• 정신신체의학
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• 제26권2호
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• pp.119-126
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• 2018

연구목적 본 연구의 목적은 알츠하이머병 및 경도인지장애 환자에서 백질고강도신호 차이에 따른 신경인지 기능 및 행동심리증상(BPSD)을 비교하는 것이다. 방 법 본 연구는 후향적 연구로서, 알츠하이머병 및 경도인지장애로 진단받은 115명을 대상으로 하였다. 뇌 자기공명영상의 백질 고강도 신호(white matter hyperintensity, WMH)는 표준화된 시각 기반 척도(Fazekas scales)에 의해 평가되었으며, 참가자들은 Fazekas 척도에 따라 두 그룹으로 분류되었다. 신경인지기능은 임상치매평가척도(CERAD-K)에 의해, BPSD는 한국형 신경정신행동검사(K-NPI)로 평가되었다. WMH의 심각도에 따른 신경인지기능 및 BPSD의 차이를 분석하기 위해 독립표본 t-test를 시행하였다. 결 과 WMH의 중증도가 높은 군은 유의하게 낮은 언어 유창성을 나타내었다(p<0.05). 또한 WMH의 중증도가 높은 군은 유의하게 높은 K-NPI 점수를 보였다(p<0.01). 결 론 WMH와 실행기능과 관련된 신경인지검사 간에는 유의한 연관이 있었다. 또한 WMH는 BPSD의 중증도에 영향을 미치는 것으로 보인다. 임상실제에서 WMH를 알츠하이머 병(Alzheimer's disease, AD)및 경도인지장애(Mild cognitive impairment, MCI)환자를 치료하는데 유용한 정보를 제공할 것이다.

• 정신신체의학
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• 제22권2호
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• pp.71-78
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• 2014

연구목적 알츠하이머병 환자들의 행동심리증상(BPSD)은 임상적인 문제들을 일으켜 결국 기능의 감퇴, 간병인 스트레스, 입원, 사망률의 증가를 가져온다. 최근의 연구는 성별차이가 BPSD에서 중요한 역할을 한다고 보고하고 있으나, BPSD와 성별 사이 연관에 대한 국내 연구는 시행된 적이 없었다. 이에 본 연구는 알츠하이머병 환자들의 BPSD가 성별 차이에 의해 영향을 받는 것인지를 검증해 보고자 실시하였다. 방 법 면담과 인지기능평가를 통해 DSM-IV 진단기준에 의하여 알츠하이머병으로 진단받은 98명의 환자들이 본 연구에 참가하였다. 간이정신상태검사(MMSE), 임상치매평가척도(CDR), 전반적 퇴화척도(GDS), 한국형 신경정신행동검사(K-NPI)를 사용하여 인지기능 및 BPSD를 평가하였다. 성별 차이를 확인하기 위해서 독립 t 검증을 사용하여 분석하였으며, MMSE, CDR, GDS와 NPI 사이의 관련성을 살펴보기 위해 피어슨 상관분석을 사용하였다. 결 과 알츠하이머병 환자들의 BPSD에서 통계적으로 유의미한 성별 차이는 관찰되지 않았다. MMSE와 NPI 총점, 그리고 NPI 하위영역인 환각과 유의한 상관관계를 보였으며, CDR의 경우 NPI 총점, 무감동/무관심, 과민/불안정과, GDS의 경우 NPI 하위영역인 환각과 유의한 상관관계를 나타내었다. 결 론 본 연구결과 우리나라 알츠하이머병 환자들의 BPSD에서 성별의 차이는 나타나지 않았지만, 추후 알츠하이머형 치매의 BPSD가 성별 차이에 의한 것인지 혹은 개인 차에 의한 것인지를 더 명확하게 밝혀내기 위한 광범위하고 지속적인 연구가 필요할 것으로 생각된다.

• 한국의류학회지
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• 제45권5호
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• pp.788-803
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• 2021

This study aims to obtain basic data to develop clothes for dementia patients by classifying types of dementia patients. Data was collected from those dementia patients who entered a nursing home. This study analyzed a total of 221 sheets. Furthermore, descriptive statistics, cross-tabulation, and K-means clustering were performed for statistical processing using Minitab 14. As a result, dementia patients were classified into four types: inactive-dependent, active-problematic behavior, activity-autonomy, and inactive-offensive. Inactive-dependent type was a group with the most severe disability in cognitive and daily activity functions; however, they lacked behavioral and psychological symptoms and problematic behavior with clothes. Active-problematic behavior type showed the most behavioral and psychological problems and problematic behavior with clothes. Activity-autonomy type was a group without any problematic behaviors. Moreover, the inactive-offensive type had very good cognitive function toward humans. The study imply that it is necessary to provide clothes with proper functions based on the types of patients rather than providing them uniform clothes because clinical and clothes behaviors differ significantly depending on the types of dementia patients.

• Journal of Korean Biological Nursing Science
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• 제7권2호
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• pp.49-57
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• 2005

There have been many trials of clinical efficacy of multi component and single component treatments for irritable bowel syndrome(IBS). We reviewed effects of non phamacological treatments in the IBS. Though the efficacy of multi-component approaches was unclear, several results suggest that cognitive behavioral therapy was effective in improving gastrointestinal symptoms of IBS. As a single component, cognitive therapy and relaxation with or without biofeedback could improve the symptoms and psychological health of IBS patients. Yoga, meditation, self-help information and hypnotherapy could be applicable to IBS.

• 생물정신의학
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• 제20권3호
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• pp.97-103
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• 2013

Objectives We aimed to identify the neuroimaging marker for prediction of the use of atypical antipsychotics (AAP) in dementia patients. Methods From April 2010 to March 2013, 31 patients who were diagnosed as dementia at the psychiatric department of Soonchunhyang University Hospital, completed the brain magnetic resonance imaging scan and cognitive test for dementia. Ten patients were treated with AAP for the improvement of behavioral and psychological symptoms of dementia (BPSD) and the other 21patients were not. Using T1 weighted and Fluid Attenuated Inversion Recovery (FLAIR) images of brain, areas of white matter (WM), gray matter (GM), cerebrospinal fluid (CSF) and white matter hyperintensities (WMH) have been segmented and measured. Multivariate logistic regression models were applied for assessment of association between AAP use and the GM/WM ratio, the WMH/whole brain (GM + WM + CSF) ratio. Results There was a significant association between AAP use and the GM/WM ratio (odds ratio, OR = 1.18, 95% confidence interval, CI 1.01-1.38, p = 0.037), while there was no association between AAP use and the WMH/whole brain ratio (OR = 0.82, 95% CI 0.27-2.48, p = 0.73). Conclusions The GM/WM ratio could be a biological marker for the prediction of AAP use and BPSD in patients with dementia. It was more likely to increase as dementia progress since atrophy of WM was more prominent than that of GM over aging.

• 가정간호학회지
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• 제27권3호
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• pp.306-320
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• 2020

Purpose: This study aimed to explore the subjective perception structures and types of empathy among nurses caring for patients with behavioral and psychological symptoms of dementia (BPSD) using Q-methodology. Methods: Thirty-eight Q-samples (statements) were derived from in-depth interviews with 10 nurses working in long-term care hospitals and nursing homes. The Q-sorting was conducted in rank order (the responses obtained by each of the 30 nurses working at 3 long-term care hospitals and 4 nursing homes) into a normal distribution grid (from -4 to +4). The types of empathy among participants were analyzed using the PC-QUANL program. Results: Five types of empathy accounting for 48.5% of the total variance were categorized as follows: (1) taking the patients' personality into consideration while helping, (2) interacting closely and emotionally, (3) supporting the patient as a companion, (4) performing the duty in a defensive manner, and (5) resolving patients' problems by focusing on their needs. Conclusion: This study shows that there are various types of empathy in nurses caring for patients with BPSD. Therefore, it is necessary to develop strategies and educative programs to enhance empathy competency and deal with burnout based on the type of empathy.

• 대한의사협회지
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• 제61권12호
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• pp.758-764
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• 2018

Dementia is a clinical syndrome characterized by a cluster of symptoms and signs that manifest as difficulties in cognitive functions such as memory, psychological and psychiatric changes, and impairments in activities of daily living. As a result of worldwide trends of population aging, dementia has had a huge impact on public health in almost all countries. Disease modification therapies for dementia have not yet been developed. However, pharmacotherapy is essential in patients with dementia to combat delays in their cognitive and functional decline. In this article, we review the current pharmacotherapy for dementia. Three acetylcholinesterase inhibitors-donepezil, rivastigmine, galantamine-and memantine are the only medications that have been approved for the treatment of dementia. We present the indications, dose recommendations, side effects, and criteria for National Health Insurance coverage in Korea of these medications for dementia treatment. Although the Ministry of Food and Drug Safety in Korea has not approved any medications for managing the behavioral and psychological symptoms of dementia, some antipsychotics and antidepressants have been studied and used clinically for those purposes. Clinicians may consider vitamin E, Ginkgo biloba extract, choline alfoscerate, or omega-3 fatty acids as additional treatment options. Non-steroid anti-inflammatory drugs, estrogen hormone therapy, and statins are not generally recommended for dementia treatment. We believe that our findings will aid clinicians in the treatment of patients with cognitive decline.

• 대한후두음성언어의학회지
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• 제27권2호
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• pp.84-86
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• 2016

Globus pharyngeus or globus sensation is the painless sensation of a lump in the throat and may be described as a foreign body sensation, a tightening or choking feeling. It is often associated with persistent clearing of the throat, chronic cough, hoarseness, and catarrh. Its etiology remains unclear ; however, laryngopharyngeal reflux may play a role in a subset of patients. Psychogenic problems have often been thought to cause or trigger the globus sensation. Personality studies have found higher levels of alexithymia, neuroticism, and psychological distress (including anxiety, low mood, and somatic concerns) and lower levels of extraversion in patients presenting with globus. Globus patients with laryngopharyngeal reflux exhibited weaker psychological symptoms than non- laryngopharyngeal reflux globus patients, and globus patients who did not respond to proton pump inhibitor had significantly higher anxiety scores. In cases with negative clinical investigations and consistent globus symptom, other treatment strategies, including speech therapy, antidepressants, and cognitive-behavioral therapy, should be considered.

• Clinical and Experimental Pediatrics
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• 제51권9호
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• pp.935-943
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• 2008

Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral developmental disorder characterized by a persistent pattern of inattention and/or hyperactivity, as well as forgetfulness, poor impulse control or impulsivity, and distractibility. The recommended evaluation includes documenting the type and severity of ADHD symptoms, verifying the presence of normal vision and hearing, screening for comorbid psychological conditions, reviewing the child's developmental history and school performance, and applying objective measures of cognitive function. Prevailing opinion characterizes ADHD as a disorder of executive function attributable to abnormal dopamine transmission in the frontal lobes and frontostriatal circuitry. A clearly defined etiology remains unknown, but studies suggest a strong genetic link. The aim of treatment is to decrease symptoms, enhance functionality, and improve well-being for the child and his or her close contacts. Stimulants remain the pharmacological agents of first choice for the management of ADHD, and psychosocial, behavioral and educational strategies that enhance specific behaviors may improve educational and social functioning in children with ADHD.

• 정신신체의학
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• 제1권1호
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• pp.81-91
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• 1993

The consulting internist will encounter patients with psychiatric symptoms and those who take psychotropic medications in many settings. The internist must loam to feel comfortable interacting with patients who display psychiatric symptoms. while maintaining an open and unprejudiced attitude toward their evaluation. The proper delineation of psychiatric disorders from normal emotional reactions resets on a careful history, a mental status evaluation. and a knowledge of psychiatric syndromes. Many physicians tend erroneously to view behavioral changes only in a psychological framework Abrupt changes in behavior, personality, mood. or ability to function should be evaluated for possible organic causes. Then, the internists should take their consultation to psychiatrists and freely discuss psychologic problems of the patients.