• 제목/요약/키워드: Psychiatric patient

검색결과 308건 처리시간 0.022초

9번 염색체 전위를 지닌 환아들의 정신과적 특성 - 예비적 연구 - (PSYCHIATRIC CHARACTERISTICS OF CHILD PATIENTS WITH INVERSION OF CHROMOSOME 9 - A PRELIMINARY STUDY -)

  • 이준영;황준원;홍강의;김재원
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제12권1호
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    • pp.71-78
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    • 2001
  • 연구 목적:본 연구는 이전의 연구들이 9번 염색체의 전위와 연관된 정신과적 특성이나 발달학적인 측면에 다루지 않았던 것에 주목, 정신과적인 문제 중 언어나 운동 발달의 지연, 지능저하, 성장지연 등과 같은 아동기의 발달학적인 문제와 행동문제에 초점을 맞추어 9번 염색체의 전위와 어떤 연관성이 있는지의 여부에 대해 알아보기로 하였다. 방 법:1) 1984년부터 2000년까지 서울대학교병원 인구의학연구소에 유전학적 검사가 의뢰된 환자들 중 9번 염색체 전위로 결과가 나온 증례들을 수집하였다. 검사를 의뢰한 진료과, 의뢰한 이유 등에 대한 정보를 얻었다. 2) 9번 염색체 전위를 지닌 소아 청소년 12명을 환아군으로 선정하고 성별, 나이 등이 일치하는 학생 45명을 대조군으로 선정하여 부모에게 과거력조사설문지와 아동청소년 행동평가척도(Korean Child Behavior Check List, 이하 K-CBCL로 약칭)를 배부, 작성하도록 하였다. 결 과:1) 9번 염색체 전위로 결과가 나온 165례 중 검사 의뢰 진료과의 분포는 산부인과(47.3%), 소아과(23.6%), 소아정신과(17.0%)의 순으로 나타났고, 소아과와 소아정신과에서 검사가 의뢰된 경우(67례), 의뢰한 주 이유는 지능저하(35.8%), 언어 또는 운동발달지연(31.3%), Fragile X 증후군 의심(23.9%), 성장지연(20.9%)의 순이었다. 2) K-CBCL 결과상 사회적 미성숙 척도에서 임상범위에 해당된 비율이 환아군에서 대조군에 비해 유의하게 높았고, 환아군이 대조군보다 언어나 운동 발달 영역에서 발달이 늦는 것으로 나타났다. 결 론:본 연구는 9번 염색체의 전위와 연관된 발달학적인 측면을 다룬 최초의 연구로 아동기의 발달학적인 문제나 행동문제에 있어서 연관성을 시사하는 결과를 보였다. 정신과적인 문제와 연관된 유전자의 다양한 표현형을 밝혀 나가는 토대가 되기를 기대해 본다.

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정신과 환자가 인지한 활동요법의 효과와 기대에 대한 연구 (A study of psychiatric patients perceived effect and expectance of the activity therapy)

  • 김소야자;김현숙;윤수진;정향인;성경미
    • 대한간호
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    • 제31권4호
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    • pp.62-76
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    • 1992
  • The intent of chis descriptive study is to investigale lhe patients perceived effect and expectance of activity therapy. The subjects for this study were 56 patients from the psychiatric ward in Severance Hospital. The data were collected during Lhe period from June 1, 1991 to January 18, 1992. The effect and expectance of the activity therapy was measured using a questionnaire developed by this study's investigators. The date were analyzed by descriptive statistics, t-test ancl one-way ANOVA, using the SPSS program. The results of this study can ue summarized as following ; 1. For motivatiorc for the accivity therapy, the response range was from 64.;] % to 89.3 %, that is, it showed a relatively positive response. 2. For the degree of improvement according to the nurse's method in the activity therapy, it was shown that the nurses need professional skill and meeting after activity therapy. 3. For the relevance of the nurse in the activity therapy, 90 % of the subjects had a positive answer for all of the activity therapy except the painting therapy. 4. For the perceived effect of the activity therapy, the following results were obtained. 1) 92% of the subjects had a positive response to the dance therapy, that is-I am vigorous physically. 2) 90 % of the subjects had a positive response to the reading therapy, that is-I acquire good ideas and instruction. 3) 98.1 % of the subjects had a positive response to the recreation therapy, that is-I am joyful. 4) 88.9% of the subjects had a posilive response to the writing therapy, that is-I am interested and become acquainted with other patients. 5) 86.8 % of tbe subjects had a positive response to the occupation therapy, that is-I am happy when I work. 6) 92.6 % of the subjeccs had a positive response to lhe painting therapy, that is-I can express myself in painting. 7) 87.3% of the subjects had a positive response to the musie therapy, that is-I am comforted. 5. For the expectance related to the activity therapy, 97.1 % the subjects had the most postive response to the music therapy which is a pleasant comfortable time. From the above-mentioned findings, it is suggested that psychiatric nurses need to development systematic and professional group activity therapy, and know the patient premorbid hobbies, interests and occupations.

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공황장애 환자의 질환행동에 관한 연구 (A Study on Illness Behavior of Panic Disorder Patients)

  • 김상수;제영묘;김상엽;이대수;이승호;최은영
    • 정신신체의학
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    • 제6권2호
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    • pp.104-119
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    • 1998
  • This study was conducted to determine the important factors in the illness behavior of panic disorder patients. And then, find the best ways to lead the patients who have recurrent panic attacks to the adequate therapeutic situations. We studied 53 patients diagnosed as panic disorder according to DSM-IV among the outpatients who had been followed up at Bong Seng Memorial Hospital for 6 Ms, from May 1997 to October 1997. To evaluate the illness behaviors, we designed a checklist including socio-demographic data, degree of subjective distress from medical and psychiatric treatment, panic symptoms, life events, places of help-seeking, Anxiety Sensitivity Index. Using the checklist, we had semistructured interviews with the panic disorder patients to elucidate their help-seeking behaviors from first panic attack to diagnosing as panic disorder. The results were as follows ; 1) After first panic attack, the patients initially sought help at 1) Emergency room 40%, 2) Rest &/or Personal emergency care 35%, 3) Pharmacy 10%, 4) Outpatient care at hospital 10%, 5) Oriental medicine 5%. 2) Considering the panic symptoms, derealization, paresthesia and the severity of panic symptoms were the most important factors affecting the patient's help-seeking behaviors who had experienced the first panic attack. 3) Most of all the patients (80%) were apt to visit the hospitals within 15 days after experiencing about 3 panic attacks. 4) Before diagnosed as panic disorder, the patients had visited 3-5 health care centers during about 1 year. 5) Primary care physicaians(for example, emergency care physicians, family doctors and internists) had the most important roles in treating or guiding the patients to the adequate therapeutic situations. From the above results, the authors propose that non-psychiatric physicians have to know the panic disorder or attacks exactly. When patients complaint sudden onset physical symptoms e.g. palpitation, dyspnea, dizziness or the cognitive symptoms like the fear of death or insanity, physicians should consider the possibility of panic attack and encourage the patients to be evaluated for psychiatric illness.

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자살 예방을 위한 집중관리 대상으로서의 중독 (Self-poisoning as a Target Group for Prevention of Suicide)

  • 곽문환;강현영;이시진;한갑수;김수진;이의중;이성우
    • 대한임상독성학회지
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    • 제16권2호
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    • pp.93-101
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    • 2018
  • Purpose: The Korean government has tried to decrease the suicide death rate over the last decade. Suicide attempts, particularly non-fatal attempts, are the most powerful known risk factor for a completed suicide. An analysis of suicide attempt methods will help establish the effective preventive action of suicide. Fit prevention according to the method of suicide attempt may decrease the incidence of suicide death. Self-poisoning is suggested as a major method of both suicide attempts and suicide death. The aim of this study was to determine if a self-poisoning patient is a suitable target for the prevention of the suicide. Methods: This was retrospective analysis of a prospective cohort, which included patients who presented to the emergency department (ED) after a self-harm or suicide attempt from Jan 2013 to Dec 2017. The proportion of methods in suicide attempts, psychological consultation, and fatality according to the suicide attempt method were analyzed. The types of poison were also analyzed. Results: Poisoning was the most common method of suicide attempts (52.1%). The rate of psychological consultations were 18.8% for all patients and 29.1% for poison patients (p<0.001). The rate of mortality in poisoning was 0.6%. Psychological consultation was performed more frequently in admission cases than discharged cases. The most common materials of poisons was psychological medicines and sedatives that had been prescribed at clinics or hospital. Conclusion: Self-poisoning is a major method of suicide attempt with a high rate of psychiatric consultation, low mortality rate, versus others methods. The prevention of suicide death for suicide attempts may focus on self-poisoning, which is the major method of suicide attempts. A suitable aftercare program for self-poisoning may be an effective method for preventing suicide if an early diagnosis and management of psychiatric disorders through psychiatric consultation can be made, and early connection to social prevention program for non-fatal patients are possible.

정신건강의학과 환자의 수면의 질과 우울 증상의 관계: 모호함에 대한 해석 편향과 불안 증상의 매개효과 (Relationship Between Sleep Quality and Depression Symptoms in Psychiatric Patients: Mediating Effect Interpretation Bias for Ambiguity and Anxiety Symptoms)

  • 이혜린;김은경;최준호;박선철
    • 정신신체의학
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    • 제30권2호
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    • pp.137-144
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    • 2022
  • 연구목적 본 연구는 정신건강의학과 환자의 수면의 질이 우울 증상에 미치는 영향과 모호함에 대한 해석 편향과 불안증상의 매개효과를 확인하고자 하였다. 방 법 한양대학교 구리병원 정신건강의학과의 외래 환자와 입원 환자를 대상으로 축적된 자료를 사용하였으며, 측정 도구로는 피츠버그 수면의 질 척도(Pittsburgh Sleep Quality Index), 모호한 상황에서의 시나리오 척도(Ambiguous/Unambiguous Situations Diary-Extended Version, AUSD-EX), 아동기 외상설문지(Childhood Trauma Questionnaire), 백 불안 척도(Beck Anxiety Inventory), 백 우울 척도(Beck Depression Inventory-II)가 사용되였다. 162명의 자료를 기초로 SPSS 25.0과 SPSS Macro를 사용하여 상관분석과 Bootstrapping 분석이 실시되었다. 결 과 연구 결과, 수면의 질과 우울 증상의 관계에서 모호함에 대한 해석 편향과 불안 증상의 이중 매개효과가 유의하게 나타났다. 결 론 본 연구는 낮은 수면의 질이 모호함에 대한 해석 편향을 거쳐 불안 및 우울 증상에 순차적으로 영향을 미친다는 점을 확인하였다. 이를 바탕으로 선행 증상에 대한 치료적 개입을 우선적으로 실시함으로써 다른 정신과적 증상 발달을 예방할 수 있을 것으로 기대된다.

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

  • 김홍자;김인숙;김도형
    • 한국콘텐츠학회논문지
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    • 제11권4호
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    • pp.458-467
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    • 2011
  • 본 연구는 무용/동작치료가 입원중인 정신분열증 환자의 정신건강 변화에 미치는 효과를 알아보고자 STAXI, BDI, STAI, PANSS 비교분석 하였다. 대상자는 대전 J병원에서 입원치료를 받고 있는 정신분열증 환자 중 선정기준에 적합한 38명을 무용/동작치료군 18명, 대조군 20명씩 할당하여 분노는 STAXI, 우울은 BDI, 불안은 STAI로, 양성 및 음성증상은 PANSS를 사용하여 비교분석하였다. 상태 분노가 유의하게 감소하였고, 분노 표현 중에서 분노 통제가 유의하게 증가하였다. 우울은 유의하게 감소하였으며, 음성 증후군 척도에서 유의한 호전을 보였다. 결과적으로 입원한 정신분열병 환자에게 무용/동작치료는 상태 분노를 감소시키고, 분노 통제를 증진시켰고, 우울을 감소와 음성 증상에 긍정적 효과가 나타났다.

암 환자의 정신사회적 치료 (Psychosocial Management of Cancer Patients)

  • 송지영
    • 정신신체의학
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    • 제2권1호
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    • pp.22-33
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    • 1994
  • The author presented several points of experienced materials obtained from the joint meetings of consultation-liaison Psychiatric division with oncologic department in Kyung Hee University Hospital. The joint meetings which have been held regularly every other week were very helpful not only for the psychiatrist but also for the cancer department stags to manage the cancer patients actively. The joint meetings have been progressed into more cohesive and active communication as time goes by. Most of the subjects discussed in the meeting was focused on the psychological and behavioral problems of the cancer patients. Besides, the difficulties arising from the chemotherapy were discussed. Probably the most difficult task for the treatment team was to provide complete information while respecting the patient's right to deny their situation The liaison psychiatrist usually gave comments to the charge doctor and/or nusing staff how to evaluate the patient's behavior and what would be the influential factors in developing the doctor-patient relationship. It was found that many cancer patients and their family members had their own peculiar illness behavior and disease concept which led patients to take non-medical or moreover, anti-therapeutic care. The family members were found to play an influential role in the choice of treatment method and progression of the disease. Another role of the liaison psychiatrist in the oncology ward was to encourage the treatment team members. In the practical point of view, it was not easy for the liaison psychiatrist to have time regularly for the cancer patients to encourage the liaison activities. And it seems to be fundamental that the consultation fee for the liaison psychiatrist should be set up at the resonable level.

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원형탈모증 환자의 정서상태와 성격특성에 관한 임상적 연구 (Clinical Study of Emotional State and Personality Characteristics in Patients with Alopecia Aerata)

  • 이경규;백기청
    • 정신신체의학
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    • 제5권2호
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    • pp.158-167
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    • 1997
  • Objectives: This study was aimed to investigate the emotional state and personality characteristics of alopecia aerata patient and to determine whether these characteristics are similar with those of neurotic patient. Methods : 20 alopecia aerata patients, 20 neurotic patients, and 20 normal healthy controls were studied. Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI) and Korean standardized edition of Catell's 16 Personality factors Questionnaire(16PF) were used for assessment. Results: 1) Total score of BDI was higher in neurosis group than alopecia aerata group and normal control group(p<0.05). Inspire of statistical non-significance, total score of in alopecia aerata group was higher than normal control group. 2) Total scores of state anxiety and trait anxiety in alopecia aerata and neurosis group were significantly higher than normal control group(p<0.001). 3) In first-stratum source traits of 16PF, normal control group was significantly higher than alopecia aerata group and neurosis group in B-factor(intelligence) and C-factor(ego-strength)(p<0.05). Alopecia aerata group and neurosis group were significantly higher than normal control group in O-factor(guilt-proneness) and $Q_4-factor(tension,\;anxiety)$(p<0.001). 4) In second-stratum source traits of 16PF, alopecia aerata group and neurosis group were significantly higher than normal control group in ANX-factor(anxiety)(p<0.05). Conclusions : These results suggest that emotional state and personality characterstics of patients with alopecia aerata are a distinguishable different to compare with normal control, and are very similar with those of neurotic patients. The authors propose that psychiatric management in patient with alopecia aerata will be more benificial.

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Zolpidem과 연관된 야간 식이 행동 증례 (Nocturnal Eating Behavior Associated with Zolpidem)

  • 김지민;백경원;신홍범;김수인;연규월;임원정
    • 수면정신생리
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    • 제12권2호
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    • pp.144-147
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    • 2005
  • Zolpidem은 벤조디아제핀 수용체에 선택적으로 작용하는 약물로 장기 투여 시에도 내성과 금단증상이 적은 장점이 있다. 최근 국외문헌에서 zolpidem 복용후 나타난 야간 식이 장애 사례들이 보고되면서 zolpidem 투약 시 역으로 나타나는 수면장애 호소에 관심이 늘어나고 있다. 저자들은 야간식이 증후군이나 수면장애 기왕력이 없으나 불면을 호소하는 정신과 환자들이 다양한 기간(2주에서 15개월) 동안 zolpidem을 투약한 후, 갑자기 부분적 혹은 전체적 기억상실을 동반한 야간 식이 충동 및 행동을 보였고 zolpidem 투약을 중단하거나 감량하자 하루 만에 증상이 사라진 6사례를 경험하였기에 보고하였다.

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간호사의 임상에서의 의사소통장애에 관한 연구 (The Study on the Communication Barrier for Nurses in Clinical Settings)

  • 장성옥;박영주
    • 기본간호학회지
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    • 제6권1호
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    • pp.130-140
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    • 1999
  • This study was designated to investigate communication barriers of nurses in clinical settings. This study was done in 2 phases, first content analysis on descriptions of 50 nurses in three general hospitals and 40 nursing students on communication barriers for nurses in clinical settings, and second a survey to investigate the factors related to communication barriers and the relation between the nurse's characteristics and the extent of communication barriers in clinical settings from two nurses educators, 13 nursing students who experienced clinical practice and 71 nurses in 11 general hospitals. The results are as follows : 1. Through content analysis, 11 properties of communication barriers for nurses in clinical settings were identified. These were inappropriate communication style as a nurse, lack of professionalism, in appropriate control of emotions, lack of knowledge about the clincal setting, the lack of preparation about content of communication, the problem in trust relation, differences in priorities in needs, uncontroleable situation for nurses, inappropriate nurses' perception about patients, conflict with medical team and inadequate systematic support were identified and grouped in to four categories, communicator, message, feed-back and communication context. 2. The four factors in communication barriers for nurses in the clinical setting were identified and named as ambiguity in the nurses' position, lack of confidence, difference in perspectives with patients and in-adequate nurse-patient relationship. 3. There was a significant difference(F=5.31, P=0.0022, F=3.62, P=0.0316, F=2.80, P=0.067, F=9.01, P=0.0003) among the groups according to work place in rating the extent of the communication barrier in the clinical setting and in the four factors, the nurses working in the psychiatric patient unit rated the communication barrier in the clinical setting lowest among the groups. There was a significant negative correlation between the length of the nurses's carrier and the extent of communication barrier in three factors, ambiguity in the nurses' position, lack of confidence and inadequate nurse-patient relationship.

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