Purpose : The purpose of this study was to investigate the relationship between depression and resilience in adolescents with congenital heart disease(CHD) and to identify the variables associated with depression. Methods : The Resilience Scale(cronbach's ${\alpha}=0.92$), Children's Depression Inventory(cronbach's ${\alpha}=0.72$) and Maternal Behavior Research Instrument(cronbach's ${\alpha}=0.88$) were applied and analyzed to assess depression and resilience among 231 adolescents after surgery for CHD from three major cardiac centers in Korea. This group consist of 114 males and 117 females. The mean age was 15.8 years(range : 13-18 years). The clinical severity of illness was rated by CHD functional index and NYHA functional class. Results : The mean score for depression and resilience was 16.74(range : 0-49) and 115.84(range : 70-132) respectively. Depression was significantly related to age(r=0.25, P<0.001) and NYHA functional class(r=0.35, P<0.001), as well as being negatively correlated with oxygen saturation(r=-0.39, P<0.001), academic achievement(r=-0.41, P<0.001), parental attitude(r=-0.49, P<0.001) and resilience (r=-0.59, P<0.001). The results of multiple regression analysis showed that parental attitude(${\beta}=-0.48$, P<0.01) and resilience(${\beta}=-0.62$, P<0.01) were related to depression. Conclusion : This study demonstrated that adolescents with CHD had a higher resilience and were less depressed with an affectionate parent. With respect to medical and nursing intervention programs, it is essential to identify strengths of adolescents with CHD in order to increase their resilience. Additionally, it is also important that parenting and counseling programs be implemented for the parents of adolescents with CHD.
Kim, Do-Yeon;Choi, Yun-Jin;Lee, Seung-Joo;Ko, Min-Seok;Choi, Chong-Hyuk
Journal of Korean Orthopaedic Sports Medicine
/
v.9
no.2
/
pp.79-84
/
2010
Purpose: In patients with meniscal tear with degenerative arthritis, controversy remains as to whether arthroscopic menisectomy is worthwhile or not. The purpose of this study was to evaluate the effect of arthroscopic medial meniscectomy in degenerative arthritis of the knee with meniscal tear. We also intended to identify pertinent indications and risk factors. Materials and Methods: 287 patients underwent arthroscopic medial meniscectomy from 2006 to 2008; 103 patients who had Kellgren-Lawrence grade II, III arthritis of the knee, were over 50 years old, and had minimum 1 year follow-up, were analyzed in this study. Clinical assessment was performed retrospectively using the arthroscopic surgery database, medical records, questionnires and interviews. Assessment included visual analogue scale (VAS) scores and Lysholm scores. Results: The mean Lysholm score increased from 69 to 85 after surgery. The mean VAS score improved from 7 to 3.1 after surgery. Kellgren-Lawrence grade II group and group with trauma history showed significant improvement of pain and function compared with grade III and group without trauma history. Outerbridge grade I showed significantly more improvement of pain than grade III and IV. Multiple regression analysis showed that trauma history and Outerbridge grade affect the improvement of Lysholm score. Conclusion: In one year follow-up, arthroscopic medial menisectomy can improve pain and function of patients in Kellgren-Lawrence grade II, III degenerative arthritis of the knee. We could expect good results especially in group with low Kellgren-Lawrence grade, trauma history, and mild articular cartilage lesion.
Kim, Young-Kyoon;Kwon, Soon-Seog;Kim, Kwan-Hyoung;Han, Ki-Don;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
Tuberculosis and Respiratory Diseases
/
v.39
no.1
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pp.7-14
/
1992
Background: Cognitive deficit by hypoxia and/or hypercapnia is one of neuropsychological impairments frequently observed in patients with chronic obstructive pulmonary disease (COPD). The degree of cognitive deficit is variable among patients with similar level of hypoxia and/or hypercapnia, although a cause of this individual difference is well not known. COPD can be divided into two characteristic clinical entities including predominant emphysema and predominant bronchitis. This study was designed to evaluate the individual difference in cognitive deficit respond to hypoxia and/or hypercapnia in patients with COPD. Method: Sixteen patients with COPD (9 emphysema-dominant and 7 bronchitis-dominant) participated in this study. On admission arterial blood gas analysis and trail-making B (TMB) test for the evaluation of cognitive function were done in all patients. Mean TMB scores and the correlations between TMB scores and arterial blood gases were compared between two clinical groups. Results: 1) Mean TMB scores and arterial blood gases between two clinical groups were not different. 2) There was a tendency to be higher TMB score in hypoxemia, acidemia, and hypercapnia. However these findings were not statistically significant. 3) In emphysema-dominant group, $PaCO_2$ was mostly well correlated with TMB score (r=0.693). 4) In bronchitis-dominant group, arterial pH was mostly well correlated with TMB score (r=-0.526). Conclusion: Our data suggest that the individual difference in cognitive deficit respond to hypoxia and/or hypercapnia in patients with COPD may be dependent on their clinical entities, and arterial blood gases mostly well correlated with cognitive function that may be different according to their clinical entities.
Objectives : The purpose of this study was to examine cognitive and psychological characteristics of patients who visited psychiatric outpatient clinic with military service suitability issues. Methods : Since January, 2017 to September, 2018, patients were recruited from the department of psychiatry of university hospital. Participants were diagnosed using DSM-5 criteria by board certified psychiatrists. And each of participants tested with K-WAIS-IV, K-SCL-95 by clinical psychologist. The data were analyzed using SPSS 18.0. Results : The results indicated 24.6% of the patients have significantly low level of intellectual functioning. and 10.8% of the patients have borderline level of intellectual functioning, and 26.3% of them were below average. The results of psychological characteristics showed patients have cautious and potentially dangerous level of depression, anxiety, agoraphobia, and suicidal idea. And PTSD subscale's mean score was above problematic level. Next, we divided patients into two groups based on question of whether the patient is eligible to serve in the military service or not arises from recruitment process or army training center. But two group didn't differ significantly. And for further analyses, we also divided patients into two groups based on if they got single psychiatric diagnosis or more than one psychiatric diagnosis. Conclusions : The results indicated that group which has coexisting psychiatric disorders were more depressed, had higher level of anger and aggression, and had more serious levels of suicidal ideas than single psychiatric diagnosis group. The implications and limitations were discussed along with some suggestions for the future studies.
PURPOSE: Tourette's disorder (TD), which is characterized by multiple waxing and waning motor tics and one or more vocal tics, is known to be associated with abnormalities in the dopaminergic system. To testify our hypothesis that risperidone would improve tic symptoms of TD patients through the change of the dopaminergic system, we measured the dopamine transporter (DAT) densities between drug-naive children with TD and normal children, and investigated the DAT density before and after treatment with risperidone in drug-naive children with TD, using iodine-123 labelled $N-(3-iodopropen-2-yl)-2{\beta}-carbomethoxy-3beta-(4-chlorophenyl)tropane$ ($[^{123}I]IPT$) single photon omission computed tomography (SPECT). MATERIALS and METHODS: $[^{123}I]IPT$ SPECT Imaging and Yale Global Tic Severity Scale-Korean version (YGTSS-K) for assessing the tic symptom severity were carried out before and after treatment with risperidone for 8 weeks in nine drug-naive children with TD. Eleven normal children also underwent SPECT imaging 2 hours after an intravenous administration of $[^{123}I]IPT$. RESULTS: Drug-naive children with TD had a significantly greater increase in the specific/nonspecific DAT binding ratio of both basal ganglia compared with the normal children. However, no significant difference in the specific/nonspecific DAT binding ratio of the basal ganglia before and after treatment with risperidone in children with TD was found, although tic symptoms were significantly improved with risperidone. CONCLUSION: These findings suggest that DAT densities are directly associated with the pathophysiology of TD, however, that the effect of risperidone on tic symptoms in children with TD is not attributed to the change of dopaminergic system.
The purpose of this study is to measure the effect of musical activities on children's aggressiveness using percussion playing through case studies and to present the therapeutic programs. Musical activities using percussion playing were organized for three aggressive children. Twenty-one small group sessions were conducted over seven weeks with 30 minutes given each session. Fourth-grade children involved in using Aggressiveness Measuring Tool for Teachers-revised by Gwak Geum-Joo(1992) was selected for case studies. Children's impulsiveness was also tested through self-test measuring tool for impulsiveness-revision of 16 questions used by Cho Hae Yeon (2001) and Lee Joo Shik (2003). As quantitative method, comparative analysis was made between the pre and post test results using measuring tools for aggressiveness and impulsiveness of children as well as between aggressive behaviors occurring in the initial stage of the first three sessions and in the latter stage of the last three sessions. Qualitative method was used at the same time to examine the effect of percussion playing on children. After the musical activities, child A showed reduced Aggressive Measuring Tool scores from 19 to 18, with child B from 23 to 19 and child C from 21 to 18. The results show that occurrence of aggressive behaviors were lowered in the post test. Impulsiveness Measuring Tool scores in the post test were decreased as well in all three children. During the music therapy programs, it was also observed that the frequency of the target behaviors in all three children has reduced more in the latter stage than the initial stage of music therapy. The qualitative findings indicate that the children experienced releasing stress through self-expression after percussion playing. These findings indicate therapeutic effectiveness of music therapy using on percussion playing in reducing aggressiveness of children as well as the effectiveness of percussion as a therapeutic intervention for aggressive children. These results can be adapted and reapplied by teachers in primary schools to approach children with behavior problems, and can present a useful therapeutic approach to therapists practicing in clinical environments.
Objectives: We intended to observe changes in sleep patterns and mood states of night-shift workers following light exposure. We also estimated the degree of tolerance of light exposure. By studying these, we investigated the possibility of applying light therapy to night-shift workers for improving their adaptation. Methods: Twelve night-shift nurses working at Yong-In Mental Hospital volunteered to participate in this study. The study consisted of 3 parts: 1) night-shift control study; 2) light exposure study; 3) day-shift control study. All the nurses accomplished 3 parts of the study, each of which continued for 3 days, except one nurse who did not participate in day-shift control study. During light exposure study, nurses were exposed to bright light for 4 hours from 1AM to 5AM. Sleep patterns were evaluated with wrist actigraphy and automatic sleep analysis program. Mood states and side effects of light exposure were assessed with self-report scales. Results: Sleep period time, total sleep time, and sleep efficiency were increased following light exposure compared with night-shift control study. Light exposure study showed no difference from day-shift control study in above-mentioned sleep parameters. Daily fluctuation of sleep efficiency was less prominent during light exposure study than during night-shift control study. During light exposure study, the subjects felt more elated and energetic in the evening after daytime sleep than during night-shift control study. None of the subjects complained of severe side effects related to light exposure on the third day of light exposure. Tolerance of side effects was noted to develop with the repetition of light exposure. Conclusion: Light exposure improved the daytime sleep of night-shift workers to the level of normal nighttime sleep, making the subjects more elated and energetic. Side effects of light exposure were found to be tolerable. Light exposure seems to be safely applicable to night-shift workers for their adaptation.
This study investigated the effectiveness of the assessment of psychosocial treatment outcome in symptomatology and social functioning as rated by the depressed client's significant other in explaining the client's symptomatology and social adjustment at 6 and 12 month follow-up period after the 16-week psychosocial treatment was terminated. The data were drawn from the National Institute of Mental Health Treatment of Depression Collaborative Research Program of the U.S. Significant others of depressed clients have rarely participated in the assessment of treatment outcome, although they are major participants of the clients' daily life and have meaningful opportunities to observe the clients' functioning in different social situations. Thus, this study aimed to examine the explanatory power of the significant others' outcome assessment in depressive symptomatology and social functioning for the long-term outcome in symptomatology and social adjustment. The outcome measures used by the significant others were actual performance, expected performance, gap between actual and expected performance, and symptomatology drawn from the Katz Adjustment Scale-Relatives Form. Three major findings were: (1) in general, the posttreatment assessment by the significant other demonstrated stronger explanatory power of the follow-up status than the assessment rated at pretreatment in all of the four outcome domains; (2) the significant other's assessment of actual and expected performance at both pre- and posttreatment demonstrated significant explanatory power of the follow-up status in symptomatology and social/leisure and work adjustment; and (3) the significant other's assessment of social functioning at pretreatment improved the explanatory power over and above the explanation by symptomatology in the follow-up status of social/leisure and work adjustment; however, at posttreatment, symptomatology improved the explanation over and above social functioning more frequently in predicting both symptomatology and social/leisure and work adjustment. These findings suggest the effectiveness of the measures of symptomatology and actual and expected performance as assessed by significant others. The results imply that mental health professionals and researchers need to involve the depressed client's significant other in the treatment and make good use of their contribution in treatment planning and further intervention in the follow-up period to prevent relapse.
Kim, Won-Sik;Koh, Seung-Hee;Koo, Yong-Jin;Kim, Hong-Chang;Suh, Dong-Hyuck;Chung, Sun-Ju
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.10
no.2
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pp.201-211
/
1999
Objectives:This study investigated the characteristics of detained delinquent adolescents and variables related to the repeated crime during 6 months after release. Methods:The socio-demographic and crime-related characteristics of 73 detained adolescents were evaluated by semi-structured interviews and police records, and the psychological characteristics of them measured by the MMPI. We also compared the characteristics between subjects with and without repeated crime during 6 months after release. Results:1) Most of detained adolescents had families with low socioeconomic status(77%) and broken families(48%). Sixty-six percent of them were dropped out of school. The most frequent crime pattern was theft(49%), and with accomplice(77%). Seventy-five percent of total subjects had the records of previous conviction. Of the previous convictions, seventy-eight percent was same with the present crimes. 2) Subjects with repeated crime during 6 months after release were younger and had higher T-score on Pa scale of MMPI than the subjects without repeated crime. More adolescents with repeated crime had broken families than those without repeated crime. They also showed the crime-related characteristics of higher percent of theft among crime patterns, higher incidence of previous conviction, younger age of the first crime, and shorter crime-free duration from the last to present crime. Conclusion:These results of present study suggest that the development and the persistence of adolescent delinquency would be resulted from interaction of factors of individual, family, school, and community. By the comparison between subjects with and without repeated crime, it was found that familial dysfunction, younger age at first crime, presence of previous conviction might be the risk factors for repeated delinquency. To prevent repeated crime of delinquent adolescents more effectively, early therapeutic intervention and the development of programs to help adaptation in school and community would be essential.
Purpose: Attention deficit hyperactivity disorder (ADHD) has been known as psychiatric disorder in childhood associated with dopamine dysregulation. In present study, we investigated changes in dopamine transporter (DAT) density of the basal ganglias using I-123 N-(3-iodopropen-2-yl) -2-carbomethoxy-3beta-(4-chlorophenyl) tropane [I-123 IPT] SPECT in children with ADHD before and after methylphenidate treatment. Materials and Method: Nine drug-naive children with ADHD and seven normal children were included in the study. We peformed brain SPECT two hours after the intravenous administration of I-123 IPT and made both quantitative and qualitative analyses using the obtained SPECT data, which were reconstructed for the assessment of soecific/nonspecific DAT binding ratios in the basal ganglia. All children with ADHD reperformed [123I]IPT SPECT after treatment with methylphenidate(0.7mg/kg/d) during about 8 weeks. SPECT data reconstructed for the assessment of specific/nonspecific DAT binding ratio of the basal ganglia were compared between before and after treatment methylphenidate. We investigated correlation between the change of ADHD symptom severity assessed with ADHD rating scale-IV and specific/nonspecific DAT binding ratio of basal ganglia. Results: Children with ADHD had a significantly greater specificinonspecific DAT binding ratio of the basal ganglia comparing to normal children(Right : z = 2.057, p = 0.041 : Left : z : 2.096, p = 0.032). Under treatment with methylphenidate in all children with ADHD, specificinonspecific DAT binding ratio of both basal ganglia decreased significantly greater than before treatment with methylphenidate (Right : t = 3.239, p = 0.018 ; Left : t = 3.133, p = 0.020). However, no significant correlation between the change of ADHD symptom severity scores and specific/nonspecific DAT binding ratio of the basal ganglia were found. Conclusions: These findings support the complex dysregulation of the dopaminergic neurotransmitter system in children with ADHD.
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