거주형태에 따른 노인 우울증과 자살경향성 비교 연구

왕희령,최용성,조명제,최윤미,신희숙,제수경,최재원,홍진표,Wang, Hee-Ryung,Choi, Yong-Sung,Cho, Myeong-Je,Choi, Yun-Mi,Shin, Hee-Sook,Je, Su-Kyung,Choi, Jae-Won,Hong, Jin-Pyo 대한불안의학회 2010 대한불안의학회지 Vol.6 No.1

본 연구는 이천시에 거주하는 65세 이상의 인구를 대상으로, 우울증의 유병률과 자살경향성, 우울증과 자살경향성에 영향을 미치는 위험요인을 살펴본 연구이다. 전체적으로 우울증의 유병률은 28% 정도로 파악되어 실제로 65세 이상의 연령대에서 상당수의 노인들이 임상적으로 의미 있는 우울증을 경험하고 있는 것으로 관찰되었다. 또한 자살경향성은 전체 조사대상자의 약 20%에서 자살생각, 자살의도, 자살계획, 자해의도, 자살시도 중 한 가지 이상을 지난 한 달 동안 경험했던 것으로 나타났다. 거주 형태별로 구분하여 비교 분석한 결과, 혼자 생활하거나 시설에서 생활하는 노인들에서 동거가족이 있는 노인들보다 우울증의 유병률이 높고, 증상도 심한 것으로 나타났으며, 이들에게서 자살경향성 역시 높은 것으로 파악되어 이들 고위험군에 대한 보다 집중적인 우울증의 조기 발견 및 자살예방사업이 필요할 것으로 판단되었다. 위험요인 분석에서는 고령, 시설거주, 낮은 사회적 지지 수준은 우울증의 위험요인으로, 독거생활, 시설거주, 낮은 사회적 지지 수준, 두통의 기왕력은 자살경향성의 위험요인인 것으로 파악되었다. Objective : This study aimed to investigate and compare the prevalence of depression and suicidality among the elderly in a rural city according to their residence type. Methods : Participants were 311 elderly people (109 male and 202 female) in Icheon City, whom trained researchers interviewed and examined Geriatric Depression Scale, Social Support Scale, Instrumental Activities of Daily Living, Activities of Daily Living, Quality of Life Scale, and Mini International Neuropsychiatric Interview (MINI), module C. Using these data, we analyzed participants' risk factors associated with depression and suicidality. Results : The prevalence of depression was 28.0%. The prevalence in the elderly living alone and those admitted to residential facilities was significantly higher than that among the elderly living with family. Suicidality frequency was 19.6%. The suicidality frequency among the elderly living alone and those admitted to facilities was significantly higher than that among the elderly living with family. The risk factors for depression were age, admission to a facility, and low economic status. The suicidality risk factors were living alone, admission to a facility, poor social support, and a history of headache. Conclusion : These results showed the prevalence of depression and frequency of suicidality among the elderly in such a city was quite high. The results of this study remind psychiatrists of the importance of early detection and therapeutic intervention for the elderly with a high risk of depression and suicidality.

양극성 조증 입원 환자에서 과체중, 비만과 연관 인자 : 예비 연구

정영은,서호준,송후림,왕희령,전태연,박원명,Jung, Young-Eun,Seo, Ho-Jun,Song, Hoo-Rim,Wang, Hee-Ryung,Jun, Tae-Youn,Bahk, Won-Myong 대한불안의학회 2010 대한불안의학회지 Vol.6 No.2

Objective : Being overweight or obesity impairs quality of life and often causes treatment noncompliance in patients with bipolar disorder. This preliminary study evaluated the prevalence of overweight and obesity in inpatients with bipolar mania. Methods : Inpatients with bipolar mania, who were treated with adequate medications at least 4 weeks were included in a retrospective study. The body weight of each patient was measured and the body mass index (BMI) was calculated. Results : Of the 80 patients, 16.4% (N=13) were overweight, and 35.0% (N=28) were obese at discharge. Female patients had higher prevalence rates of overweight and obesity. Being overweight or obesity was associated with the number of previous episodes of depression and combination treatment with atypical antipsychotics and mood stabilizers. Conclusions : Being overweight or obesity is highly prevalent in patients with bipolar mania. Clinicians should pay more attention to weight gain and obesity when prescribing combination therapies. More research is required to identify the impact of specific risk factors for overweight and obesity in patients with bipolar mania.

양극성 장애 환자에서 한국어판 Bipolar Spectrum Diagnostic Scale의 타당성 연구

왕희령,김상억,강시현,주연호,김창윤 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.6

본 연구는 한국어판 BSDS의 민감도와 특이도, 최적의 절단값을 조사하기 위해 시행되었다. SCID를 사용하여 DSM-IV에 의거하여 진단된 양극성 장애 및 주요우울장애 환자들을 대상으로 본 연구를 시행하였고, 가장 적절한 절단값은 10점, 이 때의 특이도, 민감도는 각각 0.85, 0.73 수준으로 나왔다. 본 연구 결과를 통해, 한국어판 BSDS는 양극성 장애에 선별에 있어서 높은 민감도와 특이도를 지닌 타당성 있는 자가보고형 선별도구임이 밝혀졌다. Objectives : Because bipolar spectrum disorders frequently go unrecognized in clinical practice, sensitive screening tools for bipolar spectrum disorders are much needed. This study was conducted to confirm the validity of the Korean version of the Bipolar Spectrum Diagnostic Scale (BSDS), which was originally designed by Ronald Pies. Methods : The BSDS, which was translated into Korean by the authors, was dministered to patients with known bipolar disorders (N=60) and unipolar depressive disorders (N=27). Using various cut-off scores, we calculated the sensitivities and specificities of the Korean version of the BSDS in order to determine the optimal cut-off score. Results : In this study,a cut-off score of 10 was shown to be optima1, with a sensitivity of 0.73 and a specificity of 0.85, although a cut-off score of 13 was proposed to be optima1 by the original authors of the BSDS. Conclusion : These results indicate that the Korean version of the BSDS is a valid screening tool for bipolar spectrum disorder.

소아 간질 아동 어머니의 양육 스트레스 및 부모효능감

박수빈,유한익,전정원,최순호,왕희령,김건우,김진용,고태성 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : While parents who foster children with epilepsy would have considerable parenting diSiculties, the parenting stress and sense of competence have not been investigated. We investigated matemal parenting stress, Parenting satisfaction and sense of parenting competence in children with seizure disorders, and the associations with seizure-related variables. Methods : Mothers of 79 children with seizure disorders (41 boys, 38 girls ; mean age, 9.9±2.3 years) and 79 healthy comparison subjects matched for age and sex were recruited for this study. The Korean version of the Parenting Stress Index (K-PSI-SF) and the Parenting Sense of Competence (K-PSOC) were used to assess parenting stress, parenting satisfaction and parenting effcacy. Results : Mothers of children with seizure disorders showed higher scores on stress related to difficult child and child leaming and parenting anxiety compared to mothers of healthy children. In addition, scores on stress related to parental-child interaction and child leaming were significantly associated with parental economic status. Scores on stress from parental-child interaction was also correlated with seizure severity, and stress from child leaming was correlated with seizure type. Sense of parenting competence and anxiety scores were correlated with patemal educational status, respectively. Conclusion : These fndings suggest that mothers of children with epilepsy have greater parenting stress and anxiety and social and seizure-associated factors may affect the parenting stress and anxiety.

중추신경자극제를 사용할 수 없는 주의력결핍과잉행동장애 아동에서의 Modafinil 효과 : 예비 연구

유한익,김진용,박수진,전정원,왕희령,김붕년,홍진표,김성윤,김창윤 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.6

Objectives : This study was aimed to examine the efficacy and safety of modafinil in psychostimulant-inapplicable children with attention deficit hyperactivity disorder (ADHD) due to insufficient treatment response or intolerable adverse effects. Methods : Fifteen children (8.8±1.8 years, 14 boys, total IQ 107.22±13.4) were recruited for this study. ADHD was confirmed by K-SADS-PL. The efficacy was assessed by ADHD rating scale (ADHDRS), Conner's parental rating scale-revised(CPRS-R), ADHDRS school version, clinical global impression (CGI) and computerized neurocognitive function test. Mean dose of modafnil was 250. 0±103.3 mg. Results : Total score (p=0.012) and hyperactive/impulsive score (p=0.021) of ADHDRS for investigator, as well as CPRS-R score (p<0.01) and CGI-severity score (p<0.01) were significantly reduced after 39.2±8.7 days of modafmil administration. Response time of word color test was also significantly decreased after medication. Decreased appetite (2 subjects), insomnia (2 subjects), irritability (1 subject) and alopecia (1 subject) were observed during this study period. Conclusion : Modafinil was effective and well-tolerated for the psychostimulant-inapplicable children with ADHD.

지연성 수면위상증후군 청소년에서 기상 시 어려움과 주간 졸림에 대한 Dawn Simulation 효과 연구

강시현,유한익,정석훈,왕희령,안준호,윤인영,김창윤 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : Delayed sleep phase syndrome (DSPS) is characterized by difficulties in falling asleep and waking up at a desired time. Dawn simulation is a technique using a light that gradually increases in intensity before awakening in the morning, to imitate a natural sunrise. It has been found to be effective in decreasing both morning drowsiness and difficulty in awakening as well as treating symptoms of seasonal affective disorder. The aim of this study was to determine whether dawn simulation is helpful in decreasing difficulty in morning awakening and daytime sleepiness in adolescents with DSPS. Methods : Twelve adolescents with DSPS participated in a 2-week dawn simulation trial. Each subject self-assessed level of difficulty in awakening, morning drowsiness and daytime sleepiness during a 2-week baseline period and a following 2-week trial period with dawn simulator. Subjects used Stanford Sleepiness Scale (SSS) for measuring morning drowsiness and Epworth Sleepiness Scale (ESS) for measuring daytime sleepiness. Difficulty in awakening was assessed by a single-item questionnaire. Results : Dawn simulation trial decreased morning drowsiness (p=0.016) and daytime sleepiness (p=O.013) significantly compared to baseline. It also seemed to improve difficulty in awakening, but the effect was not statistically significant (p=0.092). Conclusion : Dawn simulation may help waking up in the morning and may improve daytime functioning by deceasing both morning drowsiness and daytime sleepiness in adolescents with DSPS.