• 제목/요약/키워드: 신경정신학

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우울, 불안 척도를 통해 살펴본 우울증 환자에 대한 한의학적 치료 효과에 대한 연구 (Clinical Effects of Korean Medical Treatment on Depressive Disorder using Depression and Anxiety Scales)

  • 안윤영;김락형;유종호
    • 동의신경정신과학회지
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    • 제33권3호
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    • pp.317-327
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    • 2022
  • Objectives: To examine clinical effects of Korean medical treatment on depressive disorder. Methods: Medical records of 102 patients diagnosed with depressive disorder who were treated with Korean medical treatment (herbal-medication, acupuncture, Korean psychotherapy) for at least 12 weeks and measured psychological scales (Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and State-Trait Anger Expression Inventory (STAXI)) every 4 weeks were analyzed. Results: After 12 weeks of treatment, BDI-II, STAI-X-1/2, BAI, and STAXI-S/T all decreased statistically significantly. STAI-X-1 and BAI were significantly decreased throughout the treatment interval (comparisons every 4 weeks). The other four scales decreased significantly from 0 to 4 weeks and from 8 to 12 weeks. Conclusions: Treatment for depressive disorder with Korean Medicine was effective not only in improving overall symptoms of depressed patients, but also in improving accompanying anxiety, anger, and physical symptoms. In addition, since all scores were gradually decreased, continuous treatment would be important.

오지상승위치료법의 표준매뉴얼 개발을 위한 타당화 연구 (A Study on the Development of the Standard Manual for ETE (Emotion To Emotion) Therapy)

  • 정문주;이도은;김지수;강성현;유영수;정인철;강형원
    • 동의신경정신과학회지
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    • 제33권3호
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    • pp.227-239
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    • 2022
  • Objectives: The purpose of this study was to develop a standardization manual for Emotion To Emotion therapy. In this study, the processes and categories derived through literature search related to the Emotion To Emotion treatments, were revised and supplemented by the expert FGI (Focus Group Interview). Afterwards, the expert Delphi was conducted, to develop a standard manual for the disease types, purpose, and method of Emotion To Emotion therapy. Methods: In this study, literature analysis and expert Delphi, as a quantitative research method, were conducted, and the expert Focus Group Interview (FGI) was conducted as a qualitative study. The manual was completed by leading the consensus, on the standardization manual for Emotion To Emotion therapy. After that, a clinical expert Delphi was conducted to test the reliability as well as validity of the manual, through quantitative consensus on the manual of the Emotion To Emotion therapy. Results: First, as a result of literature studies, to date, studies related to Emotion To Emotion therapy have been qualitatively and quantitatively limited, as comparative literature related to clinical cases. Second, through expert FGI, the manual was structured with eight sub-factors for the indication diagnosis, six sub-factors for the implementation method, and 13 detailed factors. Third, through an expert Delphi, the consensus did the factor of indication, implementation methods, and implementation process, and developed a standardization manual for Emotion To Emotion therapy ver 1.0. Conclusions: Through literature analysis, expert FGI, and expert Delphi, the Emotion To Emotion therapy standardization manual ver 1.0 was completed, and will proceed with the revision and improvement report.

심박동수 변이(Heart Rate Variability) 측정법의 개념과 임상적 활용 (The Concept and Clinical Application for the Measurement of Heart Rate Variability)

  • 우종민
    • 정신신체의학
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    • 제12권1호
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    • pp.3-14
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    • 2004
  • 신경심장학의 발전으로 중추신경 활성이 심장의 전기적 활동도에 미치는 영향이 밝혀지고 있고, 심박동수변이(Heart rate variability, HRV)가 정신적 스트레스와 심혈관질환의 기계적 연관성을 나타내는 중요한 지표로 제기되고 있다. HRV란 자율신경계의 정상적 상호작용에 의해 나타나는 생리적인 심박수 변동을 타나내며, 자율신경 기능을 정량화하여 측정할 수 있는 방법론이다. 분석 방법은 시간 영역 분석과 주파수 영역 분석으로 나눌 수 있으며, 측정 시간대에 따라 단기간 측정과 24시간 측정 등의 방법이 확립되어 있다. 임상적으로는 변이 정도, 교감신경과 부교감신경의 활성과 균형도를 파악하여 다양한 질환과 스트레스 등의 진단과 치료 및 예후 판정에 활용되고 있다. HRV를 이용한 바이오피드백도 최근 자율신경 관련 질환의 치료에 활용되고 있다. 향후 다양한 프로토콜의 개발과 임상적 적용이 필요할 것으로 보인다.

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정신과 신체의 분화와 통합 (The Differentiation and Integration of Mind and Body)

  • 양병환;황혜순
    • 정신신체의학
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    • 제8권1호
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    • pp.110-121
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    • 2000
  • 1960, 1970년대 이후 정신과 신체를 적절히 조화시키려는 경향이 나타났고, 최근에는 신경생물학과 유전학의 발달로 인해 더 이상 정신과 신체를 구분해서 생각할 수 없게 되었다. 이에 저자들은 정신-선체의 개념 및 그 관계에 대한 역사를 살펴보고, 최근에 논란되고 있는 정신-신체 모형 세 가지 즉, 생물정신사회적모델, 정신-신체동일이론, 기질적단위이론에 대한 비교 및 분자유전학과 환경과의 관계, 스트레스-체질모델을 고찰하였다.

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조현병 및 정신증 고위험군에서의 작업기억 손상 (Working Memory Deficits in Ultra-High Risk for Psychosis and Schizophrenia)

  • 전임홍;박종석;박진영;조혜현;구세준;이은;안석균;유선국
    • 대한조현병학회지
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    • 제15권2호
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    • pp.66-72
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    • 2012
  • Objectives : The aim of this study was to investigate whether verbal and spatial working memory functions were impaired not only in patients with schizophrenia but also in people at ultra-high risk for first-episode psychosis. Methods : Twenty-five patients (M 13, F 12) with schizophrenia (SPR), 21 people at ultra-high risk for psychosis (UHR)(M 10, F 11) and 19 normal controls (NC)(M 10, F 9) were recruited. The working memory was assessed by using the verbal and spatial n-back test. The working memory load increased incrementally from the 0-back to the 3-back condition. Results : SPR performed significantly lower than NC and UHR in terms of hit rates of verbal and spatial n-back test. UHR subjects conducted significantly lower than NC and higher in trend-level than SPR in terms of hit rates of verbal and spatial n-back test. These differences were derived from the high working memory load (2-back and 3-back), not from the low working memory load (0-back and 1-back). There was no significant difference between the verbal and spatial n-back test across the three groups. Conclusion : These findings suggest that verbal and spatial working memory dysfunction may be general rather than differential in terms of stimuli modality, and this working memory deficit may be an important trait factor in schizophrenia.

섬유근통의 통증 및 우울증상에 대한 침치료의 효과성: 체계적 문헌고찰 및 메타분석 (Effectiveness of Acupuncture for Pain and Depressive Symptoms in Fibromyalgia: Systematic Review and Meta-Analysis)

  • 이현우;박찬;방태훈;지형민;김종우;정선용
    • 동의신경정신과학회지
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    • 제34권2호
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    • pp.95-113
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    • 2023
  • Objectives: To review studies evaluating effects of acupuncture on pain and depressive symptoms in fibromyalgia. Methods: Quantitative evidences (RCTs) were systematically reviewed. Literature were searched for a combination of fibromyalgia and depression (The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, medline (via PubMed), Kmbase, KISS, ScienceON, OASIS, CiNii, CNKI). Quantitative research findings were critically appraised by Cochrane risk of bias (RoB) tool and pooled. Meta-analysis was then conducted using Review Manager (RevMan) 5.4. Results: Eighteen studies were selected. American College of Rheumatology (ACR) classification criteria for Fibromyalgia Syndrome was most frequently used as diagnostic criteria for fibromyalgia. As for outcome measurement, Hamilton Rating Scale for Depression (HAMD), Visual Analog Scale (VAS), and Total Effective Rate (TER) were used most commonly. Meta-analysis of ten studies revealed that both Depression and VAS scores of the Acupuncture+Western Medicine group were significantly lower than those of Western Medicine group (Depression: SMD, -0.94, 95% CI, -1.17 to -0.70; VAS: MD, -1.51, 95% CI, -1.83 to -1.19). Also, TERs of both Acupuncture group and Acupuncture+Western Acupuncture+Western Medicine group were significantly higher than those of the Western Medicine group (OR: 2.38, 95% CI: 1.29 to 4.41; and OR: 7.40, 95% CI: 3.41 to 16.07). There was no significant difference in Depression or VAS score between the Acupuncture Group and the Western Medicine Group. Conclusions: Acupuncture might be an effective option for pain and depressive symptoms of fibromyalgia when it is combined with Western Medicine treatment. For more accurate results, more types of Korean medicine treatment should be conducted.

아동기 외상의 정신과적 개관 (CHILDHOOD TRAUMA:PSYCHIATRIC OVERVIEW)

  • 한성희
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제13권1호
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    • pp.3-14
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    • 2002
  • 아동에 가해지는 정신적 외상의 충격은 아동의 심리발달에 지울 수 없는 상처를 남김으로써 향후 심각한 정신장애를 일으키는 결정적 원인이 된다. 아동기 외상의 현상학적 특징과 외상에 관여하는 신경생물학적 기전을 살펴보았고, 아동기에 경험하는 외상이 인격의 발달에 미치는 영향과 그와 관련한 정신병리를 알아보았다. 외상에 노출된 아동은 공통적으로 자신이 경험한 공포사건을 시각적으로 재경험하거나 그 기억을 반복하며, 놀이나 행동을 통해서도 외상사건을 반복하려는 경향을 보인다. 일회의 충격적 사건에 노출된 아동은 사건에 대한 지나친 기억과 집착을 보이고 지각왜곡이 심한 반면 장기간 반복되는 외상을 경험하는 아동은 정신적 무감각과 자기최면, 해리, 분노의 경향이 두드러진다. 소아·청소년에서는 외상 후 퇴행이 보다 현저하고 시간감각의 왜곡이 더 심하게 나타나며 아동의 연령이 어릴수록 자율신경계의 반응성이 증가하는 경향을 보인다. 외상적 충격에 노출되면 뇌내에서 즉각적이고 방대한 신경전달물질의 방출이 있게되는데, 자율신경계, 면역계, 시상하부-뇌하수체-부신피질 축(hypothalamic-pituitary-adrenal axis)이 활성화된다. 외상시 internal opiate가 활발한 작용을 하면서 아동으로 하여금 외상에 반응하지 않도록 하고 외상에 대한 감정반응 자체를 봉쇄할 수 있도록 해준다. 아동기 외상의 경우 central noradrenergic system에 변화가 초래되어 카테콜아민에 대해 과민감한 비정상적 소견을 보이게 된다. 체내 순환되는 cortisol 수치는 감소하고, glucocorticoid 수용체 농도와 반응성이 증가한다. 외상 후 발견되는 기억력 장애는 해마의 구조적 변화와 관련이 있는 것으로 보고되고 있다. 아동기 외상은 자기(self)와 대상(object)에 대한 내적 표상(internal representation)이 지속적으로 분화 발전하는 발달과정에서 일어난다는 점에서 인격의 발달에 심각한 영향을 미치게 된다. 해리, 신체화, 자학성, 자기애 장애의 정신병리로 발전하면서 경계성 인격장애, 자기애성 인격장애, 다중인격장애 등을 초래하게 된다.

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알코올 사용장애의 한약치료 연구동향 (Current Research Trends of Traditional Herbal Medicine for Alcohol Use Disorder)

  • 박소현;조준희;김보경;임정화
    • 동의신경정신과학회지
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    • 제34권4호
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    • pp.385-401
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    • 2023
  • Objectives: To review clinical research trends of herbal medicine treatment for alcohol use disorder. Methods: Three domestic databases and eight foreign databases were used to search for published articles by November 1, 2023 in each database. A total of 9 studies were included. Results: There were eight randomized control studies and one non-randomized control study. All randomized control studies were designed with 2-arm paralleled. The non-randomized control study was designed with 2-arm crossover. The most commonly used prescriptions were Kudzu extract capsules and Seoganhaeul capsules. The most used herbs were Puerariae Radix, Hyperici Perforati Herba, and Acanthopanacis Senticosi Radix et Rhizoma seu Caulis. Conclusions: Traditional herbal medicine might be effective in alleviating drinking behavior, physical problems, and psychological problems of patients with alcohol use disorder. However, the limited number of included studies suggests that further methodologically rigorous research studies on herbal medicine treatment for alcohol use disorder are needed in the future.

정신질환에 대한 한의학과 중의학의 비교연구 (A comparative study on the differences of mental illness between Korea and China in oriental medicine)

  • 이승기
    • 동의신경정신과학회지
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    • 제16권1호
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    • pp.193-200
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    • 2005
  • Objective : This study was carried out to investigate the differences of mental illness between Korea and China in oriental medicine Method : Several main texts in oriental medicine and articles related with topic were collected and inquired. Result : There are some differences of mental illness between Korea and China in oriental medicine. Brain is more important than heart in psychophysiology of chinese medicine, and blood stasis is a main pathologic factor of mental illness. They use not only Ohaeng(five elements) theory, but also Yin-yang theory in oriental psychotherapy. Conclusion : It seems that materialism and western medicine had some influences on modern chinese medicine. On the other hand, There are respect for traditional theory and creativity in Korean medicine represented by Dongeuibogam(東醫寶鑑) and Sasang constitutional medicine.

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정신과 환자의 한의의료 이용경험 및 인식에 대한 질적 분석 - 예비연구 (A Qualitative Analysis of Psychiatric Patients' Experiences and Perceptions of Korean Medicine Utilization - Preliminary Study)

  • 문승환;장보형;서효원;김종우;정선용
    • 동의신경정신과학회지
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    • 제33권2호
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    • pp.123-131
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    • 2022
  • Objectives: The purpose of this study was to investigate the experience and perception of using Korean medicine treatments for patients with mental disorders. Methods: The method of a qualitative analysis was used, and semi-structured interviews were conducted. The researchers developed the survey questionnaires with consultation from psychiatrists from various university hospitals. Before conducting interviews, an IRB was approved KHSIRB-21-131 (RA), and the Hankook Research Company managed the interviews. The question composition comprised 11 questions based on symptoms and treatment situations accompanying treatment due to mental distress, perception of Korean medicine, awareness of treatment costs, and awareness of treatment costs. Results: A total of six patients were interviewed. Each interviewee took 90 minutes to answer questions. Through the analysis of the data, the patients comprised four categories: characteristics, awareness of Korean medicine, awareness of Western treatment, and daily life due to mental disorder. The experience and perception of patients using Korean medicine showed positive attitudes. There was an opinion among patients that Korean medicine treatment was less dependent on drugs, and had fewer side effects, than Western medicine. Some patients said that Korean medical treatment is expensive and burdensome medical expenses. Some patients were not aware of the application of insurance to mitigate medical expenses. Conclusions: Based on the findings of the study, it is urgent to expand the application of insurance benefits to Korean medicine.