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정신분열병 환자에서 인지기능 및 정신병적 증상의 상관관계 (Correlation between Cognitive Functions and Psychotic Symptoms in Schizophrenic Patients)

  • 김용구;이정애;이소연;이분희;한창수
    • 생물정신의학
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    • 제13권3호
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    • pp.191-201
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    • 2006
  • Objectives : The purpose of this study was to investigate whether the cognitive functions would be correlated with psychotic symptoms and whether antipsychotic treatments would affect the cognitive functions after 8 weeks. Methods : The thirty-five schizophrenic patients were conducted in this study. The psychopathology was measured using PANSS. The memory function, executive function, and sustained attention were measured using Memory Assessment Scale(MAS), Wisconsin Card Sorting Test(WCST), and Vigilance(VIG) and Cognitrone(COG) in Vienna Test System. After 8 weeks of antipsychotic treatment, we retested the cognitive tests. Results : 1) The cognitive tests after the 8 week's treatment showed significant improvements in memory and executive function in the schizophrenic patients. On the other side, sustained attention did not show improvement. 2) The change of PANSS were correlated with perseverative response, perseverative error and total correct in WCST at baseline. WCST scores at baseline were correlated with negative symptoms, but not positive ones. Conclusion : These study suggests that 1) the impaired sustained attention could be a vulnerability marker in schizophrenia, 2) memory & executive function deficit could be reversible after treatment, and 3) medication might have a benefit in improving the cognitive functions in schizophrenia. Furthermore, the data supports that the better premorbid executive function was, the more favorable was the treatment response in schizophrenic patients. Finally, this study indicates that executive function might be an index of treatment improvement.

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초발 주요우울장애 환자의 우울 삽화 및 관해 상태에서 신경인지기능 결함 비교 (Comparison of Neuropsychological Deficits between Depressed Episode and Remission in First-onset Patients with Major Depressive Disorder)

  • 허지원;김용구
    • 생물정신의학
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    • 제15권2호
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    • pp.92-100
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    • 2008
  • Objectives : The purpose of this study was to investigate 1) the neuropsychological deficits with major depressive disorder(MDD) in depressed state and 2) the changes of neuropsychological dysfunctions during depressed episodes and remitted periods in the MDD group. Methods : 12 patients with MDD and 70 normal controls who were diagnosed and classified by DSM-IV and SCID-IV interview participated in this study. The psychopathology was measured using the Hamilton rating scale for depression(HAM-D) and Brief Psychiatric Rating Scale(BPRS). The memory function, executive function, and sustained attention were measured by a trained psychologist using the Korean version of Memory Assessment Scale(K-MAS), Wisconsin Card Sorting Test(WCST), and Vigilance(VIG) and Cognitrone (COG) in Vienna Test System. After 6 weeks of treatment, we retested the cognitive tests in order to measure the cognitive functions in remitted states. Results : Patients with MDD achieved significantly lower score in sentence immediately recall, verbal memory score and total memory score of the K-MAS, total errors of the WCST, response time of Vigilance and response time at "Yes" response of Cognitrone than normal controls at baseline. After 6 weeks of medication, the psychiatric symptoms in the patient group were attenuated, and most of the neuropsychological functions including attention, memory, and frontal/executive function were improved except for response time of Cognitrone. Conclusions : This study provides evidence for distinct neuropsychological deficits in patients with MDD on their depressed states and remitted periods. The impairment on response time remains after remission, and this would be a trait marker of major depressive disorder.

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조현병 환자와 발병하지 않은 일차친족에서 신경인지의 결함 (Neurocognitive Deficits in Patients with Schizophrenia and Unaffected First-Degree Relatives)

  • 김도훈;김지우;황선영;김병수;원승희
    • 생물정신의학
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    • 제21권2호
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    • pp.65-73
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    • 2014
  • Objectives This study aimed to identify the differences and the profiles of cognitive deficits in remitted patients with schizophrenia and first-degree relatives of schizophrenic probands. Methods A total of 26 remitted states of schizophrenia patients were included in the study and the same number of unaffected first-degree relatives of schizophrenic probands and healthy controls were matched for age, sex, years of education. Cognitive function of all participants was measured by using the Digit span test, the Continuous performance test, the Rey auditory & visual learning test, the Complex figure test, the Verbal fluency test, the Wisconsin card sorting test and the Finger tapping test. The effects of subsyndromal symptomatology and general intelligence score were controlled. Results Schizophrenia patients' group showed more significant impairment than other groups in verbal memory (learning, immediate recall, delayed recall), visual memory (copy, immediate recall, delayed recall) and cognitive flexibility domains. The family group and the patient group commonly performed significantly worse than healthy controls in working memory and verbal fluency (category) tests. There were no differences in sustained attention, psychomotor performance. Conclusions Our research shows that the deficit in working memory and verbal fluency could be strong candidates of endophenotypic marker in schizophrenia.

과학적 추론 능력의 발달에서 전두엽연합령의 역할 (The Role of The Prefrontal Lobes in Scientific Reasoning)

  • 허명;;권용주
    • 한국과학교육학회지
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    • 제17권4호
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    • pp.525-540
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    • 1997
  • The present study tested the hypothesis that maturation of the prefrontal lobes is a crucial factor determining the performance of scientific reasoning tasks, Functions of the prefrontal lobes, such as activating relevant information, sequential planning and monitoring, and inhibiting irrelevant information, are related thinking patterns with scientific reasoning. Therefore, we inferred the idea that the prefrontal lobes play an important role in scientific reasoning. To test the hypothesis. the present study investigated a prefrontal lobe patient's task solving procedures in scientific reasoning tasks and the correlation and regression analysis between a test of prefrontal lobe function and two scientific reasoning tasks, The perseverative errors in the Wisconsin Card Sorting Test(WCST) was used as a measure of the prefrontal lobe function, The Melinark Type Task and the Classroom Test of Scientific Reasoning were used as measures of scientific reasoning abilities. Ages and Group Embedded Figure Test were also used as measures of two alternative hypotheses, general maturation and field independency respectively. The prefrontal lobe patient showed a crucial deficiency in solving scientific reasoning tasks. In the tasks, the patient could not used the reasoning of If... and... then... therefore pattern. In correlation study, the perseveration errors of the WCST showed a significantly negative correlation with two scientific reasoning tasks. Multiple regression study also showed that the perseveration errors measured as a function of the prefrontal lobes have more contribution to scientific reasoning ability than contributions of alternative hypotheses. Therefore, the present study supported the hypothesis that prefrontal lobes play a crucial role in scientific reasoning ability, What function of the prefrontal lobes do play crucial role in scientific reasoning? The present study provided an explanation for the question, which inhibiting ability of the prefrontal lobes is responsible for the scientific reasoning ability, in a part at least. That is, perseverative tendency in task-solving procedures causes a deficiency of an ability to inhibit the wrong information to solve a task. The present study provided a possibility of neuropsychological approach in science education research. The present study also showed an importance of the prefrontal lobe development in the performance of scientific reasoning task.

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Cognitive and other neuropsychological profiles in children with newly diagnosed benign rolandic epilepsy

  • Kwon, Soonhak;Seo, Hye-Eun;Hwang, Su Kyeong
    • Clinical and Experimental Pediatrics
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    • 제55권10호
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    • pp.383-387
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    • 2012
  • Purpose: Although benign rolandic epilepsy (BRE) is a benign condition, it may be associated with a spectrum of behavioral, psychiatric, and cognitive disorders. This study aimed to assess the cognitive and other neuropsychological profiles of children with BRE. Methods: In total, 23 children with BRE were consecutively recruited. All children underwent sleep electroencephalography (EEG) and were assessed on a battery of comprehensive neuropsychological tests including the Korean versions of the Wechsler intelligence scale for children III, frontal executive neuropsychological test, rey complex figure test, Wisconsin card sorting test, attention deficit diagnostic scale, and child behavior checklist scale. Results: The study subjects included 13 boys and 10 girls aged $9.0{\pm}1.6$ years. Our subjects showed an average monthly seizure frequency of $0.9{\pm}0.7$, and a majority of them had focal seizures (70%). The spike index (frequency/min) was $4.1{\pm}5.3$ (right) and $13.1{\pm}15.9$ (left). Of the 23 subjects, 9 showed frequent spikes (>10/min) on the EEG. The subjects had normal cognitive and frontal executive functions, memory, and other neuropsychological sub-domain scores, even though 8 children (35%) showed some evidence of learning difficulties, attention deficits, and aggressive behavior. Conclusion: Our data have limited predictive value; however, these data demonstrate that although BRE appears to be benign at the onset, children with BRE might develop cognitive, behavioral, and other psychiatric disorders during the active phase of epilepsy, and these problems may even outlast the BRE. Therefore, we recommend scrupulous follow-up for children with BRE.

Measuring Psychological Support for the Unemployed: The Case of Kakao NEET Project

  • Jeong, Jaekwan;Park, Kahui;Hyun, Yaewon;Kim, Daewon
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • 제15권4호
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    • pp.1502-1520
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    • 2021
  • This paper attempts to investigate Korean youth Not in Education, Employment and Training (NEET) and how daily activities and community participation may influence their positive emotions and job search desire. First, we conducted a focus group interview with 16 NEETs who participated in the Kakao NEET Company project. The project allowed participants to experience employment by founding a virtual company in which each participant selected a daily activity to perform as part of the company's operations. Second, the interview responses were categorized and assigned emotional values using the card sorting technique and multi-dimensional analysis (MDS). A total of 11 emotional values were derived through this process. Finally, a social network analysis was conducted in order to measure the density of relations among the emotional values. Results suggest that immersion, confidence, belongingness were the three highest values evaluated by participants. Furthermore, network diagrams imply that the stronger participants perceived social support and belongingness with others, the stronger their responsibility grew, further leading them to establish steady goals. In particular, the high eigenvector score for "desire for job" suggests that emotional values are sequentially connected to the immersion-social support-responsibility-goal-job desire. This sequence suggests that digital services that are developed with the aim to enhance social values such as the Kakao NEET Project may engender motivation and confidence in youth NEETs. The overall results suggest that a systematic approach to policymaking should be considered in order to provide fundamental solutions and expand opportunities for social participation and emotional comfort, as social isolation due to low self-esteem has been reported as one of the reasons for NEETs' failure in the labor market.

청각장애 운전자의 사용자경험에 기반한 자동차 내 청각정보 유형 분석 (Analysis of Auditory Information Types in Vehicle based on User Experience of Hearing Impaired Drivers)

  • 변재형
    • 스마트미디어저널
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    • 제10권1호
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    • pp.70-78
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    • 2021
  • 청각정보는 시각에 비해 방향에 제한을 받지 않으므로 자동차 내에서 긴급한 알림이나 경고의 목적으로 활용된다. 그러나 청각장애 운전자는 청각정보를 인지할 수 없으므로 이를 대체하기 위해 다양한 시각화 방법이 시도되고 있다. 청각정보를 시각화할 때는 시각에 집중되는 인지과부하를 방지하기 위해 중요한 정보만을 선별해서 제공하여야 하며, 이를 위해서는 자동차 내 청각정보의 유형 분석이 우선되어야 한다. 본 연구에서는 청각장애 운전자의 운전상황 관찰을 통해 자동차 내에서 경험하는 청각정보를 수집하였다. 수집된 33가지의 청각정보는 전문가 그룹에 의한 개방적 카드소팅을 통해 12개의 그룹으로 분류되었으며, 그룹 간 상대적 중요도 비교를 통해 4개의 계층으로 분석하였다. 제시된 자동차 내 청각정보 유형은 청각정보를 시각 또는 촉각으로 변환하여 표시할 때 중요한 정보를 선별하기 위한 가이드 라인으로서 활용이 가능하다. 본 연구는 청각장애 운전자를 대상으로 일상에서의 실제 운전상황 관찰에 의한 사용자 경험 분석이 이루어졌다는 데 의의가 있다.

65세 이상 노인의 참여활동수준과 기능장애에 관한 연구 (A Study of Activity Participation Level and Functional Disability for The Elderly Aged Over 65 years)

  • 박경영;신수정
    • 융합정보논문지
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    • 제10권9호
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    • pp.222-228
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    • 2020
  • 본 연구의 목적은 65세 이상 노인들의 참여활동수준과 ICF에 기반한 기능장애에 대해 조사하는 것이다. 도시에 거주하고 있는 노인 100명을 대상으로 하였으며, 한국형 활동분류카드(KACS)와 세계보건기구 장애평가척도 2.0(WHODAS 2.0)를 통해 자료를 수집하였다. 수집된 자료는 기술통계 및 상관분석, 다중회귀분석을 이용하여 분석하였다. 참여활동수준에 대한 조사결과, 도구적 일상생활 영역이 75.06%로 가장 높게 나타났다. WHODAS 2.0 하위영역 중 사람들과 어울리기, 사회참여 영역에 어려움이 가장 많았고, 자기관리와 일상생활활동에서의 어려움이 가장 낮게 나타났다. 참여활동 보유율과 기능장애에 대한 상관성을 분석한 결과, 모두 유의한 음의 상관관계가 있는 것으로 나타났다. 기능장애에 영향을 미치는 요인들로는 사회활동과 도구적 일상생활의 참여활동수준, 직업상태(은퇴)가 유의미한 것으로 나타났다. 연구를 통하여 참여활동수준이 기능장애를 설명하는 중요한 요인임을 확인할 수 있었다. 추후 연구결과의 일반화를 위한 표준화 연구가 이뤄질 필요가 있다.

주의력 결핍/과잉행동장애 아동의 실행 능력 (EXECUTIVE FUNCTIONS OF ATTENTION DEFICIT/HYPERACITIVITY DISORDER)

  • 김지혜;홍성도
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제10권1호
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    • pp.15-20
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    • 1999
  • 요 약:본 연구의 목적은 주의력 결핍/과잉행동 장애 아동의 실행 능력을 비교 집단인 신경증 집단과 비교하고자 하였으며, 특히 연령 변화에 따른 실행 능력의 변화를 비교 고찰하였다. 방 법:대상은 DSM-IV 진단준거에 의하여 ADHD로 진단 받은 아동들로, 연령 범위는 6세에서 16세까지의 아동 87명(남자 77명, 여자 10명)이다. 대조군은 경미한 우울 장애, 경미한 불안 장애를 보이는 19명의(남자 14명, 여자 5명) 아동들로 이하 신경증 집단으로 분류하였다. 모든 아동에게 1:1로 WCST를 실시하였으며, Heaton(1981)의 방식을 computer version으로 실시하였다. 연구에서 측정한 WCST의 종속측정치는 총시도횟수, 정반응수, 오반응수, 보속반응수, 보속오류수, 첫 범주를 마치는데 요구된 시도수, 유지실패수, 완성된 범주수 이다. 이때, 연령 및 진단을 함께 고려하여 이원변량분석(2-way ANOVA) 및 t-test 검증을 실시하였다. 결 과:ADHD 집단과 Neurosis 집단 간에 WCST의 수행을 비교한 결과는 정반응수, 오반응수, 비보속 오류수, 개념반응, 완성된 범주수에서 두 집단 간에 유의미한 차이를 나타내었다. 연령에 따라 WCST의 수행을 비교한 결과 총시행수, 오반응수, 보속 반응수, 보속 오류수, 비보속 오류수, 완성된 범주수, 첫범주 완성 시도수에서, 의미있는 차이를 나타내었다. 결 론:ADHD 집단은 대조군에 비하여, 외부 feedback에 맞춰 자신의 반응을 수정해 가는 능력이 부족하며, 자기-통제를 하지 못한 채 무작위적인 반응을 했을 가능성을 시사하고 있다. 하지만 보속 오류수, 보속 반응수에서는 차이가 나타나지 않고 있어 이에 대한 해석에 주의를 요하고 있다. 또한 연령 변화에 따라 실행 능력 전반에 걸쳐 변화가 나타나고 있다는 것은 실행 능력을 연구할 때 발달적인 측면이 꼭 고려되어야 함을 시사한다.

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만성 정신분열병 환자에서 증상과 인지기능:6개월 개월 추적연구 (Symptoms and Cognitive Function in Chronic Schizophrenia: 6 Months Follow-up Study)

  • 김철권;김성환;최병무
    • 수면정신생리
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    • 제11권1호
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    • pp.44-49
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    • 2004
  • 목 적 : 만성 정신분열병 환자에서 양성증상과 음성증상의 호전이 인지기능에 어떤 영향을 끼치는 지를 알아보기 위함이다. 방 법:증상의 호전이 예상되는 활성기 정신분열병 환자 68명을 대상으로 입원 직후에 증상과 인지기능을 측정하고 6개월 약물치료 후 증상과 인지기능을 재차 측정하여 두 영역에서의 변화간의 연관성을 조사하였다. 또 약물치료에 의해 인지기능이 어느 수준까지 호전되는지를 알아보기 위하여 나이와 교육수준이 비슷한 정상 대조군 20명의 인지기능과도 비교하였다. 증상은 PANSS로 평가하였고, 인지기능은 고난도 지속수행검사를 이용한 지속적 주의력, 위스콘신 카드분류검사를 이용한 실행능력, 숫자 주의력을 이용한 주의 집중력, 그리고 레이 청각 언어성 학습검사를 이용한 언어성 기억과 학습 등을 측정하였다. 결 과:양성증상과 음성증상에서의 호전은 각 인지검사 점수의 변화에 유의한 영향을 미치지 않았고, 인지검사 점수의 변화에서 증상의 호전으로 설명될 수 있는 정도는 미미하였다. 또 정신분열병의 활성기에 비하여 6개월 약물치료 때의 관해기때 주의력, 실행능력, 기억력 모두 유의한 호전을 보였지만, 나이와 교육수준이 비슷한 정상대조군과 비교 시는 여전히 유의한 결손을 보였다. 결 론:이러한 결과는 정신분열병에서 증상과 인지기능이 서로 다른 영역일 가능성을 시사하며, 나아가 정신분열병 치료에 있어 증상의 호전뿐 아니라 인지기능의 호전에도 초점을 두어야 할 필요성을 부각시킨다.

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