Objective This study aimed to assess the immediate stress and psychological impact experienced by healthcare workers and other personnel during the Coronavirus disease (COVID-19) pandemic. Method The sample consisted of 2554 hospital workers (i.e., physicians, nurses, allied health professionals, and auxiliary staff members) who were working in Yeungnam University Hospital in Daegu, South Korea. The Impact of Event Scale-Revised (IES-R) was administered to the hospital workers twice over a 2 week interval. A high-risk group, identified on the basic of first total IES-R, was assessed further with the Mini International Neuropsychiatric Interview (MINI) and the Clinical Global Impressions-Severity (CGI—S) scale and was offered periodic psychiatric consultations on a telephone. Results The participating nurses and auxiliary staff members had significantly higher IES-R scores ( p < 0.01) than the physicians. During the second evaluation, the IES-R scores of the high-risk participants had decreased by 13.67 ± 16.15 points ( p < 0.01), and their CGI-S scores had decreased by 1.00 ± 0.74 points (p < 0.01). The psychological symptoms of the high-risk group who received telephone-based psychiatric consultation showed improvement after 2 weeks. Conclusions The present findings suggest that hospital workers experience high levels of emotional stress during a pandemic. In particular, the present findings underscore the need to provide more information and support to nurses and other administrative workers. There is a need for greater awareness about the importance of mental health care among hospital workers, and rapid and ongoing psychiatric interventions should be provided to workers during the pandemic period.
Amputation changes the lives of patients and their families. Consequently, the patient must adapt to altered body function and image. During this adaptation process, psychological problems, such as depression, anxiety, and posttraumatic stress disorder, can occur. The psychological difficulties of patients with amputation are often accepted as normal responses that are often poorly recognized by patients, family members, and their primary physicians. Psychological problems can interfere with rehabilitation and cause additional psychosocial problems. Therefore, their early detection and treatment are important. A multidisciplinary team approach, including mental health professionals, is ideal for comprehensive and biopsychosocial management. Mental health professionals could help patients set realistic goals and use adaptive coping styles. Psychiatric approaches should consider the physical, cognitive, psychological, social, and spiritual functions and social support systems before and after amputation. The abilities and limitations of physical, cognitive, psychological, and social functions should also be considered. To improve the patient's adaptation, psychological interventions such as short-term psychotherapy, cognitive behavioral therapy, mindfulness meditation, biofeedback, and group psychotherapy can be helpful.
Sleep plays a critical role in homeostasis of the body and mind. Insomnia is a disease that causes disturbances in the initiation and maintenance of sleep. Insomnia is known to affect not only the sleep process itself but also an individual’s cognitive function and emotional regulation during the daytime. It increases the risk of various neuropsychiatric diseases such as depression, anxiety disorder, and dementia. Although it might appear that insomnia only affects the nervous system, it is also a systemic disease that affects several aspects of the body, such as the cardiovascular, endocrine, and immune systems; therefore, it increases the risk of various diseases such as hypertension, diabetes mellitus, and infection. Insomnia has a wide range of effects on our bodies because sleep is a complex and active process. However, a high proportion of patients with insomnia do not seek treatment, which results in high direct and indirect costs. This is attributed to the disregard of many of the negative effects of insomnia. Therefore, we expect that understanding insomnia as a systemic disease will provide an opportunity to understand the condition better and help prevent secondary impairment due to insomnia.
<b><i>Introduction:</i></b> Early diagnosis of dementia is important; however, the diagnostic criteria for the preclinical stage of dementia, including biomarkers and pathophysiological markers, are not suitable for application in patients in real-world clinical settings. One potential noninvasive method to predict the risk of dementia conversion is the neuropsychological test. Therefore, in this study, we examined the results of various assessments, such as comprehensive neuropsychological tests, and the daily function of participants who were evaluated periodically for 5 years. <b><i>Methods:</i></b> All participants were outpatients or inpatients with subjective cognitive complaints, who visited a local university hospital for neuropsychiatric evaluation, between January 2011 and January 2019. Of a total of 1,652 subjects who underwent initial screening during this period, 107 were nondemented individuals. These participants underwent periodic comprehensive cognitive tests for up to 5 years. Survival and factors affecting dementia conversion were analyzed using the time-dependent Cox regression analysis. Assessment items included demographic information, including age, sex, and education; 5 cognitive domains of a comprehensive neuropsychological test including memory, language, attention, visuospatial functions, and frontal (executive) function; Barthel’s activities of daily living; the mini-mental state examination findings; and clinical dementia rating (CDR) scores. <b><i>Results:</i></b> This study included 61 participants (21 women and 40 men) who developed dementia during the study period. Verification of the cognitive variables affecting dementia conversion revealed that better memory was associated with a lower risk of conversion (hazard ratio [HR] = 0.614, <i>p</i> = 0.005) and higher attention was associated with a higher risk of conversion (HR = 1.602, <i>p</i> = 0.023). In the analysis of the subscales of the CDR, a higher community affairs score (i.e., less social activities) was associated with a higher risk of conversion (HR = 10.814, <i>p</i> = 0.028). <b><i>Conclusion:</i></b> Individuals with prominent memory decline or problems with social activities should be carefully observed for dementia conversion. Cognitive intervention techniques for cognitive stimulation, such as social and leisure activities, as well as cognitive training need to be actively used for patients in whom dementia is a concern.
In this study, we divided the types of depression, focusing on defense mechanisms based on psychodynamic theory, and then explored the clinical and psychological characteristics of each group. Methods: We recruited 619 patients with depression. Cluster analysis according to defense mechanisms was conducted on each group. Defense mechanisms were rated based on the defense style questionnaire (DSQ). We compared psychological characteristics between the groups using The symptom checklist-90-revised (SCL-90-R), Beck depression inventory-II (BDI-II), Beck anxiety inventory (BAI), The Minnesota multiphasic personality inventory-2 (MMPI-2), temperament and character inventory (TCI), and personality disorder questionnaire-4+ (PDQ-4+). Results: DSQ results showed significant differences between the groups. Groups 1 and 2 had high levels of passive aggression, acting out, and omnipotence. Group 1 had higher affiliation and use the most immature defense mechanisms. Group 3 had higher projective identification and no other defense mechanisms. In SCL-90-R, BDI-II, and BAI, the severity of the symptoms was in the order of Group 1, 2, and 3. In MMPI-2, there were no significant differences between Group 1 and 2, but Group 1 had higher psychopathic deviate, Schizophrenia, and Hypomania. In TCI, Group 1 was the most temperamental, followed by Group 2 and Group 3 was the least temperament. In PDQ-4+, schizoid, schizotypal, antisocial, and borderline personality disorder were higher in Group 1. Conclusion: In the Kernberg's borderline personality organization, Group 1 is close to the borderline and psychotic personality organization, Group 2 can be termed as borderline and neurotic personality organization. Group 3 can be termed as a neurotic personality organization.
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