지리정보 서비스 모델링-충북대학교와 그 인접지역을 사례로

정현강,박병의 대한지리학회 1998 대한지리학회 학술대회논문집 Vol.1998 No.1

Distinguishing Quantitative Electroencephalogram Findings between Adjustment Disorder and Major Depressive Disorder

정현강,고영훈,한창수,김용구,조숙행 대한신경정신의학회 2013 PSYCHIATRY INVESTIGATION Vol.10 No.1

Objective Adjustment disorder (ADJ) is a common diagnosis. However, it is difficult to distinguish ADJ from other major Axis I disorders, such as major depressive disorder (MDD). The aim of this study was to determine the distinguishing neurophysiological characteristics between ADJ and MDD using quantitative analysis of an electroencephalogram (QEEG). Methods The study included 30 patients with ADJ and 51 patients with MDD. Resting (eye closed) vigilance controlled EEG recordings were assessed at 19 electrode sites according to the international 10/20 system. QEEG absolute power and coherence were calculated for the delta, theta, alpha and beta bandwidths. Results Absolute powers of alpha and high beta bands, particularly at the frontocentral area, differed between MDD and ADJ group (p<0.05). Interhemispheric coherence values for the delta and beta bands were lower in the ADJ group than in the MDD group (p<0.05). Intrahemispheric coherence values for the alpha band were also lower in the ADJ group (p<0.05). Conclusion The differences in QEEG power and coherence in our investigation suggest that underlying pathophysiologic mechanisms may be different between ADJ and MDD.

일차의료 현장에서 치매의 진단 및 치료

정현강,한창수 대한의사협회 2013 대한의사협회지 Vol.56 No.12

Dementia has became a major public health problem as the aged population is rapidly increasing. Dementia is underdiagnosed in primary care and many primary care physicians are hesitate to diagnose dementia. Early detection and starting appropriate treatment has been emphasized in managing dementia patients. The role of primary care physicians in caring for patients with demantia is important to efficiently manage dememtia and related socioeconomic burden since they meet first many patients mostly in initial stage of diseases. Primary care physicians pay attention to early sign and symptoms of dementia and are able to differentiate pathologic condition from normal age related cognitve decline. They should actively performe the screenig test and comprehensive clinical evaluation for suspected dementia patients. After diagnosis of dementia, they have to help thier patients to start and maintain appropriate pharmacological and non-pharmacological treatments and provide supports for dementia patients and their caregivers. To optimal management of dementia, primary care physicians also need to strengthen collaboration with specialists in treatment and lead their patients to utilize social servicies. It is necessary to develop systemized education programs for primary care physicians and standardized giudeline for maniging demenita in parimary care. Primary care physicians need to keep acquring up-to-date knowlege about dementia and to screen and detect dementia in suspected dementia patients. They should provide appropriate treatments for patinets in the collaboration with specialists and infrom their patients available social services.

주관적 수면평가와 활동기록기를 이용한 수면평가의 비교 - 정신과입원환자를 대상으로 -

정현강,이문수,고영훈,임세원,김승현,정인과,조숙행,Jeong, Hyun-Ghang,Lee, Moon-Soo,Ko, Yong-Hoon,Lim, Se-Won,Kim, Seung-Hyun,Jung, In-Kwa,Joe, Sook-Haeng 한국정신신체의학회 2010 정신신체의학 Vol.18 No.1

연구목적 : 임상현장에서 주로 환자나 간호사의 주관적인 수면보고에 의존하여 수면을 평가하고 있다. 본 연구에서는 주관적 수면평가와 활동기록을 이용한 수면평가를 비교하고자 한다. 방 법 : 32명의 정신과 입원 환자를 대상으로 하였고, 대상자들에게 활동기록기를 이용한 수면평가, 수면일지, 주관적인 수면의 질에 대한 시각적 증상 정도 평가, BDI, STAI를 시행하였다. 간호사도 3일 동안 한 시간마다 환자의 수면을 평가하였다. 결 과 : 환자의 보고와 활동기록기를 이용한 수면측정상 입면잠복시간에서 유의한 차이를 보였다. 환자는 간호사보다 자고 있음에도 깨어있었다고 더 많이 보고하였다. 주관적 수면평가와 활동기록 수면평가의 차이는 불안, 우울과 상관관계를 보였다. 결 론 : 주관적으로 수면의 질을 낮게 평가하는 환자일수록 활동기록기로 측정한 입면잠복시간과 더 큰 차이를 보였고, 우울, 불안 증상이 심한 환자의 수면보고는 활동기록 측정값과 큰 차이를 보였다. 이런 환자들에게 수면의 질에 대한 질문만으로는 정확한 수면평가가 어려우므로 객관적인 수면평가가 필요하겠다. Objectives:Assessment of sleep disturbance is an essential part of the diagnostic criteria used for several psychiatric disorders. Change in sleep patterns over time may indicate response to treatment. In clinical practice, sleep is usually evaluated subjectively by patient self-report. This study was aimed to compare subjective sleep assessment with objective sleep measurement by actigraphy in psychiatric inpatients. Methods:A total of 32 psychiatric inpatients were studied. Patients were asked to wear a wrist actigraphy for three consecutive days and nights and to fill out a sleep log each morning. The severity of depression and anxiety was evaluated according to Beck Depression Inventory and State-Trait Anxiety Inventory on the first day of the study. The subjective level of satisfaction with quality of sleep was also evaluated according to visual analog scale. Nurses assessed sleep at one hour interval between 10:00 PM and 6:00 AM for three consecutive nights. Results:There was statistically significant difference of sleep latency between patient's sleep log and acti-graphic measurement. Nursing reports were more consistent with actigraphic measurement than sleep log. Interestingly, subjectively poor sleepers show no significant difference in sleep parameters compared with those of good sleepers. Subjectively poor sleepers report longer sleep latency than that of actigraphic assessment. The discrepancy between subjective and objective assessment of sleep latency was significantly correlated with scores of Beck Depression Inventory and State-Trait Anxiety Inventory. Conclusion:These results show that there are discrepancies between subjective and objective assessment of sleep. The discrepancy of sleep assessment could be influenced by severe depression and anxiety. Especially objective sleep measurement is needed to assess sleep in psychiatric inpatients with severe depression or anxiety and the subjectively poor sleepers for more reliable measurements.

Long-acting Injectable Antipsychotics in First-episode Schizophrenia

정현강,이문수 대한정신약물학회 2013 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.11 No.1

Antipsychotic medications are important for the successful management of schizophrenia. Continuous treatment with medication is superior in relapse prevention and non-adherence to antipsychotic medication is associated with a poor clinical outcome. Long-acting injectable antipsychotics (LAIs) that can guarantee adherence to a treatment regimen could be a useful treatment option. With the introduction of second-generation atypical antipsychotics-long acting injection (SGA-LAI), the risks for extrapyramidal adverse events are decreased. The indications for SGA-LAI have been extended from chronic, stabilized patients to acute psychotic patients. Some studies investigated the use of LAI in first-episode schizophrenia patients and raised the possibility of prescribing LAI as a treatment option. However, there is still limited research using LAI in first-episode schizophrenia. More well-designed, randomized, controlled clinical trials using SGA-LAIs in first episode schizophrenia are needed. Additionally,studies on side effects of SGA-LAI in long-term use are required prior to recommending LAI for patients with first episode schizophrenia.

도시 독거노인의 건강 복지 서비스 요구도 조사

정현강(Hyun Gang Jung),안상미(Sangmee Ahn),박문호(Moon Ho Park),김난희(Nan Hee Kim),박건우(Kun Woo Park),조숙행(Sook Haeng Joe),정인과(In Kwa Jung),조인호(Inho Jo),한창수(Changsu Han) 대한노인정신의학회 2006 노인정신의학 Vol.10 No.2

Background : The number and proportion of live-alone elders in Korea have been increasing dramatically. We tried to identify the physical health status of live-alone elders in community and their needs for public health service in order to provide basic data for effective public health service to promote health and quality of life. Methods : The subjects for this study were 38 nurses who provide visit-nursing service to live-alone elders in Seoul and Kyunggi Province. Data were collected by semi-structured questionnaires. Results : The half of live-alone elders had disease, but only half of them took appropriate treatment. Barrier to treatment were difficulty to access to medical center, immobility, lack of drive and also poor insight. Conclusion : To solve the problems related to the elderly living alone in community, the instillation of public health policy that encompass professional medical service and comprehensive team approach are needed.

일 도시지역 고등학생의 흡연현황과 니코틴 의존도에 관한 연구

정현강(Hyun-Gang Jung),이문수(Moon-Soo Lee),고영훈(Young-Hoon Ko),김승현(Seung-Hyun Kim),조숙행(Sook-Haeng Joe),정인과(In-Kwa Jung),박정란(Jung-Ran Park),박성근(Seong-Guen Park) 한국중독정신의학회 2006 중독정신의학 Vol.10 No.1

Background:The purpose of this study was to investigate the prevalence of smoking, the level of nicotine dependence and smoking-depression relationship among high school students. Methods:Subjects were 839 high school students in Siheung city. The main assessment measures were the Fagerstrom Test for Nicotine dependence and the Zung Self-rating Depression Scale. We also used structured self-report questionnaires which included socio-demographic data, cigarette habit and alcohol consumption. Results:Our study found that the prevalence of smoking in high school students was 20.7%. Among students who had experience of smoking, 7.5% were substantially dependent on nicotine, 46.9% had mild dependence and 45.6% had no dependence. Nicotine dependence was correlated with duration and amount of cigarette smoking. Smokers tend to drink alcohol more frequently than non-smokers (smokers vs non-smokers:3.19±2.57/month vs 2.29±3.35/month). There was significant positive correlation between amounts of smoking and scores of the Zung Self-rating Depression Scale in students who had experience of smoking. Conclusion:More than 10% of high school students initiate cigarette smoking at their early teenage. Cigarette smoking is probably associated with various psychosocial factors such as depression, mental stress and poor primary support group. The-refore, multidisciplinary strategies are required to reduce the prevalence of adolescent cigarette smoking.

Effects of Psychotropic Drugs on Seizure Threshold during Electroconvulsive Therapy

지수혁,정현강,이수지,오소영,김승현 대한신경정신의학회 2017 PSYCHIATRY INVESTIGATION Vol.14 No.5

Objectives: To analyze the relationship between seizure threshold (ST) and psychotropic drugs in patients treated with ECT. Methods: We examined clinical data from 43 patients. ST was titrated at each treatment session. We examined associations between ST and psychotropic drugs using multivariate correlation analyses. Data are presented as initial ST, the difference in ST between the first and 10th sessions (ΔST10th), and the mean difference in ST between the first and last sessions (mean ΔSTlast). Results: Multivariate regression analyses showed associations between initial ST and the total chlorpromazine-equivalent dose of antipsychotics (β=0.363, p<0.05). The total fluoxetine-equivalent dose of antidepressants was associated with ΔST10th (β=0.486, p<0.01) and mean ΔSTlast (β=0.472, p<0.01). Conclusion: Our study elucidated possible effects of psychotropic drugs on ST shifts. Larger doses of antipsychotics were associated with higher initial ST, whereas higher doses of antidepressants were associated with stronger shifts in ST.

치매의 약물요법

윤현철,정현강 대한의사협회 2018 대한의사협회지 Vol.61 No.12

Dementia is a clinical syndrome characterized by a cluster of symptoms and signs that manifest as difficulties in cognitive functions such as memory, psychological and psychiatric changes, and impairments in activities of daily living. As a result of worldwide trends of population aging, dementia has had a huge impact on public health in almost all countries. Disease modification therapies for dementia have not yet been developed. However, pharmacotherapy is essential in patients with dementia to combat delays in their cognitive and functional decline. In this article, we review the current pharmacotherapy for dementia. Three acetylcholinesterase inhibitors— donepezil, rivastigmine, galantamine—and memantine are the only medications that have been approved for the treatment of dementia. We present the indications, dose recommendations, side effects, and criteria for National Health Insurance coverage in Korea of these medications for dementia treatment. Although the Ministry of Food and Drug Safety in Korea has not approved any medications for managing the behavioral and psychological symptoms of dementia, some antipsychotics and antidepressants have been studied and used clinically for those purposes. Clinicians may consider vitamin E, Ginkgo biloba extract, choline alfoscerate, or omega-3 fatty acids as additional treatment options. Non-steroid anti-inflammatory drugs, estrogen hormone therapy, and statins are not generally recommended for dementia treatment. We believe that our findings will aid clinicians in the treatment of patients with cognitive decline.

여고생에서 월경전 증후군의 빈도와 임상적 특징 및 관련요인

장형주,정현강,고영훈,한창수,조숙행,Chang, Hyung-Joo,Jeong, Hyun-Ghang,Ko, Young-Hoon,Han, Chang-Su,Joe, Sook-Haeng 한국정신신체의학회 2013 정신신체의학 Vol.21 No.1

연구목적 여고생에서 월경전 증후군/월경전 불쾌장애의 빈도와 임상적 특징을 조사하고, 다양한 사회인구학적 요인과 월경 관련 요인이 월경전 증후군/월경전 불쾌장애에 미치는 영향을 분석한다. 방 법 서울시내에 위치한 5개 여자고등학교 학생 1,688명을 대상으로, 월경전 증상, 우울, 불안 척도 및 사회인구학적, 월경 관련 문항이 포함된 자기기입식 설문조사를 시행하였다. Premenstrual Symptom Screening Tool(PSST)를 기준으로 대상자를 3군으로 분류하여 월경전 증후군/월경전 불쾌장애의 빈도와 임상적 특징을 분석하였으며, 다변량 로지스틱 회귀분석을 시행하여 관련요인을 파악하였다. 결 과 Moderate to Severe PMS와 PMDD의 빈도는 각각 20.1%와 6.4%였다. 월경전 증상 중 과민성(78.8%), 피로감(76.4%), 감정기복(69.8%)의 빈도가 높았으며, 학업 수행(67.1%)영역에서 기능의 장애가 두드러졌다. 우울, 불안 수준을 보정한 분석에서 생리통[odd ratio(OR)=3.68, 95% confidence interval(CI) 2.45-5.55], 월경전 증후군의 가족력(OR=1.91, 95% CI 1.35-2.71) 및 경구 피임약 복용 경험(OR=1.85, 95% CI 1.16-2.94)이 있을 경우 월경전 증후군/월경전 불쾌장애의 비교위험도가 유의하게 높았다. 또한, 우울, 불안 증상이 없는 대상군에서는 월경에 대한 부정적인 태도(OR=15.60, 95% CI 3.61-67.42)가 월경전 증후군/월경전 불쾌장애의 위험도를 높이는 것으로 나타났다. 결 론 여고생에서 월경전 불쾌장애를 포함한 중등도 이상의 월경전 증후군의 빈도가 25%가 넘을 정도로 상당히 높고 이로 인한 기능의 장애 역시 심하였다. 월경전 증후군은 다양한 사회인구학적 요인 및 월경 관련 요인과 관련되어 있으며, 이러한 관계는 우울, 불안 증상의 공존이환 여부에 크게 영향을 받는다. Objectives : To investigate the frequency and clinical characteristics of premenstrual syndrome(PMS)/premenstrual dysphoric disorder(PMDD) in high school students, and determine the correlates of PMS/PMDD in association with comorbid depression and anxiety. Methods : A total of 1688 students were recruited from 5 high schools in Seoul, Korea. Subjects completed the questionnaire composed of scales to measure premenstrual symptoms, depression, and anxiety, as well as sociodemographic and reproductive variables. Subjects were categorized into 3 groups by using the Premenstrual Symptom Screening Tool(PSST) to determine the frequency and clinical characteristics of PMS/PMDD. Multivariate logistic regression was used to identify the correlates of PMS/PMDD. Results : The frequency of moderate to severe PMS and PMDD was 20.1% and 6.4%, respectively. Irritability(78.8%), fatigue(76.4%), and emotional sensitivity(69.8%) were common premenstrual symptoms, and functional impairment in academic performance(67.1%) was dominant. Dysmenorrhea[odd ratio(OR)=3.68, 95% confidence interval(CI) 2.45-5.55], family history of PMS(OR=1.91, 95% CI 1.35-2.71), and use of oral contraceptive (OR=1.85, 95% CI 1.16-2.94) were associated with the increased risk of PMS/PMDD after adjustment for depression and anxiety. Negative attitude to menses(OR=15.60, 95% CI 3.61-67.42) was associated with the increased risk of PMS/PMDD, particularly in subjects without depression and anxiety. Conclusions : PMS was common, as the frequency of PMS more than moderate severity including PMDD exceeded 25%, and disrupted daily functioning in adolescents. PMS is associated with various sociodemographic and menstrual characteristics, and these associations are affected by comorbid depression and anxiety.