• 제목/요약/키워드: The mental disorders

검색결과 709건 처리시간 0.023초

주정의존 환자에서 7분선별검사를 이용한 인지장애의 평가 (Assessment of Cognitive Disorders in Alcoholics Using the 7 Minute Screening Battery)

  • 전진숙;윤한철;이광영;오병훈
    • 생물정신의학
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    • 제8권2호
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    • pp.258-265
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    • 2001
  • Objectives : Chronic alcohol consumption has been known to result in various neurocognitive deficits. Many neuropsychological studies revealed that the major disturbances occurred in the executive function, learning and short-term memory, visuospatial performance function, perceptuo-motor skills, and abstraction and problem solving abilities. This study was done to identify which cognitive areas might be mainly affected. Methods : The cognitive disturbance was evaluated using the Korean Version of the Mini Mental State Examination(MMSEK) and the 7 Minute Screen(7MS) in male inpatients with alcohol dependence(N=3 : as well as in age and education level matched healthy male controls(N=30). Four individual tests of the 7MS were consisted of the Benton Temporal Orientation Test, the Enhanced Cued Recall, the Clock Drawing and the Category Fluency. Results : 1) The average scores of four individual test of the 7MS for the alcoholics were $2.77{\pm}4.38$ for the Benton Temporal Orientation Test, $13.90{\pm}2.02$ for the Memory Test(the Cued Recall $6.77{\pm}1.94$, the Uncued Recall $7.10{\pm}2.45$), $5.84{\pm}1.86$ for the Clock Drawing, and $12.58{\pm}3.29$ for the Category Fluency. Except the Benton Temporal Orientation Test, there were statistically significant differences between test scores of alcoholics and those of controls(p<0.01). 2) The alcoholics who had MMSE-K score <24 were 9.68%. The average(${\pm}S.D.$) score of the MMSE-K for the patient group($27.23{\pm}2.62$) was significantly(p<0.001) lower than that of the healthy controls($29.20{\pm}1.24$). There were no statistically significant differences between four individual test scores of the 7MS of alcoholics with the MMSE-K score <24(N=3) and those of alcoholics with the MMSE-K score ${\geq}24$(N=28). 3) Four individual test scores of the 7MS seemed to have statistically significant association with such variables as MMSE-K, duration of alcohol drinking, blood magnesium concentration, liver function and thyroid function. Conclusion : Mild deficits of cognitive areas such as orientation, memory, visuospatial abilities and verbal fluency could be found in alcohol dependence.

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문헌정보학과 장애인서비스 교과과정에 관한 기초 연구 - 서울시 공공도서관 장애인서비스 및 문헌정보학과 장애인서비스 교과과정 현황 조사 - (A Basic Research on the Librarian Curriculum for the Disabled Users: A Survey of Public Library Disability Services in Seoul and Library and Information Science Disability Services Curriculum)

  • 김혜주
    • 한국문헌정보학회지
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    • 제46권3호
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    • pp.35-55
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    • 2012
  • 본 연구는 장애인서비스 전문사서 양성 교과과정 모형개발을 위한 기초연구이다. 이를 위하여 문헌을 통한 이론적 연구를 수행하고 국내 문헌정보학과 교육과정 장애인서비스 담당사서의 계속 교육과정 및 서울시 공공도서관의 장애인서비스 현황을 조사 분석하였다. 조사 결과를 요약하면 다음과 같다. 첫째, 학부 대학원 과정의 경우 현재 각각 한 곳에 장애인서비스 전문사서 양성과 관련된 교과과정이 개설되어 있었다. 둘째, 장애인서비스 담당사서의 계속 교육과정은 국립중앙도서관에서 2010년 처음 강좌를 개설한 이후 매년 강좌를 개최하고 있으며, 강좌 이수 후 설문조사를 실시하여 이수자들의 의견을 다음 강좌내용 선정에 반영하고 있다. 셋째, 현재 공공도서관을 이용하는 장애인은 시각장애인보다는 지체장애, 정신지체, 정서 행동장애, 자폐성 장애가 있는 이용자가 많은 것으로 나타났다. 장애인서비스는 관외대출서비스가 대부분을 차지하고 있었으며 일반자료를 대상으로 이루어지고 있었다. 전화인터뷰에 의하면 현재 장애인서비스를 적극적으로 수행하고 있는 소수 기관의 담당사서들은 장애인에 대한 이해, 장애인 문화프로그램 운영 기획에 관한 정보를 필요로 하고 있었다.

우리나라 초(初)·중(中)·고(高) 학생(學生) 신체검사결과(身體檢査結果)에 대한 분석연구(分析硏究) (An Analytical Study on Student's Physical Examination of Elementing and Seconding School in Korea)

  • 윤종덕
    • 한국학교보건학회지
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    • 제1권1호
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    • pp.114-132
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    • 1988
  • Aiming to appraise student's health status and recommend improvement and strengthening of the school health services, statistical analysis of the results of health examination were done with summarized data which were collected nation-wide through the Ministry of Education. After analysis of data obtained, the results of the study summarized as follows; 1) Requested Adequate care Requested Adequate care showed from 5 % to 3% in 1962 and 1984 respectively. In sexes, Requested Adequate in girls (2.8%) more apparent than in boys (2.5%) 2) Eyes i) Weak vision, abnormal refraction of eyes (myopia, hypermetropia and astigmatism), eye diseases (trachoma, others) were found as shown in the Table 2, Figure 3. Weak vision and abnormal refraction of eyes showed from 2 % (Elementary), 5 % ( Secondary) to 4 % (Elementary), 14 % (Secondary) in 1962 and 1984 respectively. In both sexes, the older the age of students the more weak vision and abnormal refraction of eyes had rapidly increased especially in over 15-year old. ii) Eye diseases (trachoma, others) showed from 2% to age of students the more diseases had students. 3) Ear, nose and pharynx Hearing disturbance, ear diseases (otitis mediae, others), nose (empyema, hypertrophy) and pharynx diseases were found as following 1) Hearing disturbance was found from 0.3%(Elementary), 1 %(Secondary) to 0.05 % (Elementary), 0.4 % (Secondary) in 1962 and 1984 respectively, however, recently the older the age of students the more had students. ii) Ear diseases showed from 1.7 % (Elementary) 1.0 % (Secondary) to 0.3 %(Elementary), 0.5%(Secondary) in 1962 and 1984 respectively. iii) In diseases of the nose and pharynx, tonsilitis showed from 2.5% (Elementary), 3.5 % (Secondary) to 1.8 % ( Elementary). 2.5% (Secondary) in 1962 and 1984 respectively. 4) Skin Infectious skin diseases and other skin diseases were found from 1.5% to 0.6% in 1962 am 1984 respectively. 5) Teeth Dental caries (in milk and permanent teeth) and otner oral diseases are shown from 12 % (Elementary), 8%(Secondary) to 75%( Elementary), 25% (Secondary) in 1962 and 1984 respectively. 6) Other defects and diseases A relatively higher morbidity was shown in the tubercular diseases, in anemia, and in heart diseases among the tuberculous diseases, nodular diseases, Pleurisy, heart diseases, anemia, beriberi, hernia, neurasthenia, speech difficulty, mental disorders, bone dysformity, motion difficulty of extremities. In both sexes, tuberculous diseases were found almost equally in both sexes and anemia in girls was more apparent than in boys. Trying to provide more effective health services in schools : i) A better and more effective physical examination should be carried out in each school and prior to the physical examination, the qualified daily observation of children by teacher should be keenly practiced. ii) According to the results of the required annual physical examination the leading cause of morbidity were dental caries, myopia, angina and otitis mediae and fore these diseases follow up should be carried out. iii) For prevention and treatment of diseases and defects health education for students in the classroom as well as to parents is urgently requested.

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'PTSD 시대'의 고통 인식과 대응: 외상 회복의 대안 패러다임 모색 (The awareness and coping of human suffering in the "PTSD era": Searching for an alternative paradigm of trauma recovery)

  • 최현정
    • 인지과학
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    • 제26권2호
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    • pp.167-207
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    • 2015
  • 본 연구는 외상후 스트레스 장애(Posttraumatic stress disorder, PTSD)가 등장한 이후 현대 사회에서 외상 및 고통을 인식하고 이에 대응하는 방법을 조명하였고, 한국 사회의 외상 인식과 대응 방식을 검토하면서 외상 회복을 위한 대안 패러다임의 원칙을 제시하였다. 외상은 기억을 매개로 만성적인 고통을 야기하는 외부 스트레스 사건으로서, 미국정신의학회는 1980년 정신장애 진단 및 통계 편람에서 외상후 스트레스 장애를 공식 인정하였다. 외상후 스트레스 장애 진단의 개발은 피해자에게 도덕적 정당성을 부여하였고, 성공적인 치료 개입의 길을 열었으며, 신경생리학과 인지신경과학 분야에서 연구 성과 축적에 기여하였다. 그러나 이와 동시에, 고통에 대한 인식이 협소해졌고, 기술 개입의 한계를 넘어서는 대응 방안의 중요성이 간과되고 있다. 특히 한국사회의 분리와 부인의 역사적 맥락, 의료 및 전문가 중심 관료주의 기저에는 외상을 개인의 문제로 치환하려는 전략이 발견된다. 따라서 사회적 고통으로서 외상을 인식하고 대안 패러다임을 모색할 필요가 있다. 이 글은 진실 규명과 정의 회복, 회복 주체로서 생존자와 공동체의 책임, 최신 생물-심리학적 성과의 생태학적 적용, 그리고 회복이란 무엇인가에 관한 지속적인 논의를 중시하는 대안 패러다임의 원칙을 제시하였다.

스마트폰 시청과 알코올 섭취에 따른 눈의 변화와 상관관계 (The Changes of The Eye and a Correlation Depending on Watching a Smartphone and taking in Alcohol)

  • 이정윤;윤언정;김성민;황혜경;박경주
    • 한국안광학회지
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    • 제18권4호
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    • pp.473-479
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    • 2013
  • 목적: 스마트폰 시청과 알코올 섭취에 따른 눈의 변화와 상관관계를 알아보고자 하였다. 방법: 안질환, 정신질환, 전신질환 그리고 알코올 대사에 관련된 약물복용의 병력이 없는 평소 건전한 음주습관을 가진 대상자 31명(남 18명, 여 13명)을 굴절검사, 각막곡률반경, 안압측정, 각막두께를 측정하고 분석하였다. 결과: 스마트폰 시청에 따른 호흡 중 혈중 알코올의 농도 변화는 15분, 30분, 45분, 60분 그리고 회복기에서 유의하게 감소하였다(p<0.01, p<0.001). 알코올 섭취 후 스마트폰 시청 전과 시청 후, 굴절검사 비교 결과 원주굴절력과 축에서 유의한 변화가 있었다(p=0.005, p=0.001). 알코올 섭취 후 스마트폰 시청에 따른 안압의 변화는 30분부터 유의하게 감소하였으며(p<0.001), 알코올을 섭취 한 상태에서 경과시간에 따른 스마트폰 시청은 각막두께에 유의한 변화를 주지 않았다. 결론: 스마트폰 시청과 알코올 섭취는 원주굴절력과 축 그리고 안압에 유의한 변화를 보인다. 시기능 피로를 초래할 수 있는 스마트폰 시청 및 알코올 섭취는 굴절검사 전 반드시 고려해야 할 요인이다.

불면장애에 대한 혈부축어탕의 체계적 문헌 고찰 및 메타분석 연구 (Herbal Medicine (Hyeolbuchukeo-tang, Xuefu Zhuyu Decoction) for Insomnia Disorder: A Systematic Review and Meta-analysis of Randomized Controlled Trials)

  • 김동희;이승환;임정화;김상호;이상협;김보경
    • 동의신경정신과학회지
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    • 제28권4호
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    • pp.319-332
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    • 2017
  • Objectives: The present study aimed to provide clinical evidence on the effect of herbal medicine, Hyeolbuchukeo-tang or Xuefu Zhuyu decoction for the treatment of primary insomnia using a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: This study included RCTs that verified the effects of Hyeolbuchukeo-tang or Xuefu Zhuyu decoction for the treatment of primary insomnia. Literature searches of English, Chinese and Korean databases were performed, and the selected literature was assessed for investigating the risk of bias. Results: The analysis included 10 RCTs. The Chinese Classification of Mental Disorders-3 was most frequently used to define the diagnostic criteria for Hyeolbuchukeo-tang or Xuefu Zhuyu decoction intervention in patients with primary insomnia. The effective rate was the most commonly used outcome measure. A meta-analysis revealed that the effective rate, the Pittsburgh Sleep Quality Index, and the Athens Insomnia Scale in the Modified Xuefu Zhuyu decoction (MXZD) group were higher compared to Western Medicine (WM) group (RR: 1.17, 95% Cl: 1.08 to 1.26, p<0.0001, $I^2$=0/MD: -1.29, 95% Cl: -2.09 to -0.49, p=0.002, $I^2$=0%/MD: -0.99, 95% Cl: -1.81 to -0.18, p=0.02, $I^2$=15%). The effective rate of the MXZD+WM group was significantly different compared to the WM group (RR: 1.28, 95% Cl: 1.11 to 1.47, p=0.0006, $I^2$=2%). The included RCTs were of relatively poor quality and had small sample sizes. Conclusions: Treatment with Hyeolbuchukeo-tang or Xuefu Zhuyu decoction was found to be effective in treating primary insomnia. However, the included RCTs were of relatively poor quality and had small sample sizes. It is hypothesized that this study could serve as a foundation for further clinical studies on the development of diagnosis and treatment methods for primary insomnia based on Korean medicine.

소아뇌졸중의 보험의학적 고찰 (Review of pediatric cerebrovascular accident in terms of insurance medicine)

  • 안계훈
    • 보험의학회지
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    • 제29권2호
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    • pp.29-32
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    • 2010
  • Moyamoya disease (MMD) is a progressive occlusive disease of the cerebral vasculature with particular involvement of the circle of Willis and the arteries that feed it. MMD is one of cerebrovacular accident,which is treated with sugical maeuver in pediatic neurosurgery. Moyamoya (ie, Japanese for "puff of smoke") characterizes the appearance on angiography of abnormal vascular collateral networks that develop adjacent to the stenotic vessels. The steno-occlusive areas are usually bilateral, but unilateral involvement does not exclude the diagnosis. The exact etiology of moyamoya disease is unknown. Some genetic predisposition is apparent because it is familial 10% of the time. The disease may be hereditary and multifactorial. It may occur by itself in a previously healthy individual. However, many disease states have been reported in association with moyamoya disease, including the following: 1) Immunological - Graves disease/thyrotoxicosis 2) Infections - Leptospirosis and tuberculosis 3) Hematologic disorders - Aplastic anemia, Fanconi anemia, sickle cell anemia, and lupus 4) Congenital syndromes - Apert syndrome, Down syndrome, Marfan syndrome, tuberous sclerosis, Turner syndrome, von Recklinghausen disease, and Hirschsprung disease 5) Vascular diseases - Atherosclerotic disease, coarctation of the aorta and fibromuscular dysplasia, 6)cranial trauma, radiation injury, parasellar tumors, and hypertension etc. These associations may not necessarily be causative but do warrant consideration due to impact on treatment.(Mainly neurosurgical operation.) The incidence of moyamoya disease is highest in Japan. The prevalence of MMD is 1 person per 100,000 population. The prevalence and incidence of moyamoya disease in Japan has been reported to be 3.16 cases and 0.35 case per 100,000 people, respectively. With regard to sex, the female-to-male ratio is 1.4:1. A bimodal peak of incidence is noted, with symptoms occurring either in the first decade(5-10yr) or in the third and fourth decades (30-40yr)of life. Mortality rates of moyamoya disease are approximately 10% in adults and 4.3% in children. Death is usually from hemorrhage. In aspect of life insurance, MR is 1700%, EDR is 16 per 1000 persons. Children and adults with moyamoya disease (MMD) may have different clinical presentations. The symptoms and clinical course vary widely from asymptomatic to transient events to severe neurologic deficits. Adults experience hemorrhage more commonly; cerebral ischemic events are more common in children. Children may have hemiparesis, monoparesis, sensory impairment, involuntary movements, headaches, dizziness, or seizures. Mental retardation or persistent neurologic deficits may be present. Adults may have symptoms and signs similar to those in children, but intraventricular, subarachnoid, or intracerebral hemorrhage of sudden onset is more common in adults. Recently increasing diagnosis of MMD with MRI, followed by surgical operation is noted. MMD needs to be considered as the "CI" state now in life insurance fields.

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불면장애에 대한 천왕보심단의 체계적 문헌 고찰 및 메타분석 연구 (Herbal Medicine (Cheonwangbosim-Dan, Tianwangbuxin-Pellet) for Insomnia Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials)

  • 사공종원;김동희;하지원;조윤송;김보경
    • 동의신경정신과학회지
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    • 제29권4호
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    • pp.267-280
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    • 2018
  • Objectives: The objective of this study was to provide clinical evidence to support the use of a herbal medicine (Cheonwangbosim-Dan/Tianwangbuxin-Pellet (TWBXP)) for insomnia. Methods: Randomized controlled trials that verified effects of Herbal Medicine (Cheonwangbosim-Dan, Tianwangbuxin-Pellet) treating primary insomnia were carried out. A literature search of English, Chinese, Korean databases was also performed. The selected literature were assessed by Risk of Bias (RoB). Results: The total number of selected trials was 13 RCTs. Among the 13 RCTs, 10 were meta-analyzed. The Chinese Classification of Mental Disorders-3 (CCMD-3) was frequently used as the diagnostic criteria for interventions during the analysis of the use of herbal medicine (Cheonwangbosim-Dan/Tianwangbuxin-Pellet) for management of primary insomnia. As for outcome measurement, the effective rate was used. From the Meta-analysis of the studies, it was established that the insomnia cure effective rate in the TWBXP group was higher than that in the Western Medicine (WM) group (RR: 1.15, 95% CI: 1.07 to 1.24, p<0.0001, $I^2=33%$). Also, the effective rate in the TWBXP+ACU group was significantly different compared to the WM group (RR: 1.32, 95% CI: 1.13 to 1.54, p=0.0004, $I^2=0%$). The quality of the selected RCTs was low. Conclusions: Herbal medicine (Cheonwangbosim-Dan/Tianwangbuxin-Pellet) is effective for treating primary insomnia. It is worth noting that this studies were of relatively poor quality. The sample sizes were also small. Therefore, further investigations into the diagnosis and treatment of insomnia are warranted.

조현병 환자에서 불안자극에 대한 선택적 주의 편향과 환청과의 연관성 : 예비 연구 (Relationships between Selective Attention Bias for Fear Stimuli and Hallucination in Patients with Schizophrenia : A Preliminary Study)

  • 김한석;한진희;홍승절;정종현;임현국;김태원;엄유현;채정호;이경욱;서호준
    • 대한불안의학회지
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    • 제12권1호
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    • pp.7-12
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    • 2016
  • Objective : This study was conducted to evaluate the relationships between selective attention bias for fear stimuli and hallucination in patients with schizophrenia Method : A total of 66 patients with schizophrenia admitted to psychiatry clinics were included in the study. Selective attention bias was measured by the dot-probe task. Patient symptoms were measured using the Positive and Negative Symptom Scale, Psychotic Symptom Rating Scale (PSYRATS), Korean version of the Scale to Assess Unawareness of Mental Disorder, and Clinical Global Impression-Severity scale. Results : Selective attention bias was correlated with the hallucination subscale of PSYTATS (r=0.268, p=0.029). No correlation was found between selective attention bias and other clinical measures. There was no significant difference, but a statistical trend was found (p=0.092) in hallucination severities between the biased and non-biased groups. Conclusion : The results suggest that selective attention bias for fear stimuli is associated with auditory hallucination. This preliminary study suggests the possibility of correlation between auditory hallucination in the psychotic domain and anxiety of the affective component.

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우울증 치료의 중의학 최신 임상연구 동향-무작위 대조군 임상연구와 체계적 문헌 고찰을 중심으로- (Review of Recent Clinical Trials for Depression in Traditional Chinese Medicine-Based on Randomized Controlled Trials and Systematic Reviews-)

  • 우정아;남유진;박윤진;권영규
    • 동의생리병리학회지
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    • 제29권6호
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    • pp.458-466
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    • 2015
  • The purpose of this study was to review the research on treating depression in Traditional Chinese Medicine(TCM) over the last 5 years to set the foundation for further studies. We searched for and analyzed articles about depression in CNKI(China National Knowledge Infrastructure) from January 2010 to December 2014. The results were as follows : The most frequently used diagnostic criteria was CCMD-3(The Chinese Classification of Mental Disorders-3), and the most used evaluation criteria was HAMD(Hamilton Depression Rating Scale). Prescription of decoction of medical herbs was most frequently used as a therapeutic method. Acupuncture, traditional Chinese psychotherapy, and music therapy were also used for some studies. The most frequent TCM Syndrome Differentiation Type was stagnation of liver-QI. For decoction of Chinese herbs, Soyo-san(Xiaoyao-san) and Sihosogan-san(Chaihushugan-san) were most often prescribed, and Bupleuri Radix, Paeoniae Radix Alba, Curcumae Radix, Poria cocos wolf, Angelicae Gigantis Radix, Atractylodis Rhizoma Alba were mainly used for medical herbs. BaekHoi(GV20) and Yindang(Ex-HN3) were often used as acupuncture sites. Post-Stroke Depression was the most common case of intercurrent or secondary depression. According to the Jadad Quality Assessment Scale, the quality of the reports was not high as most of the reports had a score of 3 or below. Most systematic reviews on depression were conducted by Chinese researchers. The problem with Clinical research on depression, according to those reviews, was that there were no standardized criteria for the diagnosis and treatment and the trials were usually not randomized nor controlled. We found out there are various clinical methods for treating depression in TCM, and hope that this research could provide the preliminary data for designing and conducting clinical trials for depression.