In psychiatry, the remission of diseases and the recovery of disabilities have been the critical points of treatment. And the scales which evaluate the functions and disabilities of patients were needed to see the remission of diseases and the recovery of disabilities. Among these functional scales, Global Assessment of Functioning Scale (GAF) and Social and Occupational Functioning Scale (SOFAS) were widely used to indicate psychosocial functions. GAF and SOFAS are 100 point single-item global scale to evaluate the functions of patients, and have advantages to apply in short time. And these scales have high reliability, predict the course of subjects, and reflect the patients' changes sensitively. Therefore, these scales were used frequently in clinical situation. To use GAF more effectively, clinician training and constructive use of GAF-total, GAF-symptom, and GAF-disability are needed.
Disability Evaluation ; Humans ; Weights and Measures

Chickenpox is an acute disease caused by the varicella-zoster virus (VZV), a herpesvirus that causes human infection worldwide. Primary VZV infection routinely occurs during childhood and is usually a self-limiting illness in immunocompetent children. However, chickenpox can be a severe disease in adolescents, adults, and immunosuppressed or immunocompromised patients. Although vaccination substantially attenuates disease manifestations, significant complications such as secondary soft tissue infection, encephalitis, and pneumonia can occur. We present a rare autopsy case of concurrent acute myocarditis and intussusceptions in a 3-year-old female child who presented with chickenpox followed by abdominal pain and sudden death. The present case emphasizes the potential for fatal complications of viral infections, which should be considered in cases of sudden unexpected infectious death in children.
Abdominal Pain ; Acute Disease ; Adolescent ; Adult ; Autopsy ; Chickenpox ; Child* ; Child, Preschool* ; Death, Sudden ; Encephalitis ; Female ; Herpesvirus 3, Human ; Humans ; Immunocompromised Host ; Intussusception* ; Myocarditis* ; Pneumonia ; Soft Tissue Infections ; Vaccination ; Virus Diseases

OBJECTIVES: The aim of this study was to investigate mortality rates and risk factors in dementia patients in a rural cohort. METHODS: A total of 114 subjects with clinically diagnosed dementia were followed up for eight years from 1997 to 2005. Their mortality was compared with sociodemographic and clinical variables using the Cox proportional hazards models after adjusting age, sex, and education. RESULTS: During follow-up, the mortality rate of subjects was 80.2% and the mean (SD) duration of survival from at diagnosis to death was 4 years. Mortality in subjects with dementia depended on old age (relative risk [RR] : 1.05 ; 95% confidence interval [CI] : 1.01-1.08), male (RR : 1.61 ; CI : 1.00-2.59), low Clinical Dementia Rating scale (RR : 1.54 ; CI : 1.14-2.10), low Activities of Daily Living (RR : 0.72 ; CI : 0.59-0.89), low Instrumental Activities of Daily Living (RR : 0.83 ; CI : 0.75-0.92), no physical activity (RR : 0.44 ; CI : 0.28-0.70), smoking (RR : 1.74 ; CI : 1.05-2.89). CONCLUSION: Mortality in dementia depended on age, sex, CDR, ADL, IADL, physical activity, smoking. These findings have important implications that contribute to make the disease management of dementia patients.
Activities of Daily Living ; Cohort Studies ; Dementia* ; Diagnosis ; Disease Management ; Education ; Follow-Up Studies ; Humans ; Male ; Mortality* ; Motor Activity ; Proportional Hazards Models ; Risk Factors* ; Smoke ; Smoking

This is to report a case of immediate reconstruction after hemimandibulectomy by using of bicorticocancellous block bone harvested from the iliac crest in the case of an ameloblastomaon the mandible. Because the lesion involved condylar area, it was reconstructed with titanium artificial condyle attached to A/O metal plate. Three weeks after the operation, infection developed with suppuration and was well treated with adequate antibiotic therapy and drainage. The patient has been followed up over a four-year period and taken an orthopantomogram every three or six month for the examination of mandibular movement, the potentiality of recurrence and the remodeling of the grafted bone. At present, the patient is satisfied with her appearence and has a normal occlusion with proper masticatory function, and there is no sign of recurrence.
Ameloblastoma* ; Drainage ; Humans ; Mandible ; Mandibular Osteotomy ; Recurrence ; Suppuration ; Titanium ; Transplants*

In Korea, the prevalence of major depression is 4 per 100 and the world prevalence is 10 per 100. Risk factors are women, younger cohort, separated and divorced, persons with family history, early parental death and disruptive childhood environment, negative stressful events and chronic stress, absence of confidant in women, and urban areas. The mean age of onset ranges from late twenties to early thirties, but the age of onset becomes earlier and the prevalence of major depression is increasing. The recurrence rate is 85% and patients experience four episodes of depression on average and major depression is ranked as the fourth disabling disease. It was proven that major depression is one of most chronic and disabling diseases. The prognosis is poorer with comorbid dysthymia. Anxiety disorder, substance dependence, and hypothyroidism are frequent comorbid conditions with depression. And coronary arterial disease and stroke are also frequent comorbidities and their mortality rates increase with depression. The diathesis-stress model of depression is supported by the genetic study of depression. In conclusion, the rate of depression is rising and depression is one of the most chronic and disabling diseases. Therefore, I hope the disease be prevented through future studies.
Age of Onset ; Anxiety Disorders ; Cohort Studies ; Comorbidity ; Depression ; Depressive Disorder* ; Divorce ; Epidemiology* ; Female ; Hope ; Humans ; Hypothyroidism ; Korea ; Life Change Events ; Mortality ; Parental Death ; Prevalence ; Prognosis ; Recurrence ; Risk Factors ; Stroke ; Substance-Related Disorders

OBJECTIVES: To evaluate the incidence rate and associated factors of dementia in the elderly of rural community. METHODS: This study was three and half year follow-up of Yonchon cohort, participated in a prevalence study of dementia and depression in 1996 (N=1,037). A two-phase study was conducted using the Korean version of Psychogeriatric Assessment Scale in phase I and the diagnostic interview according to DSM-IV criteria by two psychiatrists in stage II. RESULTS: Of the 968 elderly residents who had not dementia in 1996 prevalence study, 596 residents completed the incidence study. The annual incidence rate for total dementia, dementia of Alzheimer's type and vascular dementia were 1.88% (1.86% in men, 1.98% in women), 1.58% (1.39% in men, 1.80% in women) and 0.34% (0.45% in men, 0.25% in women), respectively. Increasing age was significantly associated with total dementia and dementia of Alzheimer's type (p<0.01, p<0.05, respectively). There was statistically significant difference of the three and half year mortality rate between the dementia patients who were diagnosed in prevalence study and the non-dementic elderly (chi2=28.89, df=1, p<0.001). Only the 2.8% of newly onset dementia patients sought psychiatric service in the previously year. CONCLUSIONS: The incidence of dementia among the Korean elderly in a rural community was relatively consistent with the epidemiological studies of other countries. Age was the only risk factor for total dementia and dementia of Alzheimer's type. Very few dementia patients were treated by psychiatrist.
Aged* ; Cohort Studies* ; Cross-Sectional Studies ; Dementia* ; Dementia, Vascular ; Depression ; Depressive Disorder* ; Diagnostic and Statistical Manual of Mental Disorders ; Epidemiologic Studies ; Follow-Up Studies* ; Humans ; Incidence* ; Male ; Mortality ; Prevalence* ; Psychiatry ; Risk Factors ; Rural Population

With a rapidly aging society, geriatric mental health is emerging as important public health concern. Despite the short history of psychiatric epidemiology in Korea, recently, epidemiologic data regarding geriatric psychiatric problems has started to accumulate. In the current study, we reviewed epidemiological findings regarding geriatric mental health in Korea. It was found that up to 10% of the elderly suffer from dementia, and 10% to 20% from depressive disorder. Further, prevalence estimates of Alzheimer's disease ranged from 4.2% to 9.0%, and vascular dementia from 1.0% to 4.8%. Annual incidence rates for Alzheimer's were 2.7% to 3.4% whereas that for vascular dementia was found to be as low as 0.3%. The prevalence of major depressive disorder was 4.2% to 9.1%, while that of clinically significant depressive symptom was between 9.1% and 33.0%. Finally, those with alcohol use disorders were found to comprise up to 13.6% of elderly population and additionally, 22% to 58% of the elderly were found to have sleep difficulties. Thus major mental disorders are already prevalent among the Korean elderly and are likely to increase rapidly.
Aged ; Aged, 80 and over ; Alzheimer Disease/epidemiology ; Dementia/epidemiology ; Dementia, Vascular/epidemiology ; Depressive Disorder/epidemiology ; Humans ; Mental Disorders/*epidemiology ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors

With a rapidly aging society, geriatric mental health is emerging as important public health concern. Despite the short history of psychiatric epidemiology in Korea, recently, epidemiologic data regarding geriatric psychiatric problems has started to accumulate. In the current study, we reviewed epidemiological findings regarding geriatric mental health in Korea. It was found that up to 10% of the elderly suffer from dementia, and 10% to 20% from depressive disorder. Further, prevalence estimates of Alzheimer's disease ranged from 4.2% to 9.0%, and vascular dementia from 1.0% to 4.8%. Annual incidence rates for Alzheimer's were 2.7% to 3.4% whereas that for vascular dementia was found to be as low as 0.3%. The prevalence of major depressive disorder was 4.2% to 9.1%, while that of clinically significant depressive symptom was between 9.1% and 33.0%. Finally, those with alcohol use disorders were found to comprise up to 13.6% of elderly population and additionally, 22% to 58% of the elderly were found to have sleep difficulties. Thus major mental disorders are already prevalent among the Korean elderly and are likely to increase rapidly.
Aged ; Aged, 80 and over ; Alzheimer Disease/epidemiology ; Dementia/epidemiology ; Dementia, Vascular/epidemiology ; Depressive Disorder/epidemiology ; Humans ; Mental Disorders/*epidemiology ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors

OBJECTIVES: The purpose of this study is to analyze sleep habit and investigate the association between insomnia and demographic, health and psycho-behavioral symptomatology in Korean urban elderly. METHOD: A total of 723 community residents aged 65 years or older were surveyed by two stage, random cluster sampling method. The response rate was 76.2%. Interviewers performed door to door visits and administered a questionnaire about sleep, past medical history, and several scales as the Psychogeriatric Assessment Scale (PAS), the short form Quality of Life Scale (SF-36) and etc. RESULTS: The mean scores are as follows: retiring time was ten-sixteen p.m., wake-up time was five twenty two a.m., duration of sleep was seven hours and six minutes. Among the elderly, 11.6% and 14.8% of the subjects reported chronic and intermittent difficulty in sleeping, respectively. The patients with back pain and history of stroke complained of more insomnia symptoms in univariate analysis. In ANCOVA analysis, insomnia symptoms were associated with an old age, depressive symptoms in male. Bodily pain and history of dermatologic disease were additional risk factors in female. CONCLUSIONS: The data suggest insomnia is one of most common health problems among elderly Koreans living in the community. Strong positive relationship between depressive symptoms and insomnia were found. Further research is needed to explore the causal relationship between insomnia and risk factors.
Aged* ; Back Pain ; Depression ; Epidemiology ; Female ; Humans ; Male ; Quality of Life ; Surveys and Questionnaires ; Risk Factors ; Sleep Initiation and Maintenance Disorders ; Stroke ; Weights and Measures

OBJECTIVES: In South Korea, there is limited information on nicotine dependence (ND) and its correlation with psychiatric disorders. Based on the National Epidemiologic Survey of Psychiatric Disorders in South Korea in 2006, we examined the relationship between the severity of tobacco smoking and mental disorders, paying specific attention to suicidal ideas, plans, and attempts. METHODS: A total of 6,510 adults underwent face-to-face interviews. The Korean version of the Composite International Diagnostic Interview (K-CIDI) was used to evaluate lifetime prevalence and correlates of mental disorders. According to the the severity of tobacco smoking, participants were grouped into never-smokers, ever-smokers, and ND. The frequencies of mental disorders and suicidal tendencies were analyzed among ND/ever-smokers. Multivariate logistic regression analysis was used to predict the odds ratios and significance levels among groups. RESULTS: Associations of ND with alcohol use disorder, mood disorder, anxiety disorder, pathological gambling, and suicidal tendencies were significant, even after controlling for demographic characteristics. Associations of most psychiatric disorders with smoking were stronger in females than in males. CONCLUSION: ND is highly associated with alcohol use disorder, mood and anxiety disorders, pathological gambling, and suicidal tendencies. Interventions are needed in order to prevent the development of ND from regular smoking.
Adult ; Anxiety Disorders ; Female ; Gambling ; Humans ; Logistic Models ; Mental Disorders ; Mood Disorders ; Odds Ratio ; Prevalence ; Republic of Korea ; Smoke ; Smoking ; Suicide ; Tobacco ; Tobacco Use Disorder