Full mouth rehabilitation with fixed implant-supported prosthesis using temporary denture and double digital scanning technique: a case report / 대한치과보철학회지

When restoring with a dental digital system for implant-supported prosthesis, a double digital scanning technique is required: an intraoral scan of the three-dimensional implant location and intraoral scan after placement of temporary denture or provisional prosthesis. During the intraoral scan, the use of scan body as a stable landmark can improve the accuracy of digital impression and simplify laboratory process. In this case, a full-digital system was used to plan and fabricate a custom abutment, provisional prosthesis, and definitive prosthesis. After implant placement, the scan area of the intraoral scan body connected with implant and the intraoral scan body marked on the inside of temporary denture were superimposed. Out of the superimposed files, a custom abutment and provisional prosthesis were fabricated which match the vertical dimension of temporary denture, and definitive prosthesis was fabricated based on provisional prosthesis. We report this case because result has been functionally and esthetically satisfactory by using vertical dimension and central relation set during the fabrication of temporary denture to the definitive prosthesis.

Effects in Combining Pharmacotherapy and Group Psychotherapy for Outpatients with Schizophrenia / 신경정신의학

OBJECTIVES: The objective of this study is to prove that combining pharmacotherapy and group psychotherapy is more effective way to prevent recurrence and rehospitalization, to promote their interpersonal relations and to improve their satisfaction on treatment by making a comparison with pharmacotherapy and individual psychotherapy (supportive therapy). METHODS: This study was performed from September 2000 to October 2001. The subjects were all schizophrenic outpatients who were treated by authors in the specialized mental hospital, the psychiatric department of a general hospital, and psychiatric clinics. The experimental groups and the control groups were composed in matching, sex, diagnosis, duration of illness, number of admission and function level. During this period, the experimental groups had been treated by pharmacotherapy and group psychotherapy, and the control groups by pharmacotherapy and individual supportive therapy. Numbers of admission (ratio of readmission) and changes of drug doses were traced, at the same time' group psychotherapy effectiveness scales' were applied. Just after each session, Yalom's 13 therapeutic factors scale was administered. RESULTS: During study periods, 3 cases (17%) among total 18 cases of the experimental groups were re-admitted and 6 cases (33%) among total 18 cases of the control group were re-admitted. During study periods, the doses of chlorpromazine in the experimental groups were decreased from 267 mg at start to 185 mg at closure and the doses of chlorpromazine in the control groups were increased from 264 mg at start to 265 mg at closure. The mean scores of insight, satisfaction on treatment, and satisfaction toward therapist were statistically high in the experimental groups in comparison with the control groups (<0.05). CONCLUSION: 'Combining pharmacotherapy and group psychotherapy' to outpatients with schizophrenia is very effective and expedient for therapists. We expect that this combined treatment model would be practiced more broadly as an economic treatment method which could minimize problems caused by practicing pharmacotherapy only and to give patients full service, though there are accompanied problems including the difficulties of structuring, the eack of motivation of patients, and the financial burden.

Effects of Interpersonal Group Therapy for Adolescents with Behavioral Problems / 신경정신의학

OBJECTIVES: Fast change and confusion of the value system in society affect the identity formation of adolescents. So Adolescents' behavioral problems seem to be increasing yearly. It is known that the interpersonal group therapy is the most effective treatment modality among many group programs for adolescents with behavioral problems. Objectives of this study are as follows; first, evaluate therapeutic effects of the interpersonal group therapy for adolescents with behavioral problems second, examine the therapeutic factors; third, analyze the group process; fourth, orgamize the group therapy for adolescents with behavioral problems as an applicable treatment modality. The types of group therapy performed in this study are small, closed, homogeneous, outpatient, time limited, and adolescent group. METHODS: This study was carried out at one of the adolescents mental health services in Uiwang Mental Health Center, from April to June and from September to November in 2000. The subjects were 2nd grade students in K middle school with behavioral proplems. The experimental groups were composed of 4 groups including 2 male groups and 2 female groups (male 11, female 17), and the control groups matched the same conditions as the experimental groups (male 10, female 19). The group therapy was performed weekly in CA (club activity) time, and it took 60-70 minutes at one time. They met total 10 sessions including preparatory meeting and termination meeting. Before and after this program, self-rating scales (behavioral problems, aggression, and impulsivity) were applied for subjects, and the teacher rating scales (behavioral problems, aggression and impulsivity) were performed by teachers in charge. After each session, Yalom's 13 therapeutic factors scale was performed. At the last meeting, total assessment questionnaire was completed. RESULTS: The mean scores of all self-rating scales (behavioral problem, aggression, and impulsivity) were lower in the experimental groups (both male and female group) than the control groups, but not significant statistically except the behavioral problem scale of female students. The mean scores of all teacher rating scales (behavioral problem, aggression, and impulsivity) were lower in the experimental groups (both male and female group) in comparison with the control groups, all significant statistically. As faras the therapeutic factors are concerned; first, the mean scores of all therapeutic factors in female students were higher than in male students and the mean scores of all therapeutic factors in the later half sessions were higher than the former half sessions; second, catharsis and existential factor were high in all students and sessions; third, identification with therapist factor was high in all students and sessions; fourth, during the later half sessions, interpersonal input was relatively high in male students and socializing technique was relatively high in female students. Its for the total assessment questionnaires; 100% of male students and 88.2% of female students reported that they were helped by this group therapy; 100% of male students and 82.4% of female students reported that they would participate willingly if future opportunity of the same group therapy is given for them. CONCLUSION: Adolescents with behavioral problems who participated in this study showed the decrease of behavioral problems and the change of aggressive and impulsive attitudes in comparison with the control groups although they had some differences between male and female students. The group therapy with adolescents would be practiced more broadly and extensively though there are several accompanied problems including the difficulty of structuring, the deficit of motivation, and financial problem.

A Survey of Adolescent Substance Uses in a Small City / 신경정신의학

OBJECTIVES: The purpose of this research is to help solve adolescent issues involving substance uses, which may become begin to undergo many changes(i. e. practising various roles, thereby leading to independent life styles). More often than not, adolescent drug problems develop into social problems, chiefly behavioral imitations and heavy dependence on medicine. The authors conducted a survey of adolescent substance uses to develop preventive measures against the drug habit prevalent among young people, thereby formulating a policy to deal with problematic community. Funded by a Youth Counselling Center in the city of H. the research was conducted on the following assumptions that there will be:Firstly, a comparison of drug uses by sex and age:Secondly, variance of substance users by family background and peer group:Thirdly, a combination of heavy drinking, smoking and delinquency resulting in the drug habit. METHODS: The survey included a total of 1613 students during 3 days, 12 through 14, July, 1999. The subjects were 833 pupils(51.6%) from 4 middle schools and 780 students(48.4%) from 3 high schools in the city of H with a ratio of 49.5 %(males) and 50.5%(females). RESULTS: 1) Experience of substance use is most referable to drinking(59.4%) and smoking(34.4%) while given to analgesics(33.1%) among medicines, glue(0.7%) among inhalants and philophone(0.4%) among narcotics. 2) High school students found more than double the amount of smoking and drinking as well as uses of hypnotics, stimulants and sedatives by junior high school students. 3) Our resalt showed was significantly noted that non-users had a better relationship with their parents than most users. 4) Smoking and drinking problean could be more easily developing into adolescent substance uses. 5) Alcohol, cigarette, and drug users showed more misconducts than other adolescents. 6) Most adolescents believe that drinking is necessary for making friends(55.0%), while smoking is just for killing time(50.9%). 7) Drinking, smoking, and other substance users were found to develop into more problematic habits. CONCLUSION: The present survey and several others show that adolescent substance uses in Korea are on the rise. Therefore, extensive counter-measures will be necessary followed by nationwide epidemiological survey of the pending issue, with the psychiatrists participating in the campaign.

Group Psychotherapy with Adolescents / 신경정신의학

OBJECTIVES: Group psychotherapy is more economic than individual psychotherapy and effective to adolescents especially. Group psychotherapy with adolescents will be used widely when adolescents problems are becoming more important so that government focuses on them. This article aims for the readers to understand group psychotherapy easily. METHODS: This article is based on reviewing lots of articles related to adolescent group psychotherapy published at home and abroad and our researches and practical experiences in regard with inpatient and outpatient group with adolescents for a long time. This article is described in order of history, theory, model, development stage, and therapeutic factor. RESULTS: Theories of group psychotherapy have been affected by about 200 psychotherapy theories. Among a lot of theories, psychoanalytic theory and cognitive-behavioral theory have been accepted as a perennial effective therapeutic modality. In Korea, structuralized cognitive-behavioral group therapy is currently pervaded in Youth Counselling Center or General Social Welfare Center. But because that is generally consist of skill training and problem solving centered approach, it is difficult to achieve therapeutic goal of ultimate behavioral change in basis of genetic insight. On the contrary, it is known that psychoanalytic group therapy has more benefit to raise adolescent universal value, group norms, group rules, confidentiality, and community consciousness for adolescents. and that group therapy provides adolescents with more secure and caring conditions. Here and now, adolescent group therapists apply wide theories and various techniques with flexible attitudes to go together with unapproachable adolescents. Models of group psychotherapy have various mode related to age, disorders, functional level, developmental level, clinical environment, structural modalities, and intervention goal. Developmental stages of the group psychotherapy consist of formal stage, conflictual stage, normal stage, and performing stage. And then those are divided with the first stage, middle stage, and the last stage in an adolescent group. Therapeutic factors of an adolescent group are as follows. Interpersonal learning, catharsis, existential factor, and group cohesiveness are highly evaluated in an encounter group and a long-term group for personality change. And catharsis, universality, identification, and group cohesiveness are highly evaluated in a short-term group. To handle the adolescent group, therapist capability is very critical. Special knowledge, technique, and endurance are needed for the group therapist to lead an adolescent group. Even though some therapist lead the adult group for a long time, they have to get special training and supervision to lead the adolescent group. CONCLUSIONS: Group psychotherapy has been formally accepted as one of therapeutic modalities that must be as equally effective as individual psychotherapy even if it derives from individual psychotherapy. Adolescent group psychotherapy is currently accepted as one of the most important therapeutic modalities although it is not highlighted as same as adult group psychotherapy. Group therapy is the most desirable therapeutic method for adolescents because they go through a transitional critical time for change and they are especially affected by peer group.

Training Group with Mental Health Professionals / 신경정신의학

OBJECTIVES: Training group with mental health professionals includes didactic process, experience as a member(patient) and a leader(therapist). It is divided into four parts as like 1) lecture, case conference, book reading and seminar about theory and practice, 2) observation, 3) training group(including workshop), and 4) supervision. Among them, the training group and the supervision have been accepted as the most effective methods. Authors have developed and practiced the training group model for mental health professionals including psychiatric residents which aim for the activation of group psychotherapy in mental health area, psychiatrists' initiative in group psychotherapy area, and the training and nurturing of qualified mental health professionals. The objectives of this study are as follows;firstly, we examine the change of defense mechanism and ego function after performing group psychotherapy for mental health professionals;secondly, we analyze the therapeutic factors reported that participants were helped;thirdly, we analyze main features which include group content and process manifested in training group:lastly, we have objectives that the training group is settled down as an effective educational method to foster the personal growth and qualification as a specialist, and also that this study provides a basic research data to set up the training program and the requirements for group psychotherapy. METHODS: This study was performed 5 times from 1997 to 2000. The participants were composed of 37 mental health professionals including psychiatric residents. Among them, 29 participants(male 2, female 27) were chosen as the final subjects except 9 participants dropped out in the process of this study. At first, we take an application of pre-treatment/post-treatment experimental design to evaluate the personality change after performing the training group. EDMT(Ewha Defence Mechanism Test) and EC(Egogram Checklist), the objective questionnaires, were used as the evaluation scale. And 13-therapeutic factor scale and simple subjective questionnaires were performed just after each session and the self-report total assessment questionnaires were performed at the end of this study. RESULTS: To compare mean scores between pre-treatment and post-treatment in EDMT, the mature defense was increased significantly, the immature defense was decreased significantly, and the narcissistic defense and neurotic defense were not changed significantly. To compare mean scores between pre-treatment and post-treatment in EC, Nurturing Parent(NP), Adult(A) and Free Child(FC) were increased significantly. Therapeutic factors ranked highly were interpersonal learning, existential factor, Identification with therapist, catharsis, and socializing technique in order. The total assessment questionnaires reported that the 100% of participants were helped, the 48.3% of participants were changed in their lives, the 89.7% of participants would propose training group to others positively, and the 58.6% of participants had minds to join this kind of program if given again for them. CONCLUSIONS: This result showed that the defense mechanism and ego function of participants were changed. The training group experience makes participants reflect themselves, examine their conflicts and understand others. That also gives them chances of improving insight about group phenomena and understanding about therapeutic factors essential to the mental health professionals, having confidence on the group therapy by learning leadership and techniques, and improving understanding about the psychotherapy on the whole. Therefore, it is needed in the future that the training group would be widely adapted as an educational tool of psychotherapy and group psychotherapy for the mental health professionals as well as psychiatric residents in mental health area.

Therapeutic Factors in Large Group Psychodrama with Delinquent Adolescents / 신경정신의학

OBJECTIVES: This study is designed to develop a large group phychodrama for light delin-quent adolescents (hereinafter called as "Psychodrama") thereby determining therapeutic factors for dealing with them. METHODS: The study was conducted in the program of Seoul Metropolitan Youth Centre called "the class of love" during the period of July through December, 1998. The subjects consisted of a total of 827 young delinquents (759 boys and 68 girls, with the average age of 15.9 years old). To develop "this psychodrama", after we composed of therapeutic team centered by psychiatrists, we prepared from January to June, 1998 by practicing psychodrama with delinquent adolescents and by analyzing the results. "This psychodrama" has three basic steps: (1) warming-up (small group me-eting), (2) action (situation drama and main drama), (3) sharing. A survey of treatments, from a pool of participating adolescents, based on evaluation sheets and 13 therapeutic factors scale followed every session of this psychodrama. RESULTS: "This psychodrama" was helpful for 47.4%, interesting for 49.2%, not helpful for 12.1% and not interesting for 16%. In the whole group of subjects, the important therapeutic factors were existential factor, universality, identification with the therapist and the instillation of hope in the order of rank. When categorized in four different groups (audience, participants in situation drama, auxiliary egos, participants in sharing) the 4 groups displayed different results to one another. First, the therapeutic factors of audience were similar to that of the whole group. Second, participants in situation drama showed a higher catharsis than others. Third, auxiliary egos were leading in the guidance of members and therapists. Fourth, participants in sharing displayed higher group cohesiveness. CONCLUSION: As it is getting harder to find program's suitable for the treatment of increasing number of delinquents due to limited budget and experts, this psychodrama could be more cost-effective than any other measures.

A Model of Inpatient Large Group Psychodrama / 신경정신의학

As an alternative to group psychotherapy, worked out by Dr. Moreno, the psychodrama is being carried on mainly for a large group of inpatients at 40-50% of the country's psychiatric and training hospitals. The authors have developed a Korean psychodrama model for a group mental health having following characteristics:(1) a one-time treatment, (2) open-group therapy, and (3) structured, large group approach. Korean psychodrama model was proved to be a low cost, highly effective approach in that patients could be dealt with en masse to quite a satisfactory degree: at the same time Korean psychodrama model is easily accessible for any psychiatric doctor or trainee in dealing with a patient. In addition, Korean psychodrama model is highly conducive to experiencing and training related people in psychotherapeutic practice as this model has shown up 79.4% approval rate among patients after treatment. Due to the recent crunch in medical insurance financing, psychotherapy is changing from individual long-term type to a more time-limited type. Despite the mental health law passed in 1995, from the human psychotherapy standpoint, the worsening economic situation has made it difficult for a psychiatrist to deal with patient on a one-to-one basis. As a result, the burden of most psychiatrists, is snowballing day by day. In this context psychodrama seems to be a promising, reliable alternative to group psychotherapy, both medically and economically. It will be a treatment modality for years to come.

Therapeutic Factors in the Outpatient Group Psychotherapy for the Adolescents with Conduct Disorder / 신경정신의학

OBJECTIVES: Group psychotherapy is known to be an effective treatment program for adolescents who attach importance to peer relationship, but it is not activated in Korea. Therefore, researchers performed weekly the closed, homogeneous, time-limited (10 sessions), outpatient group psychotherapy for adolescents with conduct disorder. Objectives of this study were as follows: first, we practiced the group psychotherapy for adolescents with conduct disorder and evaluated its effectiveness: second, we examined the therapeutic factors which were used by participants: third, we intended to settlee down the group psychotherapy for adolescents with CD as an effective and efficient treatment modality. METHODS: This study was performed two times from October to December in 1998 and from April to June in 1999. It was sponsored by Youth Counselling Center in H city. The case group were composed of 15 female students who were second grade in H high school, and 4 students were dropped out. The control group were composed of 18 female students who were same grade in H high school and 3 students were dropped out. Before and after this program, self-report delinquency scale, aggression scale and impulsivity scale were asked to them. And just after each session, Yalom 13 therapeutic factors scale and satisfaction questionnaire for group psychotherapy were asked to them. And at last meeting, total assessment questionnaire was asked to them. RESULTS: We compared the change of therapeutic factors between the former half sessions(1-5) and the later half sessions (6-10), and the results were as follows: in the former half, the upper ranks of therapeutic factors were existential factor, universality, catharsis, identification with leader, and identification with members in order. And in the later half, the upper ranks of therapeutic factors were catharsis, existential factor, identification with leader, identification with members, and guidance of members in order. The rank of catharsis and guidance of members went upward and the rank of universality went downward when we compared the ranks in the former half to those in the later half. Altruism and family enactment were the lowest ranked in both half. The satisfaction questionnaire for group psychotherapy showed to be helped by participants at the rate of 45.7% in former half, 83.3% in later half. The total assessment questionnaire showed the willingness of re-participation at the rate of 85.7% if future opportunity of group psychotherapy is given for them. CONCLUSIONS: The time-limited group psychotherapy for adolescents diagnosed by conduct disorder was very effectively practiced and the participants reported high level of the satisfaction. The outpatient group psychotherapy for adolescents would be expanded and practiced though there are several accompanied problems including the difficulty of structuring, the deficit of motivation, and financial problem.

Past, and Here-and-Now of Group Therapy in Korea / 신경정신의학

OBJECTIVES: A group therapy includes various types: group psychotherapy, psychodrama, activity therapy including occupational therapy as well as recreation therapy, art therapy of drawing, music, dancing and drama. It has long been in use for in-patients, and became more trendy at day hospitals and community mental health centers after the enactment of a mental health law. It was surprising that a few researches have been made in the field, including a basic fact finding and that a few Korean psychiatrists have been inclined toward it. Meanwhile, we finished a research work on: how a group therapy has been conducted so far, its current status across the country, possibly the best way to heal, and deal with, psychiatric patients. METHODS: The 1997 annual report by Korean Neuropsychiatric Association, has been available for random sampling in the following categories: training hospital, general hospital, psychiatric hospital, clinic with admissions, clinic without admissions, day hospital, community mental health center. Telephone polls were conducted on contents of frequency and status of a group therapy available with psychodrama, main therapists, co-therapists, duration & times of therapy, size of group therapy recipients etc. RESULTS: The group therapy is broken down into the order of percentage; Art therapy(30.9%), Activity therapy(28.4%), Group psychotherapy(27.2%), Others(24.1%), Large group therapy(23.2%), with the psychodrama(10.9) least of all. Against in-patients(61.6%), the group psychotherapy shows its greatest diagnosis for a combined gorup(51.4%), and finds its biggest type in a general group(83.2%), Against in-patients(65.3%), the psychodrama diagnosis is mostly conducted for a combined group (69.4%). For a main therapist, the group psychotherapy is taken care of by boardmen(31.1%), and social workers(29.5%), while psychodrama by psychiatric boardmen(36.1%), and social workers(36.1%). On the other hand, for a co-therapist, the group psychotherapy is done by nurse(40.8%), while psychodrama by social workers(25.9%), and volunteers(23.5%). At a time most group psychotherapies takes some 60 minutes, psychodrama 120 minutes. Group therapies take place each once a week. Its participation amounts to 26.0(+/-17.8) for a psychodrama, and to 11.0(+/-5.8) for a group psychotherapy. Clinics with admission rooms(83.6%), exceedingly enjoy more group therapy than ones without (2.2%). CONCLUSION: The group therapy is run at most hospitals as the main part of a psychiatric treatment. However, the job has been undertaken on a small scale by outpatient clinics as well as psychiatric boardmen. Therefore, more attention is urged toward a group therapy, its professional training, plus its more brisk business at outpatient clinics.

Therapeutic Factors of Large Group Psychodrama for Psychiatric Inpatients / 신경정신의학

OBJECTIVES: This study was performed to make a model of large group psychodrama suitable for Korean inpatients and easy for psychiatrists trained in the individual psychotherapy and the group psychotherapy to use, to investigate the therapeutic factors after applying this model to inpatients, and then to contribute to the treatment of inpatients. METHODS: The study subjects were all the inpatients and the therapists(the auxiliary ego's) who participated in psychodrama from March 1998 to September 1998. The subjects were composed of 346 inpatients(152 males, 194 females) and 60 therapists. To the inpatients 13-Therapeutic Factors Scale, Scale of General Attitude to Psychodrama, and the Questionnaire describing helpful things in psychodrama were administered. To the therapists 13-Therapeutic Factors Scale and the Questionnaire describing helpful things in psychodrama were administered. The inpatient group were divided into 4 groups(the audience, the auxiliary ego's, the participants in sharing, the protagonists). The therapeutic factors among 4 groups were compared. RESULTS: First, the therapeutic factors described by the inpatient group were as follows: 1) Most inpatients made great account of 'existential factor' and 'the corrective recapitulation of the primary family group' regardless of their roles in psychodrama. 2) The inpatients who participated in psychodrama directly as the protagonists, the auxiliary ego's, or the participants in sharing made much account of 'development of socializing techniques'. The inpatients who participated in psychodrama more directly as the protagonists or the auxiliary ego's made much account of 'catharsis'. 3) All the inpatients except the protagonists made much account of 'instillation of hope'. 4) The audience made much account of 'identification' and 'universality'. Especially, 'identification with members' was much accounted of by the participants in sharing. 'Universality' also was much accounted of by the auxiliary ego's. Next, when we compared the therapeutic factors in the inpatient group with those in the therapist group, the therapist group made much account of 'group cohesiveness' which the inpatient group made little account of. And the therapist group made no account of 'development of socializing techniques' which the inpatient group made much account of. CONCLUSION: By dividing the inpatient group according to their roles, we found the characteristics of the inpatient large group psychodrama and of the therapeutic factors according to the roles of the inpatients. This model could be applied to the treatment for the inpatients easily and was helpful to many inpatients on the whole.

The Effectiveness of a Day Hospital Model for Integrated Therapy of Psychotic Patients / 신경정신의학

OBJECTIVES: A day hospital has been remodeled after a vision to help psychotic patients quickly recover their psychological and social functions and lessen their induced regressions caused by long-term hospitalization, thereby enhancing their social abilities. The authors concerned once developed a day hospital model of an integrated therapy for psychotic patients suitable for Korean situation in their previous paper. Based on it, the present study was to determine how effective a day hospital would be, in comparison of the following two paired groups: day hospital group with experience of hospitalization(hereinafter abbreviated as DH group) & day hospital parents group with experience of hospitalization(hereinafter abbreviated as DH parents group) and OPD group with experience of hospitalization(hereinafter abbreviated as OPD group) & OPD parents group with experience of hospitalization(hereinafter abbreviated as OPD parents group). METHODS: During the 18-month long research period(from May to 1996 October 1997), 17 day hospital patients with experience of hospitalization & their parents and the same number of OPD patients with experience of hospitalization & their parents were corespondingly paired with at random, who identified themselves closest in the following categories: diagnosis, age, sex and function. All of them were asked to check questionnaires on their respective quality of life, insight, and their attitude about drug. Day hospital patients with experience of hospitalization and their parents were checked from the first day they were treated while OPD patients with experience of hospitalization and their parents were examined after discharge from hospital, commonly at the interval of 2 weeks, 3 months, 6 months, 12 months, and 18 months. RESULTS: 1) The quality of life scored higher in DH group than in OPD group. It turned increased significantly at the 3rd month and continued the same until the 12th month. At the 18th month, it showed a significant downturn. Meanwhile, DH group showed a significant upturn at the 3rd month and it turned down at 12 month. 2) The insight of DH group and DH parents group scored higher compared with OPD group and OPD parents group between the 3rd and 18th month, with the 3rd and 6th month showing a particular strength as well. Meanwhile, it continued unchanging for day DH group and DH parents group from the date on, of their discharge from hospital. 3) Attitude towards drugs scored higher in DH group than in OPD group at the 3rd and 6th month. It continued unchanging between the 6th and 18th month. It didn't score significantly higher in DH parents group than in their counterparts. 4) Satisfaction on the therapy started upward in DH group at the 3rd and 6th month, and scored higher in them than in their counterparts during the period form the 6th and 18th month. It started upward as well in DH parents group at the 3rd and 6th month, and scored higher in them than in their counterparts during the period form the 6th to the 18 month. 5) Number, and duration of DH group totalled lower than those by OPD group during the research period. CONCLUSION: The day hospital model, developed by the authors concerned, has proved a highly effective treatment for psychotic patients, as the data scored higher in the day hospital patients and their parents than in the OPD patients with experience of hospital and their parents in terms of "quality of life" by patients, insight, attitude toward drugs and satisfaction on its therapy.

A Day Hospital Model for Integrated Therapy of Psychotic Patients / 신경정신의학

OBJECTS: The purpose of this study was to present a day hospital model(hereinafter called as "this model") for integrated therapy, to evaluate the result of performing this model, and thus to develop day hospital model for helping psychotic patients effectively and promoting social readaptation. METHODS: The authors performed this day hospital model from 1996, May to December, A total of 25 psychotic Patients participated in this study. BPRS, Life Satisfaction Self-Rating Scale, Program Helpfulness Scale, 13 Therapeutic Factors, Scale, and Most Important Event Questionnaire were used at the start of day hospital treatment and at the end. RESULTS: The results were as follows: 1) In this model, it was possible to offer the wide treatment to heterogeneous patients who varied in age, number of admission, duration of illness, and functional level. 2) In the aspect of therapeutic effect, this model contributed for improving negative symptoms and increasing subjective life satisfaction. 3) When the patients were divided into the higher functional level group and the lower functional level group, the higher functional level group set a high value on group psychotherapy and psychodrama that were unstructured and could make patients explore their inner side deeply, But the lower functional level group did not so. Therefore dividing into two groups by functional level may be more effective for day hospital treatment. 4) Therapeutic factors were different between the periods of day hospital treatment, And in the higher functional level group, 'interpersonal learning' was important at the last period, but in the lower functional level group, 'socializing technique' was important at the last period. So long-term group psychotherapy may be more suitable for the after-care of the higher functional level group, and day care or other psychosocial rehabilitation programs may be more suitable for the after-care of the lower functional level group. 5) This model was easy to apply to Korean day hospital setting, and made staffs treat patients efficiently CONCLUSION: This day hospital model would be used effectively in Korean day hospital setting.

Current Concept of Anti-limphocyte Autoantibodies / 대한류마티스학회지

No abstract available.