• 제목/요약/키워드: Cognitive Therapy

검색결과 910건 처리시간 0.046초

주요우울장애에 대한 한약 단독치료의 효과와 안전성: 체계적 문헌고찰 및 메타분석 (Effectiveness and Safety of Traditional East Asian Herbal Medicine as Monotherapy for Major Depressive Disorder: A Systematic Review and Meta-Analysis)

  • 승혜빈;권희주;김상호
    • 동의신경정신과학회지
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    • 제33권1호
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    • pp.79-111
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    • 2022
  • Major depressive disorder (MDD) causes a persistent feeling of sadness and loss of interest. It can lead to emotional and physical problems. Treatments such as antidepressant and cognitive behavioral therapy for MDD have many limitations. Traditional East Asian Herbal Medicine (TEAM) is a representative modality of Complementary and Integrative Medicine (CIM) which can be used for MDD. However, no study has systematically reviewed the efficacy or safety of TEAM for MDD so far. Therefore, we performed a systematic review and meta-analysis to evaluate effectiveness and safety of TEAM as a monotherapy for MDD. We only included TEAM that could be used in context of clinical setting in Korean Medicine. Outcomes were the Hamilton Depression Rating Scale (HAMD) and total effective rate (TER). After comprehensive electronic search of 11 databases, we included 28 randomized controlled trials (RCTs) that compared HM as monotherapy with antidepressant for MDD. Meta-analysis showed that TEAM had significant benefits in reducing HAMD (MD=-0.40, 95% CI: -0.67 to -0.13, p=0.003, I2=85%) and improving TER (RR=1.06, 95% CI: 1.02 to 1.10, p=0.003, I2=0%). It also appeared to be safer than antidepressant in terms of adverse effects. Methods used for RCTs were poor and the quality of evidence was graded 'low' or 'moderate'. These findings indicate that the use of HM as a monotherapy might have potential benefits in MDD treatment as an alternative to antidepressant. However, considering the methodological quality of included RCTs, the clinical evidence is uncertain. Further well-designed RCTs are required to confirm these findings.

성인 비만 여성을 위한 체중조절 프로그램이 비만과 식행동의 개선에 미치는 효과 (Effects of Weight Control Programs on Limiting Obesity and Improving the Eating Behaviors of Adult Obese Women)

  • 김경희
    • 한국식생활문화학회지
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    • 제24권6호
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    • pp.784-792
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    • 2009
  • This study was conducted to investigate the effects of weight control programs on BMI, serum profiles, nutrition knowledge and eating behaviors of adult obese women. The subjects of this study were 33 adult obese women aged 30-65 years residing in Seoul. The weight control program for obese women included nutritional education, cognitive behavioral therapy and exercise for 12 weeks. The weight control experience of the subjects was 60.6%. They preferred physical exercise and diet restriction to weight control and 72.7% of subjects answered that the reasons for wanting to control their weight was health. The BMI of test subjects significantly decreased (p<0.001) from 28.3 to 27.1 after the 12 weeks of the weight control program. In addition, the % body fat significantly decreased (p<0.001) from 36.4% to 34.5% after completion of the weight control program. SGPT levels in the serum were also significantly decreased (p<0.05) after the program. Triglyceride levels significantly decreased from 194.9 mg/dL to 98.1 mg/dL (p<0.01) and the HDL cholesterol level significantly increased (p<0.01) from 55.8 mg/dL to 60.0 mg/dL after completion of the weight control program. Nutritional knowledge and eating behavior scores were significantly increased (p<0.001). In addition, the eating self-efficacy of the subjects was significantly increased (p<0.01); however, the food diversity scores were not changed after the program. These results suggest that the weight control program for adult obese women may be effectively used to promote weight reduction and improve nutritional knowledge and eating behavior.

The Effects of Floral Arrangement on the Stress Index of the Elderly with Chronic Diseases and Its Correlation with Cognition

  • Choi, Byung Jin;Kim, Yeon Hee;Yun, Suk Young
    • 인간식물환경학회지
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    • 제22권3호
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    • pp.269-277
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    • 2019
  • This study aims to see what changes flower arrangement programs bring to the stress index of elderly people with chronic diseases and its correlation with cognition. Furthermore, seniors from a day care center and a nursing home were compared for the purpose of identifying the effectiveness of flower arrangement activities as a supplementary remedy designed to relieve the symptoms and improve the quality of life of patients with chronic diseases. In this study, 24 seniors with chronic diseases were divided into two groups: Group A consists of 15 seniors from a day care center and Group B consists of nine seniors from a nursing home. Both groups participated in simple flower arrangement activities in 10 sessions. In each session, red and green cut flowers that were preferred by the elderly were provided to elicit and develop their thoughts and behaviors. The results showed that the overall average stress index was significantly reduced from 58.0±11.6 before the program to 50.6±17.1 after the program (p = .037). This study examined that the program was more effective for Group A (p = .021) than for Group B (p = .678). Results of the correlation analysis showed that there was no correlation between cognitive function and stress index (p = .569), but that the activity was more effective for Group A. This study shows that arranging flowers effectively lowers the stress index of elderly people with chronic diseases. Also, sharing the outcomes of such activities with others or continuously caring for the flowers even after the activity can maximize the effectiveness of the therapy and rehabilitation. Thus, the study concluded that the program needs to be applied continuously, not in the short-term, in order to relieve or treat the symptoms of elderly patients with chronic diseases.

성인 ADHD의 국내 연구동향 분석: 스코핑 리뷰 방법을 중심으로 (A Scoping Review on the Domestic Research Trends in Adult ADHD)

  • 박현서;김선중;서주희
    • 동의신경정신과학회지
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    • 제35권1호
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    • pp.101-113
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    • 2024
  • Objectives: The purpose of this scoping review is to suggest future treatment and research directions for adult ADHD by examining domestic trends in Korean research on adults with ADHD tendencies. Methods: The present review used Arksey and O'Malley's scoping review methodology. Eight domestic databases were used, and a search was conducted in July 2023 while targeting domestic papers that had been published within the last 20 years. Subject keywords included 'College student', 'Soldier', and 'Adult', and the subject-related terms that were searched for included 'ADHD'. Results: From 502 initially collected articles, 78 were ultimately selected for analysis in this work. Domestic research related to adult ADHD has been steadily conducted since 2000, and most such research has been done in psychology. Regarding the research participants, those in their 20s were the most common age group, and college students accounted for more than half of participants. In terms of study design, survey studies were the most common, while there was a lack of studies on intervention. The subject most closely dealt with in ADHD studies was interpersonal relationships, followed by depression and addiction. The main intervention used in this study was cognitive behavioral therapy, however it was limited in number. Conclusions: More multifaceted studies on adult ADHD need to be conducted using various research methodologies, and there is also a need for more studies using interventions. It is also important for such research to be expanded to broader geographic areas, ages, and occupations.

지역 사회 노인을 대상으로 한 불면증 단기 치료 프로그램의 효과 (The Effects of a Brief Intervention for Insomnia on Community Dwelling Older Adults)

  • 오의선;박경미;안석균;남궁기;심다혜;이은
    • 수면정신생리
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    • 제25권2호
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    • pp.74-81
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    • 2018
  • 목 적 : 한국 사회의 고령화와 동반되어 노인 인구의 불면증은 증가되는 추세이나 이로 인해 초래되는 개인 및 사회경제적 손실에 비해 적절한 치료를 받는 환자의 수는 많지 않다. 불면증 인지행동치료가 부작용을 최소화할 수 있는 일차적인 치료로서 추천되고 있으나, 시간 및 경제적 제약, 인지적인 자원이 필요한 부담으로 인해 치료에 대한 접근성이 제한된 실정이다. 불면증 단기 치료 프로그램은 이러한 부담을 최소화할 수 있는 대안이 될 수 있을 것이다. 본 연구의 목적은 지역사회 거주 노인을 대상으로 불면증 단기 치료 프로그램의 효과를 검증하는 것이다. 방 법 : 2016년 5월부터 2018년 1월까지 서울 소재 3개의 노인 종합복지관을 방문한 65세 이상의 불면증을 호소하는 노인들 47명을 대상으로 3주에 걸쳐 불면증 단기 치료 프로그램을 시행하였다. 프로그램의 전, 후의 수면의 질을 측정하는 피츠버그 수면의 질 지수(Pittsburgh sleep quality index, PSQI), 수면 위생 척도, 정서 관련 평가를 실시하였으며 치료 기간 중 매일 수면 일지를 작성하도록 지시하였다. 임상적 효과는 치료 전후의 총 수면 시간, 수면 잠재기, 수면 후 각성 시간 및 수면 효율로 평가하였다. 치료 전, 후의 변화를 비교하기 위해 비모수검정 방법인 윌콕슨 부호 순위 검증(Wilcoxon's signed-ranks test)을 이용하여 분석을 시행하였다. 결 과 : 불면증 단기 치료 프로그램을 시행한 뒤, 치료 전보다 대상자들의 PSQI 총점이 감소하였으며 PSQI 로 측정한 주관적 수면의 질이 유의하게 호전되었다. 치료 전후에 시행한 수면 일지를 비교한 결과에서도 개운함 및 수면 후 각성 시간에 대해서 유의한 수준의 호전을 보였다. 결 론 : 개발된 불면증 단기 치료 프로그램은 지역 사회 노인의 불면증에 대해 긍정적인 치료 효과를 보이는 것으로 나타났다 기존의 불면증 인지행동치료에 비해 시간적, 인지적 자원 부담이 적음을 고려하였을 때 불면증 단기 치료 프로그램은 지역 사회 내에서 노인 불면증 치료에 대한 접근성을 확대하는 데 사용할 수 있을 것이다.

시각기능 개선을 위한 시기능훈련이 시지각에 미치는 영향 (Effect of Visual Perception by Vision Therapy for Improvement of Visual Function)

  • 이승욱;이현미
    • 한국안광학회지
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    • 제20권4호
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    • pp.491-499
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    • 2015
  • 목적: 시각이상을 가진 아동을 대상으로 시기능훈련을 통한 시각기능이상의 개선 전후 시지각점수의 변화를 살펴보고 시지각에 미치는 영향을 알아보고자 한다. 방법: 시각기능이상을 가진 13세 미만($8.75{\pm}1.66$)의 아동 23명을 대상으로 시기능훈련 전후에 시지각기능검사(TVPS_R; test of visual perceptual skills-revised)를 실시하여 시기능훈련에 따른 시각기능의 변화와 시지각 평가점수의 변화를 분석하였다. 결과: 시기능훈련을 통해서 원거리 PRC(positive relative convergence) 분리점은 평균 $3.39{\pm}2.59{\Delta}$(prism)에서 $13.87{\pm}6.04{\Delta}$로 증가되었고, 근거리 P.R.C 분리점은 평균 $5.48{\pm}3.42{\Delta}$에서 $18.44{\pm}7.58{\Delta}$로 증가하였다. NPC(near point of convergence)는 $25.87{\pm}7.33cm$에서 $7.48{\pm}2.83cm$로 개선되었고, NPA(near point of accommodation)는 $19.57{\pm}7.16cm$에서 $7.09{\pm}1.88cm$로 개선되었다. 시지각평가에서 시각기억분야를 제외하고는 대응차가 시각완성에서 $17.74{\pm}16.94$(p=0.000), 시각적순차기억에서 $15.65{\pm}17.11$(p=0.000), 배경식별에서 $13.65{\pm}16.63$(p=0.001), 형태향상성에서 $12.74{\pm}18.41$(p=0.003), 시각구별에서 $6.49{\pm}10.07$(p=0.005), 시각적공간지각에서 $4.17{\pm}9.33$(p=0.043) 순으로 개선되었고, 이를 종합한 시지각점수는 대응차가 $15.22{\pm}8.66$(p=0.000)로서 더욱 더 유의한 결과를 나타내었다. 결론: 시기능훈련을 통해서 시각기능의 개선과 시각기억분야를 제외한 시지각점수의 향상이 시각완성, 시각적순차기억, 배경식별, 형태향상성, 시각구별, 시각적공간지각 순으로 유의하게 나타났다. 따라서 시각기능향상을 위한 시기능훈련은 시각의 기능뿐만 아니라 시지각의 기능까지 영향을 미치는 것을 확인 할 수 있으며 시각훈련의 중요성을 인식 할 수 있었다.

뉴로피드백 훈련에 의한 뇌파 변화 연구 : 일차성 불면증 환자에 대한 예비 연구 (Electroencephalographic Changes Induced by a Neurofeedback Training : A Preliminary Study in Primary Insomniac Patients)

  • 이진한;신홍범;김종원;서호석;이영진
    • 수면정신생리
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    • 제26권1호
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    • pp.44-48
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    • 2019
  • 목 적 : 불면증은 대표적인 수면 질환이다. 최근 연구에 의하면 인지적 신체적 각성이 불면증을 야기하는 주요 역할을 한다. 아울러 대뇌 피질의 과각성으로 인한 정보처리과정 장애가 정상적인 입면과 수면의 연속성을 방해한다는 연구 결과도 있다. 뉴로피드백은 행동치료의 한 방식으로 피검자의 뇌파에 영향을 미쳐서 대뇌 과각성을 감소 시킬 수 있다. 이에 본 연구에서는 불면증 환자에서 뉴로피드백 치료가 뇌파 특성에 미치는 영향을 분석하고자 한다. 방 법 : 본 연구는 불면증 진단기준을 만족하는 피검자 13명과 성별 및 연령이 매칭된 대조군 14명을 대상으로 진행하였다. 뉴로피드백 치료와 Sham 치료를 무작위로 각각 30분씩 시행하였다. 각각의 치료 세션 중 뇌파를 측정하고 스펙트럼 분석을 시행하여, 뉴로피드백 치료가 뇌파 스펙트럼에 미치는 영향을 비교 분석하였다. 결 과 : 불면증 환자에서 치료적인 1회기 뉴로피드백을 한 경우, Sham 치료를 한 경우에 비해서 세타 및 시그마 파워($13.9{\pm}2.6$ vs. $12.2{\pm}3.8$ and $3.6{\pm}0.9$ vs. $3.2{\pm}1.0$ in %, respectively ; p < 0.05)가 통계적으로 유의한 수준으로 증가하였다. 그 외 뇌파상으로 통계적으로 유의미한 변화는 없었다. 결 론 : 본 연구는 국내 최초로 불면증 환자에서 1회기 뇌파 뉴로피드백을 통해 입면에 도움이 되는 세타파의 비율이 증가하는 것을 확인하였으며, 이는 입면주기를 앞당길 수 있는 새로운 방법에 대한 제안을 줄 수 있다. 불면증 자체의 치료 반응을 평가하지 못한 제한점은 있으며, 향후 불면증상의 변화까지 평가할 수 있는 후속 연구가 이어져야 한다.

Stem-leaf saponins from Panax notoginseng counteract aberrant autophagy and apoptosis in hippocampal neurons of mice with cognitive impairment induced by sleep deprivation

  • Cao, Yin;Yang, Yingbo;Wu, Hui;Lu, Yi;Wu, Shuang;Liu, Lulu;Wang, Changhong;Huang, Fei;Shi, Hailian;Zhang, Beibei;Wu, Xiaojun;Wang, Zhengtao
    • Journal of Ginseng Research
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    • 제44권3호
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    • pp.442-452
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    • 2020
  • Backgroud: Sleep deprivation (SD) impairs learning and memory by inhibiting hippocampal functioning at molecular and cellular levels. Abnormal autophagy and apoptosis are closely associated with neurodegeneration in the central nervous system. This study is aimed to explore the alleviative effect and the underlying molecular mechanism of stem-leaf saponins of Panax notoginseng (SLSP) on the abnormal neuronal autophagy and apoptosis in hippocampus of mice with impaired learning and memory induced by SD. Methods: Mouse spatial learning and memory were assessed by Morris water maze test. Neuronal morphological changes were observed by Nissl staining. Autophagosome formation was examined by transmission electron microscopy, immunofluorescent staining, acridine orange staining, and transient transfection of the tf-LC3 plasmid. Apoptotic event was analyzed by flow cytometry after PI/annexin V staining. The expression or activation of autophagy and apoptosis-related proteins were detected by Western blotting assay. Results: SLSP was shown to improve the spatial learning and memory of mice after SD for 48 h, accomanied with restrained excessive autophage and apoptosis, whereas enhanced activation of phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin signaling pathway in hippocampal neurons. Meanwhile, it improved the aberrant autophagy and apoptosis induced by rapamycin and re-activated phosphoinositide 3-kinase/Akt/mammalian target of rapamycin signaling transduction in HT-22 cells, a hippocampal neuronal cell line. Conclusion: SLSP could alleviate cognitive impairment induced by SD, which was achieved probably through suppressing the abnormal autophagy and apoptosis of hippocampal neurons. The findings may contribute to the clinical application of SLSP in the prevention or therapy of neurological disorders associated with SD.

Oral Administration of Gintonin Attenuates Cholinergic Impairments by Scopolamine, Amyloid-β Protein, and Mouse Model of Alzheimer's Disease

  • Kim, Hyeon-Joong;Shin, Eun-Joo;Lee, Byung-Hwan;Choi, Sun-Hye;Jung, Seok-Won;Cho, Ik-Hyun;Hwang, Sung-Hee;Kim, Joon Yong;Han, Jung-Soo;Chung, ChiHye;Jang, Choon-Gon;Rhim, Hyewon;Kim, Hyoung-Chun;Nah, Seung-Yeol
    • Molecules and Cells
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    • 제38권9호
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    • pp.796-805
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    • 2015
  • Gintonin is a novel ginseng-derived lysophosphatidic acid (LPA) receptor ligand. Oral administration of gintonin ameliorates learning and memory dysfunctions in Alzheimer's disease (AD) animal models. The brain cholinergic system plays a key role in cognitive functions. The brains of AD patients show a reduction in acetylcholine concentration caused by cholinergic system impairments. However, little is known about the role of LPA in the cholinergic system. In this study, we used gintonin to investigate the effect of LPA receptor activation on the cholinergic system in vitro and in vivo using wild-type and AD animal models. Gintonin induced $[Ca^{2+}]_i $ transient in cultured mouse hippocampal neural progenitor cells (NPCs). Gintonin-mediated $[Ca^{2+}]_i $ transients were linked to stimulation of acetylcholine release through LPA receptor activation. Oral administration of gintonin-enriched fraction (25, 50, or 100 mg/kg, 3 weeks) significantly attenuated scopolamine-induced memory impairment. Oral administration of gintonin (25 or 50 mg/kg, 1 2 weeks) also significantly attenuated amyloid-${\beta}$ protein ($A{\beta}$)-induced cholinergic dysfunctions, such as decreased acetylcholine concentration, decreased choline acetyltransferase (ChAT) activity and immunoreactivity, and increased acetylcholine esterase (AChE) activity. In a transgenic AD mouse model, long-term oral administration of gintonin (25 or 50 mg/kg, 3 months) also attenuated AD-related cholinergic impairments. In this study, we showed that activation of G protein-coupled LPA receptors by gintonin is coupled to the regulation of cholinergic functions. Furthermore, this study showed that gintonin could be a novel agent for the restoration of cholinergic system damages due to $A{\beta}$ and could be utilized for AD prevention or therapy.

A neonate with hyperornithinemia-hyperammonemia-homocitrullinuria syndrome from a consanguineous Pakistani family

  • Kim, Yoo-Mi;Lim, Han Hyuk;Gang, Mi Hyeon;Lee, Yong Wook;Kim, Sook Za;Kim, Gu-Hwan;Yoo, Han-Wook;Ko, Jung-Min;Chang, Meayoung
    • Journal of Genetic Medicine
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    • 제16권2호
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    • pp.85-89
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    • 2019
  • Hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome is a rare autosomal recessive urea cycle disorder. HHH is caused by a deficiency of the mitochondrial ornithine transporter protein, which is encoded by the solute carrier family 25, member 15 (SLC25A15) gene. Recently, government supported Korean newborn screening has been expanded to include a tandem mass spectrometry (MS/MS) measurement of ornithine level. We report a case of a neonate with HHH syndrome showing a normal MS/MS measurement of ornithine level. A female newborn was admitted to neonatal intensive unit due to familial history of HHH syndrome. Her parents were consanguineous Parkistani couple. The subject's older sister was diagnosed with HHH syndrome at age of 30 months based on altered mental status and liver dysfunction. Even though the subject displayed normal ammonia and ornithine levels based on MS/MS analysis, a molecular test confirmed the diagnosis of HHH syndrome. At 1 month of age, amino acid analysis of blood and urine showed high levels of ornithine and homocitrulline. After 11 months of follow up, she showed normal growth and development, whereas affected sister showed progressive cognitive impairment despite no further hyperammonemia after protein restriction and standard therapy. Our report is in agreement with a previous Canadian study, which showed that neonatal samples from HHH syndrome patients demonstrate normal ornithine levels despite having known mutations. Considering the delayed rise of ornithine in affected patients, genetic testing, and repetitive metabolic testing is needed to prevent patient loss in high risk patients.