섬망치료에 관한 올란자핀 근주와 할로페리돌 근주의 효과와 안정성에 대한 비교 연구

임현국,백인호,오근,이창욱,이철 대한정신약물학회 2007 대한정신약물학회지 Vol.18 No.6

Objective:The present study aimed to provide preliminary data on the effectiveness and tolerability of intramuscular (IM) olanzapine and IM haloperidol for patients with delirium. Methods : Sixty-two patients with delirium were randomly assigned to either olanzapine IM or haloperidol IM groups, with a flexible dosing schedule for 7 days. The Delirium Rating Scale-revised-98(DRS-R-98), clinical global impression-severity (CGI-S) were assessed daily. The Simpson–Angus Rating Scale(SAS), the Barnes Akathisia Rating Scale(BARS) and the Abnormal Involuntary Movement Scale(AIMS) were used for the assessments of side effects. Results : The DRS-R-98 scores were significantly decreased over time (F=26.02, P<0.0001), without any significant group differences (F=0.048, P=0.829), and time by treatment group interaction (F=5.64, P=0.725). There were no serious adverse events in both groups. The scores on the SAS, BARS, and AIMS were not changed significantly during the study. Conclusions : This study showed that olanzapine IM did not show any superior efficay and safety compared with haloperidol IM in treatment delirium. But our study suggested that either olanzapine IM or haloperidol IM would be effective and tolerable. Adequately powered studies with a head-to-head comparison design will be mandatory to draw any definite conclusion. 본 연구는 섬망 환자에서 비정형 항정신병 약물인 올올란자핀 근주와 할로페리돌 근주의 섬망치료 효과 비교 Korean J Psychopharmacol 2007;18(6):423-428 428 란자핀과 전형 항정신병 약물인 할로페리돌 근육주사의 효과와 안정성을 비교하기 위하여 시행 되었다. 62명의 섬망 환자를 올란자핀과 할로페리돌 근육 주사군으로 무작위 할당하였으며 연구자의 판단에 따라 7일간 약물의 용량을 조절하여 투여 하였다. 환자의 임상 양상의 변화는 DRS-R-98(Delirium Rating Scale-revised-98)과 CGI-S(Clinical Global Impresion-severity)를 사용하여 매일 평가 하였다. 약물부작용은 SAS(Simpson-Angus Scale), BARS(Barnes Akathisia Rating S cale), AMIS(Abnormal Involuntary Movement Scale)로 평가 하였으며 환자가 주관적으로 호소하는 모든 증상을 기술 하였다. DRS-R-98은 시간이 경과함에 따라 유의하게 감소하였고(F=26.02, P<0.0001) 그룹 간의 차이(F=0.048, P= 0.829)나 교호작용은 없었다(F=5.64, P=0.725). 부작용의 발생 빈도에 있어서는 두 군 간의 유의한 차이는 없었다. 결론적으로 본 연구는 올란자핀 근육주사가 할로페리돌 근육주사보다 섬망 치료에 있어 더 우수하다는 결과를 얻지는 못하였다. 하지만 올란자핀과 할로페리돌 근육 주사가 섬망 환자의 치료에 있어 둘 다 유용하고 안전한 치료 방법임을 시사하고 있다.

For the Great Leap of Psychiatry Investigation

임현국 대한신경정신의학회 2020 PSYCHIATRY INVESTIGATION Vol.17 No.1

정신과 입원환자의 수익구조 향상을 위한 개선활동

임현국,김경희,김은영,박민현 한국의료QA학회 2008 가을학술대회 Vol.2008 No.3

합리적인 의사결정 버리기

임현국 한국시뮬레이션학회 2017 한국시뮬레이션학회 학술대회집 Vol.2017 No.-

리스페리돈과 올란자핀이 투여된 정신과 환자들에서 간 효소 변화에 대한 후?적 연구

임현국,배치운,박석준,김정진,이창욱,이수정,이철,백인호 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.3

Reliability and Validity of the Korean Version of the Cornell Scale for Depression in Dementia

임현국,홍승철,Wang-Youn Won,한창태,이창욱 대한신경정신의학회 2012 PSYCHIATRY INVESTIGATION Vol.9 No.4

Objective The aim of this study was to explore the reliability and validity of the Korean version of the Cornell Scale for Depression in Dementia (CSDD-K), a scale for assessment of depression in dementia. Methods The original CSDD was translated into Korean and the content was verified through back-translation procedures. This study included 59 depressive patients with Alzheimer’s disease (AD), 62 non-depressive patients with AD and 36 healthy elderly controls. The subjects were assessed using CSDD-K, the 17-item Hamilton Depression Rating Scale (HAM-D17), the 15-item Korean version of Geriatric Depression Scale (GDS15) and the Korean version of Mini-mental Status Examination (MMSE-K). ResultsaaIn the reliability test, Cronbach’s α coefficient and test-retest reliabilities were 0.92 and 0.91, respectively, indicating that the CSDD-K has good internal consistency. There were significant differences in CSDD-K total scores between AD patients with depression and AD patients without depression (p<0.001). In the analysis of the concurrent validity of the CSDD-K, there were significant correlations between the CSDD-K and HAM-D17 (r=0.91, p<0.001) and between the CSDD-K and GDS15 (r=0.75, p<0.001). ROC curve analysis identified a cut-off score of 7 for the CSDD-K, where the sensitivity was 87.5% and the specificity was 100%. Factor analysis resulted in a fourfactor solution accounting for 63.8% of the common variance. Conclusion The CSDD-K showed good reliability and validity for the assessment of depressive symptom severity in AD patients. The CSDD-K is a useful instrument for assessing AD patients with depressive symptoms in Korean ethnic population.

화소 기반 형태분석 방법을 이용한 알츠하이머 치매환자의 회백질 용적감소의 정량적 분석

임현국,최은형,이창욱,Lim, Hyun-Kook,Choi, Eun-Hyung,Lee, Chang-Uk 대한생물정신의학회 2008 생물정신의학 Vol.15 No.2

Objectives : The purpose of this study was to find brain regions in which gray matter volume was reduced and to show the capability of voxel-based morphpmetry(VBM) analysis for lateralizing clinically significant brain regions in dementia of Alzheimer's type patients compared to healthy group. Methods : MR T1-weighted images of the 20 dementia of Alzheimer's type patients were compared with those of the 20 normal controls. Images were transformed to standard MNI space. In order to observe gray matter volume change. Gray matter was smoothed with a Gaussian kernel. After these preprocessing, statistical analysis was performed using statistical parametric mapping software(SPM2). Results : Gray matter volume was significantly reduced in the bilateral parahippocampal gyri, Lt. anterior cingulate gyrus, Lt. posterior cingulate gyrus, bilateral superior temporal gyri Lt. middle temporal gyrus, Lt. superior, bilateral middle, Rt. anterior frontal gyri and Rt. precuneus in dementia of Alzheimer's type patient group. Conclusions : These VBM results confirm previous findings of temporal lobe and limbic lobe atrophic changes in dementia of Alzheimer's type, and suggest that these abnormalities may be confined to specific sites within that lobe, rather than showing a widespread distribution.

흡연갈망의 신경해부학적 특이성:기능자기공명영상연구

임현국,배치운,이창욱,Lim, Hyun-Kook,Pae, Chi-Un,Lee, Chang-Uk 대한생물정신의학회 2005 생물정신의학 Vol.12 No.1

Object:Nicotine dependence is the most common substance abuse disorder. One of the characteristics of nicotine dependence is craving. Regional activation of the brain induced by craving for nicotine was evaluated by using functional magnetic resonance imaging to investigate neuroanatomical site of smoking craving. Method:A smoker who satisfied DSM-IV criteria for nicotine dependence and a non smoker was studied. MRI data were acquired on a 1.5T Magnetom Vision Plus with a head volume coil. Two sets of visual stimuli were presented to subjects in a random manner. One was the film scenes of inducing smoking craving and the other was neutral stimuli not related to smoking. There were two fMRI sessions before and after smoking or sham smoking. Data were analyzed using SPM99. Results:fMRI showed significant activated area in anterior cingulate and medial frontal lobes in the smoker during smoking craving. Right dorsolateral prefrontal cortex and parietal lobes were activated in the control during visual stimulation before smoking. After smoking, there was no brain activation during visual stimulation in both of smoker and non smoker. Conclusion:Metabolic activity of the anterior cingulate and medial frontal lobes increased during craving for smoking. This result suggests that fMRI may be a valuable tool in the identification of neurobiological process of craving.

최적화 화소 기반 형태분석 방법을 이용한 알츠하이머 병환자의 회백질 용적감소의 정량적 분석

임현국(Hyun Kook Lim),윤동환(Dong Whan Yoon),원왕연(Wang Youn Won),이철(Chul Lee),이창욱(Chang Uk Lee) 대한노인정신의학회 2009 노인정신의학 Vol.13 No.1

Objective : Optimized voxel based morphometry (VBM) has been increasingly applied to investigate differences in brain morphology between a group of Alzheimer's Disease (AD) patients and control subjects. Optimized VBM permits comparison of gray matter (GM) volume at voxel-level from the entire brain. The purpose of this study was to assess the regional GM volume loss measured by optimized VBM in AD compared to controls Methods : Twenty-three AD patients and 20 cognitively normal elderly control subjects included in this study. To improve the VBM performance, the study specific template and the probability maps were generated from the control subjects. Results : Optimized VBM analysis revealed GM loss, including hippocampus, amygdala, anterior cingulate, posterior cingulate, insula, frontal lobe and middle temporal complex in the AD group as compared to normal control group Conclusion : The VBM results confirmed previous findings of temporal lobe and limbic lobe atrophic changes in AD, and suggest that these abnormalities may be confined to specific sites within that lobe, rather than showing a widespread distribution.

노인 입원 환자에 대한 일 대학 병원의 리스페리돈과 올란자핀의 처방 경향 : 자연적 연구

임현국(Hyun Kook Lim),최은형(Eun Hyung Choi),이영란(Young Ran Lee),오근(Keun Oh),배치운(Chi Un Pae),이철(Chul Lee),백인호(In Ho Paik),이창욱(Chang Uk Lee) 대한노인정신의학회 2007 노인정신의학 Vol.11 No.1

Several studies have reported that either risperidone or olanzapine is effective and tolerable in the elderly patients with psychotic symptoms. However, there is a lack of clinical data of risperidone and olanzapine prescription for elderly patients in the Aisan population. We reviewed retrospectively the medical records of risperidone (n=112) and olanzapine (n=96) treated patients older than age 60 who were admitted to a university-affiliated hospital between October 2005 and August 2006. The mean daily dose of risperidone was 3.4±1.5 mg and olanzapine, 8.8±5.6 mg, respectively. The response rate on the CGI (much and very much improved) appeared to be 67.4% in the risperidone group and 70.8% in the olanzapine group, respectively. Adverse events were reported in 48.2% in the risperidone group and 46.9% in the olanzapine group, without serious adverse events, respectively. This study showed that either risperidone or olanzapine would be effective and tolerable in elderly patients with psychotic symptoms and that provides similar results to those reported from western countries.