• Anxiety and mood
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• v.8 no.1
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• pp.9-15
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• 2012

Objectives : The purpose of this study was to assess the health-related quality of life (HRQoL) for patients with panic disorder using EQ-5D and EQ-VAS, and to examine the relationship between health-related quality of life and clinical outcomes following treatment. Methods : 29 patients with panic disorder were recruited from the Seoul Metropolitan area and 20 patients were followed up after two months of outpatient treatment. The Panic Disorder Severity Scale (PDSS) was used to assess the severity of the panic disorder and the changes in symptoms. HRQoL was assessed with EQ-5D and EQ-VAS at baseline and at two months of treatment. Results : All enrolled panic disorder patients showed significantly impairment of HRQoL in view of the subscales of EQ-5D, EQ-VAS index scores. The severity of PDSS was correlated the HRQoL in the panic patients. After treatment, the EQ-5D, EQ-VAS index scores showed significant improvement. Conclusion : Panic disorder patients suffer from lower HRQoL as well as from symptoms of the disorder. They showed clinical improvement and a restored HRQoL with treatment. These outcomes suggest using the EQ-5D, EQ-VAS such as the HRQoL in the assessment of patients with panic disorder is essential.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.157-163
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• 2019

Purpose: To investigate the incidence and associated factors of delirium after orthopedic surgery. Materials and Methods: A total of 2,122 cases, who were older than 20 years and underwent orthopedic surgery at a single medical center during a one year period were included. Among them, 132 patients who were diagnosed with delirium after surgery under the Diagnostic and Statistical Manual of Mental Disorders-V criteria and medicated under the consultation of a psychiatrist were included in the study The differences in the incidence of delirium and several affecting factors were analyzed. Results: The overall incidence of delirium after surgery was 6.2% (132 in 2,122 cases). The mean age of the delirium group was 77.4 years (range, 54-92 years), which was higher than that of the non-delirium group (58.1 years). The percentage of women in the delirium group was 63.6% (84 in 132 cases), which was higher than that of the women in the non-delirium group (49.0%). The incidence of delirium after surgery was 9.3% (85 in 916 cases) due to trauma and 3.9% (47 in 1206 cases) due to disease. The incidence of postoperative delirium according to the surgical region was 29.2% (7 in 24 cases) in two or more regions, 13.7% (72 in 526 cases) in the hip, and 9.6% (14 in 146 cases) in the spine, 3.5% (20 in 577 cases) in the knee-lower leg, 2.5% (5 in 199 cases) in the foot-ankle, 2.4% (11 in 457 cases) in the shoulder-elbow, and 1.6% (3 in 189 cases) in the forearm-wrist-hand. Delirium occurred more rapidly in women and surgery due to disease, and the duration of delirium was longer in patients with dementia and major depressive disorders. Conclusion: The incidence of postoperative delirium was high in cases of surgery due to trauma and in cases of surgery in two or more sites. The incidence of postoperative delirium according to a single surgical region was higher in the order of the hip, spine, and knee. Active intervention is needed regarding the correctable risk factor.

• 한국노년학
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• v.31 no.1
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• pp.129-141
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• 2011

This study aims to find out effects of a tailored occupational activity program(TOAP) on the activities of daily living(ADL), cognitive function, depressive mood, and caregiver burden, who live in the community. Method : From October 2009 to May 2010, the TOAP was applied to 15 dementia patients and 15 of their caregivers, who was visitors of the Y-city Center for Managing Dementia in Gyunggi-do. The TOAP was designed for habituating patients and caregivers to the techniques acquired through goal activities and task and making it capable of being routinized regularly. The TOAP was applied to dementia patients and their cvaregivers twice a week for 7 weeks(one-time home visit, one-time phone inspection), a total of 14 times. Results: Significant differences among pre-test and post-test were found in the AMPS motor skills(1.10±1.14 and 1.34±1.2 respectively) scores, AMPS process skills(0.32±0.55 and 0.77±0.66 respectively) scores, ACL(3.86±0.65 and 4.17±0.64 respectively) scores, MMSE-KC(17.33±4.6 and 19.33±4.97 respectively) scores, GDS(11.73±6.87 and 8.53±7.09 respectively) scores, and caregiver burden(31.80±20.06 and 26.13±18.07 respectively) scores(p<0.05). A significant effect was confirmed from the TOAP which ADL, cognitive function, reduced patient's depression and caregiver burden(p<0.05). Conclusion: From the above results that a TOAP has an effect on the improvement of the ability to ADL, cognitive function and reduced depression and caregiver burden of dementia patients living in community. The present author hopes that, in the future, more diverse community based on tailored occupational activity programs will be developed to improve the functions of dementia patients living in community.

• Korean Journal of Psychosomatic Medicine
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• v.17 no.2
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• pp.68-74
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• 2009

Objectives : Illness behavior is defined as the persistence of an adaptive/maladaptive mode of perceiving, evaluating and responding to health status and symptoms according to the status. In a cognitive aspect, somatizing symptoms are regarded as being originated from distortions, including magnification and/or amplification, of perceiving, evaluating and responding to symptoms such as bodily sensations. That is somatization may be explained by maladaptive illness behavior. In this study, we tried to investigate differences of illness behavior in depressive patient according to the presence of somatization. Methods : We divided 45 patients who were diagnosed as depression with ICD-10 diagnostic criteria into two groups(somatizing and non-somatizing group) according to the somatization subscale of Korean Depression Scale and compared two groups in the differences of illness behavior using the Illness Behavior Questionnaire. Results : Somatizing group showed significantly higher scores than non-somatizing group on the disease affirmation subscale($6.79{\pm}2.08$ vs. 4.76, p=0.003) and the denial subscale($3.25{\pm}1.22$ vs. $2.10{\pm}1.41$, p=0.006). There were no significant differences between two groups on the general hypochondriasis subscale and the affective unstability subscale. In a logistic regression analysis, somatizing group also showed higher odds ratio (OR) scores on the disease affirmation subscale(OR=1.418, p=0.089) and the denial subscale(OR=1.880, p=0.083). Conclusion : The disease affirmation and denial may be a discriminative mechanism of somatization in depressive patients. These subscales of Illness Behavior Questionnare could be useful markers, and psychiatric illnesses with somatizing and depressive symptoms may be differentially diagnosed and be predicted through these subscales.

• Sleep Medicine and Psychophysiology
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• v.26 no.1
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• pp.44-48
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• 2019

Objectives: Insomnia is one of the most prevalent sleep disorders. Recent studies suggest that cognitive and physical arousal play an important role in the generation of primary insomnia. Studies have also shown that information processing disorders due to cortical hyperactivity might interfere with normal sleep onset and sleep continuity. Therefore, focusing on central nervous system arousal and normalizing the information process have become current topics of interest. It has been well known that neurofeedback can reduce the brain hyperarousal by modulating patients' brain waves during a sequence of behavior therapy. The purpose of this study was to investigate effects of neurofeedback therapy on electroencephalography (EEG) characteristics in patients with primary insomnia. Methods: Thirteen subjects who met the criteria for an insomnia diagnosis and 14 control subjects who were matched on sex and age were included. Neurofeedback and sham treatments were performed in a random order for 30 minutes, respectively. EEG spectral power analyses were performed to quantify effects of the neurofeedback therapy on brain wave forms. Results: In patients with primary insomnia, relative spectral theta and sigma power during a therapeutic neurofeedback session were significantly lower than during a sham session ($13.9{\pm}2.6$ vs. $12.2{\pm}3.8$ and $3.6{\pm}0.9$ vs. $3.2{\pm}1.0$ in %, respectively; p < 0.05). There were no statistically significant changes in other EEG spectral bands. Conclusion: For the first time in Korea, EEG spectral power in the theta band was found to increase when a neurofeedback session was applied to patients with insomnia. This outcome might provide some insight into new interventions for improving sleep onset. However, the treatment response of insomniacs was not precisely evaluated due to limitations of the current pilot study, which requires follow-up studies with larger samples in the future.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.101-110
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• 2019

Objectives : It is not clear which clinical variables are most closely associated with delirium in the Intensive Care Unit (ICU). By comparing clinical data of ICU delirium and non-delirium patients, we sought to identify variables that most effectively differentiate delirium from non-delirium. Methods : Medical records of 6,386 ICU patients were reviewed. Random Subset Feature Selection and Principal Component Analysis were utilized to select a set of clinical variables with the highest discriminatory capacity. Statistical analyses were employed to determine the separation capacity of two models-one using just the selected few clinical variables and the other using all clinical variables associated with delirium. Results : There was a significant difference between delirium and non-delirium individuals across 32 clinical variables. Richmond Agitation Sedation Scale (RASS), urinary catheterization, vascular catheterization, Hamilton Anxiety Rating Scale (HAM-A), Blood urea nitrogen, and Acute Physiology and Chronic Health Examination II most effectively differentiated delirium from non-delirium. Multivariable logistic regression analysis showed that, with the exception of vascular catheterization, these clinical variables were independent risk factors associated with delirium. Separation capacity of the logistic regression model using just 6 clinical variables was measured with Receiver Operating Characteristic curve, with Area Under the Curve (AUC) of 0.818. Same analyses were performed using all 32 clinical variables;the AUC was 0.881, denoting a very high separation capacity. Conclusions : The six aforementioned variables most effectively separate delirium from non-delirium. This highlights the importance of close monitoring of patients who received invasive medical procedures and were rated with very low RASS and HAM-A scores.

• The Journal of the Convergence on Culture Technology
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• v.9 no.5
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• pp.563-568
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• 2023

The government's strengthening of the standards for mentally ill patients and expanding the scope of examinations to the entire nation reflects the changing times. According to the OECD's announcement (2021), the incidence of depression and anxiety has more than doubled since the prolonged COVID-19 pandemic in countries around the world, with Korea's prevalence ranking first. However, only 12.1% of those who have been diagnosed with mental disorders received counseling and treatment from experts. The difference between depression and simple depression is significant depending on whether it is medically treated or temporary, but it can be seen that the continuation of depression is depression. In order to reduce this depression, Kandinsky's work was visualized and created. In a study conducted by changing the playback speed of the produced Kandinsky image, beta and gamma values, which showed the largest deviation when compared to depressive patients and normal people, increased significantly when viewed at 90fps, which was most effective in relieving depression. Artistic creations are bound to be accepted differently depending on the individual's perspective, but it is hoped that research that can improve the phenomenon of individuals suffering from depression by integrating artificial intelligence and traditional mental health approaches will be further developed and widely used for treatment.

• The Korean Society of Law and Medicine
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• v.18 no.1
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• pp.297-341
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• 2017

We searched out court rulings on medical affairs through court library search sites and specialized articles on medically relevant judgments sentenced in 2016. And we selected and analyzed the judgements of the court we considered important as follows. In relation to the medical civil judgements, (1) In the case of applying surgery for female infertility during cesarean section operation but it has not been done, we expressed the regret for the lack of judgment in the process of entering the medical contract, introducing the rights infringed and the scope of compensation, (2) We pointed out that the ruling on the medical malpractice estimation goes out of limit of negligence estimation doctrine, and that the court asked very high degree duty of the traditional Korean medicine doctors to cooperate with Western medicine doctors. (3) In the case of admitting hospital's 100% responsibility, we pointed out the court overlooked the uncertainty and good intention of the medical practice. (4) Additionally, We introduced the cases admitted the hospital's responsibility in the accident related to the psychiatric patients in closed ward. Relating to a medical criminal ruling, we analyzed the supreme court decision about whether the dentist's Botox injection on the patient's face is a medical practice within the scope of the license from the viewpoint whether it is within the possible range of the word. And, concerning decisions on healthcare administration, (1) we analyzed the case about when medical personnel operate multiple medical institutions, whether it is possible to get back medical care costs under the National Health Insurance Law, (2) We commented on the ruling regarding explanation obligation in terms of object, degree, subject of explanation as a prerequisite for permissible arbitrary uninsured benefits. Finally, we reviewed the decision of the Constitutional Court about the Article 24 of the Mental Health Law, which it had allowed for a mental patient to be hospitalized forcibly by the consent of two guardians and a diagnosis of a psychiatrist. Also we indicated the problems of the revised Mental Health Law.

• Korean Journal of Psychosomatic Medicine
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• v.17 no.1
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• pp.8-14
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• 2009

Objectives : The purpose of this study was to investigate the various aspects of stress in patients with chronic prostatitis. Methods : Thirty two chronic prostatitis patients meeting the criteria of NIH-category III were compared with sixty four controls. Data pertaining to the source of, response to, and coping with stress, as well as chronic prostatitis symptom index were collected using a self-report questionnaire. The questionnaire consisted of a Global Assessment of Recent Stress(GARS), Stress Response Inventory(SRI), Ways of Coping Checklist(WCC), in addition to the NIH-CPSI. Results : From the results of GARS subscales, the scores of changes in relationship, sickness or injury and financial were significantly higher in patients with chronic prostatitis than normal controls. Chronic prostatitis patients had greater amplification of somatization, depression and anger in SRI and significantly lower score in ways of coping checklist compared with controls. In the NIH-CPSI of chronic prostatitis patients, the degree of symptom played a role in depression as stress response item and significant negative correlationship between the symptom point and problem focused, seeking social support coping strategy was observed. Conclusion : These results show that patients with chronic prostatitis have greater stress, higher stress response and insufficient coping strategy. Therefore, these efforts should be considered that enhancing healthier coping strategy and evaluation and management of stress experienced by chronic protatitis patients

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.2
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• pp.29-39
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• 2020

Purpose : This study investigated the relationship among adjustment of cancer, mental health, and family problem solving communication of women with cancer. The purpose of this study was to determine how to improve the adjustment of cancer of women and improve women's mental health to form family problem solving communication. Methods : This correlational study was conducted among 101 women with cancer living in the Seoul region. Data collection occurred from August 1, 2018, to August 23. The data are reported as means and standard deviations and were analyzed with t tests, ANOVA, and Pearson's correlation regression using SPSS version 21.0. Results : The results of this study showed that adjustment to cancer significantly correlated with the education level of the participants (F=3.27, p<.05) and self-help group participation (F=3.156, p<.05). In this study, the mental health of female cancer patients significantly affected their adjustment to cancer (F=13.13, p<.001). These results explained 19.7% of the variance (F=13.13, p<.001) in mental health and adjustment to cancer in female cancer patients. Conclusion : In this study, mental health was significantly affected adjustment to cancer. The results suggest that adjustment to cancer can be promoted through the development and application of a nursing intervention program considering the mental health of female cancer patients. In addition, further research is required to identify the factors in consideration of various variables in addition to the sociodemographic and disease-related variables that may affect the adjustment to cancer of female cancer patients in nursing hospitals.