• Korean Journal of Psychosomatic Medicine
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• v.8 no.2
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• pp.212-227
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• 2000

This study was designed to testify the reliability and validation on the Korean version of the Social Adaptation Self-rating Scale(SASS) which was developed from Bose et al. for the evaluation of social motivation and behavior of depressed patients in 1997. Interests for the social world, those of social functioning, of patients were involved in the addition of new measure of disturbance. And those were distinct from abnormalities of thought, mood and symptoms of patients with major depression. As the previous reports there were several evidences that treatments may be less likely to be effective if the system they act on is dysfunctional. Thus, a better social situation favoured better outcome. As a matter of fact, however, those reports were developed in the course of the evaluation of interpersonal therapy(IPT) and cognitive therapy. Accordingly the conversed question -whether pharmacological therapy with antidepressants can impact on social functioning in addition to addressing the core features of illness- has been addressed. To date, anyhow, it is accepted that enhancement of social functioning may be a therapeutic principle in its own right and illness rarely divorced from social context. In terms of those concepts the introduction of an assessment of social functioning into pharmacotherapeutic studies of depression has been welcomed and might be a potent instrument for evaluating the relative pharmacoeconomic benefits of different treatments. Despite of many scales which were applied for the evaluation of symptoms in the patients with depression, however, the scale for the evaluation of social functiong has not been introduced in Korea yet. Thus, this study was designed to introduce the concepts of social functioning in the patients with depression and to testify the reliability and validation on Korean version of SASS. This Korean version of SASS was submitted to a reliability and validation procedure based on the data from healthy general population survey in 291 individuals and 40 patients with major depression. Cronbach a was 0.790 in total subjects group and the correlation of test-retest was statistically significant(y=0.653, p<0.0l). Thus, the Korean version of SASS might be shown to be valid and reliable. The results of multivariate analyses allowed the identification of 3 principle factors(factor 1 = intersts in social activities, factor 2 = active interpersonal relationship, factor 3 = selfesteem) in normal group, however, it could be counted as only one factor in the depression group because nearly total items of SASS were involved in factor 1. In the view of these results, the Korean version of SASS may be useful additional tool for the evaluation of social functioning in depression.

• Journal of Korean Academy of Nursing
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• v.15 no.1
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• pp.59-75
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• 1985

Accepting the health as the fundamental human right, the nation and society came to admit the duty to give it to all the people. Korean government is expanding the Primary Health Care as one of the policies for developing the people's health by the lead of community. Like this current situation the School Health Service which is the center of community Health Service schould be active to keep, promote and maintain the health of students and teachers. This investigation was attempted to help to establish the basis of the Health Education Program which would perform the health education efficiently and bring the reforming of student's health control, by measuring the degree of junior high school student's practice concerning health care and con-firming the relationship of knowledge, concern and level of health. The subjects for this study were made up 296 boys at the third grade in a school, located in Seoul. The tool for this study was questionaire. Data were collected for five days, September 22∼26, 1983. The investigators explained the students how to answer the questions of the survey questionaire and then collected the survey cards immediately. The data were analyzed by means of percentages, Pearson Correlation Coefficient and Stepwise Multiple Regression. The results of this study are as follows. 1. The subjects' reaction to the practice concerning Health Care; According to the average proportion of practice concerning health care, subjects' practice in the aspect of Infectious Disease Care is the highest 82.4％ and they showed their practice in the aspect of the accident prevention by 77.5% and in the aspect of mental health by 74.8%. Their practice in the aspect of personal hygiene and daily lifehabit is the lowest 71.2%. 2. Health Knowledge; The whole mark distribution of health knowledge is ranged from the lowest 4 point to the highest, 30 point, therefore point range is 26.0. The Average point is 16.58. 11.2% of students solved more than two thirds of personal knowledge levels. 81.4% of students did more than one third of them. 7.415 of students did less than one third of them. 3. Health Concern; The Students of the average 3.99 point respond positively to the question about the health concern, ‘They think health is more important than money’, this is the highest rate. The students of the average 2.78 respond“when they are sick, they enter the appointed hospital where they own choose”, while it is the lowest. 4. Subjects' response to the health level are at follow: Very healthy 26.0%, healthy 47.0%, less healthy 10.5%, 34.9% of them have ever been sick within two weeks, the number of symptoms they reported amount to 114 and the number of cases poi one person is 0.35. 5. The hypotheses test about the practice concerning health care and the factor which effect on it. 1) The main first hypothesis:“The more knowledge of health the subjects have, the better they practice health care.”was accepted. (r=0.1582, p <0.05) 2) The minor first hypothesis:“The more interest in health subjects have, the better they practice”was accepted. (r=0.4354, p ＜0.001) 3) The minor second hypothesis;“The healthier subjects are, the better they practice health care”was accepted. (r=0.1069, p＜0.05) As other test, partical correlation test is performed in other refine whether health knowledge, a fact influencing the students practice concerning health care, is associated with the practice after controlling the third variables. First, after controlling health concern, the correlation of health knowledge and practice concerning health care was kept. (r=0.1347, p <0.005) Second, after controlling health level, the correlation of health knowledge and practice concerning health care was kept. (r=0.1526, p <0.005) And finally, after controlling economic state, the correlation of health knowledge and practice concern-ing health care was kept. (r=0.1413, p <0.05) Additionally Stepwise Multiple Regression between practice concerning health care and variables. 1.6591 of compliance was explained with the know-ledge (F=5.584, p <0.05), 20.0% of compliance was explained with the health concern added to knowledge. (F=63,213, p <0.005) As the above, health knowledge obviously have effects on the practice about the health care. But, contrary to researcher's expectation, health concern has more affects than health knowledge. Therefore, we must grope the plan to enhance health concern through the regular curriculum and systematic health education for students. Besides, we must study further on, to find the factors which have affect on the practice concerning health care.

• Korean Journal of Psychosomatic Medicine
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• v.22 no.1
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• pp.13-22
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• 2014

Objectives : Breast cancer has been the most prevalent female cancer in South Korea since 2001. Early detection of this disease is the most effective strategy for reducing mortality. The objective of this study was to identify factors which could predict advanced stage at diagnosis of breast cancer. Methods : Participants who were initially diagnosed with breast cancer and referred to the Stress Clinic of the Breast Cancer Center at Kyungpook National University Hospital were included. Through a semi-structured interview, the authors investigated psychosocial variables such as the extent of marital and family functioning and emotional-economic family burden as well as sociodemographic and health behavior-, health characteristic- and cancer-related variables. Results : Data were collected from 219 participants. One hundred and twenty(54.8%) subjects were diagnosed with advanced-stage breast cancer. Variables that were significantly different between the advanced-stage and early-stage groups included : monthly breast self examination(p<0.000), annual mammographic screening(p<0.000), mode of tumor detection(p<0.000), nature of the first symptoms(p<0.000), time to treatment after diagnosis(p<0.000), overloaded economic and family burden(p=0.018), marital functioning(p<0.000) and family functioning(p<0.00). Logistic regression analysis indicated that irregular annual mammography screening(OR=7.431 ; 95% CI 2.407-22.944) or a lack of screening(OR=25.299 ; 95% CI 7.855-81.482) and a dysfunctional marital relationship(OR=4.772 ; 95% CI 2.244-10.145) were significantly associated with advanced stage at diagnosis of breast cancer. Conclusions : We reconfirmed screening behavior to be a risk factor for delayed diagnosis of breast cancer. Our findings also emphasized the importance of psychosocial factors such as marital functioning in early detection of breast cancer. Psychiatric consultation in the area of martial functioning could be beneficial for increasing early detection in breast cancer.

• Journal of Preventive Medicine and Public Health
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• v.33 no.3
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• pp.334-342
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• 2000

Objectives . This study was conducted in order to investigate the degree of recognition, acceptability, and altitude towards day surgery of patients who were hospitalized with diseases that were candidates for day surgery; in order to analyze the average length of stay for treatment of the ailments; and to analyze the percentage of patients who could be discharged on the same day after the surgery ,using the post-anesthesia discharge scoring system. Methods : Data was collected between February 1 and March 31, 1999 from 353 patients who received surgery for cataract, adenoid hypertrophy, inguinal hernia, strabismus, ptosis, cholelithiasis, hemorrhoid, or anal fistula, at a general hospital in Daegu city. The patients were interviewed and surveyed by a post-anesthesia discharge scoring system(PADS) in order to collect data on patient condition such as vital signs, activity and mental status, pain, nausea and vomiting, surgical bleeding, intake and output after the surgery. Results : Among the 353 patients, 52.7% were after of the day surgery and 52.7% were interested in day surgery. Of the respondents, 43.1% said 'my ailment was not serious and the surgery was simple' and 30.4% said 'according to my condition rest at home was desirable' as the reasons for wanting day surgery Alternatively, 56.5% of those declining day surgery said the 'uncertainty of staying home' was the reason. The greatest concern in discharging within 24 hours after surgery was a post-op emergency situation. On the other hand, the shortened hospitalization was the largest advantage of day surgery with 39.1% responding this way, followed by the savings in hospitalization costs (25.8%) and emotional stability (13.7%). The majority of those surveyed (47.6%) believed that discharge should be determined within 1-2 days after the surgery. The average hospital stay was 3.1 days for dischargeable ailments. Pain (45.6%), nausea and vomiting (10.5%), and headache (7.9%) were the common symptoms following surgery. The percentage of patients who were able to be discharged within 24 hours after surgery revealed 95.2% were dischargeable after approximately 3 hours, 99.2% dischargeable after 12 hours, and 100% dischargeable after 24 hours. Conclusions : According to the PADS score, the cataract extract and strabismus correction patients were eligible for day surgery and the further evaluation concerning the reason for delayed recovery of the other diseases is needed.

• The Journal of Internal Korean Medicine
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• v.14 no.2
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• pp.50-70
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• 1993

Clinical observation was done on 92 cases of Occlusive CVD, Cerebral hemorrhage (Subarachnoid hemorrhage) which were confirmed by Brain CT scan and observed for over 4 weeks, among the 121 cases which were more than 65 years of age. they admitted to the Dept. of Internal Medicine, Oriental Medical Hospital in Dong Guk Univ. from July 1992 to June 1993. The result were as follows; 1. In this study, Occlusive CVD was 74 cases, Cerebral hemorrhage (Subarachnoid hemorrhage was 2 cases) was 18 cases. 2. The ratio of male to female was 1.09:1. The age distribution showed the large number in the 65-69 year group(52.2%), 7th decade was 44.5% over 8th decade was 3.3% in ratio. 3. The site of Occlusive CVD was most common at MCA. the site of Cb-hemorrhage was most common at Basal ganglia. 4. The most common preceding disease was hypertension(47.8%) and the next were diabetes mellitus(14.1%), heart desease(14.1%). 5. Recurrence rate was 33.7% and 2nd attack was 20.7%, 3rd attack was 8.7%, 4th attack was 4.3% 6. Predisposing factors in Occlusive CVD were initiated usually during resting and sleeping, and that in Cb-hemorrhage were represented chiefly exercising(66.6%). 7. The smoker was 52.2%, the drinker was 32.6% in whole group. the drinker was 61.1% by the Cb-hemorrhage. 8. The ratio of the season distribution was as follow, fall 35.8%, winter 29.3%, spring 19.6%, summer 15.3%, that of the month distribution was november 15.2%. 9. Duration from on set in Occlusive CVD, 60.8% was within 5 days, that in Cb-hemorrhage, 77.8% was within 5 days. 10. Level of consciousness on attack was clear 42.2%, lethargy and mental change(dull, stupid etc.) 41.3%. The common symptoms were motor disturbance(90.2%), verbal disturbance(65.2%), headache(43.5%). 11. The physical theraphy of Occlusive CVD has been performed 75.7% in whole group and the average beginning time was 6.4 days, and that of Cb-hemorrhage has been performed 61.1% in whole group and the average beginning time was 13 days. 12. Duration of hospitalization was noted 11-20 days was 31.5%, over 21 days was 46.8%, and the average admission was 22.7 day(Occlusive CVD), 32days (Cb-hemorrhage). 13. The main complication were observed in the studies; urinary tract infection and pneumonia were noted in 6.5%, bed sore in 5.4%. 14. The ratio of systolic blood pressures in admission and discharge decreased from 58.7% to 28.3% in over 160 mmHg, that of diastolic blood pressures in admission and discharge decreased from 72.8% to 51.1% in over 90 mmHg. In 31(33.7%) of the 92 cases it showed the glucose levels of more than normal. 15. The patients have done family history of hypertension and C.V.A were 32.6% of all 16. Occlusive CVD In 83.8% and Cb-hernorrhage in 72.2% were improved 17. The herb medications were various Sunghyanggeonggisan, Sopungtang, CHunmagudeungeum were used most frequently and Gamidaebotang, Boyangwhanotang, Gagamyunjotang, Mangeumtang etc. were used as discharge.

• Journal of Yeungnam Medical Science
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• v.13 no.2
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• pp.279-294
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• 1996

This study was carried out to develop a Korean language version of Zung's self-rating anxiety scale(SAS) from august, 1994 to September, 1996. The subjects consisted of 205 normal control subjects from the general population group, and 97 subjects with anxiety disorders. These 97 subjects were chosen from a group by the structured clinical interview for DSM-IV of in patients and out patients. Both normal control subjects and anxiety disorder subjects were drawn utilizing a cluster of sampling methods. In order to analyze the data on anxiety scores, Pearson's product moment correlation coefficient method was carried out, as well as reliability, factor analysis and discriminant function analysis, utilizing the SPSS/PC+ program. The results obtained were as follows: The mean average of the total anxiety scores were 32.36 + 6.35 for the normal control subjects and 50.53 + 7.67 for anxiety disorder subjects. Test-retest reliability(coefficient r=0.98, p < 0.001), and internal consistency(coefficient r=0.96, p < 0.001) were satisfactory. Factor analysis using oblique technique rotation yielded four factors. The normal control subjects scored higher concerning the symptoms such as sweating, restlessness, apprehension, insomnia and dyspnea, and lower for faintness, mental disintegration, paresthesia, dizziness and tremor. On the other hand, for the anxiety disorders, apprehension, restlessness, sweating, dyspnea and insomnia scored higher, and lower for faintness, paresthesia, nightmare, dizziness and tremor.

• Korean Journal of Psychosomatic Medicine
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• v.5 no.2
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• pp.185-194
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• 1997

A comparison was made regarding illness behavior among patients with somatoform disorders, depressive disorders and psychosomatic disorders. The subjects consisted of out-patients with somatoform disorders(N=52), depressive disorders(N=52) and psychosomatic disorders(N=51). illness behavior was assessed by illness Behavior Assessment Schedule and the questionnaire about help-seeking behavior. The patients with somatoform disorders and psychosomatic disorders more often affirmed the presence of somatic disease, were more likely to have phobia of disease, had more preoccupation with ideas of disease and more frequently shopped around oriental clinics than the patients with depressive disorders. The patients with somatoform disorders more often attributed its cause to physical factors, less often attributed the origin of affective disturbance to psychological causes, showed Less depression and irritability, and were less likely to accept psychiatric treatment recommended by other physicians than depressive patients. The patients with somatoform disorders were more likely to report having been told that they suffered from a mild illness than those with psychosomatic disorders. The patients with somatoform disorders with psychological problems tended to inhibit expression of their emotion. Female patients with somatoform disorders more often affirmed the presence of psychological disorder and attributed its cause to psychological factors than male ones. These results suggest that in illness behavior, patients with somatoform disorders are different from depressive patients, whereas the former patients are similar to psychosomatic patients except the discrepancy between therapists and patients regarding evaluation of their symptoms. Thus, it is emphasized that first, therapists need to approach patients with somatoform disorders somatically with understanding of their underlying need to deny psychological problems, followed by either psychological or biopsychosocial approach.

• Sleep Medicine and Psychophysiology
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• v.19 no.1
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• pp.27-34
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• 2012

Objectives: The analysis of heart rate variability (HRV) is a useful non-invasive tool to investigate the autonomic nerve function. Previous studies on the relationship between HRV and depression have been reported controversial results. Similarly, the correlation between the serum lipids and depression is debatable. The purpose of this study is to examine the relationship between heart rate variability, lipid profile and depression. Methods: A total of 42 patients with major depressive disorder (MDD) and 32 age and sex-matched normal subjects who had no previous history of major medical and mental illnesses were recruited for this study. A structured-interview was used to assess the general characteristics and psychiatric illness. HRV measures were assessed by time-domain and frequency-domain analyses. Psychological symptoms were measured using the Hamilton rating scale for anxiety (HAM-A), Hamilton rating scale for depression (HAM-D). In addition, the evaluation for lipid profile was performed by blood test. Results: In serum lipid profile test, MDD group showed higher cholesterol ($197.68{\pm}42.94$ mg/dL vs. $176.85{\pm}34.68$ mg/dL, p=0.044), TG ($139.45{\pm}92.54$ mg/dL vs. $91.4{\pm}65.68$ mg/dL, p=0.018), LDL ($130.03{\pm}33.18$ vs. $106.62{\pm}27.08$, p=0.004) level than normal control group. In HRV time domain analyses, the standard deviation of the NN interval (SDNN) was decreased in MDD group than normal control group, but was not significant ($32.82{\pm}14.33$ ms vs. $40.36{\pm}21.40$ms, p=0.078). ApEn (Approximate Entrophy) was significantly increased in MDD group than normal control group ($1.13{\pm}0.11$ vs. $0.91{\pm}0.18$, p<0.001). ApEn was correlated with LDL level (r=0.277, p=0.028), HAM-D scores (r=0.534, p<0.001) and HAM-A scores (r=0.470, p<0.001). Conclusions: MDD patients showed increased ApEn, one of the HRV measurement. And this ApEn was correlated with LDL, HAM-D and HAM-A scores. In this study, the analysis of ApEn would be a useful test of MDD.

• Pediatric Infection and Vaccine
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• v.7 no.1
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• pp.94-107
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• 2000

Purpose : The purpose of this study is to know the clinical manifestations and the severity of adenoviral lower respiratory tract infections(LRTI) in Korean children. Methods : Adenoviral respiratory infection was diagnosed by viral culture in HEp-2 cell and indirect immunofluorescent technique with nasal aspirates. Isolated adenoviruses were typed by neutralization test. Retrospective chart review was done in patients with adenoviruses were typed by neutralization test. Retrospective chart review was done in patients with adenoviral lower respiratory tract infection, who were brought to Seoul National University Children's Hospital from November 1990 through February 1998. Results : Adenovirus was isolated in 87 cases. Of 84 cases serotyped, type 1 was recovered in 3 cases, type 2 in 13 cases, type 3 in 13, type 4 and 5 in 4 cases each other, type 6 in 1 cases, type 7 in 36 cases, type 11 in 1 case and the other types in 9 cases. Adenoviral lower respiratory infection occurred sporadically throughout the year but from November 1995 through February 1998, an outbreak of adenovirus type 7 lower respiratory infection was observed in number upto 36 case. The incidence of adenoviral infection peaked in young children between 6 months and 5 years of age and the mean age was 1 year 11 months old. There were 10 cases of mixed infection with another pathogen. Clinical diagnosis were pneumonia(88%), acute broncholitis(5.4%), acute tracheobronchitis(5.4%), croup(1.3%). The clinical features of adenoviral lower respiratory infection were severe especially in type 3 and 7 infections in aspect of fever duration, ventilator care. Extrapulmonary manifestations were gastrointestinal symptoms in 23 cases(31%), hepatomegaly in 36 cases(53%), seizure and mental alteration in 13 cases(20.3%). In chest radiographic findings, parahilar and peribronchial infiltration were in 49 cases(67%), hyperaeration in 21 cases(29%), atelectasis in 14 cases(19%), consolidation in 39 cases(53%) and bilateral pneumonic infiltration in 28 cases(38%). Among thirty six adenovirus type 7 LRTI, 15 patients(41.6%) had pleural effusion and 3 patients had chest tube insertion. Number of fetal cases related to adenovirus were 9 cases(12%) and fetal cases due to ventilatory failure were 7(11%). Conclusion : During 7 year period of studying adenoviral lower respiratory infection, we identified the serotypes of adenovirus. Among the serotypes, adenovirus type 7 were epidemically isolated. Adenovirus were isolated in severe lower respiratory infection of young children aged between 6 months and 5 years and related to death of the patients, especially when the patients had underlyng diseases or were infected by adenovirus type 7.

• Korean Journal of Biological Psychiatry
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• v.21 no.3
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• pp.99-106
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• 2014

Objectives Previous studies suggest that the cannabinoid receptor 1 (CNR1) gene could be an important candidate gene for schizophrenia. According to linkage studies, this gene is located on chromosome 6q14-q15, which is known to harbor the schizophrenia susceptibility locus (locus 5, SCZ5, OMIM 803175). The pharmacological agent delta-9-tetrahydrocannabinol (${\Delta}$-9-THC) seems to elicit the symptoms of schizophrenia. The association between CNR1 polymorphisms and schizophrenia is actively being investigated, and some studies have linked the AAT-trinucleotide repeats in CNR1 to the onset of schizophrenia. In this study, we have investigated the association between the AAT-trinucleotide repeats in CNR1 and schizophrenia by studying schizophrenia patients and healthy individuals from Korea. Methods DNA was extracted from the blood samples of 394 control subjects and 337 patients diagnosed with schizophrenia (as per the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria). After polymerase chain reaction amplification, a logistic regression analysis, with age and gender as the covariates, was performed to study the variations in the AAT-repeat polymorphisms between the two groups. Results In total, 8 types of trinucleotide repeats were identified, each containing 7, 8, 10, 11, 12, 13, 14, and 15 repeats, respectively. $(AAT)_{13}$ allele was most frequently observed, with a frequency of 33.6% and 31.6% in the patient and control groups, respectively. The frequency of the other repeat alleles in the patient group (in the decreasing order) was as follows : $(AAT)_{13}$ 33.6%, $(AAT)_{14}$ 21.6%, $(AAT)_{12}$ 18.5%, and $(AAT)_{7}$ 11.1%. The frequency of the repeat alleles in the control group (in the decreasing order) was as follows : $(AAT)_{13}$ 31.6%, $(AAT)_{14}$ 24.5%, $(AAT)_{12}$ 17.2%, and $(AAT)_{7}$ 11.6%. However, there were no significant differences in the AAT-repeat polymorphisms of the CNR1 gene between the patient group and the control group. Conclusions Although our study revealed no significant association of the AAT-repeat polymorphism of the CNR1 gene with schizophrenia, it will serve as a good reference for future studies designed to examine the cannabinoid hypothesis of schizophrenia.