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Objectives : This cross-sectional study was aimed to investigate the factors associated with bipolar disorder in pregnant female, including sociodemographic parameters, social support, social conflict, suicidal idea and sleep. Methods : A total of 84 pregnant female were recruited. They filled out self-completing questionnaires on sociodemographic factors, obstetric history, depressive symptoms and bipolarity. Depressive symptoms were assessed using the Korean version of the Edinburgh Postnatal Depression Scale (EPDS). Bipolarity was assessed using the Korean version of the Mood Disorder Questionnaire (K-MDQ). Results : Nineteen participants (22.6%) had positive K-MDQ scores, suggesting the present of bipolarity. Positive EPDS group had twenty subjects (25%) who had depressive symptoms. The diathesis of bipolar disorder was associated with marital dissatisfaction, social conflict, depression and sleep. The multiple logistic regression analysis revealed that the only poor sleep was a risk of bipolarity. Conclusion : Pregnant female with bipolarity were more depressed and sleep problems than those without bipolarity. The results showed that the most important factor of influencing bipolarity was sleep.
Objects ; The purpose of this study was to review the clinical and biological differences between early onset depression and late onset depression among elderly. Methods ; The author reviewed the medical literature covering the past 25years. Results ; There is strong relationship between late-onset depression and brain abnormality, including subcortical, deep white matter hyperintensity. Late-onset depression also has strong relation with vascular disorder and dementia. Early-onset depression has strong genetic component, while late-onset depression has more environmental component rather than genetic component. Medical burden, life events and stress influence elderly through bidirectional way. Conclusions ; Late-onset depression is heterogeneous disorder. It appears that both type of geriatric depression has different etiology, similar phenomenology. Further investigation will be needed to develop ways to identify geriatric depression in community early in disease course and enhance therapeutic efficacy and speed therapeutic response to avoid serious complication such as suicide and high mortality.
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Objectives:Stress has been known as one of the main reasons for drinking. Depression also is a risk factor for people to have alcohol related problem. Despite of high correlation between depression and stress, little study has been done to see the simultaneous effect of depression and stress to alcohol dependence. We tried to investigate the prevalences of depressive symptom, stress and alcohol dependence among Jeju rural population. Also, we have tried to find a relationship of alcohol dependence with depressive symptom and stress. Methods:The study subjects were 1,086, 531 (48.9%) male and 555 (51.1%) female living in rural Jeju area. We collected data through face-to face interviews in 2002. With the data we investigated the prevalences of alcohol dependence, depression and stress using CAGE, Alcohol use disorder identification test (AUDIT), Beck Depression Inventory (BDI), and Psychosocial Well Being Index Short Form (SF-PWI). Results:1) The prevalence of alcohol dependence in rural Jeju area is 22.3% in male, 3.6% in female. The prevalence of depressive symptom is 14.9% in male, 18.4 in female. The prevalence of moderate distress is 70.8% in male, 67.5% in female. The prevalence of severe distress is 16.7% in male, 26.7% in female. 2) In relationship between stress and alcohol dependence, odds ratio of moderate distress is 7.76 (95% CI 1.86-32.35), severe distress is 17.29 (95% CI 3.95-75.60) in male, and the odd ratio of depressive symptom is 2,96 (95% CI 1.12-7.84) in female. 3) Multiple logistic regression analysis showed that the risk factors for male alcohol dependence were potential stress (OR=8.15 95% CI 1.91-34.65), and stress risk (OR= 22.47 95% CI 4.86-103.704). The risk factor for female alcohol dependence was depressive symptom (OR=3.42 95% CI1.10-10.56). Conclusion:Compared with national survey result, the prevalence of alcohol dependence in rural Jeju area is relatively low. Stress in male, depressive symptom in female proved to be strong risk factors. This suggests that we can apply coping strategies to stress in male alcoholics, and treat depression in female alcoholics for improving their mental health.
Objective: The primary goals of the present study were to assess intellectual function in participants with schizophrenia or bipolar disorder (BD) and to investigate the relationships between cognitive decline and the severity of each type of psychopathology. Methods: The present study included 51 patients with schizophrenia and 42 with BD who were recruited from the psychiatry outpatient clinic of Jeju University Hospital between March 2011 and March 2014. The Korean Wechsler Adult Intelligence Scale (K-WAIS) was administered to each of the 93 participants, and they were categorized into two groups based on their current intelligence quotient (IQ) and their estimated premorbid IQ: severely impaired group (SIG) and mildly impaired group (MIG). The Minnesota Multiple Personality Inventory (MMPI) and the Brief Psychiatric Rating Scale (BPRS) were used to assess psychopathology. Results: The SIG schizophrenia participants exhibited significantly higher scores on the frequent (F) and schizophrenia (Sc) subscales of the MMPI, but significantly lower scores on the correction (K) and psychopathic deviate (Pd) subscales compared with the MIG schizophrenia participants. Furthermore, the BPRS scores were significantly higher in the SIG schizophrenia participants relative to the MIG schizophrenia participants. The SIG BD participants had significantly higher F, masculinity-femininity (Mf), paranoia (Pa), and Sc but significantly lower Pd scores compared with the MIG BD participants. Conclusion: The present findings revealed a significant discrepancy between the estimated premorbid levels of cognitive function and current cognitive function in participants with schizophrenia or BD. Moreover, this discrepancy was correlated with severity of psychopathology in both groups.
Objective To investigate the prevalence of dementia and its correlates among people with poor socioeconomic status, poor social support systems, and poor performance on the Korean version of the Mini-Mental Status Exam (MMSE-KC). MethodsaaWe used 2006-2009 data of the National Early Dementia Detection Program (NEDDP) conducted on Jeju Island. This program included all residents >65 years old who were receiving financial assistance. We examined those who performed poorly (standard deviation from the norm of <-1.5) on the MMSE-KC administered as part of the NEDDP, using age-, gender-, and education-adjusted norms for Korean elders. A total of 1708 people were included in this category. Results The prevalence of dementia in this group was 20.5%. Multivariate logistic regression analysis revealed that the following factors were statistically significantly associated with dementia: age of 80 or older, no education, nursing home residence, and depression. Conclusion The prevalence of dementia is very high among those with lower MMSE-KC scores, and significant correlates include older age, no education, living in a nursing home, and depression. Enhancing lifetime education to improve individuals’ cognitive reserves by providing intellectually challenging activities, encouraging living at home rather than in a nursing home, and preventing and treating depression in its early phase could reduce the prevalence of dementia in this population.
Subsyndromal bipolar symptoms are common during maintenance treatment and appear to be associated with relapse into an episode of the same polarity. This implies subsyndromal symptoms are an important problem in recurrent bipolar disorder and require more additive and infallible therapeutic intervention. Undetected, untreated subsyndromal states lead patients to have poor prognosis and quality of life. The combination of a long undetected illness and significant psychosocial impairment renders early identification and intervention vital for the treatment of bipolar disorders. Methods for early identification includes finding prodromes, using screening tools such as the HCL-32 (Hypomania Checklist-32) and the BSDS (bipolar spectrum diagnostic scale). Various augmentation treatment methods would be needed to reduce subsyndromal symptoms, especially, psychosocial treatment has the potential to help patients address the multiple psychosocial problems associated with this chronic illness. To overcome difficulties of diagnosing subsyndromal disorder and to treat it appropriately, a staging system was suggested by some researchers. It assumes that earlier stages have better prognosis and require simpler therapeutic regimens. Staging may assist in treatment planning and prognosis of bipolar disorder, and emphasize the importance of early intervention. Further research is required in this exciting and novel area.
Objectives : In this study, we evaluated the treatment strategies of geriatric bipolar disorders of Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) 2014. Method : Sixty-four psychiatrists of the review committee who have vast clinical experiences in treating bipolar disorders completed the survey. This survey was composed of 56 main questionnaires of which the contents covered from overall treatment strategies to treatment strategies under the specific situations. The executive committee analyzed the results and discussed the final production of algorithm. Results : In geriatric bipolar disorder, the first-line treatment option for acute manic episode is monotherapy with atypical antipsychotic or mood stabilizer, and combination of mood stabilizer and an atypical antipsychotic. The first-line treatment option for acute bipolar depressive episode was combination of mood stabilizer and an atypical antipsychotic, monotherapy with atypical antipsychotic, and combination of atypical antipsychotics and lamotrigine. Valproate and lithium are chosen for the preferred mood stabilizer, and among atypical antipsychotics, aripiprazole, quetiapine, and olanzapine were preferred. Conclusion : In KMAP-BP 2014, the recommendation for treatment option in geriatric bipolar disorder was newly introduced. We expect this algorithm will be helpful in the treatment of geriatric bipolar disorder.
Objectives:We reviewed the relationships between chocolate and mood state. Method:We reviewed chocolate’s constituents and hypotheses that was suggested as the mechanisms of chocolate’s mood altering effects. Results: Orosensory properties of chocolate, carbohydrate, protein, psychoactive substances in chocolate and complex rela- tionships of chocolate with neurotransmitters such as dopamine, serotonin, and opioid could be responsible for ele- vating mood and evoking chocolate cravings. Eating in negative mood state, transient mood stabilizing effect was shown but in case of prolonged use negative mood was maintained. Conclusion:Mood state effects of the cho- colate is thought to be due to other unknown mechanism rather than its antidepressant effect.
Objective The purpose of this study was to evaluate the occurrence of the suicidal ideation and associated factors with selfreportedsuicidal ideation within the last 12 months among Korean high school students. Methods A total of 697 adolescents were recruited from high schools (age range: 15–16 years) in Jeju area. According toexistence of suicidal ideation, they were divided into two groups–suicidal ideation group and non-suicidal ideation group,and the differences between groups in terms of various sociodemographic and clinical characteristics, including depression(Beck Depression Inventory), and health related conditions. Results A total of 187 (26.8%) high school students reported suicidal ideation, and the rate of suicidal attempt was 4.9%(n=34). The associated factors of suicidal ideation were depression [odds ratio (OR)=2.42, p≤0.001], short sleep duration(OR=1.84, p=0.009), current alcohol use (OR=4.94, p≤0.001), self reported poor health (OR=2.10, p=0.004), and schoolbullying (OR=3.06, p=0.002). Conclusion These results may have important implications for the strategies and specified intervention in preventing suicidalideation in Korean high school students. 본 연구 결과, 제주지역 고등학생에서 최근 1년간 자살 사고를 경험한 비율은 26.8%로 조사되었으며, 우울 증상, 음주,흡연, 학교 왕따 경험, 낮은 사회경제적 수준이 자살 사고와밀접한 관련성을 보였다. 청소년의 경우 자살을 예측하기 어렵다는 점을 고려할 때 자살 예방을 위해서는 청소년의 심리적 특성과 자살의 위험 인자에 대한 기본적인 이해가 선행되어야 할 것이다. 특히, 본 연구 결과는 고등학생 자살 문제의예방과 치료에 있어 학교 왕따 문제의 해결, 우울증, 흡연 및알코올 사용 등 신체적, 정신적 건강 문제에 대한 체계적인 관리가 중요함을 시사한다.