• 수면정신생리
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• 제3권2호
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• pp.65-76
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• 1996

Natural sleep pattern and its physiology in childhood are much different from those in adulthood. Several aspects of clinical evaluation for sleepiness in childhood are more difficult than in adulthood. These difficulties are due to several factors. First, excessive sleepiness in childhood do not always develop functional impairments. Second, objective test such as MSLT may not be reliable since it is hard to be certain that the child understand instructions. Third, sleepiness in children is often obscured by irritability. paradoxical hyperactivity, or behavioral disturbances. Anseguently, careful clinical evaluation is needed for the sleepy children. Usual causes of sleepiness in children are the disorders that induce insufficient sleep such as sleep apnea syndrome, schedule disorder, underlying medical and psychiatric disorder, and so forth. After excluding such factors, we can diagnose the hypersomnic disorders such as narcolepsy, Kleine-Levin syndrome, and idiopathic central nervous system hypersomnia. Among the variety of those causes of sleepiness, I reviewed the clinical difference of narcolepsy and obstructive sleep apnea syndrome in childhood compared with in adulthood. Recognition of the childhood narcolepsy is difficult because even severely sleepy children often do not develop pathognomic cataplexy and associated REM phenomena until much later. Since childhood narcolepsy give srise to many psychological, academical problem. Practicers should be concerned about these aspects. Childhood obstructive sleep apnea syndrome is different from adult obstructive sleep apnea syndrome too. Several aspects such as pathophysiology. clinical feature, diagnostic criteria, complication, management, and prognosis differ from those in the adult syndrome. An important feature of childhood obstructive sleep apnea syndrome is the variety of severe complications such as behavioral disorders, cognitive impairment, cardiovascular symptoms, developmental delay, and ever death. Fortunately, surgical interventions like adenotosillectomy or UPPP are more effective for Childhood OSA than adult form. CPAP is a "safe, effective, and well-tolerated" treatment modality too. So if early detection and proper management of childhood OSA were done, the severe complication would be prevented or ever cured.

• 대한불안의학회지
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• 제10권1호
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• pp.17-23
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• 2014

Objective : Panic disorders are frequently accompanied by major depressive disorder (MDD). There is insufficient information about which clinical factors in panic disorder are associated with comorbid MDD. The aim of this study is to identify clinical factors related with comorbid MDD in patients with panic disorder. Methods : Two experienced psychiatrists diagnosed panic disorder based on DSM-IV criteria. This diagnosis in the 275 subjects was confirmed again by Mini-International Neuropsychiatric Interview (MINI). Lifetime comorbid psychiatric diagnoses were examined by MINI. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and Panic Disorder Severity Scale (PDSS) were used to assess the severity of depressive, anxiety and panic symptoms. Results : The result of MINI showed that 95 patients (34%) with panic disorder satisfied the diagnosis of MDD. Multivariate logistic regression model showed that comorbid generalized anxiety disorder (GAD) and the symptom of "fear of losing control or going crazy" were associated with MDD in patients with panic disorder. In female patients, the "chills or hot flushes" symptom was also associated with comorbid MDD. Conclusion : These results showed that coexisting GAD and certain symptoms of panic are associated with comorbid MDD.

• 대한불안의학회지
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• 제7권1호
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• pp.40-47
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• 2011

Objective : This study aimed to investigate the prevalence of obsessive-compulsive disorder (OCD) in schizophrenia, and the relationship among OCD, severity of psychopathology, and social function in stable patients with chronic schizophrenia. Methods : We interviewed 138 symptom-stable inpatients who had been on a constant dose of antipsychotics for at least 1 month prior and diagnosed as chronic schizophrenia. Subsequently, patients were classified according to the existence of OCD as investigated using the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Further, all clinical and demographic data was investigated. To investigate potential interrelationships, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Korea-Positive and Negative Symptom Scale (K-PANSS), and the Korean Personal and Social Performance (K-PSP) were used. An independent ttest and Chi-square test were used to compare groups and a Pearson's correlation coefficient was used to assess the relationship between the Y-BOCS and other clinical rating scales. Results : The prevalence of OCD in schizophrenia patients was 18.1%. Patients with schizophrenia and OCD exhibited significantly earlier onset of schizophrenia, more severe psychiatric symptoms, and lower personal and social performance ability as compared to those without OCD. There was no significant relationship among Y-BOCS, K-PANSS, and K-PSP. Conclusion : We found that comorbid OCD was relatively more frequent in patients with schizophrenia. An investigation involving larger samples of schizophrenia patients with OCD with respect to social function and thus, the effect on quality of life is required.

• Biomolecules & Therapeutics
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• 제27권2호
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• pp.168-177
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• 2019

Dysregulation of excitatory neurotransmission has been implicated in the pathogenesis of neuropsychiatric disorders. Pharmacological inhibition of N-methyl-D-aspartate (NMDA) receptors is widely used to model neurobehavioral pathologies and underlying mechanisms. There is ample evidence that overstimulation of NMDA-dependent neurotransmission may induce neurobehavioral abnormalities, such as repetitive behaviors and hypersensitization to nociception and cognitive disruption, pharmacological modeling using NMDA has been limited due to the induction of neurotoxicity and blood brain barrier breakdown, especially in young animals. In this study, we examined the effects of intraperitoneal NMDA-administration on nociceptive and repetitive behaviors in ICR mice. Intraperitoneal injection of NMDA induced repetitive grooming and tail biting/licking behaviors in a dose- and age-dependent manner. Nociceptive and repetitive behaviors were more prominent in juvenile mice than adult mice. We did not observe extensive blood brain barrier breakdown or neuronal cell death after peritoneal injection of NMDA, indicating limited neurotoxic effects despite a significant increase in NMDA concentration in the cerebrospinal fluid. These findings suggest that the observed behavioral changes were not mediated by general NMDA toxicity. In the hot plate test, we found that the latency of paw licking and jumping decreased in the NMDA-exposed mice especially in the 75 mg/kg group, suggesting increased nociceptive sensitivity in NMDA-treated animals. Repetitive behaviors and increased pain sensitivity are often comorbid in psychiatric disorders (e.g., autism spectrum disorder). Therefore, the behavioral characteristics of intraperitoneal NMDA-administered mice described herein may be valuable for studying the mechanisms underlying relevant disorders and screening candidate therapeutic molecules.

• 생물정신의학
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• 제2권2호
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• pp.157-168
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• 1995

The neuropsychiatric sequelae of traumatic brain unjury(TBI) are effects on complex aspect of behavior, cognition and emotional expression. They include psychiatric disorders such as depression, psychosis, personality change, dementia, and postconcussion syndrome. The damage is done not only to the cortex of the brain but also to subcortical and axial structures. The diffuse degeneration of cerebral white mailer is axonal damage that is caused by mechanical forces shearing the neuronal fiber at the moment of impact(diffuse axonal injury, DAI). The DAI and the changed receptor-agonist mechanism ore the most important mechanisms in genesis of neuropsychiatric sequalae by mild TBI. The most important instrument for diagnosis of neuropsychiatric sequalae of TBI is a physician or psychiatrist with experience and knowledge. The most effective therapeutic tool is a professional who understands the nature of the problem.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제16권1호
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• pp.26-32
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• 2005

신경발달학적 신경영상학은 급속하게 발전하는 분야이고 사용되는 새로운 영상학적인 기술의 수도 해마다 급속하게 증가하고 있다. 신경발달학적인 관점에서 소아청소년 정신과적 장애들에서 아직 명확한 신경병리학적인 원인은 밝혀지지 않았으나, 점차로 많은 수의 논문에서 일관적인 뇌영상학적인 이상 소견들이 발표되고 있다. 이 논문에서는 신경발달학적인 관점에서 신경영상학적인 연구에서 과거와 현재 상황을 기술하고 제한점과 함께 미래에 대한 조망을 하고자 한다.

• 정신신체의학
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• 제4권2호
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• pp.262-268
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• 1996

신체화를 이해하는데 신체화를 형성하게 된 행동이면의 정신적인 갈등배경을 이해하는 것이 중요하다. 그러나 신체화의 생물학적 과정을 파악하고 증상의 유지요인과 악화요소를 알아보아 변화되어 가는 형성과정을 이해하는 점이 더욱 중요하다. 그리고 문화-사회적 특성에 따라 신체증상호소의 방법이나 내용이 다르다는 점을 염두에 두어야 한다. 신체화를 이해하는 데에는 심리적, 생물학적, 사회, 인종, 역사적인 요소가 모두 함께 영향을 미치므로 통합적인 관점에서 파악해 나가지 않으면 안된다.

• 생물정신의학
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• 제1권1호
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• pp.31-39
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• 1994

Anxiety and anxiety disorders are one of the most common and most serious psychiatric problems. Anti-anxiety drugs are one of the most effective treatment method for these problems. Benzodiazepines have various side-effects and the risk of overuse and abuse. Therefore, physicians should prescribe benzodiazepines carefully. However, they should not be discouraged from prescribing benzodiazepines when they have a knowledge of the pharmacological characteristics of these drugs and there is a clear indication for their use. Generally speaking, problems of benzodiazepine use such as dependence withdrawal symptoms, and cognitive impairment are more likely to occur with high dose, long-term use(more than 4 months), in geriatric patients and patients with a history of alcohol or other sustance abuse. But long-term or high-dose use can be jusified for patients with panic disorder of agoraphobia, and medically-ill patients with persistent anxiety that cannot be otherwise treated. In summary, there cannot be a general prescribing formulation for benzodiazepine use. Physician should always make their decision based on the individual patient's risk/benefit factors.

• 대한한의학회지
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• 제21권4호
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• pp.271-275
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• 2000

A growing number of people are concerned about their sleep. There are many people with chronic sleep disorders. As there are various causes in a disease, proper treatment according to each cause is necessary for a more effective treatment. In general, insomnia is classified into five categories of physical, physiological, psychological, psychiatric and pharmacological aspects. Sedative-hypnotics including benzodiazepine and non-benzodiazepine have widely been used in chronic insomniacs. However, most hypnotics including non-benzodiazepine cause some of dependence, tolerance, impaired daytime function and rebound insomnia. Therefore, we are looking forward to proposing an effective oriental treatment for insomnia. A 71-year-old male who had suffered from cerebral infarction was admitted to our department for oriental treatment of stroke and insomnia. Initial treatment modalities with administration of paroxetine were not effective. However administration of oriental medicine' Gochimmuwoo-san(Gaozhenwuyou-san)' achieved a desirable effect.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1995년도 추계학술대회
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• pp.117-120
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• 1995

The electronencephalogram (EEG) is a complex electrical signal which reflects generalized brain activity. The EEG is utilized in the clinical assesment of many neurological and psychiatric disorders and offers promise for monitoring of patients undergoing operation. This paper describes a technique for quantitative analysis of EEG signals which is based on an eigenspace. Examples of the application approach to simulated and clinical EEG data illustrate the capabilities.