While depression is certainly a prevalent disorder, it is often severe and debilitating and does not always have the good prognosis we have been led to expect. Social approaches to affective disorders have not been subjected to the same level of scrutiny as the interventions used in the management of schizophrenia. Psychosocial Rehabilitation is now at a critical stage. Psychoeducation, social skill training, cognitive remediation, family education, vocational rehabilitation and case management programs are essential for the rehabilitation of chronic depression.
Case Management ; Depression* ; Humans ; Mood Disorders ; Prognosis ; Rehabilitation* ; Schizophrenia ; Vocational Education

No abstract available.
Hematology* ; Humans ; Thyroid Gland*

Conventional high-dose antipsychotics tend to result in more side effects, negative symptoms and dysphoria, and at the same time lower the cognitive function which is already impaired in most schizophrenics. Florid psychotic symptoms, negative symptoms and cognitive impairment greatly impede psychosocial performance and eventual reintegration int society. The reduction of symptom and the improvement of cognitive funtions and social skills are therefore central to the psychiatric rehabilitation process. The purpose of this study was to evaluate the dose-reduction effects of antipsychotics more than 1,500mg equivalent of chlorpromazine. Fifty-one chronic schizophrenics who maintained high-does antipsychotics for more than three months were randomly assigned to two groups : 20 patients comprised the dose-maintaining group and 31 patients made the dose-reduction group. Over a sixteen weekperiod Positive and Negative Syndrome Scale(PANSS), Extrapyramidal Symptom(EPS), Nurses' Observation Scale for Inpatient Evaluation(NOSIE-30), Continuous Performance Test(CPT), Quality of Life(QOL), and haloperidol/reduced haloperidol blood levels were determined at the base line and after 2, 4, 6, 8, 12, 16 weeks to evaluate the dose reduction effects of high-dose antipsychotics. The results were as follows: 1) Dose-reduction is highly effective in reducing positive and negative symptoms, and general psychopathology. Effects were most prominent at 8, 12, 16 weeks. Among the dose reduction group, positive symptoms in positive symptom group and negative symptoms in negative symptom group were more reduced. 2) Extrapyramidal symptoms showed no significant difference between two groups. But EPS was reduced time after time within two groups. 3) Hit rates of Continuous Performance Test, which indicate attentional capacity, increased significantly after dose reduction. 4) Haloperidol and reduced haloperidol blood levels decreased until the 4th week, after which they were constant. 5) Total scores of Nurses' Observation Scale for Inpatient Evaluation were unchanged between the two groups. But among the indices, social interest and personal neatness were improved in the dose-reduction group and retardation was aggrevated in the dose-maintaining group. 6) Total quality of life scores were unchanged between two groups. But in the dose maintaining group, satisfaction scores of attention, autonomy, and interpersonal relationship decreased progressively. These findings suggest that the dose reduction of antipsychotics for chronic schizophrenics on programs of high-dose antipsychotics were effective. Dose reduction should therefore be implemanted to spread the rehabilitation and improve quality of life for chronic schizophrenics.
Antipsychotic Agents* ; Chlorpromazine ; Haloperidol ; Humans ; Inpatients ; Psychopathology ; Quality of Life ; Rehabilitation

No abstract available.
Congenital Hypothyroidism*

OBJECTIVES: Compared with the general population, individuals with schizophrenia are known to have lower self-esteem, in part because of internalized self-stigma. The aim of this study was to assess the efficacy of a Self-stigma Overcome Program (SOP), named self-esteem enhancement program for inpatients with schizophrenia. METHODS: The 46 patients with schizophrenia from Yongin Mental Hospital Rehabilitation Ward were randomly assigned to a SOP group or to a control group. The SOP groups received 15 sessions of SOP treatment over four months. SOP combined existing structured modules for the purpose of increasing self-esteem and empowerment with cognitive behavior therapy (CBT) techniques. The program module was divided into three building blocks: sense of security, sense of purpose, and sense of competence. All the subjects were assessed before and after the treatment period on measures of psychosocial functioning, diagnostic variables, and symptomatology. RESULTS: Compared with patients in the control condition, SOP group patients showed significant improvements on measures of empowerment and internalized stigma. The SOP groups subjectively also reported more improved self-respect, self-understanding, and positive self-regard. However, there were no significant improvements on measures of self-esteem and quality of life. CONCLUSION: These results indicate that individuals with schizophrenia appear to be benefit from a self-esteem enhancement module, particularly when they are involved in a rehabilitation program. These findings encourage a reconsideration of patients' empowerment and competence in order to ensure lasting effects on overall functional outcome of chronic schizophrenics.
Cognitive Therapy ; Dietary Sucrose ; Hospitals, Psychiatric ; Humans ; Inpatients ; Mental Competency ; Power (Psychology) ; Schizophrenia

Though high stone free rates were reported with ESWL monotherapy or anatrophic nephrolithotomy, percutaneous nephrolithotomy with or without ESWL appears to be the procedure of choice for most staghorn calculi. A total of 41 patients with staghorn calculi underwent percutaneous nephrolithotomy(PNL) alone or primary percutaneous debulking followed by extracorporeal shock wave lithotripsy(ESWL) of residual stone fragments. For the objective analysis of the results of PNL stone removal rate was calculated with stone surface area which was determined by computer analyzer. For staghorn calculi smaller than 2000 mm2(38/41), a mean stone removal rate of about 90% was achieved in the PNL. When stone surface area exceeded 2000 mm2(3,41), the mean stone removal rate was 78.8%. The stone removal rates stratified by stone surface area were not significantly different. The stone free rate was 31.7% in the PNL only but 75.6% in the PNL with or without ESWL. The higher mean stone removal rate and stone free rate was achieved in the kidneys with non-dilated collecting system than those with hydronephrosis, but it was not statistically significant.
Calculi* ; Humans ; Hydronephrosis ; Kidney ; Nephrostomy, Percutaneous* ; Shock

OBJECTIVES : The primary purpose of this study was to investigate the effects of computerized cognitive rehabilitation training on inpatients with schizophrenia in the rehabilitation unit. METHODS : Thirty-eight patients with schizophrenia from the Yongin Mental Hospital Rehabilitation Ward were randomly assigned either to a computerized cognitive rehabilitation group or to a control group. The rehabilitation group received 12 sessions of computerized cognitive rehabilitation training (Cog-Trainer) over 3 months. This training program consisted of ten units, each of which consisted of 3 levels, practice, application, and advanced. Neurocognitive functions were assessed at the beginning and end of the training period. Cognitive measures included Span of Apprehension (SPAN), Continuous Performance Test (CPT), Digit Span, Trail Making Test, and the Stroop Test. RESULTS : Compared to controls, subjects receiving computerized cognitive rehabilitation training experienced a significant improvement in attention, concentration, and working memory. CONCLUSION : These results indicate that computerized cognitive rehabilitation training can contribute to improvement in cognitive function of patients with schizophrenia. Further study to generalize these results is required.
Hospitals, Psychiatric ; Humans ; Inpatients ; Memory, Short-Term ; Pilot Projects ; Schizophrenia ; Trail Making Test

Accurate anatomical reduction of the displaced acetabular fractures has a great clinical importance because acetabulum is related to weight-bearing and their fractures can lead to serious major sequelae. There are controversies and a lot of problems with regard to the management of the displaced acetabular fractures. The purpose of our study is to analyze the clinical results of operative treatment of the displaced acetabular fractures and to establish guidelines for treatment of their fractures. A clinical analysis was performed on 19 patients with displaced unstable acetabular fractures who had been operated on and followed for minimum 1 year period at Asan Medical Center from September 1989 to August 1992. The results were as follows: 1. The most common type was posterior wall fracture according to Letournel's classification. 2. Excellent or good results were obtained in 84% according to Goodwin's assessment method. All of the elementary fracture.s presented excellent or good results, while fair or poor results were observed in some T-shaped fractures or transverse and posterior wall fracture. 3. Complications were observed in 5 cases, including ectopic ossification(2 cases), traumatic arthritis(1 case), avascular necrosis of femoral head(1 case) and deep wound infection(1 case). Those seemed to be related with severe acetabular injury and extensive approach. 4. Kocher-Langenbeck approach was satisfactory for reduction and fixation of posterior column in transverse fracture, while extended iliofemoral approach was necessary for fixation of both column in T-shaped fracture. 5. Reduction of fracture of ilium was prerequisite for reduction of acetabular articular surface. 6. In displaced unstable acetabular fractures, early surgical intervention shich includes accurate anatomical reduction, and rigid internal fixation should be undertaken, and early joint motion should be followed to restore the joint function and to decrease the complication rate.
Acetabulum ; Chungcheongnam-do ; Classification ; Humans ; Ilium ; Joints ; Methods ; Necrosis ; Weight-Bearing ; Wounds and Injuries

No Abstract Available.
Allografts* ; Posterior Cruciate Ligament*

Objectives: This study examined the factors influencing the psychological problems experienced by suicide survivors to propose support measures for them. Methods: One thousand one hundred and twenty suicide survivors who participated in psychological autopsy interviews from 2015 to 2022 were examined to explore the variables affecting psychological problems (sleep problems, depression, alcohol use problems, prolonged grief, and suicidal thoughts). Results: The analysis showed that, when controlling for demographic information, the relationship with the deceased and experiencing negative changes after the loss significantly influenced the psychological problems of suicide survivors. Conclusion This study is significant in examining various psychological issues of suicide survivors. Based on the analysis results, this paper proposes interventions tailored to the demographic characteristics of suicide survivors, enhanced support for those who lost children or spouses, and interventions addressing the negative changes after bereavement.