ABSTRACT
OBJECTIVES: The purpose of this study is to surmise appropriate level of medical manpower of mental hospital from the perspectives of clinical experts, psychiatrist and psychiatric nurse. METHODS: First, we wlleded data on medical manpower of domestic mental hospitals and foreign mental hospitals. Next, psychiatrists and psychiatric nurses were asked to complete a survey. We estimated the optimal level of medical manpower examining appropriate volume of medical services that should be provided for psychiatric patients, and analizying the survey carried out by direct questions. RESULTS: The number of psychiatrists of group A of private mental hospitals was 1.7 times more than that of public mental hospitals; when the number of psychiatrists in public mental hospitals was regarded as 1.0, and group B of private mental hospitals was 0.5 times, and the university hospitals 8.2 times. The number of psychiatric of group A of private hospitals was 1.5 times more than that of public mental hospitals; when the number of psychiatric nurses in public mental hospitals was regarded as 1.0, the group B of private mental hospitals was 0.6 times and university hospitals was 2.6 times. The foreign mental hospitals had more medical manpowers in all occupations than domestic mental hospitals. The number of psychiatrists estimated according to the first method was 11.1 persons and the number of psychiatric nurses was 26.3 persons per 100 beds, and the number of psychiatrists estimated according to the second method was 4.3 persons per and the number of psychiatric nurses was 20.8 persons per 100 beds. CONCLUSION: The estimated optimal number of psychiatrists for mental hospital is 4.3 persons and of psychiatric nurses was 20.8 persons per 100 beds. However, these numbers can be flexible depending on the ratio of short-term acute patients and long term chronic patients.
Subject(s)
Humans , Hospitals, Private , Hospitals, Psychiatric , Hospitals, University , Occupations , PsychiatryABSTRACT
OBJECTIVES: The purpose of this study is to surmise appropriate level of medical manpower of mental hospital from the perspectives of clinical experts, psychiatrist and psychiatric nurse. METHODS: First, we wlleded data on medical manpower of domestic mental hospitals and foreign mental hospitals. Next, psychiatrists and psychiatric nurses were asked to complete a survey. We estimated the optimal level of medical manpower examining appropriate volume of medical services that should be provided for psychiatric patients, and analizying the survey carried out by direct questions. RESULTS: The number of psychiatrists of group A of private mental hospitals was 1.7 times more than that of public mental hospitals; when the number of psychiatrists in public mental hospitals was regarded as 1.0, and group B of private mental hospitals was 0.5 times, and the university hospitals 8.2 times. The number of psychiatric of group A of private hospitals was 1.5 times more than that of public mental hospitals; when the number of psychiatric nurses in public mental hospitals was regarded as 1.0, the group B of private mental hospitals was 0.6 times and university hospitals was 2.6 times. The foreign mental hospitals had more medical manpowers in all occupations than domestic mental hospitals. The number of psychiatrists estimated according to the first method was 11.1 persons and the number of psychiatric nurses was 26.3 persons per 100 beds, and the number of psychiatrists estimated according to the second method was 4.3 persons per and the number of psychiatric nurses was 20.8 persons per 100 beds. CONCLUSION: The estimated optimal number of psychiatrists for mental hospital is 4.3 persons and of psychiatric nurses was 20.8 persons per 100 beds. However, these numbers can be flexible depending on the ratio of short-term acute patients and long term chronic patients.
Subject(s)
Humans , Hospitals, Private , Hospitals, Psychiatric , Hospitals, University , Occupations , PsychiatryABSTRACT
OBJECTIVES: This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). METHODS: Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November 30, 2001. RESULTS: Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major depressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. CONCLUSION: The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.
Subject(s)
Adult , Female , Humans , Male , Anxiety Disorders , Surveys and Questionnaires , Depressive Disorder, Major , Diagnostic and Statistical Manual of Mental Disorders , Epidemiology , Family Characteristics , Mood Disorders , Nicotine , Phobic Disorders , Prevalence , SchizophreniaABSTRACT
OBJECTIVES: One of the objectives of this study is to estimate the prevalence rates of psychiatric diagnoses in the combined populations of psychiatric hospitals, psychiatric nursing facilities and homeless asylums using the Korean version of the Composite International Diagnostic Interview (K-CIDI), which is a comprehensive and fully standardized interview schedule to assess psychiatric disorders for diagnosis. The Other objective is to compare with previously studied prevalence rates of psychiatric diagnoses using the results of this study. METHODS : The study subjects, aged from 18 to 64 years, were randomly selected from 64,582 institutionalized population of psychiatric hospitals, psychiatric nursing facilities and homeless asylums as of 30, June, 2001. Twelve trained interviewers administered the K-CIDI to the selected respondents. A total of 1,875 respondents (male 1,194, female 681) completed the interview. RESULTS : The lifetime and one year prevalences of any diagnosis excluding nicotine dependence. withdrawal, anxiety disorder, eating disorder, somatoform disorder were 88.2% (male 88.1%, female 88.3%), and 65.8% (male 62.7%, female 73.7%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were 78.5% (male 75.3%, female 83.7%), and 56.8% (male 51.9%, female 64.8%), respectively. The lifetime and one year prevalences of alcohol use disorder (dependence/abuse) were 26.7% (male 37.9%, female 8.3%), and 8.7% (male 12.8%, female 2.1%), respectively. The lifetime and one year prevalences of mood disorder were 18.1% (male 13.5%, female 25.8%), and 10.4% (male 7.2%, female 16.9%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were comparable with the 2001 community survey by 1.19% to 1.32%, and 0.51% to 0.61%, respectively. The lifetime and one year prevalences of schizophrenia were also comparable by 0.16% to 0.28%, and 0.16% to 0.25%, respectively. There were no significant changes of prevalence rates when correction were applied to other psychiatric diagnosis. CONCLUSION : The results of this study could be used for evaluating the distribution of psychiatric diagnoses in mental health related facilities and for planning mental health policies.
Subject(s)
Female , Humans , Anxiety Disorders , Appointments and Schedules , Surveys and Questionnaires , Diagnosis , Feeding and Eating Disorders , Epidemiology , Hospitals, Psychiatric , Mental Disorders , Mental Health , Mood Disorders , Prevalence , Psychiatric Nursing , Psychotic Disorders , Schizophrenia , Somatoform Disorders , Tobacco Use DisorderABSTRACT
OBJECTIVES: This study was to analyze the results of judgement on continuing hospitalization by the Mental Health Judgement Boards and to explore the present status of judging system for continuing hospitalization. METHODS: Analyzing summary and request sheets for continuing hospitalization on August 2001, we compared the number of requests for continuing hospitalization and the dissent rate at each Mental Health Judgement Board. The selationship between dissent rate and clinical characteristics such as diagnoses, caregivers, medical care systems, institute, and the clinical state was also explored. RESULTS: The summary sheets on the judgement for continuing hospitalization from 14 Mental Health Judgement Boards were collected. Total number of the requests for continuing hospitalization was 4,853 and the nationwide dissent rate was 4.2% with broad range of 0 to 32% in each Mental Health Judgement Board. The request sheets from 10 Mental Health Judgement Boards were 3,014. The proportion of schizophrenic patients was 73.0%, followed by 9.1% for alcoholics, 4.1% for mentally retarded patients, 3.8% for dementic patients, and 10.5% for others. The different of the dissent rates of schizophrenia (2.9%) and other non-schizophrenia (4.8%)was statistically signiticant (chi2=6.797, p=0.009). The dissent rates of family members (4.0%) and majors (1.6%) were statistically different (chi2=10.294, p=.001). The dissent rates of mental hospitals (3.8%) and mental health welfare facilities (2.1%) were statistically different (chi2=5.483, p=.019). The dissent rates of medicaid (3.5%) and insured (1.7%) was statistically different (chi2=4.622, p=.032). The dissent rates by the severity of clinical status were statistically different in all six categories: the risk for self-injury or injuring others (chi2=66.507, p=.000), the disability of daily self-care (chi2=136.033, p=.000), odd, eccentric, or regressed behavior (chi2=96.558, p=.000), unreal or illogical thought pattern (chi2=122.988, p=.000), negativism (chi2=62.715, p=.000), and memory, orientation or judgement problems (chi2=38.387, p=.000). CONCLUSION: The nember of requests for continuing hospitalization and the dissent rates showed wide variations among Mental Health Judgement Boards. Also, the dissent rates of the Boards were significantly different according to diagnoses, caregivers, medical care systems, institute, and the clinical status of patients. This result suggests that the standardization of the guideline on the judgement for continuing hospitalization and the practical plans for protecting human rights of patients require thorough preparation.
Subject(s)
Humans , Alcoholics , Caregivers , Diagnosis , Dissent and Disputes , Hospitalization , Hospitals, Psychiatric , Human Rights , Medicaid , Memory , Mental Health , Persons with Mental Disabilities , Negativism , Schizophrenia , Self CareABSTRACT
OBJECTIVE: The few direct comparative studies of efficacy and tolerability of atypical antipsychotics have been done in patients commonly seen in clinical practice. We therefore compared, head-to-head, the relative efficacy and tolerability of two atypical antipsychotics, risperidone and quetiapine, commonly used in clinical practice nowadays. METHODS: This study used retrospective chart reviews of the patients who had been admitted to or treated at the outpatient department in a university hospital. The analysed population consisted of 55 patients with diagnoses of schizophrenia or schizoaffective disorder. RESULTS: Among the baseline characteristics, the proportion of patients with a history of previous antipsychotics medication was higher in the quetiapine group, as was the proportion of patients treated at the outpatient department, the proportion of female patients, and the mean age. Even though these baseline differences had been controlled as covariate, the proportion of responsive patients was higher, and the median value of the time to efficacy was shorter, in the risperidone group. The rate of sedation was higher in the quetiapine group and the rates of concomitant use of anticholinergics and benzodiazepines were higher in the risperidone group. However, these differences of sedation and concomitant use of anticholinergics and benzodiazepines were not statistically significant when controlling for the effect of baseline characteristics. Even though this study showed some useful results, the study limitations included the use of retrospective chart reviews and the small number of subjects at a single hospital, among others. Therefore, further studies controlling these limitations need to be done to confirm the results of this study. CONCLUSION: The proportion of responsive patients was higher and the median value of the time to efficacy was shorter in the risperidone group. The rates of extrapyramidal symptoms were not different between the two groups.
Subject(s)
Female , Humans , Antipsychotic Agents , Benzodiazepines , Cholinergic Antagonists , Diagnosis , Outpatients , Pilot Projects , Psychotic Disorders , Retrospective Studies , Risperidone , Schizophrenia , Quetiapine FumarateABSTRACT
OBJECTIVES: Aims of this study were 1) to estimate prevalence rates of suicidal ideation and suicide attempt, 2) to find out whether the gender difference and age difference(13-15 years vs 16-18 years) for suicide behaviors exist, 3) to analyse correlates of suicide attempts among junior and high school adolescents aged 13-18 years old. METHODS: A self-administered questionnaire was used in a cluster random sample of 2,203 school adolescents(male 1,105, female 1,098). Data were obtained on a wide range of constructs including suicidal ideation and attempts during past 2 weeks, depressive symptoms, symptoms of DSM-IV alcohol dependence, family structure, socioeconomic status, smoking, satisfaction with school achievements, and subjective health status. Chi-square test were done for analysing gender difference and age difference of suicide behaviors. Statistical analyses including uni-variate and multi-variate logistic regression analysis were done for each sex, respectively. RESULTS: 1) The prevalence of suicide ideation during past 2 week was 30.7% in the total sample. The prevalence rates of male and female ideators were 26.9% and 34.9% respectively. The prevalence of suicide attempt during past 2 week was 5.3% in the total sample. The prevalence of suicide attempt in males was 3.4% and 7.3% in females. 2) Gender difference was significant. That is, female respondents showed higher rate of suicidal ideation and suicide attempt. In our study age difference was found only at the rate of suicide attempt. That is, older adolescents(16-18 years) showed only statistically significant higher rate of suicide attempt than younger adolescents(13-15 years). 3) Multi-variate logistic regression analysis revealed that the correlates for suicide attempt were female, moderate to severe depressive symptoms, alcohol dependence in the total sample. In males the correlate for suicide attempt was alcohol dependence. In females, were moderate to severe depressive symptoms, and alcohol dependence. CONCLUSION: Depressive symptoms, alcohol dependence, presence of suicidal ideation were strong predictors for suicide attempts. This suggest that early detection of treatment of depression and alcohol dependence is important and psychiatric approach and follow-up be needed for the prevention of suicide.
Subject(s)
Adolescent , Female , Humans , Male , Alcoholism , Surveys and Questionnaires , Depression , Diagnostic and Statistical Manual of Mental Disorders , Logistic Models , Prevalence , Risk Factors , Smoke , Smoking , Social Class , Suicidal Ideation , SuicideABSTRACT
OBJECTIVES: Recently the issue on the violation of human rights has been raised in mental health system in Korea. In these cirmstances this study was conducted to investigate the length of stay of psychiatric inpatients by sociodemographic, clinical characteristics, and type of mental health facilities. METHODS: The total 1,028 subjects were randomly selected from 22 mental health facilities, including mental hospitals, general hospitals, psychiatric clinics, mental health welfare facilities, welfare facilities for homelessness, and illegal asylums. The subjects were interviewed by psychiatrists and social workers with clinical experiences. RESULTS: The average length of stay of psychiatric inpatients of mental health facilities in Korea was 1,368 days, and it was statistically different according to sociodemographic and clinical characteristics such as sex, age, education, religion, economic status, type of medical security, degree of family support, living condition before admission, diagnosis, age of onset, and number of admissions. In addition, the length of stay was associated with the type of mental health facilities. CONCLUSION: For more appropriated length of stay of psychiatric inpatients, not only various incentives for service suppliers are needed but also medical and socioeconomic incentives for patients and familiy members should be considered in order to facilitate their community-living.
Subject(s)
Humans , Age of Onset , Diagnosis , Education , Ill-Housed Persons , Hospitals, General , Hospitals, Psychiatric , Human Rights , Inpatients , Korea , Length of Stay , Mental Health , Motivation , Psychiatry , Social Conditions , Social WorkersABSTRACT
OBJECTIVES: We have aimed to estimate the direct and indirect costs of treating out-patients with schizophrenia in Korea, to use this fundamental data for the effective management and proper distribution of the medical resource. METHOD: To estimate the direct cost, we surveyed the medical cost and time of two hundred and eighty-nine out-patients with schizophrenia for six months. And the lost productivity as many months was converted into the indirect cost. Those of eighty-two coronary heart disease patients were also estimated as a comparison group. RESULTS: An unemployement rate of schizophrenic patients was 72.1 percent. Moreover the ratio of the laborer in the sample was, even if employed, 64.5 percent. The mean direct cost of schizo-phrenic patients was, about 815,000 won, higher than that of coronary heart disease, 715,000 won however it was not statistically significant. The former was also estimated 2.5 times more than the latter for the indirect cost, or 6,456, 000 won versus 2,589,000 won. CONCLUSION: Schizophrenia is a relatively costly illness compared to other chronic illness, so the systematic estimation of the cost is necessary to provide mental health service of high quality.