섬망의 운동성 아형에 따른 증상과 임상적 특징

백수현,민성호,안정숙,박기창,김민혁,Paik, Soo-Hyun,Min, Seongho,Ahn, Joung-Sook,Park, Ki-Chang,Kim, Min-Hyuk 한국정신신체의학회 2015 정신신체의학 Vol.23 No.2

연구목적 본 연구에서는 섬망의 운동성 아형 간의 증상과 임상적 특징의 차이를 알아보고자 한다. 방 법 일 대학병원에 입원하여 정신건강의학과에 협진의뢰된 환자 중 일반신체질환에 의한 섬망으로 진단된 256명을 대상으로 후향적으로 의무기록을 검토하였다. 운동성 아형은 Lipowski의 분류 체계에 따라 과활동형, 저활동형 및 혼재형으로 분류하였으며, 섬망평가척도를 이용하여 증상을 평가하였다. 결 과 과활동형이 130명(50.8%), 혼재형은 118명(46.1%), 저활동형은 118명(3.1%)이었다. 과활동형은 평균연령이 혼재형 환자보다 적었으며(p=0.022), 섬망을 치료하기 위해 항정신병 약물을 더 자주 사용하였다(p<0.001). 과활동형은 인지적 및 비인지적 증상 점수가 타 아형에 비해 높았다(각각 p=0.002, p<0.001). 결 론 섬망의 운동성 아형에 따라 증상 및 임상적 특징에서 차이가 있었다. 운동성 아형에 따라 진단 및 치료적 접근 방법을 달리하여, 특정 아형의 섬망 진단이 간과되거나 치료가 지연되지 않도록 관심을 가질 필요가 있다. Objectives : To investigate clinical and symptomatic differences among motoric subtypes of delirium. Methods : A total of 256 patients referred to psychiatric consultation services for delirium due to general medical condition were assessed retrospectively. Motoric subtypes were determined according to Lipowski's criteria for hyperactive, hypoactive and mixed subtypes. All patients were evaluated according to Delirium Rating Scale-Revised-98(DRS-98-R) by trained psychiatrists to obtain symptomatic profiles of delirium. Results : Hyperactive subtype were 50.8%(n=130), mixed 46.1%(n=118) and hypoactive 3.1%(n=8). Hyperactive patients were younger than mixed subtype($69.62{\pm}13.976$ vs. $73.97{\pm}11.569$, p=0.022) and received antipsychotics to manage symptoms of delirium more frequently(83.8% vs. 57.6%, p<0.001). Hyperactive patients had higher DRS-R-98 scores on both noncognitive($7.14{\pm}3.543$ for hyperactive, $5.62{\pm}3.279$ for mixed subtype) and cognitive subscales($10.00{\pm}3.574$ for hyperactive, $6.38{\pm}2.875$ for hypoactive, $7.43{\pm}3.771$ for mixed subtype, p<0.001). Conclusions : We demonstrated that clinical and symptomatic profiles were different across motoric subtypes in delirium. Diagnostic and therapeutic approach should be made differently according to motoric subtypes of delirium and special attention is needed not to underestimate or delay treatment in specific motoric subtype of delirium.

알코올 사용 문제가 동반된 폐암 환자의 흡연 관련 특성

백수현(Soo-Hyun Paik),김대진(Dai-Jin Kim) 한국중독정신의학회 2021 중독정신의학 Vol.25 No.2

Objectives: This study was designed to investigate the smoking-related characteristics of lung cancer patients with alcohol use problem. Methods : A total of 200 histologically confirmed lung cancer patients who had a current smoking status at the time of cancer diagnosis were recruited into this study. Demographic and smoking- related characteristics were assessed. Smoking-related characteristics, including smoking onset and duration, experiences of smoking cessation, Fagerstrom Test for Nicotine Dependence (FTND), and Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for tobacco use disorder, were assessed. The Korean version of Alcohol Use Disorders Identification Test (AUDIT-K) was used to classify the alcohol use problem group and the non-alcohol use problem group. Results : Lung cancer patients with alcohol use problem smoked more number of cigarettes per day. Smoking cessation attempts, duration of the longest smoking cessation, and experiences of smoking cessation treatment did not differ between the two groups. The alcohol use problem group showed a higher FTND score and prevalence of severe tobacco use disorder. Conclusion : The results showed that lung cancer patients with alcohol use problem had more severe nicotine dependence. This implies that the alcohol use problem comorbid with lung cancer would interfere with smoking cessation trials and aggravate lung cancer. Detection and intervention for alcohol use problem in lung cancer patients would be beneficial for smoking cessation and longitudinal course of lung cancer.

인터넷 게임 장애의 치료적 접근

백수현(Soo-Hyun Paik),조현(Hyun Cho),최정석(Jung-Seok Choi),최삼욱(Sam-Wook Choi),김대진(Dai-Jin Kim) 한국중독정신의학회 2017 중독정신의학 Vol.21 No.1

Objectives : The goal of this paper is to review current neurobi-ological findings from the literature that can be used as evidence for the treatment of Internet gaming disorder (IGD) and to suggest individualized treatment options for specific neurocognitive profiles. Methods : Articles about the neurocognitive aspects and treatment modalities for IGD have been reviewed from the PubMed and Google Scholar database at October 2016. Results:Individuals with IGD were prone to acting impulsively and making risky decisions, especially when given a game-related cue. Task-related functional neuroimaging studies demonstrated that IGD was associated with impaired response inhibition, cognitive inflexibility, and enhanced sensitivity to rewards. Reward system deficiency and functional connectivity disruption were also evident. Cognitive behavioral approaches of IGD focused on modifying dysfunctional beliefs about Internet gaming and strength-ening neurocognitive functions, whereas pharmacological approaches helped to modulate deficient reward systems and comorbidities. Conclusion : Treatment of IGD needs to focus both on enhancing cognitive function and on compensating reward system deficiency. To maximize the treatment efficacy of IGD, assessing neurocognitive features and psychiatric comorbidities thoroughly and establishing an individualized target for intervention would be essential for the effective treatment of IGD.

입원 중인 조현병 환자를 대상으로 한 심리극(싸이코드라마)이 환자의 의사소통 능력과 대인 관계 기술에 미치는 영향

추교종 ( Kyo Jong Choo ),박명현 ( Myeonghyun Park ),배영민 ( Youngmin Bae ),백수현 ( Soo Hyun Paik ),정수봉 ( Soo-bong Jung ),송명선 ( Myung Seon Song ) 한국정신병리진단분류학회 2021 精神病理學 Vol.25 No.2

Objectives Primary purpose of this study was to evaluate therapeutic effects of psychodrama on inpatients with schizophrenia. Method Psychodrama was administered to 56 patients with schizophrenia who were hospitalized in Keyo Hospital. Similarly, 56 patients who were hospitalized at Keyo Hospital and did not participate in the psychodrama were set as control group. Psychodrama was administered 50 minutes once a week for 3 months. we used Communication Skill Scale, Relationship Change Scale, Relationship Function Scale, Clinical Global Impression-Severity(CGI-S), Brief Psychiatric Rating Scale(BPRS) to assess function of the patients. Assessment was done at the beginning and end of the period. In this study, we compared assessment-score before and after psychodrama first. Then we compared patients who participated in psychodrama and patients who did not. Results After 12 sessions of psychodrama, Patients who participated psychodrama showed improvement in communication skills and interpersonal relationship. Patients also showed improvement in Brief Psychiatric Rating Scale(BPRS) score. there was no significant change in Clinical Global Impression-Severity(CGI-S) score. Conclusion Results suggested that psychodrama is useful treatment method for improving communication and interpersonal skills in hospitalized patients with schizophrenia. we can expect that psychodrama can play a useful role in treatment of schizophrenia patients. Future research to generalize of the results of this study is necessary.

마약류 치료기술 국내 도입 우선순위

김한(Hahn Kim),김양식(Yangsik Kim),김장래(Jangrae Kim),김정화(Junghwa Kim),김태형(Tae-Hyeong Kim),김화영(Whayoung Kim),백수현(Soo-Hyun Paik),장옥진(Og-Jin Jang),정현숙(Hyunsuk Jeong),이승엽(Seung-Yup Lee) 한국중독정신의학회 2024 중독정신의학 Vol.28 No.1

Objectives: To determine Korean national priority for research and development planning for drug abuse and substance use disorder treatment. Methods: A Delphi survey methodology was employed, involving 19 experts in the field of addiction. Their potential priorities were assessed based on the size of the problem, urgency, effectiveness, budget size, and feasibility of research execution. Results: After three rounds, the expert consensus was reached for 13 research plans of universal therapeutic agenda and 7 plans for specific drugs. These included developing guidelines for children and adolescents on substance use, a community-based long-term management program, and the development of intervention programs and clinical guidelines for stimulant, cannabis, and opioid use disorders. However, consensus was not reached for research on therapeutic options such as digital therapeutics. Conclusion: This study highlights priority areas for systematic and effective development of treatment programs and research agenda against illicit use of drugs. By integrating insights from multidisciplinary experts, a comprehensive research and development blueprint is proposed to address drug use, which is on the rise and threatening public health and social security in the Republic of Korea.