• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.18 no.1
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• pp.10-15
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• 2007

Probably the three most important components to a comprehensive evaluation of patients with attention-deficit hyperactivity disorder (ADHD) are the clinical interview, the medical examination, and the completion and scoring or behavior rating scales. Teachers and other school personnel are often the first to recognize that a child or adolescent might have ADHD, and often play an important role in the help-seeking/referral process. A diagnostic evaluation for ADHD should include questions about ADHD symptoms, other problems including alcohol and drug use, family history of ADHD, prior evaluation and treatment for ADHD. Screening interview or rating scales as well as interviews should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with objective assessments of the ADHD symptoms, such as psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but they may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. Screening for intellectual ability and academic achievement skills is also important in determining the presence of comorbid developmental delay or loaming disabilities. The number and type of symptoms required for a diagnosis of ADHD vary depending on the specific subtype. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in daily functioning, and must not meet criteria for other mental disorders which might better account for the observed symptoms such as mental retardation, autism or other pervasive developmental disorders, mood disorders, anxiety disorders. This report aims to suggest a practice guideline of assessment and diagnosis for children and adolescents with ADHD in Korea.

• Journal of Korean Clinical Nursing Research
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• v.19 no.3
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• pp.432-442
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• 2013

Purpose: The purpose of this study was to describe restraint use in care of patients with psychiatric disorders in an attempt to avoid unnecessary restraint use and provide information for developing standards regarding restraint use as a therapeutic maneuver. Methods: For this descriptive study, discharge records from N National Mental Hospital in the year 2009 were reviewed by trained nurses during Dec. 24, 2010 and Mar. 31, 2011. There were 596 restrains applied on 232 of 1,322 discharges. Data collected include general characteristic of patients, the frequency of restraint use, time since admission when restraint was applied, time of the day when restraint was applied, duration of restraint application, place of occurrence, reasons for restraint use, and degree of damage to the patent. Work experience of nurses who applied restraints, number of workforce at the time of restraint, and season of the year was also identified. Descriptive statistics, Chi-square test, t-test, ANOVA, $Scheff{\grave{e}}$ and Jonckheere-Terpstra were applied using SPSS 14.0 to analyze the data. Results: There were 596 restraint uses among 232 patients. Restraints were applied most frequently on males in their 40s, patients diagnosed with schizophrenia, and patients repeating admissions more than 6 times. Restraints were frequently applied within first week following admission, between 16:00 and 20:00, and the average duration of restraint was 5 hours. There were significant differences according to diagnoses of patients in the season restraint occured, time, place of occurrence, reason for restraint, and duration of restraint. Patients with alcoholism received longer restraint application. Conclusion: In order to avoid unnecessary restraint use in patients with psychiatric disorders, nurses and other health care team members need to acknowledge a group of patients such as patients with schizophrenia and alcoholism who relatively frequently restrained or receiving longer restraint. Reasonable and careful decision need to be made when applying restraint in the care of patients with alcohol problem.

• Korean Journal of Family Medicine
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• v.39 no.6
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• pp.333-339
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• 2018

Background: There is a distinction in alcohol consumption behavior between adults and college students. This study aims to verify the usability and the optimal cutoff point of Alcohol Use Disorders Identification Test-Korean revised version (AUDIT-KR) for screening alcohol use disorder in college students when the diagnostic and statistical manual of mental disorders (DSM), 5th edition diagnostic criteria is applied. Methods: A total of 922 college students living in Daejeon were enrolled and divided into two groups based on how many items they corresponded to among DSM-5 alcohol use disorder diagnostic criteria: those who corresponded to ${\geq}2$ of the 11 items were classified into the patient group (107 males, 89 females) while the others into the control group (311 males, 415 females). The participants were evaluated using AUDIT-KR to find the optimal cutoff point for screening alcohol use disorder, sensitivity, and specificity. Results: The mean${\pm}$standard deviation scores in the AUDIT-KR were $12.76{\pm}7.27$, $10.72{\pm}4.62$ for males and females, respectively, in the patient group. In contrast, in the control group the scores were $6.26{\pm}5.23$ and $3.95{\pm}3.59$ in males and females, respectively. The area under the receiver operating characteristic curve (95% confidence interval) regarding alcohol use disorder screening by AUDIT-KR was 0.768 (0.715-0.821) and 0.883 (0.848-0.919) for males and females, respectively. The optimal cutoff point of alcohol use disorder for males was >9, sensitivity 64.49%, and specificity 76.85%. The optimal cutoff point for females was >6, sensitivity 82.02%, and specificity 80.48%. Conclusion: This study suggested that AUDIT-KR can be used as a screening tool for alcohol use disorder in groups of college students when DSM-5 diagnosis criteria are applied.

• Journal of Oriental Neuropsychiatry
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• v.21 no.4
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• pp.219-231
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• 2010

Objectives : School refusal is usually considered as individual's behavioral problem. These days. however. the adolescents' school refusal needs some kind of medical approaches because it is related to mental disorder of the adolescents. Due to too much pressure and stress from the competition between classmates and from good performance in school. the number of adolescents who refuse to go to school is increasing. Despite this circumstance. school refusal is neither regarded as a single independent disorder nor endorsed as an officially classified disease. which makes difficult to conduct research on this issue and to establish standardized treatment for it. In addition. there is a lack of research on this topic. especially in oriental medicine. so there is no a case report or study on school refusal. This study is trying to comment on school refusal from the perspective of oriental medicine. Methods : We tried to examine the effect of oriental medicine treatment for school refusal with four adolescent cases. The patients commonly have at least more than one mental disorder (including depression disorder. anxiety disorder. and anorexia nervosa). have some problem with the relationship with their family. in particular with mother. do not have father or not be loved by their father. and have irregular eating habits. Thus. we diagnosed them as qi transforming into fire (氣鬱化矢) spleen-stomach deficiency cold (脾胃虛寒) and heart blood deficiency (心血虛) due to stress from the family issues and unhealthy eating habits. The patients received supportive therapy. family therapy. etc among many oriental mental treatments and their progress had been observed through hospitalization and outpatient treatment. Results : All four cases were reported positive progress on their symptoms and started coming back to school. We also examined whether they were well fitting into the school while they received outpatient treatment. and the results show that all four patients continue to settle down in normal school life. Conclusions : This study closely reviewed the mental disorder of school refusal cases and showed that the Oriental medical treatment was effective in helping the patients come back to school. More future research is required to better treatment for school refusal cases in oriental medicine.

• Korean Journal of Biological Psychiatry
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• v.24 no.3
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• pp.129-133
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• 2017

Objectives Obsessive-compulsive disorder (OCD) is a disabling psychiatric disorder, and more attention is recently paid on the quality of life (QoL) in OCD patients. The Euro-QoL-5D (EQ-5D) is a widely used self-report to calculate a single score which represents 'health utilities'. The aim of this study was to assess the health-related QoL for patients with OCD using the EQ-5D and to examine the relationship between health-related QoL and symptom severity. Methods Seventy-three patients with a Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnosis of OCD were recruited from the outpatient clinic in Seoul National University Hospital. Symptom severity was assessed using the Yale-Brown Obsessive-Compulsive Scale (YBOCS), and QoL was assessed with the EQ-5D-5L questionnaire. Using Korean valuation study, a single score of QoL was calculated. Results Most of the OCD patients were relatively young (< 45 years) with the mean YBOCS total score of 19.33. The mean EQ-5D score was 0.71 and significantly correlated with symptom severity (r = -0.483, p < 0.001). 25% of the EQ-5D score was predicted by the YBOCS total score (b = -0.011, p < 0.001) by regression analysis. Conclusions OCD patients suffer from lower health-related QoL and QoL significantly decreased as symptom severity increased. The results of the EQ-5D would enable further studies on QoL comparison across medical disease and mental disorders.

• Journal of Preventive Medicine and Public Health
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• v.46 no.3
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• pp.147-154
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• 2013

Objectives: Many epidemiological studies have suggested that a variety of medical illnesses are associated with suicide. Investigating the time-varying pattern of medical care utilization prior to death in suicides motivated by physical illnesses would be helpful for developing suicide prevention programs for patients with physical illnesses. Methods: Suicides motivated by physical illnesses were identified by the investigator's note from the National Police Agency, which was linked to the data from the Health Insurance Review and Assessment. We investigated the time-varying patterns of medical care utilization during 1 year prior to suicide using repeated-measures data analysis after adjustment for age, gender, area of residence, and socioeconomic status. Results: Among 1994 suicides for physical illness, 1893 (94.9%) suicides contacted any medical care services and 445 (22.3%) suicides contacted mental health care during 1 year prior to suicide. The number of medical care visits and individual medical expenditures increased as the date of suicide approached (p<0.001). The number of medical care visits for psychiatric disorders prior to suicide significantly increased only in 40- to 64-year-old men (p=0.002), women <40 years old (p=0.011) and women 40 to 64 years old (p= 0.021) after adjustment for residence, socioeconomic status, and morbidity. Conclusions: Most of the suicides motivated by physical illnesses contacted medical care during 1 year prior to suicide, but many of them did not undergo psychiatric evaluation. This underscores the need for programs to provide psychosocial support to patients with physical illnesses.

• Anxiety and mood
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• v.13 no.2
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• pp.123-131
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• 2017

Objective : The PTSD Checklist (PCL) is a self-report screen for posttraumatic stress disorder (PTSD) that can be scored for both diagnostic assessment and symptom severity measurement. The most recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) contains a number of changes to the definition of PTSD, and the aim of this study was to assess the psychometric properties of the Korean version of the PCL for the DSM-5 (PCL-5-K). Methods : The participants were 204 Korean veterans of the Vietnam War who completed the PCL-5-K, the Mini Mental Status Examination (MMSE), PTSD module of Structured Clinical Interview for DSM-5, Research Version (SCID5-RV PTSD module), Korean version of Impact of Event Scale-Revised (IES-R-K) and Combat Exposure Scale (CES-K). Results : The PCL-5-K demonstrated good internal consistency (${\alpha}=0.972$) and test-retest reliability (r=0.96); the suggested cut-off score for PTSD diagnosis was ${\geq}37$ with 0.88 sensitivity and 0.96 specificity. The PCL-5-K scale correlated highly with the IES-R-K and CES-K. Factor analysis identified only one factor. Conclusion : Among elderly Korean veterans of the Vietnam War, the PCL-5-K demonstrated similar psychometric qualities to those of both the original PCL and subsequent versions. It is expected that the PCL-5-K will be a useful PTSD screening tool.

• Journal of Korean Academy of Nursing
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• v.28 no.3
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• pp.801-809
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• 1998

This study was carried out the group communication program which I had composed of using the Satir's communication family theory and skills. The purpose of this study was to investigate the effects on the dysfunctional communication self-esteem and depression, executed this program for the mothers group with caring the mental disorders. and then for the test of some hypotheses it was devided two groups ; the experimental group(n=20) and control group(n=25). In the control group they were learned two session family education program in the psychiatric clinics of Pusan National University Hospital and in the experimental group they had experienced during the 10 session by the group communication program. In the methods of the statistics on this datas, it was to statistics X²test for the comparison between the experimental group and control group with general characteristics. The effect of the Group Communication Program was to analyse ANCOVA between pre-post test on the disfunctional communication, self-esteem and depression in the control group and experimental group. The conclusions were derived from the results and test of hypothesis as followings ; 1) The results were tested the differentiation between the experimental and control group, and the pre-post test in the experimental group with dysfunctional communication self-esteem and depression. Some hypothesis were tested and supported as followings : It was supported that the level of dysfunctional communication of the experimental group would be lower than the control group (Hypothesis 1) It was supported that the level of self-esteem of the experimental group would be higher than the control group (Hypothesis 2). It was supported that the level of depression of the experimental group would be lower than the control group (Hypothesis 3). 2) The relation of the dysfunctional communication with the self-esteem was presented negative correlation and with the depression was not correlation. The relation of the self-esteem with the depression was presented significantly negative correlation. The relation of the sacrificuny pattern of dysfuntional communication with the self-esteem was presented negative correlation and with the depression positive correlation.

• Korean Journal of Biological Psychiatry
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• v.24 no.1
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• pp.10-18
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• 2017

Occupational hazards of firefighting and rescue works include frequent exposure to emergencies and life-threatening situations. These stressful work conditions of being constantly under pressure and exposed to potentially traumatic events put them at higher risk of developing posttraumatic stress disorder (PTSD), compared to the general population. PTSD is a potentially debilitating mental disorder, due to persistent intrusive thoughts, negative alterations of mood and cognition, hypervigilance, avoidance of similar situations and reminders, and re-experiences of the traumatic event. Previous studies have shown a relatively high prevalence of PTSD among firefighters, indicating the need for a systematic approach of early detection and prevention. Therefore, a critical review of the current literature on PTSD in firefighters would provide valuable insights into developing effective prevention and intervention programs. Literature indicated that there are risk factors of PTSD in firefighters, such as pre-existing depression, anxiety, sleep disorders, occupational stress, physical symptoms, and binge drinking, whereas social support and adequate rewards are protective factors. Although there are differences in the prevalence of PTSD across studies, partly due to various assessment tools utilized, different sample sizes, and sample characteristics, over one tenth of the firefighters were estimated to have PTSD. The current review warrants further investigations to precisely assess PTSD and co-morbid mental disorders, functional outcomes, and associated factors, and to develop evidence-based preventive and interventional programs to help firefighters with PTSD.

• Anxiety and mood
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• v.2 no.2
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• pp.115-121
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• 2006

Objectives : We performed this '2006 Korean Anxiety Research' to understand the actual state about Korean anxiety and get the basic data for mental health promotion. Methods : Semistructured questionnaire and Beck Anxiety Inventory -Korean version (BAI) were administered to total 1,000 adults (20-69 years old 501 male & 499 female adults living in Seoul and 5 metropolitan cities in Korea) on March 20th~31st, 2006. Results : Anxious subjects by the total score of BAI was 3.3%. But the responders the item 'I am in the anxious state' was 25% among total subjects. 6% (n=59) among total subjects were the responders experienced the anxiety requiring usually the counselling or treatment. The frequency of their anxiety was most commonly 1 to 2 times/month. The main causes of their anxiety were 'their health problems or illness', 'economic difficulty', 'interpersonal conflicts'. But 'help by health professional' among their usual anxiety reduction methods' was only 15% among them. Only 19% among them were under the treatment of anxiety. Only 27% among 48 subjects not under the treatment of anxiety had a desire for the anxiety treatment in the near future. Conclusion : Some people in the anxious state impairing their daily lives were not yet under the treatment. And most of them had no desire for the anxiety treatment. Therefore we will systematically plan the further health education on the anxiety-related problems for the Korean mental health promotion and the quality of life.