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精神分裂反應患者에 對한 疫學的 調査硏究

An Epidemiologicl Study on Patients with Schizophrenic Reaction

공중보건잡지 1969년 6권 1호 p.77 ~ 87
하재덕 (  ) - 서울대학교 보건대학원

Abstract


This was a study of both patients and their family members of protectors to discover relationships and environmental factors which may be related to the mental illness as well as their attitudes or understanding of the disease.
Summary of the findings and conclusions: The summary of the findings will include basic patients data, factors and relationships, treatments and attitudes and understanding of the family members or protectors. Conclusions have drown and a summary of these will accompany each of the finding.
1. Age and sex: 63.7% of the 503 patients were in the age bracket of 20~34 years. There appeared to be a higher case rate among males (64.7) than females (60.5) within this age group, however, the case rate for females age 30~34 was higher than that of any other age group of male or female. From the above it is apparent that almost two thirds of the patients were young adults.
2. Age and Onset: 45.4% of the patients had shown symptoms of mental illness by the time they were 15~24 years of age. Almost one half of the patients had shown symptoms of mental illness during adolescence and early childhood.
3. Educational Level: 57.4% of the patients had high school or college education prior to admission.
4. Residence: 75% of the patients came from urban homes and 25% from a rurnal environment. 75.5% owned their own homes.
5. Material Status: 45% of the patients were married and 55% never married.
6. Occupational Status: 30% of the female were housewives, 30% of the total patients were unemployed, 21% were students and 10.2% were farmers. Statistics from the table on occupations appears to support the finding that schizophrenia is more prevelant among those residing in rural communities.
7. Birth Order: 5.6% of the patients had neither brothers or sisters. 33% of the patients were first borns and 17.9% were last borns. This means much higher rate in first borns than last borns.
8. Parental Loss: 53% of the patients had lost their father by the age of 19 and 31.3% had lost their mother by the age of 19. This gives rise to a significant influence for a growing boy or girl to have hard time of personality formation
9. Number of Times of Admission: 66.4% of the patients had to be readmitted one or more times after primary discharge from a mental institutions or psychiatric treatment. This finding raises the question of 1) why these patients needed re-admission and 2) is there adequate and sufficient follow-up or after-care of patients and their families following the primary discharge of the patient.
10. Treatment: Approximately 75% of both male and female patients had had non-professional treatment for their mental condition prior to admission to the hospital. Apparently there is no relationship between non-professional treatment and educational status of the patient or his protector. The same remains true for religious status of the patient of protector.
11. Methods of be Non-professional Treatment: Herb medicine appear to be the leading non-professional treatment for the illness prior to admission. More than 50% of the patients had utilized herb medicine. The four most used non-professional treatment were: herb medicine, drug store remedies, fortune telling or superstitious practice and acupuncture. This finding clearly indicates that both patients and families realize a need for treatment but are unaware of the advantages of early professional treatment or other factors prevent them from seeking professional treatment. This in itself indicates a tremendous need for education of the public on 1) the importance and advantages of professional treatment and 2) ways and means to obtain professional treatment. A more detailed study needs to be made regarding this aspect of the problem.
12. Interval between Onset of Symptoms and Primary Admission: There appeared to be no significant relation-ship between the protector´s educational level and early admission rate. Patients whose patents or protector´s educational level are beyond high school are not admitted so earlier comparing with other group of patients. It is known that two thirds of the patients came to the hospital after one month or many years of hesitation mostly due to failure of self treatment.
Final Remarks: This very meager study points up an urgent need for the specialists and health educators to continue further research of a more detailed nature on the subject and to design this research in such a manner that the results can and will be utilized for hospital and public health programme planning, development, implementation and evaluation thus achieving better setup of mental health in Korea.

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