• 생물정신의학
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• 제11권2호
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• pp.155-164
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• 2004

Objective:The present study examined the association between basic neurocognitive functions and emotional recognition in chronic schizophrenia. Furthermore, to Investigate cognitive variable related to emotion recognition in Schizophrenia. Methods:Forty eight patients from the Yongin Psychiatric Rehabilitation Center were evaluated for neurocognitive function, and Emotional Recognition Test which has four subscales finding emotional clue, discriminating emotions, understanding emotional context and emotional capacity. Measures of neurocognitive functioning were selected based on hypothesized relationships to perception of emotion. These measures included:1) Letter Number Sequencing Test, a measure of working memory;2) Word Fluency and Block Design, a measure of executive function;3) Hopkins Verbal Learning Test-Korean version, a measure of verbal memory;4) Digit Span, a measure of immediate memory;5) Span of Apprehension Task, a measure of early visual processing, visual scanning;6) Continuous Performance Test, a measure of sustained attention functioning. Correlation analyses between specific neurocognitive measures and emotional recognition test were made. To examine the degree to which neurocognitive performance predicting emotional recognition, hierarchical regression analyses were also made. Results:Working memory, and verbal memory were closely related with emotional discrimination. Working memory, Span of Apprehension and Digit Span were closely related with contextual recognition. Among cognitive measures, Span of Apprehension, Working memory, Digit Span were most important variables in predicting emotional capacity. Conclusion:These results are relevant considering that emotional information processing depends, in part, on the abilities to scan the context and to use immediate working memory. These results indicated that mul- tifaceted cognitive training program added with Emotional Recognition Task(Cognitive Behavioral Rehabilitation Therapy added with Emotional Management Program) are promising.

• 대한간호학회지
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• 제35권6호
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• pp.1125-1134
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• 2005

Purpose: This research investigated the daily experiences of patients' lives to develop a formal theory that explains the lives of schizophrenic patients. Method: A grounded theory method(Strauss & Corbin, 1998) guided the data collection and analysis. Thirteen patients who were diagnosed with schizophrenia in regional communities participated. Result: The experiences of chronic schizophrenic patients are defined as "escaping from a fallen mine" comparing their suffering to that of entrapped miners trying to free themselves from a collapsed mine tunnel with much difficulty and without hope. In observing participant's time lines of having lived with chronic schizophrenia, it advances with 'surrender', 'collapse', 'reaching out', 'rising', 'preparing to spring up', and 'starting anew'. Conclusion: The results of this study indicate that the experience of a chronic schizophrenic patient is like that of a miner caught under a fallen mine channel, who, without external help cannot escape the depths 'Of the mine, but at the same time must have conviction and hope of rescue and avert fear to cooperate with outside help. The result indicates that family members, doctors and nurses as well as an institute's persistent and active support is most critical for the patient's adjustment to social life.

• 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.

• 생물정신의학
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• 제5권2호
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• pp.263-277
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• 1998

Conventional high-dose antipsychotics tend to result in more side effects, negative symptoms and dysphoria, and at the same time lower the cognitive function which is already impaired in most schizophrenics. Florid psychotic symptoms, negative symptoms and cognitive impairment greatly impede psychosocial performance and eventual reintegration into society. The reduction of symptom and the improvement of cognitive funtions and social skills are therefore central to the psychiatric rehabilitation process. The purpose of this study was to evaluate the dose-reduction effects of antipsychotics on chronic schizophrenics prescribed conventional high-dose antipsychotics more than 1,500mg equivalent of chlorpromazine. Fifty-one chronic schizophrenics who maintained high-dose antipsychotics for more than three months were randomly assigned to two groups : 20 patients comprised the dose-maintaining group and 31 patients made the dose-reduction group. Over a sixteen weekperiod Positive and Negative Syndrome Scale(PANSS), Extrapyramidal Symptom(EPS), Nurses' Observation Scale for Inpatient Evaluation(NOSIE-30), Continuous Performance Test(CPT), Quality of Life(QOL), and haloperidol/reduced haloperidol blood levels were determined at the base line and after 2, 4, 6, 8, 12, 16 weeks to evaluate the dose reduction effects of high-dose antipsychotics. The results were as follows : 1) Dose-reduction is highly effective in reducing positive and negative symptoms, and general psychopathology. Effects were most prominent at 8, 12, 16 weeks. Among the dose reduction group, positive symptoms in positive symptom group and negative symptoms in negative symptom group were more reduced. 2 Extrapyramidal symptoms showed no significant difference between two groups. But the EPS was reduced time after time within two groups. 3) Hit rates of Continuous Performance Test, which indicate attentional capacity, increased significantly after dose reduction. 4) Haloperidol and reduced haloperidol blood levels decreased until the 4th week, after which they were constant. 5) Total scores of Nurses' Observation Scale for Inpatient Evaluation were unchanged between the two groups. But among the indices, social interest and personal neatness were improved in the dose-reduction group and retardation was aggrevated in the dose-maintaining group. 6) Total quality of life scores were unchanged between two groups. But in the dose maintaining group, satisfaction scores of attention, autonomy, and interpersonal relationship decreased progressively. These findings suggest that the dose reduction of antipsychotics for chronic schizophrenics on programs of high-dose antipsychotics were effective. Dose reduction should therefore be implemanted to spread the rehabilitation and improve quality of life for chronic schizophrenics.

• 생물정신의학
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• 제7권2호
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• pp.198-205
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• 2000

Objectives : Risperidone and clozapine belong to a new generation of antipsychotics that are reportedly more effective and better tolerated than conventional neuroleptics. However, each of these agents costs far more per unit than conventional neuroleptics. The purpose of our retrospective study was to ascertain the total cost and effectiveness of treatment before and after administration of risperidone and clozapine in "revolving door" schizophrenia patients. Method : Data collected on revolving door schizophrenics for 2 years before clozapine and risperidone treatment and for at least 2 years after clozapine and risperidone treatment. Direct cost of inpatient and outpatient treatment was measured. Effectiveness was scaled as "years of mild disability gained". Result : Both risperidone and cloazpine result in higher costs and additional benefits to patients, for example, increased mild disability, reduced number of relapse, and reduced hospital length-of-stay. An ICER of risperidone was less than Rc and ICER of clozapine was greater than Rc. According to decision-analytic this model, risperidone had favorable cost-effectiveness ratios relative to clozapine. Conclusion : We have assumed that risperidone is more cost-effective than clozapine.

• 대한간호학회지
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• 제35권3호
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• pp.555-564
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• 2005

Purpose: This study was done to uncover the nature of hope experienced by clients with chronic schizophrenia. Method: A phenomenological approach developed by Van Manen was adopted. Data was collected from intensive interviews on 7 clients with chronic schizophrenia and the expatients' biographies and arts. A phenomenological reflection was done in terms of the four life world existentials. Result: Corporeality: Perceiving the body feeling better, proudness of self, accepting their own ill body and transcending the limitation of the body, expressing self, and staying within the boundary of a healthy body were disclosed as the body's experience of hope. Spatiality :A place with safety, freedom, peace, and sharing was the space of hope. Temporality :The essential experience of time with hope was the continuity of moving forward amid cycling and moments being filled up with something. Relationality : Connecting with someone, having someone who is dependable, understandable and exchanging interest and love were identified as the relationships of hope with others. Conclusion: The results of this study show that chronic schizophrenic patients always strive hard to keep hope and they really need someone who can support them.

• 대한간호학회지
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• 제29권6호
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• pp.1314-1323
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• 1999

The purpose of the study was to determine the effects of the 8-week, 15-session group art therapy program on self-esteem and mental health status in chronic schizophrenic inpatients. The sample consisted of two groups of chronic schizophrenic inpatients: 10 patients with an average of total disease duration of 8.90 years who participated in a 8-week group art therapy program, and 8 comparison subjects with an average of total disease duration of 8.25 years who did not participate in the program. A pretest-posttest quasiexperimental design was used to assess self-esteem and mental health status at the beginning and at the end of the 8-week, 15-session group art therapy program. The time points for obtaining data were matched for both groups. The effectiveness of the 8-week group art therapy program was assessed by Rosenberg's Self-esteem Scale(Rosenberg, 1965) and SCL-90- R(Derogatis et al., 1973). SPSSWIN 8.0 was utilized for data entry and analysis employing Mann-Whitney U test. The findings of the study indicated the followings : (a) No significant differences were found between two groups in self-esteem and (b) The experimental group showed significantly lower scores in obsessive-compulsive symptom dimension and interpersonal sensitivity symptom dimension on the SCL-90-R than the comparison group after participating in the group art therapy program. In conclusion, the findings showed the possibility of applying group art therapy as an effective nursing intervention for patients with lack of verbal communication skills and social interaction to improve their interpersonal relationship.

• 근관절건강학회지
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• 제17권1호
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• pp.58-67
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• 2010

Purpose: The purpose of this study was to examine the effect of the Tai chi exercise program on the physical function, self-esteem and social behavior in patients with chronic schizophrenia. Methods: This study utilized a nonequivalent control group with pretest-posttest design. The 45 subjects were recruited from a mental health care facility in D city and randomly assigned either to the experimental group (n=23) or to the control group (n=22). The experimental group participated in the Tai chi exercise program, twice a week for 12 weeks. Data were analyzed with SPSSWIN V. 11.5 program, using $X^2$-test and t-test. Results: After 12 weeks, there were significant differences in flexibility (p=.027), balance (p=.011), self-esteem (p=.005) and social behavior (p=.003) between the experimental and the control groups. Conclusion: The findings of this study revealed the positive effects of Tai-Chi exercise program in patients with schizophrenia. Further studies are required to determine the effects on physical and social variables.

• 생물정신의학
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• 제11권2호
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• pp.127-135
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• 2004

본 연구는 비전형적 항정신병약물이 체중과 혈당에 미치는 영향을 알아보고 그에 관계되는 여러 변인들의 관련성을 알아보고자 하였으며 이를 위해 비전형적 항정신병약물인 risperidone과 clozapine을 쓰는 환자 각각 20명, 대조군으로 전형적 항정신병약물인 haloperidol을 쓰는 환자 20명을 대상으로 입원 후 4주, 8주, 12주째 체중과 공복 시 혈당을 입원 초기 체중 및 혈당과 비교하였으며 각 약물군 간의 차이를 조사하여 다음과 같은 결과를 얻었다. 첫째, 연구 대상 환자의 초기 특성 상 clozapine군이 haloperidol과 risperidone군에 비하여 입원 시 체중이 높은 상태였는데 이는 clozapine을 복용하는 환자들이 이전에 haloperidol과 risperidone을 포함한 여러 가지 항정신병약물을 복용했던 경험이 있고 이로 인해 이미 어느 정도의 체중 증가가 있었던 것으로 생각해볼 수 있다. 둘째, 체중 변화는 risperidone과 clozapine군 모두 haloperidol을 쓴 군과 유의한 차이가 없었다. 셋째, 혈당 변화도 비전형적 항정신병약물인 risperidone과 clozapine군이 haloperidol군에 비해 의미 있는 차이가 없었다. 넷째, 몇 가지 변수들이 체중과 혈당의 변화에 연관성을 가지고 있었으나 그 정도는 크지 않았고 그 인과관계를 증명할 수는 없었다. 위의 결과들에서 볼 때 유병 기간이 길고 이전에 여러가지 항정신병약물을 복용한 경험이 있는 환자, 약물 복용에 따른 증상의 호전 정도가 두드러지지 않는 만성적인 정신분열병 환자들에서는 비전형적 항정신병약물이 전형적 항정신병약물에 비해 체중 변화와 혈당의 수치를 변화시키는 경향이 크지 않다는 점을 알 수 있었다.

• 한국콘텐츠학회논문지
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• 제12권1호
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• pp.416-429
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• 2012

본 연구는 회복지향의 통합재활프로그램이 만성정신분열병 환자의 증상, 인지 사회적 기능, 재활동기, 정신건강회복수준에 미치는 효과를 검증하고자 시도되었다. 이 프로그램은 인지분화, 정서관리, 직업재활, 가족교육으로 구성된 4개의 소프로그램과 함께 동기강화프로그램이 포함되어 있다. 연구대상은 지방소재의 일개 국립병원에 입원한 정신신분열증 환자로, 실험군 18명과 대조군 16명으로 구성된 비동등성 대조군 전후시차 설계를 사용하였다. 수집된 자료는 SPSS 12.0을 이용하여 통계 분석하였다. 프로그램의 효과를 검증한 결과, 인지 사회적 기능에 별다른 효과를 나타내지 못했으나, 재활동기수준(유지단계에서 p=.027)과 정신건강회복수준(p=.039)에서만 실험군과 대조군에서 유의한 차이를 나타내어 제한적인 효과를 나타내었다. 입원세팅에서 단기간의 회복지향의 통합재활프로그램은 증상감소나 기능향상보다는 재활 동기나 정신건강회복수준을 향상시키는데 보다 효과적으로 활용될 수 있는 가능성이 있는 것으로 보인다. 임상세팅에서 보다 회복지향적인 서비스를 제공하기 위한 노력이 필요하다.