• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제34권3호
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• pp.169-174
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• 2023

Objectives: Oppositional defiant disorder (ODD) is often comorbid with other psychiatric disorders in childhood. This study aimed to investigate comorbid psychiatric symptoms and associated factors in elementary school children with symptoms of ODD. Methods: The participants consisted of 205 mother-offspring pairs. Psychiatric symptoms were measured using the Diagnostic Predictive Scales and Korean Child Behavior Checklist. Psychiatric comorbid symptoms were compared between children with ODD symptom and those without ODD symptom. Multivariate logistic regression analysis was used to estimate the odds ratio of psychiatric symptom on ODD. Results: ODD group had a significant association with internalizing and externalizing problem (p=0.001, p<0.001, respectively). ODD group were more comorbid with anxiety disorder, depressive disorder, attention-deficit/hyperactivity disorder, and conduct disorder. Among psychiatric disorder, generalized anxiety disorder (GAD) (adjusted odds ratio [AOR]=18.620, p<0.001) and conduct disorder (AOR=9.529, p=0.014) were associated with ODD symptom. Conclusion: These findings suggest that children with ODD symptom had significantly higher rates of comorbid psychiatric symptoms. And GAD and conduct disorder are related to ODD symptom.

• 정신신체의학
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• 제7권1호
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• pp.134-141
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• 1999

연구목적 : 암환자에서는 암의 임상적 특성이나, 치료방법에 따라 다양한 심리적인 문제들이 발생한다. 특히 방사선 치료는 다른 방법의 치료를 받는 환자들에서 볼 수 없는 다른 심리적 반응을 보이는 경우가 많으며, 정서적 고통과 갈등이 가중될 수 있다. 이에 저자들은 방사선 치료중인 암환자들에게는 어떠한 정신과 장애가 발생하는지 알아보고, 정신과 질환이 암과 관련된 다양한 임상적 특성과 어떠한 연관성을 지니는지 알아보고자 본 연구를 시행하였다. 방법 : 방사선 치료를 위해 치료방사선과에 입원한 암환자 47명을 대상으로 하여. DSM-IV 진단기준에 따라 정신과 장애를 평가하고, 환자들의 인구학적 자료, 암의 부위, 이환기간, 재발횟수 등의 임상적 특성, 암환자의 암에 대한 인지여부, 치료결과에 대한 기대 등의 요인과 정신과 장애의 관련성을 살펴보았다. 결과 : 1) 21 명(44.7%)의 환자가 정신과 장애를 가지고 있었다. 적응장애가 14명(66.7%)으로 가장 많았고, 다음은 5명(23.8%)의 환자에서 동반된 주요 우울장애였다. 2) 성별, 연령, 학력, 결혼상태, 종교 등의 인구학적 변인과 정선과적 장애와의 관련성은 통계적 유의성을 보이지 않았다. 3) 암의 부위별로는 골반부에 위치하는 암이 22명(46.8%)으로 가장 많았으며, 암의 부위, 이환기간과 정신과 장애와의 유의한 관련성은 없었다. 4) 암의 재발에 있어 재발의 증거가 없는 경우에 비해 재발한 경우 통계적으로 유의하게 정신과 장애의 이환율이 높았다. 5) 암의 인지여부와 정신과 장애는 통계적으로 유의한 연관은 없었다. 6) 치료결과에 대한 기대와 관련하여, 방사선 치료가 단지 보조적인 것으로 생각하는 군이 방사선치료에 의해 완치될 것으로 생각하는 군에 비해 통계적으로 유의하게 정신과 장애의 이환율이 높았다.

• Journal of Preventive Medicine and Public Health
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• 제41권1호
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• pp.51-60
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• 2008

Objectives : We examined the effect of sociodemographic factors, cancer, and psychiatric disorders on suicide by gender and age-specific patterns in South Korea. Methods : The study is a case-control study. Claim data was obtained from the national health insurance database and national death registration database. The number of people who committed suicide was 11,523, which was matched with a control group consisting of ten times as many people at 115,230 selected from the national health insurance and medical aids beneficiaries. The medical utilization of the case group was one year before death and that of the control group was from July 1,2003 to June 30, 2004. Four variables-address, economic status, presence of a psychiatric disease, and cancer-were used in multiple logistic regression analyses. Results : Living in cities or in rural areas showed a greater risk for suicide than living in a metropolitan city. Low economic status, the presence of a psychiatric disorder, and cancer were also statistically meaningful risk factors for suicide. The three major psychiatric diseases, schizophrenia, alcohol abuse, and bipolar disorder, were meaningful in all age groups, but the scale of the odds ratio differed by the age group. Only the psychiatric disorder variable was meaningful in the adolescent group, whereas a psychiatric disorder and economic status were meaningful for the young adult group, and all variables were meaningful for the middle-aged group. A psychiatric disorder and cancer were meaningful in the elderly group, economic status was meaningful for male subjects, and address was meaningful for female subjects. Conclusions : Factors such as living in city or rural areas, low economic status, the presence of a psychiatric disorder, and cancer were statistically meaningful risk factors in suicide. These factors also differed by age group. Therefore, policymakers should establish policies for suicide prevention that are relevant for each age group.

• 생물정신의학
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• 제16권1호
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• pp.37-45
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• 2009

Objectives : It is reported that panic disorder is frequently comorbid with other psychiatric illnesses. The aim of this study was to investigate differences of psychiatric comorbidity according to age of onset of panic disorder. Methods : Three hundred-two patients participated in the study. All the patients were evaluated by clinical instruments for the assessment the presence of other comorbid psychiatric disorders and various clinical features; Korean version of Mini International Neuropsychiatric Interview, Self-report questionnaires(Beck Anxiety Inventory, Beck Depression Inventory, Anxiety Sensitivity Index and State-Trait Anxiety Inventory) and clinical rating scale (Hamilton Anxiety Scale, Hamilton Depression Scale and Global Assessment of Functional score). Chi-square test was used to determine the difference between early onset and late onset panic disorder. Results : Forty percent of panic patients were found to have at least one comorbid psychiatric diagnosis. There were no differences among the groups divided by number of comorbidity in sex, agoraphobia comorbidity, duration of panic disorder, except onset age of panic disorder. Early onset group had more comorbidy with social phobia, agoraphobia, PTSD. We also found that Early onset panic disorder patients were more likely to experience derealization, nausea, parethesia than late onset panic disorder patients. Conclusion : The results of our study are in keeping with previous data from other parts of the world. Our finding suggest that earier onset of panic disorder related to more psychiatric comorbidity.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제31권4호
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• pp.214-224
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• 2020

Objectives: This study aimed to examine the trend in diagnostic prevalence of psychiatric disorders in children and adolescents. Methods: Individuals aged 0-18 years were included in the study based on the National Health Insurance Claims Data. To investigate the trends in diagnosis and diagnostic prevalence of psychiatric disorders reflecting the decrease in the birth rate, data were analyzed from 2010 as a reference year to 2015. Results: The number of patients diagnosed with psychiatric disorder decreased annually, from 23,412 on 2010 to 18,821 on 2015. The most common disorder was hyperkinetic disorder in male and depressive episode in female. Although there was no significant change in overall diagnostic prevalence rate of psychiatric disorders, age groups <10 years and some disorders had significant changes in prevalence rate. This study classified the diagnostic prevalence by age into two unique patterns: group in which the diagnosis rate increases with age and group in which the diagnosis rate peaks at a certain age and then decreases. Conclusion: Diagnostic prevalence of psychiatric disorders was different according to age and sex. These patterns should be reflected in the formulation of policies related to mental health and in medical practice for pediatric patients. It is urgent to identify how these patterns change in young adults.

• 대한간호학회지
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• 제35권5호
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• pp.896-903
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• 2005

Purpose: This study was designed to exam me the effects of an assertive training program on interpersonal relations, and psychiatric symptoms in patients with a mental disorder. Method: The study employed a quasi experimental design. The subjects included 44 patients with a mental disorder, 20 in the experimental group, and 24 in the control group. Data was collected using structured questionnaires over a 3 month period. Results: There were greater significant increases in scores of interpersonal relations and content of communication in the experimental group than the control group. Also, there was a greater significant decrease in the score of psychiatric symptoms in the experimental group than the control group. Conclusion: Assertive training has an effect on increasing content of communication and decreasing psychiatric symptoms.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권6호
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• pp.527-535
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• 2019

Purpose: There is increasing prevalence of psychiatric disorders among inflammatory bowel Disease (IBD) population. Further, presence of psychiatric disorders has been shown as an independent predictor of quality of life among patients with IBD. We intended to explore the prevalence of various psychiatric disorders among pediatric and young adult population with IBD as a population-based analysis. Methods: We did a retrospective case control analysis using a deidentified cloud-based database including health care data across 26 health care networks comprising of more than 360 hospitals across USA. Data collected across different hospitals were classified and stored according to Systematized Nomenclature of Medicine-Clinical Terms. We preidentified 10 psychiatric disorders and the queried the database for the presence of at least one of the ten psychiatric disorders among IBD patients between 5 and 24 years of age and compared with controls. Results: Total of 11,316,450 patients in the age group between 5 and 24 years and the number of patients with a diagnosis of IBD, Crohn's disease or ulcerative colitis were 58,020. The prevalence of psychiatric disorders was 21.6% among IBD mainly comprising of depression and anxiety disorder. Multiple logistic regression analysis showed, IBD is 5 times more likely associated with psychiatric disorders than controls, p<0.001). We showed a steady increasing trend in the incidence of psychiatric disorders among IBD patients (2% in 2006 to 15% in 2017). Conclusion: Largest population-based analysis demonstrated an increased prevalence of psychiatric disorders among IBD patients. Our study emphasizes the need for psychological and mental health services to be incorporated as a part of the routine IBD clinic.

• 대한불안의학회지
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• 제5권2호
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• pp.103-111
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• 2009

Objectives : We examined quality of life, psychosocial adjustments to illness, changes in sexual functioning, and prevalence of psychiatric disorders in AIDS patients compared to patients with chronic hepatitis B virus infection (CHB). Methods : Thirty-one men with AIDS and 50 men with CHB were enrolled. The Short-Form 12-Item Health Survey (SF-12), the Psychosocial Adjustment to Illness Scale (PAIS), and the Changes in Sexual Functioning Questionnaire short form (CSFQ-14) were administered. Results on these assessments were compared between the 31 AIDS patients and 50 CHB patients. The Structured Clinical Interview for DSMIV (SCID) was administered to determine the psychiatric diagnosis only for the AIDS patients. Results : The Physical Component Summary score (PCS) was lower in AIDS patients than in CHB patients (p<0.001). In the section examining sexual relationships, AIDS patients exhibited a lower level of adjustment (p<0.05) and had more changes in sexual function (p<0.05) than did CHB patients. Administration of the SCID to AIDS patients indicated that the lifetime prevalence of any psychiatric disorder was 56.7% ; 43.3% for mood disorders, 33.3% for alcohol use disorders, 26.7% for anxiety disorders, and 20% for adjustment disorder. Patients who had experienced any psychiatric disorder had more severe psychosocial distress (p=0.004) and evidenced a lower level of overall psychosocial adjustment (p=0.030) than patients who had not. Conclusion : We showed that AIDS patients have a high prevalence of psychiatric disorders, and that AIDS patients with psychiatric disorders were particularly low in levels of psychosocial adjustment. Thus, careful attention should be given to psychiatric aspects of AIDS patients emphasizing the early diagnosis and treatment of psychiatric disorders.

• 정신신체의학
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• 제4권1호
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• pp.79-84
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• 1996

We have studied 16 patients diagnosed of social phobia among the hospitalized patients for 1 year, from September 1994 to August 1995, to evaluate whether serial phobic symptoms are the prodromal symptoms of the other psychiatric disorder or concomitant disorder. The results were as follows; 1) In the subject of this study, the mean age of onset of social phobic symptoms was 17.3, and the mean age of inital hospital visit was 27.4. 2) The proportion of offensive type was higher than the simple type : 7 cases of the subjects classified as simple type, 9 cases as offensive type. 3) According to the type of social phobia, they developed different type of psychiatric disorder. Majority of patients with simple type had final diagnosis of mood disorder. Patients with offensive type had schizophrenia spectrum disorder, such as schizophrenia, delusional disorder, and schizophrenia, personality disorder. 4) Social phobic symptoms have taken various courses according to the final diagnosis. In the patients who developed major depression and delusional disorder, social phobic symptoms have not been changed during the course. Patients with the final diagnosis of schizophrenia and schizotypal personality disorder have showed various social phobic symptoms. In the patients with the final diagnosis of bipolar disorder, their social phobic symptoms disappeared with improvement of depression.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제9권1호
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• pp.54-66
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• 1998

본 연구의 목적은 정신과 환자의 자녀가 정상인의 자녀와 비교하여 불안, 우울 등의 정신병리와 자기 개념, 가정환경에 대한 인식에 있어서 차이가 있는지를 알아봄으로써 부모의 정신병리가 자녀에게 어떤 영향을 주는가를 밝히기 위함이다. 아울러 환자집단 내에서 환자의 성별에 따라, 환자의 발병 당시의 자녀의 나이에 따라, 환자 진단에 따라 자녀의 불안, 우울 등의 정신병리와 자기 개념, 가정환경에 대한 인식에서 차이가 있는가를 알아보고자 하였다. 1997년 6월부터 1998년 4월까지 서울, 경기지역의 신경정신과 성인 외래 환자 39명을 대상으로 하여 이들의 자녀 중 초등학교 4학년부터 고등학교 3학년까지의 남녀 학생 52명에게 한국형 소아 상태-특성불안척도, 한국형 소아 우울 척도, 한국형 소아자기개념척도, 한국형 가정환경척도를 작성하도록 하고 이를 동 수의 정상인 자녀와 비교하였다. 그리고 환자의 자녀 내에서는 환자가 남자인지 혹은 여자인지, 환자의 발병 연령이 자녀가 3세 이전이었는지 이후였는지, 환자의 진단이 어떤 것인지에 따라 척도들을 비교하였다. 결과는 다음과 같다. 1) 정신과 환자의 자녀들이 정상인의 자녀들과 비교하여 가정환경척도 중 표현력 척도에서 유의하게 낮은점수를 보였고 상태 불안 척도에서는 유의하게 높은 점수를 보였다(p<0.05). 그러나 소아 자기개념척도의 지적 및 학업 상태 소척도와 인기도 소척도에서는 오히려 환자의 자녀가 정상인의 자녀보다 유의미하게 높은 점수를 보였다(p<0.05). 2) 환자군 내에서 환자의 남녀 성별에 따른 자녀의 척도들의 차이는 없었다. 3) 환자군 내에서 환자가 자녀 나이 3세 이전에 발병한 경우가 3세 이후에 발병한 경우보다 가정환경척도 중 조절성 소척도 점수는 유의하게 낮고 특성불안척도는 유의하게 높았다(p<0.05). 4) 환자군 내에서 환자의 진단(정신분열병 범주 장애-정동장애-신경증)에 따른 자녀의 척도들의 차이는 없었다. 자기 보고식 설문으로 측정한 우울, 불안 등의 정신병리는 환자의 자녀와 정상인의 자녀간 유의미한 차이를 보이지 않았다. 환자의 진단이나 남녀 성별의 차이 역시 자녀에게 영향을 주지 않는 것으로 밝혀졌으나 자녀가 3세 이전에 부모가 정신질환에 이환 될 경우에는 자녀의 특성불안이 높은 경향을 보였다. 향후 고위험군 자녀의 발달학적 측면에서 영향을 주는 요인을 밝히는 연구를 위해서는 자녀의 자기보고 이외에도 부모, 선생님 등의 관찰과의 일치도에 대한 조사, 직접적인 면담 등이 필요할 것으로 보이며 통제된 환경에서의 전향적 연구가 필요할 것이다.