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Point Prevalence of Anxiety and Depression among Cancer Inpatients in a General Hospital: A Preliminary Study for the Development of Distress Management Strategies in Cancer Patients.

Min A LEE ; Hyu Jung HUH ; Jung Ah MIN ; Chang Uk LEE ; Chul LEE ; Tae Suk KIM

Korean Journal of Psychosomatic Medicine.2013;21(2):122-131.

OBJECTIVES: This study aimed to examine the point prevalence of anxiety, depression and the associated risk factors in hospitalized patients with cancer. METHODS: A total of 114 patients with cancer who admitted to the Cancer Center in St. Mary's Hospital were enrolled for a day. The patients were asked to complete Hospital Anxiety and Depression Scale(HADS). Sociodemographic and cancer related clinical variables were also evaluated. RESULTS: The point prevalence of anxiety and depression was 10.5% and 34.2%, respectively, as assessed with HADS. Logistic regression models revealed that distant metastasis was significantly associated with anxiety in patients with cancer and previous chemotherapy and Low socioeconomic status were significantly associated with depression. CONCLUSIONS: Our results indicate that more than one third of patients with cancer suffer from either anxiety or depression. In addition, previous chemotherapy as well as low socioeconomic status and distant metastasis were associated risk factors of anxiety and depression, respectively. These findings suggest the need for screening and systematized psychosocial intervention for psychological distress in hospitalized patients with cancer.
Anxiety* ; Depression* ; Drug Therapy ; Hospitals, General* ; Humans ; Inpatients* ; Logistic Models ; Mass Screening ; Neoplasm Metastasis ; Prevalence* ; Risk Factors ; Social Class

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Characteristics of Psychiatric Consultation between Presenile and Senile Inpatients.

Ji Woong LEE ; Jin Sook CHEON ; Kang Ryul KIM ; Hyun Seuk KIM ; Byoung Hoon OH

Korean Journal of Psychosomatic Medicine.2013;21(2):114-121.

OBJECTIVES: The aim of this study was to know differences of characteristics between presenile and senile patients who were consulted to the department of psychiatry during medical-surgical admission. METHODS: The demographic and clinical data obtained from the medical records of psychiatric consultation in the presenile inpatients with age 50 to 64 years(N=162) and those of the senile inpatients with age over 65 years(N=171) were reviewed and compared. RESULTS: 1) The most common chief complaints for psychiatric consultation in presenile patients were somatic symptoms, anxiety and sleep disturbance in order, while cognitive decline, clouded consciousness and depressed mood were most common in senile patients with statistical significance. 2) The most frequent psychiatric diagnoses after consultation in presenile patients were delirium, mood disorder and substance use disorder in order, while delirium, mood disorder and major neurocognitive disorder were most frequent in senile patients with statistical significance. 3) There were no significant difference in numbers of physical illnesses, while numbers of therapeutic drugs for them were more in senile patients. CONCLUSIONS: Our study found significant differences between presenile and senile patients on psychiatric symptoms and diagnoses in geropsychiatric consultation. Therefore, more subdivided age-specific approach seems to be needed for the geropsychiatric consultation activities.
Anxiety ; Consciousness ; Delirium ; Diagnosis ; Humans ; Inpatients* ; Medical Records ; Mood Disorders ; Substance-Related Disorders

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Psychosocial Characteristics and Factors Associated with Referral to Psychiatric Care in the Suicide Attempters Visiting Emergency Center.

Jung Woo KWON ; Young Hoon KO ; Chang Su HAN ; Moon Soo LEE ; Ho Kyung YOON ; Hongjae LEE

Korean Journal of Psychosomatic Medicine.2013;21(2):106-113.

OBJECTIVES: The purpose of this study was to examine the characteristics and the psychosocial factors associated to the referral to psychiatric care in the suicide attempters visiting emergency center. METHODS: We conducted a systematic chart review of 377 suicidal attempters visiting emergency center of the Korea University Ansan Hospital between January 2008 and December 2011. We gathered a data contain 20 items including psychosocial characteristics and factors related to suicide and factors related to psychiatric treatment. Multivariate logistic regression models were fitted to data to estimate the unique effects of sex, drunken status, companion, suicidal methods, place of suicide and current use of psychiatric medication on the referral to psychiatric care. RESULTS: The female gender(OR=1.63, 95% CI=0.99-2.69), suicidal attempts at home(OR=3.40, 95% I=1.21-9.56) and drunken state at visit(OR=2.34, 95% CI=1.10-5.01) are the factors that predict the risk of the non-referral of the patients to psychiatric intervention. Place of suicidal attempt was the most important factor do play a role in determining whether referral to psychiatric care will take place or not. Current use of psychiatric medication showed a trend toward significance(p=0.08, OR=1.67, 95% CI=0.95-2.95). CONCLUSIONS: These results suggest that when deciding whether to adapt or to refuse the referral to psychiatric care, the factors such as suicidal intent, lethality of suicide methods, familiar factors and alcohol may contribute onto the referral to psychiatric care. Additional research is required to investigate an association of these factors with referral to psychiatric care.
Emergencies* ; Epidemiology ; Female ; Friends ; Gyeonggi-do ; Humans ; Korea ; Logistic Models ; Methods ; Psychology ; Referral and Consultation* ; Suicide*

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Movement Disorders that Psychiatrists Should Know.

Jin Sook CHEON

Korean Journal of Psychosomatic Medicine.2013;21(2):99-105.

The movement disorders in psychiatry have been neglected, though it is an important psychiatric dimension to exert unfavorable influence on patients'quality of life. The etiologies of movement disorders in psychiatry can be classified as primary neurological disorders, psychiatric comorbidities of neurological disorders, manifestations of primary psychiatric disorders, drug-induced movement disorders and psychogenic movement disorders. For the rapid and proper treatment for movement symptoms and signs easily observed from psychiatric patients, psychiatrists' ability toward precise disgnosis and differential diagnosis of movement disorders should be preceded.
Comorbidity ; Diagnosis, Differential ; Humans ; Movement Disorders* ; Nervous System Diseases ; Psychiatry*

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Pathological Laughing and Crying: Pathophysiology and Treatment.

Ji Hyun KIM ; Beom Woo NAM ; Jin Yong CHOI

Korean Journal of Psychosomatic Medicine.2013;21(2):93-98.

Pathological laughing and crying(PLC) is a condition that is characterized by episodic, brief, contextually inappropriate, uncontrollable outbursts of laughing and/or crying. It can be observed in patients with various neurological disorders. PLC often causes distress in interpersonal functioning and activities for patients and their families. PLC can be recognized easily with proper understanding of the condition and its nature. Also it generally shows good response to various pharmacological treatments. This review aims to encourage the diagnosis and treatment of PLC by providing definition and clinical presentation of PLC, analysis of its pathophysiology and various current treatment options.
Crying* ; Diagnosis ; Humans ; Nervous System Diseases

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Adverse Effect of Newer Antidepressant ; Nausea and Vomiting, Weight Gain, Sexual Dysfunction: Mechanisms, Epidemiology, and Pharmacological Management.

Kyung Kyu LEE

Korean Journal of Psychosomatic Medicine.2013;21(2):81-92.

Newer antidepressants are commonly used in clinical practice to treat psychiatric disorder and psychosomatic disorder including chronic pain syndrome, fibromyalgia, headache. However there are many unexpected adverse effects of these drugs such as nausea and vomiting, weight gain, sexual dysfunction. These are 3 most well-recognized common adverse effects of newer antidepressant and are most common causes of treatment failure. I reviewed mechanisms, epidemiology, and pharmacological management of these adverse effects of newer antidepressants. In this paper, newer antidepressants include selective serotonin reuptake inhibitor(fluoxetine, fluvoxamine, citalopram, escitalopram, sertraline, paroxetine), serotonin norepinephrine reuptake inhibitor(venlafaxine, duloxetine), norepinephrine and dopamine reuptake inhibitor(bupropion), noradrenergic and specific serotonergic antidepressant(mirtazapine), and reversible inhibitor of MAO-A(moclobemide). I suggest that psychiatrists and clinicians in the psychosomatic field should know mechanisms, epidemiology, and management of these common and well-recognized adverse effects of newer antidepressants. Therefore it will be helpful to recognize easily and treat well for patients with psychiatric disorder and psychosomatic disorder using newer antidepressants.
Antidepressive Agents ; Chronic Pain ; Citalopram ; Dopamine ; Epidemiology* ; Fibromyalgia ; Fluvoxamine ; Headache ; Humans ; Nausea* ; Norepinephrine ; Psychiatry ; Psychophysiologic Disorders ; Serotonin ; Sertraline ; Treatment Failure ; Vomiting* ; Weight Gain*

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History of Rhetoric in Mind and Body Relationship: Case of Migraine and Headache.

Seong Hoon JEONG

Korean Journal of Psychosomatic Medicine.2014;22(2):55-62.

The relationship of mind and body has stimulated extensive discussion for a long time. However, answers are ambigous and not forthcoming yet. Meanwhile, after the western medicine had embraced materialistic paradigm, conditions which cannot be substantiated by organic change were pushed out to periphery under the banner of "Medically Unexplained Symptoms". Medical experts endeavored to understand these mysterious illnesses based on the mind-body relationship and provided a frame of interpretation called Psychosomatic Medicine. This frame of interpretation had influenced not only the communication practice but also the health-seeking behavior and even the subjective experience of patients regarding their illnesses. The frame of interpretation had been drastically changed many times keeping pace with the socio-economic situation and the new scientific discoveries. Accordingly, body or mind was given differential importance by medical experts. For instance, when treatment modalities were lacking, mind was given excessive importance and patients were blamed for their unconscious motives, characterological weaknesses and for their lack of responsibility. In contrast, after the discovery of effective drug, mind was given no more attention and patients were no longer blamed for their contribution to suffering. In this paper, the historical change of the frame of interpretation for understanding migraine and headache was presented as an example. By this, it can be demonstrated how the frame of interpretation has modified the subjective experience of patients, and how the patients' responsibilities were viewed differently. This observation can help to realize the enormous influence of the frame of interpretation provided by medical experts.
Headache* ; Humans ; Migraine Disorders* ; Psychosomatic Medicine

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Effect of Duloxetine in Functional Gastrointestinal Disorder : In the Perspective of 'Brain-Gut Axis'.

Sang Shin LEE ; Si Sung PARK

Korean Journal of Psychosomatic Medicine.2012;20(2):135-138.

The pathophysiology of functional gastrointestinal disorder(FGID) is not completely understood, but the importance of the 'Brain-Gut Axis(BGA)' model in FGID is being increasingly recognized. The BGA model is a bidirectional, hard-wired and homeostatic relationship between the central nervous system(CNS) and the enteric nervous system(ENS) via neural, neurohormonal and neuroimmunological pathways. In addition, the BGA model would provide a rationale for the use of psychotropics on FGID. The authors experienced two cases in which duloxetine, a serotonin-norepinephrine reuptake inhibitor, was effective in relieving FGID symptoms as well as psychiatric symptoms such as depression and hypochondriacal anxiety. Therefore we discuss the vignettes from the perspective of BGA theory. Duloxetine showed efficacy in these two patients by reducing visceral hypersensivity (bottom-up regulation) and by relieving depression and anxiety(top-down regulation).
Anxiety ; Depression ; Gastrointestinal Diseases ; Humans ; Irritable Bowel Syndrome ; Thiophenes

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The Reliability and Validity Studies of the Korean Version of the Perceived Stress Scale.

Jongha LEE ; Cheolmin SHIN ; Young Hoon KO ; Jaehyung LIM ; Sook Haeng JOE ; Seunghyun KIM ; In Kwa JUNG ; Changsu HAN

Korean Journal of Psychosomatic Medicine.2012;20(2):127-134.

OBJECTIVES: Perceived stress scale is a self-report inventory to estimate the degree of individual perceived stress in daily life. The aim of this study was to introduce this scale and test the reliability and validity of the Korean version of PSS. METHODS: The total of 154 female hospital workers were included in this study. The survey questionnaires were conducted for demographic information. All participants were required to complete PSS, Hamilton Anxiety scale and Beck Depression Inventory. Reliability and validity studies were conducted and internal consistency was examined. RESULTS: The mean score of the PSS reported in this sample was 20.69+/-4.56. The overall Cronbach's alpha was 0.819, and the test-retest reliability coefficient was 0.66. PSS had a significant positive correlation with the HAM-A(r=0.49, p<0.01), and the BDI(r=0.55, p<0.01). Factor analysis yielded 2 factors with eigenvalues of 3.924 and 2.608, accounting for 65 percent of variance. Factor 1 represented "stress" and factor 2 represented "control of stress". CONCLUSIONS: This study indicates that the PSS is appropriate for estimating the perceived stress levels. These results support the use of PSS in large sections of the population in Korea.
Accounting ; Anxiety ; Depression ; Female ; Humans ; Korea ; Questionnaires ; Reproducibility of Results

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A Preliminary Study on Emotion, Self-Esteem and Quality of Life in the Patients with Chest Pain.

Sook Hyun PARK ; Young Myo JAE ; Dae Su LEE ; Saeheon JANG ; Jin Hyuk CHOI ; Han Cheol LEE

Korean Journal of Psychosomatic Medicine.2012;20(2):120-126.

OBJECTIVES: The objective of this study is to measure and to compare the rate of depression, anxiety, self-esteem and the quality of life of the patients with chest pain. Based on the result of this study, the necessity of the psychiatric assessment and treatment of the patients with chest pain is emphasized. This study is a preliminary research for a larger scale investigation to be carried out in the future. METHODS: Thirty nine patients with chest pain who visited Cardiovascular Division of Dept. of Internal Medicine Pusan National University Hospital and fourty normal control group(NC) were included in this study. The patients were classified into typical chest pain group(TCP, N=19) and atypical chest pain group(ACP, N=20) based on the cause of the pain. The cause was determined by cardiac computed tomography, exercise stress test, coronary angiography, and questionaires by a cardiology specialist. The patients were assessed with Beck Depression Inventory(BDI), State-Trait Anxiety Inventory(STAI), Rosenberg Self-Esteem Scale(RSES) and Korean version of the Smith Klein Beecham 'Quality of Life' scale(KvSBQOL). RESULTS: 1) When the risk factors of cardiac disease is compared, most of the factors(Hypertension, Diabetes, Hyperlipidemia, Cerebral infarction) did not differ significantly among the two chest pain groups, except for the family history, for which TCP group showed higher risk than ACP group did. 2) As for the self-report questionaires scores, BDI score, which indicates the rate of depression, of both ACP group and TCP group was significantly higher than that of NC group in BDI for depression. STAI score, which measures anxiety, was also significantly high in both groups. Especially, STAI score was significantly higher in ACP group than TCP group. 3) In the aspect of self-esteem and quality of life, ACP group scored significantly lower than TCP group and NC group. The scores for TCP group and NC group did not differ significantly. CONCLUSIONS: The patients with chest pain showed more depression and anxiety than normal control group, regardless of the cause of the pain. However, TCP group did not show significantly larger drop in self-esteem and quality of life than ACP group did. This result implies that early psychiatric assessment and treatment is needed for the patients with such chest pain, since it is highly likely that the pain would lead to lower quality of life of the patients.
Anxiety ; Cardiology ; Chest Pain ; Coronary Angiography ; Depression ; Exercise Test ; Heart Diseases ; Humans ; Hyperlipidemias ; Internal Medicine ; Quality of Life ; Risk Factors ; Specialization ; Thorax

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