일 대학병원 정신과의 알코올 프로그램- 원주기독병원 알자회를 중심으로 -

신정호(Jongho Shin),민성호(Seongho Min) 한국중독정신의학회 1997 중독정신의학 Vol.1 No.1

Recently some treatment programs for alcohol problem have started to offer services in general hospitals in Korea. Most of them were noted to have system mainly for acute inpatients. And the treatment outcome of them has been studied only in terms of months up to one year. For about seven years we have experienced a treatment program focused on intensive group psychotherapy with cognitive-behavioral orientation which put great stress on follow up case management, and we found this program was very efficient in longer-term outcome over 1 year. Alcohol treatment program of Wonju Christian Hospital consisted of inpatient program, outpatient program and a particular form of group therapy mainly for recovering OPD patients named Alzahoe. Alzahoe is a Korean abbreviation of Alcoholics Self-esteem Recovering Meeting. It is a semi-closed intensive group psychotherapy, and one of its characteristics is the function of linking acute inpatient treatment with out-patient follow up and rehabilitation after discharge. With this modality, the treatment outcome was outstanding; one-year abstinence rate was 77.1%, two-year abstinence 57.7%, and three-year abstinence 30.8%, which was much higher than those of previous studies. One factor of this better outcome seemed to be resulted from individual intensive psychotherapy for personality problems and Alzahoe exposure during admission. Therefore its members were well known to each other and encouraged to have prudent intra- and extrasocial relations and contacts, that was much different from the policy of anonymity in A.A. meeting. We are sure that this treatment approach will be well applied for alcoholic problem in general hospital psychiatry.

고립적 일 산촌 지역사회의 알코올중독과 남용에 대한 실태조사

신정호(Jongho Shin),민성호(Seongho Min),박기창(Kichang Park),이종섭(Jongsub Lee),표진인(Jinin Pyo) 한국중독정신의학회 1999 중독정신의학 Vol.3 No.2

Besides basic epidemiologic data and alcohol behavior, we studied health behaviors such as exercise, smoking, etc. in an isolated mountainous rural community;Guyrae-myeon, Wonjusi, Kangwon-do, Korea. We surveyed 640 (84.4%) of all households and completed the study procedures on 1,058 (58.1%) of all residents. This will be a preparatory step for the future development of community-based program for alcoholism treatment and education. We measured various alcohol use behavior with Alcohol Effect Questionnaire (AEQ), Drinking Restraint Questionnaire (DRS) and Severity of Alcohol Dependence Questionnaire (SADQ) in residents of the community, living there over 18-years. The results were as following;1) The subjects were composed with 578 women (54.6%) and 480 men (43.4%), mean age was 55.0±16.87 years (men;53.0± 16.78yrs, women;56.6±16.78yrs). 2) The subject, drinking alcohol more than once a month was 63.8%, and drinking almost everyday was 22.1%. 3) Mean amount of alcohol consumed was 59.6±81.83 gm in pure form a day in men, 11.1±22.97 gm in women. The percentage of all subjects, which had consumed more than 45 gm alcohol of pure form that accounts one half bottle of regular size Soju, was 15.1% and that of men was 30.3%. 4) With AEQ, ‘alcohol induced social and physical pleasure’ was the most highly responded subscale (66.1%). Items of ‘feel good’ (75.6%) and ‘more interesting’ (68.8%) were most highly responded among this subscale. 5) The subject who showed concern that ideally they should drink much less than present amount was 28.1%, and who accepted the idea that it would be very likely that they soon will have problems from drinking with DRS was 21.1%. 6) With SADQ, average severity of alcohol dependence was 27.4±7.48 in men and 22.8±5.49 in women. Score above 30 was found in 20.2% of men and 2.9% of women. 7) The subject who suffered from insomnia was 27.8%. The insomniac who had drunken alcohol for sleep induction was 27.5%, who had used hypnotics for sleep induction was 7.8%. 8) More men had smoked than women (68.3% Vs 17.5%).

음주관련 범법자 대상 알코올프로그램

민성호(Seongho Min):신정호(Jongho Shin):박새한(Sae-Han Park),안정숙(Joung-Sook Ahn) 한국중독정신의학회 2002 중독정신의학 Vol.6 No.2

In Korea, the alcohol program for alcohol related offenders started in 1997, the model of which was Attendance Centre Orders of U.K that is group-lecture centered with an emphasis on ethics and moral concepts of drinking. The aim of this study was to investigate the effect of our modified alcohol program practiced since February 2001. Our program was long-term follow-up program and emphasized group discussion, which made those offenders get motivation of abstinence and rebuild their attitude toward drinking. We worked with 8-10 offenders each term, total 50 offenders in 6 terms, for 2 hours at once and up to 20 hours for completion of the program. During the program, six scales were used to measure their behavioral change, and expiratory alcohol concentration was tested regularly. The mean age of the subjects was 41 and most of them were married and irreligious. The mean occasion of unearthed driving and other unearthed offence while alcohol intoxication was 2.5 and 1.3, separately. Seventy-six percent of them were suffered with alcohol use disorder and 29% were alcohol dependence. As completing of the program, their amount of alcohol consumed reduced from 1 bottle of Soju before to 0.46 bottle, and the frequency of drinking day lessened from 1 per 2.3 days before to 1 per 4.2 days. But their urge and craving for drinking was not changed significantly, which means the probability of relapse is so high that further long-term followup program is still necessary. From the results of our study, we suggest the alcohol program should be done under the concept of disease of alcohol drinking and treatment order system.

보상만족도가 수해 후 정신병리와 삶의 질에 미치는 영향

김신(Shin Kim),민성호(Seongho Min),고상백(Sang-Back Koh),신정호(Jongho Shin),박기창(Ki-Chang Park),안정숙(Joung-Sook Ahn),김민혁(Min-Hyuk Kim) 대한사회정신의학회 2011 사회정신의학 Vol.16 No.2

목 적 : 본 연구의 목적은 보상만족도가 재해 후 정신병리와, 삶의 질의 변화에 미치는 영향을 알아보는 것이다. 방 법 : 강원도 인제군 가리산리는 농작업 안전관리현황 진단을 위한 코호트로 선정되어, 2006년 4월부터 수해가 일어나기 직전인 7월까지 주민 83명의 신체적 및 정신적 건강실태에 대한 기초조사가 이루어졌다. 저자들은 수해 후 18개월에 1차 조사, 24개월에 2차 조사를 시행하여, 한국판 36-단축형 건강조사(36-Item Short-Form Health Survey-Korean version, SF-36)를 사용하여 삶의 질을 측정하였고, 단축형 사회심리적 스트레스(Psychological Well-being Index Short form, PWI-SF), 개정판 사건충격척도(Impact of Event Scale-Revised, IES-R), Beck 우울척도(Beck Depression Inventory, BDI) 등을 사용하여 정신병리를 측정하였으며, 보상에 대한 만족도에 대해 조사하였다. 결 과 : 55명 중 보상만족도가 보통 이상은 12명(21.8%), 불만족은 33명(78.2%)이었으며, 두 집단간의 인구사회학적 특징은 차이가 없었다. 보상만족도에 따라 시간에 따른 BDI, IES-R, AUDIT 점수의 변화에는 차이가 없었다. SF-36은 보상만족도가 높은 집단에서 수해 후 18개월에 감소하였다가 24개월 증가하였으며, 보상만족도가 낮은 집단은 수해 후 18개월에 증가하였다가 24개월에 감소하 였다. 결 론 : 수해는 피해자들의 정신건강에 장기간 영향을 미치며 보상만족도는 수해 후 삶의 질 변화에 영향을 미친다. Objectives : This study aims to examine the effects of compensation satisfaction on psychopathology and quality of life following flood. Methods : Garisan-ri of Inje-gun, Gangwon-do was chosen as a cohort regarding evaluating of agricultural safety management status. A baseline survey had been administered just before the flood. A follow-up study was conducted for 24 months. Psychopathology and quality of life were assessed using BDI, IES-R, SF-36 and PWI-SF. Satisfaction with the flood compensation was also evaluated. Results : There was a total of 55 respondents. There was no significant difference between the low satisfaction group (N=43, 78.2%) and middle & high group (N`12, 21.8%) in the sociodemographic factors. There were no significant differences in changes in BDI, IES-R, and AUDIT score over time between the two groups. While SF-36 in the low satisfaction group was increased at 18months after the disaster and decreased at 24months, SF-36 in the middle and high satisfaction group decreased at 18 months after the disaster and increased at 24 months. Conclusion : The flood disaster had a long-term effect on the flood victims’ mental health. Satisfaction with compensation affects changes of quality of life following a flood disaster.

남자 알코올의존 환자들의 사회지향성과 집단주의적 성향에 대한 단면적 연구

민정원(Jungwon Min),신정호(Jongho Shin),민성호(Seongho Min),안정숙(Joung-Sook),박기창(Ki-Chang Park),김민혁(Min-Hyuk Kim) 한국중독정신의학회 2010 중독정신의학 Vol.14 No.2

Objectives:Previous studies reported that patients with alcohol dependence had low self-esteem, which affect interpersonal relationship. The purpose of this study was to investigate the col-lectivistic and sociotropic tendencies of male patients with alcohol dependence (AD) and it’s relations to self-esteem. Method:The subjects, all male in gender, were 91 patients who met DSM-IV criteria for AD and 97 normal controls. We administered a questionnaire for demographic data, Rosenberg Self-Esteem Scale (SES), Personal Style Inventory-II (PSI-II) for sociotropy-au-tonomy and Individualism-Collectivism (INDCOL). Results: AD patients were lower in education level and more in unmarried status than normal control group (p<0.001, p=0.002, respectively). Self-esteem score was lower in AD patients than in normal controls (t=-9.484, p<0.001). Scores of sociotropy and auton-omy subscale of PSI-II were higher in AD patients (t=3.454;p<0.001, t=3.454;p=0.001, respectively). Self-esteem of AD patients had negative correlations with sociotropy (r=-0.229, p<0.01) and autonomy (r=-0.294, p<0.01) of PSI-II. There was no significant difference in the INDCOL score between two groups. Conclusion:Our study findings show a mixed presentation of heightened sociotropy and autonomy of AD patients. From these findings we suggest that patients with AD may overly in-vest in interpersonal relations as a source of their self-esteem on one hand, and in maintaining a sense of separatedness and independence from others on the other hand.

인터넷 중독 청소년의 음주, 흡연 및 부모 음주 문제

김민혁(Min-Hyuk Kim),신정호(Jongho Shin),김태희(Tae-Hee Kim),안정숙(Joung-Sook Ahn),민성호(Sung-Ho Min),박인석(In-Suk Park) 한국중독정신의학회 2005 중독정신의학 Vol.9 No.1

This study aimed 1) to investigate experiences of alcohol drinking and smoking in adolescents with internet addiction, and 2) to identify the relationship between internet addiction and children of alcoholics (COA) in adolescents. Subjects were middle and high school students in Wonju city. 625 students completed the self-report questionnaire, which consisted of demographic data, experience of alcohol drinking and smoking, IAS (internet addiction scale), CAST(Children of Alcoholics Screening Test), SDQ-SR (Strengths-Difficulties QuestionnaireSelf Report), and SES (Self-Efficacy Scale). The results were as follows;1) In internet addiction group, there were more experiences of smoking and more children of alcoholics (COA). 2) The COA with internet addiction had more hyperactivity problem, conduct problem than COA without internet addiction, and had more emotional problem than Non-COA with internet addiction. These results suggest that COA are vulnerable to internet addiction and COA with internet addiction suffer from emotional problem. Thus, It may be helpful to pay attention to parental alcohol problem when evaluating the children of alcoholics. In addition to, we need to focus on the emotional problem of patients with internet addiction. Also in preventive intervention, we need to consider parental alcohol problem.

흡연자의 적대감과 충동성:공군장병에서

황재린(Jae-Rin Hwang),김민혁(Minhyuk Kim),신정호(Jongho Shin),박기창(Ki-Chang Park),이현정(Hyun-Jung Lee),민성호(Seongho Min) 한국중독정신의학회 2009 중독정신의학 Vol.13 No.1

Objectives:This study investigated the independent risk of hostility and impulsivity of smokers in military populations, and examined risk differences among non -smokers, light smokers and heavy smokers. Subjects and Methods:A total of 550 airmen participated in this study. They completed questionnaires including demographic data, a smoking history, the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Alcohol Use Disorders Identification Test (AUDIT), Dys-functional Impulsivity Scale (DIS), Buss &Durkee Hostility Inventory (BDHI), Fagerstrom Test for Nicotine Dependence (FTND), and the Nicotine Dependence Syndrome Scale (K-NDSS). Results:All of the subjects were male;550 individuals, with a mean age of 21.0±1.1. Most of them were single;512 people, 99.6%. 29.5% or 160 of the subjects were smokers. Demographics and smoking-related characteristics of non-smoker and smoker were similar. The mean differences of STAI (F= 3.379, P<0.05), DIS (F=8.186, P<0.001), and BDHI (F=10.332, P<0.001) between light smokers and heavy smokers were higher than that between non-smokers and light smokers. We found significant correlations between FTND and BDHI (r= 0.208, P<0.05), initiation (r=-0.260, P<0.01), duration (r= 0.206, P<0.05) and amount (r=0.546, P<0.001) among smokers. NDSS is related to BDHI (r=0.198, P<0.05), initiation (r= -0.280, P<0.001), duration (r=0.259, P<0.01) and amount (r=0.421, P<0.001). Conclusion:In this study, we found that there is a significant correlation between hostility and smoking status and nicotine dependence scales. Impulsivity has no relation with nicotine dependence scales, but was related to smoking status.

소아기 주의력결핍-과잉행동증상이 있는 알코올의존환자의 임상적 특징과 기질

홍사라(Sara Hong),안정숙(Joung-Sook Ahn),민성호(Seongho Min),신정호(Jongho Shin),박기창(Kichang Park),김민혁(Min-Hyuk Kim) 한국중독정신의학회 2012 중독정신의학 Vol.16 No.2

Objectives : The objective of this study is to explore the differences in temperament and clinical characteristics between alcohol dependent patients with and without a history of ADHD. Methods : The subjects were patients who were admitted to psychiatric hospitals for alcohol dependence. Wender Utah Rating Scale (WURS) was used to assess the history of ADHD symptoms. Temperament was assessed by the Tridimensional Personality Questionnaire (TPQ) and clinical characteristics associated alcohol dependence assessed by the Severity of Alcohol Dependence Questionnaire (SADQ), and the Children of Alcoholics Screening Test (CAST). Results : Age at first admission in-patients with a history of ADHD was younger than in patients with-out a history of ADHD. The SADQ score and the proportion of children with alcoholic parents were significantly higher in patients in the group who had a history of ADHD compared to those in the group without a history of ADHD. Novelty seeking and the harm avoidance score were higher in the group with those having a history of ADHD than the group with those not having a history of ADHD, approaching statistical significance. Conclusion :These results suggest that the history of ADHD in regard to alcohol dependent patients is associated with a poor outcome and a more thorough evaluation regarding ADHD is needed.

부모의 음주문제와 청소년 자녀의 정신병리

김민혁(Min-Hyuk Kim),권오인(Oh-In Kwon),안정숙(Joung-Sook Ahn),신정호(Jongho Shin) 한국중독정신의학회 2004 중독정신의학 Vol.8 No.1

Children of alcoholics are noted to have behavioral, emotional, and substance abuse problems, and decreased academic achievement. And other factors such as inconsistent parental discipline and inadequate care are related to adolescents’ psychopathology. The purpose of this article is to investigate the relationship between parental drinking problem perceived by adolescents and their psychopathology. Eleven hundred and forty one students from two middle schools and two high schools in Wonju were enrolled in this study. Three hundred and ninety eight students were found to have parents with drinking problems with score over 6 of Children of Alcoholics Screening Test (CAST). They were compared with the remaining 743 students as a control. On the Strengths and Difficulties QuestionnaireSelf Report (SDQ-SR), adolescents of parents with drinking problems had significantly higher score indicating the hyperactivity, emotional symptoms, conduct problems, and peer problems than in the control group. Conduct problems were more prevalent in boys, as were emotional problems in girls. And we found that adolescents of parents with drinking problems showed significantly low levels of positive attitude toward parents, which predicted the severity of adolescent’s psychopathology. Therefore, therapeutic intervention for drinking problem of parents and improving the parents-child relationship would be helpful for adolescent’s mental health.

일주기성 유형이 의과대학생의 문제음주에 미치는 영향

임지영(Jee-Young Lim),민성호(Seongho Min),박기창(Ki-Chang Park),신정호(Jongho Shin),장세진(Sei-Jin Chang),노현진(Hyun-Jean Roh),김민혁(Min-Hyuk Kim) 한국중독정신의학회 2014 중독정신의학 Vol.18 No.2

Objectives : The aim of this study is to investigate the relationships between chronotype and alcohol use in young adult. Methods : A total of 197 medical students (age range : 18-25 years, female : 34.5%) participated in this study voluntarily. Each participant completed a self-administered questionnaire that included demographics, plus the Morningness-Eveningness Questionnaire (MEQ), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Barratt Impulsiveness Scale (BIS), Pittsburgh Sleep Quality Index (PSQI), and Alcohol Use Disor-ders Identification Test (AUDIT). Results : Sixty-one (30.96%) were problem drinkers, with men making up a higher percent-age of problem drinkers (p<0.001). PD obtained a higher total score on the MEQ (p<0.01). Evening types reported significant-ly greater levels of problem drinking and worse sleep quality (p <0.05). Multiple regression analysis revealed that MEQ was correlated with AUDIT after controlling for sex, age, BDI, STAI, BIS, and PSQI (p<0.001). Conclusion : Our findings suggest a direct association between problem drinking and eveningness.