아동기에 주의력결핍 과잉행동증상을 경험한 성인의 정신병리와 기질 성격 요인

송열매(Yul-Mai Song),이건석(Kounseok Lee),한덕현(Doug Hyun Han),이영식(Young Sik Lee),민경준(Kyung Joon Min),박진영(Jin Young Park),김준원(Jun Won Kim) 대한소아청소년정신의학회 2013 소아청소년정신의학 Vol.24 No.4

Objectives:The objective of this study is to find out the differences in psychopathology, temperament, and character factors between young adults with and without childhood attention-deficit hyperactivity disorder (ADHD) symptoms. Methods:The subjects consisted of 314 university students (male=72, female=242) in Gongju. They were divided into childhood ADHD group (N=54) and normal group (N=260) to the Wender-Utah Rating Scale. Participants were assessed using Korean Adult ADHD Scale, Beck Depression Inventory-II, Beck Anxiety Inventory, Kimberly Young’s Internet Addiction Test, Barratt Impulsiveness Scale, Paranoia Scale, Korean-Schizotypal Ambivalence Scale, Lubben Social Network Scale, and Temperament and Character Inventory-Revised. Descriptive statistics, t-test, chi-square, spearman correlation, and stepwise multiple regression were applied to analyze the data. Results:Participants with childhood ADHD symptoms had high level of adult ADHD symptoms (p<.001), impulsiveness(p=.001), depression (p<.001), anxiety (p<.001), internet addiction (p<.001), paranoia tendency (p<.001) and low level of selfesteem (p<.001) compared to normal group. Self-directedness (p<.001) was lower, Harm avoidance (p=.001) and Self-transcendence (p=.029) were higher in the childhood ADHD group. In correlation and stepwise multiple regression, childhood ADHD symptoms were significantly associated with cooperativeness (r=-0.515 and β=-0.547, p<.001 respectively). Conclusion:This result showed that young adults with childhood ADHD symptoms had various forms of psychopathology and childhood ADHD symptoms were influenced by character such as cooperativeness. Therefore, more thorough evaluation regarding childhood ADHD symptoms is needed.

온라인 정신간호학실습 교육이 사회정서적 역량, 의사소통 자기효능감, 의사소통능력에 미치는 효과

송열매(Song, Yul-mai) 학습자중심교과교육학회 2020 학습자중심교과교육연구 Vol.20 No.19

본 연구는 간호대학생을 대상으로 온라인 정신간호학실습 교육 프로그램을 적용하여 사회정서적 역량, 의사소통 자기효능감, 의사소통능력에 미치는 효과를 분석하기 위한 단일군 전-후 원시실험설계 연구이다. 연구대상자는 총 118명의 간호학과 3학년 학생으로 자료수집은 2020년 5월부터 7월까지 자가보고 설문을 온라인 서베이 방식을 이용하여 비접촉 상태에서 수행하였다. 자료분석은 IBM SPSS Statistics 21.0 프로그램을 이용하여 대상자의 일반적 특성은 빈도와 백분율, 평균과 표준편차를 구하였고, 실험처치의 효과를 확인하기 위한 가설검정은 Paired t-test로 분석하였다. 연구에서 사용된 온라인 정신간호학실습 교육 프로그램은 하루 8시간, 총 10일 동안 집중적으로 운영하도록 구성하였으며, 전면 비접촉 상황에서 동영상 강의, 화상토의, 환청시뮬레이션, 가상현실 시뮬레이션, 영상콘텐츠를 활용한 간접적 정신상태평가, 치료적 의사소통 실습, 성찰적 글쓰기 등의 내용을 포함하였다. 온라인 정신간호학실습 교육 프로그램 적용 후 사회정서적 역량(사회적 유능성, 정서조절, 공감)이 통계적으로 유의하게 향상되었고, 의사소통 자기효능감(구체적 의사소통 기술, 어려운 환자의 행동 다루기), 의사소통 능력(자기제시능력, 목표설정능력, 메시지 전환능력) 또한 프로그램 적용 전에 비해 통계적으로 유의한 긍정적인 변화가 나타났다. 본 연구의 결과를 통하여 온라인 정신간호학실습 교육 프로그램의 효과를 확인할 수 있었다. 이는 추후 적용될 온라인 기반 실습교육과 후속 연구의 근거자료로 사용할 수 있을 것이다. The purpose of this study was to evaluate the effects of online psychiatric and mental health nursing practice program on the social and emotional competence, counseling self-efficacy, and communication competence among nursing students. A quasi-experimental study with one group pretest-posttest design. The 118 nursing students participated in this study from May 11 to July 3, 2020. For data collection, a structured self-report questionnaire was collected in a contactless state using Google s online survey method. Data were analyzed using descriptive statistics, paired t-test with the IBM SPSS 21.0 program. online psychiatric and mental health nursing practice program was configured to operate intensively for 8 hours a day, for a total of 10 days. Video lectures, web conferences, hallucination simulations, virtual reality simulations, indirect mental state evaluation using cinema contents. It included theraputic communication skills practice and reflective writing. The results showed that social and emotional competencies(social competence, emotional regulation, empathy) were statistically significantly improved after the program. In addition, there were statistically significant positive changes in counseling self-efficacy(microskills, dealing with difficult client behavior) and communication competence(self presentation ability, goal settings ability, message coding ability). Through the results of this study, it can be used as a basis for applying the online psychiatric and mental health nursing practice program.

우울 증상과 관련된 어려움 유무에 따른 집단 차이

이혜경,김준원,송열매,이건석,Lee, Hye-Kyung,Kim, Jun Won,Song, Yul-Mai,Lee, Kounseok 대한생물정신의학회 2013 생물정신의학 Vol.20 No.2

Objectives The purpose of this study was to examine the differences according to depressive symptom-related difficulty status. Methods 2828 participants were a divided into depressive symptom-related difficulty group (difficult group, n = 774), and a non-depressive symptom-related difficulty group (not difficult group, n = 2054). The psychological character of the participants were assessed using the Korean version of the Patient Health Questionnaire-9 (PHQ-9), Satisfaction with Life Scale (SWLS), the 12-item General Health Questionnaire (GHQ-12), and Conner-Davidson Resilience Scale (CD-RISC). Statistical analyses were done using t-test, chi-square, and analysis of covariance (ANCOVA). Results Compared with the no difficulty group, the difficulty group reported significantly higher score in all items of PHQ-9. The score of "feeling tired" was the highest and the score of "suicidal ideation" is the lowest in both groups. ANCOVA analysis that is adjusted with the total score of PHQ-9 showed the differences in SWLS, GHQ-12, and CD-RISC scores between the difficulty group and the no difficulty group. Conclusions The findings suggest that there are different characters on PHQ-9, SWLS, GHQ-12, and CD-RISC according to depressive symptom-related difficulty. Therefore, it is required not only to evaluate depressive symptoms in patients with depression, but also the depressive symptom-related difficulty to understand these differences.

정신건강전문요원의 수련 및 근무 현황

이상훈(Sanghoon Lee),송열매(Yul-Mai Song),우지연(Ji-Yeon Woo),한정미(Jeongmi Han),류미숙(Mi-Sook Ryu),황태연(Tae-Yeon Hwang) 대한사회정신의학회 2017 사회정신의학 Vol.22 No.2

연구목적 : 개정된 정신건강복지법이 도입되면서, 지역사회에서의 정신건강전문요원의 역할도 증가되고 있다. 현재 정신건강전문요원(mental health professionals)은 그 수가 14101명에 이르고 있지만, 보수 교육 제도와 개인 데이터베이스의 부재 등 자격에 대한 관리가 부실하여, 현황 파악 및 인력 수급 계획에 한계가 있다. 이에 수련현황과 전문요원의 실태에 대하여 조사하고 개선 방향을 제시하고자 하였다. 방 법 : 본 연구는 219개의 수련기관과 3396명의 정신건강전문요원으로부터의 설문 조사를 통하여 시행하였다. 결 과 : 경기와 인천 지역이 인구 10만명 대비 4.1, 3.9명으로 근무 인력이 가장 부족하였고, 전문 요원 중 유휴 인력의 81%는 복직을 희망 하고 있었다. 정신건강간호사의 경우, 최근 5년 동안 매년 600명에서 500여명으로 배출이 감소되고 있으며, 55% 이상의 정신건강임 상심리사는 치료기관 위주로 근무하고 있었다. 최근 법제화된 보수교육에 대하여는, 관련법과 정책, 정신질환의 이해, 윤리 교육에 대한 교육 수요가 높았다. 그리고, 전문요원 수련에 관하여 수련기관, 수련과정, 수련비용에 대한 보다 구체적 지침이 필요하였으며, 수련 과정에 대한 공통의 평가의 필요성도 제기되었다. 결 론 : 정신건강간호사 신규 인력의 증가와 정신건강임상심리사의 지역 사회로의 유입이 필요하겠다. 그 동안 필요성이 지속적으로 제기되어 왔던 전문요원 데이터베이스가 2018년에 사용 가능할 것으로 예상되므로, 보수교육과 더불어 향후 전문요원의 수급계획과 질 관리에 대한 초석이 될 것으로 기대된다. Objectives : Against the backdrop of reform of Mental Health Act in 2017, role of mental health specialists has been increasing in community mental health care. The number of mental health specialists has reached up to 14,101, but database for these human resources has not been built. Despite of many precedent researches, lack of database was a hurdle of accurate outcome of these studies. So, we did research on the training and current situation of mental health professionals. Methods : The authors analyzed reports from 219 training institutions and a web-based survey for the current situation and needs of 3,396 mental health professionals. Results : Gyeonggi province and Incheon showed 4.1 and 3.9 per 100,000 persons, the lowest in human resources per capita and 81% of idle manpower has a willing to be back to work. For the last 5 years, the number of new mental health nurses has decreased to 500 from 600. More than 55% of Clinical psychologists work at clinical setting. Continuing training programs were legislated and the highest need for the programs is about policy and law, psychiatric disorder, and ethics. There is a need for guideline for training institutions, training curriculum, and training tuition. Also, the examination for certification by council was suggested. Conclusion : Reinforcement of nurses and rearrangement of psychologists to community setting is needed. The reform of Mental Health Act could be a momentum of improvement of training programs for mental health professionals. Continuing training programs and database system on mental health professionals, which is available from 2018, would be expected to be a corner stone of human resources management plan for community mental health services.

조현병 및 조현정동장애 입원환자에서 혈청 염증표지자와 정신병적 증상과의 관련성

김계환,이건석,김수진,이은규,송열매,박진영,Kim, Kye Hwan,Lee, Kounseok,Kim, Su Jin,Lee, Eun Kyu,Song, Yul-Mai,Park, Jin Young 대한생물정신의학회 2012 생물정신의학 Vol.19 No.4

Objectives Despite the growing research interest in the role of immunological markers in schizophrenia, a few studies, with conflicting results, have focused on the association between high sensitivity C-reactive protein (hs-CRP) levels and clinical characteristics in schizophrenia. The aim of the present study was to examine the association of serum hs-CRP with psychopathology in schizophrenia. Methods Fifty-five inpatients with schizophrenia or schizoaffective disorder were enrolled. Serum levels of hs-CRP were measured, and each patient was assessed with the Korean version of the Positive and Negative Syndrome Scale (PANSS). Results In correlation analysis of hs-CRP with PANSS subscales, positive subscale score has significant positive correlation (r = 0.271, p = 0.046). In independent t-test analysis, subjects with hs-CRP > 0.3 mg/dL (elevated CRP group, n = 43) had significantly higher PANSS positive subscale score (t = -3.273, df = 24.107, p = 0.003) than those with hs-CRP ${\leq}$ 0.3 mg/dL (normal CRP group, n = 12). Conclusions Elevated serum levels of high sensitivity C-reactive protein in schizophrenia are associated with the severity of psychotic symptoms.