• 제목/요약/키워드: Medically ill

검색결과 16건 처리시간 0.02초

정신과에 의뢰된 내과계 환자들에 대한 치료적 접근 - 정신약물치료 - (Therapeutic Approaches to the Patients Who were Referred for Psychiatric Consultation from Medical Departments - Psychopharmacotherapy in Medically Ill Patients -)

  • 나철
    • 정신신체의학
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    • 제1권1호
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    • pp.92-97
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    • 1993
  • Successful management of mental symptoms requires proper diagnostic tools and comprehensive treatment including psychotherapy, physical therapy and psychopharmacotherapy. For this purpose. valid and reliable diagnostic instruments need to be developed. and the data regarding various treatment methods in medical and psychiatric comorbid conditions should be available. Because mental symptoms originate from various aspects of biological, psychological and social factors. each aspect may have slightly different therapeutic goal. Alterations in pharmacokinetics and pharmacodynamics of medically ill and/or old patients may complicate the treatment outcomes. Best psychopharmacological treatment needs to be elaborated in various states. Mental symptoms of the medically ill patients may be treated more effectively with an eclectic approach.

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신체질환이 있는 노인 환자의 정신신체 의학적 치료 : 자문정신의학을 중심으로 (Psychosomatic Management of Medically Ill Elderly : Focused on Consultation Psychiatry)

  • 류성곤;권희정
    • 정신신체의학
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    • 제16권1호
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    • pp.25-30
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    • 2008
  • 최근 노인인구의 급속한 증가로 인하여 정신과에서 노인에 대한 자문의 중요성이 확대되고 있다. 따라서 임상에서의 노인에 대한 정신과 자문의 특징과 지침에 대한 이해가 필요하다. 타과적 질환을 갖는 노인에 대한 정신과적 자문은 다른 연령층과는 다른 특성을 갖는다. 노화에 따른 장기 기능의 변화와 약동학 및 약력학의 변화에 대한 숙지가 노인에 대한 정신약물학적 접근에 매우 필수적이다. 타 연령층에 비해 노인에 대한 정신과적 자문은 상대적으로 적은 것으로 조사되었으나 실제 정신과적 자문이 노인질환의 재원기간이나 기타 사망률 등을 낮출 수 있음을 고려할 때, 노인에 대한 자문을 저해하는 요인들을 분석하고 교정하는 것이 매우 필요하다.

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신체질환에서 나타나는 불안의 평가와 치료 (Recognition and Treatment of Anxiety in Medically Ill Patients)

  • 나철
    • 정신신체의학
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    • 제3권2호
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    • pp.214-221
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    • 1995
  • There appears to be an increased incidence of anxiety symptoms in association with certain medical illness. It is usually assumed that certain medical disorders are directly associated with anxiety symptoms in that the pathophysilolgy of the medical illness somehow causes the anxiety symptoms. However, the pathophysilolgies of many such medical illnesses as well as anxiety are not known and no discrete group of medical illnesses is clearly more likely to produce anxiety symptoms than any other Moreover, anxiety symptoms may be the representation of other psychiatric symptoms, like depression and delirium. Though it is important to differentiate primary and other causes(secondary) of anxiety clinically, the clear differentiation is somewhat arbitrary, as the confusion of mind-body dichotomy. for the purpose of accurate treatment of anxiety symptoms relating medical illness, this review article focuses on those clinical features and mechanisms of anxiety that are potentially useful in differential diagnosis.

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신체질환 환자들에서 우울증의 평가 및 치료 (Assessment and Treatment of Depression in the Medically III)

  • 고경봉
    • 정신신체의학
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    • 제9권2호
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    • pp.111-132
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    • 2001
  • 신체질환 환자들에서의 우울증은 일차진료의나 정신과자문의가 흔히 부딪치는 임상적 문제들이다. 본 저자는 이런 환자들을 효과적으로 평가하고 치료하기 위한 방법들을 알아보고자 하였다. 첫째, 환자의 의학적 및 정신과적 상태를 동시에 평가해야 한다. 둘째, 신체질환 환자에서 우울의 평가는 다면적인 접근을 고려하는 것이 바람직하다. 때로는 심리적 도구를 이용하는 것도 좋은 평가 방법이다. 치료는 첫째, 기질적 원인을 찾아서 제거하는 일이 무엇보다 중요하다. 둘째, 정신사회적 치료로는 정신과적 치료에 대한 저항을 다루어야 하고 심한 신체적 질환에 따른 낙담 반응을 처리해 주는 일이다. 셋째, 생물학적인 치료방법으로는 적절한 항우울제를 선택하는 것이 중요하다. 선체질환 환자들에서 항우울제의 선택은 환자의 일차적인 우울증상, 약물역학 및 약물역동, 항우울제의 부작용을 평가한 후 고려한다. 이 외에도 약물-질병 및 약물-약물 상호작용의 가능성에 관해 각별히 주의를 기울일 필요가 있다. SSRI약물, bupropion, venlafaxine과 같은 새로운 항우울제들이 신체질환 환자들의 우울증 치료에 효과적이나 삼환계 항우울제는 통증장애 환자들에서는 아직도 효과적으로 사용될 수 있는 약물이다. 신체질환 환자들에서 항우울제로 우울증이 잘 치료되지 않는 경우에는 전기충격요법의 사용을 고려해 본다.

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사망신고자료(死亡申告資料)에 의한 사인분석(死因分析) (An Analysis of Cause of Death from the Reported Death Certificates in Korea)

  • 이동우
    • Journal of Preventive Medicine and Public Health
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    • 제14권1호
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    • pp.39-42
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    • 1981
  • Recent changes in the cause of death among the Korean population seem to be systematic and significant. Data on cause of death from the medically certified death certificates provide at least four types of evidence: a sudden increase in recent years in the numbers of death due to cerebrovascular disease or circulatory diseases including rheumatic fever and chronic heart diseases and atherosclerosis; increasing steadily in the numbers of death due to malignant neoplasm of various sites, and death due to accident; decreasing steadily in the numbers of death due to communicable diseases or parasite diseases; and a large number of deaths with unspecified symptoms and ill-defined conditions. The lack of complete registration of the deads occurred or the incomplete description on the cause of death reported suggests that statistical information of cause of death from the medically certified death records is meaningful in interpreting changing patterns.

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부산지구 정신요양원 실태조사 (Survey of Psychiatric Convalescent Facilities in The Busan area)

  • 송영선
    • 대한간호학회지
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    • 제3권3호
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    • pp.62-72
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    • 1973
  • THE author conducted a field survey form Feb.1, 1973 to March 31, 1973 in the Busan area, standing six "institutions" where mentally ill patients are kept. These six institutions are registered at Busan Government, but are not regular hospitals. There suits of these investigation are as follows: \circled1 There are six institutions. which are registered at Busan City Government. All six are operated by layman who have little psychiatric knowledge and little human is tic motivation. \circled2 These institutions are allegedly to promote the welfare of the mentally sick. However they give little help for the patients. And they do not even have a resident medical person. The staff of those places will not accept professional medical help, and try to keep all information secret. \circled3 The finances are largely composed of patients′fees and partially from city′s help. The buildings are of high quality compared with the poor therapeutic situation. There also exist factors which make the patients worse, i,e. very small room space, compelling the patients to sit in a uteral position. This situation makes them worse and more autistic. \circled4 At the time of this survey, those lucrative overcrowded six institutions had 1.000 patients. At the same time the legitimate hospitals in Busan area had about 200 patients, \circled5 In my opinion, the City Government must take a more positive policy for the mentally ill patients, instead of the passive attitude which has held till now. And most of all, these patients must be medically and humanistically helped, instead of being left in a forgotten, depressed snake pit.

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여성건강에 있어서의 산후풍 (Sanhoopoong in Women's health)

  • 김태희
    • 부모자녀건강학회지
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    • 제3권1호
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    • pp.35-45
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    • 2000
  • The object of this research was to examine closely through the document about how much important location Sanhoopoong had and how it influences in the women's health. In addition to that, from the result of this research. I would like to contribute to korean nursing theory development and korean traditional nursing. Sanhoopoong is only the pain of women, come out to whom experienced delivery and abortion and especially it is an important cultural disease to Korean women. This is, once be taken ill, even reputed doctors cannot cure, so this make women suffer from pain, fall ill, decrease the quality of women's life, and it is appealed by women constantly, and is just made known by traditionally. The cause of Sanhoopoong has not been recognized medically The disease is not included in the disease classification. Thus, Sanhoopoong has no special pathological cause, and because it is the desease when be not taken care after childbirth, so this is able to be prevented and relieved sufficiently. But Sanhoopoong is the important health matter to dominate women's whole life's health. It has to be researched and lightened quikly. We have to help the women to get out of the difficulties from the pain of Sanhoopoong as soon as possible.

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항불안제 사용의 임상지침 (Clinical Guidelines for Anti-anxiety Drug Use)

  • 임기영
    • 생물정신의학
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    • 제1권1호
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    • pp.31-39
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    • 1994
  • Anxiety and anxiety disorders are one of the most common and most serious psychiatric problems. Anti-anxiety drugs are one of the most effective treatment method for these problems. Benzodiazepines have various side-effects and the risk of overuse and abuse. Therefore, physicians should prescribe benzodiazepines carefully. However, they should not be discouraged from prescribing benzodiazepines when they have a knowledge of the pharmacological characteristics of these drugs and there is a clear indication for their use. Generally speaking, problems of benzodiazepine use such as dependence withdrawal symptoms, and cognitive impairment are more likely to occur with high dose, long-term use(more than 4 months), in geriatric patients and patients with a history of alcohol or other sustance abuse. But long-term or high-dose use can be jusified for patients with panic disorder of agoraphobia, and medically-ill patients with persistent anxiety that cannot be otherwise treated. In summary, there cannot be a general prescribing formulation for benzodiazepine use. Physician should always make their decision based on the individual patient's risk/benefit factors.

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조선시대 피역의서에 나타난 역병(疫病) 예방법 (Infectious Disease Prevention Act Written on Medical Books in Joseon Dynasty)

  • 조원준
    • 대한예방한의학회지
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    • 제12권2호
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    • pp.145-157
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    • 2008
  • There were many books on infectious disease prevention act, and still remained 5 books including Ganuibyeokonbang. Epidemics were seriously ill and widely contagious, so it was important to prevent them. Therefore, they wrote various preventive measures from epidemics on those books. They emphasized medication, and used not only compound prescriptions but also singular ones. They wrote 5 compound prescriptions including Sohaphyangwon and many singular ones on Ganuibyeokonbang, and they used folk medicine such as red-beans준 for practical use on that book. On Sinchanbyeokonbang, they emphasized Hyangsosan and presented many prescriptions to specialize in epidemics. Heojun presented various prescriptions for Dangdokyeok on Byeokyeoksinbang, and he excluded incantation methods to cope with epidemics medically. Since Ganuibyeokonbang they had tried to improve personal hygiene such as boiling clothes of patients.

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신체질환이 있는 소아청소년의 정신신체의학적 관리-총론 (Psychosomatic Management of Medically Ill Children and Adolescents)

  • 이문수;조숙행
    • 정신신체의학
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    • 제16권1호
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    • pp.17-24
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    • 2008
  • 소아청소년에서의 정신신체의학은 자문조정 정신의학이라고도 불리며 신체적 질환이 있는 소아청소년에서의 정신건강 서비스를 제공하는 것으로, 정신과에서는 정신사회학적 질병모델에 익숙한 반면 타과 의료진의 경우 생의학적 질병모델에 입각하여 접근하기 때문에 원활한 의사소통을 통한 타과 의료진과의 협업 체계 구축이 중요하다. 신체질환이 있는 소아청소년의 정신과적 문제에 대해서는 개별 질환에 초점을 맞추고 의학적 심리적 정신과적 인자들의 상호작용과 그 영향을 밝히는 범주적 접근법과 질병에 걸렸다는 사실로 인하여 스트레스를 경험하는 아동 자체에 대한 접근에 주안점을 두는 비범주적 접근법으로 나눌 수 있다. 이러한 신체질환이 있는 소아청소년의 치료에 그들의 발달단계에 맞는 고유한 치료기법의 적용이 필요하다. 비약물학적인 치료의 경우 경험적으로 입증된 치료(empirically supportive therapy)들을 구분하려는 시도도 이루어지고 있다.

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