• 대한한의학원전학회지
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• 제35권4호
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• pp.77-96
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• 2022

Objectives : This paper examines the medical treatise and treatment methods of Zhang Jiebin on the depressive pattern, for clinical application today. Methods : The Zazhengmo/Yuzheng chapter of the Jingyue Quanshu, related texts and annotations of the Huangdineijing, and related contents among the medical texts of the JinYuan masters were analyzed. Developmental process of the medical theories were compared and examined. Results : Zhang focused on the mechanism in which emotion affects Qi leading to a disease state, and categorized Yu[鬱, depressed state] into three: anger depression, contemplative depression and comprehensive depression. The concept of the Five Depressive Patterns and its treatment from the Huangdineijing·Suwen which was considered as excess pattern was expanded to include deficiency pattern based on comparison with annotations of Wangbing, Hwashou, and Wang Andao. Treatment methods centered on purging was also expanded to include tonifying to restore the damaged Jing Qi. The depressive patterns anger depression, contemplative depression and comprehensive depression were subdivided according to excess and deficiency, for which formulas such as Shenxiangsan, Shoupijian, Guipitang were suggested. As the depressive pattern is caused by emotions and thus the Heart, the Yiqingbianqi method that directly deals with emotions was suggested. Zhang adopted Zhu Zhenheng's opinion which expands the category of Yu, and in the perspective of excess/deficiency, it is most similar to that of Li Dongyuan. Conclusions : Before Zhang, the depressive pattern was discussed in terms of it being excess pattern. However, Zhang's discussion on depressive pattern based on anger depression, contemplative depression and comprehensive depression focuses on emotional stagnation while suggesting the possibility of deficient stagnation, expanding previous understanding. In terms of treatment, tonifying methods for deficiency pattern was added, while consideration of emotion itself became necessary in treatment.

• 생물정신의학
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• 제28권2호
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• pp.58-69
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• 2021

Objectives The aim of this study was to examine the association between the sleep pattern, chronotype (midpoint of sleep on free days) and the depressive symptoms in adults aged 19 years and over in Korea. This study also investigated the mediating effect of perceived usual stress (PUS) and self-rated health (SRH) on the association between chronotype and depressive symptoms. Methods Among the subjects of the 7th Korea National Health and Nutrition Examination Survey (KNHANES) 2016 and 2018, 16142 adults aged 19 or over responded to the survey and finally 8604 were analyzed according to the exclusion conditions. Logistic regression analysis was conducted to see the risk of depressive symptoms, suicidal ideation over sleep pattern, chronotype. Finally, mediation analysis was performed in order to clarify how PUS and SRH are associated to chronoytpe and depression. Results After controlling for potential covariates, weekly sleep duration < 5 hours, ≥ 10 hours was associated with depressive symptoms. And late bed time sleeping after am 1:00 and later midpoints of sleep was associated with a higher level of depressive symptoms. Additionally, the PUS and SRH between chronotype and depressive symptoms showed a serial multiple mediation effect. Conclusions Short or long sleep duration, late bed time and later midpoints of sleep on free days are associated with depressive symptoms. Furthermore, the mechanism between chronotype and depressive symptoms needs to be further clarified by identifying the serial multiple mediation effects of PUS and SRH.

• 한국노년학
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• 제34권2호
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• pp.387-407
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• 2014

본 연구는 우리나라 노년기 우울변화의 다중궤적을 확인하고, 각 궤적집단의 특성을 파악하는 것을 목적으로 한다. 이를 위해 한국복지패널 1차년도부터 5차년도(2006-2010) 자료를 활용하였으며, 만 60세 이상 4,181명의 자료를 분석하여 노인 우울의 다중궤적과 각 궤적집단의 결정요인을 분석하였다. 주요 분석방법으로는 잠재성장혼합모형과 다항 로지스틱 회귀분석 등이 사용되었다. 노년기 우울과 관련있는 여섯 가지 요인을 통제한 상태에서 노인 우울의 다중궤적을 분석한 결과, 감소형(10.6%), 증가후감소형(9.7%), 증가형(7.9%), 그리고 안정형(71.8%)의 네 가지 유형이 존재하는 것을 확인하였다. 우리나라 노인우울의 궤적집단을 결정하는 요인으로는 주관적 건강상태, 자아존중감, 가족관계만족, 경제활동기간, 그리고 빈곤기간은 안정형과 나머지 세 개의 우울궤적을 구분하는 공통요인으로 나타났다. 이밖에 만성질환, 배우자상실, 그리고 가구소득은 안정형과 증가후감소형을 구분하는 요인이었으며, 연령과 공적연금수급은 안정형과 증가형을 구분하는 것으로 나타났다. 연구결과를 토대로 노년기 우울을 예방하고 완화하기 위한 개입방안 제시하였다.

• 생물정신의학
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• 제9권2호
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• pp.103-111
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• 2002

Neurocognitive research focusing on cognitive deficits in Depression has resulted in several important but yet potentially contradictory findings. Much literature documents the presence of significant neurocognitive impairments in depressive patients. Studies have shown that dysthymic disorder patients demonstrate a diffuse pattern of cognitive impairment which is frequently indistinguishable from that of focal braindamaged patients. Some reports have suggested that there is a focal pattern of deficit, such as anterior cingulate dysfunction, frontal lobe impairment, or dysfunction of the temporal-limbic cortex. The aim of this study is to evaluate the neurocognitive functions in dysthymic disorder patients, and to compare the functions with those of major depressive disorder patients. The subjects are 17 dysthymic disorder patients. And their neurocognitive functions are compared with those of 23 major depressive episode patients. Patients with a history of neurologic disease, alcohol dependence, substance abuse and mental retardation are excluded. They are assessed with a part of Vienna Test System which is computerized neurocognitive function tests and can evaluate attention, eductive ability, reproductive ability, visuoperceptual analysis, vigilance, visual immediate memory, the speed of information-processing, judgement, and fine motor coordinations. There are no other specific difference between two groups, except the result of cognitrone test. This study provides information about the neurocognitive functions and some difference between major depressive disorder patients and carefully diagnosed dysthymic disorder patients.

• Child Studies in Asia-Pacific Contexts
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• 제4권1호
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• pp.27-45
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• 2014

The present study investigated the developmental pattern of Korean mothers' depressive symptoms from a week prior to birth through four months postpartum in a nationally represented survey sample in Korea, using a Latent Growth Curve model. Mother-reported four factors-maternal self-efficacy in parenting, father's participation in childcare, a number of hours mothers worked per week, child's emotional temperament-were examined as the predictors of depressive symptoms over time in the context of Korean culture. Effects of maternal depressive trajectories on their infants' developmental outcomes at the first year were also examined. Findings were as follows: First, mothers' reports of depressive symptoms decreased at the first month after birth and then increased again during the first 4 months postpartum. Second, mothers' perceived low spousal involvement in childcare, low parental self-efficacy, and their infants' difficult temperament at four-month old had significantly positive relations to the initial level of maternal depressive symptoms whereas the low spousal involvement in childcare and low maternal self-efficacy factors significantly predicted the changes of trajectories of maternal depressive symptoms. Third, the trajectories, in turn, predicted warm and responsive maternal parenting style at the fourth month. Subsequently, the parenting style had a significant longitudinal impact on the development of children's communication, problem-solving, and personal-social abilities. Based on these findings, awareness, preventive and interventional programs might be built to facilitate Korean mothers suffering severe postpartum depressive symptoms and further promote optimal early development of Korean children.

• 동의신경정신과학회지
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• 제31권3호
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• pp.213-223
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• 2020

본 논문은 제2형 양극성 장애 환자에게 한의학적 변증체계와 함께 IPSRT의 심리 치료 기법을 적용한 증례이다. 제2형 양극성 장애 환자에게 한의치료와 IPSRT를 4개월간 병용한 결과, 환자의 사회적 리듬, 우울증 및 대인관계 능력이 개선되었으며 4개월후 추적조사에서도 호전상태가 유지되었다. 향후 양극성 장애 환자에 대한 높은 근거수준의 한의 임상연구 수행과 한의표준임상진료지침의 개발 등을 통해 양극성장애에 한의치료가 보다 활발히 활용되기를 기대한다.

• 생물정신의학
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• 제13권3호
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• pp.144-151
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• 2006

Objectives : Cognitive therapy is the most extensively researched psychological treatment for nonpsychotic unipolar outpatient depressive disorders. This review focused on the utility of this approach in severe or chronic depressive disorders, in relapse prevention and also on the potential benefits of combining cognitive therapy with medication. Methods : The author reviewed original studies and quantitative analyses on the effects of cognitive therapy, predictors of response, and neuroimaging studies of cognitive therapy in major depressive disorder. The sources used for the literature search were data bases : PubMed, EMBASE, CDSR on the internet, references in papers or books. Results : This review suggests that cognitive therapy is as effective as antidepressant medication in severe depressive disorders. And cognitive therapy can be an effective alternative to antidepressant medication. Patients benefited significantly more from combined cognitive therapy and antidepressant treatment than from either treatment alone. Most importantly, the addition of cognitive therapy to usual treatment appears to protect against future relapse in individuals known to be at high risk of repeated episodes of depression. In addition, subjects who received cognitive therapy showed significantly greater improvements in chronic depression than receiving antidepressant medication. Pooled data suggests that there is a significant relationship between the therapist's level of training or experience, the type of therapy used and patient outcome. Recent functional imaging studies examining brain changes following cognitive therapy report a variety of regional effects, but there is no consistent pattern across the few published studies. Conclusion : Cognitive therapy has proved beneficial in treating depressive patients. Despite empirical data supporting its efficacy, there are still problems in gaining access to cognitive therapy in clinical practice.

• 동의신경정신과학회지
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• 제31권2호
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• pp.63-76
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• 2020

Objectives: The purpose of this study was to verify the clinical effects of herbal medicines on patients with depressive disorder. Methods: A prospective observational study on patients with depressive disorder was conducted. The patients were treated with herbal medicines for eight weeks. The Korean Hamilton Depression Rating Scale (K-HDRS) was evaluated as the primary outcome and the Korean Beck's Depression Inventory (K-BDI), Instrument on Pattern Identification for Depression, Korean Symptom Checklist-95 (KSCL-95), Insomnia Severity Index (ISI), Korean State-Trait Anxiety Inventory (STAI-K), Korean State-Trait Anger Expression Inventory (STAXI-K), EuroQol five-dimensional Questionnaire (EQ-5D), Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Heart Rate Variability (HRV) were measured as the secondary outcome. Adverse events were assessed for safety. Results: A total of 35 participants were observed for 12 weeks. The K-HDRS improved significantly in four, eight, and 12 weeks and the K-BDI showed significant differences in four, and eight weeks. There were no significant improvements in other evaluation scales. Gyejibongnyeong-hwan was the most frequently and continuously prescribed, showing significant improvements of K-HDRS after eight weeks of treatment. Conclusions: In our observational study, herbal medicine was effective for relieving the depression of patients with depressive disorder and Gyejibongnyeong-hwan showed the most significant effectiveness.

• 정신신체의학
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• 제3권2호
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• pp.126-138
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• 1995

For investigating a disease specific psychological mechanism in various dermatological disorders, we tried to explore the difference in correlation among stress perception, locus of control as a coping strategy, depressive symptoms and pruritic symptoms in the patients with psychological pruritis and chronic urticaria. The subjects were composed of 32 patients with psychol-ogical pruritis and 67 patients with chronic urticaria(subject group), and 25 patients with organic pruritis and 59 patient with major depression(control group). Global assesment of recent stress scale(GARS), I-E locus of control scale, Beck Depression Inventory(BDI) and medical college of wisconsin center pain follow up questionnaire were used for assesement. The results were as follows: 1) There were a significant positive correlation between stress perception and depressive symptom in patients with psychological pruritis, chronic urticaria, and major depression but not hi organic pruritis. 2) In relationship between locus of control and depressive symptom, patients with psychological pruritis, organic pruritis, and major depression except chronic ruticaria showed a significant negative correlation. 3) For intensity and pattern of pruritis, there were positive relations with depressive symptom and stress perception only in patients with chronic urticaria. Above results indicate that stress perception and locus of contorl may play a significant role in the formation of psychological and dermatological symptoms in psychological pruitis and chronic urticaria. But the mechanisms of these processes are different in either disorder.

• 수면정신생리
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• 제5권2호
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• pp.202-209
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• 1998

Authors report the findings of nocturnal polysomnography and multiple sleep latency test(MSLT) before and after morning light treatment in a winter depressive patient with hypersomnia. On polysomnographic recordings, the sleep pattern of this case before light treatment was similar to that of narcolepsy exhibited, sleep onset REM period(SOREMP). After treatment, the shortened REM latency changed to normal condition, but, deep sleep percentage did not changed, and stage 4 sleep percentage was decreased. Depressive symptoms were improved on clinical interview with Hamilton Depressive Rating Scale. Sleep log showed shortened sleep latency and reduced sleep duration. These findings suggest that although light treatment could alter the sleep structure in seasonal affective disorder with hypersomnia, it does not necessarily imply that antidepressant response of light treatment is result of change of sleep structure.