• 생물정신의학
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• 제12권2호
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• pp.181-188
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• 2005

Objectives:Hwa-byung has been studied clinically for several years and introduced as Korean Culture- Bound Syndrome. However, the definition and the diagnostic method are not yet clarified, and there has not been any sufficient comparative study on this disease entity. This study was conducted to determine the clinical symptoms and the profile of the neurocognitive functions in Hwa-byung(HB) and Major Depressive Disorder(MDD), and We wish to identify any critical factors that differentiate the disorders. Methods:A total of 102 participants were examined, including 34 participants with MDD, 34 with HB, and 34 healthy controls. The MDD and HB patients were recruited from among inpatients and outpatients at the National Medical Center for the period from May to December of 2004. As a major diagnostic tool of MDD, diagnostic reference of DSM-IV-TR was used and as HB's diagnostic tool, We used computerized neurocognitive function test. Psychiatric symptomatology was evaluated by the Beck Depression Inventory(BDI), and Symptom Checkist-90-Revision(SCL-90-R). Oneway ANOVA, Scheffe post-hoc test and Chi-Squre Tests were used for statistical analysis. Results:The participants in three groups did not differ in terms of age, sex, and education. Assessment of BDI indicated that the MDD group had significantly higher total score than the HB group. MDD and HB groups showed significantly higher total scores on the SCL-90-R in comparison to the controls. The MDD group was found to have significantly more symptoms of depression than the HB group, based on the depression subscale of the SCL-90-R. The computerized neurocognitive function test suggest several results 1) Within the memory domain, it was found that one of the two memory tests in MDD and HB groups were significantly impaired in comparison to the control group. 2) Within the attention domain, it was found that only the MDD group was significantly impaired in comparison to the control group. 3) Within the higher cortical function domain, it was found that significant impairment exist in MDD group and HB group compared to the control group; the severity of impairment was found to be more profound in the MDD group than in the HB group. Conclusion:These results suggest that both HB group and MDD group have significantly decreased neurocognitive function than the control group, and neurocognitive function of the HB group is better than that of the MDD group.

• 생물정신의학
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• 제12권2호
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• pp.207-215
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• 2005

Objectives:This study was to compare verbal memory ability among patients with schizophrenia, bipolar manic patients and unipolar depressive patients, and to understand their charicteristics of memory process. Methods:All subjects were hospitalized patients and had been interviewed by using the Structured Clinical Interview for DSM-IV(SCID). Schizophrenic patients(N=40), bipolar manic patients(N=17), and unipolar depressive patients(N=20) were assessed with K-AVLT for verbal memory and with K-WAIS for verbal IQ. Three groups were compared regarding total immediate recall, delayed recall, delayed recognition, learning curve, memory retention, and retrieval efficiency under controlled verbal IQ. Multiple regression analysis was performed to find which clinical factors have an influence on verbal memory ability. Results:In MANCOVA, differences of verbal memory test scores among the groups were statistically significant(F=1.800, p<.05). In post hoc analysis, Patients with schizophrenia and bipolar mania showed poorer performance in immediate recall, delayed recall, delayed recognition, retrieval efficiency than unipolar depres- sive patients. And schizophrenics performed poorly in delayed recall, delayed recognition, retrieval efficiency than nonpsychotic affective disorder group, but no difference in total immediate recall, delayed recall, delayed recognition, retrieval efficiency between the schizophrenic group and the psychotic affective group. Conclusions:These results partially confirm previous reports of verbal memory ability among major psychiatric disorders. Our results showed that psychotic symptoms were related with verbal memory, and longer duration of illness was related with poorer performance in schizophrenia and unipolar depression.

• 정보관리학회지
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• 제33권1호
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• pp.53-84
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• 2016

이 연구는 한국의 정신의학 분야 국제공동연구 활성화를 위하여, 네트워크 분석에 중점을 두어 정신의학 분야 국제공동연구의 핵심 연구동향을 반영하는 지적구조를 규명하였다. 이를 위해 데이터는 Web of Science를 기반으로 수집하였으며, 검색 대상 기간은 2009년에서 2013년까지로 하였다. 고급검색 기능을 통해 정신의학 연구 분야를 의미하는 SU="psychiatry"의 검색 식을 사용하였으며, 국제공동연구만을 선택해 총 18,590건의 논문을 수집하였다. 총 18,590건 논문의 저자 키워드와 WoS에서 부여한 키워드를 합쳐 최종 선정된 85개 키워드를 대상으로 분석한 결과는 다음과 같다. 첫째, 질환을 중심으로 총 8개의 세부 주제 영역을 확인하였다. 둘째, 높은 영향력을 가지며 다른 키워드들 간의 매개를 도모하여 주제영역을 확장시키는 총 6개의 핵심 키워드를 확인하였다. 셋째, 커뮤니티 분석을 통해 한국연구재단의 학문분류표를 이용하여 세부 주제영역으로 규명한 결과 총 15군집, 총 12세부 주제영역을 확인하였다.

• 생물정신의학
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• 제22권4호
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• pp.216-222
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• 2015

Objectives The principal aim of the present study was to investigate the characteristic depressive symptoms in patients with social anxiety disorder (SAD) and panic disorder in comparison to patients with depressive disorder. Methods This study included 132 patients with SAD, 128 panic disorder and 64 depressive disorder (major depressive disorder, dysthymia etc.) patients without comorbid psychiatric disorders. The Beck Depressive Inventory (BDI) is used to measure depressive symptoms. We divided BDI into three categories originally described by Shafer AB, including negative attitude toward self, performance impairment, and somatic symptoms. We compared the depressive symptoms of SAD, panic disorder and depressive disorder by using ANOVA. Results Negative attitude toward self was noticeable in SAD (SAD $0.54{\pm}0.23$, panic disorder $0.41{\pm}0.17$, depressive disorder $0.46{\pm}0.11$, p < 0.001). Performance impairment and somatic symptoms were remarkable in panic disorder than in SAD and depressive disorder (performance impairment : SAD $0.39{\pm}0.21$, panic disorder $0.44{\pm}0.14$, depressive disorder $0.40{\pm}0.09$, p = 0.009 ; somatic symptoms : SAD $0.07{\pm}0.10$, panic disorder $0.15{\pm}0.12$, depressive disorder $0.14{\pm}0.08$, p < 0.001). Conclusions The results facilitate an approach to optimal treatment for patients with comorbidity of anxiety disorder and depression.

• IMMUNE NETWORK
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• 제11권1호
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• pp.11-41
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• 2011

The discovery of microRNA (miRNA) is one of the major scientific breakthroughs in recent years and has revolutionized current cell biology and medical science. miRNAs are small (19~25nt) noncoding RNA molecules that post-transcriptionally regulate gene expression by targeting the 3' untranslated region (3'UTR) of specific messenger RNAs (mRNAs) for degradation of translation repression. Genetic ablation of the miRNA machinery, as well as loss or degradation of certain individual miRNAs, severely compromises immune development and response, and can lead to immune disorders. Several sophisticated regulatory mechanisms are used to maintain immune homeostasis. Regulatory T (Treg) cells are essential for maintaining peripheral tolerance, preventing autoimmune diseases and limiting chronic inflammatory diseases. Recent publications have provided compelling evidence that miRNAs are highly expressed in Treg cells, that the expression of Foxp3 is controlled by miRNAs and that a range of miRNAs are involved in the regulation of immunity. A large number of studies have reported links between alterations of miRNA homeostasis and pathological conditions such as cancer, cardiovascular disease and diabetes, as well as psychiatric and neurological diseases. Although it is still unclear how miRNA controls Treg cell development and function, recent studies certainly indicate that this topic will be the subject of further research. The specific circulating miRNA species may also be useful for the diagnosis, classification, prognosis of diseases and prediction of the therapeutic response. An explosive literature has focussed on the role of miRNA. In this review, I briefly summarize the current studies about the role of miRNAs in Treg cells and in the regulation of the innate and adaptive immune response. I also review the explosive current studies about clinical application of miRNA.

• The Korean Journal of Physiology and Pharmacology
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• 제27권1호
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• pp.113-125
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• 2023

It has been reported that stressful events in early life influence behavior in adulthood and are associated with different psychiatric disorders, such as major depression, post-traumatic stress disorder, bipolar disorder, and anxiety disorder. Maternal separation (MS) is a representative animal model for reproducing childhood stress. It is used as an animal model for depression, and has well-known effects, such as increasing anxiety behavior and causing abnormalities in the hypothalamic-pituitary-adrenal (HPA) axis. This study investigated the effect of MS on anxiety or aggression-like behavior and the number of GABAergic neurons in the hippocampus. Mice were separated from their dams for four hours per day for 19 d from postnatal day two. Elevated plus maze (EPM) test, resident-intruder (RI) test, and counted glutamic acid decarboxylase 67 (GAD67) or parvalbumin (PV) positive cells in the hippocampus were executed using immunohistochemistry. The maternal segregation group exhibited increased anxiety and aggression in the EPM test and the RI test. GAD67-positive neurons were increased in the hippocampal regions we observed: dentate gyrus (DG), CA3, CA1, subiculum, presubiculum, and parasubiculum. PV-positive neurons were increased in the DG, CA3, presubiculum, and parasubiculum. Consistent with behavioral changes, corticosterone was increased in the MS group, suggesting that the behavioral changes induced by MS were expressed through the effect on the HPA axis. Altogether, MS alters anxiety and aggression levels, possibly through alteration of cytoarchitecture and output of the ventral hippocampus that induces the dysfunction of the HPA axis.

• 정신신체의학
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• 제10권2호
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• pp.154-165
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• 2002

목적: 입원 치료 중인 항암제 투여 환자의 우울 양상을 알아보기 위해 본 연구를 시행하였다. 방법: 2001년 11월부터 12월까지 영남대학교 의과대학 부속병원 종양내과에 입원한 대상으로 Beck's depression inventory(이하 BDI), Zung's depression scale (이하 ZDS), Hamilton depression scale(이하 HDS)을 시행하였고 정신과적 면담을 통해 축 I 질환을 진단하였다. 결과: 대상군에서 각 우울 척도의 평균 접수는 BDI 18.27${\pm}$7.73, ZDS 36.51${\pm}$10.82, HDS 15.14${\pm}$6.60으로 나타났다. 성별, 결혼상태, 종교에 따른 우울척도의 차이는 나타나지 않았다. 대상은 위암 13명, 폐암 11명, 혈액종양 10명, 기타 종양 3명(자궁암 2명, 두경부암 1 명)이었다. 고용량의 항암치료를 받는 기타 종양군의 HDS, ZDS 점수가 다른 종양군에 비해 높았다. 8명(21.6%)은 주요우울장애로, 11명(29.7%)은 적응장애로 진단되었다. 주요우울장애군에서 ZDS의 우울감, 일의 어려움, 불안, 정신활동성 지체 항목의 점수가 다른 진단군에 비해 높았다. 장애군에서 ZDS의 변비, 피로, 식욕 감소, 공허감, 수면장애, 불만족, 체중감소 항목, HDS의 건강염려증, 초조, 피로, 성욕 감소 문항의 점수가 높았다. 결론: 항암제 투여 중인 입원 환자에 있어서 적응장애와 주요우울장애와 같은 정신과적 질환이 동반될 수 있다. 정신의학적 접근이 암환자의 삶의 질을 증가시키고 치료 순응도 측면에 있어서도 중요하다. 항암제 치료중인 환자의 우울 장애 진단시 우울 증상과 혼동될 수 있는 다양한 선체 증상을 감별하기 위하여 암의 부위, 임상 경과, 치료 방법, 항암제의 부작용에 대한 고려가 선행되어야 할 것으로 생각된다.

• 생물정신의학
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• 제19권2호
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• pp.106-113
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• 2012

Objectives : The purpose of this study is to investigate the relationship between the triallelic serotonin transporter gene and stressful life events to determine their effect on depression with alcohol dependence. Methods : Ninety-five hospitalized patients with alcohol dependence (73 male, 22 female) were enrolled in this study. Thirty-two (33.7%) of the total patients were diagnosed with major depressive disorder and dysthymic disorder by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV. The characteristics of stress were evaluated using the stressful life events scale, and depressive symptoms were assessed using the depression scale (Beck Depression Inventory, BDI). Alcoholism with depression (n = 32) and alcoholism without depression (n = 63) were genotyped for the triallelic serotonin transporter gene ($L_A$ : higher expressing allele, $L_G$/S : lower expressing allele). Results : There was no significant difference in the allele frequency between the depression group and the non-depression group (${\chi}^2$ = 0.345, p = 0.619). $L_G$/S alleles had more comorbid depression in the higher score of stressful life events scale [Mental-Haenszel (MH)-${\chi}^2$ = 4.477, p = 0.034]. But there was no significant difference in the comorbidity according to the scores from the stressful life event scale in the $L_A$ alleles (MH-${\chi}^2$ = 0.741, p = 0.399). In the results, alcohol-dependent individuals with $L_G$/S alleles had more comorbid depression than those with $L_A$ alleles when they had experienced severe stressful life events (MH-odds ratio = 2.699, p = 0.028). Conclusions : These results suggest that there is no direct relationship between triallelic serotonin transporter gene and depression in the alcohol dependent patients. But alcohol dependent individuals with the lower expressing alleles of the serotonin transporter gene were more susceptible to depression than those with the higher expressing alleles in response to stressful life events.

• Journal of Yeungnam Medical Science
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• 제24권1호
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• pp.1-10
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• 2007

만성 피로증후군은 인지능력 감소, 근골격 및 수면 장애증상을 가지며 심한 피로감을 특징으로 하는 증상군을 말한다. 아직 명확한 진단기법이나 확립된 표식자가 없으며, 타질환을 배제한 후 증상기준에 따라 진단하고 있다. 병태생리도 명확한 인과관계가 증명되지 않고 있으며 치료 역시 환자의 증상개선과 삶의 질 향상을 목표로 여러 방법을 동원하고 있는 실정이다. 그러나 대조군과 비교한 많은 연구들에서 중추신경계, 신경호르몬 조절 시스템 및 만성 면역 활성 등의 이상이 보고되고 있으며, 이러한 결과들을 근거로 현재 다양한 치료방법이 동원되고 있다. 또한 이 증후군은 가족력의 가능성이 크므로 향후 유전 및 환경적 요인에 관한 연구가 활발해질 것으로 보인다. 대부분의 환자들은 우울증이나 범불안 장애 등을 동반하고 있으며, 이들이 병태생리와 관련 있을 가능성도 크다고 볼 수 있다. 결론적으로 이 증후군은 개인의 유전적 요소에 생리학적, 정신적 요인과 더불어 영양, 생활습관, 스트레스, 호르몬 등의 다양한 요인들이 복합적으로 상호 작용하여 만성적인 피로감과 다양한 증상을 나타내는 것으로 볼 수 있다. 환자-의사간 긴밀한 관계를 바탕으로 약물 및 비약물요법과 인지요법, 단계적 운동요법 등 효과가 인정된 치료방법을 꾸준히 사용하면 증상개선과 삶의 질 향상에 도움이 될 것으로 생각한다.

• 의료법학
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• 제23권2호
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• pp.119-139
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• 2022

뇌에 전기적·자기적 자극을 가하는 뇌자극기술은 신경학적·정신학적 장애에 대해 다양한 범위에 걸쳐 상당한 치료 가능성을 보여준다. 뇌자극기술은 침습 여부에 따라 침습적 기술과 비침습적 기술로 구분되는데, 뇌심부자극술(이하, DBS)은 대표적인 침습적 뇌자극기술에 속한다. 현재 DBS는 식약처 고시인 "의료기기 품목 및 품목별 등급에 관한 규정"에 따라 4등급 의료기기로 분류되어 몇몇 질환에서 안정된 치료법으로 사용되고 있다. 동시에 날로 그 기술이 발전하여 다양한 방향에서 이용방법이 논의되고 있다. 반면, 이와 관련한 법적 규제에 대한 논의는 상대적으로 적은 편이다. 이러한 배경에서 본 글은 DBS의 기술 및 효과와 안전성을 간략하게 소개한 이후, DBS 이용에서 고려할 수 있는 주요한 법적 쟁점을 이용 목적별로, 즉 치료목적, 임상연구 목적, 표준적 치료법이 아니나 다른 치료법이 없는 경우, 향상 목적으로 구분하여 논의하고, 어떠한 목적의 이용이든 DBS 이용에 따른 법적 책임의 문제에서 새로이 공통적으로 부상하고 있는 쟁점-위험·이익평가, 의사의 설명의무, 환자의 동의능력, 기기의 조정, 보험의 보장-을 소개하고 논의한다.