• Title/Summary/Keyword: long-term depression

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Effect of Short-Term Pharmacotherapy on Anxiety Sensitivity, Quality of Life and Functional Disability in Panic Disorder Patients (공황장애에서 단기약물치료가 불안민감도와 삶의 질 및 기능장애에 미치는 영향)

  • Oh, Yun-Hye;Choi, Kwan-Woo;Kim, Bora;Heo, Jung-Yoon;Yu, Bum-Hee
    • Anxiety and mood
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    • v.9 no.1
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    • pp.25-30
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    • 2013
  • Objective : Panic disorder is a chroni, debilitating illness, and has been known to be affected by high anxiety sensitivity and a poor quality of life. We examined if 12 weeks of pharmacotherapy with escitalopram could affect anxiety sensitivity, quality of life, and general disability in patients with panic disorder. Method : We enrolled 27 patients who met the DSM-IV-TR criteria for panic disorder, with or without agoraphobia, and completed 12 weeks of escitalopram treatment. We enrolled 29 normal control subjects who were matched for age and sex compared with the panic patients. All subjects were assessed using the Hamilton Rating Scale for depression (HAM-D), Hamilton Rating Scale for Anxiety (HAM-A), Panic Disorder Severity Scale (PDSS), Anxiety Sensitivity Index-Revised (ASI-R), WHO quality of life assessment (WHO-QOL) and Sheehan Disability Scale (SDS) before and after 12 weeks of treatment. Result : Panic disorder patients had a higher Anxiety sensitivity, a poorer Quality of life, and significant disability than normal control subjects at baseline. After the treatment, Panic disorder patients showed significant improvement in the severity of panic symptoms in terms of the HAM-A p<0.001), HAM-D (p<0.001) in addition, the reached a remission state in terms of the PDSS score. They also showed significant improvement in the ASI-R (p<0.001), WHO-QOL (p<0.001) and SDS (p<0.001), but mean scores of the ASI-R, WHO-QOL and SDS in panic disorder patients were did not reach normal levels. Conclusion : This study suggests that 12 weeks of pharmacotherapy with escitalopram could improve anxiety sensitivity, quality of life, and disability in panic disorder patients, although their anxiety sensitivity, quality of life and disability were not yet normalized after short-term pharmacotherapy. Thus, long-term pharmacotherapy may be necessary for panic disorder patients in order to get an optimal clinical response in terms of anxiety sensitivity, quality of life, and general disability.

A DOUBLE BLIND CROSS-OVER COMPARISON OF ANTIDEPRESSANT AND ANTIANXIETY EFFECTS OF PAROXETINE AND PLACEBO IN CHILD-ADOLESCENT AND ADULT DEPRESSIVE NEUROSIS (소아 ${\cdot}$ 청소년 및 성인 우울신경증 환자에 대한 Paroxetine의 항우울 및 항불안 효과 검증 : 위약과의 이중맹 교차 비교실험)

  • Kim, S. Peter;Hong, Kyung-Sue
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.5 no.1
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    • pp.83-92
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    • 1994
  • Paroxetine is a potent and selective serotoin re-uptake inhibitor. It is well known as an effective and safe antidepressant and increasingly used for neurotic or non-psychotic depression with anxiety symptoms. The present study assessed antidepressant and antianxiety efficacy and tolerability of paroxetine against placebo in child-adolescent and adult depressive neurosis patients. 232 subjects aged 8-55 years and meeting DSM-III-R criteria for depressive neurosis or dysthymia were divided into 8 subgroups according to their sex and age(8-11 yeard old, 12-17 years old, 18-35 years old and 36-55 years old subgroup in each male and female group). In each subgroup, the randomly assigned half of the patients were treated with paroxetine(10-30mg/day) and the others with placebo for the first 2 weeks in double blind fashion. After 1 week of drug-washout period, paroxetine and placebo groups were crossed over. The depression and anxiety symptoms were assessed with Hamilton Depression Scale(HDS) and Hamilton Anxiety Scale(HAS) at baseline and every 1 week during the trial periods. The levels of reduction in HDS and HAS scores from baseline after 2-week trial were compared between paroxetine- and placebo- treated periods by paired t-test. In all the 8 subgroups, statistically significant differences between paroxetine and placebo were found on the antidepressant efficacy after 2-week treatment. The antidepressant efficacy of paroxetine compared to placebo was most prominent in child and adolescent female groups. On anxiety symptoms, paroxetine was also significantly more effective than placebo. The antianxiety efficacy of paroxetine compared to placebo was most prominent in male and female child groups and young adult female group aged 18-35 years. As for the adverse effects of paroxetine, 3 out of 232 subjects reported mild indigestion and abdominal pain. however, in all the 3 cases, the symptoms improved without reduction of dosage or discontinuation of the drug. In conclusion, paroxetine showed significantly higher antidepressant and antianxiety efficacy compared to placebo in child-adolescent and adult depressive neurosis patients after 2-week treatment. Further trials of paroxetine in depressive neurosis are warranted to elucidate the long-term antidepressant and antianxiety efficacy of paroxetine.

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Diversification of Financial Method for Effective Practice of Construction Projects (건설사업의 효율적 수행을 위한 파이낸싱 다양화 방안)

  • Han Sang-Hun;Han Choong-Hee;Kim Sun-Kuk
    • Korean Journal of Construction Engineering and Management
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    • v.4 no.2 s.14
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    • pp.99-108
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    • 2003
  • Recently, the construction companies are forced to cut down the investment amount due to increasing financial problems caused by severe recession and restructuring in the financial market as well as the long-term depression of the construction industry. To overcome this type of problems, a great many efforts have been made. An alternative may be adopting the advanced financing methods. However, during the course of enforcing process of the financing methods, many problems are revealed without any proper solutions being proposed. Therefore, the fundamental problems need to be solved through comprehensive and systematic approach under the changing environment of construction financing. In this paper, as a result of reviewing some financing methods such as ABS, REITS, and Project Financing, multiple business strategies for construction companies to cope with the changing construction market are found in the sense of effectiveness in implementing construction projects. Further, this paper presents diversified financing methods for the effective practice of construction projects through combination of above mentioned methods, and also proposes improvement plans to strengthen the financing function for the construction industry.

The Application of Brain Stimulation in Psychiatric Disorders : An Overview (정신질환에서 뇌자극술의 적용)

  • Roh, Daeyoung;Kang, Lee Young;Kim, Do Hoon
    • Korean Journal of Biological Psychiatry
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    • v.24 no.4
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    • pp.167-174
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    • 2017
  • Based on advances in biotechnology and neuroscience, neuromodulation is poised to gain clinical importance as a treatment modality for psychiatric disorders. In addition to old-established electroconvulsive therapy (ECT), clinicians are expected to understand newer forms of neurostimulation, such as deep brain stimulation (DBS), vagus nerve stimulation (VNS), repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS). Given the growing interest in non-invasive neuromodulation technologies, clinicians may seek sufficient information about neuromodulation to inform their clinical practice. A growing literature suggests that applications of non-invasive neuromodulation have evidence particularly for indications where treatments are currently insufficient, such as drug-resistant depression. However, positive neuromodulation studies require replication, and the precise interactions among stimulation, antidepressant medication, and psychotherapy are unknown. Further studies of long-term safety and the impact on the developing brain are needed. Non-invasive neuromodulatory devices could enable more individualized treatment. However, do-it-yourself (DIY) stimulation kits require a better understanding of the effects of more frequent patterns of stimulation and raise concerns about clinical supervision, regulation, and reimbursement. Wide spread enthusiasm for therapeutic potential of neuromodulation in clinical practice settings should be mitigated by the fact that there are still research gaps and challenges associated with non-invasive neuromodulatory devices.

The Relationship between Epileptic Focus and Psychiatric Symptoms of the Refractory Epileptic Patients (난치성 간질환자의 간질초점 위치와 정신증상과의 관련성)

  • Han, Wou-Sang;Kim, Jong-Hoon;Lee, Sang-Kun;Cho, Doo-Young;Kwon, Jun-Soo;Ha, Kyoo-Seob
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.1
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    • pp.64-70
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    • 1996
  • The prevalence rate of psychiatric symptoms of the refractory epileptic patients was evaluated according to the location of the epileptic focus. The subjects were 91 patients admitted to Epilepsy Monitoring Unit of Seoul National University Hospital. The psychiatric symptoms were assessed by Korean version of Symptom Checklist-90-R(SCL-90-R). The locus of epileptic focus was assessed by clinical features, 2-hour interictal EEG, long-term video-EEG monitoring, brain MRI, interictal and ictal brain SPECT, and interictal brain PET The subjects were divided into three groups according to the epileptic focus, non-temporal(N=29), left temporal (N=26), and right temporal(N=32). There were no statistical differences in demographic and seizure-related variables among groups. The number of patients with $T-score {\geq} 65$ at any subscale of the SCL-90-R were compared by $X^2-test$ among groups. The mean T-scores of each subscale of the SCL-90-R were compared by oneway-ANOVA among groups. The prevalence rate of psychiatric symptoms of the refractory epileptic patients was 38.5%. There was no statistical difference in the prevalence rate of psychiatric symptoms among groups. However, the patients with non-temporal or right temporal epileptic foci showed statistically significant higher mean T-scores of interpersonal sensitivity, depression, hostility, and phobic subscales than the patients with left temporal epileptic foci. These results suggest that the epileptic focus plays an important role in the production of interictal psychiatric symptoms of the refractory epileptics.

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The Experiences and Challenges of Caregivers of Frail or Chronically Ill Elderly: An Integrative Review

  • Han, Hae-Ra
    • Perspectives in Nursing Science
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    • v.3 no.1
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    • pp.47-60
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    • 2006
  • BACKGROUND: Social, legal, and economic factors have changed the delivery of care to elderly who are frail and/or chronically ill. Increasing number of the elderly are now treated in the community, while living with or in close proximity to their family. It is evident that families play a major role of support for elderly persons in our society. This paper provides a review and analysis of studies that have investigated informal caregiving issues encompassing physical, psychological, emotional, and social domains. RESULTS OF THE REVIEW: Family caregiving often interfered with workplace and other responsibilities, creating physical, emotional, and financial stress for caregivers. Relatively high volumes of research addressed caregiving issues in the families of Alzheimer patients and in the areas of emotional and psychological impact of caregiving. Few studies explicitly investigated the role of informal caregivers in the management of other chronic conditions such as stroke or depression or physical consequences of long-term caregiving. While most studies were focused on negative aspects of caregiving, a few studies found it rewarding. Often the burden, stress, and socio-economic effects on the family caregiving for an elderly person were not sufficiently appreciated. CONCLUSIONS: Positive outcomes for both the caregiver and the care recipient are more likely to occur when effective levels of collaboration exist between health professionals and caregivers. As a first step, a better understanding of the caregiving experience such as caregiver characteristics, care recipient characteristics, and social stigma is important for nurses to minimize the burden of care so that appropriate interventions can be developed. In addition, further studies are needed to examine the role and needs of informal caregivers in the care of increasing number of frail and/or chronic ill elderly treated in the community.

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Association of Anger Expression Patterns and Health Status in Health Care Workers (일 의료기관 종사자의 분노표현유형과 건강상태)

  • Lee Won-Hee;Kang Duck-Hee;Park Jin-Hee;Kim Soo-Hyun;Min Sung-Gil;Nho Jae-Hun
    • Journal of Korean Academy of Nursing
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    • v.36 no.5
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    • pp.821-828
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    • 2006
  • Purpose: The purpose of this study was to examine anger-expression patterns and their association with state and trait anger and physical and psychological health status in health care workers. Method: Four hundred and forty eight nurses, physicians and technicians from a large medical center completed standardized questionnaires of anger, anger-expression patterns and mood. They also had blood pressure, cholesterol, blood glucose and body mass index measured during their annual physical examinations. Data was analyzed using descriptive statistics, independent t-test, chi-square and ANOVA. Results: Subjects showed two major clusters of anger-expression patterns: anger-control and anger-in/out. Subjects with the anger-in/out pattern reported higher state and trait anger and more anxiety, depression and fatigue than subjects with the anger-control pattern. Physical health indicators, however, were not significantly different between the two clusters of anger-expression patterns. Conclusion: Anger-expression patterns are associated with psychological health status but not with physical health status. Anger-expression patterns, however, need to be examined over time to assess their long-term effects on the physical and psychological health status in future studies.

Analyzing the Problem of the Caregiver Education System through a Research of the Caregiving Service Activity (요양보호 서비스 활동 조사를 통한 요양보호사 교육과정의 문제점 분석)

  • Suh, Tae-Soo;Kim, Kyong-Tae;Jun, Kyoung-Hee
    • The Journal of Korean Physical Therapy
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    • v.20 no.4
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    • pp.61-69
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    • 2008
  • Purpose: We evaluated caregivers' understanding of patients' diseases and disuse syndrome, the understanding of exercise and massage related to rehabilitation and the necessity of education about these, the difference in education and realities of the care-giving field, and the extra services needed in the field. Methods: The survey using questionnaires was performed from June 2008 to August 2008 with 220 people participated in caregive education programme in daegu city and area near dagu city. Among the 220 submitted questionnaires, 184 which were faithfully answered were selected and they were analyzed by i-STATistics statistical program. Results: The educational focus of the first and second level caregivers, as defined by the second clause of the 29th article of the Elderly Welfare law, is on basic knowledge of diseases such as dementia, stroke, and depression. However, other diseases are not covered and the information does not include information on decreased function, complications, functional rehabilitating exercises, or preventing disuse syndrome for long term patients. The most common diseases, in order of prevalence, are stroke, dementia, diabetes mellitus, Parkinson disease, arthritis, and geriatric inertness. The general level of awareness about disuse syndrome was low, and patients, while understanding the need for massage and rehabilitative exercise, receive little education about the proper methods and therefore cannot use them. Patients also did not understand how participating in these activities could reduce medical fees, indicating that further education on massage and rehabilitative exercise is needed. Caregivers desired to include positive rehabilitation, massage, and exercise-related services in their services. Finally, differences in caregiver education and reality resulted from a lack of diversity in education. Conclusion: We suggest providing education on disuse atrophy and improving the lack of diversity in the care-giving education system.

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The Industrial Structural Change and Regional Development : The Rise of New Industrial Spaces in the Industrialized Countries and in the Newly Industralizing Countries (선진자본주의사회에서의 산업구조변화와 신흥공업국에서의 산업화에 따른 지역발달문제)

  • 고대경
    • Journal of the Korean Regional Science Association
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    • v.8 no.1
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    • pp.119-130
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    • 1992
  • Many of the industrialized countries since the 1970s have been experiencing the change in the industrial structure due to technological development, that is, from Fordism to post-Fordism, or to "flexible production system". Regional development has been undergoing some changes according to the different industrial production systems. During the Fordist mass production period, the manufacturing belt was the core region of the production system. As the system shifts to flexible production system of which characteristics are veritcal disintegration, emphasis for JIT(just-in-time) delivery system, part-time and short-time labor contracts, design-intensive industries, etc, the new system requires the new production core and has produced the new industrial spaces, such as Sunbelt cities, suburbs, small-or medium-sized cities, and non-metropolitan areas. In the perspective of global system, the Fordist production system made th NICs developed, because the mass production required many unskilled and low-wage workers. As the NICs exports of manufactured goods have incredibly expanded during the 1970s, the industrialized countries have become threatened. The industriablized countries have restructured their economies and international policies. Such restructures resulted in the economic depression of the NICs. The investment pattern of the industrialized countries has changed and particularly those industries adopting the Post-Fordism have invested from the NICs to the peripheral areas of their own countries or toward the underdeveloped countries which have much lower wage workers. The investment pattern of the NICs is also undergoing some changes like from metropolitian areas to small or non-metropolitan regions. The regional development since the post-Fordist production is still going on, thus it is not possible to generalize the tendency. That could be a particular phenomenon or a stage in the long-term cycle. But the regional development in the world system since 1980s definitely shows the different pattern.t pattern.

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An Empirical Analysis on the Fiscal Crisis of Local Governments in Korea (지방자치단체의 '재정위기'에 대한 실증분석)

  • 김범식;박원석;송영필
    • Journal of the Korean Regional Science Association
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    • v.15 no.1
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    • pp.75-92
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    • 1999
  • In this study, the present state of fiscal crisis for local governments after IMF is analyzed, firstly. its implications Characteristics of structural reform of finance after IMF bailout in Korea are examined, secondly. Since Korea was shocked by the currency crisis at the end of 1997, its local governments have also faced fiscal difficulties. The Depression of national and local economies led to decreases in tax revenues of local governments. And these shrunken revenues led to their expenditure cuts. Many investment plans were curtailed, and ordinary expenditures were also reduced sharply. The negative influences of the currency crisis on local government's finances can be examined in terms of fiscal revenue, fiscal spending, and debt burden. As a result many local governments are now experiencing fiscal stress, and some of them are even faced with fiscal crisis although the possibility of extreme measures, such as moratoriums or bankruptcies, is very slim. This is due in part to the weight of debt in local governments' budgets having remained small since the debt of local governments has been controlled by the central government. Another reason is that, central government, which functions as a lender of last resort for the local governments, will pay the debt for them. Also, without a legal system which stipulates the adjudication of bankruptcy for municipalities in Korea, local Korean governments have no legal right to declare bankruptcy. Although not a single municipality has fallen into insolvency, yet, this trend will continue to deepen as the recession continues and may lead to a situation where manu local governments fall into virtual bankruptcy in the near future, and its effects on society, as a whole, will be serious. Therefore, measures to prevent and overcome such an extreme situation are necessary, but both short-and long-term policies should be to cope with the current fiscal crisis and to prevent the deepening of the current situation.

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