• 정신신체의학
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• 제17권1호
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• pp.15-22
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• 2009

연구목적 : 산후 우울증은 10~15%의 산모가 경험하는 흔한 질환이다. 본 예비적 연구의 목적은 산후 우울증과 산전 위험요인으로 가족 적응력 및 응집성과의 관계를 알아보기 위함이다. 방법 : 24명의 산모를 대상으로 출산 전후의 시기에 전향적으로 연구하였다. 임신 36~40주에 산전 위험요인에 대한 질문지, Edinburgh 산후 우울증 척도(EPDS), 가족 적응력-응집성 평가 척도(FACES), Beck 불안 척도(BAI) 등을 시행하였다. 출산 후 4~6주에 구조적 면담으로 미니 국제신경정신인터뷰를 시행하여 산후 우울증을 진단하였으며 산후 위험요인에 대한 질문지, EPDS, BAI 등을 시행하였다. 결과 : 산후 우울증 군과 비 산후 우울증 군을 비교한 결과, 여러 v위험 요인 중 가족 적응력 및 응집성, 산전 우울증상 및 임신 중 기분 변화가 유의한 차이를 보였다. 로지스틱 회귀분석 상 임신 중 기분변화, 낮은 가족 적응력-응집성 평가 척도 총점 및 각 하위 척도 점수가 산후 우울증의 유의한 연관 요인으로 나타났다. 결론 : 본 연구의 결과는 산후 우울증에 있어 낮은 가족 적응력 및 응집성이 유의한 연관성을 가진 요인일 수 있음을 시사한다. 그러나 본 연구는 예비적 연구로 연구 대상 수가 적어 상기 결과가 지지되기 위해서는 대규모 연구가 필요하다.

• 동의신경정신과학회지
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• 제31권2호
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• pp.121-133
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• 2020

Objectives: The purpose of this study was to identify the meanings and characteristic of the stagnation syndrome, a distinctive clinical syndrome in traditional Korean medicine (KM). Methods: The major ancient Oriental medicine literature, including Huangdi neijing (黃帝內經), Danxixinfa (丹溪心法), and Jingyuequanshu (景岳全書) were examined to identify the semantic change of the stagnation syndrome (鬱證). Also, recently published articles about the stagnation syndrome were searched from databases including MEDLINE, CENTRAL, KMBASE, KISS, NDSL, and OASIS. Results: The term of stagnation was originally used to describe not flowing and clogged situations, and the stagnation syndrome appeared as an independent syndrome in Danxixinfa. As the etiology became more sophisticated over time, emotional factors were mentioned for one of the causes of the stagnation syndrome. However, the major causes and symptoms of the stagnation syndrome were somatic factors. Various articles about stagnation were searched, and most of them used "stagnation" as the KM syndrome subtype of disease, some of them referred to the "stagnation syndrome" as an independent syndrome. The recently defined stagnation syndrome commonly shows distinctive symptoms of chest stuffiness, and an obstructing sensation in the throat. Conclusions: The semantic changes and characteristics of the stagnation syndrome were examined through searching ancient and modern literature. The meaning of the stagnation syndrome has evolved over time, and at its center, there are somatic and mental symptoms characterized by stagnation, distinguished from the depressive disorder.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제26권3호
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• pp.165-175
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• 2015

Objectives : The purpose of this study was to investigate changes in child and adolescent outpatients at a university hospital in Daegu from 2004 to 2013. Methods : The subjects were first-visit patients under 18 years old, who visited Dongsan Medical Center, Keimyung University, from January 1, 2004 to December 31, 2013. Computerized medical records of 2,738 patients (male 1,906, female 832) were reviewed. Results : The ratio of male to female was 2.3 : 1 in the period of study. The most prevalent age category was 7-9 years. The mean age was $10.12{\pm}4.68$ years ($9.84{\pm}4.59$ years in males, $10.76{\pm}4.81$ years in females). The ratio of child and adolescent patients to total outpatients was 27.0%. The most common diagnostic category was the attention-deficit hyperactivity disorder (ADHD) group, followed by the mental retardation (MR) group. In males, the ADHD, MR, communication disorder groups were more prevalent, but in females, the MR, ADHD, depressive disorder groups were more prevalent. Conclusion : The female to male ratio and total mean age were on the rise. The ADHD group was the most prevalent and the depressive disorder group was also on the rise in this period.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제33권3호
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• pp.67-72
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• 2022

Objectives: This study investigated the reliability and validity of the Korean version of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Level 2 Cross-Cutting Symptom Measure-Patient-Reported Outcomes Measurement Information System (PROMIS)-Depression and the Irritability for parents of children aged 6-17 years. Methods: Participants were 190 children diagnosed with depressive disorder (n=14), anxiety disorder (n=21), attention-deficit/hyperactivity disorder (ADHD; n=111), ADHD with anxious depression (n=13), and tic disorder with somatic symptoms (n=31). Patients were 8-15 years of age. The participants' mothers completed the Korean versions of the DSM-5 Level 2 Cross-Cutting Symptom Measure-PROMIS Depression and Irritability (Affective Reactivity Index, ARI), and the Korean Child Behavior Checklist (K-CBCL). Using these data, we calculated the reliability coefficient and examined the concurrent and discriminant validity of the PROMIS Depression and the Irritability (ARI) scales for assessing depression and irritability in children. Results: The reliability coefficient of the PROMIS Depression scale (Cronbach's α) was 0.93. The correlation coefficient with the K-CBCL DSM emotional problem score was 0.71. The PROMIS Depression scale significantly discriminated children with depressive disorders from those with other conditions. The reliability coefficient of the Irritability (ARI) scale was 0.91, suggesting its high reliability. Conclusion: Our results suggest that the Korean version of the DSM-5 Level 2 Cross-Cutting Symptom Measure for Depression and Irritability Scales for parents of children aged 6-17 years is reliable and valid and may be an efficient alternative to the K-CBCL.

• 대한불안의학회지
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• 제8권2호
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• pp.146-152
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• 2012

Objective : Individuals with anxiety disorders experience a wide range of time to seeking treatment (TST) as well as various comorbid mental disorders. The present study examined the TST in social anxiety disorder (SAD) and panic disorder. This study aimed to find out the influence of comorbid mental disorder on TST of anxiety disorder through the comparison of SAD and panic disorder. Methods : This study included 311 SAD and 378 panic disorder patients at the initial visit of psychiatric clinic. Contribution of clinical (number of comorbidity, comorbid type and onset age) and demographic (current age) factors to TST were investigated by multivariate analysis. Results : The median length of TST was 14.03 years in SAD and 2.26 years in panic disorder. In social anxiety disorder, fewer comorbidity, younger onset age, and older age were factors associated with delayed TST. In panic disorder, only younger onset age was associated with delayed TST. In both disorders, comorbid depressive disorder was associated with shorter TST. Conclusion : Our data provided the differences in illness behavior needing help based on comorbid mental disorders between SAD and panic disorder. In addition to comorbid disorder, factors affecting TST of anxiety disorder requires future investigation.

• 대한불안의학회지
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• 제10권2호
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• pp.128-136
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• 2014

Objective : This study aimed to examine impact of anxiety and demographic factors on relationship between severity of depressive symptom and quality of life and disability. Methods : One hundred ninety five patients who met DSM-IV-TR criteria for depressive disorder were enrolled. It includes "Hamilton Rating Scale for Depression (HRSD)", "State-Trait Anxiety Inventory-State (STAI-S)", "General Health Questionnaire/Quality of Life-12 (GHQ/QL-12)", and "Sheehan Disability Scale (SDS)". Correlation analysis was used to see the correlations of each variable. Hierarchical regression analysis was used to see mediating effect of anxiety in the relationship. Sobel test was used to verify mediating effect. Multiple regression analysis was used to see moderating effect of demographic factors in the relationship. Results : There was partial mediating effect of anxiety on the relationship between severity of depressive symptoms and decreased quality of life (z=-11.68, p<.001)/increased disability (z=10.42, p<.001). Only religion was found to be moderating effect on the relationship between depressive symptoms and decreased quality of life. Conclusion : Rapid relief of anxiety along with depressive symptom had important implications for the treatment of patients with depression.

• Journal of Preventive Medicine and Public Health
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• 제49권3호
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• pp.176-182
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• 2016

Objectives: Prospective evaluations of the associations between depressive symptoms and suicide deaths have been mainly performed in high-risk populations, such as individuals with psychiatric disorders or histories of self-harm. The purpose of this study was to prospectively examine whether more severe depressive symptoms assessed using the Geriatric Depression Scale (GDS) were associated with a greater risk of death from suicide in a general-risk population. Methods: A total of 113 478 men from the Korean Veterans Health Study (mean age, 58.9 years) who participated in a postal survey in 2004 were followed up for suicide mortality until 2010. Results: Over 6.4 years of follow-up, 400 men died by suicide (56.7 deaths per 100 000 person-years). More severe depressive symptoms were associated with greater risk of suicide death (p for trend <0.001). The unadjusted hazard ratios (HRs) in comparison to the absence of depression were 2.18 for mild depression, 2.13 for moderate depression, 3.33 for severe depression, and 3.67 for extreme depression. After adjusting for potential confounders, men with a potential depressive disorder had an approximate 90% higher mortality from suicide (adjusted HR, 1.92; 95% confidence interval [CI], 1.38 to 2.68; p<0.001) than men without depression. Each five-point increase in the GDS score was associated with a higher risk of death by suicide (adjusted HR, 1.22; p<0.001). The value of the area under the receiver operating characteristics curve of GDS scores for suicide deaths was 0.61 (95% CI, 0.58 to 0.64). Conclusions: Depressive symptoms assessed using the GDS were found to be a strong independent predictor of future suicide. However, the estimate of relative risk was weaker than would be expected based on retrospective psychological autopsy studies.

• 정신신체의학
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• 제10권2호
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• pp.154-165
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• 2002

목적: 입원 치료 중인 항암제 투여 환자의 우울 양상을 알아보기 위해 본 연구를 시행하였다. 방법: 2001년 11월부터 12월까지 영남대학교 의과대학 부속병원 종양내과에 입원한 대상으로 Beck's depression inventory(이하 BDI), Zung's depression scale (이하 ZDS), Hamilton depression scale(이하 HDS)을 시행하였고 정신과적 면담을 통해 축 I 질환을 진단하였다. 결과: 대상군에서 각 우울 척도의 평균 접수는 BDI 18.27${\pm}$7.73, ZDS 36.51${\pm}$10.82, HDS 15.14${\pm}$6.60으로 나타났다. 성별, 결혼상태, 종교에 따른 우울척도의 차이는 나타나지 않았다. 대상은 위암 13명, 폐암 11명, 혈액종양 10명, 기타 종양 3명(자궁암 2명, 두경부암 1 명)이었다. 고용량의 항암치료를 받는 기타 종양군의 HDS, ZDS 점수가 다른 종양군에 비해 높았다. 8명(21.6%)은 주요우울장애로, 11명(29.7%)은 적응장애로 진단되었다. 주요우울장애군에서 ZDS의 우울감, 일의 어려움, 불안, 정신활동성 지체 항목의 점수가 다른 진단군에 비해 높았다. 장애군에서 ZDS의 변비, 피로, 식욕 감소, 공허감, 수면장애, 불만족, 체중감소 항목, HDS의 건강염려증, 초조, 피로, 성욕 감소 문항의 점수가 높았다. 결론: 항암제 투여 중인 입원 환자에 있어서 적응장애와 주요우울장애와 같은 정신과적 질환이 동반될 수 있다. 정신의학적 접근이 암환자의 삶의 질을 증가시키고 치료 순응도 측면에 있어서도 중요하다. 항암제 치료중인 환자의 우울 장애 진단시 우울 증상과 혼동될 수 있는 다양한 선체 증상을 감별하기 위하여 암의 부위, 임상 경과, 치료 방법, 항암제의 부작용에 대한 고려가 선행되어야 할 것으로 생각된다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제22권3호
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• pp.156-161
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• 2011

Objectives: Externalized behavioral problems are prevalent in adolescents, due to the difficulties associated with this developmental stage. Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD), as well as other psychiatric disorders, such as major depressive disorder, result in the manifestation of many behavioral problems during adolescence. Methods: For this report, we analyzed a sample of 31 adolescents, each of whom had presented with CD or ODD at Chosun University Hospital between 2002 and 2010. We separated subjects into depressed and non-depressed groups according to their Beck Depression Inventory scores (BDI<10, non-depressed ; BDI${\geq}$10, depressed). Then we analyzed for neuropsychological differences between the depressed and non-depressed groups. Results: In our sample, adolescents in the depressed group showed less of a stealing (deceitfulness and/or theft) behavioral pattern and presented with more anxiety symptoms, lower self-esteem, and greater sensitivity in interpersonal relationships, as compared to the non-depressed group. Conclusion: When adolescents exhibit disruptive behavior, clinicians should consider the underlying causes of the behavior.

• 수면정신생리
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• 제22권1호
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• pp.5-10
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• 2015

The secretion of melatonin exhibits a circadian rhythm entrained with the sleep-wake cycle. An alteration of this secretory rhythm has been found in various psychiatric disorders. This review summarizes the regulation of melatonin and its relationship to the circadian rhythm, major depressive disorder, bipolar disorder, seasonal affective disorder, Alzheimer's disease and autism. The review also looks at the effect of melatonin and melatonin agonist on sleep and symptoms of depression, bipolar disorder and seasonal affective disorder. In Alzheimer's disease, the circadian rhythm alterations are associated with the change of melatonin levels and melatonin receptors. It has been reported that melatonin and melatonin synthetic enzyme levels decrease in autism spectrum disorder.