• Title/Summary/Keyword: 정신과외래

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Clinical Characteristics of Night Eating Syndrome in Outpatients with Bipolar Disorder (양극성 장애 외래환자에서 야간식이증후군의 임상적 특성)

  • Jung, Haran;Yoon, Bo-Hyun;Sea, Young-Hwa;Song, Je-Heon;Park, Suhee;Koo, Bonki;Kim, Kyung-Min;Nam, Seok-Hyun
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.2
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    • pp.112-120
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    • 2014
  • Objectives : The aim of this study is to evaluate the clinical characteristics of night eating syndrome(NES) in bipolar disorder outpatients. Methods : The 14 items of self-reported night eating questionnaire(NEQ) was administered to 84 bipolar patients in psychiatric outpatient clinic. We examined demographic and clinical characteristics, body mass index(BMI), subjective measures of mood, sleep, binge eating & weight-related quality of life using Beck's Depression Inventory (BDI), Pittsburgh Sleep Quality Index(PSQI), Binge Eating Scale(BES) and Korean version of Obesity-Related Quality of Life Scale(KOQoL), respectively. Results : The prevalence of night eating syndrome in bipolar outpatients was 14.3%(12 of 84). Comparisons between NES group and non-NES group revealed no significant differences in demographic characteristics, BMI and clinical status except economic status and comorbid medical illnesses. However, compared to non-NES, patients with NES was more likely to have binge eating pattern and poorer weight-related quality of life. Conclusions : This study is to be the first to describe the clinical correlates of night eaters in bipolar outpatients. Although there were few significant correlates of NES in bipolar outpatients, relatively high prevalence of NES suggest that clinicians should be aware to assess the patients with bipolar disorder on NES, regardless of obesity status of patients.

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Medical Care Utilization Pattern of Medical Aid Program Beneficiaries (의료보호대상자(醫療保護對象者)의 의료이용(醫療利用) 양상(樣相))

  • Kim, Ju-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.17 no.1
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    • pp.37-45
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    • 1984
  • This study was conducted to identify the problems in the medical aid program by reviewing the medical care utilization pattern of the beneficiaries. The data were abstracted from the monthly bills and vouchers for medical care of the whole benefi챠aries(17,527) in Gyeongsan Gun submitted by the physicians to county government for the period of 1 calendar year from October 1981 to September 1982. The number of medical aid beneficiary accounted for 12.7% of the total county population, a higher proportion than the national average-9.5%. Monthly primary care utilization rate per 100 beneficiaries was 9.3 persons with 14.0 visits and 42.9 medication days. for the 2nd and 3rd care, there were 1.7 admissions and 9.3 OPD visits per 100 beneficiaries per year. The beneficiaries of the first class medical aid program had a higher utilization rate of both the primary and secondary/tertiary care facilities. Females utilized more the primary care facilities than males while males utilized more the secondary/tertiary care facilities than females. A significantly lower utilization rate was observed in January than in the other months and this was seemed due to the renewal process of the medical aid certificate. Among 1,931 patients utilized the 2nd/3rd care facilities 84.4% was out-patients and the lowest ratios were in the minor specialties including ENT, ophthalmology, dermatology and urology. The average hospital days per in-patient were 21.2 days and OPD days per out patient were 4.7 days. The average hospital days for a psychiatry in-patient was 74.4 days which was the longest average hospital days among all the specialties. Average medical care cost per beneficiary in a year was W9,821:W24,240 for the 1st class and W7,464 for the 2nd class. The medical care cost for the primary care per patient was W3.901 and W840 per day compared with W49,875 per patient and W5,822 per day for the secondary/tertiary care. From the findings of this study following recommendations were made to improve the medical care program: 1) The renewal process of the medical care certificate should be expedited. 2) Minor specialty clinics should be designated as the primary medical care facility for the medical aid program to reduce the expenses by absorbing more patients referred to the secondary/tertiary care facilities directly. 3) The medical care cost for the primary care facility should be escalated to reduce the differential between the primary and secondary/tertiary care facilities.

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Neuropsychological Tests in Psychiatric Outpatients (정신과 외래 환자에서의 신경 심리 검사)

  • Lee, Sung-Hoon;Park, Hee-Jung;Park, Hye-Jung;Lee, Hee-Sang;Kim, Chan-Hyung
    • Sleep Medicine and Psychophysiology
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    • v.4 no.1
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    • pp.120-128
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    • 1997
  • Clinical neuropsychological tests were developed originally for the diagnosis of neurological and neuro-surgical diseases. Recently, these tests are being introduced to psychiatric patients. Authors had the experience to use these tests in pychiatric outpatient clinic. Results were as follows. There was a significantly increase in language and attentional function in residual schizophrenia compared to normal control. In chronic neurosis, as visuospatial function was reduced, language and attentional functions were enhanced. With these results, authors suggest that application of neuropsychological tests in psychiatric patients may be very helpful in classifying the subgroups of disease, in selecting the modality of treatment, and in expecting prognosis.

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Synergistic Effect of Forest Environment and Therapeutic Program for the Treatment of Depression (산림활동이 우울증 환자들의 호전에 미치는 영향: 산림치유 프로그램 집단과 병원 프로그램 집단, 산림욕 집단, 대조군 비교 연구)

  • Woo, Jong-Min;Park, Sang Mi;Lim, Seong Kyeon;Kim, Won
    • Journal of Korean Society of Forest Science
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    • v.101 no.4
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    • pp.677-685
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    • 2012
  • This study was conducted to evaluate the effect of forest environment and therapeutic program to the patients with major depressive disorder in antidepressant medication. The first group participated the four sessions of therapeutic program in the forest environment ("forest therapy"), the second group did in the program in a hospital environment, the third group did merely walking in the forest ("forest bath"), and the last group was controls. All the participants was diagnosed with major depressive disorder and had been taking antidepressant medication longer than 3 months. Depressive symptoms were measured by the Hamilton Rating Scales for Depression(HRSD), Montgomery-Asberg Depressin Rating Scales(MADRS), Beck Depression Inventory(BDI), and general health perception was measured by Short Form Health Survey Questionnaire(SF-36). Heart rate variability(HRV) were also examined to observe the physiological parameters before and after the program. In the results, HRSD score of forest program group was significantly lower than controls after the program. MADRS score of forest therapy group and hospital program group was also significantly lower than controls after 4 sessions of the program. The remission rate defined as below 7 points in HRSD was higher in the forest therapy group, hospital program group, forest bath group, and controls in order. These results reveals that the therapeutic program performed in forest environment may improve unremitted depressive symptoms of patients with major depressive disorder. Although not significant, the forest therapy program showed better outcome than hosptial program and forest bath.

Attitude and Belief About Menopause and Menopausal Symptoms in Depressive or Anxiety Disorder Patients (우울, 불안장애 환자에서 폐경에 대한 태도 및 인식과 폐경기 증상)

  • Choi, In Kwang;Lee, Moon-Soo;Ham, Byung-Joo;Lee, Hwa-Young;Ko, Young-Hoon;Joe, Sook-Haeng
    • Korean Journal of Psychosomatic Medicine
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    • v.18 no.2
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    • pp.82-93
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    • 2010
  • Objectives : The purpose of this study was to explore attitude and belief about menopause and severity of menopausal symptoms according to menopausal status. This study conducted a cross-sectional assessment of the effects of depressive symptoms and the severity of trait anxiety on the severity of menopausal symptoms. Methods : Participants were all outpatients at the psychiatric outpatient clinic of Korea University Guro Hospital. All participants, aged 40 to 64, had depressive or anxiety disorders and were divided into the premenopause, perimenopause, premenopause, and postmenopause groups. Menopause Rating Scale(MRS) was used to measure the severity of menopausal symptoms. The attitude toward menopause was examined by a self-report questionnaire regarding menopause. Beck Depression Inventory(BDI) and State-Trait Anxiety Inventory(STAI) were used to assess depressive symptoms and anxiety. Results : The severity of menopausal symptoms was not different among the groups according to menopausal status. There was a significant correlation between a negative attitude toward menopause and the severity of menopausal symptoms. Patients with moderate to severe depressive symptoms and trait anxiety had more severe menopausal symptoms. Conclusion : Negative attitude toward menopause, depressive symptoms, and anxiety had a significantly negative impact on the severity of menopausal symptoms. The results of this study suggest that treatment to relieve depressive symptoms and anxiety and intervention to reduce negative attitude toward menopause are required. Further studies with larger sample size are needed to evaluate potentially effects of depressive symptoms and anxiety on severity of menopausal symptoms in middle-aged female psychiatric patients.

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KOREAN CHILD AND ADOLESCENT PSYCHIATRY - A REVIEW OF THE PAST, THE PRESENT AND THE FUTURE - (한국 소아 ${\cdot}$ 청소년정신의학 - 과거 ${\cdot}$ 현재 ${\cdot}$ 미래 -)

  • Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.2
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    • pp.139-149
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    • 2003
  • Objectives:To review the history of the development and current status of Korean Child and Adolescent Psychiatry and to propose the future tasks at this 20th anniversary of Korean Academy of Child and Adolescent Psychiatry. Methods:Records and publications of Korean Academy, personal communications with senior members of the Academy, the author's recollections and memoirs. Results:Korean Child Psychiatry started with opening Child Psychiatry Clinic at Seoul National University Hospital in 1979 and establishing Division of Child and Adolescent Psychiatry at the same hospital in 1980. A Child Psychiatry Study Group was formed in 1983 and it transformed into Korean Academy of Child and Adolescent Psychiatry in 1986. In the past 20 years, Korean child and adolescent psychiatry made an impressive progress and contributed significantly to the development of Korean medicine as well as to the establishment of child mental health service. There are 77 board-certified and 48 board-eligible child psychiatrists, and 18 child psychiatry fellows are in training as of 2003. Main forces of this successful introduction of child psychiatry are 1) 7 child psychiatry training centers at major university hospitals, 2) publication of Korean Journal of Child and Adolescent Psychiatry in 1990, 3) the establishment child psychiatry board certification system in 1996. Korean child psychiatry has extended its role in the international child psychiatry and took leadership in establishing Asian Society of Child and Adolescent Psychiatry and Allied Professions(ASCAPAP). Conclusion:Korean child psychiatry has achieved a remarkable progress for the past 20 years and is currently producing 15 or more child psychiatry each year. However, there are needs of more active involvements in adolescent problems, more active consultation-liaison services at general hospitals as well as community mental health institutions. More school consultation and preventive educational services are desired. There is a urgent need of carrying out more empirical studies with strong scientific rigor. Korean Academy should pay attention and provide assistance to the development of child psychiatry service in other countries in Asia.

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The Utilization of Health Service by Psychiatric Outpatients (정신과 외래환자들의 의료이용에 관한 연구)

  • Kim, Chae-Bong;Hwang, Sung-Wan
    • The Korean Journal of Health Service Management
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    • v.6 no.1
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    • pp.77-86
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    • 2012
  • Objective of the study represents experiences of medical utilization of Psychiatric Outpatients. This research draws on information obtained from the 2008 National-wide sampling study of the Korean Healthcare Panel(KHP) conducted. The results of our study suggest the significance of variables such as the gender(p<.001) in the social demographical characteristics, the medical security type(p<.016), medical institution utilization(p<.012) treatment type(p<.004) in the utilization factors. In the case of medical utilization cost, the financial support factor(p<.018) showed a significant relationship. Depending on the particularities of gender, medical security type, financial support, medical institution utilization, treatment type were determined through a multiple logistics regression analysis. Gender showed that, among Psychiatric outpatient age of 30-59 level was 5.358 times and 60 years and older, their the second medical examination level was 4.490 times higher than Psychiatric outpatients under the age of 29. Health insurance type showed for the others medical allowance was 6.712 times higher than job health insurance and the other treatment was 0.395 times lower than drug treatment. Psychiatric outpatients utilization are rooted in the thoughts and factor levels of the Psychiatric patients and must be understood from the Psychiatric outpatients's perspective. The point is not only to gauge the patients research during Psychiatric medical utilization. The important of social community mental healthcare services levels goes beyond the goal of enhancing healthcare.

The Importance of Treatment for the Patients with Chronic Pain (만성통증 환자 치료의 중요성)

  • Song, Ji-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.252-255
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    • 1999
  • Numbers of patients who have chronic pain seem to be increasing even in the psychiatric practice. One report in Korea showed more than 40% of psychiatric patients who visited out-patient clinic were suffered from chronic pain and one third of those patients were needed treatment for the on-going pain. For evaluating and treating those patients the charateristics of illness behavior should be understood. Abnormal Illness behavior was found as one of the most influential factors which led symptoms complicated and chronified. This symposium was planned to illustrate how to manage the patients whose pain are associated with arthropathy and connective tissue diseases, neuropathic pain and headache more effectively and efficiently. So, It is hoped to get fruitful knowledges for the management of chronic pain in the scope of consultation-liaison psychiatry.

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An Exploration of Essentials of Psychiatric and Mental Health Nursing (정신건강간호의 실체규명을 위한 업무경험 탐색)

  • Oh, In Ohg;Nam, Kyoung A
    • Journal of Korean Academy of Psychiatric and Mental Health Nursing
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    • v.27 no.4
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    • pp.415-426
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    • 2018
  • Purpose: This study aimed to explore the essentials of psychiatric and mental health nursing by identifying the care experience of the psychiatric nurses. Methods: Eleven psychiatric nurses were recruited across five geographical areas in the Korea. Data were collected using semi-structured interviews from two focus groups, which were analyzed with an inductive content analysis. Results: Participants constructed two categories including 'nursing tasks for the client' and 'nursing tasks for the organization'. Subcategories of nursing tasks for the client are 'staying alert on crisis prevention', 'leading them to be real with eager and persistent will', 'nursing beyond role boundaries', 'tuning the needs of clients' family', 'taking journey with clients' personal life history', and 'doing invisible but recognizable nursing'. Subcategories of nursing tasks for the organization are 'working as a responsible team member', 'integrating team competencies at the center of team', and 'balancing protection and control'. Conclusion: Psychiatric nurses played professional and holistic care roles for the clients, and managerial roles for the organizations. This study provides essential data for defining psychiatric nursing and estimating the appropriate ratio of psychiatric nursing staffing.

Self-perceived Stigma, Self-efficacy and Quality of Life in Psychiatric Outpatients (정신과 외래 환자가 지각하는 낙인과 자기효능감 및 삶의 만족도에 관한 연구)

  • Sung, Ki Hye
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.2
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    • pp.127-138
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    • 2009
  • Purpose: The purpose of this study was to explore self-reported perceived stigma, self-efficacy, and quality of life among psychiatric outpatients Methods: In the present study, researchers analyzed the survey responses of 195 patients recruited in the S hospital psychiatry outpatient clinic. The measurement tools used in this study were the "Devaluation & Discrimination" scale to determine perceptions of stigmatization, general and social efficacy scales to measure self-efficacy, and the "General Well-Being Index" to measure quality of life in psychiatric outpatient. Statistical analysis included means with standard deviation, t-test, ANOVA and Pearson correlation coefficients to identify relationships between the variables. Results: There was a significant difference in self-perceived stigma and quality of life in psychiatric outpatients (r=-.233, p=.001) and a negative correlation between self-efficacy and quality of life (r=-.424, p=.000). Correlation analysis results support the hypothesis that higher self-perceived stigma scores were related to reduced quality of life among patients with schizophrenia (r=-.231, p=.021), while there was a positive correlation between self-perceived stigma scores and self-efficacy scores among patients with bipolar disorder (r=.362, p=.013). Conclusion: The findings suggest that nursing imtervention strategies should include education programs to reduce stigmatization and enhance self-efficacy and quality of life among patients with chronic psychiatric illnesses.