• Title/Summary/Keyword: Psychiatric inpatients

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THE EFFICACY AND SAFETY OF RISPERIDONE IN CHILD & ADOLESCENT PSYCHIATRIC INPATIENT (소아 청소년 정신과 입원 환자에서 Risperidone의 효과 및 안정성에 관한 연구)

  • Park Jeong-Hyun;Kim Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.2
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    • pp.239-250
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    • 2005
  • Objective : The purpose of this study was obtaining data on the efficacy and safety of risperidone in child and adolescent psychiatric patients. Method : Thirty one children and adolescents (males n=18, females n=13, age ranged from 5.4 to 17.3 years) treated with risperidone were selected among child and adolescent psychiatric inpatients of Seoul National University Hospital from January, 2001 to June, 2002, and charts for them were reviewed retrospectively. Results : The primary psychiatric disorders treated with risperidone were schizophrenia and other psychosis, bipolar I disorder with psychotic features, Tourette's disorder, autism spectrum disorders, mixed receptive and expressive language disorder, attention deficit-hyperactivity disorder, conduct disorder and obsessive-compulsive disorder. twelve of these had comorbid mental retardation. Primary target symptoms of risperidone were psychotic symptoms (n=13 or $41.9\%$), behavioral symptoms (n=10 or $32.3\%$) including aggression, impulsivity, hyperactivity, stereotypy nonresponsive to other psychiatric treatments, and chronic and severe tics (n=8, $25.8\%$). The efficacy of risperidone was measured by clinical global improvement (CGI) for target symptoms, $67.7\%$ of subjects showed moderate or marked improvements and its therapeutic effect appeared to be maintained during at least 7.5 months. Mean daily dosage of risperidone was $0.05{\pm}0.01mg/kg$, the group with psychotic symptoms had significantly higher mean daily dosage (0.07mg/kg) compared with other two groups (0.04mg/kg) with behavioral symptoms or tics. A variety of adverse events were reported in this study : weight gain (n=23) most commonly reported, extrapyramidal symptoms (n=15), autonomic symptoms (n=6), sedation (n=5) and symptoms related to hyperprolactinemia (n=2) etc. Although there was no drug change related to the adverse events of risperidone, and $90\%$ of subjects at their last visits were maintained on it, thus its tolerability appeared good. Conclusions Results suggest that risperidone may be relatively safe and effective drug in managing a wide variety of child and adolescent psychopathologies such as psychotic symptoms, behavioral symptoms including aggression, impulsivity, hyperactivity and stereotypy nonresponsive to other psychiatric treatments, and chronic and severe tics. Controlled and long-term studies of efficacy and safety of risperidone treatment for children and adolescents are recommended in the future.

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A Study on the Characteristics and Consultation Request Type of Inpatients Referred for Depressive Symptoms (우울 증상으로 의뢰된 입원환자의 임상적 특징 및 자문 의뢰 형태에 관한 연구)

  • Yoon, Nara;Ryu, Seung-Ho;Ha, Jee Hyun;Jeon, Hong Jun;Park, Doo-Heum
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.1
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    • pp.34-41
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    • 2021
  • Objectives : The purpose of this study is to investigate the characteristics of depressive patients who admitted to general hospital. We examined the clinical characteristics of patients who were referred to the Department of Psychiatry as depressive symptoms, according to the type of consultation request, and comparing 'with re-consultation' and 'without re-consultation' groups. Methods : We performed a retrospective chart review of 4,966 inpatients who were referred to the Department of Psychiatry from August 2005 to December 2011. Results : For about 6 years, among the inpatients referred for psychiatric consultation, a total of 647 patients were referred for depressive symptoms, accounting for 13.82% of the total consultations. The average age of depressive patients was 58.6 years, which was higher than the average of 56.4 years of overall patients. Among the depressive patients, 275 patients were included in 'with re-consultation' group and there was no statistically significant difference when comparing 'with re-consultation' group and 'without re-consultation' group. However, there was a difference in the tendency of the two groups in the type of consultation request. 'With re-consultation' group was in the order of frequency of consultation type 3-2-1, whereas the 'without re-consultation' group was in the order of frequency of consultation type 2-3-1. Conclusions : The group of inpatients who were referred for depressive symptoms in general hospital showed the largest proportion of the group of patients referred to the Department of Psychiatry. 'With re-consultation' group had a higher rate of re-consultation due to the occurrence of new symptoms after hospitalization compared to 'without re-consultation' group. Therefore, doctors in each department and psychiatrists should pay attention to the depressive symptoms of inpatients and actively discuss treatment plans to improve the quality of medical services, identify risk factors, and make efforts to intervene early if necessary.

The Relation of Antipsychotic Drug Induced-Acute Dystonia and Serum Iron Level (정신과 입원환자에서 항정신병 약물에 의한 급성 근긴장 이상증과 혈청 철 농도와의 관계)

  • Lee, Dong-Jin;Park, In-Joon;Kwon, Young-Joon;Jeong, Hee-Yeon;Han, Sun-Ho
    • Korean Journal of Biological Psychiatry
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    • v.5 no.2
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    • pp.248-252
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    • 1998
  • Object : This study was performed in order to examine the correlation between acute neuroleptic-induced dystonic reactions and serum iron level. Method : Serum iron levels were measured in psychiatric inpatients who had developed acute neuroleptic-induced dystonia(N=41) and in control patients with no history of acute dystonic reactions(N=37). Serum iron levels were compared in acute dystonic inpatients before starting treatment with neuroleptics and after acute dystonic reaction. Results : The patients exhibiting acute dystonic reactions had significantly lower serum iron levels than the patients without acute dystonic reactions. Conclusion : This result supports an association between low serum iron and the occurrence of neuroleptic-induced acute dystonic reactions.

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A Trend in Pharmacotherapy for Inpatients with Posttraumatic Stress Disorder at a Single University Hospital (일 대학병원에서 외상 후 스트레스장애 입원환자의 약물 치료 경향)

  • Min, Jung-Ah;Jung, Young-Eun;Seo, Ho-Jun;Bahk, Won-Myong;Jun, Tae-Youn;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.4 no.1
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    • pp.42-48
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    • 2008
  • Objective : Due to a better understanding of the pathophysiology of posttraumatic stress disorder (PTSD) and the relative limitations in the treatment of patients with PTSD, a variety of medications and treatment algorithms for PTSD have been investigated. This study was conducted to investigate the trends in the pharmacotherapy used in the treatment of inpatients with PTSD at a single university hospital in Korea. Methods : Data from 75 patients diagnosed with PTSD according to the DSM-IV criteria from January 1998 to December 2007 were collected. Demographic data and clinical data, including medications prescribed, were investigated. Results : Thirty-three of the 75 subjects included in this study were male, and 42 were female. Considering psychiatric comorbidity, depressive disorder, cognitive disorder, psychotic disorder and anxiety disorder were reported in order. Approximately 97% of the subjects were treated with antidepressants, including paroxetine in 54.7%, and 24% of the subjects were treated with two different kinds of antidepressants. In addition, atypical antipsychotics were prescribed in 33.3% of patients, mood stabilizers in 17.3%, and anxiolytics in 94.7% of the subjects. Conclusion : In our study, various kinds of antidepressants were prescribed for most patients with PTSD. Antipsychotics and mood stabilizers were added to the treatment regimens of some subjects, and anxiolytics were added to the treatment regimens of most subjects. Despite its many limitations, this study shows the prescription pattern and trends in PTSD treatment in Korea. We hope that these preliminary data would be helpful for the development and integration of a practical guideline for the treatment of PTSD in Korea.

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A Clinical Study on Softening E.C.T. & Comparison of Propofol and Pentothal as Anaesthetic Agents on Seizure Duration (연성 전기 경련 요법의 임상적 고찰과 마취제 pentothal과 propofol에 따른 경련기간의 비교에 관한 연구)

  • Song, Hun-Il;Min, Kyung-Joon;Choi, Ihn-Geun;Yoo, Tae-Hyuk
    • Korean Journal of Biological Psychiatry
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    • v.4 no.2
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    • pp.259-264
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    • 1997
  • The authors performed this preliminary study to investigate the effect of softening E.C.T. and propofol was compared to pentothal for induction of anaesthesia for E.C.T. on seizure duration. The results were follows ; 1) E.C.T. was performed in 60 psychiatric inpatients who were admitted during the study period. Of them 51.7% were diagnosed as schizophrenia, 21.6% as major depressive disorder, 16.7% as bipolar I disorder, manic and 10% of others. 2) Mean number of E.C.T. was 12.2 times a patient. 3) The most common target symptoms were persecutory delusion in schizophrenia, psychomotor retardation or agitation in major depressive disorder, and violent aggressive behavior in bipolar I disorder, manic. 4) Pre-ECT medication usually used were atropine $0.0093mgkg^{-1}$, pentothal $2.76mgkg^{-1}$ or propofol $1.42mgkg^{-1}$. 5) The duration of seizure, as measured clinically, was reduced with propofol(20.5 sec) in comparison with pentothal (35.7 sec)(p<0.001). This suggests the possibility that additional treatments may be needed for the same clinical effect in psychiatric illness when propofol is used as the induction agent.

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Comparison of Antidepressants Tolerability in Cancer Patients Referred for Psychiatric Consultation (정신건강의학과 자문 의뢰된 암 환자의 항우울제 내약성 비교 연구)

  • Ko, Eunmi;Park, Jin-Seong;Ha, Juwon;Lim, Sewon;Kim, Tae-Suk;Ha, Jee Hyun;Paik, Jong-Woo;Lee, Boung Chul;Choe, Byeong Moo;Lee, Kang-Joon;Kim, Sung-Wan;Yang, Jong-Chul;Ko, Young-Hoon;Oh, Kang-Seob
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.1
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    • pp.3-10
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    • 2013
  • Objectives : Many patients diagnosed with cancer suffer from various psychiatric symptoms such as depression, anxiety and insomnia as well as cancer itself. Patients with cancer are more vulnerable to possible adverse events of psychotropic medications. Although antidepressants are widely used among cancer patients, there is little information about tolerability of antidepressants. This study was conducted to compare tolerability of antidepressants in cancer patients referred for psychiatric consultation. Methods : The participants were cancer patients who had been referred to psychiatrist for their psychiatric symptoms. We retrospectively analyzed the data of patients diagnosed with cancer from 9 general hospitals in Korea. The discontinuation rate for a 6 months period after treatment initiation for three antidepressants(Escitalopram, Mirtazapine, Paroxetine) were compared. Results : Antidepressants were prescribed for 96.3% of subjects and Escitalopram 150(47.2%), Mirtazapine 92(28.9%) and Paroxetine 76(23.9%) were prescribed frequently in order There were no significant differences in discontinuation rates among the three antidepressants during the 6 month period after initiation of pharmacotherapy. But there was a difference in discontinuation rates between inpatients versus outpatients(p<0.0001). Conclusions : In a naturalistic setting for the antidepressant treatment for cancer patients, it seems that there are no differences in discontinuation rates among these three antidepressants. It is therefore essential that such interactions are carefully considered when treating patients of antidepressants who already have cancer.

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Analyses on Sound Effects for Soundscape Design of Healing Garden at Psychiatric Hospitals - Focused Psychological and Physiological Effects - (정신병원 치유정원의 음경관 디자인을 위한 소리효과 분석 - 심리적 및 생리적 효과를 중심으로 -)

  • Ahn, Deug-Soo
    • Journal of the Korean Institute of Landscape Architecture
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    • v.43 no.1
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    • pp.82-95
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    • 2015
  • This study is intended to obtain a guideline for creating a therapeutic garden soundscape in a psychiatric hospital by analyzing the psychological and physiological effects of auditory components on mental patients. The subjects were 27 inpatients at a psychiatric institute located in Jeollabuk-do. They were recommended by their doctors and had been diagnosed with mild cases of schizophrenia. The survey was carried out in October 2011. With regard to the study, the subjects listened to single sounds(the sound of flowing water, birdsong, wind chimes and music) and 4 sounds composed of some of these, and then Electroencephalography(EEG) and psychological effects were measured. The moving water sound was perceived as pleasing and revitalizing and the birdsong as sonorous and delightful. When designing a healing garden in a psychiatric hospital, the vitality of sound should be considered. In comparison to other single sounds, water sounds were highly preferred and had greater effects on psychological vitality. Music sounds had a significant effect on enhancing tranquility while water sounds affected on both psychological vitality and tranquillity. When comparing single sounds with combined sounds, single sounds such as running water for vitality and music for tranquility had a greater psychological effect than combined sounds. In terms of combined sound preferences, the combination of water and bird sounds had higher preference rates. Generally, combined sounds including water tended to have higher preference rates. The physiological effects of single sounds showed that music had a greater therapeutic effect than natural sounds such as water sounds and birdsong in promoting tranquility. As for combined sounds adopted to enhance physiological tranquility, it is most appropriate to combine music and birdsong or music and water sounds. However, a single music sound is more effective than combined sounds. Overall, analyses of both psychological and physiological reactions showed music and water sounds to be most calming while water sounds promoted the greatest vitality.

Integrated Study on Hospitalization Stress Experience of Schizophrenic Patient (조현병 환자의 입원스트레스 경험에 대한 융합연구)

  • Park, Sun Ah;Park, Keun Woo
    • Journal of the Korea Convergence Society
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    • v.9 no.4
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    • pp.397-408
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    • 2018
  • The purpose of this study is to understand and describe the hospitalization stress experience of patients with schizophrenia. The subjects of this study were 15 inpatients who were hospitalized in three psychiatric hospital closure wards. As a result of the study, the contents of hospitalized stress were classified into five categories, 17 sub-categories and 58 meaningful contents. The five top categories were 'missing and guilt for family', 'discomfort due to poor therapeutic environment', 'not respected of rights Patient's, 'anxiety about life after discharge', 'social prejudice and self-perceived stigma. This study has significant implications for the provision of basic data to mediate hospitalization stress of patients with schizophrenia.

Effect of Dance/Movement Therapy on Mental Health in In-patient with Schizophrenia (무용/동작치료가 입원중인 정신분열증 환자의 정신건강 변화에 미치는 영향)

  • Kim, Hong-Ja;Kim, In-Suk;Kim, Do-Hyung
    • The Journal of the Korea Contents Association
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    • v.11 no.4
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    • pp.458-467
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    • 2011
  • The purpose of this study was examine the effects of dance / movement therapy on anger and anger expression, depression and anxiety, and positive as well as negative symptoms in in-patient with schizophrenia. Among inpatients with schizophrenia in J Dajeon psychiatric hospital, 38 patients were allocated to either dance and movement therapy (DMT) group (n=18), which included 24 sessions of DMT and medical treatment over 12 weeks, or a control group (n=20), which included only medical treatment. State anger and anger control of DMT group were improved after 12 weeks, and there was a significant difference in anger control after 12 weeks between two groups. Depression of DMT group was improved, and there was significant difference in depression after 12 weeks between DMT and control group. There was a significant difference in negative symptoms after 12 weeks between DMT and control group. These finding demonstrates that DMT has benefit on the reduction of state anger by increasing anger control and depression as well as may improve negative symptoms in in-patient with schizophrenia.

Impact of Comorbid Obsessive Compulsive Symptoms on Quality of Life in Stable Patients with Chronic Schizophrenia (안정화된 만성 조현병 환자에서 강박장애 증상이 삶의 질에 미치는 영향)

  • Moon, Jung Yoon;Kang, Sukhoon;Seok, Jung-Ho;Kim, Chan-Hyoung;Kim, Tae Yong;Choi, Jin Hee;So, Hyong Seok
    • Anxiety and mood
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    • v.13 no.2
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    • pp.141-147
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    • 2017
  • Objective : This study aimed to evaluate the relationship between comorbid obsessive compulsive disorder (OCD) and quality of life in stable patients with schizophrenia. Methods : We interviewed 162 symptom-stable inpatients who have been on a constant dose of antipsychotics for at least 3 months prior and diagnosed as chronic schizophrenia. Subsequently, patients were classified according to the existence of OCD as evaluated using the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). Further, all clinical and demographic data were collected and evaluated. To investigate potential interrelationships, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Korea-Positive and Negative Symptom Scale (K-PANSS), Korean Modification of the Scale to Measure Subjective Well-Being under Neuroleptic Treatment (KmSWN) and Korean Version Quality of Life Scale (K-QOLS) were performed. Independent t-test and Chi-square test were used to compare groups and regression analysis was done to assess the relationship between the Y-BOCS and quality of life. Results : Schizophrenia patients with OCD showed significantly earlier onset of schizophrenia, more severe psychiatric symptoms and lower quality of life, compared to those without comorbid OCD. OCD might be associated with lower quality of life in schizophrenia. Conclusion : Schizophrenia patients with OCD showed lower quality of life than those without OCD. In the treatment for schizophrenia, evaluation of OCD might be needed to improve their quality of life and social function.