• 대한치과교정학회지
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• 제53권1호
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• pp.3-15
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• 2023

Objective: Body dysmorphic disorder (BDD) is a form of obsessive-compulsive disorder that may be negatively associated with the self-image. It might be associated with orthodontic treatment demand and outcome, and therefore is important. Thus, this study was conducted. Methods: The Yale-Brown Obsessive-Compulsive Scale modified for Body Dysmorphic Disorder (BDD-YBOCS) questionnaire was used in 699 orthodontic patients above 12 years of age (222 males, 477 females), at seven clinics in two cities (2020-2021). BDD diagnosis and severity were calculated based on the first 3 items and all 12 items of the questionnaire. The dental health component of the index of orthodontic treatment need (IOTN-DHC) was assessed by orthodontists. Multivariable and bivariable statistical analyses were performed on ordinal and dichotomized BDD diagnoses to assess potentially associated factors (IOTN-DHC, age, sex, marital status, education level, and previous orthodontic consultation) (α = 0.05). Results: IOTN-DHC scores 1-5 were seen in 13.0%, 39.9%, 29.8%, 12.4%, and 4.9% of patients. Age/sex/marital status/education were not associated with IOTN-DHC (p > 0.05). Based on 3-item questionnaire, 17.02% of patients had BDD (14.02% mild). Based on 12-item questionnaire, 2.86% had BDD. BDD was more prevalent or severer in females, married patients, patients with a previous history of orthodontic consultation, and patients with milder IOTN-DHCs (p < 0.05). Conclusions: IOTNDHC was negatively/slightly associated with BDD in orthodontic patients. Being female and married may increase BDD risk.

• 생물정신의학
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• 제12권2호
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• pp.151-158
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• 2005

Background:Clozapine is a unique atypical antipsychotic medication. It is considered to be superior, even amongst the newer agents, in treatment-resistant schizophrenia. However, de novo emergence or exacerbation of obsessive-compulsive(OC) symptoms during treatment with clozapine has been reported. We prospectively evaluated 19 cases which newly developed OC symptoms during clozapine treatment and discussed the treatment of OC symptoms induced by it. Methods:We recruited 19 patients(8 males, 11 females) with a DSM-IV diagnosis of schizophrenia and schizoaffective disorder who had developed OC symptoms during clozapine treatment. OC symptoms were assessed using the Padua-ICMA and YBOCS on a monthly basis over three months. Results:Eleven female and eight male patients were enrolled and the average age of patients was 32.8 years. At baseline, no patients showed OC symptoms. Moderate to severe OC symptoms appeared with mean daily dose of 298.68 mg of clozapine. There were no significant differences in improving OC symptoms between the clozapine dose reduction group and the OC treatment group. Conclusion:We noticed the possibility that the appearance of OC symptoms is connected with the effect of clozapine. The clozapine-induced OC symptoms were improved both by reducing clozapine daily doses, and by adding OC treatment drugs. With other atypical antipsychotics now available, to know and treat the side effects of clozapine would be of considerable value, offering clinical guidance in making a decision on treatment-resistant schizophrenia.

• Journal of Korean Neurosurgical Society
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• 제29권4호
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• pp.514-520
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• 2000

Objective : Stereotactic psychosurgery is known as one of effective means of treating in some medically intractable psychiatric illness. However, it is unfamiliar and it's long-term clinical result has not reported in our country. The authors evaluated its long-term results of pscychosurgery and discussed its neuroanatomical basis. Methods : Since 1993, eight patients underwent stereotactic psychosurgery for medically intractable psychiatric illnesses. All were referred from psychiatrist of these disorders, one was aggressive behavior, five were obsessive-compulsive disorders(OCD), and two were depression with anxiety disorders. Bilateral amygdalotomy and subcaudate tractotomy were done for aggressive behavior, and limbic leukotomy was done for OCD and depression with anxiety. The results of OCD were evaluated with with YBOCS(Yale-Brown obsessive compulsive scale) and VAS (visual analogue scale), CGI(clinical global impairment) in OCD, and OAS(overt aggression scale), MMS, WAIS were checked for the evaluation of aggressive behavior. Hamilton depression scale(HAMD) was used for evaluation of depression. Ventriculography was used in the first five patients and MR-guided stereotaxy was used in recent three cases for localization of target. The lesions were made with radiofrequency lesion generator. Results : With long-term follow up(mean 45 months) in five OCDs, mean YBOCS declined from 34 to 3(n=5). All returned to previous social life. In OAS scores of aggressive behavior during six-year follow up, scores declined from 8 to 2 with clinical improvement. In two patients with depression with anxiety, HAMD declined from 28.5 to 16.5(n=2). There was no operative mortality and no significant morbidity except one case of mild transient urinary incontinence. Conclusion : With these long-term results, authors assumed that stereotactic psychosurgery could be one of safe and effective mtherapeutic methods in several medically intractable psychiatric illness.

• 한국콘텐츠학회논문지
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• 제19권1호
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• pp.413-420
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• 2019

본 연구는 영화 [아가씨]의 주요 등장인물의 유형을 분석하는 것을 목적으로 한다. 영화 [아가씨]의 네 캐릭터는 모두 '실존'을 보았고 악인형의 요소를 가지고 있다는 공통점이 있다. 코즈키와 히데코는 라캉의 정신 분석 방법론에 의해 각각 전형적인 도착증, 강박증 증상을 보였다. 반면 숙희와 고판돌은 범죄 환경 속에서 실존에 직면한 성장 특성을 지니고 있기 때문에 정신 분석 방법론으로 분석해 가는 것이 어려웠다. 따라서 PCL-R 진단 항목을 바탕으로 숙희와 고판돌의 성격 유형을 분석하고 구조 분석을 병행하였다. 결과적으로 코우즈키는 사디스트이며 히데코는 강박증자, 숙희는 반사회적 생활 방식을 가졌지만 정상적인 감정적 범주에 속해있다고 보았으며 고판돌은 소시오패스이며 잠재적인 사디스트의 기질을 갖고 있다고 보았다.

• 생물정신의학
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• 제10권2호
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• pp.168-176
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• 2003

Objectives:We investigated the characteristics of P300 generators in obsessive-compulsive disorder(OCD) patients by using voxel-based statistical parametric mapping of current density images. Methods:P300 generators, produced by a rare target tone of 1500Hz under a frequent non-target tone of 1,000Hz, were measured in 15 right-handed OCD patients and 15 controls. Low Resolution Electromagnetic Tomography(LORETA), using a realistic head model of the boundary element method based on individual MRI, was applied to the 128-channel EEG. Statistical parametric mapping(SPM) was applied for the statistical analysis. Results:We found that both groups had the mean current density of P300 in the parietal, temporal and prefrontal lobe. There was a trend for decreased current density in the prefrontal area in OCD patients. The statistical comparison showed current density increase in the supraparietal area, a statistically significant longer P300 latency and a trend for reduced P300 amplitude in OCD patients. Conclusion:It suggests that P300 source of both groups exists in multiple brain regions at the same time. And both groups had no statistically significant differences in the current density of P300 except for increased current density in the supraparietal area in OCD patients. But, considering the statistically significant longer P300 latency, a trend for reduced P300 amplitude and relative mean current density reduction in the prefrontal area in OCD patients, this study suggests that the frontal lobe may have a reduced normal inhibitory process in OCD patients.

• 수면정신생리
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• 제5권2호
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• pp.194-201
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• 1998

목적 : 저자들은 강박장애 환자의 대뇌기능을 알아보기 위해 신경심리검사 바테리를 이용하여 정상대조군과 비교하였다. 방법 : 강박장애군(12명)과 연령 및 교육을 짝짓기한 정상대조군(17명)에게 신경심리검사 바테리를 시행하였다. 결과 : K-WAIS 검사상 전체지능은 강박장애군 115.2(${\pm}9.9$), 정상대조군 111.8(${\pm}8.4$)로 양군간에 유의한 차이가 없었다. 그러나 언어성 지능의 경우 강박장애 환자군($118.0{\pm}10.6$)이 정상대조군($110.3{\pm}9.4$)보다 유의하게 높았으나(P=0.049), 동작성 지능은 강박장애군($108.4{\pm}11.7$)이 정상대조군($114.4{\pm}11.2$)보다 낮은 경향을 보였다. 양군간의 소검사 항목점수를 비교하면 tactual performance test의 전체시간에서 강박장애군(15.26분)이 정상대조군(9.56분) 보다 유의하게 길었으며(P=0.028), 양손 수행에서도 강박장애군(0.16)의 수행이 정상대조군(0.38) 보다 유의하게 떨어졌다(P=0.047). 전체적인 Halsted Reitan 손상지수도 강박장애군($3.17{\pm}2.1$)이 정상대조군($1.31{\pm}1.8$) 보다 유의하게 높았다(P=0.019). 웨슬러 기억검사의 시각회상에서도 강박장애군($12.3{\pm}1.6$)이 정상대조군($13.4{\pm}0.9$)에 비해 기능이 유의하게 떨어졌다. 결론 : 강박장애 환자는 정상대조군에 비해 공간구조 인지기능의 장애, 과잉된 언어 및 집중력을 보이고 있고, 이는 강박장애 환자의 언어기능과 공간구조 인식기능의 불균형이 강박장애 환자의 정신병리와연관 될 수 있음을 시사한다. 향후 강박장애 환자에서 신경 심리 검사상 보이는 이상소견이 강박장애의 특정적인 소견인가, 치료경과에 따라 선경 심리검사상의 이상소견이 영향을 받는가에 대한 연구가 이어져야할 것으로 생각된다.

• 한국멀티미디어학회논문지
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• 제24권4호
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• pp.583-592
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• 2021

Obsessive-compulsive disorder (OCD) is a mental disorder in which a person repeated a particular thought or feels. The domain of beliefs and guilt predicted OCD symptoms. Although there were some neuroimaging studies investigating OCD symptoms, resting-state functional magnetic resonance imaging (rs-fMRI) study investigating intra-network functional connectivity associated with guilt for OCD is not reported yet. Therefore, in the current study, we assessed the differences between intra-network functional connectivity of healthy control group and OCD group using independent component analysis (ICA) method. In addition, we also aimed to investigate the correlation between changed functional connectivity and guilt score in OCD. Total 86 participants, which consisted of 42 healthy control volunteers and 44 OCD patients, acquired rs-fMRI data using the 3T MRI. After preprocessing the fMRI data, a functional connectivity was used for group independent component analysis. The results showed that OCD patients had higher score in emotion state in beliefs and lower functional connectivity in fronto-parietal network (FPN) than control group. A decrease of functional connectivity in FPN was negatively correlated with feelings of guilt in OCD. Our results suggest excessive increase in guilt negatively affect to process emotional state and behavior or cognitive processing by influencing intrinsic brain activity.

• Journal of Oral Medicine and Pain
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• 제46권3호
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• pp.84-87
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• 2021

Morsicatio buccarum is a condition caused by chronic cheek biting. It means frictional hyperkeratosis by repetitive cheek biting, which may be associated with obsessive compulsion. Clinically it presents as rough, shaggy, whitish, often peeling surface. We report a 9-year-old female patient who complained oral ulceration on both buccal mucosa. The initial diagnosis was oral candidiasis because of whitish plaques which were peeled off. Topical antifungal agent was ineffective and the symptom did not disappear. By incisional biopsy, she was diagnosed with morsicatio buccarum. A soft oral appliance was placed in the patient's oral cavity. Although morsicatio buccarum improved significantly when the appliance was used, the oral lesion had a tendency to recur, when the patient stopped using the appliance. In case of recurrence, cognitive behavioral therapy for obsessive-compulsive disorder is needed for the fundamental treatment.

• 생물정신의학
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• 제9권1호
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• pp.3-7
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• 2002

Genes involved in the serotonin system are good candidates for the pathogenesis of mood disorder and mood-related disorders, such as eating disorder, obsessive-compulsive disorder, alcoholism, and suicide. Serotonin type 2A(5-HT2A) receptor gene promoter polymorphism(-1438A/G) has been reported. In this article, authors reviewed the literatures regarding association studies between -1438A/G and mood disorder and mood-related disorders. There are controversial results with limited data to date. Further researches on the -1438A/G in psychiatric disorders are required.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제30권2호
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• pp.50-56
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• 2019

Most patients with Tourette's disorder experience an uncomfortable sensory phenomenon called the premonitory urge immediately before experiencing tics. It has been suggested that premonitory urges are associated with comorbidities such as obsessive compulsive disorder, anxiety disorders, and attention-deficit/hyperactivity disorder, although these associations have been inconsistent. Most patients experience tics as a result of the premonitory urges, and after the tics occur, most patients report that the premonitory urges are temporarily relieved. As a consequence, several studies have assessed the premonitory urge and its potential therapeutic utility. Based on the concept that the premonitory urge induces tics, behavioral treatments such as Exposure and Response Prevention and Habit Reversal Therapy have been developed. However, it is still unclear whether habituation, the main mechanism of these therapies, is directly related to their effectiveness. Moreover, the observed effects of pharmacological treatments on premonitory urges have been inconsistent.