지연성 운동장애와 BDNF(Brain-derived Neurotrophic Factor) Val66Met 유전자 다형성과의 연관성연구

공보금(Bo-Geum Kong),박성우(Sung-Woo Park),이선정(Sun-Jung Lee),김선희(Sun-Hee Kim),주명진(Myung-Jin Joo),김영훈(Young-Hoon Kim) 대한생물치료정신의학회 2006 생물치료정신의학 Vol.12 No.1

목적 : 신경계의 발달, 분화, 성장에 중요한 역할을 담당하는 brain-derived neurotrophic factor(BDNF)는 지연성 운동장애와 연관된 중추신경계의 여러 질환들의 발생에 관여한다. 본 연구는 항정신병 약물로 인해 초래되는 심각한 부작용인 지연성 운동장애(tardive dyskinesia : TD)의 발생에 BDNF Val66Met 유전자 다형성이 연관성이 있는지 없는지의 여부를 알아보기 위하여 시행하였다. 방법 : 161명의 정신분열병 환자군(TD 83명, non-TD 78명)과 95명의 정상대조군을 대상으로 하였고 지연성 운동장애(TD) 평가는 AIMS(Abnormal Involuntary Movement Scale)를 사용하였다. BDNF Val66Met 유전자 다형성은 정신분열병 환자군(TD군, non-TD군)과 정상대조군을 비교하였고, 정신분열병 환자에서 지연성운동장애가 있는 군과 없는 군을 비교분석하였다. 결과 : 정신분열병 환자군과 정상대조군, 정신분열병환자에서 TD군과 non-TD군을 비교한 결과, 세가지 유전형(Val/Val, Val/Met, Met/Met)과 Val, Met 두 대립유전자빈도, 두 경우 모두 통계적으로 의미 있는 결과는 나오지 않았다. 결론 : 이번 한국인 정신분열병 환자를 대상으로 시행한 저자들의 연구에서 지연성 운동장애와 BDNF Val66Met 유전자 다형성 사이에는 연관성이 보이지 않았다. Objectives : Brain-derived neurotrophic factor(BDNF) belongs to a family of neurotrophic factors and has been demonstrated to promote the survival, differentiation, and maintenance of a broad variety of central nervous system neurons. Several reports have suggested that the BDNF gene is associated with variable psychatric disorders and neurologic disesases. We investigated the association of BDNF Val66Met polymorphism with schizophrenia and tardive dyskinesia(TD) to evaluate candidate BDNF gene for association with drug-induced TD. Methods : 161 schizophrenic patients(TD=83, non-TD=78) and 95 normal controls were included in the study. Tardive dyskinesia was assessed by the Abnormal Involuntary Movement Scale(AMIS). We examined the BDNF Val66Met genotype distribution and allele frequency. Statistical analysis was used to test the association between this polymorphism and TD development in the schizophrenic patients. Results : There were no significant differences in the genotype distribution and allele frequency of the BDNF Val66Met polymorphism between schizophrenic patients with and without tardive dyskinesia, normal controls. Conclusion : Our findings suggest that it is unlikely that the BDNF Val66Met polymorphism play a major role in the pathogenesis of TD in the Korean sample.

Haloperidol 투여후 금단기간에 따른 백서 선조체의 [$^3H$]Spiperone 결합 및 Dopamine 대사물질의 변화

이중용,공보금,김용관,정청,김선희,김영훈,Lee, Jung-Yong,Kong, Bo-Geum,Kim, Yong-Kwan,Jung, Chung,Kim, Sun-Hee,Kim, Young-Hoon 대한생물정신의학회 1996 생물정신의학 Vol.3 No.1

The effects of 3 week treatment with haloperidol(2mg/kg/day, i.p.) on dopamine(DA) D2 receptor and DA metabolism in rat striata were studied at various time points after withdrawal from the drug treatment. Striatal DA D2 receptors were characterized with the radioligand 0.5nM [$^3H$]Spiperone. Dopamine(DA), homovanillic acid(HVA), 3,4-dihydroxyphenyl acetic acid(DOPAC) in rat striatum were measured with the high performance liquid chromatography. Drug withdrawal for 1 week induced significant increase in the number of D2 receptor in striatum after withdrawal for 1 week(p<0.05), and then this change was restored to control level during the withdrawal time of 2 and 4 weeks. There was no difference in striatal concentrations of DA and its metabolites among the groups. In conclusion, one-week withdrawal from chronic haloperidol treatment induced DA D2 receptor supersensitivity in the striatum, and that was normalized rapidly. Though this adaptive change in DA receptors, it may not affect the metabolism of DA in striatum.

성인 여성 성추행 피해자들의 정신적 증상 : 강간 피해자들과의 비교

김연수,김성진,공보금,강제욱,문정준,전동욱,이상민,주현빈,정도운,Kim, Yeon-Sue,Kim, Sung-Jin,Kong, Bo-Geum,Kang, Je-Wook,Moon, Jung-Joon,Jeon, Dong-Wook,Lee, Sang-Min,Ju, Hyun-Bin,Jung, Do-Un 한국정신신체의학회 2016 정신신체의학 Vol.24 No.2

연구목적 최근 검찰청 보고에 의하면 성폭력 피해자 중 강간 피해자는 17.1%이지만 성추행 피해자는 78.0%로 강간 피해자보다 그 수가 많았다. 이러한 성추행 피해자들에게도 심각한 정신적 증상이 다수 발생한다는 국외 보고가 있음에도 불구하고 이를 보고한 국내 연구는 없다. 따라서 본 연구는 성추행 성인 여성 피해자들의 정신적 증상을 조사하였고, 아울러 강간 피해자들의 이러한 증상들의 정도와 비교분석 하였다. 방 법 성폭력 발생 후 3개월 이내에 부산 스마일센터를 방문한 58명의 성인 여성 성폭력 피해자들이 대상자들이었다. 인구 통계학적 및 성폭력 관련 변인에 대하여 설문지를 이용하여 후향적으로 조사하였으며, 정신적 증상 중, 우울, 불안 증상의 심각도와 Posttraumatic stress disorder(PTSD) 유무는 Beck Depression Inventory (BDI), Beck Anxiety Inventory(BAI), Impact of Event Scale-Revised(IES-R) 자가보고형 척도를 이용하여 조사하였다. 결 과 총 58명 중 성추행 피해자는 36명(62.1%), 강간 피해자는 22명(37.9%)이었다. 성추행 피해자들 중 80.6%가 중등도 이상의 우울 증상, 83.3%가 중등도 이상의 불안 증상, 그리고 94.4%가 PTSD선별검사에서 유의미한 결과를 보였고, 이러한 정신적 증상에 대한 강간 피해자들에서의 비율(각각 95.5%, 95.5%, 95.5%)과 유의미한 차이가 없었다. 결 론 성추행 피해자들 또한 강간 피해자들만큼 대다수에서 우울, 불안 및 PTSD 증상이 동반되었다. 이러한 결과는 성추행 피해자들에서도 피해 초기부터 정신적 증상에 대한 적절한 평가와 조기 치료가 이루어져야 한다는 것을 시사한다. Objectives : According to the recent Korean National Police Agency report, rape victims were 17.1%, but sexual molestation victims were more than the rape victims by 78.0%. Despite many international reports about the occurrence of severe psychiatric symptoms in sexual molestation victims, there is no domestic research. Therefore in this study, we investigated psychiatric symptoms of sexual molestation victims, and we also compared it with psychiatric symptoms in rape victims. Methods : 58 women who visited Busan Smile Center within 3months after sexual violence were the study subjects. Questionnaire about sociodemographic and sexual violence related characteristics were retrospectively investigated. Of the psychiatric symptoms, Beck Depression Inventory(BDI), Beck Anxiety Inventory(BAI) for severity of depression and anxiety, and Impact of Event Scale-Revised(IES-R) to check the presence of posttraumatic stress disorder(PTSD) symptoms were used. Results : Of 58 sexual violence victims, sexual molestation victims were 36(62.1%) and rape victims were 22(37.9%). In sexual molestation victims, 80.6% had more than moderate severity of depression, 83.3% had more than moderate severity of anxiety, and 94.4% had significant scores at PTSD screening test. Compared with rape victims' psychiatric symptoms(each 95.5%, 95.5%, 95.5%) there were no significant difference. Conclusions : The majority of sexual molestation victims were also accompanied by depression, anxiety and PTSD symptoms as rape victims. There results suggest that appropriate assessment and early treatment for psychiatric symptom must be made in the early stage of injury in sexual molestation victims.

항정신병약물로 인한 QTc 지연과 5-HTTLPR의 연관성

서범주,이정구,박성우,공보금,정도운,김영훈,Seo, Beom-Joo,Rhee, Jung-Goo,Park, Sung-Woo,Kong, Bo-Geum,Chung, Do-Oun,Kim, Young-Hoon 대한생물정신의학회 2004 생물정신의학 Vol.11 No.1

Objective:A Comparison of QTc prolongation for various antipsychotics and an analysis of QTc prolongation for the various types of serotonin transporter polymorphism were performed. Method:EKG was checked, followed by QTc measurement as Bazett's correction, and the serotonin transporter polymorphism was examined in 110 chronic schizophrenia patients were performed EKG before 24 weeks ago. We defiened QTc prolongation as over 450ms. The risk factor of sudden cardiac death were defiend as QTc prolongation and or 60ms in delta value. Result:The prevalence of QTc prolongation in this study was 7.3%, and the prevalence of over 60ms was 4.5%. Patients who had the risk factors were 10(9.1%). 6/52 who prescribed atypical antipsychotics and 2/58 who prescribed haloperidol showed QTc prolongation. The prevalence who had the risk factor of sudden cardiac death were 16% in atypical antipsychotics group, 3.4% in haloperidol group. QTc prolongation were observed more frequently in l/l type than s/s type. l allele frequency were 50% in QTc prolongated group, 19% in not prolongated group. l allele had an association with QTc prolongation(p<0.01). Conclusion:The prevalence of QTc prolongatin was frequent in chronic schizophrenia patients who were prescribed atypical antipsychotics. It has strong association with l allele of 5-HTTLPR.

다문화 가정과 한국 가정 청소년의 정신 건강 비교

김정민(Jung-Min Kim),공보금(Bo-Geum Kong),강제욱(Je-Wook Kang),문정준(Jung-Joon Moon),전동욱(Dong-Wook Jeon),강은찬(Eun-Chan Kang),주현빈(Hyun-Bin Ju),이윤호(Yoon-Ho Lee),정도운(Do-Un Jung) 대한소아청소년정신의학회 2015 소아청소년정신의학 Vol.26 No.4

Objectives:With the observation of factors influencing depression, self-reported happiness, self-reported stress and suicidal attempt, this study compared and evaluated the mental health of adolescents from multicultural families and monocultural families in Korea. Methods:This study compared the characteristics of adolescents from multicultural and monocultural families based on the analysis of data of The Tenth Korea Youth Risk Behavior Web-based Survey and analyzed the factors influencing adolescent depression, self-reported happiness, self-reported stress and suicidal attempt. Results:There was no significant difference in the levels of depression, self-reported happiness, and self-reported stress between adolescents from multicultural and monocultural families. However, suicidal ideation and suicidal attempt were significantly higher in adolescents from multicultural families. Conclusion:There was no significant difference between the mental health of adolescents from multicultural and monocultural families. Because depression is the greatest factor for suicidal attempt, and violence has stronger relationship with depression of adolescents from multicultural families, further study is needed to prevent this trend.

조현병 환자의 인지기능 및 심리사회적 요인과 직업재활과의 연관성

김현정(Hyun-jung Kim),김성진(Sung-Jin Kim),공보금(Bo-Geum Kong),강제욱(Je-Wook Kang),문정준(Jung-Joon Moon),전동욱(Dong-Wook Jeon),서영수(Young-Soo Seo),하태민(Tae-Min Ha),정성수(Sung-Soo Jung),정도운(Do-Un Jung) 대한생물치료정신의학회 2014 생물치료정신의학 Vol.20 No.2

Objectives:This study was performed to assess the effect of cognitive function on occupational rehabilitation and to review the clinical and psychosocial factors that may affect occupational rehabilitation in patients with schizophrenia. Methods:A total of 58 patients were enrolled and divided into three groups : group of occupational rehabilitation (n=18), day-care(n=19), and out-patient care(n=21). For the cognitive function assessment, the Korean version of the MATRICS Consensus Cognitive Battery(MCCB) and the Korean version of the UCSD Performance-based Skills Assessment (UPSA) were performed. To assess clinical symptoms, the Positive and Negative Syndrome Scale, the Korean version of the Personal and Social Performance Scale(PSP), and the Clinical Global Impression–Schizophrenia scale(CGISCH) were performed. For the psychosocial factors assessment, the Korean Insight Scale for Psychosis and the Korean Version of 4th Revision of Schizophrenia Quality of Life Scale were performed. Results:On the MCCB, the occupational rehabilitation group showed higher scores than the day-care group in the verbal learning and social cognition domains. On the UPSA, the occupational rehabilitation group showed higher scores than the day-care group in the communication domain. No significant difference was found between the groups in the total scores of these cognitive function tests. On the CGI-SCH and PSP, the occupational rehabilitation group revealed better outcomes than the other groups. Conclusion:The schizophrenia patients with occupational rehabilitation had higher cognitive functions on some subscales, which may reflect social cognitive functions, and higher CGI-SCH and PSP scores.

조현병 환자에서 정신병리와 인지 기능과의 연관성

김성진(Sung-Jin Kim),심주철(Joo-Cheol Shim),공보금(Bo-Geum Kong),강제욱(Je-Wook Kang),문정준(Jung-Joon Moon),임지섭(Ji-Seop Lim),김임규(Im-Gyu Kim),김연수(Yeon-Sue Kim),오민경(Min-Kyung Oh),정도운(Do-Un Jung) 대한생물치료정신의학회 2013 생물치료정신의학 Vol.19 No.2

Objectives:Cognitive dysfunction is one of the major symptoms of schizophrenia, and has a diverse effect on the prognosis and course of schizophrenia. Several studies have been done about the correlation between cognitive dysfunction and clinical symptoms of schizophrenia, but the results of those studies were not clear. This study was performed to confirm the correlation between cognitive dysfunction and clinical symptoms of schizophrenia. Methods:We studied 117 patients with schizophrenia. We assessed clinical symptoms and the cognitive function of the patients, and analyzed the statistical correlation between clinical symptoms and the cognitive function. For clinical symptoms, Positive and Negative Syndrome Scale(PANSS), Clinical Global Impression-Severity(CGI-S) and Hamilton Depression Rating Scale(HDRS) were performed. For cognitive function, Digit Span Test, Visual Span Test, Stroop Color Word Test(SCWT), Continuous Performance Test(CPT), Wisconsin Card Sorting Test(WCST), and Digit Symbol Substitution Test(DSST) were performed. Results:There was significant correlation between CPT and clinical symptoms. The WCST revealed that Categories Achieved(CA) have significant correlation with disorganization symptoms among 5-factor model of PANSS (p<0.05). DSST revealed that the total score(p<0.01), negative syndrome(p<0.01), general psychopathology(p<0.01) among 3 kind major area classification of PANSS and disorganization symptoms of 5-factor model of PANSS(p<0.001) have significant correlation. Conclusion:This study revealed the correlation between the cognitive function and a part of clinical symptoms in patients with schizophrenia, as shown through the CPT, WCST and DSST.

조현병 환자에서 QT 간격 지연과 흡연의 연관성

박민경(Min-Kyung Park),심주철(Joo-Cheol Shim),공보금(Bo-Geum Kong),강제욱(Je-Wook Kang),문정준(Jung-Joon Moon),신혜경(Hye-Kyung Shin),김현정(Hyun-Jung Kim),김정민(Jung-Min Kim),오민경(Min-Kyung Oh),정도운(Do-Un Jung) 대한생물치료정신의학회 2012 생물치료정신의학 Vol.18 No.2

Objectives:Abnormalities in the QT interval have been associated with an increased risk of ventricular arrhythmias and sudden cardiac death. However, there is no clear correlation between cigarette smoking and QT interval prolongation in schizophrenia. The purpose of this study is to evaluate the effects of cigarette smoking on the QT interval and estimate the prevalence of prolonged QT interval in schizophrenic patients who take antipsychotics. Methods:We studied 106 schizophrenic patients taking antipsychotics and age- and sex-matched 106 people in control group. A prolonged QTc interval was defined as >450 msec in men and >470 msec in women. The demographic data and clinical characteristics of subjects were collected from medical records. The correlations between QTc interval and other variables were assessed using a regression analysis. Results:There was no significant association between cigarette smoking and QT interval. The mean QT interval was not significantly influenced by antipsychotic dose and type of antipsychotics. However, there was significantly prolonged QT interval in schizophrenic patients(421.1±25.7 msec) compared to control group(412.1±17.1 msec) (p=0.003). The prevalence of prolonged QT interval in schizophrenic patients was 6.6%(7 of 106 patients). Five patients( 71.4%) were smoker and six patients(85.7%) had obesity. By contrast, nobody had a prolonged QT interval in control group. Conclusions:The prevalence of prolonged QT interval was relatively high among middle aged schizophrenia patients. And there was significantly prolonged QT interval and higher body mass index in schizophrenia patients.

자살 임박 시기 알코올 사용과 자살 기도의 특성

김임규(Im-Gyu Kim),임지섭(Ji-Seop Lim),공보금(Bo-Geum Kong),강제욱(Je-Wook Kang),문정준(Jung-Joon Moon),전동욱(Dong-Wook Jeon),김성진(Sung-Jin Kim),김현정(Hyun-Jung Kim),정도운(Do-Un Jung) 대한생물치료정신의학회 2016 생물치료정신의학 Vol.22 No.1

Objective:The aim of this study was to analyze the clinical characteristics of individuals who used alcohol at the time of attempting suicide. Methods:We divided 143 individuals who attempted suicide by consuming drugs into two groups on the basis of their blood alcohol concentration level: drinker group(n=79) and non-drinker group(n=64). We compared epidemio¬logical characteristics and suicidal behavior between the groups by using the Suicidal Intent Scale(SIS) and the Risk Rescue Rating Scale(RRRS). In addition, we administered the Glasgow Coma Scale(GCS) and the Acute Physiology and Chronic Health Evaluation-II(APACHE-II) to evaluate the medical lethality of the individuals who attempted sui¬cide. We used Student’s t-test, Pearson’s correlation analysis, and multiple linear regression to analyze the data. Results:The drinker group scored lower on the SIS’s planning subscale than the non-drinker group did(p=0.022). The drinker group’s blood alcohol concentration levels were negatively correlated with the rescue potential of their suicidal attempt(p=0.031) and the APACHE-II score(p=0.003). Higher blood alcohol concentration levels predicted poorer medical outcomes measured by the APACHE-II(p=0.004). Conclusion:Our findings support the notion that alcohol use increases suicidal impulsivity, decreases rescue po¬tential, and worsens medical outcomes. Therefore, suicide prevention programs need to include education and counseling about the risks associated with alcohol use.

Rim1α and Neurexin3 Regulate Synaptosomal Dopamine Release

Sang Kyeong Lee(이상경),Joo-Cheol Shim(심주철),Young-Hoon Kim(김영훈),Bo-Geum Kong(공보금),Dae-Hyun Seog(석대현) 한국생명과학회 2009 생명과학회지 Vol.19 No.9

신경전달물질의 분비는 시냅스전 신경말단의 active zone에 있는 다양한 단백질들에 의해 조절된다. 도파민은 정신분열병, 약물중독과 같은 여러 가지 행동, 정신질환의 병태생리와 연관된 필수적인 신경전달물질이다. 저자들은 본 연구에서 신경전달물질 분비와 관련된 주요 유전자가 결여된 knockout (KO) 생쥐의 시냅토좀(synaptosome) 도파민 분비를 측정하였다. 시냅토좀 도파민 흡수와 분비는 [³H]-도파민과 관류실험을 이용하여 시행, 측정하였다. 17 KO 생쥐 가운데 3 종류의 생쥐에서 그들의 littermate 대조군과 비교하였을 때 변화된 도파민 분비를 보였다. Rim1α KO에서 세포막 탈분극에 의한 [³H]-도파민은 유의하게 감소되었으며, 또한 Rim1α의 도파민 신경에서의 조건 KO에서는 생리적 완충용액에 의한 기본적인 도파민 분비 및 세포막 탈분극에 의한 도파민 분비 모두가 유의하게 감소되어 있었다. neurexin3의 도파민 신경에서의 조건 KO에서는 세포막 탈분극에 의한 도파민 분비의 증가를 보였다. 이 데이터들은 도파민 분비와 글루타메이트, GABA와 같은 전통적 신경전달물질 분비의 유사성과 차별성을 설명한다. 결론적으로, Rim1α와 neurexin3는 시냅스전 도파민 분비의 중요한 조절자이며 신경계 질환과 연관될 가능성이 있다. Neurotransmitter release is regulated by various proteins of the active zone in the presynaptic nerve terminals. Dopamine (DA) is an essential neurotransmitter associated with the pathophysiology of diverse behavioral and mental illness such as schizophrenia and drug addiction. We measured synaptosomal DA release of knockout (KO) mice which lacked major genes related to neurotransmitter release. Synaptosomal DA uptake and release were performed and measured using [³H]-DA and superfusion experiments. 3 of the 17 KO mice exhibited altered DA release compared to their littermate controls. In Rim1α KO, [³H]-DA release evoked by membrane depolarization significantly decreased. Both basal (physiological buffer-evoked) and membrane depolarization-evoked DA release significantly decreased in dopaminergic conditional KO of Rim1αβ. Dopaminergic conditional KO of neurexin3 demonstrated a significant increase of membrane depolarization-evoked DA release. These data explain the similarities and distinctions between DA and other classical neurotransmitters such as glutamate and GABA (γ-aminobutyric acid) release. In conclusion, Rim1α and neurexin3 may be important regulators of presynaptic DA release and related to disorders of the nervous system.