• Title/Summary/Keyword: Behavioral symptoms

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Risperidone as a Janus in Mood Disorder (기분장애에서 risperidone의 양면성)

  • Yoon, Doh Joon
    • Korean Journal of Biological Psychiatry
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    • v.4 no.2
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    • pp.198-210
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    • 1997
  • To examine the double-faced thymoleptic(antidepressant and antimanic) effects of risperidone in mood disorders, this article reviews the psychotropic-induced mania, thymoleptic effects of antipsychotics, therapeutic effects of risperidone and risperidone(RIS)-induced mania(RIM) in mood disorders, risk factors of RIM, possible neurochemical mechanism of these thymoleptic effects, pathophysiological and clinical significance of thymoleptic effects, and suggestive clinical guideline of RIS in mood disorders. RIS appeared effective for bipolar disorder at a lower dose than that recommended for schizophrenia, especially in the cases of maintenance of mood stabilizers, and gradual titration from low doses. Manic induction/exacerbation can occur by chance during RIS treatment in mood disorders, schizoaffective disorders, and schizophrenias. The possible risk factors for RIM are refractory mood disorder, especially in bipolar I disorder with poor initial response ; refractory schizoaffective disorders, especially in bipolar type with poor initial response ; refractory chronic schizophrenias, especially with initial responses ; psychotic features ; higher initial doses ; rapid titration ; combined therapy with antidepressants in refractory depression ; and RIS monotherapy in mania/hypomania. RIS is a drug that preferentially block 5-HT2 receptors. The effects of low dose are due mainly to the blockade of 5-HT2 receptors. There are more gradual increase in D2 blockade with increasing dose and this D2 blocking properties become apparent at higher doses. This may be related to a modulation of dopaminergic transmission by 5-HT2 antagonism at lower doses with the direct action of RIS on DA receptors coming into play at higher dose. The serotonergic antagonistic effect may be important for its effects on depressive symptoms. This, together with adequate blo-ckade of D2 receptors, may not necessarily lead to destabilization of mood disorder, but rather to more therapeutic effects. Therefore, this dose-receptor affinity relationship with both antidepressant and antimanic effects according to treatment duration can explain a continuum of antidepressant effect, antimanic effect, behavioral stimulation, and manic/hypomanic induction/exacerbation. It was the recognition of a useful psychiatric side effects by a thoughtful observer with fertile minds that led to their ultimate utilization as psychotropic drugs, i.e., phenothiazine, MAOI, TCA, and lithium. And, in vivo pharmacological challenge by novel psychotropics, as a neurochemical probe, with more specific actions is a useful tool to select pharmacologically homogeneous subgroup of the same phenotypical(clinical) condition, to further study the unknown underlying pathogenesis of various mental illnesses. Finally, RIS may be a useful alternative or adjunctive drug for patients with mood disorders without psychotic features or refractory to treatment with standard antipsychotic drugs. The more conservative doses(tirated slowly from 1-3 mg/d) of RIS, and maintenance of mood stabilizer in the cases with risk factors of RIM are recommended in mood disorder.

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A Meta-Analysis on the Effects of Social Skill Training for Schizophrenic Patients (정신분열병을 가진 사람들을 위한 사회기술훈련의 효과에 관한 메타분석)

  • Park, Jung-Im;Lee, Keum-Jin
    • The Journal of the Korea Contents Association
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    • v.13 no.12
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    • pp.309-320
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    • 2013
  • The purpose of this study was to examine the effectiveness of interventions for improving the social skills for people with schizophrenia by using method of meta-analysis. For the purpose of the study, master's theses, doctoral dissertations, and journal articles published in korea up to July, 2013 were systematically reviewed. As a result, a total of 22 studies were eligible for the inclusion criteria. The mean effect sizes and test for homogeneity of effect size(Q-statistic) were analyzed by using Comprehensive Meta-Analysis software 2.0. The main findings of the study were as follows. First, the average effect sizes for total social skill training programs were ES=0.838 of interpersonal capacity, ES=0.782 of social behavioral skills, ES=0.601 of self-assertiveness skills, and ES=0.293 of symptoms. Second, by analysing the moderate variables of the effect size for social skill training programs, 'a place of training', 'a major of trainer', 'running times' and 'sessions' were statistically significant. Based on the study results, the research and practice implications were discussed.

Effects of Brain activation Intervention Programs for Mild Dementia (경증치매노인을 위한 뇌 활성화 중재프로그램의 효과)

  • Joo, Kyung-Bock;Lim, Dong-Young;Lee, Myung-Nam;Jung, Na-Na
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.5
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    • pp.312-322
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    • 2018
  • This study was conducted with the purpose of identifying the effects of behavioral psychosomatic symptoms, cognitive functions, ability to perform daily life, and depression among the elderly with dementia. The sample for this study comprised 40 people in the experimental group and 20 in the contrastive group from the Dementia Supporting Center, located in NoWon-Gu of Seoul city. Data were collected from November 1, 2016 until March 31, 2017. The collected data were analyzed using SPSS 23.0, and descriptive statistics, chi-square test, independent t-test two-way repeated measures ANOVA, and ANCOVA were calculated. An 8-week brain activation intervention program including lectures was administered to elderly people with dementia. The results show improved cognitive function and reduced depressed feelings. Based on the results of this study, brain activation intervention programs can be applied to elderly people with dementia at the community level to help improve their cognitive function and relieve them from depression.

Needs of the elderly with dementia in long-term care facilities: from the perspectives of patients and caregivers (장기요양시설 거주 치매 노인의 욕구: 대상자와 간호제공자의 관점을 중심으로)

  • Kang, Hyunwook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.1
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    • pp.260-269
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    • 2018
  • This study investigated the needs of the elderly with dementia from the perspectives of patients and caregivers in long-term care facilities. A total of 145 older adults with dementia and 62 nurses from 3 geriatric hospitals were enrolled in this study. The cognitive function, behavioral and psychological symptoms, activities of daily living (ADL), and instrumental activities of daily living (IADL) were measured. The mean number of needs reported by the elderly with dementia was 11.94 and those with unmet needs were 2.91 on average. Nurses showed that the mean number of needs and unmet needs of the elderly with dementia was 14.71 and 1.94, respectively. The largest number of older adults with dementia (42.2%) perceived that the needs for daytime activities were unmet. On the other hand, only 24.1% of nurses evaluated that the needs for daytime activities were unmet. The factors influencing the needs of the elderly with dementia were dependency in ADL and IADL. Therefore, caregivers in long-term care facilities need to take the perception of older adults with dementia into consideration when evaluating the met and unmet needs of the elderly with dementia. In addition, sufficient assistance to IADL and ADL would help reduce the needs of people with dementia.

Risk Factors Affecting Dental Caries in Children (아동의 치아우식증에 영향을 미치는 위험 요인)

  • Hong, Min-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.5
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    • pp.320-326
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    • 2020
  • This study was conducted to investigate the risk factors affecting dental caries in children by using the 2018 children's oral health survey data. The study was conducted on 20,235 children who were 12 years of age. The survey items examined general characteristics, dental dietary behavior, the oral condition, and the behavioral factors related to oral health. The results showed that gender, region, economic level, subjective oral health condition, dental dietary behavior, oral condition and oral health-related behavior were all risk factors. Those children with oral conditions particularly showed a higher risk of the dental caries symptoms of dental calculus, dental bleeding, tooth pain and white spot teeth. The oral health-related behaviors were found to be tooth brushing less than two times a day, the risk of not using a handle to hold dental floss and not using dental floss. Our results showed that countries or communities can diagnose and manage dental well-being early on for children with the highest sensitivity of dental health and they need to continue to establish a dental well-being management system for the oral health care of children. In addition, oral health education should be expanded, which can improve oral health care habits of children and adolescents. Further, an oral health policy system for improving community programs to prevent dental and community utilization is needed.

Clinical Study of 25 Interstitial Cystitis Patients (간질성 방광염 환자 25예에 대한 임상적 고찰)

  • Son, Gi-Jeong;Oh, Hyeon-Jo;Lee, Jung-Gon;Nam, Seung-Kyu;Kim, Chul-Jung;Cho, Chung-Sik
    • The Journal of Internal Korean Medicine
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    • v.33 no.2
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    • pp.222-230
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    • 2012
  • Background : Interstitial cystitis is a disorder of the bladder characterized by urgency and frequency of urination, and pelvic pain. The cause of interstitial cystitis is not clear. Modern medical treatments include behavioral therapy, medication, intravesical infusion therapy, and surgical treatment, but the goal of treatment is based on symptom relief rather than a cure. According to a recent report, in an animal model, oriental medicine treatment, Yukmijihwang-tang improved the symptoms of interstitial cystitis. However, clinical studies and experimental research are lacking. Objectives : In this study, We investigated Chuknyojetong-tang, acupuncture, moxibustion and bee venom effect on interstitial cystitis. Methods : We targeted 25 patients diagnosed with interstitial cystitis at the university hospital and treated them for more than one month. We used acupuncture, Chuknyojetong-tang, and bee venom. The effects were evaluated using ICSI and ICPI at the begin of treatment and at the end of treatment. Results : All of the 25 patients were female, average age was $53.3{\pm}13.5$ years, and the average month of disease-duration was $69.0{\pm}59.8$. The duration of treatment was $8.0{\pm}5.4$ months, and 60% of patients were improved. After treatment, we used correlation coefficient method, multiple regression analysis. ICSI difference increased as treatment period increased. ICPI difference increased as age decreased. Total difference also increased as treatment period increased. These results imply that treatment effect was improved. Conclusions : These findings suggest that oriental medicine therapy using Chuknyojetong-tang, acupuncture, moxibustion, and bee venom would be very effective on interstitial cystitis.

A Research of School Refusal on Adolescent with Psychiatric Disorders (정신병리를 가진 청소년의 등교거부 사례보고)

  • Heo, Eun-Jung;Lee, Sang-Eon;Lyu, Heui-Yeong
    • Journal of Oriental Neuropsychiatry
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    • v.21 no.4
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    • pp.219-231
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    • 2010
  • Objectives : School refusal is usually considered as individual's behavioral problem. These days. however. the adolescents' school refusal needs some kind of medical approaches because it is related to mental disorder of the adolescents. Due to too much pressure and stress from the competition between classmates and from good performance in school. the number of adolescents who refuse to go to school is increasing. Despite this circumstance. school refusal is neither regarded as a single independent disorder nor endorsed as an officially classified disease. which makes difficult to conduct research on this issue and to establish standardized treatment for it. In addition. there is a lack of research on this topic. especially in oriental medicine. so there is no a case report or study on school refusal. This study is trying to comment on school refusal from the perspective of oriental medicine. Methods : We tried to examine the effect of oriental medicine treatment for school refusal with four adolescent cases. The patients commonly have at least more than one mental disorder (including depression disorder. anxiety disorder. and anorexia nervosa). have some problem with the relationship with their family. in particular with mother. do not have father or not be loved by their father. and have irregular eating habits. Thus. we diagnosed them as qi transforming into fire (氣鬱化矢) spleen-stomach deficiency cold (脾胃虛寒) and heart blood deficiency (心血虛) due to stress from the family issues and unhealthy eating habits. The patients received supportive therapy. family therapy. etc among many oriental mental treatments and their progress had been observed through hospitalization and outpatient treatment. Results : All four cases were reported positive progress on their symptoms and started coming back to school. We also examined whether they were well fitting into the school while they received outpatient treatment. and the results show that all four patients continue to settle down in normal school life. Conclusions : This study closely reviewed the mental disorder of school refusal cases and showed that the Oriental medical treatment was effective in helping the patients come back to school. More future research is required to better treatment for school refusal cases in oriental medicine.

Study on Temporomandibular Disorder Patients with Conservative Treatment (보존적 치료를 이용한 TMD 환자에 관한 연구)

  • Ko, Myung-Yun;Kim, Jin-Hwa;Heo, Jun-Young;Ok, Soo-Min;Jeong, Sung-Hee;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.38 no.1
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    • pp.77-86
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    • 2013
  • In order to evaluate the effect of conservative treatment for Temporomandibular Disorders(TMD), 137 patients were subjected at the Department of Oral Medicine, Pusan National University Dental Hospital from June 2012 to Sept. 2012. They were treated conservatively with behavioral therapy, physical therapy, medication and occlusal stabilizing splint therapy. Subjective symptoms and clinical findings were investigated to evaluate and compare the patients' status after 3 months treatment. The results were as follows; 1. Pain, Noise, LOM(Limitation of motion) and MCO(Maximum comfortable opening) measurements of TMD were markedly improved after conservative treatments including behavior therapy, physical therapy, medication and splint therapy. 2. There was no difference in treatment outcomes after conservative treatments when the subjects were classified and compared according to gender and chronicity. 3. Conservative treatment including stabilization splint produced better results than physical therapy with medication. 4. After 3 months of treatment, pain and LOM were significantly improved in the MD(Muscle disorder) group. Pain, LOM and noise were significantly improved in the DD(Disc displacements) group. In the OA(Osteoarthritis) group, pain, noise, LOM and MCO were significantly improved.

Role of Repeated Education to the Patients with Temporomandibular Disorders (측두하악장애 치료에 있어서 반복적 주의사항 교육의 효과)

  • Ok, Soo-Min;Heo, Jun-Young;Ko, Myung-Yun;Ahn, Yong-Woo;Jeong, Sung-Hee
    • Journal of Oral Medicine and Pain
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    • v.38 no.1
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    • pp.69-76
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    • 2013
  • Aim : The purpose of this study was to investigate the hypothesis that treatment with self-checking behavior management program was valuable in the management of temporomandibular disorders compared with a existing method treatment group. Methods : All participants who are diagnosed with temporomandibular disorders were treated with medication and physical therapy. They came into the clinic at intervals of two weeks, three times. The signs and symptoms were assessed investigating Pain NRS(Numerical Rating Scale), MCO(Maximum comfortable opening), Noise NRS, LOM(Limitation of Mouth opening) NRS at every visit. Experimental group received instructions repeatedly by using self evaluation questionnaire. Control group was educated once at the beginning of treatment. The difference Pain NRS, MCO, Noise NRS, LOM NRS between first and second visits, first and third visits were estimated.. Result :Experimental group showed greater improvement on MCO difference after stopping medication(p=0.001). This improvements were prominent in the male(p=0.001) and the first or second decade of the patients(p=0.004). Conclusion : The present study showed that there was better result when educating repeatedly with using self evaluation questionnaire than educating once at the beginning of the treatment.

MOTHER-CHILD INTERACTION PATTERNS OF ADHD CHILDREN (주의력결핍 과잉활동아의 모-자 상호행동)

  • Ha, Eun-Hye;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.84-96
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    • 1992
  • The present study was designed to investigate variables associated with mother-child interaction patterns of Attention Deficit Hyperactivity Disorder(ADHD), and also to evaluate short-term effects of stimulant medication on the behaviors of ADHD children and their mothers during interaction. 15 ADHD boys(ages 5${\sim}$10 years) were treated with metylphenidate(0.5mg/kg per day) for 1 month, and their behaviors as well as their mothers for the 10 minute free play and 20 minute task performance period were videotaped through one-way mirror. The childrens attention was also evaluated using the Continuous Performance Task(CPT) and ratings of their hyperactive behaviors were obtained from their mother prior to the treatment. The videotaped interaction were rated according to the Response Class Matrix developed by Mash, Terdal & Anderson(1973). Results indicated that percentage of behavior of the mother and child during interaction was highly correlated with each other, which, in turn, was highly correlated with the symptom severity of the ADHD child. That is the more severe the cognitive and behavioral symptoms of ADHD, the more negative the interaction behavior pattern was. After 4 weeks of stimulant medication the mothers as well as the ADHD children showed a significant decrease in the percentage of negative-aggressive behavior during the task performance period. The results indicated that negative interaction behavior of the mothers was in large part a response to the negative behavior of their ADHD children.

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