공황장애 인지행동치료의 최신 지견

서호준,이강수,이상혁,서호석,Seo, Ho-Jun,Lee, Kang-Soo,Lee, Sang-Hyuk,Suh, Ho-Suk 대한불안의학회 2016 대한불안의학회지 Vol.12 No.1

30% of patients with panic disorder (PD) show treatment-resistant and chronic waxing and waning course. Therefore, adequate treatment strategies for PD by evidence based pharmacotherapy and combined cognitive behavioral therapy (CBT) are recommended. Regarding how and why CBT for PD works, three hypotheses include the cognitive theory, anxiety control theory, and behavioral theory were discussed. The recent findings that the altered activation in frontal lobe is normalized after CBT, suggest a reduction of an altered top-down fear processing in the neural correlates of CBT in PD. In order to improve accessibility to CBT, brief CBT and internet based CBT for PD were suggested. Despite limitations of sample sizes and study design, most of studies suggest that brief CBT is more effective than control conditions, and even as equally effective as standard CBT. The evidences suggest that internet based CBT may not be significantly different from face-to-face CBT in reducing anxiety. Several advances within the field of third-wave CBT for PD have led to the development of new techniques based on mindfulness, such as mindfulness-based cognitive therapy and acceptance and commitment therapy. Based on Korean algorithm project for panic disorder, especially the psychological education and cognitive reconstruction components were recommended in CBT with PD.

외상후 스트레스장애의 평가 도구

서호준,김태석,채정호,Seo, Ho-Jun,Kim, Tae-Suk,Chae, Jeong-Ho 대한불안의학회 2010 대한불안의학회지 Vol.6 No.1

Even experienced clinicians have difficulties in diagnosing posttraumatic stress disorder (PTSD) exactly, due to its diverse clinical features, which vary according to individuals, traumas, and various comorbid psychopathologies, and its related compensation issues. It is usually mandatory for clinicians and researchers to use screening and assessment tools when diagnosing and evaluating PTSD. To date, research has developed numerous PTSD screening and assessment tools ; therefore one of the cardinal issues is to select the best of the various tools, the one most suitable for the clinician's or researcher's purposes. This article reviews several currently-available subjective and objective instruments for the diagnosis and evaluation of PTSD and groups them according to whether they are Diagnostic and Statistical Manual for Mental Disorders-Correspondent Measures ; PTSD-Focused, Non-DSM-Correspondent Measures ; or Empirically Derived Measures. We present the instruments' psychometric properties and scoring methods and describe their merits and weak points, focusing on their practical usage.

교통사고에 의한 외상 후 스트레스장애 환자의 피부 전기반응 : 예비 연구

서호준,정영은,이혜원,문현진,박주미,김선경,채정호,Seo, Ho-Jun,Jung, Young-Eun,Lee, Hye-Won,Moon, Hyun-Jin,Park, Ju-Mi,Kim, Seon-Kyung,Chae, Jeong-Ho 대한불안의학회 2007 대한불안의학회지 Vol.3 No.2

Objective : In the present study, we evaluated the differences between the skin electric conductance of patients with posttraumatic stress disorder (PTSD) and normal controls in order to determine the possibility of using skin electric conductance as a diagnostic measure. Method : The PTSD group included 14 subjects who were diagnosed with PTSD in St. Mary's Hospital after a motor vehicle accident, and the normal control group included 12 healthy subjects. The conductivity and capacitance of both groups were measured twice, and the data from each group was compared. Results : There was no significant difference in gender, but the patients in the PTSD group were significantly older than those in normal control group. The activity (conductivity) between the left head-left hand, right hand-right head, and right head-left head was significantly elevated in the PTSD group as compared with the normal control group. In addition, the reactivity (capacitance) between the right head-left head, left head-left hand, right hand-left hand, right hand-right foot, right foot-left foot, and left foot-left hand was significantly elevated in the PTSD group. Conclusion : In this study, the skin electric conductance of the patients with PTSD was significantly elevated in comparison with that of the healthy subjects. Although there were some limitations of this study, the results of this study suggested that skin electric conductance can be used to evaluate elevated psychophysiological responses in patients with PTSD. Future studies with more subjects and more structure are needed in order to confirm our results.

Tea Maker의 디자인에 있어 구조에 따른 분석 연구

서호준(Seo Ho-Jun),인석일(In Suk-Il) 한국디자인학회 2009 한국디자인학회 학술발표대회 논문집 Vol.2009 No.5

비선형 시스템에 대한 동적인 규칙 삽입을 이용한 퍼지 관측기 기반의 슬라이딩 모드 제어기

서호준(Ho-Joon Seo),김동식(Dong-sik Kim),서삼준(Sam-Jun Seo),박장현(Jang-Hyun Park),박귀태(Gwi-Tae Park) 제어로봇시스템학회 2001 제어로봇시스템학회 국제학술대회 논문집 Vol.2001 No.10

양극성 조증 입원 환자에서 과체중, 비만과 연관 인자 : 예비 연구

정영은,서호준,송후림,왕희령,전태연,박원명,Jung, Young-Eun,Seo, Ho-Jun,Song, Hoo-Rim,Wang, Hee-Ryung,Jun, Tae-Youn,Bahk, Won-Myong 대한불안의학회 2010 대한불안의학회지 Vol.6 No.2

Objective : Being overweight or obesity impairs quality of life and often causes treatment noncompliance in patients with bipolar disorder. This preliminary study evaluated the prevalence of overweight and obesity in inpatients with bipolar mania. Methods : Inpatients with bipolar mania, who were treated with adequate medications at least 4 weeks were included in a retrospective study. The body weight of each patient was measured and the body mass index (BMI) was calculated. Results : Of the 80 patients, 16.4% (N=13) were overweight, and 35.0% (N=28) were obese at discharge. Female patients had higher prevalence rates of overweight and obesity. Being overweight or obesity was associated with the number of previous episodes of depression and combination treatment with atypical antipsychotics and mood stabilizers. Conclusions : Being overweight or obesity is highly prevalent in patients with bipolar mania. Clinicians should pay more attention to weight gain and obesity when prescribing combination therapies. More research is required to identify the impact of specific risk factors for overweight and obesity in patients with bipolar mania.

Design of a new sliding mode controller for uncertain multivariable systems using continuous-time switching dynamics

김동식,서호준,서삼준,박귀태,Kim, Dong-Sik,Seo, Ho-Joon,Seo, Sam-Jun,Park, Gwi-Tae 제어·로봇·시스템학회 1996 제어·로봇·시스템학회 논문지 Vol.2 No.1

슬라이딩 모드 제어기의 실현시 발생하는 고주파 chattering 현상을 제거하기 위하여 본 논문에서는 스위칭 표면 행렬의 Range-space 동특성을 이용한 연속 시간 스위칭 다이나믹을 제안한다. 전체 폐루프 시스템은 정칙 변환에 의해 빠른 부시스템과 느린 부시스템으로 분해되어, 결국 전체 폐루프 시스템의 고유치는 각각 스위칭 표면 행렬의 Range-space와 Null-space의 동특성을 지배하는 부시스템들의 고유치들로 구성됨을 보인다. 그리고, 정합된 불확실성이 존재하는 경우 제안된 스위칭 다이나믹을 가진 제어 시스템의 응답은 일정 시간이 경과된 후 스위칭 평면의 임의의 영역으로 균일하게 유계된다는 것을 증명한다. 또한, 제어 입력의 크기에 대한 제약성을 만족하면서도 전체 제어 시스템의 정상 상태 오차를 감소시키기 위하여 두개의 스위칭 다이나믹을 도입한 수정된 슬라이딩 모드제어기를 제안한다.

2013년 정신건강박람회 불안 장애 선별검사 결과

최강록,김대호,서호준,허휴정,이동우,채정호,Choi, Kangrok,Kim, Daeho,Seo, Ho Jun,Huh, Hyu Jung,Lee, Dong-Woo,Chae, Jeong Ho 대한불안의학회 2013 대한불안의학회지 Vol.9 No.2

Objective : Despite the chronic nature and high social costs, individuals with anxiety disorders seldom seek treatment. Thus, education for public awareness and screening for the illness is tremendously important for mental health professionals. This study summaries and presents the results from Anxiety Disorder Screening Program during the Mental Health Exposition held in Seoul in April, 2013. Methods : We analyzed the data from 116 participants who agreed and completed the screening questionnaires during their visits to two-day Anxiety Disorder Screening Program prepared by the Korean Academy of Anxiety Disorder. The questionnaire comprised of modified Mobility inventory for agoraphobia, Contents of worries, Penn State Worry Questionnaire, Life Events Checklist, and Abbreviated Posttraumatic Stress Disorder Checklist. Results : Participants demonstrated high rates of anxiety symptoms and possible anxiety disorders. Experience of panic attack was reported by 45%, lifetime and 16% in the past month by respondents. Phobia was reported by 46%. Participants had an average of 3.3 pathological worries and among those, social or interpersonal content was most common (46%). At least one lifetime traumatic event was reported by 64%. By the cut-off scores in the literature, 46% had possible generalized anxiety disorder and 58% possible posttraumatic stress disorder. Conclusion : Our results suggested that many visitors to Anxiety Disorder Screening Program were in fact treatment seeking after experiencing some forms of anxiety symptoms. Further efforts for delivery of medical information and increasing public awareness for anxiety disorders are needed.

일 대학병원에서 외상 후 스트레스장애 입원환자의 약물 치료 경향

민정아,정영은,서호준,박원명,전태연,채정호,Min, Jung-Ah,Jung, Young-Eun,Seo, Ho-Jun,Bahk, Won-Myong,Jun, Tae-Youn,Chae, Jeong-Ho 대한불안의학회 2008 대한불안의학회지 Vol.4 No.1

현재 PTSD와 관련한 여러 병태생리 기전들이 밝혀지고 있으며 이에 초점을 둔 다양한 약물치료가 행해지고 있다. 본 연구에서는 일 대학병원에서 PTSD로 진단된 환자들의 의무기록을 검토하여 약물치료의 경향에 대해 알아보았다.1998년 1월부터 2007년 12월까지 DSM-IV에 의해 PTSD로 진단된 입원 환자 75명이 대상군이 되었으며, 이들의 인구학적 요인들, 입원기간, 외상의 종류, 외상 후 경과시간 및 정신과적 공존병리 및 처방 받은 약물을 조사하였다. 조사 결과, 75명 중 남자는 33명, 여자는 42명이었다. 정신과적 공존병리는 총 50명(66.7%)에서 존재하였으며, 우울장애, 인지장애, 정신장애 및 불안장애 순이었다.73명(97%)의 대상군은 항우울제를 처방 받았으며, 그 중 paroxetine이 54.7%로 가장 많았고 두 가지 이상의 항우울제를 처방 받은 경우도 24%였다. 또 거의 대부분의 환자에서 비정형 항정신병약물(33.3%), 기분안정제(17.3%),항불안제(94.7%)가 항우울제와 병용 처방된 것으로 조사되었다. 여러 제한점에도 불구하고 본 연구에서 얻어진 약물 처방 경향은 향후 국내 실정에 맞는 치료 지침을 수립하는 데에 하나의 근거 자료가 될 수 있을 것이다. Objective : Due to a better understanding of the pathophysiology of posttraumatic stress disorder (PTSD) and the relative limitations in the treatment of patients with PTSD, a variety of medications and treatment algorithms for PTSD have been investigated. This study was conducted to investigate the trends in the pharmacotherapy used in the treatment of inpatients with PTSD at a single university hospital in Korea. Methods : Data from 75 patients diagnosed with PTSD according to the DSM-IV criteria from January 1998 to December 2007 were collected. Demographic data and clinical data, including medications prescribed, were investigated. Results : Thirty-three of the 75 subjects included in this study were male, and 42 were female. Considering psychiatric comorbidity, depressive disorder, cognitive disorder, psychotic disorder and anxiety disorder were reported in order. Approximately 97% of the subjects were treated with antidepressants, including paroxetine in 54.7%, and 24% of the subjects were treated with two different kinds of antidepressants. In addition, atypical antipsychotics were prescribed in 33.3% of patients, mood stabilizers in 17.3%, and anxiolytics in 94.7% of the subjects. Conclusion : In our study, various kinds of antidepressants were prescribed for most patients with PTSD. Antipsychotics and mood stabilizers were added to the treatment regimens of some subjects, and anxiolytics were added to the treatment regimens of most subjects. Despite its many limitations, this study shows the prescription pattern and trends in PTSD treatment in Korea. We hope that these preliminary data would be helpful for the development and integration of a practical guideline for the treatment of PTSD in Korea.

자기동조형 퍼지 슬라이딩 모드 제어기

서삼준(Sam-Jun Seo),서호준(Ho-Joon Seo),박귀태(Gwi-Tae Park),김동식(Dong-Sik Kim) 한국지능시스템학회 1996 한국지능시스템학회 학술발표 논문집 Vol.6 No.1