한국인 알코올중독 환자의 예후인자에 관한 연구 : 심리적, 사회적, 생물학적 요인을 중심으로

성상경,장환일,Sung, Sang-Kyung,Chang, Hwan-Il 대한생물정신의학회 1995 생물정신의학 Vol.2 No.2

The author studied prognostic indicators of sixty Korean male alcoholics in psychological, social and biological aspects who were divided into abstinent and drinking groups. Thirty patients were assigned to each group. They were controlled in age and sex. Both groups were compared in terms of the demographic characteristics, past drinking history, treatment history, famaily history, ego strength and personality factors differences and distribution of dopamine $D_2$ receptor gene Al allele. Also the author studied relation of clinical course, alcoholic family history and dopamine $D_2$ receptor gene Al allele in both groups. The results were as follows; 1) The abstinent group had higher rate of married state, higher economic status, longer education years and maintained more stable job than the drinking group. But made no differences in occupation and religion. 2) The abstinent group showed higher rate of living with family members than the drinking group, and wives and fellows of the alcoholics anonymous were important factors for maintenance of abstinence. Family loading and parent's characters were not different. 3) The abstinent group had longer maximal length of abstinence but mean amount of alcohol consumption per day were larger than the drinking group. But there were no differences in duration of past drinking, drinking pattern, main drinking time, first drinking age and preference of the kind of alcoholic beverage in the past drinking history. 4) The abstinent group showed stronger treatment motivation, absolute abstinence in treatment goal, more voluntary adimission and maintained longer therapeutic relationship otter discharge than the drinking group. But both groups showed negative attitude toward antabuse therapy. 5) The abstinent group had higher mean score in ego strength scale than the drinking group. 6) In the personality factor questionnaire, the abstinent group showed strong laugh poise and the trait of praxernia, conservatism personality but the drinking group showed tough poise, the trait of weak ego strength(unstableness) and tough mindedness personality. 7) In comparision of dopamine $D_2$ receptor gene A1 allele, the prevalence of A1 allele was seventy percent and the frequency was 0.38 in the abstinent group. The prevalence of A1 allele was sixty percent and the frequency was 0.42 in the drinking group. Both groups were not significantly different in A1 allele prevalence and frequency. 8) In comparision of dopamine $D_2$ receptor gene A1 allele according to alcoholic family history, the prevalence of A1 allele was seventy percent and the frequency was 0.43 in the family history positive group. The prevalence of A1 allele was sixty-one percent and the frequency was 0.38 in the family history negative group. Both groups were not significantly different in A1 allele prevalence and frequency. In comparision of past drinking history according to alcoholic family history, the family history positive group showed earlier first drinking and problem drinking, but the family history negative group hod longer duration of past drinking. The mean amount of alcohol consumption per day, the longest duration of abstinence and Alcoholism Screening Test of Seoul Natoinal Mental Hospital(NAST) results were not significant. In conclusion, the results suggest that successful prognostic indicators of Korean alcoholics are married state, higher economic status, longer education years, stable job, living with family members, longer abstinence during past drinking history, strong treatment motivation, absolute abstinence in treatment goal, voluntary adimission, maintained therapeufic relationship, strong ego strength and the trait of praxernia, conservatism personality. But occupation, religion, alcoholic family history, parent's characters, duration of past drinking, drinking pattern, main drinking time, first drinking age, preference of the kind of alcoholic beverage, attitude to an

정신분열증환자에서 Nemonapride와 Haloperidol의 치료결과 및 내약성에 대한 비교분석

성상경,홍광화,Sung, Sang Kyung,Hong, Kwang Wha 대한생물정신의학회 1995 생물정신의학 Vol.2 No.1

A single-blind comparative study was performed using haloperidol as a reference drug in order to evaluate the efficacy and safety of nemonapride, a new benzamide derivative, in sixty-nine Korean schizophrenic patients. the total period of the study was 8 weeks, maximum dosage of nemonapride was 36mg and that of haloperidol was 24mg. Psychopathology and extrapyramidal symptoms were assessed every week or four weeks until the end of the 8th week using the PANSS, BPRS, and 4 point general side effect check list, The drug safety was assessed every week until the end of the 8th week using vital sign, body weight, EEG, EKG, and blood chemistry. In total. one patient discontinued nemonapride treatment and seven patients discontinued haloperidol treatment before the end of the study. Therefore sixty-one patients(88 %) completed the study. PNASS and BPRS scores of the two groups on the end study point demonstrated a significant improvement compared with baseline score. The number of patients who had a clinical improvement of at least 20% in baseline score was similiar in both treatment groups. The difference of Simpson's rating scale socres were significant in both groups, and mean scores were more high in the haloperidol group than in nemonapride group. No significant EKG, EEG changes were induced, no relevant change in body weight or clinical laboratory parameters were observed in the sixty-one patients during 8 weeks and no Significant difference in the both groups. From these results, nemonapride is considered to be a clinically useful drug having a wide range of antipsychotic effect in schzophrenic patients.

알코올중독의 약물치료

성상경,Sung, Sang Kyung 대한생물정신의학회 1999 생물정신의학 Vol.6 No.1

This review focused on the pharmacological treatment of alcoholism, especially alcoholism-related mental disorder. The pharmacological agent for alcoholism can be divided into the following categories : anticraving agent, aversive agent, agent to treat acute alcohol withdrawal, agent to diminish drinking by treating associated psychiatric pathology, agent to induce sobriety in intoxicated individuals. Following trends are included in new trends of pharmacological treatment of alcoholism. What are precise conditions amenable to pharmacological intervention? ; How can psychosocial and behavioral intervention be integrated with pharmacotherapy to enhance treatment outcome? ; Is the concept of "matching" specific pharmacotherapy treatment to different aspect of alcoholism more efficacious than a more generalized medicational approach to treatment? One of the most important factors for alcoholics treatment is good and proper therapeutic relationship with patients and setting up individually specialized treatment program is also important.

알코올중독 환자의 예후 예측에 관한 연구(Ⅱ) : 가족력 및 DRD₂와의 관계를 중심으로

성상경,차성조,이규항,이정균 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.6

알코올중독 환자의 예후인자를 알아보기 위해 나이와 성별을 통제하여 음주군과 단주군 남자환자 각각 30명을 대상으로 비교 연구하였다. 양군간의 인구통계학적 특성, 음주력, 가족력, 자아강도 등의 차이 및 도파민 D2수용체 유전자 분포를 비교하였으며, 질병경과, 가족력 및 도파민 D2수용체 유전자와의 관련성을 알아보았다. 그 결과는 다음과 같다. 1) 단주군은 음주군에 비해 기혼율이 높았으며, 높은 경제상태, 높은 학력 등이 중요한 요소였으나 직업의 종류 및 종교에 있어서는 차이가 없었다. 2) 단주군은 음주군에 비해 과거 음주력상 최대 단주기간이 길었으나 평균 음주량이 더 많았다. 또한 음주군은 단주군에 비해 사회경제적 스트레스 및 정신적 불안정이 주된 음주 이유인 경우가 많았으나 음주기간, 음주양상, 음주시기, 음주시작 연령, 술의 종류에 있어서는 차이가 없었다. 3) 알코올중독의 가족력에 따른 비교에서 단주군과 음주군 사이에 유의한 차이는 없었다. 4) 단주군은 음주군에 비해 자아강도의 평균점수가 더 높았다. 5) 도파민 D2수용체 유전자의 A1 대립유전자 비교에서 단주군에서 A1 대립유전자의 이환율은 70%, 음주군에서는 60%였다. A1 대립유전자의 빈도는 각각 0.38과 0.42로 양군간에 차이는 없었다. 6) 알코올중독 가족력에 따른 도파민 D2 수용체 유전자분포 비교에서 가족력이 있는 군에 A1 대립유전자의 이환율은 70%, 빈도는 0.43이었고, 가족력이 없는 군에서는 이환율이 61%, 빈도는 0.38로 양군간에 유의한 차이는 없었다. 가족력이 있는 경우에 음주시작의 연령이 더 낮았으며 문제음주도 보다 일찍 나타났다. 그러나 평균 음주기간은 가족력이 없는 경우에 더 길었으며, 평균 음주량, 최고 단주기간 및 NAST 비교에서는 차이가 없었다. 결론적으로 알코올중독 환자의 긍정적 예후인자로 기혼, 높은 학력 및 경제상태, 과거 음주력상 보다 긴 단주 기간 및 강한 자아강도를 들 수 있었다. 반면에 직업, 종교, 알코올중독 가족력 유무, 음주기간, 음주양상, 음주시작 연령, 술의 종류 및 도파민 D2수용체 유전자 A1 대립유전자 분포 등에서는 알코올중독의 예후의 의미 있는 상관관계가 없었다. Objectives : The purpose of the study was to identify the prognosis-predicting indicators is alcoholics by the correlation between prognosis and demographic characteristics, ego strength, family history and distribution of dopamine D2 receptor gene A1 allele. Methods : The subjects were composed of 60 alcoholics including 30 psychiatric inpatients(drinking group) and 30 alcoholics abstinent for 6 months or more after discharge(abstinent group). They were investigated with interview, questionnaire, blood sample and review of their charts. Results : The results were as follows ; 1) The abstinent group had higher rate of married state, higher economic status and longer education years than the drinking group. There were no differences in occupation and religion between the two groups. 2) There were no differences between the abstinent group and drinking group according to alcoholic family history. 3) The abstinent group had higher mean score in ego strength scale than the drinking group. 4) In comparision of dopamine D2 receptor gene A1 allele, the prevalence of A1 allele was seventy percent and the frequency was 0.38 in the abstinent group. The prevalence of A1 allele was sixty percent and the frequency was 0.42 in the drinking group. Both groups were not significantly different in A1 allele prevalence and frequency. 5) In comparision of dopamine D2 receptor gene A1 allele according to alcoholic family history, the prevalence of A1 allele was seventy percent and the frequency was 0.43 in the family history positive group. The prevalence of A1 allele was sixty-one percent and the frequency was 0.38 in the family history negative group. Both groups were not significantly different in A1 allele prevalence and frequency. Conclusions : With the above results, the authors think that successful prognostic indicators of alcoholics are married state, higher economic status, longer education years, longer abstinenence period in past history, and strong ego strength. But family history and distribution of dopamine D2 receptor A1 allele were not significantly related to the prognositc indicators of alcoholics.

여성 알코올 의존 환자의 임상적 특성에 관한 연구 : - 일 정신병원 입원환자를 중심으로 -

성상경,신동환,송종호,이규항 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 남. 여 알코올의존 환자의 인구통계학적 특성, 음주력, 가족력, 음주양상, 음주동기, 공유질병 등을 포함하는 임상적 특성의 차이 및 여성 알코올의존에 대한 질병양상과 그 가족의 태도를 파악함으로써 향후 여성 알코올의존 환자의 치료 대책수립을 위한 기초자료를 제공하는데 그 목적이 있다. 방 법: 1991년 1월1일부터 1996년 5월31일까지 일 정신병원에 입원 치료한 남. 여 각각 51명의 알코올의존 환자를 연구대상으로 하였으며, 연구방법으로 병력기록지 및 설문지 조사를 통한 자료 수집을 이용하였다. 양군간의 비교를 위해 남. 여 인원 및 나이를 통제하였고, 여성 알코올의존자의 평균 연령은 44.45±11.02세였고 남성 환자군의 평균 연령은 44.17±10.08이었다. 진단은 DSM-Ⅲ-R에 의해 이루어졌으며 대상자 모두는 알코올 의존의 진단기준을 만족하였다. 결 과: 여성 알코올의존자는 남성 알코올의존자에 비해 음주시작 연령이 늦었고 과거 음주기간은 짧았으며 일 음주량이 적었다. 그리고 여성 알코올의존자는 남성 알코올의존자에 비해 자발적 입원이 많았으며 입원후 금단증상, 알코올성 간염, 당뇨등 신체적 합병증이 적었다. 또한, 입원후 가족의 태도에서 가족의 이혼위협 등 치료에 비협조적인 경우가 남성 알코올의존자에 비해 많았으며, 과거력상 사별, 이혼, 남편의 구타 등 상실의 경험이 많았다. 결 론: 남. 여 알코올의존자간에 인구통계학적 특성, 임상 특성, 가족의 태도 등 여러가지 면에서 차이가 나는 것으로 나타났다. 여성 알코올의존자 집단은 가족의 죽음, 부부생활의 갈등과 같은 심리 사회적 좌절 경험이 더 많고 가족들이 더 비협조적이었다. 그러므로 치료자는 이러한 여성알코올의존자의 특성을 치료와 예방에 반영하고 이들에 대한 세심한 배려를 해야할 것이다. Objectives: This study aimed to provide a basic data of female alcoholics by understanding the gender differences of the clinical characteristics including demographic characteristics, alcoholic history, family history, drinking patterns, reasons for drinking, and comorbidity in male and female alcoholics. It also ained to establish the therapeutic plans through understanding the patterns of disease and the patterns of family cooperation in female alcoholics. Methods: The study subjects consisted of 51 male and female alcoholics admitted to a mental hospital from January 1, 1991 to May 31, 1996. Subjects were age-and sex-matched. We reviewed patients charts and administered questionaires. Mean age of female alcoholics was 44.45±11.02 years and that of male alcoholics was 44.17±10.08 years. All male and female patients met with the DSM-Ⅲ-R criteria of alcohol dependence. Results: Female alcoholics were later in drinking-onset age, and to had shorter duration of previous drinking history and less average amount of daily drinking than male alcoholics. And female alcoholics were found to seek treatment more voluntarily, and to have less frequent delirium tremens after admission and less medical complications such as hepatitis and diabetes mellitus. Also female alcoholics had more frustration experiences of separation such as death of family member, divorce, and husband`s physical abuse. Female alcoholic`s families had more uncooperative attitude toward treatment such as threat to divorce after admission. Conclusions: There were many differences between male and female alcoholics of demographic characteristics, clinical characteristics, and patterns of family cooperation. Female alcoholics were found to have more experiences of psychosocial frustration including death of family member and marital conflicts, and more uncooperative attitude of her family members. Therefore, it is required that therapists consider the characteristics of female alcoholics upon treatment and prevention, and have more concern about female alcoholics.

정신병환자의 통합치료를 위한 낮병원 모델

함웅,김선재,윤성철,성상경,이규항,이후경 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.6

본 연구는 통합치료를 위한 낮병원 모델을 소개하고, 이 모델의 낮병원 치료를 시행하여 그 결과를 평가하고 시행과정 중에 나타난 특징을 분석하며, 우리 실정에 맞는 낮병원 모델을 발전시켜. 정신병환자를 효과적으로 돕고 사회 재적응을 촉진시키기 위한 목적으로 실시되었다. 본 모델의 낮병원 치료를 1996년 5월부터 12월까지 총 25명의 환자를 대상으로 실시하였다. BPRS. 삶의 만족 척도, 프로그램 유익성 척도, 13가지 치료요인 척도, 가장 중요한 사건 설문지를 낮병원 치료초기와 말기에 시행하여 그 결과를 중심으로 낮병원 모델에 대한 평가를 하였다. 본 연구결과는 다음과 같다. 1) 본 낮병원 모델은 나이, 입원횟수, 유병기간. 기능수준에 있어 다양한 환자들에게 광범위한 치료를 제공할 수 있었다. 2)본 낮병원 모델은 치료효과라는 측면에서 볼 때 주로 음상증상을 호전시키고 주관적인 삶의 만족도를 높여주는데 기여하였다. 3) 상위기능집단과 하위기능집단으로 나누었을 때 상위기능집단에서는 집단정신치료, 싸이코드라마등 비구조적이고 자신의 내면을 깊이 있게 탐구를 할 수 있는 치료를 높이 평가하였으나 하위기능집단에서는 그렇지 않았다. 그러므로 두 집단으로 나누어 낮병원 치료를 진행하는 것이 더 효과적일 수 있다. 4) 치료요인의 결과를 살펴보면 상위기능집단과 하위기능집단 모두 치료가 진행됨에 따라 작용하는 치료요인에 차이가 있었으며. 상위기능집단은 말기에 대인관계학습을 더 중요시하였고. 하위기능집단은 말기에 사회화 기술의 발달을 더 중요시하였다 그러므로 상위기능집단은 낮병원 종결 후 장기외래환자 집단정신치료에. 하위기능집단은 사회복귀시설에 참여하는 것이 타당할 것으로 생각된다. 5) 본 낮병원 모델은 전체적으로 운영하기가 편하였고, 치료인력을 최대한 효율적으로 사용 할 수 있게 하였다. Objects : The purpose of this study was to present a day hospital model(hereinafter called as "this model" ) for integrated therapy, to evaluate the result of performing this model, and thus to develop day hospital model for helping psychotic patients effectively and promoting social re-adaptation. Methods : The authors performed this day hospital model from 1996, May to December. A total of 25 psychotic patients participated in this study. BPRS, Life Satisfaction Se1f-Rating Scale, Program Helpfulness Scale, 13 Therapeutic Factors Scale, and Most Important Event Questionnaire were used at the start of day hospital treatment and at the end. Results : The results were as fo11ows : 1) In this model, It was possible to offer the wide treatment to heterogeneous patients who varied in age, number of admission, duration of illness, and functional level. 2) In the aspect of therapeutic effect, this model contributed for improving negative symptoms and increasing subjective life satisfaction 3) When the patients were divided into the higher functional level group and the lower functional level group, the higher functional level group set a high value on group psycho-therapy and psychodrama that were unstructured and could make patients explore their inner side deeply. But the lower functional level group did not so. Therefore dividing into two groups by functional level may be more effective for day hospital treatment. 4) Therapeutic factors were different between the periods of der hospital treatment. And in the higher functional level group, 'interpersonal learning' was important at the last period, but in the lower functional level group, 'socializing technique' was important at the last period. So long-term group psychotherapy may be more suitable for the artier-care of the higher functional level group, and day care or other psychosocial rehabilitation programs may be more suitable for the after-care of the lower functional level group. 5) This model was easy to apply to Korean day hospital setting, and made staffs treat patients efficiently. Conclusion: This day hospital model would be used effectively and efficiently in Korean day hospital setting.

만성정신병환자의 재활치료를 위한 주간보호 모델

이규항,김한오,이후경,윤성철,성상경,함웅,윤배중 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 본 연구는 전문병원 위탁형 정신보건센터에서 실시한 주간보호의 전체적인 체계, 운영, 프로그램에 관한 모델을 소개하고, 이 모델을 주간보호에서 시행한 후 그 결과와 시행과정에서 나타난 특징을 분석하여, 우리 실정에 맞는 주간보호 모델을 발전시켜 만성정신병환자의 생활유지와 재활을 촉진시키기 위한 목적으로 실시되었다. 방 법 : 본 주간보호 모델(이하 본 모델이라 함)을 1997년 3월부터 1998년 2월까지 의왕시 정신보건센터에서 총 23명의 환자를 대상으로 실시하였다. PANSS, Quality of Life, 삶의 만족 척도를 주간보호 전과 주간보호 실시 3개월 이후에 조사하였다. 프로그램 유익성 척도, 13가지 치료요인 척도를 주간보호 1개월째와 주간보호 실시 3개월 이후에 조사하였다. 결 과 : 1) 본 모델은 만성정신병환자의 증상을 감소시키고 삶의 질을 향상시켜, 환자의 생활유지 및 재활에 도움을 주었다. 2) 본 모델은 다양한 형태의 집단치료들을 사용하여 만성정신병환자에게 유익을 주었으며, 특히 예술치료와 활동치료가 환자의 신체적, 심리적, 사회적 기능회복을 위해 중요한 역할을 하였다. 3) 본 모델에 작용하는 치료요인의 특징을 보면 주간보호 초기와 후기에 모두 중시된 치료요인은 치료자와의 동일시, 치료자의 조언, 일차가족집단의 교정적 감정경험이었다. 주간보호 초기에 중시된 치료요인은 집단응집력, 이타심이었으며, 주간보호 후기에는 희망의 고취가 중시되었다. 4) 본 모델은 여러 분야의 치료자들과 다양한 치료방법들을 전체적으로 통합하여 사용하는데 유용하였다. 결 론 : 본 모델은 만성정신병환자의 생활유지와 재활을 위해 우리 나라에서 효과적이면서 효율적으로 적용될 수 있을 것으로 생각된다. Objectives : The purpose of this study was to present general system, operation, and program of a day care model managed by a psychiatrist, to evaluate the results of performing this model, and thus to develop a day care model applied to Korean situation appropriately for promoting maintenance and rehabilitation of chronic psychotic patients. Methods : We performed this day care model(hereinafter called as this model) from March 1997 to February 1998. The subjects were composed of 23 psychotic patients. PANSS, Quality of Life Scale, Life Satisfaction Self-Rating Scale were used before beginning this model and after three months of performing this model. Program Helpfulness Scale, 13 Therapeutic Factors Scale were used at one months of day care and after three months of day care. Results : 1) This model helped maintenance and rehabilitation of chronic psychotic patients through reducing their symptoms and increasing quality of life. 2) This model used the various group therapy, especially creative art therapy and activity therapy, played an important role for recovering physical, psychological, and social functions. 3) Important therapeutic factors at early and late period of this model were identification with therapists, guidance of therapists, and the corrective recapitulation of the primary family group. Important therapeutic factors at early period were group cohesiveness and altruism, and at late period instillation of hope. 4) This model was useful for integrating the multidisciplinary therapeutic team and the various therapeutic methods. Conclusion : This model would be applied to day care in this country effectively and efficiently for maintenance and rehabilitation of chronic psychotic patients.

입원 및 외래 알코올중독 환자의 병식 차이에 대한 연구

성상경(Sang-Kyung Sung),이학구(Hak-Koo Lee),김한오(Han-O Kim),이규항(Kyu-Hang Lee) 한국중독정신의학회 2003 중독정신의학 Vol.7 No.1

Objectives:The goals of this study were to estimate level of insight in alcoholic patients and provide the fundamental data for which can be used for development of effective treatment programs. With this purpose, we compared insight status between inpatient alcoholics and outpatient alcoholics. Methods:The subjects participated in this study were 65 inpatient alcoholic patients who were admitted to alcohol/drug abuse treatment center in Kyungido between February and June, 2001 and 38 outpatient alcoholics who were undergone outpatient alcohol treatment program after discharge. We investigated demographic data, clinical characteristics, past alcoholic history by questionary survey and measured insight status by NAST (National Alcoholism Screening Test) and HAIS (Hanil Alcohol Insight Scale). Results:The outpatient alcoholic patients showed statistically significant higher NAST numbers, NAST scores and mean HAIS scores than inpatient alcoholics. In addition, outpatient alcoholics were statistically significant higher frequency of past admission, and more recognized addiction and necessary of treatment than inpatient alcoholics. Conclusion: We suggest that the necessity to adjust inpatient alcohol treatment program to insight status of individual alcoholic patient more flexibly. Further studies on correlation among other variables such as the independent program’s impact on each patient, guide goals which can increase insight status through inpatient alcohol treatment program, and development of the level of insight to abstinence may be required.

이중진단환자들의 임상적 특성에 관한 비교연구(Ⅰ) - 일 병원 입원한 알코올의존 환자 및 정신질환자를 중심으로 -

성상경(Sang-Kyung Sung),신범식(Bum-Shik Shin):강지언(Gi-Eun Kang):이규항(Kyu-Hang Lee) 한국중독정신의학회 2000 중독정신의학 Vol.4 No.1

Objectives:This study was carried out to compare the clinical characteristics between Primary Psychiatric disorder and Secondary Alcohol dependence (hereinafter PPSA) group and Primary Alcohol dependence and Secondary Psychiatric disorder (hereinafter PASP) group. So authors aimed to establish the therapeutic plan and method of approach for dual diagnosed patients through understanding the differences of the clinical characteristics between two groups. Methods:The subject consist of 128 male and female inpatients who met dual diagnosis of alcoholism and other mental disorders consecutively admitted to this mental hospital from February 1, 1999 to June 30, 1999. The questionnaires which include sociodemographic data, past alcohol history, family loading etc. Also the subjects were screened by NAST (National Alcoholism Screen Test) and CAGE scales. A dual diagnosis were made by charge doctors and chart review including past alcohol history. Results:1) There were no differences in demographic characteristics between two groups but over the half of them were lower socioeconomic status. 2) PPSA group had a preference for low degree alcoholic beverage, less recognized their addiction severity ,more frequently violent behavior and involuntary admission than PASP group (p<0.001). 3) PPSA group were mainly consisted with schizophrenia (39.1%), mood disorder (21.7%) and major depressive disorder (17.4%) but PASP group were mainly occupied with major depressive disorder (40.7%), personality disorders (30.5%) and anxiety disorder (6.8%). Conclusion:There were many clinical differences between PPSA group and PASP group of recognition of addiction severity, violent behavior, mode of admission and history of suicide. Two groups were dual diagnosed alcoholics and mentally ill patients but PPSA group which have primary psychiatric disorder were more treatment resisted and complicated “highly risk” group than PASP group which have primary alcohol dependence. There-fore, it is required that therapists consider more intensive evaluation and treatment approach according to their function in dual diagnosed psychiatric patie

3차원 FEM을 통한 급전도로 구조해석 및 공용성 평가

성상경(Sung, Sang Kyoung),박창우(Park, Chang Woo),한승우(Han, Seung Woo),박성기(Park, Sung Ki) 한국콘크리트학회 2012 한국콘크리트학회 학술대회 논문집 Vol.2012 No.11