• 정신신체의학
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• 제5권1호
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• pp.82-88
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• 1997

Background : Patients with command hallucinations are commonly assumed to be at high risk for dangerous behavior. However the issue of whether command hallucinations hold any clinical relevance in schizophrenic patients has not been established. Method : The author analyzed the clinical and research records of schizophrenic patients with auditory hallucinations who participated in outpatient research follow-up for 9 months after discharge. Patients with auditory hallucinations were classified as experiencing or not experiencing command hallucinations based on clinical psychiatric assessment. Results : Of 63 patients with auditory hallucinations, 29(46%) reported the command hallucinations and these hallucinations often were violent in content(44.8%). Patients with command hallucinations were not significantly different from patients without command hallucinations on sociodemographic and clinical characteristics, and clinical or prognostic course variables, but patients with command hallucinations had significantly more short hospitalizations(less than one month) than patients without command hallucinations. 3 of the patients with command hallucinations who committed suicide during the follow up periods were died. Conclusion : Command hallucinations may be frequent, and in most cases they have minimal influence on the outcome of schizophrenia, but if the patients with command hallucinations have a history of suicide attempts before admission, the possibility of suicide attempts by command hallucinations should be considered.

• 생물정신의학
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• 제20권3호
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• pp.80-85
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• 2013

Objectives Research suggests that content of delusion and hallucination in schizophrenia is influenced by culture and social environment. However, few studies investigated chronological change of delusions and hallucinations within a society. To investigate changes in delusions and hallucinations of schizophrenia according to time, we compared contents of symptoms between inpatients with schizophrenia at two different time frames. Methods All admissions to a psychiatric unit of Hanyang University Guri Hospital with discharge diagnoses of schizophrenia at two different five-year time frames (1996-2000 and 2006-2010) were reviewed. Using a checklist, adapted from the Scale for Assessment of Positive Symptoms, we investigated delusions and hallucinations of 247 patients (104 in the 1990s and 143 in the 2000s). Results Delusions and hallucinations of patients did not differ at two time frames. In women, however, auditory and somato-tactile hallucinations were significantly more frequent in the 1990s (p < 0.05). Conclusions Our findings support the literature emphasizing that content and frequency of hallucination may differ according to cultural environment. We speculate that attitude toward sex and defensiveness toward disclosure of symptoms may have contributed to interval difference.

• 생물정신의학
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• 제3권2호
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• pp.295-301
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• 1996

환청을 보이는 정신분열증 환자 27명을 대상으로 환청의 특성(주체, 내용, 환청에 대한 이해, 환청의 심한 정도), 환청에 대한 인지행동반응의 내용 및 그 빈도, good/fair copers와 poor copers의 환청의 특성 및 인지행동반응의 비교, 세가지 변인에 따른 인지행동반응의 차이를 살펴봄으로서 다음과 같은 결과를 얻었다. 1) 환청의 주체는 모르는 사람, 내용은 박해적인 것, 감정반응은 부정적인 것과 혼합된 것, 그리고 환청에 대한 이해는 정신역동적인 것이 가장 많았다. 2) 환청에 대한 반응중 가장 많이 사용된 인지반응은 억압, 무시와 같은 건강한 반응이었으며 가장 많이 사용된 행동반응은 생리적 각성을 증가시키는 반응이었다. 3) Good/fair copers 의 특징은 poor copers에 비하여 환청의 정도가 경하고 또 환청에 대한 병식이 있는 사람들이 많다는 것이었으며 인지행동반응에 있어서도 무반응이나 몰두와 같은 건강치 못한 인지반응과 탐닉이나 증상적 행동과 같은 건강치 못한 행동반응은 훨씬 적게, 그리고 생리적 각성을 증가시키는 건강한 행동반응은 훨씬 많이 사용하고 있었다. 4) 세가지 변인 중에서 환청에 대한 병식유무가 인지행동반응의 차이를 결정 짖는 가장 중요한 요인임을 시사 받을 수 있었다. 상기 결과는 환청을 경험하는 정신분열증 환자들이 단순히 피해자로서 수동적으로 머물러 있는 것이 아니라 이질적이고 침투적인 현상을 나름대로 받아들이고 극복하기 위하여 다양한 대응방식을 보이게 되며 이와 같은 대응방식의 형태 및 그 빈도를 결정짖는 중요한 요인이 환청에 대한 이해일 수 있음을 시사해 주고 있다.

• 대한간호학회지
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• 제39권1호
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• pp.62-71
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• 2009

Purpose: The purpose of this study was to explore the effects of listening to music in inpatients diagnosed with schizophrenia, on their auditory hallucinations, and positive and negative symptoms. Methods: A quasi-experimental research design with $2{\times}2$ cross-over trial and convenience sample was used. Eleven patients (Group AB) listened to music followed by a wash out period and then a usual care period, and 12 patients (Group BA) had a usual care period followed by a wash out period and then listened to music. For one week those who were in the experimental period listened to individualized music using an MP3 player whenever they heard hallucinations. Results: There was a statistically significant decrease in the frequency of auditory hallucinations after listening to the music. There was a decrease in the mean scores for positive symptoms, negative symptoms, and general psychopathology after listening to music, but only negative symptoms showed a statistically significant decrease. The treatment effects on scores for positive symptoms, negative symptoms, and general psychopathology were greater in Group BA than Group AB. Conclusion: These findings suggest that listening to music may be useful for managing auditory hallucinations in schizophrenia inpatients.

• 수면정신생리
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• 제8권2호
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• pp.98-106
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• 2001

Auditory hallucinations are cardinal feature of psychosis. But the mechanism of hallucinated speech is unknown. The hypothesis that these hallucinations arise from pathologically altered brain monitoring system underlying speech perception is influential. With the help of rapidly developing neuroimaging study technologies, many researchers have been finding new organic deficits in the hallucinated schizophrenic patient's brain. In this article, we reviewed the general appearance of hallucination, a computer simulation model of hallucination and several neuroimaging study findings on hallucinating schizophrenic patients. In conclusion, we presented the presumptive mechanism of hallucination based on the anatomical dysfunction of schizophrenia.

• 한국임상약학회지
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• 제28권4호
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• pp.285-292
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• 2018

Background: Long-term levodopa therapy relieves the motor dysfunction associated with Parkinson's disease (PD), but has various effects on non-motor symptoms, including cognitive dysfunction, hallucinations, and affective disorders, and can exacerbate certain aspects of dementia-like cognitive dysfunction. Here, we investigated the relationship between levodopa treatment and development of dementia in patients with PD. Methods: This retrospective study analyzed 76 consecutive patients with PD who had taken levodopa between 2011 and 2015. The participants were initially free of dementia and had initial daily levodopa doses of below 600 mg. Patients who did and did not develop comorbid dementia were compared in terms of potential predictor variables, including PD onset age, sex, levodopa doses, and non-dementia comorbidities. Results: Of the 76 patients, 21 (27.6%) developed dementia, which was followed by hallucinations and insomnia. The independent predictors of incident dementia were PD onset age and second-year and third-year average levodopa doses that were higher than the first-year average levodopa dose. Patients who developed dementia had significantly higher average daily levodopa doses and levodopa dose increases over the 6-year treatment period than those who did not develop dementia. In addition, patients with higher levodopa doses were more likely to experience hallucinations. Conclusion: These results suggest that increases in levodopa doses may be associated with a greater risk of cognitive impairment in patients with PD. Therefore, motor and cognitive functions and levodopa dose increases should be evaluated regularly during long-term levodopa therapy in patients with PD.

• 벤처혁신연구
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• 제7권2호
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• pp.41-56
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• 2024

최근들어 ChaGPT를 비롯한 생성형AI서비스가 화두가 되고 있다. 디지털 네이티브인 Z세대 뿐만 아니라 디지털 이민자인 시니어들도 관심을 가지고 있는 서비스이다. 이러한 시점에서 시니어를 대상으로 생성형AI 서비스 이용의도에 영향을 미치는 요인에 대해 실증분석을 하였다. 이를 위해 시니어를 대상으로 설문조사를 실시하였으며 유효한 250부를 분석에 활용하였다. 본 연구에서는 시니어의 기술수용에 관한 연구모형인 MATOA(Model for the Adoption of Technology by Older Adults)를 토대로 성과기대, 노력기대, 사회적영향, 사전지식, 시니어의 생리적노화현상 및 생성형AI서비스의 환각을 독립변수로 설정했다. 분석은 다중회귀분석방법을 사용하였다. 실증분석결과는 다음과 같다. 성과기대와 사회적영향은 시니어의 생성형AI서비스 이용의도에 유의한 정(+)의 영향을 미쳤다. 또한 사전지식은 시니어의 생성형AI 서비스 이용의도에 유의한 정(+)의 영향을 미쳤고 생리적노화현상은 유의한 부(-)의 영향을 미쳤다. 한편, 노력기대 및 AI 환각(hallucinations)이 시니어의 생성형AI 서비스 이용의도에 미치는 유의한 영향 관계는 검정되지 않았다. 영향을 미치는 변인의 영향력 순서는 성과기대, 사회적영향, 사전지식, 생리적노화현상 순이었다. 이러한 연구결과를 토대로 학술적 및 실무적 시사점을 제시하였다.

• 생물정신의학
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• 제24권3호
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• pp.134-141
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• 2017

Objectives A retrospective case series study was conducted to investigate the clinical characteristics of psychotic disorders induced by appetite suppressants, phentermine and phendimetrazine. Methods A retrospective electronic medical record review identified 5 admitted patients who had psychotic symptoms after taking phentermine or phendimetrazine. Clinical information was reviewed and summarized in each case. Results Hallucinations were reported in all cases, including auditory, visual, olfactory and somatic hallucinations. After discontinuation of phentermine or phendimetrazine, the symptoms rapidly improved with low dose of antipsychotics. Patients tended to have less prominent negative symptoms and higher insight into illness, and often showed depressive mood. These clinical characteristics were similar to psychosis induced by amphetamines. Two patients developed stimulant use disorder while using phentermine. Conclusions These findings call for awareness of the risks associated with use of appetite suppressants. Prescription of phentermine or phendimetrazine should be accompanied by close monitoring of mental status, and suspicion for substance/medication-induced psychotic disorder.

• 생물정신의학
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• 제7권2호
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• pp.174-179
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• 2000

연구목적 : 환청이 자기감시체계의 이상이라고 주장하는 일부 학자들은 청각적 언어상상과 관련된 뇌 활성화 소견을 이용하여 환청의 병리기전을 밝히고자 하였다. 그런데 대부분의 환청의 내용은 부정적 감정을 동반하는 내용이다. 이런 점에서 저자들은 부정적 감정이 청각적 언어상상에 의해 유발된 대뇌 피질 활성에 어떤 식으로 영향을 미치는지 알아보고, 이를 통해 부정적 감정이 환청발생에 미칠 수 있는 영향을 이해해 보고자 하였다. 방법 : 정상인과 정신분열병 환자를 대상으로 부정적 내용의 청각적 언어상상 과제와 부정적 내용의 청각적 언어상상 과제를 수행토록 하였다. 이 두 가지 과제를 수행하면서 정량화뇌파검사를 시행하였고, 이때의 대뇌피질 활성의 차이를 paired t-test를 이용하여 분석하였다. 그리고 이러한 차이가 정신분열병 환자와 정상인에서 각기 어떤 식으로 달리 나타나는가 비교하였다. 결과 : 정상인의 경우 중립적 감정일 때에 비해 부정적 감정의 청각적 언어상상시, 좌측 측두엽 부위(TCP1)에서 beta주파수대의 뇌파 진폭이 증가하였고, 대뇌 우반구의 몇몇 부위(FP2, F4, C4, CP2, P4)에서 theta주파수대의 뇌파 진폭이 감소하였다. 그러나 정신분열병 환자의 경우, 두 가지 과제를 수행하는 동안 모든 주파수대에서 뇌파 진폭의 차이가 관찰되지 않았다. 결론 : 본 연구 결과는 좌측 측두엽의 더 많은 활성이 요구되는 부정적 내용의 청각적 언어상상을 하게 될 때, 정신분열병 환자에서는 적절한 활성화가 이루어지지 못하는 것을 지지하는 소견으로 생각된다. 그리고 이에 따른 자기감시체계의 활성의 저하가 환청과 밀접하게 관련될 수 있는 것으로 시사된다.

• 생물정신의학
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• 제22권4호
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• pp.163-172
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• 2015

Objectives This study was aimed to examine the multidimensional relationship between auditory verbal hallucinations (AVHs) and Positive and Negative Syndrome Scale (PANSS) factors of psychopathology in the patients with schizophrenia. And we explored the differences between assessments to hallucination by the clinicians and patients. Methods 82 patients with schizophrenia who were assessed by the Hamilton Program for Schizophrenia Voices Questionnaire (HPSVQ), Psychotic Symptom Rating Scale-Auditory Hallucination (PSYRATS-AHS), and the PANSS were recruited. Hwang's five-factor model of PANSS, items and total scores of hallucination scales, Kim's and Haddock's factor models of hallucination were applied to examine the correlations between psychopathology and AVHs. AVH-positive patients was 50 in PANSS-HPSVQ group and 24 in PANSS-PSYRATS-AHS. These two groups were separately analyzed. Results Among the five factors of the PANSS, negative and depression/anxiety factors were correlated with the total scores of HPSVQ and PSYRATS-AHS, and positive and autistic preoccupation factors were correlated only with the total score of PSYRATS-AHS. The activation factor was correlated with none of the total scores of HPSVQ/PSYRATS-AHS. These correlation patterns of a total score of HPSVQ/PSYRATS-AHS were same in the emotional factor of HPSVQ and physical factor of PSYRATS-AHS respectively. In the items which showed significant correlations, correlation coefficients of PANSS-PSYRATS-AHS group ranged between 0.406-0.755 and those of PANSS-HPSVQ ranged between 0.283-0.420. Conclusions This study suggested that the psychopathological domains of schizophrenia were differentially correlated with AVHs and the assessment of AVHs by clinicians and patients showed substantial differences which should be integrated into the therapeutic interventions.