• The Korean Journal of Physiology and Pharmacology
• /
• 제17권5호
• /
• pp.393-403
• /
• 2013

Baicalein (BA), a plant-derived active flavonoid present in the root of Scutellaria baicalensis, has been widely used for the treatment of stress-related neuropsychiatric disorders including depression. Previous studies have demonstrated that repeated restraint stress disrupts the activity of the hypothalamic-pituitary-adrenal (HPA) axis, resulting in depression. The behavioral and neurochemical basis of the BA effect on depression remain unclear. The present study used the forced swimming test (FST) and changes in brain neurotransmitter levels to confirm the impact of BA on repeated restraint stress-induced behavioral and neurochemical changes in rats. Male rats received 10, 20, or 40 mg/kg BA (i.p.) 30 min prior to daily exposure to repeated restraint stress (2 h/day) for 14 days. Activation of the HPA axis in response to repeated restraint stress was confirmed by measuring serum corticosterone levels and the expression of corticotrophin-releasing factor in the hypothalamus. Daily BA administration significantly decreased the duration of immobility in the FST, increased sucrose consumption, and restored the stress-related decreases in dopamine concentrations in the hippocampus to near normal levels. BA significantly inhibited the stress-induced decrease in neuronal tyrosine hydroxylase immunoreactivity in the ventral tegmental area and the expression of brain-derived neurotrophic factor (BDNF) mRNA in the hippocampus. Taken together, these findings indicate that administration of BA prior to the repeated restraint stress significantly improves helpless behaviors and depressive symptoms, possibly by preventing the decrease in dopamine and BDNF expression. Thus, BA may be a useful agent for the treatment or alleviation of the complex symptoms associated with depression.

• Journal of Yeungnam Medical Science
• /
• 제3권1호
• /
• pp.229-235
• /
• 1986

rat에 주사된 lithium 이온의 배설에 미치는 수종의 corticosteroid의 영향을 검색한 결과 다음과 같은 결론을 얻었다. 1. fludrocortisone을 10mg/kg 투여하여 혈청내 lithium 농도를 줄일 수 있었고, lithium의 뇨중 배설량도 증가시켰다. 2. dexamethasone을 0.1mg/kg 투여하여 혈청내 lithium 농도를 줄일 수 있었고, 1mg/kg을 투여하여 lithium의 뇨중 배설량도 증가시켰다. 3. dexamethasone에 의하여서는 혈중 $Na^+$의 $K^+$에 대한 농도비가 감소하였고, 반대로 뇨중 $Na^+$의 $K^+$에 대한 농도비가 감소하였다. 이상의 실험 결과를 미루어 corticosteroid는 lithium의 뇨중 배설량을 증가시키고 그 혈중 농도를 감소시킬 수 있으나, 이러한 작용은 신장을 통한 $Na^+$ 이나 $K^+$의 이동과는 전혀 상관이 없다고 생각된다.

• 동의신경정신과학회지
• /
• 제14권2호
• /
• pp.183-189
• /
• 2003

복합적 외상적 사건을 겪은 후 1년 이상 히스테리성 실성증으로 고통받아 온 전환장애 환자 1례를 TFT요법과 한방요법의 병행을 통해 성공적으로 치료하였기에 문헌고찰과 함께 보고하였다. 본 증례는 1년 이상의 이환기간을 가졌으며, 이환기간 동안 아들을 방화에 의한 타살로 잃은 외상성 사건을 경험했으며, 1년 동안의 약물치료를 통해 호전이 없어 부정적 정서와 자살충동이 있는 주요 우울장애가 병발된 예후가 좋지 않은 경우에 해당된다. TFT요법은 환자의 주소인 흉민을 해결하는 일차적 목표를 달성하였으며 이후 지속적인 한방요법에 대한 환자의 반응을 좋게 만들어 주었다. 입원 10일째 용천혈의 자침을 통해 환자의 말문이 열리기 시작하여 14일째 치료를 중단했다. 이후 3개월이 지난 추적 때까지도 유창한 언어를 구사하고 있었다.

• 생물정신의학
• /
• 제17권2호
• /
• pp.94-102
• /
• 2010

Objectives : Eye movement desensitization and reprocessing(EMDR) is a novel, time-limited psychotherapy originally developed for treatment of psychological trauma. The effectiveness of this therapy has been validated only for posttraumatic stress disorder ; however, EMDR is often applied to other psychiatric illnesses, including other anxiety disorders and depression. This pilot study tested the efficacy of EMDR added to the routine treatment for individuals with acute stage schizophrenia. Methods : This study was conducted in the acute psychiatric care unit of a university-affiliated training hospital. Inpatients diagnosed with schizophrenia were randomly assigned to either three sessions of EMDR, three sessions of progressive muscle relaxation(PMR) therapy, or only treatment as usual(TAU). All the participants received concurrent typical treatments(TAU), including psychotropic medication, individual supportive psychotherapy and group activities in the psychiatric ward. The Positive and Negative Syndrome Scale(PANSS), the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale were administered by a clinical psychologist who was blinded to the patients' group assignment. Results : Forty-five patients enrolled and forty patients(89%) completed the post-treatment evaluation. There were no between-group differences in the withdrawal rates of patients during the treatment or at the three-month follow-up session. All three groups improved significantly across each of the symptomatic domains including schizophrenia, anxiety, and depressive symptoms. However, a repeated measures ANOVA revealed no significant differences among the groups over time. Effect size for change in total PANSS scores was also similar across treatment conditions, but effect size for negative symptoms was large for EMDR(0.60 for EMDR, 0.39 for PMR and 0.21 for TAU only). Conclusion : These findings supported the use of EMDR in treating the acute stage of schizophrenia but the results failed to confirm the effectiveness of the treatment over the two control conditions in three sessions. Further studies with longer courses of treatment, more focused target dimensions of treatment, and a sample of outpatients are necessary.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제3권1호
• /
• pp.97-105
• /
• 1992

본 연구에서는 여러 소아정신과 장애를 보이는 아동들의 모(母)의 MMPI 프로파일 유형을 비교, 분석함으로써 모(母)의 성격 특성이나 심리적 문제와 아동의 정신과적인 장애간의 관계를 알아보고자 하였다. 서울대학 병원 소아정신과를 방문한 아동들을 그들이 보이는 문제 행동의 유형에 따라 내면화중상 집단(n=35), 외현화증상 집단(n=35), 발달 장애 집단(n=21)으로 분류한 후, 이러한 임상 집단의 모(母)들과 정상 아동 집단의 모(母)들(n=20)이 본 연구의 피험자로 사용되었다. 4집단의 모(母)들의 MMPI결과를 5가지 프로파일 유형(정상, 우울증, 불안 장애, 신체화 장애, 성격장애)으로 분류하여 아동의 진단과 틀의 MMPI 프로파일 유형간의 관계를 알아본 결과, 아동의 진단과 모(母)의 MMPI프로파일 유형간에 유의미한 관계가 있었다. 정상 아동들의 모(母)는 대부분 정상 프로파일을 보인 반면, 임상 집단의 모(母)들은 아동의 진단과는 관계없이 통계적으로 유의미한 수준에서 우울증을 시사하는 프로파일을 많이 보였고, 외현화증상 집단의 모(母)들이 내면화 증상 집단의 모(母)보다 더 불안 장애 프로파일을 많이 보였다. 이러한 결과는 아동의 정신과적인 문제와 모(母)의 심리적 장애간에 관련이 있음을 시사하는 것으로, 아동과 모(母)의 부정적인 상호작용이 서로의 심리적인 적응에 해로운 영항을 주었을 가능성이 논의되었고, 정신병리에 대한 연구에서 부모가 아동의 적응에 미치는 영향뿐만 아니라 아동의 문제가 모(母)의 심리적 적응에 미치는 특별한 영향도 살펴볼 필요가 있음이 시사되었다.

• 대한불안의학회지
• /
• 제6권1호
• /
• pp.45-54
• /
• 2010

본 연구는 이천시에 거주하는 65세 이상의 인구를 대상으로, 우울증의 유병률과 자살경향성, 우울증과 자살경향성에 영향을 미치는 위험요인을 살펴본 연구이다. 전체적으로 우울증의 유병률은 28% 정도로 파악되어 실제로 65세 이상의 연령대에서 상당수의 노인들이 임상적으로 의미 있는 우울증을 경험하고 있는 것으로 관찰되었다. 또한 자살경향성은 전체 조사대상자의 약 20%에서 자살생각, 자살의도, 자살계획, 자해의도, 자살시도 중 한 가지 이상을 지난 한 달 동안 경험했던 것으로 나타났다. 거주 형태별로 구분하여 비교 분석한 결과, 혼자 생활하거나 시설에서 생활하는 노인들에서 동거가족이 있는 노인들보다 우울증의 유병률이 높고, 증상도 심한 것으로 나타났으며, 이들에게서 자살경향성 역시 높은 것으로 파악되어 이들 고위험군에 대한 보다 집중적인 우울증의 조기 발견 및 자살예방사업이 필요할 것으로 판단되었다. 위험요인 분석에서는 고령, 시설거주, 낮은 사회적 지지 수준은 우울증의 위험요인으로, 독거생활, 시설거주, 낮은 사회적 지지 수준, 두통의 기왕력은 자살경향성의 위험요인인 것으로 파악되었다.

• 대한불안의학회지
• /
• 제4권1호
• /
• pp.42-48
• /
• 2008

현재 PTSD와 관련한 여러 병태생리 기전들이 밝혀지고 있으며 이에 초점을 둔 다양한 약물치료가 행해지고 있다. 본 연구에서는 일 대학병원에서 PTSD로 진단된 환자들의 의무기록을 검토하여 약물치료의 경향에 대해 알아보았다.1998년 1월부터 2007년 12월까지 DSM-IV에 의해 PTSD로 진단된 입원 환자 75명이 대상군이 되었으며, 이들의 인구학적 요인들, 입원기간, 외상의 종류, 외상 후 경과시간 및 정신과적 공존병리 및 처방 받은 약물을 조사하였다. 조사 결과, 75명 중 남자는 33명, 여자는 42명이었다. 정신과적 공존병리는 총 50명(66.7%)에서 존재하였으며, 우울장애, 인지장애, 정신장애 및 불안장애 순이었다.73명(97%)의 대상군은 항우울제를 처방 받았으며, 그 중 paroxetine이 54.7%로 가장 많았고 두 가지 이상의 항우울제를 처방 받은 경우도 24%였다. 또 거의 대부분의 환자에서 비정형 항정신병약물(33.3%), 기분안정제(17.3%),항불안제(94.7%)가 항우울제와 병용 처방된 것으로 조사되었다. 여러 제한점에도 불구하고 본 연구에서 얻어진 약물 처방 경향은 향후 국내 실정에 맞는 치료 지침을 수립하는 데에 하나의 근거 자료가 될 수 있을 것이다.

• 대한불안의학회지
• /
• 제14권2호
• /
• pp.88-98
• /
• 2018

Objective : The purpose of this study was to establish a school-based mental health intervention. The success of which was indexed by its effects on the social anxiety symptoms of the enrolled adolescents. Methods : This program for promoting mental health among adolescents in the community was adopted by three middle schools that volunteered to participate in the project. The program included screening for emotional problems related to social anxiety, depression, suicide, and post-traumatic stress disorder. Case management was provided for groups considered high-risk for depression, suicide, or post-traumatic stress disorder; cognitive-behavior therapy was provided for those at high-risk of developing social anxiety. Additionally, educational programs for the prevention of suicide, a "loving life" module, and mental health promotional campaigns were also included. In total, 1,100 middle school students completed self-report questionnaires. Twenty-five students in the high-risk group for social anxiety participated in a cognitive-behavior therapy program, comprising eight sessions, and conducted by two clinical psychologists. Results : Following the suicide prevention education program, suicide awareness among students increased and coping strategies were improved. In addition, the loving life program was associated with positive self-perceptions by many students. Furthermore, social anxiety symptoms showed a statistically significant difference after the cognitive-behavior therapy program. After the therapy, not only did social anxiety symptoms improve, depressive symptoms and suicidal ideation decreased significantly, while self-esteem and psychological resilience significantly increased. Conclusion : A school-based mental health intervention was successfully implemented in three middle schools and improved the mental health of the participating students. Therefore, this intervention could be widely implemented to promote positive mental health among middle school students.

• 생물정신의학
• /
• 제25권4호
• /
• pp.118-124
• /
• 2018

Objectives Although impulsivity has long been thought as an important factor influencing suicidal behaviors, it is unknown whether impulsivity increases the risk of dying from suicidal behaviors and what specific component among constructs of impulsivity contributes to the risk of dying among suicide attempters. Methods To elucidate the association between impulsivity and medical lethality of suicide attempt among suicide attempters, we consecutively recruited 46 suicide attempters who visited an emergency room of a general hospital located in a metropolitan area, Seoul, Republic of Korea, due to suicide attempts and consented to participate in this study. Then we assessed medical lethality with the Beck Lethality Scale (LS) and impulsivity with the Korean version of the Barratt Impulsiveness Scale-11-Revised (BIS). Demographic variables were obtained from medical records and structured social work reports for suicide attempters. Results Although total scores of the BIS did not correlate with LS scores, only the scores of self-control, that is one of the Barrett's six theoretical constructs of impulsivity in which the higher score indicates less self-control and more impulsivity, had a significant positive correlation with scores of LS (p = 0.003). The association remained significant after adjusting for variables known to affect suicide lethality such as job status, recent alcohol consumption, diagnosis of depressive disorders, and having a plan for suicide (${\beta}=0.429$, p = 0.009). Conclusions Not impulsivity in general, but poor self-control, in particular, predicts lethal suicidal behaviors among suicide attempters. The degree of self-control should be evaluated when assessing patients with elevated suicide risk, and proper measures should be installed to prevent possible future lethal suicide attempts.

• 보건행정학회지
• /
• 제29권2호
• /
• pp.105-111
• /
• 2019

On December 31, 2018, an incident occurred where a doctor was attacked and killed by a patient carrying a lethal weapon in the outpatients' clinic of the psychiatric department of a tertiary general hospital. The suspect was diagnosed with bipolar affective disorder (manic depressive disorder) and has been hospitalized and cared for in the psychiatric ward of this hospital. This incident illustrates the necessity of more active cures and therapeutic intervention for mental patients with intellectual developmental disorders who require treatment considering the fact that a radical outcome has been caused by such a patient. However, on the other hand, there is also a need for an approach and analysis from the perspective of crime prevention for all medical departments. The reason for this is that even a tertiary general hospital equipped with the largest human resources, medical devices, facilities, and so forth, is susceptible to violence. As for illegal actions perpetrated against health and medical service personnel in medical institutions, such as verbal abuse, assault, injury, etc. there have neither been understanding shown for the current extent of damage in detail, nor discussions of active institutional improvement related to the seriousness of the act. It can be said that violence in the field of medical treatment is a realm requiring serious discussion and appropriate remedial actions. This is because when such incidents take place, if a patient who is supposed to get treatment from the damaged health care provider is in an urgent situation or on the waiting list of serious cases, he or she could suffer serious damage caused by deprivation of treatment opportunity, or secondary damage might be caused to the patient and/or a guardian who can hardly have an opportunity to take action. Accordingly, in this review, we would like to help create the necessary conditions for both health and medical service personnel and patients/guardians, respectively, to provide and receive medical treatment in a more secure environment. Therefore, objective assessment of the institution and issues relating to this aforementioned incident and general cases of violence occurring in medical institutions, and by suggesting legal and institutional improvements and solutions.