• Proceedings of the KAIS Fall Conference
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• 2010.05b
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• pp.898-901
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• 2010

본 연구는 만성 뇌졸중 환자를 대상으로 시각리듬자극(RVS)을 이용한 보행 운동을 적용하여 보행과 고유수용성감각에 미치는 효과를 알아보고자 하였다. 뇌졸중으로 6개월 이상 장애를 가진 21명이 연구에 참여하였고 실험군 10명과 대조군 11명으로 나누었다. 대조군은 14m의 보행로가 확보된 공간에서 준비운도 5분, 보행운동 20분, 정리운동 5분 씩 주 3회, 4주간 12회을 실시하였고, 실험군은 대조군의 운동프로그램과 같은 조건에서 보행운동시 시각리듬자극(RVS)을 추가적으로 적용하였다. 운동 전과 후에 보행과 고유수용성감각을 측정하여 효과를 비교하였다. 통계처리 방법으로 실험 전 후 차이를 검증하기 위하여 대응표본 t 검정을 실시하였고 대조군과의 차이 검증을 위하여 독립표본 t 검정을 실시하였다. 모든 통계적 유의수준은 0.05로 하였다. 본 연구의 결과 시각리듬자극(RVS)이 적용된 실험군에서 보행속도와 분속수, TUG 시간이 유의하게 증가하였고(p<.05), 고유수용성감각이 유의하게 증가하였다(p<.05). 결론적으로 시각리듬자극(RVS)을 이용한 보행운동이 만성 뇌졸중 환자의 보행과 고유수용성감각에 효과가 있는 것으로 나타났다. 향후 만성 뇌졸중 환자에게 음악적 요소인 시각리듬자극 (RVS)이 정신적 육체적 기능을 상실한 뇌졸중 환자의 재활치료 프로그램에 적용하는 연구가 필요할 것으로 기대되어진다.

• Korean Journal of Psychosomatic Medicine
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• v.9 no.1
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• pp.58-65
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• 2001

Objectives : It is well known that pharmacologic and behavioral therapies of panic disorder show remarkable acute treatment outcome, however the course of panic disorder in clinical settings is often chronic and relapsing. The purpose of this study is to investigate the treatment outcome of panic disorder and the factors related to good treatment outcome by prospective follow-up study after 6 month in clinical settings. Methods : Twenty nine patients were diagnosed to have panic disorder by SCID(Structured Clinical Interview for DSM-III-R), among the patients who had visited the psychiatric out-patients clinic of the Asan Medical Center for the first time. We determined the initial clinical and demoraphic features of each patient and reevaluated them after 6 months, investigating the treatment outcome by anxiety, phobia, impairment scales. We looked into the rate of the patients who showed good treatment outcome and determined the factors that had relation with good treatment outcome among demographic and clinical features. Results : Nineteen out of 29 patients could be followed after 6 months. Among them, 10 patients 52.6%) on the impairment scale and phobia scale each, and 8 patients(42.1 %) on the anxiety scale showed good treatment outcome. 8 patients(42.1 %) showed good treatment outcome on the all three scales. High score in initial phobia scale had significant relation with good treatment outcome. Short duration of illness did not have significant relation with good treatment outcome however there was a trend(p=0.07). Conclusion : About half(42.1 %) of the panic disorder patients showed good treatment outcome on all three scales. Severe initial phobic symptom and short duration of illness were expected to have relation with good treatment outcome.

• Korean Journal of Psychosomatic Medicine
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• v.8 no.1
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• pp.122-140
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• 2000

Somatization disorder is a chronic condition characterized by multiple somatic complaints that are not due to any apparent organic illness. Somatization disorder is related historically to hysteria and hysteria has been defined by the existence of somatic complaints for which no organic reason can be found. Therefore most theories of somatization have focused on the psychodynamic and sociological perspectives. However, the concept that the somatic presentation of emotional distress or psychiatric illness might have a neurobiological basis has also aroused considerable interest. Relative to this perspective, the case of Anna O. which has been considered the prototype of hysteria, was reformulated from a neuropsychological perspective. Several neurophysiological and neuropsychological studies, studies concerning hemispheric differences in symptom presentation of the patients with hysteria have been shown the evidences for the biological basis of somatization. Moreover, recent neuroimaging studies in somatization disorder also show that brain dysfunction in somatization. The author reviewed several candidate theories which could help to explain the process of somatization in the perspective of biological basis and proposed the new neuropsychological model of somatization. The author also examined the possible application of this model to the treatment of somatization disorder and discussed it's limitation and the future directions in this field.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.5 no.1
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• pp.150-161
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• 1994

Clinical Characteristics of 83 tic patients referred to child psychiatric clinics were studied including the patients' sexes, birth orders and onset ages. We compared the differences between patients and normal control regarding the co-morbidity, and mothering attitude using CBCL(Child Behavioral Check List) and MBRI(Mothering Behavior Rating Instrument). And we also evaluated the influence of types of tic disorder and the presence of behavioral characteristics of the tic patients. The following results were obtained. 1) The sex ration was 5.9:1, male dominant. 2) The eldest children were being twice as many as the youngest children(eldest : youngest : single=4.7 : 1.7 : 1). 3) The eldest children tended to have earlier onset than others. 4) The tic children as a whole had more accompanying behavioral problems than the normal children according to the CBCL scales' scores. 5) The mothers of tic children had more negative view of their children, more rejecting and more hostile attitude toward their children. 6) The types of tic disorder(the Tourette disorder vs chronic moter tic disorder) did not make a difference in the incidence of behavior problems. 7) Those who had attentional problems regardless the types of tic had more behavioral problems than those who had not. 8) Those who had familial loadings of tic disorder tended to have more likely Tourette disorders than chronic tic disorders.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.2
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• pp.209-217
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• 1998

Object：The purpose of this study was to investigate that infection with group $A[{\beta}]$ hemolytic streptococcus may associate the mechanisms that cause or exacerbate the tic symptoms in some cases of Tourette's disorder Method：Fourteen cases with abrupt worsening of tics participated in this study：10 males,4 females. The subjects were divided into two groups composing of the group with increasing level of ASO titer and the group with normal level of ASO titer. The subjects were administered Yale Global Tic Severity Scale(YGTSS). Result：The global severity scores and overall TS impairment rating scores of YGTSS in the group with increasing level of ASO titer were more higher than in the group with normal level of ASO titer Conclusion：These results suggest that increasing level of ASO titer, resulting from group $A[{\beta}]$ hemolytic streptococcal infection has affected worsening the tic symptoms in Touette's disorder.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.2
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• pp.263-273
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• 1999

Headache is a symptom with varied etiologies and extraordinarily frequent. Headaches can be a symptom of another diseases, such as meningitis, subarachnoid hemorrhage or brain tumor, may represent the disease entity itself as the case in migraine. The international Headache Society criteria were the first to distinguish between primary and secondary headache disorders. When evaluating a patient who presents with headache, the physician abviously needs to identify or exclude the myriad conditions that can cause secondary headache and initial diagnostic workup should be considered. If patient meets the criteria for a primary headache disorder, treatment commonly initiated without additional neurodiagnostic tests. The headache type, its associated feature, and the duration and the intensity of the pain attack all can influence the choice of acute therapy in migraine. Pharmacologically, such as NSAIDs, combination analgesics, vasoactive antimigraineous drugs, neuroleptics, antidepressants, or corticosteroids. Other approches to managing headache include a headache diary to identify triggers, biofeedback, relaxation technique and behavioral modification. Daily preventive medication should be considered by his attack frequency and intensity, and maintained for 4 to 6 months. Tension-type headaches are distinguished between episodic and chronic tension-type headache, but physician must make sure that patient is not drug-overuse or independent during symptomatic abortive therapy or preventive medication. The most difficult headache patients to treat are those with chronic daily headache. They often have physical dependency, low frustration tolerance, sleep problems, and depression. So discontinuation of overused medication is crucial. New developments in migraine therapy are broadening the scope of abortive and prophylactic treatment choices available to the physician. The enhanced ease of the use of sumatriptan and DHE will likely increase patient compliance and satisfaction.

• Journal of Oriental Neuropsychiatry
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• v.14 no.2
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• pp.213-218
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• 2003

This is a case report of a patient with Tourett's disorder treated by Ukgan-san. We evaluated the patient Tourett's disorder by behavior and sound. His tic behaviors like eye blinking, shoulder shrugging, head jerking, facial frimace have been shown frequently, and His phonic tic symptoms like coughing, throat clearing, sniffing have been presented frequently, too. We diagnosed his condition as Wind-syndrome Caused by Hyperactivity of Liver-yang by patient's redish face, taut pulse, Left umbilical throb. So we treated the patient with Ukgan-san. and the score of Yale Global Tic Severity Scale(YGTSS) was 30 at the start of treatment. and the score of YGTSS was 3 at the end. We found that Ukgan-san was effective for the patient with Tourett's disorder.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.2
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• pp.217-231
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• 1997

This paper first reviewed the current neurological theories concerning the etiology of ADHD and secondly, examined results of studies that applied neuropsychological assessment methods in the examination of ADHD children both here in Korea and abroad. ADHD children were found to exhibit characteristic responses indicating deficits in vigilance, sustained attention, distractibility, allocation and regulation of attention in many assessments of attention, in addition to deficits in executive functioning, working and associative memory. Such neuropsychological assessment results suggest that in addition to dysfunction in the frontal lobe and the reticular activation system, dysfunction may exist in other neural pathways involving many areas of the brain. However, because a substantial number of neuropsychological assessment tools being employed in Korea for ADHD children had been developed abroad, a Korean standardization project involving ADHD and normal control children, in addition to other child psychiatric population pools must be conducted in order to obtain appropriate age norms and test validity, and in order to make possible a more accurate and precise comparison and interpretation in the assessment of ADHD children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.10 no.2
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• pp.145-157
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• 1999

This study was performed by the children and adolescents who were abused or neglected physically, emotionally that were selected in child & adolescents psychiatric ward. We investigated the number of these case in admitted children & adolescents, and also observed characteristics of symptoms, developmental history, characteristics of abuse style, characteristics of abusers, family dynamics and psychopathology. We hypothesized that all kinds of abuse will influnced to emotional, behavioral problems, developmental courses on victims, interactive effects on family dynamics and psychopathology. That subjects were 22 persons of victims who be determined by clinical observation and clinical note. The results of the study were as follows：1) Demographic characteristics of victims：ratio of sex was 1：6.3(male：female), mean age was $11.1{\pm}2.5$. According to birth order, lst was 12(54.5%), 2nd was 5(23%), 3rd was 2(9%) and only child was 3(13.5%). 2) Characteristics of family：According to socioeconomic status, middle to high class was 3(13.5%), middle one was 9(41.% ), middle to low one was 9(41%), low one was 1(0.5%). according to number of family, under the 3 person was 3(13.5%), 4-5 was 17(77.5%), 6-7 was 2(9%). according to marital status of parents, divorce or seperation were 5(23%), remarriage 2(9%), severe marital discord was 19(86.5%). In father, antisocial behavior was 7(32%), alcohol dependence was 10(45.5%). In mother, alcohol abuse was 5(23%), depression was 17(77.3%), history of psychiatric management was 6(27%). 3) Characteristics of abuse：Physical abuse was 18(81.8%), physical and emotional abuse and neglect were 4(18.2%). according to onset of abuse, before 3 years was 15(54.5%), 3-6 years was 5(27.5%), schooler was 1(15%). Only father offender was 2(19%), only mother offender was 8(35.4%), both offender was 8(35.4%), accompaning with spouse abuse was 7(27%), and accompaning with other sibling abuse was 4(18.2%). 4) General characteristics and developmental history of victims：Unwanted baby was 12(54.5%), developmental delay before abuse was9(41%), comorbid developmental disorder was 15(68%). there were 6(27.5%) who didn‘t show definite sign of developmental delay before abuse. 5) Main diagnosis and comorbid diagnosis：According to main diagnosis, conduct disorder 6(27.3%), borderline child 5(23%), depression4(18%), attention deficit hyperactivity disorder(ADHD) 4(18%), pervasive developmental disorder not otherwise specified 2(9%), selective mutism 1(5%). According to comorbid diagnosis, ADHD, borderline intelligence, mental retardation, learning disorder, developmental language disorder, oppositional defiant disorder, chronic tic disorder, functional enuresis and encoporesis, anxiety disorder, dissociative disorder, personality disorder due to medical condition. 5) Course of treatment：A mean duration of admission was $2.4{\pm}1.5$ months. 11(15%) showed improvement of symtoms, however 11(50%) was not changed of symtoms.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.77-84
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• 2019

Objectives : The Illness Intrusiveness Rating Scale (IIRS) is a well-validated self-report instrument for assessing negative impact of chronic illness and/or adverse effects of its treatment on everyday life domains. Although extensive literature probed its psychometric properties in medical illness, little attention was paid for its validity for psychiatric population. This study aimed to test factorial structure of the Korean Version of the IIRS (IIRS-K) in a consecutive sample of psychiatric outpatients. Methods : Data set of 307 first-visit patients of psychiatric clinic at Guri Hanyang univ. Hospital were used. Exploratory and confirmatory factor analysis, internal consistency were tested in IIRS-K. We also checked Spearman's correlation analysis between IIRS-K, Zung's self-report anxiety scale and Zung's self-report depression scale. Results : 76.9% of the patients were with anxiety disorder and depressive disorder. The principal component factor analysis of the IIRS-K extracted three-factor structure accounted for 63.2% of total variance that was contextually similar to the original English version. This three-factor solution showed the best fit when tested confirmatory factor analysis compared to the original IIRS, two-factor model of IIRS-K suggested from medical outpatients, and one-factor solution. The IIRS-K also showed good internal consistency (Cronbach's α=0.90) and good convergent validity with anxiety and depression scales. Conclusions : The IIRS-K showed the three-factor structure that was similar but not identical to original version. Overall, this study proved factorial validity of the IIRS-K and it can be used for Korean clinical population.