The Significance and Limitations of Korean Diagnosis-Related Groups in Psychiatric Inpatients' Hospital Charges / 신경정신의학

OBJECTIVES: This study was conducted to investigate whether the charges associated with Korean Diagnosis-Related Groups for mental health inpatients adequately reflect the degree of medical resource consumption for inpatient treatment in the psychiatric ward. METHODS: This study was conducted with psychiatric inpatients data for 2014 from the National Health Insurance claim database. The main diagnoses required for admission, classification of the hospitals, and main treatment services were analyzed by examining descriptive statistics. Homogeneities of the major diagnostic criteria were assessed by calculating coefficient variances. Explanation power was determined by R2 values. RESULTS: The most frequent disorders for psychiatric inpatient treatment were alcohol-use disorder, depressive episodes, bipolar affective disorder, and dementia in Alzheimer's disease. Hospitalization and psychotherapy fees were the main medical expenses. Regardless of the homogeneity of the disease group, duration of hospital stay was the factor that most influenced medical expenses. In the psychiatric area, explanation power of Korean Diagnosis-Related Groups was 16.52% (p<0.05), which was significantly lower than that for other major diagnostic area. CONCLUSION: Most psychiatric illnesses are chronic, and the density of services can vary depending on illness severity or associated complications. The current Korean Diagnosis-Related Groups criteria did not adequately represent the amount of in-hospital medical expenditures. A novel Korean classification system that reflects the expenditures of medical resources in psychiatric hospitals should be developed in order to provide appropriate reimbursements.

Erratum: The Significance and Limitations of Korean Diagnosis-Related Groups in Psychiatric Inpatients' Hospital Charges / 신경정신의학

This correction is being published to correct the errors and to added missing contents.

Mild Impairments in Cognitive Function in the Elderly with Restless Legs Syndrome / 수면정신생리

OBJECTIVES: Cognitive impairment in restless legs syndrome (RLS) patients can be affected by sleep deprivation, anxiety and depression, which are common in RLS. The objective of this study is to investigate relationship between cognitive impairment and RLS in the non-medicated Korean elderly with controlling for psychiatric conditions. METHOD: The study sample for this study comprised 25 non-medicated Korean elderly RLS patients and 50 age-, sex-, and education-matched controls. All subjects were evaluated with comprehensive cognitive function assessment tools-including the Korean version of Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K), severe cognitive impairment rating scale (SCIRS), frontal assessment battery (FAB), and clock drawing test (CLOX). Sleep quality and depression were also assessed with Pittsburgh sleep quality index (PSQI) and geriatric depression scale (GDS). RESULTS: PSQI and GDS score showed no difference between RLS and control group. There was no significant difference between two groups in nearly all the cognitive function except in constructional recognition test, in which subjects with RLS showed lower performance than control group (t=-2.384, p=0.02). Subjects with depression (GDS> or =10) showed significant cognitive impairment compared to control in verbal fluency, Korean version of Mini Mental Status Examination in the CERAD-K (MMSE-KC), word list memory, trail making test, and frontal assessment battery (FAB). In contrast, no difference was observed between subjects who have low sleep quality (PSQI>5) and control group. CONCLUSIONS: At the exclusion of the impact of insomnia and depression, cognitive function was found to be relatively preserved in RLS patients compared to control. Impairment of visual recognition in RLS patients can be explained in terms of dopaminergic dysfunction in RLS.

A Null Mutation of the Ciliary Neurotrophic Factor (CNTF) Gene Associated Neither with Schizophrenia Nor with Bipolar Disorder in a Korean Population / 신경정신의학

Genetic factors play an important role in the development of schizophrenia and bipolar disorder, and recently the neural maldevelopment hypothesis is suggested by neuropathological and neuroimaging studies. Neurotrophic factors, including ciliary neurotrophic factor (CNTF), play a central role in the regulation of neural development. This study was designed to investigate the association between the null mutation of CNTF gene and schizophrenia and bipolar disorder in a Korean population. The CNTF gene were typed with polymerase chain reaction in 112 patients with schizophrenia, 81 with bipolar disorders and in 125 healthy controls. The distributions of the CNTF genotype in schizophrenic patients with N/N, N/M, M/M were 80 (71.4%), 32 (28.6%), 0 (0%), in bipolar disorders were 58 (71.6%), 23 (28.4%), 0 (0%) and in the controls were 94 (75.2%), 30 (24.0%), 1 (0.8%). The allele frequencies of the CNTF gene in schizophrenic patients with N and M were 192 (85.7%), 32 (14.3%), in bipolar disorders were 139 (85.8%), 23 (14.2%), and in the control were 218 (87.2%), 32 (12.8%). There were no differences in the genotype distributions and the allele frequencies of CNTF gene null mutation among the 3 groups. These results suggest CNTF gene null mutation is not causally related to the development of schizophrenia and bipolar disorder in Korea.

A Case of Pneumonia due to Occult aspiration of a Twig / 결핵

Bronchial foreign body aspirations are uncommon in adults and usually have various underlying conditions, otherwise accidentally occurred in dental procedure, medical, surgical procedure. The most commonly aspirated objects were food materials, with peanuts leading the list. When bronchial foreign body was aspirated, no definite respiratory symptoms or foreign body is may not seen, then diagnosis is delayed. Therefore late complications was developed. The tendency to use fiberoptic bronchoscope for removal of foreign bodies in adults is increased. We report a rare case of bronchial pneumonia due to occult aspiration of a twig before 1 year with a review of the literatures.

Standardization of the mini-mental state examination(MMSE) in Korea / 신경정신의학

No abstract available.