• 대한불안의학회지
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• 제11권1호
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• pp.47-53
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• 2015

Objective : Generalized anxiety disorder (GAD) is a common anxiety disorder characterized by excessive worries and anxiety symptoms. To distinguish between pathological and normal worries, this study compared the contents and severity of worries among patients with GAD with those of matched non-psychiatric control Methods : Thirty outpatients with GAD receiving treatment at the psychiatric department of Hanyang University Guri Hospital were recruited. As a matched control group, we selected 30 adults without psychiatric history who participated in the Anxiety Disorder Survey, during the Mental Health Exposition held in Seoul in April, 2014. Matched demographic data were age, sex, education, and household income. Self-questionnaires included demographic data, contents of worry (10 categories of worries and each severity), and the Pennsylvania State Worry Questionnaire (PSWQ). Results : There was no statistical difference in the contents of worry between patient and control groups. However, the total PSWQ scores significantly higher in the GAD group. Conclusion : Our findings suggest that patients and non-patients worry about the similar contents and worries in GAD cannot be differentiated by what people worry about. Only the severity of worry was a distinguishable feature. Our finding supported inclusion of the diagnostic criterion of "excesslve wornes" in GAD.

• 한국임상약학회지
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• 제32권3호
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• pp.204-214
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• 2022

Objective: This study aimed to investigate the occurrence and types of the adverse events (AEs) associated with oral fluconazole and itraconazole and factors associated with specific types of AEs. Methods: We analyzed AEs reported by community pharmacies nationwide over 10 years using the Korea Adverse Event Reporting System database. Various AE terms were categorized into 18 types, and concomitant medications were classified by drug-drug interaction (DDI) severity. The relationship between the specific type of AE and age, sex, and number of concomitant medications was investigated using multiple logistic regression analysis. Results: A total of 879 AE reports of fluconazole and 401 reports of itraconazole were analyzed; of these reports, 321 and 83 reports of fluconazole and itraconazole, respectively, described concomitant drug administration categorized as DDI severity of contraindicated or major. Women had a higher risk of psychiatric AEs associated with fluconazole use (OR, 1.587; p=0.042). Polypharmacy increased the risk for psychiatric AEs (OR, 3.598; p<0.001 for fluconazole and OR, 2.308; p=0.046 for itraconazole). In dermatologic AEs, the mean age of patients who received itraconazole was lower than that of patients who received fluconazole (46.3±16.8 vs. 54.9±15.4; p<0.001). Co-administration of fluconazole with 1-3 drugs increased the risk of neurological AEs (OR, 1.764; p=0.028). Conclusion: When using fluconazole and itraconazole, psychiatric AEs should be noted, particularly in women and in case of polypharmacy; moreover, when fluconazole is co-administered with other drugs, attention should be paid to the occurrence of neurological AEs.

• 정신신체의학
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• 제10권2호
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• pp.166-175
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• 2002

통증 생리의 생물학적 측면에 대한 새로운 지식이 폭발적으로 늘어나게 되면서, 통증에 대한 개념도 매우 많이 바뀌고 있다. 통증의 원인에 심리적, 정서적 요인들이 많이 작용하며 개인과 가족역동의 중요성, 빈번한 정신과 질환의 공존, 만성통증의 치료에 있어서 많은 정신과 약물의 사용, 그리고 다양한 치료적 접근의 중요성의 부각 동을 고려할 때 정신과 의사들은 만성통증 환자의 치료에 참여할 수 있는 능력이 있으므로 적극적으로 참여해야 한다. 그리고 현재 효과적인 통증치료에 다양한 환자의 치료가 필요한 것이 인정되고 있으며, 통증치료에서 좋은 치료 결과를 보이는 외국의 대부분의 통증센터나 통증크리닉에서는 정신과 의사의 역할이 중요하게 인식되고 있으나 아직까지 국내에서는 이러한 인식의 부족으로 정신과 의사의 참여가 거의 없어서 다양한 치료적 접근을 하지 못하고 있다. 이에 저자는 통증장애에 대하여 정신과 의사들의 관심을 환기하고 적극적인 참여를 유도하기 위하여 통증장애 환자 3 증례를 보고하고, 이에 관하여 고찰하였다. 통증장애를 다루기 위해서는 통증에 대한 생물-정신-사회적인 관점 모두에서의 전반적인 고찰을 다루어야 하지만, 본 논문에서는 심리적 요인과 관련된 통증장애 환자에 대한 종례만을 보고하므로 이를 중심으로 다루었다.

• 지역사회간호학회지
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• 제12권3호
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• pp.705-715
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• 2001

This study examined 19 papers published from 1977 to 2000 based on the objective frame evaluation. This purpose of this study was to examine the trend of Hwabyung research and to serve as a guide for the future 'Hwabyung' study. The results of studies were as follow. In the design of research, clinical studies are definitely dominant. As for the fields of research, the concept of Hwabyung was studied more frequently than the others. As for the authorship. psychiatrists prevailed but nursing professionals are on the increase. Research subject in clinical and survey study, patient was definitely dominant and the place of study was almost always a hospital (75%), data collection was higher on interview (58.3%). Hwabyung was considered unique culture bounded syndrome related to Korean culture. Frequent etiologic factor of Hwabyung were a husband's extra-marital affair, conflicts between houses wives and mothers-in-laws, and financial loss and suffering. From the incidence of Hwabyung, a greater number of patients with Hwabyung were middle aged women in the low economic and educational classes, and these were connected with the culture and the family system. The symptoms of Hwabyung included psychological and physical symptom, neurological disorder and disease behavior. Defense mechanisms and coping strategies for Hwabyung were somatization, suppression, orality, withdrawal, isolation, regression, help-seeking, complaining, and wreaking anger. Treatment of Hwabyung were medication, effort by herself, communication with families, consultation with psychologist, acupuncture, negative therapy, moxa, and Qi-kong. Psychiatric therapy, behavior therapy, nursing intervention on multi-interdisciplinary approach and psychiatric nursing approach were recommended for the nursing care of a Hwabyung patient.

• 대한불안의학회지
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• 제18권1호
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• pp.26-31
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• 2022

Objective : The levels of resilience and gratitude were examined in psychiatric patients with depression and/or anxiety disorders and compared to those of the general population. In addition, we analyzed the associations of positive affect, negative affect, depressive and anxiety symptoms, and gratitude on resilience in this patient population. Methods : The participants included a general population sample (n=155) and psychiatric outpatients with depression and/or anxiety disorders (n=108). All participants completed self-report questionnaires, which included demographic variables, the Connor-Davidson Resilience Scale (CD-RISC), the Gratitude Questionnaire-Six-Item Form (GQ-6), the Positive Affect Negative Affect Scale (PANAS), and the Hospital Anxiety and Depression Scale (HADS). Results : The CD-RISC and GQ-6 scores of patients with depression and/or anxiety disorders were significantly lower than those of the general population. In the patient population, hierarchical regression analysis showed that gratitude was significantly associated with resilience while controlling for a range of demographic and clinical variables. Conclusion : Patients with depression and/or anxiety disorder generally had lower resilience and gratitude. Moreover, our findings showed that gratitude could influence the levels of resilience in patients with depression and/or anxiety disorders.

• 대한한의학회지
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• 제21권3호
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• pp.220-224
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• 2000

After stroke, there are many cases of gastro-intestinal bleeding in patients with dysphagia who are fed by Levin tubes. Ulcers in the stomach and duodenum are occasionally produced by psychiatric stress, irritation with the Levin tube and central nerve rusturbances. Because Dansambohyul-tang has been used to treat deficiency of blood, alleviate pain, tranquilize and to treat patients differentiated with an insufficiency of the heart and the spleen in oriental medicine, we treated a 62 year-old male patient who suffered from gastric ulcers with gastro-intestinal bleeding after stroke, and who was differentiated with an insufficiency of the heart and the spleen with Dansambohyul-tang, herb complex. After 20 days of treatment with Dansambohyul-tang, we observed improvement in the gastric ulcer through gastroscopy; serum hemoglobin increased by 5.1g/dl after 2 months; and symptoms (pale complexion.dysphagia.general weekness) were alleviated. So Dansambohyul-tang shows therapeutic effects on gastric ulcers with gastro-intestinal bleeding after stroke.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제20권3호
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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 Academy of Child and Adolescent Psychiatry
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• 제31권3호
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• pp.161-164
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• 2020

Crohn's disease is a chronic inflammatory disease that involves the upper and lower gastrointestinal tracts, including the oral cavity. For the conventional treatment of inflammatory bowel diseases, steroids are usually used as induction therapy, and azathioprine is used as maintenance therapy. Steroids are associated with various side effects. Under rare circumstances, they can even cause psychotic symptoms, and reports on steroid-induced psychosis in the pediatric population are few. Here, we report the first case of steroid-induced psychosis in a 16-year-old female with Crohn's disease administered with steroids as induction therapy in South Korea. She showed psychotic symptoms, including auditory hallucination, loosening of association, and idea of reference, after 2 weeks of administering prednisolone 60 mg/day. One week after steroid discontinuation, the patient gradually recovered and was treated with quetiapine. Therefore, pediatricians should be aware of serious psychiatric adverse effects when administering corticosteroids for various indications.

• Journal of Hospice and Palliative Care
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• 제27권2호
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• pp.77-81
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• 2024

This case report explores the challenges and complexities associated with opioid management of cancer pain, emphasizing the importance of early involvement of a hospice consultation team and the adoption of a multidisciplinary approach to care. A 56-year-old man with advanced pancreatic cancer experienced escalating pain and inappropriate opioid prescriptions, highlighting the shortcomings of traditional pain management approaches. Despite procedural intervention by the attending physician and increased opioid dosages, the patient's condition deteriorated. Subsequently, the involvement of a hospice consultation team, in conjunction with collaborative psychiatric care, led to an overall improvement. The case underscores the necessity of early hospice engagement, psychosocial assessments, and collaborative approaches in the optimization of patient-centered palliative care.

• 정신신체의학
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• 제7권2호
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• pp.252-255
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• 1999

최근 만성 통증 환자가 증가하고 있다. 특히 정신과 외래환자에서는 40% 이상이 통증으로 고통을 받고 있다. 그런데 한국인의 질병관과 질병에 대한 태도와 관련되어 나타나는 비정상 질병행동은 통증 환자에게 만성화 경향을 재촉하고 치료에 많은 어려움을 야기시키고 있다. 본 심포지움은 근관절계, 신경계질환, 만성 내과질환과 관련된 만성 통증을 어떻게 효율적으로 치료 할 것인가를 조명해 보고자 한다. 이로서 자문-조정 정신의학에서 만성 통증환자에 대한 효과적인 대처 요령을 습득하고자 한다.