Numbers of patients who have chronic pain seem to be increasing even in the psychiatric practice. One report in Korea showed more than 40% of psychiatric patients who visited out-patient clinic were suffered from chronic pain and one third of those patients were needed treatment for the on-going pain. For evaluating and treating those patients the charateristics of illness behavior should be understood. Abnormal Illness behavior was found as one of the most influential factors which led symptoms complicated and chronified. This symposium was planned to illustrate how to manage the patients whose pain are associated with arthropathy and connective tissue diseases, neuropathic pain and headache more effectively and efficiently. So, It is hoped to get fruitful knowledges for the management of chronic pain in the scope of consultation-liaison psychiatry.
Rhee, Yun Jin;Sun, Yung Chen;Kim, Kwang Hyuk;Moon, Byung Soon;Yun, Jong Min
Journal of Physiology & Pathology in Korean Medicine
/
v.26
no.5
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pp.765-772
/
2012
In this study, a patient with both motor and vocal tic disorders of onset at age 34 was treated for a total of 316 days. The characteristics of the tic symptoms of the patient were examined and treated two to three times a week with herbal medicine, acupuncture, cupping, and habit reversal treatment along with western medication prescribed to the patient from a psychiatric clinic. Furthermore, the condition of the patient was evaluated once a week by the Yale Global Tic Severity Scale(YGTSS-K). Both motor and vocal tic symptoms deceased to a great amount after treatment and the patient was able to lower the dosage of western medication with the approval of her psychiatric doctor. This case suggests that Oriental medical treatment undergone with habit reversal treatment could improve tic disorders better than sole western medication treatment.
Eating disorders are psychiatric disorders characterized by abnormal eating patterns and cognitive distortions related to food, weight and shape, which is in turn result in adverse effects on nutrition status, medical complications, and impaired health status and function. The American Psychiatric Association's DSMIVTR offers two diagnoses to describe disordered eating anorexia nervosa and bulimia nervosa. A third category, eating disorder not otherwise specified(EONOS) include binge eating disorder. The prevalence of eating disorder has greatly increased among adolescence and young adults since 1990's when rapid import of western culture took place. It is likely that patients who ask for weight loss are at high risk of having eating disorder. Severe dietary restriction for weight loss may cause eating disorder. Therefore it is recomendable for doctors to have appropriate understanding and guidelines of eating disorder to help their patients.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.24
no.3
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pp.141-150
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2013
Objectives : The objective of this report is to identify the utilization of hospital school service during hospitalization among patients in their childhood and adolescence with psychiatric disorders. Methods : We retrospectively reviewed the medical record of child and adolescent psychiatric who were hospitalized during March 2009 through October 2012. We compared the one-year successful schooling and outpatient follow up rate between users and nonusers of the inpatient hospital school service. The hospital schooling experiences of the users were investigated upon follow-up visits to the outpatient clinic. Results : Sixty-three students received hospital school service during hospitalization among total 122 child and adolescent inpatients. Hospital school participants showed a significantly higher school reentry rate (61.9%) than non-participants (40.7%). However, there was no difference on follow up rate between the two groups. More than 60% of the 22 interviewed participants expressed an above-average level of satisfaction about hospital school service. Conclusion : Many patients with mental illness experience difficulty in receiving school education during treatment. That induces deterioration in disease, academic failure, poor social skills, low self-esteem, economic difficulties, and future job opportunities. The results of this study emphasize the importance of hospital school service and offer useful guidance for hospital school operation.
Object : Since autonomic nerve system dysfunction was known as the mechanism of panic disorder, many researchers used heart rate variability (HRV) as means of measuring autonomic nerve function of patients with panic disorder. We aimed to examine the effect of paroxetine medication for 3 months on symptom improvement and change of heart rate variability of the patients with panic disorder. Methods : The subjects were patients with panic disorder who visited the psychiatric outpatient clinic of Samsung Medical Center in Seoul. We included panic disorder patients who were aged from 20 to 50 and in normal BMI range (from 18 to 30) to minimize the effect of age and weight on HRV data. We excluded the patients with EKG abnormalities, hypertension or other major psychiatric disorders. They took 20-40 mg paroxetine medication a day for 3 months. Alprazolam was used only during the first month to control the acute panic symptoms and was tapered off after that. We measured the acute panic inventory (API), Hamilton rating scale for anxiety and depression (HAM-A & HAM-D), Spielberger state-trait anxiety inventory (STAIS, STAIT), and Beck depression inventory (BDI) in order to assess clinical improvement of the patients. And we measured time and frequency domain HRV in the resting, standing and cognitive stress states to assess the change of HRV. All measurements were done before and after paroxetine treatment. Result : After paroxetine medication, patients showed significant improvement in all psychiatric scales. In time domain of HRV, standard deviations of all R-R intervals (SDNN) were significantly increased in all states. In frequency domain of HRV, the ratio of high frequency to total power (HF/TP) in the standing state was significantly increased. Conclusion : After 3 months paroxetine medication, panic disorder patients showed significant clinical improvement and change in HRV data such as SDNN in all states and HF/TP ratio in the standing state. This result suggests that paroxetine medication is effective for the improvement of autonomic nerve system dysfunction in panic disorder patients.
Yang Su-Jin;Cheong Seongshim;Noh Kyung-Sun;Lee Helen
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.16
no.2
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pp.211-218
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2005
Objectives : The purpose of the study was to evaluate the related factors of depression in mothers bringing their offspring for evaluation or treatment of problematic behaviors. Methods : Fifty mothers were recruited through their offspring's evaluation or treatment for offspring's problematic behaviors. Psychological tests battery including Korean Wechsler Adult Intelligence Scale and the Korean Educational Development Institute-Wechsler Intelligence Scale for Children was administered to all mothers and their offspring. Mothers completed Korean version of Child Behavior Checklist (K-CBCL), and teachers completed Teacher's Report Form (TRF). On the basis of the maternal depression, the mothers were divided into two groups. Results : 1) Among the fifty mothers, $42\%$ of the mothers had depressive disorder, $16\%$ had anxiety disorder, and $42\%$ had no psychiatric disorder. 2) Depressed mothers rated significantly higher in aggressive behaviors, externalizing problems of K-CBCL in their children. 3) Children of depressed mothers had lower score in picture arrangement and coding subtests of KEDI-WISC than those of no psychiatric disorder mothers. 4) After controlling for the total problematic behavior scores of TRF, mother's depression is positively correlated with aggressive behaviors, externalizing problems, total problematic behaviors of K-CBCL, and negatively correlated with coding of KEDI-WISC. Conclusion : Children's aggressive behavior, externalizing behavior, total problematic behaviors and low coding score may be associated with mother's depression.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.13
no.1
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pp.93-103
/
2002
The aim of this study is to examine the diagnostic profiles and related clinical variables of children with attention and hyperactivity in psychiatric outpatient clinic. Seventy one children with age range of 5 to 14 were diagnosed by DSM-IV, and assessment battery including KEDI-WISC, KPI-C, ADS(ADHD Diagnostic System) were completed. The subjects were divided into 3 diagnostic groups:ADHD only(n=17), ADHD comorbid(n=27), Other diagnosis(n=27). The results were as follows:In ADHD comorbid group, tic disorder, developmental language disorder, borderline intellectual function, oppositional defiant/conduct disorder, and learning disorder were combined in descending order. Other diagnosis group consisted of tic disorder, borderline intellectual function, depression/anxiety, oppositional defiant/conduct disorder, and others. There were significant differences in IQ, PIQ, and VIQ among the three groups, and ADHD only group showed higher scores of IQ and VIQ than ADHD comorbid group. On the KPI-C, there were no significant differences in all subscales among the three groups. On the visual ADS, omission error and sensitivity showed significant differences among the three groups, and ADHD comorbid group represented higher omission error and lower sensitivity than other diagnostic group. The findings indicated that the inattention and hyperactivity symptoms could be diagnosed into diverse psychiatric disorders in child psychiatry, and ADHD children with comorbidity will show more problems in academic performance and school adjustment.
Suh, Hyo-Weon;Lee, Jung Hwan;Kwak, Hui-Yong;Chung, Sun-Yong;Kim, Jong Woo
Journal of Oriental Neuropsychiatry
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v.29
no.3
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pp.183-195
/
2018
Objectives: To investigate validity and effectiveness of Saam five element acupuncture treatment in psychological problems. Methods: We selected a Korean medicine doctor known to apply Saam five element acupuncture treatment to the psychiatry field. An investigator visited the doctor's clinic to observe the cases and interview patients. Duration of each interview was 30 minutes to one hour. A semi-structured questionnaire was used for in-depth interviews. All interviews were recorded and converted into texts. Converted texts were then summarized and analyzed qualitatively. Results and Discussion: Treatment process of Saam five element acupuncture designed for psychiatric use is divided into four stages: qi transformation (氣化), acupuncture treatment, deep breathing, and acupressure. In the first stage, patients are asked to express their feelings and emotions in a physical sense; to imagine their feelings have colors, weight, and physical form, and to describe those characteristics. Next, the doctor evaluates each patient's qi according to the six qi (六氣), and then determines protocol of Saam five element acupuncture treatment. This treatment is focused on suffering of the patient and specific symptoms or emotions. The treatment duration is brief and changes in symptoms are frequently checked during treatment sessions. Without discussing details of stressful events, the doctor enables patients to express physical aspects of their feelings. He also provides them with psychoeducational resources. As a result, patients experienced immediate changes in body sensation, emotions and thinking, decreased response to triggers, and increased self-control after treatment. Conclusions: The Saam five element acupuncture treatment has the potential to be used as a treatment for psychiatric disorders. Treatment can be effective in managing psychiatric disorders when applied by primary Korean medicine clinics.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.8
no.2
/
pp.232-241
/
1997
The psychological problems following the experiences of school-violence could be more important than the physical problems. Victims could suffer from fear, depression, anger, lowered self-esteem, suicidal thought, and personality changes. To study the risk factors for school violence and the psychiatric problems after the experiences to school-violence provide us important informations to prevent and solve the problems of school violence. We examined clinical characteristics and psychosocial backgrounds of 13 adolescents who visited the psychiatric clinic after exposures to school violence from September, 1996 to May, 1997. The clinical data included intensity, motivations, durations, and methods of violence, psychiatric symptoms following exposure, findings of psychological test, and treatment course. The socioeconomic data included developmental characteristics of subjects, family characteristics, school life, and peer relationships. Of the 13 adolescents who experienced exposure to violence, 8 have experienced chronic psychiatric disturbances, 5 experienced transient psychiatric symptoms such as anxiety, depression, suicidal attempt who eventually returned to home and school life. Of the 8 adolescents who experienced chronic psychiatric disturbances, 4 experienced PTSD and depression lasting 3-6 months more, otherwise 4 showed converted features, such as aggressive behavioral disorder or perpetrator by strong compensatory effects after psychological shock. The subjects who have experienced chronic psychiatric disturbance have clinical characteristics such as physical or emotional abuse, physical illness or handicap, defects of ego functionings, and lack of family support. In summary, victims by school-violence manifested serious psychiatric disturbances, and they had clinically significant risk factors and some of them became perpetrators of school-violence.
Sung, Gyhye;Park, Ji-Hyun;Kim, Keun-Hyang;Lee, Sang-Hyuk;Park, Eun-Hee;Choi, Ji Young
Korean Journal of Psychosomatic Medicine
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v.25
no.1
/
pp.33-45
/
2017
Objectives : The purpose of this study was to examine psychological characteristics of patients who visited psychiatric clinic for medical certificate for military service using MMPI-2-RF. We compared target group with general psychiatric patients with same age range. Methods : A total of 165 male patients for medical certificate and 154 general psychiatric patients were collected from the Department of Psychiatry of three university hospitals. There were significant differences of age and educational level between two groups. We used independent t-test, ANCOVA, ${\chi}^2$ test to examine differences between two groups. Results : Medical certificate group scored higher on the validity scales, the Higher-Order(H-O) scales, the Restructured Clinical(RC) Scales, the Specific Problems(SP) Scales, and the Personality Psychopathology Five (PSY-5) Scales. Especially, EID, RC7, HLP, SFD, SAV, SHY, DSF, and INTR-r showed significant differences between two groups on all three statistical tests. Conclusions : The present study showed that psychiatric patients who received psychological evaluation for military service have significantly higher emotional distress, helplessness, lower self-confidence, and lower quality of interpersonal relationships. And the difference of validity scales between two groups could be related with psychological burden of compulsory military service in the study sample which causes elevation on scales of infrequent responses. MMPI-2-RF would be helpful instrument to assess these emotional and psychological characteristics.
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