• Korean Journal of Psychosomatic Medicine
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• v.10 no.2
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• pp.142-153
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• 2002

The authors intended to investigate personality characteristics and those influence on the outcome of cognitive behavioral therapy in patients with panic disorder. 167 patients who met DSM-IV criteria for panic disorder were assessed by the PDQ-R(Personality Disorder Questionnaire-Revision) and various self-report tools for assessing symptoms of panic disorder. The effect of therapy was measured by the changes of scores and the end state functioning before and after 12-sessions of CBT. The patients with panic disorder were more likely showed obsessive-compulsive, avoidant and paranoid personality disorder and also Cluster C. If is needed when patients were divided into two groups according to total scores of PDQ-R(high or low personality disorder groups), high personality disorder group showed many evidences for increased psychopathology at the start of treatments, this suggested the close linkage between panic disorder and personality disorder. Interestingly, there were no significant differences between both groups in scores of clinical variables and the end state functioning. In conclusion, although patients with high tendency of personality disorder had more generalized problems at the beginning of treatments, they could improve as much as the patients with low tendency of personality disorder. They can be helped by cognitive behavioral therapy for panic disorder and seem to profit as much as patients with low tendency of personality disorder. If is needed to seek other factors in poor responders for cognitive behavioral therapy.

• Korean Journal of Psychosomatic Medicine
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• v.10 no.1
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• pp.27-36
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• 2002

Objectives : Stroke is a chronic condition that may carry significant negative impact on the quality of life in patients. Research, treatment and rehabilitation on stoke, however, have focused on physical aspects, neglecting its psychiatric aspects and quality of life. So, aim of this study is to compare quality of life in stroke patients and healthy controls by using WHO Quality of Life(QOL) Scale that evaluates the domains of physical health, psychological health, social relationship and environment. Additionally, relationship between clinical factors in patients with stroke and their quality of life were explored. Methods : 98 patients in acute stage of stroke and 24 healthy controls were recruited in this study and WHO QOL Scales were completed. Total scores and scores of domains of WHO QOL Scale in two groups were compared. Correlation analysis and multiple regression analysis were performed to examine the relationship between quality of life and the clinical characteristics in patients with stroke. Results : Total scores and scores of all domains of WHO QOL scale in patients with stroke were decreased compared to those in healthy controls. Clinical characteristics including the depression, anxiety, social support system showed significant correlation with quality of life in general and most of subscales of QOL. And male patients have higher level of quality of life than female patients. But, physical disabilities rated with Barthel's index did not show significant correlation with quality of life. Multiple regression revealed that the severity of depression, anxiety, gender, and level of social support system were factors directly affecting the quality of life in the patients with stroke. Conclusion : Quality of life in patients with stroke was poorer than that of healthy controls. The severity of depression, anxiety, gender, and the level of social support system were related to the quality of life in the patients with stroke.

• Korean Journal of Psychosomatic Medicine
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• v.18 no.2
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• pp.82-93
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• 2010

Objectives : The purpose of this study was to explore attitude and belief about menopause and severity of menopausal symptoms according to menopausal status. This study conducted a cross-sectional assessment of the effects of depressive symptoms and the severity of trait anxiety on the severity of menopausal symptoms. Methods : Participants were all outpatients at the psychiatric outpatient clinic of Korea University Guro Hospital. All participants, aged 40 to 64, had depressive or anxiety disorders and were divided into the premenopause, perimenopause, premenopause, and postmenopause groups. Menopause Rating Scale(MRS) was used to measure the severity of menopausal symptoms. The attitude toward menopause was examined by a self-report questionnaire regarding menopause. Beck Depression Inventory(BDI) and State-Trait Anxiety Inventory(STAI) were used to assess depressive symptoms and anxiety. Results : The severity of menopausal symptoms was not different among the groups according to menopausal status. There was a significant correlation between a negative attitude toward menopause and the severity of menopausal symptoms. Patients with moderate to severe depressive symptoms and trait anxiety had more severe menopausal symptoms. Conclusion : Negative attitude toward menopause, depressive symptoms, and anxiety had a significantly negative impact on the severity of menopausal symptoms. The results of this study suggest that treatment to relieve depressive symptoms and anxiety and intervention to reduce negative attitude toward menopause are required. Further studies with larger sample size are needed to evaluate potentially effects of depressive symptoms and anxiety on severity of menopausal symptoms in middle-aged female psychiatric patients.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.2
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• pp.109-114
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• 2009

Purpose: The purpose of this study is to compare the clinical results of ACL reconstruction between two groups using hamstring tendon autograft and tibialis anterior tendon allograft. Materials and Methods: Between January 2006 and June 2007, we analyzed 68 cases of ACL reconstruction, 32 cases using hamstring tendon autograft and 36 cases using tibialis anterior tendon allograft, with a minimum follow-up of 24 months. For the clinical evaluation, we evaluated the Lysholm score, anterior laxity by Telos device and KT-2000 arthrometer. Results: The mean diameter of graft were 8.0 mm (7.0~9.0 mm) in autograft group and 9.1 mm (8.0~10.0 mm) in allograft group. In all cases, the range of motion was above 135 degrees. The average side to side difference in Telos stress test decreased from $7.3{\pm}1.0$ mm to $2.4{\pm}1.1$ mm in autograft group and from $7.4{\pm}1.2$ mm to $2.3{\pm}1.3$ mm in allograft group. The average Lysholm knee score improved from $72.6{\pm}3.4$ to $92.3{\pm}3.5$ in autograft group and from $72.3{\pm}3.5$ to $91.6{\pm}3.3$ in allograft group. There was no significant difference between two groups in clinical results. Conclusion: Both hamstring tendon autograft and tibialis anterior tendon allograft groups showed satisfactory clinical results, with no significant difference in outcomes between the groups. We suggest that both hamstring tendon autograft and tibialis anterior tendon allograft will be considered as acceptable graft for anterior cruciate ligament reconstruction.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.2
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• pp.95-101
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• 2009

Purpose: The purpose of this study was to determine how many of our patients who had had anterior cruciate ligament (ACL) reconstruction returned to their previous levels of sports and to identify why not doing so. Material and Methods: We evaluated 43 knees with a minimum of two years follow-up among whom undergoing 109 ACL reconstruction from September 2003. The mean age of patients was 26 years (17 to 45 years) Clinical results was evaluated according to the Lysholm Knee scores, Tegner activity score, subjective IKDC questionnaires, objective IKDC evaluation form and KT-1000 arthrometer. Results: The overall clinical results demonstrated significant improvement at the final follow-up comparing to preoperative data (P<0.05). Among 43 patients, 25 patients (58%) returned to their previous level of sports and 18 patients (42%) did not. Of whom, 11 patients (61%) were not able to return to sports due to fear to re-injury and 7 patients (39%) suffered from instability and pain. The differences in the Lysholm Scores, KT-1000 arthrometer and subjective IKDC in the 3 groups of patients by ANOVA test were found to be statistically significant (P<0.001). Although there is no difference in objective IKDC and KT-1000 arthrometer, the difference was observed in Tegner activities, subjective IKDC obtained by those who returned to sport and those who had fear to reinjury (P<0.001). Conclusion: This study showed that a quater of patients could not return to their previous level of sport after ACL reconstruction because of fear to reinjury. We thought that not only improving the technique of ACL reconstruction and systemic rehabilitation but also considering psychological factor of patients could allow more patients to return to the previous level of sports.

• The Journal of the Korean life insurance medical association
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• v.22
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• pp.139-169
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• 2003

국내 보험 산업은 경제발전에 따라 많은 성장을 이루어왔으나 단체보험은 보험 회사의 외부적 또는 내부적 환경으로 인해 활성화가 미흡한 상황이다. 개인보험시장의 포화, 해외시장에서 단체보험의 지속적인 성장, 사회보험 민영화 논의, 방카슈랑스와 보험시장의 개방 등 급격한 변화를 겪고 있는 보험영업환경을 고려한다면 향후 확대될 기업복지시장에서의 성공적 역할수행을 위해서는 단체보험 영업과 지원시스템의 보완이 시급한 과제라고 할 수 있다. 특히 언더라이팅 기법은 단체보험의 핵심역량이며 회사의 경쟁력 강화와 사차익 안정화를 위해서는 단체보험 인수기법의 선진화가 필수요건이다. 단체보험은 대수의 법칙, 수지상등의 원칙 등 보험의 기본원리라는 측면에서는 개인보험과 다른 점이 없지만 하나의 계약을 통해 집단의 피보험자에게 보장을 제공하기 때문에 가지게 되는 역선택 축소, 비용절감, 기업에 의한 1차선택 등 몇 가지 특성들은 인수기법에서의 차이를 필요로 한다. 하지만 국내의 단체보험 언더라이팅은 기본개념조차 제대로 정립되어 있지 못한 초기단계로 단체보험의 특성을 제대로 반영할 수 있는 위험평가를 위해서는 선진기법의 도입이 절실하다. 첫째, 자유보장한도(FREE COVER LIMIT)의 도입이다. 자유보장한도는 단체에 대한 위험과 피보험자 개인의 위험을 구분하는 기준으로 자유보장한도내의 피보험자에 대해서는 고지나 의적 검사를 요구하지 않고 개인별 언더라이팅을 하지 않으며 거절체나 표준하체이더라도 자유보장한도 금액까지는 나머지 정상 피보험자들과 동일한 보장을 제공하는 것을 말한다. 이는 피보험자별 위험을 중심으로 심사하고 있는 현재의 국내 단체보험 인수방법에서 발생되는 고객측 불만과 심사의 비효율성을 개선할 수 있는 방안이다. 둘째, 단체별 특성에 따른 보험요율 차등화이다 단체는 산업의 종류, 피보험자의 직무, 지역적 위치, 크기(피보험자수), 성별구성비 등 여러 가지 특성들을 가지고 있으며 이런 특성들은 보장급부에 따라 발생위험에 영향을 미칠 수 있다. 하지만 현재 나이와 성별에 따라서 피보험자별로 정해지는 요율체계만으로는 이런 위험들을 적절하게 반영하지 못하고 단체별 형평성에도 문제가 생긴다. 따라서 정확한 data 구축을 통해 단체 특성별로 어떤 보장에 어느 정도로 위험 발생에 영향을 미치는지를 분석하여 보험요율을 차등부과 할 수 있는 체계를 갖추어야 한다. 셋째, 경험을 활용한 보험료 산정기법이다. 이것은 개인보험과 구분되는 가장 큰 단체보험만의 특성이라 할 수 있는데 해당 단체의 과거 경험 data 즉 청구로 인한 지급금액을 토대로 당해 계약 보험료를 결정하는 방법이다. 이를 위해서는 과거 경험 data가 얼마나 신뢰할 수 있는 지의 정도(신뢰도)를 측정하는 것이 필요하다. 과학적이고 효율적인 단체보험 인수를 위해서 경험율의 활용은 반드시 이루어져야 할 선결과제이다. 넷째, 관련규정의 정비가 필요하다 단체보험의 특성을 갖기 위해서는 가입가능한 피보험자들의 자격규정(eligibility), 활동적근무 조건(actively at work)이 요구되어야 하며 참여비율(가입비율)과 보장수준의 구성방법에 대해서도 가이드라인 설정을 통해 역선택을 최소화 할 수 있는 제도적 보완이 마련되어야 한다. 이런 선진인수기법의 도입과 함께 단체보험 언더라이터의 필요역량을 개발하고 향상시키는 노력도 병행되어야만 종합금융화, 대형화가 진전되면서 대경쟁의 구도로 바뀌고 있는 국내 보험시장에서의 경쟁력 확보가 가능할 것이다.

• Korean Journal of Psychosomatic Medicine
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• v.14 no.1
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• pp.53-61
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• 2006

Objectives: This study was designed to evaluate difference of the alexithymia between panic patients and normal controls by examination of the relationships between different components of the alexithymia construct and level of anxiety and depression in panic patients and normal controls. Methods The subjects were 167 patients who met DSM-IV criteria for panic disorder and 110 normal controls. They drew up symptom checklists and self-rating scales, and were measured by Anxiety Disorders Interview Schedule-Panic attack & Agoraphobia(ADIS-P & A), Korean version of Toronto Alexithymia Scale (TAS-20K), Spielberger State-Trait Anxiety Inventory-State & Trait (STAI-S & T), Beck Depression Inventory (BDI), and Revised Anxiety Sensitivity Index (ASI-R). For statistical analysis, we performed t-test to compare the sociodemographic characteristics and the scores of self reported scales between panic patients and normal controls. Pearson correlation was performed between TAS-20K and it's subfactors, STAI-S & T, ASI-R and BDI in panic patients and normal controls. And stepwise multiple regression analysis was preformed to explain results of correlation analysis for alexithymia. Results: The panic patients reported more significant alexithymic (p<0.001), more difficulty identifying feeling (p<0.001) and describing feeling (p=0.001) than normal controls. Futhermore, panic patients were more significant anxious, sensitive to anxious feeling and depressive than normal controls. Moreover, the alexithymia of panic patients was explained by trait-anxiety $({\Delta}R^2=0.255)$ and anxiety sensitivity $({\Delta}R^2=0.062)$, that of normal controls was predicted by depression $({\Delta}R^2=0.144)$ and anxiety sensitivity $({\Delta}R^2=0.033)$ Conclusion: The panic patients reported more anxious and sensitive to anxious feeling, and these symptoms predict alexithymia in panic patients. However, the alexithymia of normal controls was explained by depression more than anxiety sensitivity, and such a result isn't consistent with previous studies and this may be mainly due to difference of the homogeneity in object of the studies.

• Korean Journal of Psychosomatic Medicine
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• v.13 no.1
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• pp.16-23
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• 2005

Objectives : We have studied female patients with either alopecia areata or androgenetic alopecia to evaluate psychological aspects, such as anxiety, depression, alexithymia, and characteristic personalities. In addition, we tried to examine the differences in psychological characteristics between these two types of alopecia, where the alopecia areata has been cotroversial on the role of stress in its etiology and the androgenetic alopecia seems to be more influeced by genetic and biological factors. Methods : All participated patients were females with alopecia for more than 1 you. Among them, 52 were with alopecia areata and 33 were with androgenetic alopecia. They were compared with 54 normal healthy controls by using MMPI, BDI, STAI-S, STAI-T, and TAS-20K. Results The average scores of F, Hs, D, Pd, Pa, Sc, Si in MMPI of alopecia groups were significantly higher than that of normal controls, and the androgenetic alopecia group had highest Hy and Pt scores. The average scores of BDI, STAI-S, and STAI-T in alopecia groups were higher than the normal controls. 94.2% of alopecia areata patients and 97.0% of androgenetic alopecia patients had severe depression, who scored higher than 23 in BDI. In TAS-20K, the average total scores of alopecia groups were higher than the normal control group, and the average Factor 3 score in androgentic alopecia was higher than the other groups. The alopecia groups scored higher than normal control group in STAI-S and STAI-T. Conclusion : Females with chronic alopecia were more depressed, had higher levels of anxiety, and more alexithymic than normal healthy females. In spite of arguments about etiological role of stress to alopecia, psychiatric interventions are needed for depression, and considerations for personality and psychological defense mechanism were needed in both types of alopecia.

• Korean Journal of Psychosomatic Medicine
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• v.21 no.1
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• pp.62-71
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• 2013

Objectives : The purpose of this study is to investigate the characteristics of drinking patterns and the prevalence of hazardous drinking and alcohol use disorder with the assessment of alcohol policy needs in community population of urban city in Korea. Methods : Data was collected from 1,000 residents in a single urban city in Korea, from June 1 to July 31, 2011 by a questionnaire. As research tools, socio-demographic characteristics composed of variables based on study purpose, alcohol problems and alcohol use disorder state scales composed with Alcohol Use Disorder Identification Test(AUDIT) and Cut down, Annoyed, Guilty, Eye-opener(CAGE), and the assessment of alcohol policy needs in community population questions were used. Results : The lifetime experience of alcohol drinking was 97.4%. For the frequency of drinking, 21.9% of population responded 2 to 4 times per weekly. 24.4% of male had one time or more high risk drinking, defined as having four or more drinks in a sitting, per week. 51.6% experienced the first time drinking of alcohol in adolescence. The lifetime prevalence of hazardous drinking and alcohol use disorder were 14.9% and 3.3%, respectively using AUDIT. Alcohol use disorder were 9.6% with the CAGE scale. Problem drinking were 8.4% in this study. They requested the program such as prevention education(57.2%), construction of liaison system to treatment facilities(50.1%), alcohol counseling and intervention(41.7%), and rehabilitation program(39.8%). Conclusions : These results demonstrate that alcohol problem and alcohol use disorder were much prevalent, and these problem started in the earlier age. It is necessary to develop an effective alcohol prevention program or policy with considering the needs in community population.

• Korean Journal of Psychosomatic Medicine
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• v.21 no.1
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• pp.18-26
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• 2013

Objectives : Type D personality was originally introduced to study the role of personality in predicting outcomes of heart disease. However, researches showed that other medical conditions are also affected by this personality. The purpose of this study was to evaluate the relationship between type D personality and somatic symptom complaints in depressive patients. Methods : Eighty-two individuals diagnosed with depressive disorder were included. Type D personality was measured with DS14. Patient Health Questionnaire(PHQ) 9 and 15 were used to measure depression severity and somatization tendencies. For alexithymia, TAS-20 was used. Student T-test and linear regression analysis were performed. The best regression model was determined by stepwise variable selection. Results : More than half of the subjects(56%) complained at least medium degree somatic symptoms according to PHQ-15 criteria. Two-thirds of the subjects were classified as Type D personality(63.4%). The mean PHQ-15 score of the Type D individuals was significantly higher than the remaining subjects(PHQ-15 mean=12.7, $p=8.2{\times}10^{-7}$). The best regression model included age, PHQ-9 score and NA subscale score as predictor variables. Among these, only the coefficients of age($p=1.5{\times}10^{-3}$) and NA score($p=1.5{\times}10^{-7}$) were found to be statistically significant. Conclusions : The result showed that Type D personality was one of the strong predictors of somatic complaints among depressive individuals. The finding that negative affectivity rather than social inhibition was more closely associated with somatization tendencies does not fully agree with the traditional explanation that inability to express negative emotion predispose the individuals to somatic symptoms. The finding that alexithymia was not shown to be a significant predictors also substantiated this discrepancy. However, it might be possible that the high correlation between NA and SI subscore(r=0.65) and between NA and TAS-20 score(r=0.44) hid the additional effects of social inhibition and alexithymia. Further research with a larger sample would be needed to investigate the effects of the latter two components over and above the effect of negative affectivity on the somatic complaints in depressive patients.