• 정신신체의학
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• 제23권1호
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• pp.20-25
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• 2015

연구목적 정신신체의학의 발전으로 최근에는 모든 신체적 질환에 대해 생물정신사회적 접근을 추구하고 있다. 그 중 피부과 영역에서는 원형탈모증, 아토피 피부염, 발모벽, 인공 피부염, 다한증, 만성 담마진, 건선, 심상성 좌창 등의 질환과 정신과적 질환과의 연관성이 특히 강조되며, 정신 피부질환(Psychocutaneous disease)이라는 명칭이 사용되나 아직 이에 대한 연구가 미미하다. 청소년기는 2차 성징으로 인해 많은 피부 증상이 발생할 수 있으며, 이는 자아상 형성에 영향을 미칠 수 있으므로, 청소년의 피부질환에 대한 적절한 중재 및 치료의 중요성이 더욱 강조된다. 이에 저자들은 정신과 청소년 환자들의 피부과적 질환의 특성을 알아보기 위해 정신과에서 피부과로 자문 의뢰되는 청소년 환자들의 자문의뢰의 행태를 분석하고자 하였다. 방 법 대학병원에서 정신과에 입원중인 청소년 환자 중 피부과에 의뢰된 22명의 환자와 타과에서 의뢰된 108명의 환자를 대상으로 연령별 및 성별 분포, 자문율, 이환된 피부질환, 자문이유를 비교 분석하였다. 결 과 정신과 입원 환자 중 피부과로 자문 의뢰된 환자들의 평균나이는 15.9세로 관찰되었으며, 남성과 여성의 비율은 1:1.44로 관찰되었다. 정신과에서 의뢰된 청소년 환자들의 진단의 경우 정신과적으로는 기분장애(59.1%), 피부과적으로는 여드름(40.9%)이 가장 많았다. 타과 청소년에 비해 정신과 청소년 환자의 피부과로의 자문율이 유의하게 높았고(11.8% vs. 1.5%), 환자의 요청에 의해 자문이 의뢰되는 비율도 높은 것으로 나타났다(49.9% vs. 16.7%). 결 론 다양한 정신병리적인 문제와 피부과적 질환이 연관되어 환자에게 영향을 미칠 수 있다. 피부과에서는 환자의 거부나 의사의 항정신약물 사용 시작에 불편감을 이유로 질환 치료가 지연될 수 있고, 정신과에서는 피부 문제를 경미한 증상으로 생각하여 간과할 수 있으므로, 두 과 간의 적절한 정보 교환 및 협진 체계를 마련하여 생물정신사회적 접근이 필요할 것으로 보인다.

• 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.

• 생물정신의학
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• 제19권4호
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• pp.159-163
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• 2012

An appropriate research design for hypotheses and purposes leads to a good quality of research results. In this review article, we summarized the types of research methods and described the characteristics of clinical trials. Research designs are categorized into observational studies and experimental ones, depending on data collecting methods. In an observational study, there are cross-sectional, cohort and case-control studies. Parallel groups design and crossover trial studies are representative designs in a randomized controlled trial study, a kind of experimental study. Clinical researchers should understand the characteristics of clinical research designs including advantages and disadvantages and choose the suitable design according to their study purposes and the nature of collected data or subjects.

• 생물정신의학
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• 제5권1호
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• pp.71-82
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• 1998

The neuropsychiatric sequelae of traumatic brain injury are effects on complex aspect of cognition, emotion and behavior. They include problems with attention and arousal, concentration, executive function, intellectual changes, memory inpairments, personality changes, affective disorders, anxiety disorders, psychosis, apathy, aggression, and irritability. There are many useful therapeutic approaches available for people who have been brain injuries. Although a multifactioral, multidisciplinary, collaborative approach to treatment is proposed, for purposes of exposition the author have divided treatment into psychopharmacological, cognitive, behavioral, psychological, and social interventions.

• 생물정신의학
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• 제5권1호
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• pp.17-33
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• 1998

Advances in molecular biology contribute to the understanding genetic mechanism of psychiatric disorders. They have renewed hope for the discovery of disease relevant gene. However, the results somewhat confused. And we will wait for a long time for the application of gene therapy in schizophreniar. Fortunately we could classified the schizophrenia with genotypes of dopamine and serotonin receptors. It is expected that this genetic classification could provide key strategy for the therapeutic application in biological treatment for schizophrenia. The purpose of this article is to call attention of the institute participants to linkage, association, mRNA expression, genotypic classification and to the need for more systemic research. The author summarized the modified methods which were done in his laboratory in appendix.

• 생물정신의학
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• 제18권2호
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• pp.61-71
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• 2011

Substance addiction is a chronically relapsing disorder that has been characterized by a vicious cycle composed of intoxication, craving/anticipation, withdrawal, and response inhibition/bingeing. Here we summarize the findings from neuroimaging studies in addiction according to these behavioral components and suggest the integrated neurobiological model of drug addiction and related brain correlates. The roles of various prefrontal regions, thalamus, memory circuit, anterior cingulated, and insula were also suggested in addition to those of classical mesolimbic dopaminergic system and its responsivity. Limited studies of behavioral addiction demonstrated a similarity with substance addiction on the neurobiological basis. Based on the current understanding of neurobiology of addiction, further researches on interactions of behavioral components and their brain correlates, behavioral addiction, and therapeutic applications will be desired.

• 생물정신의학
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• 제20권3호
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• pp.63-65
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• 2013

The new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is published by the American Psychiatric Association. The diagnostic systems for mental disorders have come under criticism for relying on presenting signs and symptoms with the result that they do not adequately reflect relevant neurobiological and behavioral systems. Finally, the National Institute of Mental Health (NIMH) in the United States has suggested the Research Domain Criteria (RDoC) to develop a research classification system based upon dimensions of neurobiology and behavioral aspect. The present review introduces the RDoC as a new reaseach framework.

• 생물정신의학
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• 제17권3호
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• pp.119-126
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• 2010

Synaptic adhesion molecules mediate synapse formation, maturation and maintenance. These proteins are localized at synaptic sites in neuronal axons and dendrites. These proteins function as a bridge of synaptic cleft via interaction with another synaptic adhesion molecules in the opposite side. They can interact with scaffold proteins via intracellular domain and recruit many synaptic proteins, signaling proteins and synaptic vesicles. Scaffold proteins function as a platform in dendritic spines or axonal terminals. Recently, many genetic studies have revealed that synaptic adhesion molecules and scaffold proteins are important in neurodevelopmental disorders, psychotic disorders, mood disorders and anxiety disorders. In this review, fundamental mechanisms of synapse formation and maturation related with synaptic adhesion molecules and scaffold proteins are introduced and their psychiatric implications addressed.

• 생물정신의학
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• 제5권2호
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• pp.149-154
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• 1998

Antipsychotic drugs(APDs) have been effective to alleviate psychotic symptoms of schizophrenia. However, some schizophrenic patients do not respond to APDs. In addition to psychotic symptoms of schizophrenia, negative symptoms, excitement, violence, agitation, depression, and disorganization are frequently noted in patients with schizophrenia. Though APDs are the first line drugs for these symptoms, other drugs than APDs to augment the effects of APDs are efficacious for the treatment of these symptoms. Such augmenting drugs include benzodiazepines, anticonvulsants, antidepressants, lithium, and electroconvulsive therapy. These augmentation strategies can boost the effects of APDs or decrease the requirements of APDs, and consequently decrease the chance of the occurrence of side effects of APDs. Augmenting strategies are revewed for each class of drugs or treatment modality.

• 생물정신의학
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• 제18권4호
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• pp.203-209
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• 2011

In medicine, general clinical practice moves in the direction of early detection and intervention for the prevention of progressive disease. In psychiatry, research in subjects with the risk syndrome for psychosis, has been conducted for the prevention of schizophrenia, known as a devastating chronic disease. The inclusion of 'attenuated psychosis syndrome', based on the results of early intervention studies, is one of the major issues in the upcoming DSM-V. Further investigations are needed to find biological markers and endophenotypes to supplement the diagnostic criteria. In the future, adoption of clinical staging is promising to overcome the shortcoming of current diagnosis of schizophrenia. In clinical practice, more concerns are needed about attenuated psychotic symptoms which might be risk signals for the transition to psychosis.