• Title/Summary/Keyword: somatic symptoms

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A General Hospital-Based Model for Early Detection of Depression in the Geriatric Patients with Chronic Medical Diseases (만성적인 신체질환이 있는 노인 환자의 우울증 조기발견을 위한 병원기반 모델)

  • Park, Seon-Cheol;Lee, Hwa-Young;Lee, Dong-Woo;Han, Sang-Woo;Park, Sang-Ho;Kim, Yeo-Joo;Choi, Jae Sung;Jung, Sung Won;Lee, Soyoung Irene;Na, Kyoung-Sae;Kwon, Young-Joon
    • Korean Journal of Biological Psychiatry
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    • v.20 no.2
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    • pp.31-39
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    • 2013
  • The geriatric patients with chronic physical diseases are frequently associated with the continuous clusters of depression including nonpathological sadness, subsyndromal depression, minor depressive disorder, and major depressive disorder. Because of the complex and reciprocal relationships among depression, elderly, and chronic physical diseases, screening approaches with specific nosological methods should be needed in the realm of early detection of depression. Cognitive decline is frequently manifested in geriatric depression with medical or neurological diseases. Also, somatic symptoms of depression or emotional symptoms of physical diseases can play a role as a hampering factor in the early detection of depression. Furthermore, after-care has been regarded as an essential factor of depression screening in the geriatric patients with chronic physical diseases. We reviewed the most popular examples of integrated medicine for depression in primary care. Thus, we propose a general hospital-based model for early detection of depression which includes favorable response loop between screening and therapeutic intervention. Our model can be a basis for evidence-based detection and after-care for depression in the geriatric patients with chronic medical diseases.

A comparative study on pattern identification by OMS-prime of Hwa-Byung group and Hwa-Byung with Major Depression double diagnosis group (화병과 화병 ${\bullet}$ 주요우울증 중복진단군의 OMS-prime을 통한 변증유형 비교연구)

  • Kim, Jong-Woo;Kim, Sang-Ho;Chung, Sun-Yong;Park, So-Jung;Byun, Soon-Im;Kim, Ji-Young;Whang, Wei-Wan
    • Journal of Oriental Neuropsychiatry
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    • v.18 no.3
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    • pp.1-14
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    • 2007
  • The objective of tills study is to identify the difference of somatic characteristics between Hwa-Byung and Major Depression by comparing the pattern identification of Hwa-Byung group and Hwa-Byung with Major Depression group(double diagnosis) Method: According to Hwa-Byung Diagnostic Interview Schedule(HBDIS) and SCID, 17 patients as diagnosed Hwa-Byung and 20 patients as diagnosed Hwa-Byung with Major Depression group(double diagnosis) were recruited. and by depression scale like Hamilton Rating Scale for Depression(HRDS) & Montgomery-Asberg Depression Rating Scale(MADRS), we excluded patients complaining moderate & severe depression among Hwa-Byung group and excluded patients showing mild depression among Hwa-Byung with Major Depression group. After this evaluation, we analysed and compared the pattern identification of both groups by OMS-prime. Result: 1. There were no significant differences of demographic data between both groups. 2. In the result of 'analysis on pattern identification' for all participant used by OMS-prime, most frequent pattern was deficiency of Yin and Yang of the heart(49%). 3. In the result of 'analysis on most correlated pattern identification' used by OMS-prime, for Hwa-Byung group was deficiency of Yin and Yang of the heart(45%) and the next were disharmony of the liver and spleen (20%), generation of phlegm due to stagnation of Gallbladder(15%) deficiency of Qi and Yin of the heart(l0%), And for Hwa-Byung with Major Depression group(double diagnosis) was deficiency of Yin and Yang of the heart(53%), the next were generation of phlegm due to stagnation of Gallbladder(18%), and deficiency of Qi and blood of the heart(l2%), 4. In the result of 'analysis on significant pattern identification' used by OMS-prime, for Hwa-Byung group was deficiency of Yin and Yang of the heart(20%) and the next were disharmony of the liver and spleen(15%), generation of phiegm due to stagnation of Gallbladder(15%), deficiency of Qi and Yin of the heart(14%), And for Hwa-Byung plus Major Depression group(double diagnosis) was deficiency of Yin and Yang of the heart(18%), the next were deficiency of Qi and Yin of the heart(18%), deficiency of Qi and blood of the heart(l0%), generation of phiegm due to stagnation of Gallbladder(18%), Conclusion: Hwabyung is syndrome that have many different symptoms, but there is no difference between Hwa-Byung group and Hwa-Byung with Major Depression group(double diagnosis) on the side of symptoms. Therefore, Hwabyung could be a new model for research on depression in Korean.

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Characteristics of Psychiatric Consultation between Presenile and Senile Inpatients (초로기와 노년기 입원환자에 대한 정신건강의학과 자문의 특성)

  • Lee, Ji Woong;Cheon, Jin Sook;Kim, Kang Ryul;Kim, Hyun Seuk;Oh, Byoung Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.2
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    • pp.114-121
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    • 2013
  • Objectives: The aim of this study was to know differences of characteristics between presenile and senile patients who were consulted to the department of psychiatry during medical-surgical admission. Methods: The demographic and clinical data obtained from the medical records of psychiatric consultation in the presenile inpatients with age 50 to 64 years(N=162) and those of the senile inpatients with age over 65 years(N=171) were reviewed and compared. Results: 1) The most common chief complaints for psychiatric consultation in presenile patients were somatic symptoms, anxiety and sleep disturbance in order, while cognitive decline, clouded consciousness and depressed mood were most common in senile patients with statistical significance. 2) The most frequent psychiatric diagnoses after consultation in presenile patients were delirium, mood disorder and substance use disorder in order, while delirium, mood disorder and major neurocognitive disorder were most frequent in senile patients with statistical significance. 3) There were no significant difference in numbers of physical illnesses, while numbers of therapeutic drugs for them were more in senile patients. Conclusions : Our study found significant differences between presenile and senile patients on psychiatric symptoms and diagnoses in geropsychiatric consultation. Therefore, more subdivided age-specific approach seems to be needed for the geropsychiatric consultation activities.

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A Study on the Stress of Clinical Practice, Stress Coping and Somatization for Dental Hygiene Students (치위생과 학생들의 임상실습스트레스와 스트레스대처방식 및 신체화경향에 관한 연구)

  • Hong, Su-Min;Han, Ji-Hyoung;Kim, Hee-Kyoung;Ahn, Yong-Soon
    • Journal of dental hygiene science
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    • v.9 no.2
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    • pp.219-224
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    • 2009
  • The purpose of this study was to investigate the relationship among the stress on clinical practice, stress coping method and the somatization symptom of dental hygiene students and propose strategies for effective instruction of clinical practice. The survey was performed by self-reported questionnaires for 268 dental hygiene students who have recently experienced clinical practice. Collected data were analyzed using by t-test and Pearson correlation coefficient with the SPSS Win 12.0 program. Its results are as follows. 1. In the satisfaction of clinical practice, 'Satisfaction', 'Average' and 'Unsatisfactory' were 32.5%, 42.2% and 25.4%, respectively. The reason for dissatisfaction of clinical practice were 'insufficient education of college'(29.8%), 'environment of clinical practice institute'(23,4%), 'interpersonal relationship'(21.3%) in order. 2. Somatization symptoms was positive correlation(0.307, p < 0.01) associated with stress of clinical practice. Also it was negative correlation associated with satisfaction level of the subjects and stress of clinical practice. Correlation coefficient of the interpersonal relation factor was found the most significantly high as much as 0.331, according to the analysis carried out between subordinate factors of clinical practice stress and somatization. 3. According to stress coping method. Subjects were distributed into two group of active method and passive method. Thereafter as a result of verifying the difference of somatization symptoms, there was statistically significant difference between active method group and passive method group. Based on the study results, we suggests that effective management program of clinical practice should be developed and applied to the dental hygiene students to make them cope with stress and somatic symptom during their clinical practice.

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The Empirical Exploration of the Conception on Nursing (간호개념에 대한 기초조사)

  • 백혜자
    • Journal of Korean Academy of Nursing
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    • v.11 no.1
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    • pp.65-87
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    • 1981
  • The study is aimed at exploring concept held by clinical nurses of nursing. The data were collected from 225 nurses conviniently selected from the population of nurses working in Kang Won province. Findings include. 1) Nurse's Qualification. The respondents view that specialized knowledge is more important qualification of the nurse. Than warm personality. Specifically, 92.9% of the respondents indicated specialized knowledge as the most important qualification while only 43.1% indicated warm personality. 2) On Nursing Profession. The respondents view that nursing profession as health service oriented rather than independent profession specifically. This suggests that nursing profession is not consistentic present health care delivery system nor support nurses working independently. 3) On Clients of Nursing Care The respondents include patients, family and the community residents in the category of nursing care. Specifically, 92.0% of the respondents view that patient is the client, while only 67.1% of nursing student and 74.7% of herself. This indicates the lack of the nurse's recognition toward their clients. 4) On the Priority of Nursing care. Most of the respondents view the clients physical psychological respects as important component of nursing care but not the spiritual ones. Specially, 96.0% of the respondents indicated the physical respects, 93% psychological ones, while 64.1% indicated the spiritual ones. This means the lack of comprehensive conception on nursing aimension. 5) On Nursing Care. 91.6% of the respondents indicated that nursing care is the activity decreasing pain or helping to recover illness, while only 66.2% indicated earring out the physicians medical orders. 6) On Purpose of Nursing Care. 89.8% of the respondents indicated preventing illness and than 76.6% of them decreasing 1;ai of clients. On the other hand, maintaining health has the lowest selection at the degree of 13.8%. This means the lack of nurses' recognition for maintaining health as the most important point. 7) On Knowledge Needed in Nursing Care. Most of the respondents view that the knowledge faced with the spot of nursing care is needed. Specially, 81.3% of the respondents indicated simple curing method and 75.1%, 73.3%, 71.6% each indicated child nursing, maternal nursing and controlling for the communicable disease. On the other hand, knowledge w hick has been neglected in the specialized courses of nursing education, that is, thinking line among com-w unity members, overcoming style against between stress and personal relation in each home, and administration, management have a low selection at the depree of 48.9%,41.875 and 41.3%. 8) On Nursing Idea. The highest degree of selection is that they know themselves rightly, (The mean score measuring distribution was 4.205/5) In the lowest degree,3.016/5 is that devotion is the essential element of nursing, 2.860/5 the religious problems that human beings can not settle, such as a fatal ones, 2,810/5 the nursing profession is worth trying in one's life. This means that the peculiarly essential ideas on the professional sense of value. 9) On Nursing Services. The mean score measuring distribution for the nursing services showed that the inserting of machine air way is 2.132/5, the technique and knowledge for surviving heart-lung resuscitating is 2.892/s, and the preventing air pollution 3.021/5. Specially, 41.1% of the respondents indicated the lack of the replied ratio. 10) On Nurses' Qualifications. The respondents were selected five items as the most important qualifications. Specially, 17.4% of the respondents indicated specialized knowledge, 15.3% the nurses' health, 10.6% satisfaction for nursing profession, 9.8% the experience need, 9.2% comprehension and cooperation, while warm personality as nursing qualifications have a tendency of being lighted. 11) On the Priority of Nursing Care The respondents were selected three items as the most important component. Most of the respondents view the client's physical, spiritual: economic points as important components of nursing care. They showed each 36.8%, 27.6%, 13.8% while educational ones showed 1.8%. 12) On Purpose of Nursing Care. The respondents were selected four items as the most important purpose. Specially,29.3% of the respondents indicated curing illness for clients, 21.3% preventing illness for client 17.4% decreasing pain, 15.3% surviving. 13) On the Analysis of Important Nursing Care Ranging from 5 point to 25 point, the nurses' qualification are concentrated at the degree of 95.1%. Ranging from 3 point to 25, the priorities of nursing care are concentrated at the degree of 96.4%. Ranging from 4 point to 16, the purpose of nursing care is concentrated at the degree of 84.0%. 14) The Analysis, of General Characteristics and Facts of Nursing Concept. The correlation between the educational high level and nursing care showed significance. (P < 0.0262). The correction between the educational low level and purpose of nursing care showed significance. (P < 0.002) The correlation between nurses' working yeras and the degree of importance for the purpose of nursing care showed significance (P < 0.0155) Specially, the most affirmative answers were showed from two years to four ones. 15) On Nunes' qualification and its Degree of Importance The correlation between nurses' qualification and its degree of importance showed significance. (r = 0.2172, p< 0.001) 0.005) B. General characteristics of the subjects The mean age of the subject was 39 ; with 38.6% with in the age range of 20-29 ; 52.6% were male; 57.9% were Schizophrenia; 35.1% were graduated from high school or high school dropouts; 56.l% were not have any religion; 52.6% were unmarried; 47.4% were first admission; 91.2% were involuntary admission patients. C. Measurement of anxiety variables. 1. Measurement tools of affective anxiety in this study demonstrated high reliability (.854). 2. Measurement tools of somatic anxiety in this study demonstrated high reliability (.920). D. Relationship between the anxiety variables and the general characteristics. 1. Relationship between affective anxiety and general characteristics. 1) The level of female patients were higher than that of the male patient (t = 5.41, p < 0.05). 2) Frequencies of admission were related to affective anxiety, so in the first admission the anxiety level was the highest. (F = 5.50, p < 0.005). 2, Relationship between somatic anxiety and general characteristics. 1) The age range of 30-39 was found to have the highest level of the somatic anxiety. (F = 3.95, p < 0.005). 2) Frequencies of admission were related to the somatic anxiety, so .in first admission the anxiety level was the highest. (F = 9.12, p < 0.005) 0. Analysis of significant anxiety symptoms for nursing intervention. 1. Seven items such as dizziness, mental integration, sweating, restlessness, anxiousness, urinary frequency and insomnia, init. accounted for 96% of the variation within the first 24 hours after admission. 2. Seven items such as fear, paresthesias, restlessness, sweating insomnia, init., tremors and body aches and pains accounted for 84% of the variation on the 10th day after admission.

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Development of the Korean version of Postconcussional Syndrome Questionnaire (한글판 뇌진탕후증후군 척도의 개발)

  • Yoon, Mi-Ri;Ko, Young-Hoon;Han, Chang-Su;Joe, Sook-Haeng;Jeon, Sang-Won;Han, Chang-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.23 no.1
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    • pp.26-35
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    • 2015
  • Objectives:The purpose of this study was to evaluate reliability and validity of the Korean version of the Postconcussional Syndrome Questionnaire(KPCSQ) which was originally developed in 1992 by Lees-Haley. Methods:Patients with traumatic brain injury were recruited from April 2009 to December 2011 from the Korean University Ansan Hospital. We selected patients that met the ICD-10 diagnostic criteria of postconcussional syndrome and organic mental disorder including organic mood disorder, organic emotionally labile disorder, organic anxiety disorder and organic personality disorder. The KPCSQ, Trait and State Anxiety Inventory(STAI-I, II), and Center for Epidemiologic Studies Depression Scale(CESD) were administered to all subjects. Factor analysis of the items were performed and test-retest correlation were evaluated. Internal consistency of the KPCSQ and its subscales was assessed with Cronbach's alpha. External validity of the KPCSQ were examined by correlation coefficient with the STAI-I, II, and CESD. Results:The Cronbach's alpha coefficient of the total PCSQ was 0.956. The test-retest reliability coefficient was 0.845. The PCSQ showed significant correlation with STAI-I, II and CESD. The factor analysis of the PCSQ yielded 4 factors model. Factor 1 represented 'affective and cognitive symptoms', factor 2 represented 'somatic symptoms', factor 3 represented 'infrequent symptoms' and factor 4 represented 'exaggeration or inattentive response'. There was no significant difference between the PCS group and the organic mental disorder group in the score on each measure. The scores on KPCSQ and its subscales in the subjects that had scored 5 or more in 'exaggeration or inattentive response' are significantly higher than those in the subjects had scored 4 in 'exaggeration or inattentive response'. Conclusions:This study suggests that the Korean version of PCSQ is a valid and reliable tool for assessing psychiatric symptomatology of patients with traumatic brain injury. Further investigations with greater numbers of subjects are necessary to assess the clinical usefulness of the KPCSQ.

THE CLASSIFICATION OF ADOLESCENTS IN RUNAWAY SHELTERS BY THE EVALUATION OF THEIR PSYCHOPATHOLOGY (보호시설 가출청소년의 정신병리에 대한 평가와 분류)

  • Lee, Jong-Sung;Kwack, Young-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.2
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    • pp.192-217
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    • 2001
  • Object:This study was carried out to classify adolescents in runaway shelters by evaluating their psychopathology. And the ultimate purpose is to offer basic data for preventing adolescents‘ runaway and for diversifying runaway shelters suitable for the problem of individual adolescent. Method:128 adolescents who stay in the runaway shelters were asked to complete self-report qeustionnaires including basic sociodemographic data, Child Behavior Check List(CBCL), Minnesota Multiphasic Personality Inventory(MMPI), and Symptom Check List-90-Revised(SCL-90-R). Korean Wechsler Adult Intelligence Scale(K-WAIS)[or Korean Educational Developmental Institute-Wechsler Intelligence Scale for Children(KEDI-WISC)] and Bender-Gestalt test(BGT) were also done by clinical psychologists. Results:The most common age of the subjects were 15-year-old, and they dropped out their schools in the middle school most commonly. Mostly they were from middle class family and their parents' educational level were high school graduates. The first runaway episode was most common in the middleschool period, and their runaways were repeated. The most common frequency of runaways were more than 10 times. About 10% of them abused drugs and about 80% of them abused alcohol. One third of them had experiences of illegal problems and 10% of them engaged in sexual activity for money. 95 adolescents(83%) in CBCL, 42 adolescents(36%) in SCL-90-R, and 70 adolescents(69.3%) in MMPI showed clinical significance. In intelligence test, 22 adolescents(22%) were mentally retarded. In BGT, 35 adolescents(39.4%) manifested brain dysfunction signs. Conclusion:Runaway adolescents in the shelters have variable and severe psychopathology. Their psychopathology is classified as follows;The behavior disorder group, the mood disorder group with anxiety/depression, the somatic disorder group with somatic symptoms, and the psychosis group with possibility of severe psychopathology. Therefore it is very important to evaluate psychiatric problems of runaway adolescents, and specific therapeutic interventions according to their problems are required.

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Insomnia in Patients with Chronic Renal Failure on Hemodialysis (혈액투석 중인 만성 신부전증 환자에서의 불면증에 대한 연구)

  • Kim, Gyung-Ryul;Yang, Chang-Kook;Hahn, Hong-Moo
    • Sleep Medicine and Psychophysiology
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    • v.6 no.2
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    • pp.126-132
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    • 1999
  • Objectives: The purposes of this study were to investigate 1) the incidence of insomnia, 2) the clinical characteristics of the insomniacs, 3) the correlation of severity of insomnia with somatic complaints and psychological distresses, and 4) the beliefs and attitudes about sleep in patients with chronic renal failure on hemodialysis. Methods: The author evaluated 153 patients, receiving hemodialysis therapy at the four outpatients hemodialysis units in Pusan, Korea. The patients had completed a self-administered questionnaire package, which consisted of basic demographic findings, questions characterizing insomnia, Beck Depression Inventory(BDI), Spielburger's State-Trait Anxiety Inventory(STAI), and visual analogue scales measuring quantitatively the severity of the self-perceived psychological and somatic symptoms. And several laboratory data were collected. Diagnosis of insomnia was made in the base of insomnia criteria of DSM-IV and international classification of sleep disorders. Subjects were dichotomized into those who reported any characteristics of insomnia or those who had no insomnia during the preceding two weeks. Results: Insomnia was found in 100(65.4%) of 153 patients. No statistical differences were found between the patients with and without insomnia in terms of age, gender, education, marital status, mean duration of hemodialysis and all considered laboratory findings except serum albumin. The patients with insomnia had significantly higher BDI score and predialysis systolic blood pressure, and lower serum albumin as compared to non-insomnia group. Significant differences were found between two groups in terms of self-perceived distress such as sadness, anxiety, worry, pruritus, and dysfunction of daily life. The data showed statistically significant correlation between insomnia severity and some variables such as physical dysfunction, pruritus, bone pain, sadness, anxiety, worry, dysfunction of daily life and excessive daytime sleepiness. The patients with insomnia had significantly several dysfunctional beliefs and attitudes about sleep than those without insomnia. Conclusion: These results indicate that insomnia is very common in hemodialysis patients and likely contribute to the impaired quality of life experienced by many these patients. The author suggests that physical and psychological distresses would be reduced and the quality of life could be improved if their sleep disturbances are properly ameliorated in patients on hemodialysis.

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Analysis of Mutant Chinese Cabbage Plants Using Gene Tagging System (Gene Tagging System을 이용한 돌연변이 배추의 분석)

  • Yu, Jae-Gyeong;Lee, Gi-Ho;Lim, Ki-Byung;Hwang, Yoon-Jung;Woo, Eun-Taek;Kim, Jung-Sun;Park, Beom-Seok;Lee, Youn-Hyung;Park, Young-Doo
    • Horticultural Science & Technology
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    • v.28 no.3
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    • pp.442-448
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    • 2010
  • The objectives of this study were to analyze mutant lines of Chinese cabbage ($Brassica$ $rapa$ ssp. $pekinensis$) using gene tagging system (plasmid rescue and inverse polymerase chain reaction) and to observe the phenotypic characteristics. Insertional mutants were derived by transferring DNA (T-DNA) of $Agrobacterium$ for functional genomics study in Chinese cabbage. The hypocotyls of Chinese cabbage 'Seoul' were used to obtain transgenic plants with $Agrobacterium$ $tumefaciens$ harboring pRCV2 vector. To tag T-DNA from the Chinese cabbage genomic DNA, plasmid rescue and inverse PCR were applied for multiple copies and single copy insertional mutants. These techniques were successfully conducted to Chinese cabbage plant with high efficiency, and as a result, T-DNA of pRCV2 vector showed distinct various integration patterns in the transgenic plant genome. The polyploidy level analysis showed the change in phenotypic characteristics of 13 mutant lines was not due to variation in somatic chromosome number. Compared with wild type, the $T_1$ progenies showed varied phenotypes, such as decreased stamen numbers, larger or smaller flowers, upright growth habit, hairless leaves, chlorosis symptoms, narrow leaves, and deeply serrated leaves. The polyploidy level analysis showed the change in phenotypic characteristics of 13 mutant lines was not due to variation in somatic chromosome number. To tag T-DNA from the Chinese cabbage genomic DNA, plasmid rescue and inverse PCR were applied for multiple copies and single copy insertional mutants. Mutants that showed distinct phenotypic difference compared to wild type with 1 copy of T-DNA by Southern blot analysis, and with 2n = 20 of chromosome number were selected. These selected mutant lines were sequenced flanking DNA, mapped genomic loci, and the genome information of the lines is being recorded in specially developed database.

Comparison of Emotional and Psychological Characteristics between Suicide Attempters and Non-Attempters in Depressed Patients : Using MMPI-2 Profiles (우울장애 환자의 자살 시도 여부에 따른 심리적 특성의 차이 : MMPI-2 프로파일을 중심으로)

  • Lee, Seul-Ah;Kim, Keun-Hyang;Suh, Shin-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.1
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    • pp.40-49
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    • 2012
  • Objectives : To examine emotional and psychological characteristics associated with suicide attempts in depressed patients. Methods : A sample of 37 inpatients diagnosed with major depressive disorder or depressive disorder NOS was divided into two groups : lifetime suicide attempters(N=15 ; 40.54%), non-attempters(N=22 ; 59.46%). Beck Depression Scale(BDI), Beck Anxiety Scale(BAI), Hamilton Depression Rating Scale(HDRS), Hamilton Anxiety Rating Scale(HARS), and MMPI-2 were used to evaluate symptoms severity and psychological characteristics. Results : Suicide attempters scored higher on the BDI though there were no group differences on the HDRS and on the both anxiety scales. Also they showed higher scores on the F, Fb, Pa, RC1, DEP, HEA, PK, AAS among MMPI-2 subscales. Our findings suggest that suicide attempters among depressed patients undergo more severe subjective distress and difficulties in adjustment than non-attempters. Also they were more hostile to others and showed lower trust. Lastly, they showed more somatic complaints and substance related problems. Conclusion : The present study showed that suicide attempters among depressed patients have distinct emotional and psychological characteristics. MMPI-2 would be helpful to assess suicidal risk of depressed patients.

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