• 동서간호학연구지
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• 제27권1호
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• pp.14-21
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• 2021

Purpose: This study aims to examine the levels of posttraumatic stress disorder (PTSD), depression and social stigma among nurses caring for Corona Virus Disease-19 (COVID-19) patients. Methods: 169 nurses caring for COVID-19 patients participated in this study. Data collection was conducted at university hospitals from March 1 to August 31, 2020. Data analysis was performed for descriptive statistics, t-test, ANOVA, and Pearson correlation coefficients using SPSS/WIN 24.0 program. Results: The mean scores of PTSD, depression and social stigma were 25.16±16.80, 17.26±8.63 and 5.83±2.84, respectively. The PTSD scores were significantly different between the department (F=2.89, p=.037). Depressive scores were significantly different between the marital status (t=2.27, p=.024) and the department (F=4.91, p=.003). Social stigma scores were significantly different between age (F=6.49, p=.002), marital status (t=-3.30, p=.008), having or not having children (t=3.82, p=.001), department (F=5.82, p=.001) and clinical experience (F=7.43, p=.001). Positive correlations were found between PTSD and depression (r=.70, p<.001) and social stigma (r=.22, p<.004). Conclusion: Integrated assessment and management are required to address the psychological and emotional problems faced by nurses caring for COVID-19 patients, and active follow-up measures should be considered.

• Psychiatry investigation
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• 제15권11호
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• pp.1071-1078
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• 2018

Objective We developed easily accessible imagery-based treatment program for patients with post-traumatic stress disorder (PTSD) related to workplace accidents and investigated the effects of the program on various PTSD related symptoms. Methods The program was based on an online platform and consisted of eight 15-min sessions that included script-guided imagery and supportive music. Thirty-five patients with workplace-related PTSD participated in this program 4 days per week for 4 weeks. Its effects were examined using self-report questionnaires before and after the take-home online treatment sessions. Results After completing the 4-week treatment program, patients showed significant improvements in depressed mood (t=3.642, p=0.001) based on the Patient Health Questionnaire-9 (PHQ-9), anxiety (t=3.198, p=0.003) based on the Generalized Anxiety Disorder seven-item (GAD-7) scale, and PTSD symptoms (t=5.363, p<0.001) based on the Posttraumatic Stress Disorder Check List (PCL). In particular, patients with adverse childhood experiences exhibited a greater degree of relief related to anxiety and PTSD symptoms than those without adverse childhood experiences. Conclusion The present results demonstrated that the relatively short online imagery-based treatment program developed for this study had beneficial effects for patients with workplace-related PTSD.

• 디지털융복합연구
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• 제16권12호
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• pp.625-634
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• 2018

본 연구는 성인기에 장애라는 외상을 경험한 중도장애인들의 장애정체성이 외상 후 성장에 영향을 미치는지, 이러한 과정에서 레질리언스가 조절효과를 가지는지를 검증하는 것을 목적으로 하였다. 이를 위하여 본 연구에서는 만 18세 이후에 장애를 갖게 된 중도장애인 203명을 대상으로 설문조사를 하였고, 수집된 자료를 가지고 이어 각각 표준 다중회귀분석과 위계적 다중회귀분석을 실시하였다. 연구의 결과는 다음과 같다. 첫째, 장애정체성이 높을수록 외상 후 성장의 수준이 높은 것으로 나타났다. 둘째, 장애정체성이 높아질수록 외상 후 성장이 높아지는데, 이 때 레질리언스 수준이 높아지면 외상 후 성장의 수준이 더욱 높게 나타났다. 이에 연구 결과들을 바탕으로, 긍정적인 장애정체성을 형성하고 레질리언스를 강화하기 위한 앞으로의 과제에 대하여 논의하였다.

• 대한한의학방제학회지
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• 제27권2호
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• pp.121-136
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• 2019

Objective : To investigate the effect of sihogayonggolmoryeotang (SY) on Single Prolonged Stress(SPS)-induced Post Traumatic Stress Disorder(PTSD). Method : To confirm the effects of SY on SPS-induced PTSD, Changes in body weight, sucrose intake open field test(OFT) and forced swimming test(FST)were observed. After behavioral tests, the plasma corticosterone(CORT) from the abdominal aorta, serotonin(5-HT) from prefrontal cortex, hippocampus, amygdala and striatum, norepinephrine(NE) and dopamine(DA) from hippocampus was measured by ELISA. mRNA expression of brain-derived neurotrophic factor(BDNF) and cAMP response element-binding protein(CREB) in hippocampus was measured by RT-PCR. Result : Weight change and sucrose intakes of rats in 14th day after the administration of SY were significantly increased in the SPS + SY450 group compared to the SPS group (p<0.05). Numbers of crossing in the central zone in the OFT were significantly increased in the SPS + SY450 group (p<0.05) compared with the SPS group. The immobility time of FST was significantly decreased in SPS + SY450 group compared with SPS group (p<0.05). The change of plasma CORT concentration was significantly decreased in SPS + SY450 group compared with that in SPS group (p<0.05). The change of 5-HT concentration was significantly increased in the SPS + SY450 group at hippocampus and amygdala compared with the SPS group (p<0.05). The concentration of DA was significantly increased in the SPS + SY450 group compared with the SPS group (p<0.05). The expression of BDNF and CREB were significantly increased in SPS + SY450 group compared with the SPS group (p<0.05). Conclusion : SY administration lowered the increase of CORT caused by PTSD and increases the 5-HT concentration and reversed the decreased expression of NE and DA and BDNF and CREB by PTSD. It is postulated that SY is effective in treating PTSD by restoring cognitive function, memory impairment, unstable emotional disturbances.

• 신경정신의학
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• 제56권1호
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• pp.28-34
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• 2017

Objectives The purpose of this study was to evaluate psychological effects of an outbreak of Middle East respiratory syndrome (MERS), a newly emerged infectious disease, on doctors. Methods After the MERS outbreak was over, we conducted an online survey of doctors who worked at the hospitals in which exposure to MERS cases had been confirmed or who were directly involved in MERS diagnosis and treatment. The Patient Health Questionnaires-9 (PHQ-9) and the Impact of Event Scale-Revised (IES-R) assessment methods were used to assess the severity of depressive and posttraumatic stress symptoms among the 64 doctors participating in the survey. Results The results of the survey indicate that 26.6% (n=17) of participants exhibited depressive symptoms and 7.8% (n=5) had post-traumatic stress symptoms. The doctors employed at hospitals with MERS cases had higher PHQ-9 and IES-R mean scores than those in doctors were not so employed. In contrast, there was no significant difference in those test scores between doctors who participated directly in MERS diagnosis and treatment and those doctors who did not. Conclusion The survey demonstrated that 28.1% (n=18) of doctors involved in MERS care suffered from depressive or posttraumatic stress symptoms, even though the MERS infection was being controlled. Working at a hospital with MERS cases was the primary determinant of the adverse psychological outcomes among doctors ; however, direct participation in the diagnosis and care of MERS patients was not significantly related to such outcomes.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권6호
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• pp.387-395
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• 2020

Background: The anterior-middle superior alveolar (AMSA) anesthetic technique has been reported to be a less traumatic alternative to several conventional nerve blocks and local infiltration for anesthesia of the maxillary teeth, their periodontium, and the palate. However, its anatomic basis remains controversial. The present study aimed to determine if the pattern of cortical and cancellous bone density in the maxillary premolar region can provide a rationale for the success of the AMSA anesthetic technique. Method: Cone-beam computed tomography scans of 66 maxillary quadrants from 34 patients (16 men and 18 women) were evaluated using a volumetric imaging software for cortical and cancellous bone densities in three interdental regions between the canine and first molar. Bone density was measured in Hounsfield units (HU) separately for the buccal cortical, palatal cortical, buccal cancellous, and palatal cancellous bones. Mean HU values were compared using the Mann-Whitney U test and one-way ANOVA with post-hoc analysis. Results: Cancellous bone density was significantly lower (P ≤ 0.001) in the palatal half than in the buccal half across all three interdental regions. However, there was no significant difference (P = 0.106) between the buccal and palatal cortical bone densities at the site of AMSA injection. No significant difference was observed between the two genders for any of the evaluated parameters. Conclusions: The palatal half of the cancellous bone had a significantly lower density than the buccal half, which could be a reason for the effective diffusion of the anesthetic solution following a palatal injection during the AMSA anesthetic technique.

• 정신신체의학
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• 제30권2호
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• pp.80-98
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• 2022

외상후 스트레스 장애는 다양한 치료들에 대한 치료반응이 좋지 않아, 많은 임상가들에게 큰 도전이 되고 있다. 최근 발간된 여러 임상 진료지침들은 인지처리치료 및 지연노출치료를 포함한 트라우마 초점 정신치료들을 일차 치료로 공통적으로 권고하고 있다. 환자에게 근거에 기반한 치료적 선택지들에 대하여 정보를 제공함으로써 환자와 임상가가 함께 최선의 치료방법을 선택할 수 있도록 하는 것이 중요하며, 이를 위해 인지처리치료의 내용과 근거를 소개하는 것이 본 종설의 목적이다. 인지처리치료의 회기 구성과 내용을 요약하여 소개하고, 외상후 스트레스 장애에 대한 인지처리치료의 효과를 알아본 다양한 연구들을 민간인 집단과 재향군인/현역군인 집단으로 구분하여 제시하였다. 인지처리치료의 탈락율을 낮추고 치료성적을 올리며 치료접근도를 높일 수 있는 방법들 및 외상후 스트레스 장애에 대한 근거중심치료의 활성화를 위한 방안을 토의한다.

• 대한두개안면성형외과학회지
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• 제23권2호
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• pp.89-92
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• 2022

Post-traumatic pseudoaneurysms of internal maxillary artery are rare, but may be life-threatening. When arterial damage leads to pseudoaneurysm formation, delayed intractable epistaxis can occur. We report our experience with the diagnosis and management of a ruptured internal maxillary arterial pseudoaneurysm that was discovered preoperatively in a patient with a zygomaticomaxillary complex (ZMC) fracture. He presented to the emergency room with epistaxis, which ceased shortly, and sinus hemorrhage was observed with a fracture of the posterior maxillary wall. The patient was scheduled for open reduction and internal fixation (ORIF) of the ZMC fracture. However, immediately before surgery, uncontrolled epistaxis of unknown origin was observed. Angiography indicated a pseudoaneurysm of the posterior superior alveolar artery. Selective endovascular embolization was performed, and hemostasis was achieved. After radiologic intervention, ORIF was successfully implemented without complications. Our case shows that in patients with a posterior maxillary wall fracture, there is a risk of uncontrolled bleeding in the perioperative period that could be caused by pseudoaneurysms, which should be considered even in the absence of typical symptoms.

• 동의신경정신과학회지
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• 제33권3호
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• pp.301-316
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• 2022

Objectives: To compare Korean medicine (KM) and traditional Chinese medicine (TCM) psychotherapy for anxiety. Methods: Databases including MEDLINE (via PubMed), EMBASE (via Elsevier), Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, and Oriental Medicine Advanced Searching Integrated System were comprehensively searched. Prospective clinical studies on KM or TCM psychotherapy for patients with anxiety disorder or individuals with elevated anxiety levels published up to August 3, 2022 were reviewed. Psychotherapy was divided into counselling, art therapy, and meditation according to its characteristics. Results: A total of 12 clinical studies were reviewed, including nine randomized controlled trials. The most common disorder investigated was post-traumatic stress disorder. Ten studies used TCM psychotherapy and two used KM psychotherapy. As for differences between TCM psychotherapy and KM psychotherapy, TCM psychotherapy utilized pattern identification in the procedure more actively than KM psychotherapy. In addition, some TCM studies have attempted to directly converge Western psychotherapy (i.e., hypnosis) and Eastern psychotherapy (i.e., Taoin qigong therapy). In the case of KM psychotherapy, there was an attempt to incorporate psychotherapy with Sasang constitutional medicine. Reported effects of TCM psychotherapy and KM psychotherapy on anxiety were positive. Conclusions: Research status of KM psychotherapy and TCM psychotherapy for anxiety was investigated, revealing some of their characteristics, commonalities, and differences. Findings of this review have the potential to provide a clue to the development of conventional KM psychotherapy and new medical technology for KM psychotherapy.

• 대한한의학방제학회지
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• 제30권3호
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• pp.109-121
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• 2022

Objective : This study is conducted to investigate the effect of Astragali Radix on Post Traumatic Stress Disorder(PTSD) induced by the Single Proposed Stress(SPS). Methods : The experiment was conducted with five groups; SAL groups with only saline treatment, SPS group, SPS + ARX25 group, SPS + ARX50 group, and SPS + ARX100 group. After applying SPS, saline and ARX were administered for 14 days to identify the change of body weight, sucrose intake amount, and behavioral changes through Open Field Test(OFT) and Forced Swimming Test(FST). After the behavioral experiment, plasma corticosterone levels, serotonin, norepinephrine and dopamine concentrations were measured by enzyme-linked immunoassay in medical prefrontal cortex, hippocampus, and amygdala. Brain-derived neurotrophic factor(BDNF) in the hippocampus was measured using Reverse Transcription Polymerase Chain Reaction. Results : Weight change has significantly decreased in the SPS group compared to the SAL group(p<0.05). On day 14, the sucrose intake of rats has significantly increased in the SPS + ARX100 group compared to the SPS group(p<0.05). In OFT, the number of staying in the central space has significantly increased in the SPS + ARX100 group(p<0.01). In FST, immobility has significantly decreased in SPS + ARX50 group and SPS + ARX100 group(p<0.05). The concentration of serotonine, dopamine and BDNF expression has increased significantly in SPS + ARX100 group compared to SPS group(p<0.05) Conclusions : In the SPS-induced PTSD experiment, ARX increased sucrose intake and the numbers of crossing in the central zone space in OFT, decreased immobility time in FST, and increased concentration of serotonin, dopamine, and BDNF. It can be postulated that the ARX could be effective for the treatment of PTSD.