지역사회거주 노인에서 한국어판 세계보건기구 장애평가조사표의 개반

윤진상,김재민,신일선,양수진,정태길,이형영 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.1

아침형-저녁형의 측정을 위한 한국어판 조합척도의 예비연구

윤진상,신상문,국승희,이형영 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.1

Object : The Composite Scale by Smith et al.(1989) has been proposed as an improved measure of morningness-eveningness. This study attempted to endorse that a Korean translation of Composite Scale(KtCs) can be useful to differentiate people according to circadian-rhythm types. Method : KtCS and Life Habit Questionnaire(LHQ) were administered to 561 university students. LHQ consisted of items questioning sleep habits on weekdays(bedtime, rising time and sleep length), the time of perceived peak alertness(mental and physical), time of perceived peak performance(mental, physical and academic), and quality of academic performance during the morning, afternoon and evening. Subjects were categorized on basis of their KtCS scores into evening(E) types, intermediate(I) types, and morning(M) types. The cut-off points for these categories were set at the 10th and 90th percentiles. In addition 7 E-type and 7 M-type subjects were selected from the student population who had participated in the previous survey and then, oral temperature of each subject was taken every hour from 08:00 to 22:00. To assess both the internal and the external measurement properties of KtCS, descriptive statistics, reliability and validity were examined. Results : The distribution of KtCS scores was significantly, negatively skewed. The KtCS scores closest to the 10th and 90th percentiles were 26 and 41 respectively. The split-half reliability(.85), test-retest reliability(.91), and internal consistency(Cronbach alpha, .82) were obtained above the expected. Inter-item correlations were all positive and ranged from .10-.59 with a mean of .25. Item-total correlations varied from .33 to .63 with a mean of .45. Common factor analyses confirmed three factors : preferred times of performance and going to bed, arising time, and morning alertness. The validity of KtCS was further demonstrated through strong relationships between the scale and external criteria. A discernable difference in oral temperature between the M-type and the E-type across morning to evening provided additional evidence for validity of the scale. Conclusions : The results would suggest the possibility that KtCS can be employed as a tool for selection of E-type people or M-type people. It is as yet, however, uncertain that KtCS might be suitable to select people for night shiftwork because the subjects of this study are limited to university students. Therefore, future research among varying types of people are required to endorse this study.

아침형과 저녁형 사람에서 야간의 졸리움, 수행 및 체온의 비교

윤진상,국승희,신일선,신만식,최영,이무석,이형영 大韓睡眠-精神生理學會 1994 수면·정신생리 Vol.1 No.1

지역사회거주 노인에서 한국어판 세계보건기구 장애평가조사표의 개발

윤진상,김재민,신일선,양수진,정태길,이형영 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.1

Objectives : This study aimed to develop the Korean version of World Health Organization Disability Assessment Schedule II (WHODAS II-K) with community dwelling elderly population. Methods : The WHODAS II-K was administered to 1204 community residents aged 65 or over in two areas of Kwangju, South Korea, in 2001. For assessing 'health condition', data on physical illness, depression (Korean version of Geriatric Mental State Schedule B3), and cognitive dysfunction (Korean version of Mini-Mental State Examination) were collected. For evaluating 'contextual factors', informations on demographic charactehstics (age, gender, living area, marital state, and religiou), socio-economic status (education, type of accommodation, number of room, previous occupation, and current employment), and social network were obtained. Results : WHODAS II-K showed high levels of internal consistency, split-half reliability, and inter-rater and test-retest reliabilities. In the correlation analyses, scores on the WHODAS II-K were significantly correlated with the unfavorable conditions in the all variables on health condition and contextual factors. Partial correlations of scores on the WHODAS II-K with health condition were significant even after controlling for contextual factors. Conclusion : The WHODAS II-K is a reliable and valid instrument for assessing disability in elderly population since it reflects physical illness, depression, and cognitive impairment, which are common in elderly.

교대근무와 수면 : Sleep Pattern of Psychiatric Nurses on Two-Daily Phase Delay(Day/Evening/Night) Rotating Shift Schedule 2일 간격 지연상(주간/저녁/야간)의 순환교대근무제로 일하는 정신과 간호사의 수면양상

이형영,김원길,윤진상 大韓神經精神醫學會 1991 신경정신의학 Vol.30 No.2

The rapid industrialization is associated with an increase in shift systems. Sleep problem is a major complaint of shift workers. This study was undertaken as one of a series of researches on shift workers and sleep. The purpose was to understand the sleep pattern and to offer basic data in order to improve a sleep regimen. The sleep log was administered to a relatively homogenous group of 38 psychiatric nurses who were on the two-daily phase delay(day/evening/night) rotating shift schedule. Some possible influencing factors to sleep pattern(age, sex, marital status, work duration, drug use, and physical and psychiatric diseases including sleep disorders) were controlled. The sleep measures were main sleep(starting time, latency, number of awakenings, length and subjective quality). Each measure was analyzed and compared accross the rest times at which the workers can take sleep and nap. Also, the possible relationships between the main sleep(quality and length) and naps(number and length) were analyzed. The following results are based on the data of 33 of the 38 subjects. Five of the subjects who did not sleep during the rest time after the second night shift were classified seperately. 1) The beginning of the main sleep phase was delayed during the rest times after day, evening, and night shift, while advanced during the rest times after days off. 2) The sleep measures were significantly different across the rest times; for latency(F(7.224)=2.12, p〈.05), quality(F(7.224)=8.97, P〈.001), length(F(7.224)=41.13, p〈.001) of main sleep, and number of nap(F(7.224)=19.27, P〈.001) and length of nap(F(7.224)=12.79, P〈.001). The main sleep taken in the day time after night shift was generally poorer quality and shorter length than that in the night time after day and evening shifts and days off. Nap was relatively longer and more frequent during the rest time after night shifts than during the rest time after day and evening shifts and days off. 3) There were significantly negative relationships between the total length of main sleep and total number of nap(r= -.3632, p〈.001) and between the total length of main sleep and total length of nap(r= -.2253, P〈.001) across the rest times.

Eysenck의 성격차원과 수면특성의 관계

이형영,국승희,윤진상,신일선 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

연구목적 : 수면은 생리적 현상이므로 이를 성격과 관련짓기 위해서는 생물학적 이론에 기초한 성격평가도구의 선택이 바람직하다. 따라서 본 연구는 생물학적 성격차원이론을 체계화한 Eysenck의 성격차원과 수면특성의 관계를 알아보고자 하였다. 방 법 : 종합대학교 남녀학생 532명을 대상으로 주중 수면습관과 수면장애를 묻는 설문지, Eysenck의 성격차원 검사를 실시하여 509명의 자료를 얻었다. 네가지 성격차원(정신병적 경향성, 신경증적 경향성, 외향성, 허위성)점수, 주중 수면습관과 수면장애의 기술 통계치를 산출하였으며, 이들 성격차원과 수면특성(주중 수면습관, 수면장애)의 관계를 알아보기 위해 Pearson의 적률상관을 산출하였다. 결 과 : 연구대상자의 네가지 성격차원 점수와 주중 수면습관은 정상범위였고, 가장 빈도가 높은 수면장애는 입면의 어려움이었으며, 가장 빈도가 낮은 수면장애는 몽유였다. 정신병적 경향성과 주중 취침시각, 기상시각, 수면잠복기, 깨는 빈도, 수면의 규칙성, 낮잠과 깜박잠의 빈도와 지속시간 및 입면의 어려움을 포함한 수면장애는 정적 상관이 있었고, 수면의 질, 일주기 리듬의 점수는 유의미한 부적 상관이 있었다. 신경증적 경향성과 수면습관 및 수면장애의 관계도 이와 유사하였다. 외향성은 수면의 질 및 일주기 리듬의 점수와 정적 상관이 있었으나 수면장애와는 관계가 없었다. 허위성은 일주기 리듬의 점수와 정적 상관이 있었으며, 수면잠복기, 수면의 규칙성, 낮잠과 깜박잠의 빈도 및 지속시간, 수면장애와 부적 상관이 있었다. 결 론 : 정신병적 경향성과 신경증적 경향성이 높을수록 수면습관이 더 좋지 않았고, 수면장애의 빈도가 높았다. 외향성이 높을수록 수면의 질이 좋았고, 아침형에 근접하였다. 허위성이 높을수록 아침형에 근접하고, 수면이 더 규칙적이었으며, 주간의 졸음이 적었고, 수면장애의 종류 및 빈도가 적었다. 이러한 결과는 Eysenck의 성격차원과 수면특성이 밀접한 관련이 있음을 시사한다. Objectives : In order to evaluate the possible relationship between sleep and personality characteristics, it is desirable to adopt the personality theory with biological basis because sleep is a physiological phenomenon. The purpose of this study was to investigate their possible relationship using the personality dimensions of Eysenck, which is well known as a biological personality theory. Methods : Sleep Questionnaires regarding the weekday sleep habits and the sleep disorders and Eysenck's Personality Questionnaire were administered to 532 university students. Data analysis was based on 509 students who gave reliable information. Firstly, the descriptive statistics of the scores on four personality dimensions(psychoticism, neuroticism, extraversion, lie) and sleep characteristics were obtained. Secondly, the possible relationships between each personality dimension and sleep characteristics(the weekday sleep habits and sleep disorders) were tested by calculating Pearson's product moment correlations. Results : The four personality dimensions' scores and weekday sleep habits of subjects were within a normal range. The highest frequency of sleep disorder was induction difficulty of sleep and the lowest was sleep walking. Psychoticism was positively correlated with bedtime, rise time, sleep latency, number of awakening, regularity of sleep, frequency and duration of nap and doze, frequency of sleep disorders, while negatively correlated with the quality of sleep, and the score of circadian rhythm. The correlations between neuroticism and sleep characteristics were similar to those of psychoticism. Extraversion was positively correlated with the quality of sleep and the score of circadian rhythm, while not correlated with sleep disorders. Lie was positively correlated with the score of circadian rhythm, but negatively correlated with sleep latency, regularity of sleep, frequency and duration of nap and doze, and sleep disorders. Conclusions : The higher psychoticism and neuroticism, the poorer sleep habits and the higher frequency of sleep disorders. The higher extraversion, the better quality of sleep and the closer morningness. The higher lie, the closer morningness, the more regularity of sleep, the less sleepiness of daytime, and the less frequency of sleep disorders. These findings suggest that there exist the close relationships between Eysenck's personality dimensions and sleep characteristics.

항정신병약물로 야기되는 초과민성 정신병에 관한 연구

양동균,윤진상,이형영 大韓神經精神醫學會 1989 신경정신의학 Vol.28 No.2

Chronic antipsychotic treatment can induce tardive dyskinesia and supersensitivity psychosis, and these may be explained by supersensitivity phenomena of the dopamine receptor in the brain. This study was conducted to compare the clinical characteristics between tardive dyskinesia and supersensitivity psychosis in schizophrenia. The subjects of the study were composed of 8 schizophrenics with tardive dyskinesia(TD ), 10 schizophrenics with supersensitivity psychosis(SP), and 5 schizophrenics with both syndromes(TD with SP). They all had been treated with antipsychotics. We compared the difference in general and antipsychoti-related characteristics among the three groups. The results are as follows : 1) In the comparison of general characteristics ; There was a significant difference in the number of hospitalizations among the three groups. The number of hospitalizations was most frequent in SP group, and this was followed by TD with SP group(P<0.05). There was also a significant difference in the length of hospitalization : the longest in SP group and the shortest in TD group. Among the schizophrenic subtypes by Andreason-0lsen's criteria, the number of positive schizophrenics were significantly greater in SP and TD with SP group than in TD group(P<O.05) . 2) In the comparison of antipsychotic-related characteristics : There was a significant difference in the current antipsychotic dose among the three groups. The current antipsychotic dose was highest in SP group and this was followed by TD with SP group(P<0.05). The therapeutic response to antipsychotics was significantly better in SP group than in TD group, and the serum prolactin level was significantly higher in SP group than in TD group, and the serum prolactin level was significantly higher in SP group than in TD group(P<0.05; respectively) 3) Regardless TD, if SP was present, the serum prolactin level was significantly correlated to the current antipsychotic dose(P<0.05). 4) But, there was no significant difference in mean age, age of onset, duration, schizophrenic subtype by DSM-Ⅲ criteria, duration of antipsychotic treatment, prognosis, and antipsychotic potency among the three group.

양성과 음성 정신분열증에 관한 연구 : 일반적 특성 병전적응도와 인지기능을 중심으로 Focused on General Characteristics, Premobid adjustment and Cognitive Function

박준형,윤진상,이형영 大韓神經精神醫學會 1988 신경정신의학 Vol.27 No.1

Most clinicians agree that the group of disorders called schizophrenia is heterogeneous. Since Kraepelin described dementia praecox, various attempts have been taken to subdivide schizophrenia into several homogeneous subtypes. Recently some investigatiors were interested in the division of schizophrenia by use of positive & negative symptomatology that Hughlings-Jackson had tried. Crow especially hypothesized that there were some differences between the tow prominent symptoms(negative & positive) in respect of premorbid adjustment, response to neuroleptic therapy and underling pathologic process etc. But this hypothesis remains largely untested. Using Andreasen & Olsen's criteria for negative, positive and mixed schizophrenia, we subdivided a consecutive sample of 67 schizophrenic patients into 3 subtypes (negative 21, positive 23, mixed 23). We then evaluated some characteristic aspects among these 3 subtypes. The results are as follow : 1) There was s significant difference in mean age among the three subtypes. In the negative group, the mean age was most high and this was followed by the positive group(p<0.05). 2) There was a significant difference in the duration of education among the three subtypes. In the negative group, the duration of education was least and this was followed by the positive group(p<0.05). 3) There was a significant difference in premorbid adjustment among the three subtypes. The level of premorbid adjustmentwas lowest in the negative group and this was followed by the positive group.(p<0.005). 4) There was a significant difference in the number of previous hospitalizations among the three subtypes. In the negative group, the number of hospitalizations was lowest and this was followed by the positive group.(p<0.005). 5) The experience of previous modern psychiatric treatment was more reare in the negative group and this was followed by the positive group.(p<0.05). 6) The score of mini mental status for evaluation of cognitive function was significantly lower in the negative group and this was followed by the positive group.(p<0.001). 7) The scores of the BPRS for evaluation of psychotic symptoms at the times of admission and 4 weeks later were significantly most high in the positive group and this was followed by the mixied group (p<0.05, respectively). The therapeutic response rated on the BPRS after 4 weeks, was significantly prominent in the positive & mixed groups(p<0.05, respectively), but not in the negative group. 8) Besides these, there were no significant differences in occupation, onset of age, duration of illness and family history among the three subtypes. .

최근 일간지에 보도된 정신병에 대한 기사 분석

김성완,윤진상,이무석,이형영 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.5

연구목적: 정신병에 대한 사회적 편견과 낙인은 질병의 예방, 조기치료 및 재활을 어렵게 한다. 이러한 부정적 시각은 다양한 대중매체에 의해서 강화될 수 있다. 본 연구는 질병에 대한 일반인의 인식에 큰 영향을 줄 수 있는 신문이 정신병에 대해 기술하는 내용을 분석하였다. 방법: 1998년 3월부터 2000년 2월까지 2년 동안 동아일보와 조선일보의 신문기사를 천리안의 뉴스복수정보 검색 프로그램을 이용하여 조사하였다. 검색어로는 일반인과 신문기사가 정신병을 지칭한다고 생각되는 정신분열, 정신병, 정신질환, 정신이상을 선택하였다. 이러한 검색어를 포함한 총 326건의 기사를 정해진 범주에 따라 분류하여 양적 및 질적 분석을 하였다. 정신병에 대한 시각을 알아보기 위해 신문기사를 부정적(직접적 또는 간접적) ② 객관적 또는 긍정적, ③특별한 시각 없음으로 분류하였다. 결과: 326건의 기사 중 부정적 기사는 직접적 177건, 간접적 51건으로 모두 228건(69.9%)이었다. 반면 객관적 또는 긍정적인 기사는 각각 29건, 14건으로 총 43건(13.2%)이었고 특별한 시각 없음은 55건(16.9%)이었다. 부정적 기사 중 가장 많은 것은 정신병 환자는 위험하거나 난폭하며 범죄를 잘 저지른다는 용을 전달하는 기사였다(118건). 이외에도 정신병 환자는 엉뚱하거나 특이하다(27건), 사회적 기능 행을 잘 못한다(18건), 정신병은 사회적으로 창피한 병이다(14건), 낫지 않는 만성질병이며 가족은 힘들고 부담스럽다(16건), 격리 수용해야 한다(6건)는 부정적 측면의 내용이 있었다. 또한 병의 원인에 대한 편견(18건), 상대를 비하하거나 어떤 현상의 심각성을 표현하기 위해 정신병이란 용어가 사용되는 경우(35건)와 더불어, 정신병원 입원에 대해서도 수용, 감금, 처넣다 등의 단어로 부정적인 기술(18건)을 하였다. 정신이상, 정신병이라는 용어를 사용하는 경우에 부정적 기사의 비율이 높았고, 기사에 환자가 직접 묘사되는 경우에 부정적 기사의 빈도가 높았다. 사건뉴스, 정치, 방송, 문화 기사에서 부정적 기사가 많았다. 반면 건강 기사에서 부정적 기사가 상대적으로 적었고 객관적 또는 긍정적 기사의 비율은 가장 높았다. 결론: 정신병에 대한 신문의 올바른 보도를 유도하는 것은 일반인의 질병개념 형성과 치료방법의 선택에 긍정적인 영향을 미칠 것이며, 나아가 환자의 효율적인 사회적응에 도움이 될 것이다. 이를 위해 정신병에 대한 신문기사의 부정적인 기술과 편견 전달을 체계적으로 모니터 하는 것이 필요하다고 생각한다. 또한 대중매체를 적극적으로 활용하여 정신병에 대한 정보를 일반인에게 사실적으로 전달하려는 노력이 요구된다. 중심단어:정신병·신문·대중매체·낙인·정신분열. Object: Social stigma and prejudice against schizophrenia hinder the prevention of the disease, early treatment and social rehabilitation. This stigma and the negative viewpoint against schizophrenia are enhanced by the mass media. This study investigated newspaper articles on psychosis, which strongly influence the public recognition of the illness. Method: The newspaper atricles of Dong-A Ilbo and Chosun Ilbo from March 1998 to February 2000 were reviewed through a news-searching program in Chollian. The search words, which were regared as psychotic illness, were Schizophrenia, Psychosis, Mental illness, and Mental derangement. A total of 326 articles were classified by category and analyzed quantitatively and qualitatively. The viewpoint of articles on psychosis consisted of these : ①negative(direct or indirect) ② neutral or positive ③ no specific viewpoint. Result: Of the 326 articles, the number with a negative description was 228(69.9%), the number with a neutral or positive description was 43(13.2%), and the number with no specific viewpoint was 55(16.9%). The most frequent negative theme was psychotic patients are dangerous or violent or may commit a crime(n=118). Other negative themes were these : psychotic patients are bizarre or grotesque(n=27), psychotic patients can't function in society well(n=18), psychosis is incurable and families should bear great burden(n=16), psychosis is shameful(n=13) and psychotic patients should be institutionalized(n=6). There were also prejudices against the cause of the illness(n=18), the description of psychosis in degrading terms(n=22) and the negative description of psychiatric hospitalization(n=18) with the words such as institutionalization, imprisonment and put into etc. In the artcles using the terms mental derangement or psychosis compared with mental illness, schizophrenia and in the articles describing psychotic patient compared with illness itself, the frequency of negative articles was high. Within each type of artcle, news, politics and culture artcles more frequently had a negative description, while health artcles less frequently had a negative description and most frequently had a neutral or positive description. Conclusion: There should be a program for monitoring newspapers for appropriate in-formation on psychosis. It might reduce social stigma and consequently help rehabilitation of psychotic patients. Also there should be endeavors to monitor other mass media and to develop a public education campaign through the mass media. KEY WORDS:Psychosis·Newspaper·Media·Stigma·schizophrenia.

Vibrio vulnificus 박테리오 파아지의 특성

오양효,윤소겸,공은진,김민정,김영부,박영민 대한감염학회 1995 감염 Vol.27 No.5

목 적 : 이미 보고되어 있는 파아지들의 경우, 일반적인 형태, 숙주역과 몇 가지의 성질만 연구되어 있으므로 보다 상세한 특성에 대한 연구가 필요한 상태이다. 본 연구에서는 해양으로부터 분리한 V. vulnificus를 숙주균으로 하여 투명한 용균반을 형성하는 파아지를 분리해 낸 다음, 분리된 V. vulnificus 파아지의 특징을 연구하고자하였다. 방 법 : V. vulnificus 를 숙주균으로 하여 해산물로부터, 숙주균에 특이적인 파아지를 분리하고, 농축 정제과정을 거쳐 파이지입자를 순수분리하였다. 파아지의 형태를 전자현미경으로 관찰하였으며, 분리된 파아지의 숙주특이성을 조사하고, 파아지 입자의 물리적 특성을 검토하기 위해, 온도 안정성시험, pH 안정성 시험을 실시하였다. 파아지의 흡착율, 파아지의 흡착율에 미치는 무기염 이온의 영향, 온도의 영향과 pH의 영향을 관찰하였다. 파이지의 일단증식곡선을 구하였으며 토끼 면역과 교차 중화 시험, 파아지 핵산의 특성, 구조단백질의 특성을 조사하였다. 결 과 : 전자현미경관찰결과 본 연구에서 분리한 파아지는 두부와 미부를 가지는 형태로 미부에 꼬리판과 꼬리섬유를 가지고 있었다. 파아지의 물리적성질시험 결과 파아지는 50℃이하의 온도에서 안정하였으며 중성pH영역에서 안정하고 산성과 알칼리 영역에서는 활성을 잃었으며 자외선에는 35초 조사에 50% 정도 불활성화 되었다. 파아지는 약 65%의 흡착율을 나타내었으며 흡착에 ??, ??을 요구하였다. 파아지입자가 안정한 온도와 pH영역에서는 흡착에 영향을 받지 않았으며 일단증식시험 결과 108 PHU/ml의 파아지 입자를 생산하였다. 정제한 파아지를 항원으로 하여 토끼에 면역한 항혈청에 파아지가 중화되었으며 파아지 핵산은 이중나선 DNA였다. 파아지의 구조단백질은 SDS-PAGE polyacrylamide gel 전기영동 결과 2개의 밴드를 나타내었다. 그리고 Western blotting 결과 파아지의 전기영동 결과와 동일한 위치의 밴드에서 항원성을 나타내었다. 결 론 : 인체병원균으로 중요성이 인식되고 있는 V. vulnificus는 해산물의 위생과 국민건강에 직접적인 영향을 미칠 수 있는 세균으로 이에 대한 활발한 연구가 요구되는 실정이다. 파아지의 분리율은 숙주균의 분리율에 의존하므로 숙주균의 해수내 분포에 영향을 미친다고 추측되며, 파아지는 숙주균에 감염되어 숙주균을 용균시키므로 숙주균의 개체수를 조절하여 생태학적 측면에서 중요한 기능을 담당하는 것으로 여겨진다. Background : Vibrio vulnificus causes severe wound infection and life-threatening septicemia. In this study we present the characteristics of V. vulnificus bacteriophage and the basis of pathogenicity study of V. vulnificus related on bacteriophage. Methods : We isolated bacteriophage for V.vulnificus from marine products and examined its physiological and biochemical characteristics, and the ultrastructure by electron microscopy (TEM,SEM). And also, we investigated host ranges, temperature stability, pH stability, inactivation by UV irradiation, DNA isolation and analysis and structural protein analysis of the bacteriophage. Results : The adsorption rate of bacteriophage was above 80% and had a little influence at 10-45℃ and pH5-10. Isolated bacteriophage was used to produce antiserum against rabbits and its antigenicity was investigated by cross-neutralization. Western blot analysis showed the capsid protein of bacteriophage had antigenicity. The bacteriophage had double-strand DNA. In restriction analysis, the phage DNA was digested HinfI. The structural protein of phage showed two bands of 34.7kDa and 18.4kDa on SDS-PAGE. Conclusion : The specificity of bacteriophage may be due to the specific binding site that be possessed by host strain surface. Therefore, it seems that virulent bacteriophage controls the number of host strain and then takes a role on natural marine environment.