학술논문
정신과에 입원한 청소년 정신 장애자의 병원 체제에 대한 저항 유형 분석
이용수 8
- 영문명
- An Analysis of Resistances Toward Therapeutic Milieu Among Hospitalized Adolescents with Mental Disorders
- 발행기관
- 대한신경정신의학회
- 저자명
- 민경준 이길홍
- 간행물 정보
- 『신경정신의학』제32권 제5호, 826~838쪽, 전체 13쪽
- 주제분류
- 의약학 > 정신과학
- 파일형태
- 발행일자
- 1993.09.30
4,360원
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국문 초록
영문 초록
The purpose of present study was to investigate the characteristics of clinical manifestations
according to subtypes of resistances toward therapeutic milieu among hospitalized aeolescents
with mental disorders, and to set the guidelines on effective measures to cope with the resistances
of them and their parents.
The subjects in this study composed of 318 adolescents, who were admitted to the Department
of Psychiatry in Chung Ang University Pildong Hospital and Yongsan Hospital from January
1981 to December 1991, including 76 cases of persistant avoidance type, 67 outright-rebelliousness
type, 58 somatization type, 23 over-summissiveness type, 21 pseudo-stupidity type,20 cases of
the other types, and 53 cases without resistance.
Data were analysed on their resistances, socio-demographic characteristics, clinical diagnosis
& personality traits, admission history, and pharmacologic treatment in order to try to revleal
the differences between 7 subtypes of resistances. Data were precessed by SPSS/PC + Program
and were statistically analysed by chi-square test.
Summaries of the results were as follows:
1) The 83.3% of 318 hospitalized adolescents with mental disorders showed various resistances
toward the therapeutic milieu of the hospitals. The persistent avoidance was shown by 76
patients(23.9% ) ,and 67 patients(21.1 % ) resisted against the treatment by outright rebelliousness,
58 patients(1 8 .2 % ) by somatization, 23 patients(7.2%) by over-summissiveness and 21(6.6%)
by pseudo-stupidity.
2) There were no significant differences in sex, age, and educational level between the types
of resistances.
3) The 60.4% among the parents of hospitalized adolescents with mental disorders had
various resistances toward their hospitals therapeutic milieu, and these parental resistance were
closely related with their children’s resistance, particularly in the persistent avoidance type and
the over-submissiveness type.
4) Summary of the clinical characteristics of adolescent psychiatric in-patients according
to each subtypes of resistances were as follows :
(1) The persistent avoidance type, the most frequent one of all resistances, was managed
mainly with the supportive psychotherapy, and the patients who showed that type of resistance
were likely to be diagnosed as the major depression, showing dependent schizoid, and avoidant
personality traits. During hospitalization, they were apt to adm it to open ward and to be treated
mainly by antidepressants.
(2) The outright rebelliousness type of resistances was tried to alleviate through the physical
restraints or groundpass. On clinical features, psychotic disorders and manic state of bipolar
disorder were frequent and so were antisocial, schozitypal, and narcissistic personality traits
in this type of resistances. They were likely to be admitted to closed ward, and to be treated
by antimanic or antipsychotic drugs.
(3) The somatization type was inclined to be treated with the chemical sedation or supportive
psychotherapy. The patients of this type were likely to be diagnosed as the neurotic disorder
or psychoactive substance use disorder, and to show the histrionic personality trait. During
hospitalization, they were chiefly admitted to open ward, and treated by antianxiety drug or
antidepressants.
(4) Over-submissive type of resistances was managed by supportive psychotherapy. The p atients
who showed the over-submissive type were frequently diagnosed as the m ajor depression,
the neurotic disorder, or the adjustment disorder, and were inclined to have the obsessive-compulsive
or paranoid personality traits. Many of them were admitted to the open ward and
treated by antianxiety drugs.
(5) The psychotic disorders and organic mental disorders were f
목차
서 론
연구대상 및 방법
연구결과
고 찰
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References
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- 정신과에 입원한 청소년 정신 장애자의 병원 체제에 대한 저항 유형 분석
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