• Korean Journal of Biological Psychiatry
• /
• v.8 no.1
• /
• pp.53-61
• /
• 2001

The authors, in this paper, addressed a variety of problems and difficulties which Korean psychiatrists should cope with. The surprising development of neurosciences, splitting of neuropsychiatry into neurology and psychiatry, easygoing attitude of psychiatrists, changes in the delivery system of health care and ill-balanced education of psychiatry were listed as causes of or contributors to them. Social bias to psychiatry and regulations from outside are also considered as contributors. Psychiatric education, including medical school, residency training, continuing medical education and psychiatric textbooks, need to be changed in order to enlarge the boundary of psychiatry. Reestablishment of identity of psychiatry and psychiatrist is unavoidable, considering far-reaching new knowledge of neuroscience and gradually invisible borderzone between neurology and psychiatry. The other ways worth while to consider are : the expansion of psychiatrists' activities, development of medical behavioral science to a clinical specialty, creation of new psychiatric subspecialties, and additional training of psychiatric residencies in the primary medical care.

• Korean Journal of Biological Psychiatry
• /
• v.14 no.1
• /
• pp.21-27
• /
• 2007

Objectives : As a part of plan to develop evidence-based treatment guidelines for depression that is more suitable for Korean situation, we investigate the present status and client's requirements for non-pharmacological treatment of depression in Korean clinical situation. Methods : Subjects were patients with depression in 12 university hospitals which are located in metropolises in Korea. We analyzed the records from questionnaires about current clinical status and requirements for the non-pharmacological treatment of depression in Korea. Results : 50.8% of the subjects have experienced non-pharmacological treatments for their depression. The preference of non-pharmacological treatment method of depression is exercise/interesting activity, counseling by psychiatrists and psychotherapy, and the best effective treatment method is psychotherapy (Es=4.36). Actually, the mean consultation time by psychiatrist is $11.31{\pm}7.16$ min, and the appropriate consultation time for client's situation is $18.39{\pm}8.95$ min. During consultation, patients' satisfaction measurement for psychiatrist's explanation about pharmacological treatment is $64.17{\pm}27.11$, and satisfaction measurement for psychiatrist's counseling for their depression about personal problems, resent stress, interpersonal relationship is $61.66{\pm}26.63$. Conclusion : In Korea, many psychiatrists offered biologically oriented treatment to their patients with depression, and patients' satisfaction measurement about consultation by psychiatrists is low. Many patients wanted to combined pharmacological and non-pharmacological treatment for their depression, and aspired to information about complementary and self-help treatment methods. It is necessary to develop non-pharmacological treatment guideline for depression which reflect the clinical situation in Korea and meet Korean patients' need.

• Korean Journal of Psychosomatic Medicine
• /
• v.24 no.1
• /
• pp.9-19
• /
• 2016

Many patients with dizziness present with a symptom pattern that does not reveal the cause by neurotologic diagnostic approaches. In such cases, the physician frequently diagnoses psychogenic dizziness. Psychogenic dizziness is not characterized by true vertigo, and occurs in combination with other psychiatric symptom cluster. One out of two to four patients with dizziness are psychogenic dizziness. But there are few concern about this including clinical practice and study in Korea. I wrote this paper to increase concerning and attending to this for psychiatrists in Korea. I reviewed etiology including biological and psychological relations between dizziness and psychiatric disorder(especially anxiety), diagnostic approaches of, characteristics of dizziness of various psychiatric disorders related to, and the treatment of psychogenic dizziness. I also briefly reviewed the central and peripheral dizziness for psychiatrists. I suggest psychiatrists and clinicians in the psychosomatic field in Korea to acknowledge, concern, and attend to psychogenic dizziness. In turn, it will be helpful to well treat the patients with psychogenic dizziness.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.31 no.2
• /
• pp.58-65
• /
• 2020

As in western countries, divorce rates in South Korea have recently been rising, and family disruption has become one of serious social problems. Parents are able to express their opinions and wishes confidently, but the thoughts and wishes of children, especially infants and young children, tend to be ignored. Children can also experience several emotional and behavioral problems during the process of and after their parents' divorce. When South Korean family courts determine custody arrangements, they typically do not have a systematic strategy and process based on custody evaluation to help children and their parents overcome conflicts and build healthy parent-child relationships after divorce. Furthermore, under the current court system, it is difficult for mental health specialists and child psychiatrists to intervene in familial conflicts as mediators or therapists during the course of divorce proceedings. Acknowledging these limitations, the South Korean family court system implemented a formal program for custody evaluations by child psychiatrists and psychologists in 2017. However, they have faced challenges such as a shortage of experienced specialist and lack of a training system or instruments for evaluation. In this paper, the authors aim to share professional knowledge of and experiences with aspects of the custody evaluation process, such as indications, procedures, methods, psychological tests, resources, and final report writing, to better serve children and their parents undergoing a painful divorce process.

• The Korean Society of Law and Medicine
• /
• v.11 no.1
• /
• pp.331-393
• /
• 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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.13 no.1
• /
• pp.129-138
• /
• 2002

Objectives：In order to treatment guideline of ADHD, present clinical practise of child psychiatrists and their opinion of optimal intervention were evaluated. Methods：Structured questionnaire items about diagnostic workup, drug choice of 5 different situations according to different co-morbid disorders, and non - pharmacological treatment were applied to 32 child psychiatrists working at university and general hospital. we compared the data with Texas Algorithm Project guideline. Results：(1) Intelligence Test, Sentence Completion Test, sustained attention test, and Conner's questionnaire were the basic routine test that must be performed. (2) Main trend of medication in this study was not different from TAP guideline. (3) In case of co-morbid tic disorder, first recommending drug is still psychostimulant in the TAP guideline. But in this study initial psychostimulant prescription was not main trend. (4) In case of MPH non-response co-morbid disruptive behavior disorder, MPH medication combined with other drug were more common than switching to other drug as suggested the TAP guidelines. (5) In non-pharmacological treatment, most child psychiatrists reported the importance of parent management. Conclusion：There were some difference in medication trend in this study compared with TAP guideline. Further study and conference are needed for experts consensus in Korea.

• Journal of Oriental Neuropsychiatry
• /
• v.12 no.2
• /
• pp.205-213
• /
• 2001

Hwabyung is a culture-related disease generally known among people in k orea, and various studies have been done by the Psychiatrists and by the Oriental Medical Doctor. In this case, we administrated Chungsimjihwangtang to a patient suffering from hwabyung symptoms. After administration of Chungsimjihwangtang medication clinical symptons improved Chungsimjihwangtang showed desirable effect on hwabyung symptoms.

• Korean Journal of Psychosomatic Medicine
• /
• v.1 no.1
• /
• pp.75-80
• /
• 1993

To understand and evaluate the patients who were referred for psychiatric consultation from medical departments, the authors reviewed the concept of disease, psychological reaction to disease, problems on psychiatric diagnosis and evaluation which were encountered at the medical ward. In addition, we reviewed what psychiatrists should do during consultation.

• The Korean Journal of Pain
• /
• v.29 no.2
• /
• pp.78-85
• /
• 2016

Loin pain haematuria syndrome (LPHS) is an uncommon clinical entity that has divided renal physicians, pain practitioners, and even psychiatrists since its initial description. A relative paucity of data exists regarding the condition, with best practice guidelines lacking amid the existing threads of anecdotal experiences and variable follow-up observations. The aim of this article was to review the cumulative published experience of pain relief strategies for LPHS.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.18 no.1
• /
• pp.38-48
• /
• 2007

Objectives : The K-ARS (Korean ADHD Rating Scale) is one of the most important assessment tool of attention-deficit hyperactivity disorder (ADHD) in Korea. in this study, we presented detailed normative data on the K-ARS for school-aged children in Seoul metropolitan area to put it to practical use. Methods : The subjects were 2,397 students(1,223 boys and 1,174 girls, aged 6-12) from 4 elementary schools in Seoul, and one caretaker of each child completed the K-ARS for parents. Children who showed high scores of the K-ARS for parents were screened, and 2 child psychiatrists interviewed them to make a clinical diagnosis. We compared the mean scores of the K-ARS for parents between ADHD and normal group, and examined the percentage of correct classification. Results : There were some differences in score of the K-ARS for parents according to sex and age, so we presented continuous normative data with T score and subdivided cut-off points for ADHD screening. Interviews with child psychiatrists using DSM-IV criteria were performed to test diagnostic validity, and the difference in every the K-ARS for parents index between ADHD and normal group was significant(p<.001). Using 3 different cut-of points(80th, 90th, 93rd percentage), the accuracies of ADHD correct classification were 67.9, 72.2, 71.1% and all 3 canonical discriminants were significant (p<.05) between ADHD and normal group. Conclusion : The normative data and cut-off points on the K-ARS for parents are useful in screening ADHD children in Seoul metropolitan area.