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고복자 大韓神經精神醫學會 1979 신경정신의학 Vol.18 No.2
In this community survey of the working groups in Seoul, the author has tried to seek for the characteristics of attitude toward ex-mental patients as working members. The survey was conducted to 230 working men and women ranging from the managers of large companies to the unskilled labors residing in Seoul with Askenasy's questionaire form consisted of 41 items. The results were compared with Askenasy's results reported in England and the United States. Seoul subjects showed more negativistic attitude toward ex-mental patients at the point of their re-instatement or getting new job, compared with the findings in England and the United States. Educational status gave less influence on the attitude of the Seoul subjects toward ex-mental patients' getting job, while the Western subjects of Askenasy revealed that the higher in educational level, the more optimistic view. The discussion is centerd on two aspects; one was the negativistic attitude per se and the other was poor educational influence on the attitude. According to the previous studies in Korea, protective milieu of the family for the ex-mental patients from occupational and social demands would be regarded as a positive factor in tertiary prevention of mental disorders during their rehabilitation period. This protective attitude seemed to contribute to the negativistic attitude toward ex-mental patients' getting job. Thus, double aspects in the tertiary prevention should be taken into consideration in Korea; a positive aspects of family protection and a negative aspect of discouraging patients' occupational rehabilitation. Poor educational influence on the attitude could be attributed to the general trend of curriculum in Korea in which understanding of human behavior and mental health had been scarcely emphasized. Consequently, education about human behavior and mental health to the public and to the students in advanced educational institutions was suggested for the improvement of community attitude toward ex-mental patients.
抗Choilne系 및 抗精神病 藥物에 依한 知覺認知障碍
金光日,高福子 大韓神經精神醫學會 1980 신경정신의학 Vol.19 No.4
Four cases of perceptual-cognitive disorder following the use of anticholinergic and antipsychotic drugs were reported. The first case was an avoidant personality disorder who had been given 2㎎ of Benztropine in a daily single dosis for the control of dystonia from Haloperidol. On the second day of Benztropine medication, typical perceptual-cognitive disorder was developed abruptly. The second case was a patient with peptic ulcer who had used 30㎎ of Propanthiline bromide in daily devided doses into three times. The perceptual-cognitive disorder appeared on the fourth day of medication. The third case was an obsessive compulsive patient who had been given 3㎎ of Haloperidol. On the fourth day after increasing the dosis from 3㎎ to 4.5㎎, the perceptual-cognitive symptom was developed. Decrease of the dosis from 4.5㎎ to 3㎎ resulted in disappearance of the symptom. Fluphenazine decanoate 0.3㏄(7.5㎎) was injected to the same patient intramusculary after withdrawal of Haloperidol. On the third day of Fluphenazine injection, the same perceptual-cognitive symptom could be noticed again. Decrease of the dosis of Fluphenazine to 0.15㏄ in the next shot could result in symtom-free state. The fourth case was a recovered schizophrenic who had revealed perceptual-cognitive symptom following the use of 5㎎ of Thiothixene. The same symptom appeared 0.2㏄(5㎎) of Fluphenazine decanoate. Withdrawal of Thiothixene and decrease of the dosis of Fluphenazine resulted in symptom disappearance. Abrupt onset of intensified visual stimuli influx or micropsia and cognitive confusion without delirium was the main clinical picture. These symptoms were developed on the second, third or fourth day after the use or increase of the drugs, and continued several hours and, as a rule terminated by sleeping. This experience was repeated daily in the afternoon during medication, and disappeared by withdrawal of the drugs or by decrease of the dosis. The aforementioned symptoms reappeared by remedication or reincrease of the drugs in each case. Exact mechanism of the perceptual-cognitive disorders remain unknown, but anticholinergic activity of the drugs can be suspected as a possible causative factor. It was also suggested that there is a few susceptible person to perceptual cognitive side reaction to anticholinergics, and in such a case, symptom appearance seemed to be dose-related.