• 제목/요약/키워드: depressive disorder

검색결과 414건 처리시간 0.021초

메르스 대유행 생존자들이 인식한 낙인이 대처전략 및 우울 및 외상후 스트레스 증상에 끼치는 장기적 영향 (Long-Term Impact of Stigma on Coping Strategies and Depressive and Posttraumatic Stress Symptoms in MERS Survivors)

  • 유용준;박혜윤;김정란;이정재;이해우;이소희
    • 정신신체의학
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    • 제30권2호
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    • pp.145-154
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    • 2022
  • 연구목적 본 연구는 메르스 생존자에서 감염 당시 낙인에 대한 인식, 12개월 후 이들이 사용하는 대처전략, 24개월 후 우울 및 외상후 스트레스 증상에 끼치는 영향 간의 연관성을 확인하고자 하였다. 방 법 63명의 2015년 메르스 생존자를 대상으로 코호트 연구를 진행하여 12개월 및 24개월 후에 인구학적 정보, 메르스 감염의 심각도, 우울 및 외상후 스트레스 증상, 대처전략, 낙인에 대한 인식 등을 조사했다. 결 과 감염 당시 낙인의 인식은 12개월 후 부정적 대처전략(p=0.003), 24개월 후 우울(p=0.058) 및 외상후 스트레스 증상(p=0.011)과 연관성을 보였다. 12개월 후 부정적 대처전략과 24개월 후 우울(p=0.002) 및 외상후 스트레스 증상(p<0.001) 간에도 유의한 연관성이 있었다. 결 론 감염자에 대한 낙인은 생존자들의 장기적 정신 건강에 부정적 영향을 줄 수 있다. 향후 신종감염병 유행 시 낙인 문제를 개선하고 생존자들이 적응적 대처전략을 가지도록 도와야 한다.

딥러닝 기반 소셜미디어 한글 텍스트 우울 경향 분석 (A Deep Learning-based Depression Trend Analysis of Korean on Social Media)

  • 박서정;이수빈;김우정;송민
    • 정보관리학회지
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    • 제39권1호
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    • pp.91-117
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    • 2022
  • 국내를 비롯하여 전 세계적으로 우울증 환자 수가 매년 증가하는 추세이다. 그러나 대다수의 정신질환 환자들은 자신이 질병을 앓고 있다는 사실을 인식하지 못해서 적절한 치료가 이루어지지 않고 있다. 우울 증상이 방치되면 자살과 불안, 기타 심리적인 문제로 발전될 수 있기에 우울증의 조기 발견과 치료는 정신건강 증진에 있어 매우 중요하다. 이러한 문제점을 개선하기 위해 본 연구에서는 한국어 소셜 미디어 텍스트를 활용한 딥러닝 기반의 우울 경향 모델을 제시하였다. 네이버 지식인, 네이버 블로그, 하이닥, 트위터에서 데이터수집을 한 뒤 DSM-5 주요 우울 장애 진단 기준을 활용하여 우울 증상 개수에 따라 클래스를 구분하여 주석을 달았다. 이후 구축한 말뭉치의 클래스 별 특성을 살펴보고자 TF-IDF 분석과 동시 출현 단어 분석을 실시하였다. 또한, 다양한 텍스트 특징을 활용하여 우울 경향 분류 모델을 생성하기 위해 단어 임베딩과 사전 기반 감성 분석, LDA 토픽 모델링을 수행하였다. 이를 통해 문헌 별로 임베딩된 텍스트와 감성 점수, 토픽 번호를 산출하여 텍스트 특징으로 사용하였다. 그 결과 임베딩된 텍스트에 문서의 감성 점수와 토픽을 모두 결합하여 KorBERT 알고리즘을 기반으로 우울 경향을 분류하였을 때 가장 높은 정확률인 83.28%를 달성하는 것을 확인하였다. 본 연구는 다양한 텍스트 특징을 활용하여 보다 성능이 개선된 한국어 우울 경향 분류 모델을 구축함에 따라, 한국 온라인 커뮤니티 이용자 중 잠재적인 우울증 환자를 조기에 발견해 빠른 치료 및 예방이 가능하도록 하여 한국 사회의 정신건강 증진에 도움을 줄 수 있는 기반을 마련했다는 점에서 의의를 지닌다.

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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아토피 피부염 환아의 정신 건강 분석 및 아토피 피부염 교육을 통한 인식, 인지도 개선에 대한 고찰 (A Study on Mental Health Analysis of Atopic Children and Awareness Improvement through Atopic Education)

  • 박승구;노현민;조은희;박민철
    • 한방안이비인후피부과학회지
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    • 제30권2호
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    • pp.51-85
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    • 2017
  • Objectives : This study aimed to investigate the awareness improvement of atopic dermatitis(AD) for AD children's parents and to evaluate the mental health condition of AD children and QoL of their parents. Methods : We conducted elementary school visit education(the first education) and recruited children and parents who wanted to participate the hospital visit education(the Second education). In the first education, we lectured about AD, performed survey about QoL and awareness about AD and obtained 48 valid results. In the second education, we performed an education for AD again, skin condition evaluation, mental health analysis survey and obtained 29 valid results. We compared the AD and non-AD groups of each education in the first and second education. We assessed atopic awareness, FDLQI, DFI, CDI, BAI, and KISE scores by gender, age, duration of disease, onset, and severity of AD. Results : Despite children with AD, the survey showed their parents lacked knowledge about AD. However, they acquired the necessary knowledge in AD education. There was a significant difference in the total score of Atopic awareness between the AD group in the first education and the AD group in the second education. (p=0.042) In addition, the CDI and BAI scores of all patients were divided by the duration of disease, and it was estimated that depression and anxiety disorders may be aggravated by longer term illness. Conclusions and Discussions : This study confirmed duration of AD affects AD children's mental health, and verified positive changes in atopic awareness after AD education.

강원지역 소방관에서 외상후 스트레스 증상 및 동반증상에 미치는 리질리언스의 영향 (The Effect of Resilience on Posttraumatic Stress Disorder Symptoms and Comorbid Symptoms in Firefighters)

  • 이홍의;강석훈;예병석;최종혁
    • 대한불안의학회지
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    • 제8권2호
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    • pp.86-92
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    • 2012
  • Objective : This study investigated the relationship between the resilience and posttraumatic stress symptoms, as well as comorbid symptoms in firefighters. Methods : We collected 764 firefighters, who worked at six fire department stations in Gangwon-do. We investigated the impact of event scale-revised (IES-R), the life events checklists (LEC), Connor-Davidson resilience scale (CD-RISC), Beck depression inventory (BDI), state trait anxiety inventory (STAI) and alcohol use disorder identification test (AUDIT). Full PTSD groups, partial PTSD groups and non-PTSD groups, which were classified by IES-R scores, were compared in the LEC, CD-RISC, BDI, STAI and AUDIT, ; multiple linear regression analyses were done for independent predictors of variables. Results : Of the 764 firefighters, there were significant differences in LEC (p<0.001), CD-RISC (p<0.001), BDI (p<0.001), and AUDIT (p=0.001) among the full PTSD groups, partial PTSD groups and non-PTSD groups. However, STAI did not show significant difference among three groups. In multiple regression analysis, CD-RISC (${\beta}=-0.168$, p<0.001), LEC (${\beta}=0.211$, p<0.001) and AUDIT (${\beta}=0.115$, p=0.001) were significant predictors for IES-R. Conclusion : The results of the present study suggested that resilience might be a protective factor in PTSD and comorbid symptoms of PTSD.

우울과 불안의 뇌 기능 - EEG, ERP, Functional Neuroimaging, HRV 소견을 중심으로 - (Neurophysiological and Neuroimaging Characteristics of Depression and Anxiety)

  • 추정숙;이승환;정영조
    • 대한불안의학회지
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    • 제4권1호
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    • pp.3-10
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    • 2008
  • The purpose of this review was to investigate the neurophysiological and neuroimaging characteristics of patients with depression and anxiety reported in previous studies. A literature search was conducted using Medline and psychiatric textbooks. "Electroencephalography (EEG)", "Event Related Potentials (ERP)", "functional neuroimaging", "heart rate variability (HRV)" and "depression or anxiety" were used as key words. A physiological finding indicated that there was a higher degree of relativity with regards to prefrontal dysfunction in patients with depression. Right prefrontal lobe hyperactivity and left prefrontal hypoactivity were consistently observed, and abnormalities were observed in other regions (ACC, hippocampus, amygdala, etc.). Therefore, dysfunctions in these areas are related to depressive symptoms. In patients with anxiety disorder, each emotional condition showed specific activation patterns in different brain regions, such as the prefrontal cortex, occipital lobe, temporal lobe, hippocampus, and limbic system, including the amygdala. However, in the majority of patients with anxiety disorder, the degree of activation was higher in the right hemisphere than in the left hemisphere. The current data supports that there is a difference in brain dysfunction characteristics between depression and anxiety and that the different activations of various brain regions would play a significant role in the pathophysiology of depression and anxiety disorder.

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노년기 정신장애의 전기경련치료 (Electroconvulsive Therapy for Psychiatric Disorders in Elderly Adults)

  • 주은정;김희철;강웅구;이남영;박승현;김정민;김용식;정인원
    • 생물정신의학
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    • 제27권2호
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    • pp.42-57
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    • 2020
  • Electroconvulsive therapy (ECT) is indicated for various mental disorders (e.g., major depressive disorder, schizophrenia, and bipolar disorder) and the behavioral and psychological symptoms of dementia in elderly patients. Furthermore, ECT is a useful first-line treatment in emergency and crisis situations such as suicide risk, violent behavior, catatonia, and food refusal, which are more frequent in elderly patients. ECT is also effective in the treatment of the motor symptoms of neurological disorders, such as Parkinson's disease and Huntington's disease. Due to the high risk of various physical diseases, the comorbid physical conditions of elderly patients should be individually controlled to optimize ECT treatment. Compared to young adults, in elderly patients the seizure threshold is higher, the seizure duration is shorter, and the anesthetic dose is lower. On the contrary, the response rate in the elderly is both faster and higher. Considering potential cognitive decline and the prevention of further deterioration of cognitive function in elderly patients, in the absence of significant comorbidities, twice weekly sessions and right unilateral electrode placement with a lower seizure threshold and less cognitive effect are preferred to bilateral electrode placement, which has a high risk of adverse cognitive effects. After an acute course of ECT, continuation and maintenance of ECT, combined with prescription of therapeutic drugs, may prevent possible relapse or recurrence of mental disorders. In conclusion, ECT can be used to treat mental disorders in elderly adults, with safety and effectiveness comparable to that in young adults.

COVID-19 환자 간호한 간호사들의 외상 후 스트레스 장애, 우울 및 사회적 낙인 간의 관계 (Corelation between Nurses' Posttraumatic Stress Disorder, Depression and Social Stigma in Nursing COVID-19 Patients)

  • 이은자;조옥연;왕금현;장명진
    • 동서간호학연구지
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    • 제27권1호
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    • pp.14-21
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    • 2021
  • Purpose: This study aims to examine the levels of posttraumatic stress disorder (PTSD), depression and social stigma among nurses caring for Corona Virus Disease-19 (COVID-19) patients. Methods: 169 nurses caring for COVID-19 patients participated in this study. Data collection was conducted at university hospitals from March 1 to August 31, 2020. Data analysis was performed for descriptive statistics, t-test, ANOVA, and Pearson correlation coefficients using SPSS/WIN 24.0 program. Results: The mean scores of PTSD, depression and social stigma were 25.16±16.80, 17.26±8.63 and 5.83±2.84, respectively. The PTSD scores were significantly different between the department (F=2.89, p=.037). Depressive scores were significantly different between the marital status (t=2.27, p=.024) and the department (F=4.91, p=.003). Social stigma scores were significantly different between age (F=6.49, p=.002), marital status (t=-3.30, p=.008), having or not having children (t=3.82, p=.001), department (F=5.82, p=.001) and clinical experience (F=7.43, p=.001). Positive correlations were found between PTSD and depression (r=.70, p<.001) and social stigma (r=.22, p<.004). Conclusion: Integrated assessment and management are required to address the psychological and emotional problems faced by nurses caring for COVID-19 patients, and active follow-up measures should be considered.

강박장애 환자에서 강박증상차원에 부합하는 12문항 강박증상목록의 심리측정적 특성 (Psychometric Properties of the Korean Version of 12-Item Obsessive-Compulsive Inventory in Accordance With Obsessive-Compulsive Symptom Dimensions in Individuals With Obsessive-Compulsive Disorder)

  • 서호석;최미나;이승재
    • 대한불안의학회지
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    • 제19권1호
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    • pp.10-18
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    • 2023
  • Objective : The 18-item Obsessive-Compulsive Inventory-Revised (OCI-R) is widely employed to assess symptoms of obsessive-compulsive disorder (OCD). However, this instrument's factor structure does not align with contemporary dimensional models of OCD. Therefore, the objective of this study was to examine psychometric properties of the 12-item Korean OCI (OCI-12) on four obsessive-compulsive symptom dimensions, in patients with OCD. Methods : A total of 157 patients with OCD and 51 healthy controls completed psychological measures, including the OCI-R, Dimensional Obsessive-Compulsive Scale (DOCS), and scales evaluating anxiety and depressive symptoms. Pychometric characteristics of the OCI-12 with three neutralizing and three hoarding items eliminated from the OCI-R, were analyzed. Results : All OCI-12 items registered excellent internal consistency at 0.83. Confirmatory factor analysis revealed strong association between individual items and their proposed latent factors (i.e., subscales). Convergent validity was appropriate. A high correlation was particularly observed for the DOCS score (r=0.71, p<0 .001). Moreover, the OCI-12 was as sensitive as the OCI-R for determining effects of empirically supported treatment for OCD. Conclusion : The OCI-12 is a 12-item measure that adheres to the prevailing 4-factor model of OCD dimensions. Like OCI-R, it possesses good to excellent psychometric properties, including reliability, validity, and sensitivity to treatment.

과민성대장증후군의 형상의학적 고찰 -동의보감(東醫寶鑑)을 중심으로- (Hypersensitive Large Intestine Syndrome in Hyungsang Medicine)

  • 최병래;최영현;한진수;이용태
    • 동의생리병리학회지
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    • 제19권5호
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    • pp.1129-1136
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    • 2005
  • The writer reports the conclusions gained from study about the cause of the hypersensitive large intestine syndrome with Dongeuibogam as the central figure through researching the disharmony among Body Essence, Vital Energy, Mentality, and Blood, mutual action of five viscera and six bowels, and external shapes. The hypersensitive large intestine syndrome is generally chronic and recurred in many cases, so it is more efficacious than symptomatic to treat according to find the contradictions of individual shapes. The shapes and cases suffering frequently the hypersensitive large intestine syndrome are Gi-kwa and Sin-kwa, having a long nose, having a bruised spot on Triple warmer, man with inclined mouth, Taeeum type, man with congested fluids, man with colic symptoms. The hypersensitive large intestine syndrome in Oriental medicine is recognized of diarrhea, constipation, abdominal pain, abdominal distention and fullness caused by seven emotions. In Dongeuibogam it can be found out the similarity in depressive symptoms due to disorder of Gi, stagnation of Gi, dysphasia due to disorder of Gi, diarrhea due to disorder of Gi, fullness of due to Gi, diarrhea due to phlegm-retention, retention of undigested food, immoderate drinking, hypo-function of the spleen, or deficiency, abdominal pain from colic symptom, and difficulty in defecation and urination, internal injury, diarrhea due to weakness and fatigue. If the Jung, Gi, Sin, and Hyul composed the human body is broken harmony, the function of large intestinal transmission would be fallen, so similar symptoms like the hypersensitive large intestine syndrome are gotten. Especially Gi-kwa suffers diarrhea, constipation abdominal pain, and abdominal distention and fullness due to depressive symptoms from disorder of Seven emotions or Seven Gi. And Sin-kwa suffers from the hypersensitive large intestine syndrome due to emotional restlessness having an influence on rhythmic movement of abdomen. Examining between five viscera and six bowels and the hypersensitive large intestine syndrome, Liver cannot disperse well having influence on mutual relation of Liver-Large intestine, Heart reduces the function of defecation and urination not to control the seven emotions, Lung having exterior and interior relation with intestine has an influence on primordial energy and let the main symptoms occur, Spleen circulating the body fluid let the main symptoms occur due to malfunction of circulation, Kidney locating in lower part of the body has deep connection with intestine, so let the disorder. Urinary bladder is connected with intestine in moisture metabolism, Stomach is connected in receive and transmission, Small intestine is connected in absorption and excretion, from small intestine pain disturbing the abdominal movement, Samcho managing the catharsis of lower heater if declined its function causes the hypersensitive large intestine syndrome. The colic symptoms of Front private parts which disorder in lower abdomen give rise to abdominal pains, difficulty in defecation and urination due to Cold are similar to the hypersensitive large intestine syndrome. The treatments of applying the shapes of colic syndrome advocated by Master Park can be efficacious cure in clinic. Researching after the clinical cases of Master Park advocating Hyungsang medicine, we came to know that plenty of prescriptions of internal injury are applied and take good effects.