수면다원기록(睡眠多元記錄)으로 확인(確認)된 급속수구운동수면(急速眼球運動睡眠) 행동장애(行動障碍) 1례(例)

정도언,윤인영,Jeong, Do-Un,Yoon, In-Young 대한수면의학회 1994 수면·정신생리 Vol.1 No.1

The authors report a case of REM sleep behavior disorder which occurred in a 69-year-old business man. He began experiencing episodic "acting out" behavior of his dream at the age of 66. The episodes tended to be associated with dream contents, mainly being chased or threatened. Before that, his sleep was relatively quiet despite occasional nightmares, midsleep arousal, and shallowness. Injuries resulted from leaping out of bed, jumping onto furnitures, and grabbing and biting the spouse's arm. Most recent dream-incurred laceration of chin required 5 sutures. Medical and psychiatric history revealed no significant findings except that he had been overanxious all his life within himself with others' reputation of himself as pleasant and easy-going. A nocturnal polysomnogram showed repeatedly intermittent increase of chin and/or leg muscle tones during otherwise characteristic REM sleep period. The overnight video recording revealed head lifting and limb movements during REM sleep periods. Brain MRI and EEG were normal. Job-related stress was presumed to be an etiological possibility. Clonazepam 0.25-0.5mg nightly almost completely relieved the symptoms.

傳統的 養生術의 理論的 基礎硏究-東醫寶鑑을 中心으로-

李符永,禹鐘仁,鄭道彦 대한신경정신의학회 1999 신경정신의학 Vol.38 No.1

연구목적 : 전통적 양생술의 개념, 방법 및 그 이론적 배경을 조사하고 그 의미를 정신의학적, 분석심리학적 입장에서 분석고찰하여 장차 양생술의 각종 세부연구의 기초적 이해를 정립하는데 있다. 대상과 방법 : 우리나라 전통의서로 유명한 동의보감에 기술된 양생사상과 양생술을 대상으로 문헌적 비교고찰의 방법으로 구명하였다. 결과, 고찰 및 결론 : 동의보감은 도교적 신체·생리관을 그 바탕으로 삼고 있고 服氣, 導引, 養成하는 약 등의 양생술을 소개하고 있는데 방중술에 관한 기술은 극히 간략하며 丹을 몸 밖에서 만드는 外丹法은 소개되지 않았다. 양생술은 소우주로서의 인간의 신비적 신체관과 精·氣·神 3요소를 중심으로 한 상징적 생리체계, 영원불멸의 생명요소인 丹을 간직하는 장소인 3단전의 존재와 이를 통과하는 신체내 경로에 관한 인식을 전제로 실시되었다. 양생술은 정·기·신을 보존하고 기르는 것으로 마음을 비우고 도에 합치는 자세를 기본으로 하며 우주자연과의 시간적 공간적 조화를 강조하고 있다. 저자 등은 정·기·신의 개념에 관하여 여러 해석을 비교 고찰하였는데 이것은 정신생리적 활동의 여러 측면을 나타내는 것으로 분석 심리학적으로 정신과 물질 사이에 매개하는 정신양기능 psychoid function에 비유될 수 있을 것으로 보았다. 양생술은 형이상학적 신체생리관에 입각한 신비체인 몸을 그릇으로 하고 정신적 명상(imagination)을 도구로 하여 최고의 불멸의 물질 또는 상태를 몸 안에서 만들고자 한 것으로 최고의 물질을 합성하려던 서양의 연금술과 그 목표와 과정이 유사하여 天心, 道, 丹, 胎息으로 표현되는 ‘중심’의 사상과 전체성의 실현, 근원으로의 화기를 강조함으로써 분석심리학의 자기 실현의 목표를 상징적으로 표현하고 있다. 양생술의 정신적 생리적 측면의 실지 효과에 관한 여러 실험적 연구 결과를 고찰하였는데 대체로 긴장의 완화, 자율신경계의 조정 등 긍정적인 생리적 효과를 추정할 수는 있었으나 확실한 성과를 판정하기 위해서는 여러 가지 변인을 고려한 양생수행자의 체험에 관한 장기간 추적 조사와 객관적 생리적 변화에 관한 면밀한 검증을 실시해야 할 것으로 보인다. Objective : The basic concepts and methods applied in the techniques of Taoistic meditation, Yang-Sheng-Sul are analyzed and interpreted from the medico-psychological viewpoint with special reference to the descriptions on Yang-Sheng-Sul in the Korean classics of traditional medicine, Dong-Ui-Bo-Gam Result and conclusion : ‘Dong-Ui-Bo-Gam’ has adopted mainly the Taoistic concepts of body as microcosm and concepts of three basic vital forces of Ching(精), Chi(氣), Shen(神), three fields of Tan(丹), the incorruptible essence and its circulating routes in the body. The Taoistic breathing techniques Bok-Ki and physical exercises Do-In are based upon the belief on the metaphysical views of body and life. The concepts of three forces Ching, Chi, Shen the nurturing of which is regarded as the ultimate goal of Taoistic Yang-Sheng are taken into consideration. These concepts can be comparable to the concept of ‘psychoid function’ in term of Jung, the intermediator between soma and psyche. The concepts of Chon Shim(Heaven's Heart), Tao, Tan(the corruptible body), Tae-Shik(the fetal breath) represent the symbols of Self in terms of analytical psychology of Jung. Yang-Sheng-Sul can be regarded, in comparison with the Western alchemy, as an alchemical opus performed within the field of body by means of both imagination and physical exercises to achieve the state of immortality which is reflecting partly the symbolic manifestations of the self actualization in Jungian term. Authors also reviewed the results of experimental researches of Taoistic meditation on its physiologic effects and found the necessity for a more elaborated researches and investigations in this concern.

수면다원검사의 정도관리 : 한국에서의 경험 및 제언 A Korean experience and critical suggestions

정도언 한국의료QA학회 1994 한국의료질향상학회지 Vol.1 No.1

Polysomnography is an essential methodology for diagnosing and following up sleep disorders and doing researches on human steep. Sleep medicine, mainly with the utilization of polysomnographic techniques, has developed itself as one of the promising fields in the 21st century medicine. Korea is not an exception in importing and developing sleep medicine into the conventional medicine. However, it still remains to be clarified what polysomnography is for and how it should be done, considering the relatively recent introduction of sleep medicine into Korea. The author, being a board-certified sleep medicine specailist, having experienced spreading out sleep medicine within Korea for the past four years, and having recently set up a major sleep study facility in Korea at Seoul National University Hospital, attempts in this introductory critical article to review the essential issues related to quality assurance in polysomnographic study of human sleep. Also, unconditional introduction of “automated” sleep scoring system, which has been found to have significantly reduced reliability in various studies including the author's own, is critically reviewed. The author suggests that quality assurance and training program should be initiated and established by a responsible sleep medicine-related organization such as the Korean Association of Sleep Medicine and Psychophysiology.

遲延性 運動障碍의 有病率 및 臨床的 亞型에 관한 硏究

柳凡熙,趙斗英,鄭道彦 大韓神經精神醫學會 1993 신경정신의학 Vol.32 No.5

Using AIMS(Abnormal Involuntary Movement Scale), we evaluated for tardive dyskinesia in 326 patients with chronic mental illness institutionalized in an asylum of the Flower Town. We found that the prevalence of tardive dyskinesia was 22.4% and the corrected prevalence rate(with the rate of spontaneous dyskinesia subtracted) was about 16.5-17.4%. There was no difference in the prevalence rate according to various risk factors such as sex, diagnosis, daily dosage of neuroleptics, and medication of antiparkinsonian drugs. However only age was a statistically significant risk factor in this study and the rate of tardive dyskinesia remarkably increased with age. Of various clinical symptoms of tardive dyskinesia, lingual dyskinesia was most frequently observed and AIMS score of the tongue was also highest. In addition we investigated 73 tardive dyskinesia patients for some risk factors to examine the hypothesis that tardive dyskinesia should be composed of two clinical subtypes(orofacial dyskinesia and limb-truncal dyskinesia), but there was no statistical difference between them according to the risk factors.

불안장애 환자 및 정상인에서의 전두근 긴장도와 불안수준간의 상관관계에 관한 연구

정도언,이주호 서울대학교 의과대학 정신과학교실 1988 서울醫大 精神醫學 Vol.13 No.2

정신신체의학 역사의 재조명

정도언,Jeong, Do-Un 한국정신신체의학회 1993 정신신체의학 Vol.1 No.1

Since the onset of modern psychosomatic medicine decades ago. it has made significant at contribution to general medicine in terms of understanding the patient as a whole person suffering from an illness rather than as a disease per se. However, initial expectation of delineating specific psychogenesis and developing specific treatment modality has not been fulfilled. Consequently, it has raised substantial concern about the continuing utility of psychosomatic medicine in modem medicine. The author attempted to review critically the evolution of psychosomatic medicine from the perspective of the present and to make projections into the near future. It is concluded that psychosomatic medicine in the future will continue to contribute to development of modem medicine not only as the scientific principle but also as the practical methodology, working as creative interface among disciplines and fusing ideas from rapidly developing molecular biology and neuroscience with psychosomatic concepts. Finally, suggestions for further developing psychosomatic medicine in Korea are made.

불면증의 진단 및 치료

鄭道彦 대한의학협회 1995 대한의학협회지 Vol.38 No.8

境界線的 精神障碍의 最近槪念들

鄭道彦,洪剛義 서울대학교 의과대학 정신과학교실 1981 精神醫學報 Vol.5 No.2

『海外硏修經驗』報告

鄭道彦 서울大學校 醫科大學 精神科學敎室 1992 精神 醫學 Vol.17 No.2

指導監督者의 입장에서 본 精神治療 個人指導監督

柳凡熙,趙斗英,鄭道彦 大韓神經精神醫學會 1993 신경정신의학 Vol.32 No.5

The authors investigated the opinions of 53 supervisors by a questionnaire who were actively doing an individual supervision of psychotherapy in Korea and got various responses about a desirable supervision system and current problems and an improvement-direction of supervision from 33 persons among them. The results are as follows : Supervisors favor the 2nd year residency as a good period for beginning psychotherapy supervision. They favor once per week as an ideal frequency and 30-60 minutes per session as an ideal time of supervision. They also think that supervisees need to get a supervision even after finishing their residency training. Supervisors favor a verbatim-form in the presentation of supervision cases. They think that it is necessary to consider the personal relations between supervisors and supervisees for a good matching of them in supervision. Conditions to be a good supervisor are 'plentiful experiences in intensive psychotherapy' , and 'experiences of getting much supervision and training analysis'. The most important things to teach to supervisees are 'transference and counter-transference' and 'the ability to formulate psychodynamic assumptions for the patient's conflicts'. Most of supervisors think that there are many problems in the current system of psychotherapy supervision in Korea. They are especially much interested in the training programs to improve the quality of themselves and the formal system to do a better supervision. So we suggest that this study presents some basic recommendations to improve the current system of psychotherapy supervision in Korea.