The Quality of Life and Related Psychosocial Factors of Schizophrenia Patients Registered in Community Mental Health Center

OBJECTIVES: This study aimed to identify the relationship between quality of life (QoL) and psychosocial factors of schizophrenia patients registered in a community mental health center. METHODS: The ninety patients with schizophrenia, diagnosed by Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revision, registered in a community mental health center were studied cross-sectionally. Four trained personnels interviewed each subject individually for the assessment of QoL, psychopathology, severity of depressed mood, insight of illness, attitude toward drugs, social function, degree of social supports and conflicts. RESULTS: QoL was significantly related to the psychopathology, depressed mood, social conflict, social support; and other aspects of QoL were slightly differently related to depressed mood, social conflict, social support and attitude toward drug by scales. In multiple regression analysis, depressed mood (20.0%) and social conflict (10.3%) were contributed to QoL assessed by Korean version of 4th revision of Schizophrenia Quality of Life. Social support (21.4%), social conflict (20.9%) and depressed mood (3.1%) were contributed to QoL assessed by Korean modification of the Scale to measure Subjective Well-being under Neuroleptic treatment. CONCLUSIONS: These findings demonstrated that QoL of schizophrenia patients in a community is affected by depressed mood, social support and conflict rather than psychotic symptoms, insight and attitude toward drugs. And this result suggests the necessity of approaching not only to the psychotic symptoms but also to the psychosocial characteristics in caring schizophrenia patients in the community.

Cognitive Behavioral Therapy of Insomnia / 한양의대학술지

Cognitive behavioral therapy for insomnia (CBT-I) is a group of strategies which includes sleep restriction, stimulus control therapy, relaxation training, cognitive therapy, and various combinations of those methods. Growing evidence from controlled clinical trials indicates that the majority of patients (70 to 80%) with persistent insomnia respond to CBT, and approximately half of them achieve clinical remission. CBT-I produces significant improvements of sleep-onset latency, wake after sleep onset, sleep efficiency, and sleep quality. These benefits are paralleled by reductions of daytime fatigue, improvement in psychological symptoms, and decreased usage of hypnotics. Changes in sleep patterns are well maintained after completing therapy. Treatment outcomes have been documented primarily with prospective sleep diaries; studies using polysomnography and actigraphy have also supported these results. Considering the results of current peer-reviewed research, CBT-I should be the first-line therapy for persistent insomnia. Despite strong evidence supporting its efficacy and effectiveness, CBT-I remains under utilized by health care practitioners. Increased application of evidence-based CBT-I therapies and their extension into primary medical practices should be highly effective and should be recommended in the future for better clinical management of insomnia-related disorders.

Prevalence of Late Effects by Designed Health Promotion Program in Long-term Survivors of Childhood Cancer / 임상소아혈액종양

BACKGROUND: We prospectively investigated the incidence and features of late organ complications in long-term childhood cancer survivors (LTCCS) who took part in a specially designed health promotion program (HPP).METHODS: We developed our own HPP for LTCCS based on the Children's Oncology Group (COG) program, by modifying the adult HPP in Hanyang University Medical Center. The study included survivors who had received chemotherapy and/or radiotherapy for childhood cancer and had survived for at least 4 years after the end of treatment without evidence of recurrence.RESULTS: A total of 38 survivors were enrolled in the study. One or more abnormal findings were identified in 33 (87%) of the survivors, and two or more abnormal findings were present in 16 (42%) of the survivors. The most frequent type of abnormality was identified by thyroid ultrasonography, which detected benign nodules or cysts in 17 (45%) of the survivors. High-risk posttraumatic stress disorder needing medical treatment was detected in 1 of 17 survivors who were examined by psychological questionnaire.CONCLUSION: Most (87%) of childhood cancer survivors have at least 1 major or minor late effect. They must be continuously monitored after completion of treatment for early detection of late effects as well as cancer recurrence. Nationally integrated research is needed to provide standardized and comprehensive HPP for LTCCS considering domestic circumstances in Korea.

Prevalence of Late Effects by Designed Health Promotion Program in Long-term Survivors of Childhood Cancer / 임상소아혈액종양

BACKGROUND: We prospectively investigated the incidence and features of late organ complications in long-term childhood cancer survivors (LTCCS) who took part in a specially designed health promotion program (HPP). METHODS: We developed our own HPP for LTCCS based on the Children's Oncology Group (COG) program, by modifying the adult HPP in Hanyang University Medical Center. The study included survivors who had received chemotherapy and/or radiotherapy for childhood cancer and had survived for at least 4 years after the end of treatment without evidence of recurrence. RESULTS: A total of 38 survivors were enrolled in the study. One or more abnormal findings were identified in 33 (87%) of the survivors, and two or more abnormal findings were present in 16 (42%) of the survivors. The most frequent type of abnormality was identified by thyroid ultrasonography, which detected benign nodules or cysts in 17 (45%) of the survivors. High-risk posttraumatic stress disorder needing medical treatment was detected in 1 of 17 survivors who were examined by psychological questionnaire. CONCLUSION: Most (87%) of childhood cancer survivors have at least 1 major or minor late effect. They must be continuously monitored after completion of treatment for early detection of late effects as well as cancer recurrence. Nationally integrated research is needed to provide standardized and comprehensive HPP for LTCCS considering domestic circumstances in Korea.