정신분열증의 기억장애

전덕인,Jon, Duk-In 대한수면의학회 1997 수면·정신생리 Vol.4 No.1

Memory disorder is the most consistent neuropsychological finding in schizophrenia and seems to be a stable trait in it. It is suggested that memory dysfunction found in patients with schizophrenia is primary to biological abnormalities, not secondary to attention deficits they have. Although temporal lobe structures including hippocampus and thalamus have traditionally been thought to be implicated regions for memory disorder in schizophrenia, recent studies indicate the possibility of abnormalities in the frontal lobe and the neural circuits between brain regions. Advanced research methods such as functional imaging technique are expected to produce more detailed informations about memory function in schizophrenia.

국산화 EEG 및 EP Mapping System(Neuronics)의 임상적 타당성 연구

민성길,전덕인,이성훈,안창범,유선국,Min, Sung-Kil,Jon, Duk-In,Lee, Sung-Hoon,Ahn, Chang-Beom,Yoo, Sun-Kook 대한수면의학회 1997 수면·정신생리 Vol.4 No.1

The clinical validity of a korean EEG and EP mapping system(Neuronics) was evaluated with schizophrenic patients(n=20), normal controls(n=19), and 10 patients with central nervous system disease(8 patients with cerebrovascular accident, 1 patient with brain mass, and 1 patient with periodic paralysis). In the normal control group, the pattern of resting computerized EEG with eyes closed showed normal parieto-occipital dominance of alpha wave. Compared with normal controls, schizophrenic patients had more delta activity in the frontal region, and less alpha activity especially in the parieto-occipital region. In most cases patients with cortical organic lesions(n=5) revealed increased delta and theta activity and decreased alpha activity on the lesion areas. These findings were compatible with their MRI and clinical findings. However in the cases of subcortical lesions(n=5) EEG showed various findings which suggest diverse influences of subcortical abnormalities on cortical activities. The P300 of schizophrenic group was smaller and more delayed than those of normal controls. These results are generally compatible with the previous studies using other EEG and EP mapping systems consequenty and suggest that the this EEG and EP mapping system(Neuronics) has clinical validity.

인터넷 중독 예방 프로그램의 효과

박민수(Minn Suh Park),전덕인(Duk-In Jon),홍현주(Hyun Ju Hong),정명훈(Myung Hun Jung),홍나래(Narei Hong) 대한사회정신의학회 2017 사회정신의학 Vol.22 No.2

연구목적 : 인터넷이 보급되면서 인터넷 중독의 피해가 확산되고 있고, 청소년기는 중독에 대해 취약한 시기이기에 인터넷 중독에 대한 예방 책이 중요하다. 본 연구는 기존 인터넷 중독 예방 프로그램의 효과를 초등학교 고학년 학생 집단을 대상으로 중독 증상의 정도와 양상의 변화를 통해 확인하고자 했다. 방 법 : 경기도 1개 시의 5개 초등학교에 소속된 4, 5학년 초등학생 대상으로 인터넷 중독 예방 프로그램을 시행하였다. 이중 프로그램 시행 전, 직후 2번에 걸쳐 청소년 인터넷중독 자가진단 척도(KS-II)을 작성한 556명을 대상으로 분석을 시행하였다. 일반 사용자군, 위험 사용자군으로 나눠 일상생활 장애, 가상적 대인관계 지향성, 금단, 내성의 척도 내 4가지 영역에 대해 독립표본 T검정과 반복측정 분산분석을 시행하였다. 결 과 : 프로그램 시행 후 일반 사용자군과 위험 사용자군 모두 일상생활 장애, 가상적 대인관계 지향성, 금단, 내성 등 전 영역에 걸쳐 통계적으로 유의하게 점수가 감소하였다. 일상생활 장애, 금단, 총점의 경우, 두 군 사이의 상호작용 효과가 나타나 일반 사용자군에 비해 위험 사용자군에서 점수가 더 감소하였다. 결 론 : 인터넷 중독 예방 프로그램이 인터넷 중독 위험 사용자군과 일반 사용자군에서 인터넷 중독에 대한 인식 정도를 변화시키는 것을 통해 중독 증상의 정도와 양상에 영향을 준다는 것을 청소년 인터넷 중독 자가진단 척도의 변화로써 확인할 수 있었다. 또한 그중에서도 일상생활 장애, 금단 및 총점의 경우, 위험 사용자군에서 특이적으로 점수를 더욱 감소시킨다는 것을 알 수 있었다. Objectives : While Internet is being spread, the problems of internet addiction is also increasing in the world. Because adolescent is fragile to addiction, internet addiction prevention is important. This study tries to check the effect of the established internet addiction prevention program for elementary school students with change of addiction-related symptoms. Methods : The internet addiction prevention program was run for 4th and 5th grade students of 5 elementary schools in 1 city of Gyeonggi-Do, Korea. 556 participants completed Internet Addiction Scale for Adolescent (KS-II) before and after the 3-session program. We divided the participants into 2 groups, normal user group and risky user group, and conducted independent T test and repetitive ANOVA over 4 domains, disturbance in daily life, cyber world oriented, withdrawal symptom, and tolerance. Results : Over all domains, each score was statistically lowered in both normal user group and risky user group after the program. Due to interaction effect, score of disturbance in daily life, withdrawal symptom, and total score was decreased more in risky user group than in normal user group. Conclusion : This study showed that the internet addiction prevention program which would change the level of knowledge about internet addiction in normal user group and risky user group could affect severity and aspects of addiction symptom with change of score of self-report scale. Also, especially in disturbance in daily life, withdrawal symptom, and total score, decrease of the score decreased more than other domain.

회복탄력성이 직장인의 주관적 스트레스에 미치는 영향

전가혜(Ka Hye Chun),전덕인(Duk-In Jon),홍현주(Hyun Ju Hong),정명훈(Myung Hun Jung),홍나래(Narei Hong) 대한사회정신의학회 2016 사회정신의학 Vol.21 No.2

연구목적 : 직장인의 스트레스는 개인적 차원에서 삶의 질을 떨어뜨릴 뿐만 아니라 사회경제적 부담의 증가를 초래한다. 본 연구에서는 지역 사회 직장인을 대상으로 주관적 스트레스 및 우울증의 유병률을 조사하고, 회복탄력성이 주관적 스트레스에 미치는 영향에 대해 확인하고자 한다. 방 법 : 일개 시에 위치한 사업장에서 근무 중인 직장인 462명을 대상으로 설문을 시행하였다. 연구 대상자들은 사회인구학적 요인에 대한 자기보고식 설문지에 응답하였다. 또한 PWI-SF(Psychosocial Well-being Index-short form), 한국어판 CES-D(The Center for Epidemiologic Studies Depression Scale), 회복탄력성 척도를 사용하여 중증 스트레스 및 우울증의 유병률과 관련 요인을 조사하 였다. 유의미한 중증 스트레스와 우울증은 PWI-SF 27점, CES-D 21점을 각각 절단점으로 하였다. 결 과 : 연구 대상자들의 17.1%가 중증 스트레스를 겪고 있는 것으로 밝혀졌다. 중증 스트레스에 관하여 성별(p=0.004) 및 회복탄력성 (p<0.001)에 따른 차이는 통계적으로 유의하였으나 연령, 결혼상태, 교육수준, 근속연수에 따른 차이는 통계적으로 유의하지 않았다. 특히, 회복탄력성이 낮을 경우 중증 스트레스를 겪을 위험도가 4.78배인 것으로 밝혀졌다. 또한 유의미한 우울증의 유병률은 14.9%였다. 결 론 : 본 연구를 통해 지역사회 직장인의 중증 스트레스의 규모와 우울증의 유병률을 알아 볼 수 있었다. 또한 회복탄력성이 주관적 스트레스에 대해 잠재적 보호요인의 역할을 할 수 있음을 확인하였다. 이 연구를 통해 지역사회 경쟁력 강화를 위하여 직장인의 스트레스 관리가 중요하며, 이를 위하여 회복탄력성의 향상을 포함한 다양한 정신건강서비스의 제공이 필요함을 제안할 수 있다. Objectives : Stresses of employees not only reduce the quality of life but also increase socioeconomic burden. The purpose of this study was to estimate the prevalence of severe stress and depression in community employees and to confirm the effect of resilience on subjective stress. Methods : Four hundred and sixty two community employees at one city were recruited for this study. The sociodemographic data were collected through self reports. We used PWI-SF (Psychosocial Well-being Index-short form), Korean version of CES-D(The Center for Epidemiologic Studies Depression Scale), and the scale of resilience to investigate the prevalence and correlation of severe stress and depression. Cutoff of clinically significant severe stress and depression was PWI-SF≥27 and CES-D≥21, respectively. Results : Seventeen point one percent of subjects suffered with severe stress. Although the prevalence of severe stress was not different by age, marital status, educational level and service year, it was different by gender (p=0.004) and resilience (p<0.001). Employees who have low resilience experience severe stress 4.78 times more than other employees. The prevalence of depression was 14.9%. Conclusion : This study revealed the prevalence of severe stress and depression in community employees and confirmed the role of resilience as a potential protective factor against subjective stress. The results suggest that to enhance the competitiveness of community, it is important to manage the stresses of employees and require variable mental health services including enhancement of resilience.

수면 무호흡과 수면이 기억기능에 미치는 영향

이성훈,이나영,박윤조,전덕인,Lee, Sung-Hoon,Lee, Na-Young,Park, Yun-Jo,Jon, Duk-In 대한수면의학회 1998 수면·정신생리 Vol.5 No.2

Objectives : Disturbance of sleep with or without sleep apnea may impair the memory function. Sleep deficiency, sleepiness, sleep apnea and emotional problem in sleep disorders can induce an impairment of memory function. Methods : In this study, the polysomnographies were administered to 58 sleep apnea patients and 38 sleep disorder patients without sleep apnea. Their clinical symptoms were quantitatively evaluated. Short term and long term memory were evaluated before and after polysom no graphy with Digit symbol test and Rey-Osterrieth complex figure test. And correlations among various sleep, repiratory and clinical variables were statistically studied in order to explore which variables may influence on memory function. Results and Conclusions : Results are as follows. Depth of sleep cis positively correlated with memory function. As sleep apnea increases and average saturation of blood oxygen decreases, memory function is more impaired. Emotional depression, high blood pressure, obesity or alcohol impaired memory function. However, daytime sleepiness was not significantly correlated with memory function. The possible mechanisms how above factors influence on the memory function were discussed.

지역사회 거주 노인들의 우울증상 분포

하운식(Unshik Ha),전덕인(Duk-In Jon),홍현주(Hyun Ju Hong),정명훈(Myung Hun Jung),김미경(Mi Gyeong Kim),홍나래(Narei Hong) 대한노인정신의학회 2015 노인정신의학 Vol.19 No.2

Objective:This study was to understand the characteristics of depressive symptoms among the community-dwelling elderly. Methods:Through a community mental health mass screening program in senior society, 197 elderly were evaluated for de-pressive symptoms with Korean version of Short form Geriatric Depression Scale (SGDS-K). The subjects were grouped into nor-mal or caution groups with a cut-off score of 6. The response rate and odds ratio were calculated and compared within each ques-tion. Results:Although they had low total score, many subjects in normal group have the symptoms of the question 2, 13, 5, 10, 7, 4 (in order). Question 12, 6, 8, 4, 14, 3 (in order) showed higher odds ratio in caution group than normal group. Questions be-longed to a factor ‘general depressive mood’ scored much higher odds ratio than the other. Conclusion:Even the elderly with low score in SGDS-K might complain of symptoms such as decreased level of energy, ac-tivities, interests, and memory. However the subjects with high score tend to report feeling more worthless, afraid, helpless, bored, hopeless, and empty. It can be helpful to know the distribution of depressive symptoms for providing careful mental health ser-vice to the elderly dwelling in the communities.

정신건강복지센터에 등록된 정신질환자의 자살 태도에 관한 연구

김원우(Won-Woo Kim),전덕인(Duk-In Jon),홍현주(Hyun Ju Hong),정명훈(Myung Hun Jung),홍나래(Narei Hong) 대한사회정신의학회 2022 사회정신의학 Vol.27 No.2

연구 목적 : 우리나라의 높은 자살률은 지속적으로 사회적 부담으로 작용하고 있다. 자살 태도란 개인이 자살에 대하여 가지는 일관된 견해를 말하며, 이는 교육을 통해 변화하여 자살 예방을 위한 긍정적인 행동을 하도록 하는 데 효과적일 수 있다고 밝혀진 바 있다. 정신 건강복지센터에서는 다양한 사업들을 통하여 자살 고위험군을 관리해오고 있으나, 아직까지 정신건강복지센터에 등록된 정신질환 자들을 대상으로 한 자살 태도 연구는 부족한 실정이다. 따라서 본 연구에서는 일개 시 정신건강복지센터에서 사례관리 중인 정신 질환자들의 자살에 대한 태도 및 인식을 조사하여 자살 예방을 위한 기초자료로 활용하고자 하였다. 방 법 : 일개 시 정신건강복지센터에서 정신건강서비스를 제공받는 만 19세 이상의 성인 200명을 대상으로 설문조사를 진행하였다. 설문 내용은 사회인구학적 및 임상적 특성, 자살에 대한 태도와 인식, 자살을 주제로 한 대중매체에 대한 태도 등으로 이루어졌다. 결 과 : 본 연구 대상자들 중 다수가 자살에 대해서 허용적인 태도를 보였고 자살에 대한 사회책임인식도 낮았다. 60세 이상의 집단에서는 젊은 연령에 비해 자살에 대하여 금기시(p<0.001)하고 비윤리적으로 바라보았고(p<0.001), 기혼 혹은 동거 중인 집단에서도 기타 결혼상태의 집단에 비해 자살에 대해 금기시(p=0.005) 하고 비윤리적(p=0.015)이라고 생각하는 태도를 보였다. 신경증을 진단받은 집단에서는 정신증을 진단받은 집단에 비해 자살에 대해 수용적 태도를 보이면서(p<0.001) 비윤리적으로 보는 시선은 적었고(p= 0.035), 자살예방센터를 이용 중인 집단은 그렇지 않은 집단에 비해 자살에 대해 수용적인 태도를 보였으며(p=0.001), 비윤리적이라고 생각하는 시선은 적었다(p=0.029). 결 론 : 본 연구에서 조사한 지역사회의 정신질환자들은 인구사회학적 및 임상적 변인에 따라서 자살 태도의 유의미한 차이를 보였다. 이러한 점들을 바탕으로 하여 본 연구의 결과는 지역사회 정신건강서비스의 효율적인 운영 및 정책 반영을 위한 기초 자료로 활용될수 있을 것으로 사료된다. Objectives : The high suicide rate in Korea is a continuous social burden, and it is therefore necessary to establish an effective suicide prevention policy. Attitude toward suicide can be defined as a consistent view of suicide held by an individual, and it has been reported that changing attitude towards suicide through education can be effective in encouraging positive behaviors regarding suicide prevention. Although mental health welfare centers in Korea have been managing the suicide high-risk group through various programs, there remains a lack of studies on attitudes toward suicide of patients with psychiatric disorders registered in mental health centers. In this study, we investigated the attitudes and perceptions toward suicide of patients registered at one mental health welfare center. Methods : Two hundred adults aged 19 years or over who registered and received mental health services from one mental health welfare center in an urban area were assessed using self-report questionnaires. The questionnaires consisted of sociodemographic and clinical characteristics, attitudes toward and perceptions of suicide, and attitudes toward mass media on suicide-related topics. Results : Many participants in this study showed a permissive attitude toward suicide, and their perception of social responsibility regarding suicide was low. The 60 years and older group viewed suicide as taboo (p<0.001) and unethical (p<0.001) more than younger groups, and the married or living together group also considered suicide taboo (p=0.005) and unethical (p=0.015) more than other groups. Compared to the group diagnosed with psychosis, the group diagnosed with neurosis showed a more accepting attitude toward suicide (p<0.001) and viewed suicide as less unethical (p=0.035). Similarly, the group receiving services from the suicide prevention center showed a more accepting attitude toward suicide (p=0.001) and viewed suicide as less unethical (p=0.029) than other groups. Conclusion : Patients with psychiatric disorders in the community surveyed in this study showed a permissive attitude toward suicide, and had a lack of awareness of social responsibility regarding suicide. The results of this study can be used as basic data for further studies exploring efficient policies for community mental health services.

하지 골절 노인환자의 수술 후 섬망 위험성 평가

한정엽(Jung Yeop Han),전덕인(Duk In Jon),홍현주(Hyun Ju Hong),정명훈(Myung Hun Jung),유제현(Je Hyun Yoo),박재용(Jae Yong Park),류상현(Sang Hyun Rhyu),홍나래(Na rei Hong) 대한노인정신의학회 2018 노인정신의학 Vol.22 No.2

Objective:Delirium is very common in orthopedic elderly patients and increase comorbidity and mortality rates. By controling the risk factors of delirium, prevention strategy can be effective and reduce negative outcomes. The purpose of this study was to explore the usefulness of delirium risk assessment with some simple collateral questionaires. Methods:The subjects were 50 elderly patients (≥65 years old) who admitted to a department of orthopedic surgery for operations of lower extremity fractures. They were evaluated with Diagnostic and Statistical Manual of Mental Disorders, fifth edition, Confusion Assessment Method and Korean Dementia Screening Questionnaire (KDSQ) by psychiatrists. The demographic data, medical histories, and orthopedic chart were checked through medical records of patients. Results:27 subjects (54.0%) were diagnosed as delirium. There was a significant difference between delirium group and control group with all KDSQ scores. Depressive category of KDSQ score had the highest correlation (coefficient=0.399) and can be independent risk factor of delirium (p=0.045). Conclusion:Cognitive impairment and depressive symptoms have high correlation with delirium. We found that just a few questions of cognitive impairment and depressive symptoms by caregivers

항정신병 약물 사용 및 치매의 심리행동 증상과 알츠하이머 환자의 인지능력 저하와의 연관성

장준호(June Ho Chang),전덕인(Duk In Jon),홍현주(Hyun Ju Hong),정명훈(Myung Hun Jung),홍나래(Narei Hong) 대한노인정신의학회 2021 노인정신의학 Vol.25 No.2

Objective: Neuropsychiatric symptoms are common among patients with major neurocognitive disorder. Antipsychotic medications have been widely used to manage behavioral and psychological symptoms of dementia (BPSD), however efficacy and safety of these agents are conflicting. In this study, we tried to overview the association of antipsychotic medication use and neuropsychiatric symptoms with cognitive decline in patients with Alzheimer’s disease. Methods: We reviewed the medical charts of patients who were diagnosed as major neurocognitive disorder due to Alzheimer’s disease from November 2014 to October 2015. We reviewed whether the subjects had used antipsychotics, and whether patients had neuropsychiatric symptoms. We used linear mixed models to examine the statistical difference between each group. Results: Total of 106 subjects were included in the study. There was no statistically significant difference in cognitive function decline (Korean Version of Mini-Mental State Examination score change) between subjects with or without BPSD (p=0.62), and between subjects with or without antipsychotic medication (p=0.09). Conclusion: There was no evidence that antipsychotic medication and BPSD are associated with more cognitive decline. Findings imply that neuropsychiatric symptoms and cognitive impairment come from different etiologic causes, which highlights the heterogeneity of the disorder. Clinician should decide whether to use antipsychotic medication while carefully considering the effect and side effects of antipsychotic medication throughout the treatment period.

회복탄력성 및 우울 증상 개선을 위한 단기 커뮤니케이션 능력 증진 프로그램 개발

김가경(Ka Kyung Kim),전덕인(Duk –In Jon),홍현주(Hyun Ju Hong),정명훈(Myung Hun Jung),김현(Hyun Kim),김미경(Mi Gyeong Kim),홍나래(Narei Hong) 대한사회정신의학회 2015 사회정신의학 Vol.20 No.2

연구목적 : 회복탄력성은 스트레스를 잘 대처하고 회복하여 원래 상태로 돌아오는 능력으로 급변하는 현대사회에서 특히 그 중요성이 강조 되면서 회복탄력성을 키우기 위한 다양한 프로그램들이 개발되고 있다. 본 연구에서는 회복탄력성의 하위개념 중 꾸준한 훈련으로 변화할 가능성이 큰 커뮤니케이션 능력에 초점을 맞추어 그것을 증진시킬 수 있는 2회기 단기 프로그램을 개발하였고 그 효과를 입증하고자 하였다. 방 법 : 정신건강증진센터를 통해 이 프로그램을 홍보하여 자발적 동의 하에 모집된 43명의 성인을 대상으로 프로그램을 시행하였다. 프로그램의 시행 전, 시행 직후, 4주 후 총 3번에 걸쳐 회복탄력성, 우울, 자살사고를 평가하였다. 시간이 흐르면서 각각의 척도들이 점진적인 호전을 보이는지 살펴 보기 위해 반복측정 공분산분석을 이용하여 마지막까지 프로그램과 평가를 모두 완료한 33명의 데이 터를 분석하였다. 결 과 : 프로그램 시행 직후 우울과 자살사고가 프로그램 시행 전에 비해 호전 된 결과를 보였다. 또한 회복탄력성 총점과 그 소척도 중감정조절력, 충동통제력, 커뮤니케이션 능력, 공감능력은 시행 전에 비해 4주 후에서 통계적으로 의미 있는 호전을 보였다. 결 론 : 프로그램 시행 후 회복탄력성의 하위개념 중 특히 감정조절력, 충동통제력, 커뮤니케이션 능력, 공감능력의 변화가 두드러졌는데 소통의 양과 질이 개선됨에 따라 대인관계능력뿐만 아니라 자기조절능력도 함께 향상되었음을 의미한다. 이는 또한 기분개선에 영향을 주어 우울 및 자살사고가 호전되는 것을 함께 확인할 수 있었다. Objectives : The resilience that is ability to cope with stress and to turn back to the original state is important in a rapidly changing modern society, so many programs for improving the resilience are created. Communication skill is easier to change than other subgroups of resilience, so we had been developed the short-term program focused to communication competence. Methods : 43 healthy subjects participated in this study, through community mental health center’s promotion. We had conducted the 2-session program and there was a week interval between the sessions. We evaluated them with self-reporting scales of depression, suicide idea, and resilience. The subjects were evaluated 3 times, before starting the program, immediately after the program is completed, and 4 weeks later. Repeated measure ANOVA was performed for statistical analysis of 33 subjects who completed all evaluation. Results : There was a significant effect of the program in depression, suicide idea and the resilience. Also, emotion regulation, impulse regulation, communication skills, and empathy among the resilience subgroups were gradually improved after the program. Conclusion : Among the 9 resilience subgroups, emotion regulation, impulse regulation, communication skills, and empathy are improved through the program. In other words, the program has an effect on the self-control ability as well as the interpersonal skills and then it affects the improvement of mood. So we can try to run this communication competence promoting program in the general population or the depression for improving resilience and depression.