1.Korean Addiction Treatment Guidelines (III) : Psychosocial Treatment of Alcohol Use Disorder.
Seung Heon OH ; Chang Woo HAN ; Jeong Seok SEO ; Keun Ho JOE ; Hae Kook LEE ; Hong Gyun YOON ; Sam Wook CHOI ; Hyun Soo KIM ; Bo Hye LEE ; Kye Seong LEE
Journal of Korean Neuropsychiatric Association 2014;53(4):221-227
OBJECTIVES: The aim of this study is to develop guidelines for psychosocial treatment of alcohol use disorder. METHODS: According to the ADAPTE manual, the Korean alcohol use disorder treatment guidelines were developed by the guideline development committee. Recommendations from foreign guidelines were evaluated regarding the applicability and acceptability to domestic circumstances. In addition, a survey from experts was conducted, along with a review of Korean literature. By these means, recommendations of psychosocial treatment for alcohol use disorder were established. RESULTS: The main findings of the survey were as follows : 1) Although Group therapy was not recommended by foreign clinical guidelines, it was considered as a first-line treatment by Korean experts. 2) Among many psychosocial treatment programs, cognitive behavior therapy (CBT), coping skills training, 12-step facilitation, and Group therapy were commonly used programs in Korea. Finally, the following treatment methods were selected for recommendations : Group therapy, motivational enhancement treatment, CBT, behavioral self-management, alcoholic anonymous, 12-step facilitation, psychodynamic psychotherapy, psychoeducational intervention, continuous case management, and community residential rehabilitation program. CONCLUSION: Just as in treatment of chronic diseases such as hypertension, continuity is important for management of alcohol use disorder. Therefore, not only pharmacological treatment but also psychosocial treatment should be provided comprehensively after treatment of acute withdrawal symptoms.
Adaptation, Psychological
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Alcoholics
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Anonyms and Pseudonyms
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Case Management
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Chronic Disease
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Cognitive Therapy
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Humans
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Hypertension
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Korea
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Psychotherapy, Group
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Psychotherapy, Psychodynamic
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Rehabilitation
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Self Care
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Substance Withdrawal Syndrome
2.Psychodynamic Psychotherapy for Functional (Psychogenic) Movement Disorders.
Vibhash D SHARMA ; Randi JONES ; Stewart A FACTOR
Journal of Movement Disorders 2017;10(1):40-44
OBJECTIVE: As the literature for the treatment of functional (psychogenic) movement disorders (FMD) is sparse, we assessed clinical outcomes in patients with FMD who underwent treatment with psychodynamic psychotherapy (PDP). METHODS: A retrospective analysis of the data of patients with FMD who were referred for PDP from 2008−2014 at Emory University Medical Center was performed. RESULTS: Thirty patients were included, mean age at presentation was 50 years (SD 13.9) and majority were female (27/30). Most common movement disorder was involuntary shaking/jerky movements (50%) and tremor (43%). Mean duration of symptoms was 3.2 years and mean number of PDP visits was 4.9. PDP lead to good outcomes in 10, modest in 8, and poor in 9. Three patients lost to follow up. Mean duration of symptoms between two groups (good vs. poor) was not statistically significant (p = 0.11), mean number of PDP visits showed a trend towards significance (p = 0.053). In all cases of good outcomes precipitants of the movement disorder were identified and a majority (60%) was receptive of the diagnosis and had good insight. CONCLUSION: PDP lead to improvement in 60% of the patients which is encouraging as the treatment is challenging. This study supports heterogeneous causes of FMD including varied roles of past/recent events and demonstrates importance of psychological approaches such as PDP. Treatment with PDP should be considered in some patients with FMD but predicting who will respond remains a challenge. Further long term prospective studies with large sample size and placebo control are needed.
Academic Medical Centers
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Conversion Disorder
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Diagnosis
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Female
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Humans
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Lost to Follow-Up
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Movement Disorders*
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Prospective Studies
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Psychotherapy, Psychodynamic*
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Retrospective Studies
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Sample Size
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Tremor
3.Psychiatry in Former Socialist Countries: Implications for North Korean Psychiatry.
Young Su PARK ; Sang Min PARK ; Jin Yong JUN ; Seog Ju KIM
Psychiatry Investigation 2014;11(4):363-370
Very little information is available regarding psychiatry in North Korea, which is based on the legacy of Soviet psychiatry. This paper reviews the characteristics of psychiatry in former socialist countries and discusses its implications for North Korean psychiatry. Under socialism, psychiatric disorders were attributed primarily to neurophysiologic or neurobiological origins. Psychosocial or psychodynamic etiology was denied or distorted in line with the political ideology of the Communist Party. Psychiatry was primarily concerned with psychotic disorders, and this diagnostic category was sometimes applied based on political considerations. Neurotic disorders were ignored by psychiatry or were regarded as the remnants of capitalism. Several neurotic disorders characterized by high levels of somatization were considered to be neurological or physical in nature. The majority of "mental patients" were institutionalized for a long periods in large-scale psychiatric hospitals. Treatment of psychiatric disorders depended largely on a few outdated biological therapies. In former socialist countries, psychodynamic psychotherapy was not common, and psychiatric patients were likely to experience social stigma. According to North Korean doctors living in South Korea, North Korean psychiatry is heavily influenced by the aforementioned traditions of psychiatry. During the post-socialist transition, the suicide rate in many of these countries dramatically increased. Given such mental health crises in post-socialist transitional societies, the field of psychiatry may face major challenges in a future unified Korea.
Biological Therapy
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Capitalism
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Democratic People's Republic of Korea
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Hospitals, Psychiatric
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Humans
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Korea
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Mental Health
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Neurotic Disorders
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Psychotherapy, Psychodynamic
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Psychotic Disorders
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Social Stigma
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Socialism
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Suicide