• 생물정신의학
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• 제26권2호
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• pp.39-46
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• 2019

Antidepressants are widely used to treat depression in Korea, however, only a few studies have focused on the provider of the treatment. The aim of the study is to compare the differences between patients who were prescribed antidepressants by psychiatrists and those who were prescribed antidepressants by non-psychiatrists in South Korea. Patients with a diagnosis of depressive disorder who had been newly prescribed antidepressants in 2012 were selected from the Health Insurance Review and Assessment Service database. They were classified into two groups depending on whether they received the antidepressant prescription from a psychiatrist or non-psychiatrist. Sociodemographic, clinical, and depression related cost has been investigated. Treatment resistant depression, which is defined as a failure of two antidepressant regimens to alleviate symptoms, was also investigated. Prescription adequacy was assessed based on whether a regimen was maintained for at least 4 weeks. Among the 834694 patients with pharmaceutically treated depression (PTD) examined in this study, 326122 (39.1%) were treated by psychiatrists. Patients who were treated by psychiatrists were younger and had more psychiatric comorbidities than those treated by non-psychiatrists. They had longer PTD duration (229.3 days vs. 103.0 days, p < 0.05) and a larger proportion of treatment resistant depression (9.3% of PTD) when compared to those patients treated by non-psychiatrists. The patients treated by psychiatrists had a smaller proportion of inadequate antidepressant use compared to those patients in the non-psychiatrist group (44.5% vs. 65.1%, p < 0.05). The costs related to depression corrected with PTD duration were higher in the non-psychiatrist group (32214 won vs. 56001 won, p < 0.05). Patients who receive antidepressants from psychiatrists are patients with more severe, treatment-resistant depression. Psychiatrists prescribe antidepressants more adequately and cost- effectively than non-psychiatrists.

• 대한불안의학회지
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• 제11권2호
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• pp.155-161
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• 2015

Objective : The purpose of this study was to verify the effect of a single-session, positive psychology-based, strength-enhancing workshop for psychiatrists. The program is composed of lecture about positive psychology and workshop activities for identifying and utilizing character strengths. Methods : A total of 42 psychiatrists participated in this study. The program consisted of a lecture about positive psychology and workshop activities for identifying and utilizing character strengths. Results of a positive resources test, given before and after the session, were used to assess changes in the personal positive resources of the participants as a result of the program. Results : We noted significant increases in participants' satisfaction with life, positive affect, gratitude, acceptance, positive and cognitive emotion regulation, orientation of life, growth, spirit, autonomy, social support, and care factors after completion of the program. On additional analysis, spirit and care scores of female participants's were significantly increased than male participants's. Conclusion : The findings are meaningful in verifying the efficacy of a short-term intervention to improve psychiatrists's positive resources.

• 대한임상독성학회지
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• 제12권2호
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• pp.54-62
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• 2014

Purpose: The purpose of this study was to compare prescription patterns and clinical features according to clinical departments in sedative-hypnotic intoxication. Methods: This was a retrospective study of histories, substances of poisoning, acquisition routes, clinical courses, and outcomes of patients treated for acute intoxication in a single emergency medical center from January, 2011 to December, 2013. Results: A total of 769 patients were treated for acute intoxication, 281 patients ingested sedative hypnotics during the study period. Among 281 patients, 155 patients were prescribed by psychiatric department and 80 patients were prescribed by non-psychiatric department. Benzodiazepines were more likely to be prescribed by psychiatrists, and zolpidem was preferred by non-psychiatrists (p<0.001). Non-psychiatrists were more likely to prescribe short acting benzodiazepines than psychiatrists (p<0.001). However, there was no statistically significant difference in the clinical outcomes, including prevalence of admission to ICU, ventilator care, and length of stay in ICU. In patients prescribed by non-psychiatrists, there were more patients prescribed without psychiatric diagnosis and diagnosed as major depression disorder after hospitalization. Conclusion: To promote rational prescribing of sedative hypnotics, proper psychiatric evaluation should be performed before prescribing, and educational programs including the contents of interactions and side effects of sedative hypnotics are needed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제30권3호
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• pp.121-126
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• 2019

Objectives: Awareness of attention-deficit/hyperactivity disorder (ADHD) in adults has significantly increased; however, clinical data specific to the Korean population are insufficient. Clinical experience of ADHD may differ based on whether psychiatrists have received pediatric psychiatry-specific training. In order to prepare a practice parameter for adult ADHD patients in Korea, we examined questionnaire data to observe how pediatric psychiatry training could affect clinical practice for adults with ADHD. Methods: A questionnaire about the diagnosis and treatment process was distributed to both general psychiatrists (GPsy) and child and adolescent psychiatrists (CAP) at the summer and winter workshop meetings of Korean Academy of Child and Adolescent Psychiatry. Results: In total, 142 psychiatrists participated in the survey (86 GPsy, 56 CAP). GPsy and CAP preferred pharmacotherapy (GPsy 82.40%, CAP 64.30%) as the primary treatment option and answered that the clinical psychiatric interview is the most necessary step in diagnostic assessment (GPsy 22.16%, CAP 19.00%). The GPsy responded with an optimal and average treatment duration that was shorter than that reported by CAP. Conclusion: Identification of the initial presenting symptom as the correct diagnosis and the optimal duration of pharmacotherapy differed between GPsy and CAP in practice, whereas concepts in diagnosis and treatment of ADHD in adults were similar for both groups. These results suggest the urgent need for the Continuing Medical Education program for psychiatrists treating adults with ADHD.

• 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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권1호
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• pp.2-3
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• 2017

• 정신신체의학
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• 제1권1호
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• pp.98-100
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• 1993

To become an effective and successful consultation-liasion psychiatrist the psychiatrist should consider two aspects of consultation before he/she meets his/her patients. First the psychiatrist should understand the internal need and psychological state of patients who visited their physician before being refered to a psychiatrist So psychiatrists should be careful in the evaluation of the patient's intention whether they are willing to accept the psychiatric treatment approach or not Second the psychiatrist should understand the situation and the physician's internal need in the consultation. Psychiatrists should recognize whether there are any factors which interfere with the mutual understanding and cooperation between physicians and psychiatrist.

• 정신신체의학
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• 제21권2호
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• pp.99-105
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• 2013

정신의학에 있어서 운동장애는 환자의 삶의 질에 큰 영향을 끼치는, 또 하나의 중요한 정신의학적 차원임에도 불구하고, 그동안 관심을 받지 못하고 간과되어 왔었다. 정신의학에서 운동장애는 일차성 신경학적 장애, 신경학적 장애의 정신의학적 동반이환, 일차성 정신장애의 양상, 약물-유도성 운동장애, 심인성 운동장애 등의 원인에 의해서 나타날 수 있다. 정신과 환자에서 흔히 보이는 운동증상의 신속하고 적절한 치료를 위해서는, 정신과의사들의 운동장애에 관한 정확한 진단과 감별진단의 능력이 선행되어야 한다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제25권1호
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• pp.6-13
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• 2014

Objectives : The aim of this study is to assess the career paths and practice patterns of child and adolescent psychiatrists in South Korea. Methods : A survey on demographic data, work environment, opinion on fellowship training program, and current practice patterns was conducted in 76/223 (34.0%) of all child and adolescent psychiatrists (N=223) were from 1980 to 2008. The survey data from the responders were analyzed. Results : More than half of those surveyed were women. The mean age of survey participants was 40.8 years; most were married, and lived in the Seoul National Capital Area. In general, the responders were very satisfied with their work. They worked in private practice, public sector, group practice, and as consultants. Up to 87% of the patients treated were children and adolescents. The most common treatment modalities were medication and parent psychoeducation. Social skills training and play therapy were applied mainly for children aged 4 to 12 years old. Cognitive behavioral therapy and counseling were preferred in adolescents. Conclusion : The current study used a database approach in order to define current practice patterns. These data may be helpful in consideration of future training programs, workforce issues in child and adolescent psychiatry in South Korea, and also in collaboration with other mental health providers.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제13권1호
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• pp.47-66
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• 2002

성학대는 여러 종류의 아동학대 유형들 중 가장 심각한 정서적-인지-행동 상의 휴유증을 남긴다고 알려져 있다. 최근 $4{\sim}5$년간 아동과 청소년에 대한 성폭력과 성학대에 대한 사회적 관심이 국내에서도 크게 늘고 있고, 실제 임상에서도 성학대나 성폭력을 당한 소아-청소년을 자주 접하게 된다. 그러나 아직까지 이들에 대한 적절한 치료와 가이드를 제공하고 있지는 못하고 있는 것 같다. 이에 본 고에서는 성학대의 개념을 고찰하고, 정신병리로 연결되는 병태생리를 폭넓게 고찰하였으며, 성학대로 인한 단기 및 장기 휴유증에 대해 살펴보았고, 성학대 아동에 대한 적절한 초기치료전략과 현재까지의 치료결과에 대한 보고들을 종합하였다. 향후 성학대 및 성폭력에 희생된 아동과 그 부모를 위한 치료프로그램의 개발과 국가적 예방 및 치료사업에 소아-청소년 정신과 의사들의 적극적인 참여를 기대해 본다.