• Title/Summary/Keyword: psychiatric disease

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A Comparative Study Concerning the Psychopathologies between the Patients with Peptic Ulcer and Those with Essential Hypertension - Focused on Medically-Ill Out Patients - (소화성 궤양과 본태성 고혈압 환자의 정신병리에 관한 비교 연구 - 내과외래환자를 중심으로 -)

  • Choi, Hyun-Kyoung;Kim, Chan-Woo;Lee, Dong-Gun;Kwak, Chung-Whan;Park, Seung-Ken;Park, Hee-Ouk;Ok, Jong-Whan;Kim, Jeong-Gee
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.2
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    • pp.149-158
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    • 2003
  • Objectives: The authors studied the anxiety, depression and psychological characteristics of medical out-patients, which are diagnosed as peptic ulcer disorder and essential hypertension. We also examined the state of psychiatric consultation. Methods: The subjects were composed of 56 patients with peptic ulcer disorder, 44 patients with essential hypertension and 116 controls. STAI, BDI and SCL-90R was administered to all subjects. Chart review, telephone interview and Self report questionnaire of etiology and severity of illness, drug compliance and so forth were performed in disease groups. Results: Considerable depression was noticed in 39.3% among the patients with peptic ulcer disorder, 27.7% in hypertension and 12.1% in control group by BDI. State anxiety was noticed in 44.6% among the patients with peptic ulcer disorder, 54.5% in hypertension and 18.1% in control group by State anxiety. Trait anxiety was noticed in 42.9% among the patients with peptic ulcer disorder, 34.1% in hypertension and 25.8% in control group by Trait anxiety. The higher SOM, BDI, STAI, the lower drug compliance and rapport. Psychological problems are considered of the most important etiology in 48.2% of peptic ulcer group and 45.7% of hypertensive group. But psychiatric consultation is made only in 1.8% of peptic ulcer group and 2.3% of hypertensive group. Conclusions: Anxiety and depression are common phenomena in medical outpatients. In comparison with the normal control group, peptic ulcer group showed significantly higher trait anxiety and depression and hypertensive group higher state anxiety. These characteristics are related to the drug compliance and doctor-patient relationship. These results suggested the needs of active psychiatric consultation.

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Past, Present, and Future of Psychosomatic Medicine in the Field of Korean Medical Education (한국 의학 교육에서 정신신체의학의 과거와 현재 그리고 미래)

  • Kim, Eui-Joong
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.1
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    • pp.14-17
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    • 2012
  • There were several documents that might reflect the great concern on the education of psychosomatic medicine in medical school from the 1960s. But the hour of class and proportion of psychosomatic medicine have been quite small among the total lecture time of psychiatry. Notwithstanding the importance of biopsychosocial perspective in practice and research there have been no agreement on the goal and content of teaching psychosomatic medicine in the medical school curriculum. Consultation-liaison psychiatric activity in the hospital were currently under-developed and educational content and process were not systematic. We should have established the goal of psychosomatic education in the medical school that includes making doctor who could not only cure disease but also care the ill patients. And we should develop the curriculum that covers essential area of psychosomatic medicine and checking system to monitor the process of education. With the continuance of psychosomatic perspectives from medical school education to clinical subspecialty we can make progress in this field.

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Effect of Preexisting Musculoskeletal Diseases on the 1-Year Incidence of Fall-related Injuries

  • Lee, Won-Kyung;Kong, Kyoung-Ae;Park, Hye-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.45 no.5
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    • pp.283-290
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    • 2012
  • Objectives: People who have chronic diseases, as well as gait imbalance or psychiatric drug use, may be susceptible to injuries from falls and slips. The purpose of this study was to evaluate the effect of musculoskeletal diseases on incidental fall-related injuries among adults in Korea. Methods: We analyzed data from the 4th Korea National Health and Nutrition Examination Survey (2007-2009), which are national data obtained by a rolling survey sampling method. The 1-year incidence of fall-related injuries was defined by health service utilization within the last year due to injury occurring after a slip and fall, and musculoskeletal diseases included osteoarthritis, rheumatoid arthritis, osteoporosis, and back pain. To evaluate the effects of preexisting musculoskeletal diseases, adults diagnosed before the last year were considered the exposed group, and adults who had never been diagnosed were the unexposed group. Results: The weighted lifetime prevalence of musculoskeletal disease was 32 540 per 100 000 persons. Musculoskeletal diseases were associated with a higher risk of fall-related injury after adjustment for sex, age, residence, household income, education, occupation, visual disturbance, paralysis due to stroke, and medication for depression (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.03 to 1.93). As the number of comorbid musculoskeletal diseases increased, the risk of fall-induced injuries increased (p-value for trend <0.001). In particular, patients who had any musculoskeletal condition were at much higher risk of recurrent fall-related injuries (OR, 6.20; 95% CI, 1.06 to 36.08). Conclusions: One must take into account the risk of fall-related injuries and provide prevention strategies among adults who have musculoskeletal diseases.

Effects of Olanzapine on Gene Expression Changes in MK-801-induced Neurotoxicity Using a High-density DNA Microarray

  • Jo, Jae-Hoon;Kim, Seung-Jun;Yeon, Jong-Pil;Oh, Moon-Ju;Seo, Hye-Myung;Hwang, Seung-Yong;Kim, Sang-Kyum;Kim, Bong-Hee
    • Molecular & Cellular Toxicology
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    • v.3 no.4
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    • pp.282-291
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    • 2007
  • Although the etiology of schizophrenia is known to be linked with the disturbance of glutamatergic and dopaminergic neurotransmission, little is known about the relationship between gene expression and the disease process. To identify genes related to abnormalities in glutamatergic and dopaminergic function, we investigated the effects of olanzapine in the changes of mRNA levels in the animal model of schizophrenia, using a high-density DNA microarray. Olanzapine (3.0 mg/kg, i.p.) significantly reduced hyperlocomotive activities, which was induced by MK-801 (1.0 mg/kg, i.p.). We identified that the expression of 719 genes were significantly altered more than two folds in the prefrontal cortex of the rats treated with MK-801. We selected 15 genes out of them by the changes of the expression pattern in the treatment of Olanzapine and/or MK801 for the further confirmation in RT-PCR. The administration of MK-801 increased the expression of 7 genes (NOS3, Hspb1, Hspa1a, CRH, Serpine1, Igfbp6, Snf1lk) and decreased the expression of 1 gene (Aldh1a2), which was attenuated by olanzapine. One gene (Prss12) was up-regulated after olanzapine treatment although it did not show the significant changes after MK-801 treatment. These results showed that antipsychotic drug, such as olanzapine, may alter the gene expression patterns, which were accompanied by MK-801-induced psychosis. Our results also provide us high-density DNA microarray technology could be potential approaches to find the candidate molecules for the therapeutics and also for the early diagnosis of psychiatric diseases.

Electroconvulsive Therapy for CRPS (복합부위통증증후군 환자에서의 전기경련요법)

  • Lee, Jong-Ha;Ko, Young-Hoon;Yang, Jong-Yeun;Kim, Yong-Ku;Han, Chang-Soo;Youn, Hyun-Chul
    • Korean Journal of Biological Psychiatry
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    • v.18 no.3
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    • pp.163-167
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    • 2011
  • Complex regional pain syndrome (CRPS) is a disease that causes chronic spontaneous pain and hyperesthesia of one or more parts of legs and arms, which is accompanied with problems of the automatic nervous system or the motor nervous system. However, up to date, it is unclear what causes the syndrome and how to diagnose and treat it. Although several treatments including medication and sympathetic nerve block are performed against CRPS, the therapeutic effect of the treatments is limited. The electroconvulsive thera-py (ECT), of which the mechanism is not clarified, is a treatment used for treatment-resistant depression. ECT is also reported to be effective against pain. Therefore, we performed the ECT for a 24-year-old female patient who has been diagnosed as CRPS. Her pain had not been much improved by medications and interventional procedures. At admission to a psychiatric ward for ECT, she com-plained of over 8 points of pain on visual analogue scale and the constrained movement around the painful part. Eight ECTs-three times a week-were performed for three weeks in hospital and then the ECT once a week was performed after her leaving the hospital. During the ECTs, pain had been reduced and the range of movement in the constrained parts had increased. Further systematic re-search is needed to confirm the effect of electroconvulsive therapy against CRPS.

Relationship between White Matter Changes and Cognitive Dysfunction in the Elderly with Subjective Memory Complaint (주관적 기억감퇴를 가진 노인에서 백질 변화와 인지기능 장애의 관련성)

  • Shin, Eun-Young;Jung, Han-Yong;Kim, Yang-Rae;Lee, So-Young-Irene;Kim, Shin-Gyeom
    • Korean Journal of Biological Psychiatry
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    • v.18 no.3
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    • pp.141-147
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    • 2011
  • Objectives The purpose of this study is to evaluate the relationship between the severity of white matter changes (WMC), risk factors and cognitive domains, including executive function profiles. Method Forty nine subjects over 55 years with subjective memory complaints were assessed with MRI and neuropsychological tests. The WMC were assessed by MRI T2-FLAIR images and divided into 3 groups of mild vs. moderate vs. severe and 2 groups of mild-moderate vs. severe by using Mantyla's criteria and Fazeka's criteria. The risk factors were examined in hypertension, heart disease history and chemistry Lab. Medical conditions which affect to cognitive dysfunction and definite dementia were also excluded. Results Comparing 3 groups, hypertension was identified as a risk factor of the WMC. Comparing 2 groups, total cholesterol and LDL were identified for as the risk factor of WMC. The severity of WMC was significantly associated with cognitive disturbances and their main effect on cognition was working memory and inhibition. Conclusion The risk factors of the WMC in the elderly were hypertension, hyperlipidemia. The severity of WMC appears to be associated with executive dysfunction in the elderly.

Association between Quality of Life and Symptom Severity in Obsessive-Compulsive Disorder Patients Using EQ-5D (EQ-5D를 이용한 강박장애 환자의 삶의 질과 증상 중증도의 연관성 연구)

  • Kim, Sung Nyun;Moon, Woori;Han, Jaewook;Lee, Junhee
    • Korean Journal of Biological Psychiatry
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    • v.24 no.3
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    • pp.129-133
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    • 2017
  • Objectives Obsessive-compulsive disorder (OCD) is a disabling psychiatric disorder, and more attention is recently paid on the quality of life (QoL) in OCD patients. The Euro-QoL-5D (EQ-5D) is a widely used self-report to calculate a single score which represents 'health utilities'. The aim of this study was to assess the health-related QoL for patients with OCD using the EQ-5D and to examine the relationship between health-related QoL and symptom severity. Methods Seventy-three patients with a Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnosis of OCD were recruited from the outpatient clinic in Seoul National University Hospital. Symptom severity was assessed using the Yale-Brown Obsessive-Compulsive Scale (YBOCS), and QoL was assessed with the EQ-5D-5L questionnaire. Using Korean valuation study, a single score of QoL was calculated. Results Most of the OCD patients were relatively young (< 45 years) with the mean YBOCS total score of 19.33. The mean EQ-5D score was 0.71 and significantly correlated with symptom severity (r = -0.483, p < 0.001). 25% of the EQ-5D score was predicted by the YBOCS total score (b = -0.011, p < 0.001) by regression analysis. Conclusions OCD patients suffer from lower health-related QoL and QoL significantly decreased as symptom severity increased. The results of the EQ-5D would enable further studies on QoL comparison across medical disease and mental disorders.

Association of a Polymorphism in the Promoter Region of Apo-1/Fas Gene with Bipolar Disorder (양극성 장애 환자에서 Apo-1/Fas Promoter 유전자 다형성)

  • Kim, Kyu Hyun;Son, So-Jeong;Lee, Hee Jae;Kim, Jong Woo;Chung, Joo-Ho
    • Korean Journal of Biological Psychiatry
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    • v.10 no.2
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    • pp.121-125
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    • 2003
  • Objective:Recently, many experimental evidences have been reported that psychiatric diseases are closely related with neurodevelopmental abnormalities and this can be properly explained by apoptosis. It is known that Apo-1/Fas is one of the genes in charge of apoptosis related with neurodevelopmental abnormalities. In this study, the association between bipolar disorder and functional polymorphism in Apo-1/Fas promoter gene has been investigated. Method:For 81 bipolar disorder patients and 217 healthy control subjects, MvaI restriction fragment length polymorphism(RFLP) of Apo-1/Fas promoter gene was analyzed after polymerase chain reaction(PCR) amplification. Result:There was a statistical significant difference in genotypic distribution(${\chi}^2$=16.656, df=2, p=0.0002) and allelic frequencies(${\chi}^2$=14.225, df=1, p=0.0002) between bipolar disorder patients and healthy control subjects. Conclusion:Our results suggest an association between functional polymorphism in Apo-1/Fas promoter gene and bipolar disorder and provide the important genetic information related with the pathogenesis of the disease. Further studies employing larger samples are required to clarify the present results.

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Culture and Somatization (문화와 신체화)

  • Kim, Kwang-Iel
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.1
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    • pp.3-14
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    • 2003
  • In this review article, the meanings of the somatization phenomena were reviewed and discussed in terms of cultural psychiatric view point. The somatization is an universal psychopathology. But frequency, pattern of symptoms and it's cultural factors in the conversion of emotional distress to the somatization are much different from culture to culture. Conventional impression and monotonous interpretation that somatization is prevalent in the non-Western or traditional society and it is due to poor differentiation of the psyche is seriously criticized. Cultural metaphors of expressing emotional pain, traditional disease concepts, conventional way of adopting a given culture and society, and medical delivery system and milieu could be regarded as important cultural factors of the somatization. Cultural meanings of somatization in Korea were summarized and discussed. Finally, clinical guide line for transcultural practice were summarized.

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The Literary Trends of Herbal Prescription Ukgan-san and its Application in Modern Traditional Korean Medicine (동의보감에 수록되지 않았던 억간산의 문헌상 흐름과 현대 한의학에서의 응용 현황)

  • Cho, Ki-Ho;Kim, Tae-Hun;Jin, Chul;Lee, Ji-Eun;Kwon, Seungwon
    • The Journal of Korean Medicine
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    • v.39 no.3
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    • pp.17-27
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    • 2018
  • Objectives: Ukgan-san does not appear in Traditional Korean Medicine classics. However, it has been used in research and clinical applications in Korea. In this paper, we are aiming to examine the records concerned with Ukgan-san to the present, and announce the present usage state in Korea. Methods: We searched and summarized the contents of previous medical books about Ukgan-san. In order to investigate the current status of utilization of Ukgan-san in Korea, a bibliographic database of Korea, a database of clinical researches, and a database of pharmaceuticals of the Korea Food and Drug Administration were searched. Results: As a result of searching Ukgan-san related documents, Ukgan-san has been developed in China (Ming dynasty). However, its clinical application has been expanded by modern Japanese kampo medicine doctors. In Korea, cases of Parkinson's disease, other movement disorders, and psychiatric disorders have been reported, and randomized controlled trials had been done and planned. In addition, some extracts which are consisted of Ukgan-san are also available. Conclusions: In Korea, Ukgan-san has been influenced by Japan and has been used for clinical and research purposes. The utilization rate in Korea is still small, but the utilization rate will increase according to the results of clinical studies.