청소년 문제 행동에 대한 청소년 자신과 부모의 보고 내용 차이에 관련된 청소년의 정신병리

이소진(So Jin Lee),손진욱(Jin Wook Shon),한규희(Kyu Hee Hahn),박철수(Chul Soo Park),김봉조(Bong Jo Kim),김보경(Bo Kyung Kim),이철순(Cheol Soon Lee) 대한사회정신의학회 2008 사회정신의학 Vol.13 No.2

서 론 소아청소년의 문제 행동을 평가하여 진단을 내리기 위해서는 여러 명의 정보제공자가 필요하다. 부모와 청소년이 청소년의 외현화 문제와 내재화 문제에 대하여 서로 다른 평가를 내리는 경우가 있는데, 평가의 차이가 상당한 경우 이것을 어떻게 해석하 는가 하는 것이 중요하다. 목 적 본 연구는 부모와 청소년이 청소년의 정신증상에 대하여 서로 다르게 보고한 경우 그 차이의 해석을 돕기 위해 시행되었다. 본 연구의 목적은 청소년의 정신병리가 부모와 청소년의 평가 사이의 불일치에 미치는 영향을 평가하는 것이었다. 방 법 마산시의 두 고등학교 학생들 876명을 대상으로 청소년 정신건강 및 문제 행동 검사(Adolescent mental health problem behavior screening test, AMPQ)를 실시하였다. 이 검사의 절단점을 넘는 원점수가 나온 85명의 청소년과 그들의 부모를 대상으로 한국판 청소년 자기 행동 평가 척도(Korea-youth self report, K-YSR), 한국판 아동 청소년 행동평가척도(Koreachild behavior checklist, K-CBCL), 간이정신진단검사(Symptom check list-90-revision, Scl-90-R)을 시행하였다. 결 과 청소년의 우울과 신체화 증상이 내재화 문제에 대한 K-CBCL-K-YSR 차이를 36% 설명하는 중요한 변수로서 드러났다. 우울 증상이 클수록, 신체화 증상이 적을수록 청소년은 부모에 비해 내재화 문제를 더 많이 보고하는 경향을 보였다. 외현화 문제의 불일치를 설명하는 가장 중요한 변수는 강박증상이었다. 청소년의 강박증상이 클수록 부모와 청소년의 외현화 문제에 대한 보고의 차이도 커졌다. 결 론 본 연구의 결과에 따르면, 청소년의 문제 행동에 대한 평가자간의 불일치를 해석하고자 할 때 청소년의 우울, 신체화, 강박 증상에 대하여 고려하는 것이 도움이 될 것이다. Introduction:The necessity of having multiple informants for the diagnostic evaluation of children and adolescents has been repeatedly stressed in child psychiatric clinical work and research. When the discrepancies are considerable between the parents’ and adolescents’ reports on the externalizing and internalizing symptoms of adolescents, it is important to consider how to interpret these discrepancies. Objective:This study was conducted to facilitate understanding the disagreement between parents’ and adolescents’ reports on mental symptoms of adolescents. The purpose of this study was to examine how adolescents’ psychopathology influence their parents’ account of the mental problems of their adolescents, as compared to what the adolescents themselves report. Method:876 high school students in OO city participated in the adolescent mental health and problem behavior screening test(AMPQ). Among the students who were tested, we selected eighty five adolescents (whose scores were above the cut-point) and their parents completed the Korean-youth self report questionnaire(K-YSR), the Koreanchild/adolescent behavior check list(K-CBCL) and the symptom check list-1990-revised(SCL-1990-R). Results:Depression and somatization in adolescence emerged as the significant variables that predicted K-YSR-KCBCL discrepancy on internalizing symptoms, and these variables explained 36% of the variance. With increased levels of depression and decreased levels of somatization, adolescents tended to report more internalizing problems compared to their parents reports. For the discrepancy of externalizing problems, obsessive compulsive symptoms were the most significant variable. When obsessive compulsive symptoms in the adolescents were increased, there were more disagreement between the reports of the parents and adolescents. Conclusion:The psychopathologies in adolescents such as depression, somatization and obsessive compulsive symptom may be useful to consider when interpreting the informant discrepancies concerning the mental problems of adolescents.

암 환자의 정신병리와 치료 목적에 대한 인지 및 삶의 질의 관계

이다원(Da Won Lee),이소진(So Jin Lee),김승남(Seung Nam Kim),김봉조(Bong Jo Kim),이철순(Cheol Soon Lee),차보석(Bo Seok Cha),박철수(Chul Soo Park),손진욱(Jin Wook Shon) 대한생물치료정신의학회 2011 생물치료정신의학 Vol.17 No.1

Objectives : We evaluated the relationship of the psychopathology, quality of life and perception of treatment goal in patients with cancer. Methods : A sample of 102 cancer patients completed both Hospital Anxiety and Depression Scale(HADS) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30(EORTC QLQ C-30). We compared the differences of the psychopathology of patients according to perception of treatment goal by chi-square test and evaluated risk factors for palliative perception of treatment goal by multiple logistic regression. We exhibited t-test to compare HADS and EORTC QLQ C-30 and the association between HADS and EORTC QLQ C-30 was analyzed by Pearson correlation analysis. Results : Of 102, 25 cancer patients had the psychopathology(HAD-T ≥19), including 21 for anxiety(HAD-A ≥8), 59 for depression(HAD-D ≥8). The association between HADS and EORTC QLQ C-30 was negatively correlated with statistical significance. Patients with depression and severe psychopathology showed statistically significant tendency to perceive treatment goal as palliative. Depression and metastasis were risk factors for palliative perception of treatment goal. Conclusions : Psychopathology and quality of life in patients with cancer is important for perception of treatment goal. Assessment and intervention to improve psychological distress and quality of life is warranted during all periods of cancer treatment.

한국의 일 요양 시설에 거주하는 한센병 환자들에서의 치매 유병률

이철순(Cheol Soon Lee),강효승(Hyo Seung Kang),구준(Joon Gu),박철수(Chul Soo Park),손진욱(Jin Wook Shon),김봉조(Bong Jo Kim) 대한노인정신의학회 2007 노인정신의학 Vol.11 No.2

Objectives : To identify prevalence of dementia and it's subtypes in patients with Hansen's disease in a sanatorium of Korea. Methods : The study employs a two-stage design for case identification. One hundred-six patients with Hansen's disease aged 65 and over participated in the study. The Korean Version of the Consortium to Establish a Registry for Alzheimer's disease (CERADK) assessment packet was administered to One hundred-two patients with Hansen's disease. Dementia was defined using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic features of dementia. Results : The prevalence was 15.1% in Hansen's sanatorium. The prevalence of Alzheimer's and vascular dementia were 10.4% and 4.7%. The age-adjusted prevalence rate for dementia was 11.9%. The rate of patients with dementia was 12.73% in males and 17.65% in females. Conclusion : The prevalence of dementia in Hansen's disease sanatorium of Korea appears to be similar with those reported in previous study. Our result suggests that Hansen's disease was unrelated to prevalence of dementia, and also that the dementia is major neuropsychiatric disease in patient with Hansen's disease.

한국인 집단에서 알코올 의존과 세로토닌 수송체 유전자 다형성의 연관성

이철순(Cheol-Soon Lee),노양덕(Yang-Duck Noh),구준(Joon Gu),박철수(Chul-Soo Park),손진욱(Jin-Wook Shon),한규희(Kyu-Hee Hahn),김봉조(Bong-Jo Kim) 대한생물치료정신의학회 2007 생물치료정신의학 Vol.13 No.2

Objective:Family, twin, and adoption studies have demonstrated that genes play an important role in the development of alcoholism. We investigated the association between alcoholism and the genetic polymorphisms of the serotonin transporter regulatory gene(5-HTTLPR) in Korean population. We also explored the association between the genetic polymorphisms of the 5-HTTLPR and clinical characteristics in patients with alcohol dependence. Methods:The genotype and allele frequencies of the 5-HTTLPR were investigated in 172 control subjects and 162 male hospitalized patients who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition(DSMIV), criteria for alcohol dependence. Several standardized research scales were used for the clinical assessment of alcoholism, including the Alcohol Dependence Scale(ADS), the Beck Depression Inventory, the Beck Anxiety Inventory, and the Obsessive-Compulsive Drinking Scale. Results:We found that the frequency of LL genotype and L allele was higher in patients with alcohol dependence than that of control subjects. Alcoholics with the 5-HTTLPR LS or SS genotypes had a later age of onset (mean age of onset, 29.4 and 32.1 years, respectively) than those with the LL genotype(mean age of onset, 25.9 years;p=.002). Also we found that the polymorphisms of the 5-HTTLPR were associated with the scores of the ADS, but not associated with the scores of the BDI, BAI, and OCDS. Alcoholics with the L allele had an earlier age of onset and higher scores of the BDI than those with the S allele(respectively p=.019, p=.021). The scores of the ADS were higher in patients with the S allele than those with the L allele(p=.002). Conclusion:Our finding suggest that genetic polymorphisms of the 5-HTTLPR may be associated with the development of alcoholism and that the 5-HTTLPR play an important role in the development of the early onset and the severe type of alcoholism.

한국 한 중소 도시 지역의 우울 장애의 유병률 및 관련 요인

이동윤(Dong-Youn Lee),이철순(Cheol-Soon Lee),박철수(Chul-Soo Park),한규희(Kyu-Hee Hahn),손진욱(Jin-Wook Shon),차보석(Bo Seok Cha),김봉조(Bong-Cho Kim) 대한사회정신의학회 2008 사회정신의학 Vol.13 No.2

목 적 중소도시 진주에 거주하는 일반인구를 대상으로 하여 우울 장애의 유병률과 관련 인자를 조사하기 위해 본 연구를 시행하였다. 방 법 중소도시 진주에 거주하는 남자 528명(39.3%), 여자 815명(60.7%), 총 1,343명을 연구대상으로 하였고 자기 보고 형태인 K-CES-D를 사용하여 우울 장애의 유병률과 관련 인자를 조사였다. 결 과 대상군 중 19.6%가 우울 장애로 진단 되었는데, 연령, 경제 수준, 결혼 상태에 따라 유병률의 차이를 보였으며, 그 외 성별, 교육 수준에 따른 유병률의 차이는 통계적으로 유의하지 않았다. 연령과 결혼 상태가 우울 장애의 관련 인자로 조사 되었다. 이중 연령은 남, 녀 모두에서 유의한 관련이 있었지만, 결혼 상태의 경우 남자에서만 우울 장애의 관련 인자로 조사되었다. 고 찰 본 연구는 일반 인구의 우울 장애 유병률을 알아 볼 수 있었고, 우울 장애와 관련된 여러 가지 역학적 정보는 효과적인 보건 정책의 수립에 다양하게 사용될 수 있을 것이다. Objectives:The objective is to investigate the prevalence and correlates of depression in the population at a smallmedian city, Jinju. Method:Total numbers of this study subjects were 1343. Male were 528(39.3%) and female were 815(60.7%) living in a small-median city, Jinju. The data was collected through self reports in 2007. We investigated the prevalence and correlates of depression using a cut-off score of 21 by K-CES-D. Results:19.6% of samples(20% in female and 19.1% in male) were diagnosed as depression. Although the prevalence of depression was not different by sex and educational level, it was different by age, monthly income and marital status. Multivariate logistic regression analysis showed that the risk factor for depression was age and marital status. Age was significantly associated with depression both in men and women, but marital status was associated with depression only in men. Conclusion:This study revealed the prevalence of depression on the general population-base. This epidemiological information should be used to inform and implement equitable and effective health policies.

암환자 보호자의 정신병리와 삶의 질

김승남(Seung Nam Kim),이다원(Da Won Lee),김봉조(Bong Jo Kim),이철순(Cheol Soon Lee),차보석(BoSeok Cha),박철수(Chul Soo Park),손진욱(Jin Wook Shon) 대한생물치료정신의학회 2010 생물치료정신의학 Vol.16 No.2

Objectives : Cancer affects the psychological health and quality of life not only of individuals with the disease, but also, it affects their family caregivers. The aim of this study was to investigate the prevalence of psychiatric disorders and quality of life in family caregivers of patients with cancer. Materials and Methods : We enrolled 72 caregivers of patients with cancer from the Gyeongsang National University Hospital Cancer Center and obtained demographic information. The quality of life and psychopathology of caregivers was estimated using the Korean version of an abbreviated version of the World Health Organization Quality of Life assessment(WHOQOL-BREF) and the Mini International Neuropsychiatric Interview patient health survey (MINI patient health survey). Results : According to the MINI patient health survey, 18 caregivers(25%) had a psychiatric disorder : 15(20.8%) had depression ; 2(2.8%) generalized anxiety disorder ; 1(1.4%) panic disorder. Caregivers with a psychiatric disorder had a lower quality of life compared to those without a psychiatric disorder(n=54) in all domains of the WHOQOL-BREF{Overall QOL and general health(4.9±1.9 vs. 7.1±1.1, p=0.000), Physical health domain(10.0±0.6 vs. 14.6 ±0.4, p=0.000), Psychological domain(11.3±0.5 vs. 13.4±0.4, p=0.006), Social relationships domain(11.6±0.3 vs. 13.4±0.3, p=0.001), Environmental domain(11.5±0.5 vs. 13.1±0.3, p=0.017)}. Psychopathology scores were negatively correlated with all domains of the WHOQOL-BREF score {Overall QOL and general health (Spearman’s rho=-0.555, p=0.000), Physical health domain(Spearman’s rho=-0.642, p=0.000), Psychological domain(Spearman’s rho=-0.445, p=0.000), Social relationships domain(Spearman’s rho=-0.403, p=0.000), Environmental domain(Spearman’s rho=-0.345, p=0.003)}. Conclusion : Our results show that the prevalence of depression in family caregivers of patients with cancer is higher than in the general population and that quality of life is lower. Therefore, healthcare professionals should pay more attention to psychological and emotional aspects of caregivers who take care of patients with cancer, and develop comprehensive management strategies both for the cancer patients and for their caregivers.

경남 일부지역 농민들의 수면습관

정근화,손진욱 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.6

In order to investigate the sleep habits of farmers in a rural area, we studied 270 subjects(farmers) in a rural area from August 14, 1995 to August 19, 1995. Sleep habits were analyzed according to age groups(3 groups of 18-30, 31-50, over 51 years) and sex. The results were as follows : 1) The mean sleep length was 6.7±1.5 hours, and was longer in female than in male. In the above 51-year-old age group, sleep length was significantly shorter than those in the other two age groups. 2) The mean sleep latency was 21.6±21.5 minutes, and was longer in female than in male. There were no significant differences in sleep latency among age groups. 3) The sleep onset time was later in the 18-30-year-old age group than in the other two age groups. The awakening time was earlier in the over 51-year-old age group than in the other two age groups. 4) One hundred and four subjects(38.5%) complained difficulty falling asleep, 196 subjects(72.6%) complained fragmented sleep, and 86 subjects(31.9%) complained early morning awakening during the past two weeks. Difficulty falling asleep and fragmented sleep were more common in females than in male. 5) One hundred and seventeen subjects(43.3%) had napped during the past two weeks and there were no significant differences among age groups. 6) One hundred and sixty five subjects(61.1%) experienced daytime drowsiness during the past two weeks and there were no significant differences among age groups. 7) Ninety-one subjects(33.7%) reported nightmares, 32 subjects(11.9%) reported sleeptalking 3 subjects(1.1%) reported sleepwalking, and 15 subjects(5.6%) reported bruxism during past two weeks.

대형정신병원 입원환자의 수면제 처방에 관련된 인자

김현숙,서혜수,송인제,손진욱 대한생물치료정신의학회 1997 생물치료정신의학 Vol.3 No.1

만성화된 환자들이 주로 입원하여 있는 대형정신병원에서 수면제의 처방에 영향을 미치는 요소들을 조사해 보고자 하였다. 1996년 10월 2일 국립부곡정신병원에 입원해 있는 환자 402명을 대상으로 병록지조사를 통해 입원시부터 조사당일까지의 수면제 사용을 조사였다. 담당의사의 routine order에 의한 수면제 처방의 여부, 담당의사의 p.r.n. order에 의한 처방 여부, 당직의사에 의한 수면제 처방 여부를 조사하여 환자의 나이, 성별, 진단, 입원횟수, 유병기간, 담당의사의 정신과 근무 연수 등의 변수에 따라 비교해 다음과 같은 결과를 얻었다. 1) 207명(51.5%)이 재원기간동안 최소한 일회 이상 수면제를 복용하였고, 195명(48.5%)은 수면제를 복용한 적이 없었다. 2) 담당의사의 routine order에 의한 수면제 처방의 빈도는 남자에 비해 여자에서 높았다. 3) 담당의사의 routine order에 의한 수면제 처방의 빈도는 전문의가 담당의사인 환자군에서 높았다. 4) 담당의사의 p.r.n. order에 의한 수면제 처방의 빈도는 전공의 1년차가 담당하는 환자나 전문의가 담당하는 환자에서 높았다. 5) 연령, 진단, 유병기간, 입원횟수 등은 수면제 처방의 빈도와 유의한 관계가 없었다. 이상의 결과를 통해 국립부곡정신병원의 입원환자에서 수면제의 처방이 환자의 성별과 담당의사의 정신과 근무 연수와 관계됨을 알 수 있었다. The purpose of this study was to investigate the factors that were associated with the prescription of hypnotics in inpatients of a large mental hospital. The medical records were reviewed in 402 inpatients who were admitting in Bugok National Mental Hospital at October 2, 1996. The results were as follows: 1) Fifty-one percent of the whole group received a hypnotics at least once during hospitalization. 2) The prescription of hypnotics by routine order of doctor in charge was more frequent in female patients than male patients. 3) The prescription of hypnotics by routine order of doctor in change was more frequent in patients whose doctor in charge was a psychiatric specialist than patients whose doctor in charge was a psychiatric resident. 4) The prescription of hypnotics by p.r.n. order of doctor in charge was more frequent in patients whose doctor in charge was a first-year psychiatric resident or a psychiatric specialist than a second, a third, or a forth-year psychiatric resident. 5) Age, duration of illness, frequency of admission, and diagnosis were not significantly associated with frequency of hypnotics prescription. These findings suggest that the prescription of hypnotics in inpatients of Bugok National Mental Hospital was positively associated with patient's sex and duration of service of doctor in charge.

Globus Hystericus 患者의 臨床的 特徵

朴哲秀,姜東佑,申瑩均,孫鎭旭,韓圭熙 서울醫大 1990 精神醫學 Vol.15 No.1

鬱血症을 同伴한 파킨손氏病에 對한 電氣痙攣療法 治驗 1例

朴哲秀,姜東佑,申瑩均,孫鎭旭,韓圭熙 서울醫大 1990 精神醫學 Vol.15 No.1