위암 수술 환자에서의 삶의 질 -WHOQOL-BREF의 타당도 및 유용성-

박이진,정양환,한상익,김진조,박승만,Park E-Jin,Jeon Yang-Whan,Han Sang-Ick,Kim Jin-Jo,Park Seung-Man 대한위암학회 2004 대한위암학회지 Vol.4 No.4

목적: 본 연구는 위암 환자에서 한국판 단축형 세계보건 기구 삶의 질 척도의 타당도를 검증하고 이를 이용하여 위암 환자의 삶의 질을 평가하고자 하였다. 대상 및 방법: 가톨릭대학교 의과대학 성모자애병원 외과에서 근치적 절제술을 받은 50명의 위암 환자를 대상으로 하였으며 나이, 성별을 고려하여 선정된 성모자애병원 직원 50명을 대조군으로 하였다. 모든 대상군에게 100문항으로 이루어진 세계보건기구 삶의 질 척도를 구성하는 26문항을 선별하여, 환자군과 대조군에서 신체영역, 심리영역, 사회영역, 독립성 영역의 점수를 비교하였다. 결과: 각각의 영역에서 단축형 세계보건기구 삶의 질 척도 점수와 의미있는 상관관계를 보였다. 그리고 신체영역과 사회영역에서 위암 수술 환자의 삶의 질은 대조군과 비교해서 낮은 것으로 나타났다. 결론: 한국판 단축형 세계보건기구 삶의 질 척도는 위암 환자의 삶의 질을 평가하는 데 유용하고 타당한 도구라고 생각된다. Purpose: This study was designed to investigate the validity of WHOQOL-BREF (Brief form of the World Health Organization Quality of Life Assessment Instrument) and to explore quality of life (QOL) by using WHOQOL-BREF in patients with stomach cancer after a curative resection. Materials and Methods: Fifty (50) patients with stomach cancer after a curative resection were recruited with informed consents. Age- and gender matched hospital staffs served as controls. The 100-item WHOQOL instrument was employed for the all subjects. The scores of the WHOQOL-BREF, which is a short version (26 questions) of the WHOQOL, and includes four domains (physical, psychological, social, and environmental), were compared with those of WHOQOL. Results: The scores of the WHOQOL-BREF were significantly correlated with those of the WHOQOL in all domains. Two domains, physical and social, were associated with worse quality of life in patients with stomach cancer after a curative resection. Conclusion: The WHOQOL-BREF is a valid instrument that is useful for evaluating the quality of life in patients with stomach cancer.

병적 도박의 유형별 특징 : 1년 추적 조사

박이진(E-Jin Park),신경철(Kyung-Chul Shin),김지욱(Jee Wook Kim),최영숙(Young-Sook Choi),최용성(Yong-Sung Choi) 한국중독정신의학회 2011 중독정신의학 Vol.15 No.2

Objectives : This study evaluated the characteristics and prognoses of pathological gamblers in accord with the three subtypes of the Pathways Model. Methods : Subjects were inpatients with pathological gambling (N=30). We obtained these subjects’ demographic data, evaluated them using a neuropsychological battery, and investigated their prognoses at their third, sixth, and twelfth months after discharge. Results : The ‘Emotionally vulnerable problem gamblers (EV)’ and ‘antisocial, impulsive prob-lem gamblers (AI)’ subtypes had significantly more depressive illnesses than the ‘behaviorally conditioned problem gamblers (BC)’ subtype had. Moreover, the AI subtype had significantly higher relapse rates at the third, sixth, and twelfth months than either the BC or EV subtypes had. Conclusion : These results suggest the differing Pathway Model subtypes in pathological gambling have different etiologies, progressions, and prognoses, and that problem gamblers of the AI subtype have a high relapse rate. Furthermore, this suggests the Pathway Model of pathological gambling could be useful in the understanding and treatment of pathological gambling.

알코올의존 환자와 병적 도박 환자의 사건관련전위 P300

박이진(E-Jin Park),신경철(Kyung-Chul Shin),최용성(Yong-Sung Choi) 한국중독정신의학회 2010 중독정신의학 Vol.14 No.2

Objectives:This study aimed to evaluate an auditory and visual event-related potential, the P300, in patients diagnosed with alcohol dependence or pathological gambling. Methods:Subjects comprised patients with either alcohol dependence (N=24) or pathological gambling (N=24) and normal controls (N=24). To determine the subjects’ topographic auditory and visual event-re-lated P300 potentials, we used the standard “Oddball paradigm” method, measured via the conventional Global Field Power method. Results:In patients with alcohol dependence or pathological gambling, the amplitudes of auditory and visual event-re-lated P300s were significantly lower than those of normal controls (p<0.01). The auditory P300 amplitude and latency revealed no significant differences between the alcohol dependence and pathological gambling patients. In pathological gambling patients, the visual P300 latencies were significantly later at Fz, Cz, and Pz than they were in alcohol dependence patients (p<0.01). Conclusion:These results suggest patients with alcohol dependence or pathological gambling have brain dysfunctions with certain neuro-physiological aspects. Visual P300 latencies at Fz, Cz, and Pz occurred significantly later in pathological gambling patients than in alcohol dependence patients, suggesting that pathological gambling patients may have greater cognitive function impairment than alcohol dependence patients have.

여성 우울증 입원 환자에서 폐경 여부에 따른 인지기능의 차이

유지영,민정아,전양환,한상익,박이진,You, Ji-Young,Min, Jung-Ah,Jeon, Yang-Whan,Han, Sang-Ick,Park, E-Jin 대한생물정신의학회 2016 생물정신의학 Vol.23 No.4

Objectives Although forgetfulness is a common complaint among menopausal depressed women, there is still a debate about the relationship between memory impairment and menopause. The aim of this study is to examine whether menopause is related to cognitive decline among women with depressive disorders. We hypothesized that postmenopausal depressed women show generally poorer performance than premenopausal depressed women on various cognitive function tests. Methods With a retrospective chart review, we identified a total of 87 female patients (45 premenopausal patients and 42 postmenopausal patients) who were hospitalized with depressive disorders from 2000 to 2016. Demographic and clinical variables and cognitive test results were compared between two groups. Results Education year is longer in premenopausal group than postmenopausal group whereas clinical characteristics (illness duration, recurrence, and symptom severity) and mean Intelligence Quotient (IQ) were similar between two groups. The postmenopausal group took longer time for Bender-Gestalt Test (BGT) recall, Trail Making Test (TMT)-A, and TMT-B than the premenopausal group. After controlling for age and education, significant difference was remained for BGT recall (p = 0.029). Conclusions Postmenopausal state may be related with decline of visuospatial memory function, in particular, among depressed female patients. Other areas of cognitive function including complex attention, verbal memory, auditory memory, and working memory might be interpreted while considering age and education level.

청소년의 인터넷 중독 정도에 따른 정신과적 공존질환 및 행동 양상에 관한 연구

이준영(June-Young Lee),박이진(E-Jin Park),조근호(Keun-Ho Joe),채숙희(Suk-Hi Chai),김성벽(Sung-Byuk Kim),이창욱(Chang-Uk Lee),김대진(Dai-Jin Kim) 한국중독정신의학회 2010 중독정신의학 Vol.14 No.1

Objectives:This study aimed to clarify the differences in psychiatric comorbidities and, behavioral patterns correlating with the severity of Internet addiction in adolescents. Methods:We assessed 321 adolescents recruited from an Internet rescue school, psychiatric outpatients, and 4 schools in Seoul and Gyeonggido. We divided them into a non-addicted group, a potential-risk group, and a high-risk group according to Young’s Internet Addiction Test (IAT). We evaluated their psychiatric comorbidities and behavioral patterns via psychiatric clinical interview, the Children’s Depression Inventory (CDI), the State-Trait Anxiety Inventory (STAI), and a self-report questionnaire about behavioral pat-terns. Results:There were significant differences in CDI and STAI scores among the 3 groups. The IAT, CDI, and STAI scores correlated positively with each other. There were differences in psychiatric comorbidity distributions between the potential-risk and high-risk groups, but only “other mood disorder” showed a significant difference. There were also significant differences in behavioral patterns among the 3 groups. Conclusion:This study suggests that there are psychiatric comorbidity and behavioral pat-tern differences according to Internet addiction severity in adolescents. We expect further studies will reveal more profound understandings of these relationships.

마음챙김 명상, 치료인가 종교적 수행인가?

신경철(Kyung-Chul Shin),박이진(E-Jin Park) 대한사회정신의학회 2016 사회정신의학 Vol.21 No.2

동양문화에서 발생한 명상은 20세기에 와서 Maharishi Mahesh의 초월명상(Transcendental meditation)과 Jon Kabat-Zinn의마음챙김 명상(Mindfulness based stress reduction, MBSR)등의 형태로 서구에 소개된 이후, 명상이 여러 신체 질환과 정신 질환의 치료에 효과가 있음을 증명되었고, 치료의 영역에서 명상의 사용이 확대되어 왔다. 그러나 우리나라에서는 서구보다 명상에 대해 오히려 많은 편견들이 있어 명상이 치료에 사용되는데 장애로 작용하고 있다. 본 논문에서는 치료적 목적으로써의 명상과 종교적 수행으로써의 명상이 공통점과 차이점이 무엇인지 알아보고자 하였다. 마음챙김(mindfulness)이란 지금-여기에서(here and now) 일어나는 모든 것들에 대해서 또렷이 깨어있는 것(awareness)을 말한다. MBSR의 마음챙김 명상에서 삶을 보는 견해가 달라지고 심상과 욕망의 집착을 끊는 성장을 통해 치유가 이루어진다. 따라서 MBSR 프로그램을 통한 훈습이 명상의 종교적 수행과 완전히 별개의 것이라고 보기도 어렵다. 해탈이라는 목표를 명시적으로 하느냐와 해탈을 목표로 할 때 수행의 치열함 등이 다르다고 할 수 있겠다. 질환으로 고통 받는 환자들과 각종 스트레스에 직면한 일반인들은 치유적인 MBSR 프로그램을 통해 배움과 성장, 치유를 얻고 자각의 삶이 주는 건강함을 가지게 되는 것만으로도 MBSR의 의미가 충분이 있다고 하겠다. 심리적 안정이나 자아의 발달 과제가 선행되어야 할 필요가 있는 사람들은 마음챙김 명상을 통해서만 모든 문제를 해결하고자 할 것이 아니라 수행자 개인의 심리적 특성에 따라 심리치료와 같은 개입을 병행할 필요가 있다. Oriental Meditation in the 20th century was introduced to the West in the form of Transcendental meditation by Maharishi Mahesh and Mindfulness based stress reduction (MBSR) by Jon Kabat-Zinn. It has been proved to be effective in the treatment of physical illness and mental disorders, and the use of meditation in the field of therapy has been expanded. In Korea, however, there are many prejudices about meditation rather than western, which makes meditation an obstacle to its use in therapy. In this paper, we tried to investigate the similarity and difference between meditation as therapeutic purpose and meditation as religious practice. Mindfulness means awareness of everything that happens here and now. In mindfulness meditation, the view of life is changed and the healing is achieved through growth that breaks the attachment to thoughts and desires. Therefore, meditation practice in MBSR is hardly regarded as completely separate from the religious practice of meditation. They differ in the explicitness of the goal to enter into nirvana and the fierceness of practice in the goal of nirvana. Patients suffering from the disease and those facing various stresses can learn, grow and MBSR has enough meaning just to have the health of life through awareness. Those who need to achieve psychological stability or developmental tasks should not only solve all problems through mindfulness meditation but also intervene with psychological treatment according to their psychological characteristics.

정신분열병 환자에서 세가지 청각 자극 "Oddball" 모형에 의한 사건관련전위 P3a와 P3b

진용탁,박이진,남지민,한상익,전양환 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.5

Objectives : Using 3-stimulus auditory "oddball" paradigm reflecting fronto/central and temporo/parietal functions Simultaneously, we examined patients with schizophrenia. Methods : fifteen patients with schizophrenia from outpatient clinic and fifteen normal controls from hospital staffs were recruited for the study. To elicit P3a and P3b, 3-stimulus auditory oddball paradigm was employed. The 3-stimulus auditory oddball paradigm was composed of standard tone (1,000 Hz, 75 dB, 80%), target tone (2,000 Hz, 75 dB, 10%) and distracter (White noise, 95 dB, 10%). Results : P3a and P3b were prominent in fronto/central and temporo/parietal areas, respectively, in both schizophrenics and normal controls. The P300 amplitude in patients with schizophrenia was reduced across P3a and P3b (p<0.01). The P300latency in patients with schizophrenia was delayed across P3a and P3b (p<0.01). Conclusion : These results were consistent with frontal and temporo-parietal lobe dysfunctions in schizophrenics. The 3-stimulus auditory paradigm could be applied for patients with schizophrenia and useful for further exploration the disorder.

급성기 주요우울장애 환자에서 Natural Killer T 세포

박이진,이제훈,이권행,한상익,전양환 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.3

Objectives : To evaluate an association between depression and altered immunity, we examined peripheral T lymphocyte or natural killer (NK) cell measures plasma ACTH and cortisol using the flow cytometry in acute and unmedicated patients with major depressive disorder (MDD). Methods : Forty-two patients with MDD from the outpatient clinic and forty normal controls from the hospital staff were recruited. We applied Hamilton Rating Scale for Depression (HAM-D) and Hamilton Rating Scale for Anxiety (HAM-A) for depressed subjects. Peripheral T lymphocyte or NK cell measures (CD3, CD4, CD8, or CD56) and plasma hormones (ACTH and cortisol) were obtained from all subjects. Results : There were no statistical differences in CD3, CD4, CD8, or CD56 between the two subjects. The number of CD56 cells negatively correlated with HAM-D scores (r= -0.42, P<0.01), but did not correlate with HAM-A scores in patients with MDD. The number of CD56 cells showed strong negative correlation with CD4/CD8 (r= -0.47, P<0.01) in the control group, but not in the depressed group. Patients with MDD had higher cortisol level than controls within the normal range. Conclusion : The trait of immunological imbalance and HPA axis abnormality were shown in patients with MDD. Especially, the severity of depression, but not the anxiety, could be reflected as decreased number of CD56 (NK T) cells in acute and Unmedicated state.

전신경련을 동반하며 가족력이 뚜렷한 Huntington씨병 1례

김정수,박이진,홍승철,한진희,이성필 대한신경정신의학회 2001 신경정신의학 Vol.40 No.1

Huntington씨병은 진행성 무도증, 정신증상 및 치매를 주 증상으로 하며 상염색체 우성으로 유전되는 중추신경계의 퇴행성 질환이다. 저자들은 뚜렷한 가족력을 보이며 치매와 무도증을 주 증상으로 하면서 특이하게도 전신경련이 동반되어 나타나는 Huntington씨병 환자 1례를 경험하였기에 이를 문헌고찰과 함께 보고한다. 환자는 44세의 기혼 남성으로 약 7년 전부터 서서히 기억, 집중력 장애 및 우울증이 시작되었으며 이후로 사지의 불수의 운동, 무도증으로 발전되었으며 내원 4년전부터는 전신경련이 나타나기 시작하였다. 증상은 점차로 진행되어 내원 당시에는 면담이 불가능하고 실인증, 실어증이 뚜렷한 심한 치매상태였으며 무도중 및 전신경련이 자주 나타나고 보행장애로 거의 누워서 지내는 등 질환의 말기 상태로 판단되었다. 임상증상과 분명한 상염색체우성 유전의 가족력을 통하여 진단이 가능하였으며 뇌자기 공영상 검사에서 전반적인 뇌피질 위축 및 양측 기저핵 특히 미상핵의 위축이 뚜렷하여 진단을 뒷받침 하였다. 임상적으로는 전신경련이 나타난 점이 특징적이었는데 경련은 valproate로 조절이 가능하였다. Huntington's disease(HD), an autosomal dominant disorder, is characterized by progress iveinvoluntary choreiform movement, psychiatric symptoms, and dementia. We experienced a 44-year-old male HD patient with prominent family history of the disease who showed dementia and involuntary movements including chorea. The diagnosis was made by clinical symptoms, family hitsory of the disease, and brain MRI findings to show bicaudate atrophy and diffuse cortical atrophy with marked ventricualr dilatation. Interestingly, the patient frequently ex-hibited generalized tonic-clonic seizures. The seizures first appeared about 3 to 4 years after the onset of HD and were controlled with valproic acid. To our knowledge, this may be the first case of late-onset HD accompanied by generalized seizures and we report this case with lite-rature review.