• 정신신체의학
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• 제4권1호
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• pp.79-84
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• 1996

We have studied 16 patients diagnosed of social phobia among the hospitalized patients for 1 year, from September 1994 to August 1995, to evaluate whether serial phobic symptoms are the prodromal symptoms of the other psychiatric disorder or concomitant disorder. The results were as follows; 1) In the subject of this study, the mean age of onset of social phobic symptoms was 17.3, and the mean age of inital hospital visit was 27.4. 2) The proportion of offensive type was higher than the simple type : 7 cases of the subjects classified as simple type, 9 cases as offensive type. 3) According to the type of social phobia, they developed different type of psychiatric disorder. Majority of patients with simple type had final diagnosis of mood disorder. Patients with offensive type had schizophrenia spectrum disorder, such as schizophrenia, delusional disorder, and schizophrenia, personality disorder. 4) Social phobic symptoms have taken various courses according to the final diagnosis. In the patients who developed major depression and delusional disorder, social phobic symptoms have not been changed during the course. Patients with the final diagnosis of schizophrenia and schizotypal personality disorder have showed various social phobic symptoms. In the patients with the final diagnosis of bipolar disorder, their social phobic symptoms disappeared with improvement of depression.

• 수면정신생리
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• 제8권2호
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• pp.144-147
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• 2001

Chemical restraint or "rapid tranquilization" is another option in treating patients who are a danger to themselves or others and struggle violently once physically restrained. The most commonly used drugs are benzodiazepines and antipsychotics. The use of benzodiazepines, either alone or in combination with high potency neuroleptics, has increased in recent years. Benzodiazepines are extremely safe but may cause respiratory depression and hypotension. Respiratory depression is more likely with intravenous administration, therefore these medications should be given slowly and titrated to the desired effect. Special care should be taken when sedating patients who are under the influence of alcohol or narcotics and are sleep apneic patients. This report deals with a case of respiratory distress in a patient with sleep apnea syndrome after the rapid tranqulization. All patients receiving chemical restraint must be carefully monitored. For critically ill patients who require sedation or chemical restraint, the constant attendance of a physician may be warranted.

• 생물정신의학
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• 제22권2호
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• pp.29-33
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• 2015

The brain maintains homeostasis and normal microenvironment through dynamic interactions of neurons and neuroglial cells to perform the proper information processing and normal cognitive functions. Recent post-mortem investigations and animal model studies demonstrated that the various brain areas such as cerebral cortex, hippocampus and amygdala have abnormalities in neuroglial numbers and functions in subjects with mental illnesses including schizophrenia, dementia and mood disorders like major depression and bipolar disorder. These findings highlight the putative role and involvement of neuroglial cells in mental disorders. Herein I discuss the physiological roles of neuroglial cells such as astrocytes, oligodendrocytes, and microglia in maintaining normal brain functions and their abnormalities in relation to mental disorders. Finally, all these findings could serve as a useful starting point for potential therapeutic concept and drug development to cure unnatural behaviors and abnormal cognitive functions observed in mental disorders.

• 융복합기술연구소 논문집
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• 제2권2호
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• pp.5-12
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• 2012

Recently, peoples are suffering from various psychological disorders such as addiction, phobia, depression, and bipolar disorder. Moreover, children with ADD/ADHD and autism are increasing. Korean tends to regard the psychological disorders as taboo. Therefore, it is unusual case that the mental patient gets the psychological therapy. Virtual reality has come to the spotlight as a useful tool for the therapy due to its anonymity and easy accessibility. The therapy in the virtual reality is called cyber-therapy. Emotion of the patient is important for the treating process. The objective of this paper is to review the researches on the treatment of psychological disorders using the virtual reality and prospect the affective interaction technology for the cyber-therapy.

• Psychiatry investigation
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• 제15권11호
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• pp.1011-1018
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• 2018

The analysis of extracellular vesicles has been accelerated because of the technological advancements in omics methods in recent decades. Extracellular vesicles provide multifaceted information regarding the functional status of the cells. This information would be critical in case of central nervous system cells, which are confined in a relatively sealed biological compartment. This obstacle is more dramatic in psychiatric disorders since their diagnosis primarily depend on the symptoms and signs of the patients. In this paper, we reviewed this rapidly advancing field by discussing definition of extracellular vesicles, their biogenesis and potential use as clinical biomarkers. Then we focused on their potential use in psychiatric disorders in the context of diagnosis and treatment of these disorders. Finally, we tried to combine the RDoC (Research Domain Criteria) with the use of extracellular vesicles in psychiatry research and practice. This review may offer new insights in both basic and translational research focusing on psychiatric disorders.

• 생물정신의학
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• 제4권2호
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• pp.198-210
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• 1997

To examine the double-faced thymoleptic(antidepressant and antimanic) effects of risperidone in mood disorders, this article reviews the psychotropic-induced mania, thymoleptic effects of antipsychotics, therapeutic effects of risperidone and risperidone(RIS)-induced mania(RIM) in mood disorders, risk factors of RIM, possible neurochemical mechanism of these thymoleptic effects, pathophysiological and clinical significance of thymoleptic effects, and suggestive clinical guideline of RIS in mood disorders. RIS appeared effective for bipolar disorder at a lower dose than that recommended for schizophrenia, especially in the cases of maintenance of mood stabilizers, and gradual titration from low doses. Manic induction/exacerbation can occur by chance during RIS treatment in mood disorders, schizoaffective disorders, and schizophrenias. The possible risk factors for RIM are refractory mood disorder, especially in bipolar I disorder with poor initial response ; refractory schizoaffective disorders, especially in bipolar type with poor initial response ; refractory chronic schizophrenias, especially with initial responses ; psychotic features ; higher initial doses ; rapid titration ; combined therapy with antidepressants in refractory depression ; and RIS monotherapy in mania/hypomania. RIS is a drug that preferentially block 5-HT2 receptors. The effects of low dose are due mainly to the blockade of 5-HT2 receptors. There are more gradual increase in D2 blockade with increasing dose and this D2 blocking properties become apparent at higher doses. This may be related to a modulation of dopaminergic transmission by 5-HT2 antagonism at lower doses with the direct action of RIS on DA receptors coming into play at higher dose. The serotonergic antagonistic effect may be important for its effects on depressive symptoms. This, together with adequate blo-ckade of D2 receptors, may not necessarily lead to destabilization of mood disorder, but rather to more therapeutic effects. Therefore, this dose-receptor affinity relationship with both antidepressant and antimanic effects according to treatment duration can explain a continuum of antidepressant effect, antimanic effect, behavioral stimulation, and manic/hypomanic induction/exacerbation. It was the recognition of a useful psychiatric side effects by a thoughtful observer with fertile minds that led to their ultimate utilization as psychotropic drugs, i.e., phenothiazine, MAOI, TCA, and lithium. And, in vivo pharmacological challenge by novel psychotropics, as a neurochemical probe, with more specific actions is a useful tool to select pharmacologically homogeneous subgroup of the same phenotypical(clinical) condition, to further study the unknown underlying pathogenesis of various mental illnesses. Finally, RIS may be a useful alternative or adjunctive drug for patients with mood disorders without psychotic features or refractory to treatment with standard antipsychotic drugs. The more conservative doses(tirated slowly from 1-3 mg/d) of RIS, and maintenance of mood stabilizer in the cases with risk factors of RIM are recommended in mood disorder.

• 대한불안의학회지
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• 제6권2호
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• pp.119-124
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• 2010

Objective : The reliability and validity of the Korean version of the Patient Health Questionnaire-9 (PHQ- 9) was examined in Korean patients with depressive symptoms. Methods : Eighty six outpatients diagnosed as major depressive disorder or depressive episode of bipolar I disorder according to the DSM-IV criteria were assessed with the PHQ-9, Hamilton Depression Rating Scale (HDRS), the Quick Inventory of Depressive Symptomatology Self Report (QIDS-SR), and the Center for Epidemiologic Studies Depression Scale (CES-D). Results : The Cronbach's alpha coefficient from the PHQ-9 was 0.81. And the correlations of each item with the total score were statistically significant (r=0.28-0.70, p<0.01). The test-retest correlation coefficient (r=0.89, p<0.01) was relatively high and correlations of the PHQ-9 with the HDRS, QIDS-SR and CES-D were 0.70, 0.81, and 0.81 respectively. Conclusion : These results demonstrated that the Korean version of PHQ-9 could be a reliable and valid tool for the screening and assessment of depressive patients. The Korean version of PHQ-9 will be a useful tool for screening depressive symptoms in Korea.

• The Korean Journal of Physiology and Pharmacology
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• 제27권1호
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• pp.113-125
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• 2023

It has been reported that stressful events in early life influence behavior in adulthood and are associated with different psychiatric disorders, such as major depression, post-traumatic stress disorder, bipolar disorder, and anxiety disorder. Maternal separation (MS) is a representative animal model for reproducing childhood stress. It is used as an animal model for depression, and has well-known effects, such as increasing anxiety behavior and causing abnormalities in the hypothalamic-pituitary-adrenal (HPA) axis. This study investigated the effect of MS on anxiety or aggression-like behavior and the number of GABAergic neurons in the hippocampus. Mice were separated from their dams for four hours per day for 19 d from postnatal day two. Elevated plus maze (EPM) test, resident-intruder (RI) test, and counted glutamic acid decarboxylase 67 (GAD67) or parvalbumin (PV) positive cells in the hippocampus were executed using immunohistochemistry. The maternal segregation group exhibited increased anxiety and aggression in the EPM test and the RI test. GAD67-positive neurons were increased in the hippocampal regions we observed: dentate gyrus (DG), CA3, CA1, subiculum, presubiculum, and parasubiculum. PV-positive neurons were increased in the DG, CA3, presubiculum, and parasubiculum. Consistent with behavioral changes, corticosterone was increased in the MS group, suggesting that the behavioral changes induced by MS were expressed through the effect on the HPA axis. Altogether, MS alters anxiety and aggression levels, possibly through alteration of cytoarchitecture and output of the ventral hippocampus that induces the dysfunction of the HPA axis.

• 디지털융복합연구
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• 제17권12호
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• pp.509-521
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• 2019

본 연구는 인지행동치료(Cognitve Behavioral Therapy: CBT)분야 학술지에서 나타난 키워드의 출현패턴을 조사하여 국내 CBT 연구의 지식구조를 규명하는 데에 목적이 있다. 국내·외에서 수행된 CBT 연구를 비교하고자 '인지행동치료'에서 출판된 논문 234편(2008-2019)과 'Cognitive Therapy and Research'에서 출판된 논문 2,316편(1977-2019)이 수집되었다. 자료는 NetMiner 4.3 프로그램으로 분석되었으며 동시출현단어 분석은 코사인 유사도 행렬을 산출하고, 네트워크를 시각화하는 절차로 수행되었다. 본 연구의 결과로 국내 CBT연구자들의 주요 관심사가 식별되었고, 국내 CBT 지식구조는 9개의 연구영역으로 범주화되었다: '척도 타당화', '완벽주의와 속박감', '조현병 환자의 인지, 정서, 관계적 특성', '경계선 성격장애와 우울/양극성 장애 환자의 인지적 특성과 치료', '적응과 심리적 건강', '사회불안장애 환자의 인지적 특성과 치료', '우울의 원인과 공존이환', '수용전념치료', '폭식 장애 환자의 이해와 치료'. 본 연구는 지난 11년 동안 국내 CBT 분야에서 축적된 지식을 점검하였다는 데에 의의가 있으며 국내 CBT 연구의 향후 발전과제로 임상적 실천 표준을 제고하기 위한 연구가 필요하다고 제안한다.

• 생물정신의학
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• 제2권2호
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• pp.257-265
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• 1995

선형적이고 정적인 뇌파 분석의 한계를 극복하고자 비선형적이고 동적인 접근방식인 혼돈이론을 이용하여 정신분열병환자 16명, 양극성 정동장애 10명, 주요 우울증 6명 및 정상 대조군 12명을 대상으로 뇌파 분석을 시도하고, 객관적인 혼돈 연구의 도입에 있어서 고려되어야 할 문제점을 살펴보고자 하였다. 각 질환에서의 상관차원의 분포가 정상대조군보다 개인에 따른 차이가 크다는 것을 알 수 있었고, 대체적으로 측두엽 부위에서 상관차원이 크게 나타나는 경향이 있었다. 이러한 결과와 관련하여 대상환자군의 특성, 혼돈이론을 뇌파분석에 이용할 때의 주의점등에 대하여 토론하였다.