정신분열병에서의 자기공명영상의 T2이완

김용식,장기현,김임렬 大韓神經精神醫學會 1992 신경정신의학 Vol.31 No.3

The present study was undertaken to know whether there is any change of T2 relaxation times in schizophrenics. The authors measured T2 relaxation times of 10 regions of interest in 27 schizophrenic patients and 24 control subjects, using 2.0 tesla brain MRI scanner. The areas included were parahippocampal gyrus, globus pallidus, thalamus, cingulate gyrus, and prefrontal gyrus of both hemispheres. And we compared these T2 values between schizophrenics and control cases, and looked for differences between schizophrenic subgroups in terms of duration of the disorder. There were no significant differences of T2 between 27 schizophrenics and 24 control subjects in 10 areas. Also regardless of sex, we could not find no differences of T2 between schizophrenics and control subjects. the duration of illness was not associated with the T2 values of the patients. When the patients were divided into paranoid and non-paranoid groups, there was no difference except that T2 value of left cingulate gyri showed significant difference between two groups.

정신 장애인에 대한 편견에서 암묵적 태도와 명시적 태도 차이

박성용,김임렬,손인기,최태영,남범우 대한우울조울병학회 2012 우울조울병 Vol.10 No.2

Objectives : This study investigated the attitudes against mentally ill patients by comparing explicit attitude with implicit attitude. We aimed to elucidate the differences in attitudes against mentally ill patients among mental health professionals, general health professionals and general population. Method : We recruited 70 subjects and classified the subjects into mental health professionals, general health professionals and general population. We used the Community Attitudes toward Mentally Ill (CAMI) scale to assess explicit attitude. We also used the brief implicit association test (BIAT) to assess implicit attitude. Demographic and characteristics of 3 groups were analyzed. Results : There were no significant differences in demographic factors among 3 groups except experience of mentally ill patients. In explicit attitude, the score of mental health professionals was lower in authoritarianism and social restrictiveness, and higher in benevolence and community mental health ideology than that of general health professionals. The score of mental health professionals was lower in authoritarianism, higher in community mental health ideology than that of general population. In implicit attitude, mental health professionals more positive attitude than other groups. There was no significant correlation between explicit attitude and implicit attitude. Conclusion : We find that general health professionals showed more negative attitude than mental health professionals. This finding showed more negative attitude compared with general population.

자기조절 연구 현황 및 발전 방향

원성두,김임렬,이민규 한국심리학회 2015 한국심리학회지 일반 Vol.34 No.1

Self-regulation is considered as a key factor in behavioral problems and mental health. However, the concept of self-regulation is still subtle, and there are so different definitions and models in a variety of literature in psychology, including clinical psychology. To our knowledge, there is a lack of systematic researches in relation to self-regulation in Korea. We provided an overview of the status of self-regulation research, including major theories, measurement tools and psychological intervention methods. Moreover, we suggested that development of goal-focused self-regulation programme might be needed for enhancement of mental health in general populations as well as patients with clinical disorders. 자기조절(self-regulation)은 행동 문제 및 정신건강의 주요 변인인 것으로 알려져 있다. 하지만 개념 자체가 여전히 모호하며, 임상심리학을 비롯해 심리학 내 여러 분야에서 상이한 개념 및 모델이 존재한다. 우리가 아는 바로는 국내에서 자기조절에 대한 체계적인 개관이 부족한 실정이다. 본 개관에서는 자기조절과 관련해 심리학 내의 각 분야를 대표하는 주요 이론들, 측정도구 그리고 심리적 개입법을 살펴보았다. 아울러, 임상적인 수준의 장애를 가진 환자들뿐만 아니라 일반인들의 정신건강 증진을 위한 목표-중심 자기조절 프로그램 개발의 필요성을 제안하였다.

플라세보의 정신과적 응용

손인기,김임렬 대한정신약물학회 2014 대한정신약물학회지 Vol.25 No.2

As the placebo effect is inevitable in almost all types of treatment implemented in the context of the doctor-patient relationship,it would be a wise strategy to try to enhance the treatment effect by understanding its mechanism and applying it clinically. However, for various reasons there is resistance to therapeutical application of placebos. The main reason for this resistancecomes from the confusion about the concept of the placebo, and it is necessary to differentiate the placebo response and the placebo effect and understand them clearly. Meta-analytical reviews of clinical studies showed that the placebo effect accounts for part of clinical effect of drugs. Authors reviewed meta-analytic studies dealing with the placebo effect on depression,sleep disorders, dementia, anxiety and addiction. In addition, we discussed the current state of placebo use and also the way to promote the placebo effect. 의사-환자 관계의 맥락에서 시행되는 모든 치료에는 플라세보 효과가 개입한다. 이때 플라세보 효과에는 플라세보를 투여해서 나타나는 심리생물학적 반응(플라세보 반응)과 다른 반응이 포함된다. 플라세보를 연구하고 응용하기 위해서는 플라세보 반응과 다른 반응을 구분하는 것이 필요하다. 여러 연구들에서 우울증, 수면장애와 불안장애의 치료에는 플라세보 효과가 개입하는 것이 입증되었으며, 항우울약물의 경우 그 효과의 75%까지 플라세보 효과로 설명하는 연구자들도 있다. 플라세보는 뇌의 보상(reward)과 연관되므로 중독물질에 대한 반응 역시 플라세보 효과의 영향을 받는다. 치매 치료 약물에 대한 반응과 치매의 진행 정도의 상관성을 조사한 연구를 통해서 전전두엽의 기능이 플라세보 효과와 밀접한 연관이 있음을 추정할 수 있다. 약물 치료로서 플라세보를 사용하는 것에는 윤리적, 법적 문제가 제기될 수 있다. 그러나 약물치료의 효과가 실제 약물의 효과와 플라세보의 효과의 합이라고 한다면 플라세보의 효과를 증진시키는 것은 약물치료의 효과를 최대화한다는 점에서 가치 있는 일이다. 이를 위해서 긍정적 기대를 생성하거나 증진시키는 것이 필요하다. 이때 환자의 질병 경험을 잘 이해하고, 이를 바탕으로 시행될 치료가 어떻게 효과를 나타낼 것인지를 미리 설명하는 것, 비현실적인 기대를 피하는 것과 본질적인 변화가 서서히 나타나면서 결국에는 완전히 변할 것이라는 믿음을 주는 것과 함께 본인의 참여도 중요하다고 강조하는 것이 필요하다.

감마나이프 방사선수술 후 발생한 급속 순환성 이차성 조증 1예

정찬호,채정호,김임렬,이정균,이규항,Chung, Chan-Ho,Chae, Jeong-Ho,Kim, Im-Ryol,Lee, Chung-Kyoon,Lee, Kyu-Hang 대한생물정신의학회 1996 생물정신의학 Vol.3 No.2

A case of rapid cycling mania secondary to gamma-knife radiosurgery for the treatment of refractory epilepsy was reported. A 21-year old woman who had a gamma-knife radiosurgical operation for the treatment of refractory seizure two years ago was admitted because of manic episodes. Although seizure was relieved, manic symptoms like decreased need for sleep, elated mood, unprovoked laughing, grandiose delusion and bizarre behaviors were developed 11 months after the operation. These symptoms recurred lour rimes for eight months. There were no past personal and family history of mood disorders. Laboratory examinations including electroencephalogram ana endocrinological study did not show any abnormal findings. The rapid cycling secondary manic was relieved by lithium. She was then discharged after 5 months. Mood change was not significant during follow-up while hypomania emerged by dose reduction. The secondary mania seemed to be caused or triggered by the right temporal lobe damage induced by gamma-knife radiosurgery.

조현병 환자의 유병기간에 따른 강박증상

서주현,백인호,김임렬,김수룡,조정민,Seo, Ju-Hyun,Paik, In-Ho,Kim, Im-Yel,Kim, Su-Ryong,Jo, Jung-Min 대한생물정신의학회 2018 생물정신의학 Vol.25 No.2

Objectives The aim of this study was to evaluate the psychopathological features such as depression and anxiety in schizophrenics with obsessive-compulsive symptoms (OCS) as well as the severity of OCS according to duration of schizophrenia. Methods We randomly selected sixty four inpatients with schizophrenia. We classified the patients into two groups (OCS group, non-OCS group) according to the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Clinical and demographic features were evaluated. To assess OCS, Y-BOCS were performed. The Korean version of the Positive and Negative Syndrome Scale(K-PANSS), the Brief Psychiatric Rating Scale (BPRS), the Korean version of the Calgary Depression Scale for Schizophrenia (K-CDSS), the Beck Anxiety Inventory (BAI) and the Satisfaction With Life Scale (SWLS) were conducted. Independent t-test and chi-square test were conducted to compare the two groups. Pearson correlation analysis was performed to examine the relationship between the duration of schizophrenia and the Y-BOCS score. Results The Y-BOCS, K-CDSS, and BAI scores were higher in the OCS group. There was a significant correlation between the duration of schizophrenia and the Y-BOCS score. Conclusions Anxiety and depression symptoms were severe in the OCS group. In addition, the results of this study indicate that the longer duration of schizophrenia, the more severe the OCS. Therefore, the evaluation of OCS in schizophrenics should be accompanied by treatment intervention.

한국인 정신분열병 환자의 안구추적운동 이상과 COMT 유전자의 Val108/158Met 다형성의 연합 연구

장호준,문현일,이연정,김임렬,이인상,서한길,김기훈,신태민,박병래,신형두,한선호,한상우,우성일,Jang, Ho Joon,Moon, Hyun-Il,Lee, Yeon Jung,Kim, Im-Yel,Lee, In-Sang,Seo, Han-Gil,Kim, Ki-Hoon,Shin, Tae-Min,Park, Byung-Lae,Shin, Hyung Doo,Han, Sun 대한생물정신의학회 2008 생물정신의학 Vol.15 No.4

Objectives : We investigated the association of Val108/158Met polymorphism on catechol-O-methyl transferase(COMT) gene with smooth pursuit eye movement(SPEM) abnormality in Korean schizophrenia patients. Methods : We measured SPEM in 217 Korean schizophrenia patients(male 116, female 101) and divided them into two groups, one was a good SPEM function group and the other was a poor SPEM function group. Then we analyzed Val108/158Met polymorphism on COMT gene. We compared the differences of genotype and allele distributions of the polymorphism on COMT gene between the two groups. Results : The natural logarithm value of signal/noise ratio(Ln S/N ratio) of the good SPEM function group was $4.39{\pm}0.33$(mean${\pm}$s.d.) and that of poor SPEM function group was $3.17{\pm}0.71$. There were no statistically significant differences of age and male/female ratio between the two groups. There were no significant differences of genotype or allele distributions of the Val108/158Met polymorphism on COMT gene between the two schizophrenic groups. Conclusions : The results suggest that Val108/158Met polymorphism on COMT gene is not related to SPEM function abnormality in schizophrenia.

한국인 정신분열병 환자의 안구추적운동 이상과 Dystrobrevin Binding Protein 1(DTNBP1) 유전자의 SNP A와 P1763 다형성의 연합에 대한 연구

이창희,박병래,김령효,김동현,조숙현,박진수,김임렬,이인상,서한길,변기욱,김봉조,한규희,김기훈,신태민,신형두,우성일,Lee, Chang Hee,Park, Byung-Lae,Kim, Lyoung Hyo,Kim, Dong Hyeon,Cho, Sook Hyun,Park, Jin-Soo,Kim, Im-Yel,Lee, In-Sang,Seo, Han-Gil,Byun, 대한생물정신의학회 2006 생물정신의학 Vol.13 No.4

목 적: 정신분열병 환자의 안구추적운동 이상은 유력한 생물학적인 지표이나 유전자적인 원인에 대한 연구가 활발히 진행되지 못하였다. 최근 여러 연구들에서 dystrobrevin binding protein 1(DTNBP1, dysbindin)이 정신분열병의 원인 유전자의 후보 유전자로서 시사되었으나 정신분열병 환자의 안구운동 이상의 원인으로 작용할 것인지에 대한 연구는 거의 없었다. 본 연구의 목적은 DTNBP1 유전자상에 존재한 비교적 인접한 두개의 단염기 다형성들인 SNP A와 P1763이 정신분열병 환자의 안구추적운동 이상의 유전자적인 원인으로 작용할 것인지를 알아보고자 시행되었다. 방 법: 대상군은 217명의 입원한 만성 정신분열병 환자들이며 안구운동(SPEM)을 측정하였고, 신호/잡음의 자연대수 값(Ln S/N ratio)을 구하여 안구운동이 우수한 군과 열등한 군으로 구분하였다. 이후 대상군의 혈액에서 추출한 DNA로부터 DTNBP1 유전자상의 단 염기 다형성들인 SNP A와 P1763를 분석하여 유전자형과 대립인자형을 알아낸 후, 안구운동 이상 유무에 따른 두 군사이의 분포의 차이를 조사하였다. 결 과: 정신분열병 환자들 중 안구운동이 우수한 군의 신호/잡음의 자연대수 값(Ln S/N ratio)의 평균과 표준편차는 $4.39{\pm}0.33$이었고, 안구운동이 열등한 군의 신호/잡음의 자연 대수 값(Ln S/N ratio)의 평균과 표준편차는 $3.17{\pm}0.71$이었다. 두 군 사이에 나이나 성별비율의 차이는 통계적으로 의미가 없었다. SNP A와 P1763의 유전자형과 대립인자형의 분포의 차이는 안구운동 이상 유무에 따라 구분한 두군 사이에 나타나지 않았다. 결 론: DTNBP1 유전자상에 존재한 SNP A와 P1763은 정신분열병 환자의 안구추적운동 이상의 유전자적인 원인으로 작용한다는 증거를 얻지 못하였다. Objectives : We investigated the association of SNP A and P1763 polymorphisms on dystrobrevin binding protein 1(DTNBP1) gene with smooth pursuit eye movement(SPEM) abnormality in Korean schizophrenic patients. Methods : We measured SPEM function in 217 Korean schizophrenics(male 116, female 101) and divided them into two groups, one is a good SPEM function group and the other is a poor SPEM function group. We then analyzed SNP A polymorphism and P1763 polymorphism on DTNBP1 gene from their DNAs extracted from their blood. We compared the differences of genotype and allele distributions of the two polymorphisms on DTNBP1 gene between the two groups. Results : The Ln S/N ratio(mean${\pm}$SD) of the good SPEM function group was $4.39{\pm}0.33$ and the ratio of poor SPEM function group was $3.17{\pm}0.71$. There were no statistically significant differences of age and male/female ratio between the two groups. There were no significant differences of genotype or allele distributions of the SNP A polymorphism and P1763 polymorphism on DTNBP1 gene between the two schizophrenic groups divided by SPEM function. Conclusion : The results suggest that SNP A polymorphism and P1763 polymorphism on DTNBP1 gene might not be related to SPEM function abnormality in schizophrenia.

한국인 정신분열병 환자의 안구추적운동 이상과 Dystrobrevin Binding Protein 1(DTNBP1) 유전자의 P1635와 P1655 단염기 다형성의 연합에 대한 연구

박진수,박병래,김령효,김동현,장호준,김임렬,이인상,서한길,이철순,김봉조,한규희,정한용,김기훈,신태민,신형두,우성일 대한정신약물학회 2006 대한정신약물학회지 Vol.17 No.6

Objective : We investigated the association of P1635 and P1655 polymorphisms on dystrobrevin binding protein 1(DTNBP1) gene with smooth pursuit eye movement(SPEM) abnormality in Korean schizophrenia patients. Methods : We measured SPEM function in 216 Korean schizophrenia patients(male 116, female 100) and divided them into two groups, one is a good SPEM function group and the other is a poor SPEM function group. We then analyzed P1635 polymorphism and P1655 polymorphism on DTNBP1 gene from their DNAs extracted from their blood. We compared the differences of genotype and allele distributions of the two polymorphisms on DTNBP1 gene between the two groups. Results : The Ln S/N ratio(mean ± sd) of the good SPEM function group was 4.39 ± 0.33 and the ratio of poor SPEM function group was 3.18 ± 0.71. There were no statistically significant differences of age and male/female ratio between the two groups. There were no significant differences of genotype or allele distributions of the P1635 polymorphism and P1655 polymorphism on DTNBP1 gene between the two schizophrenia groups divided by SPEM function. Conclusion : The results suggest that P1635 polymorphism and P1655 polymorphism on DTNBP1 gene might not be related to SPEM function abnormality in schizophrenia. 연구목적:정신분열병 환자의 안구추적운동 이상은 유력한 생물학적인 지표이나 유전자적 원인에 대한 연구가 활발히 진행되지 못하였다. 최근 여러 연구들에서 dystrobrevin binding protein 1(DTNBP1, dysbin-din)이 정신분열병의 원인 유전자의 후보로서 시사되었고, 그 유전자에서 번역된 dysbindin의 발현의 저하가 정신분열병 환자의 해마 및 CA2, CA3 부위 조직에서 나타난다는 보고가 있었다. 그러나 DTNBP1 유전자가 정신분열병 환자의 안구운동 이상의 원인 유전자로 작용할 것인지에 대한 연구는 거의 없었다. 본 연구의 목적은 DTNBP1 유전자상에 존재한 비교적 인접한 두개의 단 염기 다형성들인 P1 635와 P165가 정신분열병 환자의 안구추적운동 이상의 유전자적인 원인으로 작용할 것인지를 알아보고자 시행되었다. 방 법 :대상군은 216명의 입원한 만성 정신분열병 환자들이며 안구운동(SPEM)을 측정하였고, 신호/잡음의 자연 대수 값(Ln S/N ratio)을 구하여 안구운동이 우수한 군과 열등한 군으로 구분하였다. 이후 대상군의 혈액에서 추출한 DNA로부터 DTNBP1 유전자상의 단 염기 다형성들인 P1 635와 P1655를 분석하여 유전자형과 대립인자형을 알아낸 후, 안구운동 이상 유무에 따른 두 군사이의 분포의 차이를 조사하였다. 결 과 :정신분열병 환자들 중 안구운동이 우수한 군의 신호/잡음의 자연대수 값(Ln S/N ratio)의 평균과 표준편차는 4.39 ± 0.3이었고, 안구운동이 열등한 군의 신호/잡음의 자연 대수 값(Ln S/N ratio)의 평균과 표준편차는 3.18 ± 0.71이었다. 두 군 사이에 나이나 성별비율의 차이는 통계적으로 의미가 없었다. P1 635와 P 1655의 유전자형과 대립인자형의 분포의 차이는 안구운동 이상 유무에 따라 구분한 두 군 사이에 나타나지 않았다.

여성 알코올중독 환자의 인격 특성에 관한 연구

성상경(Sang-Kyung Sung),강지언(Ji-Eon Kang),김임렬(Im-yel Kim),함웅(Woong Hahm) 한국중독정신의학회 1998 중독정신의학 Vol.2 No.1

Objectives:This study was performed to identify the characteristics of alcoholics by comparing the characteristics of male and female alcoholics with those of a control group and to make therapeutic consideration for female alcoholics by using the identified characteristics of female alcoholics. Subjects and Methods:1) Subjects:We made two experimental groups composed of male alcoholics (N=34) and female alcoholics (N=34) who had been admitted to Keyo Hospital from January 1992 to May 1996 and one control (normal female adult) group (N=34) composed of students, the hospital personnel, and their family members. We controlled the age and the number to compare the groups. The average age of female alcoholics was 41.12±9.9, male alcoholics 41.23±10.22, and the control group 39.47±12.80. All male and female patients satisfied the DSM-Ⅲ-R criteria of alcohol dependence. 2) Method:We reviewed the patients’ charts and used a demographic statistical questionnaire and MMPI questionnaire. 3) Data analysis:Student’s t-test and chi-square test were used where appropriate. All statistical analyses were carried out with SPSSPC+Version 4.0 software. A probability of p<0.05 (two-tailed) was accepted as statistically significant. Result:1) The demographical statistics showed that the education level, economic status, and occupational status of the male and female patient groups were significantly different from those of the female control group. 2) As regards the drinking history, the reason for alcohol drinking and use of other substances, there was no difference between the male and female patient groups. But the female patient group was significantly different from the female control group. 3) When the characteristics of the male and female patient groups were compared through mean MMPI T-scores, they were not significantly different from each other. But the female patient group was significantly different from the female control group. 4) The code type comparison showed that the female and male patient groups marked higher frequency of Pd scale score on one code digit than the female control group. Also the female patient group had higher frequency of characterological profile by Lachar classification on two code digit than the female control group. Conclusion:Therefore female alcoholics are different from normal female adults. They are more impulsive and antisocial. And they have marital problem, anxiety, insomnia, and affective problem.