• 임상간호연구
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• 제14권3호
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• pp.27-36
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• 2008

Purpose: This study was to investigate the effects of foot massage on fatigue and depression among patients undergoing chemotherapy with hematological malignancies. Method: The subjects were 60 patients hospitalized for undergoing chemotherapy from September 2007 to March 2008, and 30 of them were the experimental group and the other 30 were the control group. To the subjects in the experimental group, foot massage was provided for 30 minutes everyday before the chemotherapy at the same time for 4 days, and the effect was measured on Day 4 and 5 after chemotherapy. Fatigue was measured using the Brief Fatigue Inventory (BFI) developed by Mendoza et al. (1999), and depression was measured by psychiatric rating scale SCL-90-R developed by Derogatis (1977) and translated by Kim Gwang il et al. The data were analyzed through $x^2$-test, Fisher's exact test, unpaired t-test and repeated measures ANOVA using SPSS 12.0. Results: Fatigue and depression were significantly lower in the experimental group than in the control group. Even on Day 5, fatigue and depression were significantly lower in the experimental group than in the control after finish foot massage. Conclusion: The findings of the study demonstrated that foot massage would be an effective nursing intervention to reduce fatigue and depression in patients with hematological malignancies.

• 대한조현병학회지
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• 제23권1호
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• pp.29-37
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• 2020

Objectives: This study aimed to investigate the characteristics of early maladaptive schemas and their associations with clinical symptoms in patients with schizophrenia. Methods: Forty-eight patients with schizophrenia, 49 patients with major depressive disorder, and 50 healthy controls completed the Young Schema Questionnaire and symptom measures including the Brief Psychiatric Rating Scale-Expanded (BPRS-E). Results: The schizophrenia group had significantly higher scores than the healthy controls and lower scores than the depression group in most schemas. Compared with healthy controls, the schizophrenia group exhibited higher scores in 10 schemas, i.e., mistrust, social isolation, failure, dependence, vulnerability to harm, enmeshment, insufficient self-control, subjugation, emotional inhibition, and negativity schemas (all p<0.001). Moreover, vulnerability to harm, enmeshment, subjugation, and negativity schemas were correlated with total scores of the BPRS-E (0.37≤r≤0.43, all p<0.05). Regarding the five BPRS domains, emotional deprivation schema showed significant relationships with negative (r=0.50, p=0.005) and disorganization (r=0.39, p=0.033) symptoms, while no schemas showed correlations with positive symptoms. Conclusion: These results suggest that most schemas in patients with schizophrenia pertain to impaired autonomy and performance as well as disconnection and rejection domains and may improve our understanding and the treatment of schizophrenia from a perspective of schema therapy focused on these domains.

• 대한조현병학회지
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• 제23권1호
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• pp.8-14
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• 2020

Objectives: This study aimed to investigate suicidal behaviors and the related psychopathology across the different stages of schizophrenia. Methods: We recruited 131 patients with schizophrenia and categorized them into two groups, according to the duration of illness (DI) as follows: ≤10 years (n=39) and >10 years (n=92). Psychopathology and suicidality were assessed using the 18-item Brief Psychiatric Rating Scale (BPRS-18) and the suicidality module from the Mini-International Neuropsychiatric Interview, respectively. Results: One-quarter of the patients with a DI ≤10 years and nearly one-sixth of the patients with a DI >10 years experienced suicidal behaviors in the previous month. Suicidality scores were significantly associated with the "affect" factor scores of the BPRS-18 in patients with a DI ≤10 years (β=0.55, p=0.003) and with the "resistance" factor scores in patients with a DI of >10 years (β=0.29, p=0.006). Conclusion: The present study demonstrated that psychopathological factors were differentially associated with suicidality in patients with schizophrenia according to the illness stage. Our findings suggest that for effective suicide prevention, different approaches are required for the management of each stage of schizophrenia.

• 생물정신의학
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• 제2권1호
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• pp.77-90
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• 1995

The Purposes of this study were to examine plasma homovanillic acid(pHVA) levels and 5-hydroxyindoleacetic acid(pHIAA) levels in schizophrenics during haloperidol treatment, and to assess the association of pHVA and pHIM levels with their psychopathology and treatment responses. Fourteen patients entered the study and pHVA, pHIAA levels were measured at baseline, first week, second week and fourth week during treatment. Also, plasma haloperidol levels were measured at first week, second week and fourth week. Psychopathology was evaluated with Brief Psychiatric Rating Scale(BPRS) at baseline, 1st week, 2nd week and 4th week. 1) There were significant differences on the duration of illness and total BPRS scores at baseline between higher pHVA group(baseline pHVA level >7.72ng/mL) and lower pHVA group(baseline pHVA level <7.72ng/mL). 2) There was no significant difference on the duration of illness between higher pHIM group(baseline pHIAA level >3.18ng/mL). and lower pHIAA group(baseline pHIAA level <3.18ng/mL). 3) The Means of pHVA levels at 1 st week and 2nd week after treatment decreased significantly in the higher pHVA group and did not change in the lower pHVA group. 4) In the higher pHIAA group, the mean of pHIAA levels at 4th week after treatment decreased significantly, but did not change in the lower pHIAA group. 5) Between the higher pHIVA group and lower pHVA group, the response rates(percentile improvement) after treatment were not different from each other, but there was significant difference on the response rate between the lower pHIAA group and higher pHIM group at 2nd week. 6) There was significant correlation between total BPRS scores and pHVA levels in the higher pHVA group during treatment. The results suggest that repeated measurement of pHVA levels and pHIAA levels following antipsychotic treatment have prognostic significance for response. Also, shcizophrenics whose have relatively nigh levels of pHVA, or relatively low levels of pHIAA before treatment will show a favorable early responses to antipsychotics.

• Journal of Pharmaceutical Investigation
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• 제23권3호
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• pp.165-177
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• 1993

The relationship between the plasma haloperidol (HP) concentration and clinical response, and the effects of its active metabolite, reduced haloperidol (RH) on clinical response of HP were investigated in schizophrenic patients. In clinical study I, with 17 schizophrenic patients (male 8, fermale 9) who were administered with three different fixed doses of HP (15, 30 and 50 mg/day) for 3 weeks, the concentrations of HP and RH in plasma and blood and clinical response had been checked before and every week during the study. The clinical response was evaluated by the method of brief psychiatric rating scale (BPRS), and relative improvement of clinical response based on baseline BPRS (before drug treatment) was calculated. The concentrations of HP and RH in plasma and blood were assayed by HPLC. In clinical study II, the plasma RH/HP concentration ratios were checked in 11 patients who were administered with high doses of HP, over 60 mg a day, because of the poor clinical response at usual doses of HP. Plasma HP concentration and relative improvement of BPRS at 3 week in schizophrenic patients showed a 'curvilinear' relationship, and the clinical response was improved relatively over 50% based on the baseline BPRS in the range of $5{\sim}57\;ng/ml $ of HP in plasma. Also, the plasma RH concentrations were increased nonlinearly as the plasma HP concentration increased, and in high plasma HP concentration, over 30 ng/mI, clinical response gradually decreased, while the plasma RH/HP concentration ratio increased nonlinearly. Blood partition coefficients of HP and RH were not changed according to daily HP dose and duration of drug therapy. From these results, it is noted that the higher plasma RH/HP concentration ratio, resulted from the accumulation of RH as HP concentration increased, might explain the 'curvilinear' decrease of HP clinical response.

• 수면정신생리
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• 제17권2호
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• pp.91-99
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• 2010

목 적: 본 연구는 정신분열병의 결핍증후군과 비결핍증후군이 다른 생물학적 동등성을 가진 독립된 질환일 수 있다는 가설 아래 quantitative EEG와 standardized LORETA (sLORETA)를 이용한 전기생리학적인 방법을 통하여 생물학적 병인을 파악하고자 시도되었다. 방 법: 정신분열병 환자를 대상으로 42명의 뇌파를 비교 분석하였으며 그 중 결핍증후군 환자군은 남자 10명과 여자 11명이었고 비결핍증후군 환자군은 남자 12명, 여자 9명이었다. 주파수 대역은 delta(1.5~4 Hz), theta(4~8 Hz), alpha(8~12 Hz), low beta(12~15 Hz), high beta(15~30 Hz)의 5가지로 분할하였고 EEG LAB을 이용한 파워스펙트럼 분석 및 standardized sLORETA software package를 이용하여 신호원을 국소화 하였다. 결 과: 파워 스펙트럼 분석에서 결핍증후군 집단은 비결핍증후군과 비교하였을 때 전두엽, 두정엽 및 측두엽 영역에서 delta파와 theta파의 유의한 활성도 증가를 보였으며 뇌파 스펙트럼은 간편 정신상태 평정 척도 중 철퇴/지연과 적대/의심 항목의 임상적인 특징과 유의한 상관관계를 보였다. sLORETA분석 결과에서는 배측 전대상피질에서 결핍증후군에서 유의하게 delta파의 활성도가 증가되었다. 결 론: 결핍증후군은 비결핍증후군과는 연관된 뇌 영역이 다를 수 있으며 특히 전두엽 영역의 신경회로 이상이 일차적 음성증상에 영향을 줄 것으로 생각된다.

• 정신신체의학
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• 제5권2호
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• pp.143-150
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• 1997

본 연구는 정신분열병 환자의 흡연성향 및 흡연이 임상양상이나 증상, 혈청 prolactin에 미치는 영향을 조사해 보고자 하였다. 연구결과는 다음과 같다. 1) 흡연군과 비흡연군의 연령, 발병연령, 이환기간, 복용하는 항정신병 약물 및 항파킨슨 약물의 용량은 유의한 차이가 없었으나, 기호 식품인 커피를 매일 한잔이상 마신다고 답한 경우가 흡연군에서 유의하게 많았다(p<0.05). 2) 흡연 이유는 긴장 완화(85.7%), 권태로움을 피하고 싶어서(45.2%), 습관(38.1%), 친구들과 어울리고 싶어서나 또는 친구를 모방(23.8%)하여 담배를 피운다고 응답했다. 80.1%가 금연을 시도했었으나, 94%에서 craving때문에 금연에 실패하였다. 금단증상으로 불안감(52.9%), 정신과적 증상의 악화(23.5%), 환청의 악화(8.8%), 약물부작용의 악화(14.7%), 졸리움의 증가(47.1%)등이 있었다. 3) BPRS 총점수는 흡연군과 비흡연군에서 유의한 차이가 없었으나, 불안척도가 흡연군에서 유의하게 낮았다(p<0.05). HAM-D에 의한 우울증상 및 SCL-90-R의 대인관계 민감도 항목과 공포증 항목이 흡연군에서 유의하게 낮았다(p<0.05). PANSS. AIMS는 두군에서 유의한 차이를 보이지 않았다. 4) 흡연군에서는 혈청 prolactin이 비흡연군에 비해 유의하게 낮았고(p<0.01) 공변량분석결과 흡연이 혈청 prolactin에 의미 있는 영향을 미치는 것으로 나타났다.(p<0.05). 5) 정신 분열병 환자에서 금연 유도시 적절한 항불안 약물이나 항우울 약물의 일시적인 병합치료로서 금단증상을 최소화 시켜야 하며, 환자들의 낮은 자존심 및 높은 의존심을 충족시키는 정신치료가 병행되어야 될 것으로 사료된다.hromatography를 반복(反復)하여 stilbene 계열(系列)의 화합물(化合物)인 Rhapontigenin (Compound 1)과 Rhaponticin (Compound 2)을 얻었다. S. aureus SG 511에 대(對)해 Rhapontigenin은 50 mg/ml 이상(以上) 농도(濃度)에서 항균(抗菌) 효과(效果)를 나타내었고, Rhaponticin은 $200\;mg/m{\ell}$ 농도(濃度)에서 미약(微弱)하게 유효(有效)한 항균(抗菌) 효과(效果)를 나타내었으며, B. subtilis ATCC 6633에 대(對)해 Rhapontigenin은 50 mg/ml 이상(以上) 농도(濃度)에서 항균(抗菌) 효과(效果)를 나타내었고, Rhaponticin은 200 mg/ml 농도(濃度)에서 우수(優秀)한 항균(抗菌) 효과(效果)를 나타내었으며, 100 mg/ml 농도(濃度)에서 미약(微弱)하게 유효(有效)한 항균(抗菌) 효과(效果)를 나타내었다. 또한 E. coli 055에 대(對)해서는 Rhapontigenin과 Rhaponticin 모두 200 mg/ml 농도(濃度)에서 미약(微弱)하게 유효(有效)한 항균(抗菌) 효과(效果)를 나타내었다. 이상(以上)의 결과(結果)로 보아 선방활명음(仙方活命飮)의 항균(抗菌) 효능(效能)은 군약(君藥)인 대황(大黃)의 성분(成分) 중(中)의 하나인 stilbene 계열(系列)의 화합물(化合物)인 Rhapontigenin과 Rhaponticin의 작용(作用)에 의(依)한 것이며, 이는 한의학(韓醫學) 방제(方劑) 원리(原理)인 군신좌사(君臣佐使) 이론(理論)에서 군약(君藥)이 주증(主症)에 주(主)로 작용(作用)하는 약물(藥物)이라는 것을 밝혀주는 것이라고 사료(思料)된다.

• 생물정신의학
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• 제7권1호
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• pp.85-98
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• 2000

1) 성기능장애 빈도는 정신분열병 환자군이 80%로 대조군 42%에 비해 유의하게 높았다(p<0.001). 성반응 주기에 따른 장애유형은 성적욕망장애 76%, 발기장애 75%, 발기유지장애 75%, 성적극치감의 질적감소 61%, 지루 50%, 사정시 정액량의 감소 44% 순서로 많았다. 성적극치감 횟수의 감소는 32%로 다른 장애유형에 비해 적었으며, 조루를 호소하는 경우도 15%나 되었다. 2) PRL 및 5-HT 측정치는 환자군에서 $28.5{\pm}20.6ng/ml$, $298.5{\pm}89.1ng/ml$으로서 대조군 $10{\pm}5.6ng/ml$, $169.2{\pm}37.8ng/ml$보다 유의하게 높았다(p<0.001). TST 측정치는 환자군이 $4.3{\pm}1.5ng/ml$, 대조군이 $4.5{\pm}1.2ng/ml$로 양군 모두 유의한 차이가 없었다. 3) 성기능장애를 증가시키는 변인은 결혼(미혼), 초발연령, 이병기간, 입원기간, 총약물투여기간 그리고 5-HT 측정치이었다. 특히 5-HT 비정상치군이 정상치군보다 성기능장애가 유의하게 높았다. 그러나 연령, 교육연한, 종교, 경제상태, PRL 및 TST 측정치, 항정신병약물용량, 약물역가, benztropine, ACSE, CGI, BPRS, PANSS, PANSS-CF, MMSE-K 점수와 성기능장애와는 무관하였다. 성기능장애는 정신분열병군에서 높았고, 성기능장애 유형별로는 성적욕망장애와 발기장애가 많았다. 미혼이거나, 초발연령이 높을수록, 질병에 이환된 기간이 길수록, 5-HT 농도가 높을수록 성기능장애가 증가하였다. 비록 혈중 5-HT 농도가 뇌 5-HT 활성을 어느정도 반영하는지는 알 수 없으나, 정신분열병 환자의 일차 병인인 과도한 5-HT 활성으로 인한 직접적인 성기능 억제효과 때문에 장애가 초래한다고 생각된다.