000/mm^3$), anticoagulant use, spinal instability, tumour nodule, lymphedema, prosthesis, intracranial deficits, confused patients, significant arrhythmia, patient refusal to treatment, severe neurotic patients and intracardiac defribillator. Contraindications for using semi-permanent needles are neutropenia (ANC less than $500/mm^3$), splenectomy, valvular heart disease, B, C hepatitis and keloids. Conclusions : Acupuncture for cancer patients pose significant risks but these guidelines are proposed in the hopes of providing certain boundaries in practicing oncology acupuncture. A more systematic and rigorous research is needed to establish a more reliable oncology acupuncture guidelines.

정신분열병(精祥分裂病) 환자(患者)의 사회적(社會的) 지지망(支持網) 분석(分析) (A Study of Social Support Network in the Course of Schizophrenic Patients)

  • 한창환;김광진;석재호
    • 정신신체의학
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    • 제4권2호
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    • pp.226-244
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    • 1996
  • This study was designed to evaluate the social support network of schizophrenic patients. 64 schizophrenic patients being treated as out-door patient were compared with 30 neurotic control patients. Schizophrenics were divided into positive, subpositive, subnegative and negative subgroups by present symptom and social network of both schizophrenics and control group were evaluated. The results are as follows: 1) Social network of schizophrenics was smaller than that of control group. Size of social network of schizophrenics was 10.6 and that of control group was 23.5. 2) In both kin and nonkin, social network of schizophrenics was smaller than that of control group. Of the kin, schizophrenics were more supported by wife or husband, father, and mother, but were less supported by brother, son and other relatives. 3) There was no difference in the kin or nonkin or total supporters between the four subgroups of schizophrenics. But, subgroup of schizophrenics which was divided as having negative symptom had smaller network than control group in active formal and informal supporters. 4) When divided into 4 support areas, schizophrenics was remarkably less supported in emotional, instrumental and appraisal support area than control group, but there was no difference in the informational support areas. 5) Compared with control group, schizophrenics more often mentioned parent and ten often mentioned nonkin supporter as the one that is most important to him. 6) Schizophrenics had smaller cluster and less leisure activity than control group. Subgroup of schizophrenics who was divided as having negative symptom had less frequency of leisure activity than other subgroups.

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신체형 장애 환자에서 동반되는 인격 장애/성향의 유형 및 빈도에 대한 연구 (A Study on the Types and the Frequencies of Personality Disorders/Traits in the Patients with Somatoform Disorders)

  • 김원식;이철;김창윤;한오수
    • 정신신체의학
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    • 제5권1호
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    • pp.43-51
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    • 1997
  • This study was conducted to identify the relationships between personality disorders/traits and somatoform disorders. After the patients were screened through self-rated SCID-II Questionnaire(Structured Clinical Interview for DSM-III-R, Questionnaire), the researcher got psychiatric history, performed clinician-rated SCID-P(Structured Clinical Interview for DSM-III-R, Patient Edition), classified and diagnosed mental disorders with SCID-P, and evaluated SCID-II(Structured Clinical Interview for DSM-III-R, Personality Disorders) by direct interview. The prevalencies of avoidant, obsessive-compulsive, schizotypal, narcissistic, paranoid, dependent, self-defeating, borderline personality disorders/traits in patients with somatoform disorders were diagnosed as 67.4%, 48.8%, 44.2%, 41.9%, 37.2%, 34.9%, 34.9%, 32.6%, respectively. The frequencies of self-defeating and schizotypal PD/traits were significantly higher than those of other neurotic control group. The results of this study could be regarded as replicating the results of previous studies that had reported most of all patients with somatoform disorder had presented with personality disorders/traits. This study, however, showed that the patients with somatoform disorders accompanied not with any specific types of personality disorders/traits but with various types of personality disorders/traits, which was much different from the previous usual clinical impressions. Thus, it is necessary for clinicians to approach the patients with somatoform disorders through more flexible and more supportive methods and attitude, in order that they should treat them more effectively.

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Review on Diagnostic Criteria of Neurasthenia : Suggesting Pathway of Culture-bound dieases

  • Lee, Myeong Hun;Kim, Yunna;Cho, Seung-Hun
    • 대한약침학회지
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    • 제20권4호
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    • pp.230-234
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    • 2017
  • Objective: Neurasthenia is a disease which consists of increased fatigue or bodily weakness and exhaustion plus pantalgia, dizziness, headache and other symtoms relevant to autonomic nerve dysfunction. There are plenty of studies investigating the history of diagnostic criteria of neurasthenia, which is influenced by diverse cultural(or social) environment. The obejective of this study is to provide review of the previous studys on the changes of neurasthenia diagnoses in the context of local area to find meanings of these transition and improve health care for psychiatric patient. Methods: Literature review was conducted on studies demonstrating diagnostic criteria of neurasthenia with cultural(or social) environment. We investigated the literature reviews or observative studies which described alteration of diagnostic criteria of neurasthenia and assessed its significance. After selecting eligible studies, the authors read the articles and summarized the meaningful contents those were significant in clinical practice. Results: Transformation of Chinese Classification of Mental Disorder(CCMD) integrated with internationally utilized DSM-IV or ICD-10 is controversial about its significance in that it had limited effect on public health care due to the variables of sociocultural context, but primarily differentiated neurasthenia from other disorders. The latter one can be the directing point of the diagnostic criteria of other culture-bound diseases, which is the traits of not outstanding mood(or affect) than other neurotic disorders. Conclusion: As diagnostic criteria of neurasthenia varies, the significance of this variation is controversial, but could be the paragon of other culture-bound diseases.

신체형 장애의 정신치료 (Psychotherapy for Somatoform Disorder)

  • 이무석
    • 정신신체의학
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    • 제4권2호
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    • pp.269-276
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    • 1996
  • 신체형장애의 정신역동에 대하여 이론적 고찰을 하였다. 신체화(身體化)란 본능적 욕동을 방어하는 과정에서 생긴 갈등을 정신적으로 처리하지 못하고. 신체 증상으로 처리하는 것을 말한다(Moore 1990). Ford(1983)는 인생을 사는 방법 중의 하나라고 하였고, Dunbar(1954)는 정신 에너지가 신체증상으로 바뀌어진 것이라고 했다. Schur(1955)에 의하면, 신체화(身體化)는 갈등에 의해서 일어나는 하나의 퇴행현상이라고 한다. Schur는 이런 현상을 '재(再) 신체화(身體化)(resomatization)'라 했다. 갈등의 신체화(身體化) 반응중 가장 흔한 것이 통증(痛症)(pain)이다. 통증(痛症)은 어린시절의 경험에서 유래한 무의식적 의미를 가지고 있다. 통증(痛症)(pain)은 사랑 획득의 방법이며, 잘못한 행동에 대한 벌로 사용되기도 하고, 속죄(贖罪)의 수단이 되기도 한다. 통증(痛症)중에서도 흉통(胸痛)(chest pain)은 특별한 의미를 갖는다. 일반적으로 '가슴이 아프다'는 말은 '마음이 아프다'는 의미와 같이 쓰인다. 그리고 가슴은 마음을 상징하고 마음은 심장을 생각나게 하여 마음의 아픔을 심장의 통증(痛症)(pain)으로 인식하는 경향이 높다. Kellner(1990)는 적개심과 분노, 특히 억압된 적개심이 신체화(身體化)의 중요한 인자라고 하였다. 정신분석가인 Bacon(1953)dms '심장동통(心臟疼痛)에 대한 정신분석적 관찰'에서 정신분석 시간에 사랑받고 싶은 욕구가 좌절된 환자가 이로 인한 분노와 두려움 때문에 왼편 가슴에서 왼쪽 팔로 뻗쳐 내려가는 심장동통을 호소하는 증례(症例)들을 발표했다. 그녀는 심장동통과 관계된 욕구들이 의존욕구와 공격욕구라고 하였다. 신체형장애의 정신치료에서는 공감적인 관계와 치료적 동맹이 필수적이며, 증상시작의 시점을 중심으로 유발인자를 가려내고 증상과 유발인자의 관계를 이해하도록 돕는 것이 출발이다. 증상을 통하여 표현되고 있는 환자의 심리내적인 갈등을 발견하여 해석해 주는 것이 치료의 과정이다. 이런 기법을 기초로 치료한 세 사람의 신체형장애 증례를 소개하였다. 첫 번째 소개한 히스테리성 실어증을 가진 H군은 억압된 분노가 역동적인 원인이었다. 유발인자와 관련지어 해석을 해주었고, 이차이득을 얻은 후에 회복되었다. 두 번째 소개한 심장노이로제에 빠진 치과의사의 경우는 아버지의 사랑을 잃을 것에 대한 불안이 역동적 원인이었다. 유발인자와 관련지어 증상을 해석하였고, 아버지의 사랑을 잃을까봐 두려워하는 마음속의 아이를 보여주었고, 이제는 어른이 되었으니 자신의 주인이 되어 살라고 교육적인 해석을 듣고 호전되었다. 세 번째 부인은 심한 흉통발작으로 내과에서 의뢰되어 왔는데 의존욕구의 좌절과 이로 인한 분노, 그리고 분리 불안이 역동적 원인이었다. 이 부인은 holter monitor를 메자 증상이 극적으로 사라졌는데 이것을 계기로 자신의 중상이 심인성이라는 것을 알고부터 치료동맹이 이루어졌고, 그 후 정기적인 정신치료 시간에는 증상과 유발인자들 사이의 관계를 해석해 주었다. 이를 통하여 분리불안이 증상과 관계되어 있다는 것을 이해하고 환자는 증상이 일어나도 덜 두려워하게 되었고, 해외여행이나 사회적인 활동이 가능해졌다.

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