Virtual reality (VR) provides an immersive and interactive 3-dimensional system, which allows an individual to become immersed in a computer-generated situation. VR technology has been administered in the exposure-based treatment of a variety of psychiatric disorders, including acrophobia, fear of flight, and post-traumatic stress disorder. Furthermore, VR systems have also been developed for the use of research and treatment in addiction. They might have advantages in cue exposure therapy, by increasing the salience of cues, as well as assessments of cue reactivity in addiction. This article summarizes the application of VR in the field of psychiatry. More importantly, it suggests the possibilities of clinical use of VR technology, in the treatment of addiction.
This case report is a unique case of solar retinopathy following antidepressant-induced mydriasis and highlights the need for comprehensive ophthalmic evaluation in patients treated with medications having mydriatic effects. A 49-year-old female patient who had received long-term antidepressant therapy presented with bilateral visual impairment after prolonged sun exposure. Fundoscopy confirmed solar retinopathy, which was attributed to drug-induced mydriasis. Medication adjustments and sun protection strategies led to full visual recovery, underscoring the importance of interdisciplinary awareness. This case emphasizes the challenges associated with the simultaneous management of psychiatric and ophthalmic conditions and highlights the need for routine ophthalmic evaluation of patients prescribed antidepressants with reported ocular side effects.
Journal of agricultural medicine and community health
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v.28
no.2
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pp.1-14
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2003
Objectives: This paper introduces need and supply level of rural mental health care service and especially focuses on the evaluation for the community mental health programs of Public Health Centers(PHCs) in rural areas as the facilities for primary mental health care. Methods: We defined the need as prevalance rate and service utilization rate, for which reviewed the results of the epidemiological study of mental disorders using Korean Composite International Diagnostic Interview surveyed on a nationwide scale in 2001. Supply was appraised in terms of psychiatric beds and primary mental heath care facilities such as private psychiatric clinics, facilities for social rehabilitation, PHCs running community mental health programs. For this, we reveiwed a variety of annual reports related mental health published by Ministry of Health and Welfare. To evaluate the community mental health programs of PHCs in rural areas, we selected. randomly samples out of the 3rd community health plans including the contents of community mental health programs, which submitted by 89 rural counties and 44 cities mixed with rural areas, and used the program's guideline established by central government as a standard. Results: Prevalence rates of major psychiatric diseases such as schizophrenia, alcoholism, major depression, anxiety disorder were higher in rural area than in urban area and 8.9% of psychiatric patients in both areas stayed at homes contacted with mental health manpower more than one time during the last year. Psychiatric beds were sufficiently supplied, but urban area had less beds than rural area contrary to general health care service. Psychiatric clinics were supplied very insufficiently in rural areas and PHCs bridged the gap instead. However rural PHCs got less financial support for community mental health programs from higher positioned agencies than urban PHCs. Rural community health programs not supported hardly worked out. Conclusions: Central government should consider a special policy for rural primary mental health care, because private psychiatric clinics can't be introduced in rural areas due to demand-deficiency and the financial independence of rural counties was very vulnerable.
Objects : Aimed to test the hypothesis that neonatal testosterone exposure in female mice influences the development of testosterone-related pain inhibitory system and that testosterone administered in adulthood decreases the pain sensitivity. Methods : Thirty androgenized(testosterone propionate $100{\mu}g$ ip within 24 hrs after birth) adult female and twenty five control(normal saline $100{\mu}g$ ip within 24 hrs after birth) adult female mice were injected with testosterone propionate 1mg/kg/day for 3 consecutive days from 84th experimental days. Nociceptive sensitivity was measured before and after treatment of testosterone by tail flick latency on 84th and 86th experimental days. Results : 1) On the 84th experimental day, basal nociceptive sensitivity was significantly higher in the androgenized group($2.7{\pm}0.4$ sec) as compared to the control group($3.3{\pm}1.1$ sec). 2) Testosterone treatment on the 84th experimental day significantly lowered nociceptive sensitivity in both androgenized($5.2{\pm}0.9$ sec) and control groups($4.6{\pm}1.8$ sec). However the effect was significantly greater in the androgenized group. 3) Nociceptive sensitivity on 86th experimental day before administration of testosterone was significantly lower in the androgenized group($4.8{\pm}1.9$ sec) as compared to the control group($3.9{\pm}1.2$ sec). 4) Testosterone treatment on the 86th experimental day significantly lowered the nociceptive sensitivity in both groups, but the androgenized group($5.9{\pm}0.9$ sec) showed significantly lower post-treatment nociceptive sensitivity as compared to the control group($4.9{\pm}1.5$ sec). 5) Nociceptive sensitivity was decreased significantly after injection of testosterone once a day for two consecutive days in the androgenized group(${\Delta}2.1{\pm}1.0$ sec), but not in the control group(${\Delta}0.5{\pm}1.3$ sec). Conclusions : There may be a testosterone-related pain inhibitory system, the development of which is enhanced by exposure to testosterone in the neonatal period, and the activity of which is also mediated by testosterone in the later life.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.13
no.1
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pp.85-92
/
2002
Objectives:This study was conducted to compare the memory function among the attention deficit/hyperactivity disorder(ADHD), the learning disorder(LD) and the comorbidity disorder(ADHD+LD) groups. Methods:Thirty-four children(11 ADHD, 5 LD, 9 ADHD+LD, and 8 Psychiatric control) were individually assessed using the KEDI-WISC and Memoty Assessment Scale(MAS), and then the results of those test were analyzed. Results:In memory test, all of three group showed lower performances than control group. The comorbidity, the LD and the ADHD group showed lower scores in almost subtests of MAS respectively. The good performance in memory test was significantly correlated with the types of memory strategy and error response children used during testing. Discussion:The clinical utility of the memory test like MAS was discussed in terms of differential diagnosis for ADHD, LD and ADHD+LD children.
Kim, Dong Joo;Kim, Daeho;Lee, Jinbok;Kim, Yaeseul;Sohn, Sujin
Korean Journal of Psychosomatic Medicine
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v.28
no.1
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pp.53-62
/
2020
Objectives : This study investigated lifetime experiences of trauma, treatment retention, and psychiatric symptoms among outpatients with panic disorder after initiation of pharmacotherapy. Our research hypothesis was that panic patients with childhood trauma would display more severe symptoms and less treatment retention compared to those without such history. Methods : A total of 135 first-visit outpatients with DSM-IV panic disorder were approached during the period from March 2012 to August 2016. Fifty-three patients (39%) either refused or returned incomplete questionnaires, leading to a final sample size of 82. Participants completed the Trauma History Screen, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. Results : The number of lifetime trauma was significantly correlated with treatment retention (rho=-0.269, p=0.015). Among subtypes of trauma, only childhood physical abuse was significantly correlated with treatment retention (rho=-0.298, p=0.007). Conclusions : Our results indicated that psychological trauma, particularly of an interpersonal nature from childhood, can affect pharmacotherapy treatment retention in panic disorder. This may be mediated by poor patient-doctor relationships originating from trust issues among childhood trauma survivors or lack of perceived improvement due to the more severe symptoms and unfavorable course experienced by those with childhood trauma. Further studies are needed to explore the reasons for poor treatment adherence in this population.
Lee, Ju Young;Moon, Duk-Soo;Shin, Suk-Ho;Yoo, Hee-Jung;Byun, Hee-Jung;Suh, Dong-Soo
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.28
no.4
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pp.213-219
/
2017
Objectives: Early intensive interventions are very important for children with autism spectrum disorder. We examined the actual conditions of hospital-based early intensive interventions for autism spectrum disorder in Seoul, in order to help develop and implement an evidence-based early intensive intervention model for use in Korea. Methods: Nine hospital-based institutes running an early intensive intervention program for children with autism spectrum disorder responded to a questionnaire in September 2014. They provided a brief introduction to their program, explained its theoretical bases, and reported the number of children, their age, intervention time, duration and so on. Results: In the majority of the institutions, the intervention was provided for over 20 hours every week, and the theoretical bases included various applied behavioral analysis (ABA) methods and other therapies (language and occupational therapy). The therapist-child ratio ranged from 1:1 to 5:3. Various types of therapists were involved, including behavioral analysts, special education teachers and (or) language pathologists. There was only one clinic where the behavioral analyst was the main therapist. Usually, the intervention was terminated just before the child entered elementary school. The main merit of the hospital-based intervention in our survey was the effectiveness of the multi-disciplinary intervention plan and its other merits were the accuracy of the diagnosis, its ability to be combined with medicine, and so on. Conclusion: The current hospital-based early intensive intervention programs provide interventions for over 20 hours per week and employ multidisciplinary approaches. However, there are very few institutes for children with autism and very few intervention specialists and specialist education courses in the country. We need more educational programs for intervention therapists and have to try to develop policies which encourage the implementation of an evidence-based early intensive intervention program nationwide.
Objectives: To report the effectiveness of a comprehensive Korean medical approach, incorporating acupuncture, herbal medicine, Chuna therapy, and traditional Korean psychotherapy, in the management of a patient with cerebellar ataxia and major depressive disorder. Methods: A 45-year-old female patient diagnosed with cerebellar ataxia and major depressive disorder received a comprehensive Korean medicine treatment, including acupuncture, moxibustion, herbal medicine, Chuna therapy, and traditional Korean psychotherapy such as Giungoroen therapy, IiGyeungByunQi therapy, M&L therapy, and Emotional Freedom Technique (EFT). The efficacy was assessed through both subjective symptom reports and a range of psychological assessment tools, including the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Korean Symptom Checklist-95 (KSCL-95), Korean Beck Depression Inventory-II (K-BDI-II), Spielberger's State-Trait Anxiety Inventory XYZ form (STAI-XYZ), Korean version of the State-Trait Anger Expression Inventory (STAXI-K), Padua Inventory-Washington State University Revision (PI-WSUR), Penn State Worry Questionnaire (PSWQ), and the Korean Version of the Insomnia Severity Index (ISI-K). Results: Throughout treatment, the patient experienced marked improvements in physical symptoms, notably dizziness, and gait instability. Psychological evaluations demonstrated significant reductions in anxiety, depression, and insomnia. The overall quality of life was enhanced, with sustained benefits observed during follow-up assessments. Conclusions: This case suggests that a comprehensive Korean medicine approach that integrates acupuncture, herbal medicine, Chuna therapy, and traditional Korean psychotherapy may be effective in alleviating both physical and psychological symptoms associated with cerebellar ataxia and major depressive disorder.
Kim, Seol-Yeon;Ha, Jee-Hyun;Hwang, Won-Sook;Yu, Jae-Hak
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.20
no.2
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pp.76-81
/
2009
Ovjectives: As the attention devoted to children's mental health increases, medical costs and burdens mount as well. In the present study, we evaluated the association between socioeconomic status(SES) and major child psychiatric symptoms. Methods: The subjects of this study were children of recruited from a mental health screening program in the Seoul Sungbuk mental health center over the course of 3 months. To establish the SES of each child, we collected data about each child's medical insurance, years of parental education, household income, family structure and housing. 149 children & parents completed questionnaires including the Childhood Depression Inventory(CDI) and the Korean Attention Deficit Hyperactivity Disorder Rating Scale(K-ARS). Results: The mean K-ARS-P score was $12.1{\pm}11.1$ and the suspected prevalence of ADHD was 20.8%(n=31). The mean cm score was $12.9{\pm}7.9$, and the prevalence of suspected depression was 16.8%(25). Depressive symptoms and ADHD symptoms were both more severe than those observed in a previous epidemiologic study in Korea. Depressive symptoms were more closely associated with family SES status. Conclusion: SES status is one of the most important risk factors in the development of major child psychiatric symptoms. In our study we found that depressive symptoms in particular were most tightly associated with psychosocial factors. Evaluation of the risk factors, early screening and intervention for low SES children would be valuable mental health management tactics to implement in a community mental health system.
Park, Jong-Min;Kim, Seong Yup;Chung, Il Yong;Kim, Woo-Shik;Shin, Yong-Chul;Kim, Yeong Cheol;Park, Sei Hyeog
Journal of Trauma and Injury
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v.26
no.4
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pp.304-307
/
2013
Food bolus impaction is the most common cause of esophageal foreign body obstruction in adults. Other causes include intentional ingestion in psychiatric patients or prison inmates. We experienced successful treatment of a patient with intentional ingestion of multiple sharp foreign bodies(25 cutter and razor fragments). A 47-year-old male patient who was suffering from chronic alcoholism was admitted, via the emergency room, with dysphagia and neck pain. He was suffering from alcoholic liver cirrhosis and psychiatric problems, such as chronic alcoholism, anxiety disorder and insomnia. The patient had intended to leave the hospital after having swallowed the sharp objects. Plain radiographs and computed tomography (CT) scan showed multiple, scattered metal fragments in the esophagus, stomach, and small bowel. We performed emergent endoscopy and successfully removed one impacted blade in the upper esophagus using by a snare with an overtube. The rest of the fragments had already passed through the pylorus, so we could not find them with endoscopy. We checked the patient with simple abdominal radiographs and careful physical examinations every day. All remaining fragments were uneventfully excreted through stool during the patient's 6 day hospital stay. Finally, we were able to confirm the presence of the objects in the stool, and radiographs were negative. The patient was discharged without complications after 14 days hospital stay and then was followed by the Department of Psychiatry.
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