• Title/Summary/Keyword: post traumatic disorder

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Tc-99m HMPAO Brain SPECT in Patients with Post-Traumatic Organic Mental Disorder (두부외상후 만성 기질성 정신장애 환자에서 Tc-99m HMPAO Brain SPECT 분석)

  • Lee, Kang-Wook;Lee, Jong-Jin;Shong, Min-Ho;Kang, Min-Hee;Ghi, Ick-Sung;Shin, Young-Tai;Ro, Heung-Kyu
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.293-300
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    • 1994
  • It is well known that Tc-99m HMPAO brain SPECT can reflect the functional lesions better than X-ray computerized tomography(CT) and magnetic resonance imaging(MRI) in the cerebral disorders. In order to evaluate the clinical utilities of Tc-99m HMPAO brain SPECT in patients with post-traumatic chronic organic mental disorder(OMD), we included 28 patients diagnosed as OMD in department of psychiatry after traumatic head injury. And we compared the results of Tc-99m HMPAO SPECT with those of MRI, EEG and MINI mental status ex amination(MMSE). The results were as follows 1) All patients diagnosed as OMD showed diffuse or focal decreased cerebral perfusion on Tc-99m HMPAO SPECT. 2) Most frequent lesion on brain Tc-99m HMPAO SPECT was decreased perfusion on both frontal lobe. And most frequent lesion on brain Tc-99m HMPAO SPECT showing normal brain MRI result was also decreased both frontal perfusion. 3) Eight of 28 patients showed focal brain MRI lesions(4 small frontal hygroma, 3 small cerebral infarction and 1 cerebellar encephalomalacia) which were not detected in brain Tc-99m HMPAO SPECT. 4) The patients showing less than 20 points on MMSE disclosed abnormal results of EEG more frequently than those disclosing more than 20 points. In conclusion, we think that Tc-99m HMPAO brain SPECT is sensitive method to detect functional lesions of the brains in patients with chronic post-traumatic organic mental disorder.

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The Use of Virtual Reality in Psychiatry: A Review

  • Kim, Suji;Kim, Eunjoo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.31 no.1
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    • pp.26-32
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    • 2020
  • With the advancement in modern information technology, virtual reality (VR) is being increasingly used for the diagnosis, assessment, and treatment of mental disorders. Recently, a VR-based cognitive behavioral therapy for social phobia has been recognized as a new medical technology in South Korea. This might lead to an increase in the use of VR in the field of psychiatry. The present review provides an overview of the status of VR therapies in various psychiatric conditions such as anxiety disorder, post-traumatic stress disorder, psychosis, addiction, and eating disorder. Besides, it summarizes the role of VR therapy in the management of disorders associated with child and adolescence psychiatry as well as various other clinical applications. Additionally, we discuss the merits and limitations of VR therapy, which might serve as a useful reference for researchers. In the current environment wherein novel medical models consisting of a combination of digital devices and medicine are being developed; understanding new technologies such as VR could open new doors to mental health treatments.

Development and Evaluation of Resilience Enhancement Program Applying Mindfulness Meditation in Patients with Ileostomy (회장루 보유자의 마음챙김명상을 접목한 회복탄력성 증진 프로그램 개발 및 효과)

  • Shin, Jee Hye;Choi, Ja Yun
    • Journal of Korean Academy of Nursing
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    • v.51 no.3
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    • pp.334-346
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    • 2021
  • Purpose: The purpose of this study was to develop a resilience enhancement program applying mindfulness meditation (REP-MM) and evaluate the effects of the program on post-traumatic stress (PTS), resilience, and health-related quality of life (HRQoL) in patients with ileostomy. Methods: The REP-MM was developed by combining the resilience enhancement program with mindfulness meditation according to four patterns. The program was developed through identifying patients' needs, reviewing relevant literature, developing a preliminary program, and testing content validity and user evaluation. The participants were 55 patients with ileostomy. We conveniently assigned 27 patients to the experimental group and 28 to the control group. The study was conducted in conducted in a hospital from January 22 to May 30, 2019. The REPMM was provided to the experimental group, and conventional ileostomy care was provided to the control group using a nonequivalent control-group pretest-posttest design. Results: ANCOVA revealed that the levels of PTS (F = 321.64, p < .001), resilience (F = 111.86, p < .001), and HRQoL (F = 31.08, p < .001) in the experimental group were higher than those in the control group when comparing pretest to posttest changes. Conclusion: The REP-MM is effective in PTS, resilience, and HRQoL in patients suffering from post-stoma creation crisis. The REP-MM can induce positive self-recognition changes in patients with ileostomy through dispositional, situational, relational, and philosophical interventions. We suggest nurses reduce PTS and improve resilience and HRQoL in patients with ileostomy.

Reliability and Validity of Korean Version of Depression and Somatic Symptom Scale(DSSS) (한국판 우울과 신체 증상 평가 척도(Depression and Somatic Symptom Scale, DSSS)의 신뢰도와 타당도)

  • Kim, Kun-Woo;Hong, Jin-Pyo;Park, Seung-Jin;Choi, Ji-Hye;Choi, Hye-Ra
    • Anxiety and mood
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    • v.7 no.1
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    • pp.9-15
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    • 2011
  • Objectives : We examined the reliability and validity of the Korean version of the Depression and Somatic Symptom Scale (DSSS) in Korean patients with depressive symptoms. Methods : Participants were 55 outpatients diagnosed with major depressive disorder, a depressive episode of bipolar I disorder, somatoform disorder, panic disorder, generalized anxiety disorder, or post-traumatic stress disorder according to the DSM-IV criteria. We assessed them using the Korean versions of the DSSS, Hamilton Depression Rating Scale (HDRS), and Quick Inventory of Depressive Symptomatology Self Report (QIDS-SR). Results : The Korean version DSSS had a Cronbach's alpha of 0.90. Moreover, each item's correlation with the total score was statistically significant (r=0.24-0.71, p<0.01). The test-retest correlation coefficient (r=0.83, p<0.01) was relatively high, and the DSSS correlations with the HDRS and QIDS-SR were 0.77 and 0.74, respectively. Conclusion : These results demonstrate that the Korean version of the DSSS could be a reliable and valid tool for screening and assessing depressive patients. The Korean version of the DSSS will be a useful tool for screening both depressive and somatic symptoms in Korea.

Decompressive Surgery in a Patient with Posttraumatic Syringomyelia

  • Byun, Min-Seok;Shin, Jun-Jae;Hwang, Yong-Soon;Park, Sang-Keun
    • Journal of Korean Neurosurgical Society
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    • v.47 no.3
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    • pp.228-231
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    • 2010
  • Posttraumatic syringomyelia may result from a variety of inherent conditions and traumatic events, or from some combination of these. Many hypotheses have arisen to explain this complex disorder, but no consensus has emerged. A 28-year-old man presented with progressive lower extremity weakness, spasticity, and decreased sensation below the T4 dermatome five years after an initial trauma. Magnetic resonance imaging (MRI) revealed a large, multi-septate syrinx cavity extending from C5 to L1, with a retropulsed bony fragment of L2. We performed an L2 corpectomy, L1-L3 interbody fusion using a mesh cage and screw fixation, and a wide decompression and release of the ventral portion of the spinal cord with an operating microscope. The patient showed complete resolution of his neurological symptoms, including the bilateral leg weakness and dysesthesia. Postoperative MRI confirmed the collapse of the syrinx and restoration of subarachnoid cerebrospinal fluid (CSF) flow. These findings indicate a good correlation between syrinx collapse and symptomatic improvement. This case showed that syringomyelia may develop through obstruction of the subarachnoid CSF space by a bony fracture and kyphotic deformity. Ventral decompression of the obstructed subarachnoid space, with restoration of spinal alignment, effectively treated the spinal canal encroachment and post-traumatic syringomyelia.

Plasma Serotonin Level of Vietnam War Veterans with Post-Traumatic Stress Disorder and Symptom Severity (혈장 세로토닌과 외상후 스트레스 장애 : 월남전 참전 재향군인을 대상으로)

  • Lee, Soo-Young;Kang, Suk-Hoon;Chung, Moon-Yong;Lee, Myung-Hee;Kim, Tae-Young;So, Hyung-Seok;Chung, Hae-Kyung;Choi, Jin-Hee
    • Anxiety and mood
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    • v.5 no.1
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    • pp.14-20
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    • 2009
  • Objective : The objective of this study was to examine the relationship between plasma serotonin concentration and posttraumatic stress disorder (PTSD) symptoms in chronic PTSD patients who have been taking medication. Methods : Plasma serotonin level of 14 PTSD patients and a control group of 28 Vietnam War veterans was measured by HPLC (high performance liquid chromatography). The Combat Exposure Scale (CES), Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (M-PTSD), Clinician Administered PTSD Scale (CAPS), Hamilton Rating Scale for Depression (HRSD), and Hamiltion Anxiety Scale (HAS) were used to evaluate PTSD symptom severity. Results : Serotonin level was significantly higher in the PTSD group than in the control group (p=0.036, p=0.006, respectively). M-PTSD (p<0.001), CAPS (p<0.001), HRSD (p<0.001), and HAS (p<0.001) scale scores were significantly higher in the PTSD group than in the control group; however, the CES score failed to show a significant improvement (p=0.964). There were no significant differences between plasma serotonin and PTSD symptoms. Conclusion : In chronic PTSD patients who have been taking medications, we can not predict treatment effect and symptom severity by measuring only plasma serotonin levels. PTSD is a complicated disorder which may likely be related to a variety of neurotransmitter systems. Therefore, further research which investigate relationships with norepinephrine, dopamine, and other neurotransmitters as well as serotonin is needed to improve the treatment of PTSD.

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Effects of an Online Imagery-Based Treatment Program in Patients with Workplace-Related Posttraumatic Stress Disorder: A Pilot Study

  • Lee, Won Joon;Choi, Soo-Hee;Shin, Jung Eun;Oh, Chang Young;Ha, Na Hyun;Lee, Ul Soon;Lee, Yoonji Irene;Choi, Yoobin;Lee, Saerom;Jang, Joon Hwan;Hong, Yun-Chul;Kang, Do-Hyung
    • Psychiatry investigation
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    • v.15 no.11
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    • pp.1071-1078
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    • 2018
  • Objective We developed easily accessible imagery-based treatment program for patients with post-traumatic stress disorder (PTSD) related to workplace accidents and investigated the effects of the program on various PTSD related symptoms. Methods The program was based on an online platform and consisted of eight 15-min sessions that included script-guided imagery and supportive music. Thirty-five patients with workplace-related PTSD participated in this program 4 days per week for 4 weeks. Its effects were examined using self-report questionnaires before and after the take-home online treatment sessions. Results After completing the 4-week treatment program, patients showed significant improvements in depressed mood (t=3.642, p=0.001) based on the Patient Health Questionnaire-9 (PHQ-9), anxiety (t=3.198, p=0.003) based on the Generalized Anxiety Disorder seven-item (GAD-7) scale, and PTSD symptoms (t=5.363, p<0.001) based on the Posttraumatic Stress Disorder Check List (PCL). In particular, patients with adverse childhood experiences exhibited a greater degree of relief related to anxiety and PTSD symptoms than those without adverse childhood experiences. Conclusion The present results demonstrated that the relatively short online imagery-based treatment program developed for this study had beneficial effects for patients with workplace-related PTSD.

Incident shock and Related Factors in Rescue Workers (구조대원의 사건충격 정도와 관련 요인 분석)

  • Yoo, Eui-Tae;Cho, Sung-Je
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.5
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    • pp.2225-2233
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    • 2013
  • This study was designed to identify the extent of incident shock who are in high risk of post traumatic shock stress, and analyze the related factors that affect the extent of incident shock. The subjects are 415 rescue workers from Seoul Metropolitan Fire & Disaster Headquarters, who are in high frequency of fire outbreaks and rescue mobilization. With a reliability of Cronbach's ${\alpha}$=.975, the results show invasion, avoidance, sleep disorder and emotional paralysis, dissociative symptom, hyper arousal as foremost causes respectively. Moreover, the results imply that the extent of incident shock was higher in people with more age or being married. Also, from the occupational perspective, the number of years as fire fighters, as rescue workers, mobilization and experiences at work in proportion to incident shocks has risen exponentially. It is notable that the groups who alleviate stress by consuming liquors had higher extent of incident shock. In conclusion, to deal with groups in high risk, management system and prevention care programs for incident shocks need to be introduced immediately and put into effect.

Validity and Reliability of Korean Version of Post-traumatic Stress Disorder Scale (K-PTSD) Measuring Attitudes and Knowledge of PTSD (한국판 외상 후 스트레스 장애에 대한 태도와 지식 측정도구(K-PTSD)의 타당도와 신뢰도)

  • Bang, Kyung-sook;Bang, Hwal Lan;Hong, Sun-Woo;Lim, Jihee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.26 no.1
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    • pp.47-55
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    • 2020
  • Purpose: The aim of this study was to examine the validity and reliability of the Korean version of the PTSD scale (K-PTSD) for measuring attitudes and knowledge of PTSD. Methods: A cross-sectional study design was used. The K-PTSD scale consisted of 8 items for attitudes, 8 items for general knowledge of PTSD, and 3 items for knowledge of PTSD treatment; 211 nursing students and paramedic students participated. Content validity, item analysis, and factor analysis were used to examine the construct validity. Criterion validity was tested by using educational experience with PTSD as a criterion. Cronbach's α was used to identify internal consistency reliability in the attitude scale. Results: Construct validity of the K-PTSD was verified by exploratory factor analysis, with factor loadings for attitude ranging from .59 to .84. Criterion validity in comparing knowledge of PTSD (t=2.02, p=.044) and PTSD treatment (t=3.19, p=.022) showed a significant difference according to PTSD educational experience. Cronbach's α for the attitude scale was .79 and .59. Conclusion: The findings suggest that the K-PTSD is a valid and reliable tool that can measure attitudes and knowledge of PTSD among nursing and paramedic students. However, further study is needed to retest the verification of this scale with more diverse participants.

The Effects of M&L Trauma Psychotherapy on Impact of Events, Affection, and Quality of Life among Female Vicims of Family Violence (가정폭력 피해여성들의 사건충격과 정서 그리고 삶의 질에 대한 M&L 트라우마 심리치료 프로그램의 효과에 대한 임상연구)

  • Sue, Joo-Hee;Kim, Jung-suk;Ko, Kyung-sook;Oh, Jung-lan;Ko, In-sung;Kang, Hyung-won
    • Journal of Oriental Neuropsychiatry
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    • v.26 no.2
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    • pp.79-88
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    • 2015
  • Objectives: The purpose of this study is to investigate the effects of the M&L Trauma Psychotherapy Program on: Impact of Event Scale - Revised (IES-R-K); Euro QOL-5 Dimension (EQ5D); Five-facet Mindfulness Questionnaire (FFMQ); and psychological tests. Methods: Eight middle-aged women subjected to domestic violence participated in the two-day M&L Trauma Psychotherapy Program. The Program was executed 5 times 2 days for about 3 hours. We evaluated IES-R-K, EQ5D, FFMQ, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), State-Trait Anger Expression inventory (STAXI) and SUDS before the Program and for four weeks afterwards, to analyze the effects of the M&L Trauma Psychotherapy Program. Results: The scores of IES-R-K, BDI, STAI-S, STAI-T, Hwa ST and Hwa CT decreased significantly (p<0.05). EQ5D scores increased significantly (p<0.05) and overall physical condition scale (VAS) increased. In the FFMQ scores, all five facet scores increased slightly. Scores of SUDS decreased significantly right after the program, and remained decreased four weeks later, rather than before the Program (p<0.05). Conclusions: The results suggested that the M&L Trauma Psychotherapy Program improved post-traumatic stress, quality of life and mindfulness skills, and had positive responses to psychological problems - depression, anxiety, anger and distress.