• Title/Summary/Keyword: 생물심리사회적 치료

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Biological Mechanism of Somatization : Mainly Focused on the Neuropsychological Model of Somatization (신체화의 생물학적 기전 : 신체화의 신경심리학적 모델을 중심으로)

  • Lee, Young-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.1
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    • pp.122-140
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    • 2000
  • Somatization disorder is a chronic condition characterized by multiple somatic complaints that are not due to any apparent organic illness. Somatization disorder is related historically to hysteria and hysteria has been defined by the existence of somatic complaints for which no organic reason can be found. Therefore most theories of somatization have focused on the psychodynamic and sociological perspectives. However, the concept that the somatic presentation of emotional distress or psychiatric illness might have a neurobiological basis has also aroused considerable interest. Relative to this perspective, the case of Anna O. which has been considered the prototype of hysteria, was reformulated from a neuropsychological perspective. Several neurophysiological and neuropsychological studies, studies concerning hemispheric differences in symptom presentation of the patients with hysteria have been shown the evidences for the biological basis of somatization. Moreover, recent neuroimaging studies in somatization disorder also show that brain dysfunction in somatization. The author reviewed several candidate theories which could help to explain the process of somatization in the perspective of biological basis and proposed the new neuropsychological model of somatization. The author also examined the possible application of this model to the treatment of somatization disorder and discussed it's limitation and the future directions in this field.

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Assessment and Treatment of Depression in the Medically III (신체질환 환자들에서 우울증의 평가 및 치료)

  • Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.2
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    • pp.111-132
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    • 2001
  • Depression in the medically ill is a common clinical problem that primary physicians and psychiatric consultants encounter. Treatment of such patients begins with a careful evaluation of the patient's medical and psychiatric conditions. The assessment of depression in the medical patients requires a multidimensional approach. Psychological instruments are also used as a method of assessment in these patients. First of all, what the therapists have to do is to find and remove organic causes. Psychosoical treatment includes dealing with the patient's resistance and despondency relevant to physical diseases. For biological treatment, it is important to select appropriate antidepressants. Therapists should be familiar with the side effects of the antidepressants as well as the patient's primary depressive symptoms, pharmacokinetics and pharmacodynamics of the available agents. In addition, special attention should be paid to the potential for drug-illness and drug-drug interactions. Tricyclic antidepressants can be still effectively used for patients with pain disorder, although a variety of new antidepressants such as selective serotonin reuptake inhibitors (SSRI), bupropion and venlafaxine could have more benefits in depression of the medically ill. However, electroconvulsive therapy can be recommended for refractory cases of depression in patients with medical illness.

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Analyzing Online News Media Coverage of Depression (우울증에 관한 언론 보도 분석: 온라인 뉴스 미디어를 중심으로)

  • Roh, Soojin;Yoon, Youngmin
    • Korean journal of communication and information
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    • v.61
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    • pp.5-27
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    • 2013
  • Media coverage of depression, the mental disorder, is on the high rise following the soaring number of reported celebrity suicide. This study is an exploratory attempt to get a glance on how online news media are portraying depression. The content analysis results indicate that celebrity was the most cited source, outnumbering the others such as non-celebrity patients and experts. More than half of the sample attributed the cause of depression to socio-psychological factors. Medical consultation was the most reported means of treating depression among the sample, while over the half did not suggest any treatment methods at all. Overall, celebrity related news were less likely to talk about the cause and treatment methods. In addition, the more neuro-biological factors were designated as the main cause of depression in the articles, the more chances of treatment method of all kinds were brought up. The frame of human interest dominated a little less than half of the articles examined, and only few reported positive outcome or achievements after coping with depression.

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Neurocognitive Function Assessment of Traumatic Brain Injury (외상후 뇌손상의 신경인지기능 평가)

  • Oh, Byoung Hoon
    • Korean Journal of Biological Psychiatry
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    • v.2 no.2
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    • pp.177-185
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    • 1995
  • 외상후 뇌손상은 대표적이며, 가장 중요한 신경정신계 질환의 하나이다. 더욱이 외상후 뇌손상 환자들은 각종의 사고 및 산업재해 등으로 인해 그 수가 급증하고 있으며, 특히 인지기능의 장애로 인한 다양한 기질성 정신장애로 고통을 겪게 된다. 따라서 외상후 뇌손상은 손상의 시점에서부터 정확하고 올바른 평가는 물론 손상후의 경과 및 치료대책의 수립에 있어서 체계적이며 종합적인 신경인지기능의 평가는 필수적이다. 왜냐하면 신경인지기능평가는 뇌의 손상부위와 이와 관련된 기능장애 및 행동의 변화에 대한 객관적인 자료를 제시해 주기 때문이다. 신경인지기능 평가의 영역은 지각, 운동기능은 물론 주요인지기능인 기억, 언어, 실행 및 감정조절능력에 이르기까지 다양하며, 외상후 뇌손상환자들은 손상부위 및 정도에 따라 신경인지기능의 장애를 초래하게 된다. 대표적인 신경인지기능평가 도구로는 KWIS, Halstead-Reitan, Luria-Nebraska batteries, 특히 전두엽기능검사인 Wisconsin Card Sorting Test (WCST)를 비롯하여, 현재는 PC/S Vienna Test System 및 Stim등의 각종 전산화 인지기능검사가 개발되어 임상에서 활발히 사용되고 있다. 즉 외상후 뇌손상환자를 위한 신경인지기능평가의 목적은 뇌손상과 관련된 신경인지기능장애를 정확히 평가하여, 환자 개개인에 적합한 인지재활치료 계획을 수립하는데 있다. 물론 여기에는 신경정신상태검사(neuropsychiatric mental status examination)를 통하여 외상 후 뇌손상의 경과 및 예후에 결정적인 영향을 미칠 수 있는 나이, 의식소실 및 외상후 기억 손상 시간의 정확한 측정은 물론 심리 사회 문화적인 상태와 두부외상전 환자의 지적수준 및 사회 적용기능이 함께 평가되어야 할 것이다.

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Primary Nocturnal Enuresis: An Overview (일차성 야뇨증의 개관)

  • Song, Dong-Ho
    • Sleep Medicine and Psychophysiology
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    • v.2 no.1
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    • pp.23-30
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    • 1995
  • Bedwetting is the most common urologic complaint among children. Wetting frequency decreases from birth to adolescence. Etiology is multifactorial : genetic, neuromuscular or urologic maturation, psychosocial stressors, toilet training, or biologic aspects. Treatment has been also multimodal : drugs to depress bladder activity, increase urethral resistance, or modulate sleep. and recently urine reduction modulation. All of these approaches reflect a lack of sufficient knowledge of the underlying pathophysiology of nocturnal enuresis. Recent researches have focused on sleep disturbances, bladder reservoir function, urine output, and a combination of the three. Sleep studies indicate that enuretic patients are normal sleepers, and enuresis can take place during any stage of sleep, but generally occurs when the bladder is filled to the equivalent of maximal daytime functional capacity. Bladder reservior capacity appears to be normal, and bladder instability is somewhat related with the pathology of nocturnal enuresis. However, enuretic patients have shown the lack of normal nocturnal increase in antidiuretic hormone levels, and nocturnal urine production increases up to 2-4 times volume of functional bladder capacity, which explains the need for bladder emptying. But behavioral approaches, especially Bell-alarm method, remain important in the treatment of primary enuresis.

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A Comparison of Illness Behavior among Patients with Somatoform Disorders, Depressive Disorders and Psychosomatic Disorders (신체형장애, 우울장애 및 정신신체장애 환자들간의 질병행동의 비교)

  • Koh, Kyung-Bong;Ki, Sun-Wan
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.2
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    • pp.185-194
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    • 1997
  • A comparison was made regarding illness behavior among patients with somatoform disorders, depressive disorders and psychosomatic disorders. The subjects consisted of out-patients with somatoform disorders(N=52), depressive disorders(N=52) and psychosomatic disorders(N=51). illness behavior was assessed by illness Behavior Assessment Schedule and the questionnaire about help-seeking behavior. The patients with somatoform disorders and psychosomatic disorders more often affirmed the presence of somatic disease, were more likely to have phobia of disease, had more preoccupation with ideas of disease and more frequently shopped around oriental clinics than the patients with depressive disorders. The patients with somatoform disorders more often attributed its cause to physical factors, less often attributed the origin of affective disturbance to psychological causes, showed Less depression and irritability, and were less likely to accept psychiatric treatment recommended by other physicians than depressive patients. The patients with somatoform disorders were more likely to report having been told that they suffered from a mild illness than those with psychosomatic disorders. The patients with somatoform disorders with psychological problems tended to inhibit expression of their emotion. Female patients with somatoform disorders more often affirmed the presence of psychological disorder and attributed its cause to psychological factors than male ones. These results suggest that in illness behavior, patients with somatoform disorders are different from depressive patients, whereas the former patients are similar to psychosomatic patients except the discrepancy between therapists and patients regarding evaluation of their symptoms. Thus, it is emphasized that first, therapists need to approach patients with somatoform disorders somatically with understanding of their underlying need to deny psychological problems, followed by either psychological or biopsychosocial approach.

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Assessment and Understanding of Chronotype (일주기 유형의 평가와 이해)

  • Kim, Somin;Kim, Seog Ju
    • Sleep Medicine and Psychophysiology
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    • v.26 no.1
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    • pp.5-15
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    • 2019
  • Chronotype (CT) is defined as an inter-individual difference in sleep-wake cycles and daily activities. Previous studies have suggested that this individual difference can influence our biological and psychological functioning. Literature regarding the psychometric properties and validity of CT measures are reviewed. We provide an overview of biological indicators (sleep-wake cycle, body temperature, cortisol, and melatonin) that are used for distinguishing two chronotypes: morningness (MT) and eveningness (ET). We also review the differences between CT in relation to personality traits and the occurrence of psychopathology. In addition, the methodological limitations of studies on CT are discussed. Finally, future research directions in terms of CT are proposed.

Mental Health Literacy and Vulnerable Group Analysis of Korea (한국인의 정신건강이해력 평가와 취약집단분석)

  • Seo, Mikyoung;Rhee, Minkyu
    • Korean Journal of Social Welfare
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    • v.65 no.2
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    • pp.313-334
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    • 2013
  • A study aims to assess Korean mental health literacy and analyze the characteristics of vulnerable population. This study presented typical vignettes of schizophrenia, depression and alcoholism to 1,197 adults randomly. All respondents were asked for recognition of mental illness, beliefs about causes, professional help and self-help, stigma for receiving psychiatric treatment for the person described. The results showed that the recognition of mental health problem in a vignette was very poor and that personal causes were seen by public as more important than environmental and bio-genetic causes. When the public were asked about various professional therapies and self-help activities, psychotherapy was favored while other professional help were considered to be less helpful than self-help activities. Among professionals, psychiatrist were viewed as most helpful. We used cluster analysis to compare high mental health literacy group with low mental health literacy group(vulnerable population). Vulnerable population were found to be more aged and to live in county area. We proposed government initiated program for enhancing public mental health literacy.

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Alcohol Use Disorder in Consultation-Liaison Psychiatry (자문 조정의학에서의 알코올 사용 장애)

  • Seo, Jeong-Seok
    • Korean Journal of Psychosomatic Medicine
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    • v.19 no.1
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    • pp.15-19
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    • 2011
  • Alcohol is so-called "a magic bullet" affecting on the various organs and central and peripheral nervous systems and causes mental illness as well as physiological and psychological dependence. Also, alcohol problem is related with serious social problems including family violence, suicide, loss of job and crimes. Because alcohol use disorder is a common cause of consultation and liaison in general hospital, we could consider alcohol use disorder of one of psychosomatic disorder. Thus, I reviewed the prevalence, rate of consultation, and general consultant and treatment issues in treating patients with substance use disorder in a psychosomatic medicine.

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Depression after Traumatic Brain Injury (외상성 뇌 손상이후의 우울증)

  • Jung, Han Yong;Han, Sun Ho
    • Korean Journal of Biological Psychiatry
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    • v.6 no.1
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    • pp.21-29
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    • 1999
  • Traumatic Brain Injury(TBI) of any severity can result in broad and persisting biopsychosocial sequelae. Depression after TBI occur at a greater frequency than in the general population, with estimates approaching 25% to 50% for major depression, and 155 to 30% for dysthmia. Acute onset depressions are related to lesion location and may have their etiology in biological response of the injured brain, whereas delayed onset depressions may be mediated by psychosocial factors, suggesting psychological reactions as a possible mechanism. Anxious depressions are associated with right hemisphere lesions, whereas major depressions alone are associated with left dorsolateral frontal and left basal ganglia lesions. However, there is insufficient information to postulate a specific neuroanatomic model for TBI-related depression.

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