• 제목/요약/키워드: psychiatric disorders

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여자 청소년의 신체이미지와 식사태도가 우울감과 자살사고에 미치는 영향 (Effect of Body Image and Eating Attitude on Depressive Mood and Suicide Ideation in Female Adolescents)

  • 송만규;하지현;박두흠;유승호;오정현;유재학
    • 정신신체의학
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    • 제18권1호
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    • pp.40-47
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    • 2010
  • 연구목적 : 자기신체상은 자아존중감과 체중조절행위와 밀접한 연관이 있고 특히 여자 청소년에서는 중요한 관련이 있다고 알려져있다. 이 연구는 체질량지수로 측정한 신체이미지와 식이장애와 연관된 비정상식이행동이 우울증과 자살사고에 미치는 영향을 알아보고자 한다. 방 법 : 서울 한 지역의 고등학교 여학생 239명을 대상으로 체질량지수를 측정하고, 청소년을 위한 식이태도검사(Eating Attitude Test for Korean Adolescents), 자아존중감척도, 충동성척도, 벡 우울척도, 벡 자살사고 척도를 시행하였다. 결 과 : 연구대상에서 식이장애 위험군은 총 10%(24명)이었다. 대조군에 비해 우울증상을 강하게 경험하고 있었고 현재 체질량지수와 이상적 체질량지수의 차이가 클수록 우울감, 자살사고, 비정상적 식이행동의 정도가 커지고 자아존중감은 낮아졌다. 그중에서 체질량지수의 차이가 통계적으로 가장 의미있는 예측인자였다. 결 론 : 연구대상군이 전체적으로 정상체중 범위임에도 불구하고, 현재의 체형과 이상적 체형사이의 괴리가 클수록 우울과 자살사고가 컸다. 여자 청소년의 식이장애 발생과 우울, 자살사고의 예방을 위해 체중조절, 정상식이습관에 대한 교육적 접근이 필요하다는 것을 알 수 있었다.

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양극성 장애 환자에서 불안이 질병 경과에 미치는 영향 : 전향적 추적관찰에 대한 중간분석 (Anxiety Hastened Depressive Recurrence in Bipolar Disorder : An Interim Analysis of Prospective Follow-Up Study)

  • 김수정;김소정;송혜현;이원혜;전명욱;남윤영;박동연
    • 생물정신의학
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    • 제28권1호
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    • pp.13-22
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    • 2021
  • Objectives Despite growing attention to anxiety in bipolar disorder (BD), little research has assessed anxiety symptoms in the course of BD. The current prospective follow-up study examines the influence of subjectively and objectively measured anxiety symptoms on the course of BD. Methods A total of 49 patients with BD were followed-up prospectively for average of one year at an average of four months interval. The Korean version of the Beck Anxiety Inventory (K-BAI), the Hamilton Anxiety Rating Scale, heart rate variability (HRV) were used to measure anxiety subjectively, objectively and physiologically. Participants were divided into high and low anxiety groups based on their K-BAI scores. Kaplan-Meier survival analysis was performed to compare the recurrence of mood episode, suicide attempt, emergency room visit, and psychiatric hospitalization between two groups. Mediators were investigated with Cox proportional hazards models. Results Compared to the low anxiety group, the high anxiety group reported significantly higher impulsiveness (p = 0.016) and lower high frequency component on HRV (p = 0.007) after controlling for severity of BD. Regarding survival analysis, the high anxiety group showed hastened depressive episode recurrence (p = 0.048) and suicidal ideation was the mediator of the hazard ratio (HR) 1.089 (p = 0.029) in the Cox model. Moreover, the high anxiety group showed a tendency of accelerated suicide attempt (p = 0.12) and impulsivity was the risk factor of suicide attempt (HR = 1.089, p = 0.036). Conclusions This interim analysis of prospective study suggests that high anxiety level in BD may anticipate unfavorable course. Further studies are needed to understand the multifactorial mechanism of anxious bipolar patients.

간헐적 복통과 오심, 구토로 내원한 Trichobezoar 1례 (A Case of Trichobezoar in a Child Who Visited with Intermittent Abdominal Pain, Nausea and Vomiting)

  • 안승인;유정석;오경창;김봉림;김성섭;김연호;장진근
    • Clinical and Experimental Pediatrics
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    • 제48권4호
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    • pp.433-437
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    • 2005
  • 위석은 비교적 흔하지 않은 질환이지만, 진단을 못할 경우 위궤양과 출혈, 장천공, 장중첩증, 장폐쇄, 복막염 등의 심각한 합병증을 동반할 수 있는 만성적 복통의 한 원인이며, 모발석 환아의 대부분은 발모벽과 식모증의 과거력이 있다. 저자들은 내원 4년 전까지 자기 머리카락을 뽑아서 먹는 습관이 있었고, 이후 간헐적 복통과 오심, 구토를 일으킨 11세 여아에서 모발석을 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

조현병 환자의 인지기능과 뇌 사건유발전위의 관계 (Cognitive Abilities and Auditory Event Related Potentials in Patients with Schizophrenia)

  • 김가영;민정아;채정호
    • 생물정신의학
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    • 제19권3호
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    • pp.115-120
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    • 2012
  • Objectives : Event-related potentials have been suggested as an objective marker for brain functions in psychiatric disorders. This study was aimed to investigate the relationships between P300, the mismatch negativity (MMN), the loudness dependence of the auditory evoked potential (LDAEP), demographic and clinical variables including neurocognitive abilities in patients with schizophrenia. Methods : P300, the MMN, and the LDAEP were measured and the Korean Stroop color-word test (K-stroop test) and the Wisconsin Card Sorting Test (WCST) were performed in 43 patients with schizophrenia. The relationship of the latency and amplitude of P300 and the MMN as well as regression slope of the LDAEP with demographic and clinical variables were analyzed by t-test and correlation analyses for categorical and continuous variables, respectively. Results : After controlling for age, the latency of central (Cz) and parietal (Pz) P300 posivitively correlated with GAF at admission (Cz ; ${\gamma}$ = 0.385, p = 0.047, Pz ; ${\gamma}$ = 0.421, p = 0.029). The amplitude of parietal P300 correlated with the correction rate of the K-stroop test (${\gamma}$ = 0.575, p = 0.002). In addition, the frontal (Fz) P300 latency tended to negatively correlated with the correction rate of the WCST (${\gamma}$ = -0.371, p = 0.057). Conclusions : Our findings suggest that the values of P300 latency and amplitude might be correlated with GAF at admission and working memory measured by the K-Stroop test and the WCST. Meanwhile, the MMN and the LDAEP did not correlate with demographic and clinical variables. These results support the results of previous studies showing associations with P300 and impaired cognitive ability.

한국 정신신체의학연구의 과거와 현재 그리고 미래 (The Past, Present and Future of Korean Research in Psychosmatic Medicine)

  • 고영훈
    • 정신신체의학
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    • 제20권1호
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    • pp.9-13
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    • 2012
  • 정신신체의학은 심리적, 행동적, 의학적 요인들이 인간의 신체에 미치는 영향을 알아보기 위해 생물정신사회적 관점에서 통합적으로 접근하는 의학 분야이다. 초기의 정신신체의학은 신체 질환의 원인을 심리적인 요인으로 이해하고 접근하고자 하였으며 이후 다양한 관련 분야의 발전을 통해 보다 확대된 관점에서 신체 질환을 바라보기 시작하였다. 이러한 결과 내외과 질환 환자들의 정신과적인 문제를 다루는 자문조정이 임상적으로 주목을 받게 되었다. 여러 내과적 질환들의 원인, 경과, 치료에 스트레스 혹은 정신과적 요인이 영향을 미친다는 사실이 확인되었고 더 나아가 질환뿐 아니라 삶의 질이나 인격 특성 등 인간의 행동적인 측면 역시 연구 대상으로 확대되게 된다. 최근 내외과 질환이 보다 세분화되고 그 원인에 대한 생물학적 연구들이 진행되며 다양한 검사 및 평가 도구가 개발되는 등 연구 여건이 변화됨에 따라 정신신체의학 연구도 더욱 다양화되고 세분화되고 있다. 이에 저자는 한국 정신신체의학 연구의 발전을 모색하기 위해 국내 정신신체의학 연구의 과거와 현주소를 확인하고 미래를 전망하고자 한다.

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Brain-Derived Neurotrophic Factor(BNDF) Val66Met 유전자 다형성과 성격 특성에 대한 연합연구 (An Association Study of the Brain-Derived Neurotrophic Factor Genes Polymorphisms and Personality Traits)

  • 함병주;안희범;조수민;류성곤;최명진;이민수;최인근
    • 생물정신의학
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    • 제12권2호
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    • pp.216-220
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    • 2005
  • Background:Brain-derived neurotrophic factor(BDNF) genes are thought to be important factors in some personality traits. The goal of this study was to determine the role of these genes in personality traits. Method:The participants included 170 healthy adults with no history of psychiatric disorders and other physical illnesses for the last 6 months. All participants were tested by the Temperament and Character Inventory (TCI). BDNF Val64Met gene polymorphisms were analyzed with PCR(Polymerase Chain Reaction). Differences on TCI dimensions and sub-scales among groups were examined with ANOVA. Result:There was a significant correlation between BDNF Val64Met and Persistence(PS)(p=0.036) in female subjects, but none with the other TCI dimensions. A post-hoc comparison revealed significant a difference between Val/Val and Met/Met (p=0.031). Conclusion:Our study suggests that the BDNF Val64Met gene polymorphism is associated with persistence in Korean female subjects, but the small number of subjects limits generalization of our results. Further studies with a larger number of homogenous subjects are needed to confirm whether the BDNF gene is related to personality traits.

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정신분열병과 기분장애 환자의 언어적 기억능력과 기억과정의 특성에 대한 연구 (Verbal Memory Function and Characteristics of Memory Process in Schizophrenia and Affective Disorder)

  • 이소연;이분희;이정애;김계현;김용구;박선화
    • 생물정신의학
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    • 제12권2호
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    • pp.207-215
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    • 2005
  • Objectives:This study was to compare verbal memory ability among patients with schizophrenia, bipolar manic patients and unipolar depressive patients, and to understand their charicteristics of memory process. Methods:All subjects were hospitalized patients and had been interviewed by using the Structured Clinical Interview for DSM-IV(SCID). Schizophrenic patients(N=40), bipolar manic patients(N=17), and unipolar depressive patients(N=20) were assessed with K-AVLT for verbal memory and with K-WAIS for verbal IQ. Three groups were compared regarding total immediate recall, delayed recall, delayed recognition, learning curve, memory retention, and retrieval efficiency under controlled verbal IQ. Multiple regression analysis was performed to find which clinical factors have an influence on verbal memory ability. Results:In MANCOVA, differences of verbal memory test scores among the groups were statistically significant(F=1.800, p<.05). In post hoc analysis, Patients with schizophrenia and bipolar mania showed poorer performance in immediate recall, delayed recall, delayed recognition, retrieval efficiency than unipolar depres- sive patients. And schizophrenics performed poorly in delayed recall, delayed recognition, retrieval efficiency than nonpsychotic affective disorder group, but no difference in total immediate recall, delayed recall, delayed recognition, retrieval efficiency between the schizophrenic group and the psychotic affective group. Conclusions:These results partially confirm previous reports of verbal memory ability among major psychiatric disorders. Our results showed that psychotic symptoms were related with verbal memory, and longer duration of illness was related with poorer performance in schizophrenia and unipolar depression.

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제1형 양극성장애 환자에서 대뇌피질 주름 패턴의 변형 : Local Gyrification Index 분석 (Alterations of Cortical Folding Patterns in Patients with Bipolar I Disorder : Analysis of Local Gyrification Index)

  • 이준용;한규만;원은수;이민수;함병주
    • 생물정신의학
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    • 제24권4호
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    • pp.225-234
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    • 2017
  • Objectives Local gyrification reflects the early neural development of cortical connectivity, and is regarded as a potential neural endophenotype in psychiatric disorders. Several studies have suggested altered local gyrification in patients with bipolar I disorder (BD-I). The purpose of the present study was to investigate the alterations in the cortical gyrification of whole brain cortices in patients with BD-I. Methods Twenty-two patients with BD-I and age and sex-matched 22 healthy controls (HC) were included in this study. All participants underwent T1-weighted structural magnetic resonance imaging (MRI). The local gyrification index (LGI) of 66 cortical regions were analyzed using the FreeSurfer (Athinoula A. Martinos Center for Biomedical Imaging). One-way analysis of covariance (ANCOVA) was used to analyze the difference of LGI values between two groups adjusting for age and sex as covariates. Results The patients with BD-I showed significant hypogyria in the left pars opercularis (uncorrected-p = 0.049), the left rostral anterior cingulate gyrus (uncorrected-p = 0.012), the left caudal anterior cingulate gyrus (uncorrected-p = 0.033). However, these findings were not significant after applying the multiple comparison correction. Severity or duration of illness were not significantly correlated with LGI in the patients with BD-I. Conclusions Our results of lower LGI in the anterior cingulate cortex and the ventrolateral prefrontal cortex in the BD-I group implicate that altered cortical gyrification in neural circuits involved in emotion-processing may contribute to pathophysiology of BD-I.

성주체성장애 환자의 정신의학적 분석 (Psychiatric Analysis about Transsexuals)

  • 김석권;김명훈;권용석;차병훈;이근철;최병무;손호성
    • Archives of Plastic Surgery
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    • 제34권6호
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    • pp.705-712
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    • 2007
  • Purpose: Transsexualism is considered to be the extreme end of the spectrum of gender identity disorders characterized by, among other things, a pursuit of sex reassignment surgery (SRS). We evaluated psychologic status, health-related quality of life in female-to-male (FTM), male-to-female (MTF) transgender individuals. Methods: We used the Minnesota Multiphasic Personality Inventory, Beck Anxiety Inventory, Beck Depression Inventory, Moudsley obsessive-compulsive Inventory, SCL-90-R, Short-Form 36-Question Health Survey version 2 (SF-36v2). We enrolled 40 transsexual participants. Results: Analysis of quality of life health concepts demonstrated statistically significant (p<0.01) diminished quality of life among the transsexual participants as compared to the Korea male and female population. FTM transgender participants reported more higher hostile, phobic than MTF transgenders. Overall, in all psychologic status examination, Transgender individuals are within normal population boundary. On all category, result is improved post-operatively. Conclusion: Transgender participants reported mental status within normal boundary. SRS improved their quality of life and mental stability.

주의력결핍.과잉운동장애의한의학적 치료 (1995-2002년까지의 중국논문을 중심으로) (A Review of Attention Deficit Hyperactivity Disorder in Traditional Chinese Medicine)

  • 이태호;장인수;김정연;김락형
    • 동의신경정신과학회지
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    • 제14권1호
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    • pp.161-174
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    • 2003
  • Attention deficit hyperactivity disorder(ADHD) is one of the most common childhood-onset psychiatric disorders. It is distinguished by symptoms of hyperactivity, inattention, and impulsivity. The etiology of ADHD is unknown, and the disorder may several different causes. The pharmacotherapy most widely used for ADHD occasionally gives rise to ill effects. The studys of ADHD were approached from the viewpoint of medicine and pedagogics, but it is rare from the viewpoint of the Korean Medicine. So, we searched for the studies on ADHD of Chinese Traditional Medicine(TCM) in last eight years(1995-2002). In TCM, ADHD was placed under the category of 'wind(風)-one of the five pathogenic factors', 'insomnia(失眠)', 'forgetfulness(健忘)' and 'restlessness(躁動)', etc. Jang and Bu(the internal organs; 臟腑) related with the differentiations of syndrome about ADHD were liver(肝), heart(心), spleen(脾), kidney(腎) and gallbladder(膽). Among them, liver(肝), kidney(腎) and spleen(脾) were important. The herbal medicines used in ADHD had the effects of spirit-calming(安神), orifices-opening(開竅), Eumyang-balance(陰陽平衡). And acupuncture therapy, ear-acupuncture therapy and dietary treatment, etc. were used in the treatment of ADHD. We expect that this review about ADHD in TCM help the clinical study of ADHD in Korean Medicine.

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