• 정신신체의학
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• 제28권1호
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• pp.1-7
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• 2020

연구목적 본 연구는 불안장애, 우울장애, 불안장애와 우울장애를 공병으로 지닌 환자군의 심리적 특성을 탐색하기 위해 시행되었다. 방 법 2017년 1월부터 2019년 5월까지 한양대학교 구리병원 정신건강의학과에 내원 및 입원하여 심리평가를 진행한 환자들 중 정신건강의학과 전문의 혹은 임상심리사에 의해 DSM-5에 근거하여 불안장애, 우울장애, 불안장애와 우울장애를 공병으로 진단받은 환자를 대상으로 이루어졌다. 참가자들이 실시한 MMPI-2를 연구자들이 RF로 변환한 뒤 SPSS를 활용하여 집단 간 차이에 대하여 검증하였다. 결 과 MMPI-2-RF의 결과 EID, RC2, HLP, SAV, INTR-r가 공병 집단에서 가장 높았다. 또한 BXD, RC4, JCP, AGGR-r가 우울 집단에서 가장 높았다. 결 론 공병 집단은 단일 집단에 비하여 낮은 긍정 정서와 무력감 등과 같은 우울 증상, 사회적 회피 및 불편감과 같은 내면화 증상이 더 심각한 수준으로 나타났다. 또한 우울 집단은 불안 집단과 공병 집단에 비해 분노감과 공격성과 같은 외현화 증상이 더 많은 것으로 밝혀졌다. 이러한 연구 결과를 토대로 본 연구의 의의와 제한점에 대하여 논의하였다.

• Nutrition Research and Practice
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• 제5권3호
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• pp.230-235
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• 2011

Insomnia has become a major public health issue in recent times. Although quality of sleep is affected by environmental, psychophysiological, and pharmacological factors, diet and nutrient intake also contribute to sleep problems. This study investigated the association between nutrient intake and co-morbid symptoms associated with sleep status among selected adults. Subjects in this study included 87 men and women aged 21-45 years. Presence of insomnia was assessed using the Insomnia Screening Questionnaire, and dietary intake was measured over three consecutive days by dietary survey. Descriptive analysis, ANOVA, and Chi-Square tests were performed to compute and interpret the data. Approximately 60% of the participants were insomniacs. People with insomnia consumed significantly lesser quantities of nutrients as compared to normal sleepers. Differences in intakes of energy, carbohydrates, folic acid, and $B_{12}$ were highly significant (P < 0.002). Further, intakes of protein, fat, and thiamine were significantly different (P < 0.021) between insomniacs and normal sleepers. The nutrient intake pattern of the insomniacs with co-morbid symptoms was quite different from that of the normal sleepers. Based on these results, it is probable that there is an association between nutrition deficiency, co-morbid symptoms, and sleep status. More studies are required to confirm these results.

• 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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제13권1호
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• pp.129-138
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• 2002

목 적：소아청소년 정신과 질환의 가장 대표적이라 할 수 있는 주의력결핍-과잉행동장애(ADHD)의 최적치료모델 개발을 위한 연구의 일환으로, 우선 실제 ADHD로 의심되는 환자가 병원을 방문했을 때 임상의들이 현재 (1) 어떠한 진단 평가적 도구를 사용하여 진단적 접근을 하며, (2) 어떠한 치료적 접근을 시행하고 있는지, (3) 현재 시행하고 있지는 않지만, 어떤 모델을 추구하는지에 대해 구조화된 설문도구를 이용하여 파악하고자 하였다. 방 법：대학병원 및 종합병원 소아정신과 담당 전문가 32명을 대상으로 구조화된 설문조사를 하였고, 여기에 포함되는 조사내용으로는 진단검사도구, 약물치료, 비약물치료 현황파악이었다. 이 자료를 Texas Algorithm Project(TAP)와 비교 검토하였다. 결 과：(1) 모든 ADHD 환아에게 실시해야 할 기본적인 검사는 지능검사, 문장완성검사, 지속적 집중력검사, 코너씨 설문지였고, (2) 전반적 ADHD 투여 약물은 TAP 지침과 차이가 없었고, 다만 약효가 인정된 aderall, bupropion, guanfacin의 국내이용이 요구된다고 하였으며, (3) 틱 장애가 동반된 경우는 임상의들이 정신자극제 사용을 자제하는 경향을 보여 TAP 지침과 분명한 차이를 보였고, (4) 파탄적 행동장애가 동반된경우 임상의들은 다른 약물로 교체하기보다는 MPH 투여에 다른 약물을 추가하는 경향을 보였으며, (5) 과반수 이상의 임상의가 꼭 실시하여야 한다고 보고한 치료로는, 개별적 부모상담, 부모교실, 개인별 행동인지 치료였다. 결 론：본 연구 결과를 통해 알 수 있었던 여러 제한점들을 보완하고 또한 본 연구에서 제기된 논쟁점을 위주로 하여서, 한국적 실정에 맞는 ADHD 최적치료모델 개발을 위한 연구와 더불어 전문가들의 합의가 이루어져야 하겠다.

• 대한불안의학회지
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• 제3권1호
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• pp.32-40
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• 2007

Objectives : To investigate the validity of an abbreviated self-rated Korean version of MINI (Mini International Neuropsychiatric Interview) patient health survey which screening social anxiety disorder, panic disorder, generalized anxiety disorder, and major depressive disorder. Methods : 115 subjects completed MINI and MINI patient health survey. The validity of MINI patient health survey was assessed by whether the results from MINI patient health survey were compatible with the results from MINI or not. The Cohen's kappa value, specificity, sensitivity, positive predictive value, and negative predictive value was calculated for this purpose. Results : The Kappa values of social anxiety disorder (0.60), panic disorder (0.49), generalized anxiety disorder (0.60) and major depressive disorder without other co-morbid disorder (0.59) were at least moderate in strength of agreement. Conclusion : The abbreviated self-rated Korean version of MINI patient health survey has the moderate to good validity in social anxiety disorder, panic disorder, generalized anxiety disorder, and major depressive disorder without other co-morbid disorders. Our result suggests that this instrument might be useful for screening above 4 disorders if it is used under careful supervision of experienced clinicians.

• Journal of Korean Neurosurgical Society
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• 제37권6호
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• pp.410-415
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• 2005

Objective: The aim of our study is to evaluate the effectiveness of unilateral hemilaminectomy for bilateral decompression in elderly patients with degenerative spinal stenosis. For this purpose, we studied the co-morbid condition and clinical outcome of patients who underwent decompressive surgery using the unilateral approach technique. Methods: Thirty-four patients over 65years of age who underwent unilateral partial laminectomy for bilateral decompression from January 2000 to October 2003 were analyzed. These patients were studied for preoperative co-morbid condition and physical status according to the American Society of Anesthesiologists(ASA) classification, postoperative morphometrical change, and clinical outcomes, including visual analogue scale(VAS) score. The mean follow-up was 23months (range 6 - 48months). Results: A patient's physical status was recorded as class I, II, or III by ASA classification, which correlated to 41.2%, 44.1%, and 14.7% of patients, respectively. The cross-sectional area of the pre- and postoperative dural sac at the level of the stenosis was $52.5{\pm}19.9mm^2$ and $110.6{\pm}18.2mm^2$, respectively. The outcome was excellent in 8.8%, good in 58.8%, fair in 23.6%, and poor in 8.8% of the patients. The VAS was changed postoperatively to $3.1{\pm}1.2$. There was no operation-related transfusion yet there was no evidence of postoperative instability at the follow-up examination. Conclusion: Unilateral laminectomy for bilateral decompression, in spite of the limited exposure, can result in satisfactory decompression of the lumbar spinal stenosis and tolerable clinical outcome. This approach is thought to be appropriate for elderly patients who have a greater surgical burden.

• Nutritional Sciences
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• 제5권3호
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• pp.129-133
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• 2002

Obesity is a major public health problem in western countries. Genetic and environmental factors, separately or in combination are major determinants of fat mass. Both central effectors (primarily hypothalamus) and peripheral tissues (such as adipose tissue) are implicated in the pathogenesis of obesity. A significant number of studies have documented potential contribution of adipose tissue -via its newly discovered secretory function- to the pathogenesis of obesity and co-morbid conditions including cardiovascular disease, diabetes and hypertension. Applications of analytical techniques such as genomics and proteomics have enabled better understanding of biological sciences in general and have only being applied recently to nutritional sciences including obesity research. Here, we review the recent progress in adipose tissue functional genomics and proteomics, and the importance of these studies in energy metabolism and obesity research.

• 수면정신생리
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• 제18권2호
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• pp.67-71
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• 2011

Schizophrenia is a chronic, currently incurable, and devastating syndrome. Although sleep disturbances are not primary symptoms of schizophrenia, they are important aspects of schizophrenia. Difficulties initiating or maintaining sleep are frequently encountered in patients with schizophrenia. Many schizophrenics report low subjective sleep quality. Measured by polysomnography, increased sleep latency as well as reduced total sleep time, sleep efficiency, slow wave sleep, and rapid eye movement sleep latency (REM latency), are found in most patients with schizophrenia and appear to be an important aspect of the pathophysiology of this disorder. Some literatures suggest that worsening sleep quality precedes schizophrenic exacerbations. Co-morbid sleep disorders such as obstructive sleep apnea (OSA) and restless legs syndrome (RLS), and sleep-disrupting behaviors associated with schizophrenia may lead to sleep disturbances. Clinicians should screen the patient with sleep complaints for primary sleep disorders like OSA and RLS, and carefully evaluate sleep hygiene behaviors of all patients with schizophrenia who complain of sleep disturbances.

• 수면정신생리
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• 제19권2호
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• pp.59-62
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• 2012

Borderline personality disorder (BPD) is characterized by identity and interpersonal problem, affective dysregulation and pervasive severe impulsivity. Although sleep disturbances are not primary symptoms of BPD, they are important aspects of this disorder. However, clinicians and researchers did not give much attention to the sleep symptoms of BPD yet. Measured by nocturnal polysomnography, increased sleep latency as well as reduced total sleep time and sleep efficiency, and 'depression-like' REM abnormalities (i.e., reduced REM latency and increased REM density) are found in BPD patients. Co-morbid sleep disorders such as chronic insomnia, nightmare disorder or circadian rhythm sleep disorder associated with BPD have been reported. Clinicians should focus on the sleep complaints of BPD patients, and carefully manage such symptoms with sleep hygiene education, cognitive psychotherapy or light therapy.

• Tuberculosis and Respiratory Diseases
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• 제71권1호
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• pp.1-7
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• 2011

Many findings suggest that chronic obstructive pulmonary disease (COPD) imposes an enormous burden on patients, health-care professionals and society. COPD contributes to morbidity and mortality and to a significant use of health-care resources. In spite of a higher prevalence of COPD in Korea, the result of COPD treatment is not effective. The purpose of this article was to review recent advances in the study of COPD in Korea with the aim of improving effective management. This review highlights articles pertaining to the following topics; prevalence, assessment of COPD, risk factors for hospitalization, co-morbid diseases, phenotypes, and treatment issues.