자살시도 환자의 혈소판내 세로토닌 농도와 심리학적 특성에 관한 연구

정희연,권영준,박인준,홍세용,최의정,진혁희,Jeong, Hee Yeon,Kwon, Young Joon,Park, In Joon,Hong, Se Yong,Choi, Eui Jung,Jin, Hyuk-Hee 대한생물정신의학회 1999 생물정신의학 Vol.6 No.1

자살 시도군 21명, 우울증 환자군 14명, 그리고 정상 대조군 10명을 대상으로 혈소판내 세로토닌의 농도, 반 구조화된 설문조사, 다면적 인성검사, HAM-D, 충동성 검사를 시행하여 비교한 결과는 다음과 같았으며, 자살 시도군의 자살방법은 대부분 농약 중독이었다. 1) 자살 시도자의 남녀 비는 차이가 없었다. 2) 혈소판내의 세로토닌의 농도는 자살 시도군, 우울증 환자군 및 정상 대조군간에 차이가 없었다. 3) 다면적 인성검사 결과는 자살 시도군의 경우 D, Hs, Pt 척도가 높았으며, 우울증 환자군의 경우 D, Pa, Si 척도가 높았다. 4) HAM-D 점수는 우울증 환자군과 자살 시도군 모두에서 높았으며, 특히 우울증 환자군의 경우 더 의미 있게 높았다. 5) 충동성 검사 결과는 자살 시도군이 우울증 환자군에 비하여 무계획 충동성, 운동 충동성이 의미 있게 높았다. Objectives : Significant progress has been made in understanding psychosocial, psychological, and environmental factors associated with suicide. However it is only recently that attention has been paid to the understanding of the neurobiology of suicide. The aim of this study was to examine the relationship between platelet serotonin level and suicidal behavior and psychological features of the suicidal attempters. Methods : After a suicidal attempt platelet serotonin level was measured from 21 patients and compared it with those from depression patients and normal controls. Also MMPI, HAM-D, Barratt impulsiveness scale(BIS) were done to evaluate their psychological features. Results : 1) There was no significant difference in sex ratio of the suicidal attempters. 2) There was no significant difference in platelet serotonin levels among three groups. 3) The analysis of MMPI revealed that the scores of D, Hs, Pt in clinical scales were significantly higher in suicide patients and scores of D, Pa, Si were in depression patients. 4) The HAM-D score was significantly higher in depression and suicide patients, especially in depression patients. 5) The analysis of Barratt impulsiveness scale revealed that the scores of nonplanning, motor and cognitive impulsiveness scale were significantly higher in suicide patients. Conclusions : There was no significant difference in platelet serotonin levels among three groups. However the analysis of psychological features revealed significant differences. Therefore we concluded that psychological examinations are benefit to evaluate the suicidal tendency.

주요우울증에서 Fluoxetine과 Amitriptyline의 치료효과에 대한 이중맹검법 비교연구

정희연,배재남,권준수,조두영,Jung, Hee-Yeon,Bae, Jae-Nam,Kwon, Jun-Soo,Cho, Doo-Young 한국정신신체의학회 1995 정신신체의학 Vol.3 No.1

The efficacy of fluoxetine was evaluated in 32 patients with major depression in double-blind amitriptyline-controlled clinical trials. Patients were randomly assigned to 6 weeks of treatment with 20mg/day of fluoxetine and 25-100mg/day of amitriptyline. We used the Hamilton rating scale for depression(HAM-D) and the Clinical Global Improvement(CGI) to evaluate the improvement of depression. In addition, we also used the Covi Anxiety Scale and the Anxiety/Somatization subscale of HAM-D to investigate the relieving effect of anxiety. The improvement by fluoxetine in mean total score of HAM-D and CGI was comparable to amitriptyline. Fluoxetine also reduced anxiety significantly, but there was no difference between fluoxetine and amitriptyline in relieving anxiety symptoms. Fluoxetine showed considerably less adverse effects, especially anticholinergic effect and weight gain than amitriptyline. In conclusion, 20mg/day of fluoxetine was sufficiently effective in the treatment of depressive patients and was better tolerated than amitriptyline.

정신분열병과 면역학적 이상

정희연,김용식,Jung, Hee Yeon,Kim, Yong-Sik 대한생물정신의학회 2008 생물정신의학 Vol.15 No.3

There have been vast amount studies regarding immunologic dysregulation in schizophrenia. The mechanism of immune pathogenesis in schizophrenia still is unclear, even though various immune dysfunction have been reported. We endeavored to report on two major hypothesis on immunologic dysregulation in schizophrenia, the infection hypothesis and autoimmune hypothesis. We went on to focus on the autoimmune hypothesis, which has received the most attention over the years. We explored the accumulated data and the rational behind the autoimmune hypothesis and the implications of the autoimmune hypothesis for future research in the pathogenesis of schizophrenia.

노인 자살의 신경생물학

정희연(Hee Yeon Jung) 대한노인정신의학회 2001 노인정신의학 Vol.5 No.2

Older persons are ant higher risk for suicide than any other groups of the population. Recently, it has been suggested that, in addition to the psychological and sociocultural factors, the neurobiological determinants also might play an important role in increasing the risk of suicide in late-life. For explaining such a high suicidal risk, the neurochemical changes in-volved aging, and the biologic abnormalities of the psychiatric illnesses associated with suicidal ideation and suicide itself. Although research on elderly suicide continues to grow, there rem-ains limited knowledge oh the biologic changes that increase risk for suicide in old age. In this article, the biologic changes in the central nervous system occurring with normal aging process were reviewed and then, a few findings from the neurobiological studies on elderly suicides were discussed.

눈깜박임을 주소로 내원한 아동에서의 틱 장애

정희연 ( Hee Yeon Jung ),정선주 ( Sun Ju Chung ),황정민 ( Jeong Min Hwang ) 대한안과학회 2002 대한안과학회지 Vol.43 No.2

여자 정신분열병 환자에서 혈중 에스트로겐 농도와 추체외로 증상과의 관계

정동선,정희연,권영준,박인준,한선호,정한용,Chung, Dong Seon,Jung, Hee Yeon,Kwon, Young Joon,Park, In Joon,Han, Sun Ho,Jung, Han Yong 대한생물정신의학회 2001 생물정신의학 Vol.8 No.1

Objective : It has been thought that estrogen has neuroleptic like effect in women schizophrenic patients. This study aimed to investigate neuroleptic side-effects severity in women with schizophrenia and to investigate their putative association with variations in sex steroids over menstrual cycle. Based on the estrogen theory, The author hypothesized that parkinsonian side-effects would be exacerbated when estrogen levels were high. Method : 26 schizophrenic women were assessed using the ESRS(Extrapyramidal Symptom Rating Scale) and estrogen analysis. Tests were conducted twice, in the mid luteal and mid follicular phase. Result : It was hypothesized that high level of estrogen would lead to an exacerbation of parkinsonian side-effects but the results indicated that parkinsonian side effects decreased overall when estrogen levels were high. This effects were more marked for the group taking typical neuroleptics than those taking atypical neuroleptics. Conclusion : The results of this study suggest that estrogen and progesteron may reduce the severity of neuroleptic induced extrapyramidal side effects over menstrual cycle in women with schizophrenia. It was concluded that estrogen has different effects on dopamine dynamics in the mesolimbic and mesostriatal pathways according to estrogen, progesteron, catecol estrogen, prolactine.

Wish to Die and Associated Factors in the Rural Elderly

Guk-Hee Suh(서국희),Jang Kyu Kim(김장규),Hee Yeon Jung(정희연),Moo Jin Kim(김무진),Maeng-Je Cho(조맹제) 대한노인정신의학회 1999 노인정신의학 Vol.3 No.1

연구목적 : 본 연구의 목적은 노인의 자살 사고 유병률과 관련요인을 파악하고자 하는 것이다. 특히 우울증 이외의 어떤 인자들이 자살 사고와 관련되는지를 알아보고자 한다. 연구방법 : 경기도 연천군 지역에서 1996년 12월부터 1997년 8월사이 만 65세 이상의 노인 1,037명을 대상으로 역학조사를 행하여 자료를 얻었다. 조사참여자들에게 지난 2주동안 죽고싶다는 생각이 든 적이 있는지를 묻고, 있다고 답하면 지난 2주동안 여러 번 죽고 싶었는지를 물어 자살사고를 파악하였다. 가능한 관련 인자들을 다음의 다섯 군으로 분류하였다. 사회인구학적 인자(성별, 연령, 결혼상태, 아들과 딸의 숫자, 교육, 종교), 경제적 인자(재정 상태, 현재 및 과거 직업, 의료보험 또는 의료보호), 사회적 지지 인자(APGAR, 사회적 활동, 거주형태), 신체적 건강 인자(질병유무, 복약여부, 과거 입원력, 흡연년수, 음주년수, ADL과 IADL에 의한 기능장해여부) 그리고 정신적 건강 인자(DSM-III-R 치매, 우울장애, 망상증상, 감각기능 장해). 자료의 통계분석에서는 유병률을 계산하고 관련요인들을 로짓회귀분석을 사용하여 분석하였다. 연구결과 : 1013명의 조사노인중 148명(14.6%)이 지난 이주일동안 반복적으로 죽고싶다는 생각을 했다고 보고하였다. 이들 148명중 56명(37.8%)은 치매, 우울장애, 망상장애 혹은 감각기능 장해의 진단을 받지 않았고, 148명중 42명이 주요우울증을 앓고 있었고 70명(47.3%)이 우울장애의 진단을 받았다. 148명중 20명(13.5%)은 치매의 진단을 받았다. 죽고 싶다는 욕구가 우울증과 관련되지만, 우울증과 독립적으로 관련이 되는 몇몇 다른 요인들이 발견되었다. 85세 이상의 고령과 낮은 경제상태가 통계적으로 유의한 수준의 관련인자이다. 일상생활 수행능력 장해, 자신이 평가한 건강 불량, 낮은 사회적 지지와 배우자없이 생활함 등은 95% 신뢰구간의 하한이 0.9를 넘는 거의 유의한 수준에 있다. 죽고 싶다는 욕구만을 표현한 소수의 기분상태는 정상이었다. 결론 : 노인이 죽고 싶다는 표현을 하면, 면밀한 정신과적인 평가를 해야 할 필요가 있다. 죽고 싶다는 욕구는 우울증 이외의 다른 요인들과도 관련되며 거의 우울증상이 없는 사람에게도 있을 수 있다. 이런 자살 사고와 관련된 요인들을 교정하면, 삶의 의욕을 회복할 수 있을 것인가에 대해서 연구할 필요가 있다.것으로 나타났다.

한국 남성 화장품 브랜드 및 제품 개발에 관한 연구

이희원(LEE Hee Won),이성훈(LEE Sung Hoon),이주연(LEE Joo Yeon),이순종(LEE Soon Jong),정희연(JUNG Hee Yun) 한국디자인학회 2008 한국디자인학회 학술발표대회 논문집 Vol.- No.-

정신질환을 가진 부모의 자녀들의 정신건강 상태 조사 연구

서화연(Hwo Yeon Seo),박수미(Su Mi Park),김예니(Yeni Kim),양영희(Young Hui Yang),이지연(Ji Yeuon Lee),이해우(Hae Woo Lee),정희연(Hee Yeon Jung) 대한소아청소년정신의학회 2017 소아청소년정신의학 Vol.28 No.4

Objectives: This study aimed to evaluate the mental health status of the children of psychiatric patients in order to plan for the resources that may be necessary to help these children achieve their full potential. Methods: Forty-eight children (age 9–18) whose parents were registered in 5 community mental health centers located in Seoul were recruited. Tests assessing 3 psychological domains were conducted: 1) cognition: Korean version of Learning Disability Evaluation Scale, Comprehensive Attention Test, 2) parent reported emotion and behavior: Korean Child Behavior Checklist, Korean attention-deficit hyperactivity disorder Rating Scale, and 3) self-reported emotion and behavior: Korean Beck’s Depression Inventory-II/Children’s Depression Inventory-II, Korean Youth Self Report). We defined the children as having a high risk of developing mental health problems if their test scores were over the cut-off levels in 2 or more of the 3 domains assessed. Results: Twelve (25%) children were classified as having a high risk of developing mental health issues. 20 (41.6%) children scored above the cut-off in only one of the domains. Conclusion: Our results suggest that the children of psychiatric patients might be vulnerable to mental illness and need early prevention or interven-tions for the sake of their mental health.

Fluoxetine 투여 후 Amitriptyline의 혈장농도 변화

전용호,권영준,정희연,한선호,Jun, Yong-Ho,Kwon, Young-Joon,Jung, Hee-Yeon,Han, Sun-Ho 대한생물정신의학회 2001 생물정신의학 Vol.8 No.2

Objective : The purpose of this study was to compare the plasma amitriptyline and nortriptyline level between before and after fluoxetine addition with patients who were currently taking amitriptyline. Method : From the inpatient and outpatient unit of Soon Chun Hyang University Hospital, Chunan, fourteen subjects who were taking amitriptyline 25mg more than 1 week at least were given fluoxetine 20mg. Before and 2 weeks after fluoxetine addition, the plasma level of amitriptyline and nortriptyline are analyzed simultaneously by High Performance Liquid Chromatography(HPLC). At the same times, HAM-D(Hamilton Rating Scale for Depression) score and the UKU(Uldvalg for Klinske Unders${\Phi}$ gelser) side effect scale were checked. Results : After fluoxetine addition to the patients who were taking amitriptyline, the plasma level of amitriptyline, nortriptyline and sum of amitriptyline and nortriptyline had risen. The mean plasma amitriptyline level increased from $168.9{\pm}89.4ng/ml$ to $183.0{\pm}102.0ng/ml$ after fluoxetine addition(p=0.011), but the change was not statistically significant. The mean plasma nortriptyline level increased significantly from $114.3{\pm}70.2ng/ml$ to $168.0{\pm}86.2ng/ml$ after fluoxetine addition(p=0.011). In addition, the mean plasma level of total amitriptyline and nortriptyline increased significantly from $283.1{\pm}125.3ng/ml$ to $350.9{\pm}78.4ng/ml$ after fluoxetine addition(p=0.016). After fluoxetine addition, no significant change was noted in the UKU side effect scale score. Conclusion : As consequence of comparison of plasma amitriptyline and nortriptyline level before and after fluoxetine addition, mean amitriptyline, nortriptyline and total plasma level was increased after fluoxetine addition. This suggests that coadministration of amitriptyline and fluoxetine may induce improvement of depressive symptom in depressive patients by way of increased plasma level of amitriptyline.