• 대한간호학회지
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• 제29권2호
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• pp.314-327
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• 1999

In this study, domains, contents, and effects of pre-existed intervention programs for individuals with arthritis were meta-analyzed to develop arthritis health promotion program based on Holistic Model. The developed program includes strategies of cognition, environment, and behavior. and also generates positive changes in the physical, psychological, and social demensions. Then needs assessment on conveniently selected 153 women who visited a university hospital in Seoul or in Inchon are conducted to identify the objective domains of arthritis health promotion program According to the study results. target health problems of the arthritis health promotion program were shown as pain, disability, depression, and role impediment in social domain. These objectives could be achieved by including the strategies of changing cognition, the strategies of changing behavior through learning the skill related to the health promoting behavior. and the strategies of changing environment in the health promotion program. That is, it is analyzed that the contents of program are not exclusive one another in physical. psychological. and social demensions, and also are not exclusive one another in aspect of cognition, behavior, and environment. The necessary methods to achieve the desired objectives for the developed arthritis health promotion program and evaluation subjects are as follows : (1) In the arthritis health promotion program, knowledge on management of arthritis, efficacy related to arthritis management, skill for pain management, skill for exercise, establishment of positive self-concept, enhancement of positive thinking, stress management. skill for problem solving, skill for setting goals. skill for requesting help, and skill for communication are all included. Through the improvement of all those strategies, intermediate objectives, such as “joint protection, and maintenance of pain management behavior”, “maintenance of regular exercise”, and “promotion of coping skill in psychosocial dimension” are achieved. (2) These intermediate objectives are also the methods for achieving objectives in next stage. It implies that through the intermediate objectives. the final objectives such as “minimization of physical symptoms and signs”, “maximization of psychological function”, and “maximazation of role performance in social domain” could be achieved. Each of these final objectives reflects the different dimension of quality of life, respectively. When these objectives are achieved, the quality of life that client perceives is improved. Therefore, through evaluation of these final objectives, the level of achieving final outcome of arthritis health promotion such as quality of life is determined.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제13권1호
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• pp.93-103
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• 2002

저자는 소아정신과 영역에서 흔하게 관찰되는 주의산만과 과잉운동을 주소로 하는 아동들의 진단특성과 이와 관련된 임상변인들을 알아보기 위하여 본 연구를 시행하였다. 대학병원 소아정신과에 내원한 아동들에서 주의력과 과잉운동 문제를 보이는 5세에서 14세 사이 총 71명(남자 63 명, 여자 8명)을 대상으로 하여, KEDI-WISC, KPI-C, ADS를 시행하였고 진단 분류에 따라 1) ADHD만 있는 군 2) 공존 질환이 있는 ADHD군 3) ADHD 이외의 진단군으로 나누어 비교한 결과 아래와 같은 결과를 얻었다. 1) ADHD 단독 진단군이 17명(23.9%), 공존질환이 ADHD는 26명(38.0%)이었으며 공존질환은 틱장애가 가장 많고 발달성 언어장애, 경계성 지능, 적대적 반항/품행장애, 경계성 지적능력, 학습장애의 순서를 보였으며, ADHD 이외의 진단군 27명(38.0%)은 틱장애, 경계성 지능, 우울/불안장애, 적대적 반항/품행장애의 진단 분포를 나타냈다. 2) 지능검사에서 전체지능, 언어성 지능, 동작성 지능 모두 군별 차이를 보였고 ADHD만 있는 군에서 공존질환 ADHD군보다 전체지능과 언어지능이 유의하게 높은 수치를 나타냈다. KPI-C 임상 척도는 군별 차이를 보이지 않았다. ADS 시각자극 검사에서 누락오류(omission)와 민감도(d')가 세 군 사이에 의미있는 차이를 보였고, 공존질환이 있는 ADHD 군이 ADHD이외의 진단군에 비해 유의하게 누락오류가 많고 민감도는 낮았다. 본 연구 결과를 볼때 아동의 주의산만과 과잉운동 증상은 주 진단인 ADHD 이외에도 다양한 정신과 질환으로 진단될 수 있으므로 이에 대한 감별이 필요하며, 또한 공존질환이 있는 ADHD군이 ADHD만 있는 군이나 기타 질환군보다 주의력에 문제가 많고 지능 수치가 상대적으로 낮아 학습 및 학교 생활 적응에 어려움이 더 많을 것이므로 적극적인 치료개입이 필요할 것으로 생각되었다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제22권3호
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• pp.162-168
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• 2011

Objectives: Alcohol problems of parents have an influence on not only their psychological problems but also on their children's psychosocial adaptation. The purpose of this study was to compare the emotional and behavioral problems, including school bullying and social skills, between children of alcoholics (COAs) and children of non-alcoholics (non-COAs). Methods: We recruited $4^{th}$ grade children (n=741) from 7 primary schools in Seoul and their parents as subjects. The self-rated psychiatric symptoms were assessed with the Korean version of the Children of Alcoholics Screening Test (CAST-K), the Children's Depression Inventory (CDI), the Rosenberg's Self-esteem Scale (RSES), the School Bullying Scale, the Social Skill Rating Scale and the Korean version of Alcohol Expectancy Questionnaire-Adolescent (AEQ-A). The Attention-deficit Hyperactivity Disorder Rating Scale-IV (ARS) was completed by the parents. Results: 518 children were non-COAs and 223 were COAs. The COAs showed higher CDI and ARS-IV scores and lower RSES scores than the non-COAs. Especially, the COAs also showed higher school bullying scale scores and lower cooperative scale scores on the social skill rating scales. But there was no difference of alcohol expectancy between the COAs and non-COAs. Conclusion: It was plausible that the COAs had more behavioral & psychosocial problems than the non-COAs among the school aged children. It is important to identify and intervene to solve the problems of peer relationships of school age COAs in order to prevent victimization by bullying and to improve psychosocial adaptation.

• 생물정신의학
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• 제18권3호
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• pp.148-158
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• 2011

Objectives The eye movement (EM) has been reported to play a role in enhancing the retrieval of episodic memories and reducing effects of fearful episodes in the past and worries for the futures. However, it is still unclear in the mechanism of EM in normal subjects. We examined the horizontal eye movement (HEM) effect using an aiding apparatus on mental health indices including negative and positive psychological factors, and psychophysiological measures such as heart rate variability and quantitative electroencepaholography (qEEG) in healthy subjects. Methods Twenty eight healthy subjects were recruited and randomly allocated into two groups : active HEM group and control group. The active HEM group conducted the HEM training with usual stress management audio-intervention using the apparatus inducing eye movement once a day for 14 days. The control group also conducted the same training once a day for 14 days, however, the saccadic eye movement was not included in this training. Psychological measurements, neurocognitive function tests, heart rate variability measurement and qEEG were conducted before and after the training in both groups. Results In the active HEM group, sleep status using Sleep Quality Scale (SQS) positive factors significantly increased after the training. By contrast, scores on the negative items of Psychological Well-Being Scale (PWBS), and negative items of the Life Orientation Test-Revised (LOT-R) were significantly decreased after the training. The percentage of delta amplitude (1-3 Hz) in qEEG significantly decreased after the HEM training. The percentage of alpha amplitude (8-12 Hz) significantly increased after HEM training. The change of delta amplitude in the active HEM group was positively correlated with the change of sleep satisfaction of Visual Analogue Scale (VAS), and the change of alpha amplitude was negatively correlated with depression of VAS, anxiety of VAS and Beck Anxiety Inventory (BAI). Conclusions The HEM training improved sleep quality and well-being, and sense of optimism. The HEM training also increased alpha amplitude and decreased delta amplitude in qEEG. The qEEG changes were well correlated with subjective improvement of mental health indices in healthy subjects. These results suggest some evidences that HEM training using the apparatus that induces EM would be helpful in improving subjective mental health in healthy subjects. Further study with larger samples size would be needed.

• 생물정신의학
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• 제6권1호
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• pp.96-101
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• 1999

Background : Since dysthymia begins in late childhood or adolescence and has a chronic course, long-term pharmacotherapy may be required. New generation antidepressant, moclobemide, with more acceptable side effect profiles, is effective in the treatment of dysthymia. The main objective of this study was to determine whether they exhibit comparable efficacy and tolerability in dysthymia to amitriptyline. Method and Materials : The efficacy and tolerability of the moclobemide and amitriptyline, were compared in a eight-week single-centre double-blind study in patients(n=37) with dysthymia using he HAMD-17, the Clinical Global Impression Scale(CGI), the Montgomery-Asberg Depression Rating Scale (MADRS), Efficacy Index-Therapeutic Index(EITE), 4-point Index Side Effect Scale(4-PISES), and Efficacy Index- Side Effect Scale(EISE). Results : A total of 37 patients entered the study, 19 were randomly assigned to the moclobemide group and 18 to be amitriptyline group. Demo-graphic and illness characteristics were similar in both groups. There were no significant difference between two groups at the total 17-HDRS score, the HAMD-17% improvement, the total MADRS score, CGI response, and the EITE. In the comparison of EISE between two groups, the scores of the moclobemide group were relatively lower than the amitriptylinen group in full treatment. And the differences were significant(moclobemide group $1.39{\pm}0.61$ ; amitriptyline group $2.00{\pm}0.85$, p<.001). At the 4-PISE, There was no serious or treatment threatening side effects. And there was no specific difference in side effects between two groups. The moclobemide group reported higher EIR scores than the amitriptyline group at every follow up day, but the differences were not significant. And, there was no significant differences in the scores of five HRQOL subcategories which is compared between two groups at every follow up days. Conclusions : In terms of 17-HDRS and MADRS, moclobemide and amitriptyline are equally effective at least in allevating dysthymic symptoms. But moclobemide tended to be less troubling and better tolerated than amitriptyline. Therefore, moclobemide treatment can be used as a safe, and higher satisfactory treatment strategy for the dysthymia.

• 동의신경정신과학회지
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• 제3권1호
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• pp.25-45
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• 1992

Many phychiatrists have reported that the change of serotonin concentration would cause mental disorder and affect the pathological conditions such as schizophrenia, depression and eating behabior. The end product of serotonin metabolism was excreted as 5-HIAA in urine. Serum lipids, according to the report, were concerned with obesity, said it was. This study aims to observe the changes of plasma serotonin, urinary 5-HIAA and serum lipids, making use of Fat Cell Mass rate of 27 normal persons and 42 psychosomatic patients. For this, I also observed the change of serotonin, 5-HIAA and lipids of the psychosomatic patients by the use of 3 kinds of herbs as treatment medication on the basis of physical symptoms and the results were obtained as follows; 1. Urinary 5-HIAA is correlated with the body water rate(r=0.381), while reversely correlated with the Fat Cell Mass rate(r=-0.330). 2. Compared the control group with the patients group for the serum lipids value, they showed the significant results ; $146.4{\pm}5.71$ mg/dl and $166.9{\pm}6.56$ mg/dl in the total cholestrol value over- weights, $471.2{\pm}42.99$ mg/dl in the total lipid value, and $158.1{\pm}6.50$ mg/dl and $181.1{\pm}6.30$ mg/dl in the phospholipid of the obesity, respectively. 3. With comparison of each group to other group to the others for Fat Cell Mass rate, the total cholesterol showed the significant differences when the Fat Cell Mass rate was 20% or more, HDL-cholesterol value when 30% or more, and triglyceride when 30% or more, respectively. 4. there was significant variations in the relations between Fat Cell Mass rate and body water, which body mass index was increased as the body water was decreased. 5. Fat Cell Mass rate was correlated with Cholesterol(r = 0.420), triglyceride (r = 0.443), and $\beta$-lipoprotein(r = 0.450) of serum lipids, while reversely correlated with HDL -Cholesterol(r = -0.354) and urinary 5- HIAA had the correlation coefficient of -0.330. 6. What related with body water rate urinary 5-HIAA (r = 0.381) and $\beta$-lipoprotein(r = -0.405). 7. there were significant changes in the total cholesterol value and HDL-Cholesterol Value of serum lipids after dose of Ondamtang, significant increase in the 5-HIAA value after dose of Samulansintang, and significant devrease in the Trigylceride value of serum lipids after dose of Shihosogansan. As a result, it was seen that there was direct correlations among the Fat Cell Mass, urinary 5-HIAA, and serum lipids and stress from the mental conditions was not correlated directly to Serotonin, 5-HIAA, and serum lipids. I would like to conclude, therefore, that the detailed study should be performed on the function of serotonin of hypothalamus.

• 한국임상수의학회지
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• 제27권2호
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• pp.202-204
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• 2010

아가미 덮개 아래에 종괴를 가진 플라워혼이 서울의 사설 수족관에서 사육되다가 폐사 전 진단의뢰 되었다. 이 플라워혼은 무기력, 식욕부진, 침울 및 호흡곤란의 증상을 보인 후 폐사하였다. 종괴와 내장기관을 조직병리학적으로 조사한 결과, 갑상선에서 많은 양의 교질을 가진 다양한 크기의 낭포가 관찰되었고 간에서는 지방변성을 확인할 수 있었다. 본 증례는 플라워혼에서의 갑상선종 발생과 그것이 간에 미치는 영향을 보고하고자 한다.

• 한국인구학
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• 제29권2호
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• pp.167-194
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• 2006

Jesse Bernard(1973)와 Gove(1972)등이 결혼과 부모됨이 여성의 건강에 부정적인 영향을 미친다고 발표한 후, 성 차별성 관점은 극히 최근까지 서구는 물론이고 우리나라에서도 성과 가족 그리고 건강 문제를 바라보는 일반적인 관념으로 자리 잡아 왔다. 이후 가족 역할과 건강 그리고 성의 연계에 대한 다양한 논의들이 진행되어 왔지만, 실증 연구의 부재로 남녀 차이가 무엇이며, 그 차이는 어느 정도인지에 대한 정보는 매우 부족한 실정이다. 이 연구의 목적은 차별성 관점 이외의 다양한 관점들을 함께 살펴보면서, 현재 한국 사회에서 결혼을 하고 부모가 되는 일련의 가족 역할 수행 경험이 남성과 여성의 건강에 어떠한 영향을 미치고, 이러한 관련성에서 남녀 차이는 무엇인지, 어떠한 사회적 설명이 가능한지를 실증적으로 규명하는데 있다. 결혼 및 부모 지위의 점유가 남녀의 건강 문제에 갖게 되는 혜택과 비용을 알아보기 위해, 각 역할의 점유 여부의 조합 형태로 현재 수행하고 있는 가족 역할 유형을 알아보았고 각 유형별 신체 및 정신 건강을 비교하였다. 연구 결과, 남성과 여성 모두에서 결혼 지위와 부모 지위를 함께 가지고 있는 유형은 다른 어떤 역할 유형들(역할 없는 유형, 부모지위만 있는 유형, 결혼 지위만 있는 유형)보다 신체 정신 건강이 더 양호하였다. 성차도 발견할 수 있었는데, 결혼이나 부모 지위를 점유하지 않았을 때 취약해지는 건강의 차원이 성에 따라 달랐다. 또한 건강에 특별히 더 부담이 되는 역할 조합도 성에 따라 상이하였다.

• 대한한방소아과학회지
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• 제12권1호
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• pp.133-143
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• 1998

Myofascial pain syndrome is one of the pain syndrome resulted from myofascia which covered muscles and clinically characteristic feature by sensitive trigger point in skeletal muscles and referred pain reactivated by stimulating each trigger point. The origin of headache are local lesion such as head, chest, abdominal organ, systemic lesion with fever or in toxic state. the other factors are consciousness, personality, anxiety, depression, which cause muscle strain in physiological environment. The Oriental Medical therapy for headache has herb medication and acupuncture. especially acupuncture therapy has not only classical systemic acupuncture(體鍼) but also neo-acupuncture(新鍼) such as commonly using auricular acupuncture(耳鍼) and manual acupuncture (手鍼), recently trigger point acupuncture is used. The author analyzed 27 cases of patient with headache treated by trigger point acupuncture therapy in Dong-yu Oriental Medical Hospital from March 1st 1997 to February 28th 1998. The following results were obtained. 1. The sex ratio of the female was 59.26%(16 cases) and male was 40.74%(11 cases), the ratio of high school student was 62.96%(17cases) as first. 2. The headache duration ratio of 2-3 years was 37.04%(10 cases) as first, 1-2 years was 25.93%(7 cases) as second. 3. The portion ratio of whole headache was 33.33%(9 cases) as first, lateral headache was 29.63%(8 cases) as second 4. The combined symptoms ratio of anorexia was 40.74%(11 cases) as first, fatigue was 33.33%(9 cases) as second, neck stiffness and dizziness was each 25.93%(7 cases) as third. 5. The therapeutic duration ratio of below 1 week was 29.63%(8 cases) as first, 2-3 weeks was 22.22%(6 cases) as second, 1-2 weeks and 3-4 weeks was each 18.52%(5 cases) as third. 6. The ratio of family history was 11 cases(40.74%). mother with headache was 6 cases, father was 3 cases, and brothers & sisters was 2 cases. 7. The herb medication ratio of Chungsanggyuntongtang(淸上?痛湯) was 37.04%(10 cases), Kamiondamtang(加味溫膽湯) was 22.22%(6 cases), Hyangsapyunguisan(香砂平胃散) was 18.25%(5 cases) etc. 8. The remedial effect ratio of good was 25.93%(7 cases), fair was 48.15%(13 cases), not improved was 7.41%(2 cases), side effect was 3.70%(1 cases), and unknown was 14.81%(4 cases).

• 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.