인터넷 중독증

사공정규 대한생물치료정신의학회 2002 생물치료정신의학 Vol.8 No.1

우울증 환자에서 불안장애의 동반이환 : 우울증 임상연구센터 코호트연구

사공정규,이도윤,서호석,성형모,김정범,정영은,이민수,김재민,조선진 대한우울조울병학회 2011 우울조울병 Vol.9 No.1

Purpose : Anxiety disorder and depressive disorder are often comorbid with each other, and the comorbidity is associated with poorer psychiatric outcome, resistance to treatment, increased risk for suicide, greater chance for recurrence. We aimed to investigate the comorbidity of anxiety disorder in Korea. Method : Subjects were total of 867 depressed patients recruited CRESCEND-K multicenter trial. We used SCID (Structured Clinical Interview for DSM - IV) to find comorbidity of anxiety disorders in depressed patient. Results : Of 867 patients, total 8.2% had anxiety disorder. Proportion of anxiety disorder Not Otherwise Specified was 3.5%, panic disorder was 1.7%, generalized anxiety disorder was 1.1%, post traumatic stress disorder was 0.9%, obsessive compulsive disorder was 0.6%, social phobia was 0.4%. Conclusion : In this study, anxiety disorder in depression were measured at a low comorbidity rate in compare to previous studies. Selection bias, use of antidepressants at registration, severity of depression symptoms, and point of SICD administration seems to have affected these results. It is probable that comorbidity evaluation would be more precise if shorter, structured interviews such as M.I.N.I.-Plus were used during first clinical interview for depression diagnosis. (J of Kor Soc for Dep and Bip Disorders 2011;9:30-36)

아동기 학대 경험 및 인지된 부모의 양육 태도가 불안장애 환자의 해리 증상에 미치는 영향

사공정규,송창진,손인기,이종훈,이광헌 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.1

Objectives : To compare clinical symptoms and the degree of dissociative symptoms between patients who have with or without childhood adverse experiences. Method : Sixty female anxiety patients were administered the Childhood Abuse Questionnare , the Dissociative Experiences Scale(DES), the Parent-Child Bonding Inventory(PBI), and the Symptoms Checklist 90-R(SCL-90-R) Results : 1) The clinical diagnosis were not different between patients with and without a history of childhood abuse. 2) The anxiety disorders patients have a history of childhood sexual abuse showed significantly higher scores in the DES, and somatization subscale of the SCL 90-R. 3) The anxiety disorders patients have a history of childhood physical abuse showed not different in the DES, but showed higher scores in the somatization subscale of the SCL 90-R. 4) The maternal care subscale of the PBI were inversely correlated with the DES. Conclusions : Experiences of childhood sexual abuse and low perceived maternal care are associated with higher dissociative experience scores. Experiences of childhood sexual and physical abuse are associated with higher somatization scores.

정신보건관련인력의 정신질환자에 대한 태도 연구

사공정규,송창진,손인기 東國大學校 2000 東國論叢 Vol.39 No.-

Attitudes of the health personnel toward the mentally ill affect the development and utilization of the community mental health program and reintegration of the mentally ill into society. Therefore the authors carried out a survey of attitudes toward mentally ill in the health personnel by measuring Community Attitudes to the Mentally Ⅲ Inventory(CAMI). The purpose of this survey was to get basic data to develop plan and strategy of community mental health in Pohang city. The results were as follows : (1) The health personnel of Pohang community showed positive attitude of 'Benevolence' and 'Community mental health ideology' and negative attitude of "Authoritarianism' and 'Social restrictiveness'. Therefore community mental health project in Pohang city will be established and activated easily. (2) The male group had more authoritative, less community mental health oriented attitude. (3) the more aged group had more authoritative, social restrictive attitude. (4) the unmarried group had less authoritative, social restrictive attitude. (5) The lower educated group had more authoritative, social restrictive and less benevolent, community mental health oriented attitude. (6) Monthly income 1-2 million Won group had more authoritative, social restrictive attitude, less community mental health oriented attitude. (7) The respondents who have never met mentally ill had less community mental health oriented attitude. (8) The respondents who themselves had used mental health services more benevolent, less authoritative, social restrictive attitude. From the above results, authors propose that planning of mental health project be necessary containing information and education for negative group and making resource for positive attitude group.

포항시 지역주민의 정신질환자에 대한 태도 연구

사공정규,채정욱 대한신경정신의학회 2001 신경정신의학 Vol.40 No.1

Objectives:The purpose of this study is to get basic data to develop plan and strategy of community mental health in Pohang city by identifying attitudes toward mentally ill in Pohang community. Methods:The subjects of this study are the 491 persons aged between 20 and 59 who live in Pohang. Methods of selection for the subjects based on multistage stratified cluster sampling, i.e. by sex, by age, by place of residence(“Up”·“Myeon”·“Dong”), and by ratio to total populations. Tool of the study is Community Attitudes to the Mentally Ill Inventory(CAMI). Results: 1) The residents of Pohang community showed positive attitude in ‘Benevolence’ and ‘Community mental health ideology’ subscale and negative attitude in ‘Authoritarianism’ and ‘Social restrictiveness’ subscale. Therefore community mental health project in Pohang city will be established and activated easily. 2) Aged group had more authoritative, social restrictive and less community mental health oriented attitude. 3) The lower educated group had more authoritative, social restrictive and less benevolent, community mental health oriented attitude. 4) The unmarried group had less authoritative, less social restrictive attitude. 5) The home-owners had more authoritative, more social restrictive attitude. 6) The opinion leaders had more authoritative and less community mental health oriented attitude. 7) The respondents whose family had used mental health services had less benevolent attitude. The respondents who themselves had used mental health services had more authoritative, less benevolent and community mental health oriented attitude. Conclusions:Therefore, it will be necessary to give public information and education for those who have negative attitude groups of aged, low educated, home-owners, opinion leaders and respondents who themselves or whose family had used mental health services. If resource could be made of persons of positive attitude groups of younger aged, highly educated and unmarried, community mental health project will be more efficient 연구목적: 포항시 지역사회 정신보건사업을 수행함에 있어, 포항시 지역주민의 정신질환자에 대한 태도를 평가하고 이를 결정하는 요인과의 상관관계를 밝혀서 향후 포항시에 적합한 지역사회 정신보건사업의 기초자료로 활 용하기 위함이다. 방 법: 2000년 3월에 포항시 지역에 거주하는 지역 주민 중 20∼59세 사이의 성인 인구수를 모집단으로 하였으 며, 성별, 연령별, 읍·면·동별 인구 비율을 준거로 표본 수를 정하는 다단계 층화 표집법을 사용하였다. 총 대상자는 491명이었다. 조사도구는 Community Attitudes to the Mentally Ill Inventory(이하‘CAMI’로 약칭함)를 사용하였다. 결 과: 포항시 지역주민들의 정신질환자에 대한 전반적인 태도를 CAMI 하위척도별로 보면, 권위주의 33.5± 4.84, 자비심 22.8±5.87, 사회생활제한 31.1±5.08, 지역정신보건개념 26.9±4.92로 전반적으로는 긍정적 인 경향을 보였다. 고연령, 저학력, 기혼 집단, 자가 집단, 여론 주도층, 정신질환자 가족 및 본인의 정신과 치료 경험군에서 부정적인 태도를 보였고, 저연령, 고학력, 미혼 집단에서 긍정적인 태도를 보였다. 결 론: 정신질환자에 대해 부정적인 태도를 보인 고연령, 저학력, 기혼 집단, 자가 집단, 여론 주도층, 정신질환자 가족 및 본인의 정신과 치료 경험군에 정신질환자에 대한 부정적 견해, 편견 등을 교정시키기 위한 교육, 계 몽 사업을 우선적으로 시행하여야 할 것으로 생각되며, 정신질환자에 대해 긍정적인 태도를 보인 저연령, 고 학력, 미혼 집단을 지역사회 정신보건사업의 자원으로 활용하여 효율적인 정신보건사업이 될 수 있도록 사업 계획을 수립하는 것이 필요할 것으로 생각된다.

인터넷 중독증

사공정규 대한생물치료정신의학회 2002 생물치료정신의학 Vol.8 No.2

According to the abrupt increase of internet users, there happened some problems in internet usage. Some pathological internet user showed problems in psychological, behavioral areas. they are called 'internet addictor'. So author tried to review the concept of internet addiction, in the realm of 'behavior addiction', and diagnostic issues, cause, related problems. Then author proposed the therapeutic process of internet addiction. 인터넷 중독은 이제 하나의 새로운 사회현상이다. 이 새로운 사회현상을 우리는 병리로 볼 수 있는지, 병리라면 이 인터넷 중독이 기존 정신병리의 새로운 표현형의 하나일 뿐인지, 아니면 독립적인 새로운 정신 질환의 출현으로 봐야 할 지에 대한 진지한 논의가 필요한 단계이다. 그러나 지금까지의 연구는 단편적이며, 연구마다 기준과 시각이 모두 달라 통합하는 것이 어려웠다. 이를 위해서는 앞으로의 연구는 인터넷 중독에 대한 통합되고 공통된 진단기준이 확립되는 것이 선행되어야 할 것이다. 그리고 인터넷 중독이 질병으로서의 진단적 가치를 차치하고라도 현재 많은 사람들이 과도한 인터넷 사용으로 정신적 문제와 학업적, 가정적, 및 직업 및 사회적 장애를 겪는 경우가 많으므로 이에 대한 보다 적절한 평가법과 치료법이 개발되어야 할 것이다.

미래의 항우울제

사공정규,이민수 대한생물치료정신의학회 2011 생물치료정신의학 Vol.17 No.2

Recent advances in research on depression have confirmed that it is common, chronic, recurrent and disabling mental disorder. The treatment of depression has gained growing importance because of its major impact on the patient’s wellbeing, personal and social achievements. Recently, as an increasing number of antidepressants of various types continue to be developed for the treatment of depression, psychopharmacotherpy is the major approach to depression in clinical setting. Unfortunately, there are clear limitations to the currently approved pharmacotherapies of depression, including the fact that they are all essentially monoamine based, have modest efficacy and a relatively slow onset of efficacy, and suffer from significant tolerability issues. Recently, several promising hypotheses of depression and antidepressant action have been formulated. These hypotheses are based on dysregulation of hypothalamic-pituitaryadrenal(HPA) axis, neurotrophic mechanisms, glutamate, neurokinin, phosphodiesterase, cytokines. This article reviews these most promising novel mechanisms that are not represented in compounds currently approved for depression in either the United States or Europe and that may represent the future of the psychopharmacologic treatment of depression.

섬망 치료에 있어서 Quetiapine과 Risperidone의 효과 비교

사공정규,정성원 대한생물치료정신의학회 2011 생물치료정신의학 Vol.17 No.2

본 연구에서는 최근에 개발된 비전형 항정신병 약물인 quetiapine이 섬망의 치료에 효과가 있는지와 비전형 항정신병 약물인 risperidone과 효과의 차이가 있는지 평가하고자 하였다. 총 71명의 환자가 본 연구 대상에 포함되었고 CGI, K-DRS, K-DRS-R-98, K-MMSE를 평가 도구로 하여 치료 전과 치료 일 주일 후 측정한 전체 점수를 비교하였다. 부작용에 대한 평가도구로는 ESRS 점수를 치료 전후에 비교하였다. 연구 결과 두 군 모두에서 일주일 후 측정한 CGI-S, K-DRS, K-DRS-R-98, K-MMSE에서 통계학적으로 유의한 차이를 보였다. 두 군 간 치료전후의 통계학적인 차이는 보이지 않았다. 부작용은 두군 모두에서 나타나지 않았다. 이번 연구에서 quetiapine은 섬망 환자의 치료에 있어 risperidone과 동등한 효과를 보이고 부작용이 적어 섬망 환자의 치료에 안전하게 사용할 수 있을 것으로 기대된다. Objectives:It has been shown that risperidone, an atypical antipsychotics, has effectiveness for treatment of delirium as good as haloperidol and has less side effects than haloperidol. Quetiapine also has less extrapyramidal side effects and has effectiveness for treatment of delirium. The aim of this study was to investigate whether quetiapine is effective for the treatment of delirium compared with risperidone. Methods:All subjects(71 patients) were randomized to receive either risperidone(35 patients) or quetiapine(36 patients) with fixed dose at the first day of treatment. Then, all subjects received either medications with flexible doses according to judgement on clinical status of patients. The effectiveness was evaluated using Clinical Global Impression-Severity(CGI-S), Korean version of Delirium Rating Scale(K-DRS), Korean Mini Mental Status Examination(K-MMSE), and Korean version of Delirium Rating Scale-Revised-98. Results:There was no significant difference between both groups in the baseline K-DRS, K-DRS-R-98, K-MMSE and CGI scores. At the seventh day of the treatment, K-DRS, K-DRS-R-98 and CGI scores were significantly improved from the baseline both in the quetiapine and risperidone treatment group. Conclusion:Quetiapine is effective for treatment of delirium.

일차진료에서 우울증의 진단과 약물치료

사공정규 東國大學校醫學硏究所 2005 東國醫學 Vol.12 No.2

일차 진료를 받는 환자에서 우울증의 빈도는 약 30%에 이르고, 우울증은 기본-정서, 사고-인지, 정신운동활동성, 신체적 영역의 증상들을 수반하며 전반적인 개인적, 사회적 기능 뿐만 아니라 삶의 질에도 영향을 준다. 그러므로 정신과 의사가 아니라도 모든 의사들은 우울증의 진단과 치료에 대한 정확한 이해를 하는 것이 중요하다. 최근 새로운 항우울제가 많이 개발되어 사용됨으로서, 정신약물치료는 임상에서 우울증의 주요한 치료법이 되었다. 의사들은 다양한 항우울제의 사용이 가능하게 되어 항우울제의 선택의 폭이 넓어졌지만, 한편으로는 가장 적절한 항우울제를 선택하는데 어려움이 있다. 그러므로 이 논문은 우울증의 진단과 효과적인 치료방법, 특히 약물치료를 중심으로 살펴보고자 한다. Depression is commonly encountered in a primary care setting. The diagnosis and treatment of depression has gained growing importance because of its major impact on the patient,s wellbeing, personal and social achievements. Depressive disorders are characterized by mood-affect, thought-cognition, psychomotor activity and somatic manifestations. Thus, physicians need to be familiar with accurate diagnosis and treatment. Recently, as an increasing number of newer antidepressants of various types continue to be developed for the treatment of depression, psychopharmacotherpy is the major approach to depression in clinical setting. While physicians have a good chance of choosing the diverse antidepressant, they have difficulties in selecting an appropriate antidepressant. Therefore, this paper summarizes the diagnosis and treatment of depressive disorders, using psychophamacotherapy.

주의력 결핍 과잉 운동장애에 대한 Methylphenidate의 임상 효과

사공정규,박형배,이종범 大韓神經精神醫學會 1994 신경정신의학 Vol.33 No.2

The objectives of this study were to evaluate the effect of methylphenidate on attention deficit hyperactivity disorder, using child attention problem checklist to 42(male : 29, female : 13) attention deficit hyperactivity disorder patients from March 1992 to February 1993. The results were as follows : There was significant improvement on symptoms in the scores rated by teachers in 7th & 28th day after methylphenidate administration compared to baseline score(p<0.05) and 28th day score showed significant improvement compared to 7th day scores(p<0.05). There was significant improvement on symptoms in the scores rated by parents in 28th day after methylphenidate administration compared to baseline score(p<0.05) and 28 th day score showed significant improvement compared to 7th day score. In single administration of methylphenidate in Sunday morning, there was significant improvement on symptoms in morning score compared to afternoon score(p<0.05). In the administration of methylphenidate of same dosage, the 7th day rating score of teacher showed significant improvement on symptoms compared to the Sunday morning rating score of parents(p<0.05) and the 28th day comparision was also showed signigicant improvement on symptoms in the scores rated by teachers compared to the scores rated by parents(p<0.05).