CADASIL의 정신과적 증상 발현에 대한 고찰

임선진 ( Seon Jin Yim ) 한국정신병리진단분류학회 2020 精神病理學 Vol.24 No.2

Cerebral autosomal dominant arteriopathy with subcortical infarcts(CADASIL) is an autosomal-dominantly inherited small artery disease characterized by variable neurologic symptoms and typical brain MRI findings. Psychiatric symptoms and cognitive decline are relatively common symptoms observed in CADASIL, and mood disturbance is second most common initial symptom of CADASIL in patients of 50 or older. However, CADASIL is underdiagnosed by psychiatric experts. In this article we review and discuss about variable psychiatric symptoms of CADASIL to promote more precise diagnosis in psychiatric clinics.

COVID-19와 노인정신건강

임선진 ( Seon Jin Yim ) 한국정신병리진단분류학회 2021 精神病理學 Vol.25 No.2

COVID-19 pandemic has been found to cause disproportionately high morbidity and mortality, and social distancing has been recognized as one of the most verified way to protect the elderly population from the viral disease. However, enduring social distancing created social isolation among the elderly causing psychological consequences such as depression and anxiety disorders. Various psychological consequences of social distancing and quarantine measures have been reported during previous viral outbreaks. For there has also been recent reports about social isolation and the psychological consequences among the elderly since the COVID-19 outbreak, it is important to consider and suggest the ways to minimize the mental health problems and promote well-being of the elderly population. This article aims to review mental health problems among the elderly population caused by COVID-19 pandemic, and discuss the suggestions to prevent the problems.

온라인과 오프라인 설문자의 기질 특성 : 성인 인터넷 중독 검사 설문자를 대상으로

김건,임선진,김진훈,윤해주,Kim, Geon,Yim, Seon-Jin,Kim, Jin-Hoon,Yoon, Hae-Joo 한국정신신체의학회 2008 정신신체의학 Vol.16 No.1

연구목적 : 기존의 종이 설문지를 이용한 전통적인 오프라인 설문 방법과 더불어 전자화된 문서를 통한 인터넷 온라인 설문이 연구 방법으로 이용되어 왔고 그를 통한 여러 연구 결과들이 알려지고 있지만, 아직까지 설문 방법에 따른 결과의 차이를 보고한 결과는 없었다. 우리는 성인 인터넷 중독 설문 검사에 온라인 설문에 참여한 대상과 오프라인을 통해 참여한 대상 사이에 기질적인 특성의 차이가 나타나는지를 알아보고자 하였다. 방법 : 기초 인구학적 정보, 인터넷 중독 설문, Young의 기질 검사 척도가 포함된 설문을 통하여 두 군 간의 특성의 차이가 있는 지를 비교하였다. 총 430명(오프라인 286명, 온라인 144명)이 연구에 참여하였다. 성별과 중독 점수, 정신과적 치료력의 차이가 있어 MANCOVA를 통해 기질 점수에 끼칠 영향을 통제하였다. 결과 : 기질 특성에서 harm avoidance(HA), novelty seeking(NS), reward dependence(RD)의 척도에서는 모두 두 집단 간에 유의미한 차이가 있었다. HA와 NS의 경우 온라인군에서 오프라인군에 비해 유의하게 높게 측정되었고, RD는 온라인군에서 유의하게 낮게 측정되었다. 결론 : 이 연구는 온라인군과 오프라인군 사이에 유의한 기질적 특성의 차이가 있음을 보였다. 방법의 차이만으로 설명할 수 없는 이 결과를 더 잘 이해하기 위해선 아직 많은 연구가 필요할 것으로 보인다. Objectives : There may be methodological differences between pencil-and-paper and web-based questionnaires. But there are few reports about influences of that methodological differences. The Aim of this study is investigation of the differences in temperament characteristics in subjects who answered internet addiction questionnaires. Methods : We compare the characteristics between two groups. Four hundred thirty participants(189 males, 241 females) answered the online and offline questionnaires. We controlled sexes, addiction scores and psychiatric treatment histories using general linear model of MANCOVA. Results : There were statistically significant differences in temperament characteristics between two groups. Harm avoidance(HA) and novelty seeking(NS) scores were significantly higher in on-line group than off-line group. Reward dependence(RD) scores were significantly lower in on-line group than off-line group. Conclusion : This study suggested significant differences of temperament characteristics between on-line and off-line subjects. And there have been many studies on equivalence of on-line and off-line survey methods. Further studies on the difference are expected for the understanding of this results.

정신분열병의 결핍증후군과 비결핍증후군에서 QEEG와 sLORETA를 이용한 비교연구

이상은,임선진,이미경,이재원,한규희,이종일,심민영,윤해주,신병학,Lee, Sang-Eun,Yim, Seon-Jin,Lee, Mi-Gyung,Lee, Jae-Won,Han, Kyu-Hee,Lee, Jong-Il,Sim, Min-Young,Yoon, Hai-Joo,Shin, Byoung-Hak 대한수면의학회 2010 수면·정신생리 Vol.17 No.2

목 적: 본 연구는 정신분열병의 결핍증후군과 비결핍증후군이 다른 생물학적 동등성을 가진 독립된 질환일 수 있다는 가설 아래 quantitative EEG와 standardized LORETA (sLORETA)를 이용한 전기생리학적인 방법을 통하여 생물학적 병인을 파악하고자 시도되었다. 방 법: 정신분열병 환자를 대상으로 42명의 뇌파를 비교 분석하였으며 그 중 결핍증후군 환자군은 남자 10명과 여자 11명이었고 비결핍증후군 환자군은 남자 12명, 여자 9명이었다. 주파수 대역은 delta(1.5~4 Hz), theta(4~8 Hz), alpha(8~12 Hz), low beta(12~15 Hz), high beta(15~30 Hz)의 5가지로 분할하였고 EEG LAB을 이용한 파워스펙트럼 분석 및 standardized sLORETA software package를 이용하여 신호원을 국소화 하였다. 결 과: 파워 스펙트럼 분석에서 결핍증후군 집단은 비결핍증후군과 비교하였을 때 전두엽, 두정엽 및 측두엽 영역에서 delta파와 theta파의 유의한 활성도 증가를 보였으며 뇌파 스펙트럼은 간편 정신상태 평정 척도 중 철퇴/지연과 적대/의심 항목의 임상적인 특징과 유의한 상관관계를 보였다. sLORETA분석 결과에서는 배측 전대상피질에서 결핍증후군에서 유의하게 delta파의 활성도가 증가되었다. 결 론: 결핍증후군은 비결핍증후군과는 연관된 뇌 영역이 다를 수 있으며 특히 전두엽 영역의 신경회로 이상이 일차적 음성증상에 영향을 줄 것으로 생각된다. Objectives: Deficit schizophrenia (DS) constitutes a disease separate from non-deficit schizophrenia (NDS). The aim of the current study was to compare the quantitative EEG and low resolution electromagnetic tomography (LORETA) imaging between DS and NDS. Methods: This study was performed by 32 channels EEG for 42 schizophrenia patients who we categorized into DS and NDS using proxy instrument deficit syndrome (PDS). We performed the absolute power spectral analyses for delta, theta, alpha, low beta and high beta activities. We compared power spectrum between two groups using Independent t-test. Partial correlation test was performed with clinical parameters. Standardized LORETA (sLORETA) was used for comparison of cortical activity, and statistical nonparametric mapping (SnPM) was applied for the statistical analysis. Results: DS showed significantly increased delta and theta absolute power in fontal and parietal region compared with NDS (p<0.05). Power spectrum showed significant correlation with 'anergia' and 'hostility/suspiciousness' subscale of brief psychiatric rating scale (BPRS)(p<0.05). sLORETA found out the source region (anterior cingulate cortex/limbic part) that delta activity was significantly increased in DS (p=0.042). Conclusions: DS showed different cortical activity compared with NDS. Our results may suggest QEEG and LORETA could be the marker in differentiating between DS and NDS.

주관적 인지장애를 호소하는 지역사회 노인에 대한 다요인 인지능력 향상프로그램(‘씽씽두뇌 발전소’)의 효과성 검증을 위한 비교 연구

김효진 ( Hyojin Kim ),임선진 ( Seon-jin Yim ),이준노 ( Joon-noh Lee ),이원혜 ( Won Hye Lee ),한주현 ( Joo Hyun Han ),김경미 ( Kyungmi Kim ),김가영 ( Kayoung Kim ) 한국정신병리진단분류학회 2020 精神病理學 Vol.24 No.2

Objectives: This study explored the effects of nonpharmacological multifactorial memory improvement program (‘Ssing-Ssing Doonoi baljeonso (SSD)’) developed by the National Center of Mental Health in 2015 in community-dwelling elderly complaining of subjective memory impairment (SMI). Methods: A randomized, controlled, 8-weeks trial of SSD with double-blind assessments at baseline and end-point of treatment. A total of 117 elderlies with SMI were recruited from 10 community-based welfare centers in Seoul, Korea. Participants were randomly assigned to two groups: SSD and art therapy group. 8 sessions of treatment were administrated to the groups. Results: SSD significantly improved immediate recall, delayed recall of word memory test, all items of the logical memory test, and immediate recall, delayed recall, and recognition of the visuospatial function test (all p<0.05). Korean short version of Geriatric Depression Scale(S-GDS-K) was also significantly improved, and Memory Efficacy Questionnaire(MEQ), Prospective-Retrospective Memory Questionnaire(PRMQ), and Korean Dementia Screening Questionnaire(K-DSQ) were all significantly improved. In particular, compared to the art therapy group, the K-DSQ showed better results(time * group, F(1, 114)=6.585, p=0.012, η²=0.055), and S-GDS-K was a tendency to improve in SSD group (time * group, F(1, 114)=3.596, p=0.060, η²=0.031). Conclusion: Our multifactorial memory training program significantly enhanced memory, visuospatial function, mood and subjective memory efficacy. Compared with art therapy, SSD had more advantages in memory function of daily life and showed a tendency to improve depression. It is likely to be applied as a nonpharmacological treatment for the prevention of cognitive decline in the elderly with SMI/MCI.

증상 안정기의 노년기 우울증에서 심혈관 위험과 인지기능 장애 간의 관련성 : 예비연구

황인선(Insun Hwang),임선진(Seon-Jin Yim),이준노(Joon-Noh Lee),송윤영(Yun Young Song),홍경기(Kyungki Hong),홍문화(Moon-Hwa Hong),윤해주(Hai Joo Yoon),엄주란(Jooran Eom) 대한노인정신의학회 2015 노인정신의학 Vol.19 No.2

Objective:The purpose of this study was to test the hypothesis that cardiovascular risk is associated with cognitive impairments in clinically stable late-life depression. Methods:A total of 59 clinically stable late-life depression patients over age 60 were enrolled in a cross-sectional study. Evalu-ation tools used in this study include Hamilton Rating Scale for Depression, Geriatric Depression Scale, State-Trait Anxiety Inven-tory, the Framingham general cardiovascular disease risk profile and the cognitive function battery designed for this study. Corre-lation analysis, analysis of variance and analysis of covariance were performed. Results:Patients with higher cardiovascular risk performed significantly poorer in the domains of executive function and short-term or long-term memory. In models adjusted for age, sex, education, 10% higher cardiovascular risk was associated with poorer executive function. Conclusion:Our findings suggested that cardiovascular risk could be a significant factor associated with poor executive func-tion in clinically stable late-life depression and the management which is necessary as a component of treatment planning. This pi-lot study provided good prospects for future studies to document this relationship on larger samples.

일상생활 수행능력 평가도구의 유효성 분석 연구

주채린(Chaelin Joo),김가영(Kayoung Kim),이원혜(Won Hye Lee),한주현(Joo Hyun Han),노은정(Eunjung Noh),임선진(Seon Jin Yim) 대한노인정신의학회 2023 노인정신의학 Vol.27 No.2

Objective: The study’s aim was to evaluate the validity of the Korean version of the University of California San Diego Performance- based Skills Assessment, Validation of Intermediate Measures (K-UPSA-2-VIM) in patients with dementia (D), mild cognitive impairment (MCI), and cognitive normal control group (CN). Methods: Study participants were 25 patients with D, 43 patients with MCI, and 111 controls with CN group, respectively. For cognitive assessment, Mini Mental State Examination, Consortium to Establish a Registry for Alzheimer’s Disease neuropsychological battery, and Clinical Dementia Rating were used. For functional assessment, Barthel-Activities of Daily Living, Instrumental Activities of Daily Living, Dementia Screening questionnaire, and K-UPSA-2-VIM were used. Results: Statistically significant differences were observed in all subdomains and total score of the K-UPSA-2-VIM among three cognitive groups. K-UPSA-2-VIM demonstrated 75.7% of sensitivity and 65.1% of specificity, with an area under the curve (AUC) of 0.731 (95% confidence interval [CI]: 0.641-0.821, p<0.001) in discriminating between CN and MCI groups. In discriminating between MCI and D groups, 76.7% of sensitivity and 64.0% of specificity, with an AUC of 0.706 (95% CI: 0.580-0.833, p=0.005) were demonstrated. Conclusion: The K-UPSA-2-VIM is useful to evaluate activities of daily living function in Korean patients with D and MCI.

성인 인터넷 중독자의 기질 특성

임선진,김진훈,장동원,정은기,윤해주,김의정 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.6

Objectives : Since mid-90s there have been numerous studies to understand and establish the concept of internet addiction as one of diagnostic classifications in psychiatry. Among them, many studies on the personality characteristics of internet addiction have been conducted. Recently, interests are expanding to temperament characteristics of internet addictors but the subjects have been limited to adolescents, In this study, the temperament characteristics of internet addiction in adults were investigated using Tridimensional Personality Questionnaire (TPQ). Methods : 430 participants (189 males, 241 females) answered the on-line and off-line questionnaires from January to December in 2005. Participants completed questionnaires on demography and the onset of internet use, Young's Internet Addiction Scale and Korean Contracted Version of Cloninger's Tridimensional Personality Questionnaire (TPQ). Rcsults : There were statistically significant differences in age, marital status, occupation, psychiatric history, smoking history, alcohol history and onset age of internet use among non-addiction, overuse and addiction groups by Young's scale. Of the TPQ items harm avoidance (HA) scores were significantly higher in addiction and overuse groups than non-addiction group. Reward dependence (RD) scores were significantly lower in addiction group than non-addiction group. Novelty seeking (NS) scores were significantly higher in addiction group than non-addiction group. Conclusion : This study suggests a significant difference of novelty seeking in temperament characteristics between adults and adolescents with internet addiction. Further studies are expected for profound understanding of internet addiction.

초경 시작 시기가 여성 정신분열병 환자의 병의 경과에 미치는 영향

김진훈,윤선욱,배명지,임선진,정은기,장동원 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.5

Objectives : The protective effects of estrogen against the development of schizophrenia have been investigated in various perspectives, Previous studies showed patients with earlier age of menarche had later onset of schizophrenia and less frequent admissions. This study was performed to evaluate the effect of the age of menarche on subsequent courses including hospitalizations, suicidal attempts, Physical harm to others, and psychotic symptoms in women with schizophrenia. Methods : Self-report menarche age, onset of psychotic symptoms, and clinical status were collected in a sample of 108 Premenopausal women with the diagnosis of schizophrenia. Results : There was significant correlation between the age of menarche and the frequency of admissions (r=.321, p=.006). Also, Patients with history of physical harms to others showed later age of menarche than those without (t=2.025, df=106, p=.045). Conclusion : In women with schizophrenia, the age of onset of menarche affects subsequent courses indicated by frequency of admissions and violent behaviors. It is suggested that identifying the age of menarche might be helpful to predict the courses in women with schizophrenia. Further investigations regarding the relationship between estrogen and the courses of Schizophrenia in women are needed.

한국어판 정신분열병 삶의 질 척도의 개발과 PANSS와의 관련성

김진훈,임선진,민성길,김승업,손소정,Diane J Wild,박성혁,이황빈 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.5

Objectives : The present study was performed to verify the validity and value of 4th revision of Schizophrenia Quality of Life Scale (SQLS-R4) as an assessment tool in a Korean-language version (SQLS-R4K). Methods : The subjects for present study were 174 patients with a diagnosis of schizophrenia as defined by DSM-IV. The SQLS-R4K was administered together with self-report Korean version of World Health Organization Quality of Life-Brief Scale(WHOQOL-BREF) to assess validity. A subset of respondents also completed the SQLS-R4K for a second time to assess test-retest reliability. To evaluate the relationship SQLS-R4K and clinical characteristics, psychotic symptoms and general functioning were evaluated using the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning Scale (GAF) score respectively. Results : All the scales of SQLS-R4K showed good internal consistency reliability. The correlations of items with their scale total revealed that all items were significantly correlated with their own scale score. In test-retest reliability, paired t-tests indicated that responses did not alter significantly between the two assessment. There was moderate correlation between WHOQOL-BREF sub-scores and SQLS-R4K score total. Also relevant correlations between PANSS, current GAF and SQLS-R4K were proved. Conclusion : From the results of the testing the reliability and validity of the SQLS-R4K, it is concluded that the SQLS-R4K is a simple and reliable scale for measuring quality of life in schizophrenic patients.