• The Journal of the Korea Contents Association
• /
• v.15 no.1
• /
• pp.140-151
• /
• 2015

This study apply concept mapping to realize of client participation and self-determination in social welfare program for the mental disorders. They are relatively easily marginalized in decision-making process of their program. But realization of client participation and self-determination is directly connected with effect of service. For this reason, we confirmed the applicability of concept mapping in program planning that support client participation. Case of this study is social welfare program of B community psychiatric rehabilitation center located in the A city. This program is community interchange service for the mental disorders. Interchange type is to have a food with the mental disorder and the solitary elderly. We took advantage of the concept mapping to derive the outcomes that are expecting the mental disorders and mental health social workers. Concept mapping was proceeding in six steps; preparation stage ${\rightarrow}$ idea collection stage ${\rightarrow}$ structuralization stage ${\rightarrow}$ analysis stage ${\rightarrow}$ interpretation stage ${\rightarrow}$ application stage. Participants were a total of 25 people including the mental disorders and community psychiatric rehabilitation center employees. The participants produced 42 statements. Sorting results, the mental disorders produced 6 clusters; community psychiatric rehabilitation center employees produced 3 clusters. The mental disorders classified better detail than community psychiatric rehabilitation center employees. Two group were found gap of expected outcomes each other, went narrowed it. They agreed 3 expected outcomes finally. We identified empirically the usefulness of concept mapping to realize self-determination and program participation.

• Journal of Preventive Medicine and Public Health
• /
• v.49 no.1
• /
• pp.53-60
• /
• 2016

Objectives: The purpose of this study is to examine the magnitude of and the factors associated with the downward mobility of first-episode psychiatric patients. Methods: This study used the claims data from the Korean Health Insurance Review and Assessment Service. The study population included 19 293 first-episode psychiatric inpatients diagnosed with alcohol use disorder (International Classification of Diseases, 10th revision [ICD-10] code F10), schizophrenia and related disorders (ICD-10 codes F20-F29), and mood disorders (ICD-10 codes F30-F33) in the first half of 2005. This study included only National Health Insurance beneficiaries in 2005. The dependent variable was the occurrence of downward mobility, which was defined as a health insurance status change from National Health Insurance to Medical Aid. Logistic regression analysis was used to assess factors associated with downward drift of first-episode psychiatric patients. Results: About 10% of the study population who were National Health Insurance beneficiaries in 2005 became Medical Aid recipients in 2007. The logistic regression analysis showed that age, gender, primary diagnosis, type of hospital at first admission, regular use of outpatient clinic, and long-term hospitalization are significant predictors in determining downward drift in newly diagnosed psychiatric patients. Conclusions: This research showed that the downward mobility of psychiatric patients is affected by long-term hospitalization and medical care utilization. The findings suggest that early intensive intervention might reduce long-term hospitalization and the downward mobility of psychiatric patients.

• Korean Journal of Biological Psychiatry
• /
• v.20 no.1
• /
• pp.1-5
• /
• 2013

Glutamate receptors are important components of synaptic transmission in the nervous system. Especially, ${\alpha}$-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptors mediate most abundant excitatory synaptic transmission in the brain. There is elaborate mechanism of regulation of AMPA receptors including protein synthesis/degradation, intracellular trafficking, exocytosis/endocytosis and protein modification. In recent studies, it is revealed that functional dysregulation of AMPA receptors are related to major psychiatric disorders. In this review, we describe the structure and function of AMPA receptors in the synapse. We will introduce three steps of mechanism involving trafficking of AMPA receptors to neuronal membrane, lateral diffusion into synapses and synaptic retention by membrane proteins and postsynaptic scaffold proteins. Lastly, we will describe recent studies showing that regulation of AMPA receptors is important pathophysiological mechanism in psychiatric disorders.

• Korean Journal of Psychosomatic Medicine
• /
• v.7 no.1
• /
• pp.134-141
• /
• 1999

Objects : Cancer patients receiving radiotherapy have many psychological problems. Those problems depend on clinical factors of cancer and the characteristics of patients. This study was designed to estimate the morbidity of psychiatric disorder and to investigate the relationship between psychiatric disorders and clinical variables. Methods : The subjects were 47 patients who had been treated by radiotherapy. Psychiatric disorder was diagnosed according to DSM-IV. The authors assessed the relation between psychiatric disorder and demographic features, clinical features of cancer such as site, duration, frequency of recurrence of cancer, and patients' awareness of disease and expectation of outcome of radiotherapy. Results : 21 patients(44.7%) had a psychiatric disorder. The most common psychiatric disorder were adjustment disorder(66.7%), and the next major depressive disorder(23.8%). There was a significant positive relationship between psychiatric disorder and recurrence of cancer, patients' expectation of poor outcome after radiotherapy. Psychiatric morbidity was significantly low in those who had no evidence of recurrence and who considered radiation treatment as curative. However, site and duration of cancer, patients' awareness about serious illness were not related with psychiatric disorder. Conclusion : Psychiatric disorders are common among cancer patients on radiotherapy. Further clinical attention and effective treatment of psychiatric complication in cancer patients are needed not only for reducing symptoms but for better adjustment.

• Korean Journal of Biological Psychiatry
• /
• v.17 no.3
• /
• pp.119-126
• /
• 2010

Synaptic adhesion molecules mediate synapse formation, maturation and maintenance. These proteins are localized at synaptic sites in neuronal axons and dendrites. These proteins function as a bridge of synaptic cleft via interaction with another synaptic adhesion molecules in the opposite side. They can interact with scaffold proteins via intracellular domain and recruit many synaptic proteins, signaling proteins and synaptic vesicles. Scaffold proteins function as a platform in dendritic spines or axonal terminals. Recently, many genetic studies have revealed that synaptic adhesion molecules and scaffold proteins are important in neurodevelopmental disorders, psychotic disorders, mood disorders and anxiety disorders. In this review, fundamental mechanisms of synapse formation and maturation related with synaptic adhesion molecules and scaffold proteins are introduced and their psychiatric implications addressed.

• Clinical and Experimental Pediatrics
• /
• v.58 no.2
• /
• pp.64-68
• /
• 2015

Purpose: The purpose of this study was to investigate the importance of initial screening tests for depression and anxiety disorders in children with headache. In addition, this study evaluated whether the Children's Depression Inventory (CDI) and Revised Children's Manifest Anxiety Scale (RCMAS) are suitable for screening symptoms of depression and anxiety. Methods: A retrospective chart review was conducted of 720 children aged 7-17 years who had visited a pediatric neurology clinic for headaches and were referred to a pediatric psychiatric clinic for psychiatric symptoms from January 2010 to December 2011. All patients completed the CDI and RCMAS. Among them, charts of patients with clinically significant total scores (cutoff>15) for psychiatric symptoms, as defined by the CDI and RCMAS scoring scales, were reviewed. Results: Nineteen patients had headaches and clinically significant total scores for psychiatric symptoms. The mean age at headache diagnosis was 11.7 years, and 57% were male. Mean duration of headache was 11.5 months. Two point eight percent of the patients were diagnosed with psychiatric disorders including major depression (1.7%), generalized anxiety disorder (1.1%), and bipolar disorder (0.1%). Four patients (0.6%) were diagnosed with attention deficit/hyperactivity disorder (ADHD). Total mean CDI and RCMAS scores of patients referred to the psychiatric clinic were 18.8 and 22.2, respectively. There was no correlation between CDI or RCMAS total scores and headache frequency, duration, or severity. Conclusion: We recommend that all patients with headache should be screened for depression and anxiety by CDI and RCMAS scores.

• Korean Journal of Biological Psychiatry
• /
• v.14 no.1
• /
• pp.28-41
• /
• 2007

Virtual reality technology is now being used in neuropsychological assessment and real-world applications of many psychiatric disorders, including anxiety disorders, schizophrenia, child psychiatric disorders, dementia, and substance related disorders. These applications are growing rapidly due to recent evolution in both hardware and software of virtual reality. In this paper, we review these current applications and discuss the future work of clinical, ethical, and technological aspects needed to refine and expand these applications to psychiatry.

• Korean Journal of Psychosomatic Medicine
• /
• v.6 no.2
• /
• pp.120-125
• /
• 1998

Objectives : The purposes of present study were to identify weight increment in female psychiatric patients during hospitalization and to evaluate the relationship between weight gain and daily calorie intake, daily activity and other variables of disease itself. Methods : 20 patients were studied. Body weight were measured once a week, and daily activity(total amounts of walking/day) and total amount of daily calorie intake were measured twice a week. We examined psychiatric and medical illness history, eating disorders' history and family history of eating disorders and obesity. Results: Mean body weight and Body Mass Index(BMI) at admission are 49.40kg and 19.59kg/$m^2$. Mean weight increment during hospital stays of mean 65 days is 4.90kg. Mean amounts of daily calorie intake and daily activity(daily walks) were increased during hospital stays, but not statistically significant. The degree of weight increment is higher in longer hospital stay group, but not statistically significant. Mean body weight at admission of mood disorder group is higher than that of schizophrenia group, but not statistically significant. Conclusion : This results suggested that weight increment in female psychiatric hospitalized patients is present. However, it is not resulted by amount of calorie intake and daily activity level.

• Korean Journal of Psychosomatic Medicine
• /
• v.1 no.1
• /
• pp.81-91
• /
• 1993

The consulting internist will encounter patients with psychiatric symptoms and those who take psychotropic medications in many settings. The internist must loam to feel comfortable interacting with patients who display psychiatric symptoms. while maintaining an open and unprejudiced attitude toward their evaluation. The proper delineation of psychiatric disorders from normal emotional reactions resets on a careful history, a mental status evaluation. and a knowledge of psychiatric syndromes. Many physicians tend erroneously to view behavioral changes only in a psychological framework Abrupt changes in behavior, personality, mood. or ability to function should be evaluated for possible organic causes. Then, the internists should take their consultation to psychiatrists and freely discuss psychologic problems of the patients.

• Korean Journal of Biological Psychiatry
• /
• v.22 no.4
• /
• pp.195-204
• /
• 2015

Objectives This study investigated the patterns of psychotropic medications prescribed to patients admitted to an open psychiatric ward. Methods We reviewed 4282 medical records of patients who were discharged from an open psychiatric ward from May 2003 through April 2014. Data were collected on each patient's age, sex, length of hospital stay, number of past admissions, discharge diagnosis, and kinds and dosages of psychotropic medications at discharge. Results Among the 1384 male and 2898 female patients, 3.56 psychotropic medications were prescribed on average, with the number increasing across years, from 3.30 in 2003-2008 to 3.76 in 2009-2014. Prescription rates of antipsychotics, anxiolytics, and hypnotics significantly increased in patients with depressive disorders, bipolar disorders, anxiety disorders, delirium, dementia, and amnestic and other cognitive disorders. Only lithium prescription rates decreased significantly. Prescriptions for two or more anxiolytics and antipsychotics increased during the survey years, while antidepressant polypharmacy rates decreased. Conclusions Recently, there has been a significant increase in the number of psychotropic medications prescribed, including antipsychotics, anxiolytics, and hypnotics. Caution should be exercised when prescribing medications to avoid cost increases and the risk of side effects, with uncertain gains in the quality of care.