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From the Onset of Panic Symptoms to Getting to a Psychiatric Treatment : The Change by Improved Public Awareness of Panic Disorder in Korea

증상의 발현부터 치료의 시작까지 : 한국인의 공황장애 인식도 변화가 치료적 접근에 미친 영향

  • Choi, Yong-Won (Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Seo, Ho-Jun (Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Han, Sang-Woo (Department of Psychiatry, Soonchunhyang University Seoul Hospital, College of Medicine, Soonchunhyang University of Korea) ;
  • Hong, Jin-Pyo (Department of Psychiatry, Samsung Medical Center, College of Medicine, Sungkyunkwan University of Korea) ;
  • Lee, Kyoung-Uk (Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Se-Joo (Department of Psychiatry and Institute of Behavioral Science in Medicine, College of Medicine, Yonsei University of Korea) ;
  • Lim, Se-Won (Department of Psychiatry, Kangbuk Samsung Hospital, College of Medicine, Sungkyunkwan University School of Korea) ;
  • Lee, Sang-Hyuk (Department of Psychiatry, CHA Bundang Medical Center, School of Medicine, CHA University of Korea) ;
  • Yang, Jong-Chul (Department of Psychiatry, Chonbuk National University Medical School) ;
  • Lee, Seung-Jae (Department of Psychiatry, School of Medicine, Kyungpook National University) ;
  • Park, Seon-Cheol (Department of Psychiatry, Inje University Haeundae Paik Hospital) ;
  • Gim, Min-Sook (Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Chae, Jeong-Ho (Department of Psychiatry, Seoul St.Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • 최용원 (가톨릭대학교 의과대학 성빈센트병원 정신건강의학교실) ;
  • 서호준 (가톨릭대학교 의과대학 성빈센트병원 정신건강의학교실) ;
  • 한상우 (순천향대학교 의과대학 서울병원 정신건강의학교실) ;
  • 홍진표 (성균관대학교 의과대학 삼성서울병원 정신건강의학교실) ;
  • 이경욱 (가톨릭대학교 의과대학 의정부성모병원 정신건강의학교실) ;
  • 김세주 (연세대학교 의과대학 정신건강의학교실 의학행동과학연구소) ;
  • 임세원 (성균관대학교 의과대학 강북삼성병원 정신건강의학교실) ;
  • 이상혁 (차의과학대학교 분당차병원 정신건강의학교실) ;
  • 양종철 (전북대학교 의과대학 정신건강의학교실) ;
  • 이승재 (경북대학교 의과대학 정신건강의학교실) ;
  • 박선철 (인제대학교 해운대백병원 정신건강의학과) ;
  • 김민숙 (인제대학교 의과대학 상계백병원 정신건강의학교실) ;
  • 채정호 (가톨릭대학교 의과대학 서울성모병원 정신건강의학교실)
  • Received : 2019.05.23
  • Accepted : 2019.08.05
  • Published : 2019.10.31

Abstract

Objective : This study aimed to investigate the general process from the symptom onset to the psychiatric treatment in Korean panic patients and the effect of improved public awareness on it. Methods : This study has a retrospective design. The subjects were the new patients with panic disorder who visited the psychiatric outpatient clinic in twelve university-affiliated hospitals all across Korea. The medical chart was reviewed retrospectively and the data were collected including chief complaints of symptoms, recent stressors, the time to visit the psychiatric outpatient clinic, and visit of other departments and diagnostic approaches for their symptoms. Results : A total of 814 participants were included in the study. The most common department other than psychiatry the panic patients visited were cardiology (28.3%), general internal medicine (16.0%) and neurology (11.4%). The most frequently used diagnostic tests were a echocardiography (17.9%), 24-hour Holter monitoring (11.2%), and brain MRI (8.2%). Only 37.3% of participants visited psychiatric clinic directly. About 80% of participants visited psychiatric department within 1 year after their first panic symptoms and it took $13.8{\pm}13.7weeks$ on average. Comparing before and after 2012, the number of participants increased who visit directly the psychiatric clinic without visiting other departments (p=0.002) and without visiting emergency room (p<0.001). Conclusions : Our results suggest that a substantial number of patients visit departments other than psychiatry when they experience first panic symptoms. However, most patients begin psychiatric treatment within 1 year after their first symptoms and the number of patient are increasing who visit psychiatric department directly without visiting other departments.

Keywords

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