• 정신신체의학
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• 제20권2호
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• pp.98-104
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• 2012

연구목적 : 본 연구는 뇌졸중 급성기에 신경 및 정신 증상간의 연관성을 조사하고자 하였다. 방 법 : 뇌졸중 환자 412명을 대상으로, 신경증상 중 뇌졸중의 심각성는 미국국립보건원 뇌졸중척도(NIHSS), 일상생활 수행장애는 바델지수(BI) 및 수정 랑킨척도(mRS), 인지기능은 한국판 간이정신상태검사(K-MMSE), 그리고 근력은 표준화된 악력측정을 통해 평가하였다. 정신증상은 간이정신진단검사(SCL-90-R)를 통해 9가지의 증상영역(신체화, 강박증, 대인예민성, 우울, 불안, 적대성, 공포불안, 편집증, 정신증)과 한가지의 부가적 항목을 조사하였다. 신경 및 정신 증상간 연관성은 입원 당시와 퇴원직전(뇌졸중 치료시작 전과 후)에 각각 분석하였다. 결 과 : 입원 당시 NIHSS 점수는 공포불안 및 부가항목과 연관이 있었고, BI와 mRS 점수는 우울, 공포불안, 그리고 부가항목과 연관성을 보였다. 퇴원 당시의 NIHSS 점수는 신체화, 우울, 공포불안, 부가 항목과 연관이 있었고, BI와 mRS 점수는 우울, 공포불안, 부가항목과 연관이 있었으며, MMSE 점수는 강박증, 우울, 공포불안, 부가 항목과 연관을 보였고, 악력은 신체화, 우울, 불안, 부가항목과 연관되었다. 결 론 : 뇌졸중의 급성기에는 신경 증상이 심할수록 우울, 공포불안, 수면 및 식욕 장애 등 정신 증상이 동반될 가능성이 높았다. 뇌졸중 후 신경증상이 심각한 환자에 대해 신경학적 치료와 함께 적극적인 정신과 치료가 필요하다.

• 정신신체의학
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• 제29권2호
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• pp.207-212
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• 2021

항-N-methyl-D-aspartate 수용체 뇌염(Anti-NMDAR encephalitis)은 NMDA 수용체에 대한 자가항체로 매개되는 신경 염증성 질환으로 초기에 뚜렷한 신경학 증상 없이 망상, 지각이상, 와해된 행동, 심한 불안, 인지기능저하 등의 정신증상이 두드러질 수 있다. 면역치료 혹은 종양제거와 같은 조기치료가 좋은 예후 인자이므로 질병초기에 정신질환과 구분하여 항-NMDAR 뇌염을 진단하는 것이 중요하다. 본 증례에서는 간질과 정신병적 증상을 보이는 26세 여성 A씨를 조기에 항-NMDAR 뇌염으로 확진한 뒤 양성 및 음성증상 척도(Positive and Negative Syndrome Scale, PANSS)를 사용하여 평가하였다. A씨의 항-NMDAR 뇌염 초기의 정신증상으로 PANSS에서 양성하위척도 보다 음성하위척도 점수가 더 높았다. 정신장애와 비교하여 항-NMDAR 뇌염 초기에 음성증상과 인지장애가 더욱 두드러질 가능성이 있다. A씨의 치료로는 rituximab과 난소 기형종의 제거가 효과적이었고 항정신병제로는 quetiapine을 사용하였다. 특히 젊은 여성에서 망상, 행동장애와 함께 음성증상, 인지장애, 긴장증, 의식수준의 변화, 운동이상증상 등이 관찰될 때 항-NMDAR 뇌염에 대한 평가를 고려해야 한다.

• 정신신체의학
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• 제21권2호
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• pp.99-105
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• 2013

정신의학에 있어서 운동장애는 환자의 삶의 질에 큰 영향을 끼치는, 또 하나의 중요한 정신의학적 차원임에도 불구하고, 그동안 관심을 받지 못하고 간과되어 왔었다. 정신의학에서 운동장애는 일차성 신경학적 장애, 신경학적 장애의 정신의학적 동반이환, 일차성 정신장애의 양상, 약물-유도성 운동장애, 심인성 운동장애 등의 원인에 의해서 나타날 수 있다. 정신과 환자에서 흔히 보이는 운동증상의 신속하고 적절한 치료를 위해서는, 정신과의사들의 운동장애에 관한 정확한 진단과 감별진단의 능력이 선행되어야 한다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제32권3호
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• pp.99-103
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• 2021

The purpose of this review is to examine the clinical use of functional near-infrared spectroscopy (fNIRS) in children and adolescents with psychiatric disorders. Many studies have been conducted using objective evaluation tools for psychiatric evaluation, such as predicting psychiatric symptoms and treatment responses. Compared to other tools, fNIRS has the advantage of being a noninvasive, inexpensive, and portable method and can be used with patients in the awake state. This study mainly focused on its use in patients with attention-deficit/hyperactivity disorder and autism spectrum disorder. We hope that research involving fNIRS will be actively conducted in various diseases in the future.

• 생물정신의학
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• 제18권4호
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• pp.254-259
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• 2011

Objectives The aim of this study was to assess variations in caudate volume according to dopamin receptor D2/ankyin repeat and kinase domain containing 1 (DRD2/ANKK1) Taq 1a polymorphisms in young healthy adults and to evaluate the relationship between caudate volumes and psychiatric symptoms as measured by the Brief Psychiatric Rating Scale. Methods Genetic information regarding DRD2/ANKK1 Taq 1a and T1-weighted brain magnetic resonance images were acquired from 30 young healthy adults. Automatic segmentation of caudate was performed using the FreeSurfer program. Results Individuals with A2 homozygotes of DRD2/ANKK1 Taq 1a polymorphisms (n = 10) had greater right caudate volumes compared to those with A1 allele (s)(18.4% greater ; p = 0.019). Right caudate volumes were negatively associated with total scores of the Brief Psychiatric Rating Scale (${\beta}$=-0.50 ; p = 0.016). Conclusions Our findings suggest the possibility that DRD2/ANKK1 Taq 1a polymorphisms may underlie the psychiatric symptoms by influencing the structure of the right caudate.

• 대한불안의학회지
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• 제14권2호
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• pp.135-141
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• 2018

Objective : This study evaluated the role of smartphone application in the self-assessment of three psychiatric symptoms: stress, depression, and suicidal ideation. Methods : A total of 5,646 respondents were evaluated with three scales (Perceived Stress Scale, PSS, Center for Epidemiologic Study for Depression, CES-D, Scale for Suicidal Ideation, SSI) via smartphone application 'mindscan'. We analyzed the sociodemographic variables, the levels of three symptoms, and the association between the scores on all three scales. Results : The mean total scores of PSS, CES-D, and SSI were 24.86, 35.15, and 18.03, respectively. Women showed significantly higher scores on PSS, CES-D, and SSI when compared with men. Younger users showed a significantly higher score on all three scales when compared with older users. The scores on all three scales were higher than in other studies with off-line surveys. The PSS was positively correlated with CES-D (r=0.690), and with SSI (r=0.367). The CES-D was positively correlated with SSI (r=0.540). Conclusions : A smartphone application for mental health based on three scales (PSS, CES-D, and SSI) is a relatively useful screening tool compared with off-line general population surveys. The association between the three scales reflects the relationship between the three psychiatric symptoms observed in clinical practice.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제30권1호
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• pp.42-44
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• 2019

Hashimoto's encephalopathy (HE) is a rare and underdiagnosed neuropsychiatric illness. We present the case of a 17-year-old girl who was admitted to a tertiary-care psychiatric center with acute onset psychosis and fever. Her psychotic symptoms were characterized by persecutory and referential delusions, as well as tactile and visual hallucinations. Her acute behavioral disturbance warranted admission and treatment in a psychiatric setting (risperidone tablets, 3 mg/day). She had experienced an episode of fever with a unilateral visual acuity defect approximately 3 years before admission, which was resolved with treatment. Focused clinical examination revealed an enlarged thyroid, and baseline blood investigations, including thyroid function test results were normal. Abnormal laboratory investigations revealed elevated anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) levels (anti-TPO of 480 IU/mL; anti-TG of 287 IU/mL). Results of other investigations for infection, including cerebrospinal fluid examination, electroencephalography, and brain magnetic resonance imaging were normal. She was diagnosed with HE and was treated with intravenous corticosteroids (methylprednisolone up to 1 g/day; tapered and discontinued after a month). The patient achieved complete remission of psychotic symptoms and normalization of the anti-thyroid antibody titers. Currently, at the seventh month of follow-up, the patient is doing well. This case highlights the fact that in the absence of well-defined clinical diagnostic criteria, a high index of suspicion is required for early diagnosis of HE. Psychiatrists need to explore for organic etiologies when dealing with acute psychiatric symptoms in a younger age group.

• 동의신경정신과학회지
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• 제14권2호
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• pp.155-167
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• 2003

Objective : The aims of this study were to show the clinical aspects and to investigate psychiatric traits by SCL-90-R in patients who visited Oriental Medicine Hospital Emergency Room. Method : We studied twenty patients who visited Daejeon University Oriental Medicine Hospital from May, 2003 to September, 2003. Results : 1. The ratio of male to female patients was 1:3 and age distribution was most frequent in 30s&40s. 2. The most frequent cause of illness was stress in occupation and overwork. The greater part of patients came to hospital in 12hours after an attack. 3. In chief problem, somatic symptoms such as headache, dizziness, numbness and chest discomfort were most frequent. In diagnosis, somatization disorder was most frequent. 4. After treatment, most of symptoms were improved. 5. Psychiatric traits by SCL-90-R correlated with somatization and anxiety.

• 생물정신의학
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• 제30권1호
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• pp.1-6
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• 2023

Many psychiatric disorders are associated with brain functional dysfunctions and neuronal degeneration. According to the research so far, enhanced brain plasticity reduces neurodegeneration and recovers neuronal damage. Brain-derived neurotrophic factor (BDNF) is one of the most extensively studied neurotrophins in the mammalian brain that plays major roles in neuronal survival, development, growth, and maintenance of neurons in brain circuits related to emotion and cognitive function. Also, BDNF plays an important role in brain plasticity, influencing dendritic spines in the hippocampus neurogenesis. Changes in neurogenesis and dendritic density can improve psychiatric symptoms and cognitive functions. BDNF has potent effects on brain plasticity through biochemical mechanisms, cellular signal pathways, and epigenetic changes. There are pharmacological and non-pharmacological interventions to increase the expression of BDNF and enhance brain plasticity. Non-pharmacological interventions such as physical exercise, nutritional change, environmental enrichment, and neuromodulation have biological mechanisms that increase the expression of BDNF and brain plasticity. Non-pharmacological interventions are cost-effective and safe ways to improve psychiatric symptoms.

• 정신신체의학
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• 제30권2호
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• pp.137-144
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• 2022

연구목적 본 연구는 정신건강의학과 환자의 수면의 질이 우울 증상에 미치는 영향과 모호함에 대한 해석 편향과 불안증상의 매개효과를 확인하고자 하였다. 방 법 한양대학교 구리병원 정신건강의학과의 외래 환자와 입원 환자를 대상으로 축적된 자료를 사용하였으며, 측정 도구로는 피츠버그 수면의 질 척도(Pittsburgh Sleep Quality Index), 모호한 상황에서의 시나리오 척도(Ambiguous/Unambiguous Situations Diary-Extended Version, AUSD-EX), 아동기 외상설문지(Childhood Trauma Questionnaire), 백 불안 척도(Beck Anxiety Inventory), 백 우울 척도(Beck Depression Inventory-II)가 사용되였다. 162명의 자료를 기초로 SPSS 25.0과 SPSS Macro를 사용하여 상관분석과 Bootstrapping 분석이 실시되었다. 결 과 연구 결과, 수면의 질과 우울 증상의 관계에서 모호함에 대한 해석 편향과 불안 증상의 이중 매개효과가 유의하게 나타났다. 결 론 본 연구는 낮은 수면의 질이 모호함에 대한 해석 편향을 거쳐 불안 및 우울 증상에 순차적으로 영향을 미친다는 점을 확인하였다. 이를 바탕으로 선행 증상에 대한 치료적 개입을 우선적으로 실시함으로써 다른 정신과적 증상 발달을 예방할 수 있을 것으로 기대된다.