• Title/Summary/Keyword: 의학적 정신치료

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BORDERLINE PERSONALITY DISOREDER IN ADOLESCENTS (청소년기의 경계선 인격장애)

  • Jang, Kyung-June;Chung, Jea-Yun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.6 no.1
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    • pp.34-42
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    • 1995
  • Borderline personality disorder in adolescents present with suicide attempts or gestures, and they are characterized by the same patterns of splitting, devaluation, manipulation, need-gratifying object relations, impulsivity, and ego deficits that are finds in borderline adults, Symptomatolgy are depression, anxiety, identity crisis, and occasionally antisocial behavior in borderline personality disorder in adolescents. These findings should be differentiated to normal stormy adolescents. Theses borderline personality disorder in adolescents are known about the instability of object relations, labile affect, splitting, and psychotic episode in severe stress. According to thses finding, schizophrenia, mood disorder, schizoptypal personality disorder, paranoid personality disorder could be differentiated. Etiology is complex including psychodynamic, genetic, familial factor. Treatments are individual psychotherapy, group therapy, and pharmacotherapy. The continuity or discontinuity of borderline states from childhoon to adult life is controversy.

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TREATMENT OF TEST ANXIETY - Theoretical Background of the Treatment of Test Anxiety - (시험 불안의 치료 - 이론적 배경 -)

  • Paik, Young-Suk
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.2 no.1
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    • pp.49-55
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    • 1991
  • Test anxiety has been defined as a situational-specific personality trait, with cognitive worry and affective emotionality components. Various treatments differ in the extent to which they attempt to modify the emotional and cognitive components of test anxiety, and can thus be placed along a cognitive-emotional continum on the basis of the intended locus of impact of the therapeutic techniques. Various treatments along a cognitive-emotional continum and study habits, test-taking skills and modeling in the treatment of test anxiety were reviewed. On the basis of a recent review of a number of test-anxiety treatment studies, most cognitively-focused treatments tend to be more effective in reducing test anxiety and its worry and emotionality components.

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A CLINICAL STUDY ON CHILD SEXUAL ABUSE (소아 성학대에 대한 임상 연구)

  • Lee, Soo-Kyung;Kwack, Young-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.5 no.1
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    • pp.184-193
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    • 1994
  • This study was purposed to find out clinical characteristic of intra and extrafamilial sexual abuse, nature of offenders, difference of symptoms describe that sexually abused children and adolescents were experienced. Subjects were 10 sexually abused children and adolescents who visited Seoul National Mental Hospital, from Jan. 1992 to Dec. 1993. In intrafamilial sexual abuse, they had more chronic course than extrafamilial abuse and had more family psychopathology. In symptomatology, The preschool children mainly presented to somatic symptoms and anxiety, and The school children prominently exhibited depressive reaction and withdrawal. Most common reaction of parents was anger and guilt. They were treated with crisis intervention, play therapy, and hospitalization, if needed. The maintenance of treatment was difficult due to parent's avoidance and repression.

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Management of Weight Gain and Obesity Associated With Antipsychotics (항정신병약물 사용과 연관된 체중 증가와 비만의 관리)

  • Lee, Na-Hyun;Lee, Jae-Chang
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.86-94
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    • 2021
  • Objectives : The risk of weight gain is high when using antipsychotic drugs, and the prevalence of obesity in people with mental illness is high. Obesity management in psychiatric patients is important because obesity causes various complications and lowers treatment adherence and quality of life. Methods : In this review, we summarized the management strategies for obesity that can occur when using antipsychotic drugs through a web search. Results : Evaluate obesity-related risk factors and related indicators from the beginning of treatment, and conduct regular monitoring. If an antipsychotic drug is used and obesity is induced, a change to a drug with a low metabolic risk may be attempted. Sufficient interventions are also needed on the need to manage obesity, a healthy diet, and exercises in patients and their families. If weight loss is not achieved and obesity-related complications are associated, the use of anti-obesity drugs may be considered. Pharmacological treatment approaches should be carefully considered. Conclusions : Non-pharmacological and pharmacological therapies can be applied to manage weight gain and obesity caused by the use of antipsychotic drugs. When using anti-obesity drugs, the characteristics of mental disorders, drug safety, and drug interactions should be considered.

A Review on Sleep Disorders Similar to REM Sleep Behavior Disorder (렘수면 행동장애 유사 수면장애에 대한 고찰)

  • Eunyoung, Lee;Jihye, Song;Heewon, Bae;Hayun, Choi
    • Sleep Medicine and Psychophysiology
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    • v.29 no.2
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    • pp.35-39
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    • 2022
  • REM sleep behavior disorder is parasomnia characterized by unpleasant dreams and dream-enactment behaviors associated with excessive electromyography activity in REM sleep. This may appear idiopathic or secondary to other neurological or medical conditions. REM sleep behavior disorder, which appears to be idiopathic, most often implies the possibility of later neurodegenerative diseases due to synucleinopathy, so accurate diagnosis is important in predicting prognosis. For the diagnosis of REM sleep behavioral disorder, REM sleep without atonia, which appears in the polysomnography, is essential. Obstructive sleep apnea, trauma-related sleep disorders, and vigorous periodic leg movements during sleep are known as diseases that show dream enactment behavior in elderly patients. Considering that it may be accompanied by other sleep disorders that can mimic REM sleep behavioral disorders, it is important to differentiate sleep

Depression as a Mediator of the Relationship Between Resilience and Posttraumatic Stress Symptoms and Dissociation in Firefighters (소방공무원에서 탄력성이 외상후스트레스 증상과 해리에 미치는 영향 : 우울의 매개 효과)

  • Kwon, Tae Hoon;Hyun, So Yeon;Chung, Young Ki;Lim, Ki Young;Noh, Jae Sung;Kang, Dae Ryong;Ha, Gwiyeom;Kim, Nam Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.109-116
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    • 2016
  • Objectives : This study aimed to investigate the effects of resilience on posttraumatic stress symptoms and dissociation and whether depression mediates the relationships between resilience and posttraumatic stress symptoms and dissociation. Methods : A total of 115 firefighters participated in the study. Data were collected via the Life Events Checklist, Impact of Event Scale-Revised, Dissociative Experience Scale, Beck Depression Inventory, and Connor-Davidson Resilience Scale. Structural equation modeling and path analysis were applied to estimate the relationships between resilience, depression, posttraumatic stress symptoms, and dissociation. Results : Greater resilience was associated with lower posttraumatic stress symptoms and dissociation, and the relationship between them was fully mediated by depression. Conclusions : Specific aspects of depression may help explain the relationships between resilience and posttraumatic stress symptoms and dissociation. Tailored prevention programs and treatments based on resilience and depression may prevent posttraumatic stress symptoms and dissociation in firefighters and improve treatments outcomes among firefighters with posttraumatic stress symptoms and/or dissociation.

TASKS AND TECHNIQUES IN THE INITIAL PHASE OF PLAYPSYCHOTHERAPY ILLUSTRATED BY GROUP SUPERVISION PROCESSES (집단 지도 ${\cdot}$ 감독 과정을 통해 본 초기 놀이치료의 기법과 과제)

  • Hong, Kang-E;Park, Min-Sook;Nam, Min
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.4 no.1
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    • pp.142-163
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    • 1993
  • A 8 year old boy with problems of hyperactivity, impulsivity received playpsychotherapy. Through the detailed examination of their contents and group supervision of play therapy session, common mistakes novice therapist make frequently and tasks in the initial phase of play psychotherapy are illustrated. Therapist's personality and anxiety frequently interferes therapeutic processes. Common mistakes therapist makes during initial phase of play therapy are ; therapist's over-enthusiasm, overinvolvement or non-responsiveness, premature or inappropriate interpretation and direct connection of play theme to reality. It is utmost important for the therapist to make positive and trusting relationship with the patient in the initial phase of the therapy. In order to do so therapist must accept the patient as he is, permit the patient takes his leads. And as a result, the Patient can go through corrected developmental experience. In conclusion, it is a therapist's main task to establish relationship.

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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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Changes in Mental Health Status of Patients in the Community Treatment Center during the Quarantine Period (생활치료센터 환자의 격리 치료 기간 중 정신건강 상태 변화)

  • Jeong-Wook Seo;Jeonga Yoo;Jin-Yong Jun;Jiho Lee
    • Health Policy and Management
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    • v.34 no.3
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    • pp.293-308
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    • 2024
  • Background: Assessing the change in mental health status of quarantined patients in community treatment centers at the time of admission and discharge, and inferring the influencing factors. Methods: The study was conducted on a sample of 1,941 quarantined patients from three community treatment centers. Changes in anxiety, psychological distress, post-traumatic stress, depression, and self-harm ideation between admission and discharge were categorized as either "improved" or "worsened." Inference was performed to determine the probability of worsening in mental health status. Results: The mental health status of quarantined patients, such as anxiety and depression, was relatively higher than that of the general population. Anxiety (84.3% improved) and psychological distress (79.0% improved) were reduced during quarantine treatment. However, some patients continued to experience moderate to severe levels of anxiety (11.2%) and psychological distress (11.0%) at discharge. As for depression, the depression of moderate or higher level was increased at the time of discharge (28.7%→36.7%) compared to admission. The deterioration of anxiety and psychological distress was found to be the most significant factor influencing the worsening of depression at discharge (odds ratio [OR] for anxiety deterioration, 2.04; OR for psychological distress deterioration, 3.56). These effects were also observed similarly in post-traumatic stress and self-injury ideation. Conclusion: Improving anxiety and psychological distress among quarantined patients in community treatment centers can reduce the worsening of post-traumatic stress, depression, and self-injury ideation at the time of discharge. These findings provide evidence for the need for active mental health management from the initial stages of quarantine treatment.

Transference and Individuation Process in 'Rosarium Philosophorum' ('현자의 장미원'에 나타난 전이와 개성화 과정)

  • Sang Ick Lee
    • Sim-seong Yeon-gu
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    • v.33 no.2
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    • pp.99-140
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    • 2018
  • After a careful review on the concept of transference from the perspective of analytical psychology with Jung's view in the center, the author had proposed that an interpretation for the whole series of 'Rosarium Philosophorum' including its posterior part to which Jung didn't refer in 'The Psychology of The Transference' be carried out for the genuine understanding of transference. The symbolic meaning of the twenty woodcuts' pictures in 'Rosarium Philosophorum' could be interpreted as the alchemical stages of blackening, whitening, yellowing, reddening and etc. The transformation through each stage could be associated with the process of psychotherapy as well as individuation process and the meaning of transference could be elucidated as a kind of initiating process for the individuation process. The eastern traditional thoughts on psychic transformation and human development were also compared. The individuation process would be coexistent with the development of human relationship including the therapeutic relationship and the concept of human (人 and 人間) in the eastern traditional thoughts would have many meaningful implications for further studies.