• 제목/요약/키워드: Obsessive-compulsive symptoms

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강박장애 치료에 대한 중의학 임상연구 동향 (Review of Clinical Studies on the Treatment of Obsessive Compulsive Disorder Using Traditional Chinese Medicine)

  • 임교민;안윤영;송건의;이주현;박세진
    • 동의신경정신과학회지
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    • 제29권4호
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    • pp.291-303
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    • 2018
  • Objectives: The objective of this study is to analyze the Clinical reports of treatment of obsessive compulsive disorder (OCD) in traditional Chinese medicine (TCM). Methods: Clinical reports on obsessive compulsive disorder treatment from 2001 to 2017 were searched using the following key words in the China National Knowledge Infrastructure (CNKI). 'OCD', 'qiangpo zheng'. Results: A total of 22 papers were selected, 12 of which were clinical research papers and 10 case report papers. The acupuncture and moxa treatment was more effective in relieving the clinical symptoms of OCD patients as compared to only using western medicine, and it was also possible to reduce the adverse effects of western medicine. Conclusions: It was established that Traditional Chinese medicine has some effect on the treatment of OCD, but there were limitations as follows. The selected papers were retrieved from only one site of CKNI and did not follow a systematic review methodology. Therefore generalized results could not be derived, further studies should therefore be carried out.

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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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.

Fluoxetine 투여 후 조증과 자살 사고를 보인 강박증 환자 1례 (A Case of Fluoxetine-induced Mania & Suicidal Ideation in Obsessive-Compulsive Disorder)

  • 이승환;이민수
    • 생물정신의학
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    • 제6권2호
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    • pp.253-258
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    • 1999
  • The fluoxetine is one of the most frequently prescribed drugs for the treatment of depression and obsessive-compulsive disorder(OCD). This has been known as one of the most safest medication. But since the advent of this drug, there have been several reports of side effects-the mania and suicidal ideation-encountered during coadministration of fluoxetine with or without other psychotropic drugs. We experienced a case of 20 years old male OCD patient who developed into abrupt manic state and also was preoccupied with intense suicidal ideation following fluoxetine use. He was a only child in his family and his father had a history of alcoholism about 15years ago. Our patient's obsessive-compulsive symptoms have been occured since puberty. His OCD symptoms and anxiety were aggravated since joining the army. Beside these facts, we could not find any other psychiatric history such as depressive disoder and bipolar disorder. We used the fluoxetine starting dosage of 20mg and increased to 40mg at second week. About 3 weeks after the treatment, he developed sudden manic symptom and more aggravated suicidal ideation without any OCD symptoms. He felt vitalized and energetic without having enough sleep and food. These symptoms were ceased over two weeks by stopping medication. Up to this point, the reason why fluoxetine induces mania and suicidal preoccupation is unclear. But somehow the fluoxetine has effects on serotonin receptor and serotonin-dopamine regulations, thus we could make an assumption that fluoxetine can induce mania, extrapyramidal symptoms(EPS) and suicidal ideation in some part of the serotonin unbalanced patients. We think this would be the first report to remark on fluoxetine's suicidal and manic side effects in Korea. So here we present the case with the summary of reviewed articles.

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불안장애 (Anxiety Disorder)

  • 정한용
    • 보험의학회지
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    • 제29권1호
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    • pp.7-11
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    • 2010
  • Anxiety disorders Anxiety disorders are among the most prevalent mental disorders in the general population. Anxiety disorders can be viewed as a family of related but distinct mental disorders, which include following as classified in the text revision of fourth edition of Diagnostic and Statistical Manual Disorders(DSM-IV-TR): (1) panic disorder with or without agoraphobia; (2) agoraphobia with or without panic disorder; (3) specific phobia; (4) social phobia; (5) obsessive-compulsive disorder; (6) posttraumatic stress disorder; (7) acute stress disorder; (8) generalized anxiety disorder. An acute intense attack of anxiety accompanied by feeling of impending doom is known as panic disorder. The term phobia refer to an excessive fear of a specific object, circumstance, or situation. Obsessivecompulsive disorder is represented by a diverse group of symptoms that include intrusive thoughts, rituals, preoccupations, and compulsions. Posttraumatic stress disorder is a condition marked by development of symptoms after exposure to traumatic life events. Generalized anxiety disorder is defined as excessive anxiety and worry about several events or activities for most days during at least a 6-month period.

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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.

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.

글루타메이트 수용체(GRIN2B) 유전자와 강박장애 발병 연령과의 관련성 (Association between the GRIN2B Gene and Age of Onset in Obsessive-Compulsive Disorder)

  • 황성식;노대영;김찬형
    • 대한불안의학회지
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    • 제7권1호
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    • pp.34-39
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    • 2011
  • Objectives : An early age at onset of obsessive compulsive symptoms in family studies has been strongly associated with a more familial form of obsessive compulsive disorder (OCD). Further, many reports have suggested that early- and late- onset OCD represent separate subtypes of the disorder. The aim of this study was to investigate the associations between the glutamate receptor, the ionotropic, n-methyl-d-aspartate (NMDA) subunit 2B gene (GRIN2B) polymorphisms, and onset of OCD in the Korean population. Methods : We recruited 109 OCD patients and classified them into early- (age of onset <18 years) and late-onset groups (age of onset${\geq}$18). Genomic DNA was extracted from their blood after which the genotypes and allelic frequencies of the two GRIN2B polymorphisms (5072T/G and 5988T/C) were compared in the two groups. We also compared genetic data between child- (age of onset${\leq}$15) and adult-onset groups (age of onset${\geq}$19) using the same protocol. Results : There were no significant differences between the early- and late-onset groups with respect to genotype. Moreover, we could not find any differences in genotype frequencies between child and adult-onset groups. Conclusions : Our study suggested that GRIN2B polymorphisms (5072T/G and 5988T/C) do not affect the onset of OCD in Koreans. However, this finding has resulted from a preliminary study and thus, further study is required.

한국판 아동용 Leyton 강박증 척도의 개발 (DEVELOPMENT OF THE KOREAN FORM OF LEYTON OBSESSIONAL INVENTORY-CHILD VERSION(LOI-CV))

  • 이정섭;신민섭;홍강의
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제5권1호
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    • pp.162-171
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    • 1994
  • 소아의 강박증 평가 도구인 아동용 레이톤 강박증 척도를 한국판 집단용 지필 검사로 개발하기 위하여 본 연구를 시행하였다. 국민학교 4학년부터 고등학교 3학년까지 127명을 대상으로 한국어로 번역한 지필 검사 양식의 아동용 레이톤 강박증 척도를 실시하였고, 검사-재검사 신뢰도 검증을 위하여 3주뒤에 82명에게 재검사를 시행하였다. 또한 전 대상 군에 신뢰도와 타당도가 이미 입증된 간이진단검사(SCL-90-R)를 함께 실시하여 공존타당도가 있는 지를 알아 보았고, 강박환아군과 정신과 환아대조군 그리고 정상대조군을 9명씩 비교하여 진단 변별력이 있는 지를 보았다. 검사-재검사 신뢰도, 내적 일관성 등은 상당히 만족스러운 수준이었고, 간이진단검사와의 공존 타당도도 비교적 높게 나왔다. 강박환아군이 정신과 환아대조군이나 정상 대조군보다 유의하게 높은 점수가 나와서 변별력 또한 높은 것으로 나타났다. 요인분석상 문항들을 5개의 요인으로 묶을 수 있었다. 한편 증상과 저항척도에서 여아가 남아보다 유의하게 높은 점수를 보고하였으며, 특히 국민학교 여아에서 높은 점수를 보여 주었다. 결론적으로 한국판 아동용 레이톤 강박척도는 실시하기 간편하고, 신뢰도와 타당도가 좋은 척도임이 입증되었다. 향후 전국 규모의 규준을 작성하고, 미흡한 부분을 보완한 후속 연구가 필요하다.

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