• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제26권1호
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• pp.38-44
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• 2015

Objectives : The purpose of this study is to examine the effects of the characteristics of victim and sexual abuse on posttraumatic psychiatric symptoms in children and adolescents with a history of sexual abuse. Methods : A total of 137 children and adolescents were recruited from the Seoul Sunflower Children Center, a nation-funded sexual violence victim protection center, from January 2009 to December 2013. We collected the demographic data of the victims and the Trauma Symptom Checklist for Children (TSCC) from victims. We hypothesized victims' age, sex, and intelligence quotient, and the characteristics of sexual abuse as the affecting factors of posttraumatic psychiatric symptoms. Descriptive analysis and hierarchical regression analysis were performed for analysis of demographic data, TSCC scores, and psychiatric symptoms. Results : The victims' age and the characteristics of sexual abuse were significantly related to the traumatic distress of sexual abuse. R-square was 23% for anxiety, 39% for depression, 21% for posttraumatic stress, and 37% for dissociation on TSCC. Conclusion : This study suggests that victims' age, type, frequency and duration of exposure, and disclosure of sexual abuse are significant affecting factors on posttraumatic psychiatric symptoms in children and adolescents. Exploration of psychiatric symptoms other than posttraumatic symptoms, and relations between pretraumatic and posttraumatic psychiatric symptoms is needed through collection of larger samples.

• 보건의료산업학회지
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• 제12권4호
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• pp.103-113
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• 2018

Objectives: The study aimed to compare the indicators of infrastructure of the whole country with those of Busan through National Medical Care Psychiatric (hospital level) Quality Assesment and to provide the basic evidence for presenting vision and strategies of mental health policy. Methods: National Medical Care Psychiatric (hospital level) Quality Assesment Data was used from 2011 to 2015. A total of 8 indicators were analyzed including facility and workforce. Results: The median value of the capacity per ward was decreasing with years both whole country and Busan. The number of beds out of total inpatient occupancy was improved over the years. There was no clear change in the number of inpatients per toilet in the hospitalized ward, but the indicator was decreasing obviously. Therefore, the median value of whole country and Busan was same with 10.2 in 2015. Conclusions: We confirmed that indicators for infrastructure were improving in a generally positive change over the years. The infrastructure is related to the patient-centered treatment environment, and the workforce is related to the quality of care. Therefore, the structural area should be continuously evaluated and improved.

• 동서간호학연구지
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• 제28권2호
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• pp.160-169
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• 2022

Purpose: This study was conducted to identify predictors related to aggressive behavior of patients with mental illness admitted to a closed psychiatric ward. Methods: This study adopted a retrospective design which analyzed the hospital medical records of 363 patients with mental illness admitted to the psychiatric closed ward of a university hospital in Seoul, Korea. The collected data were analyzed using SPSS IBM 20.0 and STATA 12.0 SE. ZIP (Zero-Inflated Poisson) and count data analysis were used for the factor influencing the occurrence and frequency of aggressive behavior. Results: The results of ZIP model showed that the factors influencing non-probability of aggressive behavior were anxiety, non-adherence, and frustration. In addition, the factors influencing frequency of aggressive behavior were bipolar disorder and personality disorder trait. Conclusion: We found that bipolar disorder, frustration, and non-adherence are more likely to increase the likelihood of aggressive behavior in patients with mental illness. In particular, patients diagnosed with bipolar disorder were 1.95 times more likely to engage in repetitive aggressive behavior compared to those without a diagnose. However, since the results were different form previous studies, further studies on the traits of anxiety and personality disorders are needed.

• 생물정신의학
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• 제30권1호
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• pp.1-6
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• 2023

Many psychiatric disorders are associated with brain functional dysfunctions and neuronal degeneration. According to the research so far, enhanced brain plasticity reduces neurodegeneration and recovers neuronal damage. Brain-derived neurotrophic factor (BDNF) is one of the most extensively studied neurotrophins in the mammalian brain that plays major roles in neuronal survival, development, growth, and maintenance of neurons in brain circuits related to emotion and cognitive function. Also, BDNF plays an important role in brain plasticity, influencing dendritic spines in the hippocampus neurogenesis. Changes in neurogenesis and dendritic density can improve psychiatric symptoms and cognitive functions. BDNF has potent effects on brain plasticity through biochemical mechanisms, cellular signal pathways, and epigenetic changes. There are pharmacological and non-pharmacological interventions to increase the expression of BDNF and enhance brain plasticity. Non-pharmacological interventions such as physical exercise, nutritional change, environmental enrichment, and neuromodulation have biological mechanisms that increase the expression of BDNF and brain plasticity. Non-pharmacological interventions are cost-effective and safe ways to improve psychiatric symptoms.

• 수면정신생리
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• 제22권1호
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• pp.5-10
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• 2015

The secretion of melatonin exhibits a circadian rhythm entrained with the sleep-wake cycle. An alteration of this secretory rhythm has been found in various psychiatric disorders. This review summarizes the regulation of melatonin and its relationship to the circadian rhythm, major depressive disorder, bipolar disorder, seasonal affective disorder, Alzheimer's disease and autism. The review also looks at the effect of melatonin and melatonin agonist on sleep and symptoms of depression, bipolar disorder and seasonal affective disorder. In Alzheimer's disease, the circadian rhythm alterations are associated with the change of melatonin levels and melatonin receptors. It has been reported that melatonin and melatonin synthetic enzyme levels decrease in autism spectrum disorder.

• Archives of Plastic Surgery
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• 제46권6호
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• pp.589-593
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• 2019

Post-traumatic defects of the distal third of the leg often require skipping a few steps of the well-established reconstructive ladder, due to the limited local reliable reconstructive options. In rare cases, the reconstructive plan and flap choice may encounter challenges when the patient has psychiatric illness affecting compliance with postoperative care. We describe a case of a patient with severe intellectual disability and an open fracture of the distal lower limb. After fracture management and debridement of devitalized tissues, the resultant soft tissue defect was covered with a free gracilis flap. On postoperative day 7, the patient ripped out the newly transplanted flap. The flap was too traumatized for salvage, so a contralateral free gracilis muscle flap was used. The patient showed good aesthetic and functional outcomes at a 1-year follow-up. When planning the postoperative management of patients with psychiatric illness, less complex and more robust procedures may be preferred over a long and complex surgical reconstruction requiring good compliance with postoperative care. The medical team should be aware of the risk of postoperative collapse, focus on the prevention of pain, and be wary of drug interactions. Whenever necessary, free tissue transfer should be performed despite potential compliance issues.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제33권3호
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• pp.73-81
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• 2022

Since dissociative identity disorder (DID) has symptoms similar to schizophrenia, such as auditory hallucinations and delusional thoughts of being controlled, there are difficulties in its differential diagnosis. A 16-year-old adolescent male patient who was previously diagnosed with schizophrenia from a different hospital was admitted to our inpatient psychiatric unit for the evaluation of auditory hallucinations and suicide attempts. Through psychiatric evaluations, it was determined that the patient suffered from identity alternation, dissociation, and amnesia. As for the diagnostic evaluations, the following measures were implemented: a psychiatric interview regarding the diagnostic criteria, mental status examination, laboratory tests, brain imaging studies, electroencephalography, and full psychological test for adolescents, and the self-reported measure of the Adolescent Dissociative Experiences Scale. The patient was diagnosed with DID, and the following treatments were administered: pharmacotherapy, ego state therapy, psychoeducation regarding emotions, trauma-focused psychotherapy including stabilization, and family therapy. Following treatment, in the internal dimensions, the patient was able to recognize the nine alternate identities in charge of his emotions, which established a basis for the potential integration of identities. In the external dimensions, he showed improvements in the aspects of family conflicts and issue of school refusal. This is the first reported case of DID in an adolescent in Korea; it emphasizes the consideration of DID in the differential diagnosis of other mental illnesses such as schizophrenia, bipolar disorder, and posttraumatic stress disorder and expands the treatment opportunities for DID by sharing the procedures of ego state therapy.

• 대한조현병학회지
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• 제22권2호
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• pp.42-50
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• 2019

Objectives: In this preliminary study, we investigated the clinical characteristics of patients who were first diagnosed with psychotic disorder and explored the impact of the adherence to antipsychotics on long-term medical use. Methods: All national health insurance claims related to psychotic disorders including gender, age, income, and drug compliance, from January 1, 2008 to December 31, 2015, were examined. With trend test using Medication Possession Ratio (MPR), we compared the medical use between the compliant group (MRP≥0.8) and the comparative non-compliant group (0.2≤MPR<0.8). Results: Among 28,095 participants in total, 16,239 patients (57.8%) were diagnosed as schizophrenia; the 30s were the most common (n=7,151, 25.5%). Drug compliance was generally low regardless of the diagnosis and was the lowest among 20s with the 40-60% range of income. The compliant group showed lower psychiatric and medical use than the comparative group in the following years (p<0.0001). Conclusion: These findings suggest that patients in the 20s and 30s with the 40-60% range of income, who are diagnosed with schizophrenia at the first psychiatric visit, may need more clinical and political attention. The results also emphasize the importance of initial drug adherence to antipsychotics in reducing long-term psychiatric costs.

• 대한간호학회지
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• 제3권3호
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• pp.15-26
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• 1973

(Directed by Professor Hong, Shin Yong) Today, over seventy five Percent of the schools of nursing in Korea Provide a psychiatric experience in the basic curriculum. The psychiatric presents numerous major problems of adjustment to the student. The importance of positive attitudes toward the nursing care of psychiatric patients is recognized by the nursing profession. The purpose of this study was to determine the expressed attitudes of fifty-three nursing students toward their psychiatric affiliation. An attempt, also, was made to determine what implications these attitudes revealed relative to future program planning for students during the psychiatric nursing affiliation. A questionnaire, a Korean translation of the "psychiatric Nursing Attitude Questionnaire" by Milder Elizabeth Fletcher, was administered to fifty-three nursing students from three schools of nursing in Seoul, Who had completed a four-week psychiatric affiliation in a large mental hospital during Mar. 19, 1973 to May 19, 1973. The questionnaire of 100 statements was administered in the following way: (1) Part 1, Preconceptions. was. given in individual conferences with each subject, during the first few days of their affiliation, and again during the final week of the affiliation. The responses to Part Ⅰ were oral. (2) Part Ⅱ , Expectations, Part Ⅱ, Personal Relations, Part Ⅳ, Personal Feelings, and Part V , Attitudes and Activities of Patients were given to all of the subjects in a group meeting during the second week of the affiliation, and again. during the fourth week at the termination of the affiliation. Responses to Parts B, B, n, and f, wire written. Each of the 100 statements of the questionnaire was considered to be either Positive or Negative. A favorable response was assigned the Positive value of land an unfavorable response was assigned the Negative value of O. The coefficient of correlation was computed between the two sets of scores for the fifty-three nursing students., The mean score, the standard deviation, and the differences in the means on each of the five parts of the questionnaire were computed and the relationships calculated by a t-test. The results. of the study were as follows: 1. There was no significant correlation between the two sets of scores for the fifty-three nursing students during the four-week psychiatric affiliation. (r=573) 2. There was no significant difference in the mean scores between the first and final tests for any of the five parts of the questionnaire. 3. The Part.1, Preconceptions, data indicated nursing students enter the psychiatric affiliation with certain attitudes and preconceptions toward tile psychiatric affiliation which affect their psychiatric nursing experience, 4. The Part Ⅰ, Expectations, data indicated inappropriate expectations of students related to lack of experience, Lack of pre-psychiatric affiliation orientation, lack of social understanding, and feelings of insecurity. 5. The Part Ⅲ, Personal relations, data indicated some students have negative attitudes in personal relations with normal people in respect to psychological security and social responsibilities. 6. The Part Ⅳ, Personal feelings, data indicated nursing students have psychological insecurity & inappropriateness. 7. The Part Ⅴ, Attitudes and activities of patients, data indicated nursing students have negative attitudes of fear and frustration due to the psychotic behavior of certain patients in certain situations. 8. The data indicated preconceptions are predominate in unfavorable attitudes of students toward psychiatric nursing affiliation. Further researches indicated in the following areas: 1. Because of the limited number of students in this study, similar studies should be performed with larger groups for further validation of the results. 2. Because of the findings concerning the influence of the opinions of people in close contact with the students, similar studies of the attitudes of the staff in nursing schools, attitudes of graduate nurses and attitudes of the public should be done to determine weakness and strengths of present programs.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제9권1호
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• pp.54-66
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• 1998

본 연구의 목적은 정신과 환자의 자녀가 정상인의 자녀와 비교하여 불안, 우울 등의 정신병리와 자기 개념, 가정환경에 대한 인식에 있어서 차이가 있는지를 알아봄으로써 부모의 정신병리가 자녀에게 어떤 영향을 주는가를 밝히기 위함이다. 아울러 환자집단 내에서 환자의 성별에 따라, 환자의 발병 당시의 자녀의 나이에 따라, 환자 진단에 따라 자녀의 불안, 우울 등의 정신병리와 자기 개념, 가정환경에 대한 인식에서 차이가 있는가를 알아보고자 하였다. 1997년 6월부터 1998년 4월까지 서울, 경기지역의 신경정신과 성인 외래 환자 39명을 대상으로 하여 이들의 자녀 중 초등학교 4학년부터 고등학교 3학년까지의 남녀 학생 52명에게 한국형 소아 상태-특성불안척도, 한국형 소아 우울 척도, 한국형 소아자기개념척도, 한국형 가정환경척도를 작성하도록 하고 이를 동 수의 정상인 자녀와 비교하였다. 그리고 환자의 자녀 내에서는 환자가 남자인지 혹은 여자인지, 환자의 발병 연령이 자녀가 3세 이전이었는지 이후였는지, 환자의 진단이 어떤 것인지에 따라 척도들을 비교하였다. 결과는 다음과 같다. 1) 정신과 환자의 자녀들이 정상인의 자녀들과 비교하여 가정환경척도 중 표현력 척도에서 유의하게 낮은점수를 보였고 상태 불안 척도에서는 유의하게 높은 점수를 보였다(p<0.05). 그러나 소아 자기개념척도의 지적 및 학업 상태 소척도와 인기도 소척도에서는 오히려 환자의 자녀가 정상인의 자녀보다 유의미하게 높은 점수를 보였다(p<0.05). 2) 환자군 내에서 환자의 남녀 성별에 따른 자녀의 척도들의 차이는 없었다. 3) 환자군 내에서 환자가 자녀 나이 3세 이전에 발병한 경우가 3세 이후에 발병한 경우보다 가정환경척도 중 조절성 소척도 점수는 유의하게 낮고 특성불안척도는 유의하게 높았다(p<0.05). 4) 환자군 내에서 환자의 진단(정신분열병 범주 장애-정동장애-신경증)에 따른 자녀의 척도들의 차이는 없었다. 자기 보고식 설문으로 측정한 우울, 불안 등의 정신병리는 환자의 자녀와 정상인의 자녀간 유의미한 차이를 보이지 않았다. 환자의 진단이나 남녀 성별의 차이 역시 자녀에게 영향을 주지 않는 것으로 밝혀졌으나 자녀가 3세 이전에 부모가 정신질환에 이환 될 경우에는 자녀의 특성불안이 높은 경향을 보였다. 향후 고위험군 자녀의 발달학적 측면에서 영향을 주는 요인을 밝히는 연구를 위해서는 자녀의 자기보고 이외에도 부모, 선생님 등의 관찰과의 일치도에 대한 조사, 직접적인 면담 등이 필요할 것으로 보이며 통제된 환경에서의 전향적 연구가 필요할 것이다.