• 제목/요약/키워드: Obsessive compulsive-disorder

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강박장애 환자의 한방치료 효과에 대한 후향적 연구 (A Retrospective Study on the Effect of Traditional Korean Medicine on Obsessive-Compulsive Disorder)

  • 최강의;이유진;김연주;유종호
    • 동의신경정신과학회지
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    • 제33권3호
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    • pp.329-337
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    • 2022
  • Objectives: To examine effects of traditional Korean medical treatment on obsessive-compulsive disorder (OCD). Methods: Effects of Korean medical treatment on patients with OCD who visited the neuropsychiatric clinic of Korean medicine were examined. Patients were treated with acupuncture, herbal medication, and oriental psychotherapy. Padua-ICMA, Y-BOCS, BDI-2, STAI-X1/X2, BAI were compared before and after 8 and 12 weeks of treatment to determine whether symptoms of patients were improved. Results: After 8 weeks treatment (n=19), Padua-ICMA, Y-BOCS, BDI-2, STAI-X1/X2, and BAI scores were significantly decreased. After 12 weeks treatment (n=12), Padua-ICMA, Y-BOCS, BDI-2, STAI-X1/X2, and BAI scores were also significantly decreased. Conclusions: Traditional Korean medicine is clinically effective in treating OCD.

틱 장애 및 소아기 발병 강박 장애 (TIC DISORDER AND OBSESSIVE COMPULSIVE DISORDER IN CHILDHOOD)

  • 홍현주;송동호
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제16권2호
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    • pp.183-191
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    • 2005
  • 뚜렛 장애는 음성틱과 운동틱을 특징으로 하는 소아기의 대표적인 신경발달학적 행동장애이다. 소아기 발병 강박장애는 강박장애의 한 아형으로써 틱장애와의 연관성이 알려져 있다. 두 질환은 처음 진단시, $40\~75\%$에서 서로 공존질환으로서 발견되며, 유전학적으로도 관련성이 있으며 신경해부학적으로도 피질-선초체-시상 회로(cortico-striato-thalmic circuit)의 이상이 보고되며 증상적인 면에서도 유사점이 발견되고 있다. 최근 10여년 동안 틱장애와 소아기 발병 강박장애 영역에서는 놀라울 정도로 많은 연구들이 진행되었다. 본 연구는 뚜렛 장애를 포함하는 틱장애와, 소아 청소년 발병 강박 장애에서 1) 임상 양상 2) 유전학 및 역학 연구 3) 뇌영상 연구 4)신경화학 5) 연쇄구균 감염 관련 소아기 자가면역성 신경정신과적 질환(pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection : PANDAS)에 대해 고찰하고자 한다.

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안정화된 만성 정신분열병 환자에서 강박장애 동반과 사회적 기능 (Comorbid Obsessive Compulsive Disorder and Social Function in Stable Patients with Chronic Schizophrenia)

  • 강석훈;석정호;김찬형;김윤중;김형주;최종혁
    • 대한불안의학회지
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    • 제7권1호
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    • pp.40-47
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    • 2011
  • Objective : This study aimed to investigate the prevalence of obsessive-compulsive disorder (OCD) in schizophrenia, and the relationship among OCD, severity of psychopathology, and social function in stable patients with chronic schizophrenia. Methods : We interviewed 138 symptom-stable inpatients who had been on a constant dose of antipsychotics for at least 1 month prior and diagnosed as chronic schizophrenia. Subsequently, patients were classified according to the existence of OCD as investigated using the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Further, all clinical and demographic data was investigated. To investigate potential interrelationships, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Korea-Positive and Negative Symptom Scale (K-PANSS), and the Korean Personal and Social Performance (K-PSP) were used. An independent ttest and Chi-square test were used to compare groups and a Pearson's correlation coefficient was used to assess the relationship between the Y-BOCS and other clinical rating scales. Results : The prevalence of OCD in schizophrenia patients was 18.1%. Patients with schizophrenia and OCD exhibited significantly earlier onset of schizophrenia, more severe psychiatric symptoms, and lower personal and social performance ability as compared to those without OCD. There was no significant relationship among Y-BOCS, K-PANSS, and K-PSP. Conclusion : We found that comorbid OCD was relatively more frequent in patients with schizophrenia. An investigation involving larger samples of schizophrenia patients with OCD with respect to social function and thus, the effect on quality of life is required.

강박장애의 약물효과 증대 전략 (Augmentation Strategies in Obsessive Compulsive Disorder)

  • 이철
    • 생물정신의학
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    • 제5권2호
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    • pp.162-165
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    • 1998
  • The serotonin reuptake inhibitors(SRIs) and the serotonin selective reuptake inhibitors(SSRIs) are considered the first choice agents for pharmacologic treatment of obsessive-compulsive disordr(OCD). However, many patients with OCD experience little or no improvement in their symptoms when treated with SRIs or SSRIs. Patients who have experienced a partial or no response to an SRI/SSRI at 10 to 12 weeks are often considered for augmentation strategies. Nearly every class of psychotropic medications has been tried in an open fashion, though augmentation strategies have been somewhat disappointing.

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강박장애의 병태생리와 치료에 있어 세로토닌의 역할 (Role of Serotonin in Pathophysiology and Treatment of OCD)

  • 김찬형
    • 생물정신의학
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    • 제4권2호
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    • pp.179-187
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    • 1997
  • The clinical efficacy of serotonin reuptake inhibitors such as clomipramine in the treatment of obsessive compulsive disorder(OCD) has fueled interest in the neurobiological basis of this illness. OCD is responsive exclucively to potent serotonin reuptake inhibitors clomipramine, fluoxetine, fluvoxamine, sertraline, and paroxetine and this point forms the important evidence supporting a cental role for serotonin in the pathogenesis of the disorder. Other serotonergic medications such as lithium, buspirone, trazodone, or fenfluramine may be useful as adjuvant treatments in treatmentrefractory OCD and adjuvant antipsychotics are useful in tic disorders, personality disorders, and psychotic disorders. This paper reviews results of treatment studies, investigations of biological markers, and neuroendocrine challenges and implications for the role of serotonin in pathophysiology and treatment of OCD.

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안정화된 만성 조현병 환자에서 강박장애 증상이 삶의 질에 미치는 영향 (Impact of Comorbid Obsessive Compulsive Symptoms on Quality of Life in Stable Patients with Chronic Schizophrenia)

  • 문정윤;강석훈;석정호;김찬형;김태용;최진희;소형석
    • 대한불안의학회지
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    • 제13권2호
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    • pp.141-147
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    • 2017
  • Objective : This study aimed to evaluate the relationship between comorbid obsessive compulsive disorder (OCD) and quality of life in stable patients with schizophrenia. Methods : We interviewed 162 symptom-stable inpatients who have been on a constant dose of antipsychotics for at least 3 months prior and diagnosed as chronic schizophrenia. Subsequently, patients were classified according to the existence of OCD as evaluated using the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). Further, all clinical and demographic data were collected and evaluated. To investigate potential interrelationships, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Korea-Positive and Negative Symptom Scale (K-PANSS), Korean Modification of the Scale to Measure Subjective Well-Being under Neuroleptic Treatment (KmSWN) and Korean Version Quality of Life Scale (K-QOLS) were performed. Independent t-test and Chi-square test were used to compare groups and regression analysis was done to assess the relationship between the Y-BOCS and quality of life. Results : Schizophrenia patients with OCD showed significantly earlier onset of schizophrenia, more severe psychiatric symptoms and lower quality of life, compared to those without comorbid OCD. OCD might be associated with lower quality of life in schizophrenia. Conclusion : Schizophrenia patients with OCD showed lower quality of life than those without OCD. In the treatment for schizophrenia, evaluation of OCD might be needed to improve their quality of life and social function.

사고-행동 융합과 인지적 융합의 개념적 이해 : 강박증을 중심으로 (Conceptual Understanding of Thought-Action Fusion and Cognitive Fusion : Focus on Obsessive-Compulsive Symptoms)

  • 이상원;이경욱;최미나;이승재
    • 대한불안의학회지
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    • 제15권1호
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    • pp.1-12
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    • 2019
  • Thought-action fusion (TAF) is a tendency to blindly assume causal relations between their thoughts and external reality. On the other hand, cognitive fusion (CF) is a tendency to take internal experiences, such as thoughts and feeling, literally rather than view them as random events. However, these two terms are often confusedly used and, in fact, have conceptual overlaps. Therefore, this study aimed to identify their distinctive features through a comprehensive review of the definition, origin, measurements and clinical implications especially on the understanding of obsessive-compulsive symptoms. The cognitive-behavioral concept of TAF is confined to erroneous and maladaptive beliefs about the connection between thoughts and behaviors. The CF is a broader construct that entails taking thoughts and feelings as facts and engaging or struggling with them such that the quality of life is lowered. They also have different theoretical backgrounds, developing processes and therapeutic approaches. From the perspective of the obsessive-compulsive disorder, both concepts have been studied as mid-structures for this illness. Recently, the effectiveness of psychological therapies related to these concepts such as defusion therapy has been tested. However, it is yet still in its infancy. In the future, complementary advances between the two concepts with studies on biological substrates is needed.

강박장애 및 조현병 환자에서의 정량뇌파 소견과 신경인지기능 간의 연관성 (Correlation between Quantitative Electroencephalogram Findings and Neurocognitive Functions in Patients with Obsessive-Compulsive Disorder and Schizophrenia)

  • 김서영;신정은;김민주;권준수;최수희
    • 생물정신의학
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    • 제23권4호
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    • pp.193-198
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    • 2016
  • Objectives Obsessive-compulsive disorder (OCD) and schizophrenia have many common clinical and neurocognitive features. However, not all of them share the same underlying mechanism. The aim of this study was to discover evidences that indicate a pathophysiological mechanism specific to OCD by comparing correlations of quantitative electroencephalography (QEEG) patterns and neurocognitive function in patients with OCD and schizophrenia. Methods Resting-state QEEG data of total 265 patients were acquired retrospectively and parameters such as absolute power, relative power and peak frequency were analyzed from the data. Stroop test and Trail Making Test results as well as demographic features were reviewed for this study. The correlation of neurocognitive functions and brain electrical activities in each group were assessed and compared by correlation analysis. Results Compared with the OCD group, the schizophrenia group performed poorly in neurocognitive tests. Mean values of QEEG parameters in patients with OCD and schizophrenia did not show significant differences. Both absolute and relative power of alpha rhythm in central and frontal regions showed significant positive correlation with Stroop test results in OCD patients. Conclusions Findings in this study shows distinctive correlations between frontal executive dysfunction and frontal alpha rhythm in the OCD patients, both of which might be a candidate for endophenotype underlying obsessive rumination.

섭식장애 환자의 섭식장애 증상, 우울, 강박성이 자해행동에 미치는 영향 (Impact of Eating Psychopathology, Obsessive-Compulsion and Depression on Self-Harm Behavior in Patients with Eating Disorders)

  • 공성숙
    • 대한간호학회지
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    • 제39권4호
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    • pp.459-468
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    • 2009
  • Purpose: The purpose of the study was to investigate psychological factors such as eating psychopathology, depression, and obsessive-compulsion that might influence self-harm behavior in patients with eating disorders. Methods: Patients with eating disorders (n=135) who visited "M" clinic for eating disorders participated in the study. Data were collected from March to August 2007 using the Eating Disorder Inventory-2, Beck Depression Inventory, Maudsley Obsessional-Compulsive Inventory, and Self-Harm Inventory (SHI). Results: The participants scored high on self-harm as well as on depression and obsessive-compulsion. On the SHI, a high frequency of self harm behavior such as 'torturing self with self-defeating thoughts', 'abused alcohol', 'hit self', and 'suicide attempt' were found for the participants. There were significant correlations between most eating psychopathology variables, depression, obsessive-compulsion, and self-harm behavior. 'Interoceptive awareness' (eating psychopathology), depression, and 'checking' (obsessive-compulsion) were significant predictors of self-harm behavior. Conclusion: Future interventions for patients with eating disorders should focus on assessing the possibility of self-harm and suicidal attempts, especially in those patients with high levels of eating psychopathology, depression, or obsessive-compulsion. Early intervention for depression and obsessive-compulsion could contribute to preventing self-harm and suicide in patients with eating disorders.

강박장애와 글루타메이트 기능 이상 (Obsessive-Compulsive Disorder and Glutamatergic Dysfunction)

  • 황성식;김찬형
    • 대한불안의학회지
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    • 제3권1호
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    • pp.20-25
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    • 2007
  • The definite causes of obsessive-compulsive disorder (OCD) are still unknown. OCD has been suggested to be related to many neurotransmitters in brain, such as serotonin, dopamine and glutamate. It has been shown that serotonergic neurons play a crucial role in the pathophysiology of OCD. Recently, it is known that neurotransmitters other than serotonin also play a role in the pathophysiology of OCD, and a series of studies have provided a few evidence that glutamate may be involved in some OCD patients. The purpose of this article was to review the literatures on glutamatergic dysfunction in OCD. We suggest that glutamatergic dysfunction may be implicated in the pathophysiology of OCD.

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