• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제10권2호
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• pp.145-157
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• 1999

이 논문은 소아청소년 정신병동에 입원한 아동에서 신체적, 정서적 학대와 방임이 동반된 아동을 선별하여 이루어졌다. 입원 아동중 이에 해당하는 아동이 얼마나 되는지 살펴보았으며 학대가 아동의 정서행동에 미치는 영향이 다양하고 가족의 특성과 발달과정에 따른 영향이 서로 상호 작용할 것으로 생각되어 특징적 증상과 발달력, 학대의 특성, 학대자의 특성, 가족역동, 정신병리의 임상적 특징을 알아보았다. 1995년 9월부터 1997년 8월까지 서울대학교 병원 소아청소년 정신과 병동에 입원한 아동 중 주치의의 면담과 병록지를 참조하여 학대와 방임이 뚜렷하다고 판단된 아동, 22명을 대상으로 조사하였다. 1) 아동의 인구학적 특징：성별은 남아가 1：6.3의 비율로 압도적으로 많았고 평균연령은 $11.1{\pm}2.5$세였다. 형제순서는 첫째가 12명(54.5%), 둘째 5명(23%), 셋째는 2명(9%)이었고 독자는 3명(13.5%)이었다. 2) 가족의 특징：사회경제적 상태는 중상 3명(13.5%), 중 9명(41%), 중하 9명(41%), 하 1명(0.5%)이었다. 가족 수는 3인 이하 3명(13.5%), 4∼5인이 17명(77.5%), 6∼7인 2명(9%)이었다. 부가 직업이 있는 경우는 18명(81.8%)이었고 모가 직업이 있는 것은 7명(32%)이었다. 결혼상태는 이혼과 별거가 5명(23.0%), 재혼 2명(9%)이었고 심각한 부부불협화는 19명(86.5%)에서 보였다. 부에서 반사회적 행동은 7명(32%), 알콜 중독은 10명(45.5%)이었다. 모의 알콜남용이 5명(23%)이었고 우울은 17명(77.3%)에서 보였으며 정신과 진료력이 6명(27%)에서 있었다. 3) 학대의 특징：신체적 학대가 18명(81.8%), 신체적 방임과 정서적 방임은 4명(18.2%)이었다. 학대 시작시기는 3세 이전이 15명(54.5%) 3세 이후가 5명(27.5%), 학령기가 1명(5%)이었다. 학대가 부에 의해서만 일어나는 경우는 2명(9%)이었고 모에 의해서만 일어나는 경우는 8명(35.4%)이었으며 부모에 의해 동시에 일어나는 경우는 8명(35.4%)이었다. 배우자 구타가 동반된 것은 7례(27%)에서 였고 배우자 학대의 피해자는 자녀에 대해 신체적 학대나 정서적 학대를 가하고 있었다. 형제자매가 같이 학대를 받고 있는 것은 4명(18.2%)이었다. 4) 학대아동의 일반적 특징 및 발달력：원하던 아이로 태어난 것은 10명(45.5%)이었고 원하지 않는 아이로 태어난 아동이 12명(54.5%)이었다. 학대이전에 언어나 운동발달상의 이상을 보인 아동은 9명(41%)이었으며 공존하는 발달장애가 있는 아동은 모두 15명이었는데 이들 중 학대이전에 뚜렷한 발달지체의 증거가 없었던 경우는 6명(27.5%)이었다. 또 학대이전 과잉운동을 보인 아동은 9명(41%), 키우기 어렵게 지각한 아동이(difficult child) 6명(27.5%)이었다. 뇌파의 이상소견은 5명(23%), 두뇌의 컴퓨터단층촬영이나 핵자기 공명술 이상소견은 4명(18.2%), 벤더-게스탈트검사에서 기질성 뇌장애를 의심할만한 소견은 14명(63.5%)에서 보였다. 지능검사의 결과는 평균이상 IQ는 12명((54.5%), 지능지체 및 경계선 지능은 9명(41.0%)이었다. 5) 주 진단 및 공존진단：주 진단으로는 행실장애가 6명(27.3%), 경계선장애(borderline child) 5명(23.0%), 우울병 4명(18%), 주의력결핍-과잉운동장애 4명(18%), 달리 분류되지 않는 전반적 발달장애 2명(9%), 선택적 함구증 1명(5%)이었다. 모든 대상 아동이 주 진단 이외의 2∼6개 이상의 다양한 공존진단을 보였다. 공존진단에는 주의력결핍-과잉운동장애, 우울병, 경계선지능 및 정신지체, 학습장애, 언어발달장애, 적대적 반항장애, 만성 틱장애, 기능성 유뇨증과 유분증, 달리 분류되지 않는 불안장애, 해리 장애, 기질성 성격장애순이었다. 6) 치료경과：이들 아동의 입원기간은 평균 2.4개월(${\pm}1.5$)이었고. 이들 중 권유에 의한 퇴원은 14명(63.5%), 조기거역퇴원은 6명(27.3%)이었고 증상의 호전을 보인 것은 모두 11명(50%)이었고 변함이 없는 경우도 11명(50%)였다.

• 동의신경정신과학회지
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• 제21권2호
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• pp.215-227
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• 2010

Objectives : Jeon-Jeung(癲證) is one of negative symptoms from schizophrenia in Western medecine, which causes flattening of affect, emotional bluntness, and avolition. Compared with positive symptoms of schizophrenia, there is no established treatments that have been proved to be effective for negative symptoms, and since negative symptoms are chronically processed, they finally lead to devastate the mental health. Since Jeon-Jeung(癲證) is usually in set in adolescent period and tends to become chronic through life time, it is important to start getting treatments in early stage by being distinguished from other diseases, such as anxiety disorder. A patient in this case was affective blunting, general weakness, and delusion when sixteen years old. However, he refused to get Western medicine treatment and wanted oriental medicine treatment. Methods : The patient in this case had been suffered from severe stress from his family since he was young and had kept having irregular and unhealthy eating habits. Therefore, he diagnosed stagnant qi transforming into fire(氣鬱化火), heart blood deficiency(心血虛), and spleen-stomach deficiency cold(脾胃虛寒) and since then he had received several treatments including herbal treatment, acupumcture treatment, supportive therapy, and family therapy. These treatments were successful and reduced the level of symptoms. After discharged from the hospital, he had continued receiving outpatient treatment with his family for 8 months and his progress had been still observed after the discharge. Results : The symptoms of patient had been almost reduced and eliminated after he received 29days of admission treatment and the patient got better and better and now lives a normal life 8 months outpatient treatment. Conclusions : This result suggests that our oriental medical treatments and family treatments was effective on schizophrenia.

• The Journal of Korean Physical Therapy
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• 제16권4호
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• pp.23-37
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• 2004

Fibromyalgia syndrome(FMS) is a chronic pain disorder of unknown etiology characterized by widespread musculoskeletal aches and pains, stiffness, and general fatigue, disturbed sleep and sleepiness. Frequently misdiagnosed, FMS is often confused with myofascial pain syndrome, polymyalgia rheumatica, polymyositis, hypothyroidism, metastatic carcinoma, rheumatoid arthritis (RA), juvenile rheumatoid arthritis, chronic fatigue syndrome, or systemic lupus erythematosus, any of which may occur concomitantly with FMS. The management of FMS often begins with a thorough examination and a diagnosis from a physician who is formally trained in tender-point/trigger-point recognition. An initial diagnosis provides reassurance to the patient and often reduces the anxiety and depression patterns associated with FMS. The most common goals in the management of FMS are (1) to break the pain cycle, (2) to restore sleep patterns, and (3) to increase functional activity levels. Because FMS is a multifactorial syndrome, it is likely that the best treatment will encompass multiple strategies. Medication with analgesics and antidepressants and also physiotherapy, are often prescribed and give some relief. The other most effective intervention for long-term management of FS to date is physical exercise. Physical therapists can instruct patients in the use of heat at home (moist hot packs, heating pads, whirlpools, warm showers or baths, and hot pads) to increase local blood flow and to decrease muscle spasm and tension. Also instruct patients in the proper use of cold modalities (ice packs, ice massage, and cool baths) to anesthetize localized areas of pain (tender points) and break the pain cycle. Massage and tender-point massage also may promote muscle relaxation. To date, the two most important interventions for the long-term management of FS are patient education and physical exercise. Lately, is handling FMS and Chronic Fatigue syndrome(CFS) together, becuase FMS and CFS are poorly understood disorders that share similar demographic and clinical characteristics. Because of the clinical similarities between both disorders it was suggested that they share a common pathophysiological mechanism, namely, central nervous system dysfunction.

• 동의생리병리학회지
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• 제29권1호
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• pp.1-10
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• 2015

This article is a study on palpitation of which disease cause, disease mechanism and formulas were analyzed with reference to annotations on "Shanghanlun" and "Jinkuiyaolue". And the scope of modern diseases related with palpitation was drawn by research on clinical papers. The source books are "Zhujieshanghanlun" and "Jinkuiyaoluefanglun" and the clinical papers are searched in China Academic Journals(CAJ) of China National Knowledge Infrastructure(CNKI). 13 clauses in "Shanghanlun" and 9 clauses in "Jinkuiyaolue" and 12 formulas are related with palpitation. Disease mechanisms of palpitation were classified as yang deficiency, yin deficiency, qi deficiency, blood deficiency, retained fluid, cold, etc and these days, qi stagnation, phlegm turbidity, blood stasis and fire heat are also considered as disease mechanisms. Modern diseases related with palpitation are arrhythmia(extrasystole, atrial fibrillation, bradycardia, tachycardia, sick sinus syndrome, atrioventricular block), vascular diseases(arterial occlusion, phlebothrombosis, Buerger's disease, coronary artery disease, vasculitis), blood pressure disorder(hypertension, hypotension) and heart diseases such as heart failure, angina pectoris, myocardial infarction, myocarditis, cardiomyopathy, pericardial effusion. And diseases related with psychological change(cardiac neurosis, anxiety neurosis, neurosis, depression, hyperthyroidism, hypothyroidism), pyrexia, anemia, drug intoxication, etc are also related with palpitation. Zhen Wu Tang showing an efficacy in dilating blood vessels and strengthening cardiac function, Wuling Powder with diuretic effect and Fried Glycyrrhizae Decoction acting on the ${\beta}$ receptor are applied to heart failure in different ways. Fried Glycyrrhizae Decoction(308 cases), Zhen Wu Tang(154), Wuling Powder(54), Xiao Chaihu Tang(34), Sini San(20) are reported to have been clinically applied to cardiovascular diseases and Zhen Wu Tang and Wuling Powder mainly applied to heart failure, Fried Glycyrrhizae Decoction, Lizhong Wan, Sini San and Zhen Wu Tang chiefly applied to arrhythmia related diseases. This study focuses on the general research and consideration on clinical applications and is a preliminary study to understand relations between Korean Medicine's symptoms and categories of modern diseases.

• 한국간호교육학회지
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• 제27권1호
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• pp.39-48
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• 2021

Purpose: This study aimed to explore factors influencing on the preventive behaviors of dementia in older Koreans enrolled in senior welfare centers to provide basic information on dementia prevention. Methods: A total of 182 older Koreans participated in this study, which employed a cross-sectional design. Data were collected using questionnaires with items related to general characteristics, depression, self-esteem, knowledge and attitudes about dementia, preventive behaviors of dementia, dementia management self-efficacy, and anxiety about dementia. Using SPSS WIN 23.0, data were analyzed by descriptive statistics, t-test, ANOVA, Scheffé test, Pearson's correlation coefficient, and multiple regression. Results: Living with a spouse (p=.013), a higher monthly income (p=.018), better nutrition (p=.010), not having a sleep disorder (p<.001), and higher number of participating programs (p=.001) were associated with better dementia prevention behaviors. Attitudes about dementia (��=.18, p=.006) and the number of programs older Koreans were participating in (��=.17, p=.006) influenced positively on the preventive behaviors of dementia, while depression (��=-.41, p<.001) and sleep disorders (��=-.17, p=.006) influenced negatively on dementia preventive behaviors. Overall, approximately 35% of the variability in dementia preventive behaviors was explained by these four variables in this study (F=24.97, p<.001). Conclusion: The findings of this study suggest that depression reduction, good attitudes about dementia, program participation, and good sleep should be encouraged to promote dementia prevention. In addition, effective and structured educational programs should be developed for older Koreans to encourage dementia preventive behaviors to reduce the risk of dementia.

• 동의신경정신과학회지
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• 제19권3호
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• pp.143-169
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• 2008

Objective: This study was to investigate the relation of what insomnia patients' symptoms with Heart Rate Variability(HRV), Pittsburgh Sleep Quality Index (PSQI) and Insomnia Questionaire(IQ). Methods: For this study, we carried out HRV, PSQI and IQ of 43 patients with insomnia who have come to Donguei oriental hospital of Donguei university from September 2007 to May 2008. We studied the relationship HRV with PSQI and IQ. For every symptom, this study classified the patients as none-symptom, symptom groups and analyzed each group's HRV, PSQI and IQ. Result : 1. The rate of xerostomia in female group is significantly higher than male group. 2. P1 (hypnagogic time), P3(awakening time), LF has negative correlation with age. The score of PI (hypnagogic time), P3(awakening time), P4(time of recoverable sleep) in the group whose age is more than 50 are higher than the group whose age is lesser than 50. 3. The frequency of using hypnotics(P6) in the group whose duration of onset are over 1 year was significantly higher than the score in the group whose duration of onset were below 1 year. 4. The accompanied symptoms in the group who started sleep disorder after stressor are higher than the number in the group whose duration of onset were poor-defined. 5. The drinking group have lower rate of anorexia, higher score of P1 (hypnagogic time) and TP than non-drinking group. 6. The score of P-total(general quality of sleep) have negative correlation with NNSO, HF, TP and positive correlation with LF/HF. 7. The score of P1(hypnagogic time) have negative correlation with LF. 8. The score of P5a(frequency of delayed hypnagogue) have positive correlation with LF/HF. 9. The score of P5e(frequency of cough or snoring) have negative correlation with RMSSD. 10. The score of I1a(degree of onset insomnia), I1b(degree of maintenance insomnia) have negative correlation with NN50, pNN50, HF. 11. The score of I1c(degree of termination insomnia) have negative correlation with RMSSD, NN50, pNN50, HF, TP and positive correlation with MHR, LF/HF. 12.. The score of P5i(frequency of night pain), LF/HF in the group with headache are higher than the group without headache. 13. The score of P5a(frequency of delayed hypnagogue), P5c(frequency of awakening for urine of stool) in the group with xerostomia are higher than the group without xerostomia. 14. The score of P9(degree of unrecoverable sleep) and I5a(degree of onset insomnia) in the group with chest discomfort are lower than the group without chest discomfort. 15. The score of P7(frequency of drowsiness for daytime) in the group with palpitation are lower than the group without palpitation. 16. The score of P5c(frequency of awakening for urine of stool), P5f(frequency of burning sensation), P5h(frequency of nightmare), I1c(degree of termination insomnia) in the group with burning sensation of upper trunk are higher than the group without burning sensation. 17. The score of NN50, pNN50, LF, TP in the group with anorexia are lower than the group without anorexia. 18. The score of P-total(general quality of sleep), P2(duration for sleep start) in the group with constipation are higher than the group without constipation. 19. The score of P4(recoverable sleep time) in the group with depression are higher than the group without depression. 20. In the group with anxiety, the score of P1(time of hypnagogue), P5a(frequency of onset insomnia) are lower and the score of I1b(degree of maintenance insomnia), I4(objective degree of impairment by insomnia) are higher than the group without anxiety. 21. The score of NN50, pNN50, HF, TP in the group with inertia are lower than the group without inertia. 22. The accompanied symptoms haver posirive correlation with P5f(frequency of burning sensation), P5h(frequency of nightmare), P5i(frequency of night pain) and LF/HF. Conclusion: This study provides insights into the complicated relations of the pattern of sleep disorder with many symptoms such as headache, chest discomfort, depression and any others. And this study showed that autonomic nervous system have important function in the regulation of sleep.

• 대한가정학회지
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• 제46권5호
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• pp.97-109
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• 2008

Atopic dermatitis is the fastest growing skin disorder among children from infancy to adolescence in Korea. The side-effects of atopic dermatitis not only include physical discomfort, but also psychological trauma which ultimately affects the developmental growth of children. This study was conducted in order to investigate the behavioral characteristics of an atopic dermatitis sufferer. As part of this research, the relative influence of behavioral problems and, self-perceived competence were analyzed in relation to the social competence of an atopic child. In total, 301 atopic and non-atopic children, between 2 and 6 years of age, and their mothers and teachers participated in the study. From this number, 109 children had atopic dermatitis, while 192 children did not. Mothers were asked to complete a parent-report questionnaire that required information on parental stress, according to the scale parenting methodology of Abbdin(1990) and Cho(1999). Teachers were subjected to teacher-report questionnaires which included topics on social competence, socia-emotional assessment and behavioral problems of an atopic child. Furthermore, children also completed questionnaires on self-perceived competence. According to analysis on K-CBCL, ITSEA, social competence, self-perceived competence and parental stress, children with atopic dermatitis showed higher scores in depression/anxiety and depression/withdrawal, compared to children in the normal control group. In relation to parental stress, daily stress, parental role stress, and stress related disease, mothers with atopic dermatitis children exhibited higher scores. In establishing relationships among the related variables, atopic children who demonstrated more social competence were more likely to suffer less from withdrawal, attention problems, and depression/anxiety. Stress related disease in mothers with atopic children was positively related to attention problems of the child. In terms of relative influences, behavioral problems was the most significant variable, accounting for 23% of variance. Lower behavioral problems was positively related to more social competence. In summation, this study investigated the general characteristics of atopic children. In conclusion, atopic children and their mothers had difficulty in dealing with this disease. It is our belief that an atopic child would not only require physical treatment, but also need appropriate psychological care.

• 정신신체의학
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• 제28권2호
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• pp.99-107
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• 2020

섬유근통은 피로, 수면장애, 기분변화, 인지장애 및 만성 전신통증을 핵심 증상으로 하는 질환이다. 섬유근통은 유전적 취약성, 통증 처리과정 및 스트레스 반응 체계의 변화 등을 포함하는 생물학적 요인과 불안, 우울, 분노, 스트레스 등의 심리적 요인, 그리고 감염, 발열 질환, 외상 등의 환경적 요인이 함께 작용하여 발생하는 것으로 알려져 있으며, 핵심 병인으로 감각 자극이 인식되는 과정에서 증폭되어 통증이 증진되는 중추성 감작의 역할이 강조되고 있다. 가이드라인들은 개별 환자의 필요에 따라 선택된 다원적 접근을 권고하며, 임상의는 충분한 교육을 통해 지적 이해의 틀을 제공하고 자기 관리의 중요성을 강조해야 한다. 섬유근통에서 정신건강 문제의 유병률은 일반인구집단의 7~9배로 유의하게 높으며, 특정 정신병리 및 수면장애와의 관련성도 제기되고 있다. 정신과적 상태는 섬유근통과 양방향성 상호작용을 하며 경과에 영향을 주고, 취약성을 공유하며 서로의 위험 요인으로 작용할 수 있으므로, 동반질환을 면밀히 평가하여 보다 통합적인 관리가 필요할 것이다.

• 동의신경정신과학회지
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• 제30권3호
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• pp.209-220
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• 2019

Objectives: As a general emotion, everyone can temporarily experience depression, but depressive disorder is a disease that excessively affects daily life. Among the various causes of depression, the deficiency of monoamine-based neurotransmitters such as serotonin and epinephrine are considered significant. Thus, antidepressants that target monoamines are used frequently. However, side effects such as nausea, vomiting, insomnia, anxiety, and sexual dysfunction are observed. Thus, it is necessary to develop a new therapeutic agent with fewer side effects. In this study, we investigated the antidepressant effect of JG02, used to treat depression by normalizing the flow of qi (氣) in Korean medicine. Methods: C57BL/6 mice were selected and randomly divided into six groups: normal, control, amitriptyline, and JG02 (50, 125, 250 mg/kg), respectively. Except for normal, depression was induced by applying restraint stress at the same time for six hours daily for 14 consecutive days. Saline, amitriptyline or JG02 samples were orally administered two hours before applying the stress. After that, a forced swimming test and an open field test were performed. Additionally, serum corticosterone, serotonin mRNA, BDNF mRNA, and protein in the hippocampal region were measured and compared. Results: JG02 decreased immobility time rate in the FST and increased the zone transition number and travel distance in the OFT. Also, JG02 inhibited the release of serum corticosterone, and increased serotonin, BDNF gene expression, and BDNF protein in the hippocampus. Conclusions: In this study, JG02 showed significant antidepressant effects on the chronic restraint stress mice model. When further research is performed based on JG02, the development of a new antidepressant is considered highly possible.

• 사물인터넷융복합논문지
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• 제8권5호
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• pp.63-70
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• 2022

본 연구는 연구자가 정신건강사회복지 전문가로서 신개념의 전문적인 정신건강 모바일 서비스 플랫폼을 개발하고 상용화시켜 새로운 도전을 하기까지의 전 과정에서의 실제경험을 질적연구방법인 자문화기술지를 통해 자료를 수집하고 분석한 연구이다. 본 연구의 결과는 다음과 같다. 첫째, 우리나라 국민들 중에는 정신건강 이슈에 직접 노출되어 전문적인 의료서비스를 받아야 하는 사람들도 있으나 치료적 개입 수준을 요하지는 않지만 일반적인 정신건강 서비스에 대한 욕구를 가진 대중들 또한 상당히 많다는 것이다. 둘째, 현대사회의 특성을 고려하고 특히 코로나-19와 같은 감염병 팬더믹 상황에서 모바일을 활용한 다양한 정신건강 서비스 플랫폼을 선호하는 대중들이 많아 지고 있다는 것이다. 셋째, 전 세대에서 가족문제, 스트레스, 대인관계, 직업 등에서의 정신건강 관련 이슈들을 많이 호소하고 있고 이와 같은 문제들이 우울이나 불안, 중독 및 외상후스트레스장애 등의 정신병리와 연관되어 자해나 자살사고와 같은 또 다른 정신건강 문제들과 잣은 빈도로 언급되고 있다는 것이다. 넷째, 청소년들이 다양한 정신건강관련 이슈들에 노출되어 있다는 것과 무엇보다 자해 및 자살사고와 같은 심각한 정신건강 문제들을 호소하고 있었다. 다섯째, 전문적인 정신건강 서비스를 전달하는데 있어 모바일 기기를 통한 온라인에서의 서비스 제공과 오프라인에서의 서비스 제공이 가능한 역량을 갖춘 정신건강전문가들이 필요하다는 것이다. 마지막으로 본 연구 결과를 바탕으로 향후 정신건강서비스 제공과 관련한 정책 및 실천적 제언과 후속 연구에 대한 방향성을 제언하였다.