• Title/Summary/Keyword: 주요 우울 장애

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Incidence and Associated Factors of Delirium after Orthopedic Surgery (정형외과 수술 후 발생한 섬망의 발생 빈도와 관련 인자)

  • Lee, Si-Wook;Cho, Chul-Hyun;Bae, Ki-Cheor;Lee, Kyung-Jae;Son, Eun-Seok;Um, Sang-Hyun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.157-163
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    • 2019
  • Purpose: To investigate the incidence and associated factors of delirium after orthopedic surgery. Materials and Methods: A total of 2,122 cases, who were older than 20 years and underwent orthopedic surgery at a single medical center during a one year period were included. Among them, 132 patients who were diagnosed with delirium after surgery under the Diagnostic and Statistical Manual of Mental Disorders-V criteria and medicated under the consultation of a psychiatrist were included in the study The differences in the incidence of delirium and several affecting factors were analyzed. Results: The overall incidence of delirium after surgery was 6.2% (132 in 2,122 cases). The mean age of the delirium group was 77.4 years (range, 54-92 years), which was higher than that of the non-delirium group (58.1 years). The percentage of women in the delirium group was 63.6% (84 in 132 cases), which was higher than that of the women in the non-delirium group (49.0%). The incidence of delirium after surgery was 9.3% (85 in 916 cases) due to trauma and 3.9% (47 in 1206 cases) due to disease. The incidence of postoperative delirium according to the surgical region was 29.2% (7 in 24 cases) in two or more regions, 13.7% (72 in 526 cases) in the hip, and 9.6% (14 in 146 cases) in the spine, 3.5% (20 in 577 cases) in the knee-lower leg, 2.5% (5 in 199 cases) in the foot-ankle, 2.4% (11 in 457 cases) in the shoulder-elbow, and 1.6% (3 in 189 cases) in the forearm-wrist-hand. Delirium occurred more rapidly in women and surgery due to disease, and the duration of delirium was longer in patients with dementia and major depressive disorders. Conclusion: The incidence of postoperative delirium was high in cases of surgery due to trauma and in cases of surgery in two or more sites. The incidence of postoperative delirium according to a single surgical region was higher in the order of the hip, spine, and knee. Active intervention is needed regarding the correctable risk factor.

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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Clinical Epidemiology for Elderly Patients of Oral Medicine Clinic (구강내과에 내원하는 노인 환자들의 임상 역학 연구)

  • Oh, Hyun-Sun;Kim, Hye-Kyoung;Park, Jo-Eun;Kim, Ki-Suk;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.38 no.1
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    • pp.19-28
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    • 2013
  • With Korea's rapid entry to aged society, elderly population has become a major age group both in the whole society and medical field and its importance will be constantly stressed out. Elderly population is also important in the field of oral medicine which deals with chronic and recurrent diseases in the orofacial region of non-dental origin but there exist few studies indicating epidemiology of elderly patients in this regards. This study aimed to investigate change of age distribution of new patients in a university-based dental hospital and oral medicine clinic for last decade and to investigate clinical epidemiology of elderly patients (${\geq}$ 65 years) of oral medicine clinic. This study was performed retrospectively using medical records of the new patients in Dankook University Dental Hospital in 2001 and 2011. According to the study, percentage of elderly new patients increased in both dental hospital and oral medicine clinic and degree of the increase was greater in oral medicine clinic than in the whole hospital (p=0.000). 13.5% of adult patients ${\geq}$ 18 years of oral medicine clinic were elderly patients ${\geq}$ 65 years. 83% of elderly patients were suffering from one or more systemic diseases. Although TMD was the most common reason for elderly patients who visited oral medicine clinic, oral soft tissue diseases, dry mouth, burning mouth syndrome and oromandibular dystonia was more frequently diagnosed in elderly patients compared to adult patients aged 18 to 64 years. Pain severity and interference of Brief Pain Inventory and depression and anxiety scores of Hospital Anxiety Depression Scales were higher in elderly patients than in the adult patients (p<0.05). Increase of elderly patients with chronic oral diseases and pain needs more attention of dentists and specialists of oral medicine to improvement of assessment and development of tailored management because large portion of the elderly patients have systemic diseases, polypharmacy and impaired communication, possibly restricting treatment options.

Investigation of aerodynamic evaluation in female patients undergoing thyroidectomy (갑상선절제술을 받은 여성 환자의 공기역학 검사변수 조사)

  • Kang, Young Ae;Kwon, In Sun;Won, Ho-Ryun;Chang, Jae Won;Koo, Bon Seok
    • Phonetics and Speech Sciences
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    • v.12 no.2
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    • pp.73-80
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    • 2020
  • Breathing is the voice's driving force and also acts as a regulator of larynx function and efficiency. Respiratory distress is a side effect of general anesthesia in thyroid surgery. Therefore, this study's objective was to provide practical and complementary information for voice recovery after thyroid surgery, based on aerodynamic evaluation pre- and post-thyroidectomy. From May 2014 to July 2015, aerodynamic evaluations were performed on 34 female patients diagnosed with thyroid papillary cancer one week before surgery (PRE), one month after surgery (P1), and three months after surgery (P3). The Phonatory Aerodynamic System (model 6600, KayPENTAX, USA) was employed for this purpose, and a total of 29 analysis parameters were selected. The results showed statistically significant differences in peak expiratory airflow (p=0.004), mean pitch (p<0.01), expiration airflow duration (p=0.001), and expiratory volume (p=0.018), based on time factors. In the comparison of time factors, peak expiratory airflow and mean pitch parameters were different in PRE-P1 and PRE-P3. Expiration airflow duration and expiratory volume parameters were different in PRE-P3 and P1-P3. The interaction effect of time and surgical range was significant only for expiratory volume (p=0.024). Female patients who undergo thyroidectomy require post-operative breathing training, and exhalation improvement is considered to reflect a positive lifestyle after surgery.

Risk Factors for Binge-eating and Food Addiction : Analysis with Propensity-Score Matching and Logistic Regression (폭식행동 및 음식중독의 위험요인 분석: 성향점수매칭과 로지스틱 회귀모델을 이용한 분석)

  • Jake Jeong;Whanhee Lee;Jung In Choi;Young Hye Cho;Kwangyeol Baek
    • Journal of the Korean Applied Science and Technology
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    • v.40 no.4
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    • pp.685-698
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    • 2023
  • This study aimed to identify binge-eating behavior and food addiction in Korean population and to determine their associations with obesity, eating behaviors, mental health and cognitive characteristics. We collected clinical questionnaire scores related to eating problems (e.g. binge eating, food addiction, food cravings), mental health (e.g. depression), and cognitive functions (e.g. impulsivity, emotion regulation) in 257 Korean adults in the normal and the obese weight ranges. Binge-eating and food addiction were most frequent in obese women (binge-eating: 46.6%, food addiction: 29.3%) when we divided the participants into 4 groups depending on gender and obesity status. The independence test using the data with propensity score matching confirmed that binge-eating and food addiction were more prevalent in obese individuals. Finally, we constructed the logistic regression models using forward selection method to evaluate the influence of various clinical questionnaire scores on binge-eating and food addiction respectively. Binge-eating was significantly associated with the clinical scales of eating disorders, food craving, state anxiety, and emotion regulation (cognitive reappraisal) as well as food addiction. Food addiction demonstrated the significant effect of food craving, binge-eating, the interaction of obesity and age, and years of education. In conclusion, we found that binge-eating and food addiction are much more frequent in females and obese individuals. Both binge-eating and food addiction commonly involved eating problems (e.g. food craving), but there was difference in mental health and cognitive risk factors. Therefore, it is required to distinguish food addiction from binge-eating and investigate intrinsic and environmental risk factors for each pathology.