입원한 입시 스트레스 증후군 환자의 임상 양상에 관한 정신의학적 연구

A Psychiatric Study on the School Entrance Test Stress Syndrome(SETS)

The purpose of the present study was to investigate the effect of college entrance test on adolescent’ s mental disorder, and to secure effective measures coping with college entrance test stress syndrome. The subjects consisted of 20 third grade middle school students, 29 third grade high school students and 24 repeatee who were admitted to Department of Neuro-psychiatry of Chung ang University Hospital and Yong San Hospital from January 1981 to September 1987. Summary of the results were as follows • 1) 15.9 % of the total number of adolescent psychiatric in-patients was found to be examinees, of which 56.2% was found to be hospitalized due to school entrance test stress syndrome (SETS). This rate of school entrance test stress syndrome was the highest among the group of the third grade of middle school 65.0% 62.3% of the third grade of high school and 41.7% of the repeatee. Hospitalization rate of SETS was significantly increased from 42.1% during the period of 1985-1986 to 78.3% in 1987. 2) In comprehensive analysis of examinee’ s clinical manifestations, premorbid personality, and MMPI finding, it was concluded that obsessive compulsive trend, anxious trend, introverted trend, and competetive trend were closely related with school entrance test stress. 3) The school entrance test stress syndrome had more severe psycho-pathology such as emotional confusion than control group. Particularly, SETS group had more from stress originated from changes in school life, more frequent complaints of nervousness, more frequently visit to doctor’s office, more frequent admission and readmision to psychiatric hopsital than control group. 4) The SETS repeatee group showed relatively higher exogenous anxious tendency, more hostility, and lower endogenous depressive tendency, higher personality trait such as borderline personality disorder, and suffered from life changes originated from their change of health condition compared with control group. They also showed more complaints of nervousness and depressive symptom, and tend to have longer in hospital than control group. 5) The SETS high school group showed more severe psychopathology such as emotional confusion or adolescent turmoil than control group. Paricularly, they tended to suffer from identity diffusion, show more profound psychopathology due to their obsessive compulsive traits, poorer adjustment in their premorbid life, more psychosocial stress than the control group. They were admitted usuallyin March and April under the impression of neurotic disorder or affective disor der. And they also tend to resist toward therapeutic efforts such as persistent avoidance and frequently discharge against medical advice in spite of short term admission. 6) The SETS middle school group showed higher depressive and anxious tendency, admitted to psychiatric hospital usually in May and June under the impression of adjustment disorder. They apted to treat their problems by family therapy and antidepressants during hospital stay. Sedation by medication was required to reduce resistances toward therapeutic efforts than control group.