Educational Applications of Psychotherapy for the Medical Students: Development of Psychotherapy Education Model / 신경정신의학

Objectives@#We have been providing psychotherapy training for medical students enrolled in the course of ‘Clinical Practice.’ The aim of this study is to introduce the psychotherapy education developed in this process, conceptualize objective education methods, and check the impact of educational applications of psychotherapy for medical students. @*Methods@#Psychotherapy was applied to the medical students during their clerkship in psychiatry. 221 medical students participated in this program from 2017–2019, which consisted of 2–3 people in a group. One was in charge of clients, and the other was an observer. Their clerkship was based on psychodynamic psychotherapy, especially Taopsychotherapy. Before and after the practice, participants completed a self-reporting questionnaire about ego identity, self-concealment, and professional help-seeking attitudes. Statistical analysis using a two-way repeated measure analysis of variance was conducted. @*Results@#Participants learned of the nuclear feelings associated with the current problem and were surprised to find a connection with past experiences, but accepted the connection. Selfidentity decreased in the client role students (p=0.001), and professional help-seeking attitude increased in both client and observer role students (p=0.001). @*Conclusion@#In the general course of psychotherapy, patients are reminded of their first interpersonal relationships, like parents, and in the beginning, they only think of positive aspects under repressed emotions. However, they gradually recalled negative emotions. The above practical course featured this same pattern. As they recognized negative emotions that were repressed, self-identity decreased in client role students.

Study of the characteristics of dietary behavior and the effects of nutrition education for sodium reduction according to the stages of behavioral change in sodium reduction of male adult subjects in Gwangju·Jeonnam regions / 한국영양학회지

PURPOSE: This study examined the dietary behavior and the effects of nutrition education according to the stages of behavioral changes in sodium reduction of healthy male adults (20~69 years) in Gwangju·Chonnam Regions. METHODS: The research subjects were 200 male adults. RESULTS: A significantly higher mean age was observed in the stage of Action·Maintenance (A·M) than in the stage of Precontemplation (PC) and stage of Contemplation·Preparation (C·P). Significant differences in the frequency of exercise, eating out, and preference for salty food, intake frequency of Udon, Ramen and Sundae according to the stages of behavior change in sodium reduction were observed. The dietary behavior scores and intake frequency-related dietary behavior scores of A·M were significantly higher than PC and C·P. Nutrition education for sodium reduction improved the dietary behavior score significantly in PC and C·P, as well as the rate of correct answers of sodium-related nutrition knowledge in all stages. After the nutrition education, PC decreased greatly, and A·M increased. CONCLUSION: Subjects in PC and C·P had an undesirable propensity in dietary behavior, and nutrition knowledge compared to A·M, but the nutrition education for sodium reduction greatly improved their dietary behavior and nutrition knowledge.

Patterns of Delusions and Hallucinations in Schizophrenia : Comparison between the 1990s and the 2000s

OBJECTIVES: Research suggests that content of delusion and hallucination in schizophrenia is influenced by culture and social environment. However, few studies investigated chronological change of delusions and hallucinations within a society. To investigate changes in delusions and hallucinations of schizophrenia according to time, we compared contents of symptoms between inpatients with schizophrenia at two different time frames. METHODS: All admissions to a psychiatric unit of Hanyang University Guri Hospital with discharge diagnoses of schizophrenia at two different five-year time frames (1996-2000 and 2006-2010) were reviewed. Using a checklist, adapted from the Scale for Assessment of Positive Symptoms, we investigated delusions and hallucinations of 247 patients (104 in the 1990s and 143 in the 2000s). RESULTS: Delusions and hallucinations of patients did not differ at two time frames. In women, however, auditory and somato-tactile hallucinations were significantly more frequent in the 1990s (p < 0.05). CONCLUSIONS: Our findings support the literature emphasizing that content and frequency of hallucination may differ according to cultural environment. We speculate that attitude toward sex and defensiveness toward disclosure of symptoms may have contributed to interval difference.

Print Media Coverage of Post-Traumatic Stress Disorder: Content Analysis of Three Major Korean Newspapers

The print media is still one of major sources for health-related information. To shed light on how the media accurately delivers information for post-traumatic stress disorder (PTSD), we searched the newspaper articles and analyzed their contents for accuracy in the description of symptoms, causes, and treatment of PTSD. The articles featuring PSTD were searched from the very first available to 2010 at on-line search systems of three major Korean newspapers. A total of 123 articles appeared and the first article appeared in 1984. The number of articles steadily increased till the early 2000s but we found the robust increase in the late 2000s. Among the mentioned symptoms of PTSD: re-experience (39%) was most common, followed by avoidance or numbing (28%) and hyperarousal (22%). Of the 29 articles mentioning treatment of PTSD, 13 mentioned psychotherapy only and 11 mentioned both psychotherapy and medication equally. However, the psychotherapies mentioned were non-specific and only five articles mentioned any empirically supported therapies. The number of articles on PTSD in Korean newspapers has continually increased during the last three decades. However, the quality of information on the treatment of PTSD was questionable.

The Relationship between Psychotherapy and Neurobiological Findings

The mechanism of psychotherapy is explained by the recent developments in neuroscience and neuroimaging. The purpose of this study is to understand the nature of psychotherapy and to discuss the future of psychotherapy improvement with the help of advances of the neurobiological findings in psychotherapy. For this study, we investigated a wide range of materials. We searched for various researches on psychotherapy, brain, and neurobiology. In addition to the conventional psychodynamic psychotherapy, we investigated research findings on cognitive behavioral therapy, interpersonal psychotherapy and eye movement desensitization and reprocessing (EMDR). Moreover, based on the actual experiences of treating patients, we speculated the neurobiological mechanisms of the process and results of psychotherapy. With the development of neuroscience, we are now able to understand the personal consciousness, unconsciousness and developmental process. Also subdividing the disease is made possible. Personalized treatment has become available, and we are able to predict the prognosis of patients. Our memories are composed by implicit memory and explicit memory. By psychotherapy, we can consciously remember explicit memory, and it becomes easier to explore implicit memory through free association. Through psychotherapy, we will also be able to learn the effect of acquired environment and experience. Psychotherapy is able to correct human behaviors by modifying the memories. Through the regulation of emotions, it becomes possible to modify the memories and correct the behaviors. In this process, doctor-patient relationship is the main factor which cause positive treatment effects. Furthermore imagination therapy or unconscious, non-verbal stimuli could bring about positive treatment effects. Now psychotherapy could be explained and studied by neuroscientific researches. In this sense, we could provide the direction of future advances in neuroscience by the neurobiological understanding of psychotherapy.

Nature of Persecutors and Their Behaviors in the Delusions of Schizophrenia: Changes between the 1990s and the 2000s

OBJECTIVE: Research suggests that the contents of delusions in schizophrenia are influenced by culture and social environment. However, few studies have investigated the chronological change of such delusions within a society. To investigate specifically the changes in the persecutory delusions of schizophrenia that have occurred over time, we compared the nature of the persecutors and their persecutory behaviors among inpatients with schizophrenia. METHODS: All admissions to the psychiatric unit of Hanyang University Guri Hospital with discharge diagnoses of schizophrenia during two different five-year time frames (1996-2000 and 2006-2010) were reviewed. From their inpatient medical records, we investigated the descriptions of persecutors and their persecutory behaviors in the delusions of 124 patients (54 in the1990s and 72 in the 2000s). RESULTS: Overall, persecutory behaviors and nature of persecutors in the delusions of schizophrenia did not differ between the two time frames. However, subgroup analysis revealed that in women but not in men, rejection as a persecutory behavior was significantly higher in the 1990s (p<0.05). CONCLUSION: The ten-year time interval may be too short to find significant changes in delusional content in general. However, our additional finding in women may be a result of the tremendous change in status of Korean women during the last decade.