신경정신과 학생교육의 문제점과 대책

공보금,김영훈 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.1

Medical education, especially psychiatry, is now in a state of evolution and change but has difficulty in adapting to the even more rapidly changing health care systems. we will continue to debate what will be the roles of doctors in mind and how we can continue to prepare medical students for their tasks within this framework of change.

우울증을 올바로 치료하기 위한 제언

공보금,정도운,강제욱,심주철 대한신경정신의학회 2010 신경정신의학 Vol.49 No.5

여성 우울증

공보금 인제대학교 백병원 2003 仁濟醫學 Vol.24 No.2

Depression is a common disorder in psychiatry. Women experience different features of age at onset, clinical symptoms, subtypes, treatment, and comorbidity from men. Women tend to have more earlier onset, atypical symptoms, comorbidity. Especially, Types of depression depend on reproductive life cycle in women. To successful management, it is very important that we understand specific features of depression in women.

택시技士의 職務特性과 社會心理的 스트레스와의 聯關性

공보금,이종태,최은경,박진국,손혜숙,정귀원,정성준,이성훈 인제대학교 2001 仁濟醫學 Vol.22 No.1

Objectives: The Job strain model was applied to taxi drivers and to assess the relationship between job characteristics, general characteristics and psychosocial distress. Methods and Materials: In this cross-sectional study, 72 taxi drivers in Pusan are inclouded. Psychosocial distress was measured using PWI (Psychosocial well-being index). The Karasek's Job Content Questionnaire was utilized to evaluate job characteristics. Results: Higher education level was significantly related to higher social support(p<0.05), lower monthly income, which was related to higher psychological job demand(p<0.05). PWI socres were higher in current smoker. High PWI scores was associated with low decision authority, decision latitude level (p<0.01) and high job insecurity (p<0.05). Conclusions: The Job strain model was supported in this study, suggesting the level of psychosocial distress was modified by job demand and Job control.

소아, 청소년기의 우울증

공보금 인제대학교 2003 仁濟醫學 Vol.24 No.2

Depression is a common psychiatric disorder. Epidemiological data, clinicalmanifestations and treatment modalities are different according to the age, sex differences. Child and adolescent depressive disorders are complex clinical problems. Children and adolescents may require significant modification of adult treatment. It is very important to understand children and adolescents are different from adults.

지연성 운동장애와 BDNF(Brain-derived Neurotrophic Factor) Val66Met 유전자 다형성과의 연관성연구

공보금(Bo-Geum Kong),박성우(Sung-Woo Park),이선정(Sun-Jung Lee),김선희(Sun-Hee Kim),주명진(Myung-Jin Joo),김영훈(Young-Hoon Kim) 대한생물치료정신의학회 2006 생물치료정신의학 Vol.12 No.1

목적 : 신경계의 발달, 분화, 성장에 중요한 역할을 담당하는 brain-derived neurotrophic factor(BDNF)는 지연성 운동장애와 연관된 중추신경계의 여러 질환들의 발생에 관여한다. 본 연구는 항정신병 약물로 인해 초래되는 심각한 부작용인 지연성 운동장애(tardive dyskinesia : TD)의 발생에 BDNF Val66Met 유전자 다형성이 연관성이 있는지 없는지의 여부를 알아보기 위하여 시행하였다. 방법 : 161명의 정신분열병 환자군(TD 83명, non-TD 78명)과 95명의 정상대조군을 대상으로 하였고 지연성 운동장애(TD) 평가는 AIMS(Abnormal Involuntary Movement Scale)를 사용하였다. BDNF Val66Met 유전자 다형성은 정신분열병 환자군(TD군, non-TD군)과 정상대조군을 비교하였고, 정신분열병 환자에서 지연성운동장애가 있는 군과 없는 군을 비교분석하였다. 결과 : 정신분열병 환자군과 정상대조군, 정신분열병환자에서 TD군과 non-TD군을 비교한 결과, 세가지 유전형(Val/Val, Val/Met, Met/Met)과 Val, Met 두 대립유전자빈도, 두 경우 모두 통계적으로 의미 있는 결과는 나오지 않았다. 결론 : 이번 한국인 정신분열병 환자를 대상으로 시행한 저자들의 연구에서 지연성 운동장애와 BDNF Val66Met 유전자 다형성 사이에는 연관성이 보이지 않았다. Objectives : Brain-derived neurotrophic factor(BDNF) belongs to a family of neurotrophic factors and has been demonstrated to promote the survival, differentiation, and maintenance of a broad variety of central nervous system neurons. Several reports have suggested that the BDNF gene is associated with variable psychatric disorders and neurologic disesases. We investigated the association of BDNF Val66Met polymorphism with schizophrenia and tardive dyskinesia(TD) to evaluate candidate BDNF gene for association with drug-induced TD. Methods : 161 schizophrenic patients(TD=83, non-TD=78) and 95 normal controls were included in the study. Tardive dyskinesia was assessed by the Abnormal Involuntary Movement Scale(AMIS). We examined the BDNF Val66Met genotype distribution and allele frequency. Statistical analysis was used to test the association between this polymorphism and TD development in the schizophrenic patients. Results : There were no significant differences in the genotype distribution and allele frequency of the BDNF Val66Met polymorphism between schizophrenic patients with and without tardive dyskinesia, normal controls. Conclusion : Our findings suggest that it is unlikely that the BDNF Val66Met polymorphism play a major role in the pathogenesis of TD in the Korean sample.

Haloperidol 투여후 금단기간에 따른 백서 선조체의 [$^3H$]Spiperone 결합 및 Dopamine 대사물질의 변화

이중용,공보금,김용관,정청,김선희,김영훈,Lee, Jung-Yong,Kong, Bo-Geum,Kim, Yong-Kwan,Jung, Chung,Kim, Sun-Hee,Kim, Young-Hoon 대한생물정신의학회 1996 생물정신의학 Vol.3 No.1

The effects of 3 week treatment with haloperidol(2mg/kg/day, i.p.) on dopamine(DA) D2 receptor and DA metabolism in rat striata were studied at various time points after withdrawal from the drug treatment. Striatal DA D2 receptors were characterized with the radioligand 0.5nM [$^3H$]Spiperone. Dopamine(DA), homovanillic acid(HVA), 3,4-dihydroxyphenyl acetic acid(DOPAC) in rat striatum were measured with the high performance liquid chromatography. Drug withdrawal for 1 week induced significant increase in the number of D2 receptor in striatum after withdrawal for 1 week(p<0.05), and then this change was restored to control level during the withdrawal time of 2 and 4 weeks. There was no difference in striatal concentrations of DA and its metabolites among the groups. In conclusion, one-week withdrawal from chronic haloperidol treatment induced DA D2 receptor supersensitivity in the striatum, and that was normalized rapidly. Though this adaptive change in DA receptors, it may not affect the metabolism of DA in striatum.

우울증의 약물치료

이정구,공보금,김영훈 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

As The Celluar and molecular pathology of depression were revealed, the newer drugs will be adapted by the treatment of depression. For the adequate treatment of deperssion psychiatrist must know the typical symptoms of depression and the target symptoms of pharmacotherapy and the profile of adverse effects, the genetic inforamtion of individulas. The selection of antidepressant according to the indvidual variation of genetics will be very improtant.

정신분열병 여성환자에서 항정신병 약물로 인한 무월경이 치료에 대한 환자의 태도와 삶의 질에 미치는 영향

김민효,공보금,정도운,강제욱,문정준,김정은,송태홍,신혜경,임지섭,심주철 대한정신약물학회 2011 대한정신약물학회지 Vol.22 No.4

Objective This study was aimed to identify the correlation between antipsychotics-induced amenorrhea, and attitudes toward treatment and quality of life in women with schizophrenia. Methods Twenty female schizophrenic patients with antipsychotics-induced amenorrhea and thirty female schizophrenic patients without antipsychotics-induced amenorrhea were evaluated. Attitudes toward treatment were assessed by the Korean version of Drug Attitude Inventory (KDAI-10) and quality of life was assessed by the Korean version of World Health Organization Quality of Life Assessment Instrument-BREF (WHOQOL-BREF). The psychopathology of each patient was assessed by the Positive and Negative Syndrome Scales and the Clinical Global Impression-Severity. Adverse effects were evaluated using the Drug-Induced Extrapyramidal Symptoms Scale. Correlation analysis and multiple linear regression were conducted. Results The KDAI-10 score was not significantly correlated antipsychotics-induced amenorrhea. In WHOQOL-BREF score, social relation domain only showed significant correlation with antipsychotics-induced amenorrhea. Multiple linear regression analysis revealed that the number of family members contributed significantly to the Positive Subjective Feelings Scores of KDAI-10 and marital status contributed significantly to the social relation domain of WHOQOL-BREF in amenorrhea group. Conclusion The results of present study suggest that antipsychotics-induced amenorrhea lower part of the quality of life domain in women with schizophrenia. Clinicians must pay attention to treatment of amenorrhea and various factors that correlated with attitudes toward treatment and quality of life in women with schizophrenia. 본 연구는 여자 정신분열병 환자들에서 무월경의 여부에 따른 치료에 대한 태도와 삶의 질의 연관성에 대해 알아보고자 하였다. 그 결과 무월경군이 대조군에 비해 치료에 대한 환자의 태도에 있어서 통계학적으로 유의한 상관관계를 보이지 않았지만, 무월경군은 삶의 질 중, 사회적 관계 영역이 대조군에 비해 저하되는 소견을 보였다. 이것은 무월경 자체가 정신분열병 환자들의 삶의 질 중 일부영역을 저하시킬 수 있다는 것을 시사한다. 치료자들은 정신분열병의 약물치료에 있어 빈번하게 나타나는 무월경을 쉽게 간과해서는 안 될 것이고, 치료에 대한 태도 및 삶의 질에 대한 다른 요인들을 파악하고 교정함으로써 치료 효과의 증대와 더불어 환자의 치료에 대한 순응도를 높일 수 있을 것이다.

리스페리돈으로 유발된 무월경에 대한 아리피프라졸 부가치료

심주철,공보금,정도운,강제욱,오민경 대한정신약물학회 2011 대한정신약물학회지 Vol.22 No.1

본 연구는 아리피프라졸 부가치료가 리스페리돈으로 인해 발생되는 고프로락틴혈증 및 이와 동반된 무월경 치료에 효과적임을 지지했다. 그러나 아리피프라졸 부가치료가 리스페리돈 감량, 도파민 효현제 부가 치료, 아리피프라졸 단독 투여로 교체하는 방법들과 비교해서 효과, 안정성 및 경제성에서 우수한가에 대해선 여전히 검증이 필요하다. 리스페리돈에 의해 유발된 무월경치료에 어느 방법을 선택할 것인가는 환자의 개인적인 특성을 고려한 임상의의 판단이 중요하리라 사료된다. ObjectivezzHyperprolactinemia and associated side effect, amenorrhea, often occur with risperidone treatment. We investigated the effect of adjunctive treatment with aripiprazole on risperidone induced amenorrhea in female patients with schizophrenia. MethodszzA retrospective chart review of 24 female patients with adjunctive aripiprazole treatment for risperidone induced amenorrhea between August 2008 and July 2009 was conducted. The information collected included age, menstrual cycle, duration of no menstruation, prolactin level (before aripiprazole treatment and after regaining menstruation), dose of risperidone and aripiprzole, time from starting aripiprazole adjunctive treatment to regaing menstruation. The Student’s t-test, Pearson’s Chi-square test were used for data analysis. ResultszzMean percent decrease in prolactin level for all aripiprazole-treated patients was 71.4±8.6%. 85.7% (18/21) of patients resumed menstruation, while 14.3% (3/21) did not regain. In patients with regaining menstruation, mean time from starting aripiprazole to restarting menstruation was 6.6±2.4 weeks, mean dose of aripiprazole was 12.2±3.9 mg/day (dose range, 5 mg to 20 mg/day). Aripiprazole dose for regaining menstruation was not significantly correlated with baseline prolactin level. CGI score was not significantly changed after aripiprazole treatment. The cutoff point of prolactin level significantly increasing amenorrhea was 40 ng/mL. ConclusionzzAdjunctive aripiprazole treatment is very effective to treat risperidone induced amenorrhea in female patients with schizophrenia.