• Title/Summary/Keyword: 신체적 병력

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The Effect of Subjective Quality of Life and Self-esteem on Suicide Ideation among the Older Adults: Focused on the Mediating Effect of Depression (노인의 주관적인 삶의 질과 자아존중감이 자살사고에 미치는 영향: 우울을 매개변인으로 하여)

  • Hwang, Mi-Gu;Kim, Eun-Joo
    • 한국노년학
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    • v.28 no.4
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    • pp.865-885
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    • 2008
  • This study addresses a number of issues related to suicide among older persons in Korea. The study investigates various aspects of elderly's suicide ideation, and how this quality of life and self-esteem impacts on their suicide ideation through depression. For the purpose of the study, the survey was conducted and 8,135 elderly 65 years old and over who reside in Gyeonggi-do participated. The result of the study indicated that quality of life, self-esteem and depression of the elderly showed statistically significant suicide ideation of the elderly. Participants were divided into two groups according to their physical health status. That is, to find out how quality of life and self-esteem of the elderly impact on the suicide ideation directly and indirectly through depression among elderly people with physical disease and no disease. The results showed that depression of the elderly people with physical disease was the most highly significant factors in explaining the elderly's suicidal ideation directly a comparison of elderly people with no physical disease. Therefore, depression is a major mental health problem associated with suicide. Finally, these findings of the study can improve the elderly people's quality of life and reduce suicide ideation.

CASE STUDY : FLUOXETINE INDUCED MANIA IN A SCHIZOPHRENIC PATIENCT AND REVIEW OF LITERATURES (정신분열증 여아환자에서 Fluoxetine 투여후 발생한 조증 증례보고 및 문헌고찰)

  • Kim, Bung-Nyun;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.6 no.1
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    • pp.116-122
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    • 1995
  • 목적 : 다음과 같은 fluoxetine으로 유발된 조증 증례를 보고한다. 이와 함께 fluoxetine사용이후 보고된 조증 증례보고를 모아서 정리하고 함께 문헌고찰을 하였다. 증례요약 : 가족력상 기분장애의 병력이 없었으며, 다른 주요 정신과적 질환의 병력은 없었다. 환아는 개인력상 5세경에 주의력 결핍, 과잉행동의 양상을 보였던 병력이 있었고, 13세때에 피해 망상, 환청이 지속되어 haloperidol로 치료받기 시작하였다. 이후 피해 망상의 내용을 언급하거나 환청에 영향받는 행동은 없어졌고 간혹 우울감을 호소하였다. 이후 정신분열증의 진단 하에 haloperidol만으로 3년간 유지하였다. 1994년 환아는 18세때 고3이 되면서 대입에 대한 걱정과 신체적인 허약감을 자주 호소하며, 우울증상이 두드려져 fluoxetine 20mg를 3일간 투여하던 중 갑자기 조증의 임상적 양상을 보이기 시작하여 본원의 입원치료를 받게 되었는데, 입원당시 보인 임상양상은 앙양된 기분, 이자극성(irritability), 사고의 비약, 연상의 이완과 지리멸렬, 과대망상, 피해망상, 관계망상, 환청 등이었고 사람, 장소, 시간에 대한 지남력까지 일시적으로 상실되는 심헌 정신병적 조증상태였다. 토의 : fluoxetine 사용이후 현재까지 세계적으로 문헌상 보고된 14개의 증례보고를 모아서 정리하였다. fluoxetine-induced mania의 병태생리학적인 기전은 명확하지 않지만 가능한 기전에 대해 토론하였다. 이 약물의 중대한 부작용중의 하나인 조증을 예방하기 위해, 이 약물을 다루는 의사는 가능한 조증 발병의 위험인자들에 대하여 인식하고, 약물의 용량조절시에도 주의를 하여야 한다. 가능한 발병 위험인자들에 관해서도 검토하였다.

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Pain and Stress (통증과 스트레스)

  • Sihn, Woo-Yong;Yu, Bum-Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.1
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    • pp.29-34
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    • 2007
  • Pain is subjective and greatly influenced by prior experiences, but it is real. Pain associated with an organic(objective) pathology is more easily explained and treated. However, atypical or unexplainable pain is usually a source of greater confusion and frustration. Pain may be divided into four general diagnostic categories. 1) pain with anatomic features and objective findings 2) pain with anatomic features and without objective findings 3) pain with non-anatomic features associated with stress and somatization 4) pain with non-anatomic features associated with perceived physical injury. There is a well-established relationship between emotional, physical and/or sexual abuse history and development of chronic pain. It has been suggested that the link between somatization and abuse involves a paradoxical pattern of hiding feelings and reality, while seeking acknowledgment of suffering. History of abuse may physiologically and developmentally increase a person's susceptability to pain and organic changes can be associated with psychogenic disease. Patients with chronic pain should be treated with multidisciplinary approaches including exercise, meditation, cognitive therapy, medications, and biofeedback. Cognitive therapy alters patient's cognition and management of pain and alleviates pain, especially associated with stress. Antidepressants are the most commonly used medications and pain control effects have no relation with mood changes. Biofeedback with relaxation training, exercise and meditation may also be effective in pain control.

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Dissociative Symptoms in Patients with Somatization Disorder (신체화 장애 환자의 해리 증상)

  • Kim, Seong-Hwan;Choe, Byeong-Moo;Kim, Yoon-Won;Hahn, Hong-Moo
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.116-123
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    • 1999
  • Objectives : The authors attempted to assess how much the mechanism of dissociation affects somatization disorder patients psychopathologically, and explore the relationship between sexual or physical abuse and somatic symptoms in somatization disorder patients. Methods : The authors administered the Dissociative Experiences Scales-Korean version(DESK) and Dissociative Disorders Interview Schedule to 25 patients with somatization disorder and 51 normal subjects. Results : There were no significant demographic differences between patient and control groups. The mean score of DES-K for patient group was 18.2, and 10.0 for the control group. The percentage of the individuals with high scores(20 and over) was 36.0 in the patient group and 7.8 in the control group, respectively. The percentage of the individuals with sexual and/or physical abuse was 16.0 in the patient group and zero in the control group. Our results showed that DES-K scores were not influenced by the factor of age or religion in either group, but the scores of the patients with somatization disorder were significantly higher than those in the normal subjects. Conclusion : There was an implication that the mechanism of dissociation affects issues of psychopathogenesis and psychopathology in Korean patients with somatization disorder, even though they have different sociocultural backgrounds in comparison to Western patients. The authors suggest it is useful to focus attention on childhood abuse and dissociation in the evaluation and dynamic psychotherapy of patients with somatization disorder.

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Evaluation and Management of Nocternal Enuresis (소아 야뇨증의 진단과 치료)

  • Park, Yong Hoon
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.425-434
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    • 2002
  • 야뇨증은 소아뿐만 아니라 부모들에게 매우 애를 먹이는 현상이며, 때로는 정신적, 정서적 장애 또는 행동장애를 유발할 수도 있다. 적절한 치료를 하기 위하여서는 세심한 병력, 신체검사와 필요에 따라서 적절한 실험실 검사 및 방사선검사으로 단인증상성 야뇨증인지를 제대로 구별하여야 한다. 실제 임상에서 야뇨증의 치료는 그렇게 용이하지만은 않아 우선 어린이와 부모들이 야뇨증을 제대로 이해할 수 있도록 사전 교육을 통하여 적극적인 치료 의지를 갖도록 하는 것이 중요하다. 여러 가지 행동요법 및 야뇨경보기, 적절한 약물요법을 환자의 상황에 맞도록 적절한 치료 방법을 모색하여 보다 치료 효과가 높고 재발이 적도록 노력하여야 한다.

Effect of Long-Term Stay Forest Therapy Program on User's Positive and Negative Emotions and Physical Changes (장기체류 산림치유프로그램이 이용객의 긍정·부정 감정과 신체변화에 미치는 영향)

  • Lee, Beom;Park, Choong-Hee;Park, Sujin
    • Journal of Korean Society of Forest Science
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    • v.109 no.4
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    • pp.544-552
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    • 2020
  • This study investigated the effectiveness of "Healing Stay in Forest," a long-term stay forest therapy program implemented by National Center for Forest Therapy in 2019 with 49 participants by measuring pre- and post-questionnaire responses and physical changes, such as blood pressure, body composition, and HRV. Results confirmed statistically significant reduction in negative emotions and enhancement of autonomic nerve balance in the participants. Regarding the changes in the evaluation of physical fitness based on medical history, some significant differences were observed in grip strength and standing high jump, in which participants with no medical history showed better results than those with medical history. These findings are important for verifying the effectiveness of long-term stay forest therapy (6 nights and 7 days).

운동 중 이럴 때 주의하라

  • Song, Sang-Uk
    • The Monthly Diabetes
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    • s.208
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    • pp.25-28
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    • 2007
  • 운동요법은 인슐린이 발견되기 수세기 이전부터 당뇨병의 치료로 이용되어 왔으며, 운동이 당뇨병환자의 신체 대사에 미치는 단기 및 장기 효과에 대해서도 이미 많은 연구결과들이 보고되어 그 유용성이 증명되었다. 그러나 많은 당뇨병환자들이 막상 운동을 시작하려해도 어떻게 시작하는 것이 효과적이고 어떤 점을 유의해야하는 지에 대해서는 잘 알지 못하고 있는 것이 사실이다. 그래서 여기서는 당뇨병환자에게 있어서 실제적인 운동 시 주의해야 할 점에 대해서 알아보고자 한다. 사실 운동프로그램을 시작하기 전에 당뇨병환자는 적절한 진단 검사와 자세한 의학적 평가가 이루어져야만 한다. 여기에는 운동에 의해서 악화될 수 있는 혈관성 합병증의 유무도 자세히 살펴보아야만 한다. 심장, 혈관, 눈, 신장, 신경계에 영향을 미치는 질병의 증상과 증후에 초점을 맞추어 세심한 병력과 신체진찰을 받고 환자 개개인에 대한 위험을 최소화 할 수 있는 개별화된 운동처방에 따라 운동을 시작하는 것이 바람직하다.

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Multi-Agent Based Real-Time TELE Healthcare Service (멀티 에이전트를 이용한 실시간 원격처리 헬스케어 시스템)

  • Kang, Eun-Young;Kim, Y.H.;Kim, Ung-Mo
    • Proceedings of the Korean Information Science Society Conference
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    • 2006.10b
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    • pp.130-133
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    • 2006
  • 본 논문에서는 가정이나 직장 등에서 사용자의 신체적 상태를 센서를 활용하여 측정하고 그 측정된 데이터와 과거의 병력에 따라 사용자의 상태를 분석, 그에 따른 의사의 처방 및 진단을 제공함으로써 유비쿼터스 환경을 이용한 원격 진단 및 처방 헬스케어 시스템을 제안한다. 기존 헬스케어 시스템은 중앙서버와 생체 신호를 보내는 모바일 디바이스의 자체적으로 지원되는 부족과 무선 네트워크를 통한 환자와 병원 중앙 서버와의 원활한 커뮤니케이션의 제공을 보장하지 못하는 단점도 있다. 이런 문제점을 해결하기 위하여 본 논문에서는 환자와 병원 사이의 중간 역할을 하는 써로게이트 시스템과 JADE를 기반으로 하는 멀티 에이전트 기술을 적용하였다.

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Factors for Completing Case Management of Suicide Attempters: A Coihort Follow-Up Study Based on Data From Case Management of Emergency Room-Based Suicide Attempters (자살시도 환자의 지속적 관리 완수 요인: 응급실 기반 자살시도자 사후관리 사업 자료를 기반으로 한 코호트 추적 연구)

  • Ryou, Jae Hyun;Heo, Yoon Kyung;Kim, Da Seul;Kim, Sun Mi;Han, Doug Hyun;Min, Kyoung Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.176-183
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    • 2021
  • Objectives : The purpose of this study was to find out how demographic factors, suicide attempt patterns, psychiatric history and management of suicide attempters affect the completion of emergency department (ED) based case management program. Methods : Among the patients who attempted suicide and visited the emergency department of Chung-Ang University Hospital from June 1, 2018 to May 31, 2021, 661 patients who agreed to case management were studied. After being discharged from the emergency department, subjects were registered for an eight-week follow-up service program. Hierarchical logistic regression analysis was conducted with demographic factors, suicide attempt patterns, psychiatric history and management as independent variables, and completion of case management program as dependent variables. Results : Suicide attempt pattern had the most significant influence on the completion of case management program, followed by demographic factors, psychiatric history and management. Those who completed the case management program were significantly more likely to have suicide plans in the future, more authentic in suicide attempts, and had higher proportion of past suicide attempts than those who did not complete the program. Conclusions : To ensure that the subjects complete the follow-up project program and get connected to community services, an individualized approach with consideration of suicide attempt patterns, demographic factors, and psychiatric history is needed.

Clinical Efficacy of the Ultrasonography in the Diagnosis of the Palpable Soft Tissue Masses (촉지되는 연부조직 종괴의 진단에서 초음파 검사의 유용성)

  • Park, Tae Soo;Kim, Hong Sik;Kim, Sungjun;Ryu, Jeong Ah
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.4 no.2
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    • pp.59-65
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    • 2011
  • Purpose: To determine the clinical efficacy of the ultrasonography (US) for the diagnosis of the soft tissue masses comparing to the clinical diagnosis through the physical examination. Materials and Methods: 83 consecutive patients with palpable soft tissue masses were presented retrospectively. On the basis of the pathological diagnosis after the operation, the diagnostic accuracies were evaluated the cases diagnosed by history taking and physical examination, and the cases diagnosed by US before the operation. Results: The diagnostic accuracy of the cases using US was higher(86.7%) than that of the cases using physical examination and history taking. The accuracy of US of the epidermal inclusion cyst was 71.4%, ganglion cyst 85.7%, lipoma 88.6%, respectively. Accurate diagnosis were made 54 cases with 65.1% sensitivity in the cases diagnosed by history taking and physical examination. In this case, its accuracy of the ganglion cyst was 56.0%, and the lipoma was 67.9%. Conclusion: US is a useful diagnostic tool for the diagnosis of the palpable soft tissue masses before the operation.

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