• Title/Summary/Keyword: Non-pharmacological treatment

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The Current Status and Requirements for Non-pharmacological Treatment of Depression in Korea (한국에서 우울증의 비약물학적 치료의 현황과 요구도)

  • Oh, Hong Seok;Lee, Hae Won;Park, Yong Chon
    • Korean Journal of Biological Psychiatry
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    • v.14 no.1
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    • pp.21-27
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    • 2007
  • Objectives : As a part of plan to develop evidence-based treatment guidelines for depression that is more suitable for Korean situation, we investigate the present status and client's requirements for non-pharmacological treatment of depression in Korean clinical situation. Methods : Subjects were patients with depression in 12 university hospitals which are located in metropolises in Korea. We analyzed the records from questionnaires about current clinical status and requirements for the non-pharmacological treatment of depression in Korea. Results : 50.8% of the subjects have experienced non-pharmacological treatments for their depression. The preference of non-pharmacological treatment method of depression is exercise/interesting activity, counseling by psychiatrists and psychotherapy, and the best effective treatment method is psychotherapy (Es=4.36). Actually, the mean consultation time by psychiatrist is $11.31{\pm}7.16$ min, and the appropriate consultation time for client's situation is $18.39{\pm}8.95$ min. During consultation, patients' satisfaction measurement for psychiatrist's explanation about pharmacological treatment is $64.17{\pm}27.11$, and satisfaction measurement for psychiatrist's counseling for their depression about personal problems, resent stress, interpersonal relationship is $61.66{\pm}26.63$. Conclusion : In Korea, many psychiatrists offered biologically oriented treatment to their patients with depression, and patients' satisfaction measurement about consultation by psychiatrists is low. Many patients wanted to combined pharmacological and non-pharmacological treatment for their depression, and aspired to information about complementary and self-help treatment methods. It is necessary to develop non-pharmacological treatment guideline for depression which reflect the clinical situation in Korea and meet Korean patients' need.

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Survey of Insomnia Treatment Status for Doctors (의사 대상 불면증 치료 현황 조사 연구)

  • Choi, Yeonsun;Lee, Mi hyun;Choi, Jae-Won;Kim, Soohyun;Kim, Jichul;Lee, Yu Jin
    • Sleep Medicine and Psychophysiology
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    • v.23 no.2
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    • pp.77-83
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    • 2016
  • Objectives: The present study investigated current practices of insomnia treatment among Korean doctors in clinical settings. Methods: A total of 100 doctors participated in the present study and filled out a series of survey questions regarding their treatment of insomnia patients. Results: The results revealed that the primary type of insomnia treatment was pharmacological and that the most popular medication was zolpidem. The majority of doctors reported that they also utilized non-pharmacological treatments such as sleep hygiene education and cognitive-behavioral therapy. However, these treatments tended to result in low satisfaction. In addition, the doctors perceived that patients largely preferred pharmacological treatments to non-pharmacological ones and did not have sufficient knowledge of non-pharmacological treatments. Conclusion: Many doctors believed that non-pharmacological treatments for insomnia were important, but reported that they were difficult to implement in practice. The results of this study suggest that improved medical conditions for non-pharmacological treatments and education of physicians are necessary to appropriately treat insomnia.

Depression and Executive Dysfunction in Stroke (뇌졸중에서 우울증과 실행기능부전에 대한 고찰)

  • Na, Kyoung-Sae;Kim, Shin-Gyeom;Lee, Soyoung Irene;Jung, Han-Yong
    • Korean Journal of Biological Psychiatry
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    • v.19 no.4
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    • pp.179-186
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    • 2012
  • Depression and executive dysfunction are common neuropsychiatric sequelae of stroke. Patients with stroke are more predisposed to depression and executive dysfunction compared to patients with similar degree of physical disability. Both depression and executive dysfunction are also associated with poor prognosis such as high mortality and delayed recovery after stroke. Complex neurobiological and anatomical mechanisms are associated with the development of depression and executive dysfunction after stroke. Activation of pro-inflammatory cytokines is thought to be associated with onset of depression, whereas injuries in frontal-subcortical circuit are thought to be a link between depression and executive dysfunction. Early detection of depressive symptoms and both pharmacological and non-pharmacological treatment would be helpful. In this review paper, the authors investigated 1) biological and neuroanatomical substrate for poststroke depression and executive dysfunction, 2) the relationship and common etiopathology for poststroke depression and executive dysfunction, and 3) pharmacological and non-pharmacological treatment for poststroke depression. The contents of the paper are as follows : the prevalence, clinical manifestation, and biological etiology for poststroke depression, neuroanatomical abnormalities as a common etiological factor for depression and executive dysfunction, pharmacotherapy and non-pharmacological approach.

Characteristics of Depression in Korea and Non-Pharmacological Treatment (한국에서 우울증의 특징과 비약물학적 치료)

  • Roh, Sungwon;Park, Yong Chon
    • Korean Journal of Biological Psychiatry
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    • v.13 no.4
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    • pp.226-233
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    • 2006
  • Depression is one of the most common mental disorders. Some characteristics of depression in Korea were elucidated. The tendency to express depressive feeling through somatic complaints is more prominent in Korea than in Western countries. Careful studies on depressive symptoms suggest that guilt and suicidal idea are apparent among Korean depressive patients as well as among Western subjects. But most depressive patients in Korea are reluctant to express suicidal idea, which is hidden under the somatic complaints. We should remember the possibility of research artifacts or cultural bias with regard to the evaluation of depressive symptoms of a country in comparison with other countries. Non-pharmacological treatment of depression includes dynamic psychotherapy, cognitive behavioral therapy, interpersonal psychotherapy, self-care treatment, etc. Some kinds of Korean culture relevant psychotherapies are introduced: Tea therapy, Imago therapy, Tao psychotherapy, and combined approach. Interest in the aged people is growing recently, and the research about the factors which affect the depressive disorders in older patients and treatment strategy for them is ongoing.

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The effects of non-pharmacological interventions for adults with eating disorders: A systematic review and meta-analysis (섭식장애에서 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석)

  • Yun, So Hyeon;Kim, Gaeun
    • Korean Journal of Health Education and Promotion
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    • v.35 no.5
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    • pp.35-45
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    • 2018
  • Objectives: Despite the importance of Non-pharmacological interventions for Eating Disorders, no meta-analysis providing definite conclusions in this field has been reported. The purpose of the this study was to conduct meta-analysis of Non-pharmacological interventions for the improvement of eating disorders. Methods: We searched the Koreamed, KISTI, KMBASE, RISS and KISS and so on up to October 2017 using search terms such as ((Eating disorders OR anorexia OR binge) AND (Mediation OR program OR treatment OR therapy OR technique)) in Korean. Results: Initial searches yielded 602 citations. Of these results, seven met selection criteria. Interventions reduced the risk of binge eating disorder (standardised mean difference [SMD] -2.133, 95% CI -3.107~-1.159). Interventions reduced drive for leanness (-1.857, -3.143~-0.571), body dissatisfaction (-1.357, -2.238~-0.477), depression (-0.745, -1.298~-0.192), but not physical function (0.191, -0.089~0.471). Conclusions: The results from this study indicate that Non-pharmacological Interventions may help Eating disorders' binge eating, drive for thinness, body dissatisfaction, depression. However, larger-scale studies are needed to confirm this conclusion.

Non-Pharmacological Interventions for Behavioral and Psychological Symptoms of Neurocognitive Disorder (신경인지장애의 정신행동증상에 대한 비약물학적 개입)

  • Hyun Kim;Kang Joon Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.1
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    • pp.1-9
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    • 2023
  • Patients with neurocognitive disorder show behavioral psychological symptoms such as agitation, aggression, depression, and wandering, as well as cognitive decline, which puts a considerable burden on patients and their families. For the treatment of behavioral psychological symptoms, patient-centered, non-pharmacological treatment should be used as a first line approach. This paper describes non-pharmacological interventions to manage and treat behavioral psychological symptoms in patients with neurocognitive disorder. In order to control behavioral psychological symptoms such as agitation, depression, apathy, insomnia, and wandering, it is important to identify and evaluate factors such as environmental changes and drugs, and then solve such problems. Non-pharmacological interventions include reassurance, encourage, distraction, and environmental change. It is necessary to understand behavior from a patient's point of view and to approach the patient's needs and abilities appropriately. Reminiscence therapy, music therapy, aroma therapy, multisensory stimulation therapy, exercise therapy, light therapy, massage therapy, cognitive intervention therapy, and pet therapy are used as non-pharmacological interventions, and these approaches are known to improve symptoms such as depression, apathy, agitation, aggression, anxiety, wandering, and insomnia. However, the quality of the evidence base for non-pharmacological approaches is generally lower than for pharmacological treatments. Therefore, more extensive and accurate effectiveness verification studies are needed in the future.

Pharmacological Analysis of Vorinostat Analogues as Potential Anti-tumor Agents Targeting Human Histone Deacetylases: an Epigenetic Treatment Stratagem for Cancers

  • Praseetha, Sugathan;Bandaru, Srinivas;Nayarisseri, Anuraj;Sureshkumar, Sivanpillai
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1571-1576
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    • 2016
  • Alteration of the acetylation status of chromatin and other non-histone proteins by HDAC inhibitors has evolved as an excellent epigenetic strategy in treatment of cancers. The present study was sought to identify compounds with positive pharmacological profiles targeting HDAC1. Analogues of Vorinostat synthesized by Cai et al, 2015 formed the test compounds for the present pharmacological evaluation. Hydroxamte analogue 6H showed superior pharmacological profile in comparison to all the compounds in the analogue dataset owing to its better electrostatic interactions and hydrogen bonding patterns. In order to identify compounds with even better high affinity and pharmacological profile than 6H and Vorinostat, virtual screening was performed. A total of 83 compounds similar to Vorinostat and 154 compounds akin to analogue 6H were retrieved. SCHEMBL15675695 (PubCid: 15739209) and AKOS019005527 (PubCid: 80442147) similar to Vorinostat and 6H, were the best docked compounds among the virtually screened compounds. However, in spite of having good affinity, none of the virtually screened compounds had better affinity than that of 6H. In addition SCHEMBL15675695 was predicted to be a carcinogen while AKOS019005527 is Ames toxic. From, our extensive analysis involving binding affinity analysis, ADMET properties predictions and pharmacophoric mappings, we report Vorinostat hydroxamate analogue 6H to be a potential candidate for HDAC inhibition in treatment of cancers through an epigenetic strategy.

Minimal sedation using oral sedatives for multi-visit dental treatment in an adult patient with dental phobia

  • Song, Seung-Rye;You, Tae Min
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.4
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    • pp.369-376
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    • 2021
  • In adult patients with dental phobia, dental treatment may be difficult, or may not be possible. Depending on the level of fear or anxiety, non-pharmacological or pharmacological behavior management techniques are used in the dental treatment of such patients. Among the pharmacological behavior management techniques, minimal sedation, that is, the lowest depth of sedation, can be easily obtained in adult patients using oral sedatives, does not require special equipment or tools, and does not affect ventilatory and cardiovascular function. Diazepam is an anxiolytic drug belonging to the benzodiazepine family that, in addition to relieving anxiety, produces muscle relaxation, and is a representative drug used in adult patients with fear of dental treatment. Herein, we report the case of a 50-year-old woman with severe dental fear who successfully underwent long-term dental treatment in approximately 20 visits with minimal sedation using oral diazepam. In addition, we reviewed the considerations for the use of benzodiazepines for minimal sedation.

Exacerbation Prevention and Management of Bronchiectasis

  • Joon Young Choi
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.3
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    • pp.183-195
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    • 2023
  • Bronchiectasis, which is characterized by irreversibly damaged and dilated bronchi, causes significant symptoms, poor quality of life, and increased economic burden and mortality rates. Despite its increasing prevalence and clinical significance, bronchiectasis was previously regarded as an orphan disease, and ideal treatment of this disease has been poorly understood. The European Respiratory Society and British Thoracic Society have recently published guidelines to assist physicians in the clinical field. Guidelines and reports suggest comprehensive management that includes both non-pharmacological and pharmacological treatment. Physiotherapy and pulmonary rehabilitation are two of the most important non-pharmacologic therapies in bronchiectasis patients; long-term inhaled antibiotics and macrolide therapy have gained significant evidence in reducing exacerbation risk in frequent exacerbators. In this review, we summarize recent updates on bronchiectasis treatment to prevent exacerbation and manage clinical deterioration.

Improving Cognitive Abilities for People with Alzheimer's Disease: Application and Effect of Reality Orientation Therapy (ROT) (알츠하이머병 치매 환자의 인지재활: 현실감각훈련(ROT)의 적용과 효과)

  • Kim, JungWan
    • Phonetics and Speech Sciences
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    • v.5 no.1
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    • pp.27-38
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    • 2013
  • Healthcare providers in Korea are using conservative pharmacological treatment for Alzheimer's disease (AD) to delay the progress of the disease or to mitigate its behavioral and neurological symptoms. However, there is a growing need for interventions using practical non-pharmacologic treatment, as the effects of pharmacological treatments has faced limitations. This research provided a cognitive rehabilitation program to 3 AD patients and used a multiple baseline design across subjects to examine the effects. Performing reality orientation therapy (ROT) for 1 cycle (4 weeks) resulted in a slight increase in accuracy and responsiveness on an orientation task, mainly with patients with mild cases of AD. Also, in the sub-domain of the Korean-Mini Mental Status Examination performed to examine changes in cognitive ability, there were minimal changes in place orientation. In functional communication, however, there were no significant differences before and after the intervention. In conclusion, we found that ROT was an effective intervention for improving accuracy and responsiveness in the orientation of patients with mild cases of AD. In future studies, the effect of non-pharmacological interventions can be evaluated more reliably by examining the interaction effects of sample size, length of the intervention, outcome measurements, and pharmacological intervention.