• Title/Summary/Keyword: 정신과외래

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A study on the Family Caregiver Burden for Psychiatric Out-Patients (정신과 외래환자의 자가간호수행 및 가족기능과 가족 부담감의 관계)

  • Kim, Yeon-Hee
    • Research in Community and Public Health Nursing
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    • v.5 no.1
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    • pp.64-80
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    • 1994
  • The purpose of this study was to identify factors affecting family caregiver burden, and to identify the relationship between family caregiver burden and family function /self-care of psychiatric out-patient. These data were collected by questionnaire from September 20 to October 8, 1993. The subjects were 285 family caregiver of psychiatric out-patients. The instruments used in this study were Caregiver Burden Inventory(CBI) by Novak(1989), self-care performing by Yu(1992), and Family APGAR by Smilkstein(1979). The data were analyzed by cronbach's $\alpha$, mean, standard deviation, percentage, t-test, ANOVA, Pearson's correlation coefficient, and Stepwise Multiple Regression with SPSS /pc+ program. The result of this study were as follows ; 1. The means of family caregiver Burden revealed total 2.00, Time-Dependence Burden 78, developmental Burden 2.22, physical Burden 1.90, social Burden 1.43, emotional Burden 2.18, financial Burden 1.51. family caregiver burden score showed moderate level. time-dependence burden showed the highest score and social burden showed the lowest score. 2. The means of family function revealed total 5.67. 7 through high-21.4% (61), low through 3-38.6%(110). family function score showed moderate level. 3. The means of patient's self-care performance revealed total 137.71. self-care performance showed moderate level. 4. A ststistically significant correlation between family caregiver burden and patient's demographic variables, age (F=3.83, p<.01), marrital status(F=3.50, p<.01), job(F=3.17, p<.01), diagnosis(F=4.46, p<.01), income (F=4.46, p<.01). No significant differences between family caregiver burden and prevalent period, religion, sex (p>.05). S. A ststistically significant correlation between family caregiver burden and family's demographic variables, age (F=7.34, p<.01), sex(t=-2.63, p<.01), education level(F=7.61, p<.01), income (F=8.13, p<.01), relation with patient (F=6.92, p<.01), job(F=2.03, p<.05), medical service (F=3.89, p<.05), presence of chronically ill without patient(t=-2.01, p<.05) 6. Family function was the highest factor predicting family caregiver burden(R=.4168, $R^2=.1737$), low education level of family, patient's self-care, family income accounted for 36% in family caregiver burden.

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The Comparison Study of Quality of Life between Hemodialysis Patients and Depressive or Anxious Psychiatric Patients (혈액투석 환자와 우울 또는 불안장애 환자의 삶의 질 비교연구)

  • Kim, Ji-Woong;Shin, Sang-Eun;Kim, Hyung-Ki;Jang, Eun-Young;Jung, Gun;Lee, Kye-Seong
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.2
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    • pp.170-181
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    • 2003
  • Objectives: The purpose of this study was to evaluate the quality of life in hemodialysis patients and compare it with those of depression or anxiety patients. Methods: Quality of life in hemodialysis patients(n=33) and depression or anxiety patients(n=34) was evaluated. we performed Korean Version of WHO Quality of Life Scale Abbreviated Version(WHOQOL-BREF), Beck Depression Inventory(BDI), State-Trait Anxiety inventory(STAI) to both hemodialysis patients and depression or anxiety patients. Results: The WHOQOL mean scores showed no differences between hemodialysis patients and depression or anxiety patients. Among WHOQOL domains, psychological domain score of WHOQOL was significantly higher in hemodialysis patients than in depression or anxiety patients. Anxiety score of hemodialysis patients was significantly lower than that of depression or anxiety patients, while depression score showed no difference. Conclusion: These results show that psychological domain score of WHOQOL was higher and anxiety score was lower in hemodialysis patients than in depression or anxiety patients. However, there were no significant differences in total QOL and depression between hemodialysis patients and depression or anxiety patients, and the prevalences of depression and anxiety were higher in hemodialysis patients than those of general population. This suggest that hemodialysis patients need more specialized help for psychiatric problems.

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Amisulpride-Induced Hyperprolactinemia: Preliminary Study (아미설프라이드로 유발된 고프로락틴혈증: 예비 연구)

  • Lee, Jung-Woo;Park, Young-Min;Lee, Seung-Hwan;Kang, Seung-Gul;Lee, Bun-Hee;Park, Eun-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.19 no.1
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    • pp.41-47
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    • 2011
  • Objective: Hyperprolactinemia is common side effect associated with antipsychotics use. Nevertheless, hyperprolactinemia is relatively neglected by clinician. Especially, there is no study related to amisulprideinduced hyperprolactinemia in korea. This study aimed to determine whether amisulpride can be induced hyperprolactinemia in Korean psychiatric patients. Methods: This study methodology consisted of a retrospective review of medical charts and prolactin levels. Serum prolactin levels were measured in 24 Korean patients(12 males and 12 females) with psychosis who were treated over 400mg of amisulpride per day. Results: All patients had hyperprolactinemia. Prolactin levels significantly increased after receiving amisulpride(z=-3.702, p=0.000). The prolactin level was significantly higher in females($156.29{\pm}63.75$ng/mL) than in males($69.04{\pm}39.91$ng/mL) after administering amisulpride(p=0.000). There was a correlation between dosage and prolactin levels(r=0.61, p=0.002). However, there was no correlation between duration of treatment and prolactin levels. Conclusions: Antipsychotics, especially amisulpride can increase serum prolactin levels and may results in short and long term side effects. Routine clinical assessment of initial and additional prolactin level and associated symptoms should be done

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Sleep Paralysis in Schizophrenia and Mood Disorder (정신분열병과 기분장애에서의 수면마비)

  • Park, Jae-Hong;Yang, Chang-Kook
    • Sleep Medicine and Psychophysiology
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    • v.9 no.2
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    • pp.115-121
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    • 2002
  • Objectives: Although sleep paralysis (SP) has been known as one of the symptoms of narcolepsy, recently it has become recognized as occurring frequently in the general population. However, the prevalence of SP and its associated factors in patients with major psychiatric disorders remain unknown. This study investigated the prevalence of SP and a variety of associated experiences in those patients. Methods: The subjects were 160 psychiatric patients and 143 age- and sex-matched controls. The Korean version SP questionnaire as well as the Sleep-Wake Schedule, Epworth Sleepiness Scale and Insomnia Severity Index were administered to all the subjects. The patients were referred from Dong-A University Hospital and consisted of 74 diagnosed as schizophrenia (47.7%), 26 as bipolar disorder (16.8%) and 55 as major depression (35.5%). Results: Nearly 42% of the patient group and 39% of the control group had experienced at least one episode of SP in their lifetime, with no significant difference between the groups. However, the patient group had experienced SP more frequently than the control group. Among all subjects, no gender difference in SP incidence was found. The peak age of onset was in the range of 16-25 years for both groups. Over eight tenths of both groups reported hallucinations and over seven tenths of both groups experienced fear accompanying SP. Conclusion: This study shows that there is no difference in the lifetime prevalence of SP between psychiatric patients and the general population, whereas frequency of SP experience is higher in psychiatric patients. Terrifying hallucinations and fearful feelings frequently accompany SP in both groups.

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A Preliminary Study on Method for Evaluation and Diagnosis of Late Luteal Phase Dysphoric Disorder in Women - Focusing on Psychiatric Outpatients - (후기 황체기 불쾌기분 장애의 평가 방법 및 진단에 관한 예비 연구 - 정신과 외래환자를 대상으로 -)

  • Yi, Sang-Kyu;Joe, Sook-Haeng;Kwak, Dong-Il
    • Korean Journal of Psychosomatic Medicine
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    • v.3 no.2
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    • pp.115-125
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    • 1995
  • Reports about the prevalence of premenstrual symptoms state that occurs in 20 to 100% of most reproductive-age women. There is a close association between premenstrual syndrome and affective disorders as well as same some other psychiatric disorders. Late luteal phase dysphoric disorder (LLPDD) is a premenstrual condition defined in DSM-III-R by severe mood changes and other symptoms that repeatedly occur only in the luteal phase of the menstrual cycle. However, DSM-III-R does not specify how to compute the change from the follicular to the luteal phase or how to determine when the amount of change is great enough to warrant the diagnosis nor how to determine occupational or social functional impairment. This study was conducted to evaluate the nature, severity and magnitude of premenstrual syndrome in women with current psychiatric disorders by using prospective Daily Rating Form(DRF), and to measure symptom changes according to three scoring methods for diagnosing LLPDD. Our study obtains the data about premenstrual changes estimated by DRF from 22 women with psychiatric disorders who had met criteria for major depressive syndrome on the Premenstrual Assessment Form (PAF). The data was scored by each three methods and was determined to meet criteria A for LLPDD. The results are as follows: 1) the subjects, when scored according to the percent change method, effect size method and absolute severity method, met the DSM-III-R criteria A for LLPDD in 36.4% (8 subjects), 14% (3 subjects) and 4.5% (1 subject) of the cases respectively. 2) The items of irritability, anger and impatience were occurred most frequently on the DRF, when it was scored according to the three scoring methods. And the item of breast pain was next frequent according to the effect size method and the percent change method but according to the absolute severity method. 3) The PAF item of impaired social functioning was reported by 16 (73%) of the subjects. 4) 4 (18%) of the subjects met criteria A for LLPDD and reported impaired social functioning. The prevalency of LLPDD according to each method varied. The percent change method yielded the greatest (36.4%), and the absolute seventy method yielded the laest (4.5%), The effect size method yielded an intermediate frequency (14%). Therefore, for maximizing the diagnostic accuracy of LLPDD, a diagnostic procedure including a measure of change (e.q., effect size method, percent change method) as well as confirmed diagnosis by DRF, will be needed. Also, an accurate tool to evaluate impaired social functioning will be required.

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Development of the Perceived Stress Response Inventory (스트레스반응 지각척도의 개발)

  • Koh, Kyung-Bong;Park, Joong-Kyu;Kim, Chan-Hyung
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.26-41
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    • 1999
  • The perceived stress response inventory(PSRI) was developed to measure 4 types of current stress responses : emotional, somatic, cognitive, and behavioral responses. 242 patients with psychiatric disorders(71 patients with anxiety disorders, 73 patients with depressive disorders, 47 patients with somatoform disorders, 51 patients with psychosomatic disorders) and 215 healthy subjects completed the questionnaire including the PSRI. Global assessment of recent stress(GARS) scale, perceived stress questionnaire(PSQ) and symptom checklist-90-revised(SCL-90-R) were also administered at the same time. Factor analysis for each of 4 types of stress responses yielded 8 factors : negative emotional responses, general somatic symptoms, specific somatic symptoms, lowered cognitive function and general negative thinking, self-depreciative thinking, impulsive-aggressive thinking, passive-responsive and careless behavior, and impulsive-aggressive behavior. Both test-restest reliability(r= .83 -.93) and internal consistency(Cronbach's alpha : .79 -.96 for each of 8 subscales and .98 for total items of the scale) were all at statistically significant levels. Total scores of the PSRI significantly correlated with total scores of GARS scale, PSQ, and global indicies of SCL-90-R, respectively. The patient group had significantly higher scores than healthy subjects in each of all the subscales except impulsive-aggressive behavior subscale. These results suggest that the PSRI is a reliable and valid tool stable over time which may be effectively used for the research in stress-related field including psychosomatic medicine.

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Development of the Korean Form of Zung's Self-Rating Anxiety Scale (한국형 자가평가 불안척도의 개발)

  • Lee, Jung-Hoon
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.279-294
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    • 1996
  • This study was carried out to develop a Korean language version of Zung's self-rating anxiety scale(SAS) from august, 1994 to September, 1996. The subjects consisted of 205 normal control subjects from the general population group, and 97 subjects with anxiety disorders. These 97 subjects were chosen from a group by the structured clinical interview for DSM-IV of in patients and out patients. Both normal control subjects and anxiety disorder subjects were drawn utilizing a cluster of sampling methods. In order to analyze the data on anxiety scores, Pearson's product moment correlation coefficient method was carried out, as well as reliability, factor analysis and discriminant function analysis, utilizing the SPSS/PC+ program. The results obtained were as follows: The mean average of the total anxiety scores were 32.36 + 6.35 for the normal control subjects and 50.53 + 7.67 for anxiety disorder subjects. Test-retest reliability(coefficient r=0.98, p < 0.001), and internal consistency(coefficient r=0.96, p < 0.001) were satisfactory. Factor analysis using oblique technique rotation yielded four factors. The normal control subjects scored higher concerning the symptoms such as sweating, restlessness, apprehension, insomnia and dyspnea, and lower for faintness, mental disintegration, paresthesia, dizziness and tremor. On the other hand, for the anxiety disorders, apprehension, restlessness, sweating, dyspnea and insomnia scored higher, and lower for faintness, paresthesia, nightmare, dizziness and tremor.

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The Content Analysis of the Earliest Memories and Dreams of Psychiatric Disorders (정신질환자(精神疾患者)의 최초기억(最初記憶)과 꿈의 내용분석(內容分析))

  • Park, Byung-Tak
    • Journal of Yeungnam Medical Science
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    • v.1 no.1
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    • pp.67-87
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    • 1984
  • The earliest memories and dreams have been investigated in many aspects; biological, psychological, statistical, and psychotherapeutic, in psychiatric field. The approach methods to these psychic contents are innumerable according to the schools, the collector's attitudes to these materials, the collecting methods and the variable factors of the reporter. In this study the author attempted to compare the distribution of the aggression and dependency themes in these psychic contents among groups of different sexes and clinical diagnoses. In this purpose the author devised new scales, the Aggression and the Dependency Scales for the earliest memories and dreams which are composed of 12-theme classes, according to 3 aspects of the ego attitudes and 4 degrees of the intensity of drives. The scales were tested on a series of the earliest memories and dreams from 100 male medical students by two raters. The interrater reliabilities, measured by kappa method, were all significant at better than the .001 level. The author collected the reports of the earliest memories and dreams from 293 schizophrenics (161 males and 132 females) and 301 neurotics (164 males and 137 females) who were either outpatients or inpatients of 5 general hospitals and 2 private neurospychiatric clinics and from 310 controls (169 males and 141 females) who were either students, housewives or employees in Taegu area during the periods from March to August, 1980 and from April to August, 1983. The author compared the contents of the earliest memories and dreams from these 3 clinical groups on the newly devised scales and the results could be summarized as follows: In general, the contents of the earliest memories showed more differences among diagnostically different groups, while the contents of dreams showed more differences among sexually different groups. The dependency themes were more frequent than the aggression thems in all groups. The aggression themes were more frequent in dreams than in the earliest memories. Of the earliest memory themes, the distribution of the aggression themes was different among clinical groups, i.e., most frequent in schizophrenics, next in neurotics, and least in controls. The distribution of the dependency themes was in reverse order. Attitudes of being attacked were more frequent in schizophrenics. Observing attitudes of dependency need were more frequent in neurotics while gratifying attitudes were more frequent in controls. Highest degrees of aggression and delpendency were more frequent in neurotics. In the distribution of the dream themes, there were some differences among male and female schizophrenics. Aggression themes, especially active and the highest degree of aggression, were more frequent in male sclizophrenics, while dependency themes, especially frustrated themes, were more frequent in female schizophrenics. Among 3 clinical groups, observing attitudes of dependency need were more frequent in female groups, while gratifying attitudes were more frequent in male groups.

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A STUDY ON COMORBID DISORDERS AND ASSOCIATED SYMPTOMS OF PERVASIVE DEVELOPMENTAL DISORDER CHILDREN (전반적 발달장애 아동들의 공존질환 및 동반증상에 대한 연구)

  • Kwak, Young-Sook;Kang, Kyung-Mee;Cho, Seong-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.64-75
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    • 1999
  • Objective:The purpose of this study was to investigate the prevalence and characteristics of comorbid disorders and associated symptoms in pervasive developmental disorder(PDD) and to examine the correlation between associated symptoms and developmental characteristics in PDD children. Method:The sample consisted of 209 cases of PDD and 143 cases of developmental language disorder(DLD)(control group) who were treated at the Seoul National Mental Hospital from Jan. 1996 to Mar. 1999. The diagnostic work based on DSM-IV criteria was performed by one or two child psychiatrists, while the clinical feature was evaluated by doctors’s notes, occupational/speech therapy reports, and results of social maturity scale(SMS), childhood autism rating scale(CARS), and psycho-educational profile(PEP). Two groups were compared on a wide range of measures including comorbid disorders, associated symptoms, treatment drugs, and PEP. The relation between associated symptom & PEP was investigated in total(106 cases) and in each dignostic group. Sixty-four cases of PDD were divided into three groups by CARS and then compared on associated symptoms. Result:The prevalence of comorbid disorder was 19.6% in PDD, 41.2% in DLD. The rate of manifestation of 13 associated symptoms was 31.47% in PDD, 22.13% in DLD on the average. Associated symptoms significantly high in PDD were preoccupation, obsession, self-mutilation, stereotypy, sleep problems, and odd response. In total patient group, associated symptoms that significantly influenced PEP were preoccupation, self-stimulation, stereotypy, inappropriate affect, sleep problems, and odd response. But, in each diagnostic group, no associated symptom influenced PEP. Associated symptoms significantly different between the 3 groups of CARS were stereotypy, anxiety, and sleep problems. Conclusion:These preliminary results suggest that developmental characteristics may influence associated symptoms in PDD children and a realistic approach considering minute diagnosis by associated symptoms and comorbid disorders is required.

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Polymorphisms in Glutamate Receptor, Ionotropic, N-methyl-D-aspartate 2B(GRIN2B) Genes of Autism Spectrum Disorders in Korean Population : Family-based Association Study (한국인 자폐스펙트럼장애에서 Glutamate Receptor, Ionotropic, N-methyl-D-Aspartate 2B(GRIN2B) 유전자 다형성-가족기반연구)

  • Yoo, Hee Jeong;Cho, In Hee;Park, Mira;Yoo, Hanik K.;Kim, Jin Hee;Kim, Soon Ae
    • Korean Journal of Biological Psychiatry
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    • v.13 no.4
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    • pp.289-298
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    • 2006
  • Objectives : Autism is a complex neurodevelopmental spectrum disorder with a strong genetic component. Previous neurochemical and genetic studies suggested the possible involvement of glutamate N-methyl-D-aspartate(NMDA) receptor in autism. The aim of study was to investigate the association between the NMDA2B receptor gene(GRIN2B) and autism spectrum disorders(ASD) in the Korean population. Methods : The patients with ASD were diagnosed with Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule based on DSM-IV diagnostic classification. The present study was conducted with the detection of four single nucleotide polymorphisms(SNPs) in GRIK2 and family-based association analysis of the single nucleotide polymorphisms in Korean ASD trios using transmission disequilibrium test (TDT). Results : One hundred twenty six patients with ASD and their biological parents were analyzed. 86.5% were male and 85.1% were diagnosed as autistic disorder. The mean age was $71.9{\pm}31.6$ months(range : 26-185 months). We found that rs1805247 showed significantly preferential transmission(TDT ${\chi}^2$=12.8, p<0.001) in ASD. Conclusion : One SNP in GRIN2B gene was significantly associated with ASD in the Korean population. This result suggests the possible involvement of glutamate NMDA receptor gene in the development of ASD.

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