• 대한불안의학회지
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• 제4권1호
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• pp.19-27
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• 2008

Objective : This study was conducted to evaluate the changes in the levels of neurotransmitters and cortisol in patients with chronic posttraumatic stress disorder (PTSD) and to evaluate their correlation with symptoms after long-term pharmacological treatment. Methods : Twenty-eight Vietnam veterans with chronic PTSD and 34 non-PTSD patients were consecutively recruited. The Combat Exposure Scale (CES), Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (M-PTSD), Clinician Administered PTSD Scale (CAPS), Hamilton Rating Scale for Depression (HRSD) and Hamilton Anxiety Scale (HAS) were used to evaluate symptom severity. High performance liquid chromatography (HPLC) was used to measure the plasma levels of epinephrine, norepinephrine, and dopamine, and a radioimmunoassay (RIA) was performed to evaluate the plasma level of cortisol. Results : Plasma cortisol was significantly lower in PTSD patients than in control subjects, while there was no significant difference in plasma epinephrine, norepinephrine and dopamine between the two groups. The scores of M-PTSD, CAPS, HAMD and HAMA were signigicantly higher in PTSD patients than control group. Conclusion : After long-term treatment, the levels of neurotransmitters in PTSD patients returned to within the normal range, and the patients' symptoms showed some improvement. However, the core symptoms of PTSD continued to appear intermittently, and they are thought to be associated with hormonal systems, such as the HPA axis. It is also suggested that PTSD should be considered to be a complex disorder associated with multiple systems and that combinations of the effective medications for each system should be used to treat patients with PTSD.

• Psychiatry investigation
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• 제15권11호
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• pp.1071-1078
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• 2018

Objective We developed easily accessible imagery-based treatment program for patients with post-traumatic stress disorder (PTSD) related to workplace accidents and investigated the effects of the program on various PTSD related symptoms. Methods The program was based on an online platform and consisted of eight 15-min sessions that included script-guided imagery and supportive music. Thirty-five patients with workplace-related PTSD participated in this program 4 days per week for 4 weeks. Its effects were examined using self-report questionnaires before and after the take-home online treatment sessions. Results After completing the 4-week treatment program, patients showed significant improvements in depressed mood (t=3.642, p=0.001) based on the Patient Health Questionnaire-9 (PHQ-9), anxiety (t=3.198, p=0.003) based on the Generalized Anxiety Disorder seven-item (GAD-7) scale, and PTSD symptoms (t=5.363, p<0.001) based on the Posttraumatic Stress Disorder Check List (PCL). In particular, patients with adverse childhood experiences exhibited a greater degree of relief related to anxiety and PTSD symptoms than those without adverse childhood experiences. Conclusion The present results demonstrated that the relatively short online imagery-based treatment program developed for this study had beneficial effects for patients with workplace-related PTSD.

• 대한불안의학회지
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• 제17권2호
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• pp.67-72
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• 2021

Objective : This study examined the prevalence of posttraumatic stress disorder (PTSD) among North Korean defectors during preparation for early settlement. In addition, the correlation between PTSD and other mental disorders with suicidal ideation was assessed. Methods : A total of 639 North Korean defectors aged 19-65 years were included from resettlement and training centers. PTSD was assessed using the PTSD Diagnostic Scale (PDS). The prevalence of other mental disorders and suicidal ideation were assessed using the Korean version of the Psychiatric Diagnostic Screening Questionnaire (K-PDSQ). Results : A total of 6.8% of North Korean defectors had a PDS score >23, which was suggestive of a diagnosis of PTSD. Prior repatriation to North Korea was significantly associated with PTSD. The defectors with PTSD had a higher prevalence of other mental disorders (major depressive disorder prevalence: adjusted odds ratio [AOR], 14.5; 95% confidence interval [CI], 6.7-31.2, panic disorder prevalence: AOR, 9.5; 95% CI, 4.6-20.0, generalized anxiety disorder prevalence: AOR, 5.6; 95% CI, 2.4-13.2). No significant association was found between suicidal ideation and PTSD. Conclusion : North Korean defectors had a relatively high prevalence of PTSD and suicidal ideation during preparation for early settlement. Cohort studies are needed to assess the lasting effects of PTSD on North Korean defectors' settlement in Korea for a longer period.

• 동의신경정신과학회지
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• 제33권4호
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• pp.377-388
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• 2022

Objectives: For diagnosis and evaluation, evaluation tools are needed. Various tools can be used to diagnose and evaluate mental disorders. Among them, psychological tests are widely used. For Korean Standard Classification of Diseases (KCD) diagnosis, psychological tests are also required. Currently developed critical pathway (CP) presented tools for diagnosis and evaluation of mental disorders. The CP suggests the use of tools based on the Clinical Practice Guideline (CPG). Therefore, CPG-based tools should be able to be used in the clinical scene of Korean Medicine for diagnosing and evaluating mental disorders according to CP. Methods: Tools suggested by CPs are summarized. The degree of utilization of tools in CPGs is also summarized. A review was conducted by Korean Medicine neuropsychiatrist experts on tools and user's usage plan. Results: As a result, developed CPs suggested using 19 tools for anxiety disorder, 13 tools for insomnia), 12 tools for Hwabyeong, and 9 tools for dementia. In CPG, 48, 34, 44, and 44 tools were used for anxiety disorder, insomnia, Hwabyeong, and dementia, respectively. Among tools presented in CP, HAM-A, HAM-D, CGI, SAS, and TESS for anxiety disorder, CPG, ISI, and PSQI for insomnia disorder, CPG, STAI, and STAXI for Hwabyeong were frequently used in CPG. For dementia CPG, MoCA, MMSE, HDS, ADL, and ADAS-cog were frequently used. Among them, MoCA, ADL, and ADAS-cog were suggested tools in CP. Conclusions: As a result of analyzing tools suggested and used in the developed CPs and CPGs, it was verified that various tools were used in each study. Most of them were symptom and behavioral evaluation scales. Therefore, symptoms and behavior evaluation scales used more frequently should be able to be used in the clinical scene of Korean Medicine.

• 대한상한금궤의학회지
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• 제8권1호
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• pp.109-119
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• 2016

Objective : The purpose of this paper is to report the effect of Daehamhyung-tang(DHHT) on tinnitus with panic disorder from the disease pattern identification diagnostic system based on Shanghanlun provisions. Methods : According to a disease pattern identification diagnostic system based on Shanghanlun provisions, the patient was diagnosed with 'Taeyang-byung Gyeolhyung'. He took DHHT for 82 days. This paper evaluated the results of treatment on tinnitus by Tinnitus Handicap Inventory(THI) and Verbal Numercial Rating Scale(VNRS). To assess the mental state of anxiety, this paper used Hamilton Anxiety Rating Scale(HAM-A) Results : The THI score was declined from 58 to 6 And the VNRS score was declined from 6 to 1. HAM-A score was declined from 28 to 3. Conclusions : This case study suggests that DHHT has effectiveness on a patient suffers from tinnitus with panic disorder and diagnosed with 'Taeyang-byung Gyeolhyung'.

• 대한불안의학회지
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• 제4권1호
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• pp.11-18
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• 2008

Obsessive-compulsive disorder (OCD) affects approximately 2-3% of the adult population. OCD is associated with impairments in social and occupational functioning. Although there are effective treatments for OCD, many individuals who suffer from OCD go undiagnosed and untreated. Thus, improvements in the assessment and diagnosis of OCD are needed. This paper provides a review of the instruments used to assess and diagnose patients with OCD. We reviewed clinician-administered inventories and self-report questionnaires. The characteristics, strengths, weaknesses, reliability and validity of each instrument are discussed. We also reviewed the psychometric properties of the Korean version of each instrument.

• 대한불안의학회지
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• 제18권1호
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• pp.1-9
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• 2022

Mindfulness has been widely researched in mental, physical health, and healthy populations. The effectiveness of mindfulness-based interventions have also been demonstrated in research studies. This report reviews the research on mindfulness based interventions currently employed for the treatment of posttraumatic stress disorder (PTSD). Mindfulness-based theories postulate that symptoms of PTSD are developed and maintained by experiential avoidance and non-mindful behaviors. Recent emerging work indicates that mindfulness based interventions, such as mindfulness-based stress reduction and mindfulness-based cognitive therapy, may improve the symptoms of PTSD. Further advances are needed to gain a better understanding of the ability of mindfulness based interventions to target specific symptom dimensions of PTSD and the psychological/neurobiological mechanisms of actions underlying these interventions.

• 대한불안의학회지
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• 제3권1호
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• pp.8-14
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• 2007

Although treatments of anxiety symptom have been available for decades, the biological basis for anxiety disorders in humans is just beginning to emerge. Recently, there is a growing body of literature suggesting that group II metabotrpic glutamate (mGlu) receptors and group I mGlu receptors are important in the physiological and behavioral sequelae associated with stressful stimuli. Moreover, compounds selective for mGlu receptors, particularly mGlu2/3 and/or mGlu5, have proven as effective as classical anxiolytics in various animal models of anxiety without producing many of the unwanted side effects that are typical of current therapies. This article will focus on the emerging preclinical and clinical data that implicate modulation of the mGlu receptors as a potential anxiolytic strategy.

• 대한불안의학회지
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• 제1권1호
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• pp.14-17
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• 2005

By the influence of the descriptive approach of DSM-III, the anxiety became the same thing as the anxiety disorder to the clinicians. This unfortunate result sacrificed psychodynamic model of symptom formations and simplified the anxiety as one of the disease entity not as the overdetermined symptoms. These phenomenon awakened the psychoanalytic interest which was in sleep. Freud was the first major articulator of the basic significance of anxiety in human behavior. He attributed the particular quality of the anxiety experience to the trauma of birth, and subsequently to the fear of castration. Such classification of the anxiety according to the psychosexual development is helpful for the clinicians in understanding the origin of anxiety which the patient shows during the psychotherapy. The other analytical view of interpersonal psychoanalysis came from Sullivan. A large part of his therapy is taken up with recognizing and correcting parataxic distortions that interfere with realistic self-appraisal of events and of oneself in relation to others. Perhaps no explanation is the 'most basic' explanation for human anxiety. Anxiety is a multifaceted entity consisting of aspects of realm of discourse. Existential anxiety is inescapable in Western culture but it can be transcended by the cultivation of mind in Eastern culture. The analysts need to stay attuned to their own propensities for anxiety and must permit their own experiences with anxiety to be the grist for the psychotherapeutic mill.

• 정신신체의학
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• 제31권2호
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• pp.118-124
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• 2023

연구목적 우울장애와 불안장애는 흔히 공존하며 임상전단계에서도 흔히 공존한다. 본 연구는 일반인구 집단에서 우울장애와 불안장애가 공존시의 복합 네트워크를 구성하여 중심 증상과 중개 증상을 밝히고자 했다. 방 법 2022년 아산시 청년 정신건강실태조사 데이터를 활용하여 진행하였다. 일반 인구집단 810명의 성인을 대상으로 PHQ-9과 GAD-7을 이용하여 각각 우울과 불안증상의 정도를 측정하였고, 각 증상에 대해 Isingfit model을 기반으로 네트워크 구조를 도출하였다. 주요 증상 및 중개 증상을 찾기 위해 네트워크 지표 중 강도 중심성과 bridge expected influence를 활용하였다. 결 과 우울한 기분, 안절부절 못함과 초조함이 네트워크에서 가장 높은 강도중심성을 보였으며, 불안증상과 우울증상 간의 높은 중개 역할을 하는 증상은 안절부절 못함과 과민성이었다. 결 론 일반 인구집단에서 우울증상과 불안증상이 공존할 때의 중심증 상과 중개증상을 규명하였고 치료적 중재의 목표가 되면 두 질환의 동반이환율을 감소시키는데 기여할 수 있을 것으로 기대된다.