• 제목/요약/키워드: Child depression

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Fluoxetine 투여 후 조증과 자살 사고를 보인 강박증 환자 1례 (A Case of Fluoxetine-induced Mania & Suicidal Ideation in Obsessive-Compulsive Disorder)

  • 이승환;이민수
    • 생물정신의학
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    • 제6권2호
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    • pp.253-258
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    • 1999
  • The fluoxetine is one of the most frequently prescribed drugs for the treatment of depression and obsessive-compulsive disorder(OCD). This has been known as one of the most safest medication. But since the advent of this drug, there have been several reports of side effects-the mania and suicidal ideation-encountered during coadministration of fluoxetine with or without other psychotropic drugs. We experienced a case of 20 years old male OCD patient who developed into abrupt manic state and also was preoccupied with intense suicidal ideation following fluoxetine use. He was a only child in his family and his father had a history of alcoholism about 15years ago. Our patient's obsessive-compulsive symptoms have been occured since puberty. His OCD symptoms and anxiety were aggravated since joining the army. Beside these facts, we could not find any other psychiatric history such as depressive disoder and bipolar disorder. We used the fluoxetine starting dosage of 20mg and increased to 40mg at second week. About 3 weeks after the treatment, he developed sudden manic symptom and more aggravated suicidal ideation without any OCD symptoms. He felt vitalized and energetic without having enough sleep and food. These symptoms were ceased over two weeks by stopping medication. Up to this point, the reason why fluoxetine induces mania and suicidal preoccupation is unclear. But somehow the fluoxetine has effects on serotonin receptor and serotonin-dopamine regulations, thus we could make an assumption that fluoxetine can induce mania, extrapyramidal symptoms(EPS) and suicidal ideation in some part of the serotonin unbalanced patients. We think this would be the first report to remark on fluoxetine's suicidal and manic side effects in Korea. So here we present the case with the summary of reviewed articles.

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건강증진학교에서 초등학교와 중학교 학생들의 정신건강 실태 및 관련된 가정-사회적 요인들 (Mental Health of Elementary and Middle School Students, and Related Familial-Social Factors in Health Promoting School)

  • 안동현;정승아;김석현;송화진;이미순
    • 한국학교보건학회지
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    • 제21권2호
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    • pp.35-46
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    • 2008
  • Purpose: This study was a part of preliminary survey for establishing Korean HPS(Health Promoting School) model which was originally suggested by WHO. Methods: Three elementary and middle schools were sampled in urban and rural area across three level of social-economic status, and survey was conducted on one class in each grade by random selection. To measure mental health and social and familial factors, self-esteem scale, self-efficacy scale, depression scale, family cohesion scale, parent-child communication scale, adolescent's mental health and problem behavior questionnaire(AMPQ), and other question items about family status and economic level were conducted. Students' mental health level was compared by region, sex, grade, and other familial and economic factors. Results: Familial and social factors such as economical and educational level of parents, number of family members were different between rural and urban area. Also, students of rural area got lower scores at self-esteem, self-efficacy, but higher scores at extroverted problem behavior than their urban counterparts. In pre-school students, high grade students' self-esteem, and family cohesion scores were lower than low grade students. And sexual differences were found across problem behavior domain and region in middle school students. Especially, the students of single-parent family and lower economic family got insistently low scores at various mental health related scales. Conclusion: These results should be considered, when the HPS model is designed and applied in Korea.

청소년 성장발달자산의 건강위험행태 방어효과 (The Protective Effects of Development Assets on Health Risk Behaviors among Korean Adolescents)

  • 이명순
    • 보건교육건강증진학회지
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    • 제22권4호
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    • pp.137-154
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    • 2005
  • Objectives: This study aims to examine the positive effects of developmental assets on the prevention of health risk behaviors among Korean adolescents. The framework of developmental assets was introduced as building blocks for healthy child and adolescent development by Benson and his colleagues. These assets represent positive external environmental factors and internal personal qualities which strongly influence the quality of life of adolescents. Methods: In 2001, we administered self-reported questionnaires to 3,739 girls and boys in grade 9 at eight schools in two cities, Chinju and Suwon in South Korea. The data was compiled into a 'Korean Youth Health Related Behaviors and Developmental Assets Survey' and then analyzed Youth health risk behaviors, which we measured in terms of their frequency, included tobacco, alcohol, and substance use, sexual intercourse, anti-social behaviors, violence, feelings of social isolation at school, depression or attempted suicide, absenteeism from school, gambling. Results: Overall, with respect to developmental assets, the Korean adolescents surveyed only 12.6 of the 40 assets, and 88 percent of adolescents had 20 or fewer of the assets. Based on their number of developmental assets(DA), adolescents were categorized into four groups: Group I(DA 0-10): Group II(DA 11-20): Group III(DA 21-30): Group IV(DA 31-40). We examined the differences in the frequency of each health risk behavior across the four groups, Group I-IV, and found that the frequency of most health risk behaviors decreased as the number of developmental assets increased. Conclusion: We therefore concluded that in order to make effective approaches for the prevention of health risk behaviors among adolescents, we should consider and develop more comprehensive and adolescents-based policy and programs to promote various aspects of adolescents' health and quality of life.

노인성치매 발생요인과 돌보는 가족원의 스트레스에 관한 조사 연구 (A Study on risk factors for senile dementia)

  • 홍여신;이선자;박현애;조남옥;오진주
    • 대한간호학회지
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    • 제24권3호
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    • pp.448-460
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    • 1994
  • This study was conducted to investigate risk factors for senile dementia as well as care givers' stresses and thier needs for nursing care. It was done using a retrospective survey. A convenience sample or In senile dementia patients and l20 nor-mal elders in a rural area was used. The tools used in the study were the MMSE-K(Mini-Mental State Examination-Korea) for dementia screening test and a questionaire developed by the research team. Data were collected through home visits by Com-munity Health Practitioners. Data were analyzed using descriptive statistics, T-test, and Chi-square test. The findings are as follows : 1. There were significant differences in age, marital status, and religions between the two groups. 2. There was a significant difference in smoling behavior between the two groups. 3. There was a significant difference in past his-tory of cancer between groups. 4. There was a significant difference in past and present elderftmily relationship between the two groups. 5. There were significant differences in intellectual activities, assuming major role in family and seeking other's help in daily life troubles between the two groups. 6. There were significant differences in stress factors such as child problem, family conflict, health problem and illegal behavior between the two groups. 7. The major problems out by families in caring for dementia patient were catastrophic reactions, dirtiness, mood change, devouring and tremor. The most serious problems faced by families was dirtiness. with catastrophic reactions, sleep distrubance, changeableness, and a suspcio-usness following. The care givers expressed chronic fatigue, anxiety, tension, depression, disorder in daily life, shamefulness, blame from neighbours and guiltiness. 8. There is need for geriatric hospitals, nursing homes, burden sharing, and counselling or education for family care givers. A replicate study in the urban area is recommended to validate the findings of this study. To explore the impact of stress in life and ‘han’ on senile dementia, a qualitative study is recommended.

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부정적 가족 생활사건, 배우자 지지와 정신건강 - 성별차이를 중심으로 - (Negative Family life Events, Spousal Support and Mental Health: Focus on Gender Differences)

  • 강혜원;한경혜
    • 대한가정학회지
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    • 제43권8호
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    • pp.55-68
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    • 2005
  • The purpose of this study is to examine the effects of negative life events on mental health and to explore possible main and moderating effects of spousal support on mental health with a focus on gender differences. The data for this study were taken from a nationwide random sample of 1,504 married men and women ranging in age from 30 to 59 through structured questionnaires. The data were analyzed using the SPSS WIN program which was used to calculate frequency, mean, 1-test, multiple regressions. The main results were as follows: First, by examining mental health of Korean men and women, women were more likely than men to experience higher levels of depression. Second, there was no gender difference in the sum of experience of negative life events, therefore the date of this study did not support the differential exposure hypothesis. In addition, men perceived more support from their spouses than women. Third, results show that especially the event concerning with job/financial problems has negative impacts on mental health of both men and women, and vulnerability to undesirable life events was not found. Fourth, spousal support is associated with better mental health regardless of gender, and it reduces the harmful effects of life events concerning with job/financial area for both men and women. Also, spousal support reduces the magnitude of the harmful effects of life events concerning with health of men. This study focused on the impact of negative life events and the couple process. It was possible to explore the strength of social support provided from spouse of most importance to the individuals. These results affirm the importance of supportive relationships between couples as a buffer, mitigating harmful effects of negative life events on mental health.

신증후군 환아에서 발생한 독성표피괴사용해 치료를 위해 사용된 고용량 스테로이드로 인한 정신질환 1례 (A case of steroid-induced psychosis in a child having nephrotic syndrome with toxic epidermal necrolysis)

  • 김세윤;이재민;박용훈
    • Clinical and Experimental Pediatrics
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    • 제53권3호
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    • pp.437-441
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    • 2010
  • 독성표피괴사용해(TEN)와 스티븐-존슨 증후군(SJS)은 약물이나 감염에 의해 발생하는 피부점막을 침범하는 드물지만 치명적인 질병이다. 스테로이드는 TEN의 치료에 많이 이용되어왔지만, 아직까지도 논쟁중이다. 스테로이드에 의한 정신과적 영향은 두통, 불면증, 우울증, 심리질환 등이 있다. 스테로이드에 의한 정신질환에서 치료는 스테로이드의 감량 또는 중단이고, 항정신성 약물을 투여한다. 신증후군으로 진단된 11세 남아에서 스테로이드 치료 후 관해상태에서 유지치료를 시행하고 있던 중에 TEN이 발생하였다. 저자들은 이 환아에서 치료목적으로 투여한 고용량 스테로이드 정맥주사로 인해 정신질환이 동반되었고, 이후 스테로이드 감량과 항정신성 약물과 면역글로불린으로 증상이 호전되는 것을 경험하여 이를 보고하는 바이다.

청소년의 휴대전화 의존 예측변인에 대한 성차 연구 (The Gender Difference in Predictors of Mobile Phone Dependency in Youth)

  • 김현순;최영준
    • 한국콘텐츠학회논문지
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    • 제15권5호
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    • pp.340-352
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    • 2015
  • 본 연구의 목적은 청소년의 성별에 따라 휴대전화 의존 예측변인에 차이가 있는가를 검증하는 것이다. 이를 위해 한국청소년정책연구원에서 실시한 한국아동 청소년패널조사(KCYPS) 중에서 중학교 1학년 패널 3차 년도(2012)의 데이터를 활용 분석하였다. 예측 변인으로 주의집중결핍, 공격성, 우울, 사회적 위축, 부모의 학대, 부모의 방임, 학습활동, 또래소외를 설정하고 단계적(stepwise) 회귀분석을 통해 분석하였다. 연구결과는 다음과 같다. 첫째, 휴대전화 의존도는 성별에 따라 유의미한 차이를 보여, 여학생의 휴대전화 의존도는 남학생의 휴대전화 의존도보다 유의미하게 높았다. 둘째, 남학생의 휴대전화 의존을 가장 잘 설명하는 예측변인은 공격성이고 그 다음이 부모의 학대, 주의집중 결핍, 그리고 학습활동 순이었으며, 여학생의 예측변인은 첫째가 우울이고 그 다음이 주의집중 결핍, 공격성, 학습활동 그리고 사회적 위축 순으로 나타났다. 여학생의 휴대전화 의존은 남학생의 경우보다 더 많은 변인의 영향을 받으며, 남학생의 경우와는 달리 우울과 사회적 위축과 같은 관계지향적인 변인에 의해 더 영향을 받고 있음을 확인할 수 있었다. 본 연구결과에 근거하여 청소년의 휴대전화 의존의 예방 및 치료를 위한 개입의 실천적 방안은 모든 대상자들에게 일괄적으로 적용되기 보다는 성별에 따라 차별적으로 이루어져야 할 필요가 있음을 제언하였다.

한국판 주산기 외상 후 스트레스장애 척도의 신뢰도 및 타당도 (Reliability and Validity of the Korean Version of the Perinatal Post-Traumatic Stress Disorder Questionnaire)

  • 박유경;주현옥;나현주
    • 대한간호학회지
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    • 제46권1호
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    • pp.29-38
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    • 2016
  • Purpose: The Perinatal Post-Traumatic Stress Disorder Questionnaire (PPQ) was designed to measure post-traumatic symptoms related to childbirth and symptoms during postnatal period. The purpose of this study was to develop a translated Korean version of the PPQ and to evaluate reliability and validity of the Korean PPQ. Methods: Participants were 196 mothers at one to 18 months after giving childbirth and data were collected through e-mails. The PPQ was translated into Korean using translation guideline from World Health Organization. For this study Cronbach's alpha and split-half reliability were used to evaluate the reliability of the PPQ. Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and known-group validity were conducted to examine construct validity. Correlations of the PPQ with Impact of Event Scale (IES), Beck Depression Inventory II (BDI-II), and Beck Anxiety Inventory (BAI) were used to test a criterion validity of the PPQ. Results: Cronbach's alpha and Spearman-Brown split-half correlation coefficient were 0.91 and 0.77, respectively. EFA identified a 3-factor solution including arousal, avoidance, and intrusion factors and CFA revealed the strongest support for the 3-factor model. The correlations of the PPQ with IES, BDI-II, and BAI were .99, .60, and .72, respectively, pointing to criterion validity of a high level. Conclusion: The Korean version PPQ is a useful tool for screening and assessing mothers' experiencing emotional distress related to child birth and during the postnatal period. The PPQ also reflects Post Traumatic Stress Disorder's diagnostic standards well.

Clinical Effects of Korean Red Ginseng on Attention Deficit Hyperactivity Disorder in Children: An Observational Study

  • Lee, Suk-Hwa;Park, Woo-Sung;Lim, Myung-Ho
    • Journal of Ginseng Research
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    • 제35권2호
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    • pp.226-234
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    • 2011
  • We investigated the clinical effects of Korean red ginseng on attention deficit hyperactivity disorder (ADHD) in children. Eighteen subjects aged between 6 and 14 diagnosed with ADHD based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition diagnosis criteria were enrolled. Korean red ginseng (Panax ginseng) at 1,000 mg b.i.d. was administered to the subjects for 8 weeks. Eighteen children completed the questionnaire and clinical assessment by visiting the hospital at baseline, then in the first, fourth and eighth weeks. Clinical assessments were performed by using the ADHD Diagnostic System (ADS, a computerized attention assessment program), the abbreviated Conners' rating scale in addition to psychiatric interviews. After 8 weeks, significant differences were found in the omisssion errors of ADS ($78.56{\pm}43.33$ at baseline, $55.17{\pm}21.44$ at 8 weeks, p<0.023), Conners ADHD Rating Scale ($13.78{\pm}6.32$ at baseline, $9.50{\pm}4.80$ at 8 weeks, p<0.042) and Spielberger State Anxiety Scale ($30.94{\pm}6.25$ at baseline, $28.83{\pm}6.23$ at 8 weeks, p<0.024). In the Korean Personality Inventory for Children, a significant reduction of score was found in the physical development scale ($56.44{\pm}9.63$ at baseline, $50.94{\pm}8.91$ at 8 weeks, p<0.017) and social dysfunction scale ($56.33{\pm}6.82$ at baseline, $51.94{\pm}7.13$ at 8 weeks, p<0.025). These results suggest that Korean red ginseng may be effective in improving inattentiveness in ADHD children, but it remains uncertain if it improves the general severity of ADHD, depression, anxiety personality and behavioral changes.

배낭으로 인한 상완 신경총 마비 (Backpack Palsy)

  • 윤웅용;이규용;이영주;김희태;김주한;김명호
    • Annals of Clinical Neurophysiology
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    • 제3권2호
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    • pp.143-146
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    • 2001
  • Background : Backpack palsy was described in military personnel with shoulder girdle and proximal upper extremity symptoms, predominantly motor in nature related to the use of heavy backpack. Currently, backpack were used for sports, transporting school books and child carriers. We evaluated clinical and electrophysiological feature of backpack palsy. Methods : We included 11 patients with brachial plexopathy as a result of wearing a heavy backpack on long distance marches. All patients were done routine blood sampling, chest X-ray, C-spine X-ray and electrophysiological studies. Results : All patients were right handed person and were not as having a thoracic outlet syndrome. Sensory changes were main initial symptoms and major persistent symptoms were motor weakness. 9 patients(81.8%) were damaged the brachial plexus on non-dominant side, 1 patient was dominant and 1 patient was bilateral involvement. 10 patients(90.9%) were damaged to upper trunk of the brachial plexus by EMG findings. The prognosis was good, 10 patients(90.9%) were complete recovery during 8 weeks, 1 patient was developed reflex sympathetic dystrophy confirmed by 3-phase bone scan. Conclusions : Depression of the clavicle and costoclavicular space probably plays a certain role in pathogenic mechanism. The non-dominant side is more frequently affected, probably due to underdevelopment of the musculature in that side.

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