• Title/Summary/Keyword: 정신과 치료

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Psychosomatic Integrative Care for Psychosocial Distress of Patients With Breast Cancer (유방암 환자의 정신사회적 디스트레스에 대한 정신신체의학적 통합치료)

  • Yang, Chan-Mo;Jang, Seung-Ho;Lee, Hye-Jin;Lee, Sang-Yeol
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.77-85
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    • 2021
  • Breast cancer is the most prevalent oncological disease among women. Various psychosocial distress is common at the diagnosis, treatment, and posttreatment phase of breast cancer. For the treatment of breast cancer, not only medical treatment but also psychosomatic integrative care will be needed. Patients with breast cancer may lead to increased vulnerability to stress, adjustment disorder, anxiety disorder, and depressive disorder, and these psychiatric diseases and conditions are associated with recurrence or exacerbation of breast cancer. Psychosocial treatment of anxiety and depression could increase the quality of life of patients and decrease the recurrence and progression of breast cancer. In this article, we reviewed 5 clinical breast cancer survivorship guidelines focused on psychosomatic integrative care including psychosocial treatment and alternative treatment for psychosocial distress. Because 5 treatment guidelines were using various definitions of evidence, we confirmed evidence of various psychosocial treatments for patients with breast cancer based on the definition of evidence by the US Preventive Service Task Force (USPSTF) guideline. We also reviewed the effect size of psychosocial treatment for anxiety, depression, mood, and quality of life in patients with breast cancer. This article discusses the barrier to the delivery of psychosomatic integrative care and suggests integrative care planning for breast cancer. Multi-disciplinary teams, patient's needs assessment, information technology support, patient and caregiver engagement, planned periodic monitoring of psychosocial distress by a psychosomatic specialist or consultation-liaison psychiatrist are recommended as key features of a psychosomatic integrated care plan.

마음챙김이 정신건강에 미치는 효과

  • Choe, Yeon-Hui;Byeon, Sang-Hae
    • 한국벤처창업학회:학술대회논문집
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    • 2016.04a
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    • pp.239-241
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    • 2016
  • 본 연구는 마음챙김(Mindfulness)의 심리치료적 과정을 기술해 보고 현대인의 정신적 질병인 우울증에 대한 마음챙김의 치료효과를 검증하는데 있다. 마음챙김은 최근 미국을 중심으로 심리학과 정신의학 분야에서 크게 주목을 받고 있는 심리치료 프로그램이다. 마음챙김은 일상생활에서 well-being을 추구하는 정신건강에 효과가 있으며, 정신적 스트레스 감소와 임상치료에서 우울, 불안, 강박, 중독, PTSD, ADHD 등 각종 정신병리의 증상완화에도 치료에 효과가 있다고 밝혀졌다. 본 연구는 신경정신과에서 의뢰받은 3명의 내담자들을 대상으로 마음챙김 심리치료를 실시하고 그 결과를 분석하여 우울증에 대한 치료효과를 알아보았다. 내담자의 특성은 장기간 우울증을 겪고 있으며 약물을 복용하고 있는 50대 여성을 대상으로 하였고, 그 결과 마음챙김은 우울증으로 인한 우울감과 불안감, 반추적 성향, 정서조절 곤란 정도에서 감소되는 효과가 있었으며, 정신건강의 긍정적인 지표인 마음챙김 기술 척도는 증가하는 것으로 나타났다. 이러한 연구 결과는 마음챙김이 인지행동치료 뿐만 아니라 약물치료를 대체하는 정신적 치료법으로도 효과가 있다는 시사점이 있다.

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A STUDY ON THE PSYCHOTHERAPEUTIC PROCESS OBSERVED IN AN OBSESSIVE COMPULSIVE ADOLESCENT (강박장애 청소년에서 관찰된 정신치료 과정에 관한 연구)

  • Kim, Hak-Riong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.4 no.1
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    • pp.164-172
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    • 1993
  • By observing the psychotherapy process expressed by an adolescent with obssessive compulsive disorder, the author suggests that the main problem of OCD is not merely a product of an unconscious process as traditionally thought, but a learned problem solving process as a method surviving the more realistic conflicts, and therefore the treatment should be directed to more or less conscious and realistic issues and conflicts, family therapy should be offered too.

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A Relation between Clinical Characteristics of Cancer Patients on Radiotherapy and Psychiatric Disorders (방사선 치료중인 암환자의 임상적 특징과 정신과 장애의 관련성)

  • Kim, Ho-Chan;Moon, Chang-Woo;Park, Si-Sung
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.134-141
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    • 1999
  • Objects : Cancer patients receiving radiotherapy have many psychological problems. Those problems depend on clinical factors of cancer and the characteristics of patients. This study was designed to estimate the morbidity of psychiatric disorder and to investigate the relationship between psychiatric disorders and clinical variables. Methods : The subjects were 47 patients who had been treated by radiotherapy. Psychiatric disorder was diagnosed according to DSM-IV. The authors assessed the relation between psychiatric disorder and demographic features, clinical features of cancer such as site, duration, frequency of recurrence of cancer, and patients' awareness of disease and expectation of outcome of radiotherapy. Results : 21 patients(44.7%) had a psychiatric disorder. The most common psychiatric disorder were adjustment disorder(66.7%), and the next major depressive disorder(23.8%). There was a significant positive relationship between psychiatric disorder and recurrence of cancer, patients' expectation of poor outcome after radiotherapy. Psychiatric morbidity was significantly low in those who had no evidence of recurrence and who considered radiation treatment as curative. However, site and duration of cancer, patients' awareness about serious illness were not related with psychiatric disorder. Conclusion : Psychiatric disorders are common among cancer patients on radiotherapy. Further clinical attention and effective treatment of psychiatric complication in cancer patients are needed not only for reducing symptoms but for better adjustment.

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Hypnotherapy in Cases with Psychosomatic Disorders (정신신체장애의 최면치료)

  • Choe, Byeong-Moo
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.2
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    • pp.176-180
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    • 2002
  • Hypnosis as a traditional healing method, in its recent development, has generated a multitude of techniques. These serve as practical tools which can be combined with other therapy techniques for the treatment of a variety of psychiatric and medical conditions. The empirical evidence for the effectiveness of hypnosis is considerable and proves its clinical impact in various areas of application. This case review describes the integration of hypnotherapeutic methods into the continuum of psychiatric encounters in a general practice. Guidelines for the application of hypnosis in approaching and treating each patients with headache, sexual dysfunction and bronchial asthma were illustrated. As hypotheses mechanism of effectiveness in psychosomatic disorders has been formulated. Training in hypnotherapy provides the psychiatrist with skills needed to address psychophysiological disorders. Emphasis is placed on the necessity and opportunity for research on the efficacy and specific technique of hypnosis in the psychosomatic disorders.

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Cognitive Processing Therapy as a First-line Treatment for Post-Traumatic Stress Disorder (인지처리치료: 외상후 스트레스 장애의 일차 치료)

  • Jin-Hee, Choi;Hyung-Seok, So;Soonjo, Hwang;Ji-Woo, Suk;Hayun, Choi;Seung-Hoon, Lee;EunYoung, Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.2
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    • pp.80-98
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    • 2022
  • Posttraumatic stress disorder (PTSD) is well known to have a limited response to drug treatment. Many recently published clinical care guidelines recommend trauma-focused psychotherapies such as cognitive processing therapy (CPT) and prolonged exposure therapy (PE) as first-line treatment and medication such as serotonin reuptake inhibitors and venlafaxine as second-line treatment. Current review introduces the session composition and contents of CPT and presents various CPT studies that show therapeutic effect for civilian and veterans/military with PTSD. In order for clinicians to help effectively patients with PTSD, it is necessary to learn and actively use evidence-based trauma-focused psychotherapies including CPT and PE.

Psychiatric Treatment of Chronic Pain Disorder (만성 통증장애의 정신과적 치료)

  • Rho, Seung-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.256-262
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    • 1999
  • Because chronic pain disorder may has multiple causes or contributing factors, including physical, psychological, and socio-environmental variables, the treatment of patients with the disorder requires biopsychosocial approaches in a multidisciplinary setting. In treating chronic pain, it is important to address functioning as well as pain, and treatment should be to increase functional capacity and manage the pain as opposed to curing it. Therefore treatment goal should be adaptation to pain or minimizing pain with corresponding greater functioning. Treatment begins with the initial assessment, which includes evaluation of psychophysiologic mechanisms, operant mechanisms, and overt psychiatric comorbidity. Psychiatric treatment of the patients requires adherence to sound pharmacologic and behavioral principles. There are four categories of drugs useful to psychiatrist in the management of chronic pain patients : 1) narcotic analgesics, 2) nonsteroidal antiinflammatory drugs, 3) psychotropic medications, and 4) anticonvulsants, but antidepressants are the most valuable drugs in pharmnacotherpy for them. Psychological treatments tend to emphasize behavioral and cognitive-behavioral modalities, which are divided into self-management techniques and operant techniques. Psychodynamic and insight-oriented therapies are indicated to some patients with long-standing interpersonal dysfunction or a history of childhood abuse.

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Survey of Work Experiences and Practices of Occupational Therapists in the Mental Health Field: A Focus on Physical Function Enhancement Interventions (정신건강 분야에서 근무하는 작업치료사의 업무 경험 및 실태조사: 신체기능 향상 중재를 중심으로)

  • Kim, Min-Jee;Kim, Young-wook;Kim, Jun-hyeok;Kim, Ga-hee;Choi, Hong-seok;Moon, Kwangtae
    • Therapeutic Science for Rehabilitation
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    • v.12 no.4
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    • pp.53-65
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    • 2023
  • Objective : This study aimed to identify the experiences and practices of occupational therapists in mental health and provide interventions for improving body function in individuals with mental illness. Methods : Data were collected from mental health therapists between November 7 and November 14, 2022. A survey was distributed via email and 46 responses were analyzed using descriptive statistics and correlations. Results : The majority were female (58.7%), aged 20-30 years (84.8%), working in mental health centers (41.3%), and undergoing mental health occupational therapy training (91.3%). They had 1-3 years of mental health experience (65.2%) and were commonly involved in programs (71.1%), case management (62.2%), and administration (57.8%). Interventions for physical functioning were common (73.9%), including group interventions (41.2%), such as stretching, aerobic exercise, and walk training, and individual interventions (38.1%), such as walking, stretching, and aerobic exercise. Conclusion : Occupational therapists play a crucial role in enabling individuals with mental illness to engage in daily life activities. However, relevant studies in this field are lacking. This study emphasizes the importance of mental health occupational therapy and the need for evidence-based services for physical function improvement interventions to provide more effective treatments for mental illnesses.

Assessment and Treatment of Somatization (신체화의 평가 및 치료)

  • Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.2
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    • pp.149-164
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    • 2000
  • Somatization is regarded as a process rather than a diagnostic entity. It should be emphasized to identify psychopathology rather than to make a choice regarding diagnosis in assessing somatizing patients. Psychiatrists should be aware of the psychosocial cues underlying the patients' physical symptoms. Special skills and strategies are required by nonpsychiatric physicians to facilitate the patients' acceptance of psychiatric treatment. The goal of treatment for somatization is management but not cure. The approach should be flexible, depending on the patients' responses and need. The difficulty in diagnosing and treating somatization is likely to be related to abnormal illness behavior such as the patients' denial of their psychosocial problems and resistance to psychiatric approach. In conclusion, biopsychosocial approach is needed to treat these patients effectively. Psychiatrists should also teach other physicians the interview skill that they could identify these patients as early as possible and facilitate their acceptance of psychiatric treatment.

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Pain Disorder Associated with Psychological Factors - Case Report and Review - (심리적 요인과 관련된 통증장애 - 증례 및 고찰 -)

  • Lee, Kyung-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.2
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    • pp.166-175
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    • 2002
  • Recently many researches support the use of traditional psychiatric treatments in the management of chronic pain. Chronic pain is a significant public health problem and frustrating to everyone affected by it. Psychiatrists offer skills with treatments now recognized as effective in the management of chronic pain. In addition to the diagnosis and treatment of psychiatric co-morbidity, the application of psychological treatments to chronic pain, and the development of interdisciplinary efforts to provide comprehensive health care to the patient disabled with chronic pain, psychiatrists have particular skill in pharmacological treatment that have proven efficacy for a variety of chronic pain conditions. With their expertise in the use of psychoactive medication plus their interest in the personal and family dynamics of patients, psychiatrists have the capacity to be involved in the treatment of patients with chronic pain. So, the author reported three cases of patient with pain disorder associated with psychological factors, and reviewed to propose that psychiatrists in Korea should take an active role in the care of these patients.

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