• 제목/요약/키워드: preventive psychiatry

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소방 공무원에서 간접 외상이 정신 건강에 미치는 영향 (Effects of Vicarious Trauma on Mental Health in Firefighters)

  • 백준혁;정영은;채정미;명준표;임현우;채정호
    • 대한불안의학회지
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    • 제6권1호
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    • pp.65-70
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    • 2010
  • Objectives : Indirect contact with trauma may occur when a person empathically listens to detailed descriptions, exposing the person to intense emotional pain from trauma victims. Although less severe than direct trauma, indirectly traumatized persons may experience the same fear, rage, and despair as direct trauma victims. This phenomenon has been variously termed vicarious trauma, traumatic countertransference, burnout, compassion fatigue, and secondary traumatic stress. Using a psychiatric symptoms questionnaires, this study investigated the effects of indirect exposure to co-worker's trauma on the mental health of firefighters who had not directly experienced traumatic events in the previous year. Methods : We administered self-report questionnaires, such as the Impact of Event Scale-Revised (IESR) and Alcohol Use Disorder Identification Test (AUDIT), to firefighters working at two fire stations in a metropolitan city. We analyzed 188 of 232 collected surveys, after excluding falsely entered data (28 cases) and questionnaires by directly-traumatized victims (16 cases). Results : Alcohol consumption and posttraumatic stress disorder (PTSD) symptoms, as determined by the AUDIT and IES-R, were significantly higher in the indirectly-traumatized group. The ratio of high-risk members scoring higher than 23 in IES-R was larger in the indirectly traumatized group, although this was not statistically significant. Conclusion : Alcohol consumption was significantly higher in the indirectly traumatized group. This group also included more members at high risk for PTSD. Further research, with a larger group of indirectly traumatized firefighters and ongoing investigation of PTSD development and other psychiatric symptoms, is needed.

재해를 당한 소아청소년에 대한 치료적 접근 (THERAPEUTIC APPROACH FOR CHILD AND ADOLESCENT AFTER DISASTER)

  • 이영식
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제13권1호
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    • pp.24-29
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    • 2002
  • 본고는 최근 미국의 911 사태이후 정신의학 분야에서 관심사로 떠오르고 있는 재해정신의학 (Disaster Psychiatry)에대한 고찰을 통해 국내에서 대형재해 발생시 소아청소년 정신과 의사로서의 일정역할을 모색코자하는 목적의 일환이다. 우선 성인과 달리 소아청소년 재해환자에대한 치료를 다룰 때 어떤점을 고려하여야하는가에대한 연령 발달적 특이성를 살펴보고, 예방프로그램과 소아청소년 특유의 치료법은 무엇인가에대해 살펴보았다. 이를 요약하면 1) 소아는 타인에게 의존해야하는 존재로 부모 혹은 가족의 아이에대한 태도와 지지가 예후 결정에 가장 중요한 요소임으로 가족치료 부모교육의 중요성이 강조되며, 2) 개인치료에서는 인지행동적 요소가 여러 연구 문헌을 통해 가장 효과가 입증된 치료기법이고, 3) 놀이면담치료, fellow victim으로 구성된 집단치료 역시 효과적이며, 4) 1회성 재해를 당한 공포환자의 경우 특수기법인 EMDR(Eye Movement Desensitization and Reprocessing)의 시도가 추천되고, 5) 약물치료의 경우 2차적 혹은 보조치료수단이 되는데 성인에서 시도되는 다양한 약물의 적용이 가능하지만 부작용에대한 주의가 필요하다.

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한국판 아동용 외상 후 증상 보고와 부모용 외상 후 증상 보고에 대한 신뢰도 및 타당도 연구 (Reliability and Validity of the Korean Version of the Child Report of Post-Traumatic Symptoms (CROPS) and the Parent Report of Post-Traumatic Symptoms (PROPS))

  • 이광민;정성훈;이원기;정운선
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제22권3호
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    • pp.169-181
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    • 2011
  • Objectives: The Child Report of Post-traumatic Symptoms (CROPS) and the Parent Report of Post-traumatic Symptoms (PROPS) are screening measures for post-traumatic symptoms in children. The present study aimed to investigate the reliability and validity of the Korean versions of the CROPS and the PROPS. Methods: The Korean versions of the CROPS and the PROPS were administered to a sample of 304 children aged 6 to 15 years old. The internal reliability, test-retest reliability, factorial validity, predictive validity and concurrent validity were evaluated. Results: The reliability of the CROPS and the PROPS was shown to have excellent internal consistency and test-retest correlation. The single factor structure of the PROPS was good and that of the CROPS was borderline acceptable according to confirmatory factor analysis. Other validity measures such as the predictive validity and concurrent validity were also shown to be satisfactory. Conclusion: This study demonstrated that the Korean versions of the CROPS and the PROPS were reliable measures with satisfactory psychometric qualities. Because it takes less than 5 minutes to fill out the CROPS and the PROPS, respectively they can be quick and easy screening scales for assessing post-traumatic symptoms in Korean children.

지역사회 거주 노인의 자살경향성 유병률과 위험요인 (Prevalence and Risk Factors of Suicidality among Community-Dwelling Elderly)

  • 김문범;이광헌;이관;곽경필
    • 생물치료정신의학
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    • 제24권3호
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    • pp.209-217
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    • 2018
  • Objectives : The purpose of this study was to investigate the prevalence and risk factors of suicidality among community-dwelling elderly. Methods : The participants were 2,201 elderly people whose ages were over 65. The participants were asked to complete questionnaires, including Mini International Neuropsychiatric Interview(MINI), module C, Short Geriatric Depression Scale of Korean version(SGDS-K), Korean Geriatric Anxiety Inventory(K-GAI), The Korean Health Status Measure for Elderly V 1.0, Korean version of Mini-Mental Status Examination for Dementia Screening(MMSE-DS). Their sociodemographic factors were investigated. The data were analyzed using the chi-square test and the logistic regression test to examine the relationship between suicidality and participants' risk factors. Results : The prevalence rate of suicidality was 23.3%. In multiple logistic regression, depressive symptoms (OR=3.301, 95% CI : 2.453-4.440), anxiety symptoms(OR=3.289, 95% CI : 2.515-4.303), low physical function (OR=1.606, 95% CI : 1.229-2.098), no spouse(OR=1.571, 95% CI : 1.037-1.690), elderly aged 80 years or older (OR=1.506, 95% CI : 1.094-1.740) were independently associated with suicidality. Conclusion : Suicidality in community-dwelling elderly was quite high, particularly related to depressive symptoms. The results of this study can be useful for development of community-based prevention and management programs for suicidality.

Educational Intervention Based on the Health Belief Model to Modify Risk Factors of Cardiovascular Disease in Police Officers in Iran: A Quasi-experimental Study

  • Saffari, Mohsen;Sanaeinasab, Hormoz;Jafarzadeh, Hassan;Sepandi, Mojtaba;O'Garo, Keisha-Gaye N.;Koenig, Harold G.;Pakpour, Amir H.
    • Journal of Preventive Medicine and Public Health
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    • 제53권4호
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    • pp.275-284
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    • 2020
  • Objectives: Police officers may be at a greater risk for cardiovascular disease (CVD) than the general population due to their highstress occupation. This study evaluated how an educational program based on the health belief model (HBM) may protect police officers from developing CVD. Methods: In this single-group experimental study, 58 police officers in Iran participated in a 5-week intervention based on HBM principles. Outcomes included changes in scores on an HBM scale, time spent on moderate to vigorous physical activity (International Physical Activity Questionnaire), body mass index (BMI), blood lipid profile, blood glucose, and blood pressure. The intervention consisted of 5 HBM-based educational sessions. Follow-up was conducted at 3 months post-intervention. The paired t-test was used to examine differences between baseline and follow-up scores. Results: All aspects of the HBM scale improved between baseline and follow-up (p<0.05), except the cues to action subscale. Self-efficacy and preventive behaviors improved the most. BMI decreased from 26.7±2.9 kg/㎡ at baseline to 25.8±2.4 kg/㎡ at follow-up. All components of the lipid profile, including triglycerides, cholesterol, high-density lipoprotein, and low-density lipoprotein, showed significant improvements post-intervention. Blood glucose and blood pressure also decreased, but not significantly. Nearly 25% of participants who were not physically active at baseline increased their physical activity above or beyond the healthy threshold. Conclusions: A relatively brief educational intervention based on HBM principles led to a significant improvement in CVD risk factors among police officers. Further research is needed to corroborate the effectiveness of this intervention.

새로운 치매 선별검사를 이용한 도시지역 노인의 치매 유병률과 관련요인 (Prevalence and Related Factors of Dementia in an Urban Elderly Population Using a New Screening Method)

  • 신희영;이정애;윤진상;김재민;정은경
    • Journal of Preventive Medicine and Public Health
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    • 제38권3호
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    • pp.351-358
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    • 2005
  • Objectives : Dementia has rapidly increased with the prolongation of life expectancy and aging in Korea. This study was conducted to estimate the prevalence of, and find related factors for, dementia in an urban elderly population, using a newly developed screening method. Methods : Seven hundred and six people, aged over 65 years-old, in Dong district of Gwangju, Korea, were recruited using stratified cluster sampling, and completed Korean version of Geriatric Mental State Schedule B3 (GMS B3-K), the Korean version of the Community Screening Interview for Dementia (CSID-K) and modified 10 word list-learning from the Consortium to Establish a Registry of Alzheimer's Disease (CERAD). Dementia was diagnosed by an algorithm derived from all three of these measures. Results : The crude and age adjusted prevalence rates of dementia were 13.0 and 11.5%, respectively. Age, education, marital status and a history of cerebrovascular disease were identified as factors related with dementia. Conclusions : The new instrument, using the GMS B3-K, CSID-K and modified 10 word list-learning from the CERAD, was considered effective as a community screening and diagnostic tool for dementia. The results of this study can also be used to develop a community-based prevention and management system for dementia in the future.

한국인 주의력결핍 과잉행동장애와 Dopamine Beta Hydroxylase 유전자의 관련성 : 가족기반 연구 및 환자-대조군 연구 (A FAMILY-BASED AND CASE-CONTROL ASSOCIATION STUDY OF THE DOPAMINE BETA HYDROXYLASE GENE POLYMORPHISM IN ATTENTION DEFICIT HYPERACTIVITY DISORDER)

  • 박태원;김붕년;임명호;유희정;강대희;조수철
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제16권1호
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    • pp.54-62
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    • 2005
  • 목적 : 이번 연구는 최근 주목을 받고 있는 dopamine beta hydroxylase 유전자의 Taq I 절단부위 다형성과 주의력결핍 과잉행동장애 발병 간에 어떤 관련성이 있는지를 알아보기 위한 연구이다. 방법 : 주의력결핍 과잉행동장애 아동 106명을 환자군으로 선정하고, 환자군과 성별, 연령별로 빈도짝짓기된 일반 아동 212명을 대조군으로 하는 환자-대조군 연구를 실시했다. 아울러 환자군과 부모를 대상으로 가족기반 연구를 병행했다. 결과 : 환자-대조군 연구에서는 환자군과 대조군 간의 유전자형이나 대립유전자 분포에 있어 유의한 차이를 발견하지 못했다. 그러나 가족기반 연구에서는 대립유전자 Al의 선택 전달이 관찰되었다. 결론 : 이번 연구를 통해 주의력결핍 과잉행동장애와 dopamine beta hydroxylase 유전자의 Taq I 절단부위 다형성 간의 관련성을 부분적으로 확인했으나 이를 뒷받침하기 위해 서는 추가적인 연구가 필요할 것이다.

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한국인 자폐스펙트럼장애와 SLC6A4 유전다형성의 연관 연구 (No Association Study of SLC6A4 Polymorphisms with Korean Autism Spectrum Disorder)

  • 유희정;조인희;박미라;양소영;김순애
    • 생물정신의학
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    • 제16권2호
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    • pp.121-126
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    • 2009
  • Objectives : The serotonin transporter gene(SLC6A4) is one of the most widely studied candidate genes in autism spectrum disorder(ASD), but there have been conflicting results from studies into the association between SLC6A4 and ASD. The aim of this study was to evaluate the association between single nucleotide polymorphisms(SNPs) in the SLC6A4 gene and ASD in the Korean population. Methods : We selected 12 SNPs in SLC6A4 and observed the genotype of 151 Korean ASD trios. We tested the family-based association for each individual polymorphism and haplotype by using the standard TDT method in Haploview(http://www.broad.mit.edu/mpg/haploview/). Results : Through transmission-disequilibrium testing and haplotype analysis, we could not find any statistically significant transmitted allele or haplotype. In addition, a case-control association test with Korean HapMap data did not reveal any statistical significance. Conclusion : Although serotonin-related genes must be considered candidate genes for ASD, we suggest that common SNPs of SLC6A4 are not important markers for associations with Korean ASD.

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아동 성학대 - 개념, 병태생리, 정신과적 휴유증, 치료적 개입 - (CHILD SEXUAL ABUSE - CONCEPT, PATHOPHYSIOLOGY, PSYCHIATRIC SEQUELAE, INTERVENTION -)

  • 김붕년
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제13권1호
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    • pp.47-66
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    • 2002
  • 성학대는 여러 종류의 아동학대 유형들 중 가장 심각한 정서적-인지-행동 상의 휴유증을 남긴다고 알려져 있다. 최근 $4{\sim}5$년간 아동과 청소년에 대한 성폭력과 성학대에 대한 사회적 관심이 국내에서도 크게 늘고 있고, 실제 임상에서도 성학대나 성폭력을 당한 소아-청소년을 자주 접하게 된다. 그러나 아직까지 이들에 대한 적절한 치료와 가이드를 제공하고 있지는 못하고 있는 것 같다. 이에 본 고에서는 성학대의 개념을 고찰하고, 정신병리로 연결되는 병태생리를 폭넓게 고찰하였으며, 성학대로 인한 단기 및 장기 휴유증에 대해 살펴보았고, 성학대 아동에 대한 적절한 초기치료전략과 현재까지의 치료결과에 대한 보고들을 종합하였다. 향후 성학대 및 성폭력에 희생된 아동과 그 부모를 위한 치료프로그램의 개발과 국가적 예방 및 치료사업에 소아-청소년 정신과 의사들의 적극적인 참여를 기대해 본다.

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