• 제목/요약/키워드: qi depression

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정신병리를 가진 청소년의 등교거부 사례보고 (A Research of School Refusal on Adolescent with Psychiatric Disorders)

  • 허은정;이상언;류희영
    • 동의신경정신과학회지
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    • 제21권4호
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    • pp.219-231
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    • 2010
  • Objectives : School refusal is usually considered as individual's behavioral problem. These days. however. the adolescents' school refusal needs some kind of medical approaches because it is related to mental disorder of the adolescents. Due to too much pressure and stress from the competition between classmates and from good performance in school. the number of adolescents who refuse to go to school is increasing. Despite this circumstance. school refusal is neither regarded as a single independent disorder nor endorsed as an officially classified disease. which makes difficult to conduct research on this issue and to establish standardized treatment for it. In addition. there is a lack of research on this topic. especially in oriental medicine. so there is no a case report or study on school refusal. This study is trying to comment on school refusal from the perspective of oriental medicine. Methods : We tried to examine the effect of oriental medicine treatment for school refusal with four adolescent cases. The patients commonly have at least more than one mental disorder (including depression disorder. anxiety disorder. and anorexia nervosa). have some problem with the relationship with their family. in particular with mother. do not have father or not be loved by their father. and have irregular eating habits. Thus. we diagnosed them as qi transforming into fire (氣鬱化矢) spleen-stomach deficiency cold (脾胃虛寒) and heart blood deficiency (心血虛) due to stress from the family issues and unhealthy eating habits. The patients received supportive therapy. family therapy. etc among many oriental mental treatments and their progress had been observed through hospitalization and outpatient treatment. Results : All four cases were reported positive progress on their symptoms and started coming back to school. We also examined whether they were well fitting into the school while they received outpatient treatment. and the results show that all four patients continue to settle down in normal school life. Conclusions : This study closely reviewed the mental disorder of school refusal cases and showed that the Oriental medical treatment was effective in helping the patients come back to school. More future research is required to better treatment for school refusal cases in oriental medicine.

갱년기장애 및 폐경기증후군 변증진단 도구의 진단결과 도출을 위한 변증별 절단점 연구 (A Clinical Study on the Pattern-Specific Cut-Point for the Pattern Identification Diagnostic Tool for Climacteric and Postmenopausal Syndrome)

  • 이인선;김종원;전수형;지규용;강창완
    • 대한한방부인과학회지
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    • 제32권2호
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    • pp.29-49
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    • 2019
  • Objectives: This study was a methodological study to verify the reliability and validity and to make a diagnosis of a diagnostic tool for climacteric and postmenopausal syndrome pattern identification (CaPSPI). Methods: This study was conducted from June 1, 2018 to October 18, 2018 with ${{\bigcirc}{\bigcirc}}$ University Korean Medicine Hospital IRB's approval (2018-3). To make a diagnosis using CaPSPI, we decided the cut-points for the tool. Three professors of ${{\bigcirc}{\bigcirc}}$Korean Medical University conducted pattern identification diagnosis. The result is marked from 0 to 3, 0 is 'No', 1 is 'Slightly Yes', 2 is 'Yes' and 3 is 'Very Yes'. And if two or more professors' diagnoses are the same, we took the diagnoses as a diagnostic criteria. The decision of pattern by three experts converted to 0-1 scores in two ways. In "method 1", if the diagnosis was zero points, the score was 0 (have no such identification), and the rest was 1 (have such identification). In "method 2", if the diagnosis was zero or 1 point, the score was 0, and the rest was 1. After that, intraclass correlation was calculated for experts agreement. And logistic regression was conducted. A response variable was the results of the experts' diagnosis and an explanatory variable was the results of the pattern identification diagnostic tool. Results: The diagnosis of the three experts showed excellent concordance of more than 0.794 and showed a significant correlation with the diagnostic tool. Both 'Method 1' and 'Method 2' showed statistically significant effects with the diagnosis of 3 experts and the results of the diagnostic tool. The frequency of cumulative pattern identification diagnosis in 'Method 1' and 'Method 2' were found to be 578 occasions and 203 occasions, respectively. The average number of pattern held by participants in 'Method 1' and 'Method 2' were found to be 5.26 and 1.85, respectively. In both "Method 1" and "Method 2," the yield frequency of liver qi depression was the highest, and the frequency of kidney yin deficiency and liver-kidney yin deficiency was relatively high. Conclusions: Based on the above results, it is thought that, in diagnosis using CaPSPI of menopausal women, 'method 1' could be used for the health diagnosis and prevention, 'method 2' could be used for the pattern diagnosis. On the conclusion, CaPSPI is thought to be available for pattern diagnosis of menopause women.

갱년기장애 및 폐경기 후 증후군 변증진단 도구의 변증분류 조정과 진단의 간의 진단일치도 연구 (A Study on Aadjustment of the Patterns, and the Correlation between the Diagnostic Tool for Climacteric and Postmenopausal Syndrome Pattern Identification (CaPSP) and Korean Medicine Doctors' Diagnosis)

  • 이인선;김종원;전수형;지규용;강창완
    • 대한한방부인과학회지
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    • 제34권1호
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    • pp.1-14
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    • 2021
  • Objectives: We studied for the adjustment of the patterns of 'The Diagnostic Tool for Climacteric and Postmenopausal Syndrome Pattern Identification (hereinafter CaPSPI)' (studyI) and the correlation between CaPSPI and Korean medicine doctors' diagnosis which was carried out without knowing the results of CaPSPI (studyII). Methods: The studyI followed the previous study method in 2018 (2018-3). The studyII was conducted from June 1, 2019 to July 10, 2020 with ◯◯ University Korean Medicine Hospital IRB's approval (2019-4). Doctors' diagnosis was conducted face-to-face with the subjects. Doctors' diagnosis was carried out based on the Kupperman's questionnaire, 'Diagnosis System of Oriental Medicine (hereinafter DSOM)' and four examinations (四診) records. The diagnosis was marked with 0 for 'no', 1 for 'somewhat', 2 for 'yes' and 3 for 'very yes'. The correlation between CaPSPI and the mean of doctors diagnostic scores were investigated statistically. Results: The studyI showed that heart-heat (心火) pattern was added. The Factor loading coefficient for heart-heat was 0.551 to 0.789, and the Cronbach's coefficient was 0.896. The studyII showed that the diagnosis (Kappa statistic) of two doctors showed statistically significant concordance (all eight patterns), with correlation of them were 0.3 or higher. And the correlation between the CaPSPI score and the mean of doctors' diagnostic score showed a statistically significant correlation, with liver qi depression (肝鬱) being the highest at 0.552 and dual deficiency of the heart-spleen (心脾兩虛) being the lowest at 0.301. Conclusions: Since the diagnosis results of CaPSPI showed a significant correlation with the diagnosis of Korean traditional medicine experts, it was believed that the CaPSPI results can be trusted and used for clinical purposes.

불면증 변증도구 신뢰도와 타당도 평가 및 심리검사와의 상관성에 대한 초기연구 (A Pilot Study of Evaluating the Reliability and Validity of Pattern Identification Tool for Insomnia and Analyzing Correlation with Psychological Tests)

  • 정진형;이지윤;김주연;김시연;강위창;임정화;김보경;정인철
    • 동의신경정신과학회지
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    • 제31권1호
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    • pp.1-12
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    • 2020
  • Objectives: The purpose of this study was to evaluate the reliability and validity of the instrument on pattern identification for insomnia (PIT-Insomnia) and verify the correlation between PIT-Insomnia and psychological tests. Methods: Two evaluators examined the pattern identification of the participants who met insomnia disorder diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition (DSM-5) and took the Insomnia Severity Index (ISI) score over 15 once manually and twice using the PIT-Insomnia to measure the inter-rater and test-retest reliability. We also conducted the following surveys: the Pittsburgh Sleep Quality Index (PSQI), the Korean version of Beck's depression inventory (K-BDI), the Korean version of the State-Trait Anxiety Inventory (STAI-K), the Korean Symptom checklist-95 (KSCL-95), and the EuroQol-5 dimension (EQ-5D), to measure concurrent validity and correlation between the PTI-Insomnia and psychological tests. Results: 1. The test-retest reliability analysis of the pattern identification results showed moderate agreement, and test-retest reliability analysis of each pattern identification score showed agreements from poor to moderate. 2. The inter-rater reliability analysis of the pattern identification results via manual showed slight agreement, when analysis was performed with calibration, the inter-rater reliability analysis of the pattern identification results via manual showed fair agreement. 3. The concordance analysis between results via manual and the PIT-Insomnia showed poor agreement, when the analysis was performed with calibration, concordance analysis showed fair agreement. 4. The concordance analysis between the PIT-Insomnia and the PSQI showed positive linear correlation. 5. The concordance analysis between the PIT-Insomnia and the PSQI, K-BDI, STAI-K, KSCL-95, and EQ-5D showed that non-interaction between the heart and kidney have positive linear correlation with the K-BDI, anxiety item of KSCL-95, dual deficiency of the heart-spleen have positive linear correlation with somatization item of KSCL-95, paranoia item of KSCL-95, heart deficiency with timidity have positive linear correlation with stress vulnerability item of KSCL-95, parania item of KSCL-95, phlegm-fire harassing the heart have positive linear correlation with K-BDI, paranoia item of KSCL-95, depressed liver qi transforming into fire have positive linear correlation with the anxiety item of KSCL-95, parania item of KSCL-95, all pattern identification have negative linear correlation with EQ-5D. Conclusions: The PIT-Insomnia has moderate agreement of reliability and reflects the severity of insomnia since it has some concurrent validity with the PSQI. There are some correlations between the PTI-Insomnia with specific psychological tests, so we could suggest it can be used appropriately in the clinical situation.

순우의(淳于意) 진적(診籍)에 나타난 질병(疾病)의 고찰(考察) (A study of the diseases which are in the Sun Woo-Yee(淳于意)' charts)

  • 김부환;박현국
    • 동국한의학연구소논문집
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    • 제4권
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    • pp.1-23
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    • 1995
  • The aim of this study is to compare the diseases which are in the Sun Woo-Yees charts with the diseases which are in the medical books excavated in MA WANG TEI(馬王堆), "YOUNG COO(靈樞)" and "SO MUN(素問)", and to investigate their interactions. The results obtained are as follows : 1. JOE(疽) which is made in stomach and bowels is not found at the medical books excavated in MA WANG TUI(馬王堆), "YOUNG COO(靈樞)" and "SO MUN(素問)". JOE(疽) which is made on the breast is similar to JOE(疽) which is made on the chest of "YOUNG COO(靈樞)". 2. It is said in Sun Woo-Yee(淳于意)'s charts that mental depression blocks up the circulation of Kl(氣), and it is the same viewpoint of "YOUNG COO(靈樞)"and "SO MUN(素問)". 3. The POONG GYUL(風厥) and the YOUL GYUL(熱厥) that are found in the Sun Woo-Yee(淳于意)'s charts is similar to those of "SO MUN(素問)", but different from those of "YOUNG COO(靈樞)". 4. It is regarded that YONG SAN(涌疝) in the Sun Woo-Yee(淳于意)'s charts is similar to the COONG SAN(퇴산) in "SO MUN(素問)", KI SAN(氣疝) in the Sun Woo-Yee(淳于意)'s charts is related to the TUI SAN(癡疝) of the medical books excavated in MA WANG TUI(馬王堆), "YOUNG COO(靈樞)" and "SO MUN(素問)", MO SAN(牡疝) in the Sun Woo-Yee(淳于意)'s charts is considered PE SAN(肺疝) and PE POONG SAN(肺風疝) in "SO MUN(素問)", but more and deeper study is required. In the change of the terms ; from TUI SAN(癡疝) to TUI SAN(퇴산), from PYUN SAN(偏疝) to HO SAN(狐疝), it can be guessed that the terms changed, as new doctrines were introduced and reorganiged with the development of the medical theory. 5. POONG BI in the Sun Woo-Yee(淳于意)'s charts is not found in "YOUNG COO(靈樞)", but it is similar to DAN FEVER(단열) in "SO MUN(素問)". It is regareded that PE SO DAN(폐소단) in the Sun Woo-Yee(淳于意)'s charts is the same as that of "YOUNG COO(靈樞)". 6. DONG PUNG in Sun Woo-Yee(淳于意)'s charts is not found in "YOUNG COO(靈樞)"and "SO MUN(素問)", but it seems like DONG SOEL(洞泄) in "YOUNG COO(靈樞)". It is regareded that the DONC PUNG(동풍) in the Sun Woo-Yee(淳于意)'s charts was at first changed into DONG SOEL(洞泄), and later differentiated into DOHG SOEL(洞泄) and SON SOEL. 7. In the Sun Woo-Yee(淳于意)'s charts, the treatment of the decayed tooth had the classification of the right and left, seeing cauterization with moxa on SU YANG MYOUNG MAEK(手陽明脈), it is considered that the tooth was decayed in the lower right. region. A tooth was related to QI MAEK(齒脈) and BI YANG MYUNG MAEK(臂陽明脈) in the early stage, but gradually was related to not only SU YANG MYUNG MAEK(手陽明脈) but also JOK YANG MYUNG MAEK(足陽明脈), JOK SO YIN MAEK(足少陰脈), JOK TAE YIN MAEK(足太陰脈), and in regards to the tooth and KYUNG MAEK(經脈), "YOUNG COO(靈樞)" emphasised the course of the KYUNG MAEK(經脈), "SO MUN(素問)" emphasised the attachment of the five elements. 8. In regards to BI(痺), the importance of the five elements theory given in the Sun Woo-Yee(淳于意)'s charts is similar to that of "SO MUN(素問)", and "YOUNG COO(靈樞)" and the medical books excavated in MA WANG TUI(馬王堆) give the same importance to the Kyung MAEK(經脈) theory. 9. The explanation of the irregular menstruation in the Sun Woo-Yee(淳于意)'s charts was fundamentally similar to that of "SO MUN(素問)", but it shows the another theory that can not found in "SO MUN(素問)".

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