• Title/Summary/Keyword: department of psychiatry

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Stress and Immune Function (스트레스와 면역기능)

  • Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.1
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    • pp.146-154
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    • 1996
  • The impact of stress on immune function is known to be associated with the interactions among the central nervous system(CNS), neuroendocrine system, and immune system. The main pathways between stress and immune system are wiring of lymphoid organs and neuroendocrine system. Immune system also produces neuropeptides, which modulate immune system. Mediators of psychosocial influences on immune function are found to be peptides released by the pituitry, hormones, md autonomic nervous system. Hypothalamus integrates endocrine, neural and immune systems. Particularly, paraventricular nucleus appears to play a central role in this integration. On the other hand, endocrine system receives feedback from the immune system. The major regulatory pathways which pituitary modulates include the hypothalamic-pituitary-adrenal-thymic(HPAT) axis, hypothalamic-pituitary-gonadal-thymic(HPGT) axis, pineal-hypothalamic-pituitary(PHP) axis. Bidirectional pathways such as feedforward and feedback pathways are suggested in the interaction between stress and immune system. It suggests that psychosocial inputs affect immune function, but also that immunological inputs affect psychosocial function. Thus, prospective studies for elucidating the relationship between stress and immune function should incorporate measures of immune function as well as measures of endocrine, autonomic, and brain activities at the same time.

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The Introduction and Clinical Applications of Nuerofeedback (Neurofeedback의 이해와 임상적용)

  • Park, Hyung-Bae;Sung, Hyung-Mo
    • Korean Journal of Psychosomatic Medicine
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    • v.14 no.1
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    • pp.8-17
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    • 2006
  • Neurofeedback, also known as EEG biofeedback or neurotherapy, is a new therapy differentiated from biofeedback in that brain waves are monitored to study brain itself as well as its functions. Needless to say, it has originated from biofeedback, however it has established itself as an independent and specialized therapy in the field of neurotherapy. In order to have a better understanding of neurofeedback we are going to have a look into its historical and theoretical background first and then we will explain how it can be used clinically. Neurofeedback was clinically introduced for epilepsy for the first time and its effect was proved. Since then it has been used successfully for a number of psychiatric disorders, such as attention deficit hyperactivity disorder(ADHD), anxiety, anxiety and mood disorder, sleep disorder, substance dependency, etc. Furthermore, it has been used for non-psychiatric or psychosomatic symptoms, such as headache, chronic pains, chronic fatigue symptoms, etc. Recently, it has been also used for non-medical areas, such as improvement of peak performance for sports and art activities, enhancement of cognitive function, etc, making the neurofeedback a very promising field for its potential and effectiveness.

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Psychoanalytic Aspect of Obesity (비만의 정신분석적 고찰)

  • Lee, Moo-Suk
    • Korean Journal of Psychosomatic Medicine
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    • v.3 no.2
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    • pp.207-213
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    • 1995
  • Author reviewed psychodynamics and psychoanalytic treatment of obesity. A variety of psychodynamics and unconscious conflicts have been described in obese patients : eating as a defense against depression, eating as a substitute for maternal love, obese body as a larger penis, and eating as a self-soothing. There was a gross neglect of certain normal parenting roles in obese family. The parenatal superego structure was not as perfectionistic. As with children and other patients with preoedipal pathology, in obese patients the analyst in addition to being transference object is a new and different object who promote healthy maturation. Because of obese parients, in there projective identification, can provoke intense countertransference, the analyst have to consider it. On the other hand, many analysts' countertransferences to superobese patients is that huge person recalls one's own childhood relationship with adults and bring forth a feeling of helplessness.

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The Effects of Socioeconomic Position and Health Behavior on Geriatric Depressive Symptom (노인우울증에 대한 사회경제적 지위요인과 건강행태요인에 관한 연구)

  • Lee, Hyun-Joo;Kahng, Sang-Kyoung;Lee, Jun-Young
    • 한국노년학
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    • v.28 no.4
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    • pp.1129-1145
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    • 2008
  • In order to develop practical implications for depression among the elderly, this study examines socioeconomic and health-behavioral risk factors of geriatric depression diagnosis. Sample consists of 964 elders aged 65 and over, living in an urban community. Using the Short-form Geriatric Depression Scale(SGDS), study subjects were screened for geriatric depression to those who presented 10 points and over in SGDS. Descriptive statistics shows that about 22.2% elders are estimated to suffer from geriatric depression. Predictors of geriatric depression diagnosis were examined through logistic regression. Results show that elders who live with family, who have medical insurance, who have higher education, who don't smoke, and who do more physical activities were less likely to suffer from geriatric depression. These findings indicate that socioeconomic position such as health insurance, education and health behaviors such as smoking, physical activities are closely related to geriatric depression, suggesting that interventions on socioeconomic position and health behaviors may be effective to reduce depression among the elderly.

The Correlation of Psychopathology and Suicide in North Korean Refugee Adolescents (탈북 청소년의 정신병리와 자살과의 관련성)

  • Im, Donggyun;Park, Subin;Kim, Seung Hyun;Im, Woo Young;Jun, Jin Yong
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.95-100
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    • 2017
  • Objectives : This study was designed for the purpose of the relationship between psychopathology and suicide in North Korean Refugee Adolescents. Methods : The subjects were 104 North Korean Refugee Adolescents. We investigated the The Korean version of the Center for Epidemiologic Studies for Depression, Revised Children's Manifest Anxiety Scale and Rosenberg Self-Esteem Scale. We also investigated the suicide ideation, planning and attempt. The self-report was taken to the North Korean Refugee Adolescents. Results : The Center for Epidemiologic Studies for Depression Score(Z=-4.050, p<0.001), Revised Children's Manifest Anxiety Score(t=-2.757, p<0.01), Rosenberg Self-Seteem Score(Z=-2.328, p<0.05) were significantly associated with the suicide ideation in North Korean Refugee Adolescents. In logistic regression analysis, only The Center for Epidemiologic Studies for Depression Score(p<0.005) expected the suicidal ideation. Conclusions : The management of depression would be helpful to reduce the suicide in North Korean Refugee Adolescents.

Mindlog: An application that supports mental health record management and psychiatric treatment procedures (마인드로그(Mindlog) : 정신건강을 위한 생각 기록 관리와 정신건강의학과 진료 절차를 지원하는 어플리케이션)

  • Ha-Eun Park;Jeong-Won Lee;Ji-Min Jang;You-Rim Ha;Seong-Yong Ohm
    • The Journal of the Convergence on Culture Technology
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    • v.10 no.6
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    • pp.709-714
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    • 2024
  • In this paper, we introduce the application 'Mindlog' system that helps patients seeking psychiatric treatment and counseling to record their thoughts and medical records. This system was developed to prevent patients from ending the treatment with an uncomfortable feeling due to not being able to clearly convey what they want to say during a short consultation time, or from not receiving detailed treatment instructions due to this. It allows patients to objectively observe and organize their feelings through simple tasks and systematic guides. In addition, it helps patients more conveniently check what changes have occurred compared to previous treatment and what they want to discuss in actual treatment by allowing them to systematically manage the treatment schedule and content.

A Study for The Prognostic Indicators of Korean Alcoholics in Psychological, Social and Biological Aspects (한국인 알코올중독 환자의 예후인자에 관한 연구 : 심리적, 사회적, 생물학적 요인을 중심으로)

  • Sung, Sang-Kyung;Chang, Hwan-Il
    • Korean Journal of Biological Psychiatry
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    • v.2 no.2
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    • pp.218-236
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    • 1995
  • The author studied prognostic indicators of sixty Korean male alcoholics in psychological, social and biological aspects who were divided into abstinent and drinking groups. Thirty patients were assigned to each group. They were controlled in age and sex. Both groups were compared in terms of the demographic characteristics, past drinking history, treatment history, famaily history, ego strength and personality factors differences and distribution of dopamine $D_2$ receptor gene Al allele. Also the author studied relation of clinical course, alcoholic family history and dopamine $D_2$ receptor gene Al allele in both groups. The results were as follows; 1) The abstinent group had higher rate of married state, higher economic status, longer education years and maintained more stable job than the drinking group. But made no differences in occupation and religion. 2) The abstinent group showed higher rate of living with family members than the drinking group, and wives and fellows of the alcoholics anonymous were important factors for maintenance of abstinence. Family loading and parent's characters were not different. 3) The abstinent group had longer maximal length of abstinence but mean amount of alcohol consumption per day were larger than the drinking group. But there were no differences in duration of past drinking, drinking pattern, main drinking time, first drinking age and preference of the kind of alcoholic beverage in the past drinking history. 4) The abstinent group showed stronger treatment motivation, absolute abstinence in treatment goal, more voluntary adimission and maintained longer therapeutic relationship otter discharge than the drinking group. But both groups showed negative attitude toward antabuse therapy. 5) The abstinent group had higher mean score in ego strength scale than the drinking group. 6) In the personality factor questionnaire, the abstinent group showed strong laugh poise and the trait of praxernia, conservatism personality but the drinking group showed tough poise, the trait of weak ego strength(unstableness) and tough mindedness personality. 7) In comparision of dopamine $D_2$ receptor gene A1 allele, the prevalence of A1 allele was seventy percent and the frequency was 0.38 in the abstinent group. The prevalence of A1 allele was sixty percent and the frequency was 0.42 in the drinking group. Both groups were not significantly different in A1 allele prevalence and frequency. 8) In comparision of dopamine $D_2$ receptor gene A1 allele according to alcoholic family history, the prevalence of A1 allele was seventy percent and the frequency was 0.43 in the family history positive group. The prevalence of A1 allele was sixty-one percent and the frequency was 0.38 in the family history negative group. Both groups were not significantly different in A1 allele prevalence and frequency. In comparision of past drinking history according to alcoholic family history, the family history positive group showed earlier first drinking and problem drinking, but the family history negative group hod longer duration of past drinking. The mean amount of alcohol consumption per day, the longest duration of abstinence and Alcoholism Screening Test of Seoul Natoinal Mental Hospital(NAST) results were not significant. In conclusion, the results suggest that successful prognostic indicators of Korean alcoholics are married state, higher economic status, longer education years, stable job, living with family members, longer abstinence during past drinking history, strong treatment motivation, absolute abstinence in treatment goal, voluntary adimission, maintained therapeufic relationship, strong ego strength and the trait of praxernia, conservatism personality. But occupation, religion, alcoholic family history, parent's characters, duration of past drinking, drinking pattern, main drinking time, first drinking age, preference of the kind of alcoholic beverage, attitude to antabuse therapy and distribution of dopamine $D_2$ receptor A1 allele were not significantly related to the prognostic indicators of Korean alcoholics.

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Influence of Ischemic Lesions on $^{99m}Tc$-HMPAO SPECT Findings in the Diagnosis of Alzheimer's Disease ($^{99m}Tc$-HMPAO SPECT를 이용한 알쯔하이머병의 진단에서 허혈성 뇌병변이 미치는 영향)

  • Lee, Kyung-Han;Lee, Myung-Chul;Lee, Dong-Soo;Kwon, June-Soo;Kim, Jong-Ho;Chung, June-Key;Woo, Jong-In;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.282-292
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    • 1994
  • Brain perfusion SPECT shows typical regional perfusion abnormalities in Alzheimer's disease(AD) and is useful for its diagnosis. However, there is also arguement that these patterns show significant overlap with other causes, and the accuracy for SPECT in differentiating AD has shown conflicting results. We postulate that the variation in re-ported results are partly due to a difference in patient or control selection with special reference to the mixture of ischemic cerebral disease in the studied population. To deter-mine the effect of ischemic lesions and the nature of control subjects on SPECT studies for AD, we performed $^{99m}Tc$-HMPAO single photon emission computed tomography (SPECT) in 11 probable AD patients with a low (<4) Hachinski ischemic score and 12 non-demented age matched controls. Magnetic resonance imaging(MRI) disclosed ischemic cerebral lesions in 27% (3/11) of the PAD group and 25% (3/12) of the control group. Regional perfusion indices were quantitated from the SPECT images as follows and the distribution of perfusion indices from both groups were compared. This was repeated with controls after excluding those with significant ischemic lesions by MRI : regional perfusion index = average regional count/average cerebellar count All PAD patients showed perfusion abnormality in SPECT. However, 53% (10/12) of controls also showed perfusion at-normalities, and no pattern could reliably differentiate the two groups. After excluding controls with significant cerebral ischemia, the difference in temporal and parietal perfusion index was increased. A decreased tempore-parietal and any parietal or temporal per-fusion index had a sensitivity of 18% and 36% in detecting AD, respectively. When using a separate group of normal age mathced controls, the indices showed an even more difference in the temporal and parietal lobes and the sensitivity of a decreased tempore-parietal and any parietal or temporal perfusion index had a sensitivity of 36% and 55% in detecting AD, respectively. Thus, the type of control with special reference to the pres-once of ischemic cerebral lesions contribute significantly to the accuracy of perfusion SPECT in diagnosing AD. This nay have particular importance in the diagnosis of AD in populations where the prevalance of cerebrovascular disease is high.

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Polysomnographic Characteristics and Prescription Status of Restless Legs Syndrome Patients in Naturalistic Setting (임상현장에서 하지불안증후군 환자의 수면다원검사결과의 특징과 약물처방현황)

  • Kang, Seung-Gul;Nam, Ji-Hye;Kim, Hana;Shin, Hong Beom
    • Sleep Medicine and Psychophysiology
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    • v.20 no.1
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    • pp.35-40
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    • 2013
  • Objectives: The aim of this study is to evaluate the polysomnographic characteristics and prescription status of restless legs syndrome (RLS) patients in naturalistic setting. Methods: We reviewed medical record of the patients over 18 years olds who (i) satisfied the clinical RLS diagnostic criteria and (ii) had the polysomnography and got treatment related thereto. As a baseline, we evaluated the four diagnostic criteria of the International Restless Legs Syndrome Study Group (IRLSSG) and the International Restless Legs Scale (IRLS) of the subjects. Then the polysomnography and the suggested immobilization test (SIT) were conducted and, after one month of pharmacotherapy using dopamine agonist, the IRLS was evaluated again. Results: A total of 211 subjects participated in this analysis and 94 (44.5%) of them were male and the other 117 (55.5%) were female and the average age of the 211 subjects was $46.9{\pm}14.2$. Out of such 211 subjects, 136 subjects (64.5%) also had the obstructive sleep apnea (OSA), and 53 subjects (25.1%) also had the periodic limb movement disorder (PLMD). 185 subjects (87.7%) out of the 211 subjects had some other sleep disorders except RLS. The results of the polysomnography were as follows : 78.0% of sleep efficiency, 86.8 min of wake after sleep onset, and 3.4% of N3. More specifically, 12.4/h of the average apnea hypopnea index, 14.8/h of the periodic limb movement during sleep (PLMS), 41.2/h of the periodic limb movement during wake during SIT and 21.6/h of total arousal index during sleep. Out of the total subjects, 149 (70.6%) of them took the ropinirole and 47 (22.3%) of them took the pramipexole, and the average dosage of ropinirole was 0.9mg(dosage range 0.125-5 mg) while the average dosage of pramipexole was 0.5 mg (dosage range 0.125-4 mg). The dosage of the ropinirole showed a significant positive correlation with the age (r=0.25, p=0.002) and also with the IRLS (r=0.23, p=0.038). The IRLS at the baseline was 24.9 while the same was decreased down to 13.4 after one month. Conclusions: Analyzing the result of this study, a majority of clinical RLS subjects demonstrated comorbidity with some other sleep disorder such as the OSA or PLMD. 25.1% of the subjects showed a PLMD, which was less than in previous researches and the average PLMS was not very high as 14.8/h. The dosage of dopamine agonist taken was often a bit more than the amount recommended in Korea. A prospective research using a large scale controlled subjects will be necessary with respect to this topic.

A Study on the Purpose-in-Life Level in Patients with Traumatic Brain Injury (외상성 뇌 손상 환자의 삶의 목적 수준에 관한 연구)

  • Rho, Seung-Ho;Kim, Sung-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.184-195
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    • 1999
  • Objectives : As traumatic brain injury(TBI) leaves chronic sequelae in mind and body, the injured patients should rectify the meaning and object that they have pursued in their lives and set up a new purpose in life that they may make the rest of their lives meaningful. This study was designed to investigate the purpose and quality of life levels and the influence of demographic and clinical variables on the levels in the patients with TBI, and to be of some help to their rehabilitation. Methods : In order to assess the purpose in life(PIL) and the quality of life(QOL) levels, Purpose-in-Life Test, Sickness Impact Profile, Quality of Life Index, Head Injury Symptom Ckecklist, and Neurobehavioral Rating Scale were administered to the subjects. The subjects were thirty-two patients with TBI and the same numbered normal controls. The TBI group was composed of 16 to 65 year-aged patients who had received mild or severe TBI at least 12 months before, and the controls were siblings or friends of the patients whose age, sex, and educational level were similar to them. Results : 1) The PIL and QOL levels of the patients with TBI remained significantly lower than that of control group after their symptoms of injury were stabilized(p<.01, p<.01). 2) The mean PIL score of TBI group was $58.8{\pm}23.2$, which was to be regarded as the level of existential vacuum. 3) The PIL level of TBI group was significantly correlated with the QOL level(p <.01). 4) The subgroup with lower PIL level in patients with TBI has significantly higher rate of female than that with higher PIL(p<.05), the PIL level of female patients was significantly lower than that of male patients(p <.05). 5) The significant differences in PIL levels were not found, in which comparison was performed between each pair of subgroups of patients with TBI divided by severity of injury(mild vs severe), marital status(married vs unmarried), and occupational status prior to injury(employed vs unemployed). Conclusion : The PIL of patients with TBI still remained the level of existential vacuum after symptoms of sequelae had been stabilized, The QOL level was also extremely low, and as the PIL level was low the QOL was also low. The demographic and clinical variables except sex did not have influence on the PIL level in brain-injured patients. It is suggested that every patient should admit their mental and physical limitations caused by brain injury and revise their purpose in life for successful rehabilitation.

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