지역사회 거주노인에서 주관적인 성공적 노화의 예측인자

백혜원(Hye-Won Baek),신일선(Ll-Seon Shin),신희영(Hee-Young Shin),김재민(Jae-Min Kim),김성완(Seong-Wan Kim),윤진상(Jin-Sang Yoon) 대한생물치료정신의학회 2013 생물치료정신의학 Vol.19 No.2

Objectives:This study was aimed to investigate factors affecting successful aging in community-dwelling elderly Korean population. Also, the purpose of this study is to compare factors in living alone elderly and living with others. Methods:This study is a community-based, cross-sectional study that included 434 elderly subjects aged 60 years and more. Subjects completed the questionnaire including sociodemographic characteristics, health behavior, and chronic medical illness. Korean MMSE in the Korean version of the CERAD assessment packet(MMSE-KC), and Short Form of Geriatric Depression Scale(SGDS) were also evaluated. Participants were asked to rate their own degree of successful aging on a scale from 1 to 10(1=least successful, 10=most successful). Results:The mean score for self-rated successful aging was 5.91 in overall sample. In living alone group, mean score was 5.61, whereas 6.04 in living with others group. Subjective ratings of successful aging were significantly correlated with sex, marital status, education, rheumatism/arthritis, MMSE-KC score, and SGDS score in all participants. Education, SGDS score were found to predict subjective successful aging in overall participant(β=0.137, p=0.003 ; β= -0.422, p<0.001). While MMSE-KC score and SGDS score were significant predictors(β=0.212, p=0.020 ; β=-0.302, p=0.001) in living alone group, SGDS score was a significant predictor of subjective successful aging in living with others group(β=-0.503, p<0.001). Conclusion:Depression and education were important predictors of successful aging in all participants, and depression was a common predictor in living alone group and living with others group. Appropriate psychiatric management of depression in elderly is needed to enhance successful aging.

인지기능장애가 있는 지역사회 거주노인에서 삶의 질의 관련인자

김남준(Nam-Jun Kim),신일선(ll-Seon Shin),신희영(Hee-Young Shin),김재민(Jae-Min Kim),김성완(Seong-Wan Kim),윤진상(Jin-Sang Yoon) 대한생물치료정신의학회 2017 생물치료정신의학 Vol.23 No.3

Objectives:This study aimed to investigate the factors affecting the quality of life(QOL) of community-dwelling elderly with cognitive impairment Methods:This was a community-based, cross-sectional study that included 490 elderly subjects aged ≥60 years. Subjects completed a questionnaire that encompassed sociodemographic characteristics, health behavior, and chronic medical illness. Korean MMSE in the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease(CERAD) assessment packet(MMSE-KC), the Korean version of Quality of Life-Alzheimer’s Disease(KQOL-AD) and the Short Form of Geriatric Depression Scale(SGDS) were also evaluated. Cognitive impairment was defined as having a test scores 1.5 SD below MMSE-KC norms adjusted for age, gender, and education. A stepwise multiple linear regression analysis was performed to determine factors associated with QOL. Results:The participants were allocated into cognitive impairment group(mean age=73.07, N=127) and no cognitive impairment group(mean age=72.51, N=363). The mean score for self-rated KQOL-AD was 26.45 in the former and 28.62 in the latter. The SGDS score(β=−0.741, p<0.001) was significantly associated with QOL in the former. SGDS score(β=−0.711, p<0.001), education(β=0.136, p<0.001), and living conditions(β=0.117, p=0.001) were factors significantly associated with QOL in the latter. Conclusion:Self-rated symptoms of depression were significantly associated with QOL in both groups of community- dwelling elderly. Thus, appropriate psychiatric management of depression in elderly is needed to enhance QOL.

경도인지장애와 알츠하이머병에서 삶의 질

김석헌(Seok-Heon Kim),김선영(Seon-Young Kim),배경렬(Kyung-Yeol Bae),김성완(Seong-Wan Kim),김재민(Jae-Min Kim),신일선(ll-Seon Shin),윤진상(Jin-Sang Yoon) 대한생물치료정신의학회 2012 생물치료정신의학 Vol.18 No.2

Background and Aims:Relatively few studies have explored the quality of life(QOL) in mild cognitive impairment (MCI) and Alzheimer’s disease(AD). This study aimed to compare the QOL in MCI with that in AD. Methods:24 normal controls, 29 mild MCI patients, 20 AD patients, and their caregivers participated. QOL was assessed using the Korean version of QOL-AD(KQOL-AD). Korean version-Mini Mental State Examination(K-MMSE), Activities of Daily Living(ADL), Clinical Dementia Rating(CDR), and Neuropsychiatric Inventory(NPI) were also used to assess the participants. Results:Both patient and caregiver-reported QOL scores of AD group were lower than those of MCI and control groups. However, there were no significant differences among the three groups in QOL(p=0.069, p=0.058). Patientreported QOL scores of all participants showed were significant negative correlations with ADL scores and NPI scores, but not with K-MMSE scores(r=-0.316, p=0.009 ; r=-0.349, p=0.010 ; and r=0.094, p=0.430). Caregiverreported QOL scores of all participants showed significant negative correlations with ADL scores and NPI scores, but not with K-MMSE scores(r=-0.369, p=0.015 ; r=-0.413, p=0.007 ; and r=0.147, p=0.341). Conclusion:Both patient-reported and caregiver-reported QOL scores of AD patients were not significantly different from those of MCI patients and normal controls. NPI and ADL scores were negatively associated with QOL, while K-MMSE scores were not. Thus, therapeutic strategies for behavioral and psychological symptoms of MCI and AD will be need to improve patient QOL.

폐쇄성 수면무호흡증 환자에서 하지불안증후군과 우울, 불안 및 불면과의 연관성

김주완(Ju-Wan Kim),김성완(Sung-Wan Kim),김재민(Jae-Min Kim),신일선(ll-Seon Shin),윤진상(Jin-Sang Yoon),배경렬(Kyung-Yeol Bae) 대한생물치료정신의학회 2016 생물치료정신의학 Vol.22 No.3

Objectives:An association between obstructive sleep apnea syndrome(OSAS) and restless legs syndrome(RLS) has long been reported. Both syndromes are associated with depression, anxiety, insomnia, and daytime sleepiness. However, these relationships have not been studied extensively, and many questions remain unanswered. This study investigated the prevalence of RLS and its association with depression, anxiety, insomnia, and daytime sleepiness in OSAS patients in Korea. Methods:The study enrolled 152 Korean OSAS in patients Chonnam National University Hospital. The International Restless Legs Syndrome Study Group criteria and International Restless Legs Scale were used to determine the diagnosis and severity of RLS. To assess depression, anxiety, insomnia, and day time sleepiness, all patients completed the Beck Depression Inventory(BDI), Beck Anxiety Inventory(BAI), Insomnia Severity Index(ISI), and Epworth Sleepiness Scale(ESS). Results:Overall, 65(42.6%) patients met least one of the RLS diagnostic criteria, and 17(11.1%) were diagnosed with RLS. The mean BDI, BAI, and ISI scores were higher in subjects with RLS symptoms compared with those without such symptoms. ESS scores were not significantly associated with RLS symptoms. There were significant positive correlations between RLS severity and BDI(r=0.246, p=0.049), BAI(r=0.247, p=0.031), and ISI(r=0.275, p=0.026) scores. Conclusion:There were significant relationships between RLS symptoms and depression, anxiety, and insomnia. We recommend that patients with OSAS be evaluated for symptoms of RLS.

불면증 환자에서 수면시간에 대한 주관적 지각과 객관적 소견의 불일치

김하현(Ha-Hyun Kim),배경렬(Kyung-Yeol Bae),김성완(Sung-Wan Kim),김재민(Jae-Min Kim),신일선(ll-Seon Shin),김선영(Seon-Young Kim),윤진상(Jin-Sang Yoon) 대한생물치료정신의학회 2012 생물치료정신의학 Vol.18 No.2

Objectives:Polysomnography in insomnia patients has often revealed a mismatch between the subjective perception and the objective findings of sleep time. We aimed to examine this mismatch and investigate the characteristics associated with the mismatch in insomnia patients. Methods:In 121 insomnia patients, findings of nocturnal polysomnography, responses to a subjective questionnaire after sleep, and medical records were reviewed. The patients were classified into two groups-total sleep time (TST) underestimation group(N=56) and TST non-underestimation group(N=65)-depending on the presence of a 2-h difference between the subjective and the objective TSTs. The demographic characteristics, type of insomnia, use of sleep-promoting medication, polysomnography findings, and subjective reports were compared between the two groups. Results:Nocturnal polysomnography showed significantly longer TST(p<0.001) and shorter sleep latency(p< 0.001) than the subjectively reported values. In comparison with the TST non-underestimation group, the TST underestimation group were significantly older(p=0.043) ; more likely to have longer TST(p=0.012), shorter sleep latency (p=0.002), and a smaller proportion of slow-wave sleep(p<0.001) in the polysomnographic analysis ; and more likely to show shorter TST(p<0.001) and shallower sleep(p<0.001) in the subjectively reported values. Conclusions:We found a significant mismatch between the subjective perception and the objective findings of sleep time as determined using polysomnography in insomnia patients. Underestimation of sleep time may be more closely associated with the proportion of slow-wave sleep, which reflects sleep depth, than with objective TST.

지역사회 정신보건 서비스에 정신건강의학과 전문의의 역할 : 광주광역시 마음건강주치의 사업 분석

전민(Min Jhon),왕수연(Soo-Yeon Wang),김선영(Sun-Young Kim),이주연(Ju-Yeon Lee),김재민(Jae-Min Kim),신일선(ll-Seon Shin),김성완(Sung-Wan Kim) 대한신경정신의학회 2021 신경정신의학 Vol.60 No.1

Objectives The treatment rate for mental illness is low in Korea (22%) compared to Western countries (40-50%). Thus, Gwangju city commenced a mental health project termed “Mind Doctor” in 2016. Psychiatrists regularly visit mental health centers to provide services, including counseling. This paper summarizes the achievements and significance of the project. Methods The project has been in progress for four years. This study evaluated 7,483 clients assisted by 322 center staff and 55 participating psychiatrists. The characteristics of the mental health center and addiction management center clients were identified. The center staff opinions and satisfaction were analyzed. Results Psychiatrists placed in community mental health services played a variety of roles as counselors, supervisors, lecturers, and program organizers. During the time since the project commenced, referral rates to mental health clinics after in-center counseling increased from 9.4% to 41.6%. Half of the psychiatrists worked in psychiatric hospitals (45.5%), and were in their 30s (43.6%). Of those seen by psychiatrists in mental health centers, 42% were aged under 30 years, and almost half were male (46%). Most clients were satisfied with their consultations (90%) and were willing to recommend the project to others (88%). More than 85% of center staff responded positively to the project, particularly in 2019. Conclusion “Mind Doctor” readily identified the mental problems of community residents and provided smooth referrals to mental health clinics. Collaboration between the psychiatrists and mental health workers in mental health centers contributed to mental health promotion and early intervention to treat mental problems.