The Stress Perception, Depressive Symptoms and Medical Comorbidity in Healthcare Center / 정신신체의학

OBJECTIVES: We surveyed this study for knowing the relation within stress, depression and medical comorbidities, and finding the risk factors of major depression. METHODS: 1764 subjects were enrolled from Jan. 2009 to Dec. 2009 who visit Korea University Guro hospital healthcare center. The subjects answered the questionnaire of PSS(Perceived Stress Scale), PHQ-9(Patient Health Questionnaire-9) and the demographic data. We categorized them as the stress group, depressive group, medical comorbidity group and analyzed the correlation analyses and logistic regression analyses. RESULTS: 198 of 1764 subjects(11.8%) were applied to major depression, and the depressive group showed the higher mean stress score(23.19) and mean depression score(12.95) than the normal group. The total PHQ-9 score was increased by perceiving more stress, having more medical comorbidities. The subjects with female, visiting due to recent health problems, irregular exercise, current smoking, history of angina and cerebrovascular disease showed the increased risk of major depression. CONCLUSIONS: In this study, we find the PSS, PHQ-9 were valuable for mental health screening in healthcare center. As perceiving more stress and having more medical comorbidity, risk of major depression were increased. Accordingly the individuals with medical diseases or unhealthy lifestyle would need the mental health screen.

Comparison of the transvaginal procedure and retropubic procedure for stress incontinence / 대한비뇨기과학회지

For the successful surgical treatment of genuine stress urinary uncontinence many procedures have been applied. We report on 36 cases of stress incontinence surgically treated by the tansvaginal procedure (19 cases) and retropubic procedure(17 cases) during the period from November, 1981 to October, 1991. The patient varied in age from 34 to 65 years in the transvaginal procedure and 26 to 68 years in the retropubic procedure(total mean age was 47.2 years). The surgical procedures were performed by Pereyra`s method 17 cases. Stamey`e method 2 cases. MMK's method 11 cases. Montague`s method 1 case. Burch`s method 5cases. Clinical symptom classification (grade I - Grade IV)of stress incontinence reported by Ball was used. There were symptom distribution of Grade I, 3 cases ; Grade II, 14 cases; Grade III, 2 cases in the transvaginal procedure. Grade I, 3 cases; Grade II, 11 cases : Grade III, 3 cases were done by the retropubic procedures. The success rate was 84% in the trensvaginal procedure and 89% in the retropubic procedure with minimum follow up of six months. Postoperative complications were urinary retention 8 cases, bladder perforation 1 case, vaginitis 1 case (total 59%) in the transvaginal procedures, while urinary retention10 cases. wound infection 1 case (total 70%) in the retropubic procedures. The values of post-operative days on catheter, operative time and postoperative hospitalization in the transvaginal procedures were 6.8+/-2.1 days. 91.6+/-23.2 minutes and 7.2+/-0.5 days, and in the retropubic procedures 6.9+/-3.2, 123.5+/-21.5 and 7.8+/-0.6 respectively (p<0.01). On the basis of the results we concluded that the transvaginal procedure had advantages including operative simplicity, extensive indication, rarer postoperative complication, compared with retropubic procedures.