• 제목/요약/키워드: Chronic schizophrenia

검색결과 82건 처리시간 0.023초

지역사회 거주 조현병 범주 장애 환자의 신체건강관리 관련 요인 (Factors Related to Physical Health Monitoring in Community-Dwelling Patients with Schizophrenia Spectrum Disorder)

  • 김미나;전민;이주연;김선영;김재민;윤진상;김수진;김성완
    • 대한조현병학회지
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    • 제22권1호
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    • pp.14-20
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    • 2019
  • Objectives: To identify factors related to physical health monitoring of patients with schizophrenia spectrum disorder. Methods: A total of 172 patients with schizophrenia spectrum disorder registered in mental health welfare centers and rehabilitation facilities in Gwangju were recruited. Physical health monitoring was defined by two health behaviors; fasting blood tests within recent 2 years in all participants and routine medical check-ups covered by national insurance within recent 5 years in participants aged 40 years or older. Demographic and clinical characteristics including overweight, metabolic syndrome and knowledge about physical illness were compared according to physical health monitoring. Results: Prevalence of overweight and metabolic syndrome were 62.8% and 40.1%, respectively. The rates of fasting blood tests and routine medical check-ups were 34.9% and 67.9%, respectively. The rates of fasting blood tests were significantly higher in general hospital and university hospital compared to mental hospital or private clinic. Rates of routine medical check-ups were significantly lower in individuals using daily rehabilitation service and smokers. Knowledge about cancer and chronic illness were significantly better in individuals receiving routine medical check-ups compared with those not receiving it. Conclusion: Education about physical health should be integrated to mental health service in community mental health center.

사혈요법과 기타 한방치료를 이용하여 치료한 만성 비염을 동반한 전증(癲證) 환자의 증례보고 (A clinical Report of Jeon-zeong(癲證) with Chronic hypertrophic rhinitis by Blood-Letting therapy and other Korean Traditional treatment)

  • 강희철
    • 동의신경정신과학회지
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    • 제21권3호
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    • pp.129-137
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    • 2010
  • Objectives : The purpose of this study was to investigate the clinical application of Korean Traditional treatment to Jeon-zeong(癲證) with Chronic hypertrophic rhinitis. Methods : In this case, a 25 years old male patient has suffered by schizophrenia for 2 years and by Chronic rhinitis for 9 months. During 171 days, we treated the patient with Korean Traditional treatment. Specially blood-Letting therapy helped the patient to decrease the auditory hallucination, catalepsy and retardation as well as the snuffles. Results : After treatment. the chief complain and accompanying symptoms were subsided and improved. And Personal and social performance scale was increased. Conclusions : According to this study, Korean Traditional treatment such as Blood-Letting therapy, acupuncture and heb-medication is effective for the cure of Jeon-zeong(癲證) with Chronic hypertrophic rhinitis.

전증(癲證) 환자의 치험 1례 (A Case of Negative Symptoms of Schizophrenia)

  • 허은정;김지현;류희영
    • 동의신경정신과학회지
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    • 제21권2호
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    • pp.215-227
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    • 2010
  • Objectives : Jeon-Jeung(癲證) is one of negative symptoms from schizophrenia in Western medecine, which causes flattening of affect, emotional bluntness, and avolition. Compared with positive symptoms of schizophrenia, there is no established treatments that have been proved to be effective for negative symptoms, and since negative symptoms are chronically processed, they finally lead to devastate the mental health. Since Jeon-Jeung(癲證) is usually in set in adolescent period and tends to become chronic through life time, it is important to start getting treatments in early stage by being distinguished from other diseases, such as anxiety disorder. A patient in this case was affective blunting, general weakness, and delusion when sixteen years old. However, he refused to get Western medicine treatment and wanted oriental medicine treatment. Methods : The patient in this case had been suffered from severe stress from his family since he was young and had kept having irregular and unhealthy eating habits. Therefore, he diagnosed stagnant qi transforming into fire(氣鬱化火), heart blood deficiency(心血虛), and spleen-stomach deficiency cold(脾胃虛寒) and since then he had received several treatments including herbal treatment, acupumcture treatment, supportive therapy, and family therapy. These treatments were successful and reduced the level of symptoms. After discharged from the hospital, he had continued receiving outpatient treatment with his family for 8 months and his progress had been still observed after the discharge. Results : The symptoms of patient had been almost reduced and eliminated after he received 29days of admission treatment and the patient got better and better and now lives a normal life 8 months outpatient treatment. Conclusions : This result suggests that our oriental medical treatments and family treatments was effective on schizophrenia.

만성조현병환자 어머니의 감사경험 (Gratitude Experience of Mothers who cares Child with Chronic Schizophrenia)

  • 홍주은
    • 디지털융복합연구
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    • 제18권1호
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    • pp.199-209
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    • 2020
  • 본 연구의 목적은 조현병 자녀를 돌보는 어머니들의 감사경험의 본질을 탐색하고자 하였다. 서울시 일개 정신건강복지센터에 등록된 회원 중 조현병 진단 후 만 5년이 경과된 회원의 어머니 5명을 대상으로 심층면담을 하고, Giorgi(1997)의 현상학적 연구방법으로 분석하였다. 결과 조현병 자녀 어머니의 감사경험은 18개의 하위구성요소와 감사할 것 없이 척박한 땅에 떨어진 씨앗 같은 나, 새싹처럼 움트기 시작하는 감사, 포용을 통해 나무로 자란 감사, 자족과 바람의 열매를 맺는 감사, 베풂으로 인해 더 풍성해진 감사의 5가지 구성요소가 도출되고, 역동적 순환체계로 진행되어감을 확인하였다. 이로서 조현병 자녀 어머니의 감사경험은 원망, 수용, 용서, 소망, 나눔의 순방향으로 진행되기 위해서 정신건강전문가들의 적극적인 상담과 조현병 자녀 어머니들의 개별 또는 집단교육 및 중재프로그램 개발 연구가 더욱 확대되어야 한다.

만성 정신분열병 환자들의 인지 기능과 정서 인식 능력의 관련성 (The Relationship between Neurocognitive Functioning and Emotional Recognition in Chronic Schizophrenic Patients)

  • 황혜리;황태연;이우경;한은선
    • 생물정신의학
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    • 제11권2호
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    • pp.155-164
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    • 2004
  • Objective:The present study examined the association between basic neurocognitive functions and emotional recognition in chronic schizophrenia. Furthermore, to Investigate cognitive variable related to emotion recognition in Schizophrenia. Methods:Forty eight patients from the Yongin Psychiatric Rehabilitation Center were evaluated for neurocognitive function, and Emotional Recognition Test which has four subscales finding emotional clue, discriminating emotions, understanding emotional context and emotional capacity. Measures of neurocognitive functioning were selected based on hypothesized relationships to perception of emotion. These measures included:1) Letter Number Sequencing Test, a measure of working memory;2) Word Fluency and Block Design, a measure of executive function;3) Hopkins Verbal Learning Test-Korean version, a measure of verbal memory;4) Digit Span, a measure of immediate memory;5) Span of Apprehension Task, a measure of early visual processing, visual scanning;6) Continuous Performance Test, a measure of sustained attention functioning. Correlation analyses between specific neurocognitive measures and emotional recognition test were made. To examine the degree to which neurocognitive performance predicting emotional recognition, hierarchical regression analyses were also made. Results:Working memory, and verbal memory were closely related with emotional discrimination. Working memory, Span of Apprehension and Digit Span were closely related with contextual recognition. Among cognitive measures, Span of Apprehension, Working memory, Digit Span were most important variables in predicting emotional capacity. Conclusion:These results are relevant considering that emotional information processing depends, in part, on the abilities to scan the context and to use immediate working memory. These results indicated that mul- tifaceted cognitive training program added with Emotional Recognition Task(Cognitive Behavioral Rehabilitation Therapy added with Emotional Management Program) are promising.

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정신분열병 환자의 도파민 $D_5$ 수용체 유전자형과 치료반응과의 연관 (The Association between the Dopamine $D_5$ Receptor Genotype and Treatment Response for Korean Schizophrenic Patients)

  • 강성민;이민수;이충순
    • 생물정신의학
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    • 제7권2호
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    • pp.159-163
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    • 2000
  • Background : Dopamine receptors are strong candidates for involvement in schizophrenia and are target of a wide variety of antipsychotics. Dopamine $D_5$ receptor(DRD5) gene polymorphisms may be associated with various treatment response. The purpose of our study was define to what significance can be held as a predictor of treatment response in this polymorphism. Method : The total number of 116 Korean chronic schizophrenic patients was assessed after 48 weeks treatment. The Positive and Negative Syndrome Scale(PANSS) was rated for the clinical response to various antipsychotics. With the use of polymerase chain reaction amplification, we assessed this dopamine $D_5$ receptor polymorphism in schizophrenic patients who had been treated with antipsychotics, and related genotype with treatment response, to test the hypothesis that DRD5 polymorphism may lead to varying response to antipsychotics. Result : DRD5 polymorphism was not associated with treatment response to a variety of antipsychotics in chronic schizophrenic patients. Conclusion : Genetic variation of $D_5$ receptors do not predict treatment response to antispychotics.

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클로자핀 처방 패턴 및 클로자핀 중단과 관련된 임상 요인 (Prescribing Pattern of Clozapine and Clinical Factors associated with Discontinuation of Clozapine)

  • 강시현;이혜원
    • 대한조현병학회지
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    • 제22권1호
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    • pp.1-7
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    • 2019
  • Objectives: Clozapine is the drug of choice in treatment-resistant schizophrenia. However, its use is often delayed and a significant proportion of clozapine treated patients fails to respond and experience potentially dangerous side-effects. The aim of this retrospective study was to describe the clinical characteristics of patients started on clozapine and the rate and reason of discontinuation of clozapine. Methods: Medical records of 83 patients started on clozapine during the period of 2012-2016 were reviewed. Results: Clozapine started on patients in chronic phase; the mean age of start was 38.1 years old and the mean number of psychiatric admission was 6.5. A majority (80.7%) of the patients had been subjected to antipsychotic polypharmacy prior to clozapine and most (61.5%) of them were being treated with polypharmacy including clozapine. Overall, 39 (47.0%) subjects had continued clozapine whereas 15 (18.1%) discontinued it; 29 (34.9%) were lost to follow-up. The most common reason for discontinuation was side-effects (n=13) including six life-threatening cases, most of which occurred within 6 months of its start. Conclusion: This study demonstrated that there is some evidence of delays to clozapine use, high rates of polypharmacy and significant rate of discontinuation during the early phase of clozapine treatment.

정신과 외래 환자에서의 신경 심리 검사 (Neuropsychological Tests in Psychiatric Outpatients)

  • 이성훈;박희정;박혜정;이희상;김찬형
    • 수면정신생리
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    • 제4권1호
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    • pp.120-128
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    • 1997
  • Clinical neuropsychological tests were developed originally for the diagnosis of neurological and neuro-surgical diseases. Recently, these tests are being introduced to psychiatric patients. Authors had the experience to use these tests in pychiatric outpatient clinic. Results were as follows. There was a significantly increase in language and attentional function in residual schizophrenia compared to normal control. In chronic neurosis, as visuospatial function was reduced, language and attentional functions were enhanced. With these results, authors suggest that application of neuropsychological tests in psychiatric patients may be very helpful in classifying the subgroups of disease, in selecting the modality of treatment, and in expecting prognosis.

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일부 만성 중증 정신질환자의 약물 복용에 따른 구강건조증상과 자극성 타액분비율 (Subjective oral dryness and stimulated salivary flow rate in medicated patients in chronic severe psychiatric patients)

  • 문소정;서혜연;전현선;백지현;노희진;정원균
    • 한국치위생학회지
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    • 제14권3호
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    • pp.353-362
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    • 2014
  • Objectives : The purpose of the study is to investigate the xerostomia in the chronic severe psychiatric patients in Korea because there were few reports on xerostomia in the psychiatric patients. Methods : The subjects were 61 psychiatric patients in the mental hospital by convenience cluster sampling. A self-reported symptom questionnaire was filled out by the three researchers on the basis of medical records by the informed consent. The stimulated salivary flow rate of the patients was measured by saliva sampling. Results : The subjects consisted of 45.9% of male and 54.1% of female. High school graduation accounted for 40.0% and 20.0% did not attend the school. The majority of the patients were medicaid recipients. Schizophrenia accounted for 86.9% and most patients were long term care recipients. A total of 68.9% of the patients suffered from salivary dysfunction. The medication in schizophrenia seemed to decrease the stimulated salivary flow rate and made the patients difficult in chewing and swallowing due to xerostomia and low saliva secretion(p<0.05). Conclusions : Medication in schizophrenic patients caused the salivary dysfunction. So the collaboration between the psychiatry doctors and dental hygienists is very important to improve the salivary secretion in the schizophrenic patients. The continuous and long term care of the xerostomia will help the patients maintain the good oral hygiene.

만성 정신분열병 환자에서 Risperidone과 Clozapine이 체중과 혈당에 미치는 영향 - Haloperidol과의 비교 연구 - (The Influences of Risperidone and Clozapine on Body Weight and Glucose Level in Patients with Chronic Schizophrenia - Comparison Study with Haloperidol -)

  • 남천우;양병환;이준노
    • 생물정신의학
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    • 제11권2호
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    • pp.127-135
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    • 2004
  • 본 연구는 비전형적 항정신병약물이 체중과 혈당에 미치는 영향을 알아보고 그에 관계되는 여러 변인들의 관련성을 알아보고자 하였으며 이를 위해 비전형적 항정신병약물인 risperidone과 clozapine을 쓰는 환자 각각 20명, 대조군으로 전형적 항정신병약물인 haloperidol을 쓰는 환자 20명을 대상으로 입원 후 4주, 8주, 12주째 체중과 공복 시 혈당을 입원 초기 체중 및 혈당과 비교하였으며 각 약물군 간의 차이를 조사하여 다음과 같은 결과를 얻었다. 첫째, 연구 대상 환자의 초기 특성 상 clozapine군이 haloperidol과 risperidone군에 비하여 입원 시 체중이 높은 상태였는데 이는 clozapine을 복용하는 환자들이 이전에 haloperidol과 risperidone을 포함한 여러 가지 항정신병약물을 복용했던 경험이 있고 이로 인해 이미 어느 정도의 체중 증가가 있었던 것으로 생각해볼 수 있다. 둘째, 체중 변화는 risperidone과 clozapine군 모두 haloperidol을 쓴 군과 유의한 차이가 없었다. 셋째, 혈당 변화도 비전형적 항정신병약물인 risperidone과 clozapine군이 haloperidol군에 비해 의미 있는 차이가 없었다. 넷째, 몇 가지 변수들이 체중과 혈당의 변화에 연관성을 가지고 있었으나 그 정도는 크지 않았고 그 인과관계를 증명할 수는 없었다. 위의 결과들에서 볼 때 유병 기간이 길고 이전에 여러가지 항정신병약물을 복용한 경험이 있는 환자, 약물 복용에 따른 증상의 호전 정도가 두드러지지 않는 만성적인 정신분열병 환자들에서는 비전형적 항정신병약물이 전형적 항정신병약물에 비해 체중 변화와 혈당의 수치를 변화시키는 경향이 크지 않다는 점을 알 수 있었다.

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