• 제목/요약/키워드: depression insomnia

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스트레스에의한 여성 울증(鬱證) 환자의 가미소요산(加味逍遙散) 치험 3례 (The Clinical Review on Three Cases of UL-syndrome(鬱證) induced by Chronic Stress)

  • 강병철;성경화;송일헌;김의철;권도익;박경훈;정성민;박준하;고은상
    • 대한한방내과학회지
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    • 제25권3호
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    • pp.615-624
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    • 2004
  • UL-syndrome(鬱證) is a syndrome of emotional depression and various physical symptoms generally due to chronic psychological stress, without constitutional abnormality. These are cases of female patients suffering from headache, chest discomfort, heart burning, insomnia, dyspepsia, anorexia, fatigue and some other minor symptoms due to chronic stress. We diagnosed these cases as UL-syndrome and treated them with oriental medicine, specifically Gamisoyosan(加味逍遙散). This paper describes the symptoms that the patients suffered, the treatment used, and identifies stages in the development of UL-syndrome, and suggests a stage in which Gamisoyosan is efficacious.

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불면증 환자의 수면인식과 객관적, 주관적 수면변수의 연관성에 대한 연구 (Association of Sleep Perception With Objective and Subjective Sleep Variables in Insomnia Patients)

  • 윤가희;오성민;서민철;이미현;윤소영;이유진
    • 수면정신생리
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    • 제28권2호
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    • pp.70-77
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    • 2021
  • 목 적 : 본 연구의 목적은 불면증 환자의 주관적 수면인식과 관련 있는 임상적, 객관적 요인들을 알아보고 임상에서 불면증 환자의 이해와 평가 및 치료에 도움을 주기 위함이다. 방 법 : 109명의 불면증 환자들을 대상으로, 수면다원검사 결과와 자가보고 설문지를 후향적으로 분석하였다. 주관적 수면인식은 아침자가보고 설문지의 주관적 총 수면시간(subjective total sleep time, subjective TST), 입면 잠복시간(subjective sleep onset time; subjective SOL), 각성횟수, 아침 개운함 정도로 측정하였으며, 주관적-객관적 수면차이를 계산하였다. 임상적 특징은 Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), Epworth Sleepiness Scale (ESS)를 측정하였다. 변수들 사이의 관련성을 알아보기 위하여 상관분석을 시행하였다. 결 과 : 109명의 불면증 대상자(남성 = 72명, 나이 43.49 ± 15.32세)를 분석한 결과, 주관적 총 수면시간(subjective TST)은 수면다원검사에서의 입면 후 각성시간(wake after sleep onset, WASO) (p < 0.001), N1 수면(p = 0.039), PSQI (p < 0.001), BDI (p = 0.014)와 유의한 음의 상관관계를 보였다. 수면차이는 PSQI (p = 0.018)와 유의한 음의 상관관계가 있었다. 아침 개운함 정도는 PSQI (p = 0.019), BDI (p < 0.001)와 유의한 음의 상관관계가 있었다. 결 론 : 불면증 환자에서 주관적 수면인식은 수면다원검사의 입면 후 각성시간(WASO), N1 수면과 관련성이 있었으며, 우울감과 평소 수면의 질과 관련성이 있었다. 불면증 환자에서 다양한 객관적 수면변수, 평소 수면의 질 및 우울감이 주관적 수면인식에 영향을 미치므로, 이를 고려하여 환자를 평가 및 치료해야 하겠다.

통계적 분석을 통한 우울증 변증도구와 심리검사의 상관성 연구 (Correlation between Instrument on Pattern Identification for Depression and Psychological Tests by Statistical Analysis)

  • 김환;이헌수;이은정;박준호;강위창;정인철
    • 동의신경정신과학회지
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    • 제27권3호
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    • pp.131-146
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    • 2016
  • Objectives: This study was performed to determine the correlation between Instrument on Pattern Identification for Depression and Psychological tests by Pearson Correlation Coefficient and Regression analysis.Methods: Two assessors carried out the evaluation using the instrument on pattern identification for depression. They also performed the following psychological tests: Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), State-Trait Anger Expression Inventory (STAXI), the Temperament and Character Inventory (TCI), Insomnia Severity Index (ISI_Total), Self-disclosure Inventory, subjective well-being Inventory, Health perception Inventory, and Personality Assessment Inventory (PAI). A total of 167 participants who got HAM-D score over 12 were targeted for the evaluation. Our research team carried out Pearson correlation coefficient analyses and regression analysis between pattern identification for depression and Psychological tests. We listed the results by descending order and interpreted the results.Results: Pearson correlation analysis revealed the following results: 1) Stagnation of Liver Gi was associated with BDI (0.60) and STAI (0.55); 2) Dual Deficiency of the Heart and Spleen was associated with BDI (0.60), ISI_Total (0.52), and STAI (0.42); 3) Relieving stagnation of Phlegm-Gi was associated with BDI (0.65), STAI (0.54), and Subjective well-being inventory (−0.52); 4) Gi-deficiency Mingled with sputum was associated with BDI (0.50), ISI_Total (0.40), and STAI (0.395); 5) Stagnant Gi transforming into fire was associated with BDI (0.56), STAI_TR (0.51), and Health perception Inventory (−0.458); 6) Yin-Deficiency with Effulgent Fire was associated with BDI (0.55), ISI_total (0.54), and STAI (0.41).Conclusions: Through correlation analysis between Instrument on Pattern Identification for Depression and Psychological tests, we could suggest a System for Oriental Medical Diagnosis for Depression.

여성 우울증 환자에서 Aripiprazole과 Bupropion 부가요법의 우울증상 및 안전성에 대한 효과 비교 : 사후분석연구 (Comparison of the Bupropion versus Aripiprazole Adjunctive Therapy for the Treatment of Female Depression : Post-Hoc Analyses from a Randomized Prospective Open-Label Multi-Center Study)

  • 금무성;천은진;이광헌;구본훈;이영지;박영우;이종훈;이승재;성형모
    • 우울조울병
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    • 제16권3호
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    • pp.140-151
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    • 2018
  • Objectives : The purpose of this study was to examine effects of adjunctive aripiprazole versus bupropion, on depressive symptoms of female depression. Methods : Sixty six female patients with major depressive disorders were enrolled from a six-week, randomized prospective open-label multi-center study. Participants were randomized to receive aripiprazole (2.5-10 mg/day) or bupropion (150-300 mg/day). Montgomery Asberg Depression Rating Scale, 17-item Hamilton Depression Rating scale (HAM-D17), Iowa Fatigue Scale, Drug-Induced Extrapyramidal Symptoms Scale, Psychotropic-Related Sexual Dysfunction Questionnaire scores, and Clinical Global Impression-Severity (CGI-S) were obtained at baseline and after one, two, four, and six weeks. Changes on individual items of HAM-D17 were assessed as well as on composite scales (anxiety, insomnia and drive), and on four core subscales that capture core depression symptoms. Results : Overall, both treatments improved depressive symptoms, without causing serious adverse events. There were significant differences in the HAM-D17 total score (p=0.046) and CGI-S (p=0.004), between aripiprazole and bupropion augmentation, favoring aripiprazole over bupropion. Aripiprazole revealed significantly greater effect size in depressed mood (p=0.006), retardation (p=0.005), anxiety psychic (p=0.032), and general somatic symptom (p=0.01). Conclusion : While both treatments were effective, results of this study suggested that aripiprazole may be preferable, in treating general and core symptoms of female depression.

우울증 환자의 주간기분변동과 수면 양상 (Diurnal Variation and Sleep Pattern in Depressive Patients)

  • 박영민;김린;서광윤;조숙행;강승걸;윤호경
    • 수면정신생리
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    • 제8권1호
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    • pp.30-36
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    • 2001
  • 배 경 : 주간기분변동은 주요 우울장애, 멜랑콜리아 형의 세부진단으로 포함되어 있다. 그러나 현재까지의 연구를 종합해 보면 주간기분변동은 우울증의 고유한 증상인지 수면 양상의 변화와 관련된 현상인지, 혹은 별개의 다른 기전을 갖는 현상인지에 대해서 서로 모순되는 주장들이 혼재되어 있다. 이에 본 연구에서는 우울증의 세부 진단에 따른 주간 기분변동의 유무를 조사하고, 주간기분변동의 유무에 따른 수면 양상의 차이를 비교함으로써 주간기분변동과 수면 양상 사이의 관계를 찾아 보고자 하였다. 방 법 : 입원 혹은 의뢰된 우울장애 환자 62명을 대상으로 하여 주간기분변동은 Visual Analogue Mood Scale로, 수면 양상은 Pittsburgh Sleep Quality Index, 우울증의 심각도는 Hamilton Depression Rating Scale을 이용하여 측정하였다. 주간기분변동이 있는 군과 없는 군으로 나누고 HDRS 총점과 소항목, 그리고 PSQI 총점과 소항목을 변수로 하여 통계적 분석을 시행하였다. 결 과 : 주간기분변동의 빈도는 각각의 진단별로 차이가 없었으며, 주간기분변동이 있는 군과 없는 군으로 나누었을 때 중기 불면증과 수면 시간에 있어서 유의한 차이가 있었다(p<0.05). 또한 멜랑콜리아 형만을 대상으로 주간기분변동이 있는 군과 없는 군을 비교하였을 때 중기 불면증, 수면 시간뿐만 아니라 PSQI 총점, 수면 잠복기, 수면 장애, 주간의 기능 면에서 유의한 차이를 보였다(p<0.05). 결 론 : 주간기분변동은 멜랑콜리아 형의 우울장애 뿐만 아니라, 다른 우울장애에서도 존재하기 때문에 주간기분변동이 멜랑콜리아 형 우울장애의 특유한 증상으로 보기는 어려웠다. 주간기분변동이 있는 군에서 수면의 질이 더 좋은 것으로 나타났는데 이는 수면과 관련될 가능성이 높으며 향후 심도있는 연구가 필요할 것이다. 주간 기분변동은 외부 환경의 영향을 받기 쉬움으로 신뢰성을 높이기 위해서는 측정 기간과 횟수 등의 방법론적 연구도 필요할 것으로 생각된다.

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Reflection of Pain in Cancer Patients Using a New Screening Tool for Psychological Distress

  • Oh, Seung-Taek;Lee, San;Lee, Hyeok;Chang, Myung Hee;Hong, Soojung;Choi, Won-Jung
    • 정신신체의학
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    • 제25권1호
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    • pp.56-62
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    • 2017
  • Objectives : The objective of this study was to investigate the relationship between psychological distress and pain in cancer patients. Methods : 249 patients with cancer who visited National Health Insurance Service Ilsan Hospital between April 2013 and March 2014 were evaluated with National Cancer Center Psychological Symptom Inventory(NCC-PSI) which consisted of Modified Distress Thermometer(MDT) and Modified Impact Thermometer(MIT). Each scale was divided into 3 subscales targeting separate symptoms: insomnia, anxiety, and depression. Psychological distress was defined as positive for those who scored above the cutoff values in at least one of all six subscales. The Numeric Rating Scale for Pain(NRS-Pain) was used to assess the subjective severity of pain. Logistic regression was performed to investigate the association between psychological distress and pain. Results : Univariate logistic regression analysis showed that pain, gender, compliance, and two subscale scores of Hospital Anxiety and Depression Scale(HADS) were significantly associated with psychological distress. Multivariate logistic regression analysis showed that pain and HADS anxiety subscale score maintained a statistically significant association with psychological distress adjusted for variables including age, gender, years of education, Eastern Cooperative Oncology Group performance status, cancer stage, Charlson Comorbidity Index, compliance, and HADS depression subscale score. One point increase in pain was 1.31 times more likely to cause psychological distress. In secondary analysis, pain was significantly associated with all subscales of NCC-PSI, except MIT-anxiety subscale. Conclusions : This study suggests that NCC-PSI, a screening tool for psychological distress, reflects pain. We recommend that physicians who treat cancer patients consider the examination of psychological distress which provides comprehensive evaluation of various factors regarding quality of life.

정신병적 우울증 양상을 나타낸 Sheehan씨 증후군 1례 (A Case of Sheehan's Syndrome Mimicking Psychotic Depression)

  • 정종현;홍승철;이성필;한진희
    • 정신신체의학
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    • 제5권1호
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    • pp.118-122
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    • 1997
  • 저자들은 13년전 심한 산후 출혈 후에 서서히 진행된 성선, 갑상선, 부신피질호르몬결핍증상과 함께 피해망상, 환청과 이에 따른 행동, 심한 불면증, 정신운동의 지체, 사회적 철퇴 등의 증상을 보인 51세 여자환자의 증례를 경험하였다. 환자는 일견 심한 정신병적 우울증의 양상을 보여 정신과에 입원하였으나 자세한 병력 청취 및 임상양상의 관찰로 내과적 질환에 의한 정신증의 가능성이 고려되었고, 호르몬 검사상 범뇌하수체기능 부전소견과 저혈당증 및 저나트륨혈증 등을 나타내 Sheehan시 증후군의 진단이 가능하였다. 갑상선과 부신피질호르몬의 투여 기타 보존적인 치료에 의해 정신과적증상을 포함한 제반 임상증상이 1주이내에 호전되었다. 저자들은 본 증례의 보고를 통해 정신과 환자에 대한 임상적 접근에서 간과되기 쉬운 내재된 내과적 문제의 감별의 중요성을 다시 한 번 강조하고자 한다.

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2-Nonadecanone Alleviates Depression through Inflammation Relief in SD Rat

  • Lee, Gil-Hyun;Hyun, Kyung-Yae
    • 대한의생명과학회지
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    • 제24권3호
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    • pp.206-212
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    • 2018
  • Depression is a type of mood disorder characterized by hypochondriasis, decreased appetite, and insomnia. Depression is a disease that affects more than 100 million people worldwide. 2-Nonadecanone (NAC) is a bioactive substance that constitutes Fomes fomentarius, and NAC is expected to have an antidepressant effect. By using the forced swimming test (FST), we investigated the effects of treatment with NAC on immobility subacutely in rats after oral dosing once a day for 2 days. Serum levels of cytokine interleukin-1 beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha) were determined by enzyme-linked immunosorbent assay (ELISA). Nuclear factor-2 (Nrf-2) and inducible nitric oxide synthases (iNOS) were analyzed by western blot method. NAC dose-dependently decreased immobility in the FST. NAC dosedependently decreased FST-induced increase of cytokine levels, as manifested by significantly stronger effects on $IL-1{\beta}$ and $TNF-{\alpha}$ levels at higher doses than the lowest dose of NAC. Western blot analysis showed that Nrf-2 was significantly lower in the NAC-treated group than in the disease-induced group. The iNOS results were also significantly lower in the NAC-treated group than in the other groups. Considering FST results, the antidepressant effect of NAC is effective. Considering the results of cytokine and protein expression, this anti-depressant effect may be related to the anti-inflammatory effect. Therefore, it can be said that the anti-inflammatory effect of NAC increases the antidepressant effect in the FST experiment.

"동의보감(東醫寶鑑)"에 수록(收錄)된 온담탕(溫膽湯), 귀비탕(歸脾湯), 소요산(逍遙散) 및 그 가감방(加減方)에 대한 고찰(考察) (The Literature Study of Ondamtng, Guibitang, Soyosan & Their Gagambang Recording in Dong-Eui-Bo-Gam)

  • 서승호;정인철;이상룡
    • 혜화의학회지
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    • 제14권1호
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    • pp.129-140
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    • 2005
  • 1. In Dong-Eui-Bo-Gam, Ondamtng & its Gagambang are applied for the sudden palpitation, epilepsy, the insomnia of exhaustion and an acute convulsion which are caused by the asthenia of heart and gall bladder(心膽虛怯). 2. In Dong-Eui-Bo-Gam, Guibitang & its Gagambang are applied for amnesia, amenorrhea, upper abdominal pain, the itching sign the pubic region, the hernia of the vulva which are caused by the asthenia of heart and spleen(心脾兩虛). 3. In Dong-Eui-Bo-Gam, Soyosan & its Gagambang are applied for epilepsy, the hemorrhage in time of coughing, the intermittent fever, metrorrhagia, various woman's diseases which are caused by the depression of vital energy of liver(肝氣鬱結).

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경계성 인격 장애 환자의 수면 (Sleep in Borderline Personality Disorder Individuals)

  • 이소진
    • 수면정신생리
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    • 제19권2호
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    • pp.59-62
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    • 2012
  • Borderline personality disorder (BPD) is characterized by identity and interpersonal problem, affective dysregulation and pervasive severe impulsivity. Although sleep disturbances are not primary symptoms of BPD, they are important aspects of this disorder. However, clinicians and researchers did not give much attention to the sleep symptoms of BPD yet. Measured by nocturnal polysomnography, increased sleep latency as well as reduced total sleep time and sleep efficiency, and 'depression-like' REM abnormalities (i.e., reduced REM latency and increased REM density) are found in BPD patients. Co-morbid sleep disorders such as chronic insomnia, nightmare disorder or circadian rhythm sleep disorder associated with BPD have been reported. Clinicians should focus on the sleep complaints of BPD patients, and carefully manage such symptoms with sleep hygiene education, cognitive psychotherapy or light therapy.