• 동서간호학연구지
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• 제20권2호
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• pp.93-102
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• 2014

Purpose: This study aimed to investigate the characteristics of patients attempting suicide and to analyze treatment determination factors for patients with mental illness who go to an emergency center for treatment. Methods: Data collected from 117 suicide attempters who visited Busan Regional Emergency Medical Center were analyzed using frequency, percentage, ${\chi}^2$-test with SPSS/WIN 15.0. Results: Only 31 cases consulted with the psychiatric department; the other attempters' refused to consult (26.5%). Among the 31 attempters who consulted, 23 cases (74.2%) were suffering from depression. The most common reason (38.6%) suicidal attempters gave to refuse psychiatric treatment was "I'm not mad. I don't need the psychiatric treatment". Treatment determination factors for mental illness were religion (p<.001), past history (p=.017), financial satisfaction (p=.048), previous history of suicidal attempts (p=.006), sleep disturbance (p<.001), expression of suicide (p=.010), and type of leaving the emergency room (p=.020, p<.001). Conclusion: Results suggest that people frequently misunderstand psychiatric treatment which leads to their refusal to accept psychiatric treatment. Therefore hospitals need to develop standard guidelines and procedures for suicidal attempters with the collaboration of emergency and psychiatry departments. In addition, medical teams need to provide attempters appropriate information and encourage them to actively seek psychiatric treatment.

• 정신신체의학
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• 제19권2호
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• pp.66-73
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• 2011

연구목적: 종합병원에서 정신과에 자문 의뢰된 입원 환자 및 그 자문의뢰의 특성을 살펴보고 이를 통해 정신과 치료의 순응도에 관련된 요인을 찾아보고자 하였다. 방 법: 2009년 9월 1일부터 2010년 8월 31일까지 고려대학교 안산병원에서 정신과에 자문 의뢰된 입원환자 333명을 대상으로 자문기록지와 의무기록을 참고하여 연구를 진행하였다. 기본적인 인구 역학적 정보, 자문을 의뢰한 임상 각과, 의뢰 요청자, 의뢰된 사유, 정신과적 진단과 과거력, 입원 중 정신과 치료의 시행 여부 및 추후 통원 치료의 여부 등을 조사하였다. 이들 중 정신과 치료의 시행 여부 및 통원 치료의 여부를 치료순응도로 정하였다. 순응도와 기타 변수간의 이분형로지스틱 회귀분석을 시행하여 순응도에 영향을 미치는 요인을 확인하였다. 결 과: 입원 중 정신과 치료를 권유 받은 310명의 환자들 중, 치료에 순응한 환자는 82.9%이었으며, 외래 통원치료를 권유 받은 111명의 환자들 중에는 통원치료에 순응한 환자가 55.8%이었다. 64세 이하 연령층보다 65세 이상의 노인에서 입원 중 치료에 대한 순응도가 높았다(OR=4.838, p=0.004). 외래 통원치료를 권유받은 환자들 중 내과적 질환으로 인해 이차적인 정신과적 증상이 나타난 경우가 외래 순응도가 더 높았다(OR=8.520, p=0.008). 결 론: 노인 환자는 입원중 정신과 치료에 대해서는 순응도가 높았으나 신체 질환의경과에 영향을 미치는 섬망 및 기분장애가 흔하므로 정신과적 증상에 대한 평가와 치료가 보다 적극적으로 이루어져야 할 것이다. 또한, 내외과적 질환과 관련이 없는 정신과 문제로 자문 의뢰된 환자들은 외래 통원치료 순응도가 낮으므로 치료순응도를 높이기 위해 다방면의 치료적 접근 방법을 모색하여야 할 것으로 판단된다.

• 정신신체의학
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• 제22권1호
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• pp.31-39
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• 2014

연구목적 이 연구는 2년 6개월 동안 일 병원에 입원 중인 HIV감염/AIDS환자에 대한 정신건강의학과 자문 의뢰를 분석하였다. 방법 일 병원에서 2011년 1월 1일부터 2013년 6월 30일까지 자문 의뢰된 97명의 HIV감염/AIDS 환자와 282개의 자문 의뢰를 대상으로 후향적 의무기록 연구를 수행하였다. 결과 97명의 HIV감염/AIDS 환자 중 91명(93.8%)이 남자였으며, 평균연령은 48세, 연구 기간 동안 평균 1인당 자문건수는 2.8건이었다. 주로 호소한 증상으로는 우울 102건(55.3%), 불면 60건(14.0%), 불안감 31건(7.2%) 등이었으며, 최초 자문의뢰 시 진단된 정신과적 질환은 우울장애 37명(37.0%), 인지장애 11명(11.0%), 섬망 9명(9.0%) 등 이었고 투약 권고된 향정신병 약물은 Lorazepam 99건(17.2%), Escitalopram 90건(15.7%), Quetiapine 84건(14.6%) 순이었다. 결론 HIV감염/AIDS 입원 환자들은 '우울감', '불면', '자살사고/시도' 등을 주문제로 정신건강의학과로 자문의뢰 되었고, 자문의뢰 환자의 85명(93.3%)에서 정신장애로 진단을 받았다 그러나 자문의뢰 환자의 16.9%만 퇴원 후 본원 정신건강의학과로 외래 추적 진료가 이루어져, 향후, 정신건강문제가 HIV감염 및 AIDS의 치료 순응도, 예후, 전파에 미치는 영향에 대한 장기적 연구가 필요할 것으로 보인다.

• 한국직업건강간호학회지
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• 제32권1호
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• pp.30-38
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• 2023

Purpose: This study aimed to investigate the effect of positive psychological capital, empathy ability, and stress coping style on psychiatric ward nurses' compassion fatigue. Methods: Data were collected using structured questionnaires for 140 psychiatric ward nurses. The data were analyzed using t-test, one-way ANOVA, and hierarchical regression. Results: The variable predictors of compassion fatigue were as follows: positive psychological capital (β=-.35, p<.001), empathy ability (β=.32, p<.001), and passive coping (β=.25, p=.004). These factors explained 27% of compassion fatigue, and psychological capital was found to have the greatest influence among these variables. Conclusion: Positive psychological capital, empathy ability, and passive coping are important factors influencing nurses' compassion fatigue in psychiatric wards. It is necessary to develop interventions and appropriate coping styles that strengthen positive psychological capital to prevent and reduce nurses' compassion fatigue in psychiatric wards. In addition, it is necessary to identify the required level of empathy ability to maintain a therapeutic relationship.

• The Korean Journal of Pain
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• 제31권2호
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• pp.116-124
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• 2018

Background: We aimed to investigate the prevalence of unrecognized depression in patients with chronic pain, but with no history of psychiatric diseases. Methods: Patients with chronic pain who did not have a history of psychiatric disease were selected for this study. The Beck Depression Index (BDI) was used to evaluate depression. Participants' socio-demographic characteristics and pain-related characteristics were also recorded. Results: The study included 94 consecutive patients with chronic pain (28 men and 66 women). Based on the BDI scores, 33/94 (35.1%) patients with chronic pain had comorbid depression. The prevalence of depression was significantly higher in our cohort than it was in the general population (P < 0.001). The standardized incidence ratio, adjusted for age and sex, was 2.77 in men and 2.60 in women. Patients who were unmarried (odds ratio [OR] = 3.714, P = 0.044), and who had subjective sleep disturbance (OR = 8.885, P < 0.001), were more likely to have moderate to severe depression. Patients with high education levels (OR = 0.244, P = 0.016), and who were economically active (OR = 0.284, P = 0.023), were less likely to have moderate to severe depression. Conclusions: Our results indicate that unrecognized depression in patients with chronic pain is common. Therefore, pain physicians should actively seek to identify these problems rather than relying on the patient to volunteer such information.

• 정신신체의학
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• 제30권2호
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• pp.179-186
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• 2022

연구목적 본 연구에서는 정신건강의학과 환자의 우울과 자살사고의 관계에서 자살하지 않는 이유의 조절효과를 확인하고자 하였다. 방 법 본 연구는 한양대학교 구리병원 정신건강의학과에 진료를 위해 내원 및 입원한 환자 137명을 대상으로 자기보고식 질문지를 실시하였다. 결 과 자살하지 않는 이유의 4개의 하위 요인 중 생존과 대처 신념, 죽음 공포와 사회적 비난 그리고 미래 기대의 조절효과가 관찰되었다. 결 론 본 연구의 결과는 정신건강의학과 환자의 우울과 자살사고의 관계에서 자살하지 않는 이유가 보호 요인이 될 수 있음을 확인하였다.

• 대한임상독성학회지
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• 제13권1호
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• pp.25-32
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• 2015

Purpose: The aim of this study was to investigate the independent factors associated with the registration rate for the community-based post suicidal care program in the emergency department (ED). Methods: This prospective observational study was conducted between March and December 2013 at the academic ED at the tertiary urban hospital. During the study period, the pre-designed registry was recorded. The variables examined included the following: patients' demographic data (Sex, age, address, type of insurance, marital status, level of education, and history of previous psychiatric disease), suicide-related data (suicidal methods, combined drink of alcohol and number of previous attempts), and management-related data (disposition at ED, physician's training level, etc.). Univariated and multivariated logistic regression analyses were performed for identification of factors affecting the registration rate for the community-based post suicidal care program. Results: A total of 163 suicides were included during the study period. Of these, 33 (20.2%) patients were registered in the post-suicide care program. Factors including a patient's address (OR: 14.92, 95% CI: 3.606-61.711), immediate intervention by psychiatric healthcare center (OR: 5.05, CI: 1.688-15.134), admissions in hospital (OR: 3.69, CI: 1.286-10.605), and history of previous psychiatric disease (OR: 3.52, CI: 1.216-10.201) showed significant association with registration for the program. Conclusion: The community-based post-suicidal care program, which is available 24 hours a day, should be operated in each district in order to increase the registration rate. Emergency physicians should actively consider the inpatient treatment program for suicidal patients and strongly recommend registration to the program, particularly for patients without previous history of psychiatric disease.

• 생물정신의학
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• 제27권1호
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• pp.18-26
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• 2020

Objectives The aim was to find effective vectorization and classification models to predict a psychiatric diagnosis from text-based medical records. Methods Electronic medical records (n = 494) of present illness were collected retrospectively in inpatient admission notes with three diagnoses of major depressive disorder, type 1 bipolar disorder, and schizophrenia. Data were split into 400 training data and 94 independent validation data. Data were vectorized by two different models such as term frequency-inverse document frequency (TF-IDF) and Doc2vec. Machine learning models for classification including stochastic gradient descent, logistic regression, support vector classification, and deep learning (DL) were applied to predict three psychiatric diagnoses. Five-fold cross-validation was used to find an effective model. Metrics such as accuracy, precision, recall, and F1-score were measured for comparison between the models. Results Five-fold cross-validation in training data showed DL model with Doc2vec was the most effective model to predict the diagnosis (accuracy = 0.87, F1-score = 0.87). However, these metrics have been reduced in independent test data set with final working DL models (accuracy = 0.79, F1-score = 0.79), while the model of logistic regression and support vector machine with Doc2vec showed slightly better performance (accuracy = 0.80, F1-score = 0.80) than the DL models with Doc2vec and others with TF-IDF. Conclusions The current results suggest that the vectorization may have more impact on the performance of classification than the machine learning model. However, data set had a number of limitations including small sample size, imbalance among the category, and its generalizability. With this regard, the need for research with multi-sites and large samples is suggested to improve the machine learning models.

• Journal of Preventive Medicine and Public Health
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• 제49권1호
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• pp.53-60
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• 2016

Objectives: The purpose of this study is to examine the magnitude of and the factors associated with the downward mobility of first-episode psychiatric patients. Methods: This study used the claims data from the Korean Health Insurance Review and Assessment Service. The study population included 19 293 first-episode psychiatric inpatients diagnosed with alcohol use disorder (International Classification of Diseases, 10th revision [ICD-10] code F10), schizophrenia and related disorders (ICD-10 codes F20-F29), and mood disorders (ICD-10 codes F30-F33) in the first half of 2005. This study included only National Health Insurance beneficiaries in 2005. The dependent variable was the occurrence of downward mobility, which was defined as a health insurance status change from National Health Insurance to Medical Aid. Logistic regression analysis was used to assess factors associated with downward drift of first-episode psychiatric patients. Results: About 10% of the study population who were National Health Insurance beneficiaries in 2005 became Medical Aid recipients in 2007. The logistic regression analysis showed that age, gender, primary diagnosis, type of hospital at first admission, regular use of outpatient clinic, and long-term hospitalization are significant predictors in determining downward drift in newly diagnosed psychiatric patients. Conclusions: This research showed that the downward mobility of psychiatric patients is affected by long-term hospitalization and medical care utilization. The findings suggest that early intensive intervention might reduce long-term hospitalization and the downward mobility of psychiatric patients.

• 정신신체의학
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• 제4권1호
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• pp.64-70
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• 1996

The prevalence rate of psychiatric symptoms of the refractory epileptic patients was evaluated according to the location of the epileptic focus. The subjects were 91 patients admitted to Epilepsy Monitoring Unit of Seoul National University Hospital. The psychiatric symptoms were assessed by Korean version of Symptom Checklist-90-R(SCL-90-R). The locus of epileptic focus was assessed by clinical features, 2-hour interictal EEG, long-term video-EEG monitoring, brain MRI, interictal and ictal brain SPECT, and interictal brain PET The subjects were divided into three groups according to the epileptic focus, non-temporal(N=29), left temporal (N=26), and right temporal(N=32). There were no statistical differences in demographic and seizure-related variables among groups. The number of patients with $T-score {\geq} 65$ at any subscale of the SCL-90-R were compared by $X^2-test$ among groups. The mean T-scores of each subscale of the SCL-90-R were compared by oneway-ANOVA among groups. The prevalence rate of psychiatric symptoms of the refractory epileptic patients was 38.5%. There was no statistical difference in the prevalence rate of psychiatric symptoms among groups. However, the patients with non-temporal or right temporal epileptic foci showed statistically significant higher mean T-scores of interpersonal sensitivity, depression, hostility, and phobic subscales than the patients with left temporal epileptic foci. These results suggest that the epileptic focus plays an important role in the production of interictal psychiatric symptoms of the refractory epileptics.