• 정신신체의학
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• 제27권1호
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• pp.25-34
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• 2019

연구목적 본 연구에서는 기능성위장질환 환자집단, 기능성 위장증상 양성 집단 및 정상대조집단에서 정신사회적 특성을 비교하고, 기능성위장질환 환자의 삶의 질과 연관된 요인들을 알아보고자 하였다. 방 법 일 대학병원 소화기 내과 전문의에 의해 기능성위장질환으로 진단받은 환자 65명을 기능성위장질환 환자집단으로 선정하였다. 167명의 일 도 지역 공무원을 대상으로 로마III 진단 기준에 따라 기능성 위장증상을 보이지 않는 79명을 정상대조집단, 기능성위장증상을 나타내는 88명은 기능성위장증상 양성 집단으로 선별하였다. 인구통계학적 요인을 조사하였으며 정신사회적 요인을 평가하기 위해 Korean-Beck Depression Inventory-II (K-BDI-II), Korean-Beck Anxiety Inventory (K-BAI), Korean version of Childhood Trauma Questionnaire (K-CTQ), Multi-dimensional Scale of Perceived Social Support (MSPSS), Korean Version of Connor-Davidson Resilience Scale (K-CD-RISC), World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOL-BREF)를 사용하였다. 일원배치 분산분석을 사용하여 집단들 간의 차이를 비교하고 기능성위장질환 환자군의 삶의 질과 정신사회적 요인들의 상관관계를 분석하기 위해 Pearson correlation test를 시행하였다. 모든 통계는 SPSS 21.0을 사용하였다. 결 과 인구통계학적 특성에서는 학력에서 집단간 차이가 유의했다(p<0.001). FGID 환자집단이 정상대조집단과 FGID-positive집단에 비해 우울(F=29.012, p<0.001) 및 불안(F=27.954, p<0.001)이 유의하게 높았다. 아동기 외상에서 정서학대(F=6.994, p<0.001)와 신체방임(F=5.573, p<0.001)은 FGID환자집단이 정상대조집단과 FGID-positive집단에 비해 유의하게 높았으나, 신체학대, 성 학대 및 정서방임은 세 집단간의 차이가 없었다. 사회적 지지 또한 FGID환자집단이 정상대조집단과 FGID-positive집단에 비해 유의하게 낮은 것으로 나타났다(F=27.664, p<0.001). 회복 탄력성(F=9.623, p<0.001)과 하위영역인 강인성(F=5.123, p<0.001), 인내력(F=8.402, p<0.001), 낙관성(F=15.039, p<0.001) 및 영성(F=5.129, p<0.001)에서도 FGID환자집단이 정상 대조집단과 FGID-positive 집단보다 유의하게 낮은 것으로 나타났다. 삶의 질 척도(F=35.991, p<0.001)와 그 하위영역인 전반적 안녕(F=30.463, p<0.001), 신체적 건강(F=45.247, p<0.001), 심리(F=22.852, p<0.001), 사회(F=20.070, p<0.001), 환경(F=17.851, p<0.001) 모두에서 FGID환자집단이 정상대조집단과 FGID-positive집단에 비해 유의하게 낮은 점수를 나타냈다. FGID 환자집단에서 삶의 질은 회복탄력성과 양의 상관관계를 보였으며(r=0.475, p<0.01), 우울(r=-0.641, p<0.01), 불안(r=-0.441, p<0.01) 및 아동기 외상(r=-0.278, p<0.05)과는 음의 상관관계를 나타냈다. 결 론 연구결과 기능성위장질환 환자집단은 기능성 위장증상 양성 집단 및 정상대조집단에 비해 우울, 불안과 아동기 트라우마가 유의하게 높았으며 사회적 지지 및 회복 탄력성이 낮았다. 따라서 추후 기능성 위장질환 환자의 치료에 있어 정신사회적 요인에 대한 적극적인 개입이 요구된다고 하겠다.

• 대한물리의학회지
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• 제15권3호
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• pp.135-147
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• 2020

PURPOSE: The purpose of this paper is to provide a review of physiotherapy intervention for patients with COVID-19 during their hospital admission and post-discharge. METHODS: The recommendations and guidelines of physiotherapy management, medical management, and general information of the WHO, Australian Physiotherapist, European Respiratory Society, British Thoracic Society, and American Thoracic Society were reviewed. RESULTS: This paper contains general information on COVID-19, including medical management, and the importance of physiotherapy approaches including an assessment of the patients' function, such as the 6-minute walking test, five sit to stand or sit to stand for one minute to measure their function as their recovery journey. The patients' quality of life, anxiety, and depression should be considered. Physiotherapy management should be based on an assessment of the patient's presenting impairments, including inclusion and exclusion of physiotherapy intervention. The paper also approaches step by step with the disease progress, from an intensive care unit, the general ward in the acute phase, through to the rehabilitation ward if needed, and post-discharge as an outpatient.. CONCLUSION: The paper has a limitation due to the unknown factor of the natural history of COVID-19. Depending on the patients' recovery journey and the rehabilitation needed, any physiotherapy interventions should focus on what the patients' need on their journey to recovery, e.g., pulmonary, cardiac, neurological, and general rehabilitation. In addition, applying personal protection equipment for treating physiotherapists is a mandatory requirement because this protects from the transmission of COVID-19.

• 대한중풍순환신경학회지
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• 제16권1호
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• pp.89-102
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• 2015

■ Objectives This study aimed to investigate the domestic research trend about Amyotrophic Lateral Sclerosis(ALS) treated with Traditional Korean Medicine(TKM). ■ Methods Searches of two major TKM databases were conducted for articles published up to July 2015. Searching keyword was "Lou Gehrig's disease" OR "amyotrophic lateral sclerosis". Studies dealt TKM for ALS were included. ■ Results 18 studies were met our inclusion criteria(two prospective studies, one retrospective study, one follow-up study, 14 case reports). Complex TKM intervention of herbal medication, acupuncture and pharmacopuncture was the most frequently used treatment. Individually, herbal medication was the most frequent followed by acupuncture. Short-term assessment showed improvement in ALS symptoms but long-term assessment showed progression of disease. Accessory symptoms including depression, anxiety and insomnia were improved in four studies. ■ Conclusion For more definite evidence, larger studies with long-term follow-up period are needed. Moreover, benefits that TKM can provide for ALS patients as a part of multi-disciplinary approach should be studied in depth.

• 동의신경정신과학회지
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• 제35권1호
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• pp.15-26
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• 2024

Objectives: The objective of this study is to develop a specialized clinical research protocol for acupuncture treatment specifically designed for disaster survivors based on insights from an expert survey. Methods: An expert panel comprising specialists in neuropsychiatry, acupuncture, and clinical research methodology was assembled. Initial data to inform the clinical research protocol design was collected utilizing open-ended responses, multiple-choice questions, and a 5-point Likert scale to gauge agreement levels. Next, this data was disseminated to a panel of experts. A cohesive clinical research protocol was then formulated during a core panel meeting by integrating insights from a panel of 10 experts. Results: The protocol developed herein entails a non-randomized controlled study involving participants aged 19~64 years old who have been identified as high-risk or cautious according to the National Trauma Center screening test. The study design includes the establishment of an active control group, which allows for the assessment of an additional effect through comparison with conventional therapy. The selected acupuncture approach involves a combination of manual acupuncture and ear acupuncture. For clinical outcome assessment, the Clinician-Administered Posttraumatic Stress Disorder Scale for DSM-5 was proposed to gauge trauma symptoms. Representative scales for various domains such as depression, anxiety, anger, insomnia, pain, and quality of life were also provided for reference. Conclusions: The developed protocol is anticipated to streamline the swift design and initiation of clinical trials during disaster scenarios. It is also designed to be scalable, thereby enabling its application in both non-randomized control group studies and single-group before-and-after comparisons.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권2호
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• pp.58-69
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• 2017

Attention-deficit hyperactivity disorder (ADHD) is a highly prevalent, impairing, and comorbid disorder that persists into adulthood. ADHD should be diagnosed in the same manner as other common adult mental health disorders. The three most important components in the comprehensive evaluation of patients with ADHD are the clinical interview, medical examination, and completion and scoring of behavior rating scales. The diagnostic evaluation of ADHD should include questions about the symptoms, family history, prior evaluation and treatment of ADHD, as well as other problems including alcohol and drug use. Screening interviews or rating scales, as well as interviews, should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with the objective assessments of the ADHD symptoms, such as through psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. As comorbidity is the rule rather than the exception, clinicians should carefully screen for comorbid disorders as part of a comprehensive assessment of ADHD. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in his or her daily functioning, and must not meet the criteria for other mental disorders which might better account for the observed symptoms, such as mental retardation, autism or other pervasive developmental disorders, mood disorders and anxiety disorders. This report aims to suggest practice guidelines for the assessment and diagnosis of children, adolescents and adults with ADHD in Korea.

• 한국환경보건학회지
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• 제46권3호
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• pp.335-343
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• 2020

Objectives: The Korean Ministry of Environment has identified cases of people suspected of suffering lung disease potentially caused by polyhexamethylene guanidine (PHMG) used in humidifier disinfectants (HDs). Exposure assessment for the HDs was conducted using a questionnaire during face-to-face interview. The main purposes of this study were to develop a methodology to effectively classify levels of exposure to HDs based on a questionnaire. Methods: We first identified the overall participants' exposure characteristics by HD exposure levels; Second, we selected misclassified subjects and investigated characteristics of overestimated and underestimated subjects, focusing on exposure cases to PHMG-containing HDs. An inhalation reference concentration (RfC) for PHMG was produced on the basis of inhalation toxicity values. We made a cross-tabulation of the exposure classes (Exposure classes 1-to-4) by clinical classes based on the RfC. When the value of the exposure class minus the clinical class was 0 or 1, we assumed these were true values. When the value was ≥2 and ≤ -2, we assigned these cases to the overestimation group and underestimation group, respectively. Results: The overestimated group may have already recovered and responded excessively due to psychological anxiety or in order to receive compensation. On the other hand, relatively high mortality rates and surrogate responses for those under 10 years of age may have resulted in inaccurate exposure assessment for underestimated groups. For the characteristics of exposure, it was shown that for the underestimated group, the exposure was relatively weaker than the overestimated group, even though a high overall clinical rating was determined. Conclusions: This study may suggest ways to reduce bias and overcome the limitations of current HD exposure assessment.

• 정신신체의학
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• 제17권1호
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• pp.30-36
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• 2009

연구목적 : 갑상선기능은 기분, 인지기능, 불안, 수면 등의 증상과 관련된다. 갑상선기능이상 시에 정신분열병 환자에서 음성증상, 기분, 신체증상에 어떤 차이가 있는지, 또 각각의 증상 변화와 어떻게 연관되는지를 연구하였다. 방법 : 정신분열병으로 입원했던 환자 65명을 입원 당시의 갑상선호르몬 수치에 따라 갑상선기능불안정 군과 갑상선기능정상 군으로 나누었다. 두 군의 입원 당시와 8주 후에 평가했던 음성증상평가척도(Scale for the Assessment of Negative Symptoms ; 이하 SANS), 양성증상평가척도(Scale for the for the Assessment of Positive Symptoms ; 이하 SAPS), 벡우울증척도(Beck Depression Inventory ; 이하 BDI), 신체감각증폭척도(Somatosensory Amplication Scale ; 이하 SSAS)의 변화를 비교하였다. 각 환자들은 항정신병약물 치료를 포함한 입원 치료를 받았으며, 갑상선기능이 불안정했던 경우 4주 후에 갑상선호르몬의 정상화를 확인하였다. 결과 : 8주 뒤에 갑상선기능정상 군과 갑상선기능불안정 군에서 SANS, BDI, SSAS 변화 차이가 의미 있게 나타났다. 갑상선기능정상 군에서 갑상선기능불안정 군에 비해 척도 점수가 크게 낮아졌는데, SANS는 23.3%(F=57.0, p<0.01), BDI는 19.6%(F=12.9, p<0.01), 신체감각증폭척도는 16.2%(F=17.1, p<0.01) 더 변화가 컸다. SANS, BDI, SSAS 세 지표 간에 유의한 상관관계는 없었다. 결론 : 정신분열병 환자들에게서 갑상선기능이 음성증상, 우울감, 신체증상에 관련된 예후에 표지가 될 수 있을 것이다.

• 정신신체의학
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• 제4권1호
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• pp.21-36
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• 1996

본 연구는 월경전기 평가서(PAF)의 신뢰도와 타당도를 검증하고자 하였다. 서울시내 모 여고생 300명을 대상으로 PAF를 실시하여 검사 실시 상의 신뢰성이 의심되는 것을 제외한 250명 중에서 월경전기에 불편감을 느끼는가라는 질문에 예라고 응답한 230명의 자료에 대해 통계분석을 하였다. 피험자의 평균 연령은 $16.8{\pm}30.71$세, 초경연령은 $13.1{\pm}61.12$세였다. PAF 95문항의 평균과 반응빈도를 살펴본 결과 모든 문항에 골고루 응답되어 PMS의 다양성을 확인할 수 있었고 그 중에서도 한국 청소년의 주된 월경전기증상을 반영하는 것으로 보이는 21개 문항을 확인할 수 있었다. 검사의 내적 일치도는 ${\alpha}=.95$로 상당히 높아 문항의 동질성이 있음이 밝혀졌으며 검사-재검사 신뢰도는 r=.80으로 시간경과에 따른 검사의 안정성을 확인할 수 있었다. 요인분석 결과 충동성 및 불안정성 요인, 우울 요인, 철수 및 사회적 기능 손상 요인, 불안 및 인지기능 손상 요인, 신체생리적 변화 요인, 전반적 불편감 요인, 안녕감 증가 요인, 기타요인의 8개 요인구조가 확인되었다. 결론적으로 타당도 연구에서는 추출된 하위 요인구조 들이 월경전기 증상을 잘 반영하고 있으며 신뢰도 연구 결과도 만족스러운 수준을 보여 PAP가 월경전기 변화를 선별평가 하는데 유용하게 쓰일 수 있을 것으로 기대된다. 논의에서는 요인분석에 의한 분류체계를 Halbreich등(1982)의 주관적 평가기준에 의해 만들어진 형태학적 분류와 비교하여 보았고 마지막으로 본 연구의 제한점에 대해 논의해보았다.

• Human Ecology Research
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• 제54권1호
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• pp.69-81
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• 2016

Consumer anxiety about food safety is increasing, and the ability to make an accurate assessment is inadequate due to the lack of food safety information. This research focuses on relations among main variables, such as food hazard awareness, food apprehension, food safety information awareness, and food safety management system evaluation. In addition, to the moderating effects of food safety information awareness between food hazards awareness, food apprehension, and food safety management system evaluation. First, food hazards awareness and apprehension was slightly higher than the average level, also there was a significant difference in food hazard apprehension according to food hazard awareness. However, the level of food safety information was not high, meaning consumers were not as well informed as expected. We divided food safety management system evaluation into awareness and practice, subsequently, the results of both were at a low level. Food safety information awareness' moderating effect was also confirmed. Consumer organizations and the government need to provide specific and correct information to Korean consumers, that also implement a wide range of consumer education related policies.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제31권1호
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• pp.26-32
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• 2020

With the advancement in modern information technology, virtual reality (VR) is being increasingly used for the diagnosis, assessment, and treatment of mental disorders. Recently, a VR-based cognitive behavioral therapy for social phobia has been recognized as a new medical technology in South Korea. This might lead to an increase in the use of VR in the field of psychiatry. The present review provides an overview of the status of VR therapies in various psychiatric conditions such as anxiety disorder, post-traumatic stress disorder, psychosis, addiction, and eating disorder. Besides, it summarizes the role of VR therapy in the management of disorders associated with child and adolescence psychiatry as well as various other clinical applications. Additionally, we discuss the merits and limitations of VR therapy, which might serve as a useful reference for researchers. In the current environment wherein novel medical models consisting of a combination of digital devices and medicine are being developed; understanding new technologies such as VR could open new doors to mental health treatments.