• Title/Summary/Keyword: 정신과 진단

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The Concept of Mental Disease in Plato (정신 질병의 탄생: 고대 그리스 의학적 시선의 철학적 기원 플라톤의 정신 질병 개념을 중심으로)

  • Jang, Misung
    • Journal of Korean Philosophical Society
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    • no.121
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    • pp.1-24
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    • 2018
  • The aim of this paper is to expound upon the concept of mental health and disease in Plato. In ancient Greece, philosophy was to care for the health of the soul and to pursue the happiness of the life, while medicine was to care for the health of the body. It is the role of philosophy that defines what the mental disease is, rather than the realm of medicine, and the practical function of philosophy is the life of caring for our souls. In order to take care of the soul, it is important to diagnose what the mental disease is and where it comes from. In ancient Greek, medicine disease was initially regarded as a divine punishment and healing as, quite literally, a gift from the gods. Plato, however, insists that mental illness is not just brain problem but a human whole problem, (2) it is caused by imbalance and discord, and (3) ignorance is also a mental disease, (4) and furthermore, injustice and vice are mental diseases as well. Therefore Plato argues that the aim of philosophy is to practice a virtue as the mental health and further to achieve political justice to maintain the health of the soul.

급성 정신분열병 환자에 대한 Risperidone(R 64766)의 임상 효과 및 안정성 연구

  • 우종인;권준수;김성윤
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1993.04a
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    • pp.165-165
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    • 1993
  • 목적:지금까지 Risperidone의 치료 효능과 안전성에 대한 연구들이 모두 만성 정신분열병 환자들만을 대상으로 이루어졌고, 효율적인 약물 요법의 중요한 지침이 되는 유효치료용량(effective therapeutic dosage)에 대한 연구가 이루어지지 않고 있는 바, 본 연구에서는 초발인 급성 정신분열병 환자들을 대상으로 첫째, Risperidone의 항정신병 효과(antipsychotic effect)와 추체외로계증상(extrapyramidal symptoms)을 평가하고 둘째, Risperidone의 항정신병 효과와 혈장 Risperidone 및 9-hydroxyrisperidone 농도와의 상관관계를 분석하여 유효혈장농도(therapeutic dose range)와 유효치료용량(effective therapeutic dosage)의 존재 여부를 검토코자 한다. 방법: DSM-III-R 진단기준(APA 1987)예 의해 정신분열병형 장애로 진단된 환자 11명(남자 5, 여자 6)을 대상으로 Risperidone을 이중맹검법(double blind design)으로 6주간 투약하였다. 정신병리의 평가는 PANSS(Kay 1988)를 이용하였고 추체외로계 부작용의 평가는 ESRS(Chouinard 1980)를 이용하였다. 혈장 Risperidone 농도와 혈장 9-hydroxyrisperidone 농도는 Jansen사의 Radioimmunoassay Kit를 이용하여 3회 측정하였다. 결과: PANSS 점수는 Risperidone 투여 후 1주째부터 통계적으로 유의하게 감소하였다. Parkinsonism과 dyskinesa에 대한 physician's examination 점수는 전체 연구 기간 동안 유의한 변화를 보이지 않았다. Dystonia에 대한 physician's examination 점수는 Risperidone 투여 후 1주째에는 평균 5.96점으로 높았으나 2주째부터 통계적으로 유의하게 감소되어 6주째에는 유지되었다. 혈장 Risperidone 농도와 혈장 9-hydroxyrisperidone 농도는 PANSS 점수와 유의한 상관관계를 보이지 않았다.

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Premenstrual Dysphoric Disorder : A Clinical Review (월경전 불쾌기분 장애에 대한 임상적 고찰)

  • Hwang, Gul
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.1
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    • pp.14-21
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    • 2007
  • Premenstural dysphoric disorder(PMDD) imposing 4-5% of women is possibly caused by an enhanced responsiveness to the changes of sex steroid hormones and the decrease of serotonin, melatonin and GABA. The common clinical features between PMDD and depression, seasonal affective disorder, panic disorder and anorexia nervosa suggest a relatedness between PMDD and each of them. The diagnostic criteria of DSM-IV-Tr for PMDD requires psychological symptoms, that commonly include irritability, anger, depression, mood swing, affect lability, tension, anxiety, fatigue and food craving. As of today, the best pharmacological treatment for PMDD is the selective serotonin reuptake inhibiter, and leuprolide, danazol, estradiol, spironolactone and bromocriptine are possible alternatives. Nonpharmacological treatments for patients with mild to moderate symptom severity are diet, exercise, light therapy, psychotherapy and keeping a diary.

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BORDERLINE DISORDER OF CHILDHOOD : 8 CASES (아동기 경계선 장애 : 8증례)

  • Hong, Kang-E;Lee, Jeong-Seop;Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.6 no.1
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    • pp.3-17
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    • 1995
  • The so-called borderline children are characterised by disturbances in the sense of reality and interpersonal relationships, lack of control, fluctuation of functioning, uneven development and excessive anxiety. But the concept of borderline disorder of childhood is very difficult to define and diagnose in current classification system. The present study adapted the consensus symptoms in borderline children by Bemporad and Vera eight cases aged 7-11 were examined in 37 variables. Results are as follows 1) All subjects are boys and girl hardly be diagnosis n current diagnostic system and have many concurrent diagnoses. Common chief complaints in the sense of reality. 2) In KEDI-WISC test, the borderline children showed average intelligence, but performance IQ tends to be higher than verbal IQ. In Rorscharch test, they showed high thought disorder index, emotional instabilities and aggressive impulses. The results of TOVA suggested attentional deficit in half of the subjects. The organicity is not prominent. 3) Many of the borderline children were unwanted baby. Although primary care takers of all the subjects were their mothers there were moderate problems in caring attitude of their children and marital relationship with their husband. Sccioeconomic status was generally below middle class. Most of all subjects have delayed language development, but have overcome subsequently. Many subjects were rejected by peers because of their aggression. 4) The first visit of the subjects was about 6 years of age. Average duration of treatment was 2 years. All of them were treated in the outpatient basis except one. The effect of pharmacotherapy was doubtful and the necessity of long term play therapy was suggested. Although there were many limitations of method in present study, it was suggested that further research is needed for diagnostic criteria, epidemiology and treatment.

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MMPI PROFILE TYPES OF MOTHERS WITH PSYCHIATRIC DISORDERED CHILDREN (정신 장애 아동들의 어머니의 MMPI 유형 분석)

  • Shin, Min-Sup;Oh, Kyung-Ja;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.3 no.1
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    • pp.97-105
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    • 1992
  • Present study investigated the relationship between children's psychiatric disorders and their mothers' psychological problems. Ninety-one psychiatric outpatients from a children's hospital were classified into three diagnostic groups - internalizing symptom group(n=35), externalizing symptom group(n=35), and developmental disorder group(n=21) - based on their psychiatric problems. A normal control group was formed by matching on the age and education of mothers. Mothers' MMPI profiles which were classified into five types - normal, depression, anxiety disorder, somatization disorder, and personality disorder - were examined in relation with children's diagnoses. The profiles of the mothers in the normal control group were mostly normal, while depressive profiles were dominant among those of the clinical groups regardless of the children's diagnoses. Therefore, the data implied association between children's psychiatric problems and their mothers' psychological problems. A possibility of negative reciprocal interactions between children and their mothers was discussed. It was also suggested that further research need to examine the specific effects of children's psychiatric problems on the psychological adjustment of their mothers, as well as the effects of parental psychiatric problems on the adjustment of their offsprings.

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IMPACT OF PARENTAL PSYCHIATRIC DISORDER ON OFFSPRING'S DEPRESSION, ANXIETY, SELF CONCEPT AND PERCEPTION OF FAMILIAL RELATIONSHIP (정신과 환자 자녀의 우울, 불안, 자기 개념 그리고 가정환경의 특성에 대한 연구)

  • Lee, Jung-Bum;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.1
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    • pp.54-66
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    • 1998
  • Objectives:This study was to investigate the impact of parental psychiatric disorder on offspring's depression, anxiety, self concept, perception of familial relationship compared with offspring of normal control. In offsprings of parents with psychiatric disorder, this study explored whether their psychopathology, self concept, and perception of familial relationship were influenced by parent’s sex, onset time of parent’s psychiatric disorder and parent’s psychiatric diagnosis. Methods:52 offsprings aged 10-18 years of 39 psychiatric outpatient were surveyed from June, 1997 to April, 1998 and completed several questionnaaire, including Korean from of the Family Environment Scale, Korean form of the State-Trait Anxiety Inventory for Children, Korean form of Kovac’s Children’s Depression Inventory, and Korean form of Piers-Harris Children’s Self-Concept Scale. Their score was compared with offsprings’ of normals. In offsprings of parents with psychiatric disorder, they were compared according to parent’s sex, onset time of parent's psychiatric disorder and parent’s psychiatric diagnosis. Results:The results were as follows:1) Offsprings of parents with psychiatric disorder reported higher level of state anxiety and lower level of the FES expressive subscale than offsprings of normals(p<0.05). But they reported higher level of PHCSCS intellectual & school status subscale and popularity subscale than normals(p<0.05). 2) There were no differences in anxiety, depression, self concept, and perception of familial relationship between patient’s sex. 3) Offsprings less than 3 years old when parent’s psychiatric disorder had developed showed higher level of trait anxiety and lower level of FES control subscale than offsprings more than 3 years old (p<0.05). 4) There were no diferences in anxiety, depression, self concept, and perception of familial relationship between patient’ diagnostic groups(schizophrenia spectrum disorder-mood disoderneurosis). Conclusion:The finding indicated that self reported scale of anxiety and depression showed no significant difference between offsprings of psychiatric patients and offsprings of normals. In offsprings of parents with psychiatric disorder, parent’s sex and psychiatiric diagnosis had no influence on offspring’s psychopathology. But the offspring’s age(before 3 years old) when the parent’s psychiatriric disorder developed had influence on higher level of offspring’s trait anxiety. For further high risk group study, direct interview and evaluation of parent-child agreement or teacher-child agreement will be needed in longitudinal study.

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PRELIMINARY STUDY OF MENTAL REPRESENTATIONS OF PRESCHOOL CHILDREN EXPERIENCING SINGLE, SEVERE TRAUMA (심한 정신적 외상 경험을 한 학령 전기 아동의 정신적 표상에 대한 예비연구)

  • Eon, So-Yong;Song, Won-Woung;Oh, Kyung-Ja;Choi, Eui-Gyum;Shim, Eun-Ji;Shin, Yee-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.1
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    • pp.61-74
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    • 2004
  • Objectives:This study was performed to introduce a psychoeducational family therapy model for the families of schizophrenic patient and to investigate the effect of this model on the changes in coping style and depressive symptoms of the family members, and in perception of emotional support by families and depressive symptoms of patients. Methods:Nine preschool children, 3-5 years old, experiencing physical injuries caused by attack from a psychotic patient at kindergarten, were evaluated for psychological assessments;Intelligence test, MSSB(MacArthur Story-Stem Battery), H-T-P test(House-Tree-Person test). And their parents completed rating scale, KPI-C(Korean Personality Inventory for Children about children’s psychological conditions). Results:With respects to the contents and emotional reactions of MSSB, 9 preschool children showed generally high levels of anxiety, depression, avoidance, aggression, probably related to the traumatic experiences. Even though children couldn't verbally report directly about their traumatic experiences, in both MSSB, structured play narrative assessment tool, and HPT, free drawing and association test, they demonstrated psychiatric problems through reenactment plays, regardless of clinical diagnoses. Conclusion:Present study allowed us the chance to see beyond the outer pathological behaviors of PTSD in preschool children, through deeper evaluations of their mental representation. These preliminary data suggest deep understanding of internal representation would be of help for thorough evaluations and treatment plan for preschool children, experiencing severe trauma.

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Complementarity between SDQ-SR and MMPI-A in Assessing Adolescents with Internalizing Disorder : A Preliminary Study (내재화장애 청소년의 평가에서 자기보고용 강점난점척도와 MMPI-A의 상호보완성 : 예비연구)

  • Shin, Kyo Jung;Ahn, Joung Sook;Lim, Jee Young;Lee, Jin Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.1
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    • pp.9-18
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    • 2018
  • Objectives : The aims of this study were to investigate the psychopathology in adolescents with internalizing disorder using the self-report version of Strengths and Difficulties Questionnaire (SDQ-SR) and the Minnesota Multiphasic Personality Inventory for adolescents (MMPI-A), and to explore the complementarity between these two inventories for diagnostic assessment. Methods : Ninety-one patients aged 13-17 were divided into two groups by clinical diagnosis, 44 with internalizing disorder and 47 comparison group with other disorders. The data of SDQ-SR and MMPI-A completed by them were analyzed for the ability to predict internalizing disorder. Results : The logistic regression analysis revealed that diagnostic predictability increased by 2.27 times with every 1 point of SDQ-SR emotional symptom score increment. Comparison of ROC curves for internalizing disorders showed that the SE and SP of SDQ-SR emotional symptom with score over 4 was 88.94 and 78.72, respectively. For A-anx of MMPI-A with score over 56, SE and SP was 77.27 and 74.47, respectively. However, combination of these scales could not enhance the predictability of diagnostic classification more than that of SDQ-SR emotional symptom alone. Conclusions : Emotional symptom scale of SDQ-SR and A-anx, A-aln, A and INTR of MMPI-A should be important subscales for diagnosing the internalizing disorder of adolescents, however, which needs to be examined further with a larger sample size including normal control group.

Examining Psychometric Properties of the Brief Symptom Inventory(BSI-18) in Korean People with Mental Disorders (정신장애인에 대한 Brief Symptom Inventory-18의 신뢰도와 타당도에 관한 연구)

  • Hoe, Maanse;Lee, Soonhee
    • Korean Journal of Social Welfare
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    • v.66 no.3
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    • pp.253-276
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    • 2014
  • The purpose of the present study was to examine psychometric properties of the BSI-18 in Korean adults with mental disorders. This study examined internal consistency, test-retest reliability, convergent validity, and a factor structure of the BSI. The sample consisted of 180 adults with mental disorders, who enrolled in mental hospitals and in a day hospital. Data was analysed using reliability analysis, correlation analysis, and confirmatory factor analysis. Major findings were as follows. The Korean version of the BSI showed good internal consistency and test-retest reliability, as well as excellent convergent validity. The original three-factor structure of the BSI-18, proposed by Derogatis, 2001, fitted to the data. These findings indicate that the BSI-18 is a reliable and valid measure as a psychiatric assessment tool and a treatment outcome measure.

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