• 제목/요약/키워드: Anxious symptoms

검색결과 37건 처리시간 0.024초

공황장애환자에서 감정표현불능증에 대한 연구 (A Study for Alexithymia in the Patients with Panic Disorder)

  • 최영희;장혁진;김민숙
    • 정신신체의학
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    • 제14권1호
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    • pp.53-61
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    • 2006
  • 연구목적 : 본 연구는 표준화된 한국판 20항목 Toronto alexithymia scale (TAS-20K)을 이용하여 공황장애에서 나타나는 감정표현불능증의 특성 및 감정표현불능증에 영향을 주는 불안과 우울 수준과의 연관성을 알아보아 이들 환자군에서의 감정표현불능증이 정상군에서와 어떤 다른 특성을 보이는지 살펴보기 위해 시도되었다. 방법: 서울 소재 일 대학병원 신경정신과 공황장애 클리닉에 방문하여 두 명의 정신과 전문의가 DSM-IV 진단기준을 사용하여 진단한 공황장애 환자 167명, 일 대학 병원 직원 및 직장인, 대학원생 등을 포함하는 110명의 정상 대조군을 대상으로 연구를 수행하였다. 정상 대조군과 공황장애 환자군 간의 사회인구학적 특성, 감정표현불능증과 그 하위 척도, 상태 및 특성 불안, 불안 민감도, 우울 척도를 이용하여 비교하였다. 또한, 정상대조군 및 공황장애 환자군에서 감정표현불능증과 나머지 척도와의 상관관계를 살펴보고 이를 통해 감정표현 불능증을 가장 잘 설명하는 변수를 찾기 위해 다중 회귀분석을 시행하였다. 결과 : 공황장애 환자군은 정상 대조군과 비교해서 감정표현불능증, 상태 및 특성 불안, 불안 민감도, 우울, 감정표현불능증의 총점(p<0.001) 및 하위척도의 요인 1(p<0.001)과 요인 2(p=0.001)는 유의하게 높은 점수를 보였으나 요인 3은 두 군간의 유의한 차이가 없었다. 또한 공황장애 환자군에서 감정표현불능증을 설명하는 변수는 특성불안$({\Delta}R^2=0.255)$과 불안 민감도$({\Delta}R^2=0.062)$였고 정상 대조군에서는 우울$({\Delta}R^2=0.144)$과 불안 민감도$({\Delta}R^2=0.033)$였다. 결론: 공황장애가 있는 경우 신체감각이 위험한 결과를 일으킨다고 믿는 정도를 측정하는 불안 민감도가 높으며 이러한 불안 민감도는 특성 불안과 유의미한 상관관계를 보이는 점을 고려할 때 불안 민감도와 특성 불안이 공황장애 환자에서 감정표현불능증을 설명하는 적합한 변수가 됨을 알 수가 있었다. 반면, 정상 대조군의 감정표현불능증은 불안 민감도보다는 우울이 좀 더 많은 설명 변량을 가진 것으로 나타났으며, 이는 기존의 연구들과는 차이를 보이는데 본 연구와 기존 연구간의 대상군의 균질성에 있어서 차이가 있으므로 좀 더 구체적인 연구로 반복 확인이 필요하겠다.

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Phosphodiesterase-5 Inhibitor Attenuates Anxious Phenotypes and Movement Disorder Induced by Mild Ischemic Stroke in Rats

  • Yu, Yeon Hee;Kim, Seong-Wook;Kang, Juhyeon;Song, Yejin;Im, yHyuna;Kim, Seo Jeong;Yoo, Dae Young;Lee, Man-Ryul;Park, Dae-Kyoon;Oh, Jae Sang;Kim, Duk-Soo
    • Journal of Korean Neurosurgical Society
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    • 제65권5호
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    • pp.665-679
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    • 2022
  • Objective : Patients with mild ischemic stroke experience various sequela and residual symptoms, such as anxious behavior and deficits in movement. Few approaches have been proved to be effective and safe therapeutic approaches for patients with mild ischemic stroke by acute stroke. Sildenafil (SIL), a phosphodiesterase-5 inhibitor (PDE5i), is a known remedy for neurodegenerative disorders and vascular dementia through its angiogenesis and neurogenesis effects. In this study, we investigated the efficacy of PDE5i in the emotional and behavioral abnormalities in rats with mild ischemic stroke. Methods : We divided the rats into four groups as follows (n=20, respectively) : group 1, naïve; group 2, middle cerebral artery occlusion (MCAo30); group 3, MCAo30+SIL-pre; and group 4, MCAo30+SIL-post. In the case of drug administration groups, single dose of PDE5i (sildenafil citrate, 20 mg/kg) was given at 30-minute before and after reperfusion of MCAo in rats. After surgery, we investigated and confirmed the therapeutic effect of sildenafil on histology, immunofluorescence, behavioral assays and neural oscillations. Results : Sildenafil alleviated a neuronal loss and reduced the infarction volume. And results of behavior task and immunofluorescence shown possibility that anti-inflammation process and improve motor deficits sildenafil treatment after mild ischemic stroke. Furthermore, sildenafil treatment attenuated the alteration of theta-frequency rhythm in the CA1 region of the hippocampus, a known neural oscillatory marker for anxiety disorder in rodents, induced by mild ischemic stroke. Conclusion : PDE5i as effective therapeutic agents for anxiety and movement disorders and provide robust preclinical evidence to support the development and use of PDE5i for the treatment of mild ischemic stroke residual disorders.

인지행동치료 후 약물 중단 예측 요인에 관한 연구 (Predicting Factors of Discontinuation of Medication after Cognitive Behavioral Therapy for Panic Disorder)

  • 최영희;박기환;김한석;하오령
    • 생물정신의학
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    • 제7권2호
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    • pp.186-190
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    • 2000
  • Objective : The authors experienced that cognitive behavioral therapy(CBT) could replace medication for controlling panic attacks and anticipatory anxiety symptoms. The objective of this study was finding out predicting factors of discontinuation of medication after CBT for patients with panic disorder. Method : A hundred forty-eight patients who met DSM-IV criteria for panic disorder with or without agoraphobia for at least 3 months had completed 12 weekly sessions of Panic Control Therapy(PCT ; Barlow et al). Eighty-one patients who could discontinue medication and sixty-seven patients who could not discontinue medication were measured with several scales as the pre- and post-treatment aassessment. The scales were Beck Depression Inventory(BDI), Clinical Global Impression(CGI), Spielberger State Anxiety Inventory(STAI-state), Anxiety Sensitivity Index(ASI), Body Sensation Questionnaire (BSQ), Panic Belief Questionnaire(PBQ), Agoraphobic Cognition Questionnaire(ACQ), Fear Questionnaire(FQ), Toronto Alexithymia Scale(TAS). Results : At the pre-treatment assessment, the scores of BDI, CGI, STAI-state, ACQ, BSQ were higher in the patients who could discontinue medication than in the patients who could not discontinue medication(t=-2.68, t=-4.88, t=-3.07, t=-3.68, t=-3.35, p<0.01). Conclusion : Patients with panic disorder who were less depressed, less anxious, less agoraphobic and who had less negative cognitions for the bodily sensation and who had higher scores in the therapist's assessment could discontinue their medications.

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Preferences and Acceptance of Colorectal Cancer Screening in Thailand

  • Saengow, Udomsak;Chongsuwiwatvong, Virasakdi;Geater, Alan;Birch, Stephen
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권6호
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    • pp.2269-2276
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    • 2015
  • Colorectal cancer (CRC) is now common in Thailand with an increase in incidence over time. Health authorities are planning to implement a nationwide CRC screening program using fecal immunochemical test (FIT) as a primary screening tool. This study aimed to estimate preferences and acceptance of FIT and colonoscopy, explore factors influencing the acceptance, and investigate reasons behind choosing and rejecting to screen before the program was implemented. Patients aged 50-69, visiting the primary care unit during the study period, were invited to join this study. Patients with a history of cancer or past CRC screening were excluded. Face-to-face interviews were conducted. Subjects were informed about CRC and the screening tests: FIT and colonoscopy. Then, they were asked for their opinions regarding the screening. The total number of subjects was 437 (86.7% response rate). Fifty-eight percent were females. The median age was 58 years. FIT was accepted by 74.1% of subjects compared to 55.6% for colonoscopy. The acceptance of colonoscopy was associated with perceived susceptibility to CRC and family history of cancer. No symptoms, unwilling to screen, healthy, too busy and anxious about diagnosis were reasons for refusing to screen. FIT was preferred for its simplicity and non-invasiveness compared with colonoscopy. Those rejecting FIT expressed a strong preference for colonoscopy. Subjects chose colonoscopy because of its accuracy; it was refused for the process and complications. If the screening program is implemented for the entire target population in Thailand, we estimate that 106,546 will have a positive FIT, between 8,618 and 12,749 identified with advanced adenoma and between 2,645 and 3,912 identified with CRC in the first round of the program.

입시병의 아형과 대처방안 (CLINICAL SUBTYPING AND TREATMENT STRATEGY OF COLLEGE ENTERANCE EXAMINATION STRESS SYNDROME)

  • 이영식;구영진;이길홍
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제2권1호
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    • pp.43-48
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    • 1991
  • 입시병이란 진로선택의 갈등이나 시험불안, 입시실패에 대한 예기불안이 복합적으로 작용하여 생긴 일종의 불안장애인데 입시 자체가 정신장애를 일으키기 보다는 입시라는 정신사회적 스트레스로 인해 내재해 있던 문제가 표면화되고 악화되는 것이다. 흔한 ${\cdot}$ 증상으로는 두통 피로 현기증 식용부진 시력장애 기억력장애 불면증등의 정신생리적 신체증상, 우울절망감, 불안등의 정서장애가 동반되며 심할 경우 잠재해 있던 정신병리가 활성화되어 정신증을 유발하는 등 다양한 형태의 복합적 증상을 나타낸다. 이외에 넓게 원인적 측면에서 볼 때 학업포기, 등교거부, 가출, 비행, 약물남용, 자살등의 청소년 문제를 야기시킨다. 임상에서 이러한 환자를 치료하는데 있어 수험생이라는 특수상황을 고려하여 되도록 단기간에 치료에 대한 저항을 줄이며 환자의 핵심문제를 파악하는 것이 치료의 관건이라 하겠다. 따라서 이러한 목적의 일환으로 임상양상에 따라 입시병을 1) 불안초조형, 2) 공허형, 3) 절망형, 4) 탈진형, 5) 권태형으로 분류하였으며 각 아형의 대표적 증례를 통하여 구체적 치료방안을 제시하였다.

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염증성 장 질환을 가진 청소년의 삶의 질 (Quality of Life of Adolescents with Inflammatory Bowel Disease)

  • 정주연;박영숙;권미경;방경숙
    • 임상간호연구
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    • 제18권2호
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    • pp.264-274
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    • 2012
  • Purpose: This study was conducted to identify the quality of life (QOL) of adolescents who have inflammatory bowel disease. Methods: This was a descriptive comparative study, and participants were 58 adolescents with inflammatory bowel disease and 55 healthy adolescents. The Korean version of $PedsQL^{TM}$ 4.0 scale was used. Ten adolescents with inflammatory bowel disease were also interviewed. Data were analyzed with SPSS Win. Results: Average score on QOL for these adolescents was statistically lower (p<.001) than healthy adolescents, especially for physical and school functioning. QOL of the adolescents who had the disease for more than 4 years, and were taking 3 or more medications was lower QOL than other adolescents with this disease. In interviews, adolescents complained of physical malfunctioning. In emotional functioning, they worried about the reoccurrence of bloody diarrhea, and mood changes. As for social functioning, dietary restrictions, gastrointestinal symptoms, and poor peer relationships were primary concerns. Lastly, in school functioning, frequent absences and lower academic performance were problems. Conclusion: Considering these results, adolescents with inflammatory bowel disease felt anxious because of the uncertain origin of their disease and unpredictable course of the illness. Interventions should include diaries on food, along with education and counseling as nursing interventions.

1, 2호 보호 처분 청소년의 정신의학적 특성 및 6개월 보호처분 후 추적조사 (Psychiatric Characteristics of Adolescents with Minor Offenses and Follow-Up after a 6-Month Protective Disposition)

  • 정운선;서상수;이승재;정성훈
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제21권2호
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    • pp.95-102
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    • 2010
  • Objectives : This study investigated the differences between the psychiatric characteristics of minor juvenile offenders and normal adolescents as well as differences in psychiatric symptoms after a six month protective disposition. Further, the current study aimed at determining psychiatric screening methods for evaluating delinquent adolescents. Methods : The Latent Delinquency Questionnaire (LDQ), the Revised Children's Manifest Anxiety Scale (RCMAS), the Children’s Depression Inventory (CDI), the Reynolds Suicidal Ideation Questionnaire (SIQ), the Piers-Harris Children's Self Concept Inventory (SCI), and the Korean Youth Self Report (K-YSR) were administered to 134 normal adolescents (114 males) and 109 minor offenders (97 males) aged 12 to 16 years. After six months, 46 offenders (all males) completed the RCMAS, CDI, SIQ, and SCI again. Results : Adolescents with minor offenses had more delinquent, aggressive behavior and externalizing behavior problems, but were significantly less depressive, anxious, or suicidal than normal controls. Further, recidivists had more anxiety, depression, and delinquent behavior than non-recidivists. Minor offenders reported that their anxiety and depressive mood decreased after six months of protective disposition. Conclusion : Adolescents with minor offenses had more delinquent, aggressive behavior and externalizing behavior problems suggesting that psychiatric screening tools for minor offenders should measure disruptive behavior disorder.

Preliminary Findings on the Effectiveness of Meaning-Centered Psychotherapy in Patients with Pancreatobiliary Cancer

  • Ryu, Jin Sun;Choi, Sun Woo;Yun, Sung Su;Koo, Bon Hoon;Choi, In Seok;Kim, Seung Jun;Park, Joon Seong;Seok, Jeong-Ho;Yoon, Dong-Sup
    • Yonsei Medical Journal
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    • 제59권9호
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    • pp.1107-1114
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    • 2018
  • Purpose: This study investigated the effectiveness of meaning-centered psychotherapy (MCP), which is known to be a helpful psychotherapeutic intervention in distressing conditions, for patients with pancreatobiliary cancer. Materials and Methods: We recruited 37 patients with pancreatobiliary cancer from three university general hospitals and assessed their psychological characteristics. Patients who reported clinically significant emotional distress were recommended to undergo MCP. Patients who consented to MCP were provided four sessions of the therapy. Patient psychological characteristics were assessed again 2 months after MCP. For statistical comparison, outcome variables included anxiety, depression, mental adjustment to cancer, and quality of life (QoL), as well as the degree of stress and physical symptoms. Results: Sixteen patients completed the MCP and the final assessment 2 months later. In the initial assessment, the patients receiving MCP showed higher levels of anxiety and depression than those not receiving MCP, and QoL was also lower in terms of role function, emotional function, social function, and global QoL. At the 2-month follow-up, the MCP group showed a significant improvement in anxiety (p=0.007), depression (p=0.010), and anxious preoccupation (p<0.001). In addition, QoL significantly improved in the MCP group, while there was no significant change in the non-MCP group. Conclusion: In this study, MCP showed potential therapeutic benefits against emotional distress in patients with pancreatobiliary cancer, improving their QoL.

Preliminary Validation Study of the Korean Version of the DSM-5 Level 2 Cross-Cutting Symptom Measure: Depression and Irritability for Parents of Children Aged 6-17 Years

  • Shin, Min-Sup;Kim, Bung-Nyun;Jang, Mirae;Shin, Hanbyul;Seo, Gyujin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제33권3호
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    • pp.67-72
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    • 2022
  • Objectives: This study investigated the reliability and validity of the Korean version of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Level 2 Cross-Cutting Symptom Measure-Patient-Reported Outcomes Measurement Information System (PROMIS)-Depression and the Irritability for parents of children aged 6-17 years. Methods: Participants were 190 children diagnosed with depressive disorder (n=14), anxiety disorder (n=21), attention-deficit/hyperactivity disorder (ADHD; n=111), ADHD with anxious depression (n=13), and tic disorder with somatic symptoms (n=31). Patients were 8-15 years of age. The participants' mothers completed the Korean versions of the DSM-5 Level 2 Cross-Cutting Symptom Measure-PROMIS Depression and Irritability (Affective Reactivity Index, ARI), and the Korean Child Behavior Checklist (K-CBCL). Using these data, we calculated the reliability coefficient and examined the concurrent and discriminant validity of the PROMIS Depression and the Irritability (ARI) scales for assessing depression and irritability in children. Results: The reliability coefficient of the PROMIS Depression scale (Cronbach's α) was 0.93. The correlation coefficient with the K-CBCL DSM emotional problem score was 0.71. The PROMIS Depression scale significantly discriminated children with depressive disorders from those with other conditions. The reliability coefficient of the Irritability (ARI) scale was 0.91, suggesting its high reliability. Conclusion: Our results suggest that the Korean version of the DSM-5 Level 2 Cross-Cutting Symptom Measure for Depression and Irritability Scales for parents of children aged 6-17 years is reliable and valid and may be an efficient alternative to the K-CBCL.

결장루형성술 환자 간호를 위한 일 연구

  • 모경빈
    • 대한간호학회지
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    • 제1권1호
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    • pp.27-43
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    • 1970
  • This study is designed to find out proper nursing activities for the needs of the colostomy patients, i.e., mental and psychological as well as physical needs for rapid recovery, and to help them build up the follow-up care for proper social adjustment. The study is based on 268 cases out of 381 colostomy patient's records kept in Ewha Womans University Hospital, Yonsei Medical Center, and National Medical Center in between the period from Jan. 1953 to Jan. 1970. The items of study are mainly on etiology, sex, age, duration of hospitalization, mortality rate, seasonal frequency, time from the onset of illness to the admission of the hospital, signs and symptoms. 1. Frequency of onset by etiology: Neoplastic disease 112 cases (42%), Inflammatory disease 33 cases (12%), Congenital malformation 30 cases (11%), Intussusception 25 cases (9.3%), Trauma 24 cases (9%), Volvulus 17 cases (6.3%), and Crohn's disease 6 cases (2.2%). 2. By sex: male 167 cases (62.9%), and female 101 cases (37.1%). So the ratio of portion of male and female 2:1. 3. By age: under 1·year·old 27 cases (10.1%) highest, 41-50 yrs 54 cases (20.2%), 51-60 yrs 42 cases (15.5%), above 71 yrs 5 cases (1.9%). 4. Duration of hospitalization: the shortest is 2-days and the longest is 470 days. 1-20-days 52%, 40-60 days 14%. 5. Mortality rate: Under the 10-days-admission 19.5%, and the beyond 30-days-admission 3.9%. 6. Seasonal frequency: Higher in summer (32% ). 7. Signs and symptoms: abdominal pain (56%), abdominal distention (54%), vomiting (40%), bloody mucoid diarrhea (38%) , pain of anal region (18%), abdominal tenderness, anorexia, indigestion, constipation, disuria, tenesmus, high fever and chilling sensation, bile tingled vomiting. Nursing activities for the patient's physical needs are as follows: Skin care for colostomy region, Prevention of colostomy constriction and depression, Removal of an offensive odor, The use of colostomy bag-selection for, and demonstration of the use of inexpensive colostomy irrigation equipment, Personal hygiene, general skin care, care of hair, finger nails and toe-nails, Oral hygiene, sleep and rest, aquate, Daily activities, etc. Measures for regulation of bowl movement. Keeping the instruction of taking food, Preparing the meal and help for anorexia, Constipation and it's solution, Prevention of diarrhea, helping the removal of mucous, and stretch constricted steam as needed. Nursing activities for pt's socio-psychological needs are as follows; Help the patient to make decision for the operation, Remove pt's anxiety toward operation and anesthesia, To meet the pt's spiritual needs at his death bed, Help to establish family and friends cooperation, Help to reduce anxiety at the time of admission and it's solution, Help to meet religious need, Help to remove pt's anxiety for loosing his job and family maintenance, Follow-up studies for 7 cases have been done to implement the present thesis. The items of the personal interviews with the patients are as follows: Acceptability for artificial anus, The most anxious thing they had in mind at the time of discharge, The most anxious thing they hat·e in mind at present, Their friends and family's attitudes toward the patient after operation, Relations with other colostomy patients, Emotional damage from the operation, Physical problem of enema, irrigation, Control of diet, Skin care, Control of offensive odor, Patient's suggestions to nurses during hospital stay and after discharge. In conclusion, the follow-up care for colostomy patients shares equal weight or perhaps more than the post-operative care. The follow-up care should include the spiritual care for moral support of the patient, to drag him out of isolation and estrangement, and make him fully participate in social activities. It is suggested that the following measures would help to rehabilitate the colostomy patients (1) mutual acquaintance with other colostomy patients if possible form a sort of club for the colostomy patient to exchange their experiences in care (2) through the team work of doctor, nurse and rehabilitation specialists, to have a sort of concerted effort for betterment of the patient.

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