• 제목/요약/키워드: 조현병(調鉉病)

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조현병 외래환자의 회복에 대한 견해와 회복 의지 (Opinions on the Recovery of Outpatients with Schizophrenia and Their Wills to Recover)

  • 이재민;김철권
    • 대한조현병학회지
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    • 제24권1호
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    • pp.17-25
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    • 2021
  • Objectives: To examine the opinions regarding recovery and assess their will to recover in outpatients with schizophrenia. Methods: Total 98 stable outpatients with schizophrenia were enrolled. To investigate the outpatients' opinions regarding recovery, we asked the subjects to write down the ways they could think they had recovered from their current disease. We classified their answers and chose final 39 statements. Using this questionnaire, they were asked to what extent they agreed with each statement. Moreover, the Recovery Assessment Scale (RAS) was used to measure the subjects' will to recover. Results: Many of the 39 subjects who were surveyed about their opinions on recovery agreed on 11 statements about taking medicine, social life, daily life, social functioning, positivity about life (happiness, hope, confidence, and tranquility), symptoms, occupation, and self-control. The RAS score showed a significant correlation with age (r=-0.26, p<0.01), age at onset (r=0.26, p<0.01), duration of illness (r=-0.52, p<0.01), and number of hospitalization (r=-0.46, p<0.01). Conclusion: This study shows that positivity about life is an important part of the patients' subjective recovery criteria in schizophrenia. Therefore, if clinicians pay more attention to this part of subjective recovery, it would strengthen the patients' will for recovery.

Prompt 기반의 Full-Shot Learning과 Few-Shot Learning을 이용한 알츠하이머병 치매와 조현병 진단 (Prompt-based Full-Shot and Few-Shot Learning for Diagnosing Dementia and Schizophrenia)

  • 정민교;나승훈;김고운;신병수;정영철
    • 한국정보과학회 언어공학연구회:학술대회논문집(한글 및 한국어 정보처리)
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    • 한국정보과학회언어공학연구회 2022년도 제34회 한글 및 한국어 정보처리 학술대회
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    • pp.47-52
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    • 2022
  • 환자와 주변인들에게 다양한 문제를 야기하는 치매와 조현병 진단을 위한 모델을 제안한다. 치매와 조현병 진단을 위해 프로토콜에 따라 녹음한 의사와 내담자 음성 시료를 전사 작업하여 분류 태스크를 수행하였다. 사전 학습한 언어 모델의 MLM Head를 이용해 분류 태스크를 수행하는 Prompt 기반의 분류 모델을 제안하였다. 또한 많은 수의 데이터 수를 확보하기 어려운 의료 분야에 효율적인 Few-Shot 학습 방식을 이용하였다. CLS 토큰을 미세조정하는 일반적 학습 방식의 Baseline과 비교해 Full-Shot 실험에서 7개 태스크 중 1개 태스크에서 macro, micro-F1 점수 모두 향상되었고, 3개 태스크에서 하나의 F1 점수만 향샹된 것을 확인 하였다. 반면, Few-Shot 실험에서는 7개 태스크 중 2개 태스크에서 macro, micro-F1 점수가 모두 향상되었고, 2개 태스크에서 하나의 F1 점수만 향상되었다.

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제1형 당뇨병을 동반한 조현병 환자의 총 의료비용 및 입원 위험 (A Study of Total Medical Cost and Hospitalization Risk of Patients with Schizophrenia and Type 1 Diabetes Mellitus)

  • 이상욱;김유석
    • 대한조현병학회지
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    • 제22권1호
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    • pp.8-13
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    • 2019
  • Objectives: The aim of this study was to explore the prevalence of type 1 diabetes in patients with schizophrenia and their total medical costs and risk of hospitalization. Methods: This study used Health Insurance Review and Assessment Service data in Korea. To examine total medical costs and risk of hospitalization, we selected 1,510 subjects with schizophrenia (half with and half without type 1 diabetes) that were 1:1 matched via propensity score matching. In health care system perspective, total medical costs included out-of-pocket and insurer's costs. Logistic regression models were used to examine the risk of hospitalization. Results: The prevalence of type 1 diabetes in patients with schizophrenia was 3.87 per 1,000 person year. Among patients with schizophrenia, the amount of total average medical costs and hospitalization costs in patients with type 1 diabetes was 1.49 and 1.59 times higher than those in patients without it, respectively. The odds of hospitalization were higher among patients with type 1 diabetes compared with those without it (odds ratio, OR=1.97 ; 95% CI 1.60-2.43). Conclusion: This study showed that medical costs and risk of hospitalization were higher in schizophrenia patients with type 1 diabetes. Therefore, these individuals may require specific care programs.

조현병 외래 환자에서 병식 모순 (The Insight Paradox among Outpatients with Schizophrenia)

  • 김태용;김준기;김철권
    • 대한조현병학회지
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    • 제22권2호
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    • pp.56-65
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    • 2019
  • Objectives: The primary objective was to test the phenomenon known as the insight paradox, which refers to the association between higher levels of insight and lower self-esteem, higher hopelessness, and a higher perception of social prejudice among patients with schizophrenia. Methods: A total of 216 outpatients with schizophrenia according to the DSM-IV diagnostic criteria were recruited. All participants were receiving ongoing outpatient treatment and were in a stable phase of the disorder. The participants were divided into a good-insight (N=109) and a poor-insight (N=107) group by the direct interview and the mean score of questionnaire. The parameters used for analysis and comparison were demographic variables (age, gender, education), clinical variables (age at onset, number of hospitalizations), self-esteem, hopelessness, self-stigma, and quality of life. Results: Compared with the poor-insight group, the good-insight group was found to have a lower number of hospitalizations, lower self-esteem, higher hopelessness, lower quality of life, and a higher level of internalized stigma. Conclusion: The insight can cause the negative consequences in patients with schizophrenia. Therefore, clinicians should pay attention to the negative aspects of insight for improving the quality of life in the treatment of patients with schizophrenia.

조현병 환자의 입원스트레스 경험에 대한 융합연구 (Integrated Study on Hospitalization Stress Experience of Schizophrenic Patient)

  • 박순아;박근우
    • 한국융합학회논문지
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    • 제9권4호
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    • pp.397-408
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    • 2018
  • 본 연구의 목적은 심층면담을 통해 조현병환자의 입원스트레스 경험을 규명하고 입원스트레스를 중재 할 수 있는 기초 자료를 마련하고자 한다. 연구방법은 두 지역의 3개 정신과 병원 폐쇄 병동에 입원중인 조현병환자 15명을 대상으로 심층 면담을 시행하여 면담 내용을 질적 내용분석하였다. 연구 대상자는 15명으로 평균 나이는 40세였다. 현재 입원 기간은 평균 2년이었다. 연구기간은 2015년 10월 21일부터 11월 10일까지이다. 연구결과 입원스트레스 내용은 5개의 상위범주와 17개의 하위범주 및 58개의 의미 있는 내용이 도출되었다. 5개의 상위범주는 '가족에 대한 그리움과 죄책감', '미흡한 치료적 환경으로 인한 불편함', '환자의 권리를 존중받지 못함', '퇴원 후 삶에 대한 불안', '사회적인 편견과 자기낙인감'이었다. 본 연구 결과는 조현병환자의 입원스트레스를 중재 할 수 있는 기초자료를 마련한 것에 의의가 있다. 후속연구에서는 같은 환경에 입원중인 조울증, 알코올 중독 등 다른 정신질환을 가진 대상자의 입원스트레스를 파악하여 비교 분석해보는 연구를 제언한다.

조현병 환자의 개별목표달성 향상을 위한 목표달성척도의 적용에 관한 탐색적 연구 (An Exploratory Study on the Application of Goal Attainment Scale to Improve Individual Goal Attainment of Schizophrenia)

  • 김묘정;이석호;김용석
    • 한국융합학회논문지
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    • 제10권9호
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    • pp.249-255
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    • 2019
  • 본 연구는 조현병스펙트럼 및 기타정신병적장애 진단을 받은 환자들(이하 조현병 환자)을 대상으로 목표달성척도를 적용하고 효과성을 평가하는데 있다. 연구 대상자들은 목표달성척도를 활용하여 자신의 개별목표를 설정하고 목표의 달성 정도를 정기적으로 자가 평가하였다. 연구 대상자들의 목표달성점수를 계산하여 목표달성 정도를 나타냈다. 평가를 위해 사전-사후검사를 실시하였고 선형혼합효과모형을 사용하여 목표달성척도 적용의 효과를 분석하였다. 평가결과, 연구 대상자들의 목표달성점수는 측정시점에 따라 점차 증가하였고 이러한 증가는 통계적으로도 유의미하였다. 본 연구는 조현병 환자들을 위해 자기결정을 통한 목표 설정, 목표성취 그리고 그 과정을 지원하는 것이 중요하다는 것을 보여준다. 본 연구결과를 통해 도출된 임상적 함의, 연구의 한계 등이 추가로 논의되었다.

신문기사를 통해 본 조현병의 의미연결망 분석 (Semantic network analysis of schizophrenia through newspaper articles.)

  • 송혜진;김석선
    • 한국산학기술학회논문지
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    • 제22권6호
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    • pp.375-384
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    • 2021
  • 본 연구는 조현병 관련 기사에 나타난 키워드와 주요 주제의 변화를 파악하는 의미연결망 분석, 계량적 내용분석 연구이다. 연구대상은 강남역 살인사건 전후 5년간 보도된 조현병 관련 신문기사이다. 수집된 자료는 NetMiner 프로그램 4.4.1을 이용하여 네트워크 통계분석을 시행하였다. 2013년부터 2018년까지 8개 중앙지에서 610개의 신문기사가 검색되었다. 출현빈도가 가장 높은 주요 키워드는 강남역 살인사건 이전에는 '치료', 사건 이후에는 '사건'으로 나타났다. 사건 이전에는 '편견으로 치료시기를 놓치면 만성화 됨', '조기 치료하면 치료가 가능함', '약물치료로 정상적인 생활이 가능함', '심신미약 상태에서 살인 혐의로 기소됨'이라는 네 가지 주제가 도출되었다. 반면, 사건 이후 '여성혐오주의자가 아니라 피해망상이 심해져 살인을 저지름', '약물치료 중단으로 충동적인 행동이 유발됨', '범행 후 심신미약으로 인한 감형을 주장함', '흉기 난동에 출동한 경찰을 살해함'이라는 네 가지 주제가 도출되었다. 이러한 결과는 신문기사가 조현병 및 기타 정신질환자에 대한 편견과 낙인을 줄이기 위해 조현병에 대한 정확한 정보를 제공해야 함을 시사한다.

유럽인 자료로 산출된 조현병 다유전자 위험도 점수의 한국인 조현병 환자를 대상으로 한 적용 (Comparison of Polygenic Risk for Schizophrenia between European and Korean Populations)

  • 이진영;이동빈;조은영;백지현;홍경수
    • 대한조현병학회지
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    • 제23권2호
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    • pp.65-70
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    • 2020
  • Objectives: This study aimed to explore whether common genetic variants that confer the risk of schizophrenia have similar effects between Korean and European ancestries using the polygenic risk score (PRS) analysis. Methods: Study subjects included 713 Korean patients with schizophrenia and 497 healthy controls. The Korea Biobank array was used for genotyping. Summary statistics of the most recent genome-wide association study (GWAS) of the European population were used as baseline data to calculate PRS. Logistic regression was conducted to determine the association between calculated PRS of European patients with schizophrenia and clinical diagnosis of schizophrenia in the Korean population. Results: Schizophrenia PRS was significantly higher in patients with schizophrenia than in healthy controls. The PRS at the p-value threshold of 0.5 best explained the variance of schizophrenia (R2=0.028, p=4.4×10-6). The association was significant after adjusting for age and sex (odds ratio=1.34, 95% confidence interval=1.19-1.51, p=1.1×10-6). The pattern of the association remained similar across different p-value thresholds (0.01-1). Conclusion: Schizophrenia PRS calculated using the European GWAS data showed a significant association with the clinical diagnosis of schizophrenia in the Korean population. Results suggest overlapping genetic risk variants between the two populations.

조현병 환자의 범죄에 대한 대중의 관심과 조현병 환자의 정신의료서비스 이용과의 상관관계 (Public Attention to Crime of Schizophrenia and Its Correlation with Use of Mental Health Services in Patients with Schizophrenia)

  • 박현우;이유상;이상엽;이승연;홍경수;;권준수
    • 대한조현병학회지
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    • 제22권2호
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    • pp.34-41
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    • 2019
  • Objectives: This study was performed to examine the effects of the public attention to 'crime of schizophrenia' on the use of mental health services in patients with schizophrenia using big data analysis. Methods: Data on the frequency of internet searches for 'crime of schizophrenia' and the patterns of mental health service utilization by patients with schizophrenia spectrum disorders by month were collected from Naver big data and the Health Insurance Review and Assessment Services in Korea, respectively. Their correlations in the same and following month for lagged effect were examined. Results: The number of outpatients correlated negatively with public attention to 'crime of schizophrenia' in the same month. The lagged relationship between public attention and the number of admissions in psychiatric wards was also found. In terms of sex differences, the use of outpatient services among female patients correlated negatively with public attention in the same month while the number of male patients' admissions in both same and following month correlated positively with public attention. Conclusion: These findings suggested that public attention to 'crime of schizophrenia' could negatively affect illness behavior in patients with schizophrenia.

조기 발병 조현병과 후기 발병 조현병의 임상 양상에 대한 비교 연구 (Comparative Study of Clinical Features between Early- and Late-Onset Schizophrenia in South Korea)

  • 고미애;이선구;이정석
    • 대한조현병학회지
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    • 제22권2호
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    • pp.51-55
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    • 2019
  • Objectives: Late-onset schizophrenia (LOS, age at first onset ≥40 years) is characterized by including predominance of women, better premorbid social adjustment and lower severity of positive/negative symptoms. However, few studies have been conducted on LOS, especially in Asian countries. This study aimed to examine the clinical features of LOS in comparison with early-onset schizophrenia (EOS). Methods: By retrospectively reviewing medical records, we assessed demographic data and clinical features of 76 LOS (20 males) and 357 EOS (144 males) who admitted to the psychiatric ward of a general hospital. Results: The mean ages of onset were 47.3±5.1 (LOS) and 25.7±6.5 (EOS) years. There were significantly more women in LOS (73.7%) than EOS (59.6%). Significantly more LOS patients had a marital (88.2% vs. 25.8%) and employment history (28.9% vs. 13.1%) than EOS. Patients with LOS had fewer negative (14.3±9.0 vs. 19.9±9.3), general psychopathology score (36.9±11.1 vs. 42.3±13.9) than EOS patients. Conclusion: In line with previous studies, this study demonstrated that LOS patients have better premorbid social adjustment. Our finding also replicates previous findings that LOS patients differ from EOS in predominance of women and relative lack of negative symptoms. These results suggest that LOS may be a distinct subtype of schizophrenia.