• Title, Summary, Keyword: treatment outcome

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6-months Prospective Follow-up Study of Panic Disorder Treatment (공황장애 환자 치료 결과에 대한 6개월간의 전향적 추적조사)

  • Yu, Je-Chun;Lee, Chul
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.1
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    • pp.58-65
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    • 2001
  • Objectives : It is well known that pharmacologic and behavioral therapies of panic disorder show remarkable acute treatment outcome, however the course of panic disorder in clinical settings is often chronic and relapsing. The purpose of this study is to investigate the treatment outcome of panic disorder and the factors related to good treatment outcome by prospective follow-up study after 6 month in clinical settings. Methods : Twenty nine patients were diagnosed to have panic disorder by SCID(Structured Clinical Interview for DSM-III-R), among the patients who had visited the psychiatric out-patients clinic of the Asan Medical Center for the first time. We determined the initial clinical and demoraphic features of each patient and reevaluated them after 6 months, investigating the treatment outcome by anxiety, phobia, impairment scales. We looked into the rate of the patients who showed good treatment outcome and determined the factors that had relation with good treatment outcome among demographic and clinical features. Results : Nineteen out of 29 patients could be followed after 6 months. Among them, 10 patients 52.6%) on the impairment scale and phobia scale each, and 8 patients(42.1 %) on the anxiety scale showed good treatment outcome. 8 patients(42.1 %) showed good treatment outcome on the all three scales. High score in initial phobia scale had significant relation with good treatment outcome. Short duration of illness did not have significant relation with good treatment outcome however there was a trend(p=0.07). Conclusion : About half(42.1 %) of the panic disorder patients showed good treatment outcome on all three scales. Severe initial phobic symptom and short duration of illness were expected to have relation with good treatment outcome.

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Interaction between Personality and Depression Outcome (인격과 우울증 치료결과의 상호작용)

  • Park, Yong Chon;Kim, Seok Hyeon
    • Korean Journal of Biological Psychiatry
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    • v.8 no.1
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    • pp.47-52
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    • 2001
  • It is known that the personality is the crucial factor in the treatment outcome of depression. The authors tried to identify the results of such studies and various components which determine the treatment outcome of depression. Nearly 60 papers published between the year 1990 and 2000 about the treatment of depression and personality were reviewed. Among them about 30 papers were selected to compare the research methods, results and discussions. The arguments and critics of the papers were discussed. In the many debates, the authors admitted the fact that premorbid personality trait influences the treatment outcome of depression negatively regardless of treatment method. Subtyping of depression is feasible along the presence of good or bad predictors of treatment outcome for depression. Differentiation of depression and personality seems to have no problem, however test of personality state before the development of psychiatric disorder such as depression is not amenable. For example, cluster A personality trait is often misunderstood as depression in clinical setting. In some cases cognitive behavioral therapy is effective in the treatment of depression accompanying personality disorder. The authors insist that the analysis of personality in the dimensional aspect rather than in the categorical aspect gives more information in the research of personality influencing the treatment outcome of depression. In addition, the reason why we understand the relationship between depression and personality were discussed.

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Relationship between Nutritional Status and Clinical Outcome in 120 Hepatoma Patients (간암환자의 영양상태와 치료결과와의 관련성)

  • Han, Bu;Kim, Young-ok
    • The Korean Journal of Food And Nutrition
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    • v.13 no.5
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    • pp.434-439
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    • 2000
  • This study was conducted to investigate the association between initial nutritional status and treatment outcome of hepatoma patients. Initial nutritional status was measured based on weight, serum albumin and total lymphocyte counts. Treatment outcome was measured in the three categories such as complication, treatment status at discharge and mortality. The study subjects were 120 patients with hepatoma cancer admitted at a university hospital in Seoul. The information about initial nutritional status and treatment outcome was collected from medical records. Chi-square test was used to test the association between initial nutritional status and treatment outcome As a result. 76.6% of the subjects were classified as the nutritional risk group based on initial nutritional states. Prevalence of complication was higher in nutritional risk group I and II than that in non-risk group(p<0.05). Death rare of the nutritional risk group was significantly higher than that of non-risk group(p<0.001). The findings suggest the strong association between the initial nutritional status and treatment outcome of hepatoma cancer.

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The Improvement and Completion of Outcome index: A new assessment system for quality of orthodontic treatment

  • Hong, Mihee;Kook, Yoon-Ah;Kim, Myeng-Ki;Lee, Jae-Il;Kim, Hong-Gee;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.46 no.4
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    • pp.199-211
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    • 2016
  • Objective: Given the considerable disagreement between the Peer Assessment Rating (PAR) index and the American Board of Orthodontics Cast-Radiograph Evaluation, we aimed to develop a novel assessment system-the Improvement and Completion of Outcome (ICO) index-to evaluate the outcome of orthodontic treatment. Methods: Sixteen criteria from 4 major categories were established to represent the pretreatment malocclusion status, as well as the degree of improvement and level of completion of outcome during/after treatment: dental relationship (arch length discrepancy, irregularity, U1-SN, and IMPA); anteroposterior relationship (overjet, right and left molar position, ANB); vertical relationship (anterior overbite, anterior open-bite, lateral open-bite, SN-MP); and transverse relationship (dental midline discrepancy, chin point deviation, posterior cross-bite, occlusal plane cant). The score for each criterion was defined from 0 or -1 (worst) to 5 (ideal value or normal occlusion) in gradations of 1. The sum of the scores in each category indicates the area and extent of the problems. Improvement and completion percentages were estimated based on the pre- and post-treatment total scores and the maximum total score. If the completion percentage exceeded 80%, treatment outcome was considered successful. Results: Two cases, Class I malocclusion and skeletal Class III malocclusion, are presented to represent the assessment procedure using the ICO index. The difference in the level of improvement and completion of treatment outcome can be clearly explained by using 2 percentage values. Conclusions: Thus, the ICO index enables the evaluation of the quality of orthodontic treatment objectively and consecutively throughout the entire treatment process.

Outcome criteria in nocturnal enuresis treatment (야뇨의 치료 평가 기준에 관한 연구)

  • Oh, Ju-Young;Kim, Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.20 no.3
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    • pp.61-74
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    • 2006
  • Objectives : Nocturnal enuresis is one of common disorders in children. However, there are not a lot of researches going on about this disease, and also standardized criteria for analyzing were insufficient in Korea. Therefore, clinical researches were not in the confidence level. Methods : Korean journals which were published in 1990 to 2006, and online journals about nocturnal enuresis were used for analyzing based on outcome criteria. Results : The International Children's Continence Society and the World Health Organization have published outcome criteria about nocturnal enuresis, but different, often idiosyncratic, outcome criteria and/or definitions have been adopted in published research on treatment for nocturnal enuresis in recent years. But a new set of criteria suggested by Butler, Robinson, and et. al. referred to as a "dryness scale", which focuses on the percentage of dry nights accomplished at a point in time, will be an alternative proposal. These criteria will be of help to make standardized and proper outcome criteria in oriental medical studies. Conclusions : Agreed standardized outcome criteria in nocturnal enuresis treatment is needed.

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Treatment of Unruptured Intracranial Aneurysms in South Korea in 2006 : A Nationwide Multicenter Survey from the Korean Society of Cerebrovascular Surgery

  • Kim, Jeong-Eun;Lim, Dong-Jun;Hong, Chang-Ki;Joo, Sung-Pil;Yoon, Seok-Mann;Kim, Bum-Tae
    • Journal of Korean Neurosurgical Society
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    • v.47 no.2
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    • pp.112-118
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    • 2010
  • Objective : There have been no clinical studies regarding the epidemiology and treatment outcome for unruptured intracranial aneurysm (UIA) in South Korea yet. Thus, The Korean Society of Cerebrovascular Surgery (KSCVS) decided to evaluate the clinical and epidemiological characteristics, and outcome of the treatment of UIA in 2006, using the nationwide multicenter survey in South Korea. Methods : A total of 1,696 cases were enrolled retrospectively over one year at 48 hospitals. The following data were obtained from all patients : age, sex, presence of symptoms, location and size of the aneurysm, treatment modality, presence of risk factors for stroke, and the postoperative 3D-day morbidity and mortality. Results : The demographic data showed female predominance and peak age of seventh and sixth decades. Supraclinoid internal carotid artery was the most common site of aneurysms with a mean size of 5.6 mm. Eight-hundred-forty-six patients (49.9%) were treated with clipping, 824 (48.6%) with coiling, and 26 with combined method. The choice of the treatment modalities was related to hospital (p=0.000), age (p=0.000), presence of symptom (p=0.003), and location of aneurysm (p=0.000). The overall 30-day morbidity and mortality were 7.4% and 0.3%, respectively. The 30-day mortality was 0.4% for clipping and 0.2% for coiling, and morbidity was 8.4% for clipping and 6.3% for coiling. Age (p=0.010), presence of symptoms (p=0.034), size (p=0.000) of aneurysm, and diabetes mellitus (p=0.000) were significant prognostic factors, while treatment modality was not. Conclusion : This first nation-wide multicenter survey on UIAs demonstrates the epidemiological and clinical characteristics, outcome and the prognostic factors of the treatment of UIAs in South Korea. The 30-day postoperative outcome for UIAs seems to be reasonable morbidity and mortality in South Korea.

Bayesian Network Model to Evaluate the Effectiveness of Continuous Positive Airway Pressure Treatment of Sleep Apnea

  • Ryynanen, Olli-Pekka;Leppanen, Timo;Kekolahti, Pekka;Mervaala, Esa;Toyras, Juha
    • Healthcare Informatics Research
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    • v.24 no.4
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    • pp.346-358
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    • 2018
  • Objectives: The association between obstructive sleep apnea (OSA) and mortality or serious cardiovascular events over a long period of time is not clearly understood. The aim of this observational study was to estimate the clinical effectiveness of continuous positive airway pressure (CPAP) treatment on an outcome variable combining mortality, acute myocardial infarction (AMI), and cerebrovascular insult (CVI) during a follow-up period of 15.5 years ($186{\pm}58$ months). Methods: The data set consisted of 978 patients with an apnea-hypopnea index (AHI) ${\geq}5.0$. One-third had used CPAP treatment. For the first time, a data-driven causal Bayesian network (DDBN) and a hypothesis-driven causal Bayesian network (HDBN) were used to investigate the effectiveness of CPAP. Results: In the DDBN, coronary heart disease (CHD), congestive heart failure (CHF), and diuretic use were directly associated with the outcome variable. Sleep apnea parameters and CPAP treatment had no direct association with the outcome variable. In the HDBN, CPAP treatment showed an average improvement of 5.3 percentage points in the outcome. The greatest improvement was seen in patients aged ${\leq}55$ years. The effect of CPAP treatment was weaker in older patients (>55 years) and in patients with CHD. In CHF patients, CPAP treatment was associated with an increased risk of mortality, AMI, or CVI. Conclusions: The effectiveness of CPAP is modest in younger patients. Long-term effectiveness is limited in older patients and in patients with heart disease (CHD or CHF).

Outcome of Low-Back Pain and Sciatica : Relationship among Self-reported Pain Intensity, Disability, Sleep Disturbance and Fatigue (요통 및 좌골신경통 환자의 치료결과 : 수면장애 및 피로감과 자각적 통증 및 장애정도의 관계)

  • Lee, Kyeong-Seok;Yoon, Seok-Mann;Doh, Jae-Won;Bae, Hack-Gun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.324-329
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    • 2000
  • Objective : Psychological factors may have a major influence on the outcome of treatment for back pain. We investigated the relationship between the outcome and some psychological factors, such as self-reported pain intensity, disability, sleep disturbance and fatigue. Method : The study was conducted as a survey using a questionnaire and telephone interviews. The survey included consecutive 294 patients who visited the neurosurgical out-patient department complaining of low back pain and contacted by telephone on average seven months after the first visit. Pain intensity was measured by visual analog scale, and disability was assessed by Waddell's chronic disability index. Results : The outcome of treatment for back pain was recovered in 36.7%, improved in 30.6%, almost same in 28.6%, and aggravated in 4.1%. Overall rate of improvement was 67.3%. The rate of improvement was related to the duration, patterns and intensity of the symptom, and Waddell index. It was not influenced by the doctors, special studies, and methods of treatment. When the duration was more than 6 months, there were the symptoms of both back and legs, and the self-reported Waddell index was 1-3, the rate of improvement was relatively low. Although the intensity of the pain and disability was closely related to the degree of sleep disturbance, fatigue, appetite, or indigestion, the outcome of treatment for back pain was not always bad in patients with high psychological stress. Actually the outcome of the patients who complained severe pain and disability was better than the outcome of the others. Conclusion : The outcome of the back pain can be predicted by the duration, patterns and intensity of the symptom, and Waddell index. The multidisciplinary treatment will be necessary for the patients whose expected outcome is not good to reduce not only the physical symptoms but also the psychological stress.

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Socio-economic Status Plays Important Roles in Childhood Cancer Treatment Outcome in Indonesia

  • Mostert, Saskia;Gunawan, Stefanus;Wolters, Emma;van de Ven, Peter;Sitaresmi, Mei;van Dongen, Josephine;Veerman, Anjo;Mantik, Max;Kaspers, Gertjan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6491-6496
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    • 2012
  • Background: The influence of parental socio-economic status on childhood cancer treatment outcome in low-income countries has not been sufficiently investigated. Our study examined this influence and explored parental experiences during cancer treatment of their children in an Indonesian academic hospital. Materials and Methods: Medical charts of 145 children diagnosed with cancer between 1999 and 2009 were reviewed retrospectively. From October 2011 until January 2012, 40 caretakers were interviewed using semi-structured questionnaires. Results: Of all patients, 48% abandoned treatment, 34% experienced death, 9% had progressive/relapsed disease, and 9% overall event-free survival. Prosperous patients had better treatment outcome than poor patients (P<0.0001). Odds-ratio for treatment abandonment was 3.3 (95%CI: 1.4-8.1, p=0.006) for poor versus prosperous patients. Parents often believed that their child's health was beyond doctor control and determined by luck, fate or God (55%). Causes of cancer were thought to be destiny (35%) or God's punishment (23%). Alternative treatment could (18%) or might (50%) cure cancer. Most parents (95%) would like more information about cancer and treatment. More contact with doctors was desired (98%). Income decreased during treatment (55%). Parents lost employment (48% fathers, 10% mothers), most of whom stated this loss was caused by their child's cancer (84% fathers, 100% mothers). Loss of income led to financial difficulties (63%) and debts (55%). Conclusions: Treatment abandonment was most important reason for treatment failure. Treatment outcome was determined by parental socio-economic status. Childhood cancer survival could improve if financial constraints and provision of information and guidance are better addressed.

Intense Pulsed Light Alone and in Combination with Erbium Yttrium-Aluminum-Garnet Laser on Small-to-Medium Sized Congenital Melanocytic Nevi: Single Center Experience Based on Retrospective Chart Review

  • Lee, Mi So;Jun, Hee Jin;Cho, Sang Hyun;Lee, Jeong Deuk;Kim, Hei Sung
    • Annals of dermatology
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    • v.29 no.1
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    • pp.39-47
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    • 2017
  • Background: Treatment of congenital melanocytic nevi (CMN) with intense pulsed light (IPL) has recently produced promising results. Objective: To evaluate the clinical and histological outcomes of small-to-medium sized CMN treated with IPL alone and in combination with erbium: yttrium-aluminum-garnet (Er: YAG) laser. Methods: We performed a retrospective chart review of 26 small-to-medium sized CMN treated as described above. The reduction in visible pigmentation, signs of recurrence and any adverse skin changes were evaluated by two independent clinicians. Results: Seventeen patients completed treatment and were followedup. Nine were not able to complete treatment due to work, change in residence, and treatment related stress. Ten patients received IPL alone (mean: 10.5 sessions) and 7 underwent treatment with IPL (mean: 7.7 sessions) and Er: YAG/IPL combination therapy (mean: 4.7 sessions). The initial treatment outcome was cleared in 5 patients and excellent in 12. Fourteen patients (82.4%) showed CMN recurrence one year after treatment completion. The histological results from a patient with an excellent clinical outcome showed remnant nevus cells nests in the deep dermis. Conclusion: IPL treatment alone and in combination with Er: YAG laser are not definitive treatments for CMN and should not be considered as first-line treatment.