治療的 三角關係

李澤重 서울대학교 의과대학 정신과학교실 1983 精神醫學報 Vol.7 No.8

韓國人 男子에서 Aldehyde Dehydrogenase Ⅰ의 變異와 알코올 敏感性, 飮酒習慣 및 알코올 中毒과의 關係에 관한 硏究

李澤重,白基淸,朴信,李哲元,金亨來,金容植,李定均 서울醫大 1991 精神醫學 Vol.16 No.2

우울증(장애)의 이해

이택중 한국불교상담학회 2016 한국불교상담학회 학술대회지 Vol.9 No.-

환자를 효과적으로 잘 치료하기 위한 전제는 정확한 진단이라는 것은 너무나 자명하다. 모든 질병을 진단하는데 있어서 가장 중요한 것은 그의 주소(主訴)에 따른 자세한 병력과 과거력, 가족력과 더불어 자세한 진찰이 필수적이며 이에 따른 이화학적인 검사 등으로서 객관적인 최종 임상적 진단에 이르는 것이 일반적이다. 그러나 정신장애는 신체적인 질병과 달리 그 진단분류나 객관적인 검사가 현재로서는 완 벽하지 않다. 즉 병인적인 진단이 아니고 현상의 기술적인 진단체계이며 초보적인 이화학 검 사나 임상심리검사가 있기는 하지만 신체질환의 그것과 비교할 때, 그 진단적 가치가 미흡하 며 과학적인 객관성이 충분하다고 볼 수는 없다.

C . G . Jung ; 정신치료의 기본원칙

이택중,한오수 한국분석심리학회 1986 心性硏究 Vol.1 No.1

綜合病院 應急室에서의 精神科專攻醫의 體驗

李澤重 서울대학교 의과대학 정신과학교실 1981 精神醫學報 Vol.5 No.8

精神分裂症 繪畵의 特徵에 관한 考察

李符永,李澤重 大韓神經精神醫學會 1983 신경정신의학 Vol.22 No.1

著者들은 1979年 3月부터 1982年 3月初까지 수집된 精神科 入院患者의 그림중 8백 83점을 硏究目的에 따라 선택하여, H.Rennert등과 L.Navratil의 정신분열증 환자의 繪畵上의 특징에 대한 見解를 종합하여 特性指標를 作成, 일를 精神分裂症 患者와 그 對照群인 기타의 精神科患者가 그린 그림에 適用, 兩群의 統計的인 檢討돠 더불어 입원환자들의 그림의 産出量에 대해서도 예비적으로 조사하였다. 特性指標 적용상의 結果와 問題點은 다음과 같다. 1. Rennert등의 特性指標가 출현하는 그림의 比率은 정신분열증 환자군에서 有意한 水準으로 높아서 전체적으로 特性指標중 兩群間을 구별할 수 있는 特徵은 本調査에서도 하나도 발견되지 않았다. 그러나 形態的 表現의 繪畵的인 凝縮現象에 해당하는 각개의 指標를 합하여 比較했을 때는 정신분열증 환자군의 그림에서 有意하게 많이 출현하였다. 2. Rennert등의 特性指標의 出現率이 극히 희소하거나 대부분 兩群間에 有意한 羞異를 보이지 않는 것은 처음부터 指標設定의 基準을 그 頻度에 두지 않고 그의 意義에 따른 점도 있겠으나, 措定되는 다른 要因중에는 對象患者의 특성상 精神分裂症群에 慢性患者가 적고 退行이 심하지 많은 비교적 發願期의 患者가 많다는 범, 對照群이 正常人이 아니고 現實檢證 능력에 장애가 있을 수도 있는 蹂 病등도 포함되어 있다는점과 더불어 文化的인 羞異등도 고려되어야할 것이다. 3. Rennert등의 特性指標중 客觀的으로 판정하는데 主觀이 많이 介入될 素地가 있는 項目이 있어 판정 誤謬를 최소한으로 하기 위해서는 보다 客觀的인 指標의 作成이 요구되며 特性指標의 出現 度도 그의 意義와 더불어 중요시되어야 하겠다. 4. 全般的으로 精神科 환자들의 그림에서 幼兒的 表現이 많이 발견되었고 특히 그림의 中心主題나 技法上 Synchronism 현상도 찾아볼 수 있어서 앞으로 어린이의 그림과도 體終的으로 比較硏究해 볼 필요가 있겠다. 5. 兩群을 통하여 Rennert등의 지표에 해당하지 않으나 전체환자들의 그림에서 발견되는 특징중 背景을 처리하지 않은 그림 약 20%, 基지線이 없는 그림 5%, 그리고 特性指標에 해당하지 않으나 題目등 그림에 文字가 삽입되어 있는 그림이 18%의 비율로 발견되었다. 이는 사초物에 의한 集中力의 저하와 일부 受動的인 作畵態度가 그 요인중의 하나일 것으로 추측되었다. 6. 1982年 1月이래 8月 10日까지의 입원환자중 약 63%가 최소한 한 장 이상의 그림을 그렸고, 5장이상의 그림을 그린 환자는 精神分析症群에서 28.7%, 對照群에서 10.4%를 나타냈다. 그러나 精神分裂症 환자가 더 自發的으로 그림을 그린다는 主張을 뒷받침하기 위해서는 보다 계획적인 硏究가 필요하겠다. 따라서 앞으로 精神分裂症 患者의 그림에서 보다 의미있는 特性指標를 연구하기 위하여 對象患者의 일반 人口學的 變因, 작업 條件의 恒常性 出現頻度와 客觀性등에 따른 特性指標의 取捨補完, 精神分析症 自體의 輕重程度나 그의 臨床經過에 따른 그림의 全體的인 變化過程등을 考에 넣어야 하겠고, 무엇보다도 對照群으로 正常人을 選定할 필요가 있다고 생각된다. The graphic works produced by the admitted mental patients from March, 1979 to the beginning of August, 1982, are reviewed to investigate the schizophrenic's characteristic signs of the graphic works. To 883 selected graphic products according to the design among collected graphic works, we apply the combined criteria of schizophrenic signs on the basis of H. Rennert's and L. Navratil's opinion. The mental patients are classified into two groups; the schizophrenic group(M=104) and the remaining other mentally-ills, the control one(N=46) to compare the frequency of each characteristic sign between two groups. The graphic productivity of the schizophrenics is also taken into consideration for the preliminary study. The results make us arrive at some conclusion as followings. 1. There is no single schizophrenic sign of the graphic products discrimination between two groups but there is the statistical significance in the overall productivity of graphic works between not having any schizophrenic sign and having one, which is an indirect evidence of the value of those criteria. Also the characteristic formal expression of condensation as a group criterion has statistical meaning. 2, Although the value of schizophrenic sign doesn't lie in its frequency but in its meaning, its low frequency and the less statistical significance between two groups result from the next possible factors in this study. The one the schizophrenic group has the less regressed cases, and the other the control group is not consist of "normal”population, but of other psychiatric patients including such as manic depressive patients. 3. Especially we find out that there are few schizophrenic signs in graphic contents; which probably reflects one aspect of the cultural difference between the East and the West. 4. some graphic products show the empty space left without drawing in the pictures(20%), the object floating in the air without baseline(5%), and intervening of the letter in the drawings(15%) in both groups. The reflection on these findings includes the probable influence of some psychotropic drugs impairing the patient's concentration, of passive participation in the drawing activity, and of the oriental painting style to a certain extent. 5. The tentative survey of graphic productivity results in the finding that the graphic productivity of the schizophrenic is higher comparing to the control. But further well-defined control study is required to examine the graphic productivity exactly. With above-mentioned findings it is suggested that the consideration of demographic characteristics as some variables, the more clear-cut objectivity of some criteria, and the application of normal group as the control, and the comparison of illness severity including illness-progression with graphic expression, are necessary to the establishment of such a criterion. Also the influence of Korean cultural difference on graphic expression is the task studied in the near future.

다중이용시설의 라돈농도 분포 및 특성 연구

이택중(T. J. Lee),정명상(M. S. Jeong),김흥락(H. R. Kim),박혜숙(H. S. Park) 한국환경관리학회 2010 環境管理學會誌 Vol.16 No.1

For studying on concentration distribution and characteristic of radon for public facilities, we analyzed radon from 13 hospitals, 8 large stores, 8 fomentation rooms, 5 nurseries, 5 indoor parking lots, 2 postpartum clinics, 1 underground shopping center from January to December in Cheonan area. The results were as follow 1. Indoor average radon concentrations investigated were 0.73 pCi/L in underground shopping center. That value was highest one. and other average radon concentrations were 0.42 pCi/L in fomentation room, 0.34 pCi/L indoor parking lot, 0.32 pCi/L in nursery, 0.28 pCi/L in large store and postpartum clinic, 0.25 in hospital. Indoor average radon concentration of public facilities were 0.37 pCi/L, it was lower than 4.0 pCi/L of recommended criterion. 2. Investigating the distribution of concentration in underground facilities and above ground, the average radon concentration in underground facilities was 0.38 pCi/L that was higher than 0.17 pCi/L in above ground. The ratio of underground concentration to above ground in hospital was 1.0, so there was no significant difference between underground and above ground. But there was significant difference between indoor parking lot and large store as 4.0 and 2.8. 3. Investigating the time variation with radon concentration for a day, average radon concentration for a day in large store and hospital were 0.28 pCi/L, 0.63 pCi/L respectively. The difference with radon concentration for a day was 0.7 pCi/L in large store and 1.10 pCi/L in hospital. in Respect of ventilation system, The average concentration in large shopping center was 0.18 pCi/L with ventilation working, 0.38 pCi/L without ventilation working and in hospital 0.53 pCi/L, 0.72 pCi/L. This showed that radon concentration accumulated in a hermetic chamber without ventilation were high. There fore the ventilation was considered as a main means of indoor radon reduction. 4. When anticipating each facility worker"s annual effective dose by the inhalation in public facilities that the mean concentration was 0.37 pCi/L, annual effective dose was 13.54 mRem/yr. And underground shopping center has the highest value as 26.71 mRem/yr. This is much lower than 130 mRem/yr(1.3 mSv/yr) which is worldwide annual effect dose by The inhalation of radon and Its daughter announced in International Commission on Radiological Protection(ICRP). In conclusion, The Radon average concentration public facilities in Cheonan was lower than that of recommended indoor criterion and annual effective dose was lower than that of ICRP, But considering a main cause of lung cancer and increase of living in indoors and an area with much Radon in soil, The investigation of regional Radon condition, research on health effect of Radon, the measure of Radon reduction must be needed to carry out.

만성정신분열병에서 Diazepam의 항정신병 효과에 대한 예비적 연구

최휘영,이택중,김용식,이정균 대한신경정신의학회 1985 신경정신의학 Vol.24 No.1

The purpose of this study was to test the antipsychotic effect of diazepam. Twenty-five hospitalized chronic schizophrenic patients who had been resistant to standard neuroleptic treatment were included. The patients were subdivided into two groups and the study was run double-bline, cross-over, with twc successive periods of three weeks each. Thus all patients were received once diazepam (30〜90mg/day) and once placebo alternatively. The effect of diazepam was assessed weekly by the Brief Psychiatric Rating Scale (BPRS) and the Clinical Global Impression Scale (CGI). Diazepam showed no difference from placebo in antipsychotic effect during total six weeks, that is, two successive periods of three weeks, but there were significant antipsychotic effect of diazepam, during first three weeks. This result seems to be due to the carry-over effect of diazepam during second three weeks for placebo medication and due to the masking of antipsychotic effect by the side effects of diazepam. So further longterm clinical studies are needed. In addition, there were no significant differences in sex, age, duration of illness, maintenance daily dosage of diazepam, neuroleptic dosage and duration of neuroleptic medication over chlorpromazine 600mg equivalent between the patients who did respond to diazepam and who did not. Eight patients dropped out mainly because of the side effects. Seventeen patients completed this study and ten of them showed the side effects during the maintenance periods of diazepam.

만성정신분열병에서 Diazepam의 향정신병 효과에 대한 예비적 연구

최휘영,이택중,김용식,이정균 大韓神經精神醫學會 1985 신경정신의학 Vol.24 No.1

The purpose of this study was to test the antipsychotic effect of diazepam. Twenty-five hospitalized chronic schizophrenic patients who had been resistant to standard neuroleptic treatment were included. The patients were subdivided into two groups and the study was run double-bline, cross-over, with two successive periods of three weeks each. Thus all patients were received once diazepam (30∼90㎎/day) and once placebo alternatively. The effect of diazepam was assessed weekly by the Brief Psychiatric Rating Scale(BPRS) and the Clinical Global Impression Scale(CGI). Diazepam showed no difference from placebo in antipsychotic effect during total six weeks, that is, two successive periods of three weeks, but there were significant antipsychotic effect of diazepam, during first three weeks. This result seems to be due to the carry-over effect of diazepam during second three weeks for placebo medication and due to the masking of antipsychotic effect by the side effects of diazepam. So further long-term clinical studies are needed. In addition, there were no significant differences in sex, age, duration of illness, maintenance daily dosage of diazepam, neuroleptic dosage and duration of neuroleptic medication over chlorpromazine 600㎎ equivalent between the patients who did respond to diazepam and who did not. Eight patients dropped out mainly because of the side effects. Seventeen patients completed this study and ten of them showed the side effects during the maintenance periods of diazepam.

정신과 병동의 강박처치에 대한 연구

김욱중,이택중,장경준 大韓神經精神醫學會 1990 신경정신의학 Vol.29 No.3

The authors analyzed clinically 86 patients who had experienced restraint among 489 pa-tients admitted in Seoul National Mental Hospital from May 1988 to July 1988. The results were as follows : 1) Among the 489 patients, 86 patients (17.6%) were restrained. There were no differe-nces in frequency of restraint by age and sex. 2) There were no differences in frequencies of restraint between the general and the special ward. 3) The group of schizophrenia experienced restraint less frequently, and the group of al-coholism experienced restraint more frequently than the other groups. 4) The restraints were carried out more frequently at night than in the daytime. 5) There were no significant differences in attitude on restraint by educational level. 6) The group of affective disorder showed the worst negative attitude on restraint. 7) Patients restrained by non-violent behavior showed more positive attitude on restraint than patients restrained by violent behavior.