• Journal of Digital Convergence
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• 제15권8호
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• pp.289-299
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• 2017

This study was conducted to investigate the effect of pain, sleep, and depression on quality of life in elderly patients with chronic pain. The subjects of this study were 170 elderly aged over 65 years. Data collected from July 1 to September 30 in 2016 at local community center were analysed by multiple regression. As a result, the pain, sleep, depression and quality of life of elderly significant difference by general characteristics and pain-related characteristics. In addition, In this study, the positive correlation between sleep (.471, p<.001) and quality of life, and negative correlation between quality of life and each of pain (-.332, p<0.001) and depression (-.720, p<0.001) were presented. The factors affecting the quality of life of the elderly with chronic pain were subjective health status (${\beta}=.236$, p=.001), depression diagnosis (${\beta}=.123$, p=.048), and depression (${\beta}=-.526$, p<.001), and depression related factors were most influential factor. Therefore, in order to improve the quality of life of elderly people with chronic pain, nursing and management programs should be prepared to reduce depression and pain.

• Journal of Hospice and Palliative Care
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• 제16권4호
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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.

• Korean Journal of Biological Psychiatry
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• 제14권1호
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• pp.21-27
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• 2007

Objectives : As a part of plan to develop evidence-based treatment guidelines for depression that is more suitable for Korean situation, we investigate the present status and client's requirements for non-pharmacological treatment of depression in Korean clinical situation. Methods : Subjects were patients with depression in 12 university hospitals which are located in metropolises in Korea. We analyzed the records from questionnaires about current clinical status and requirements for the non-pharmacological treatment of depression in Korea. Results : 50.8% of the subjects have experienced non-pharmacological treatments for their depression. The preference of non-pharmacological treatment method of depression is exercise/interesting activity, counseling by psychiatrists and psychotherapy, and the best effective treatment method is psychotherapy (Es=4.36). Actually, the mean consultation time by psychiatrist is $11.31{\pm}7.16$ min, and the appropriate consultation time for client's situation is $18.39{\pm}8.95$ min. During consultation, patients' satisfaction measurement for psychiatrist's explanation about pharmacological treatment is $64.17{\pm}27.11$, and satisfaction measurement for psychiatrist's counseling for their depression about personal problems, resent stress, interpersonal relationship is $61.66{\pm}26.63$. Conclusion : In Korea, many psychiatrists offered biologically oriented treatment to their patients with depression, and patients' satisfaction measurement about consultation by psychiatrists is low. Many patients wanted to combined pharmacological and non-pharmacological treatment for their depression, and aspired to information about complementary and self-help treatment methods. It is necessary to develop non-pharmacological treatment guideline for depression which reflect the clinical situation in Korea and meet Korean patients' need.

• The Journal of the Korea Contents Association
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• 제15권5호
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• pp.592-606
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• 2015

Depression and mental illness across all age groups, and steady increasing in suicide rate are our major social problems which cause dramatically decreasing government competitiveness. While Korean government has implemented various policies to improve mental health and prevent suicide, it faces revealing issues in progress on implementation and referral management systems. The current research examined domestic and foreign cases to understand the actual status and directivity of ICT convergence plan in terms of mental health. The United States and the United Kingdom have provided convergent ICT service, telepsychiatric care to senior citizens in rural areas, children and adolescents, socially disadvantaged class, etc. In Korea, emergency-notice devices are installed to prevent suicide for single elderly people, and diverse mobile health devices are developing to cure depression and Alzheimer's disease. ICT convergent mental health care service is needed to save socioeconomic costs and realize universal welfare for an aging society. Social consensus on sharply conflict issues, medical law and medical devices about telepsychiatry service, effectiveness studies on users' unique psychiatric characteristics by life cycle, and region-specialized strategies for the least densely populated rural regions with lower access to medical care should be considered.

• The Journal of Korean Medicine
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• 제28권2호통권70호
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• pp.34-43
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• 2007

Objective : The purpose of this study is to report improvement after application of herbal medicine (Soshiho-tang) treatment to a patient who has Parkinson's disease with pontine infarction. Methods : We treated the patient with acupuncture and herbal medication (Soshiho-tang). Results : We have experienced one case of patient who has Parkinson's disease with pontine infarction. This case improved significantly through herbal medication (Soshiho-tang) treatment. Conclusions : This study suggests herbal medication (Soshiho-tang) is effective for the improvement of the symptoms of a patient's who has Parkinson's disease with pontine infarction.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제12권1호
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• pp.125-137
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• 2001

We investigated the self-concept, subjective depression, and state-trait anxiety of the school boys with learning disabilities(abbr. LD, n=86) and compared them with normal boys(n=52) using Piers-Harris Self-Concept Inventory, Child Depression Inventory(abbr. CDI), and State-Trait Anxiety Inventory(abbr. STAI). With regard to Piers-Harris Self-Concept Inventory total scores, there was no significant difference between two groups, but normal boys showed higher scores in intellectual and school status, physical appearance, and happiness-satisfaction subscales than patients with LD. The male patients with LD showed significantly higher ratings in CDI total scores, and CDI subscales - ineffectiveness, anhedonia, negative self-esteem than normal children. The patients with LD reported significantly higher state anxiety, but not trait anxiety. Correlation analyses revealed that self-concept decreased over time, and depression-anxiety increased across grades in the patients with LD, but not in normal children. Especially, negative mood, anhedonia, negative self-esteem subscales of CDI, and state-trait anxiety showed significant positive correlation with grades. In both groups, CDI scores were inversely correlated with Piers-Harris Self-Concept and positively with State-Trait anxiety. In conclusion, self-concept problems which were related with school achievement and self-esteem were more abundant in the patients with LD than normal children, self-image problem, depression and anxiety increased across grades. According to regression analysis, age, behavior subscale, intellectual-school status, anxiety, popularity, happiness-satisfaction, CDI-ineffectiveness, interpersonal problem, negative self-esteem, and state anxiety could explain the self-concept in the patients with LD, not in normal children. So, the self-concept of the patients with LD were found to be related to the school achievement and stress when comparing with peers. In conclusion, elementary school boys with LD showed lower self-concept, higher depression and anxiety, and these differences increased across grades. Since the patients with LD have concomitant depression and anxiety disorders, it is important that comorbidity with emotional problems should be explored and managed properly.

• Tuberculosis and Respiratory Diseases
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• 제62권1호
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• pp.11-18
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• 2007

Background: Patients with chronic obstructive pulmonary disease (COPD) have often been reported to suffer from depression and anxiety possibly due to the exacerbation, hospitalization and mortality of COPD. However,scarce data are available in Korea. This study assessed degree of depression and anxiety, and evaluated the factors associated with depressive symptoms in COPD. Methods: The cross-sectional data on the lung function measurements, smoking behavior, body mass index (BMI), age, gender, depressive symptoms using Beck Depression Inventory (BDI) and anxiety using the State-Trait Anxiety Inventory (STAI) were evaluated in 72 outpatients with COPD and 50 controls without underling lung diseases from September, 2005 to October, 2006 in the Ewha medical center. Results: 1) The age, body mass index (BMI) and serum albumin levels were similar in the patients and controls. The BDI scores (16(0-37) vs. 12(1-30), p=0.001) and the prevalence of depression (36% vs. 6%, p<0.0001) were higher in the COPD patients than in the controls. In the COPD group, the prevalence of depression increased with increasing GOLD stage (p=0.008). The prevalence was 18%(4/22), in mild cases, 30%(6/20) in moderate cases, 52%(13/25) in severe cases and 60%(3/5) in very severe cases. 2) The SAI and TAI scores were higher in the COPD patients (44(20-67) and 47(20-66)) than in the healthy controls (39(26-65) and 44(33-90)). There were a significant correlation between the depression and anxiety scores (p<0.001). 3) A lower BMI, lower postbronchodilator $FEV_1$, current smoking behavior and severity of COPD were univariately associated with the depressive group in COPD, 4) while multivariate logistic analysis revealed only the severe-to-very severe group (OR 3.9, 95% CI 1.2 to 12.9) to be independently associated with depressive symptoms. Conclusion: COPD is strongly associated with depression and anxiety. Therfore, screening for psychological problems in COPD patients is essential, particularly in patients with severe-to-very severe COPD.

• Korean Journal of Psychosomatic Medicine
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• 제6권2호
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• pp.147-154
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• 1998

Objective : This study was designed to find the characteristics of MMPI that could influence the outcome of cognitive behavioral therapy(CBT) for panic disorder. Methods : 34 patients who met DSM-IV criteria for panic disorder with or without agoraphobia had completed 11 weekly sessions of cognitive behavioral therapy. All the patients were assessed with MMPI before the initiation of treatment. Five self-report measures including Beck Depression Inventory(BDI), Spielberger State-Trait Anxiety Inventory(STAI), Agoraphobic Cognition Questionnarie(ACQ), Body Sensation Questionnaire(BSQ), and Daily Anxiety Selfrating (0 - 8 scales) were also assessed as a pre- and post-treatment assessment. After the completion of treatment, patients were classified by the High End-State(HES) functioning group and the Low End-State(LES) functioning group for the data analysis. Results : 1) The LES group showed significantly higher scores in Hypochondriasis Scale(HS), Depression Scale(D), Hysterical Scale(Hy), Obsessive Scale(Pt), Schizophrenia Scale(Sc) and Validity Scale(F) of MMPI than the HES group. However, these differences gave impressions that the LES group had more severe symptoms rather than that they could be the factors influencing the outcome of CBT. 2) Though, the severity of symptoms of the LES group in the 5 measures of pre-assessment was basically higher than that of the HES group. The fact that both group showed the similar improvement between pre- and post-assessment supported the above interpretation. Conclusion : In regarding the above results, MMPI was not a proper tool that could provide the factors influencing the outcome of CBT. In the future study, the authors need to use a different tool that can find the personality characteristics more directly.

• Korean Journal of Psychosomatic Medicine
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• 제16권1호
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• pp.5-16
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• 2008

Several treatment programs putting mindfulness to practical use are being utilized in the various clinical settings as well as educational fields since 1980's. In this article, I studied several books and journals related with mindfulness and tried to show that mindfulness may have its neural circuits in the brain and can be utilized in the form of MBSR, MBCT, ACT, DBT not only to reduce stress and the symptoms of various psychosomatic conditions but to be applied to psychiatric illness such as, anxiety disorders, depressive disorders, and eating disorders, predicting its usefulness as a new psycho-social treatment.

• Korean Journal of Biological Psychiatry
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• 제6권2호
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• pp.227-234
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• 1999

An association of low total cholesterol in blood with psychiatric diseases and suicidal behavior has been suggested. As part of an attempt to further explore this relationship, we examine first, whether serum cholesterol levels in psychiatric patients with suicidal attempt would be lower than in non-suicidal psychiatric inpatients or normal controls, second, whether such significant difference of cholesterol levels would be present when the diagnostic groups are analyzed separately, third, whether low cholesterol level would be associated with a history of serious suicidal attempts, and finally, whether low cholesterol level in suicide attempters is a state or a trait marker. We determined the serum cholesterol levels in 231 patients admitted to an emergency room following an suicidal attempt, in the same numbers of age-, sex- and diagnosis- matched non-suicidal psychiatric controls, and in the same numbers of age-, sex matched normal controls. The seriousness of an attempt was divided into 5 grades according to the degree of the resulting medical injury. Total cholesterol levels in suicide attempters were significantly lower compared with both psychiatric and normal controls, when sex, age, and nutritional status (i.e., body mass index) were controlled for. This significant relationship was observed in major depressive disorders and personality disorders, but not in schizophrenia and bipolar type I disorders. The severity of suicide by a lowering of blood cholesterol was related to the magnitude of the cholesterol reduction. After treatment of their psychiatric ailments, the cholesterol levels in suicide attempters were significantly increased. This result suggests that low cholesterol level in psychiatric patients might be a potential biological marker of suicide risk. It is hypothesized that low cholesterol levels is associated with the suicide by modifying the serotonin metabolism, the production of interleukin-2 and melatonin metabolism in psychiatric patients.