60세 이상 노인 인구에서 인지기능과 우울증, 자살사고, 혈청지질농도와의 연관성

문정준,이봉주,김정은,김우진,김민효,박민경,송태홍,심주철,김경미,이정구,김영훈,Moon, Jung-Joon,Lee, Bong-Ju,Kim, Jeong-Eun,Kim, Woo-Jin,Kim, Min-Hyo,Park, Min-Kyong,Song, Tae-Hong,Shim, Joo-Cheol,Kim, Gyung-Mee,Lee, Jung-Goo,Kim, Young 대한생물정신의학회 2010 생물정신의학 Vol.17 No.4

Objectives : We investigated a correlation of cognitive function, depression, suicidal idea and serum lipid levels in Korean elderly over 60 years old to find risk factors of deprssion and cognitive decline. Methods : 834 persons participated in this study. Clinical evaluation was done at a point by using Mini-Mental State Examination in the Korean version of CERAD assessment packet(MMSE-KC). We also evaluated 165 persons that agreed to our exact examination for Geriatric Depression Scale(GDS), Scale for Suicidal Ideation(SSI), Hachinski Ischemic Score and serum lipid profile. Correlation analysis was used to evaluate correlation among serum lipid levels, MMSE-KC and SSI. One-way ANOVA was used for comparison of serum lipid levels and cognitive function, depression and SSI. We did a post-hoc analysis. Results : Depression and suicidal ideation were related with cognitive impairment in Korean elderly over 60 years old. Those who have more severe cognitive impairment and depressive symptom, have higher Hachinski ischemic score. We can see high HDL cholesterol levels only in the normal control group. Low total, HDL, LDL cholesterol were related with depression. Conclusion : There was high prevalence of depression in the Korean elderly over 60 years old and low serum lipid level was related with severity of depression and high suicidal ideation. In the normal control group, we can see high HDL cholesterol levels. To confirm this result, we need well-designed and wide range study.

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.

한국 성인에서 주관적 인지저하를 동반한 우울증의 특성과 삶의 질 : 제 7기 국민건강영양조사를 중심으로

정재훈,김성진,정도운,문정준,전동욱,김연수,최현석,이민주,전경수,Jeong, Jae-Hoon,Kim, Sung-Jin,Jung, Do-Un,Moon, Jung-Joon,Jeon, Dong-Wook,Kim, Yeon-Sue,Choi, Hyeon-Seok,Lee, Min-Joo,Jeon, Gyeong-Su 한국정신신체의학회 2021 정신신체의학 Vol.29 No.1

Objectives : This study aimed to investigate quality of life, severity of depression, suicidality, subjective health and subjective stress of depression with subjective cognitive decline in Korean adults. Methods : We used the 7th KNHANES data to enroll 415 participants with a score of 10 or higher on Patient Health Questionnaire-9 (PHQ-9), aged 20-64. Depression was divided into two groups based on the presence/absence of subjective cognitive decline. Demographic and psychological characteristics were compared between two groups. Correlation analysis of subjective cognitive decline, quality of life, depression, suicidal idea was carried out. To detect which variables influenced quality of life, a multiple regression analysis was carried out. Results : Among the 415 participants, 98 had depression with subjective cognitive decline. We identified significant differences in age, marital status, education, employment between the two groups. After adjusting for these variables, depression with subjective cognitive decline had lower EuroQol-5D index scores, more severe depressive symptoms without cognition and worse subjective health than depression without cognitive decline. There was a significant correlation between subjective cognitive decline and quality of life (r=-0.236, p<0.001), suicidal idea (r=0.182, p<0.001), depression score without cognition (r=0.108, p=0.028). Through multiple regression analysis, subjective cognitive decline was predictor of reduced quality of life (β=-0.178, p<0.001). Conclusions : Depression with subjective cognitive decline has poor quality of life and severe depression. Cognitive decline should be considered to improve treatment result in depression. 연구목적 국내의 성인을 대상으로 주관적 인지 저하를 동반한 우울증에서 삶의 질, 우울의 심각도, 자살 관련 특성, 주관적 건강 상태 및 스트레스 인지에 대해 조사하고자 하였다. 방 법 국민건강영양조사 제 7기 자료를 이용하여 Patient Health Questionnaire (PHQ-9)에서 10점 이상인 인구 415명을 대상으로 하였다. 주관적 인지 저하 유무에 따라 두 군의 특성 차이를 비교했다. 주관적 인지 저하와 삶의 질, 우울, 자살사고의 상관성을 보기 위해 상관분석 및 회귀 분석을 실시했다. 결 과 주관적 인지 저하를 동반한 우울증 집단이 삶의 질과 주관적 건강이 더 좋지 않았고 우울의 심각도가 심했다. 주관적 인지 저하와 삶의 질은 음의 상관관계, 자살사고와 우울은 양의 상관관계를 보였다. 회귀 분석을 통해 주관적 인지 저하가 삶의 질에 부정적 영향을 미치는 것을 확인했다. 결 론 주관적 인지 저하를 동반한 우울증은 삶의 질을 저해하고 우울의 심각도가 심하며 삶의 질, 자살사고 및 우울을 악화시키는 것으로 확인되었다.

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.

알코올 의존 환자에서 진전섬망과 금단증상의 연관성

임지섭(Ji-Seop Lim),김현정(Hyun-Jung Kim),김임규(Im-Kyu Kim),강은찬(Eun-Chan Kang),이상민(Sang-Min Lee),공보금(Bo-Geum Kong),강제욱(Je-Wook Kang),문정준(Jung-Joon Moon),전동욱(Dong-Wook Jeon),정도운(Do-Un Jung) 대한노인정신의학회 2014 노인정신의학 Vol.18 No.2

Objective:This study was performed to analyze the clinical variables associated with occurrence of delirium tremens (DT) in inpatients with alcohol dependence initially admitted with diseases unrelated to alcohol. Methods:This study included 132 inpatients seeking treatment for medical problem with acute alcohol withdrawal. The cases were divided into two groups : with DT group (n=44), without DT group (n=88). We compared the epidemiologic data, alcohol withdrawal symptoms and serum analysis data between two groups. We used the logistic regression to predict risk factors for DT. Results:The DT group had more severe alcohol withdrawal symptoms, more amount of drinking alcohol, more number of drinking per month, higher blood urea nitrogen (BUN), creatinine, amylase, C-reactive protein and lower serum total protein than the without-DT group. According to the result of a logistic regression, occurrence of DT showed correlation with the following factors : sweating, hallucination, agitation, amount of alcohol consumption, number of drinking per month. Conclusion:Our study suggests development of DT was correlated with severe alcohol withdrawal symptoms, high BUN, creatinine and low total serum protein. Therefore, during assessment of alcohol dependent patients, clinicians should keep these parameters in mind in order to prevent DT.

조현병 장애 등급 평가와 한국판 University of California San Diego 실행에 기초한 기술평가 척도의 유용성

김유나(You-Na Kim),정도운(Do-Un Jung),강제욱(Je-Wook Kang),문정준(Jung-Joon Moon),전동욱(Dong-Wook Jeon),김성진(Sung-Jin Kim),이윤호(Yoon-Ho Lee),박성용(Sung-Young Park),이충열(Chung-Yeal Lee) 대한생물치료정신의학회 2018 생물치료정신의학 Vol.24 No.2

Objectives:The purpose of this study was to supplement the evaluation criteria for the schizophrenia disability grading system through a standardized test. Methods:Patients with schizophrenia were divided into three groups according to their Global Assessment Function(GAF) scores, which correspond to the disability grade of schizophrenia. We evaluated and compared the functional outcomes of patients with schizophrenia belonging to different severity groups. We performed the UCSD Performance-Based Skills Assessment(UPSA) and GAF to assess functioning in daily life, and the Positive and Negative Syndrome Scale(PANSS) and Clinical Global Impression-Schizophrenia Scale(CGI-SCH) to assess clinical symptoms. One-way analysis of variance was used for comparison between the three groups. The correlation between UPSA and other scale scores was analyzed by Pearson’s correlation coefficient. Results:A total of 117 patients were enrolled in this study. Of these, 46 were mild, 38 were moderate, and 33 were severe group. Significant differences in UPSA scores were identified between groups. The UPSA score was 71.54±14.12, 60.66±17.97, and 48.65±18.55 points for the mild, moderate, and severe group, respectively(p<0.001). The PANSS score was 53.83±15.67, 69.48±12.52, and 95.33±17.17 points for the mild, moderate, and severe group, respectively(p<0.001). The CGI-SCH score was 2.57±0.89, 3.08±0.94, and 4.18±1.01 points for the mild, moderate, and severe group, respectively(p<0.001). In addition, GAF, PANSS, and CGI-SCH showed a significant correlation with UPSA(correlation coefficient: 0.557, -0.497, and -0.570, respectively). Conclusion:The UPSA is a useful tool for assessing functions of daily living in patients with schizophrenia, and can be used to systematically measure the functional ability of patients according to their disability grade.

지역사회 노인의 정신건강 기초조사를 위한 예비연구

주현빈(Hyun Bin Ju),정도운(Do-Un Jung),김성진(Sung Jin Kim),김현정(Hyun Jung Kim),박재홍(Jae Hong Park),서영수(Young Soo Seo),문정준(Jung Joon Moon),전동욱(Dong Wook Jeon),김유나(You Na Kim) 대한노인정신의학회 2017 노인정신의학 Vol.21 No.2

Objective:With the burgeoning elderly population, mental health among the elderly has surfaced as an important medical, social, and economic issue. This study was a pilot study testing the assessment module that was developed to survey mental health among the elderly living in the city of Busan. Methods:Basic demographic data and mental health problems were investigated using the General Health Questionnaire-12 (GHQ-12), suicide risk screening tool, subjective memory deterioration scale, sleep disorder and sleep pattern scale, health-related quality of life scale (EuroQoL-5 dimension), and alcohol abuse screening tool (Cut down, Annoyed, Guilty, Eye-opener Questionnaire). Results:Four-hundred adults aged 65 years or older living in either of two districts in the Busan metropolitan city participated in the study, of whom 219 (54.8%) were female. About 26.8% of the participants were obese, while 2.3% were underweight. One hundred and twenty-five (31.3%) participants were in need of attention to or improvement of nutrition management, and 19.1% perceived themselves to be in poor health. In the GHQ-12, 68.8% were in psychological distress (≥2). About 49.8% of the participants had insomnia, 61.8% had subjective memory disturbance, and 6% were at risk of suicide. The GHQ-12 score, proportion of participants with sleep disturbance, and subjective memory deterioration was significantly higher among women than in men, while health-related quality of life was higher in men. Conclusion:A considerable number of older adults living in the Busan region were suffering from psychological stress, were in need of nutrition management, had low quality of life, and had poor mental health, and women were particularly more vulnerable

조현병 환자에서 장애에 대한 자기인식과 병식의 연관성

남상훈(Sang-Hun Nam),정도운(Do-Un Jung),김성진(Sung-Jin Kim),문정준(Jung-Joon Moon),전동욱(Dong-Wook Jeon),김연수(Yeon-Sue Kim),신동진(Dong Jin Shin),최현석(Hyeon-Seok Choi),정재훈(Jae-Hoon Jeong) 대한생물치료정신의학회 2020 생물치료정신의학 Vol.26 No.3

Objectives:We aimed to evaluate the relationship between disability self-awareness and insight in patients with schizophrenia. Methods:We enrolled 58 clinically stable patients with schizophrenia. The World Health Organization Disability Assessment Schedule (WHODAS) self-report was used to identify self-awareness of functional ability. The Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Schizophrenia Scale (CGI-SCH), and Personal and Social Performance Scale (PSP) were utilized to evaluate clinical symptoms and global function. Whereas Insight Scale for Psychosis (ISP) was applied for insight. Statistical analyses were performed using correlation and linear regression. Results:The WHODAS had a significant correlation with the general psychopathology subscale and total score of PANSS, CGI-SCH, and PSP. Moreover, ISP had a strong correlation with the overall WHODAS score and all domains. In the linear regression analysis, ISP had significant effects on the overall WHODAS score after adjusting for additional variables. Conclusion:Disability self-awareness was significantly correlated with the level of insight in patients with schizophrenia. Clinicians need to consider patients’ insight during the discussion of functional ability.

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.