• 정신신체의학
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• 제24권2호
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• pp.200-207
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• 2016

연구목적 알츠하이머병은 대표적인 증상인 인지 기능의 저하 외에도 다양한 행동심리증상(Behavioral Psychological Symptoms of Dementia, BPSD)을 흔히 동반하며, 이는 간병인들로 하여금 부양 부담을 야기한다. 본 연구에서는 한국의 치매 환자들과 그들의 간병인들을 대상으로 행동심리증상의 각 항목들과 간병인의 부양 부담에 대한 상관관계를 알아보고자 한다. 방 법 80명의 치매 환자들을 대상으로 행동심리증상을 한국형 신경정신행동검사(Korean neuropsychiatric inventory, K-NPI)를 통해서 평가하였고, 부양자들의 부양부담은 한국판 Zarit Burden Interview(ZBI)를 이용하여 평가하였다. 결 과 K-NPI의 망상, 환각, 초조/공격성, 우울/낙담, 불안, 탈억제, 과민/불안정 빈도와 간병인 부양부담의 평가척도인 ZBI 사이에 통계적으로 유의한 상관이 있었으며, K-NPI의 환각, 초조/공격성, 불안, 탈억제, 이상운동증상, 수면/야간행동의 심각도와 ZBI 척도 간에 유의한 상관이 있었다. K-NPI의 빈도${\times}$심각도 영역에서는 망상, 환각, 초조/공격성, 우울/낙담, 불안, 탈억제, 이상운동증상, 수면/야간행동과 ZBI가 유의한 상관관계를 보였다. 또한 인지기능척도(MMSE-KC, CDR, GDS)와 ZBI 척도 사이에 유의한 상관이 있었으며, 일상생활수행능력(Barthel-ADL, K-ADL)과 ZBI 척도 사이에도 유의한 상관관계를 보였다. 결 론 알츠하이머병 환자의 BPSD와 간병인의 부양부담과 상관관계가 있었다. 또한 간병인의 부양부담은 인지기능 및 일상생활수행능력과도 상관이 있었다. BPSD를 조기에 발견하고 적절하게 치료함으로써 치매 환자의 삶뿐만 아니라 보호자의 삶의 질도 개선시킬 수 있을 것이다.

• 대한한방내과학회지
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• 제42권5호
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• pp.833-845
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• 2021

Parkinson's syndrome is a degenerative brain disease that presents characteristic motor symptoms of tremor, rigidity, and gait disturbance. In addition to these motor symptoms, Parkinson's syndrome also presents non-motor symptoms (NMSs) such as sleep disturbance and cognitive decline. NMSs reduce patient's quality of life and psychosocial functioning and cause economic burden on the patient, so appropriate evaluation and treatment are required. Lewy body dementia is one of the several diseases belonging to Parkinson's syndrome. Its symptoms such as cognitive function, memory impairment, and hallucinations occur with Parkinsonism. Although drug therapy is being used with drug treatment to treat non-motor symptoms, it has limitations such as side effects, which stimulated interest in other complementary treatment methods such as oriental medicine treatment, dance, and yoga. The patient in this case complained of tremor in the right upper extremity, muscle hypertension and pain, and persistent vision, memory, and cognitive decline. The patient was diagnosed with probable Lewy body dementia. The patient was hospitalized for 4 months and received acupuncture and herbal medicines. After treatment, the patient's NMS scale scores decreased from 90 to 63, and the Unified Parkinson's Disease Rating Scale scores (summed I, II, and III) decreased from 17 points to 8 points. The Beck Depression Inventory score decreased from 22 points to 13 points. In addition, the patient's subjective evaluation revealed improvement. In this case, a patient diagnosed with probable Lewy body dementia who did not respond to the standard treatment and did not want to take medications showed improvement in not only motor symptoms but also NMSs after integrative Korean medicine treatment.

• 한방비만학회지
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• 제20권2호
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• pp.178-192
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• 2020

Objectives: The present study aimed to compare the impacts of cognitive behavioral therapy (CBT) and behavioral treatment (BT) on weight loss and psychological outcomes among patients with three different subtypes of obesity: simple obesity, obesity with binge eating disorder, and obesity with depression. Methods: Embase, PubMed, the Cochrane Central Register of Controlled Trials, Research Information Sharing Service, and Korean Studies Information Service System were systematically searched for randomized controlled trials conducted on or before May 2020, that used CBT to treat obesity. Methodological quality was assessed using Cochrane's risk of bias tool 2 and publication bias was evaluated through the funnel plot using the trim and fill method, Egger's test, and Begg and Mazumdar rank correlation test. A meta-analysis was conducted using a random-effects model and the standardized mean difference with 95% confidence interval (CI) was used to determine effect size. Results: Twenty-one randomized controlled trials with a total of 22 intervention arms and 2,590 patients were included. Our study results revealed that the effects of CBT, compared with BT, on weight loss distinctly differed across all patient subgroups. In the simple obesity group, CBT was more effective than BT (Hedges' g=0.138, CI=0.012~0.264); however, in the obesity with binge eating disorder group, BT was more effective than CBT (Hedges' g=-0.228, CI=-0.418~-0.038); in the obesity with depression group, the effect of CBT was not statistically different from that of BT (Hedges' g=0.276, CI=-0.307~0.859). Further studies with larger sample sizes are required to confirm the outcomes observed in this study. Conclusions: Our results indicated that the effects of CBT on obesity treatment vary based on patient subtype. Therefore, our findings suggest that CBT or BT should be selectively recommended as a treatment strategy for different obesity subtypes.

• 한국산학기술학회논문지
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• 제22권4호
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• pp.466-472
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• 2021

본 연구는 치매노인에게 적용되고 있는 다양한 비약물적 중재 방법과 효과에 대해 알아보고, 치매의 임상적 증상에 따른 비약물적 중재의 효과성을 분석하여 치매노인을 치료하고 관리하는 전문가들에게 도움을 주고자 한다. 이를 위해 RISS를 비롯한 5개의 데이터베이스를 사용하여 치매노인의 비약물적 중재에 대한 연구들을 검색한 후, 선정 및 배제기준에 따라 14편의 연구들을 분석하였다. 대상자 특성과 연구 특성으로 나누어 코딩을 진행하였고, 공통되는 증상별로 분류하여 메타분석을 실시하였다. 공통되는 종속변수는 인지기능, 기억력, 일상생활수행능력, 삶의 질, 우울, 행동심리증상등 6개의 하위영역으로 분류되었으며, 메타분석 결과 인지기능에서는 홀니스 프로그램, 기억력에서는 제과제빵 활동, 일상생활수행능력에서는 복합중재 프로그램, 삶의 질에서는 클라이언트 중심적 인지자극치료, 우울과 행동심리증상에서는 리듬움직임 활동이 가장 효과가 좋은 것으로 나타났다. 본 연구결과를 보아 치매노인에게 적용되고 있는 비약물적 중재는 매우 다양하며 중재들이 나타내는 효과성에서도 서로 다른 차이를 나타내고 있음을 알 수 있었다. 따라서 증상별로 중재에 대한 효과의 차이를 구별하여 적용한다면 보다 효율적인 중재가 제공될 수 있을 것으로 사료된다.

• 한국가정과교육학회지
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• 제33권4호
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• pp.31-48
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• 2021

본 연구는 고령화연구패널조사(KLoSA)의 1-6차 연도 자료를 분석하여 노년기의 우울, 만성질환, 인지기능의 다중적 측면에서의 건강 변화 유형을 파악하고 이와 관련이 있는 요인들을 분석하고자 하였다. 연구의 대상은 1차 연도 조사 시점에서 65세 이상이고 결측률이 없는 총 2,059명이다. 잠재성장모형을 통해 세 가지 건강 측면이 시간에 따라 어떠한 변화궤적을 보이는지 살펴보았으며, 성장혼합모형을 활용해 세 건강 요인에서 서로 다른 변화 궤적을 보이는 집단들을 유형화하였다. 또한 일원분산분석 및 Scheffé 사후검증, 교차분석을 통해 건강 변화유형 집단에 따라 인구사회학적 특성, 건강행동, 삶의 만족도에서 차이가 나타나는지를 살펴보았다. 본 연구의 주요 결과는 다음과 같다. 첫째, 잠재성장모형 분석 결과 우울과 만성질환의 수는 연령에 따라 점차 증가하고 인지기능은 점차 감소했다. 둘째, 성장혼합모형을 분석한 결과 노인의 건강 변화는 일반적 노화, 질환 증가, 만성적 문제의 세 집단으로 유형화되었다. 셋째, 노인의 인구사회학적 특성, 건강행동, 삶의 만족도는 세 집단에 따라 유의한 차이가 나타났다. 특히 만성적 문제 집단의 경우 교육 및 소득수준이 낮고, 전반적으로 낮은 삶의 만족도를 나타냈다. 본 연구는 노년기 건강증진 교육 프로그램에 있어 노인들이 경험하는 건강의 다중적 측면을 고려하는 것이 중요함을 보여주며, 노년기 건강증진 교육 프로그램을 위한 제언을 제공한다. 또한 전생애적 건강관리를 위한 건강정보문해력 증진에 있어서 가정과 교과과정이 갖는 중요성에 대해 논의하고자 한다.

• 동의신경정신과학회지
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• 제23권3호
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• pp.77-88
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• 2012

Objectives : This study was founded to identify the differences of stress responses, according to Sasang Constitutions (the Taeyangin, Taeumin, Soyangin and Soumin) of highly stressed oriental medicine college students. Methods : The subjects were 76 students who majored in oriental medicine. We processed 'University students Stress Scale', and 'Medical Stress Scale'. We selected 30 students who stressed higher than average. We then processed 'QSCC II (Questionnare for the Sasang Constitution Classification II)' and 'Scale for the Stress Response'. Collected data was analyzed with the SPSS 19.0 for windows statistical program. Results : The university students stress score of oriental medicine students was 1.97 that was higher than the other college students. The medical stress score was 2.77, which was similar with other medical college students. The symptoms of stress score was 2.53, which was higher than the others. Particularly, the depressive syndrome and rage syndrome were highly ranked. The frequently appearing symptoms of each type of Sasang Constitutions (the Taeyangin, Taeumin, Soyangin and Soumin) showed as follows. The Soyangin's symptoms of stress showed in order of Anxiety, Depression, and Emotional irritability. The Soumin's symptoms of stress showed in order of Depression, Emotional irritability, and cognitive disorganization. The Taeumin's symptoms of stress showed in order of Anxiety, Depression, and Emotional irritability. However, there was were no significant differences among the results of each constitution. Conclusions : The results show that oriental medicine students have as much stress as other medical college students and there was tendency of showing different patterns of stress response, according to Sasang Constitution, but it's not significantly different.

• 대한간호학회지
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• 제45권5호
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• pp.627-640
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• 2015

Purpose: The objective of this systematic review was to assess the effects of family support programs on caregiving burden, depression, and stress in family caregivers of people with dementia. Methods: A literature search was conducted of electronic databases to identify randomized controlled studies with family support programs done between 2000 and 2014. Studies published in English and/or Korean were included for the analysis with search strategies adapted from the Cochrane Dementia and Cognitive Improvement Group. Studies were rated for quality assessment by two independent reviewers using the appraisal checklist developed by Cochrane Reviews and Dissemination. Of 8,334 articles identified in the literature search, full texts of 76 articles that met the inclusion criteria were reviewed and 38 were found to include relevant outcomes. Results: Results from selected studies were pooled in statistical meta-analysis using Review Manager Software and heterogeneity between combined studies was assessed using the Chi-square test. Meta-analysis showed that the effect sizes of family caregiver support programs were small to medium for categories of caregiving burden (Hedge's g= - 0.17, 95% CI= - 0.30~ - 0.04), depression (Hedge's g= - 0.30, 95% CI= - 0.40~ - 0.20), and stress (Hedge's g= - 0.39, 95% CI= - 0.52~ - 0.25). Conclusion: The review results indicate that a support programs can assist family caregivers in reducing their psycho-emotional distress.

• 보건의료산업학회지
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• 제5권2호
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• pp.173-186
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• 2011

The purpose of this study was to know dysfunctions degree, daily living activity, depression and quality of life among stroke elderly person; and to know what kind of factors affecting to quality of life of the stroke elderly person; after that provide a fundamental data to nursing arbitration plan about increase height quality of life of the stroke elderly person. The study subjects were collected 119 people, over than 60 age, who were diagnosed with stoke in D hospital, living in B city. The data was collected by using personal interviews and questionnaire, from Nov 2008 to Jan 2009. The questionnaire were Pre-Stroke MRDS(Modified Rankin Disability Scale), Barthel-ADL(Activities of Daily Living), K-IADL(Korean-Instrumental Activities of Daily Living), GDS-15(Geriatric Depression Scale-15-question form) methods. The pre-stroke MRDS was appeared a functional obstacle. The mean score of activity of daily living was 18.24 which showed the subjects were mildly disabled, the score of instrumental activities of daily living was 7.94 which showed the mildly abled, and score of depressiveness was 7.41 which showed the subjects were mildly depression. There was a significantly correlation among MRDS, ADL, IADL, depressiveness and quality of life. Through these study result, important to check the old subjects' depressiveness, cognitive functions, daily living abilities, dysfunctions degree to main tain their quality of life.

• 생물치료정신의학
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• 제24권3호
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• pp.218-229
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• 2018

Objectives : Antipsychotic-induced hyperprolactinemia causes physical symptoms, such as amenorrhea, galactorrhea, gynecomastia, sexual dysfunction, and bone density loss, as well as psychiatric symptoms, such as depression and cognitive impairments. This study aimed to clarify the associations among hyperprolactinemia caused by antipsychotics in patients with schizophrenia, psychiatric pathology, and psychosocial factors. Methods : Ninety-nine patients with schizophrenia in the psychiatry department of a university hospital were registered between 2015 and 2017. All participants were assessed using structured questionnaires to elucidate psychopathology, social function, quality of life, and hyperprolactinemia-related side effects. The standard levels for hyperprolactinemia were 24ng/mL for women and 20ng/mL for men. Results : The average prolactin levels were $73.45{\pm}49.37ng/mL$ in patients with hyperprolactinemia and $9.16{\pm}6.42ng/mL$ in those without hyperprolactinemia. The average prolactin level in women was significantly higher than that in men(p=0.04). Risperidone was most commonly administered in patients with hyperprolactinemia(58.1%, p<0.01), while aripiprazole was most commonly administered in those without hyperprolactinemia(44.7%, p<0.01). Patients with hyperprolactinemia had significantly higher Positive and Negative Syndrome Scale(p=0.03) and Patient Health Questionnaire-9(p=0.05) scores and had significantly lower Social and Occupational Functioning Assessment Scale(p=0.04) and Strauss-Carpenter Levels of Functioning Scale(p=0.03) scores than patients without hyperprolactinemia. There were no significant differences in side effects or quality of life between the two groups. Conclusion : These findings demonstrate that hyperprolactinemia confers negative effects on depression and social function, but does not directly affect the quality of life. These results suggest that patients with schizophrenia who take antipsychotics that increase prolactin or cause side effects of hyperprolactinemia need to be assessed and receive interventions for depression.

• 대한불안의학회지
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• 제18권1호
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• pp.10-16
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• 2022

Objective : The present study examined the effectiveness of the mindful self-compassion (MSC) program on anxiety, depression, self-compassion and emotion regulation. Methods : A total of 29 subjects (mean age 27.5±6.5 years, 15 males and 14 females) participated in a standardized 8-week MSC program. The control group consisted of age- and sex-matched twenty participants (mean age 26.0±2.9 years, 11 males and 9 females). All subjects completed self-report measurements at two weeks before and after the MSC program. Results : MSC training improved self-compassion as demonstrated by the significant group x time interaction effects on the total Self-Compassion Scale scores (F[1, 47]=8.324, p<0.01). Regarding the subscale scores, a significant improvement in self-kindness, isolation and mindfulness components of self-compassion was observed after MSC training. A significant group x time interaction was observed on the self-kindness subscale (F[1, 47]=4.664, p<0.05), with a significant main effect of time (F[1, 47]=23.723, p<0.001). The isolation subscale showed a significant group x time interaction (F[1, 47]=8.698, p<0.001). For the mindfulness subscale, there was a significant group x time interaction (F[1, 47]=6.611, p<0.05) and main effect of time (F[1, 47]=6.611, p<0.05). MSC training also improved the acceptance emotion regulation strategy, as demonstrated by the significant group x time interaction in the acceptance subscale scores of the Cognitive Emotion Regulation Questionnaire (F[1, 47]=6.845, p<0.05). Conclusion : MSC training showed efficacy in fostering self-compassion and improving emotion regulation. Thus, this program might be applicable to improve mental health.