상상의 재개념화

이시은(Shi Eun Lee),정영주(Young Joo Jeong),박병기(Byung Gee Bak) 한국교육심리학회 2014 敎育心理硏究 Vol.28 No.1

이 연구의 목적은 상상을 재개념화 하여 상상의 본질적 특성을 밝히는 것이다. 연구자는 상상을 ``과거 일화의 실재적 요소를 정신적으로 다루어 새로운 일화로 구성하는 인지적 과정``으로 새롭게 정의하였다. 상상의 재개념화는 구조와 과정을 중심으로 하였다. 첫째, 상상의 구조는 ``자원``, ``조작`` 및 ``결과``의 3차원으로 제안하였다. 자원은 ``상상을 하기 위한 일화적 정보``로서 지각체, 맥락, 정서, 의미를 포함한다. 조작은 ``상상의 자원을 정신적으로 다루는 사고 과정``으로서 분해, 변형, 확장, 조합을 포함한다. 결과는 ``새롭게 구성된 일화의 속성``으로서 통합성, 일관성, 신기성, 구체성, 실현가능성을 포함한다. 둘째, 상상의 과정은 ``일화의 환기``, ``일화의 구성``, ``일화의 인식`` 등 3단계 순환과정모형으로 제안하였다. 일화의 환기는 과거 일화에서 추출한 ``상상의 자원들을 기억 속에서 특별히 선택하여 주의집중 하는 것``이고, 일화의 구성은 과거 일화에서 환기된 ``상상의 자원들을 조작하여 새로운 일화를 생성하는 것``이며, 일화의 인식은 ``상상된 일화를 동화 또는 대조하는 것``이다. 구조와 과정 중심으로 상상을 재개념화 한 작업의 의의는 교육 및 연구에 대한 시사점과 더불어 논의되었다. The purpose of this study was to reconceptualize imagination focused on its structure and processes. In this study imagination was defined as "the cognitive processes by which a new episode is constructed by mentally manipulating the real elements of prior episodes." First, the structure of imagination was proposed as three dimensions of ``resource``, ``manipulation``, and ``consequence.`` The resource dimension involves percepts, context, emotion, and meaning of the prior episodes. The manipulation dimension involves the thinking operations of disassociation, transformation, extension, and combination. The consequence dimension involves five characteristics of newly constructed episode: integrity, consistency, novelty, specificity, and feasibility. Second, the processes of imagination was modeled as a three step recurrent cycle of ``episode attention``, ``episode composition``, and ``episode recognition.`` Episode attention is the process to extract resources from the prior episodes and to pay attention to them. Episode composition is the process to manipulate the resources and to generate a new episode. Episode recognition is the process to acknowledge the imagined episode by assimilation and/or contrast. The significance of this study was discussed in that the reconceptualization of imagination can be contributable to the practices of imagination education and imagination research.

왜상으로서의 (나의) 죽음: 윌리엄 워즈워스의 『서곡』 속 「익사자 에피소드」 와 「와이난더의 소년 에피소드」 다시 읽기

강희원 한국현대정신분석학회 2020 현대정신분석 Vol.22 No.2

The purpose of this essay is to re-read the “Drowned Man episode” and the “Winander Boy episode” in William Wordsworth’s The Prelude, on the basis of Mladen Dolar’s elaborations of Lacanian theory of the gaze and anamorphosis. In his essay entitled “Anamorphosis,” Dolar examines in detail what was guiding Lacan’s steps in his formulation of the gaze as an object. According to Dolar, the Lacanian notion of gaze cannot be simply considered as “subjective opening to objectivity”, which enables him to problematize visual metaphoricity of western philosophy. This is why we should redirect our attention to the gaze as objet petit a that serves as the inner torsion or blind spot in the visual field, thereby making it not-all. In the “Drowned Man episode” and the “Winander Boy episode,” the speakers keep their eyes on natural objects that are placed at a safe distance, but they are unexpectedly faced with what can be called anamorphic images that amount to traumatic presence of the gaze in the Lacanian sense. The speaker of the “Drowned Man episode” is faced with the corpse of drowned man while, in the “Winander Boy episode”, the speaker is exposed to the unimaginable event of confronting his own grave. The primary focus of this essay is placed on the way in which the gaze and anamorphosis, as Lacan elaborates them, can establish a context for teasing out the specifically ethical implications of the corpse in “Drowned Man episode” and of the speaker’s own grave in the “Winander Boy episode.” 이 글의 목적은 라캉의 ‘응시’ 개념을 재고한 돌라의 ‘왜상’ 논의를 토대로 워즈워스의 『서곡』 속 「익사자 에피소드」와 「와이난더의 소년 에피소드」를 다시 읽어보는 데 있다. 돌라는 「왜상」이란 글에서, ‘응시는 대상’이라는 라캉의 주장이 함축하는 의미를 다시 확인할 필요가 있다고 주장한다. 전통적 의미의 응시로 설명될 수 없는 대상 소타자 a로서의 응시는, 돌라가 보기에, 기존의 서구 철학이 의존해왔던 시각적 프레임 자체를 문제적인 것으로 만든다. 라캉이 말하는 응시는 시각 영역 속에 왜상적 뒤틀림으로 이미 항상 들어와 있는, 그래서 시각 영역 자체를 비-전체로 만드는 것이기 때문이다. 워즈워스의 「익사자 에피소드」와 「와이난더의 소년 에피소드」의 화자들은 모두 자연이라는 대상 세계를 ‘바라보고’ 있다. 대상 세계를, 그것으로부터 일정한 거리를 유지한 채 바라보던 그들은 대상으로 파악되거나 재현될 수 없는 왜상에 돌연 노출된다. 「익사자 에피소드」의 화자는 익사자의 시체라는 왜상에, 「와이난더의 소년 에피소드」의 화자는 내가 죽어 누워있는 무덤이라는 왜상에 직면하게 되는 것이다. 본 논문에서는 익사자의 시체와 내가 죽어 누워있는 무덤이 어떤 측면에서 라캉이 말하는 왜상으로 고려될 수 있는지, 또 왜상과 맞닥뜨린 화자가 자신을 방어하기 위해 어떤 전략을 동원하고 있는지 검토해보려 한다. 왜상이라는 수수께끼를 내용의 차원으로 환원시키려는 방어적 노력은 화자뿐만 아니라 시인인 워즈워스 자신에 의해서도 감행되는데, 이는 「익사자 에피소드」와 관련된 일련의 수정 작업들에서 확인될 것이다.

제품옵션 수준의 선택에 대한 의사결정방식 프레이밍 효과와 구매 에피소드 및 지식 수준의 조절적 역할

전성률(Jun Sung Youl),전정배(Jun Jung Bae) 한국마케팅학회 2003 마케팅연구 Vol.18 No.1

본 연구에서는 소비자들의 제품옵션 수준의 선택에(예: 옵션의 업그레이드 혹은 다운그레이드 결정)의사결정 방식에 대한 프레이밍(상향조정식/하향조정식 의사결정방식)과 구매상황에서의 에피소드(동일 구매상황에서 이미 주어진 대상제품의 특성)가 어떠한 영향을 주는지에 대해서 살펴보고, 이들의 상호작용 및 소비자들의 지식수준에 따른 이들 효과의 차별적 변화에 대해 살펴보았다. 소비자의 의사결정상의 왜곡과 휴리스틱의 사용이 옵션프레이밍 방식에 의한 옵션선택의 과정을 통해 나타나고 있다. 옵션을 선택함으로써 부담해야하는 비용을 지각함에 있어 옵션가격을 기준제품에 대한 비율로서 상대적 지각을 하고, 옵션프레이밍 방식에 의해 제공된 옵션들을 유지하려는 경향을 보이는 의사 결정상의 특성들이 하향조정식 옵션프레이밍 상황에서 더 많은 프리미엄 옵션을 선택하게 하는 이유로 작용하고 있다. 또한 일반적인 소비상황과 같이 시간적으로 근접한 혹은 동일 목적을 가지고 소비되어지는 제품들 간에는 기능적인 유사성이 전제되지 않는 경우에도, 하나의 제품 선택결정이 다른 제품의 선택결정에도 영향을 미치는 에피소드 효과(consumption episode effect)가 제품 옵션수준 결정상황에도 적용될 수 있음이 나타났다. 한편 옵션프레이밍과 에피소드 효과의 상호작용 역시 나타났다. 상향적 옵션프레이밍과 하향적 옵션프레이밍 간의 소비자의 프리미엄 옵션 선택에 있어서의 차이는 구매 에피소드(자원관련 혹은 목적관련 에피소드)가 제시된 경우 그렇지 않은 경우에 비해 더 작게 나타났다. 한편 전문가들은 제품군에 대해 잘 발달된 개념적 구조를 가지고 있기 때문에 적은 인지적 노력으로 많은 정보를 획득하고 회상할 수 있는 반면, 초보자는 제품속성에 친숙하지 않기 때문에 정보처리 과정에서 먼저 그 속성들에 대해 학습한 후에야 속성들을 제품과 연결시키게 되므로 전문가에 비해 요구되는 인지적 노력의 양도 더 많다. 또한, 전문가는 제품이 가진 내재적 속성에 대해 더 많은 정보를 탐색할 가능성이 높은 반면, 초보자는 제품평가에 활용할 충분한 지식이 없어 추가적으로 가격 등의 외재적 속성에 대한 정보를 바탕으로 비분석적 규칙을 활용하여 의사결정을 할 가능성이 높아 초보자가 전문가에 비해 옵션프레이밍 방식과 같은 의사결정 프레이밍 및 에피소드 효과에 영향을 받기 쉽다는 것이 밝혀졌다. 끝으로 소비자들은 옵션프레이밍 방식과 일관된 목적의 에피소드가 제시될 경우에 더 적은 시간을 의사결정에 할애하였다. 이러한 결과는 옵션프레이밍과 일관된 에피소드가 자극으로 주어질 경우 소비자들은 그들의 구매전략이나 제품옵션 평가에 대한 일관된 기준을 유지함으로써 더 적은 소요시간을 보이는 것으로 볼 수 있다. This study examines whether and how decision framing(additive versus subtractive decision framing) and consumption episode affect consumers` choice of product option level and their potential interaction effect. In addition, we also investigate the moderating influence of consumer knowledge on the main effects of decision framing and consumption episode. Biases and heuristics in consumer decision making process render decision framing have a significant impact on consumer judgments. Specifically, consumers` tendency to perceive an option price as a proportion of the reference product price, not as an absolute amount, together with the status quo effect results in choice of more premium options in subtractive option framing situation versus additive option framing situation. Consumption episode effect also applies to this task of product option level choice, and this effect turns out to interact with option framing effect described above. That is, the difference in the number of premium options chosen between subtractive and additive framing situation appears to be greater when no consumption episode is given versus when consumption episodes such as resource or benefit episode are given. In addition, the results show that consumers` product knowledge plays a moderating role for the decision framing and consumption episode effects since experts are more likely to rely on intrinsic product attributes for their product evaluation and judgments while novices tend to depend on extriasic attributes of a product thus more susceptible to framing effects and decision heuristics.

The Relationship between the Number of Manic Episodes and Oxidative Stress Indicators in Bipolar Disorder

Sü,leyman Akarsu,Abdullah Bolu,Emre Aydemir,Selma Bozkurt Zincir,Yasemin Gü,lcan Kurt,Serkan Zincir,Murat Erdem,Ö,zcan Uzun 대한신경정신의학회 2018 PSYCHIATRY INVESTIGATION Vol.15 No.5

Objective Bipolar disorder (BD) is a chronic mood disorder characterized by recurrent episodes that has a lifetime prevalence of 0.4– 5.5%. The neurochemical mechanism of BD is not fully understood. Oxidative stress in neurons causes lipid peroxidation in proteins associated with neuronal membranes and intracellular enzymes and it may lead to dysfunction in neurotransmitter reuptake and enzyme activities. These pathological processes are thought to occur in brain regions associated with affective functions and emotions in BD. The relationship between the number of manic episodes and total oxidant-antioxidant capacity was investigated in this study. Methods Eighty-two BD patients hospitalized due to manic symptoms and with no episodes of depression were enrolled in the study. Thirty of the 82 patients had had their first episode of mania, and the other 52 patients had had two or more manic episodes. The control group included 45 socio-demographically matched healthy individuals. Serum total antioxidant capacity (TAC) and total oxidant capacity (TOC) measurements of the participants were performed. The oxidative stress index (OSI) was calculated by TOC/TAC. Results There were no significant differences in OSI scores between BD patients with first-episode mania and BD patients with more than one manic episode. However, OSI scores in both groups were significantly higher than in the control group. TOC levels of BD patients with first-episode mania were found to be significantly higher than TOC levels of BD patients with more than one manic episode and healthy controls. There were no significant differences in TAC levels between BD patients with first-episode mania and BD patients with more than one manic episode. TAC levels in both groups were significantly higher than in the control group. Conclusion Significant changes in oxidative stress indicators were observed in this study, confirming previous studies. Increased levels of oxidants were shown with increased disease severity rather than with the number of manic episodes. Systematic studies, including of each period of the disorder, are needed for using the findings indicating deterioration of oxidative parameters.

한국인 정동장애 환자에서 조증삽화, 우울증삽화와 혈중 Creatine Kinase의 관계

하태성,정상근 대한우울조울병학회 2009 우울조울병 Vol.7 No.2

Objectives:The aim of this study was to investigate the difference of serum creatine kinase (CK) level between manic and depressive episode. The study was based on the assumption that serum CK level is higher in manic episode than in depressive episode. Method:Serum CK levels were checked for the subjects. The subjects were composed of 19 manic and 21 depressive episode patients. Manic and depressive episode were evaluated using the Korean version of the Young Mania Rating Scale (K-YMRS) and the Korean version of Hamilton Depression Rating Scale 17-item version (K-HDRS). All data was analysed by SPSS (ver12.0). Results:The serum CK levels were higher in manic episode than in depressive episode (t=2.202, df=38, p=0.034). There was no signifi- cant correlation between the serum CK level and the motor item of K-YMRS (r=0.081, p=0.411). Conclusion:This was the first Korean study about the relationship between serum CK level and mood state. Our results were consistent with previous studies. Above results need to be further investigated.

일반논문 : 『위씨오세삼난현행록』 소재 "어사 경학" 이야기의 연구

반재유 ( Jae Yu Ban ) 연민학회 2011 연민학지 Vol.15 No.-

<위씨오세삼난현행록>은 일반적 장편소설과 다름이 없어 보이면서도 <위씨오세삼난현행록>만의 특이성이 돋보이는 작품이라 할 수 있다. 주된 특징으로 지나치게 많은 삽입시문과 삽화적 경향의 일화, 방대한 기물 묘사?나열 등을 들 수 있는데, 이는 여러 연구자들에 의해 작품의 긴밀성 내지 완성도를 저해하는 요인으로 지적되었다. 이렇듯 작품의 완성도에 대한 의문은 <위씨오세삼난현행록>이 연구자들의 주목을 받지 못하는 계기로 작용하였다. 본고에서 다룰 삽화(揷話)인 ``어사 경학``이야기도 <위씨오세삼난현행록>의 전체적 흐름과는 무관한 내용으로 구성되어 있다. 기존 논의대로라면, 이러한 삽화 역시 단순한 ``습작기 작품``의 결과물로 치부할 수 있겠지만, 끊임없이 새로운 변화를 모색했던 조선후기 서사의 흐름을 생각해 본다면 본 삽화에 대한 연구와 함께 <위씨오세삼난현행록>의 평가는 재고될 소지가 있다.``어사 경학``이야기는 <위씨오세삼난현행록>의 삽화 가운데 하나로, 송사사건의 발생과 해결이 작품의 발단과 결말에 완전히 일치하는 전형적 송사소설(訟事小說)의 면모를 갖추고 있다. 송사소재가 장편가문소설인 <위씨오세삼난현행록>에서 독립적 삽화를 통해 형상화되었다는 것은, 비록 ``작품의 완성도`` 측면에서 볼 때 무리하다시피 설정된 이야기라 할지라도 소재의 다양성과 작품의 대중성 측면에서는 큰 의미를 가질 수 있다. ``어사 경학``이야기에 대한 연구는 <위씨오세삼난현행록>의 여러 특징적 면모를 살필 수 있는 작업의 일환이며, 조선 후기 송사소설의 분화된 형태를 파악하는 데 미약하나마 참고가 될 것이다. 『Wuissiosesamnanhyeonhaengrok』 is a specular work which seems that it is the same one as the other family sagas of the time but has its own special features. The work contains excessively many inserted poems, episodic anecdotes, and massive description and enumeration of objects, which was regarded by several researchers as defective aspects of the work hindering its connectivity or perfection. The doubts about the perfection of 『Wuissiosesamnanhyeonhaengrok』 have been the reason for researchers not to pay attention to the work. This study will discuss an episode about ``a secret royal inspector kyunghak``. The episode consists of materials which are not related to 『Wuissiosesamnanhyeon -haengrok』 itself. According to the existing discussions, the episode would be discounted as a practice piece. However, considering the narrative currency of the late Joseon Dynasty which was unceasingly seeking new changes, the evaluation of 『Wuissiosesamnanhyeonhaengrok』 is open to dispute along with this study of the episode. The episode of ``a secret royal inspector kyunghak`` is one of the episodes of 『Wuissiosesamnanhyeonhaengrok』 and possesses the aspects of typical lawsuit novels containing the incident of a case at the beginning and its resolution at the ending concordantly. The fact that a lawsuit was given a shape by an independent episode of a family saga 『Wuissiosesamnanhyeonhaengrok』 means so much in terms of a diversity of subjects and an aspect of popularity even though the episode is relatively unreasonable in terms of degree of perfection. The study of the episode about`a secret royal inspector kyunghak` is a part of work to probe the distinguishing aspects of 『Wuissiosesamnanhyeonhaengrok』 and also a guide to apprehend divided forms of lawsuit novels in the late Joseon Dynasty.

포토제닉 에피소드 : Chapter Ⅱ-Historical Memorial

권순평 한국사진학회 2004 AURA Vol.0 No.11

A picture has a preconception called truth this historically. also, as for the people, picture inside image is easy to transit in epistemology a few trap that agreed with the actual object while seeing a picture. It is not deny be credulous about these perfect recurrences unconditionally, and to comment, rather wanted to recognize used this and how affected with intervention in the method that a person sees things, and media called camera interpret. However, more rather than talking about a huge picture's discussion and wanted to speak stories about a small and peripheral picture, and that I wanted to look with pictures to have continued like this story a series of episodes to listen to as I finished these, and short one act plays were made with an a series of series. Therefore, it was planned a picture called 'Photogenic Episode , and this picture is the second episode among three total episodes. The first picture 'Photogenic Episode - Chapter I : Apropriation. I used here the picture system how a copy photographed the documentary picture that recorded Seoul. It was work for meaning of a picture image recorded with documentary to seem to put up what was able to compose with at all other course through a picture with an image. This work Photogenic Episode - Chapter 2: Historical MemoriaL Historical Memorial is having commonness point called copy 'about a' copy like the first work. But it was the picture that was the image that materials of the first picture worked to a plane, on the contrary, materials of this work are the miniature which is an image to be able to think as a solid. It makes model as a miniature so that simulation holds the past historic fact. Besides, a model gives the help that holds a recurrence as it actually sees historical knowledge. that is, it is to be simulation for a situation to reappear to give faith called fact historically. but if it is not an objective method and copies an image of this model through a picture technique it gives a crevice to an objectivity, a model has lost intrinsic meaning and function as simulation. 'A crevice copy about a copy' ,that is, in the boundary of a function of "A recurrence about actuality" and "A virtual image as fact" which are model intrinsic characteristics, it is looked dimly if it makes simulation from 2dimensions of images to have been cracked through camera law. (In this way if simulation is copied on a picture again, the original meaning that existed disappear and show only an external form and cuticle. cause, I wanted to ask I how actualization worked through these situations, in our consciousness or actuality.) * (Reconstruction work about simulations by this picture "Photogenic Episode - Chapter Ⅲ:Architecture monument" think architecture to the image that lives, and there is that a symbol holds a specific space, one accident to compose space theory and will watch on reconstruction having done construction as one image with `accident' and what is interpreted, read by us.)*

조중 삽화로 입원했던 환자의 재평가 : 혼재성 삽화 진단의 가능성

전덕인,김경란,이 은,손상준 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.4

Objective : Mixed states are difficult to define precisely and to recognize accurately. Moreover, the DSM-IV criteria for diagnosis of a mixed episode might be too restrictive. The purpose of this study was to investigate the possibility of a mixed episode in bipolar inpatients hospitalized with DSM-IV manic episodes using the Cincinnati criteria, which is a broader criteria compared to DSM-IV. Methods : Inpatient charts of manic patients were carefully evaluated to determine the presence of depressive symptoms in the Cincinnati criteria. The probable mixed patient group was compared with the definitely manic patient group on demographic and clinical variables. The predictability of depressive symptoms for a mixed episode was assessed. Results : Twenty-one out of 101 manic inpatients were possibly diagnosed as mixed episodes. They showed more psychiatric family history, comorbid personality disorder and suicide attempts. Two symptoms (suicidal ideation and helplessness or hopelessness) had good positive predictive value. Conclusion : Diagnosis of a mixed episode can be increased with careful interview and by using a broader diagnostic criteria. The presence of suicidal ideation and helplessness or hopelessness may suggest a mixed state.

한국형 양극성 장애 약물치료 알고리듬 2010 : 조증 삽화

김원,신영철,박원명,주연호,서정석,민경준,이은,전덕인,안용민,이정구,김병수,윤보현 대한우울조울병학회 2011 우울조울병 Vol.9 No.2

Objective : The pharmacotherapy of bipolar disorder has many difficulties such as various clinical feature according to each episode, recurrence, breakthroughs, treatment resistance, switching and worsening of its course. Recent rapid development and research of bipolar disorder and psychopharmacology, including atypical antipsychotics and new anticonvulsants, make it more difficult to choose the appropriate pharmacological options. Therefore, we decided to revise the Korean Medication Algorithm Project for Bipolar Disorder 2006 (KMAP-BP 2006) in order to provide more proper guideline for clinicians. Methods : Like the previous version, KMAP-BP 2006, we performed the first survey using questionnaire comprising 40 special clinical situations and 1151 selection item. Sixty-five members of the review committee completed the first survey. After the discussion of the results at the review committee meeting, we performed the second adjunctive survey. Finally, the executive committee analyzed the results and discussed the final production of algorithm considering scientific evidence. Results : The first-line pharmacotherapeutic strategy for acute manic episode is combination of mood stabilizer and atypical antipsychotics, and it is the treatment of choice. Valproic acid and lithium is chosen for the preferred mood stabilizer of the first-line treatment of acute manic episode. Atypical antipsychotics is more widely accepted than before, as the effective medication for all subtypes of manic episodes. Conclusion : Compared with the previous version. we find out that ‘treatment of choice’ increases and ‘no-consensus’ decreases in this revision. These suggests that the many clinicians agree with others in the treatment of acute manic episode, and the pharmacotherapy of manic episode become more obvious than before. Newer agents such as aripiprazoe and lamotrigine gains more awareness in the treatment of bipolar disorder. We expect this algorithm may provide clinicians good information and help about the treatment of bipolar disorder, manic episode. (J of Kor Soc for Dep and Bip Disorders 2011;9:87-9)

한국형 양극성 장애 약물치료 알고리듬 2014: 조증 삽화

우영섭,박원명,전덕인,서정석,이정구,정종현,김문두,손인기,심세훈,민경준,윤보현,신영철 대한정신약물학회 2014 대한정신약물학회지 Vol.25 No.2

Objective The pharmacotherapy of bipolar disorder has many difficulties such as various clinical feature according to eachepisode, recurrence, breakthroughs, treatment resistance, switching and worsening of its course. Recent rapid developmentand research of bipolar disorder and psychopharmacology, including atypical antipsychotics and new anticonvulsants, makeit more difficult to choose the appropriate pharmacological options. Therefore, we decided to revise the Korean MedicationAlgorithm Project for Bipolar Disorder (KMAP-BP) 2010 in order to provide more proper guideline for clinicians. Methods Like the previous version, KMAP-BP 2010, we performed the survey using questionnaire comprising 55 mainquestions in which 8 main questions and 478 sub-items for treatment of manic or hypomanic episode were included. Sixtyfourmembers of the review committee completed the survey. The executive committee analyzed the results and discussedthe final production of algorithm considering scientific evidence. Results The first-line pharmacotherapeutic strategy for acute manic episode is combination of mood stabilizer and anatypical antipsychotic, and it is the treatment of choice for euphoric, psychotic and dysphoric/mixed mania. The preferencefor monotherapy with atypical antipsychotic (for all three types of mania) or mood stabilizer (for euphoric mania) was increasedin KMAP-BP 2014. Valproic acid and lithium are chosen as the preferred mood stabilizer of the first-line treatment ofacute manic episode and valproic acid was the treatment of choice for all types of mania. Atypical antipsychotics is morewidely accepted than before in manic and hypomanic episode. Moreover, the preference for combination treatment in manicpatients who failed to respond in early stage treatment was increased. Conclusion Compared with the previous version, we found that ‘no-consensus’ decreases in this revision. These suggestthat the many clinicians agree with others in the treatment of acute manic/hypomanic episode, and the pharmacotherapy ofmanic/hypomanic episode become more obvious than before. Atypical antipsychotics such as aripiprazole, olanzapine andquetiapine gain more awareness in the treatment of bipolar mania and hypomania. We expect this algorithm may provide cliniciansgood information and help about the treatment of bipolar disorder, manic/hypomanic episode. 정신과적 질환의 약물치료의 발전에 따라, 이를 실제 임상상황에 맞도록 정리하여 제시하는 지침서 또는 알고리듬의역할은 점점 확대되고 있다. 이에 2002년 발간되었던 KMAPBP2002와 2006년 개정판(KMAP-BP 2006), 2010년 개정판(KMAP-BP 2010)에 이어 2014년판 한국형 양극성 장애 약물치료 알고리듬을 발간하였다. 본 개정판에서는 양극성 장애에 대한 근거자료의 축적과 치료 전략과 진단적 접근의 변화를 반영한 전문가들의 의견을 취합하였다. 모든 조증 유형에서 기분조절제(valproic acid 또는 lithium)와 비정형 항정신병약물의 병합 치료가 최우선 치료였으며, 경조증의 경우에는 기분조절제 혹은 비정형 항정신병약물 단독 치료가 1차 선택이었다. 급성기 조증의 치료에 사용하는 기분조절제로서는 valproic acid가 모든 형태의 조증에서 최우선 치료로 선택되었고, lithium은 모든 형태의 조증에서 1차 약물로 평가되었다. 기분조절제 단독 치료에 반응이없는 경우에는 비정형 항정신병약물을 추가하는 것이 최우선치료였으며, 단독 치료에 반응이 전혀 없다면 비정형 항정신병약물로 교체하는 것 또한 1차 치료로 평가되었다. 또한 비정형 항정신병약물 단독 치료에 반응이 불충분하다면 기분조절제를 추가하는 것이 1차 치료 전략이었다. 급성기 조증 삽화에 대하여 선호되는 비정형 항정신병약물은 aripiprazole,olanzapine, quetiapine, risperidone이었으며, 특히 혼재성 조증 및 정신병적 조증에서는 olanzapine이 최우선 치료로 선택되었다. 조증 삽화 부분에서 KMAP-BP 2014의 특징은 이전 판에비하여 유쾌성 조증에 대해서는 기분조절제 단독 치료의 선호도가 증가하고, 혼재성 조증에서는 기분조절제와 비정형항정신병약물 병합 치료의 선호도가 증가하였고, 비정형 항정신병약물 단독 치료에 대한 선호도는 개정을 거듭할수록증가하고 있다는 점이다. 이는 조증의 각 아형과 비정형 항정신병약물의 다양한 치료 효과에 대한 연구결과가 축적되고이해가 증가하면서, 증상의 특성에 따른 좀 더 특화된 치료가선호되고 있음을 의미한다고 할 수 있다. 또한 전문가들 사이에 컨센서스를 이루지 못한 항목이 이전에 비하여 줄어들어,조증 삽화의 치료에 대하여 많은 전문가들의 의견이 일치되고 있음을 알 수 있었다. 양극성 조증의 치료에 대해서는 지속적으로 새로운 약물이도입되고, 기존의 약물들의 치료적 적용에 대한 새로운 접근도 계속되고 있다. 향후 이러한 변화를 반영한 알고리듬의 제작과 실제 임상에서의 적용 효과에 대한 관심은 지속적으로필요할 것이다.