• Title/Summary/Keyword: psychiatric disorder

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Current State of Vocational Rehabilitation Program for Individuals with Disabling Mental Illness in Korea (우리나라 정신장애인 직업재활 현황 조사연구)

  • Han, Myung Hun;Kim, Ji-Woong;Kim, Do Yoon;Park, Hye Sun;Park, Hanson;Hwang, Tae-Yeon;Seo, Yongjin;Kim, Seung-Jun;Im, Woo-Young;Lee, Sang Min
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.145-152
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    • 2017
  • Objectives : There has been long lasting trend of deinstitutionalization and public health centered care in management of individuals with disabling mental illness. We aimed to investigate current vocational rehabilitation state and effectiveness of system in korea. Methods : We carried basic survey via telephone and e-mail beforehand to figure out how many and which institutions are operating vocational rehabilitation programs to psychiatric patients. A questionnaire packages were sent to total of 108 institutions in Korea which were operating occupation rehabilitation program. Results : Of 108 institutions, 40.74% were returned with answers. The person in charge of vocational rehabilitation at each institution was mainly mental health social worker(48.8%), and the budget under \1,000,000 was the majority(61.5%) among surveyed institutions. The most commonly used vocational rehabilitation programs was case management(23.1%), followed by psychosocial rehabilitation program(21.2%), and on-the-job training(17.9%). The most effective program was case management(27.4%), followed by psychosocial rehabilitation program(19.8%), on-the-job training(17.9%). The main barrier of occupation rehabilitation to be conducted widely was 'worries about being excluded from beneficiary of National Basic livelihood Protection Act'. Conclusions : Our results suggest that, in spite of high demand in vocational rehabilitation programs, government financial support is still lacking.

PRELIMINARY STUDY OF MENTAL REPRESENTATIONS OF PRESCHOOL CHILDREN EXPERIENCING SINGLE, SEVERE TRAUMA (심한 정신적 외상 경험을 한 학령 전기 아동의 정신적 표상에 대한 예비연구)

  • Eon, So-Yong;Song, Won-Woung;Oh, Kyung-Ja;Choi, Eui-Gyum;Shim, Eun-Ji;Shin, Yee-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.1
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    • pp.61-74
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    • 2004
  • Objectives:This study was performed to introduce a psychoeducational family therapy model for the families of schizophrenic patient and to investigate the effect of this model on the changes in coping style and depressive symptoms of the family members, and in perception of emotional support by families and depressive symptoms of patients. Methods:Nine preschool children, 3-5 years old, experiencing physical injuries caused by attack from a psychotic patient at kindergarten, were evaluated for psychological assessments;Intelligence test, MSSB(MacArthur Story-Stem Battery), H-T-P test(House-Tree-Person test). And their parents completed rating scale, KPI-C(Korean Personality Inventory for Children about children’s psychological conditions). Results:With respects to the contents and emotional reactions of MSSB, 9 preschool children showed generally high levels of anxiety, depression, avoidance, aggression, probably related to the traumatic experiences. Even though children couldn't verbally report directly about their traumatic experiences, in both MSSB, structured play narrative assessment tool, and HPT, free drawing and association test, they demonstrated psychiatric problems through reenactment plays, regardless of clinical diagnoses. Conclusion:Present study allowed us the chance to see beyond the outer pathological behaviors of PTSD in preschool children, through deeper evaluations of their mental representation. These preliminary data suggest deep understanding of internal representation would be of help for thorough evaluations and treatment plan for preschool children, experiencing severe trauma.

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Low Frequency Noise Induces Stress Responses in the Rat (흰쥐에서 저주파소음에 의한 스트레스 반응)

  • Choi, Woong-Ki;Lee, Kyu-Sop;Joung, Hye-Young;Lee, Young-Chang;Sohn, Jin-Hun;Lee, Bae-Hwan;Pyun, Kwang-Ho;Shim, In-Sop
    • Science of Emotion and Sensibility
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    • v.10 no.3
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    • pp.411-418
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    • 2007
  • Exposure to low frequency noise(LFN) can lead to vibroacoustic diseases(VADs), which include a systemic disease with lesions in a broad spectrum of organs and a psychiatric condition. It is known that VAD is an established risk factor for the development of many psychological conditions in humans and rodents, including major depression and anxiety disorder. The present study investigated the effects of LFN on neuronal stress responses in the rat brain. The neuronal expression of the proto-oncogene c-fos in the paraventricular nucleus(PVN) of the hypothalamus and tyrosine hydroxylase(TH) in the LC was observed. The immunocytochemical detection of the Fos protein and TH has been used as a marker of neuronal activation in response to stress. In addition, corticosterone concentration was evaluated by using an enzyme-linked immunosorbent assay(ELISA). The LFN groups were exposed to 32.5Hz and 125Hz of noise(4hr/day for 2days). The numbers of c-fos and TH-immunoreactive cells in the PVN and LC were significantly increased in the LFN groups(32.5Hz and 125Hz) compared to the normal group. Corticosterone concentration in plasma was also increased in LFN groups. The present results demonstrated that exposure with LFN produced a pronounced increase in expression of c-Fos and TH in stress-relevant brain areas. These results suggest that the neural characteristics involved in LFN are similar to those activated by typical processive stressors. These results also suggest that the central and peripheral activations by LFN may be related to LFN-related negative behavioral dysfunctions such as VADs.

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Study of Radiological Approach to Treat a Chronic Constipation (만성변비환자의 방사선학적 접근방법에 관한 고찰)

  • Yoon, Seok-Hwan
    • Journal of radiological science and technology
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    • v.27 no.3
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    • pp.5-12
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    • 2004
  • I. Introduction : The constipation is one of the common gastrointestinal symptoms seen in the clinical practice. When people come to the clinic complaining of the constipation, it is generally one of the cases of infrequent, painful or difficult evacuation as well as the hardened feces and unsatisfactory evacuation sense. Since the constipation is heavily influenced by dietary habit as well as the social and medical environment, the diagnostic radiology is useful to establish the objective and standardized definition in consideration of those various factors before diagnosis and treatment of the constipation patient. This paper describes the study of such diagnosis. II. Main Subject : Testing of CTT (colon transit time) is key study of the colon performance. CTT is very helpful in classifying the pathologic physiological types and defining the treatment plan for the chronic constipation. The study methods include using the radipaque marker, multiple marker technique and scintigraphic measurement. The defecography is the functional radiologic examination a that provides not only the anatomical information of anorectal but also performance of the pelvic floor and rectal change during evacuation. Study of dynamic movement of the anorectal during evacuation is helpful for diagnosis and treatment planning as well as follow-up testing for the constipation patient. One of the issues essential for the case history is the thorough observation of whether the patient shows the psychic psychological symptoms such as the behavior disorder or emotional disturbance. In that case, the decision must be made whether or which type of medication is needed for such psychiatric problem. III. Conclusion : The main causes of the constipation are insufficient intake of fiber or liquid. The key objective of such tests is to check etiology of the constipation. In general, the radiological examination does not provde the colon or anorectal performance information. It is envisaged that this study will provide the information to decide the testing and treatment plans and predict the prognosis of the patient by classifying the pathologic physiological types.

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The Side Effects and Correlates of OROS-Methylphenidate in the Treatment of Children and Adolescents with ADHD (ADHD 환자에 대한 OROS-Methylphenidate 약물치료의 부작용과 관련요인들에 대한 연구)

  • Kim, Jin-Sun;Kim, Bung-Nyun;Cho, Soo-Churl;Shin, Min-Sup;Yoo, Hee-Jeong;Kim, Jae-Won;Song, Dong-Ho;Shin, Dong-Won;Joung, Yoo-Sook;Cheon, Keun-Ah;Shin, Yee-Jin;Kim, Ye-Ni;Ha, Eun-Hye
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.21 no.2
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    • pp.63-71
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    • 2010
  • Objectives : The aim of this study was to investigate the effect of the clinical and demographic variables such as body weight, dosage, family history of attention-deficit hyperactivity disorder (ADHD), and psychiatric co-morbidity on the side-effects of OROS-Methylphenidate (OROS-MPH), and to evaluate the relationship between drug response and side effect severity. Methods : A total of 144 children (ages 6-18) with diagnosed ADHD were treated with OROS-MPH. Children were examined at baseline and after 1, 3, 6, 9, and 12 weeks of each treatment condition. The stimulant drug side effect rating scale (SERS), pulse rate, systolic blood pressure, diastolic blood pressure, and electrocardiogram (ECG) were evaluated to assess side effect profiles. Changes in these parameters from baseline were examined and analyzed. Results : Anorexia (30.95%) and insomnia (13.10%) were the most commonly reported side effects during this study. Insomnia and loss of appetite score increased at one week follow-up, but was sustained or decreased as treatment progressed. Small but significant increases in pulse rate and diastolic blood pressure were observed during treatment ; however, no clinically meaningful changes in ECG parameters were noted during the study. Low body weight, high dosage of OROS-MPH, and family history of ADHD were associated with cardiovascular side effect. In contrast, there was no significant relationship between OROS-MPH treatment response and the severity of side effect and no difference resulted between the responder and non-responder groups with respect to OROS-MPH dosage in the 12 weeks of follow-up. Conclusion : To the best of our knowledge, this study is the first Korean study to investigate comprehensive side effect profiles and their correlates in OROS-MPH treatment for ADHD children. OROS-MPH was well tolerated with no clinically significant side effects during the treatment period. In conclusion, low body weight, high dosage of OROSMPH, and family history of ADHD could be used as predictive factors in increasing pulse rate and blood pressure.

Changes in prevalence of obesity according to gender in Korea adults: Using a population-based Korea National Health Check-up Database, 2011-2013 (우리나라 성인의 성별에 따른 비만유병률의 변화 : 국민건강보험 건강검진(2011-2013) 자료 이용)

  • Choi, Oh-Jong;Cho, Sung-Il
    • Korean Public Health Research
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    • v.44 no.4
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    • pp.87-97
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    • 2018
  • Background: Recently, the prevalence of obesity (body mass index [BMI] ${\geq}25kg/m^2$) has been increasing rapidly worldwide over a short period. In Korea, the prevalence of obesity has also increased rapidly due to the rapid socio-economic development and lifestyle changes, with differing patterns according to gender. This study aimed to compare the change in obesity prevalence according to gender among the adult population in Korea using representative data, the National Health Check-up Database (NHCD), to follow-up individuals who had undergone checkups during both years in Korea (2011~2013). Methods: To analyze the changes in obesity prevalence in the recent two years, data regarding men and women who had undergone health check-ups in both two years (2011, 2013) were extracted. The final study population comprised 144,934 persons: 83,604 (58%) males and 61,330 (42%) females. Chi-square test within a univariate analysis, and the level of factor difference was verified with t-test, one-way ANOVA and multiple comparison. Results: In 2011, one out of three participants was obese (BMI ${\geq}25kg/m^2$; male, 37.7%; female, 27.3%) and more than half of the subjects were overweight (BMI ${\geq}23kg/m^2$; male, 65.6%; female, 50.4%) requiring obesity management. For the two years, the BMI of the participants significantly increased (p < .0001) and the prevalence of obesity increased among both males and females. The prevalence of obesity was higher among both genders with a longer duration of smoking, more smoking, family history of hypertension, and family history of diabetes. However, residence, income level, drinking status, psychiatric disorder, disability status and severity of disability were the opposite gender. Conclusion: In the analysis of data, the prevalence of obesity among both men and women was increasing. The degree of change in the prevalence of obesity among men and women was different in each variable. Thus, it will need to consider gender in developing health policies for obesity mediation and to provide integrated healthcare and management for those people.

A Study on the Characteristics and Consultation Request Type of Inpatients Referred for Depressive Symptoms (우울 증상으로 의뢰된 입원환자의 임상적 특징 및 자문 의뢰 형태에 관한 연구)

  • Yoon, Nara;Ryu, Seung-Ho;Ha, Jee Hyun;Jeon, Hong Jun;Park, Doo-Heum
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.1
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    • pp.34-41
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    • 2021
  • Objectives : The purpose of this study is to investigate the characteristics of depressive patients who admitted to general hospital. We examined the clinical characteristics of patients who were referred to the Department of Psychiatry as depressive symptoms, according to the type of consultation request, and comparing 'with re-consultation' and 'without re-consultation' groups. Methods : We performed a retrospective chart review of 4,966 inpatients who were referred to the Department of Psychiatry from August 2005 to December 2011. Results : For about 6 years, among the inpatients referred for psychiatric consultation, a total of 647 patients were referred for depressive symptoms, accounting for 13.82% of the total consultations. The average age of depressive patients was 58.6 years, which was higher than the average of 56.4 years of overall patients. Among the depressive patients, 275 patients were included in 'with re-consultation' group and there was no statistically significant difference when comparing 'with re-consultation' group and 'without re-consultation' group. However, there was a difference in the tendency of the two groups in the type of consultation request. 'With re-consultation' group was in the order of frequency of consultation type 3-2-1, whereas the 'without re-consultation' group was in the order of frequency of consultation type 2-3-1. Conclusions : The group of inpatients who were referred for depressive symptoms in general hospital showed the largest proportion of the group of patients referred to the Department of Psychiatry. 'With re-consultation' group had a higher rate of re-consultation due to the occurrence of new symptoms after hospitalization compared to 'without re-consultation' group. Therefore, doctors in each department and psychiatrists should pay attention to the depressive symptoms of inpatients and actively discuss treatment plans to improve the quality of medical services, identify risk factors, and make efforts to intervene early if necessary.

The Study of the Two-Dimensional Suicidal Type Based on Psychological Autopsy: A Focus on Suicidal Behaviors and Suicidal Risk Factors (한국형 심리부검 기반 이차원적 자살유형 연구: 자살행동과 자살위험요인을 중심으로)

  • Sung-pil Yook;Jonghan Sea
    • Korean Journal of Culture and Social Issue
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    • v.29 no.1
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    • pp.75-99
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    • 2023
  • The current study aimed to explore the suicidal behaviors and risk factors of completed suicides using psychological autopsy and use them as index variables to classify suicidal types. In addition, this study looked into the influential factors that affect each suicidal type. related to suicidal behaviors and suicidal risk factors by psychological autopsy. In addiction, the distinctions among the classes were analyzed. For this, psychological autopsies were conducted on the families and the close ones of 128 completed suicides. Then, the index variables were finally chosen for classifying suicidal types. The selected index variables for suicidal risk factors were mental disorders, suicide/self-harm, significant changes in physical appearance, marital conflict, adjustment and relationship issues at work/school, unemployment/layoff, jobless status and serious financial problems. The selected index variables for suicidal behaviors were expressing their suicidal attempts, writing suicidal notes, asking for help, the time/place/method of suicidal behavior, past suicidal/self-harm experience and the first person who witnessed the suicide. The Latent Class Analysis(LCA) and the 3-step method were used for classifying suicidal types. Then external variables(financial changes, cohabitation, existence of stressors, changes in stress level or relationships and family members with mental disorder/alchohol problems/ physical disorders, and work/school stisfaction) were applied for distinguishing classes. As a result, 5 classes(financial problems, adjustment problems, complex problems, psychiatric problems, and response to event[s]) were revealed on suicidal behaviors and 3 classes(residence- suicidal attempt- found by family, nonresidence- nonsuicidal attempt- found by acquaintances, residence- nonsuicidal attempt- found by family) were presented on suicidal risk factors. External variables such as gender, marital status, cohabitation, changes in relationships significantly differentiated among the 3 classes. Especially, class 3(residence- nonsuicidal attempt- found by family) tended to cohabit with others, were married, and had a significantly high level of interpersonal conflicts. When comparing the 5 classes of suicidal risk factors, auxiliary variables such as economic changes, cohabitation, stress, relationship changes, and family-related problems, and school/work satisfaction significantly differentiated the 5 classes. Especially class 3 (complex problems) experienced comparatively less family-related problems, but showed an aggravating level of personal stress. Suicial prevention strategies should be provided considering the characteristics of each class and the influential factors.