• Title/Summary/Keyword: Psychiatric factors

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Analyses of User Behavior and Preference Factors in the Outdoor Spaces of Psychiatric Hospitals (정신병원 옥외공간의 이용행태 및 선호요인 분석)

  • Ahn, Deug-Soo
    • Journal of the Korean Institute of Landscape Architecture
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    • v.42 no.6
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    • pp.72-88
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    • 2014
  • This study was conducted in order to analyze user behavior and preference factors in the outdoor spaces of mental hospitals. Among hospitals with 250 or more beds, 5 hospitals were selected in consideration of size of garden and diversity of garden elements. The subject of the study was restricted to mild cases of schizophrenia while 30~50 patients were selected on the recommendation of their doctor from 5 hospitals, respectively. The physical environment was analyzed, focusing on space components, after visiting the sites of study. A face to face interview method was selected in consideration of patients' cognitive abilities, a total of 230 questionnaires were used for the analysis. The results of the study can be summarized as follows. Rest facilities occupy the largest numbers in the components of garden, and those are followed by landscape facilities, walking/exercise facilities, and experience facilities. Outdoor walking/exercise programs are classified into group walks and free walks with most patients taking group walks. Most of the patients visit these outdoor spaces every day but some of them rarely use the outdoor areas. In order to increase the efficiency of using these outdoor spaces, the percentage of space for ensuring a sense of control should properly harmonize with the percentage of space to facilitate patients in having social contact. With regard to the reasons for preferring the most widely-used outdoor spaces, landscape/environment property was the most important, followed by functionality and then accessibility. Major activities in the preferred space are mainly composed of walking/exercise and rest. The preferred facilities are waterscape facilities such as ponds, waterfalls and fountains, rest facilities such as pergolas and shade trees, and lawn. It was understood that naturalness should be considered to be the most important factor in constructing a new healing garden, followed by aesthetics and amenities. Single facilities rated by preference for introduction were flower beds, trails, and lawn. According to type, waterscape facilities such as fountains, ponds, waterfalls and waterwheels were most preferred. Space for natural distraction and programs for the cultivation of flower beds were also preferred. The ideal image of a healing garden should be bright, familiar, and orderly as a whole, having plenty of introduced facilities. Open spaces were preferred to enclosed spaces. Finally, the image of a garden that helps patients feel calm was thought to be that of the most ideal garden.

A study for diagnosis and pattern identification of Hwa-Byung (화병의 진단 및 변증유형에 관한 연구)

  • Lee, Hui-Young;Park, Jong-Hoon;Whang, Wei-Wan;Kim, Jong-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.16 no.1
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    • pp.1-17
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    • 2005
  • Objective : This empirical research is performed to recognize diagnostic concept, pattern identification, and clinical features of Hwa-byung. In other words, the aims of this research are to examine the differences of the diagnosis between Hwa-Byung and the other psychiatric disorders, and to find out pattern identification, and clinical characteristics of Hwa-Byung for prescriptions of this syndrome. Method : In the experiment, there were participated 30 patients who were met for our criterions according to HBDIS (Hwa-Byung Diagnostic interview Schedule). These patients were diagnosed as Axis1 according to criterions of DSM-IV with administering SCID-I. OMS-prime was utilized for finding out pattern identification of oriental medicine. Symptom Check List-90-Revision(SCL-90-R), Hemilton rating Scale for Depression(HRSD), Heart Rate Variability(HRV), and Digital Infrared Thermographic imaging(D.I.T.I.) were also utilized to discover clinical characteristics of Hwa-Byung Patients. Results : 1. Regarding Sex-ratio, male subjects were 3(10%), and female subjects are 27(90%). The age of subjects ranged from 22 year old to 75 $(51.87{\pm}11.04;\:Mean{\pm}SD)$ 2. In the results of diagnosis on the basis of DSM-IV, the 17(56.67%) patients were MOD (Major Depressive Disorder), the 5(16.67%) patients were USD (Undifferentiated Somatoform Disorder), the 4(13.33%) patients were Dysthymic Disorder, the 3(10%) patients were GAD (Generalized Anxiety Disorder), and the 1(3.33%) was Panic Disorder. Two of the patients who diagnosed as MOD were diagnosed as Panic Disorder too, and one of them was diagnosed as Pain Disorder too. 3. Regarding pattern identification, Hwa-Byung is positively correlated to deficiency of Heart(心). and then to stagnancy of Liver-Gall bladder. Hwa-Byung is correlated deficiency symptom-complex rather than excessiveness symptom-complex. That is also correlated positively to Pathological heat and fire. 4. In SCL90-R, the mean of PSDI was $(75.3{\pm}10.7;\:Mean{\pm}SD)$. The each mean of the other 11 factors was distributed between50-70. 5. The mean of HRSD was $(17.9{\pm}5.6;\:Mean{\pm}SD)$ in the entire subject's group. Then the group of MDD was $20.9{\pm}4.4$ and the group of USD was $12.0{\pm}4.8$ 6. In the results of HRV. the mean of TP is $972.4{\pm}1174(Mean{\pm}SD)$, this is lower than normal range 1000-200. The other factors were within normal range. Then, there were no significant differences between them (p<0.05). 7. The temperatures of each acupoint have significant differences between HNl(印堂) and PC6(內關), between CV17(顫中) and PC6(內關), between HN1(印堂) and CV8(神闕), between CV17(顫中) and CV8(神闕) in comparison with the average of body temperature in the use of D.I.T.I. (p<0.01) 8. In the analysis of correlation between SCL-90-R, HRSD, HRV. and D.I.T.I. there were no significant results. According to results that the correlation was analyzed with only the MDD group as subjects, there was negative correlation between RMSSD of HRV and HRSD, between LF of HRV and PDSIof SCL-90-R, and between LF/HF of HRV and ANX, PSY, and PDSI of SCL-90-R. Conclusion : In the observation of clinical features of 30 cases of Hwa-Byung patients by using diverse structured tests, there could make diverse diagnosis as depressive disorder, anxiety disorder, and Somatoform Disorder. Particularly. MDD was highly distributed. Considering oriental medicine's pattern identification of Hwa-Byung, this syndrome is related strongly to Heart, and there were demonstrated deficiency symptom-complex, and Pathological heat and fire. One of the limits of this study is lack of control subject's group, therefore, in the future study, it requires reexamination through a comparative research with these data to complete this study.

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Prediction of Sleep Disturbances in Korean Rural Elderly through Longitudinal Follow Up (추적 관찰을 통한 한국 농촌 노인의 수면 장애 예측)

  • Park, Kyung Mee;Kim, Woo Jung;Choi, Eun Chae;An, Suk Kyoon;Namkoong, Kee;Youm, Yoosik;Kim, Hyeon Chang;Lee, Eun
    • Sleep Medicine and Psychophysiology
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    • v.24 no.1
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    • pp.38-45
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    • 2017
  • Objectives: Sleep disturbance is a very rapidly growing disease with aging. The purpose of this study was to investigate the prevalence of sleep disturbances and its predictive factors in a three-year cohort study of people aged 60 years and over in Korea. Methods: In 2012 and 2014, we obtained data from a survey of the Korean Social Life, Health, and Aging Project. We asked participants if they had been diagnosed with stroke, myocardial infarction, angina pectoris, arthritis, pulmonary tuberculosis, asthma, cataract, glaucoma, hepatitis B, urinary incontinence, prostate hypertrophy, cancer, osteoporosis, hypertension, diabetes, hyperlipidemia, or metabolic syndrome. Cognitive function was assessed using the Mini-Mental State Examination for dementia screening in 2012, and depression was assessed using the Center for Epidemiologic Studies Depression Scale in 2012 and 2014. In 2015, a structured clinical interview for Axis I psychiatric disorders was administered to 235 people, and sleep disturbance was assessed using the Pittsburgh Sleep Quality Index. The perceived stress scale and the State-trait Anger Expression Inventory were also administered. Logistic regression analysis was used to predict sleep disturbance by gender, age, education, depression score, number of coexisting diseases in 2012 and 2014, current anger score, and perceived stress score. Results: Twenty-seven percent of the participants had sleep disturbances. Logistic regression analysis showed that the number of medical diseases three years ago, the depression score one year ago, and the current perceived stress significantly predicted sleep disturbances. Conclusion: Comorbid medical disease three years previous and depressive symptoms evaluated one year previous were predictive of current sleep disturbances. Further studies are needed to determine whether treatment of medical disease and depressive symptoms can improve sleep disturbances.

Depressive Symptoms in Patients with Parkinson's Disease (파킨슨병 환자에서의 우울증상)

  • Lee, Moon-Sook;Yang, Chang-Kook;Hah, Hong-Moo;Kim, Jae-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.1
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    • pp.25-35
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    • 2003
  • Objectives: The aim of this study was to investigate 1) the prevalence of depressive symptoms, 2) the severity of depressive symptoms, 3) the correlation of depressive symptoms with clinical variables, and 4) factors that contribute to depressive symptoms in patients with Parkinson's disease. Methods: One hundred eighteen patients with Parkinson's disease referred from the Parkinson's Disease Clinic of Dong-A University Hospital, Busan, Korea, completed a self-administered questionnaire package, which included basic demographic data, the Beck Depression Inventory, the Parkinson's disease quality of life questionnaire, the Symptom Checklist-90-Revision(SCL-90-R), and the Spielberger's State-Trait Anxiety Inventory. In addition, a structured interview and a complete neurological examination, including the Hoehn and Yahr stage, the motor part of the Unified Parkinson's Disease Rating Scale(some selected scales of UPDRS part III), the Schwab and England Activities of Daily Living scale(ADL), and the Korean version of Mini-Mental State Examination were performed. Results: 1) Based on BDI score, subjects were divided into four groups:severely(40.7%), moderately(13.6%) and mildly(12.7%) depressive and non-depressive(33.1%). 2) The severity of depressive symptom in Parkinson's disease was positively correlated with Hoehn and Yahr(H & Y) stage(r=0.34, p<0.0001), the severity of motor symptom(r=0.35, p<0.0001), and trait anxiety inventory(r=0.33, p<0.001). On the other hand, the severity of depressive symptom was negatively correlated with educational level(r=-0.34, p<0.001), ADL(r=-0.37, p<0.0001) and Parkinson's disease quality of life (PDQL)(r=-0.69, p<0.0001). Among several clinical variables, the PDQL was the most influential factor predicting whether the depressive symptom was present or not. Conclusion: This study suggests that depressive symptom is very prevalent among patients with Parkinson's disease. Data from this study indicate that medical staffs who take care of patients with Parkinson's disease should pay attention to finding and treating depressive symptom among their patients. With appropriate psychiatric intervention, patient's depressive symptom can be minimized or alleviated and thus, the quality of life in these patients is likely enhanced.

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Development of the Perceived Stress Response Inventory (스트레스반응 지각척도의 개발)

  • Koh, Kyung-Bong;Park, Joong-Kyu;Kim, Chan-Hyung
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.26-41
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    • 1999
  • The perceived stress response inventory(PSRI) was developed to measure 4 types of current stress responses : emotional, somatic, cognitive, and behavioral responses. 242 patients with psychiatric disorders(71 patients with anxiety disorders, 73 patients with depressive disorders, 47 patients with somatoform disorders, 51 patients with psychosomatic disorders) and 215 healthy subjects completed the questionnaire including the PSRI. Global assessment of recent stress(GARS) scale, perceived stress questionnaire(PSQ) and symptom checklist-90-revised(SCL-90-R) were also administered at the same time. Factor analysis for each of 4 types of stress responses yielded 8 factors : negative emotional responses, general somatic symptoms, specific somatic symptoms, lowered cognitive function and general negative thinking, self-depreciative thinking, impulsive-aggressive thinking, passive-responsive and careless behavior, and impulsive-aggressive behavior. Both test-restest reliability(r= .83 -.93) and internal consistency(Cronbach's alpha : .79 -.96 for each of 8 subscales and .98 for total items of the scale) were all at statistically significant levels. Total scores of the PSRI significantly correlated with total scores of GARS scale, PSQ, and global indicies of SCL-90-R, respectively. The patient group had significantly higher scores than healthy subjects in each of all the subscales except impulsive-aggressive behavior subscale. These results suggest that the PSRI is a reliable and valid tool stable over time which may be effectively used for the research in stress-related field including psychosomatic medicine.

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The Characteristics of Illness Behavior in Patients with Somatization (신체화에 따른 질병행동의 특성에 관한 연구)

  • Song, Ji-Young;Yum, Tae-Ho;Oh, Dong-Jae;Cho, Seong-Wook
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.2
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    • pp.176-184
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    • 1997
  • Abnormal illness behavior in patients with somatoform disorders were known formed by their traditional disease concepts and somatization-prone socio-cultural factors. The authors evaluated the characteristics of abnormal illness behavior in patients with somatoform disorders(who had somatization) by using abnormal illness behavior questionnaire. Methods : 29 somatoform disorders(SD) and 57 disease controls were compared by clinical characteristics, severity of pain, state anxiety(by Spielberger's State & Trait Anxiety Inventory), depression(by Beck's Depression Inventory) and level of psychosocial stess(by DSM-III-R). The illness behavior was measured by illness Behavior Questionnaire(IBQ). Results SD group had longer period of somatic symptoms with less severity in pain. The degree of anxiety and depression were higher in SB compared with controls. However, the degree of psychosocial stress was almost same between both groups. In IBQ, SD showed higher scores in general hypochondriasis, disease conviction, and affective disturbance subscales compared to control group. Conclusion: High disease conviction and hypochondriacal nature revealed by IBQ seemed to be a role in making somatization by way of somatic focusing and hypervigilance. And those tended to lead patients visit hospital frequently and report various somatic complaints. Evaluating abnormal illness behavior in somatoform disorders would be not only helpful in understanding the natures of somatoform disorders but also useful differentiating SD with other psychiatric conditions.

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Psychological Characteristics of Alopecia Areata and Androgenetic Alopecia in Women (원형 탈모증과 안드로겐성 탈모증 여성의 정신적 특성에 관한 연구)

  • Park, Doo-Byoung;Jin, Seong-Nam;Min, Kyung-Jun;Noh, Byung-In
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.1
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    • pp.16-23
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    • 2005
  • Objectives : We have studied female patients with either alopecia areata or androgenetic alopecia to evaluate psychological aspects, such as anxiety, depression, alexithymia, and characteristic personalities. In addition, we tried to examine the differences in psychological characteristics between these two types of alopecia, where the alopecia areata has been cotroversial on the role of stress in its etiology and the androgenetic alopecia seems to be more influeced by genetic and biological factors. Methods : All participated patients were females with alopecia for more than 1 you. Among them, 52 were with alopecia areata and 33 were with androgenetic alopecia. They were compared with 54 normal healthy controls by using MMPI, BDI, STAI-S, STAI-T, and TAS-20K. Results The average scores of F, Hs, D, Pd, Pa, Sc, Si in MMPI of alopecia groups were significantly higher than that of normal controls, and the androgenetic alopecia group had highest Hy and Pt scores. The average scores of BDI, STAI-S, and STAI-T in alopecia groups were higher than the normal controls. 94.2% of alopecia areata patients and 97.0% of androgenetic alopecia patients had severe depression, who scored higher than 23 in BDI. In TAS-20K, the average total scores of alopecia groups were higher than the normal control group, and the average Factor 3 score in androgentic alopecia was higher than the other groups. The alopecia groups scored higher than normal control group in STAI-S and STAI-T. Conclusion : Females with chronic alopecia were more depressed, had higher levels of anxiety, and more alexithymic than normal healthy females. In spite of arguments about etiological role of stress to alopecia, psychiatric interventions are needed for depression, and considerations for personality and psychological defense mechanism were needed in both types of alopecia.

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A Validation Study for the Practical Use of Screening Scale for Potential Drug-use Adolescents(SPDA) (청소년 약물사용 잠재군 선별척도(SPDA) 활용을 위한 타당화 연구)

  • Lee, Ki-Young;Kim, Young-Mi;Im, Hyuk;Park, Mi-Jin;Park, Sun-Hee
    • Korean Journal of Social Welfare
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    • v.57 no.3
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    • pp.305-335
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    • 2005
  • This paper is a result from validation study for SPDA(A Screening Scale For Potential Drug-use Adolescents) created in 2003 and newly developed during 2004. SPDA aims to screen adolescents in their early stage of drug-use and to help practitioners make a preventive approach for the adolescents. 4307 junior and senior high school students were selected as primary research subjects by stratified and quota sampling methods. 305 adolescents on probation were also selected as a comparison group and asked to answer the same questionnaire. Reliability for SPDA recorded 0.914, which proved to be better than previous year's (0.898). Exploratory and confirmatory factor analyses to test construct validity proved that SPDA could be divided into 7 factors and that each factor structure of SPDA could be a proper measurement model with high level of fitness and factor loadings. Discriminant analysis to test predictive validity confirmed that SPDA could classify the adolescents excellently by the frequency of drug-use, with hit ratio of 86.6 percent(78.8% and 87.4% for junior and senior high school students respectively). For concurrent validity test, Hare Home Self-Esteem Scale, Hare School Self-Esteem, Zuckerman-Kuhlman Sensation-seeking Scale were employed to find correlation with SPDA and all the three scales had significant Pearson correlation coefficients with SPDA. Known-groups validity test indicated that SPDA had an adequate power to classify out adolescents on probation from those in schooling, with a hit ratio of 71.8 percent. Cut-off point to detect adolescents with high risk of substance use was 77, which indicated approximately T score, 55 (0.5 SD), satisfying sensitivity, specificity, and efficiency criteria.

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Study of Radiological Approach to Treat a Chronic Constipation (만성변비환자의 방사선학적 접근방법에 관한 고찰)

  • Yoon, Seok-Hwan
    • Journal of radiological science and technology
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    • v.27 no.3
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    • pp.5-12
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    • 2004
  • I. Introduction : The constipation is one of the common gastrointestinal symptoms seen in the clinical practice. When people come to the clinic complaining of the constipation, it is generally one of the cases of infrequent, painful or difficult evacuation as well as the hardened feces and unsatisfactory evacuation sense. Since the constipation is heavily influenced by dietary habit as well as the social and medical environment, the diagnostic radiology is useful to establish the objective and standardized definition in consideration of those various factors before diagnosis and treatment of the constipation patient. This paper describes the study of such diagnosis. II. Main Subject : Testing of CTT (colon transit time) is key study of the colon performance. CTT is very helpful in classifying the pathologic physiological types and defining the treatment plan for the chronic constipation. The study methods include using the radipaque marker, multiple marker technique and scintigraphic measurement. The defecography is the functional radiologic examination a that provides not only the anatomical information of anorectal but also performance of the pelvic floor and rectal change during evacuation. Study of dynamic movement of the anorectal during evacuation is helpful for diagnosis and treatment planning as well as follow-up testing for the constipation patient. One of the issues essential for the case history is the thorough observation of whether the patient shows the psychic psychological symptoms such as the behavior disorder or emotional disturbance. In that case, the decision must be made whether or which type of medication is needed for such psychiatric problem. III. Conclusion : The main causes of the constipation are insufficient intake of fiber or liquid. The key objective of such tests is to check etiology of the constipation. In general, the radiological examination does not provde the colon or anorectal performance information. It is envisaged that this study will provide the information to decide the testing and treatment plans and predict the prognosis of the patient by classifying the pathologic physiological types.

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Oral Health Status of Some Patients with Chronic Mental Illness in Korea (일부 만성 정신질환자의 구강건강 상태)

  • Seo, Hye-Yeon;Jeon, Hyun-Sun;Park, Su-Kyung;Park, Ki-Chang;Chung, Won-Gyun;Mun, So-Jung
    • Journal of dental hygiene science
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    • v.13 no.4
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    • pp.493-500
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    • 2013
  • The study aims to determine the status of oral health of mental illness patients and establish the preliminary data. The examinations and questionnaire survey were done 92 psychiatric patients to measure sociodemographic characteristics, decayed, missing and filled teeth (DMFT) index, patient hygiene performance (PHP) index, community periodontal index of treatment need (CPITN). Result of the missing teeth index in the state of oral health was higher in the hospital group (6.42) while the filled teeth index was higher in the center group (4.78). In the DMFT index, mental illness patients were higher than the national sample. The oral health status of medical aid recipients was poorer as the subjects were older and less educated (p<0.05). The PHP index was 3.41, close to the bad oral hygiene state. The hospital group (81.7%) required higher need for periodontal treatment. The periodontal health state was much poorer especially when the subject was in the age of 40's and 60's, received less education, and had no family (p<0.05). $CPITN_3$ was higher in the hospital group (13.3%) than the national sample (5.7%). The mental illness patients were socially vulnerable, therefore oral health care program should be needed and age, education level, health insurance type, presence of family and other factors needs to be considered in this approach.