• 생물정신의학
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• 제6권2호
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• pp.253-258
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• 1999

The fluoxetine is one of the most frequently prescribed drugs for the treatment of depression and obsessive-compulsive disorder(OCD). This has been known as one of the most safest medication. But since the advent of this drug, there have been several reports of side effects-the mania and suicidal ideation-encountered during coadministration of fluoxetine with or without other psychotropic drugs. We experienced a case of 20 years old male OCD patient who developed into abrupt manic state and also was preoccupied with intense suicidal ideation following fluoxetine use. He was a only child in his family and his father had a history of alcoholism about 15years ago. Our patient's obsessive-compulsive symptoms have been occured since puberty. His OCD symptoms and anxiety were aggravated since joining the army. Beside these facts, we could not find any other psychiatric history such as depressive disoder and bipolar disorder. We used the fluoxetine starting dosage of 20mg and increased to 40mg at second week. About 3 weeks after the treatment, he developed sudden manic symptom and more aggravated suicidal ideation without any OCD symptoms. He felt vitalized and energetic without having enough sleep and food. These symptoms were ceased over two weeks by stopping medication. Up to this point, the reason why fluoxetine induces mania and suicidal preoccupation is unclear. But somehow the fluoxetine has effects on serotonin receptor and serotonin-dopamine regulations, thus we could make an assumption that fluoxetine can induce mania, extrapyramidal symptoms(EPS) and suicidal ideation in some part of the serotonin unbalanced patients. We think this would be the first report to remark on fluoxetine's suicidal and manic side effects in Korea. So here we present the case with the summary of reviewed articles.

• Annals of Clinical Neurophysiology
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• 제11권2호
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• pp.48-53
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• 2009

Background: Bell's palsy produces a complex problem that involves not only facial motor weakness, but also psychiatric issues. However, the relationship between facial neuromotor system impairment and psychological adjustment has not been well understood. Methods: We have performed psychological evaluations in patients with acute unilateral Bell's palsy within 2 weeks after onset. Thirty patients with Bell's palsy (10 men, 20 women) were included, who were diagnosed by neurologic examination, electrophysiologic study and/or brain MRI. We measured facial motor scale of impairment (House-Brackmann, HB scale) and psychosocial adjustment [Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI)] at the time of initial presentation and 1 month after diagnosis. Results: The age of the enrolled patients ranged from 16 to 80 years. The mean grade of initial and follow up HB scale were 3.87 (SD: 0.63, range 2~5) and 1.77 (SD: 1.10, range 1~5). The mean score of initial and follow up BAI, BDI were 11.93 (range; 0 to 47, SD: 9.65, very low anxiety), 14.73 (range; 0 to 41, SD: 9.21 minimal depression) and 7.5 (range; 0 to 36, SD: 8.58, very low anxiety), 9.33 (range; 0 to 30, SD: 8.19 minimal depression). There was positive correlation between improvement of HB scale and improvement of BAI and BDI score. Conclusions: Bell's palsy is associated with the psychological problems such as depression and anxiety, and the improvement of motor symptom is associated with the improvement of these psychological problems.

• 대한한방소아과학회지
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• 제28권3호
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• pp.1-16
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• 2014

Objectives The purpose of this study is to investigate the incidence and clinical features of adverse events associated with herbal medicine, and to analyze their causality and severity. Methods This study was carried out from 159 children and adolescents who took herbal medicine in the Department of Pediatrics, ${\bigcirc}{\bigcirc}$ Korean Medical Hospital from december, 2013 to april, 2014. The data was collected by survey in person or telephone. The World Health Organization (WHO)-Uppsala Monitoring Center (UMC) criteria was used to analyze causality for each adverse events. Results 1. 207 cases were surveyed from 159 children and adolescents who took one or more kinds of herbal medicine. 2. A total of 12 general adverse events (5.8%) were reported from the study. Among these adverse events, 8 cases (3.9%) were associated with herbal medicine. 3. Gastro-intestinal system disorders were most frequently reported (70%) as adverse events, which is followed by psychiatric disorders (15%), skin and appendages disorders (10%), urinary system disorders (5%). 4. The most common clinical symptom was abdominal pain (20%), followed by diarrhea (15%), loose stools (10%), vomiting (10%) and borborygmus (10%). 5. The severity of adverse drug reactions was mostly mild (87.5%), and moderate (12.5%). There was no severe case. Conclusions The adverse events from herbal medicine on children and adolescents were mostly minor, most of them could continue herbal medicines.

• 생물정신의학
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• 제22권4호
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• pp.216-222
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• 2015

Objectives The principal aim of the present study was to investigate the characteristic depressive symptoms in patients with social anxiety disorder (SAD) and panic disorder in comparison to patients with depressive disorder. Methods This study included 132 patients with SAD, 128 panic disorder and 64 depressive disorder (major depressive disorder, dysthymia etc.) patients without comorbid psychiatric disorders. The Beck Depressive Inventory (BDI) is used to measure depressive symptoms. We divided BDI into three categories originally described by Shafer AB, including negative attitude toward self, performance impairment, and somatic symptoms. We compared the depressive symptoms of SAD, panic disorder and depressive disorder by using ANOVA. Results Negative attitude toward self was noticeable in SAD (SAD $0.54{\pm}0.23$, panic disorder $0.41{\pm}0.17$, depressive disorder $0.46{\pm}0.11$, p < 0.001). Performance impairment and somatic symptoms were remarkable in panic disorder than in SAD and depressive disorder (performance impairment : SAD $0.39{\pm}0.21$, panic disorder $0.44{\pm}0.14$, depressive disorder $0.40{\pm}0.09$, p = 0.009 ; somatic symptoms : SAD $0.07{\pm}0.10$, panic disorder $0.15{\pm}0.12$, depressive disorder $0.14{\pm}0.08$, p < 0.001). Conclusions The results facilitate an approach to optimal treatment for patients with comorbidity of anxiety disorder and depression.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권3호
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• pp.183-189
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• 2017

Objectives: The study aimed to identify the characteristics of attention-deficit hyperactivity disorder (ADHD) that was not diagnosed in childhood or adolescence, but only in adulthood. Methods: The characteristics of patients diagnosed with ADHD in adulthood were compared with those of patients diagnosed in childhood were assessed via a retrospective review of the medical records at one university hospital from 2005 to 2013. If the age at which they were confirmed as having ADHD was less than 19 years old, they were grouped as childhood-diagnosed group (CD); if they were 19 years old or more, they were grouped as adulthood-diagnosed group (AD). Results: The CD and AD included 50 (46.3%) and 58 (53.7%) patients, respectively. Inattention was the most common symptom in both groups. Behavioral and emotional problems were the second most frequent symptoms in the CD and AD, respectively. The intelligent quotient was significantly higher in the AD than in the CD. The most common comorbidity was depression in the CD and personality disorder in the AD. The most common reason for visiting the hospital was referral by acquaintances in the CD and media coverage in the AD. Conclusion: Clinicians should put ADHD on the index of suspicion when they examine adults with various psychiatric symptoms, because the diagnosis of ADHD might have been missed in childhood and the symptoms of ADHD might have changed as they grew up.

• 동의신경정신과학회지
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• 제11권1호
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• pp.59-73
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• 2000

Depression is a psychiatric syndrom consisting of dejected mood, psychomotor retardation, insomnia and weight loss, sometimes associated with irrational guilt feeling. And it is also similiar to Hwa-byung(火病) symptom in oriental medicine. But it is difficult to diagnose with objective method. Digital Infrared Thermographic Imaging(D.I.T.I.) is one of diagnotic method that measure the changes of skin temperature in body. Specially we checked the skin temperature on depressed patients by using D.I.T.I. and compared with Bell's palsy patients and normal persons group. The results are as follows; Average body temperature of the depressed patient group is $36.68{\pm}0.43^{\circ}C.$ and that of the control group is $36.73{\pm}0.40^{\circ}C.$. So there is no meaningful difference. The depressed patient group has higher temperature than the control group by ${\triangle}T>1.0^{\circ}C$ at the following acupuncture points in these body parts - upper and lower, left and right, anterior and posterior. When acupuncture points temperature was compared superior and inferior part of the body, depressed patient group have meaningful difference at the GV-4(Myung-moon) and also in the control group. When acupuncture points temperature was compared left and right part of the body, depressed patient group have no meaningful difference and also in the control group. When acupuncture points temperature was compared in the anterior and posterior part of the body, depressed patient group have meaningful difference at the GV-4(Myung- moon) and also in the control group. From this study, we think that D.I.T.I. could be used to diagnose objectively on the depressed patients and useful to another psychoneurogenic diagnosis in oriental medicine.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제5권1호
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• pp.194-200
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• 1994

성학대보고가 부모로부터 먼저 나왔을 경우, 부모가 양육권이나 면접권과 연관된 분쟁중에 보고되었을 경우 및 아동이 학령전 아동일 경우, 정신감정자는 위(僞) 성학대를 일단 의심하여야 한다고 한다. 저자는, 보육원에 수용된 10세 여아로서 경도의 정신지체를 보이고 있고 자발적으로 성학대보고를 한 환아의 정신감정을 하는 과정중에 위 성학대보고라고 판단된 환아 1예를 보고하고자 한다. 환아의 거짓보고에 대한 병리적 기전에 대한 고찰과 함께 이와 연관된 문헌고찰을 하였다.

• 디지털융복합연구
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• 제11권1호
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• pp.381-388
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• 2013

본 연구는 지역사회 만성정신질환자를 대상으로 건강위험행위와 스트레스생활사건, 정신증상, 병식, 우울간의 관계 및 건강위험행위에 영향을 미치는 요인을 파악하여 효율적인 만성정신질환자의 건강증진프로그램 개발을 위한 기초자료를 마련하고자 시도되었다. 연구의 대상은 D시와 C도에 위치한 정신보건센터와 사회복귀시설을 이용하고 있는 성인 만성정신질환자 255명이며 자료수집기간은 2011년 8월 1일에서 9월 20일까지였다. 수집된 자료는 실수, 백분율, t-test, ANOVA, Pearson 상관계수, 다중회귀분석을 이용하여 분석하였다. 연구결과 성별, 진단명, 스트레스 생활사건, 병식, 우울이 통계적으로 유의한 영향요인으로 나타났으며, 이들 전체 요인들은 만성정신질환자의 건강위험행위를 24% 설명하였다. 따라서 지역사회 만성정신질환자의 성별과 진단을 반영하여 병식교육과 스트레스 및 우울관리를 통해 건강위험행위를 효율적으로 관리할 수 있는 건강증진프로그램이 개발되어야 할 것이다.

• 대한기관식도과학회지
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• 제10권1호
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• pp.46-50
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• 2004

The majority of esophageal Foreign body ingestions occur in the pediatric population. In adults, true foreign object ingestion occurs more commonly among those with psychiatric disorders, mental impairment. The management of esophageal foreign bodies is influenced by the age, clinical condition of ingested material, anatomic location and technical abilities of the endoscopist. Recently the therapeutic endoscopy is becoming wider and more rational in application. We evaluated the role of endoscopy for removal of esophageal foreign bodies during the period of 4 years from January 2000 to December 2003 at the Department of Otolaryngology and Gastroenterology, Seonam University Hospital. The results were as follow, 1) The age ranged from 21 to 74 years old (mean 50.5), most frequent age group was between 61-70 years old and male to female ratio was 1:1.4. 2) Fish bone was the most frequent foreign body in the esophagus ($47.1\%$), food material ($23.5\%$) and meats ($17.6\%$) were next frequent foreign bodies. The most frequent site of lodgement was the first ($78.4\%$), second ($17.6\%$) and third narrowing ($3.9\%$) in order. 3) The most common symptom was foreign body sensation (28.6%). the next common symptoms were chest discomfort($23.8\%$) and dysphagia($19\%$). 4) In duration of lodgement, 49cases ($96.1\%$) were lodged for less than one day. 5) The foreign bodies of esophagus were removed successfully by flexible endoscope with basket, snare, forceps, overtube and endoscopic variceal ligation cap. There were only 3 cases of minimal complications, esophageal mucosal tearing. In conclusion, endoscopic esophageal foreign body removal is useful and safe with minimal or no complications.

• 생물정신의학
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• 제28권2호
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• pp.70-77
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• 2021

Objectives Our study aimed to present the distinctive correlates of formal thought disorder in patients with schizophrenia, using the Clinical Language Disorder Rating Scale (CLANG). Methods We compared clinical characteristics between schizophrenia patients with (n = 84) and without (n = 82) formal thought disorder. Psychometric scales including the CLANG, the Brief Psychiatric Rating Scale (BPRS), the Young Mania Rating Scale (YMRS), the Calgery Depression Scale for Schizophrenia (CDSS) and the Word Fluency Test (WFT) were used. Results After adjusting the effects of age, sex and total scores on the BPRS, YMRS and WFT, the subjects with disorganized speech presented significantly higher score on the abnormal syntax (p = 0.009), lack of semantic association (p = 0.005), discourse failure (p < 0.0001), pragmatics disorder (p = 0.001), dysarthria (p < 0.0001), and paraphasic error (p = 0.005) items than those without formal thought disorder. With defining the mentioned item scores as covariates, binary logistic regression model predicted that discourse failure (adjusted odds ratio [aOR] = 5.88, p < 0.0001) and pragmatics disorder (aOR = 2.17, p = 0.04) were distinctive correlates of formal thought disorder in patients with schizophrenia. Conclusions This study conducted Clinician Rated Dimensions of Psychosis Symptom Severity (CRDPSS) and CLANG scales on 166 hospitalized schizophrenia patients to explore the sub-items of the CLANG scale independently related to formal thought disorders in schizophrenia patients. Discourse failure and pragmatics disorder might be used as the distinctive indexes for formal thought disorder in patients with schizophrenia.