• 제목/요약/키워드: psychiatric factor

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아동기 대인관계 외상, 정신 증상의 복잡성 및 해리의 매개 효과 (The Association Between Childhood Interpersonal Trauma and Psychiatric Symptom Complexity, and the Mediating Impact of Dissociation)

  • 김예슬;김석현;김대호;김은경;김지영;최나연
    • 대한불안의학회지
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    • 제18권2호
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    • pp.72-79
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    • 2022
  • Objective : Any traumatic event can be a risk factor, for subsequent mental disorder. However, childhood trauma, especially in interpersonal nature, is associated with later development of complex symptom patterns. This study examined the role of dissociation as a mediator between childhood trauma and symptom complexity. Methods : A pooled data of 369 psychiatric outpatients at a university-affiliated hospital was analyzed for descriptive statistics, group differences, and bivariate correlation analysis to verify a structural model. The questionnaires included the Symptom Checklist-90-Revised, the Trauma History Screen, the Dissociative Experiences Scale-Taxon, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. Results : When other trauma variables were controlled, childhood interpersonal trauma had significant correlation with symptom complexity (r=0.155, p=0.003). Among the paths analyzed, that of childhood interpersonal trauma and dissociation showed the greatest impact on symptom complexity (b=9.34, t=5.75, p<0.001). Based on the significance of the indirect impact, the results suggest a complete mediation impact of dissociation on symptom complexity. Conclusion : This study validated that childhood interpersonal trauma impacts symptom complexity, through the sequential mediating impact of dissociation. Thus, clinicians should understand childhood interpersonal trauma, dissociation, and symptom patterns in a complex and interacting mode, and develop effective pertinent treatment strategies.

전두측두엽 치매 (Frontotemporal Dementia)

  • 전병선;박준혁
    • 생물정신의학
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    • 제23권3호
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    • pp.69-79
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    • 2016
  • Frontotemporal dementia (FTD) is a degenerative disease characterized by the selective frontal and temporal lobe atrophy, and progressive deficits in behavior, executive function, or language. The prevalence and incidence of FTD are 15-22/100000 and 2.7-4.1/100000, respectively, in midlife. Hereditary is an important risk factor for FTD. Although there is some controversy regarding the further syndromatic subdivision of the different types of FTD, FTD is clinically classified into behavioral variant of frontotemporal dementia, semantic dementia and progressive nonfluent aphasia. FTD can be misdiagnosed as many psychiatric disorders because of similarity of the prominent behavioral features. Advances in clinical, imaging, and molecular characterization have increased the accuracy of FTD diagnosis, thus developing for the accurate differentiation of these syndromes from psychiatric disorders. We also discuss about therapeutic strategies for symptom management of FTD. Medications such as serotonin reuptake inhibitors, antipsychotics, and other novel treatments have been used in FTD with various rates of success. Further advanced research should be directed at understanding and developing new diagnostic and therapeutic modalities to improve the FTD patients' prognosis and quality of life.

간호대학생의 대인관계, 비합리적 신념 및 사회적 지지 간의 관계 (Associations of Interpersonal Relations with Irrational Beliefs and Social Supports among Nursing Students)

  • 이은주;이수정
    • 정신간호학회지
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    • 제27권4호
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    • pp.313-320
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    • 2018
  • Purpose: The purpose of this study was to identify the associations of interpersonal relations with irrational beliefs and social supports among nursing students. Methods: Subjects were 149 nursing students attending a university in C city. The data were collected in June, 2018 using questionnaires. The collected data were analyzed by descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient, and multiple regression with the SPSS 23.0 program. Results: There were statistically significant differences by the level of interpersonal relations according to gender (t=3.65, p<.001) and major satisfaction (t=5.04, p=.008). Also, interpersonal relations showed a significant negative correlation with irrational beliefs (r=-.24, p=.003) and a significant positive correlation with social support (r=.44, p<.001). The influencing factor of interpersonal relations were social supports, gender, irrational beliefs and major satisfaction. These factors explained 38.2% of interpersonal relations. Conclusion: Our study finidngs support developing educational and professional training with intepersonal relationships to improve social support as a prospective health care provider.

The Korean Repeatable Battery for the Assessment of Neuropsychological Status-Update : Psychiatric and Neurosurgery Patient Sample Validity

  • Park, Jong-Ok;Koo, Bon-Hoon;Kim, Ji-Yean;Bai, Dai-Seg;Chang, Mun-Seon;Kim, Oh-Lyong
    • Journal of Korean Neurosurgical Society
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    • 제64권1호
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    • pp.125-135
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    • 2021
  • Objective : This study aimed to validate the Korean version of the Repeatable Battery for the Assessment of Neuropsychological Status Update (K-RBANS). Methods : We performed a retrospective analysis of 283 psychiatric and neurosurgery patients. To investigate the convergent validity of the K-RBANS, correlation analyses were performed for other intelligence and neuropsychological test results. Confirmatory factor analysis was used to test a series of alternative plausible models of the K-RBANS. To analyze the various capabilities of the K-RBANS, we compared the area under the receiver operating characteristic (ROC) curves (AUC). Results : Significant correlations were observed, confirming the convergent validity of the K-RBANS among the Total Scale Index (TSI) and indices of the K-RBANS and indices of intelligence (r=0.47-0.81; p<0.001) and other neuropsychological tests at moderate and above significance (r=0.41-0.63; p<0.001). Additionally, the results testing the construct validity of the K-RBANS showed that the second-order factor structure model (model 2, similar to an original factor structure of RBANS), which includes a first-order factor comprising five index scores (immediate memory, visuospatial capacity, language, attention, delayed memory) and one higher-order factor (TSI), was statistically acceptable. The comparative fit index (CFI) (CFI, 0.949) values and the goodness of fit index (GFI) (GFI, 0.942) values higher than 0.90 indicated an excellent fit. The root mean squared error of approximation (RMSEA) (RMSEA, 0.082) was considered an acceptable fit. Additionally, the factor structure of model 2 was found to be better and more valid than the other model in χ2 values (Δχ2=7.69, p<0.05). In the ROC analysis, the AUCs of the TSI and five indices were 0.716-0.837, and the AUC of TSI (AUC, 0.837; 95% confidence interval, 0.760-0.896) was higher than the AUCs of the other indices. The sensitivity and specificity of TSI were 77.66% and 78.12%, respectively. Conclusion : The overall results of this study suggest that the K-RBANS may be used as a valid tool for the brief screening of neuropsychological patients in Korea.

20대 한국 직장인의 음주 심각도에 대한 직무 스트레스와 BDNF 유전자 다형성의 역할 (The Role of Job Stress and Brain-Derived Neurotrophic Factor Gene Polymorphism on the Severity of Alcohol Drinking in Korean Office Workers in Their Twenties)

  • 김보아;이상익;김시경;신철진;손정우;홍주봉;남영우;주가원
    • 생물정신의학
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    • 제19권2호
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    • pp.91-98
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    • 2012
  • Objectives : The aim of this study was to examine the effects of brain-derived neurotrophic factor (BDNF) genetic polymorphism and job stress on the severity of alcohol drinking. It was hypothesized that individuals with the Met/Met BDNF genotype would be more vulnerable than those carrying the Val allele. Methods : Participants were 133 healthy Korean adults (mean age $28.2{\pm}1.1$). Job stress and the severity index of drinking were investigated through self-reported questionnaires. BDNF (rs6265) gene was genotyped. Results : There was no significant association between job stress and the severity of alcohol drinking. Although the severity of alcohol drinking was not associated with BDNF genetic polymorphism, there was a significant difference in men according to genotype and job stress. Men with homozygous BDNF Met allele were more severe in alcohol drinking when job stress was high, less severe in alcohol drinking when job stress was low than those carrying the Val allele (F = 4.47, p = 0.038). Also higher level of job stress was correlated with higher severity of alcohol drinking in men homozygous for BDNF Met allele (rs = 0.620, p = 0.005). Conclusions : These findings suggest the possibility that Met allele could have differential susceptibility, with men homozygous for BDNF Met allele being more susceptible to both more adverse and less adverse environmental influences.

병원과 지역사회에 근무하는 정신보건간호사의 전문직 자아개념 (Professional Self-concept of Psychiatric Mental Health Nurse Practitioners in Hospitals and Public Health Centers)

  • 양수;유숙자
    • 한국보건간호학회지
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    • 제15권2호
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    • pp.351-362
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    • 2001
  • This study was conducted to investigate and compare the degree of professional self -concept (PSC) of the psychiatric mental health nurse practitioners (PMHNP) in hospitals and public health centers and to identify the factors predicting PSC of them, in order to provide basic data for developing PSC increasing program PSC. The 355 PMHNP were sampled from the university or general hospitals. mental hospitals, community mental health centers and public health centers across the country. The scales used in this study were PSCNI by Arthur (1990), PSI by Heppner & Petersen (1982) and the Index of work satisfaction by Slavitt et al. (1978). The results of the study were as follows : 1. The average item score of PSCNI of PMHNP in hospitals was $2.83\pm0.27$, and that of PMHNP in public health centers was $2.76\pm0.28$. There was significantly different between two groups (p=0.0202) 2. A comparison of the scores for the dimensions of the PSCNI were as follows ; the mean item score of professional practice of nurses in hospital was $2.90\pm0.30$, and that in public health centers was $2.83\pm0.35$. There were significant differences between two groups in the scores of professional practices (p=0.0315), leadership (p=0.0071) and skills (p=0.0231). 3. There were significant differences between two groups according to education (p=0.0057) with no significant interaction effect of group and education. 4. Job satisfaction (JS) was the highest factor predicting PSC of PMHNP in hospitals $(34.5\%)$, and problem solving inventory score (PS) was the highest factor predicting PSC of PMHNP in public health centers $(33.6\%)$. JS and PS accounted for $42.6\%$ in PSC of PMHNP in hospitals. and PS, JS, age, marital status, religion, and career accounted for $57.6\%$ in PSC of PMHNP in public health centers. In the light of these results. to gam the professional self-concept. nurses should be educated continuously through role modeling in clinical nursing and research. Also, nurse educators and administrators need to develop programs and policies to increase professional self-concept of nurses, particularly of community PMHNP.

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Relationship between BrACs and BACs of Healthy Koreans for BAIIDs

  • SeungHwan Yi;BeomWoo Nam;Jeong-seok Seo
    • 센서학회지
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    • 제33권1호
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    • pp.1-6
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    • 2024
  • This study aims to suggest the partition ratio (Q-factor) of healthy Koreans and the comparison results of breath alcohol concentration (BAC) measurements using two methods (photoacoustic and electrochemical methods) for developing breath alcohol ignition interlock devices (BAIIDs). Given the relationship between BACs and BrACs and the Q-factor, the alcohol metabolism of healthy Koreans (96 males and 91 females) is revealed for understanding the digestion of alcohol and surveying the fundamental data of alcohol-related problems, CO2 concentrations vs. alcohol concentrations, and the performance of alcohol sensors in the marketplace. The average Q-factor of healthy Korean males and females are 1,913 (95% confidence interval from 1,889-1,937) and 1,991 (95% confidence interval from 1,945-2,036). Photoacoustic measurements could be applied to predict the BACs of drinkers, which is confirmed by the Bland-Altman plots presented in this study. The biases based on the partition ratios (Q=1,913 and Q=1,991) in the Bland-Altman plots were -0.0004% (95% CI from -0.0011 to +0.0003% for males) and -0.0017% (95% CI from -0.020 to +0.017% for females).

정신건강의학과 환자들의 우울 및 불안이 삶의 만족도에 미치는 영향 : 유머양식의 조절효과 (The impact of depression and anxiety on life satisfaction in psychiatric patients : Moderating effect of humor style)

  • 김근향;조영은
    • 한국융합학회논문지
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    • 제7권6호
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    • pp.125-132
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    • 2016
  • 전통적으로 유머는 정신건강의 지표로 여겨졌으나 유머양식에 따라 긍정적 또는 부정적 기능을 한다는 연구들이 보고되고 있어 유머의 양식과 역할에 대한 연구의 필요성이 크다. 본 연구에서는 유머의 역할 중에서도 정신병리로 인한 정신적 웰빙 저하에 대한 완충효과에 주목했고 정신건강의학과 환자들에게 흔한 증상인 우울과 불안이 삶의 만족도를 낮추는 데 어떤 양식의 유머가 완충효과를 가지는지 검증하고자 했다. 이를 위해 101명 환자들의 유머양식, 삶의 만족도, 우울, 불안 자료를 상관분석한 뒤 위계적 회귀분석을 통해 유머양식의 조절효과를 분석했다. 그 결과, 자기고양적 유머가 우울과 불안 모두에서 삶의 만족도에 유의한 조절효과를 가졌고 친화적 유머는 우울과만 유의한 상호작용을 보였다. 따라서 정신건강의학과 환자들에게 긍정적 유머가 우울과 불안 증상으로 인한 정신적 웰빙 저하에 보호요인으로 작용할 수 있으며 특히 자신을 고양시키는 유머 사용이 삶의 만족도를 높이는데 효과적임이 시사되었다. 나아가 본 연구는 비록 정신병리를 겪고 있는 정신건강의학과 환자라 할지라도 긍정적 유머를 사용함으로써 통합적이고 융합적인 의미에서의 적응 가능성을 생각해 볼 수 있게 한다.

응급실 기반 자살 시도자 사후 관리사업의 등록률에 영향을 미치는 인자 (The Factors Affecting the Registration Rates for Emergency Department Based Post-suicidal Care Program)

  • 이준철;강형구;김창선;오재훈;임태호;안동현;이정임;박민희;김경희
    • 대한임상독성학회지
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    • 제13권1호
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    • pp.25-32
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    • 2015
  • Purpose: The aim of this study was to investigate the independent factors associated with the registration rate for the community-based post suicidal care program in the emergency department (ED). Methods: This prospective observational study was conducted between March and December 2013 at the academic ED at the tertiary urban hospital. During the study period, the pre-designed registry was recorded. The variables examined included the following: patients' demographic data (Sex, age, address, type of insurance, marital status, level of education, and history of previous psychiatric disease), suicide-related data (suicidal methods, combined drink of alcohol and number of previous attempts), and management-related data (disposition at ED, physician's training level, etc.). Univariated and multivariated logistic regression analyses were performed for identification of factors affecting the registration rate for the community-based post suicidal care program. Results: A total of 163 suicides were included during the study period. Of these, 33 (20.2%) patients were registered in the post-suicide care program. Factors including a patient's address (OR: 14.92, 95% CI: 3.606-61.711), immediate intervention by psychiatric healthcare center (OR: 5.05, CI: 1.688-15.134), admissions in hospital (OR: 3.69, CI: 1.286-10.605), and history of previous psychiatric disease (OR: 3.52, CI: 1.216-10.201) showed significant association with registration for the program. Conclusion: The community-based post-suicidal care program, which is available 24 hours a day, should be operated in each district in order to increase the registration rate. Emergency physicians should actively consider the inpatient treatment program for suicidal patients and strongly recommend registration to the program, particularly for patients without previous history of psychiatric disease.

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불안 장애에서 벡우울척도의 요인구조 (Factor Structure of the Beck Depression Inventory in Anxiety Disorder)

  • 양현주;김대호;장은영;한창우;박용천
    • 대한불안의학회지
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    • 제7권1호
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    • pp.16-21
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    • 2011
  • Objective : Depressive symptoms often coexist with other anxiety disorder symptoms. Furthermore, an anxiety disorder that is comorbid with a depressive disorder results in more severe symptoms and a poorer outcome prognosis. To understand the construct of depressive symptoms in anxiety disorder, this study investigated the factor structure of the Beck Depression Inventory among outpatients with anxiety disorders. Methods : All data were from psychiatric department outpatients at a university-affiliated hospital. We conducted a principal component analysis using data from 194 outpatients with DSM-IV anxiety disorders and calculated goodness-of-fit-indices. Results : Exploratory factor analysis revealed a four factor structure--Cognitive-affective symptoms (Factor 1), Somatic symptoms (Factor 2), Self-reproach (Factor 3), and Hypochondriasis/indecisiveness (Factor 4)--and a 57% total variance. This four-factor model demonstrated an acceptable level of model fit, and it fit better than did a three-factor solution from the literature on depressive disorder. Conclusion : This study's results suggest a difference in the construct of self-reported depressive symptoms in anxiety disorders. These findings also support a dimensional approach to studying anxiety and depression. Further studies may benefit from including comorbid depressive disorder and its influence on anxiety disorders.