• 생물정신의학
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• 제3권1호
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• pp.30-36
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• 1996

Tardive dyskinesia is a syndrome of involuntary hyperkinetic abnormal movements that occurs during or shortly after the cessation of neuroleptic drug treatment. Typically, the movements are choreoatheoid. Other movements such as tics and dystonia may be present. Nonetheless, any dyskinesia seen in a neuroleptic-treated patient is not always neuroleptic-induced tardive dyskinesia. The prevalence of tardive dyskinesia varies widely, which reflects many methodological problems, such as differential diagnosis. symptom fluctuation, masking effect of neuroleptics, validated diagnostic criteria. Of suggested risk factors, only old age has been consistently found to be associated with an increased frequency of tardive dyskinesia. Many hypotheses about the pathophysiolgy of tardive kinesia are proposeed, but time-honored ones are not present. No consistently safe and effective treatments are found. Various treatment modalities signifies the general ineffectiveness of these agents for most patients. In general, reduction or cessation of neuroleptics, if possible, is recommended. Remission or improvemets of tardive dyskinesia after neuroleptics withdrawal usually occurs among most patients within three months.

• 대한조현병학회지
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• 제22권2호
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• pp.51-55
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• 2019

Objectives: Late-onset schizophrenia (LOS, age at first onset ≥40 years) is characterized by including predominance of women, better premorbid social adjustment and lower severity of positive/negative symptoms. However, few studies have been conducted on LOS, especially in Asian countries. This study aimed to examine the clinical features of LOS in comparison with early-onset schizophrenia (EOS). Methods: By retrospectively reviewing medical records, we assessed demographic data and clinical features of 76 LOS (20 males) and 357 EOS (144 males) who admitted to the psychiatric ward of a general hospital. Results: The mean ages of onset were 47.3±5.1 (LOS) and 25.7±6.5 (EOS) years. There were significantly more women in LOS (73.7%) than EOS (59.6%). Significantly more LOS patients had a marital (88.2% vs. 25.8%) and employment history (28.9% vs. 13.1%) than EOS. Patients with LOS had fewer negative (14.3±9.0 vs. 19.9±9.3), general psychopathology score (36.9±11.1 vs. 42.3±13.9) than EOS patients. Conclusion: In line with previous studies, this study demonstrated that LOS patients have better premorbid social adjustment. Our finding also replicates previous findings that LOS patients differ from EOS in predominance of women and relative lack of negative symptoms. These results suggest that LOS may be a distinct subtype of schizophrenia.

• 정신신체의학
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• 제16권1호
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• pp.25-30
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• 2008

최근 노인인구의 급속한 증가로 인하여 정신과에서 노인에 대한 자문의 중요성이 확대되고 있다. 따라서 임상에서의 노인에 대한 정신과 자문의 특징과 지침에 대한 이해가 필요하다. 타과적 질환을 갖는 노인에 대한 정신과적 자문은 다른 연령층과는 다른 특성을 갖는다. 노화에 따른 장기 기능의 변화와 약동학 및 약력학의 변화에 대한 숙지가 노인에 대한 정신약물학적 접근에 매우 필수적이다. 타 연령층에 비해 노인에 대한 정신과적 자문은 상대적으로 적은 것으로 조사되었으나 실제 정신과적 자문이 노인질환의 재원기간이나 기타 사망률 등을 낮출 수 있음을 고려할 때, 노인에 대한 자문을 저해하는 요인들을 분석하고 교정하는 것이 매우 필요하다.

• 수면정신생리
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• 제13권2호
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• pp.59-66
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• 2006

목 적：일반인에서 불면증의 심각도와 우울, 불안 및 불안 민감성과의 연관을 조사하고 불면증의 심각도를 설명할 수 있는 요인을 알아보고자 하였다. 방 법：2006년 9월 강북삼성병원 건강검진센터에 건강 검진을 받으러 온 일반인 95명을 대상으로 AIS-8, BDI, STAI, ASI를 실시하였다. 연령을 통제변수로 하여 AIS-8, 수면 항목을 제외한 BDI, SA, TA, ASI 등의 변수에 편상관관계 분석을 시행하였다. 이들 척도 중 AIS-8을 설명할 수 있는 척도를 다중회귀 분석을 통해 도출하였다. 결 과：일반인 95명에서 불면증의 심각도는 수면 항목을 제외한 BDI(r=0.541, p<0.001), SA(r=0.267, p<0.05), TA(r=0.642, p<0.001), ASI(r=0.312, p<0.01)와 모두 유의한 상관 관계를 보였으나 TA와 가장 높은 상관 관계를 보였다. 다중회귀 분석에서 불면증의 심각도를 유의하게 설명할 수 있는 척도는 TA였다(p<0.001). 결 론：이 연구를 통해서 우리는 불면증의 심각도가 우울, 불안 및 불안 민감성과 양의 상관 관계에 있으며 특히 특성 불안과 유의하게 상관성이 높다는 것을 확인했다. 이는 특성불안이 우울, 불면과 관련 있다는 기존 연구들과 일치하는 결과이다.

• 생물정신의학
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• 제19권1호
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• pp.53-59
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• 2012

Objectives : Autobiographical memory (ABM) is a special type of episodic memory, containing events that have occurred in a personal life. Overgeneral tendency of ABM refers to the retrieval of memory with only general and categorical descriptions rather than specific events. ABM specificity in depression and posttraumatic stress disorder is a robust finding with relation to cognitive vulnerability, affect regulation, problem-solving ability. It is also implicated in bipolar disorder with frequent relapses. In this study, we investigated whether ABM specificity was related to manic or euthymic mood states in patients with bipolar disorder. Methods : Forty bipolar patients with manic and euthymic episodes and 25 healthy controls participated in this study. Prompted by 5 positively and 5 negatively valenced emotional cue words, each participant was instructed to recall positive or negative memories and describe them in detail. The One-way ANOVA was used to compare ABM scores and post-hoc analyses were done. Results : Comapred to the healthy persons, the bipolar patients reported significantly more general than specific negative memories in both manic and euthymic episodes (p = 0.003). However, there was no significant difference between manic and euthymic patients (p = 0.074). Conclusions : These results suggest that overgeneral tendency of negative ABM may be a trait abnormality in bipolar disorder. Moreover, this phenomenon might be related to underlying cognitive deficits or affect regulation irrespective of the mood state.

• 대한불안의학회지
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• 제5권1호
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• pp.29-35
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• 2009

Background : In spite of the worldwide relevance of obsessive-compulsive disorder Ed-highlight : Unclear. Perhaps consider changing word choice. (OCD), there are considerable differences in prevalence, sex ratio, comorbidity patterns, and sociodemographic correlates. Data on subclinical OCD have been sparse to date. Methods : Data stemmed from the Korea Epidemiologic Catchment Area (KECA) study which had been carried out from April to December 2001. Korean versions of DSM-IV adapted Composite International Diagnostic Interview were administered to a representative sample of 6275 persons aged 18-64 living in the community. DSM-IV based criteria for subclinical OCD were applied. Results : The lifetime prevalence rates for OCD and subclinical OCD were 0.8% and 6.6%, respectively. In both OCD and subclinical OCD, the rates for males and females were not statistically different. OCD was demonstrated to be associated with depressive disorder, bipolar disorder, social phobia, generalized anxiety disorder, and alcohol and nicotine dependence. Additionally, subclinical OCD was associated with posttraumatic stress and somatoform disorders. Comorbidity rates in subclinical OCD were lower than those in OCD. Conclusions : The lifetime prevalence rate for OCD was less than 1% in the Korean general population. Age distribution and comorbidity patterns suggest that subclinical OCD represents a broad and heterogeneous syndrome and not simply a milder form of OCD.

• Psychiatry investigation
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• 제15권12호
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• pp.1162-1167
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• 2018

Objective Motor, perceptual, and cognitive functions are known to affect driving competence. Subcortical ischemic changes on brain magnetic resonance imaging (MRI) can reflect reduction in cognitive and motor performance. However, few studies have reported the relationship between subcortical ischemic changes and driving competence of the elderly. Thus, the objective of this study was to investigate the association between subcortical ischemic changes on MRI and driving abilities of the elderly. Methods Participants (n=540) were drawn from a nationwide, multicenter, hospital-based, longitudinal cohort. Each participant underwent MRI scan and interview for driving capacity categorized into 'now driving' and 'driving cessation (driven before, not driving now)'. Participants were divided into three groups (mild, n=389; moderate, n=116; and severe, n=35) depending on the degree of white matter hyperintensity (WMH) on MRI at baseline. Driving status was evaluated at follow-up. Statistical analyses were conducted using ${\chi}^2$ test, analysis of variance (ANOVA), structured equation model (SEM), and generalized estimating equation (GEE). Results In SEM, greater baseline degree of WMH was directly associated with driving cessation regardless of cognitive or motor dysfunction (${\beta}=-0.110$, p<0.001). In GEE models after controlling for age, sex, education, cognitive, and motor dysfunction, more severe change in the degree of WMH was associated with faster change from 'now driving' state to 'driving cessation' state over time in the elderly (${\beta}=-0.508$, p<0.001). Conclusion In both cross-sectional and longitudinal results, the degree of subcortical ischemic change on MRI might predict driving cessation in the elderly.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제27권3호
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• pp.188-195
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• 2016

Objectives: The aim of this study was to investigate the relationship between internet addiction, smartphone addiction, and psychosocial factors. This study was designed to examine the vulnerability factors for internet and smartphone addiction. Methods: The participants were 1041 children and adolescents in a small and medium-sized cities. All of the participants were evaluated in terms of their demographic characteristics and present use of the internet and smartphone, as well as using internet and smartphone addiction and other psychological scales. Statistical analyses were performed to compare the psychosocial factors between the high risk, potential risk, and general user groups of internet and smartphone addiction. Results: The participants were classified into three groups, the high risk (N=33), potential risk (N=203), and general user (N=805) groups with regard to their internet and smartphone addiction level. There were statistical significantly differences between the groups in terms of the economic status of the family, academic performance, parents, use of internet and smartphone, loneliness, family cohesion, family adaptability, perceived social support, and peer relationship. Conclusion: These results suggest that the internet and smartphone addiction of children and adolescents is related to various psychosocial vulnerability factors.

• 정신신체의학
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• 제8권2호
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• pp.172-180
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• 2000

연구목적 : 상부 위장관의 소화 장애를 가진 환자들이 스트레스를 지각하였을 때 나타내는 반응 및 소화장애 증상의 여러 변인들과의 관계를 알아봄으로써 특정 정신신체질환군에서의 스트레스에 대한 반응특성과 해당 질환과의 연관성을 알아보고자 한다. 방법 : 소화장애 증상으로 인천기독병원 소화기내과를 방문하여 위내시경 소견 상 병변이 확인된 84명의 환자와 94명의 정상 대조군을 대상으로 국내에서 개발된 스트레스반응 지각척도를 사용하여 스트레스를 인지하였을 때 나타내는 반응을 비교분석하였다. 또한 환자군에서 현재 호소하는 소화장애 증상의 기간, 소화장애의 과거력, 증상의 심각도, 심리적 고통의 존재 여부에 따라 스트레스에 대한 지각반응이 어떻게 나타나는지 평가하였다. 결과 : 스트레스반응 지각척도는 8개의 하위척도로 구성되어 있으며 연구 대상자 178명에서 8개 하위척도와 척도전체의 내적 일치도는 .65~.95로써 통계적으로 유의하게 높았다. 환자군이 대조군에 비해서 척도의 전체총점과 일반적 신체증상척도, 특정신체증상척도의 접수가 통계적으로 유의하게 더 높았다. 소화장애 증상과 스트레스반응 지각척도와의 관련성은 소화장애의 기간, 소화장애의 과거력, 증상의 심각도는 특정신체증상을, 심리적 고통의 존재는 인지기능의 저하와 일반적 부정적 사고를 잘 예측해 주는 것으로 나타났다. 결론 : 실제 상부위장관에 병변을 가진 소화장애 환자들은 정상인에 비해서 강한 스트레스 반응 지각을 나타내었으며 특히 스트레스를 경험하고 인지하였을 때 감정, 인지, 행동 영역의 반응보다는 자율신경계 및 특정신체부위와 연관된 신체증상을 주로 경험하고 있음을 알 수 있다. 또한 이들은 소화장애의 기간이 길고, 과거력이 있을수록, 그리고 증상이 심할수록 스트레스에 대해 소화기 증상을 주로 한 특정신체증상으로 반응하며 심리적 고통을 주는 스트레스의 존재는 인지기능을 저하시키고 부정적인 사고반응을 일으킴을 알 수 있다.

• 우울조울병
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• 제16권3호
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• pp.140-151
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• 2018

Objectives : The purpose of this study was to examine effects of adjunctive aripiprazole versus bupropion, on depressive symptoms of female depression. Methods : Sixty six female patients with major depressive disorders were enrolled from a six-week, randomized prospective open-label multi-center study. Participants were randomized to receive aripiprazole (2.5-10 mg/day) or bupropion (150-300 mg/day). Montgomery Asberg Depression Rating Scale, 17-item Hamilton Depression Rating scale (HAM-D17), Iowa Fatigue Scale, Drug-Induced Extrapyramidal Symptoms Scale, Psychotropic-Related Sexual Dysfunction Questionnaire scores, and Clinical Global Impression-Severity (CGI-S) were obtained at baseline and after one, two, four, and six weeks. Changes on individual items of HAM-D17 were assessed as well as on composite scales (anxiety, insomnia and drive), and on four core subscales that capture core depression symptoms. Results : Overall, both treatments improved depressive symptoms, without causing serious adverse events. There were significant differences in the HAM-D17 total score (p=0.046) and CGI-S (p=0.004), between aripiprazole and bupropion augmentation, favoring aripiprazole over bupropion. Aripiprazole revealed significantly greater effect size in depressed mood (p=0.006), retardation (p=0.005), anxiety psychic (p=0.032), and general somatic symptom (p=0.01). Conclusion : While both treatments were effective, results of this study suggested that aripiprazole may be preferable, in treating general and core symptoms of female depression.