Elderly Patient Trends in a Chronic Mental Hospital and Accompanying Medical Diseases

OBJECTIVE: It investigated the tendency of the increase of elderly patients in a psychiatric hospital. In this regard, it examined whether the number of patients with outpatient consultant, discharge, medical diseases, and neurocognitive disorder increased or not. METHODS: It retrospectively reviewed inpatient medical records for the years 2008, 2011, 2014, 2017. To investigate the changes of elderly patients admitted to psychiatry, it examined the changes of patients who are older than 50 or 60 years in addition to the people who are older than 65 years. It analyzed diagnosis, discharge, medical diseases, and outpatient consultant of the three groups respectively. RESULTS: It confirmed that the number of elderly patients who are older than 50, 60, and 65 years has increased in mental hospital for 10 years. There was a significant increase in the number of neurocognitive disorder patients, the ratio of consultant outpatient, and the mean number of outpatient consultant. Diabetes increased in all three groups. Especially it has significantly increased for patients who are older than 50 and 60 years. In the case of patients discharged due to transfer, the number of patients increased in all three groups but it was statistically significant for the patients who are older than 50 years. CONCLUSION: The study shows that the number of elderly patients increased with the trend of aging society. In relation to this, the rate of outpatient consultant and discharge, including diabetic and dementia patients, also increased. Therefore, if the mental health department provides a system to manage the elderly ward or nursing ward to respond to the increase of elderly patients, or to manage the accompanying chronic diseases such as diabetes and its complications, it could solve the inconvenience of patients due to the consultation outside a hospital or discharge.

Relationship between Metabolic Syndrome and Cognitive Functions in Patients with Chronic Schizophrenia / 정신신체의학

OBJECTIVES: The aim of this study was to investigate the relationship between metabolic syndrome and cognitive functions among chronic schizophrenia patients. METHODS: The survey participants were 105(40 metabolic syndrome and 65 non-metabolic syndrome) chronic schizophrenia patients at Yang-san Hospital. Each score of cognitive test(A Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet, stroop test), Positive and Negative Syndrome Scale, Hamilton rating scale for Depression were assessed. Statistical analysis of the relationship between various tests of A Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet and metabolic syndrome were performed using ANCOVA and logistic regression. RESULTS: Schizophrenia patients with lower score on construction praxia were likely to be included in Metabolic syndrome group. However, there were no significant relationships in other tests between the two groups. CONCLUSION: This study found metabolic syndrome caused cognitive decline in chronic schizophrenia patients, especially Construction praxia. This study could be a basis to show metabolic syndrome has to be treated appropriately in schizophrenia patients and suggests the necessity of following longitudinal designed study.

Reliability and Validity of the Korean Version of the Psychotic Symptom Rating Scale / 신경정신의학

OBJECTIVES: Psychotic Symptom Rating Scale (PSYRATS) is an assessment tool to measure the severity of different dimensions of auditory hallucinations and delusions. The reliability and validity of the Korean version of PSYRATS (K-PSYRATS) were examined in Korean patients with major psychosis. METHODS: The inter-rater reliability of the K-PSYRATS was determined from the videotaped interviews of the five schizophrenic patients. To measure validity and internal consistency reliability, the 109 patients with auditory hallucinations or delusions were assessed using the K-PSYRATS, Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression-Severity (CGI-S) scale. RESULTS: K-PSYRATS was found to have excellent inter-rater reliability (intra-class correlation coefficient of auditory hallucination= 0.81, p<.001, intra-class correlation coefficient of delusion=0.97, p<.001) and internal consistency reliability (Cronbach's alpha of auditory hallucination=0.77, Cronbach's alpha of delusion=0.76). Significant correlation was found between K-PSYRATS and positive syndrome subscale of PANSS and CGI. CONCLUSION: K-PSYRATS is a useful assessment instrument for psychotic symptoms in Korea.

A Case of Common Bile Duct Stone Formed around a Surgical Clip after Laparoscopic Cholecystectomy / 대한소화기학회지

Laparoscopic cholecystectomy has now rapidly replaced open cholecystectomy. Rarely a calculus may arise from a metallic surgical clip migrated into the common bile duct (CBD) after this surgical procedure was performed. We report a 50-year-old man with CBD stone formed around a surgical clip, who had undergone a laparoscopic cholecystectomy because of acute calculous cholecystitis 14 months before. Abdominal CT revealed a single stone in mildly dilated CBD. A high density core within the CBD stone, was suspected to be a surgical clip. The stone was removed using a retrieval balloon catheter and basket after endoscopic sphincterotomy.