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      • 살인 행동을 보인 정신분열병 환자에서 MMPI와 SCL-90-R 검사의 특징

        강시현(Shi Hyun Kang),정석훈(Seockhoon Chung),정재열(Jaeyeul Jung),정혜윤(Hye Yoon Chung),성명제(Myung-Jae Sung),김민후(Min Hoo Kim),송해철(Hae-Cheol Song),권수희(Soo Hie Kwon),진영식(Young Sik Jin),백상빈(Sang-Bin Baek) 대한사회정신의학회 2005 사회정신의학 Vol.10 No.2

        목 적: 공격성은 정신분열병 환자에게 나타나는 심각한 문제 중 하나이다. 공격성의 가장 극단적 형태인 살인 행동을 보인 정신분열병 환자들이 경험하는 주관적인 정신 증상 및 심리 상태의 특성을 알아보고자 본 연구를 시행하였다. 방 법: 살인 행동이 있었던 정신분열병 입원 환자(n=64)를 연구대상으로 하였고 살인 행동은 없었으며 실험군과 나이, 교육 연한, 항정신병 약물 용량을 짝짓기하여 선정한 정신분열병 입원 환자를 대조군(n=75)으로 선정하여 두 군간의 주관적 정신 증상 및 심리상태를 비교 연구하였다. 주관적 상태는 Minnesota Multiphasic Personality Inventory(MMPI)와 Symptom checklist-90-R(SCL-90-R)로 평가하였다. 살인 행동 환자군은 살인 행동 후 정신감정 시점에 검사된 MMPI와 SCL-90-R결과를 얻었다. 결 과: 살인 행동을 보인 환자군은 대조군에 비하여 MMPI와 SCL-90-R검사 모두에서 전반적으로 더 높은 점수를 받았다. MMPI 검사에서 우울증, 히스테리, 반사회성, 편집증, 내향성 척도가 살인 행동군에서 대조군에 비해 유의하게 높았다. SCL-90-R 검사에 서는 강박증, 대인관계 예민성, 불안, 편집증, 정신증 항목에서 살인 행동군에서 통계적으로 유의하게 높은 점수를 보였다. 결 론: 살인 행동을 보인 정신분열병 환자군은 주관적으로 사회적 상황에서 정서적으로 불안정하여 피해의식을 쉽게 느끼고 분노와 정감 조절이 어려울 때 인지적 왜곡에 부합하여 공격적 행동이 유발될 가능성이 있다. Objectives:Violence is a serious problem in some patients with schizophrenia. Homicide is one of the most extreme aggressive behavior. The purpose of this study was to investigate the characteristics of subjective symptomatology and psychological state of schizophrenia with homicidal behavior. Methods:Subjects were schizophrenia patients hospitalized in a mental hospital due to their homicidal behavior (n=64, group 1). Control subjects were schizophrenia patients without homicide also hospitalized in another mental hospital(n=75, group 2). Subjects were matched by age, years of education and dosage of antipsychotics. Minnesota Multiphasic Personality Inventory(MMPI) and Symptom checklist-90-R(SCL-90-R) were used to evaluate the subjective symptomatology. In group 1, the results of MMPI and SCL-90-R had been acquired following the incident that led to hospitalization. Results:Schizophrenia patients with homicide showed overall elevated MMPI clinical scales and SCL-90-R scales. The group with homicidal behavior had significantly higher scores than patients without homicidal behavior on the subscales of depression, hysteria, psychopathic deviance, paranoid, social introversion as assessed by the MMPI. They also had significantly higher scores on the subscales of obsessive-compulsive, interpersonal sensitivity, anxiety, paranoid ideation, psychoticism as assessed by the SCL-90-R. Conclusion:Schizophrenia patients with homicidal behavior did present different clinical subjective pictures : unstable emotion, more paranoid tendency, difficulty with control of anger, more perceptual disturbance. Under those subjective states they had a risk of violent behavior.

      • KCI등재후보

        정신과 전문병원에서 적정 의료 인력의 추산

        이동은,서동우,이태경,박종익,홍진표,권수희,이종일,정은기,장동원 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.5

        Objectives : The purpose of this study is to surmise appropriate level of medical manpower of mental hospital from the perspectives of clinical experts, Psychiatrist and psychiatric nurse. Methods : First, we wlleded data on medical manpower of domestic mental hospitals and foreign mental hospitals. Next, psychiatrists and psychiatric nurses were asked to complete a survey. We estimated the optimal level of medical manpower examining appropriate volume of medical services that should be provided for psychiatric patients, and analizying the survey carried out by direct questions. Results : The number of psychiatrists of group A of private mental hospitals was 1.7 times more than that of public mental hospitals ; when the number of psychiatrists in public mental hospitals was regarded as 1.0, and group B of private mental hospitals was 0.5 times, and the university hospitals 8.2 times. The number of psychiatric of group A of private hospitals was 1.5 times more than that of public mental hospitals ; when the number of psychiatric nurses in public mental hospitals was regarded as 1.0, the group B of private mental hospitals was 0.6 times and university hospitals was 2.6 times. The foreign mental hospitals had more medical manpowers in all occupations than domestic mental hospitals. The number of psychiatrists estimated according to the first method was 11.1 persons and the number of psychiatric nurses was 26.3 persons per 100 beds, and the number of psychiatrists estimated according to the second method was 4.3 persons per and the number of psychiatric nurses was 20.8 persons per 100 beds. Conclusion : The estimated optimal number of psychiatrists for mental hospital is 4.3 persons and of psychiatric nurses was 20.8 persons per 100 beds. However, these numbers can be flexible depending on the ratio of short-term acute patients and long term chronic patients.

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