• 제목/요약/키워드: psychosomatic

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정신과 자문이 의뢰된 내과 환자들의 추적치료 결정요인 (Significant Variables Affecting Follow-up after Psychiatric Consultation in General Medical Units)

  • 이상규;김도훈;손봉기
    • 정신신체의학
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    • 제6권2호
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    • pp.176-187
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    • 1998
  • This study was performed to identify the significant variables affecting Follow-up after psychiatric consultation in General medical units and the trends of psychiatric consultation at the Hallym University hospital in Chunchon. Subjects of this study were 107 patients from April 1, 1998 to August 31, 1998, who were referred for psychiatric consultation during hospitalization. The results were as follows ; 1) Referral rate of General medical units was 7.5% and ordered Gastroenterology, Cardiology, nephrology, Other part. 2) The rate of total follow-up was 58% and the rate of No-follow-up was 42%. 3) In the cases of referral timing over admission 8th days, the days hospitalized after consultation performed were lengthened, significantly. 4) Common reasons for no follow-up of consultation were 'early- discharge' and 'patient's unwillingness to psychiatric reconsult. 5) Significant variables affecting follow-up were 'treatment recommendation', 'concordance with psychiatric drug recommendation', 'concordance with laboratory recommendation', 'total days hospitalized', 'Days hospitalization after consult was performed' and 'referral reason'.

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전기경련요법에 의하여 유발된 심부정맥(PVC) 1례 (A Case of ECT-induced Arrhythmia(PVC))

  • 김덕호;이호택;백주희;이상연
    • 정신신체의학
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    • 제5권2호
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    • pp.214-217
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    • 1997
  • Electroconvulsive therapy(ECT) is one of the most effective treatment modalities for the treatment of depression, mania, schizophrenia, or other neuropsychiatric disorders. But, reportedly ECT also can produce various forms of cardiac arrhythmia. We experienced a case of ECT-induced arrhythmia(PVC) accompanied with chest pain in a schizophrenic patient during the course of plain ECT. We conclude that there is a possible causal relationship between ECT and cardiac arrhythmia(PVC). The mechanisms of cardiac arrhythmia(PVC) due to ECT may be explained by the effects of ECT to vagal and sympathetic nervous systems. from this case report, We suggest that careful cardiac monitoring before, during, and after ECT with appropriate anesthetic preparation to a patient may enable to minimize the cardiovascular side effects of ECT in the patients with neuropsychiatric disorders.

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신경행동학적 연구의 동물모형 (Animal Models in the Neurobehavioral Research)

  • 김동구
    • 정신신체의학
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    • 제2권1호
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    • pp.46-51
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    • 1994
  • Model' is one of the well-used, but poorly understood word in the neurobehavioral research. After Darwin's evolutionary theory, it has been generally believed that human is different from animals in terms of the complexity, not of the essential. This notion could be applied to the mind as well as body. Therefore, it became possible to establish animal models in the scientific field of mind. Experimental analysis of the animal behavior becomes an important area for establishing an animal model of human psychopathology because behavior is the ambassador of the mind. A model emphasizes a structural correspondence between sets of causally related variables in two different domains such as the animal and the human. The first selection of elements of the two domains in correspondence called the initial analogy. Once the initial analogy is formed. causally related variables in the two domains are examined and arrayed The structural parallel is the formal analogy of a model, and similarities between corresponding variables are called material analogy. Models may serve any of three major functions ; heuristic, evidential and representative. In many cases, utilizing models may be more practical than directly assessing the domain of primary interest, since technical and/or ethical problems are more serious in the human domain. Although modeling is important to study human psychopathology, rare animal models approved to be a good model for the human psychopathology up to now. Developing the appropriate model is urgent to solve many problems raised from human psychopathology.

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신체화의 현존재분석적 이해 (Somatization in the Perspective of Daseinsanalysis)

  • 이죽내
    • 정신신체의학
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    • 제10권2호
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    • pp.69-77
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    • 2002
  • 신체화의 개념과 기전에 관해, 정신분석 이론을 비롯한 많은 이론들이 제시되어 왔다. 저자는 인간의 본질(존재의미의 이해)에 대한 통찰력에서 출발하고 있는 현존재분석의 관점에서 신체화의 개념을 제시하려는 것이다. 현존재분석에서 보는 신체화 현상은 인간의 세계관계의 직접적 표현이다. 현존재분석에서는 신체라는 말 대신에, 의미를 드러내는 '신체성'을 말하고 있기 때문에, 신체화 현상의 이해란 그 현상이 드러내는 의미를 보는 것이다. 그리고 신체화 현상은 세계관계의 직접적 표현이기 때문에 그 현상이 드러내는 의미는 그 인간의 세계관계에 의해 결정된다. 그 현상의 의미를 이해하는 방법은 현상학적 방법이다.

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내분비질환에 영향을 미치는 심리적 요인 (Psychological Factors Affecting Endocrine Disease)

  • 조숙행
    • 정신신체의학
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    • 제6권2호
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    • pp.221-227
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    • 1998
  • Although there has been a considerable research in psychoneuroendocrinology, particularly in relation to the biology of mood disorders, there has been a paucity of research regarding the effects of psychological factors on endocrine diseases. Of the existing literature, the most research is focused on diabetes mellitus, graves' disease. Especially diabetes appears to be the only endocrine disease that has been the focus of recent research studies. Most of the studies had retrospective designs or several methodological flaw. There has been no consistent results demonstrating that psychological factors affect the onset of diabetes mellitus. Several studies have suggested that psychological factors affect the course of diabetes. A small number of studies showed some evidence that psychological stress was associated with changes in glucose regulation in a subset of diabetic patients. There was also evidence to suggest that some temperament and coping skill influence glycemic control in child, adolescent diabetics. Studies of behavioral or psychosocial intervention on diabetic control have been small and have produced mixed results. There was a few controlled study suggested that stressful life events might be a causal role in Cushing's disease and Graves'disease, but there is no presently sufficient evidence to suggest that psychological factors affect the onset and the course of Cushing's disease and Graves' disease. In future, there is need for a well-designed biopsychosocial research with prospective designs, well defined patient population and control groups to study the relationship between psychological factors and endocrine diseases.

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사마귀의 최면치료 1례 (Hypnotherapy for Warts : A Case Report)

  • 박희관
    • 정신신체의학
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    • 제6권2호
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    • pp.188-192
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    • 1998
  • 저자는 6년 동안 만성적으로 양손에 사마귀가 재발한 20세 남자 환자를 5회의 단기 최면치료를 통해 성공적으로 치료하였기에 문헌고찰과 함께 보고하였다. 증례의 사마귀는 7개월이 지난 추적때까지 재발하지 않았다. 화학요법이나 전기소작 등과 같은 일반적인 치료법에 만족스런 반용이 없거나, 이완을 통해 긴장을 완화하고 자아를 강화하여 증상 통제를 할 필요가 있는 경우 자기최면 연습을 포함한 최면치료가 적용될 수 있다. 또한 papova 바이러스에 의한 피부질환에 세포면역의 역할과 더불어 정신과 신체의 상호 연관을 연구하는 피부의 정신면역학 분야에 사마귀의 최면치료가 시사하는 바를 논의하였다.

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정신과 여자 입원 환자의 체중 증가 (Weight Gain of the Psychiatric Female Hospitalized Patients)

  • 서동향;박기창;신정호
    • 정신신체의학
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    • 제6권2호
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    • pp.120-125
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    • 1998
  • Objectives : The purposes of present study were to identify weight increment in female psychiatric patients during hospitalization and to evaluate the relationship between weight gain and daily calorie intake, daily activity and other variables of disease itself. Methods : 20 patients were studied. Body weight were measured once a week, and daily activity(total amounts of walking/day) and total amount of daily calorie intake were measured twice a week. We examined psychiatric and medical illness history, eating disorders' history and family history of eating disorders and obesity. Results: Mean body weight and Body Mass Index(BMI) at admission are 49.40kg and 19.59kg/$m^2$. Mean weight increment during hospital stays of mean 65 days is 4.90kg. Mean amounts of daily calorie intake and daily activity(daily walks) were increased during hospital stays, but not statistically significant. The degree of weight increment is higher in longer hospital stay group, but not statistically significant. Mean body weight at admission of mood disorder group is higher than that of schizophrenia group, but not statistically significant. Conclusion : This results suggested that weight increment in female psychiatric hospitalized patients is present. However, it is not resulted by amount of calorie intake and daily activity level.

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청소년심리(靑少年心理) (Adolescent Psychology)

  • 조두영
    • 정신신체의학
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    • 제6권2호
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    • pp.97-103
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    • 1998
  • A dolescence can be defined as the period between pubescence and physical maturity, and the passage through adolescence(age of 12-19) forms a critical period. Major developmental tasks of adolescence are construction of an emancipated identity, realistic ambitions, and reasonable ideals, and the further development of sexual and social identities. In early adolescence one struggles to adjust psychologically to the spurt in growth and tensions filled with sexual and aggressive impulses. There are reshuffling of peer groups due to differing rates of maturation, early adolescence crushes, sublimation of sexuality, and the resurgence of oedipal feelings. One reaches so-called period of formal operations in cognitive development. In mid-adolescence one struggles to overcome family attachments and controls, and it is a time marked by revolt and conformity. One has to overcome sexual repression while caught in reactivation of oedipal attachment. Peer groups gains in importance, and the peer group changes into a youth group that carries the youth culture. Late adolescence is a period of achieving an ego identity and capacities for intimacy. One has to prevent premature closure : Identity foreclosure limits both opportunity and the ability to guide one's own life. Gradually adolescent begins to have a loss self-centered and narcissistic orientation to one's sexual and affectional needs, and becomes involved in love relationship.

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폐경기 증후군의 생물학적 접근 (Biological Approach to Menopausal Syndrome)

  • 강병조;이죽내;임효덕;강석헌
    • 정신신체의학
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    • 제4권1호
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    • pp.109-119
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    • 1996
  • 최근 호르몬 대치요법으로 갱년기 증상들만 없어질 뿐 아니라 심장질환, 골다공증 등의 예방은 물론이고 젊음의 유지 및 삶의 질이 높아지자 산부인과 의사는 물론이고 정신과 의사들도 갱년기 증상에 대해서 다시 더 많은 관심을 갖게 되었다. 그리하여 저자는 일반 정신과 의사들이 갱년기 증상을 이해하는데 도움을 주기 위하여 갱년기 증상중 정신과와 관련이 있는 열성홍조와 갱년기 우울증을 중심으로 다음과 같은 몇 가지 점을 문헌고찰을 통하여 재검토하였다. 갱년기 및 폐경기의 정의. 갱년기의 생리(난소의 노화, 주간 율동의 변화, 초일주기 율동의 변화, 시신경교차 상부핵의 일주기 율동의 변화), 혈관운동성 홍조(정의와 병태생리, 원인, 진단, 치료), 갱년기 우울증(정의, 원인, 치료) 등을 재고찰하여 보았다.

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생쥐에서 전기자극 스트레스에 의한 행동반응과 면역 기능 변화 (Behavioral Response and Immune Alterations by Electric Footshock in Mice)

  • 김정범;박원균;송대규
    • 정신신체의학
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    • 제4권1호
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    • pp.44-53
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    • 1996
  • The present experiment was designed to investigate the effects of behavioral, response to immune function in response to electric footshock in mice. Mice were subjected to electric footshock for 3 days(two sessions a day, 11 times of shock for about 31 minutes a session). The humoral immune response was measured using mice immunized with rat RBC. The cell-mediated immune responses were evaluated by contact hypersensitivity to 2, 4-dinitrofluorobenzene(DNFB) and by phytohemagglutin(PHA)-stimulated splenocytes proliferation assay. In stressed group, electric footshock suppressed significantly anti-rat RBC antibody production(p<0.05), but enhanced significantly $T_{48}$ relative to $T_{24}$ in contact hypersenstivry (P<.01) and T-cell proliferation response(P<.05) by PHA stimulation elative to control group. T-cell proliferation response by PHA stimulation was significantly correlated to the movement than the sensitivity and coping behavior in the mouse, in response to the electric footshock. These data supper the importance of behavioral response in stress-induced changes of immune functions.

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