• 제목/요약/키워드: depressive disorder

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정신건강의학과 외래환자 대상 한국판 외상 증상 체크리스트(Trauma Symptom Checklist-40)의 타당도 연구 (Validation of the Korean Version of the Trauma Symptom Checklist-40 among Psychiatric Outpatients)

  • 박진;김대호;김은경;김석현;윤미림
    • 정신신체의학
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    • 제26권1호
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    • pp.35-43
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    • 2018
  • 연구목적 복합 외상을 겪는 경우에는 PTSD의 증상을 넘어선 증상들이 다양하게 나타난다. 그러나 그러한 다양한 증상을 평가하는 도구가 부족한 실정이다. 외상 증상 체크리스트-40은 자기보고식 검사로 아동기 혹은 성인기의 외상 경험과 관련된 이러한 다양한 증상들을 측정하기 위한 도구로 원척도 연구에서 높은 신뢰도와 타당도가 검증된 검사 도구이다. 이번 연구의 목적은 정신건강의학과 외래 환자를 대상으로 한국판 외상 증상 체크리스트-40 (KTSC-40)의 타당도를 검증하기 위해 설계 되었다. 방 법 한양대학교 구리병원 정신건강의학과 외래를 진료 목적으로 방문한 367명의 환자를 대상으로 하였다. 환자들의 자기보고식 평가 자료를 사용하였으며 외상 증상 체크리스트-40 (TSC-40), 사건 충격척도 개정판(IES-revised), 일생 사건 체크리스트(LEC), Zung 자가평가 우울척도(Zung's Self-Rating Depression Scale), Zung 자가평가 불안척도(Zung's Self-Rating Anxiety Scale)를 이용하였다. 신뢰도는 내적 일치도(Cronbach's ${\alpha}$)로 산출하였고, 요인타당도는 Varimax 직각 회전을 이용한 탐색적 주성분 분석, 각 척도와의 수렴 및 공존 타당도를 위해서는 Spearman 상관분석을 하였다. 결 과 KTSC-40은 Varimax 직각회전을 이용한 주성분 요인 분석을 통해 7개의 요인을 추출하였고, 총 분산의 59.55%를 설명하였다. 이는 원척도 연구에서의 6개의 요인, 5개의 요인과 요인 수는 다르지만 그 내용은 비슷하였다. KTSC-40은 Cronbach's ${\alpha}$ 값이 0.94로 높은 내적 일치도를 가졌다. 또한 다른 PTSD scale과 우울, 불안 척도와의 비교에서 높은 수렴 및 공존 타당도를 보였다. 결 론 KTSC-40의 정신측정학 성질을 조사하여 우수한 타당도를 보이는 것을 확인하였다. 다만, 요인 분석에서의 원척도와의 약간의 차이를 보였는데 이는 문화적인 요소와 외상 관련 질환이 아닌 정신건강의학과 환자군 등 이질적인 외래 구성 집단에 따른 것으로 보인다. 결과적으로 KTSC-40은 높은 타당도로 향 후 다양한 임상영역에서 외상과 관련된 증상들을 평가 하는데 유용할 것으로 예상된다.

임상실천 평가를 위한 단일체계설계의 적용 -우울증 감소를 위한 인지행동치료에 대한 평가를 중심으로- (Use of Single-System Design to Evaluate the Effectiveness of Cognitive Behavioral Therapy of Depression)

  • 김용석;손동균
    • 한국사회복지학
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    • 제60권2호
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    • pp.175-209
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    • 2008
  • 임상실천의 평가를 위한 도구로 단일체계설계를 강조하는 본 연구는 우울증 치료를 위해 정신과 병원에 입원한 3명의 클라이언트들에게 인지행동치료를 제공하고 개입의 효과성을 평가하기 위해 AB 설계를 사용하였다. 본 연구에 참여하기로 동의한 3명의 클라이언트는 모두 약 2주간의 기초선 단계와 약 3주간의 개입단계에 참가하였다. 평가결과의 타당성을 높이기 위해 다각적 측정원칙을 적용하였고, 기초선 단계와 개입단계 동안 수집된 자료는 시각적인 방법과 통계적인 방법으로 분석되었다. 시각적 분석의 정확성을 높이기 위해 추세선, 추세지수 등과 같은 방법을 활용하여 분석한 결과, 클라이언트 3명의 우울증상이 개입단계에서 모두 나아진 것으로 나타났으며 이러한 개선은 통계적으로도 유의미하였다. 본 연구는 모니터링, 클라이언트를 실천과정에 적극적으로 참여시킬 수 있는 기회 제공, 자료분석의 용이성을 임상실천평가를 위해 단일체계설계를 사용함으로써 얻게 되는 장점으로 들고 있다.

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Effects of Sumsu (Bufonis venenum) Pharmacopuncture Treatment on Depression in Mice

  • Choi, Min-Ji;Kim, Ka-Na;Lee, Jae-Eun;Suh, Jin-Woo;Kim, Sung-Chul;Kwon, Ki Rok;Cho, Seung-Hun
    • 대한약침학회지
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    • 제17권2호
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    • pp.27-33
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    • 2014
  • Objectives: The main objective of this study was to evaluate the anti-depressant effects of pharmacopuncture using sumsu (Bufonis venenum). Methods: Animals were divided into three groups (control, sham, and experimental), with eight mice per group. The sham and the experimental groups were exposed to 2 hours of immobilization stress daily for 14 days. They were also injected with normal saline (sham) or subjected to pharmacopuncture with sumsu at the acupoints HT7, SP6, and GV20 (experimental). The depression or anxiety-like behaviors of the mice in each group were evaluated 1 day after treatment. Results: There was no difference in locomotor activity between the groups during the open-field test; i.e., all groups had normal motor function. However, the open-field and the forced-swimming tests revealed that depression and anxiety-like behaviors were decreased significantly in the group treated with sumsu pharmacopuncture. Conclusion: Sumsu pharmacopuncture attenuated depressive or anxiety-like behavior in mice stressed with chronic immobilization. These results suggest that sumsu pharmacopuncture has therapeutic potential for treating neuropsychiatric disorders such as anxiety or depression disorder.

Long-Term Tolerability of Escitalopram in Korean Adolescents

  • Goo, Ae-Jin;Won, Eun-Kyung;Lee, Cheolsoon;Lee, Jong-Il;Jung, Hee-Yeon;Kim, Yeni
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제24권4호
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    • pp.207-212
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    • 2013
  • Objectives : We investigated the long-term tolerability of escitalopram in Korean adolescents. Methods : The subjects were 37 adolescents, who had been diagnosed with depressive disorder in accordance to DSM-IV. Clinical effectiveness was assessed by Clinical Global Impression-Improvement (CGI-I) scale at the final follow-up visit. Tolerability was assessed through a medical record of the reason for discontinuation of escitalopram and documented adverse events. Results : The mean duration of treatment was $78.1{\pm}89.5$ days, and the mean dosage was $10.0{\pm}4.4$mg/day. Out of the total 37 patients, two (5%) patients sustained use of escitalopram. Twelve patients (32.4%) discontinued use of escitalopram due to target symptom remission, and 23 patients (61.9%) due to insufficient efficacy. Six patients (16.2%) had at least one documented adverse event. However, no suicidal ideation or self-injurious behavior was reported. Significant differences in clinical symptom improvement efficacy were seen between the patients who were receiving escitalopram for less than 8 weeks (4.3%, 1/13) and those for more than 8 weeks (92.9%, 13/14). There was no significant difference between the tolerability of monotherapy compared to the concomitant use group. Conclusion : The results of this study suggest that long-term use of escitalopram may result in superior efficacy than shortterm use, and is tolerable in Korean adolescents with depression.

Ingestion of Gouda Cheese Ameliorates the Chronic Unpredictable Mild Stress in Mice

  • Yun, Bohyun;Yoo, Ja Yeon;Park, Mi Ri;Ryu, Sangdon;Lee, Woong Ji;Choi, Hye Jin;Kang, Min Kyoung;Kim, Younghoon;Oh, Sangnam
    • 한국축산식품학회지
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    • 제40권1호
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    • pp.145-153
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    • 2020
  • Depression is a kind of mood disorder characterized by decline in motivation, interest, attention, mental activity, and appetite. Although depression is caused by a variety of causes, including genetic, endocrine and environmental stress, mild depression has been reported to improve with diet. Therefore, various type of food sources including functional and nutritional supplement are required to treat the depressive patients. Cheese contains bioactive peptides that have beneficial effects on host health. In particular, Jersey milk has been reported to contain higher solids than does Holstein milk. This study investigated the effects of Gouda cheese from Jersey and Holstein milk on chronic, unpredictable, mildly stressed (CUMS) mice. Here, spontaneous alterations in cheese-fed stressed mice were noted to be effectively recovered with statistical significance regardless cow species. Interestingly, for the analysis of fecal microbiota, Bacteroidetes were noted to increase with a reduction in Firmicutes at the phylum level with Jersey cheese. Taken together, we suggest that cheese intake provided a beneficial effect on stressed mice in recovering recognition ability. In particular, changes in internal microbiota were observed, suggesting that the bioactive ingredients in cheese act as improvement agents with respect to mood and brain function.

응급실을 경유하여 입원한 자살시도자들의 분석 -정신병력, 자살시도력 및 정신과적 진단을 중심으로- (Analyses of Suicide Victims Admitted via the Emergency Department -Based on Psychiatric Histories, Past Suicidal Attempts and Psychiatric Diagnoses-)

  • 허재민;전우찬;민영기;정윤석
    • 대한임상독성학회지
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    • 제2권2호
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    • pp.106-115
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    • 2004
  • Purpose: This study analyzed the general features, psychiatric histories, past suicidal attempts and psychiatric diagnoses of suicide victims admitted via the emergency department (ED). Methods: Reviewing the charts of 138 inpatients of suicide attempts admitted via the ED from January 2002 to December 2003, we analyzed various data, including sex, age, season, stressful events, psychiatric histories, previous suicidal attempts, and psychiatric diagnoses during admission, and we used a chi-square test to chart the statistical data. Results: A significant difference was found between 1 st attempts and repeated attempts as to the mechanical methods used for the suicide attempts, There was a significant difference in the kinds of drugs between patients with and without psychiatric histories. In the psychiatric diagnosis, there was a significant difference in AXIS I between patients with and without psychiatric histories. In AXIS II, there was a significant difference between patients with and without psychiatric histories, 1st attempts and repeated attempts. Conclusion: We emphasize the importance of psychiatric consults, treatments, and follow-ups for suicide victims and the emergency physicians' function in helping them to contact psychiatric doctors.

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실음(失音)의 병인(病因) 병기(病機)에 대(對)한 문헌적(文獻的) 고찰(考察) (A Literatual Study on the Dysphonia)

  • 송각호;노석선
    • 대한한의학회지
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    • 제16권1호통권29호
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    • pp.251-270
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    • 1995
  • In the Literatual Study on the Dysphonia, the results were as follows. 1. The causes of dysphonia are exogenous pathogenic factors,(specially cold evil)internal damage and meridian in The Yellow Emperor's Canon of Interal Medicine, since then endogenous pathogenic factors are lung-asthenia and deficiency of lung-yin etc. The main causes are disease caused by exogenous evils, general body weakness, emotional stimulation and excess of high voice rescently. 2. The pathogenesis of dysphonia originated from two factors; The first internal damages are consumption of body fluid with the formation of dryness evil resulting from the insufficienty of lung-yin and lung-collaterals damaged by heat-evil caused by deficiency of lung and kidney-yin. The second disease caused by exogenous evils is sluggishness of lung-energy caused by exogenous pathogenic factors. 3. The main relative organ are heart, lung and kidney etc. 4. The prescriptions of wind-cold symptoms are Samyoutang(三拗湯) and Hangsosan(杏蘇散), in the prescriptions of phlegm-heat symptom is Chenginyongphetang(淸咽寧肺湯), in the prescriptions of depressive syndrome due to disorder of vital energy are Sogangkitang(小降氣湯) and Shihochenggantang(柴胡淸肝湯加減), in the prescriptions of consumption of body fluid with the formation of dryness evil resulting from the insufficiency of lung-yin symptoms are Sanghangtang(桑杏湯) and Chenginguphetang(淸咽救肺湯, in the prescriptions of deficiency of lung and kidney-yin are Baekhabgokumtang(百合固金湯) and Maekmigiwhangtang(麥味地黃湯). 5. The treatment of acupunctures are used by LI-4(合谷), H-7(湧泉), Liv-3(太衝), K-3(太谿), Sp-6(三陰交), H-5(通里), GV-15(아門), CV-23(廉泉), S-40(農隆), K-6(照海), L-7(列缺), S-36(足三里) etc.

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Effects of Long- and Short-term Consumption of Energy Drinks on Anxiety-like, Depression-like, and Cognitive Behavior in Adolescent Rats

  • Lee, Joo Hee;Lee, Jong Hyeon;Choi, You Jeong;Kim, Youn Jung
    • Journal of Korean Biological Nursing Science
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    • 제22권2호
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    • pp.111-118
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    • 2020
  • Purpose: The purpose of this study was to understand the impact of long- and short-term energy drinks on anxiety-like, depressionlike, and cognitive behavior in adolescent rats. Methods: Adolescent rats (age six weeks) were randomly classified into a control group (CON), a long-term administration group (LT), and a short-term administration group (ST). The LT group was orally administered 1.5 mL/100 g (body weight) of energy drink twice daily for 14 days, the ST group was orally administered for one day, and the control group applied the same amount of normal saline. Later, an open-field test, a forced swim test, novel object recognition test, and an 8-arm radial maze test was conducted to assess the rats' anxiety, depression, and cognitive function. Results: There were different effects in the long- and short-term groups of energy drink administration. In the LT group, anxiety- and depressive-like behavior increased because of increased movement in the side corner and decrease of immobility time. Also, the time to explore novel objects decreased, and the number of correct responses was reduced, indicating a learning and memory function disorder. However, the ST group was not different from the control group. Conclusion: These results indicate that long-term consumption of energy drinks can increase anxiety-like, depression-like behavior, and this can lead to decrease in learning and memory functions. Thus, nurse and health care providers should understand the impact of energy drink consumption in adolescence to provide appropriate practices and education.

조증 및 정신분열병 환자에서 덱사메사손/인슐린-유도성 저혈당 병합검사 (Combined Dexamethasone/Insulin-induced Hypoglycemic Test in Manic and Schizophrenic Patients)

  • 성시용;박철수;손진욱
    • 생물정신의학
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    • 제4권2호
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    • pp.272-278
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    • 1997
  • Many investigators are trying to elucidate the pathogenesis of psychiatric disorders on the basis of neuroendocrine responses to stimulation or perturbation. Dexamethasone(DEX) suppression has been the most widely utilized as the prototypical challenge test. Dexamethasone suppression test(DST) has proven to be valuable in diagnosing the depressive spectrum disorder. Reported specificity of diagnosis of depression is relatively high, but sensitivity is limited. Some researchers used the combination of dexamethasone and corticotropin releasing hormone(CRH) in order to improve the sensitivity. They reported that combined DEX/CRH test is more sensitive than DST alone. In this study the authors modified the DEX/CRH test, i.e., we administered the insulin instead of CRH. Total subjects were 28(7 normal controls, 10 manic patients, 11 schizophrenic patients). Subjects were taken DEX(1.5mg p.o.) at 11 p.m., insulin 16 hours later(0.1 unit/kg i.v.). Five blood samples for the determination of cortisol and ACTH were serially drawn at 15 minute interval. The results are as followings : 1) The cortisol and ACTH levels of manic subjects increased following insulin administration. Manic subjects showed higher levels of cortisol and ACTH than schizophrenic and normal control subjects. The cortisol and ACTH levels of schizophrenic and normal control subjects did not show gross changes. 2) The sensitivity of the test was lower than that of reported DEX/CRH test.

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국내 우울증 평가도구 타당화 연구의 체계적 고찰-진단적 타당성을 중점으로 : 한국형 우울 선별 도구 개발을 위한 예비 연구 (A Systematic Review of Validation Studies on Depression Rating Scales in Korea, with a Focus on Diagnostic Validity Information : Preliminary Study for Development of Korean Screening Tool for Depression)

  • 정수연;김신향;박기호;제갈은주;이원혜;최윤영;이승환;최기홍
    • 대한불안의학회지
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    • 제13권2호
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    • pp.53-59
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    • 2017
  • Reliable and valid diagnostic screening tools in the primary care setting enable accurate estimation of depression in individuals at risk or in need of treatment, and provide patients with an opportunity to receive optimal treatments. Although there have been extensive studies on screening tools for depression used in domestic mental health settings, there is little consideration and lack of a thorough review of the diagnostic validity of screening tools. In the current review, we selected 13 representative screening tools for depression which were evaluated in a total of 19 validation studies conducted in Korea. We summarized DSM-5 target domains, diagnostic indices, sensitivity, specificity, cut-off scores, and diagnostic validity information for each tool. Finally, the depression measurement expert group was constituted to evaluate the current status of screening tools for depression, and their recommendations for a new screening tool were summarized. This study was conducted as part of the Mental Health Technology Development project to develop the Korean screening tool for depression (K-DEP).