• 정신신체의학
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• 제11권2호
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• pp.137-148
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• 2003

연구목적: 비만클리닉에 내원한 여성들을 대상으로 식이제한 태도 및 우울증상, 스트레스 등 심리적인 문제들에 대한 특성을 파악하고 비만과의 상관관계를 조사하고자 본 연구를 시행하였다.방 법: 2001년 5월 한 달 동안 아주대학교병원과 서울 시내에 소재한 비만 클리닉에 내원한 여성 150명을 대상으로 사회인구학적 특성 및 신체적 특성, Three Factor Eating Questionnaire, Symptom Check List-90-R(SCL-90-R), 스트레스 인지척도 등을 설문 조사하였고 저자가 Hamilton Depression Rating Scale를 측정하였으며, 이 중 설문지의 답을 충실히 기입한 116명을 대상으로 하였다. 결 과: 연구대상 중 체질량지수 $25.0kg/m^2$ 이상인 비만군은 50.0%였으며, 연령이 증가함에 따라 체질량지수가 증가하였다(p<0.001). 정상이하 체중군에서 미혼인 경우가 48.8%로 비만군 13.8%에 비해 유의하게 높았으며(p<0.01), 흡연률 및 음주율과 체질량지수와는 유의한 관계가 없었다. Three Factor Eating Questionniare는 체질량지수와 체지방과 비교해 볼 때 유의한 차이를 보이지 않았으나, Factor 2(Disinhibition)와 Global Severity Index(r=0.27, p<0.01), Factor 3(Hunger)과 Global Severity Index(r=0.24, p<0.01)와는 각각 유의한 상관관계가 있었다. 체질량지수에 따른 Symptom Check List-90-R의 각 증상척도는 편집증 척도만이 과체중군과 비만군 간에 통계적으로 유의한 차이가 있었다(p<0.05). 대상군 모두 Symptom Check List-90-R의 전체 척도가 50점 이하였으나 각 증상척도는 정상이하 체중군과 비만군이 과체중군에 비해 높은 경향이 있었다. Global Severity Index와 Hamilton Depression Rating Scale(r=0.75, p<0.01), Global Severity Index와 스트레스 인지척도(r=0.32, p<0.01) 간에 각각 유의한 상관관계가 있었다. Hamilton Depression Rating Scale를 체지방 정도에 따라 정상군과 비만군 두 군으로 나누어 비교한 결과 비만군에서 우울증상이 유의하게 높았다(p<0.05). 스트레스의 정도는 체질량지수 및 체지방과 유의한 차이가 없었고 대상군 모두 높은 스트레스를 느끼고 있는 것으로 나타났으며, 스트레스 인지척도가 Factor 2(r=0.29, p<0.01) 및 Factor 3(r=0.37, p<0.01)과 유의한 상관관계가 있는 것으로 보아 스트레스가 식이제한 태도에 영향을 미치는 것으로 생각된다. 또한, 스트레스 인지척도가 Symptom Check List-90-R 중 우울척도, Global Severity Index 및 Hamilton Depression Rating Scale와도 유의한 상관관계가 있는 것으로 보아 스트레스가 심리적인 특성에 영향을 미치는 것으로 생각된다(r=0.33, r=0.32, r=0.34, p<0.01). 결 론: 비만한 사람들은 우울을 비롯한 심리적 고통을 더 많이 가지며 스트레스 점수가 높고, 이는 식이제한 태도와도 관계가 있을 것으로 생각된다. 향후 비만클리닉을 방문하는 사람들의 정신과적 문제에 대한 적극적인 평가 및 정신과적 개입이 필요할 것으로 생각된다.

• 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.

• 정신신체의학
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• 제21권2호
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• pp.132-139
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• 2013

연구목적 본 연구는 갑상선암 환자에서 인지장애의 발생 빈도와 이에 관계되는 변인을 규명하기 위하여 시행되었다. 방 법 갑상선암으로 진단받고 갑상선전절제술 받은 지 6~12개월 후, 방사성요오드 잔여갑상선제거술을 받기 위해서 입원한 환자 42명을 대상으로 개인력, 병력조사와 우울지수 및 인지기능(Korean Version of the Montreal Cognitive Assessment, 이하 MoCA-K)의 평가를 시행하였다. 결 과 1) 대상 환자 중 MoCA-K 총점이 22점 이하인 환자는 21명(50.0%)이었다. 2) 나이, 교육수준, 방사성 요오드 치료 전 갑상선자극호르몬 농도는 MoCA-K 총점 23점 이상군과 MoCA-K 총점 22점 이하군 간에 통계적으로 유의한 차이가 있었다. 3) MoCA-K 총점과 통계적으로 유의한 연관성이 있는 변인은 나이, 교육수준, 병행질환, 방사성 요오드 치료 전 갑상선자극호르몬 농도, HDRS-17 총점이었다. 결 론 갑상선절제술 후 방사성 요오드 치료를 받기 전 갑상선암 환자에서 인지장애는 50%에서 있었다. 추후, 치료과정의 갑상선암에서 인지장애의 기전을 규명하기 위한 연구가 더 필요하며, 치료 과정의 환자에서 인지장애의 인식과 예방 대책이 요구된다.

• 동의신경정신과학회지
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• 제29권4호
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• pp.305-314
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• 2018

Objectives: The objective of this study was to report the clinical effectiveness of the complex Korean medicine therapy and M&L (Mindfulness & Loving presence) psychotherapy on the patient with panic disorder. Methods: The subject for this study was the patient diagnosed with panic disorder who complained about intermittent panic attack and accompanying insomnia. During the treatment period, the patient received complex Korean therapy and M&L psychotherapy. The clinical effects were evaluated through Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS), State-Trait Anxiety Inventory (STAI), Panic Disorder Severity Scale (PDSS), and Pittsburgh Sleep Quality Index (PSQI). Results: After the complex Korean medicine therapy and M&L psychotherapy, the overall symptoms of depression, anxiety, panic disorder and insomnia of the patient were lessened in a relatively short period. No specificities or adverse effects were reported during the treatment period. Conclusions: This study established that the complex Korean medicine therapy and M&L psychotherapy was effective in treating patients with panic disorder.

• 생물정신의학
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• 제2권1호
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• pp.70-76
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• 1995

A few researchers have reported that major depression may be associated with higher levels of positive acute phase proteins(APPs), such as haptoglobin(Hp), ${\alpha}1$-antitrypsin(${\alpha}1AT$), ceruloplasmin(Cp) and lower levels of negative APPs(visceral proteins), such as albumin(Alb) and transferrin(Tf). Elevated levels of positive APPs and a drop in negative APPs constitute important indicators of immune activation. This study was designed to investigate whether altered serum concentrations of positive APPs and of negative APPs reflect the state of depression. Twenty patients who fulfilled DSM-III-R criteria for major depressive disorder and for dysthymic disorder and twelve normal healthy controls were included. The authors measured positive APPs(Hp, ${\alpha}1AT$, Cp) and negative APPs(Alb, Tf) using rate nephelometry and bromcresol green method. 1) There were significant increases of ${\alpha}1AT$, Cp in major depressed patients as compared with normal controls. Trends towards higher Hp and lower Alb, Tf in major depressed patients were observed. 2) No significant difference of APPs concentrations between dysthymic patients and normal controls was found. 3) Severity of depression(HDRS, BDI score) was related to Hp, Cp, ${\alpha}1AT$ value positively. Our findings are partially compatible with the hypothesis that major depression may be accompanied by acute phase response with higher levels of positive APPs and lower levels of negative APPs.

• 대한한방내과학회지
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• 제35권2호
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• pp.145-156
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• 2014

Objectives : The aim of this study was to compare Tianwangbuxin-dan to Fluoxetine for antidepressive efficacy and safety in poststroke depression (PSD). Methods : A randomized, double blinded, non-inferiority trial was conducted. 113 PSD patients were recruited from a stroke center. Except for the 25 excluded patients, 88 PSD patients were randomly given either Tianwangbuxin-dan 1100 mg or Fluoxetine 20 mg per a day for 16 weeks. PSD was evaluated using Beck's depression inventory (BDI) and Hamilton depression rating scale (HDRS) and followed every fourth week. Repeated measure analysis of variance (ANOVA) was used to compare and contrast the depression scores of the two groups and to compare them among the evaluation times, at the beginning, $4^{th}$, $8^{th}$, $12^{th}$ and $16^{th}$ weeks. In addition, independent t-tests were used to find the difference between two groups at every evaluation time. Results : Finally, 88 PSD patients were included in the study, 63 PSD patients completed the procedure and 25 PSD patients were dropped out by the incompliance or withdrawal of consent. Tianwangbuxin-dan (or Fluoxetine) improved the depression of stroke patients and the efficacy of Tianwangbuxin-dan was not inferior to that of Fluoxetine. In addition, there was no significant side effect in two groups. Conclusions : This study showed that antidepressive efficacy and safety of Tianwangbuxin-dan in PSD patients.

• 생물정신의학
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• 제13권2호
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• pp.95-102
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• 2006

Object : Nerve growth factor(NGF) is a protein involved in neuronal survival and plasticity in the central nervous system, which might play an important role in stress, depression and suicide. This study was performed to determine whether there is an alteration in plasma NGF concentrations in depressed patients with suicidal attempt. Methods : The subjects were 32 depressed patients who attempted suicide and admitted in emergency room. Forty-four hospitalized non-suicidal depressive patients and the 30 normal controls were closely matched with the suicidal group in terms of age and sex. Individuals in all 3 groups were evaluated independently by a semi-structured interview for the purpose of establishing a DSM-IV criteria diagnosis. The severity of depressive symptoms was evaluated using Hamilton depression rating scale(HDRS). The severity of the suicidal behavior was evaluated by Weisman and Worden's risk-rescue rating(RRR) system and the Lethality Suicide Attempt Rating Scale(LSARS). Plasma NGF level was measured by the enzyme linked immunosorbent assay(ELISA) method. Results : There were no statistically significant differences of the plasma NGF levels among groups. LSARS and RRR did not reveal any significant correlation with ${\beta}$-NGF level in suicidal depressive patients. Conclusion : This study do not support an association between ${\beta}$-NGF and suicidal depression. However it is necessary to investigate this association through other route such as postmortem brain.

• 생물정신의학
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• 제14권1호
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• pp.42-47
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• 2007

Objectives : Studies have reported differences between depressed adults and controls in quantitative measures of EEG alpha asymmetry, but, there are few using Korean subjects. So, the present study compared EEG regional alpha asymmetries of patients having major depressive disorder(MDD) and normal controls. Methods : The subjects in this study were 11 unmedicated unipolar depressed patients and 11 non-depressed, age matched controls. Resting EEG(eyes closed and eyes open) was recorded from each participant using 8 scalp electrodes. Beck Depression Inventory(BDI), 17-item Hamilton Depression Rating Scale(HDRS), Zung's Self-Rating Depression Scale(SDS) and Spielberger's State-Trait Anxiety Inventory(STAI) were used to evaluate depression and anxiety symptoms. Results : The severities of depression measured by self-report questionnaires were positively associated with those of anxiety(state and trait) ; The subjects were both anxious and depressed. Anxious-depressed patients differed from controls in alpha asymmetry at T4 channels. They showed evidence of greater activation over right than left temporal site. Conclusion : These findings are consistent with the previousely reported alpha asymmetry of depressed patients with an anxiety disorder. The failure to find the evidence of reduced right parietal activity in depression is presumed to be due to opposing effects of comorbid anxiety on parietotemporal activity.

• 대한불안의학회지
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• 제10권2호
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• pp.115-127
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• 2014

Objective : Existing depression rating scales do not fully reflect depressed patients' perspective of remission, which goes beyond symptom resolution. The Remission from Depression Questionnaire (RDQ) captures a broader array of domains, and the present study examines the reliability and validity of the Korean Version of the RDQ (K-RDQ). Methods : The test-retest reliability of the K-RDQ was studied in 60 depressed patients and 30 normal subjects working at a university hospital. Subjects were evaluated at baseline and again 1-2 weeks later. The validity of the K-RDQ was studied in 200 depressed patients who were rated on the 17-item HDRS and the CGI-S ; each patient also completed the QIDS-SR, STAI-S, GHQ/QL-12, and SDS. Results : The K-RDQ demonstrated excellent internal consistency, with a Cronbach's ${\alpha}$ of 0.965 for the total scale and above 0.80 for each of the 7 subscales. The test-retest reliability of the total scale was 0.951. Mean K-RDQ scores ($45.79{\pm}18.65$) of the depressed patients were significantly higher than those ($15.87{\pm}10.60$) of the mentally healthy subjects (t=12.8, p<0.001). Five factors from the K-RDQ were extracted by principal axis factoring with equimax rotation. Conclusion : These results indicate that the K-RDQ is a reliable and valid measure that evaluates multiple domains that depressed patients consider important in determining remission. Thus, the K-RDQ maybe considered an appropriate tool for use in the clinical setting.

• 생물정신의학
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• 제12권2호
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• pp.189-195
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• 2005

Objects:Some studies have suggested that brain-derived neurotrophic factor(BDNF), one of the most important neurotrophins, is involved in pathophysiology of depression and suicide. This study was performed to determine whether there is an abnormality in plasma BDNF concentration in suicidal attempters. Methods:The subjects were 71 suicidal attempters who visited emergency rooms in multi-medical centers. All subjects had been interviewed by using Structured Clinical Interview for DSM-IV(SCID), Hamilton Depression Rating Scale(HDRS), Young Mania Rating Scale(YMRS), and Positive And Negative Syndrome Scale(PANSS). The severity of the suicidal behavior was measured by Lethality of Suicide Attempt Rating Scale(LSARS) and Risk-Rescue Rating(RRR) system. Seventy-one age, sex, and diagnosis matched non-suicidal psychiatric patients who were consecutively admitted to a psychiatric ward during the same period recruited as psychiatric controls. They were drug-naive or drug-free at least more than 2 months. In addition, 80 healthy controls were randomly selected as normal controls. Plasma BDNF level was measured by the enzyme linked immunosorbent assay(ELISA) methods. Results:In overall F-test, differences of the plasma BDNF levels among the groups were statistically significant(F=20.226, p<0.001). In the multiple comparisons(Scheffe), while mean levels of plasma BDNF between normal controls and non-suicidal psychiatric patients were similar(p=0.984), the BDNF levels of suicidal attempters were lower than those of other two groups(p<0.001). LSARS and RRR did not reveal any significant correlations with BDNF levels in suicidal attempters. Conclusion:These results suggest that reduction of plasma BDNF level is related to suicidal behavior and BDNF level may be a biological marker of suicidal behavior.