Beyond the target of scientific researches, meditation is now one of the main tools for palliative and integrative medicine in Western society. Despite theof valuable heritages of meditation in Korea, meditation is not considered to have clinical implications as in Western medical society. It is partly due to the fact that while the mysterious aspect of meditation has been emphasized, a large number of scientific researches on meditation had not been known to Korean medical society. The authors reviewed several studies that examined the clinical effect of meditation and speculated its possibility as a method of clinical intervention.
Integrative Medicine ; Korea ; Meditation* ; Palliative Care ; Societies, Medical

OBJECTIVES: Despite the fact that delirium is a frequent neuropsychiatric disorder in cancer patients, there are, in Korea, no guidelines for the pharmacological treatment of such delirium. This systematic review evaluated the efficacy and safety of some pharmacological interventions and summarized the results. METHODS: We searched PubMed, Embase, CINAHL, the Cochrane Library, and the KMbase, targeting from January 1990 to October 2008, using key words. Moreover, we included systematic reviews, meta-analyses, and randomized controlled trial literature in the search. Then, we stratified the trials based on their evidence levels. RESULTS AND CONCLUSION: We identified 13 randomized, controlled studies and 2 case-control studies that met our inclusion criteria. These showed that haloperidol was the medication of choice to treat delirium. In addition, they revealed that atypical antipsychotics have not shown clear superiority with regard to effectiveness as compared to haloperidol. Neither donepezil nor rivastigmine were shown to be effective in preventing or treating delirium.
Antipsychotic Agents ; Case-Control Studies ; Delirium ; Haloperidol ; Humans ; Indans ; Korea ; Phenylcarbamates ; Piperidines ; Rivastigmine

OBJECTIVE: This study aims to access the distributions of psychiatric disorders in a community population using the Korean version of Composite International Diagnostic Interview(K-CIDI). METHODS: CIDI is a comprehensive, fully standardized interview suitable for epidemiologic study. Subjects were selected by taking two-stage, cluster samples of 1,763 adult household residents, 18 to 64 years of age, in Namyangjusi, Kyunggido. Ten trained interviewers administered the K-CIDI to the selected respondents, from July 1 to August 30, 1999. RESULTS: Total 1,060 respondents completed the interview. Lifetime prevalences and male/female ratio of lifetime prevalences of alcohol use disorders(abuse/dependence), nicotine dependence, specific phobia, major depressive disorder, and posttraumatic stress disorder were 15.6%(6.8%/8.9%) and 5.8 (12.3/3.7), 5.7% and 5.5, 3.9% and 0.3, 3.3% and 0.4, and 1.5% and 0.6, respectively. One-year prevalences and male/female ratio of one-year prevalences of alcohol use disorders, nicotine dependence, specific phobia, major depressive disorder were 7.5% and 6.8, 3.8% and 5.3, 3.4% and 0.4, and 2.0% and 0.3, respectively. CONCLUSION: Compared with previous Korean results, the prevalence of alcohol use disorder was decreased and the prevalence of major depressive disorder showed little change. The prevalence of alcohol use disorder was comparable with the results of other countries, whereas mood disorders and anxiety disorders were less frequent than in other countries. Remarkable differences of distributions of psychiatric disorders across the areas and times were observed. Systematic cross-cultural comparison study is needed to overcome the methodological problems and to explore the cause of differences of distributions of psychiatric disorders.
Adult ; Anxiety Disorders ; Cross-Cultural Comparison ; Surveys and Questionnaires ; Depressive Disorder, Major ; Epidemiologic Studies ; Epidemiology ; Family Characteristics ; Gyeonggi-do ; Humans ; Mood Disorders ; Phobic Disorders ; Prevalence* ; Stress Disorders, Post-Traumatic ; Tobacco Use Disorder

OBJECTIVES: With the increase in cancer prevalence, the health behavior of cancer survivors has become an important issue. This study was conducted to examine the psychosocial correlates of behavior changes after cancer diagnosis. METHODS: 95 patients completed questionnaires assessing depression, anxiety, insomnia, posttraumatic stress symptoms, social constraints, personal beliefs about cancer cause and health-related behavior changes after cancer diagnosis. RESULTS: In the multiple logistic regression analysis, insomnia was the only significant predictor of positive change in physical behavior : normal sleep group(Odds ratio=9.462, 95% CI 1.738-51.509) and subthreshold insomnia group(Odds ratio=10.529, 95% CI 1.701-65.161) showed a larger increase compared to the insomnia group. In psychosocial behavior, low age, religion and causal belief in hormonal factors were independent factors that predicted increase in positive change. CONCLUSIONS: This study showed a difference between predictors of physical and psychosocial health behavior change after breast cancer diagnosis. Multi-faceted approaches are required to promote positive change in health behavior in cancer patients.
Anxiety ; Breast ; Breast Neoplasms ; Depression ; Health Behavior ; Humans ; Logistic Models ; Prevalence ; Questionnaires ; Sleep Initiation and Maintenance Disorders ; Survivors

OBJECTIVES: This study is to evaluate the prevalence, incidence, and risk factors of cognitive impairment and depression in the elderly in community. METHODS: This study was a one-year follow-up of Yonchon cohort aged 65 years and over, selected initially in a prevalence study of dementia and depression. A sample of 790 elderly persons who completely interviewed in a prevalence study was re-interviewed with one year interval using the Korean version of Psychogeriatric Assessment Scale (K-PAS). RESULTS: A total of 631 elderly persons was completely interviewed in this follow-up study. The prevalence of cognitive impairment and depression were 21.4% (11.9% in males and 28.3% in females) and 8.4% (6.3% in males and 10.0% in females), respectively. The one-year incidence of cognitive impairment and depression were 11.4% (5.7% in males and 16.2% in females) and 5.1% (3.1% in males and 6.6% in females), respectively. The risk factors of the prevalence of cognitive impairment were education, age, sex, history of stroke, and economic status. The risk factors of the prevalence of depression were family history of depression, history of stroke, marital status, and economic status. The risk factors of the incidence of cognitive impairment were female gander, education, age, alcohol use disorder, marital status, and economic status. The risk factors of the incidence of depression were low education, disrupted marital status, and poor economic status. CONCLUSION: Cognitive impairment and depression were frequent in the elderly. Several risk factors for cognitive impairment and depression were identified. These results suggest that comprehensive health and social services were needed for the elderly.
Aged* ; Cohort Studies ; Cross-Sectional Studies ; Dementia* ; Depression ; Depressive Disorder* ; Education ; Female ; Follow-Up Studies* ; Humans ; Incidence* ; Male ; Marital Status ; Prevalence* ; Risk Factors* ; Social Work ; Stroke

Purpose: This study reviewed screening and assessment tools that are used to measure delirium in patients with cancer in hospice and palliative care settings and examined their psychometric properties. Methods: Four databases were searched for studies using related search terms (delirium, tools, palliative care, cancer, and others). The inclusion criteria were a) studies that included screening/assessment tools for measuring delirium in cancer patients receiving hospice/palliative care, and b) studies published in English or Korean. The exclusion criteria were a) studies that were conducted in an intensive care setting, and b) case studies, qualitative studies, systematic reviews, or meta-analyses. Results: Out of the 81 studies identified, only 10 examined the psychometric properties of tools for measuring delirium, and 8 tools were ultimately identified. The psychometric properties of the Memorial Delirium Assessment Scale (MDAS) were the most frequently examined (n=5), and the MDAS showed good reliability, concurrent validity, and diagnostic accuracy. The Delirium Rating Scale had good reliability and diagnostic accuracy. The Delirium Rating Scale-Revised 98 also showed good reliability and structural validity, but its diagnostic performance was not examined in hospice/palliative care settings. The Nursing Delirium Screening Scale showed relatively low diagnostic accuracy. Conclusion The MDAS showed evidence of being a valid assessment tool for assessing delirium in patients with cancer in palliative care. Few studies examined the diagnostic performance of delirium tools. Therefore, further studies are needed to examine the diagnostic performance of screening/assessment tools for the optimal detection of delirium in patients with cancer in hospice/palliative care.

OBJECTIVES: Despite evidence of its therapeutic benefits and popular use for health purposes, meditation is out of the medicine in Korea. For the promotion of clinical use and research, it is needed to develop the standardized and structured meditation treatment program. METHODS: The authors selected a traditional Korean meditation as the model for a new meditation treatment program and surveyed the practitioners of this form of meditation to collect information about its effects and safety. The original meditation was modified for the physically or mentally compromised to practice it. The modified meditation was then used with psychiatric patients and breast cancer patients. RESULTS: The practitioners of a traditional Korean meditation were satisfied with the positive effects of meditation on physical and mental health. Original meditation was modified as a shorter and simpler form. In an empirical trial of the modified meditation technique, psychiatric inpatients showed low motivation and little benefit, but the breast cancer patients reported improvements in physical and mental status. There were no obvious adverse effects in either of the two clinical groups. CONCLUSION: A meditation treatment program based on a traditional Korean meditation was developed and found to be safe in psychiatric and breast cancer patients. The program proved effective in improving the quality of life for breast cancer patients. Further research into the clinical efficacy and the mechanisms of this meditation treatment program is needed.
Breast Neoplasms ; Humans ; Inpatients ; Korea ; Meditation ; Mental Health ; Motivation ; Quality of Life

Cancer statistics shows a high risk and increasing incidence of cancer among Koreans. Considerable burdens related to cancer and its treatment causes significant psychosocial distress among cancer patients and their family. Due to early detection and progress in cancer treatments, cancer is becoming a chronic illness and the quality of life and long-term impact of cancer is receiving increasing attention. Psycho-oncology is a subspecialty of oncology that addresses a psychosocial dimension of cancer throughout 'the continuum of cancer care', viz. from prevention and early detection to palliative and end-of-life care. This paper reviews the development of psycho-oncology and its current status in international and national context so as to promote efforts toward an integrative cancer care in Korea.
Chronic Disease ; Humans ; Incidence ; Korea ; Quality of Life

OBJECTIVE: The few direct comparative studies of efficacy and tolerability of atypical antipsychotics have been done in patients commonly seen in clinical practice. We therefore compared, head-to-head, the relative efficacy and tolerability of two atypical antipsychotics, risperidone and quetiapine, commonly used in clinical practice nowadays. METHODS: This study used retrospective chart reviews of the patients who had been admitted to or treated at the outpatient department in a university hospital. The analysed population consisted of 55 patients with diagnoses of schizophrenia or schizoaffective disorder. RESULTS: Among the baseline characteristics, the proportion of patients with a history of previous antipsychotics medication was higher in the quetiapine group, as was the proportion of patients treated at the outpatient department, the proportion of female patients, and the mean age. Even though these baseline differences had been controlled as covariate, the proportion of responsive patients was higher, and the median value of the time to efficacy was shorter, in the risperidone group. The rate of sedation was higher in the quetiapine group and the rates of concomitant use of anticholinergics and benzodiazepines were higher in the risperidone group. However, these differences of sedation and concomitant use of anticholinergics and benzodiazepines were not statistically significant when controlling for the effect of baseline characteristics. Even though this study showed some useful results, the study limitations included the use of retrospective chart reviews and the small number of subjects at a single hospital, among others. Therefore, further studies controlling these limitations need to be done to confirm the results of this study. CONCLUSION: The proportion of responsive patients was higher and the median value of the time to efficacy was shorter in the risperidone group. The rates of extrapyramidal symptoms were not different between the two groups.
Antipsychotic Agents ; Benzodiazepines ; Cholinergic Antagonists ; Diagnosis ; Female ; Humans ; Outpatients ; Pilot Projects* ; Psychotic Disorders* ; Retrospective Studies ; Risperidone* ; Schizophrenia* ; Quetiapine Fumarate

OBJECTIVES: The prevalence of psychiatric disorders in homeless people is higher than the prevalence in a general population. With the increasing interests in homeless people after the economic crisis in Korea, psychiatrists started to investigate the prevalence of psychiatric disorders in homeless people. This study is to assess the prevalence of psychiatric disorders in homeless men living in a city shelter in Seoul and to compare these results with those of previous epiaemiological studies in Korea of homeless people and abroad. METHODS: Among 960 homeless men living in a city shelter in Seoul, 420 men were selected randomly from December 14 to December 29, 1999. Eight trained interviewer administered the Korean version of Composite International Diagnostic Interview (K-CIDI) to the subjects. The lifetime, one-year, and one-month prevalence of the psychiatric disorders in this study were compared to those of the previous studies of Korean general population and of homeless people abroad. RESULTS: The lifetime, one-year, and one-month prevalence of total psychiatric disorders were 71.7%, 49.8% and 45.0% respectively. The lifetime prevalence of nicotine dependence/withdrawal, alcohol use disorders (abuse/dependence), substance use disorders, major depressive disorder, psychotic disorders, and anxiety disorders were 31.0%, 58.6% (39.3%/19.3%), 3.1%, 11.7%, 2.4%, and 16.9% respectively. CONCLUSION: This study suggested that the prevalence of psychiatric disorders in homeless men is higher than the prevalence in general population, as the previous studies in Korea. The prevalence of alcohol use disorder was highest. The prevalence of non-alcohol substance use disorder and psychotic disorder were lower than the prevalence of these disorders in homeless people of other countries. These results suggest that there is a need to treat the psychiatric disorders, especially alcohol use disorder which is the major psychiatric problem in homeless men.
Anxiety Disorders ; Depressive Disorder, Major ; Epidemiology ; Humans ; Korea ; Male* ; Multiple Endocrine Neoplasia Type 1 ; Nicotine ; Prevalence* ; Psychiatry ; Psychotic Disorders ; Seoul ; Substance-Related Disorders