• Title/Summary/Keyword: 불안증상

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Management of Non-pain Symptoms in Terminally Ill Cancer Patients: Based on National Comprehensive Cancer Network Guidelines (말기암환자에서 통증 외 증상의 관리: 최신 NCCN(National Comprehensive Cancer Netweork) 권고안을 중심으로)

  • Lee, Hye Ran
    • Journal of Hospice and Palliative Care
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    • v.16 no.4
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    • pp.205-215
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    • 2013
  • Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.

One Clinical Case Report of Lung Cancer Patient with Depression and Anxiety Disorder Improved by Korean Traditional Medical Treatment and Breathing Meditation (한방치료와 호흡명상으로 호전된 폐암 환자의 불안 및 우울 증상 치험 1례)

  • Gu, Ja-Hwan;Kim, Se-Ran;Im, Eun-Young;Kim, Soo-Hyun;Kim, Jong-Dae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.25 no.6
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    • pp.1102-1107
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    • 2011
  • This study was case report to show the good effects of korean traditional medical treatment and breathing meditation. The methods were applied to lung cancer patients. We treated one patient who scored 27 point at Beck's depression inventory(BDI) and 28 point at Hamilton rating scale for depression(HRSD) and 22 point at Beck's anxiety inventory(BAI) and 20 point at Anxiety status inventory(ASI) by korean traditional medical treatment and breathing meditation. After treatment, the clinical symptoms were improved and the score of BDI, HRSD, BAI, ASI were decreased. According to this study korean traditional medical treatment is effective for the cure of depression and anxiety disorder and breathing meditation forifies the korean traditional medical treatment.

The Effect of Multidimensional Five Senses Treatment on Patients with Depression or Anxiety (오감을 이용한 다각적 치료의 불안, 우울 증상 치료 효과)

  • Lee, Jae-Eun;Heo, Eun-Jung;Lee, Jung-Min;Kim, Nam-Yeol;Hwang, Min-Young;Yoo, Jong-Ho
    • Journal of Oriental Neuropsychiatry
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    • v.25 no.3
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    • pp.263-270
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    • 2014
  • Objectives: This study aimed to examine the effects of multidimensional five senses treatment on patients with depression or anxiety. Methods: This study examined the effects of multidimensional five senses treatment for patients with depression or anxiety who visited the neuropsychiatric clinic of Korean medicine. STAI-X1,X2, BDI, BAI, PAS were used to determine whether the mood (depression or anxiety) of patients was improved. Results: Our results showed that multidimensional five senses treatment improved the depressive symptoms or anxiety symptoms. In addition, after the multidimensional five senses treatment, PAS score in patients with panic disorder was improved. Conclusions: The multidimensional five senses treatment was effective for the improvement of patients with depression or anxiety.

소 해면형 뇌증(일명 광우병) -임상증례 비디오 스크립트-

  • 강영배;위성환;진영화;장국현
    • Journal of the korean veterinary medical association
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    • v.32 no.5
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    • pp.317-327
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    • 1996
  • 소의 해면형 뇌증(Bovine Spongiform Encephalpathy; BSE)은 우리나라에서의 발생보고는 없으나, 우리에게 그리 생소한 질병만은 아니다. 저자중 한사람인 진 영 화 박사는 일찌기 소 해면형 뇌증의 발견 초창기인 1987년도에 UNDP 가축위생강화계획에 의하여 영국 중앙수의연구소(CVL)에 파견되어 소 해면형 뇌증의 진단병리 연구에 참여한 바 있으며, 강 영 배 박사는 전국 각 시도 가축위생시험소장을 인솔하여 영국 중앙수의연구소를 3차례 다녀온 바 있다. 본편에서는, 1991년 해외출장 기간 중 영국정부를 통하여 입수한, 새로운 질병 즉 소의 해면형 뇌증(Bovine Spongiform Encephalpathy)에 대한 Video tape 자료중, 'BSE 이야기 - 모든 합리적인 대책방안(MAFF V710)'과 'BSE 임상증예 5예 보고(MAFF V659)'를 기본으로하여 사진 또는 영문자료와 함께 소개하고자 한다. BSE의 잠복기는 2년 이상으로 매우 길며, 3-5세의 성우에서 다발한다. 주요 임상증상은, 정신상태, 정서 및 운동의 이상으로 특징지어 지는데, 광증과 침울 등 행동이상을 나타내며, 특히 후지파행, 비틀거림, 미끄러짐, 넘어짐 등의 보행이상을 나타낸다. 초기의 관찰사항으로는, 출입구 통과나 착유실 입실을 거부하는 등 불안 상태를 흔히 나타내는 것이다. 건드리거나 소리에 민감하게 반응하는 지각과민증, 경증의 보행실조, 발로차기, 동물이나 관리자에 대한 공격적 자세, 그리고 공포자세가 흔히 수반된다. 임상소견은 발병기간 중 일관되게 유지되며, 개체별로는 수주일부터 수개월간 지속된다. 젖소에서는 산유량이 떨어지며, 6개월내지 1년 정도 경과후 100$\%$ 폐사되는 것이 특징이다. 치료시도는 전혀 효과가 없다.

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Comparison of Clinical Characteristics Between Respiratory and Non-Respiratory Subtypes of Panic Disorder (공황장애 호흡기 아형과 비호흡기 아형의 임상 특성 비교)

  • Ha, Ju-Won;Lim, Se-Won;Oh, Kang-Seob
    • Korean Journal of Biological Psychiatry
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    • v.16 no.1
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    • pp.46-52
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    • 2009
  • Objectives : The goal of this study was to compare the clinical characteristics of panic disorder respiratory subtype(PD-R) and non-respiratory subtype(PD-NR). Methods : 84 patients with panic disorder were enrolled and divided into 2 groups, 29 PD-R and 55 PD-NR. Diagnosis of panic disorder was evaluated using Diagnostic and Statistical Manual of Mental Disorders $4^{th}$ edition and Mini International Neuropsychiatric Interview. They were also measured with Hamilton Rating Scale for Anxiety(HAM-A), Hamilton Rating Scale for Depression(HAM-D), and Panic Disorder Severity Scale (PDSS). Results : PD-R group showed significantly higher scores in PDSS than those of PD-NR group(p=.027). After controlling for the severity of panic disorder and gender, PD-R group showed higher HAM-D and somatic anxiety subscale of HAM-A than those of PD-NR group. Furthermore, results of logistic regression analysis suggested that the somatic anxiety was a possible risk factor of PD-R(OR=1.404,p=0.009). Conclusion : These results suggest that somatic anxiety and depressive symptom would be important clinical characteristics of PD-R.

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A Psychoanalytic Study on the Phantasy Freud and Klein (환상에 대한 정신분석적 고찰 : 프로이트와 클라인을 중심으로)

  • Park Seon-Young
    • Science of Emotion and Sensibility
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    • v.8 no.2
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    • pp.137-153
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    • 2005
  • Phantasy is the psychic reality in which drive, sadism and anxiety are represented and constructed. It is one of important metapsychological concepts of the psychoanalysis which explains the formations of symptoms, internal psychic structure, and the mutual relationship between internal subjective world of man and external world. Through the understanding of phantasy we can approach the man's unconsciousness and fathom the structure of the subject itself. Especially S. Freud and M. Klein's psychoanalysis give us the deep insight into the phantasy, on the basis of which we can investigate the cause and structure of the pathological phenomena of the man.

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Shoulder Injuries in Throwing Athletes (Throwing athletes에서 어깨 관절의 손상)

  • Lee Kwang-Won
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.119-126
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    • 2003
  • The shoulder is a complex joint and, by virtue of having a large range of motion, is inherently unstable, relying on the surrounding soft tissue structures for stability. The bony joint consists of the glenoid, acromion, and humoral head, while the soft tissues include the glenoid labrum, the glenohumeral ligaments. and coracoacromial ligament as well as the muscles of the rotator cuff, the long head of the biceps, and the scapulothoracic muscles. Dysfunction in any one of these components can cause shoulder problems. The throwing motion involves a series of phases that stress to their limits the dynamic and static restraints of the glenohumeral and scapulothoracic joints. . Therefore, maintaining a balance of proper biomechanical forces is essential to avoiding shoulder injuries in throwing athletes. Over the last decade, signficant advances have been made in the study and understanding of the shoulder mechanics, and pathophysiology of injury. Additionally, advances in surgical techniques, particularly arthroscopy , have aided in the diagnosis of and the developement of less invasive surgical treatments for injuries that do not respond to nonoperative measures. In this article, we reviewed the pathophysiology of injuries , diagnostic techniques, and surgical management of shoulder injuries in throwing athletes .

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Posterior Instability of the Shoulder (견관절 후방 불안정성)

  • Jeong, Jin-Young
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.1
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    • pp.4-7
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    • 2011
  • Rotator cuff disease is one of the most common shoulder problems. When dealing with patients suffering from rotator cuff disease, whether to perform surgery or not is the most common difficulty faced by the outpatient clinic. Choosing the adequate operation time as well as the method of operation is important when deciding to perform surgery. Selecting the type of non-surgical treatment is an important issue when opting not to perform surgery. This review article will focus on the decision-making process involved in the treatment of rotator cuff disease.

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THE PROCESS OF PLAYTHERAPY OF A CHILD WITH ELECTIVE MUTISM (선택적 함구증을 보인 6세아동의 놀이치료)

  • Kwak, Young-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.3 no.1
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    • pp.138-146
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    • 1992
  • The study presented the experience of playtherapy of a 6-yr old girl with elective mutism and attempted to understand her psychopathology and formulated her psychodynamic which was expressed though the therapeutic process of playtherapy in the viewpoint of developmental model. Therapist's attitude was nondirective and supportive. Main theme of her play, fantasy and art was separation anxiety and abandonment fear as the result of continued psychic traumas such as separation from her grandmother and physical abuse by her father and mother etc. So she couldn't achieve developmental tasks such as autonomy and separation individuation and became generally inhibited and selectively mute. The process of play therapy was summarized and coceptualized as her successful progress through sequential developmental phases within the therapeutic relation ship. By reexperiencing this developmental process, she could accomplish her autonomy and separation individuation and developed to oedipal stage and successfully resolve oedipal conflict.

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A Clinical Study on the Correlation between Gastrointestinal Symptoms, Depression, and Anxiety in Patients with Irritable Bowel Syndrome (과민성 장증후군 환자의 위장관 증상과 우울, 불안과의 상관관계 연구)

  • Hur, Bong-soo;Choi, Seo-hyung;Lyu, Yeoung-su
    • The Journal of Internal Korean Medicine
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    • v.40 no.4
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    • pp.629-636
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    • 2019
  • Objective: This study was designed to assess the correlation between gastrointestinal symptoms, depression, and anxiety in patients with irritable bowel syndrome (IBS). Method: New patients who visited the ${\bigcirc}{\bigcirc}$ Oriental Hospital completed standardized questionnaires. These consisted of questionnaires for IBS based on Rome III criteria, the Gastrointestinal Symptom Rating Scale (GSRS), the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). Results: A total of 103 patients participated. Among them, IBS was observed in 42 patients. There was a weak correlation between GSRS and BDI, but it was not statistically significant. There was a statistically significant weak correlation between GSRS and BAI. The main symptom factors affecting BAI were borborygmus, increased flatus, sucking sensations in the epigastrium, and abdominal distension. Conclusion: There was a statistically significant correlation between gastrointestinal symptoms and anxiety in patients with irritable bowel syndrome.