• Journal of Hospice and Palliative Care
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• v.23 no.3
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• pp.103-113
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• 2020

A clinical practice guideline for patients in the dying process in general wards and their families, developed through an evidence-based process, is presented herein. The purpose of this guideline is to enable a peaceful death based on an understanding of suitable management of patients' physical and mental symptoms, psychological support, appropriate decision-making, family care, and clearly-defined team roles. Although there are limits to the available evidence regarding medical issues in patients facing death, the final recommendations were determined from expert advice and feedback, considering values and preferences related to medical treatment, benefits and harms, and applicability in the real world. This guideline should be applied in a way that takes into account specific health care environments, including the resources of medical staff and differences in the available resources of each institution. This guideline can be used by all medical institutions in South Korea.

• Journal of muscle and joint health
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• v.6 no.1
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• pp.22-36
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• 1999

The purpose of the study was to identify disease characteristics and behavior pattern of treatment for patients with Fibromyalgia. This study was carried out between May to Aug. in 1998 through direct interview in Rheumatism clinic at H. University Hospital and subject in this study were 125 outpatients diagnosed with Fibromyalgia. Collected data were analyzed by descriptive statistics and t-test, ANOVA using SPSS Window program. The results of this study are as follows. 1. General Characteristics : All of the persons with Fibromyalgia were female who were mostly in their forties(37.5%). A third of them(38.4%) were graduated from high school. The greatest part of them(54.4%) were christians but little part of them(16.8%) were employed 2. Disease Characteristics : They have struggled with Fibromyalgia for 10 years on an average. About half of them(56.9%) suffered from Fibromyalgia only but the others had another diseases which were in greatest part occupied by Osteoarthritis. The number of tender point which is a feature of Fibromyalgia differed according to measuring criteria. Yunus criteria. however, was proved to be the most proper measuring criteria than any other method as it showed high correlations between symptoms and physical activities. The most serious symptoms that complained the patients among subjective symptoms are pain, sleep disorder, and fatigue in sequence, and activities most hard to do among physical activities are washing by hand, scrubbing by hand, and shopping in sequence. 3. Behavior Pattern of Treatment : The largest part of them(42.4%) had received medical treatment after they were determined to have the disease and most of them were taking medicine as prescribed by physician(88.8%) or other medicines(16.8%), Of them, two thirds stated that the medicine they took were effective. Around a third of them took exercises mostly composed of swimming. The medical institution they visited in the past were orthopedic surgical department, Oriental hospital, physical therapy department in sequence and, in a slight percent(11.4%), psychiatric department. 4. Relations between Disease Characteristics and Behavior pattern of Treatment : It shows that number of tender point and level of symptom are significantly different according to duration of disease and medical intervention. As a results, it can be suggest that persons with Fibromyalgia need to take exercises and medicine continually regardless of medical treatment as it is a chronic disease whose symptoms are hardly mitigated.

• Korean Journal of Psychosomatic Medicine
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• v.9 no.1
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• pp.58-65
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• 2001

Objectives : It is well known that pharmacologic and behavioral therapies of panic disorder show remarkable acute treatment outcome, however the course of panic disorder in clinical settings is often chronic and relapsing. The purpose of this study is to investigate the treatment outcome of panic disorder and the factors related to good treatment outcome by prospective follow-up study after 6 month in clinical settings. Methods : Twenty nine patients were diagnosed to have panic disorder by SCID(Structured Clinical Interview for DSM-III-R), among the patients who had visited the psychiatric out-patients clinic of the Asan Medical Center for the first time. We determined the initial clinical and demoraphic features of each patient and reevaluated them after 6 months, investigating the treatment outcome by anxiety, phobia, impairment scales. We looked into the rate of the patients who showed good treatment outcome and determined the factors that had relation with good treatment outcome among demographic and clinical features. Results : Nineteen out of 29 patients could be followed after 6 months. Among them, 10 patients 52.6%) on the impairment scale and phobia scale each, and 8 patients(42.1 %) on the anxiety scale showed good treatment outcome. 8 patients(42.1 %) showed good treatment outcome on the all three scales. High score in initial phobia scale had significant relation with good treatment outcome. Short duration of illness did not have significant relation with good treatment outcome however there was a trend(p=0.07). Conclusion : About half(42.1 %) of the panic disorder patients showed good treatment outcome on all three scales. Severe initial phobic symptom and short duration of illness were expected to have relation with good treatment outcome.

• Korean Journal of Psychosomatic Medicine
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• v.22 no.2
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• pp.112-120
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• 2014

Objectives : The aim of this study is to evaluate the clinical characteristics of night eating syndrome(NES) in bipolar disorder outpatients. Methods : The 14 items of self-reported night eating questionnaire(NEQ) was administered to 84 bipolar patients in psychiatric outpatient clinic. We examined demographic and clinical characteristics, body mass index(BMI), subjective measures of mood, sleep, binge eating & weight-related quality of life using Beck's Depression Inventory (BDI), Pittsburgh Sleep Quality Index(PSQI), Binge Eating Scale(BES) and Korean version of Obesity-Related Quality of Life Scale(KOQoL), respectively. Results : The prevalence of night eating syndrome in bipolar outpatients was 14.3%(12 of 84). Comparisons between NES group and non-NES group revealed no significant differences in demographic characteristics, BMI and clinical status except economic status and comorbid medical illnesses. However, compared to non-NES, patients with NES was more likely to have binge eating pattern and poorer weight-related quality of life. Conclusions : This study is to be the first to describe the clinical correlates of night eaters in bipolar outpatients. Although there were few significant correlates of NES in bipolar outpatients, relatively high prevalence of NES suggest that clinicians should be aware to assess the patients with bipolar disorder on NES, regardless of obesity status of patients.

• Korean Journal of Psychosomatic Medicine
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• v.22 no.2
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• pp.93-103
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• 2014

Objectives : The aim of study was to examine the prevalence of night eating syndrome(NES) and its correlates in schizophrenic outpatients. Methods : The 14 items of self-reported night eating questionnaire(NEQ) was administered to 201 schizophrenic patients in psychiatric outpatient clinic. We examined demographic and clinical characteristics, body mass index(BMI), subjective measures of mood, sleep, binge eating, and weight-related quality of life using Beck's Depression Inventory(BDI), Pittsburgh Sleep Quality Index(PSQI), Binge Eating Scale(BES) and Korean version of Obesity-Related Quality of Life Scale(KOQoL), respectively. Results : The prevalence of night eaters in schizophrenic outpatients was 10.4%(21 of 201). Comparisons between NES group and non-NES group revealed no significant differences in sociodemographic characteristics, clinical status and BMI. Compared to non-NES, patients with NES reported significantly greater depressed mood and sleep disturbance, more binge eating pattern, and decreased weight-related quality of life. While 'morning anorexia' and 'delayed morning meal'(2 of 5 NES core components in NEQ) were not differed between groups, 'nocturnal ingestions', 'evening hyperphagia', and 'mood/sleep' were more impaired in NES group. Conclusions : These findings are the first to describe the prevalence and its correlates of night eaters in schizophrenic outpatients. These results suggest that NES has negative mental health implications, although it was not associated with obesity. Further study to generalize these results is required.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.23 no.3
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• pp.134-142
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• 2012

Objectives : Childhood depressive disorder one of the most prevalent chronic health conditions affecting school aged children. The objective of this study was to examine the prevalence and epidemiological characteristics of childhood depressive disorder in Korea. Methods : In this study, a survey was conducted of elementary school children in the Cheonan area from September 2009 to August 2010. A total of 12,084 children were included in the analyses. The primary measure of depression was the 27-item Kovacs' Children's Depression Inventory (CDI), the Korean Dupaul attention-deficit hyperactivity disorder Rating Scales (K-ARS), Autism Spectrum Screening Questionnaire (ASSQ) and Restless Legs Syndrome Questionnaire (RLSQ) were also administered. Results : The prevalence rate of childhood depressive disorder was 3.07%. The mean age was $9.21{\pm}1.81$ years for the control group (5,969 male, 6,054 female) and $9.91{\pm}1.83$ years for the depression group (CDI score${\geq}$22 ; 159 male, 210 female). Age, height, weight, and economic status were similar for the two groups. However, there were statistically significant differences in the distribution of sex. The distribution of school grade also differed between the two groups. Scores for CDI, K-ARS, and ASSQ in the depressive group were higher than those of the control group. Conclusions : This is the first large-scale population-based study to report on the prevalence of childhood depressive disorder in South Korea. Increased rates of childhood depressive disorder, as reported by primary caretakers, might reflect the increasing negative impact of environmental risk factors on neurobehavioral health. Longitudinal study of the prevalence of childhood depressive disorder should be considered for further evaluation.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.21 no.3
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• pp.174-181
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• 2010

Objectives: To identify the factors affecting long-term adherence to methylphenidate treatment in children with attention-deficit hyperactivity disorder (ADHD). Methods: A retrospective medical record review of 239 ADHD patients (mean age $9.3{\pm}2.6$ years, range 6.0-17.4 years) who had visited the child and adolescent psychiatry clinic at a university hospital, in Seoul, Korea from March 2005 to February 2008. Subjects were diagnosed as ADHD based on the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision version (DSM-IV-TR) and underwent neuropsychological tests including the continuous performance test (CPT). Treatment discontinuation was defined as the last prescription date when the medication possession rate (MPR) became less than 0.80. Subjects were divided into three groups and labeled as Group I, non-adherence without pharmacotherapy, Group II, non-adherence with short-term pharmacotherapy, and Group III, adherence with long-term pharmacotherapy. Results: Ninety (37.7%) patients were grouped as non-adherent (Groups I+II) and 149 (62.3%) as adherent (Group III). The adherence group exhibited lower intelligence, higher symptom severity, and a higher number of comorbid psychiatric disorders than controls. The use of stimulants was significantly associated with long-term adherence to treatment. Additionally, the duration of interval between the date of the first visit and the date of the first prescription was positively associated with long-term adherence. Conclusion: About two-thirds of patients diagnosed as ADHD adhered to the treatment six months after the first visit. With respect to patient evaluation and the development of treatment strategies, factors affecting early drop-out and longer follow-up must be considered.

• Korean Journal of Biological Psychiatry
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• v.19 no.2
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• pp.106-113
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• 2012

Objectives : The purpose of this study is to investigate the relationship between the triallelic serotonin transporter gene and stressful life events to determine their effect on depression with alcohol dependence. Methods : Ninety-five hospitalized patients with alcohol dependence (73 male, 22 female) were enrolled in this study. Thirty-two (33.7%) of the total patients were diagnosed with major depressive disorder and dysthymic disorder by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV. The characteristics of stress were evaluated using the stressful life events scale, and depressive symptoms were assessed using the depression scale (Beck Depression Inventory, BDI). Alcoholism with depression (n = 32) and alcoholism without depression (n = 63) were genotyped for the triallelic serotonin transporter gene ($L_A$ : higher expressing allele, $L_G$/S : lower expressing allele). Results : There was no significant difference in the allele frequency between the depression group and the non-depression group (${\chi}^2$ = 0.345, p = 0.619). $L_G$/S alleles had more comorbid depression in the higher score of stressful life events scale [Mental-Haenszel (MH)-${\chi}^2$ = 4.477, p = 0.034]. But there was no significant difference in the comorbidity according to the scores from the stressful life event scale in the $L_A$ alleles (MH-${\chi}^2$ = 0.741, p = 0.399). In the results, alcohol-dependent individuals with $L_G$/S alleles had more comorbid depression than those with $L_A$ alleles when they had experienced severe stressful life events (MH-odds ratio = 2.699, p = 0.028). Conclusions : These results suggest that there is no direct relationship between triallelic serotonin transporter gene and depression in the alcohol dependent patients. But alcohol dependent individuals with the lower expressing alleles of the serotonin transporter gene were more susceptible to depression than those with the higher expressing alleles in response to stressful life events.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.2
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• pp.174-182
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• 2003

Objective：Present study compared the Rorschach responses characteristics between ADHD without depression and ADHD with depression. Method：60 children diagnosed ADHD(30 ADHD without depression and 30 ADHD with depression) were assessed with The Rorschach. Responses characteristics between two groups were compared by t test and ${\chi}^2$ test. Results：ADHD without depression had more Rorschach response ration and frequency, with statical significance, in m, M-, DV, (3r+(2)/R>.44 and Fr+rF=0, OR(3r+(2)/R>.33)=YES, pure H<2=YES, H+(H)+Hd+(Hd), FQ none, Sc than ADHD with depression. ADHD with depression had more Rorschach response ration and frequency, with statical significance, in p, H+(H)+Hd+(Hd), (Hd), M than ADHD without depression. Conclusion：This results suggest that we had better consider the impulsivity of idation and cognition for ADHD without depression, preferred introversive coping style for ADHD with depression in diagnosing and intervening.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.20 no.2
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• pp.68-75
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• 2009

Objectives: This study was conducted in order to develop and obtain the nonnative data of the computerized Comprehensive Attention Test(CAT) in Korean children and adolescents. It also aimed to evaluate the reliability and validity of the CAT. Methods: We developed the computerized CAT which includes the selective attention task, the sustained attention to response task, the flanker task, the divided attention task, and the spatial working memory task. We investigated the test-retest reliability and the construction validity of this computerized version by using the data from 21 children, and gathered the nonnative data of 9l2 subjects, aged 4 to 15 years, dwelling in the Metropolitan Seoul area in 2008. Results: No statistical differences between means of the tests and retests of the CAT were observed. The mean of the correlation coefficient of the test-retest scores was 0.715. The results from the factor analyses explained 51.7% of the cumulative variance. In addition, the nonnative data for all of the CAT subtests were obtained. Conclusion: The computerized CAT can be used as a reliable and valid tool in both clinical and research settings for Korean children and adolescents with or without neuropsychiatric conditions such as attention deficit.