• 제목/요약/키워드: 생물정신의학

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치료저항성 뚜렛장애를 가진 소아청소년에서 저빈도 반복적 경두개자기자극술의 효과 : 오픈 라벨 연구 (The Effect of Low-Frequency Repetitive Transcranial Magnetic Stimulation on Treatment-Resistant Tourette's Syndrome among Children and Adolescents : An Open-Label Study)

  • 이영지;채진혁;서완석
    • 생물치료정신의학
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    • 제24권3호
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    • pp.239-246
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    • 2018
  • 목 적 : 본 연구의 목적은 치료저항성 뚜렛장애를 가진 소아 청소년들에 대해서 보조운동영역을 표적으로 한 저빈도 반복적 경두개자기자극술의 효과를 평가하는 것이다. 방 법 : 이 연구는 미국정신의학회 진단기준 및 통계편람, 제 4판을 기준으로 뚜렛장애로 진단받은 10명의 소아 청소년(평균연령 $12.56{\pm}1.04$세)을 대상으로 하였다. 모든 참가자들은 1년 이상 지속적으로 충분한 용량의 약물치료를 받았음에도 불구하고 한국판 예일 틱 증상 평가척도(YGTSS) 20점 이상, 임상인상척도(CGI-TS) 4점 이상을 받았다. 참가자들은 보조운동영역을 표적으로 1 Hz 반복적 경두개자기자극 치료를 매일 20분간 받았으며, 총 20회 치료를 받았다. YGTSS, CGI-TS 및 이상반응 체크리스트는 연구 시작 전과 연구 시작 후 4, 8, 12주에 시행되었다. 결 과 : 틱 증상은 연구 12주차까지 호전된 상태로 지속되었으며, YGTSS와 CGI-TS가 통계적으로 유의하게 감소하였다. 특히 음성 틱 점수의 감소가 운동 틱 점수의 변화보다 전체 YGTSS 점수의 감소에 큰 역할을 한 것으로 나타났다. 그리고 전체 10명의 참가자 중 9명이 심각한 부작용 없이 연구를 끝까지 완료하였다. 결 론 : 본 연구는 보조운동영역을 표적으로 한 저빈도 반복적 경두개자기자극술이 치료 저항성 뚜렛장애를 가진 소아 청소년들에게 효과적이고 안전한 치료도구가 될 수 있음을 시사한다. 이러한 반복적 경두개자기자극술의 치료효과를 확정하기 위해서는 보다 많은 환자를 대상으로 한 잘 통제된 연구가 필요할 것이다.

만발성 정신분열증 4례 (Four Cases of Late-Onset Schizophrenia)

  • 박종득;윤도준
    • 생물정신의학
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    • 제2권2호
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    • pp.295-300
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    • 1995
  • Late-onset schizophrenia(LOS) is a controversial entity. It has been thought that onset of schizophrenia is limited to early adulthood, but many European psychiatrists have reported on the occurrence of schizophrenia in late life. DSM-III restricted the diagnosis of schizophrenia to patients with onset of illness before age 45 years. But, DSM-III-R, DSM-IV, and ICD-10 recognize no upper limit to the age at onset of schizophrenia. Patients with LOS have more visual, tactile, and olfactory hallucinations. Patients with LOS have more persecutory delusions, premorbid schizoid personality traits, and less affective blunting. The course of illness was favorable in LOS. We present four cases of LOS. Their detailed clinical features are reported hear with brief review.

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정신분열병 환자에서 정신병적 증상과 인지기능의 관련성 (Relationships between Psychotic Symptoms and Cognitive Functions in Schizophrenic Patients)

  • 이민영;김홍근
    • 생물정신의학
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    • 제14권2호
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    • pp.122-128
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    • 2007
  • Objectives : The aim of this study was to investigate relationships between psychotic symptoms and cognitive functions in schizophrenia. Methods : The study group was composed of 36 schizophrenic patients. Positive, negative, and disorganization symptoms were assessed using the PANSS. Verbal, visuospatial, attention, memory, and executive functions were assessed using a battery of cognitive tests. Results : Correlation analysis between symptom vs. cognitive measures showed that (a) positive symptoms were significantly correlated with no cognitive measures, (b) negative symptoms were significantly correlated with all cognitive measures, and (c) disorganization symptoms were significantly correlated with executive and memory measures. Correlation analyses between symptom vs. cognitive factors showed that negative-disorganization factor is significantly correlated with executive-memory factor. Conclusion : Significant relationships were confined mostly to frontal symptoms vs. frontal cognitive functions. Thus, the relationships may be mediated mainly by variations in severity of frontal pathology among patients.

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신경아교세포와 알츠하이머 병 (Neuroglial Cell and Alzheimer's Disease)

  • 김정란
    • 생물정신의학
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    • 제22권2호
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    • pp.40-46
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    • 2015
  • Neuroglial cells are fundamental for brain homeostasis and defense to intrinsic or extrinsic changes. Loss of their function and over-reactivity to stimuli contribute to the aging of brain. Alzheimer's disease (AD) could be caused by more dramatic response in neuroglia associated with various chemokines and cytokines. Neuroglia of the AD brain shares some phenotypes with aging neuroglia. In addition, neuroglial activation and neuroinflammation are commonly showed in neurodegeneration. Thus neuroglia would be a promising target for therapeutics of AD.

뇌진탕증후군의 평가와 치료 (Assessment and Treatment of Postconcussion Syndrome)

  • 노승호
    • 생물정신의학
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    • 제2권2호
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    • pp.186-192
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    • 1995
  • The Neuropsychiatric assessment and management of postconcussion syndrome(PCS), the most prevalent and controversial neuropsychiatric sequelae of traumatic brain injury, were reviewed. First, the definition and general concept of postconcussion syndrome Were summerized. This summary was followed by an overview of the clinical manifestation including cognitive, somatic, and behavioral components of PCS. Next, neuropsychological findings related to PCS were presented. Finally, the treatment issues including psychotherapy and pharamacotherapy were briefly summerized.

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외상성 뇌손상의 영상진단 (Neuroimaging of Traumatic Brain Injury)

  • 최우석
    • 생물정신의학
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    • 제2권2호
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    • pp.169-176
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    • 1995
  • 두부 외상은 많은 발생율과 사망율을 차지하고 있으며, 건강한 생활을 위해 큰 관심을 갖게 되었다. 신경방사선영상은 외상성 뇌손상 환자들의 진단과 치료에 필수적인 방법이다. 뇌손상의 기본 기전, 병리, 그리고 영상 소견을 이해 하는 것은 매우 중요하다. 1970년대에 Glasgow coma scale의 형상과 전산화단층촬영(CT)의 발달은 임상의사들이 두부외상에 대한 평가와 환자들의 경과를 예상하는데 극적인 변화를 주었다. 최근 자기공명영상(MRI)의 발달로 외상성 뇌손상의 형태를 더욱 이해 하게 되었고, 두부 외상의 발견율이 높아지게 되었다.

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외상성 뇌손상이후 발생하는 외상후 스트레스장애와 급성스트레스 장애의 평가 및 치료 (The Evaluation and Treatment of Post-Traumatic Stress Disorder and Acute Stress Disorder After Traumatic Brain Injury)

  • 박기창
    • 생물정신의학
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    • 제2권2호
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    • pp.193-204
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    • 1995
  • Traumatic brain injury(TBI) used to be developed after a severe traumatic event. Therefore TBI usually induces acute or chronic stress reaction. I reviewed the concept, epidemiology, biological or psychosocial etiology, diagnosis and treatment of post-traumatic stress disorder (PTSD), and discussed about PTSD or stress reaction after TBI. Early evaluation and management of stress reaction after TBI are important.

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케타민의 빠른 항우울효과 (Ketamine as a Rapid-Acting Antidepressant)

  • 오대영
    • 생물정신의학
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    • 제20권2호
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    • pp.29-30
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    • 2013
  • First-line therapy of depression is a pharmacological treatment. Many prescribed antidepressants modulate monoamine neurotransmitters including serotonin, norepinephrine and dopamine. Recently, Ketamine, an N-methyl-D-aspartate receptor antagonist, has received attention and has been investigated for clinical trials and neurobiological studies. Here, I introduce ketamine as a rapid-acting antidepressant.

불안의 신경생물학 (Neurobiology of Anxiety)

  • 류성곤;한창환
    • 생물정신의학
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    • 제8권1호
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    • pp.71-78
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    • 2001
  • The current understanding of the neurobiology of anxiety is generally based on experimental animal model, empirical effective psychopharmacological agents, chemical and naturalistic challenge paradigms, and psychoendocinological assessment. This article focuses on reviewing neuroanantomical, neuroendocinological and neurofunctional research of anxiety disorder. In the decade ahead, we anticipate that extension of current research and the new integrated approach promise novel insight into mechanism of anxiety.

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SSRIs 이후의 항우울제 (Beyond the SSRIs)

  • 이민수;남종원
    • 생물정신의학
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    • 제6권1호
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    • pp.34-40
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    • 1999
  • New antidepressants have become available for clinical use in the 1990s. Before this decade, the drugs available to treat depression consisted essentially of monoamine oxidase inhibitors, tricyclic antidepressants, and lithium. Following the introduction of SSRIs, the options have expanded and now include SSRIs, nefazodone, venlafaxine, mirtazapine, reboxetine, tianeptine. Newer antidepressants possess a variety of pharmacological characteristics that are relevant to the choice of an antidepressant for clinical use. This review summarizes some of the major pharmacological characteristics among the drugs.

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