골수이형성증 환자에서 발생한 베체트병

민정아 ( Jung Ah Min ),김정은 ( Jung Eun Kim ),오신택 ( Shin Taek Oh ),조석구 ( Seok Goo Cho ),조백기 ( Baik Kee Cho ),박현정 ( Hyun Jeong Park ) 대한피부과학회 2009 대한피부과학회지 Vol.47 No.11

Behcet`s disease (BD) is a multisystemic inflammatory disease that affects various organs and it causes mucocutaneous lesions. BD is only rarely associated with leukemia or other hematologic disorders. Many cases of BD associated with myelodysplastic syndrome (MDS) have recently been reported and these cases are mainly in East Asia and the Mediterranean. We herein report on a case of a 34-year-old man who developed Behcet`s disease 8 years after the onset of MDS. He had two, firm, subcutaneous nodules on both shin and recurrent oral ulcer for 2 months. He also had a retinal vasculitis. Skin biopsy from the left shin showed the septal panniculitis, which was consistent with erythema nodosum. He had multiple ileal ulcers observed on the colonoscopy exam, so he was diagnosed with intestinal Behcet`s disease. Yet the chromosomal analysis revealed nonspecific abnormality and not trisomy 8. This is the first reported case of intestinal Behcet`s disease associated with MDS in the Korean dermatologic literature. (Korean J Dermatol 2009;47(11):1309~1313)

우울 및 불안장애 환자에서 리질리언스와 감사 성향의 관련성

민정아,이원희,정영은,홍현미,채정호,Min, Jung-Ah,Lee, Won Hee,Jung, Young-Eun,Hong, Hyeonmi,Chae, Jeong-Ho 대한불안의학회 2022 대한불안의학회지 Vol.18 No.1

Objective : The levels of resilience and gratitude were examined in psychiatric patients with depression and/or anxiety disorders and compared to those of the general population. In addition, we analyzed the associations of positive affect, negative affect, depressive and anxiety symptoms, and gratitude on resilience in this patient population. Methods : The participants included a general population sample (n=155) and psychiatric outpatients with depression and/or anxiety disorders (n=108). All participants completed self-report questionnaires, which included demographic variables, the Connor-Davidson Resilience Scale (CD-RISC), the Gratitude Questionnaire-Six-Item Form (GQ-6), the Positive Affect Negative Affect Scale (PANAS), and the Hospital Anxiety and Depression Scale (HADS). Results : The CD-RISC and GQ-6 scores of patients with depression and/or anxiety disorders were significantly lower than those of the general population. In the patient population, hierarchical regression analysis showed that gratitude was significantly associated with resilience while controlling for a range of demographic and clinical variables. Conclusion : Patients with depression and/or anxiety disorder generally had lower resilience and gratitude. Moreover, our findings showed that gratitude could influence the levels of resilience in patients with depression and/or anxiety disorders.

일 대학병원에서 외상 후 스트레스장애 입원환자의 약물 치료 경향

민정아,정영은,서호준,박원명,전태연,채정호,Min, Jung-Ah,Jung, Young-Eun,Seo, Ho-Jun,Bahk, Won-Myong,Jun, Tae-Youn,Chae, Jeong-Ho 대한불안의학회 2008 대한불안의학회지 Vol.4 No.1

현재 PTSD와 관련한 여러 병태생리 기전들이 밝혀지고 있으며 이에 초점을 둔 다양한 약물치료가 행해지고 있다. 본 연구에서는 일 대학병원에서 PTSD로 진단된 환자들의 의무기록을 검토하여 약물치료의 경향에 대해 알아보았다.1998년 1월부터 2007년 12월까지 DSM-IV에 의해 PTSD로 진단된 입원 환자 75명이 대상군이 되었으며, 이들의 인구학적 요인들, 입원기간, 외상의 종류, 외상 후 경과시간 및 정신과적 공존병리 및 처방 받은 약물을 조사하였다. 조사 결과, 75명 중 남자는 33명, 여자는 42명이었다. 정신과적 공존병리는 총 50명(66.7%)에서 존재하였으며, 우울장애, 인지장애, 정신장애 및 불안장애 순이었다.73명(97%)의 대상군은 항우울제를 처방 받았으며, 그 중 paroxetine이 54.7%로 가장 많았고 두 가지 이상의 항우울제를 처방 받은 경우도 24%였다. 또 거의 대부분의 환자에서 비정형 항정신병약물(33.3%), 기분안정제(17.3%),항불안제(94.7%)가 항우울제와 병용 처방된 것으로 조사되었다. 여러 제한점에도 불구하고 본 연구에서 얻어진 약물 처방 경향은 향후 국내 실정에 맞는 치료 지침을 수립하는 데에 하나의 근거 자료가 될 수 있을 것이다. Objective : Due to a better understanding of the pathophysiology of posttraumatic stress disorder (PTSD) and the relative limitations in the treatment of patients with PTSD, a variety of medications and treatment algorithms for PTSD have been investigated. This study was conducted to investigate the trends in the pharmacotherapy used in the treatment of inpatients with PTSD at a single university hospital in Korea. Methods : Data from 75 patients diagnosed with PTSD according to the DSM-IV criteria from January 1998 to December 2007 were collected. Demographic data and clinical data, including medications prescribed, were investigated. Results : Thirty-three of the 75 subjects included in this study were male, and 42 were female. Considering psychiatric comorbidity, depressive disorder, cognitive disorder, psychotic disorder and anxiety disorder were reported in order. Approximately 97% of the subjects were treated with antidepressants, including paroxetine in 54.7%, and 24% of the subjects were treated with two different kinds of antidepressants. In addition, atypical antipsychotics were prescribed in 33.3% of patients, mood stabilizers in 17.3%, and anxiolytics in 94.7% of the subjects. Conclusion : In our study, various kinds of antidepressants were prescribed for most patients with PTSD. Antipsychotics and mood stabilizers were added to the treatment regimens of some subjects, and anxiolytics were added to the treatment regimens of most subjects. Despite its many limitations, this study shows the prescription pattern and trends in PTSD treatment in Korea. We hope that these preliminary data would be helpful for the development and integration of a practical guideline for the treatment of PTSD in Korea.

중독 정신 병리의 이해 : 뇌영상 연구를 중심으로

민정아,김대진,Min, Jung-Ah,Kim, Dai-Jin 대한생물정신의학회 2011 생물정신의학 Vol.18 No.2

Substance addiction is a chronically relapsing disorder that has been characterized by a vicious cycle composed of intoxication, craving/anticipation, withdrawal, and response inhibition/bingeing. Here we summarize the findings from neuroimaging studies in addiction according to these behavioral components and suggest the integrated neurobiological model of drug addiction and related brain correlates. The roles of various prefrontal regions, thalamus, memory circuit, anterior cingulated, and insula were also suggested in addition to those of classical mesolimbic dopaminergic system and its responsivity. Limited studies of behavioral addiction demonstrated a similarity with substance addiction on the neurobiological basis. Based on the current understanding of neurobiology of addiction, further researches on interactions of behavioral components and their brain correlates, behavioral addiction, and therapeutic applications will be desired.

우울 및 불안장애 환자에서 아동기 학대와 정서증상 및 리질리언스와의 관계

경미하,민정아,채정호,Kyoung, Miha,Min, Jung-Ah,Chae, Jeong-Ho 대한불안의학회 2013 대한불안의학회지 Vol.9 No.1

Objective : The aim of this study is to identify the relationship between childhood abuse and affective symptom including resilience in patients with depression or anxiety. Methods : A total 256 outpatients diagnosed with depressive disorder or anxiety disorder according to DSM IV-TR, were evaluated with Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Parent-Child Conflict Tactics Scale (PCCTS), Connor-Davidson Resilience Scale (CD-RISC). Independent t-test, Chi-square analysis and analysis of covariance (ANCOVA) were performed to identify the demographics of patients and the relationship between affective symptoms including resilience and childhood abuse. Results : Among demographic and clinical variables, patients with childhood abuse history were significantly higher rate in patients who were living alone and unemployed. In affective symptoms, patients with childhood abuse history were significant more severe in depressive symptoms, and state anxiety score than patients without history of childhood abuse. Patients with childhood abuse history had higher score for trait anxiety and lower score for resilience than patients who had no history of childhood abuse. Conclusion : These finding suggest that history of childhood abuse might be risk factor on depressive and anxiety symptoms severity. And this might be a predictable factor of poor treatment outcome.

위암 환자의 디스트레스 유병률과 관련 위험 인자

전찬수,민정아,마지영,송교영,류인균,이창욱,이철,김태석,Jun, Chansoo,Min, Jung-Ah,Ma, Ji-Young,Song, Kyo Young,Lyoo, In Kyoon,Lee, Chang-Uk,Lee, Chul,Kim, Tae-Suk 한국정신신체의학회 2012 정신신체의학 Vol.20 No.2

연구목적 : 위암은 국내에서 매우 빈번하게 발생하는 암이지만, 위암과 디스트레스 간의 관련성을 규명한 연구는 거의 없었다. 본 연구에서는 위암 환자의 디스트레스의 유병률을 조사하고 관련 위험인자를 알아보고자 한다. 방 법 : 일 종합병원 암센터에 입원한 274명의 위암 환자가 본 연구에 참여하였다. 모든 참여자에게 디스트레스를 평가하는 병원 불안 우울 척도가 시행되었으며, 사회인구학적 및 암 관련 임상 자료가 조사되었다. 결 과 : 153명(55.8%)의 위암 환자가 유의한 디스트레스를 나타내었다. 로지스틱 회귀분석에서 음주 경험이 있는 경우[오즈비(OR)=2.10, p=0.034]와 수행능력이 저하된 경우(OR=2.40, p=0.002)가 위암 환자의 디스트레스에 유의한 영향을 미치는 요인으로 밝혀졌다. 결 론 : 본 연구에서 약 반 수 이상의 위암 환자가 디스트레스를 겪고 있으며, 음주 경험과 낮은 수행 능력이 관련 위험 인자로 나타났다. 본 연구의 결과로 위암 환자의 디스트레스에 대한 선별 평가 및 심리사회적 중재의 필요성을 확인하였다. Objectives : Though gastric cancer is one of the most common cancer in Korea, there have been few studies to explore psychological distress in gastric cancer. The purpose of this study was to investigate the prevalence and associated risk factors of psychological distress among patients with gastric cancer. Methods : With consecutive sampling, a total of 274 patients with gastric cancer who admitted to a cancer center in a general hospital were recruited and assessed on psychological distress using the Hospital Anxiety and Depression Scale(HADS). Sociodemographic and cancer-related clinical variables were also evaluated. Results : One hundred fifty-three(55.8%) patients with gastric cancer showed psychological distress. Logistic regression models revealed that having alcohol drinking experience[odds ratio(OR)=2.10, p=0,034] and low performance status(OR=2.40 p=0.002) were significantly associated with psychological distress in patients with gastric cancer. Conclusions : These findings indicate that approximately half of patients with gastric cancer suffered from psychological distress and having alcohol drinking experience and low performance status would be associated risk factors, suggesting the need for distress screening and psychosocial supportive care in patients with gastric cancer.

캄보디아인의 집단 외상과 정신건강

이나빈,민정아,채정호,Lee, Nabin,Min, Jung-Ah,Chae, Jeong-Ho 대한불안의학회 2012 대한불안의학회지 Vol.8 No.2

The mass social trauma, such as organized violence, wars, oppression by dictatorships and massive terrorist attacks, exposes thousands of people to trauma in a short period of time. Therefore, the mass social trauma is distinguished from individualized trauma, such as a violent attack, rape or a traffic accident in that it results in multiple and extended consequences beyond the individual. During the Khmer Rouge regime, one quarter of the Cambodian population was killed as a result of malnutrition, forced labor and mass killings. Until now, its evil continues to affect Cambodian's physical and mental health problems. Although there is ongoing debate, to date, no consensus has been reached supporting a clear set of recommendations for the intervention and longitudinal study regarding the influence of killing field massacre being too little. And comparative cultural studies, such as comparing the East to West or other Asian cultures are also lacking. This article gives an overview of previous study results about the mental health of Cambodians, and suggests a possible research issue and therapeutic interventions to determine the impact of mass trauma to the members of society and post-traumatic recovery factors.

조현병 환자의 인지기능과 뇌 사건유발전위의 관계

김가영,민정아,채정호,Kim, Ka-Young,Min, Jung-Ah,Chae, Jeong-Ho 대한생물정신의학회 2012 생물정신의학 Vol.19 No.3

Objectives : Event-related potentials have been suggested as an objective marker for brain functions in psychiatric disorders. This study was aimed to investigate the relationships between P300, the mismatch negativity (MMN), the loudness dependence of the auditory evoked potential (LDAEP), demographic and clinical variables including neurocognitive abilities in patients with schizophrenia. Methods : P300, the MMN, and the LDAEP were measured and the Korean Stroop color-word test (K-stroop test) and the Wisconsin Card Sorting Test (WCST) were performed in 43 patients with schizophrenia. The relationship of the latency and amplitude of P300 and the MMN as well as regression slope of the LDAEP with demographic and clinical variables were analyzed by t-test and correlation analyses for categorical and continuous variables, respectively. Results : After controlling for age, the latency of central (Cz) and parietal (Pz) P300 posivitively correlated with GAF at admission (Cz ; ${\gamma}$ = 0.385, p = 0.047, Pz ; ${\gamma}$ = 0.421, p = 0.029). The amplitude of parietal P300 correlated with the correction rate of the K-stroop test (${\gamma}$ = 0.575, p = 0.002). In addition, the frontal (Fz) P300 latency tended to negatively correlated with the correction rate of the WCST (${\gamma}$ = -0.371, p = 0.057). Conclusions : Our findings suggest that the values of P300 latency and amplitude might be correlated with GAF at admission and working memory measured by the K-Stroop test and the WCST. Meanwhile, the MMN and the LDAEP did not correlate with demographic and clinical variables. These results support the results of previous studies showing associations with P300 and impaired cognitive ability.

우울증 및 불안장애 환자에서 특성불안 차이에 따른 긍정심리요인의 특징

안희영,민정아,김선영,채정호,An, Hee-Young,Min, Jung-Ah,Kim, Sun-Young,Chae, Jeong-Ho 대한불안의학회 2013 대한불안의학회지 Vol.9 No.1

Objective : The aim of this study was to investigate the relationship between trait anxiety and positive psychological factors. Methods : A total of 429 outpatients diagnosed with depression and/or anxiety disorders surveyed with questionnaires measuring socio-demographic, clinical, and positive psychological factors. The relationships of trait anxiety with clinical symptoms and positive psychological factors were evaluated. Results : Patients with low trait anxiety showed high optimism, gratitude, hope, spirituality and purpose in life. After adjusting age, scores of BDI and STAI-S, the results showed low trait anxiety was associated with high spirituality and purpose in life. Conclusion : The result revealed that trait anxiety had negative-relationship with spirituality and purpose in life in patients with depressive and/or anxiety disorders. Although trait anxiety was known as a general tendency which is stable, approach to trait anxiety by modulating these associated positive psychological factors would be newer approach of treatment to patients with depressive and/or anxiety disorders.

대마초 및 메스암페타민 남용자들의 기질 및 성격 특성

권민,민정아,최지혜,김대진,Kwon, Min,Min, Jung-Ah,Choi, Ji-Hye,Kim, Dai-Jin 대한생물정신의학회 2012 생물정신의학 Vol.19 No.2

Objectives : This study aims to identify temperament and characteristics of cannabis and methamphetamine abusers for elucidating psycho-biological variables related to certain substance abuse. Methods : A total of 320 patients who registered in the 'Hepatitis C cohorts study of intravenous drug users' between March 2006 and March 2010 participated in this study. Data on demographic variables were obtained and the Temperament and Character Inventory (TCI) and measures for nicotine dependence, alcohol dependence, depression and anxiety were assessed. After comparing TCI between cannabis, methamphetamine, and co-abusers, correlations between TCI and other clinical variables were examined. Results : The methamphetamine abuser group showed significantly higher scores in Novelty Seeking (NS2) and Harm Avoidance (HA3) in temperament than the cannabis abuser and co-abuser groups, whereas the cannabis abuser group had higher scores in purposefulness (SD2), congruent second nature (SD5), and self-directedness (SD) in character than the methamphetamine abuser group. In addition, temperaments and characters correlated with various psychiatric symptoms. Conclusions : We found the differences in temperament and characters among cannabis abusers, methamphetamine abusers. These findings might contribute to further understanding of mechanisms of cannabis and methamphetamine abuse.