• 대한불안의학회지
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• 제14권1호
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• pp.44-52
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• 2018

Objective : The present study had examined the psychiatric symptoms and physical health consequences for the bereaved parents of the high school students who died in the 2014 Sewol ferry accident. Methods : Forty bereaved parents participated in the study. The authors administered self-report questionnaires about the parents' health behaviors and psychiatric symptoms. The authors also conducted laboratory tests to assess the parents' physical health at 18 and 30 months after the accident. Univariate descriptive statistics were performed to report the prevalence and severity of psychiatric symptoms and health-related behaviors. Paired t-test and Mcnemar test were performed to compare the 18-and 30-month findings. Correlation analysis between psychiatric symptoms and laboratory findings were performed to find a relationship between the two variables. Results : At 30 months after the accident, most of the bereaved parents still appeared to suffer from complicated grief (97.5%), post traumatic stress disorder (80%), insomnia (77.5%) and severe depression (62.5%) based on the scores on the Inventory of Complicated Grief (ICG), the PTSD Check List-5 (PCL-5), the Insomnia Severity Index (ISI) and the Patient Health Questionnaire-9 (PHQ-9). One quarter of the bereaved parents reported high-risk drinking, and 47.5% reported increased drinking amount and frequency after the accident. In objective laboratory results, 55% of the bereaved parents were obese as defined by body mass index ${\geq}25$. The parents' mean low-density lipoprotein shows a significant increase over time (118.5 mg/dL at 18 months. vs. 132.5 mg/dL at 30 months. paired t-test t=-4.061, $$p{\leq_-}0.001$$). Total cholesterol and low-density lipoprotein at 30 months after the accident were in clinically borderline high range. In correlation analysis, triglyceride was positively correlated with ISI. Conclusion : The loss of children in the Sewol ferry accident, a disaster caused by human error, continued to have considerable impact on the victims' parents' mental and physical health 18 and 30 months after the accident. A longitudinal study following the parents' physical health would be necessary to investigate the long-term effects of this traumatic experience on physical health.

• 대한간호학회지
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• 제4권2호
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• pp.78-92
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• 1974

It is the purpose of this study to make clear the way in which people can lead a more desirable human life, that is, to ascertain the method of achieving therapeutic change through transaction between nurses and psychiatric patients. The various problems proposed by th9 above-stated aims of study can be shown, such as: What kind of influences does the method of a nurse′s communication have upon the response of psychiatric patients? 1) What are the general methods of communication used by the nurses? 2) Are there any differences between the control group and experimental group in the patients′ "Child" response? 3) Are there any differences between the control group and experimental group in the Patients "Adult" response? 4) What is the most desirable method of communication for therapeutic change in the patients? In an effort to solve the above questions this study attempted and managed to draw a random sampling of 200 patients being accommodated in the National Mental Hospital by dividing them into two groups, experimental groups and control groups, and recording the transactions between nurses and patients. In the course of carrying,: out this study, the experimental group was interviewed by the nurses specially trained In the P.A.C theory. and the control group interviewed at random by the nurses with no special training in communication. Further, the communication between nurses and patients in a free, relaxed atmosphere was allowed only for 15 minutes, whereupon the nurses were requested to make process-recording according to her memory of nurse patient transaction. The process-recording which recorded a series ol transactions between the nurses and the patients was analyzed according to Berne and Harris′transactional Analysis Standard. Through this standard, the writer of this study examined the significance of difference to compare the transactions brought forth between the experimental group and the control group. The following is a summary of the study which the writer of this thesis undertook. Hypothesis to The method of communication which the nurses usually apply to the patients will be higher in "Parent" than in "Adult". The communication which the nurses carried out in the control group turned out to be not significant between "Adult" and "Parent" Accordingly hypothesis 1. carne to be rejected. Hypothesis 2. The patients "Adult" response will be higher in the experimental group than in the control group. According to the result of a CR examination, as the communication showed a significant difference on P〈.01 level′ hypothesis 2 became affirmative. Hypothesis 3. The patients′"Child" response will be higher in the control group than in the experimental group. Hypothesis 3 proved affirmative since it showed an significant degree on P〈.01 level according to the result of a CR examination. Hypothesis 4 "Adult" response of the patient will be higher in frequency by nurses′"Adult" stimulus than nurse′s "Parent" stimulus Chi-square examination revealed significant difference on P〈.05 level. Hypo. 4 is affirmed. The following conclusions are drawn out based on the result of this study. 1) The generally used method of communication stimulus used by nurses for patients proved to be "Adult" and "Parent" in similar proportion. 2) The group in which the nurses could increase the patients "Adult" response proved to be higher in the experimental group than in the control group. Therefore, the communication (or stimulus) which has been applied in the experimental group can be said to be possible method of achieving therapeutic change. 3) Since the patients′"Child" response were higher in the control group than in the experimental group the communication method used In the control group was suggested as the less agreeable method of achieving therapeutic change than that used in the experimental Group. 4) "Adult" response of patient was elicited in significantly greater percentage when the "Adult" stimulus was used by the nurse. Therefore the most desirable method of-communication to give therapeutic change definitely was shown to be the "Adult" stimulus. Recommendations for further studies are as follows: 1) Studies on nurses′role perception in nurse-patient relationships. 2) Studies on patients′response to the method of communication used by nurses according to variables such as sex, social status, educational background, state of health. 3) Application of T.A, method to various groups of patients. 4) Study of various methods to improve student skill in use of process recording.

• 동의신경정신과학회지
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• 제11권1호
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• pp.59-73
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• 2000

Depression is a psychiatric syndrom consisting of dejected mood, psychomotor retardation, insomnia and weight loss, sometimes associated with irrational guilt feeling. And it is also similiar to Hwa-byung(火病) symptom in oriental medicine. But it is difficult to diagnose with objective method. Digital Infrared Thermographic Imaging(D.I.T.I.) is one of diagnotic method that measure the changes of skin temperature in body. Specially we checked the skin temperature on depressed patients by using D.I.T.I. and compared with Bell's palsy patients and normal persons group. The results are as follows; Average body temperature of the depressed patient group is $36.68{\pm}0.43^{\circ}C.$ and that of the control group is $36.73{\pm}0.40^{\circ}C.$. So there is no meaningful difference. The depressed patient group has higher temperature than the control group by ${\triangle}T>1.0^{\circ}C$ at the following acupuncture points in these body parts - upper and lower, left and right, anterior and posterior. When acupuncture points temperature was compared superior and inferior part of the body, depressed patient group have meaningful difference at the GV-4(Myung-moon) and also in the control group. When acupuncture points temperature was compared left and right part of the body, depressed patient group have no meaningful difference and also in the control group. When acupuncture points temperature was compared in the anterior and posterior part of the body, depressed patient group have meaningful difference at the GV-4(Myung- moon) and also in the control group. From this study, we think that D.I.T.I. could be used to diagnose objectively on the depressed patients and useful to another psychoneurogenic diagnosis in oriental medicine.

• 정신신체의학
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• 제9권2호
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• pp.111-132
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• 2001

신체질환 환자들에서의 우울증은 일차진료의나 정신과자문의가 흔히 부딪치는 임상적 문제들이다. 본 저자는 이런 환자들을 효과적으로 평가하고 치료하기 위한 방법들을 알아보고자 하였다. 첫째, 환자의 의학적 및 정신과적 상태를 동시에 평가해야 한다. 둘째, 신체질환 환자에서 우울의 평가는 다면적인 접근을 고려하는 것이 바람직하다. 때로는 심리적 도구를 이용하는 것도 좋은 평가 방법이다. 치료는 첫째, 기질적 원인을 찾아서 제거하는 일이 무엇보다 중요하다. 둘째, 정신사회적 치료로는 정신과적 치료에 대한 저항을 다루어야 하고 심한 신체적 질환에 따른 낙담 반응을 처리해 주는 일이다. 셋째, 생물학적인 치료방법으로는 적절한 항우울제를 선택하는 것이 중요하다. 선체질환 환자들에서 항우울제의 선택은 환자의 일차적인 우울증상, 약물역학 및 약물역동, 항우울제의 부작용을 평가한 후 고려한다. 이 외에도 약물-질병 및 약물-약물 상호작용의 가능성에 관해 각별히 주의를 기울일 필요가 있다. SSRI약물, bupropion, venlafaxine과 같은 새로운 항우울제들이 신체질환 환자들의 우울증 치료에 효과적이나 삼환계 항우울제는 통증장애 환자들에서는 아직도 효과적으로 사용될 수 있는 약물이다. 신체질환 환자들에서 항우울제로 우울증이 잘 치료되지 않는 경우에는 전기충격요법의 사용을 고려해 본다.

• 의료법학
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• 제11권1호
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• pp.331-393
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• 2010

Psychiatrists who treat violent or potentially violent patients may be sue for failure to control aggressive outpatients and for the discharge of violent inpatients. Psychiatrists may be sued for failing to protect society from the violent acts of their patients if it was reasonable for the psychiatrists to have known or should have known about the patient's violent tendencies and if the psychiatrists could have done something that could have safeguarded in public. The courts of a number of jurisdictions have imposed a duty to protect the potential victims of a third party on persons or institutions with a special relationship to that party. In the landmark case of Tarasoff v Regents of University of California, the California Supreme Court held that the special relationship between a psychotherapist and a patient imposes on the therapist a duty to act reasonably to protect the foreseeable victims of the patient. Under Tarasoff, when a therapist has determined, or under applicable professional standards should determine, that a patient poses a serious threat of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger. In addition to a Tarasoff type of action based on a duty to warn or protect foreseeable victims of psychiatric outpatients, courts have also imposed liability on mental health care providers based on their custody of patients known to have violent propensities. The legal duty in such a case has been stated to be that where the course of treatment of a mental patient involves an exercise of "control" over him by a physician who knows or should know that the patient is likely to cause bodily harm to others, an independent duty arises from that relationship and falls on the physician to exercise that control with such reasonable care as to prevent harm to others at the hands of the patient. After going through a period of transition, from McIntosh, Thompson and Brady case, finally, the narrow rule of requiring a specific or foreseeable threat of violence against a specific or identifiable victim is the standard threshold or trigger element in the majority of states. Judgements on these kinds of cases are not enough yet in Korea, so that it may be too early to try find principles in these cases, however it is hardly wrong to read the same reasons of Tarasoff in the judgements of Korea district courts. To specific, whether a psychiatric institute was liable for violent behavior toward others depends upon the patients conditions, circumstances and the extent of the danger the patients poses to others; in short, the foreseeability of a specific or identifiable victim. In this context if a patient exhibit strong violent behavior toward others, constant observation should be required. Negligence has been found not exist, however, when a patient abruptly and unexpectedly attack others or unidentifiable victim. And the standard of conduct that is required to meet the obligation of "due care" is based on what the "reasonable practitioner" would do in like circumstances. The standard is not one of excellence or superior practice; it only requires that the physician exercise that degree of skill and care that would be expected of the average qualified practitioner practicing under like circumstances. All these principles have been established in cases of the U.S.A and Japan. In this article you can find the reasons which you can use for psychotherapist's liability for failure to protect third person in Korea as practitioner.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4311-4314
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• 2012

Posttraumatic growth (PTG) is the experience of positive change that occurs as a result of the struggle with highly challenging life crises. The need to understand PTG in relation to actual changes in an individual's life has recently been raised. Little is known about the role of social support in the experience of positive outcomes. The purpose of this study is to investigate the role of perceived social support in enhancing PTG in cancer patients. This study involved 105 cancer patients. The data were collected using a questionnaire that determined the socio-demographic features, posttraumatic growth inventory (PTGI) and perceived social support. Participants reported relatively high levels of PTG and social support. Total perceived social support, support from family, and friends were significantly positive associated with the development of PTG among cancer patients. Accordingly, the social surroundings of the patient should be informed about the importance of social support and how it helps the patient; they should be made aware of necessity of social support.

• Journal of Yeungnam Medical Science
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• 제33권2호
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• pp.159-161
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• 2016

Brain meningioma, the most common benign brain tumor, has been reported to account for 13-26% of all intracranial tumors, with a crude incidence rate of 2.3 per 100,000 persons for all types of meningiomas. The prevalence of neuropsychiatric lupus erythematosus is 15-91% and its clinical manifestations are diverse: from mild cognitive dysfunction to serious neurological or psychiatric symptoms. Here, we report the first Korean patient with brain meningioma and systemic lupus erythematosus who had undergone surgical tumor resection.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.723-731
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• 2016

Background: Cancer is a major public health problem in many parts of the world. Gastrointestinal (GI) cancers are responsible for 20% of all cancer-related deaths. In Turkey, stomach cancers account for 8.9%, colon cancer for 6.9%, and pancreatic cancer for 5.9%. This study examined the anxiety-depression levels and the quality of life of patients with GI cancer. Materials and Methods: This descriptive study was carried out on 335 adult patients who had gastrointestinal cancer and who were hospitalized in medical oncology clinics. Data were collected by using hospital anxiety and depression scale, EORTC QLQ C-30 and a patient information form. Results: Patients who were male and secondary school graduates/graduates/postgraduates experienced more functional difficulties. Patients with poor economic status experienced more symptoms. Patient general wellbeing decreased with increase disease duration. The level of functional difficulties decreased with an increasing number of hospital stays. Anxiety scores increased with decreasing age. Both anxiety and depression scores increased with increasing disease duration. Patients who were female, single/widowed/divorced, and literate/elementary school graduates had higher anxiety and depression scores. Life quality decreased with increasing anxiety and depression. Conclusions: Patients should be supported to prevent anxiety and depression, and should be followed up with this in mind.

• 정신신체의학
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• 제9권2호
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• pp.133-142
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• 2001

정신 신체 장애 환자를 치료하는데 있어서는 우선 광범위한 정신선체 장애에서 이용되는 향정신 약물 뿐만이 아니라 관련 내과 치료 약물에 대한 기본적인 지식과 활용책이 요망(要望)된다. 그리고 다양한 종류의 치료 약물과 치료 방법은 환자의 질병관, 질병행동에 의거하여 변형될 수 있어야 한다. 최근에 소위 대체치료에서 활용되는 한약제, 생약제제, 향기 치료 등에 대해서, 적어도 이것이 결정적인 부작용이 없다면 의사가 적극적으로 활용(活用)하는 자세가 바람직하다. 그리고 약물 작용 등의 과학적인 기전과 효험도는 의사의 주도(主導) 하에 연구해 나가야 할 것이다.

• 생물정신의학
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• 제11권1호
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• pp.61-63
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• 2004

We describe the case of a 73 year-old female patient, YSG, who initially presented with a manic episode without any previous psychiatric history and was later diagnosed as having a meningioma in the left frontal lobe. YSG's symptoms were characterized by hyperactivity, insomnia, aggressive behavior with an auditory hallucination. She showed no abnormal signs on a complete neurologic examination. A gadolinium-enhanced MRI study showed a huge, extra-axial mass with homogenous enhancement in the left high convexity of the frontal lobe. Her manic symptoms subsided after administration of risperidone 1mg and valproic acid 500mg daily, for three weeks without surgical resection of the tumor. These findings suggest that YSG's mania might have resulted from the left-sided frontal tumor, and that her symptoms were treated rapidly by small doses of risperidone combined with valproic acid. Medical staff who care for manic patients should be aware of this possibility of a organic lesion without evidence of neurologic disease.