정신분열증의 기억장애

전덕인,Jon, Duk-In 대한수면의학회 1997 수면·정신생리 Vol.4 No.1

Memory disorder is the most consistent neuropsychological finding in schizophrenia and seems to be a stable trait in it. It is suggested that memory dysfunction found in patients with schizophrenia is primary to biological abnormalities, not secondary to attention deficits they have. Although temporal lobe structures including hippocampus and thalamus have traditionally been thought to be implicated regions for memory disorder in schizophrenia, recent studies indicate the possibility of abnormalities in the frontal lobe and the neural circuits between brain regions. Advanced research methods such as functional imaging technique are expected to produce more detailed informations about memory function in schizophrenia.

우울 증상이 있는 공공기관 근로자의 특성에 관한 연구

강인우(In-Woo Kang),전덕인(Duk-In Jon),홍현주(Hyun Ju Hong),정명훈(Myung Hun Jung),홍나래(Narei Hong) 대한사회정신의학회 2023 사회정신의학 Vol.28 No.2

목적 : 우울 증상은 직장인의 삶의 질을 떨어뜨리고 직장 및 국가 경쟁력의 손실을 초래한다. 정신건강문제가 민간 근로자들 뿐만 아니라 공공기관 근로자들에게도 중요함에도 불구하고 아직까지 공공기관 근로자들의 정신건강 특성에 대한 국내 연구는 부족하였다. 따라서 본 연구에서는 일개 시의 공공기관에서 근무 중인 근로자들을 대상으로 우울 증상과 자살에 대한 태도 및 인식을 조사하고, 우울 증상을 가진 공공기관 근로자들의 특성에 대해 확인하고자 한다. 방법 :일개 시의 공공기관에서 근무 중인 근로자 1,012명 전원에게 문자를 통해 설문조사를 공지하였다. 설문 내용은 사회인구학적 특성, Center for Epidemiologic Studies Depression Scale, Perceived Stress Scale, 7-item Generalized Anxiety Disorder Scale, 자살에 대한 인식 및 태도 등으로 이루어졌다. 결과 : 설문조사는 자발적으로 동의를 한 367명을 대상으로 실시되었다. 연구 대상자들의 40%가 우울 증상을 겪고 있는 것으로 밝혀졌다. 우울 증상에 관하여 성별에 따른 차이는 보이지 않았으나 우울 증상군에서 무증상군에 비해 젊은 연령의 비율이 높았다(p=0.017). 또한, 우울 증상군에서 무증상군에 비해 스트레스(p<0.001)와 불안 증상(p<0.001)을 보이는 경우가 많았다. 연구대상자들 중 다수가 자살에 대해서 허용적인 태도를 보였다. 무증상군에 비해 우울 증상군에서 자살에 대해 자살의 합리성(p<0.001) 및 자살에 대한 수용적 태도(p<0.001)에 동의하는 비율이 높았다. 결론 : 공공기관 근로자들 중 다수가 우울 증상을 겪고 있었고 자살에 대해 허용적인 태도를 보였다. 본 연구의 결과는 공공기관근로자들 중 우울 증상을 가진 사람들을 대상으로 한 보다 적합한 정신건강서비스를 개발하는 데에 활용될 수 있을 것으로 사료된다. Objectives: Depressive symptoms among employees reduce their quality of life and cause loss of work competence. The importance of mental health is not only applied to private workers but also to municipal personnel. However, studies on the characteristics of mental health among municipal personnel in Korea are limited. Therefore, this study aimed to investigate depressive symptoms and attitudes toward suicide among municipal personnel in a metropolitan city near Seoul, and to identify the characteristics of municipal personnel with depressive symptoms. Methods: In this survey, short messages were sent to 1,012 municipal personnel in the city. The survey included sociodemographic characteristics, Center for Epidemiologic Studies Depression Scale, Perceived Stress Scale, 7-item Generalized Anxiety Disorder Scale, and perceptions and attitudes toward suicide. Results: The survey was conducted in one city among 367 municipal personnel who voluntarily agreed to participate. Forty percent of the participants had depressive symptoms. Although the prevalence of depressive symptoms did not differ by sex, the number of participants with younger age was higher in the depressive symptom group (p=0.017) than that in the control group. Additionally, in the depressive symptom group, there were more participants with psychological stress (p<0.001) and anxiety symptoms (p<0.001) than those without depressive symptoms. Many participants in this study showed a permissive attitude towards suicide. The ratio of agreeing to the rationality of suicide (p<0.001) and accepting attitude towards suicide (p<0.001) was higher in the depressive group than that in the control group. Conclusion: Many municipal personnel had depressive symptoms and permissive attitude towards suicide. The results of this study can be used to develop more appropriate mental health services targeting individuals with depressive symptoms among municipal personnel in Korea.

사교육 시간에 따른 외현화 문제와 내면화 문제의 성별 차이

송정은(Jungeun Song),전덕인(Duk-In Jon),석정호(Jeong Ho Soek),홍나래(Narei Hong),김영신(Young Shin Kim),홍현주(Hyun Ju Hong) 대한소아청소년정신의학회 2010 소아청소년정신의학 Vol.21 No.1

Objectives:The purpose of this study was to evaluate gender differences with respect to the internalization or externalization of symptoms according to the amount of time spent engaged in extracurricular education. Methods:The study included a community sample of 755 boys and girls (mean age, 6.6 years), collected from five elementary schools in Gunpo, South Korea. Primary caregivers completed a questionnaire which included information on demographics, the amounts of time children spent in extracurricular education and with other activities, and an adapted form of the Behavior Assessment System for Children (BASC-2). Gender differences regarding externalizing and internalizing behavior problems were examined according to extracurricular education. Results:With respect to the boys, there was a difference in the frequency of those who had externalizing behavior problems according to their time spent in extracurricular education. In contrast, the girls exhibited no difference. With respect to those children who spent a lot of time engaged in extracurricular education, there was a gender-specific difference only with respect to externalizing behavior problems. Conclusion:A gender-specific difference exists only in terms of externalizing behavior problems according to time spent engaged in extracurricular education.

정신건강복지센터에 등록된 정신질환자의 자살 태도에 관한 연구

김원우(Won-Woo Kim),전덕인(Duk-In Jon),홍현주(Hyun Ju Hong),정명훈(Myung Hun Jung),홍나래(Narei Hong) 대한사회정신의학회 2022 사회정신의학 Vol.27 No.2

연구 목적 : 우리나라의 높은 자살률은 지속적으로 사회적 부담으로 작용하고 있다. 자살 태도란 개인이 자살에 대하여 가지는 일관된 견해를 말하며, 이는 교육을 통해 변화하여 자살 예방을 위한 긍정적인 행동을 하도록 하는 데 효과적일 수 있다고 밝혀진 바 있다. 정신 건강복지센터에서는 다양한 사업들을 통하여 자살 고위험군을 관리해오고 있으나, 아직까지 정신건강복지센터에 등록된 정신질환 자들을 대상으로 한 자살 태도 연구는 부족한 실정이다. 따라서 본 연구에서는 일개 시 정신건강복지센터에서 사례관리 중인 정신 질환자들의 자살에 대한 태도 및 인식을 조사하여 자살 예방을 위한 기초자료로 활용하고자 하였다. 방 법 : 일개 시 정신건강복지센터에서 정신건강서비스를 제공받는 만 19세 이상의 성인 200명을 대상으로 설문조사를 진행하였다. 설문 내용은 사회인구학적 및 임상적 특성, 자살에 대한 태도와 인식, 자살을 주제로 한 대중매체에 대한 태도 등으로 이루어졌다. 결 과 : 본 연구 대상자들 중 다수가 자살에 대해서 허용적인 태도를 보였고 자살에 대한 사회책임인식도 낮았다. 60세 이상의 집단에서는 젊은 연령에 비해 자살에 대하여 금기시(p<0.001)하고 비윤리적으로 바라보았고(p<0.001), 기혼 혹은 동거 중인 집단에서도 기타 결혼상태의 집단에 비해 자살에 대해 금기시(p=0.005) 하고 비윤리적(p=0.015)이라고 생각하는 태도를 보였다. 신경증을 진단받은 집단에서는 정신증을 진단받은 집단에 비해 자살에 대해 수용적 태도를 보이면서(p<0.001) 비윤리적으로 보는 시선은 적었고(p= 0.035), 자살예방센터를 이용 중인 집단은 그렇지 않은 집단에 비해 자살에 대해 수용적인 태도를 보였으며(p=0.001), 비윤리적이라고 생각하는 시선은 적었다(p=0.029). 결 론 : 본 연구에서 조사한 지역사회의 정신질환자들은 인구사회학적 및 임상적 변인에 따라서 자살 태도의 유의미한 차이를 보였다. 이러한 점들을 바탕으로 하여 본 연구의 결과는 지역사회 정신건강서비스의 효율적인 운영 및 정책 반영을 위한 기초 자료로 활용될수 있을 것으로 사료된다. Objectives : The high suicide rate in Korea is a continuous social burden, and it is therefore necessary to establish an effective suicide prevention policy. Attitude toward suicide can be defined as a consistent view of suicide held by an individual, and it has been reported that changing attitude towards suicide through education can be effective in encouraging positive behaviors regarding suicide prevention. Although mental health welfare centers in Korea have been managing the suicide high-risk group through various programs, there remains a lack of studies on attitudes toward suicide of patients with psychiatric disorders registered in mental health centers. In this study, we investigated the attitudes and perceptions toward suicide of patients registered at one mental health welfare center. Methods : Two hundred adults aged 19 years or over who registered and received mental health services from one mental health welfare center in an urban area were assessed using self-report questionnaires. The questionnaires consisted of sociodemographic and clinical characteristics, attitudes toward and perceptions of suicide, and attitudes toward mass media on suicide-related topics. Results : Many participants in this study showed a permissive attitude toward suicide, and their perception of social responsibility regarding suicide was low. The 60 years and older group viewed suicide as taboo (p<0.001) and unethical (p<0.001) more than younger groups, and the married or living together group also considered suicide taboo (p=0.005) and unethical (p=0.015) more than other groups. Compared to the group diagnosed with psychosis, the group diagnosed with neurosis showed a more accepting attitude toward suicide (p<0.001) and viewed suicide as less unethical (p=0.035). Similarly, the group receiving services from the suicide prevention center showed a more accepting attitude toward suicide (p=0.001) and viewed suicide as less unethical (p=0.029) than other groups. Conclusion : Patients with psychiatric disorders in the community surveyed in this study showed a permissive attitude toward suicide, and had a lack of awareness of social responsibility regarding suicide. The results of this study can be used as basic data for further studies exploring efficient policies for community mental health services.

인터넷 중독 예방 프로그램의 효과

박민수(Minn Suh Park),전덕인(Duk-In Jon),홍현주(Hyun Ju Hong),정명훈(Myung Hun Jung),홍나래(Narei Hong) 대한사회정신의학회 2017 사회정신의학 Vol.22 No.2

연구목적 : 인터넷이 보급되면서 인터넷 중독의 피해가 확산되고 있고, 청소년기는 중독에 대해 취약한 시기이기에 인터넷 중독에 대한 예방 책이 중요하다. 본 연구는 기존 인터넷 중독 예방 프로그램의 효과를 초등학교 고학년 학생 집단을 대상으로 중독 증상의 정도와 양상의 변화를 통해 확인하고자 했다. 방 법 : 경기도 1개 시의 5개 초등학교에 소속된 4, 5학년 초등학생 대상으로 인터넷 중독 예방 프로그램을 시행하였다. 이중 프로그램 시행 전, 직후 2번에 걸쳐 청소년 인터넷중독 자가진단 척도(KS-II)을 작성한 556명을 대상으로 분석을 시행하였다. 일반 사용자군, 위험 사용자군으로 나눠 일상생활 장애, 가상적 대인관계 지향성, 금단, 내성의 척도 내 4가지 영역에 대해 독립표본 T검정과 반복측정 분산분석을 시행하였다. 결 과 : 프로그램 시행 후 일반 사용자군과 위험 사용자군 모두 일상생활 장애, 가상적 대인관계 지향성, 금단, 내성 등 전 영역에 걸쳐 통계적으로 유의하게 점수가 감소하였다. 일상생활 장애, 금단, 총점의 경우, 두 군 사이의 상호작용 효과가 나타나 일반 사용자군에 비해 위험 사용자군에서 점수가 더 감소하였다. 결 론 : 인터넷 중독 예방 프로그램이 인터넷 중독 위험 사용자군과 일반 사용자군에서 인터넷 중독에 대한 인식 정도를 변화시키는 것을 통해 중독 증상의 정도와 양상에 영향을 준다는 것을 청소년 인터넷 중독 자가진단 척도의 변화로써 확인할 수 있었다. 또한 그중에서도 일상생활 장애, 금단 및 총점의 경우, 위험 사용자군에서 특이적으로 점수를 더욱 감소시킨다는 것을 알 수 있었다. Objectives : While Internet is being spread, the problems of internet addiction is also increasing in the world. Because adolescent is fragile to addiction, internet addiction prevention is important. This study tries to check the effect of the established internet addiction prevention program for elementary school students with change of addiction-related symptoms. Methods : The internet addiction prevention program was run for 4th and 5th grade students of 5 elementary schools in 1 city of Gyeonggi-Do, Korea. 556 participants completed Internet Addiction Scale for Adolescent (KS-II) before and after the 3-session program. We divided the participants into 2 groups, normal user group and risky user group, and conducted independent T test and repetitive ANOVA over 4 domains, disturbance in daily life, cyber world oriented, withdrawal symptom, and tolerance. Results : Over all domains, each score was statistically lowered in both normal user group and risky user group after the program. Due to interaction effect, score of disturbance in daily life, withdrawal symptom, and total score was decreased more in risky user group than in normal user group. Conclusion : This study showed that the internet addiction prevention program which would change the level of knowledge about internet addiction in normal user group and risky user group could affect severity and aspects of addiction symptom with change of score of self-report scale. Also, especially in disturbance in daily life, withdrawal symptom, and total score, decrease of the score decreased more than other domain.

일개 시 지역의 정신건강 인식에 대한 10년 전후 비교 분석

전우혁(Woo-Hyeok Jeon),조명선(Myung Sun Cho),전덕인(Duk-In Jon),홍현주(Hyun Ju Hong),홍나래(Narei Hong),정명훈(Myung Hun Jung) 대한사회정신의학회 2020 사회정신의학 Vol.25 No.2

연구목적 : 정신질환에 대한 적절한 관리의 필요성이 점점 증가하는 한편 이에 대한 사회적인 인식과 태도는 여전히 부정적인 것이 현실이다. 본 연구는 각각 2008년과 2018년에 조사한 안양 시민의 정신건강에 대한 인식과 정신건강 수준을 비교 평가하고자 한다. 방 법 : 안양시에 거주 중인 20세 이상의 성인 남녀 600여 명을 대상으로 설문조사 하였다. 설문 내용은 사회 인구학적 요인과 함께 정신 건강 종합서비스 욕구, 정신건강 문제 해결을 위한 질문, 연령에 따른 대상자 별 정신건강 서비스 욕구에 관한 질문, 자살 사고에 대한 인식도 및 경험 유무 등으로 이루어졌다. 결 과 : 안양시민은 2008년에 비해 2018년에 스스로의 정신건강 점수를 더 낮게 평가하였으며, 정신건강에 대한 도움의 필요성을 인식하는 비율 및 실제 도움을 받은 비율 또한 감소하였다. 연령별로는 청소년과 노인에서 정신건강 문제의 중요도가 증가하였으며 연령 전반에서는 ‘정서’ 문제의 중요도가 크게 상승하였다. 한편 자살에 대한 인식에 개선이 뚜렷하지 않았고 자살 위기 시 정신건강의 도움에 대한 필요성은 낮게 평가되었다. 결 론 : 일반 시민들이 정신건강에 대한 도움을 부정적으로 인식하는 것은 정신질환 자체에 대한 편견과 부정적인 인식에 의한 것으로 추론된다. 이와 같은 정신건강에 대한 인식 및 편견 해소와 정신건강 서비스 이용을 향상시키기 위하여 다각도의 노력이 필요할 것이다. 또한 청소년 및 노인의 정신건강 문제가 중요하게 보고되며 시민들의 자살 문제는 여전히 개선되지 않아 해당 연령층 및 위험 군을 대상으로 한 세분화된 개입과 지원이 필요할 것이다. Objectives : While the necessity of proper management for mental illness increases gradually, the attitude toward mental health and psychiatric treatment is still remaining negative. The purpose of this study was to compare Anyang citizens’ aware-ness and level of mental health surveyed in 2008 and 2018, respectively. Methods : About six hundred men and women over 20 years old residing at Anyang city were recruited for this study. The selfreport questionnaire consists of the sociodemographic data, needs for overall mental health service, methods to solve their own mental health problem, age-specific needs for the mental health service, and awareness and experience of sui-cidal ideation. Results : Anyang citizens rated their mental health score lower in 2018 than in 2008, and the rate of the need for help to mental health as well as the rate of getting actual help were decreased. Age-specifically, there were large increases in the impor-tance of adolescent and senior citizens’ mental health problem. In all ages, there was a large increase in the importance of emotional problem. Meanwhile, there is no clear improvement in the perception of suicide, and the need for help to mental health at suicidal crisis was estimated low. Conclusion : It is inferred that a negative awareness of the help to mental health is due to negative perception and prejudice toward mental illness itself. Therefore we suggest that multifarious efforts are needed to reduce citizens’ negative perception and prejudice toward mental health as well as to make use of the mental health services. Furthermore, as adolescent and se-nior citizens’ mental health problem were reported importantly, as well as suicide problem is still unimproved, specific intervention and support targeting the relevant groups are necessary.

국산화 EEG 및 EP Mapping System(Neuronics)의 임상적 타당성 연구

민성길,전덕인,이성훈,안창범,유선국,Min, Sung-Kil,Jon, Duk-In,Lee, Sung-Hoon,Ahn, Chang-Beom,Yoo, Sun-Kook 대한수면의학회 1997 수면·정신생리 Vol.4 No.1

The clinical validity of a korean EEG and EP mapping system(Neuronics) was evaluated with schizophrenic patients(n=20), normal controls(n=19), and 10 patients with central nervous system disease(8 patients with cerebrovascular accident, 1 patient with brain mass, and 1 patient with periodic paralysis). In the normal control group, the pattern of resting computerized EEG with eyes closed showed normal parieto-occipital dominance of alpha wave. Compared with normal controls, schizophrenic patients had more delta activity in the frontal region, and less alpha activity especially in the parieto-occipital region. In most cases patients with cortical organic lesions(n=5) revealed increased delta and theta activity and decreased alpha activity on the lesion areas. These findings were compatible with their MRI and clinical findings. However in the cases of subcortical lesions(n=5) EEG showed various findings which suggest diverse influences of subcortical abnormalities on cortical activities. The P300 of schizophrenic group was smaller and more delayed than those of normal controls. These results are generally compatible with the previous studies using other EEG and EP mapping systems consequenty and suggest that the this EEG and EP mapping system(Neuronics) has clinical validity.

지역사회 거주 노인들의 우울증상 분포

하운식(Unshik Ha),전덕인(Duk-In Jon),홍현주(Hyun Ju Hong),정명훈(Myung Hun Jung),김미경(Mi Gyeong Kim),홍나래(Narei Hong) 대한노인정신의학회 2015 노인정신의학 Vol.19 No.2

Objective:This study was to understand the characteristics of depressive symptoms among the community-dwelling elderly. Methods:Through a community mental health mass screening program in senior society, 197 elderly were evaluated for de-pressive symptoms with Korean version of Short form Geriatric Depression Scale (SGDS-K). The subjects were grouped into nor-mal or caution groups with a cut-off score of 6. The response rate and odds ratio were calculated and compared within each ques-tion. Results:Although they had low total score, many subjects in normal group have the symptoms of the question 2, 13, 5, 10, 7, 4 (in order). Question 12, 6, 8, 4, 14, 3 (in order) showed higher odds ratio in caution group than normal group. Questions be-longed to a factor ‘general depressive mood’ scored much higher odds ratio than the other. Conclusion:Even the elderly with low score in SGDS-K might complain of symptoms such as decreased level of energy, ac-tivities, interests, and memory. However the subjects with high score tend to report feeling more worthless, afraid, helpless, bored, hopeless, and empty. It can be helpful to know the distribution of depressive symptoms for providing careful mental health ser-vice to the elderly dwelling in the communities.

하지 골절 노인환자의 수술 후 섬망 위험성 평가

한정엽(Jung Yeop Han),전덕인(Duk In Jon),홍현주(Hyun Ju Hong),정명훈(Myung Hun Jung),유제현(Je Hyun Yoo),박재용(Jae Yong Park),류상현(Sang Hyun Rhyu),홍나래(Na rei Hong) 대한노인정신의학회 2018 노인정신의학 Vol.22 No.2

Objective:Delirium is very common in orthopedic elderly patients and increase comorbidity and mortality rates. By controling the risk factors of delirium, prevention strategy can be effective and reduce negative outcomes. The purpose of this study was to explore the usefulness of delirium risk assessment with some simple collateral questionaires. Methods:The subjects were 50 elderly patients (≥65 years old) who admitted to a department of orthopedic surgery for operations of lower extremity fractures. They were evaluated with Diagnostic and Statistical Manual of Mental Disorders, fifth edition, Confusion Assessment Method and Korean Dementia Screening Questionnaire (KDSQ) by psychiatrists. The demographic data, medical histories, and orthopedic chart were checked through medical records of patients. Results:27 subjects (54.0%) were diagnosed as delirium. There was a significant difference between delirium group and control group with all KDSQ scores. Depressive category of KDSQ score had the highest correlation (coefficient=0.399) and can be independent risk factor of delirium (p=0.045). Conclusion:Cognitive impairment and depressive symptoms have high correlation with delirium. We found that just a few questions of cognitive impairment and depressive symptoms by caregivers

항정신병 약물 사용 및 치매의 심리행동 증상과 알츠하이머 환자의 인지능력 저하와의 연관성

장준호(June Ho Chang),전덕인(Duk In Jon),홍현주(Hyun Ju Hong),정명훈(Myung Hun Jung),홍나래(Narei Hong) 대한노인정신의학회 2021 노인정신의학 Vol.25 No.2

Objective: Neuropsychiatric symptoms are common among patients with major neurocognitive disorder. Antipsychotic medications have been widely used to manage behavioral and psychological symptoms of dementia (BPSD), however efficacy and safety of these agents are conflicting. In this study, we tried to overview the association of antipsychotic medication use and neuropsychiatric symptoms with cognitive decline in patients with Alzheimer’s disease. Methods: We reviewed the medical charts of patients who were diagnosed as major neurocognitive disorder due to Alzheimer’s disease from November 2014 to October 2015. We reviewed whether the subjects had used antipsychotics, and whether patients had neuropsychiatric symptoms. We used linear mixed models to examine the statistical difference between each group. Results: Total of 106 subjects were included in the study. There was no statistically significant difference in cognitive function decline (Korean Version of Mini-Mental State Examination score change) between subjects with or without BPSD (p=0.62), and between subjects with or without antipsychotic medication (p=0.09). Conclusion: There was no evidence that antipsychotic medication and BPSD are associated with more cognitive decline. Findings imply that neuropsychiatric symptoms and cognitive impairment come from different etiologic causes, which highlights the heterogeneity of the disorder. Clinician should decide whether to use antipsychotic medication while carefully considering the effect and side effects of antipsychotic medication throughout the treatment period.