• Korean Journal of Psychosomatic Medicine
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• v.30 no.2
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• pp.80-98
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• 2022

Posttraumatic stress disorder (PTSD) is well known to have a limited response to drug treatment. Many recently published clinical care guidelines recommend trauma-focused psychotherapies such as cognitive processing therapy (CPT) and prolonged exposure therapy (PE) as first-line treatment and medication such as serotonin reuptake inhibitors and venlafaxine as second-line treatment. Current review introduces the session composition and contents of CPT and presents various CPT studies that show therapeutic effect for civilian and veterans/military with PTSD. In order for clinicians to help effectively patients with PTSD, it is necessary to learn and actively use evidence-based trauma-focused psychotherapies including CPT and PE.

• Journal of the military operations research society of Korea
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• v.34 no.3
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• pp.93-105
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• 2008

Recently, mental patients are increasing by secondary gain, that is, purpose for avoiding a military service as the social prejudice about mental disease decreases. In particular, it is unique diagnostic tool to a patient's subjective symptoms complaint and a doctor's special judgment, in occasion of psychiatry problem that an objective diagnostic tool does not exist. In this paper, we provide an objective basis to help in a quick decision-making of discharging from military service using the datamining, that analyzes mental patient's prescription to find a special rule. Therefore, we propose the decision support system of discharging from service using the analysis of mental patient's prescription.

• Journal of Trauma and Injury
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• v.36 no.4
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• pp.376-384
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• 2023

Purpose: The Armed Forces Trauma Center of Korea was established in April 2022. This study was conducted to report our 1-year experience of treating soldiers with open fractures of the lower extremity. Methods: In this case series, we reviewed the medical records of 51 Korean soldiers with open fractures of the lower extremity between April 2022 and March 2023 at a trauma center. We analyzed patients with Gustilo-Anderson type II and III fractures and reported the duration of transportation, injury mechanisms, injured sites, and associated injuries. We also presented laboratory findings, surgery types, intensive care unit stays, hospital stays, rehabilitation results, and reasons for psychiatric consultation. Additionally, we described patients' mode of transport. Results: This study enrolled nine male patients who were between 21 and 26 years old. Six patients had type II and three had type III fractures. Transport from the accident scene to the emergency room ranged from 75 to 455 minutes, and from the emergency room to the operating room ranged from 35 to 200 minutes. Injury mechanisms included gunshot wounds, landmine explosions, grenade explosions, and entrapment by ship mooring ropes. One case had serious associated injuries (inhalation burn, open facial bone fractures, and hemopneumothorax). No cases with serious blood loss or coagulopathies were found, but most cases had a significant elevation of creatinine kinase. Two patients underwent vascular reconstruction, whereas four patients received flap surgery. After rehabilitation, six patients could walk, one patient could move their joints actively, and two patients performed active assistive movement. Eight patients were referred to the psychiatry department due to suicidal attempts and posttraumatic stress disorder. Conclusions: This study provides insights into how to improve treatment for patients with military trauma, as well as medical services such as the transport system, by revising treatment protocols and systematizing treatment.

• Journal of the Korean society of biological therapies in psychiatry
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• v.24 no.3
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• pp.142-155
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• 2018

Insomnia in patients with hematopoietic stem cell transplantation(HSCT) has been underdiagnosed and undertreated. This study reviewed the frequency, characteristics, physical and psychological effects, and treatments of insomnia in HSCT patients to highlight clinical importance in this specialized population. Furthermore, the authors intended to suggest a model that would conceptualize insomnia in the context of HSCT. In the pre-transplant period, about half of patients with HSCT suffered from sleep disturbance. A substantial number of patients experienced distressing insomnia during the HSCT procedure and recovered to the level of the pre-transplant period. However, sleep disruption could be a chronic symptom in HSCT survivors and could negatively impact quality of control, cancer-related fatigue(CRF), immune function, and psychological distress. The 3P's model(Predisposing, Precipitating, Perpetuating) explains insomnia in cancer population and could be also relevant to HSCT patients with specific consideration of CRF, graft-versus-host diseases, specific properties of hematological disease, and protective isolated milieu. Effective treatment of insomnia in HSCT includes non-pharmacological(e.g., cognitive behavioral therapy, environmental modification) and pharmacological interventions. The decision of pharmacological treatment should be based on the issue of safety due to high risk of potential drug-drug interactions. Screening, treatment, and further research of insomnia in HSCT patients using validated subjective and/or objective measures are warranted.

• The Korean Journal of Pain
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• v.27 no.1
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• pp.3-15
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• 2014

As our population ages and the rate of spine surgery continues to rise, the use epidural lysis of adhesions (LOA) has emerged as a popular treatment to treat spinal stenosis and failed back surgery syndrome. There is moderate evidence that percutaneous LOA is more effective than conventional ESI for both failed back surgery syndrome, spinal stenosis, and lumbar radiculopathy. For cervical HNP, cervical stenosis and mechanical pain not associated with nerve root involvement, the evidence is anecdotal. The benefits of LOA stem from a combination of factors to include the high volumes administered and the use of hypertonic saline. Hyaluronidase has been shown in most, but not all studies to improve treatment outcomes. Although infrequent, complications are more likely to occur after epidural LOA than after conventional epidural steroid injections.

• Anxiety and mood
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• v.2 no.1
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• pp.9-16
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• 2006

As an aging population is increasing, more elderly people are exposed to traumatic stress. Although this issue has received more attention in some literature, it is clear that numerous questions exist in aftermath of trauma exposure in elderly people. In case of Korean elderly suffers, traumatic experience includes the Korean war, military dictatorship and violent demonstration. Studies regarding elderly PTSD is not active and a lot of patients are not still engaged in treatment. We suggest that concerns that are unique to this population are necessary.

• Anxiety and mood
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• v.5 no.2
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• pp.89-95
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• 2009

Objective : This study examined changes in the depression, anxiety, and suicidal ideation among Air Force conscripts during their Basic Military Training. Methods : Study participants were 500 Air Force conscripts. The study reviewed participants' self-reports on depression, symptoms of anxiety, and suicidal ideation at weeks 2, 4, and 6 of their training. Results : At weeks 2 and 4 of training, participants' mean BDI, BAI, and SCL-90-R depression and anxiety subscale scores were within the mild ranges. However, at week 6, those mean scores were in the normal ranges. The mean scores for the BDI, the BAI, and the depression and anxiety subscales of the SCL-90-R at weeks 2 and 4 were significantly elevated over the corresponding scores for week 6 (each F=8.78, df=2, p<0.01 ; F=22.16, df=2, p<0.01 ; F=11.08, df=2, p<0.01 ; F=3.42, df=2, p<0.05). Suicidal ideation, revealed by the mean BSIS score, fell within the normal range (F=9.94, df=2, p<0.01) throughout the study period. Conclusions : These results suggest that conscripts' initial levels of psychological distress in the form of depression and anxiety are slightly elevated, but most adapt to this distress during basic training. Therefore, more attention must be paid to the early stages of conscripts' basic training in order to address these concerns.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.119-129
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• 2019

Objectives : The purpose of this study was to examine cognitive and psychological characteristics of patients who visited psychiatric outpatient clinic with military service suitability issues. Methods : Since January, 2017 to September, 2018, patients were recruited from the department of psychiatry of university hospital. Participants were diagnosed using DSM-5 criteria by board certified psychiatrists. And each of participants tested with K-WAIS-IV, K-SCL-95 by clinical psychologist. The data were analyzed using SPSS 18.0. Results : The results indicated 24.6% of the patients have significantly low level of intellectual functioning. and 10.8% of the patients have borderline level of intellectual functioning, and 26.3% of them were below average. The results of psychological characteristics showed patients have cautious and potentially dangerous level of depression, anxiety, agoraphobia, and suicidal idea. And PTSD subscale's mean score was above problematic level. Next, we divided patients into two groups based on question of whether the patient is eligible to serve in the military service or not arises from recruitment process or army training center. But two group didn't differ significantly. And for further analyses, we also divided patients into two groups based on if they got single psychiatric diagnosis or more than one psychiatric diagnosis. Conclusions : The results indicated that group which has coexisting psychiatric disorders were more depressed, had higher level of anger and aggression, and had more serious levels of suicidal ideas than single psychiatric diagnosis group. The implications and limitations were discussed along with some suggestions for the future studies.

• Anxiety and mood
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• v.8 no.2
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• pp.120-126
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• 2012

Objective : Previous studies reported a correlation between the low serum cholesterol level and impulsive behaviors. In this study, we investigate an association between the serum lipid levels and psychological parameters in maladaptive soldiers in the Korean Army. Methods : A total of ninety-six maladaptive subjects and thirty-six normal controls in the Korean army were evaluated with the Korean version of Barratt Impulsiveness Scale (K-BIS), Korean version of Beck Suicidal Ideation Scale (K- BSIS), Korean version of Beck Depression Inventory (K-BDI) and Korean version of Beck Anxiety Inventory (K-BAI). Serum total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL) level were measured by overnight fasting blood sampling. Results : There were no significant differences between the groups in demographic characteristics. Serum total cholesterol levels (t=-2.209, p=0.032), triglyceride levels (t=-4.593, p<0.001), and LDL levels (t=-3.753, p=0.001) of maladaptive subjects were significantly lower than those of normal controls, and maladaptive subjects had higher K-BIS scores than normal controls (t=7.542, p<0.001). Negative correlation was found between LDL levels and non-planning impulsiveness in the maladaptive subjects (r=-0.253, p=0.013). LDL levels (${\beta}=-0.258$, p=0.008) and K-BDI scores (${\beta}=0.266$, p=0.043) emerged as significant predictors for non-planning impulsiveness. Conclusion : These results suggested that LDL level was associated with non-planning impulsiveness. These findings suggested that serum cholesterol levels might be available as a biological marker of impulsiveness. However, more large samples, longitudinal biological study and psychiatric evaluations should be needed to develop a preventive intervention for maladaptive male conscripts in the Korean army.

• Anxiety and mood
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• v.10 no.1
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• pp.59-67
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• 2014

Objective : To obtain the incidence rate of anxiety disorders among the active duty Korean military personnel, who visited the military hospitals from 2011 to 2013, this descriptive epidemiological study was performed. Methods : After acquiring the data for the anxiety disorders from Defense Medical Statistics Information System, the annual incidence rates were analyzed by forces, position status, and specific disease entities. Results : One thousand, nine hundred and thirteen (1,913) active duty male military personnel were diagnosed with any kinds of anxiety disorders in their first visit to the psychiatric outpatient department (OPD). The total OPD visit counts were 7,870 during the same period. Anxiety disorder, NOS was the most frequent disorder, followed by panic disorder. While the incidence rate for anxiety disorder, NOS decreased, panic disorder displayed increasing tendency. Stress-related disorders and obsessive-compulsive disorder were positioned third and fourth, respectively, for the number of first visit and they both showed decreasing tendency in annual incidence rates. Social anxiety disorder, specific phobias, generalized anxiety disorder (GAD) and mixed anxiety-depressive disorder followed next. The annual incidence rates for anxiety disorders showed decreasing tendency, particularly evident in army soldiers. However, naval officers showed higher anxiety disorder incidence rate compared to those of the army and the air forces. Conclusion : Comparing to general population, panic disorder was higher while specific phobias and GAD were lower in the Korean military. It is interesting to observe higher incidence rate for anxiety disorder in naval officers and warrants further evaluation.