대학생의 자살위험도와 MMPI-2의 관계

이건석,이혜경,김석현,장은영,김대호,Lee, Kounseok,Lee, Hye Kyung,Kim, Seok Hyeon,Jang, Eun-Young,Kim, Daeho 대한불안의학회 2015 대한불안의학회지 Vol.11 No.2

Objectives : The Minnesota Multiphasic Personality Inventory (MMPI) is a commonly used psychological test measuring personality and psychopathology in both clinical and non-clinical population. This study was to evaluate characteristic MMPI-2 profile associated with the risk of suicide among college students. Methods : We analyzed the survey response of 2,964 college students who participated in a health survey from a school health center at a national university in 2011. Those who endorsed any of six items on the suicidaity module of MINI were classified as a suicide risk group and remaining students who did not as a control group. Then we compared the Patient Health Questionnaire (PHQ-9) score, the MMPI-2 Clinical scales and Restructured Clinical (RC) scales. To evaluate the correlation RC scales with suicidality score, Pearson correlation analysis was performed. Results : The suicide risk group was 464 students, and the control group was 2,500. The classification result of suicidality, 255 (8.6%) students were low-risk group, 149 (4.8%) students were moderate-risk group and 60 (2.0%) students were high-risk group. In the suicide risk group, VRIN, F scale, Clinical scale and RC scales were significantly higher. In the control group L, K and S scales were significantly higher. Suicidality score has significant correlation with all RC scales. Conclusion : In the suicide risk group, overall psychopathology was higher than the control group. Taken together, features of depressive symptom, antisocial behavior, aggressiveness, introversion may indicate the risk of suicide in college students. These results display both clinical and public health implications for clinicians and school health professionals.

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.

대학생의 일주기유형과 우울한 기분이 인터넷 중독에 미치는 영향

오규수,이혜경,이건석,Oh, Kyu Soo,Lee, Hye-Kyung,Lee, Kounseok 대한생물정신의학회 2016 생물정신의학 Vol.23 No.4

Objectives The purpose of this study was to investigate the relationships among circadian types, depressive mood and internet addiction and to identify the mediating effect of depressive mood between circadian types and internet addiction in Korean College Students. Methods A total of 2632 participants completed questionnaires, which included the Korean translation of the Composite Scale of Morningness (CSM), the Patient Health Questionnaire (PHQ-9), and the Korean version of the Internet Addiction Test (KIAT). Statistical analyses were done using correlation analysis, analysis of covariance and multiple linear regression. Results The CSM score was negatively associated with the PHQ-9 score (r = -0.226, p < 0.001) and the KIAT score (r = -0.218, p < 0.001). The eveningness group showed higher scores in depressive mood and internet addiction than the morningness group (p < 0.001). Depressive mood showed a partial mediating effect between circadian types and internet addiction (${\beta}=0.255$, p < 0.001). Conclusions Internet addiction was associated with circadian types and depressive mood. These results suggest that depression and circadian rhythm management would contribute to the prevention of internet addiction.

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.

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.

일주기 유형에 따른 삶의 만족도와 양극성 경향

박환진,이혜경,신용진,이건석,Park, Hwanjin,Lee, Hye-Kyung,Shin, Yong Jin,Lee, Kounseok 대한생물정신의학회 2015 생물정신의학 Vol.22 No.3

Objectives The purpose of this study was to investigate the relationships among circadian typology, bipolarity and life satisfaction of university students. Methods A total 1232 participants completed questionnaires, which included Composite Scale of Morningness (CSM), Satisfaction with Life Scale (SWLS), and Mood Disorder Questionnaire (MDQ). Statistical analyses were done using correlation analysis, and analysis of covariance. Results The CSM score was positively associated with SWLS score (r = 0.232 ; p < 0.001). The morningness group has higher life satisfaction than the eveningness group (p < 0.001). The eveningness group has higher bipolarity than the morningness group (p < 0.001). The CSM score was negatively associated with MDQ score (r = -0.128 ; p < 0.001). Conclusions Bipolarity and life satisfaction were associated with circadian typology. Morningness was the important determinant of life satisfaction and bipolarity.

한국판 역학연구 우울척도 개정판(K-CESD-R)의 표준화 연구

이산,오승택,류소연,전진용,이건석,이은,박진영,이상욱,최원정,Lee, San,Oh, Seung-Taek,Ryu, So Yeon,Jun, Jin Yong,Lee, Kounseok,Lee, Eun,Park, Jin Young,Yi, Sang-Wook,Choi, Won-Jung 한국정신신체의학회 2016 정신신체의학 Vol.24 No.1

연구목적 역학연구 우울척도 개정판은 우울 증상을 평가하는 데에 유용성이 입증된 척도로 알려져 있으며 '정신장애의 진단 및 통계 편람 제4판(DSM-IV)'에 기술되어 있는 주요우울장애의 주요한 우울 증상들을 포괄하고 있다. 이 연구에서는 한국판 역학연구 우울척도 개정판을 제작하여 척도의 신뢰도, 타당도와 특성을 평가하고자 하였다. 방 법 DSM-IV의 진단기준에 근거한 MINI를 사용하여 주요우울증, 기분부전증, 달리 분류되지 않는 우울장애로 진단된 48명의 환자군과 48명의 정상 대조군이 연구에 참여하였다. 연구 참여자들은 한국판 역학연구 우울척도 개정판, 몽고메리-아스버그 우울증 평가척도, 우울증 선별척도, 단축형 우울증상 평가 척도, 상태-특성 불안척도를 포함한 척도검사를 시행하여 교차 검증하였다. Cronbach's alpha 계수, Pearson 상관계수, 주성분 분석, Receiver Operating Characteristic(ROC) 곡선, 최적 절단점 산출을 위한 통계분석을 시행하였다. 결 과 한국판 역학연구 우울척도의 Cronbach's alpha 계수는 0.98이었으며, 한국판 역학연구 우울척도 개정판의 총점은 본 연구에서 시행하였던 다른 우울 및 불안척도의 점수와 높은 상관 관계를 보였다. 주성분 분석에서는 두 요인이 전체 분산의 76.29%를 설명하였으며, ROC 곡선을 이용하였을 때, 한국판 역학연구 우울척도 개정판의 최적 절단점은 13점이었다. 결 론 본 연구는 한국판 역학연구 우울척도 개정판의 표준화를 위한 첫 번째 연구로, 한국판 역학연구 우울척도는 우울 증상을 평가하는데 있어 신뢰성 있고, 타당한 척도임을 밝혔다. 또한 이 척도가 진료 및 역학 연구에서 유용한 선별검사 도구로 사용될 수 있을 것으로 기대한다. Objectives : The Center for Epidemiologic Studies Depression scale-Revised is a recently revised scale which has been reported as a valid tool for the assessment of depressive symptoms. It encompasses cardinal symptoms of depression described in the Diagnostic and Statistical Manual of Mental disorders, fourth edition. In this study, we assessed the reliability, validity and psychometric properties of the Korean version of the CESD-R(K-CESD-R). Methods : Forty-eight patients diagnosed as major depressive disorder, dysthymia, depressive disorder NOS according to the DSM-IV criteria using Mini International Neuropsychiatric Interview and 48 healthy controls were enrolled in this study. They were assessed with K-CESD-R, K-MADRS, PHQ-9, KQIDS-SR, STAI to check cross-validation. Statistical analyses were performed using calculation of Cronbach's alpha, Pearson correlation coefficient, Principal Component Analysis, ROC curve and optimal cut-off value. Results : The Cronbach's alpha of K-CESD-R was 0.98. The total score of K-CESD-R revealed significantly high correlations with those of K-MADRS, PHQ-9, KQIDS-SR(r=0.910, 0.966 and 0.920, p<0.001, respectively). Factor analysis showed two factors account for 76.29% of total variance. We suggested the optimal cut-off value of K-CESD-R as 13 according to analysis of the ROC curve which value sensitivity and specificity both equally. Conclusions : These Results showed that the K-CESD-R could be a reliable and valid scale to assess depressive symptoms. The K-CESD-R is expected as a useful and effective tool for screening and measuring depressive symptoms not only in outpatient clinic but also epidemiologic studies.

치료 저항성 조현병 환자를 위한 가상현실 기반 환청 평가 및 교육 도구의 개발

김경진(Kyungjin Kim),조현인(Hyunin Jo),김석현(Seok Hyeon Kim),이건석(Kounseok Lee),전진용(Jin Yong Jeon) 한국소음진동공학회 2020 한국소음진동공학회 학술대회논문집 Vol.2020 No.11

갈망 : 생물학적 이해와 치료적 접근

한창우(Changwoo Han),최영숙(Young Sook Choi),김영호(Young-Ho Kim),이건석(Kounseok Lee) 한국중독정신의학회 2018 중독정신의학 Vol.22 No.2

Objectives : Craving is defined as the desire for using the substance. It plays an important role in the recurrence of the substance- related disorder. The purpose of this review was to summarize the pathophysiology behind craving and pharmacological and psychological treatment of craving. Methods : We searched and reviewed articles on craving for the substance. Results : The neurotransmitters involved in craving are dopamine and serotonin. Dopamine acts on the enhancement of action, while serotonin acts by inhibiting the release of γ-Aminobutyric acid. Both acamprosate and naltrexone could be used for craving treatment. Moreover, cognitive behavioral therapeutic methods have been employed for the treatment. Conclusion : The systematic management of craving aimed at preventing the recurrence of substance- related disorders could result in improvement of compliance and reduction in recurrence and treatment cost.

정신병원 입원 환자들의 휴대 전화 사용에 대한 고찰

최영숙(Young Sook Choi),신경철(KyoungChul Shin),박한선(Han Sun Park),임미래(Mee Rae Lim),신용진(Yong Jin Shin),이호선(Ho Sun Lee),이건석(Kounseok Lee),오규수(Kyu Soo Oh) 대한사회정신의학회 2016 사회정신의학 Vol.21 No.2

디지털 테크놀로지(Digital Technology)는 모든 현대인의 일상 생활과 의료 환경에 막대한 영향을 주고 있다. 정신병원 입원 환자들에게 휴대 전화 사용을 제한하지 않았을 때 환자들의 사생활의 자유, 표현의 자유, 알 권리 등의 기본권이 보장되어 인권이 보호된다고 볼 수 있는 측면이 있다. 한편으로 휴대 전화 사용이 타 환자뿐만 아니라 휴대 전화를 이용하는 환자 자신의 사생활의 보호, 진료 정보의 비밀유지와 안전하고 치료적인 환경 조성에 미치는 영향을 고려해야 한다. 그러므로 환자의 기본권 보호와 안전한 치료 환경 형성과 사생활 보호의 효과를 얻기 위해서, 개별 기관은 환자뿐만 아니라 직원, 방문자의 휴대전화, 녹음기기, 무선 전자기기 사용에 대한 구체적인 정책과 절차를 마련해야 한다. 환자의 휴대 전화 사용을 허용할 때, 기관은 환자에게 올바른 휴대 전화, 스마트폰 사용에 대한 교육을 제공하고, 문제성 인터넷 사용 및 비디오 게임 사용 등에 대해 사전 평가를 하는 것이 필요할 것으로 보인다. 또한 향후 정신질환을 가진 사람들의 휴대 전화·모바일 전자기기(Mobile Device)·인터넷·소셜 네크워킹 서비스(Social Net-working Service)사용 양상 및 치료재활 서비스에 모바일 전자기기의 이용 등, 디지털 테크놀로지와 정신 건강에 대한 연구가 필요할 것으로 보인다. Digital technology has a great effect on a daily life and medical environment of human. In mental hospital, many things thus should be considered when deciding a restriction of use of mobile phone by patients. There is positive effect of use of mobile phone on protecting human rights such as freedom of private life and expression, and right-to-know. However, Unchecked used of mobile phone can make the other person distracted and uncomfortable and can disturb treatment. Therefore, mental hospitals should establish their policy for the use of recording devices, mobile phone and other electronic wireless devices. Prior to the permission of mobile phone, mental hospital should provide an education of proper use of mobile phone for patients and should evaluate their risk for misuse of it.