BACKGROUND: A considerable portion of patients in primary care are thought to have mental disorders in Korea. But they are not easily noticed and are thus underdiagnosed and approached improperly. This study was done to assess the prevalence of common mental disorders in a hospital-based family practice and to evaluate the utility of a diagnostic tool, the Patient Health Questionnaire (PHQ). METHODS: Ten or more patients each day were systematically selected in family practice clinics for two weeks in a university and a community hospital-based family practice clinics in Seoul, Korea. Routine care was delivered as a control during the first week and the PHQ was administered to patients during the second week and the physicians were allowed to review the PHQ just before making clinical decisions. Physicians were asked to answer whether they recognized patients' with mental disorders before reviewing the PHQ. RESULTS: The prevalence of mental disorders was higher in the test group than the control except for eating disorders and other anxiety disorders (P <0.05)(test vs. control group): major depressive disorders 1.75% vs. 3.8%, other depressive disorders 6.8% vs. 11.4%, panic disorders 0.6% vs. 2.3, somatoform disorders 3% vs. 5%, alcohol abuse 2.2% vs. 8.7%, and any mental disorders 20.9% vs. 29.4%. In the test group, the percentage (95% confidence interval in parenthesis) of newly diagnosed mental disorders after physicians' review of the PHQ were 66% (49~82) in major depressive disorders, 70% (50~90) in panic disorders, 70% (56~83) in somatoform disorders, 84% (75~92) in alcohol abuse, and 68% (62~74) in any mental disorders. Patients' response to the PHQ was overall very receptive. CONCLUSION: One-week prevalence of common mental disorders in the hospital-based family practice was 29.4% and the PHQ tool was efficient to help the family physicians recognize hidden mental disorders.
Alcoholism ; Anxiety Disorders ; Confidence Intervals ; Depressive Disorder ; Depressive Disorder, Major ; Diagnosis ; Eating Disorders ; Family Practice* ; Humans ; Korea* ; Medical History Taking ; Mental Disorders* ; Panic Disorder ; Physicians, Family ; Prevalence* ; Primary Health Care ; Seoul ; Somatoform Disorders ; Surveys and Questionnaires

BACKGROUND: Obesity increases morbidities and mortalities due to cardiovascular diseases. In previous studies, decrease in heart rate variability was associated with cardiovascular death and reduced heart rate variability in the obese had been reported. The authors investigated immediate changes in the heart rate variability after weight reduction in obese individuals. METHODS: The subjects for this study were 39 Korean adults (35 female, 4 male), who visited obesity clinic in a university hospital from January 2002 to July 2003. At first visit, weight, height, body mass index (BMI) and waist circumference of the subjects were measured. We also measured parameters of heart rate variability: Mean Heart Rate (MHR), Standard Deviation of N-N interval (SDNN), The Square Root of the Mean Squared Difference of successive NN intervals (RMSSD), Total Power (TP), Low Frequency (LF), High Frequency (HF), and LF/HF ratio. Weight reduction protocol included nutritional counseling, exercise, behavioral modification and anti-obesity medications, if needed. RESULTS: At 12 weeks of intervention, weight, BMI, waist circumference, fat mass, and lean body mass significantly decreased (3.90+/-3.11 kg, -1.50+/-1.21 kg/m2, -4.45+/-5.61 cm, -3.03+/-2.45 kg, -1.32+/-1.16 kg, P <0.01, respectively). MHR (-6.17+/-9.65 bpm, P <0.01) and LF/ HF (-0.61+/-1.56, P <0.05) showed significant reduction. Changes of weight and LF were positively correlated (r=0.338, P <0.01). Changes of waist circumference was correlated with changes of SDNN (r= 0.331, P <0.05). Changes of BMI showed positive correlation with changes in TP (r=0.327, P <0.05) and LF (r=0.345, P <0.05). CONCLUSION: Short term intervention for obese people decreased sympathetic nervous activity.
Adult ; Body Height ; Cardiovascular Diseases ; Counseling ; Female ; Heart Rate* ; Heart* ; Humans ; Mortality ; Obesity ; Waist Circumference ; Weight Loss*

BACKGROUND: Smoking greatly increases the risk of cancer, cardiovascular diseases and osteoporosis. Besides direct harm from smoking, some dietary pattern of smokers have been reported to increase such risk. This study aimed to analyze various nutrients by smoking status, and to find out whether smokers maintain harmful dietary patterns. METHODS: One thousand and six hundred fourteen men were selected who visited the health promotion center of an university hospital in Seoul. The inclusion criteria was the completion of dietary survey. Dietary analysis was done by calculation of amounts of each nutrients from 24-hour recall method. We compared total intake of each nutrients and total calories by smoking status with analysis of variance (ANOVA). Then we adjusted the results for exercise and education level by ANCOVA (analysis of covariance). RESULTS: The study subjects were 840 current smokers (52.0%), 479 ex-smokers (29.7%) and 295 non-smokers (18.3%). The consumption of total fat and cholesterol was significantly high in smokers than non-smokers (P=0.012, P=0.005). The alcohol intake was higher in smokers and ex-smokers than non-smokers (P <0.001, P=0.007). The smokers and ex-smokers had less calcium than non- smokers (P=0.001, P=0.044). Furthermore, the smokers exercised less than ex-smokers and non-smokers (P <0.001). CONCLUSIONS: The smokers consumed more total fat and cholesterol which increases the risk of cardiovascular diseases. They also had less calcium and drank more alcohol. Comprehensive approach which includes intervention for dietary intakes in addition to smoking cessation is desirable to decrease health risk for smokers.
Analysis of Variance ; Calcium ; Cardiovascular Diseases ; Cholesterol ; Diet ; Education ; Health Promotion* ; Humans ; Male* ; Osteoporosis ; Seoul ; Smoke* ; Smoking Cessation ; Smoking*

BACKGROUND: The purpose of this study was to assess the lifestyle associated with weight gain and persistent overweight for 2 years. METHODS: The subjects were 580 workers (109 men, 471 women) at one university affiliated hospital. Their height and weight were measured twice in 2000 and 2002. A questionnaire, about lifestyle was filled out in 2000. The questionnaire included the average amount of alcohol intake and the number of days per week in which alcohol was consumed, smoking status, and the number of days per week in which exercise was done. Their weight change in 2 years was calculated and their weight status was classified into two groups: persistent normal weight (BMI <23 kg/m2) and persistent overweight (BMI> or =23 kg/m2). RESULTS: Among the total, 54.3% of men and 10.0% of women had persistent overweight over 2 years. Overall 93.4% of overweight men and 68.7% of overweight women remained overweight after 2 years. Compared with male non-smokers and male ex- smokers, current male smokers gained weight as much as 1.17 kg over 2 years after adjusting for age and initial BMI (P=0.033). Compared with females who exercised less than 3 per week, those who exercised 3 or more per week lost weight as much as 1.21 kg over 2 years after adjusting for age and initial BMI (P=0.005). Compared with males who consumed alcohol an average of< or =30 g per consumption, those who consumed an average of > 30 g were 4.1 times (95% C.I. 1.04~16.21) more likely to maintain persistent overweight over 2 years after adjustment for age and frequency of alcohol use. However no particular lifestyle was shown to predict the risk of persistent overweight for women. CONCLUSION: Regular exercise of moderate intensity and modest alcohol consumption seemed to prevent weight gain and persistent overweight. Such lifestyle may be encouraged to maintain healthy weight.
Alcohol Drinking ; Female ; Follow-Up Studies ; Humans ; Life Style* ; Male ; Overweight* ; Smoke ; Smoking ; Weight Gain*

BACKGROUND: Elevated plasma total homocysteine is a risk factor for cardiovascular diseases. The authors investigated the parameters such as habit, body index, cardiovascular risk factors, nutrition relative to the plasma homocysteine concentration. METHODS: The subjects were 6,223 adults (3,377 males, 2,846 females) who were over 18 years of age and visited a health promotion center of a university hospital from March 2002 to January 2003. We assessed the relationship between the homocysteine level and the following parameters: sex, age, weight, body mass index, waist circumference, smoking, alcohol, systolic and diastolic blood pressure (BP), triglyceride, total cholesterol, high density lipoprotein cholesterol, creatinine, albumin and hemoglobin. RESULTS: The homocysteine levels was 10.5+/-5.9micromol/L in males, 7.3+/-2.6micromol/L in female. Thus it was significantly higher in males (P <0.001). After adjusting for variables that affect the homocysteine, the subjects over the age of 54 showed 10.7micromol/L (9.5, 12.0, 95% Confidence Interval), which was significantly (P=0.002) higher than the below the age of 38 groups 8.5micromol/L (7.8, 9.2, 95% CI). Non-smoking group showed 8.6micromol/L (8.4, 8.9, 95% CI), while over 28 pack-year group showed 9.6micromol/ L (9.2, 10.0, 95% CI), which was significantly (P <0.000) higher than the non-smoking groups. For the group with systolic BP over 132mmHg, it was 9.3micromol/L (8.8, 9.5, 95% CI). This was significantly (P=0.004) higher than 8.7micromol/L (8.4, 9.0, 95% CI) in the group whose systolic BP was less than 108 mmHg. The homocysteine was 10.4micromol/L (10.1, 11.7, 95% CI) for the group with creatinine over 1.0 mg/dL, which was significantly (P <0.000) higher than 7.9micromol/L (7.6, 8.2, 95% CI) in the group whose creatinine was less than 0.8 mg/dL. CONCLUSION: After adjusting for variables that affect the homocysteine, significant difference in its values was found between males and females. The homocysteine was significantly increased in the group whose age, systolic BP, amount of smoking, and creatinine were higher.
Adult ; Blood Pressure ; Body Weight ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Creatinine ; Female ; Health Promotion ; Homocysteine* ; Humans ; Male ; Plasma ; Risk Factors ; Smoke ; Smoking ; Triglycerides ; Waist Circumference

No abstract available.
Diagnosis* ; Hyperaldosteronism*

BACKGROUND: To understand why primary physicians prescribe antibiotics for some cases of acute upper respiratory infections and to explore the factors that influence their prescribing. METHODS: Qualitative analysis of semi-structured interviews. Participants were 12 primary physicians in the maximum variety sample. RESULTS: Interviewees were identified the problems of antibiotics abuse and misuse in Korea. Primary physicians were certain that patients will benefit from antibiotics and prescribe for the patients' expectation of fast relief. Doctors are mostly comfortable with their prescribing decisions by their clinical experiences. They are also more likely to prescribe antibiotics in pressures of time and in competitive clinical environment. CONCLUSION: Multiple factors are involved in primary physicians' decision of their prescribing for acute upper respiratory infections. Further interventions to reduces prescribing would need to improve identification of patients at risk of complications and be workable in busy clinical situations. Repeating evidence for lack of effectiveness and lack of efficiency in general might be helpful.
Anti-Bacterial Agents* ; Humans ; Korea ; Prescriptions ; Respiratory Tract Infections

BACKGROUND: As people have been interested in healt,h and as the microcomputers with multimedia steeing have been supplied more and more, there is increasing need of multimedia information about health. The CD-ROM, which is a representative multimedia tool, is capable of interacting between information-provider and users, offering audiovisual interface, and saving great deal of knowledge. METHODS: We developed the health-information system to provide ordinary people with hea1th information using multimedia tools. It, has 7 parts ; self-diagnosis, exploring human body, drug information, hospital information, first-aid treatment, Q and A, and medical common sense. We got image data such as figures, photos, X-rays, electrocardiograms and pathologic specimens with scanner and film scanner, also moving image(video) with video-capturing program. RESULTS & CONCLUSIONS: We hope the multimedia health-information system to become a useful methodology of patient education and to be used as an information source in medical information network in the near future.
CD-ROM ; Electrocardiography ; Hope ; Human Body ; Information Services ; Microcomputers ; Multimedia* ; Patient Education as Topic

BACKGROUND: Family physicians should actively carry out adult immunization. DM is a common risk factor of influenza and pneumococcal pneumonia related complications, so DM patients should receive influenza and pneumococcal vaccinations. The authors investigated recognition and performance of influenza and pneumococcal vaccination among DM patients. METHODS: We surveyed knowledge and performance of influenza and pneumococcal vaccination among the 203 diabetic patients living in Seoul and responding to telephone interview, who visited one DM center in general hospital from March 3, to March 7, 1997. RESULTS: Among 203 DM patients, the risk factors for influenza and pneumococcal pneumonia other than DM were old age of 65 or over(35.0%), cardiovascular diseases(5.9%) and chronic pulmonary diseases(4.9%). The recognition rate and performance rate of influenza vaccination were 27.6% and 21.2% respectively, there was a statistically significant relationship between these rates(P<0.01). Those vaccinated 43 patients for influenza knew the need of vaccination through family members and relatives(58.1%) and through medical doctors(32.6%). Although 85.2% of 203 DM patients answered that they received education about need of vaccination through DM education program conducted at hospitals, but only 9 patients(4.4%) recognized well. The reasons for not performing influenza vaccination were lack of knowledge(63.1%), no experience of influenza(12.5%), 'forget for the moment(5.0%) and regard injection as a nuisance(2.5%) in descending order. The recognition rate and performance rate of of pneurnococcal vaccination were all zero percents. The reasons for not performing pneumococcal vaccination were lack of knowledge(91.1%) no experience of pneumococcal pneumonia(6.4%), regard injection as a nuisance(1.5%) and forget for the moment(1.0%) in descending order. CONCLUSIONS: The recognition and performance rates of influenza vaccination were low and those of pneumococcal vaccination were all zero percents among DM patients because they did not recognize well the need of these vaccinations. Therefore, the doctors who see DM patients should actively recommend influenza and pneumococcal vaccination and DM educational programs must include education for these vaccinations.
Adult ; Education ; Hospitals, General ; Humans ; Immunization ; Influenza, Human* ; Interviews as Topic ; Physicians, Family ; Pneumonia, Pneumococcal ; Risk Factors ; Seoul ; Vaccination*

BACKGROUND: Diet and weight concerns are commonplace and almost accepted features of life for girls during adolescence. Until recently, younger age groups haue largely been ignored, as these concerns were thought to be a product of pubertal development and sexual maturity. Girls under the age of fifteen therefore, have been assumed to be free of the pressures experienced by adult women. However, this belief is now hard to sustain. The object of the present study was to investigate the self-perception and body shape satisfaction in different weight categories of boys and girls aged 12-years old in Korea. METHODS: In May, 1995, one hundred and sixty seven boys and one hundred and twenty girls from two schools in Seoul completed assessments of body-esteem, self-esteem, body shape preference. The children's body weight and height were also measured. RESULTS: The heaviest children expressed the most discontent, having a low body-esteem, a desire for thinness. By the age of 12, girls boys already differ in their body shape satisfaction and differ in their body shape aspirations. There was a significant effect of weight category on the children's body esteem(boys(P =.005), girls(P=.0001). Children in both extreme categories, under-and over-weight, had lower body-esteem scores than those in other weight categories. However, it was the overweight children who had the lowest. reported body-esteem. Body esteem was highest among girls in the 'slightly underweight' category and highest among boys on the 'average weight' category. There was no effects of either weight category or gender on the childrens appraisal of self-esteem. A comparison of the points chosen on the silhouette scales to reflect current and preferred body shapes revealed clear gender differences. Of the girls, 63% placed their preferred body shape at a point thinner than their currently perceived shape, while only 15% chose a broader figure. In contrast,, 41% of the boys rated their preferred figure as broader than their current perception, and 37% as thinner than their current perception. CONCLUSIONS: This study has noted a relationship between body weight and self-perception in 12-year old children. The heaviest children expressed low body-esteem, a desire for thinness. This pattern was more characteristic of girls than boys. Even at this age, well before they have completed physical maturation, girls are aspiring to a body shape which is thinner than their average. This discontent experienced by the heaviest children on this sample was apparent in their lower body-esteem and the distance between their current and preferred body shapes. The girls preference was for thinness, while in the boys it was for a body shape which was broader than their current shape. From their responses, it would appear that the boys' desire was not for fatness, but for a more athletic and muscular build.
Adolescent ; Adult ; Aspirations (Psychology) ; Body Weight ; Child* ; Diet ; Female ; Humans ; Korea ; Overweight ; Self Concept ; Seoul ; Sports ; Thinness ; Weights and Measures