• 한국노년학
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• 제30권4호
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• pp.1281-1292
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• 2010

본 연구의 목적은 노인의 자가 보고에 따른 각종 의료정보의 주관적인 이해 및 활용수준에 대해 조사하고 신체적, 정신적 건강상태와의 연관성을 확인하며, 노인의 연령대 및 교육수준에 따라 구체적으로 어떠한 의료 정보의 이해와 활용에 어려움이 있었는지를 파악하기 위함이다. 본 연구의 대상자는 총 103명으로 2007년 7월부터 8월까지 대구, 경북, 부산지역의 노인복지회관과 노인정에서 선정되었다. 연구결과 노인의 자가 보고에 따른 의료정보 이해수준의 전체 평균점수는 15-75점 기준에 약 50점이었고, 가장 이해하기 어려워 한 부분은 의료인으로부터 받은 자료, 환자 교육자료, 병원서식 자료였다. 노인의 의료정보 활용수준은 노인의 신체적, 정신적 건강상태와 연관성이 있었으나, 의료정보 이해수준은 신체적, 정신적 건강상태와 연관성이 없었다. 또한 후기노인들은 전기노인들보다 약물명 이해수준과 병원용지 기입에 대한 자신감이 더 낮았고, 병원자료 이해부족으로 인한 건강상태 파악, 복약 설명서 이해부족으로 인한 약물 복용, 병원 설명서 이해부족으로 인한 예약 시간 도착에 있어서 더 많은 어려움을 경험하였다. 이 밖에도 초등학교 이하의 교육수준을 가진 노인일수록 의료인으로부터 받은 자료, 환자 교육자료, 병원서식, 진료 예약표, 약물명, 안내표지판 등에 대한 이해수준이 낮았고, 병원용지 기입이나 복약설명에 따른 약 복용에 대한 자신감이 낮았으며, 병원용지 기입과 건강상태 파악에 문제를 경험한 적이 더 많았다. 본 연구 결과를 바탕으로 의료인들은 의료기관의 시설 및 서식, 교육자료 등의 개발에 있어서 노인의 연령과 교육수준을 고려하여 정보의 이해와 처리를 강화할 수 있는 방법을 활용하여야 할 것이다.

• 대한조현병학회지
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• 제22권2호
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• pp.42-50
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• 2019

Objectives: In this preliminary study, we investigated the clinical characteristics of patients who were first diagnosed with psychotic disorder and explored the impact of the adherence to antipsychotics on long-term medical use. Methods: All national health insurance claims related to psychotic disorders including gender, age, income, and drug compliance, from January 1, 2008 to December 31, 2015, were examined. With trend test using Medication Possession Ratio (MPR), we compared the medical use between the compliant group (MRP≥0.8) and the comparative non-compliant group (0.2≤MPR<0.8). Results: Among 28,095 participants in total, 16,239 patients (57.8%) were diagnosed as schizophrenia; the 30s were the most common (n=7,151, 25.5%). Drug compliance was generally low regardless of the diagnosis and was the lowest among 20s with the 40-60% range of income. The compliant group showed lower psychiatric and medical use than the comparative group in the following years (p<0.0001). Conclusion: These findings suggest that patients in the 20s and 30s with the 40-60% range of income, who are diagnosed with schizophrenia at the first psychiatric visit, may need more clinical and political attention. The results also emphasize the importance of initial drug adherence to antipsychotics in reducing long-term psychiatric costs.

• 사상체질의학회지
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• 제11권1호
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• pp.241-252
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• 1999

1. 목적(目的) 및 방법(方法) 음양오행적(陰陽五行的) 기미론(氣味論)에 입각(立脚)한 기존약물(旣存藥物)들을 사상의학내(四象醫學內)의 각 체질병증(體質病證)에 사용코자 했을때 아직까지도 그 약물(藥物)의 정확한 체질소속(體質所屬)과 사상의학적(四象醫學的) 약리(藥理)를 설명하지 못하고 혼돈(混沌)과 논쟁(論爭)에 빠져 있는 경우가 많았다. 이에 본 연구(硏究)는 석창포(石菖浦)이라는 약물(藥物)을 통해 약물(藥物)의 체질소속(體質所屬)과 체질병증하(體質病證下)에서의 용약정신(用藥精神) 그리고 체질약물(體質藥物)의 공통속성(共通屬性)을 객관화(客觀化)하며 각 다른 약물(藥物)의 약리규명(藥理糾明)의 객관화(客觀化) 연구(硏究)에 그 실마리를 찾고자 한다. 문헌적(文獻的) 고찰(考察)의 방법(方法)을 위주로 현재 사용되는 석창포(石菖浦)의 종류(種類)와 학명(學名)을 살펴보고 각 문헌(文厭) 상(上)에서 기술된 석창포(石菖浦)의 약효(藥效)를 검토하였고 필요에 따라 다른 약물(藥物)을 인용(引用)하였으며 동의보감(東醫寶鑑)과 사상처방(四象處方) 중에 석창포(石菖浦)을 단방(單方)으로 사용하거나 포함한 방제(方劑)가 있는 문(門)을 종합 정리하여 그를 통해 석창포(石菖浦)의 체질소속(體質所屬)과 효능(效能)을 비교 검토하였다. 2. 결과(結果) 및 결론(結論) 기존 본초론적(本草論的)으로 석창포(石菖浦)는 기미(氣味)가 신온(辛溫)하여 향(香)이 있고 약용부위(藥用部位)가 뿌리여서 상초(上焦)인 폐(肺)와 상하초(中下焦)인 간(肝)를 겸(薦)하여 상승(上昇)하며 조습거담(燥濕祛痰) 및 분리청탁(分別淸獨)하여 기석(氣液)의 저체(沮滯)와 착종(錯綜)을 균조(均調)한다. 이런 약리(藥理)는 단미(單味)를 떠나 사상의학내(四象醫學內)의 체질병증(體質病證)에 소속되는 과정(過程)중에서 태음인(太陰人)의 기석(氣液)의 분리청탁(分別淸獨)작용을 통한 폐이호(肺以呼), 간이급(府I以吸)의 승강조절(昇降調節)의 용약정신(用藥精新)을 찾을 수 있고 착종폐기지참오균조(錯綜肺氣之參伍均調)의 약성(藥性)을 가짐을 알 수 있다. 기능(機能)과 구조(構造)를 동시에 개선(改善)시키며 단순 치습(治濕)이 아닌 기파지기(氣波之氣)의 호산흡취(呼散吸聚)관계로만 설명 가능함을 또한 확인 할 수 있었다. 향후 사상체질(四象體質) 약물의 객관화(客觀化)에 문헌적(文獻的) 고찰(考察)의 방법은 그 유용성 및 가치가 크다 할수 있다.

• 사상체질의학회지
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• 제10권2호
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• pp.151-162
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• 1998

1. 목적(目的) 및 방법(方法) 음양오행적(陰陽五行的) 기미론(氣味論)에 입각(立脚)한 기존약물(旣存藥物)들을 사상의학내(四象醫學內)의 각 체질병증(體質病證)에 사용코자 했을때 아직까지도 그 약물(藥物)의 정확한 체질소속(體質所屬)과 사상의학적(四象醫學的) 약리(藥理)를 설명하지 못하고 혼돈(混沌)과 논쟁(論爭)에 빠져 있는 경우가 많았다. 이에 본 연구(硏究)는 위령선(威靈仙)이라는 약물(藥物)을 통해 약물(藥物)의 체질소속(體質所屬)과 체질병증하(體質病證下)에서의 용약정신(用藥精神) 그리고 체질약물(體質藥物)의 공통속성(共通屬性)을 객관화(客觀化)하며 각 다른 약물(藥物)의 약리규명(藥理糾明)의 객관화(客觀化) 연구(硏究)에 그 실마리를 찾고자 한다. 문헌적(文獻的) 고찰(考察)의 방법(方法)을 위주로 현재 사용되는 위령선(威靈仙)의 종류(種類)와 학명(學名)을 살펴보고 각 문헌(文獻) 상(上)에서 기술된 위령선(威靈仙)의 약효(藥效)를 검토하였고 필요에 따라 다른 약물(藥物)을 인용(引用)하였으며 동의보감(東醫寶鑑)과 사상처방(四象處方) 중에 위령선(威靈仙)을 단방(單方)으로 사용하거나 포함한 방제(方劑)가 있는 문(門)을 종합 정리하여 그를 통해 위령선(威靈仙)의 체질소속(體質所屬)과 효능(效能)을 비교 검토하였다. 2. 결과(結果) 및 결론(結論) 기존 본초론적(本草論的)으로 위령선(威靈仙)은 기미(氣味)가 고신온(苦辛溫)하여 색이 검고 약용부위(藥用部位)가 뿌리여서 상초인 폐(肺)를 겸(兼)하여 하강(下降)하며 조습거담(燥濕祛痰) 및 분별청탁(分別淸濁)하여 후박(厚朴)과 같이 조열(燥熱)이 응결(凝結)한 질환(疾患)에도 사용할 수가 있다. 이런 약리(藥理)는 단미(單味)를 떠나 사상의학내(四象醫學內)의 체질병증(體質病證)에 소속되는 과정중에서 태음인(太陰人)의 기액(氣液)의 분별청탁(分別淸濁)작용을 통한 폐이호(肺以呼), 간이흡(肝以吸)의 승강조절(昇降調節)의 용약정신(用藥精神)을 찾을 수 있고 성폐지진기(醒肺之眞氣)의 약성(藥性)을 가짐을 알수 있다. 기능(機能)과 구조(構造)를 동시에 개선(改善)시키명 단순 치습(治濕)이 아닌 기액지기(氣液之氣)의 호산흡취(呼散吸聚)관계로만 설명가능함을 또한 확인 할 수 있었다. 향후 사상체질(四象體質) 약물의 객관화(客觀化)에 문헌적(文獻的) 고찰(考察)의 방법은 그 유용성 및 가치가 크다 할수 있다.

• 대한간호학회지
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• 제23권1호
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• pp.130-141
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• 1993

This study was to find out variables influenced on the medication patterns (voluntary medication, in-voluntary medication) of antipsychotics taken by schizophrenic outpatients. Purposes of this study were to be identified that there was the significant difference between the group of voluntary medication and involuntary, and that which variables had infuence on outpsychotics medication. The sample consisted of 30 patients takeing their pills voluntary (voluntary medication group), and 15 patients involuntary(involuntary medication group) at a psychiatry hospital and a psychiatric unit of a The findings of the study are as follows : university hospital in Daegu. Data were collected from September to October, 1991 through interview using questionare about antipsychotics medication. Data were analyzed by the technique of two group discriminant function analysis using SPSS pc$^{+}$ 1) Discriminant function discriminating between voluntary medication and involuntary medication was significant at the level of 10% significance (sig.=.055, p〈.10) Hit-ratio was very high (91. 1％) 2) One of General variables, SEX, was significant of discriminating between two medication patterns at the level of 10% significance. 3) One of Family Environmental Variables, BROTH(a number of brother), were significant between two medication patterns. (p〈.10) 4) One of Therapeutic Environmental Variables, FAMHX, was significant between two medication patterns at the level of 10% significance. 5) One of Variables Related to Drug and Medication, NECESS, was significant between two medication patterns. (p〈.05) 6) Variables Related to Disease was not significant between two medication patterns.s.

• 수면정신생리
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• 제8권1호
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• pp.5-10
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• 2001

The prevalence of insomnia and the degree of impairment due to insomnia is greater than in the of young. The cause for insomnia in the elderly are various factors among the elderly is known to be high including medical, psychiatric, drug issues, circadian rhythm changes, sleep disorders, and psychosocial. So the careful evaluation to find the cause of insomnia is needed for the eldery. Treatment options for insomnia include behavior modification and pharmacotherapy. Outcome data from previous studies indicate that behavioral approaches produce reliable and durable therapeutic benefits, as evidenced by improved sleep efficiency and continuity and enhanced satisfaction with sleep patterns. Treatment methods such as stimulus control and sleep restriction, which target maladaptive sleep habits, are especially beneficial for older insomniacs, whereas relaxation-based interventions aimed at decreasing arousal, produce more limited effects. Cognitive and educational interventions are instrumental in altering age-related dysfunctional beliefs and attitudes about sleep. The choice of hypnotics is based on matching the nature of the insomnia to the hypnotic agent. The ideal agent has rapid onset, duration of action that lasts through the night but no residual daytime effects, and no adverse effects. The key for the healthcare professional is finding the appropriate treatment or treatment combination, including behavioral modification and pharmacotherapy. When hypnotics are indicated, the most appropriate short-acting agent should be considered.

• 생물정신의학
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• 제3권2호
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• pp.149-155
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• 1996

Doctors who treat pregnant women ore usually cautious in writing their prescription for the drugs. The problem of which psychotropic medications ore sale during pregnancy seems to remain unsolved for many years. Although the rate of absorption is reduced due to a reduced rate of gastric emptying, the extent of absorption of drug is generally unchanged during pregnancy. Plasma volume and total body water increase during pregnancy. There is suggestion that drug metabolizing activity may be increased in pregnancy. Since the pregnancy increase the glomerular filtration rate significantly, drugs mainly eliminated by renal excretion will be cleared more quickly. Factors contributing to the potential teratogenecity of a drug include the type of compound, dose and duration of use, developmental stage of fetus at the time of exposure, and the effect of the drug on fetal pharmacokinetics. All major classes of psychotropic agents should be assumed to diffuse readily across the placenta to the fetus and to be present in some quantity in the breast milk. To decide when and how to start the drug treatment depends on an assessment of the risks related both with and without drug treatment of psychiatric disorders.

• 한국간호교육학회지
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• 제5권2호
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• pp.300-314
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• 1999

This study is an attempt to evaluate the effect of the medication and symptoms self-care education on the psychiatric patients' quality of life. This exploratory study was designed to a quasi-experiment of pretest-postest with a non equivalent control group. Subjects of 40 patients who were discharged from a mental hospital in Pusan were selected to be experiment and control group, with each group consisting of 20. The research period was from March, 6 to May, 29, 1999 and the pre-post test was given before and after implementing MSSE to the both experiment and control group. The results finding were summarized as follows ; 1. subjects who attended self-care education scored significantly higher than control group in quality of life.(Z=-2.06, P=0.034) 2. Those who were in the experiment group reported more significant higher scores than control group in item of quality of life, living situation(A=-2.62 P=0.012), relations with spouse (Z=-2.31 P=0.038) and children (Z=3.37, P=0.008), fear (Z=-1 95, P=0.049) and anger(Z=-2.07 P=0.041), work functioning (Z=-2.34, P=0.021), environmental adjustment. (Z=-2.05, P=0.039)

• 생물정신의학
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• 제23권3호
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• pp.69-79
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• 2016

Frontotemporal dementia (FTD) is a degenerative disease characterized by the selective frontal and temporal lobe atrophy, and progressive deficits in behavior, executive function, or language. The prevalence and incidence of FTD are 15-22/100000 and 2.7-4.1/100000, respectively, in midlife. Hereditary is an important risk factor for FTD. Although there is some controversy regarding the further syndromatic subdivision of the different types of FTD, FTD is clinically classified into behavioral variant of frontotemporal dementia, semantic dementia and progressive nonfluent aphasia. FTD can be misdiagnosed as many psychiatric disorders because of similarity of the prominent behavioral features. Advances in clinical, imaging, and molecular characterization have increased the accuracy of FTD diagnosis, thus developing for the accurate differentiation of these syndromes from psychiatric disorders. We also discuss about therapeutic strategies for symptom management of FTD. Medications such as serotonin reuptake inhibitors, antipsychotics, and other novel treatments have been used in FTD with various rates of success. Further advanced research should be directed at understanding and developing new diagnostic and therapeutic modalities to improve the FTD patients' prognosis and quality of life.

• 생물정신의학
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• 제11권2호
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• pp.77-87
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• 2004

Due to the high population prevalence of major depression and the strong emphasis on pharmacotherapy for this disorder, antidepressants are among the most frequently prescribed pharmacological agents. But the clinicians are still unable to predict accurately the response of their depressed patients to medication. This article reviews the biological predictors of treatment response including monoamine, neuroendocrine, pharmacogenetic, and psychophysiologic markers. The biological predictors of response, despite some interesting leads that may in the long term be of considerable importance, are not yet sufficiently established to be of routine clinical usefulness. Many of the predictive factors explored in this article are examples of mediators and moderators that affect outcomes. Each one alone may not provide definitive answers for predicting response to treatment, but each must be taken into account at the outset of treatment. It is clear that treatments must be individualized for each patient. It would be necessary to develop the algorithm in order to predict the responsiveness of antidepressant treatment with integration of the results from the previous studies.