한국인에서의 도파민 수송체 유전자 다형성(Dopamine Transporter Gene(DAT1) Polymorphism)과 사회공포증과의 연관성에 관한 예비 연구

오강섭,윤형근,이민수,Oh, Kang Seob,Yoon, Hyung Kun,Lee, Min Soo 대한생물정신의학회 2004 생물정신의학 Vol.11 No.2

Objective:Although polymorphism of dopamine transporter gene(DAT1) has been considered to be implicated in the pathogenesis of social phobia, previous investigations have been inconsistent and controversial. The authors investigated the relationship between DAT1 polymorphism and social phobia in Koreans. Methods:DAT1 and alleles of fifty subjects who met DSM-IV criterion of social phobia, and those of age- & sex- matched fifty normal controls in Korea were compared. Additionally, patients were grouped into generalized(33) and nongeneralized(17) types and DAT1 polymorphism was compared with that of age- & sex- matched controls. DAT1 with variable number of tandem repeats(VNTR) were determined by using polymerase chain reaction. To compare the distribution of the DAT1 polymorphism between different groups, Fisher's exact test was used. Results:There were no significant differences in either genotypic(p=0.451) or allelic(p=0.452) distributions between the social phobia patients and the controls. There also were no differences in genotypic distribution between subtypes of social phobia patients and the controls. Conclusion:We couldn't find any association between DAT1 polymorphism and social phobia. Further studies including larger number of samples and diverse clinical variables should be conducted to elucidate the present findings.

한국어판 WHO-CIDI 사회공포증의 개발 : 타당도 및 신뢰도 검사

오강섭,이시형,서주원 한국정신신체의학회 2000 정신신체의학 Vol.8 No.2

사회공포증의 아형 분류와 가해형 사회공포증의 임상적 의의

오강섭,임세원 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.3

The prevalence rate of Social Phobia (Social anxiety disorder) varies among cultures and patient populations. Possible reasons for this differences are that the expression of social anxiety may differ according to cultures. It has been suggested that offensive type of social phobia (which is similar with taijin kyofusho ; a kind of culture-bound syndrome in DSM-Ⅳ) exist in east-asian countries, especially Korea and Japan, and it shares many common aspect with the western concept of social phobia. It is important to consider cultural influences of social phobia and understand various clinical presentations of this disorder. In this paper, the authors reviewed current diagnostic classification of diverse social phobia subtype and relationship among subtypes and also suggested the offensive type as a subtype of social phobia.

한국인 정신분열병 가계의 염색체 5번 D5S39(p105-153Ra), D5S76(p105-599Ha) 및 도파민 $D_2$, $D_3$ 수용체 유전자좌간의 연관관계 연구

오강섭,김영태,이민수,Oh, Kang-Seob,Kim, Young-Tae,Lee, Min-Soo 대한생물정신의학회 1994 생물정신의학 Vol.1 No.1

The author examined the relationship of two markers, D5S39(p105-153Ra), D5S76(p105-599Ha) of chromosome 5 and $D_2$, $D_3$ receptor genes in a Korean schizophrenic pedigree using polymerase chain reaction(PCR). The results were as follows : 1) On D5S39 locus, 5 different alleles(224/226 bp : 4 cases, 218/226 bp : 3 cases, 222/226 bp : 3 cases, 218/230 bp : 1 case, 222/224 bp : 1 case) were produced. 2) On D5S76 locus, 5 different alleles(102/112 bp : 4 cases, 94/112 bp : 3 cases, 108/112 bp 3 cases, 94/94 bp : 1 case, 102/108 bp 1 case) were produced. 3) On $D_2$ receptor gene, 3 different alleles($A_1A_2$ : 8 cases, $A_1A_1$ : 2 cases, $A_2A_2$ : cases) were produced. 4) On $D_3$ receptor gene, 2 different alleles(1/2 : 7 cases, 1/1 : 5 cases) were produced. The author had not find any specific alleles on all four loci in all pedigree nor any specific alleles in the schizophrenic patients. Though the author has not found absolute relationship between the four loci and the onset of schizophrenia, there still remains the possibilities if the more detailed and elaborated pedigree studies are done.

사회공포증 환자의 자살사고에 영향을 미치는 요인에 관한 연구

오강섭,안영균,이시형 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구목적 : 사회공포증 환자의 자살사고에 영향을 줄 수 있는 요인으로 인구통계학적 특징, 사회공포증상, 주관적 감정상태를 고려하여 어떤 요인이 자살사고에 더 큰 영향을 줄 수 있는 지 알아보고자 본 연구를 시행하였다. 방 법 : DSM-IV에 의하여 사회공포증으로 진단된 34명을 대상으로 사회공포증상, 우울감, 절망감, 기능장애를 평가하였으며 자살사고 측정을 위해 Suicide Ideation Scale(SIS)을 작성하도록 하였다. 인구학적 특성과 사회공포증의 유형별 특성은 T검정 또는 일원분산분석(One way ANOVA)을 실시하였으며 자가평가 척도들의 점수는 SIS점수와 상관관계분석을 실시하였다. 결 과 : 1) 결혼 경험이 없는 경우, 나이가 어린 경우, 자살시도의 과거력이 있었던 경우 자살 사고가 더 높게 측정되었다. 2) 각 척도 점수들과 SIS 점수의 상관관계분석에서는 우울감, 절망감의 정도가 커질수록 자살사고가 커지는 것으로 나타났다. 3) 사회공포증의 증상정도를 평가하는 척도점수와 SIS점수와의 의미있는 상관관계를 발견할수 없었다. 결 론 : 본 연구결과 사회공포증 환자의 자살사고에는 사회공포증상 자체보다 우울감, 절망감이 더 큰 영향을 미치는 것으로 나타났다. Objective : The purpose of this study was to evaluate the suicide ideation considering sociodemographic factor and degree of symptoms, subjective emotional state of the social phobia patients. Methods : Study subjects consisted of 34 social phobia patients diagnosed with the criteria of DSM-IV. The authors evaluated the degree of symptomes, depression, hopelessness, disability. For the evaluation of suicide ideation, Beck Suicide Ideation Scale(SIS) was applied to the patients. Sociodemographic data and Clinical characterictics was analyzed by t test of Oneway ANOVA. We employed the correlation test for the evaluation of reationship between suicide ideation and self reported scale score. Results : 1) Suicide ideation was higher in the young aged, unmarried patients, and past suicide attemptors. 2)In the correlation test, Suicide ideation was highly correlated with depression and hopelessness. 3)There were no significant correlations between suicide ideation and degree of symptomes. Conclusion : In this study. We concluded that the most powerful predictor of suicide ideation in social phobia is not the degree of symptomes itself but the depression and hopelessness.

사회공포증 환자의 기능장애에 관한 연구

오강섭,오명신,이시형,Oh, Kang-Seob,Oh, Myung-Shin,Lee, Si-Hyung 한국정신신체의학회 1999 정신신체의학 Vol.7 No.1

본 연구는 1996년 10월에서 1997년 7월까지 강북 삼성병원 신경정신과를 처음 방문하여 사회공포증으로 진단 받은 66명의 환자들을 대상으로 사회공포증의 증상정도, 기능장애의 정도, 이환 기간, 아형간의 연관성을 살펴보았다. 대상환자들에게 SPS(Social phobia scale), SDS(Social disability scale), LSRDS(Liebowitz self-rated disability scale)을 시행하여 다음과 같은 결과들을 얻었다. 1) 상당수의 사회공포증 환자들은 일, 여가, 가정, 사회생활 등 여러 영역에서의 중등도 이상의 기능장애를 보이고 있다. 2) 사회공포증 환자들의 기능장애는 여가, 일, 가정 순으로 높게 나타났다. 3) 사회공포증 환자들의 기능장애의 정도는 이환 기간보다는 현재의 증상 정도와 관련성이 높았다. 4) 비가해형 보다는 가해형 사회공포증 환자에서 타인에 의해 주시될 상황에 대한 주관적 두려움의 정도가 의미 있게 높았다. 5) 비가해형 보다는 가해형 사회공포증 환자에서 전반적인 기능장애의 정도가 심각하였으며 현재의 증상이 심할수록 기능장애의 정도가 심해지는 양상이다. 결론적으로 사회공포증 환자들은 교육, 직업, 가족관계, 애정관계, 사회적 관계 등 전반적 생활영역에서의 기능장애가 있음을 확인할 수 있었으며 특히 가해형 사회공포증 환자에서 그 정도가 심각하였다. This study was aimed to investigate the nature of functional impairment in social phobia and the correlation between the functional impairment and the duration of the disease, and the severity of the symptoms. In 66 patients with social phobia, the functional impairments were assessed with the SDS(Sheehan's disability scale) and the LSRDS(Liebowitz self-rated disability scale), and the severity of the symptoms was assessed with the SPS(social phobia scale). The results were summarized as follow : 1) Most of the social phobic patients reported moderate to severe impairment in their lives in areas of education, employment, family relationships, romantic relationships, social networks, and other interests, etc. 2) There was a significant correlation between the severity of the symptoms and the disability in their lives. 3) The offensive social phobic patients reported that they had more disability in their lives and more severe symptoms than non-offensive patients did. 4) There was no significant correlation between the duration of disease and the disability in their lives. Conclusively, we confirmed that social phobia was associated with the functional impairment in most areas of their lives.

Early Improvement in One Week Predicts the Treatment Response to Escitalopram in Patients with Social Anxiety Disorder: A Preliminary Study

오강섭,신은숙,하주원,신동원,신영철,임세원 대한정신약물학회 2016 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.14 No.2

Objective: Social anxiety disorder (SAD) shows relatively delayed responses to pharmacotherapy when compared to other anxiety disorders. Therefore, more effective early therapeutic decisions can be made if the therapeutic response is predictable as early as possible. We studied whether the therapeutic response at 12 weeks is predictable based on the early improvement with escitalopram at 1 week. Methods: The subjects were 28 outpatients diagnosed with SAD. The subjects took 10-20 mg/day of escitalopram. The results of the Liebowitz social anxiety scale (LSAS), Hamilton anxiety rating scale, and Montgomery-Asberg depression rating scale were evaluated at 0, 1, 4, 8, and 12 weeks of treatment. Early improvement was defined as a ≥10% reduction in the LSAS total at 1 week of treatment, and endpoint response was defined as a ≥35% reduction in the LSAS total score. The correlation between clinical characteristics and therapeutic responses was analyzed by simple linear regression. The correlation between early improvement responses and endpoint responses was analyzed by multivariate logistic regression analysis and receiver operating characteristic curves. Results: When we adjusted the influence of a ≥35% reduction in the LSAS total endpoint score on a ≥10% reduction of the LSAS total score at 1 week of treatment for the patients’ age, the early improvement group at 1 week of treatment was expected to show stronger endpoint responses compared to the group with no early improvement. Conclusion: The results suggest that a ≥10% reduction in the LSAS total score in a week can predict endpoint treatment response.

불면증 환자의 정신생리 상태 -수면 직전 각성 정도, 자기 효율 정도, 수면 위생, 불안과 우울 정도-

오강섭,이소희,이시형,Oh, Kang-Seob,Lee, So-Hee,Lee, Si-Hyung 대한수면의학회 1995 수면·정신생리 Vol.2 No.1

Objectives : Insomnia is significantly influenced by the pre-sleep arousal, self efficacy, sleep hygiene, depression and anxiety. The authors tried to explore how these factors are related with the clinical features of sleep. Methods : Fifty three patients diagnosed as insomnia by DSM-IV criteria were studied. They filled up the pre-sleep arousal scale(PSAS), sleep efficacy scale(SES), sleep hygiene awareness and practice scale, BDI, and state and trait anxiety scales. Results: 1) The mean values of sleep-related variables were as follows : Sleep latency,136.89 minutes ; frequences of awakening during a night, 2.28 ; minutes to get back to sleep, 42.70 ; total sleep time, 180.19 minutes ; duration of illness, 72.00 months. 2) The mean scores of scales were as follows : PSAS(cognitive), 22.40 ; PSAS(somatic), 17.32 ; SES, 20.16 ; sleep hygiene knowledge, 25.96 ; caffein knowledge, 59.78 ; sleep hygiene practice, 42.12 ; BDI. 18.2 ; state anxiety, 41.24 ; trait anxiety ; 44.50. 3) In the subjects with superimposed depression, the mean frequency of awakening during a night and the mean pre-sleep arousal scale score were higher than in those without depression. 4) Frequency of awakening were correlated positively with a PSAS(a tight tense feeling in your muscle) and sleep hygiene awareness. PSAS(cognitive) were correlated positively with a PSAS(somatic). BDI correlated positively with a PSAS item(a jittery, nervous feeling in your body)and a SES item (not allow a poor night's sleep to interfere with daily activities). Anxiety scales were correlated positively with sleep hygiene practice scale sleep, and PSAS were correlated negatively with SES. Conclusions : The mean scores of PSAS, SES, sleep hygiene awareness and practice scale, BDI, state and trait anxiety scales of insomniacs were correlated either positively or negatively in insomnia patients. These factors seem to contribute to the development and maintainence of insomnia.

정신과 영역에서 벤조다이아제핀계 약물의 사용과 문제점

오강섭,Oh Kang-Seob 대한불안의학회 2005 대한불안의학회지 Vol.1 No.1

Benzodiazepines are widely used for a variety of conditions in psychiatric field. In this article, the author reviewed the indications, the effects on anxiety and sleep disorders, the side effects, the drug-drug interactions, and the tapering strategies. Benzodiazepines were relatively safe and useful for the treatment of anxiety and sleep disorders. However, used clinically, benzodiazepines can induce many adverse effects (e. g. over-sedation, cognitive impairments, paradoxical effects, dependence and withdrawal symptoms, and so on). Currently available informations about their effects on the developing fetus is controversial. For this reason, pregnant women and nursing mother should be cautioned against the use of benzodiazepines. Drug-drug interactions have to be considered in combination treatments. For the tapering issues, gradual tapering was important to prevent the withdrawal symptoms. Especially, the tapering schedules have to be individualized for the each long-term benzodiapzepine users.

[지상 명강의 : 우울증에 걸린 가족을 돕는 방법] 소중한 사람이라고 느끼게 해주세요

오강섭 샘터사 2009 월간 샘터 Vol.477 No.-