루이소체 치매의 개정 진단기준 및 치료의 고찰

손보경(Bo Kyung Sohn),이동우(Dong Woo Lee) 대한노인정신의학회 2020 노인정신의학 Vol.24 No.2

Dementia with Lewy bodies (DLB) is the second most common cause of neurodegenerative dementia. The Dementia with Lewy Bodies Consortium has revised DLB consensus diagnostic criteria. We reviewed recent (fourth) clinical diagnosis criteria and treatment options. The revised DLB clinical criteria included clinical features and updated diagnostic biomarkers. Compared with third criteria, they removed suggestive features and reassigned rapid eye movement sleep behavior disorder (RBD) in core clinical features with fluctuating cognition, recurrent visual hallucination, and parkinsonism. They classified biomarkers into two groups, indicative and supportive biomarkers, according to diagnostic specificity and evidence quality. Indicative biomarkers included reduced dopamine transporter uptake in basal ganglia demonstrated by single-photon emission CT or positron emission tomography, low uptake 123Iodine- metaiodobenzylguanidine myocardial scintigraphy, and RBD in polysomnography. In treatment of DLB, cholinesterase inhibitor can improve cognitive function and activities of daily living. Neuroleptics should use with caution due to sensitivity in DLB.

한국어판 일차의료 인지 선별검사 General Practitioner Assessment of Cognition(GPCOG)의 타당도

이동우(Dong Woo Lee),유지인(Ji In You),손보경(Bo Kyung Sohn) 대한노인정신의학회 2008 노인정신의학 Vol.12 No.2

Objectives : This study was conducted to prove the validity of the Korean version of the General Practitioner Assessment of cognition (GPCOG-K) as a screening instrument for Alzheimer's dementia. Methods : The old people (n=131) who visited the dementia clinic and their care giver were asked to complete GPCOG-K. The diagnosis was based on the criteria of dementia of the Alzheimer's type of DSM-IV and the criteria of the probable Alzheimer's disease of NINCDS-ADRDA. Sensitivity and specificity of the GPCOG were evaluated. Results : The GPCOG-K showed higher sensitivity and specificity than MMSE-KC. And optimal cut-off value was 5/6. Conclusion : The GPCOG-K is very useful instrument to screen dementia of the Alzheimer's type. And it is easy to perform for general physician.

인터넷 중독 고위험 청소년의 성별에 따른 임상적, 정신병리적 특성

이지윤(Ji Yoon Lee),권준근(Jun-Gun Kwon),이준영(Jun-Young Lee),정희연(Hee Yeon Jung),손보경(Bo Kyung Sohn),최삼욱(Sam Wook Choi),김대진(Dai Jin Kim),최정석(Jung-Seok Choi) 한국중독정신의학회 2016 중독정신의학 Vol.20 No.1

Objectives : Most previous studies of Internet addiction (IA) have been performed on males, and little is known about gen-der differences in IA. We examined gender differences in the clinical and psychopathological features related to high-risk for IA among adolescents. Methods : 714 (male : N=389 ; fe-male : N=325) have reported questionnaires as follows ; 1) clinical and psychopathological features (depression, anxiety, Attention Deficit Hyperactivity Disorder (ADHD) symptoms, Smartphone addiction, impulsivity, behavioral inhibition and approach systems, state-trait anger, aggression, beliefs about aggression, and resilience) 2) Internet and Smartphone usage patterns. In 691 who completed the Young’s Internet Addiction Test (YIAT), A total of 487 adolescents were classified into the normal Internet use group, with YIAT scores of 20-39 (male :N=232 ; female : N=255) and 204 adolescents were classified into high-risk for IA group (male : N=144 ; female : N=60). Results : Most factors described above predicted high-risk for IA in male and female adolescents. Especially, the present study found that psychological resilience had negative association with possibility of IA in female, while cognitive impulsivity and hostile aggression were associated with possibility of IA in male adolescents. Conclusion : This study found gender-re-lated features in adolescents at high-risk for IA. Thus, gender-specific strategies are needed to maximize prevention and treatment effectiveness of IA.

경도인지장애에서 우울증 유병률과 관련요인

이준호(Jun Ho Lee),최영민(Young Min Choe),변민수(Min Soo Byun),최효정(Hyo Jung Choi),백혜원(Hyewon Baek),손보경(Bo Kyung Sohn),이동영(Dong Young Lee) 대한노인정신의학회 2014 노인정신의학 Vol.18 No.2

Objective:The aims of this study were to investigate the prevalence of co-morbid depression and related factors of depression in mild cognitive impairment (MCI) patients. Methods:Nine hundred and six MCI individuals were included in this study. Depression was defined as major and minor depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). Depression-related demographic and clinical factors were also explored through multivariate logistic regression analysis. Results:In MCI patients, the prevalence of depression as defined according to the DSM-IV diagnostic criteria was 1.8% for major depressive disorder, 11.4% for minor depressive disorder, and overall 13.2% for both. Multivariate logistic regression showed that increased prevalence of overall depression was associated with female gender and non-amnestic subtype of MCI. Conclusion:Our findings based on a large number of MCI subjects who visited memory clinic indicated that more than ten percent of MCI patients have comorbid depression. In addition, female and non-amnestic subtype of MCI patients seems to be more vulnerable to depression.

레미마졸람을 사용하여 전신마취로 고관절 수술을 시행한 환자에서의 섬망 발생: 후향적 연구

강승재(Seung Jae Kang),전인정(In Jung Jun),김원(Won Kim),장윤영(Yoon Young Chang),손보경(Bo Kyung Sohn),이동우(Dong Woo Lee) 대한사회정신의학회 2023 사회정신의학 Vol.28 No.2

목적 :본 연구는 고관절 수술 환자를 대상으로, 최근 국내에 도입되어 사용하고 있는 레미마졸람을 마취에 사용한 환자들을 대상으로 섬망 발생률 및 섬망 발생 관련 인자들을 파악하고자 하였다. 방법 : 2021년 3월 1일부터 2022년 10월 31일까지 레미마졸람을 사용하여 마취 후 고관절 골절 수술을 받은 60세 이상의 환자들의 임상 정보를 바탕으로 후향적 연구를 진행하였다. 입원 시부터 퇴원 전까지의 섬망 발생률 및 과거력, 현병력 및 사회력, 수술 전후의 혈액검사 결과 등을 수집하여 섬망 발생과 유의미한 연관이 있는 요인들을 분석하였다. 결과 : 전체 106명 중 수술 후 섬망이 발생한 환자는 46명(43.40%)이었다. 카이 제곱 검정 및 t-test 결과 연령(p=0.004), 교육년수(p=0.028), 뇌졸중 과거력(p=0.016), 정신과적 과거력(p=0.015), 수술 전 전해질 불균형 여부(p=0.036) 및 수술 전 혈당(p=0.023)이 수술 후 섬망 발생한 군과 그렇지 않은 군 간에 유의미한 차이가 있었다. 로지스틱 회귀분석을 실시한 결과 연령이 증가할수록(B=0.083, OR=1.086, 95% CI=1.007-1.172, p=0.032), 뇌졸중의 과거력이 있는 경우(B=1.312, OR=3.714, 95% CI=1.066-12.939, p=0.039), 수술 전 전해질 불균형이 있는 경우(B=1.028, OR=2.796, 95% CI=1.021-7,659, p=0.046), 수술 전 혈당이 높은 경우(B=0.019, OR=1.019, 95% CI=1.004-1.034, p=0.014) 섬망 발생 위험도가 더 높았다. 결론 :본 연구 결과, 60세 이상의 노인 환자들에게 최근 승인된 레미마졸람을 사용하여 정형외과 고관절 수술을 하였을 때 섬망의 발생률이 기존에 비슷한 군들을 대상으로 한 연구들과 간접적으로 비교하였을 때, 기존 마취제를 사용한 결과와 크게 다르지 않다는 것을 알 수 있었다. 또한 본 연구를 통해 파악된 레미마졸람 사용 시 수술 후 섬망 발생을 일으킬 수 있는 위험 요인들을 고려하고 개선 가능한 요인들은 적극 개입하여 섬망 발생을 예방할 필요가 있다. Objectives: This study aims to determine the incidence of delirium and delirium-related factors in patients undergoing hip surgery who were under remimazolam, a drug recently introduced and used in Korea. Methods: This is a retrospective study based on clinical information of patients aged ≥60 years who underwent hip fracture surgery after anesthesia with remimazolam from March 1, 2021 to October 31, 2022. We investigated the incidence of delirium during the admission period and delirium-related factors by analyzing the current medical and social history, and pre- and postoperative blood tests results. Results: Of the 106 patients, 46 (43.40%) developed postoperative delirium. Chi-square and t-tests showed that age (p=0.004), years of education (p=0.028), history of stroke (p=0.016), psychiatric history (p=0.015), presence of preoperative electrolyte imbalance (p=0.036), and preoperative blood glucose levels (p=0.023) were significantly different between those who developed postoperative delirium and those who did not. In logistic regression analysis, the risk of the occurrence of delirium was significantly related to increasing age (B=0.083, OR=1.086, 95% CI=1.007-1.172, p=0.032), history of stroke (B=1.312, OR=3.714, 95% CI=1.066-12.939, p=0.039), preoperative electrolyte imbalance (B=1.028, OR=2.796, 95% CI=1.021-7,659, p=0.046), and high preoperative blood sugar levels (B=0.019, OR=1.019, 95% CI=1.004-1.034, p=0.014). Conclusion: This study found that the incidence of delirium following orthopedic hip surgery using remimazolam was not significantly different from that using conventional anesthetics if indirectly compared to previous studies in similar populations. Moreover, if we use remimazolam, we should consider the delirium-related factors and treat modifiable factors for delirium prevention

인터넷게임장애 환자에서의 삶의 질과 심리사회적 건강

서승완(Seung Wan Suh),곽아름(Ah Reum Gwak),임재아(Jae-A Lim),이지윤(Jiyoon Lee),박수미(B.A. Su Mi),이준영(Jun-Young Lee),정희연(Hee Yeon Jung),손보경(Bo Kyung Sohn),최삼욱(Sam-Wook Choi),김대진(Dai Jin Kim),최정석(Jung-Seok Choi) 한국중독정신의학회 2015 중독정신의학 Vol.19 No.1

Objectives : Although Internet Gaming Disorder (IGD) is an important phenomenon, its impact on subjective happiness is less appreciated. This study aimed to compare the quality of life (QOL) and psychosocial well-being of individuals with IGD with those of individuals with alcohol dependence (AD) and healthy controls (HC). Methods : Eighty-six subjects were divided into two groups seeking outpatient treatment, one for IGD (n=37) and the second for AD (n=21), as well as a HC group (n=28) which was age-matched to the IGD group. Participants completed the World Health Organization’s Quality of Life assessment - Brief Form (WHOQOL-BREF) and the Psychosocial Well-being Index (PWI) questionnaire, which measures levels of distress. Results : Both addiction groups had lower scores in all WHOQOL-BREF domains (general, psychological, physical health, social relationships, and environmental) com pared with the HC group. Additionally, both addiction groups showed higher PWI scores than the HC group, indicating higher levels of distress in the former groups. However, no significant difference in PWI was found between the IGD and AD groups. Conclusion : Those with IGD reported poorer QOL and higher levels of distress compared with HCs, but their QOL and dis-tress scores were comparable to those of AD subjects. Thus, individuals with IGD require assistance to manage their distress.