Journal of Oriental Neuropsychiatry (동의신경정신과학회지)

The Korean Society of Oriental Neuropsychiatry (대한한방신경정신과학회)
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A Case Study on a Patient with Major Depressive Episode of Bipolar II Disorder Treated with a Combination of Interpersonal and Social Rhythm Therapy and Korean Medicine

제2형 양극성 장애의 주요우울 삽화에 대한 복합 한방 치료 사례보고: 대인관계 및 사회적 리듬 치료와 변증 치료를 중심으로

  • Lee, Ji-Yoon (Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University) ;
  • Kim, Ju-Yeon (Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University) ;
  • Jeong, Jin-Hyung (Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University) ;
  • Jung, In Chul (Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University)
  • 이지윤 (대전대학교 한의과대학 한방신경정신과) ;
  • 김주연 (대전대학교 한의과대학 한방신경정신과) ;
  • 정진형 (대전대학교 한의과대학 한방신경정신과) ;
  • 정인철 (대전대학교 한의과대학 한방신경정신과)
  • Received : 2020.08.24
  • Accepted : 2020.09.24
  • Published : 2020.09.30
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Abstract

Objectives: To determine treatment effects of a combination of interpersonal and social rhythm therapy and Korean medicine for a patient with major depressive episode of bipolar II disorder. Methods: A patient was treated with Korean medicine (acupuncture, herbal medicine, etc.) and interpersonal and social rhythm therapy (IPSRT) for four months. Pattern identification for depressive mood and sleep associated symptoms was evaluated using Patient Health Questionnaire-9 (PHQ-9) and Social rhythm metric II-5 (SRM II-5). Results: At the end of the treatment, depression and delayed sleep symptoms were improved and social rhythm was recovered to the regular range. The patient acquired an insight to his interpersonal tensions and conflicts. Conclusions: Korean medicine in combination with interpersonal and social rhythm therapy can be used to treat patients with major depressive episode of bipolar II disorder. More cases are needed to develop guidelines for treating bipolar disorder.

본 논문은 제2형 양극성 장애 환자에게 한의학적 변증체계와 함께 IPSRT의 심리 치료 기법을 적용한 증례이다. 제2형 양극성 장애 환자에게 한의치료와 IPSRT를 4개월간 병용한 결과, 환자의 사회적 리듬, 우울증 및 대인관계 능력이 개선되었으며 4개월후 추적조사에서도 호전상태가 유지되었다. 향후 양극성 장애 환자에 대한 높은 근거수준의 한의 임상연구 수행과 한의표준임상진료지침의 개발 등을 통해 양극성장애에 한의치료가 보다 활발히 활용되기를 기대한다.

Keywords

References

  1. Tohen M, Frank E, Bowden CL, Colom F, Ghaemi SN, Yatham LN, Malhi GS, Calabrese JR, Nolen WA, Vieta E, Kapczinski F, Coodwin GM, Suppes T, Sachs GS, Chemgappa KR, Grunze H, Mitchell PB, Kanba S, Berk M.. The International Society for Bipolar Disorders (ISBD) Task Force report on the nomenclature of course and outcome in bipolar dis orders. Bipolar Disord 2009;11(5):453-73. https://doi.org/10.1111/j.1399-5618.2009.00726.x
  2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA:American Psychiatric Publishing. 2013:991.
  3. Jung YE, Kim MD. Psychosocial Treatment for Bipolar Disorder. Mood Emot 2016;14:19-24.
  4. Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Beaulieu S, Alda M, et al. Canadian Network for Mood and Anxiety Treatments(CANMAT) and International Society for Bipolar Disorders(ISBD) col laborative update of CANMAT guidelines for the management of patients with bipolar disorder. Bipolar Disord. 2018; 20(2):97-170. https://doi.org/10.1111/bdi.12609
  5. Goodwin GM, Haddad PM, Ferrier IN, Aronson JK, Barnes TRH, Cipriani A, Coghill DR, Fazel S, Geddes JR, Grunze H, Holmes EA, Howes O, Hudson S, Hunt N, Jones I, Macmillan IC, McAllister-Williams H, Miklowitz DR, Morriss R, Munafo M, Paton C, Sahakian BJ, Saunders KEA, Sinclair JMA, Taylor D, Vieta E, Young AH. Evidencebased guidelines for treating bipolar disorder: Revised third edition recommendations from the British Association for Psychopharmacology. J Psychopharmacol 2016;30(6):495-553. https://doi.org/10.1177/0269881116636545
  6. Miklowitz DJ, Johnson SL. Social and familial risk factors in bipolar disorder: basic processes and relevant interventions. Clin Psychol (New York). 2009;16(2): 281-96. https://doi.org/10.1111/j.1468-2850.2009.01166.x
  7. Harvey AG. Sleep and circadian functioning: critical mechanisms in the mood disorders? Ann Rev Clin Psychol 2011;7:297-319. https://doi.org/10.1146/annurev-clinpsy-032210-104550
  8. Kim BN. Evidence-Based Treatments of Bipolar Disorder. Korean Journal of Clinical Psychology 2019;38(4):427-44. https://doi.org/10.15842/kjcp.2019.38.4.008
  9. Lee HJ. Is the Circadian Rhythm Dysregulation a Core Pathogenetic Mechanism of Bipolar Disorder? J Korean Neuropsychiatr Assoc 2018;57(4):276-86. https://doi.org/10.4306/jknpa.2018.57.4.276
  10. Choe EH. Interpersonal and Social Rhythm Therapy(IPSRT). J of Kor Soc for Dep and Bip Disorders 2004;2:211-6.
  11. Cho YS, Kim BK. Effects of Tianwangbuxin-dan, Wendantang, Guipi-tang on the expression of MT1 and MT2 melatonin receptors in C6 glial cells. J of Oriental Neuropsychiatry 2010;21(2):103-23.
  12. Kang HC, Choi WJ, Hu YS, Lee SG. Clinical study on a case of Bipolar disorder with MBTI and OMT. J of Oriental Neuropsychiatry 2005;16(1):201-9.
  13. Roh YB, Choi YH. 49 Case reports of Depressive disorder and Bipolar disorder Patients, treated with Herbal Medicine. J of KMediACS 2010;2(1):15-24.
  14. Lee SM, Shin YS, Nam DW, Choi DY. Korean Translation of the CARE guidelines. The Acupuncture 2015;32(4):1-9.
  15. Mental health Scale Research team. Manual of Evidence-Based Mental health Scale. National Center for Mental Health. 2020:175.
  16. Lee SH, Huh YJ, Kim JH, Han CS. Finding Optimal Cut Off Points of the Korean Version of the Patient Health Questionnaire-9(PHQ-9) for Screening Depressive Disorders. J of Kor Soc for Dep and Bip Disorders 2014;12:32-6.
  17. Sasdelli A, Lia L, Luciano CC, Nespeca C, Derardi D, Menchetti M. Screening for Bipolar Disorder Symptoms in Depressed Primary Care Attenders: Comparison between Mood Disorder Questionnaire and Hypomania Checklist (HCL-32). Psychiatry Journal 2013:n.pag
  18. Kim CH, Min KJ, Shin YC, Yun BH, Cho HS, Jon DI, Kim YK, Kwon JS, Bahk WM et al. Feasibility of Korean Medication Algorithm for Bipolar Disorder(I):Global Assessment. Korean J Psychopharmacol 2005;16(3):225-33.
  19. Lee EH, Choi WC, Jung IC. Preliminary Study to Develop the Instrument on Pattern Identifications for Depression. J of Oriental Neuropsychiatry 2013;24(4):435-50. https://doi.org/10.7231/jon.2013.24.4.435
  20. Jeong JH, Lee JY, Kim JY, Kim SY, Kang WC, Lim JH, Kim BK, Jung IC. A Pilot Study of Evaluating the Reliability and Validity of Pattern Identification Tool for Insomnia and Analyzing Correlation with Psychological Tests. J of Oriental Neuropsychiatry 2020;31(1):1-12.
  21. Abdullah S, Murnane EL, Matthews M, Choudhury T. Circadian Computing: Sensing, Modeling, and Maintaining Biological Rhythms. Rehg J eds. Murphy SA. Kumar S. Mobile Health: Sensors, Analytic Methods, and Applications. 1st ed. Springer International Publishing. 2017:35-58.
  22. Choe EH. Interpersonal and Social Rhythm Therapy(IPSRT). J of Kor Soc for Dep and Bip Disorders 2004;2:211-6.
  23. Kim EJ, Yook SP, Cho YJ. The Study of a Group Counseling Effect Based on Interpersonal Psychotherapy(IPT) for Elders Who Lives Alone. Journal of the Korean Gerontological Society 2016;36(2):233-57.
  24. Jin SM, Son CN. Effects of Interpersonal Psychotherapy for Group (IPT-G) on Depression Decrease, Anger Control, and Suicidal Ideation Decrease of Depression-prone Adolescents. Korean Journal of Clinical Psychology 2015;34(3):649-66. https://doi.org/10.15842/kjcp.2015.34.3.004
  25. Curriculum for Practitioner Training in Interpersonal Psychotherapy(Trainee). Available from: https://interpersonalpsychotherapy.org/ [Accessed Aug 25 2020]
  26. Department of Prescriptions of Oriental Medicine. Medical Prescriptions. Revised edition. Younglim-sa. 2019:620.
  27. Song IS, Lee JL, Ha KS, Shin JN. A clinical study on the effect of Insook-san on disorder of sleep in childhood. J Korean Oriental Pediatrics. 2004;18(2):201-8.
  28. Institute of Korean Acupuncture & Moxibustion Medicine. Acupuncture Medicine. Korean Acupuncture & Moxibustion Medicine Society. Jipmumdang. 2012:928.
  29. Kim SH, Lee CH, Yuk SW, Lee KG, Lee TY, Lee SR. Central neural pathways projecting to the acupoints B62 and K6 using the neural tracer. J Acupunct Res. 2001;18(2):51-66.
  30. Frederick KG, Kay RJ. Manic-depressive illness: Bipolar disorders and recurrent depression. New York, NY: Ox ford University Press. 2nd rev. ed. NY:Oxford University Press. 2007:1262.
  31. Kim BN. Evidence-Based Treatments of Bipolar Disorder. Korean Journal of Clinical Psychology. 2019;38(4):427-44. https://doi.org/10.15842/kjcp.2019.38.4.008
  32. Chantal H, Donatienne VDB, Frank B, Isabelle R, Joel S, Katia MB, Larry JS, Marion L. Affective lability and affect intensity as core dimensions of bipolar disorders during euthymic period. Psychiatry Res. 2008;30(159):1-6.
  33. David EK. Managing the side effects associated with commonly used treatments for bipolar depression. J Affect Disord. 2014;169:34-44.