• 신경정신의학
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• 제57권4호
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• pp.276-286
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• 2018

Circadian rhythm is a periodic and continuous change in physiological, behavioral, and mental characteristics that occurs in most organisms on the Earth, because the Earth rotates in a 24-hour cycle. The circadian system regulates daily rhythms of physiology and behavior, such as the sleep/wake cycle, body temperature, hormonal secretion, and mood. The influence of circadian rhythm is very powerful, but limited research has addressed its effects. However, many recent studies have shown that circadian dysregulation may play an important role in the pathogenesis of bipolar disorder. This review study examined current and noteworthy studies, including the authors' own works, and proposes a possible clinical application of bipolar disorder based on evidence that circadian rhythm dysregulation in bipolar disorder may be a key pathogenetic mechanism.

• 신경정신의학
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• 제57권4호
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• pp.287-300
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• 2018

Of the different phases of bipolar disorder, bipolar depression is more prevailing and is more difficult to treat. However, there is a deficit in systemic research on the pharmacological treatment of acute bipolar depression. Therefore, consensuses on the pharmacological treatment strategies of acute bipolar depression has yet to be made. Currently, there are only three drugs approved by the Food and Drug Administration for acute bipolar depression : quetiapine, olanzapine-fluoxetine complex, and lurasidone. In clinical practice, other drugs such as mood stabilizers (lamotrigine, lithium, valproate) and/or the other atypical antipsychotics (aripiprazole, risperidone, ziprasidone) are frequently prescribed. There remains controversy on the use of antidepressants in bipolar depression. Here, we summarized the evidence of current pharmacological treatment options and reviewed treatment guidelines of acute bipolar depression from recently published studies.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제25권2호
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• pp.95-96
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• 2014

• 생물정신의학
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• 제2권1호
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• pp.115-122
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• 1995

This study was performed to know the relationship between neurologic soft signs (NSS) and clinical variables such as psychopathology. history of illness, and premorbid social adjustment in patients with schizophrenia. The authors evaluated NSS in 31 patients with schizophrenia using the structured tool for measuring neurologic abnormalities, Neurological Evaluation Scale- Korean Version(NES-K). Relationships between NSS and clinical variables such as duration of illness, intensity of precipitating stressors, duration of outpatient treatment, schooling, peer relationship, total duration of unemployment, total days of psychiatric admission, age, total days of being medicated, age at the first psychiatric admission, frequency of admissions, content of treatment, social adjustment, and severity of symptoms were analyzed. Differences between paranoid and non-paranoid schizophrenics were examined. In addition, Differences between patients with schizophrenia who have predominant positive symptoms and who have predominant negative symptoms were examined too. Total scores of NES-K were correlated with lower schooling (${\gamma}$=0.44, p<0.01). Scores of motor coordination subcategory were correlated with poor peer relationship(${\gamma}$=0.67, p<0.001). Other clinical variables were not correlated with any scores of NES-K. Paranoid and non-paranoid schizophrenics were not different in scores of NES-K. Also positive and negative schizophrenics were not different in scores of NES-K. Most clinical variables except schooling and peer relationship were not related with NSS. This results indicated that the meaning of these signs was not fully be understood. Introduction of the new classification concepts such as deficit or non-deficit syndrome will be helpful to elucidate the meaning of NSS in patients with schizophrenia.

• 한국한의학연구원논문집
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• 제16권3호
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• pp.15-22
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• 2010

Objective : This study aims to search Four-constitution Medicine based acupuncture by investigators and its effect on constitution-specific symptoms. Method : Among 463 oriental medical doctors who are the members of society of Four-constitution Medicine, 191 results are collected. The items of the questionnaire are sex, age, work experiences, working type, constitution diagnosis & prescription, the use of constitution acupuncture and so on. Result : The proportion of acupuncture treatment applied constitution-based acupuncture to patients are "Must Use" 12.6%, "Almost Use" 14.1%, "Sometimes Use" 42.9% and "Never Use" is 1.0%. The average ratio of patients treated by constitution-based acupuncture to all patients is 47%. 1. Digestive tract disease is found to be the most effective disease with constitution based acupuncture. Musculoskelectal problems, cardiovascular disease, respiratory disease, neuropsychiatric disease and urogenital disease are followed. On the oriental medicine, spleen system disease is the most frequently applied and heart system disease, neuropsychiatric disease, liver system disease, locomotorium disease and pulmonary system disease are followed. 2. Acupuncture therapeutic measures are different according to disease. For example, Sa-am acupuncture is the most widely used for spleen system disease, locomotorium disease, heart system disease, neuropsychiatric disease, pulmonary system disease. Eight constitution medicine acupuncture is effective for ophthalmic & otolaryngologic disease. Conclusion : This study is to investigate constitution-based acupuncture technique. In conclusion, the most widely used technique is Sa-am acupuncture and it is the most successful in treating digestive tract disease.

• Journal of Yeungnam Medical Science
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• 제15권2호
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• pp.371-380
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• 1998

저자들은 최근 루푸스가 뇌 혈관계를 침범하여 신경 정신과적 이상 증상을 보였으며 면역 검사, 뇌파 검사 및 뇌 자기공명사진에서 중추 신경 루푸스의 소견에 부합되는 양상을 보였고 고용량의 부신피질 호르몬 충격 요법에 반응이 좋았던 2례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 동의신경정신과학회지
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• 제23권4호
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• pp.107-122
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• 2012

Objectives : The purpose of this study is to examine the general personality profiles of patients who visited an oriental neuropsychiatric clinic and to investigate the specific profiles of patients diagnosed with Hwa-byung. Methods : We analyzed the profiles of 122 patients who completed TCI-RS questionnaire for the purpose of counseling. Patients were divided by sex, age and diagnosis related groups. Scales and subscales of each group were compared by an independent t-test and ANCOVA with SPSS windows 16.0. Types of temperament and character were classified by percentile ranks of the total patients and diagnosis related groups. Results : 1. Total patients were classified as the high harm avoidance type of temperament and of low self-directedness type of character. 2. Male patients showed significantly higher scores on NS, all subscales of NS, P2 and P3 than female patients. HA4 and C5 scores were significantly higher in the female group. Younger patients showed significantly higher scores on NS, all subscales of NS, HA1 and P3. However, older patients had significantly higher scores on SD4, SD5, ST2 and ST3. 3. Between diagnosis related groups, Hwa-byung group had significantly higher scores on RD, ST, SD3 and ST2. However P3 score of non-hwa-byung patients was higher than hwa-byung patients. In typical classification, both hwa-byung and non-hwa-byung groups were classified as the same types as total patients. Conclusions : This study showed that the patients visited an oriental neuropsychiatric clinic and had similar personality with that of general psychiatric disorders. Hwa-byung patients exhibited higher RD and ST scores than other disorders, but they had no typical differences.

• 혜화의학회지
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• 제26권1호
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• pp.1-10
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• 2017

Objectives: The aim of this study is (1) to investigate the historic changes and pharmacological efficacies of Woohwangchungsim-won and (2) to discuss the necessities for Woohwangchungsim-won's clinical applications. Methods: This study was performed through (1) investigating the ancient literature records related with Woohwangchungsim-won and analyzing Woohwangchungsim-won's composition, dosage and indications, (2) searching articles about Woohwangchungsim-won on 10 major Korean web and 3 major foreign web article search engines and analyzing Woohwangchungsim-won's pharmacological efficacies and indications. Results: Woohwangchungsim-wom has been used for cerebrovascular diseases such as stroke and palpitation. Also, there are some ancient literature records of Woohwangchungsim-won's clinical applications in neuropsychiatric disorders such as depression and bipolar disorder. In addition, there have been a number of experimental studies which demonstrate Woohwangchungsim-won's neuroprotective effect on cerebral cortex and hippocampus injury. So, it is possible to infer that Woohwangchungsim-won can be used for the treatments of neuropsychiatric disorders associated with neuronal cell death in cerebral cortex and hippocampus. But there have been no or less experimental studies which demonstrate the pharmacological efficacy of Woohwangchungsim-won on such disease. Conclusion: It is necessary that further experimental studies which demonstrate Woohwangchungsim-won's pharmacological efficacy on neuropsychiatric disorders should be done and Woohwangchungsim-won's clinical applications should be expanded on the basis of those related experimental results.

• 의학교육논단
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• 제20권1호
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• pp.51-59
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• 2018

Psychiatry residency training in South Korea currently has many limits in developing proper competencies of residents. To address this problem, the Korean Neuropsychiatric Association has been developing a new competency-based training program since 2015, using the educational systems of advanced countries such as Canada, the United Kingdom, the United States, and Australia as references. It was found that within the referenced countries' residency training systems, objectives based on competencies are stated in detail by psychiatric topics as well as various assessment methods and feedback about the resident's competency level. In addition, we surveyed psychiatric resident training hospitals, and found that more than 80% of the respondents answered positively in reference to the new training program. This paper briefly reviews competency-based residency training systems of advanced countries and compares them to the current training program in South Korea. Many resources are needed to run a new competency-based training program, and governmental supports are essential to improve the quality of the residency training system.

• 대한응급의학회지
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• 제29권5호
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• pp.519-528
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• 2018

Objective: Delayed neuropsychiatric sequelae (DNS) following carbon monoxide (CO) poisoning, which may result from a demyelinating leukoencephalopathy, is a disease with a poor prognosis. This study examined the factors affecting the long-term prognosis of DNS and the efficacy of hyperbaric oxygen therapy (HBOT) in patients with DNS. Methods: This retrospective study included 84 patients with DNS following CO poisoning from January 2013 to June 2016. HBOT was given to 24 patients. The patients were divided into an improvement group and non-improvement group based on their clinical condition on a telephone interview at intervals between 3 months and 3 years after the onset of DNS. The improvement group was defined as having Cerebral Performance Category (CPC) scores in their daily life that improve to 1 or 2 grade. Results: Of the 594 patients, DNS were found in 18.2%, and 70.2% (59 of 84) of the patients with DNS improved. The prognostic factors for the improvement of DNS were an age of 45 years or less (odds ratio [OR], 12.068; 95% confidence interval [CI], 2.393-60.858; P<0.005), CPC score of 1 or 2 group at the time of DNS onset (OR, 12.361; 95% CI, 3.161-48.330; P<0.005), and a lucid interval longer than 20 days (OR, 5.164; 95% CI, 1.393-19.141; P<0.01). HBOT was not associated with the improvement of DNS in CO poisoning (OR, 0.467; 95% CI, 0.172-1.269; P>0.1). Conclusion: Patients aged less than 45 years, low grade CPC score of 1 and 2, and lucid interval longer than 20 days are more likely to have a good prognosis. On the other hand, HBOT failed to produce a benefit for DNS patients.