• 제목/요약/키워드: Psychiatric patient

검색결과 308건 처리시간 0.027초

심한 상열감으로 인한 불면을 호소하는 환자의 한의 치료 1례: 증례보고 (Application of Korean Medicine Therapy to a Patient with Insomnia from Severe Hot Flashes: Case Report)

  • 배진수;장에스더;김보성;안선주;김경옥
    • 동의신경정신과학회지
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    • 제33권1호
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    • pp.113-122
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    • 2022
  • Objectives: To report the effect of Korean medicine on a patient with insomnia from severe hot flashes. Methods: The patient suffered from extreme hot flashes for months. Symptoms were so severe that the patient attempted suicide. After starting psychiatric medication, symptoms persisted and hospitalization began. During hospitalization, herbal medicine, acupuncture, and psychotherapy were conducted. For evaluating therapeutical effect, Digital Infrared Thermal Imaging was performed twice during the treatment process. It was divided into major facial area and back area. The facial area was divided into two small units to measure the difference in temperature between two points. The back area was measured in the same way. Results: The temperature difference between the two points decreased over time and the patient's subjective symptoms reduced. Conclusions: Korean medicine therapy can improve symptoms of patients with insomnia accompanied by hot flashes.

증상의 발현부터 치료의 시작까지 : 한국인의 공황장애 인식도 변화가 치료적 접근에 미친 영향 (From the Onset of Panic Symptoms to Getting to a Psychiatric Treatment : The Change by Improved Public Awareness of Panic Disorder in Korea)

  • 최용원;서호준;한상우;홍진표;이경욱;김세주;임세원;이상혁;양종철;이승재;박선철;김민숙;채정호
    • 대한불안의학회지
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    • 제15권2호
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    • pp.61-67
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    • 2019
  • Objective : This study aimed to investigate the general process from the symptom onset to the psychiatric treatment in Korean panic patients and the effect of improved public awareness on it. Methods : This study has a retrospective design. The subjects were the new patients with panic disorder who visited the psychiatric outpatient clinic in twelve university-affiliated hospitals all across Korea. The medical chart was reviewed retrospectively and the data were collected including chief complaints of symptoms, recent stressors, the time to visit the psychiatric outpatient clinic, and visit of other departments and diagnostic approaches for their symptoms. Results : A total of 814 participants were included in the study. The most common department other than psychiatry the panic patients visited were cardiology (28.3%), general internal medicine (16.0%) and neurology (11.4%). The most frequently used diagnostic tests were a echocardiography (17.9%), 24-hour Holter monitoring (11.2%), and brain MRI (8.2%). Only 37.3% of participants visited psychiatric clinic directly. About 80% of participants visited psychiatric department within 1 year after their first panic symptoms and it took $13.8{\pm}13.7weeks$ on average. Comparing before and after 2012, the number of participants increased who visit directly the psychiatric clinic without visiting other departments (p=0.002) and without visiting emergency room (p<0.001). Conclusions : Our results suggest that a substantial number of patients visit departments other than psychiatry when they experience first panic symptoms. However, most patients begin psychiatric treatment within 1 year after their first symptoms and the number of patient are increasing who visit psychiatric department directly without visiting other departments.

정신병원 간호사의 낙상에 대한 지식, 태도, 환자안전문화인식이 낙상예방활동에 미치는 영향 (The Effect of Knowledge, Attitude and Perceptions of Patient Safety Culture on Fall Prevention Activities in Mental Hospital Nurses)

  • 장경오;이태진;정민영
    • 한국산학기술학회논문지
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    • 제20권5호
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    • pp.372-383
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    • 2019
  • 본 연구는 정신병원 간호사를 대상으로 낙상에 대한 지식, 태도 및 환자안전문화인식이 낙상예방활동에 미치는 영향을 파악하기 위한 목적으로 시도되었다. 연구방법은 부산광역시와 경상남도 지역의 7개 기관의 정신병원에 근무하는 간호사 153명을 대상으로 한 서술적 조사연구로, 2018년 3월 5일부터 2018년 3월 30일까지 자료를 수집하였다. 연구통계방법은 IBM SPSS/win 24.0 프로그램을 t-test, ANOVA 그리고 다중회귀분석을 이용하였다. 그 결과, 연구 대상자의 면허나 자격에 따라 낙상태도에 차이가 있었고, 교육수준이 높을수록 환자안전문화인식정도가 높았으며, 근무경력이 많을수록 낙상예방활동이 높았다. 그리고 환자안전문화인식이 높을수록 낙상간호에 대한 태도가 높았으며, 낙상예방활동이 높을수록 낙상태도와 낙상안전문화인식이 높은 것으로 나타났다. 연구대상자의 낙상에 대한 지식, 태도, 환자안전문화인식이 낙상예방활동에 미치는 영향을 다중회귀분석 한 결과, 낙상예방활동에 대한 설명력은 12.5%로 나타났다. 그러므로 정신병원 간호사의 낙상예방활동을 증진시키기 위해서는 계속적인 교육을 통해 지식을 확장하며 낙상태도를 변화시킬 수 있는 교육프로그램 개발 및 제공이 요구된다. 또한 병원조직 차원에서 안전에 대한 전반적인 인적, 제도적 환경의 변화 등 다방면의 지원이 요구된다.

주관적 기억력 저하를 호소하는 노인 환자의 인지기능 양상 (Manifestation of Cognitive Function in Geriatric Patient with Subjective Memory Complaint)

  • 박한결;김진성;이종범;서완석;구본훈;배대석
    • Journal of Yeungnam Medical Science
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    • 제27권1호
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    • pp.27-36
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    • 2010
  • 본 연구에서는 주관적인 기억력 저하를 호소하는 환자의 인지기능 특성에 대해 알아보기 위해, 2005년 3월 1일부터 2009년 5월 31일까지 영남대학교 의료원 건강검진 센터를 방문한 대상자들 중 주관적인 기억력 저하를 호소하는 155명을 대상으로 인지평가참고 진단시스템 (CARDS)을 실행하였다. 대상자 138명 중 정상은 107명(약 78%), 치매 21명(약 15 %), 10명(7 %)은 우울장애, 불안장애, 적응장애 등의 정신과적 환자로 진단되었다. CARDS의 6개 소검사 중 기억력, 실인증, 실어증, 집중력과 계산력, 고위수행 불능증에서는 WNL군에 비해 DEM군, PSY군이 유의하게 낮은 수행을 보였다. 한편, 실행증에서는 DEM군이 PSY군과 WNL군에 비해 낮은 수행을 보였다. 기억력 저하 증상을 호소하는 환자들은 치매 초기와 다른 정신과 질환 이환의 가능성이 있으므로, 민감도가 높은 치매 선별검사와 정신과적 조기 진단이 필요할 것으로 보인다.

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청소년 정신과 입원 환자들의 피부과 자문 의뢰에 관한 행태 분석 및 고찰 (Review of Psychiatric Adolescent Inpatient with Dermatologic Consultations)

  • 권현정;조현영;김영일;박경덕;정현;박준수
    • 정신신체의학
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    • 제23권1호
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    • pp.20-25
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    • 2015
  • 연구목적 정신신체의학의 발전으로 최근에는 모든 신체적 질환에 대해 생물정신사회적 접근을 추구하고 있다. 그 중 피부과 영역에서는 원형탈모증, 아토피 피부염, 발모벽, 인공 피부염, 다한증, 만성 담마진, 건선, 심상성 좌창 등의 질환과 정신과적 질환과의 연관성이 특히 강조되며, 정신 피부질환(Psychocutaneous disease)이라는 명칭이 사용되나 아직 이에 대한 연구가 미미하다. 청소년기는 2차 성징으로 인해 많은 피부 증상이 발생할 수 있으며, 이는 자아상 형성에 영향을 미칠 수 있으므로, 청소년의 피부질환에 대한 적절한 중재 및 치료의 중요성이 더욱 강조된다. 이에 저자들은 정신과 청소년 환자들의 피부과적 질환의 특성을 알아보기 위해 정신과에서 피부과로 자문 의뢰되는 청소년 환자들의 자문의뢰의 행태를 분석하고자 하였다. 방 법 대학병원에서 정신과에 입원중인 청소년 환자 중 피부과에 의뢰된 22명의 환자와 타과에서 의뢰된 108명의 환자를 대상으로 연령별 및 성별 분포, 자문율, 이환된 피부질환, 자문이유를 비교 분석하였다. 결 과 정신과 입원 환자 중 피부과로 자문 의뢰된 환자들의 평균나이는 15.9세로 관찰되었으며, 남성과 여성의 비율은 1:1.44로 관찰되었다. 정신과에서 의뢰된 청소년 환자들의 진단의 경우 정신과적으로는 기분장애(59.1%), 피부과적으로는 여드름(40.9%)이 가장 많았다. 타과 청소년에 비해 정신과 청소년 환자의 피부과로의 자문율이 유의하게 높았고(11.8% vs. 1.5%), 환자의 요청에 의해 자문이 의뢰되는 비율도 높은 것으로 나타났다(49.9% vs. 16.7%). 결 론 다양한 정신병리적인 문제와 피부과적 질환이 연관되어 환자에게 영향을 미칠 수 있다. 피부과에서는 환자의 거부나 의사의 항정신약물 사용 시작에 불편감을 이유로 질환 치료가 지연될 수 있고, 정신과에서는 피부 문제를 경미한 증상으로 생각하여 간과할 수 있으므로, 두 과 간의 적절한 정보 교환 및 협진 체계를 마련하여 생물정신사회적 접근이 필요할 것으로 보인다.

한의치료와 미술치료을 통한 조현병 환자 치험례 (A Case Report of a Schizophrenic Patient Treated with Art Therapy and Korean Traditional Medicine)

  • 박나은;박준현;김대억;김상호;정대규
    • 동의신경정신과학회지
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    • 제27권3호
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    • pp.147-155
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    • 2016
  • Objectives: Schizophrenia is a serious disease that influences not only the patients themselves but also their family and the society. In this case, we employed art therapy and Korean traditional medicine for treating a schizophrenia patient.Methods: The patient was diagnosed with schizophrenia, and the main complaints were hallucination, visual hallucination and catatonic behavior. We treated the patient with art therapy and Korean traditional medicine including acupuncture, moxa and herbal medicine. We used the Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale (PANSS) for assessment.Results: After treatment, clinical symptoms were improved and the BPRS and PANSS scores were decreased, especially the scores for anxiety, depression and poor rapport.Conclusions: Combined treatment with art therapy and Korean traditional medicine can be effective for treating chronic schizophrenia.

정신 장애 환자에서 외상후 통증증후군의 관리 : 증례보고 (CARE OF POSTTRAUMATIC PAIN SYNDROME IN THE PSYCHIATRIC DISORDER PATIENT : REPORT OF CASES)

  • 오지현;유재하;김종배
    • 대한장애인치과학회지
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    • 제11권1호
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    • pp.9-16
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    • 2015
  • Pain and sensory disorder resulting from injury to peripheral nerves of the face and jaws are a major source of patient dissatisfaction and suffering. The majority of patient who sustain injuries to the peripheral sensory nerves of the face and jaws experience a slow but orderly return of sensation that is functional and tolerable in quality, if not "normal". For many patients, however, the long-term effects are a source of aggravation, and for a few, a significant cause of suffering. Common complaints relate to reduced sensory information causing embarrassing food accumulations or drooling, biting a burning the lip or tongue, and difficulty in performing routine activities such as shaving and apply makeup. For some patients posttraumatic symptoms become pathological and frankly painful. The predominent pain components are (1) numbing anesthesia dolorosa pain, (2) triggered neuralgiaform pain, (3) burning, aching causalgiaform pain, and (4) phantom pain. This is a report of cases about posttraumatic pain syndrome associated with dental treatment in a psychologically disabled patient.

독서요법과 뉴로피드백을 시행한 심비양허형(心脾兩虛型) 울증(鬱證)환자 치험(治驗) 1례(例) (The Case Study of a Patient with Simbiyangheo type Ul-zeong who has treared by Bibliotherapy and Neurofeedback)

  • 임정화;최강욱;정인철;이상룡
    • 동의신경정신과학회지
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    • 제17권2호
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    • pp.187-198
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    • 2006
  • Bibliotherapy is the field of clinical counceling to treat the emotional, psychiatric and social maladjustment. Neurofeedback is a means by which participants can team voluntary control of the EEG and has been applied to a range of clinical conditions such as epilepsy, attention deficit hyperactivity disorder, depressive disorder. 'Ul-zeong' comes from obstruction of qi by stress. The mind affect the body. The patient has depressed mood, irritable sign, chest discomfort, flank pain, angry state and some strange feeling on the throat. In this case, a female patient, 30 years old, who complained of amnesia, deficiency of the power of the attention and concentration depersonalization, depressed mood, insomnia ect. We treated the patient with bibliotherapy, neurofeedback and oriental medical treatment such as heral medicine, acupuncture treatment and aroma therapy. In result, the symptoms which she complained were improved.

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스트레스 사건과 적응행동이 정신건강에 미치는 경향에 대한 연구 (A Study on the Influences of Stressful Events and Coping Behavior on Mental Health)

  • 이평숙;임현빈
    • 대한간호학회지
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    • 제10권1호
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    • pp.57-64
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    • 1980
  • The purpose of the study was to find out the relationship between experienced stressful events and its coping behavior within mentally wellness and illness, and to define the effective coping method under the stressful situation. By doing so, during the period of April, 1978- to March, 1979 the objects of this study were 100 persons who were under the psychiatric facilities in their first hospitalization, and who were registered in psychiatric out patient department in the form general hospitals located at Seoul selected as a experimental group. As a control group 100 persons who never experienced psychiatric treatment who were not under the current medical treatment, and who were tarring appropriate social roles in their community were selected, and in both groups utilized questimaires for Social Readjustment Pating Scale and Coping Scale. This study was tested by X$^2$ examinationand by F-ratio(analysis of variance). Results were as follows : Hypothesis 1. The actually experienced life events were expected to be higher in the experimental group than in the control group, but they did not show the significant difference between the groups.( p >0.05) Thus hypothesis 1 was rejected. Hypothesis : 2. The stress scores were expected to be higher in the experimental group than in the control group, and also did show the significant difference between the groups ( p< 0.05). Therefore hypothesis 2 was supported. Hypothesis 3. The non-effective coping behavior were expected to be higher in the experimental group than in the control group, and also did show the significant difference between the two groups(p < 0.001). Also hypothesis 3 was supported. Hypothesis 4 . The higher stress score groups (above 250 LCU ) were expected to utilize non.effective coping method more frequently than in the lower stress score groups (below 249 LCU ), and not only they showed high in utilizing non-effective coping method but also showed high in utililzing effective coping method. Thus hyphothesis 4 was partially supported. (p < 0.001) The following are drawn out based on the result of this study that the stress scores were higher, and more utilized non-effective coping method in the emotionally disturbances than in the emtionally healthies.

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Prevalence of unrecognized depression in patients with chronic pain without a history of psychiatric diseases

  • Lee, Ho-Jin;Choi, Eun Joo;Nahm, Francis Sahngun;Yoon, In Young;Lee, Pyung Bok
    • 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.