• Korean Journal of Psychosomatic Medicine
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• v.21 no.2
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• pp.114-121
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• 2013

Objectives: The aim of this study was to know differences of characteristics between presenile and senile patients who were consulted to the department of psychiatry during medical-surgical admission. Methods: The demographic and clinical data obtained from the medical records of psychiatric consultation in the presenile inpatients with age 50 to 64 years(N=162) and those of the senile inpatients with age over 65 years(N=171) were reviewed and compared. Results: 1) The most common chief complaints for psychiatric consultation in presenile patients were somatic symptoms, anxiety and sleep disturbance in order, while cognitive decline, clouded consciousness and depressed mood were most common in senile patients with statistical significance. 2) The most frequent psychiatric diagnoses after consultation in presenile patients were delirium, mood disorder and substance use disorder in order, while delirium, mood disorder and major neurocognitive disorder were most frequent in senile patients with statistical significance. 3) There were no significant difference in numbers of physical illnesses, while numbers of therapeutic drugs for them were more in senile patients. Conclusions : Our study found significant differences between presenile and senile patients on psychiatric symptoms and diagnoses in geropsychiatric consultation. Therefore, more subdivided age-specific approach seems to be needed for the geropsychiatric consultation activities.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.1
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• pp.74-82
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• 2016

Objectives : Suicide attempters have impaired decision making and are at high risk of reattempt. Therefore it is important to refer them to psychiatric treatment. Especially, People with medical comorbidity are at higher risk of suicidal attempt and mortality. The aim of this study was to investigate the characteristics of suicidal attempters and to analyze the influence of the medical comorbidity on decision to receive psychiatric treatment after visit to an emergency department. Methods : One hundred and thirty two patients, who visited the emergency room of a general hospital in Gyeonggi-do between January, 2012 and December, 2012 were enrolled as the subjects of this study. After reviewing each subject's medical records retrospectively, demographic and clinical factors were analyzed. Results : Regardless of the engagement type, either via admission or outpatient clinic, the determinant factors of psychiatric treatment engagement were psychiatric diagnosis, employment status, previous psychiatric treatment history, and previous attempt history. Comparison of severity of medical comorbidity(Charlson Comorbidity Index) showed that suicide attempters who received psychiatric treatment via admission or refused the treatment tended to have higher level of medical comorbidity than who received psychiatric treatment via outpatient department. Conclusions : Our findings showed that medical comorbidity of suicide attempters affected the decision to accept psychiatric treatment. All psychiatrists should evaluate the presence and the severity of medical comorbidity of the suicide attempters and consider implementing more intervention for the medically ill attempters who are willing to discharge against advice.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.27 no.3
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• pp.196-206
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• 2016

Objectives: Individuals with autism spectrum disorder (ASD) are considered to have problems with empathy. It has recently been suggested that there are two systems for empathy; cognitive and emotional. We aimed to investigate the neural response to cognitive and emotional empathy and elucidate the neurobiological aspects of empathy in patients with ASD. Methods: We recruited patients with ASD (N=17, ASD group) and healthy controls (HC) (N=22, HC group) for an functional magnetic resonance imaging study. All of the subjects were scanned while performing cognitive and emotional empathy tasks. The differences in brain activation between the groups were assessed by contrasting their neural activity during the tasks. Results: During both tasks, the ASD group showed greater neural activities in the bilateral occipital area compared to the HC group. The ASD group showed more activation in the bilateral precunei only during the emotional empathy task. No brain regions were more activated in the HC group than in the ASD group during the cognitive empathy task. While performing the emotional empathy task, the HC group exhibited greater neural activities in the left middle frontal gyrus and right anterior cingulate gyrus than the ASD group. Conclusion: This study showed that the brain regions associated with cognitive and emotional empathy in ASD patients differed from those in healthy individuals. The results of this study suggest that individuals with ASD might have defects both in cognitive empathy and in emotional empathy.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.29 no.3
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• pp.101-113
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• 2018

Objectives: The purpose of this study was to investigate whether the neural activity of autism spectrum disorder (ASD) patients is different from that of normal individuals when performing aesthetic judgments. Methods: We recruited typical ASD patients without savant skills (ASD group, n=17) and healthy controls (HC group, n=19) for an functional magnetic resonance imaging study. All subjects were scanned while performing aesthetic judgment tasks on two kinds of artwork (magnificent landscape images and fractal images). Differences in brain activation between the two groups were assessed by contrasting neural activity during the tasks. Results: The aesthetic judgment score for all images was significantly lower in the ASD group than in the HC group. During the aesthetic judgment tasks, the ASD group showed less activation than the HC group in the anterior region of the superior frontal gyrus, and more activation in the temporoparietal area and insula, regardless of the type of images being judged. In addition, during the aesthetic judgment task for the fractal images, the ASD group exhibited greater neural activity in the amygdala and the posterior region of the middle/inferior temporal gyrus (Brodmann area 37) than the HC group. Conclusion: The results of this study suggest that the brain activation patterns associated with aesthetic experiences in ASD patients may differ from those of normal individuals.

• Anxiety and mood
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• v.14 no.2
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• pp.53-62
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• 2018

Objective : The Korean Association of Anxiety Disorders developed Korean guidelines for treatment of panic disorder (PD) 2018. In this paper, we discussed the consensus among psychiatrists, regarding initial and maintenance treatment strategies for pharmacological treatment of PD in Korea. Methods : Based on current treatment guidelines published by the American Psychiatric Association, the National Institute for Clinical Excellence, and the Canadian Psychiatric Association, we developed questionnaires pertinent to initial and maintenance treatment strategies for pharmacological treatment of PD. Seventy-two experts in PD answered questionnaires. We classified expert opinions into three categories, first, second, and third-line treatment strategies, by analyzing the 95% confidence interval. Results : Antidepressants, benzodiazepine anxiolytics, and cognitive-behavioral therapy (CBT) were recommended as treatments of choice (ToC), and first-line strategies for initial treatment of PD. Escitalopram, paroxetine, sertraline, and venlafaxine were preferred from among many anti-panic drugs. Mean starting dose of anti-panic drugs for initial treatment of PD was relatively lower, than that for other psychiatric illnesses such as major depressive disorder. In the case of maintenance treatment of PD, antidepressants and CBT were selected as ToC and first-line strategies. Patients were typically examined every four weeks during treatment, to review effectiveness and side effects of the drug. Pharmacotherapy was generally continued for one year or more. Conclusion : This study provides information about consensus among Korean experts regarding pharmacological treatment strategies for patients with panic disorder.

• Journal of Oriental Neuropsychiatry
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• v.23 no.4
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• pp.107-122
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• 2012

Objectives : The purpose of this study is to examine the general personality profiles of patients who visited an oriental neuropsychiatric clinic and to investigate the specific profiles of patients diagnosed with Hwa-byung. Methods : We analyzed the profiles of 122 patients who completed TCI-RS questionnaire for the purpose of counseling. Patients were divided by sex, age and diagnosis related groups. Scales and subscales of each group were compared by an independent t-test and ANCOVA with SPSS windows 16.0. Types of temperament and character were classified by percentile ranks of the total patients and diagnosis related groups. Results : 1. Total patients were classified as the high harm avoidance type of temperament and of low self-directedness type of character. 2. Male patients showed significantly higher scores on NS, all subscales of NS, P2 and P3 than female patients. HA4 and C5 scores were significantly higher in the female group. Younger patients showed significantly higher scores on NS, all subscales of NS, HA1 and P3. However, older patients had significantly higher scores on SD4, SD5, ST2 and ST3. 3. Between diagnosis related groups, Hwa-byung group had significantly higher scores on RD, ST, SD3 and ST2. However P3 score of non-hwa-byung patients was higher than hwa-byung patients. In typical classification, both hwa-byung and non-hwa-byung groups were classified as the same types as total patients. Conclusions : This study showed that the patients visited an oriental neuropsychiatric clinic and had similar personality with that of general psychiatric disorders. Hwa-byung patients exhibited higher RD and ST scores than other disorders, but they had no typical differences.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.20 no.3
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• pp.158-164
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• 2009

Trichotillomania is a neuropsychiatric disorder characterized by repetitive pulling out of one's hair. We present a trichotillomania case study illustrating the effectiveness of habit reversal training, which has recently been found, in western countries, to be a very effective cognitive behavioral treatment. The refractory patient in our study had previously received 1 year of drug treatment and psychiatric consultation for the disorder. We administered 10 habit reversal training sessions, which was followed by an obvious improvement in the patient's trichotillomania symptoms. Our observations indicate that habit reversal training might be effective in the treatment of trichotillomania.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.17 no.2
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• pp.103-106
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• 2006

Listeners' perception toward stuttering has been considered an important factor to the diagnosis and treatment of stuttering. This study intended to examine perceptual differences between speech language pathologists and laypeople toward children and adults with stuttering. A Total of 102 subjects were surveyed. speech language pathologists' perception was more stereotypical than that of laypeople. laypeople perceived adults and children with no significant differences but, clinicians viewed adults more stereotypically. speech language pathologists were not influenced by experiencer, but experienced laypeople perceived children more negatively although people who have stuttering family members showed a less stereotypically. item analysis revealed that both groups showed different perspectives between adults and children with stuttering.

• Psychoanalysis
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• v.29 no.4
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• pp.72-82
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• 2018

What should a therapist do if the patient has lost the ability to speak in sessions? How should the therapist understand and approach this 'deadly silence'? Psychosomatic patients have poor ability to mentalize their experience, so they create a 'shunt' from emotional experience to body bypassing symbolic sphere. This makes psychosomatic patients vulnerable to expressing their emotions in words. With the case vignette 'When words are unspeakable: a bridge beyond the silence' written by Wirth in a book "From soma to symbol" we observe how psychosomatic pathology arises, from inappropriate mirroring and poor containment; and how this escalates into a vicious cycle of sin and punishment in the patient's conscience. This conscience scenario imprisons a talented and creative mind in a dark, silent place, wherein symbols and words are forbidden. This seemingly impossible task of providing silent patients with a 'talking cure' finds breakthrough with containment, and transformative thinking using therapists' reveries.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.32 no.2
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• pp.79-81
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• 2021

The film "The World of Us (2016)" shows the acquisition and loss of friendship that occur in the process of interpersonal shifts in latency school girls. Connection to the peer group helps compensate for the latency child's loss of parent-child intimacy and the ensuing feelings of loneliness. The protagonists realize that the relationship is not for retaliation or for victory, but for playing together. However the reality that lies in front of them will not be so easy. Watching this film reminds one of childhood.