• Korean Journal of Psychosomatic Medicine
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• v.6 no.1
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• pp.79-84
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• 1998

Authors report a case of poststroke bipolar disorder that occurs much less frequently than poststroke depression(PSD). A MRI study performed to identify the etiology of a secondary manic episode in a patient with preceded PSD after left basal ganglia infarction revealed newly developed right basal ganglia infarction associated with poststroke bipolar disorder. It is interesting to note that (1) the temporal relationship was found between the occurrence of PSD after left hemisphere stroke and the occurrence of poststroke bipolar disorder following right hemisphere stroke, and that (2) the occurrence of PSD and the occurrence of poststroke bipolar disorder are associated with lesion location respectively. It has been reported that bipolar disorders were associated with subcortical lesions of the right hemisphere, whereas right-cortical lesions led to unipolar mania and that risk factors for mania included a family history of psychiatric disorders and mild subcortical atrophy. In this case, MR image shows subcortical lesions of the right hemisphere and mild subcortical atrophy. The investigation of the relationships among stroke lesion locations and potstroke mood disorders and risk factors for poststroke bipolar disorder may contribute to understanding the neurobiology of primary mood disorder. A clinical implication is that the risk of secondary bipolar disorder after cerebral infarction should be highlighted.

• Journal of Digital Convergence
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• v.17 no.6
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• pp.439-446
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• 2019

Poststroke depression can have a secondary effect on social cognition, and this can lead to behavioral problems. The purpose of this study was to verify the effects of a Cognitive Stimulation Circulative Program(CSCP) based on occupational therapy. The participants of this study were 12 stroke patients. The CSCP was organized in such a way to promote the cognitive process. This program were carried out as a circuit program(16 sessions). As a result of this study, the depression scale of the subjects had statistically significant benefit(p<.05). Also, the evaluation results verified partial improvement in quality of life, and the relationship change scale which was used to evaluate role of physical and social cognitive function ability had statistically significant benefit(p<.05). The above results of this study verified that the CSCP was an efficient intervention program that reduces the depression of stroke patients and improve their social cognitive function ability, thus enhancing the quality of life.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.5
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• pp.211-218
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• 2017

This study examined the effects of a computer-assisted cognitive rehabilitation program on the depression, cognitive functions, and daily functions of stroke patients. Forty-four stroke patients were divided into the treatment group and control group, consisting of 22 patients each. The patients in the treatment group were treated with a computer-assisted cognitive rehabilitation program for 6 weeks, 5 times a week, for a total of 30 times. Depression, cognitive functions, and daily functions was gauged by the BDI, NSCE, and k-MBI, respectively. The treatment group showed decreases in depression, and increases in both cognitive functions and daily functions by the end of the rehabilitation program. Compared to the treatment group, the control group did not show significant improvements in depression, cognitive functions, and daily functions. Therefore, these findings indicate that a computer-assisted cognitive rehabilitation program has a positive effect on depression, cognitive functions, and daily functions in stroke patients.

• Proceedings of the KAIS Fall Conference
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• 2009.12a
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• pp.484-486
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• 2009

본 연구는 본 연구는 입원중인 뇌졸중 환자들이 겪는 경제적 스트레스 및 우울이 삶의 질에 미치는 영향을 알아보기 위해 대전에 소재하고 있는 대학병원, 종합병원, 재활센터 등에서 치료를 받고 있는 뇌졸중환자 209명으로 하였다. 자료수집방법은 각각 구조화된 설문지를 통해 1:1 면접조사를 실시하였다. 연구도구는 경제적-불편감척도(Gore, 1978)와 Arruda J.E가 개발한 시각상사척도와 GHO-60(Goldberg, 1972), MOS SF-36(Ware 등, 1992)을 김건엽(2002)이 표준화한 23문항 중 삶의 질을 측정하는 12문항을 수정, 변경하여 사용하였다. 수집된 자료는 SPSS(Statistical for the Social Science)12.0을 이용하여 분석하였고, 뇌졸중 환자의 일반적 특성, 물리치료 관련 특성, 질병 관련 특성, 경제적 스트레스, 독립변수로 빈도와 백분율, 평균과 표준편차를 구하고, 전체 연구 대상자의 기술 역학적 특성을 파악하기 위하여 기술통계와 일반적 특성, 물리치료, 질병관련 특성에 따른 환자의 경제적 스트레스, 우울, 삶의 질과의 차이를 알아보기위해 t-검정과 일원분산분석(analysis of variance, ANOVA)을 사용하였다. 발병 후 가계수입(p<0.05), 재정적 압박 수준(p<0.01), 삶의 질(p>0.05), 생활수준(p<0.05)이 통계적으로 유의한 것으로 나타났다. 감정상태가 낮고 생활수준과 재정적 압박 정도가 매우 심할 경우 더 유의하게 경제적 스트레스 점수가 높게 나왔다. 이는 뇌졸중환자가 겪는 경제적 스트레스 요인이 우울과 함께 중요한 영향을 미치며,인구분석학적 결과를 보더라도 가구의 소득수준이 큰 영향을 미치는 것으로 건강에 대한 재정적 부담, 가족으로부터 소외 일과에의 영향, 올가미를 쓴 느낌 이상의 결과로 볼 때 본 연구에서는 시각적 감정 상태, 재정적 압박상태, 우울, 생활수준, 질병 관련 특성, 삶의 질을 위주로 하여 경제적 스트레스 관련 요인을 살펴본 결과 후속연구에서는 보다 정확한 경제적 부담 수준을 측정하고 더불어 보다 객관적인 경제적 스트레스를 측정할 수 있는 도구를 이용하여 조사를 한다면 임상적으로 중요한 자료가 될 것이다. 또한 뇌졸중 환자의 경제적 스트레스를 감소하고 삶의 질 수준을 증진시킬 수 있는 치료적 중재의 개발이 절실히 요구된다.

• Korean Journal of Psychosomatic Medicine
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• v.20 no.2
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• pp.98-104
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• 2012

Objectives : This study aimed to investigate the correlations between neurological and psychiatric symptoms at two weeks after stroke. Methods : For 412 stroke patients, stroke severity was evaluated by the National Institutes of Health Stroke Scale(NIHSS), disability by the Barthel Index(BI) and modified Rankin Scale(mRS), cognitive function by the Korean Mini-Mental State Examination(K-MMSE), and muscle power by grip strength. Psychiatric symptoms were assessed by Symptom check list-90-Revision(SCL-90-R), consisted of nine symptom domains : Somatization, Obsessive-compulsive, Interpersonal sensitivity, Depression, Anxiety, Hostility, Phobic anxiety, Paranoid ideation, Psychoticism, and Additional items. The correlations between the neurological and psychiatric symptoms were investigated at the time of admission and before discharge(i.e. before and after treatment). Results : At the time of admission, NIHSS score was associated with scores on Phobic anxiety and Additional items ; and scores on BI and mRS were associated with Depression, Phobic anxiety and Additional items. At the time of discharge, NIHSS score was associated with scores on Somatization, Depression, Phobic anxiety, and Additional items ; scores on BI and mRS were associated with scores on Depression, Phobic anxiety and Additional items ; MMSE score was associated with Obsessive-compulsive, Depression, Phobic anxiety, and Additional items ; and grip strength was associated with Somatization, Depression, Anxiety and Additional items. Conclusions : More severe neurological symptoms were associated with higher psychiatric morbidity particularly in depression, phobic anxiety, sleep and appetite disturbance at acute stage of stroke. More intensive psychiatric care and intervention are needed for the high risk group.

• Journal of Yeungnam Medical Science
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• v.11 no.1
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• pp.63-71
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• 1994

The purpose of this study was to evaluate the effect of stroke on hypothalamic-pituitary axis using dexamethasone suppression test. The effects were evaluated according to age, sex, type, size, and lesion site of stroke. These tests were performed in 62 patients with stroke(cerebral infarction, 42 cases : intracerebral hemorrage, 20 cases) and 21 disabled controlled patients without intracranial diseases at Yeungnam University Hospital from June 1992 to June 1993. The results summarized as follows. 1. Cerebral infarction showed significantly higher frequency of DST non-suppression in stroke patients than control(p<0.05). 2. Patients with left hemisphere stroke showed more frequent abnormal neuroendocrine test results(p<0.01) 3. Patients with large infarction revealed strongly non-suppressed DST results(p<0.01). 4. Sinificantly higher basal cortisol level in patients with cerebral infarction was noted(p<0.01). 5. There are no statistical significance between DST results and sex, age, motor impairment, type of cerebral infarction.

• Journal of Music and Human Behavior
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• v.12 no.1
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• pp.43-64
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• 2015

This study investigated the effects of song discussion on depression and rehabilitation motivation in stroke patients. Older adults with chronic stroke participated in this study: nine for the experimental group and eight for the control group. The experimental group was divided into three subgroups and participated in 12 sessions over 6 weeks. Target lyrics were selected by the investigator among popular songs from the participants' young adulthood. The song-based discussion was facilitated to address issues targeted at supportive, insight-focused, or reconstructive stage. The control group was provided with delayed intervention. At pre and posttest, the short form of Geriatric Depression Scale and the Rehabilitation Motivation Scale were measured. The experimental group showed significantly decreased depression and significantly increased rehabilitation motivation (p < .01), while the control group showed no significant changes. Positive changes were also observed in all subcategories of rehabilitation motivation in the experimental group, particularly in significantly increased task-oriented motivation and decreased amotivation. This study suggests that song discussion will be effectively applied in rehabilitative settings to address psychological issues of older adults with stroke.

• Journal of Digital Convergence
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• v.13 no.2
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• pp.237-244
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• 2015

The purposes of this study are to examine the correlations among mental health and quality of life in stroke patients and find the factors affecting quality of life. The participants were 224 inpatients diagnosed with stroke. The Stroke Specific Quality of Life(SS-QOL) was used for measuring Quality of life and the Symptom Check-List-90-Revised(SCL-90-R) was utilized to measure mental health. The relationships among the variables were examined with Pearson correlation coefficients. And the simple regression analysis and stepwise multiple regression analysis were performed to identify the predictive variables that explain changes of quality of life. There were statistically significant correlations between quality of life and mental health. Mental health was identified as a factor that explains 28% of change in quality of life. And depression was identified as a factor that explains 42% of change in quality of life. The quality of life in stroke patients, the depression was negatively related with it. When working with a stroke patient, an occupational therapist needs to address mental health aspects from the beginning of the rehabilitation process for a holistic approach and optimal outcome.

• Journal of Digital Convergence
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• v.18 no.3
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• pp.195-205
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• 2020

The purpose of this study was to investigate the effects of early cognitive training and tailored telephone coaching program for ischemic stroke. Among 28 participants, assigned into the experimental(n=15) and control group(n=13). Only the experimental group was received a 4-week cognitive training and 11 session of tailored telephone coaching. The effect ot the program was evaluated four times(baseline, 4weeks, 8weeks, 12months) using the tool on Depression, Mini Mental State Examination(MMSE), Neuropsychological battery, Activities of Daily Living(ADL). The repeated measures ANOVA showed that the experimental group showed improvement in MMSE, verbal memory and executive function compared to the control group. Especially, the improvement of executive function which is related to ADL was a remarkable result. This suggests that early intervention is very important for recovery cognitive function and independent daliy life after stroke, and periodic telephone coaching should be done together for mid-to long term effects.

• Therapeutic Science for Rehabilitation
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• v.10 no.4
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• pp.39-52
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• 2021

Objective : This study aimed to identify the characteristics and analyze the quality of studies on memory improvement using a single-subject research design. Methods : Six studies were selected through the Research Information Sharing Service (RISS), Korean Studies Information Service System (KISS), and National Digital Science Library (NDSL). Keywords were memory training, stroke, early dementia, mild cognitive impairment, and single-subject research design. The characteristics and quality levels were analyzed between January 2011 and October 2020. Results : Regarding the quality level, the middle level (7-10 points) was 66.7% of the four articles, and the high level (11-14 points) was 33.3% of the two articles. Reversal designs were used in all studies. Independent variables were errorless learning, smartphone application, cognitive training system (CoTras), spaced retrieval training (SRT) with errorless learning, spaced retrieval training, and iPad applications. The dependent variables included memory, attention, electroencephalogram, instrumental activities of daily living, depression etc., which increased after the intervention. The total session, study period, and intervention time were varied. Conclusion : In single-subject research design related to memory training, occupational therapy intervention was confirmed as an effective method for improving memory and attention. The quality level of single-subject research design was moderate or higher, and high-quality level of studies should be conducted by additional design to increase the validity in the future.