• Korean Journal of Psychosomatic Medicine
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• v.20 no.2
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• pp.112-119
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• 2012

Objectives : Delirium is a disorder defined as a sudden disturbance in thinking, speaking, acting and sleep pattern due to altered level of consciousness and cognitive function. The objective of this study is to analyze characteristics and therapeutic methods of the delirious patients during the recent 5 years, and provide basic data for further studies and investigation regarding delirium in the occurrence and treatment. Methods : We retrospectively reviewed medical records of 475 patients who were consulted for delirium in Kyunghee University Medical Center from January 2007 to December 2011. Results : During the 5 years, among the 475 patients who were diagnosed as delirium, men were more common(61.7%). The most commonly consulted reason and cause were sleep disturbance(80.8%) and post-operational delirium(30.9%), respectively. The medication prescription percentage was 76.6% and was significantly increased year after year. Ratio of using antipsychotics were 76.4% among prescribed medication and the most frequently prescribed antipsychotic drug was quetiapine(46.8%). Other specialists commonly misdiagnosed delirium when the patient was previously diagnosed as dementia(6.8%). Conclusions : In our study, post-operational delirium was the most commonly referred reason and the percentage of medication prescription tended to increase. Patients with history of dementia were more easily misdiagnosed as diseases other than delirium. Our study suggests that we should evaluate symptoms, causes, reasons of consultation, management tendency of delirium. We should also closely observe changes in sleep patterns and establish the prevention strategies for post-operational delirium and therapeutic bases for pharmacotherapy.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.15 no.2
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• pp.160-167
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• 2004

Objectives : There have been very few studies on the compliance of methylphenidate-immediate releasing form(MPH-IR), which is the most frequently used drug in Korea, in Attention Deficit Hyperactivity Disorder(ADHD). This study was conducted to investigate the compliance rate and the related factors in the one year pharmacotherapy process via OPD for children with ADHD. Method : Total 100 ADHD patients were selected randomly among patients who have been treated with MPH-IR from September in 2002 to December in 2002. All the selected patients were diagnosed with DSM-IV-ADHD criteria and fulfilled the inclusion criteria. In March, 2003(at the time of 6 month treatment), all the patients and parents received the questionnaire for the compliance and satisfaction for MPH-IR treatment. In October 2003(at time of 1 year treatment), we, investigators evaluated the socio-demographic variables, developmental data, medical data, family data, comorbid disorders, treatment variables, and compliance rate. Through these very comprehensive data, The compliance rate at the time of mean 1 year treatment and the related factors were investigated. Result : 1) In the questionnaire for compliance and satisfaction for MPND treatment, the 60% of respondents(parents) reported more than moderate degree of satisfaction in the effectiveness of MPND. Their compliance rate for the morning prescription was 81%, but the rate of afternoon prescription was 43%. 2) In the evaluation at the time of 1 year treatment(October 2003), the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1 year treatment was 62%. the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1year treatment was 62%. 3) Compared with the noncompliant group(drop-out group), compliant group showed higher total, verbal and performance IQ scores. In the treatment variables, higher reposponder rate(clinician rating), higher medication dosage and more compliance rate in afternoon prescription were found in the compliant group compared with the noncompliant group. There were no statistical differences in the demographic variables(age, sex, SES, parental education level), medical data, developmental profiles and academic function. Conclusion : To our knowledge, this is the first report about the compliance rate of the MPH-IR treatment for the children with ADHD. The compliance rate at the time of mean 1year treatment was 62%, which was comparable with other studies performed in foreign countries, especially States. In this study, the compliance related factors were IQ score, clinical treatment response, dosage of MPH-IR, and early compliance for the afternoon prescription. These results suggest that clinician plan the strategies for the promotion of the early compliance for the after prescription and enhancement of overall treatment response.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.1
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• pp.103-115
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• 1999

Objectives : A large of studies have found an association between premenstrual syndrome and affective disorder, in particular, depression. Some studies have reported that women with depressive disorders may experience menstrual cycle-associated changes in the severity of their symptoms. This study was designed to compare the characteristics of premenstrual changes between control group and affective patient group, and to assess possible risk factors for premenstrual changes in patients. Methods : Eighty normal controls and eighty outpatients given maintenance therapy with fixed dose for at least more than four weeks were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and functional impairment. In addition, to compare the characteristics of premenstrual changes, 16 items based on DSM-IV criteria A for premenstrual dysphoric disorder were rated on the following scale : 0(no change), 1(mild), 2(moderate), 3(severe). Moderate or severe change in each item was considered as premenstrual change and the subjects who reported more than one premenstrual change were defined as premenstrual change group. Results : The results were as follows : 1) The percentage of premenstrual change group was 32.6% in patient group and 50% in control group. 2) Frequently reported premenstrual changes were as follows in control group : breast tenderness; anger ; affective liability ; lethargy, easy fatigability, or marked lack of energy ; abdominal pain or discomfort. In patients, the mood or behavioral changes were frequently reported. The changes were as follows : lethargy, easy fatigability, or marked lack of energy ; change in appetite; affective liability ; sense of difficulty in concentrating : hypersomnia or insomnia. 3) In the premenstrual change group, the patients with only mood or behavioral changes were significantly more than those with only physical changes or both changes. 4) The severity of functional impairment was significantly correlated with the frequency of mood or behavioral changes in patients. 5) There were no significant differences in menstrual characteristics between patients with premenstrual changes and patients without them except the severity of dysmenorrhea. And the severity of dysmenorrhea was correlated with the frequency of premenstrual change. Conclusion : The proportion of patients with affective disorder, who reported moderate-to-severe premenstrual changes, experiencing mood or behavioral changes larger than those experiencing physical changes during premenstrual period. It is possible that some patients with affective disorder, who reported premenstrual mood or behavioral changes, suffer from coexisting premenstrual syndrome with affective disorder or premenstrual exacerbation of affective disorder. Since the more premenstrual changes, the severer functional impairment, the patients reporting mood or behavioral disturbance in premenstrual period should be carefully evaluated, and appropriate therapeutic stategies might be considered.

• The Journal of Korean society of community based occupational therapy
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• v.10 no.1
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• pp.17-30
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• 2020

Objective : The purpose of this study is to provide basic data for the development of a instrumental activities of daily living training program called grocery shopping for schizophrenic patients in Delphi. Methods : The final program items and contents were completed through the first and third delphi surveys from August 2018 to March 2019. The expert composition selected 26 occupational therapists related to mental health. Three surveys were conducted and 23 experts participated in the Delphi survey. The second questionnaire, which was created from an open questionnaire, was designed to indicate the degree of importance using the Likert 5-point scale. As a result of the response of the 3rd questionnaire, the level of expert consensus was reconfirmed by analyzing average, standard deviation, and content validity ratio (CVR). Results : Three rounds of Delphi research reveal four categories of questions: grocery shopping views, product purchase strategies, necessary functions, and expert knowledge and experience on how to make purchase decisions. 24 items were selected. Through the 2nd and 3rd Delphi surveys, 4 items that did not meet the criteria of goodness of fit of each item or duplicated the contents were deleted and finally 20 items were extracted. Conclusion : Experts' agreement on grocery shopping technology was drawn from an occupational therapy perspective so that patients with schizophrenia living in the community could recover and participate as a member of society.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.4 no.1
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• pp.54-67
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• 1993

This study is to investigate the stress and stress degree in mothers of autistic children. In order to obtain data for planning nursing strategies for mothers of autistic children The assessment tool for the stress was constructed through reviewing literatures on the stress and gathering the stress items by nonstructed face to face interviewing 14 mothers of autistic children The stress tool consists of 74 items each with five point rating scale A data collection was made front 160 mothers of autistic children from 11 institutions for autistic children in Seoul and Kyung-Ki province. The reliability coefficients by Cronbach's a test was 0.94 for the stress scale. The results are as follows : 1) The mean of stress is 3.19, in the area of the etiology, prognosis and the treatment-education, with cause of the treatment the edeucatlon and the prognosis of child's handicap. The mean of stress is 2.85 In the area of the negative of mother's self image, 2.45 in the area of the mother's ordinary life. The mean of stress was 2.05, lowest in the family and social relationship 2) The mean score for the total was 2.62 points. The items with highest stress score were 'All autistic child has not been understood by the society', 'If we die, 1'm afraid that this child will not be cared by someone', 'There is no institution that the child get the schoolibg', etc The stress item with the lowest mean score were 'Keep away the child from husband', 'Being divorced by husband', etc. 3) An analysis of relationship of stress degree to general characteristic shows a statisically significants difference in the number of children in the family and the cognition of the seventy of the child problem

• Korean Journal of Psychosomatic Medicine
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• v.21 no.2
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• pp.122-131
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• 2013

Objectives: This study aimed to examine the point prevalence of anxiety, depression and the associated risk factors in hospitalized patients with cancer. Methods: A total of 114 patients with cancer who admitted to the Cancer Center in St. Mary's Hospital were enrolled for a day. The patients were asked to complete Hospital Anxiety and Depression Scale(HADS). Sociodemographic and cancer related clinical variables were also evaluated. Results: The point prevalence of anxiety and depression was 10.5% and 34.2%, respectively, as assessed with HADS. Logistic regression models revealed that distant metastasis was significantly associated with anxiety in patients with cancer and previous chemotherapy and Low socioeconomic status were significantly associated with depression. Conclusions: Our results indicate that more than one third of patients with cancer suffer from either anxiety or depression. In addition, previous chemotherapy as well as low socioeconomic status and distant metastasis were associated risk factors of anxiety and depression, respectively. These findings suggest the need for screening and systematized psychosocial intervention for psychological distress in hospitalized patients with cancer.

• Korean Journal of Biological Psychiatry
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• v.9 no.1
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• pp.25-33
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• 2002

Serotonin transporter(5-HTT) is one of the major action site of antidepressants in neuronal cells. According to the recent studies, it is known that the functional polymorphism in the promoter region of the 5-HTT gene(5-HTT linked polymorphism repetitive element in promoter region, 5-HTTLPR) is associated with antidepressant responsiveness, and the distributions of 5-HTTLPR is various among the different populations. Our preliminary study suggested that it is possible to measure the endophenotype of 5-HTTLPR genotype by examining the pharmacodynamic research of the 5-HTT in platelet membranes. However, there are limitations to predicting the antidepressant responsiveness only from the endophenotypic characteristics of 5-HTT gene promoter polymorphism, and therefore we propose to use the pharmacogenomic methods for overcoming these limitations. We found that the significant correlations existed among the genetic polymorphisms of biogenic amine transporters whose structure and characteristics are similar to the 5-HTT, and the predictable odds ratio of antidepressant responsiveness are increased significantly by combining the effect with other associated polymorphisms, compared to the effect of 5-HTT promoter polymorphism only. These results support the hypothesis that antidepressant treatment has to be individualized according to the genetic and ethnic background of depressed patients. It would be possible to develope the evaluation tools to predict the antidepressant responsiveness and its side effect profile, if scientists reveal the genes related to the action mechanism as well as the metabolism of antidepressants so as to discover the interaction of those genes and contribution of endogenotypes toward antidepressant responsiveness.

• Korean Journal of Psychosomatic Medicine
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• v.10 no.2
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• pp.110-119
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• 2002

Objectives : Numbers of patients who have chronic pain seem to be increasing in the psychiatric practice. Many investigators have used models of stress and coping to help explain the differences in adjustment found among persons who experience chronic pain. Coping strategies appear to be associated with adjustment in chronic pain patients. The objectives of this study were to develop a self-report questionnaire which is the most widely used measures of pain coping strategies, Coping Strategies Questionnaire (CSQ) into Korean version and to study the different coping strategies with which chronic pain patients frequently use when their pain reaches a moderate or greater level of intensity. Methods : One hundred twenty-eight individuals with chronic pain conditions and two hundred fifty-two normal controls were administered the Korean version-Coping Strategies Questionnaire(KCSQ) to assess the frequency of use and perceived effectiveness of a variety of cognitive and behavioral pain coping strategies. We also obtained their clinical features in chronic pain patients. Reliability of the questionnaire were analyzed and evaluated differences of coping strategies between two groups. Results : Data analysis revealed that the questionnaire was internally reliable. Chronic pain patients reported frequent use of a variety of pain coping strategies, such as coping self-statements, praying and hoping, catastrophizing, and increase behavior scales which were higher compared to the normal controls. Conclusion: K-CSQ revealed to be a reliable self-report questionnaire which is useful for the assessment of coping strategies in clinical setting on chronic pain. And analysis of pain coping strategies may be helpful in understanding pain for chronic pain patients. The individual K-CSQ may have greater utility in terms of examining coping, appraisals, and pain adjustment. A consideration of pain coping strategies may allow one to design pain coping skills training interventions so as to fit the individual chronic pain patient. Further research is needed to determine whether cognitive-behavioral intervention designed to decrease maladaptive coping strategies can reduce pain and improve the physical and psycho-social functioning of chronic patients.

• Journal of the Korean Society for Library and Information Science
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• v.42 no.3
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• pp.103-131
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• 2008

Today. the mental health has a great deal of impact on individuals and the society surrounding. Therefore. this research is to propose a way of bibliotherapical intercession by stages and patterns as to examine the recovery process of students with negative emotion by using the grounded theoretical method. This research collected materials through focus-interview, participant observation and book reports of 4 experiments involving female college students aged from 21 to 23, all having emotional and psychological difficulties. The recovery process of female students with negative emotion involved causal factors such as "recognition of hidden wound" "Sense of inferiority", and "difficulty in forming relationships", as well as contextual factors like "sympathetic attitude". which altogether brought about the core phenomenon. "pursuit for healthy ego". This core phenomenon induced to recovering the bright and positive attitude through using the strategies of 'self insight' and application of 'management plan', influence by such incoherent conditions as 'intimate surroundings' and $\setminus$ 'support system patterns'. And as time passed. the recovery process appeared tin four stages: 'issues recognition'. 'emotional responses', 'issue solution' and 'self application'.

• Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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• v.7 no.10
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• pp.865-878
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• 2017

To realize the healthy life of human, mental, physical, and environmental factors must be managed continuously and stably. In order to manage human health, the 21st century healthcare field is essential ongoing interactions and convergence with ICT technologies. Such demands have created a convergence of technologies (fusion technology) in combination with the heterogeneous technologies. And, with the convergence of medical technology and ICT technologies, the development of personalized therapy environments is created. Advances in ICT-converged healthcare services are progressing due to the development of diverse wearable devices. Such ICT fusion system is exponentially increasing the complexity of the ICT convergence healthcare system and is resulting in various technical, institutional, environmental, and cultural issues. This study explores the status of developments in ICT healthcare technologies from the past to date, identifies major technology and policy issues to address these challenges. Finally it will recommend healthcare policies and a future road-map.