알코올 의존 환자의 혈장 5-hydroxyindoleacetic Acid 농도와 음주 행태와의 상관 관계

이황빈(Hwang-Bin Lee):정혜경(Hae-Gyung Chung):최진희(Jin-Hee Choi):김규현(Kyu-Hyun Kim):장동원(Dong-Won Chang) 한국중독정신의학회 2001 중독정신의학 Vol.5 No.1

Objectives:The purpose of this study was to investigate the difference between alcoholics and normal controls on plasma 5-hydroxyindoleacetic acid (5-HIAA) concentration, alcohol consummatory behavior and aggression and to examine their interrelationship in alcoholics. Methods:We studied 70 recently abstinent, treatment-seeking alcoholics and compared with 40 normal controls. All subjects were assessed by plasma 5-HIAA concentration and State-Trait Anger Expression Inventory. Severity and age at onset of alcohol consumption were documented with selected alcoholism screening questionnaires (National Mental Hospital Alcoholism Screening Test). Results:1) Plasma 5-HIAA concentrations were more lower in alcoholics than in controls. 2) Alcoholic group had drunken more amount of alcohol and more frequently than control group. 3) Scores of anger in alcoholic group were significantly higher than in control group. 4) Reduced plasma 5-HIAA concentrations were correlated with amount and frequency of alcohol intake and early onset alcoholism. 5) There was no statistically significant correlation between reduced plasma 5-HIAA concentrations and scores of aggression in alcoholics. Conclusion:It is tempting to conclude that alcoholics may have lowered plasma 5-HIAA concentration. Reduced plasma 5-HIAA concentration is associated with more severe alcohol consumption and early onset alcoholism in alcoholics.

한국판 전투 노출 척도의 신뢰도와 타당도

김동수,정혜경,최진희,소형석,김해정,고창민,김태용,정문용,Kim, Dong Su,Chung, Hae Gyung,Choi, Jin Hee,So, Hyung Seok,Kim, Hae Jung,Go, Chang Min,Kim, Tae Yong,Chung, Moon Yong 대한불안의학회 2012 대한불안의학회지 Vol.8 No.2

Objective : In posttraumatic stress disorder (PTSD), it is essential to evaluate the severity of trauma with a reliable instrument. The combat exposure scale (CES) is one of the most widely used measures for the combat-related trauma. The present study was conducted to test the reliability and validity of the Korean version of CES (CES-K). Methods : One hundred and forty-five male Korean veterans of the Vietnam War participated in this study. CES-K, the structured clinical interview for DSM-III-R (SCID), clinician administered PTSD scale (CAPS), and the Korean version life events checklist (LEC-K) were administered. Results : Cronbach's coefficient of CES-K was .85, and the test-retest reliability was .94. The mean [standard deviation (SD)] scores of CES-K were 20.4 (9.0) in the PTSD group and 12.0 (8.6) in the non-PTSD group (p<.001). CES-K showed a significant correlation with LEC-K (r=.31, p<.001) and CAPS (r=.52, p<.001). Only one factor was revealed by the factor analysis. Conclusion : CES-K showed good reliability and validity for assessing the severity of combat exposure. Further, it demonstrated comparable psychometric properties to the previous study. It is expected that CES-K will be a useful tool for evaluating the severity of combat exposure in Korea.

월남전 참전자에서 문제음주와 관련한 외상 후 스트레스 장애의 증상 차이

권태효,정혜경,김동수,최진희,김태용,소형석,정문용,Kwon, Tae Hyo,Chung, Hae Gyung,Kim, Dong Su,Choi, Jin Hee,Kim, Tae Yong,So, Hyung Seok,Chung, Moon Yong 대한불안의학회 2011 대한불안의학회지 Vol.7 No.2

Objectives : The three symptom clusters of posttraumatic stress disorder (PTSD) are reexperience, avoidance, and hyperarousal. Alcohol use disorders frequently co-occur with PTSD, and possible functional correlations are suspected. Scholarly evaluation of the differences between the symptoms of PTSD and those of alcohol problems may be useful in understanding the pathophysiology of the comorbidity. Methods : We recruited Vietnam veterans with PTSD (n=97) and without PTSD (n=132). The alcohol use disorder identification test (AUDIT), and clinician-administered PTSD scale (CAPS) were administered to participants. The PTSD group was divided into two categories: those with PTSD only (n=57) and those with concurrent alcohol-related problems (n=40). Results : The PTSD group showed higher AUDIT scores compared to the control group. In the PTSD group, participants with alcohol problems had a severer symptoms of recurrent dream and sleep disturbance symptoms compared to the PTSD only group. No significant differences were found in the three major symptom clusters of PTSD. Conclusion : These findings support the proposed existence of a functional correlation between PTSD and alcohol use disorder. Clinicians should carefully evaluate and treat comorbid alcohol use disorder in patients with PTSD.

월남전 참전 노인에서 한글판 외상후 스트레스 장애 체크리스트-5의 정신측정학적 특성

김종원,정혜경,최진희,소형석,강석훈,김동수,문정윤,김태용,Kim, Jong Won,Chung, Hae Gyung,Choi, Jin Hee,So, Hyung Seok,Kang, Suk-Hoon,Kim, Dong Soo,Moon, Jung Yoon,Kim, Tae Yong 대한불안의학회 2017 대한불안의학회지 Vol.13 No.2

Objective : The PTSD Checklist (PCL) is a self-report screen for posttraumatic stress disorder (PTSD) that can be scored for both diagnostic assessment and symptom severity measurement. The most recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) contains a number of changes to the definition of PTSD, and the aim of this study was to assess the psychometric properties of the Korean version of the PCL for the DSM-5 (PCL-5-K). Methods : The participants were 204 Korean veterans of the Vietnam War who completed the PCL-5-K, the Mini Mental Status Examination (MMSE), PTSD module of Structured Clinical Interview for DSM-5, Research Version (SCID5-RV PTSD module), Korean version of Impact of Event Scale-Revised (IES-R-K) and Combat Exposure Scale (CES-K). Results : The PCL-5-K demonstrated good internal consistency (${\alpha}=0.972$) and test-retest reliability (r=0.96); the suggested cut-off score for PTSD diagnosis was ${\geq}37$ with 0.88 sensitivity and 0.96 specificity. The PCL-5-K scale correlated highly with the IES-R-K and CES-K. Factor analysis identified only one factor. Conclusion : Among elderly Korean veterans of the Vietnam War, the PCL-5-K demonstrated similar psychometric qualities to those of both the original PCL and subsequent versions. It is expected that the PCL-5-K will be a useful PTSD screening tool.

월남전 참전 재향군인에서 도파민 D2 수용체 유전자 다형성과 외상후 스트레스 장애

이수영,정혜경,김태용,최진희,정문용,소형석,신한상,이시은,Lee, Soo-Young,Chung, Hae-Gyung,Kim, Tae-Yong,Choi, Jin-Hee,Chung, Moon-Yong,So, Hyoung-Seok,Shin, Han-Sang,Lee, Shi-Eun 대한불안의학회 2008 대한불안의학회지 Vol.4 No.2

Objective : Evidence from recent studies supports the role of genetic factors in the development of Posttraumatic Stress Disorder (PTSD). The primary aim of this study is to investigate the association between the dopamine D2 receptor (DRD2) TaqI A polymorphism and PTSD. The second aim is to examine the association between the DRD2 TaqI A polymorphism and clinical symptoms in patients with PTSD. Methods : We recruited 189 Vietnam veterans for participation in this study, among whom 99 were PTSD patients and 90 were control subjects. The presence of the DRD2 TaqI A polymorphism was determined by polymerase chain reaction (PCR). Several standardized research scales were used in the clinical assessment of PTSD, including the Combat Exposure Scale (CES), Clinician Administered PTSD Scale (CAPS), Beck Depression Inventory (BDI), and Clinical Global Impression (CGI). Results : There was no significant difference in the distribution of the DRD2 genotype, frequency and prevalence of the A1 allele, or the frequency of heterozygotes between the patients with PTSD and the controls. In the PTSD group, the patients with the A1 allele (A1A1, A1A2) scored higher on the CAPS-total (p=0.044), CAPS-avoidance symptoms (p=0.016) and BDI (p=0.024) than those without the A1 allele (A2A2). Conclusion : We could not find an association between the dopamine D2 receptor (DRD2) TaqI A polymorphism and PTSD. However, the A1 allele of DRD2 seemsto influence avoidance symptoms in patients with PTSD.

베트남전 참전 퇴역 군인에서 외상후스트레스장애와 삶의 질과의 관계

엄세준,최진희,김태용,정혜경,정문용,소형석,Oum, Se-Joon,Choi, Jin-Hee,Kim, Tae-Yong,Chung, Hae-Gyung,Chung, Moon-Yong,So, Hyung-Seok 한국정신신체의학회 2011 정신신체의학 Vol.19 No.2

연구목적:외상후스트레스장애(posttraumatic stress disorder, PTSD)는 정신, 신체, 사회적 영역 등 다양한 영역의 삶의 질에 중대한 영향을 주는 것으로 알려져 있다. 이에 본 연구에서는 베트남전 참전 퇴역 군인에서 PTSD 발생 유무에 따른 삶의 질을 비교하고, 참전 퇴역 군인의 삶의 질에 영향을 주는 요인들을 알아보고자 한다. 방 법:연구에 참여한 전체 베트남전 참전 퇴역 군인 중 PTSD군 39명, 비PTSD군 43명을 대상으로, 한국판 Mini International Neuropsychiatric Interview-Plus, 한국판 임상가를 위한 외상 후 스트레스 장애 척도, 한국판 단축형 세계보건기구 삶의 질 척도, 전투노출척도 등을 실시하였다. PTSD군과 비PTSD군의 삶의 질 영역별 차이를 확인하기 위해 독립표본 t검정을 시행하였으며, 전체 베트남전 참전 퇴역 군인의 삶의 질과 관련이 있을 수 있는 변수들과 삶의 질 척도 각 영역 사이에 단계별 다중선형회귀분석을 실시하였다. 결 과: PTSD군은 비PTSD군에 비해 삶의 질의 모든 세부 영역들 및 전체 삶의 질 점수(p<0.01)에서 유의하게 저하된 소견을 보였다. 베트남전 참전 퇴역 군인의 삶의 질에 영향을 주는 요인들은 PTSD, 우울증, 교육 수준이었다. 이 중 PTSD는 전반적인 삶의 질 및 건강상태(${\beta}$=-1.411, $R^2$=0.180), 신체 건강영역(${\beta}$=-2.806, $R^2$=0.089), 전체 삶의 질(${\beta}$=-11.479, $R^2$=0.104)을 가장 잘 설명하였다. 결 론: 베트남전 참전 퇴역 군인에서 PTSD군이 비PTSD군에 비해 삶의 질이 저하된 소견을 보였다. 참전 퇴역 군인에서 PTSD는 다양한 삶의 질 영역에 영향을 줄 수 있을 것으로 생각된다. Objectives: Posttraumatic stress disorder(PTSD) has devastating effects on multiple aspects of the quality of life(QoL). Therefore, the purpose of this study is to compare the QoL between PTSD group and non-PTSD group, and identify the variables affecting the QoL of the Vietnam War veterans. Methods: We recruited 39 veterans with PTSD and 43 veterans without PTSD, all of whom had deployed to the Vietnam War. We used the Korean version of Mini International Neuropsychiatric Interview-Plus, the Korean version of Clinician-Administered PTSD Scale, Combat Exposure Scale and the Korean version of World Health Organization Quality of Life Assessment Instrument abbreviated version. We used independent samples t-test to identify the differences between PTSD and non-PTSD group in each domains of the quality of life. We also used stepwise multiple linear regression analysis to figure out the variables affecting the QoL of the Vietnam War veterans. Results: In the PTSD group, all domains of the QoL and the QoL total score(p<0.01) were significantly lower than those in the non-PTSD group. In the Vietnam War veterans, PTSD, major depressive disorder and education levels were the variables affecting the QoL. Among these, PTSD uniquely explained the QoL of the overall and general health(${\beta}$=-1.411, $R^2$=0.180), the physical health domain(${\beta}$=-2.806, $R^2$=0.089) and the total score (${\beta}$=-11.479, $R^2$=0.104). Conclusions: These results suggest that among the Vietnam War veterans, the QoL of the PTSD group is significantly lower than that of the non-PTSD group. Among the combat exposed veterans, PTSD may be one of the main reasons that affect the multiple domains of the QoL.

외상 후 스트레스 장애 환자의 한국판 웩슬러 지능검사 및다면적 인성검사의 특성

이태영(Tae Young Lee),정혜경(Hae Gyung Chung),최진희(Jin Hee Choi),정문용(Moon Yong Chung),최영안(Young An Choi),김태용(Tae Yong Kim) 대한사회정신의학회 2007 사회정신의학 Vol.12 No.2

연구목적: 외상 후 스트레스 장애(PTSD)는 많은 혼란요소로 인해 정확한 평가에 어려움이 있다. 단일 외상에 노출된 PTSD 환자군을 대상으로 임상에서 널리 사용하는 지능검사 및 인성검사를 실시하여 PTSD 증상의 특성을 평가하고자 하였다. 방 법: 11명의 PTSD 환자군과 12명의 정상 대조군을 대상으로 다면적 인성검사, 웩슬러 지능검사를 시행하여 결과를 비교하였다. 결 과: 다면적 인성검사 검사 결과 타당도 척도에서 F 척도가 유의하게 높았고, K 척도가 유의하게 낮았으며, 임상척도에서 Hs, D, Hy, Pd, Pa, Pt, Sc, Si 척도가 유의하게 높았다. 웩슬러 지능검사 검사 결과 환자군에서 언어성 지능이 유의하게 낮았다. 결 론: PTSD군의 MMPI 결과 대부분의 임상척도의 상승 소견을 보였고 지능검사에서 나타난 낮은 언어성 지능은 이전의 연구결과를 지지하는 소견이다. Objectives:It’s difficult to evaluate PTSD due to many comfounding factors. This study was conducted to evaluate the characteristics of PTSD symptoms for patients with PTSD having experienced single traumatic event with K-WIS and MMPI which are widely used clinically. Methods:K-WIS and MMPI were performed and compared on the 11 patients with PTSD and 12 normal comparison. Results:The result of MMPI test concluded that the patients group had significantly high F, low K scale in validity scales, and also significantly high of Hs, D, Hy, Pd, Pa, Pt, Sc, Si in clinical scales. The result of K-WIS test showed that the verbal intelligence was significantly low in patients with PTSD. Conclusion:The MMPI results from the patients with PTSD showed overall elevation in clinical scales. Low verbal intelligence of K-WIS test supports previous study results.

한국인 남성 알코올 의존 환자에서 제2알데히드 탈수소 효소 유전자형과 도파민 D2 수용체 A1 대립유전자의 빈도에 관한 비교 연구

김신태(Shin-Tae Kim),정혜경(Hae-Gyung Chung),백용수(Yong-Sue Paik),이경아(Kyung-A Lee),윤갑준(Kab-Jun Yun),장동원(Dong-Won Chang),손봉기(Bong-Ki Son) 한국중독정신의학회 1999 중독정신의학 Vol.3 No.2

The purpose of this study is to evaluate the association polymorphic patterns of DRD2 and ALDH2 gene with alcohol dependence. The patient group consisted of 47 male patients with alcohol dependence and the control group consisted of 20 healthy male volunteers without alcohol dependence. Polymorphic patterns of ALDH2 gene and DRD2 gene were determined by PCR method. And then we compared allele frequencies of two loci between patient and control groups. The results were as follows:1) The frequencies of ALDH2*1/1 in patient group were significantly higher than those in the healthy controls. The frequencies of mutant ALDH2 (ALDH2* 1/2 and ALDH2*2/2) were significantly lower in patient group than those in healthy controls. 2) There was no significant difference in A1A1 A1A2 A2A2 genotype frequencies in DRD2 gene between patient group and healthy controls. 3) In patient group with A1 allele, frequencies of ALDH2*1/1, ALDH2*1/2, ALDH2*2/2 were 61.7%, 3%, 0%, respectively. In patient group without A1 allele, frequencies of ALDH genotypes were 29%, 2%, 0%, respectively. In conclusion, mutant ALDH2 genotype seems to have influence on the occurrence of alcohol dependence. The interaction of DRD2 A1 alleles and ALDH2 alleles should be studied to find some effect on pathogenesis of alcohol dependence.

노인에서 외상 후 스트레스 장애의 증상과 혈압의 연관성

방유진,강석훈,김태용,최진희,정혜경,소형석,고창민,Bang, Yu Jin,Kang, Suk Hoon,Kim, Tae Yong,Choi, Jin Hee,Chung, Hae Gyung,So, Hyung Seok,Go, Chang Min 대한불안의학회 2013 대한불안의학회지 Vol.9 No.2

Objective : Several studies have reported the association between posttraumatic stress disorder (PTSD) and hypertension (HTN). The aim of this study was to evaluate the impact of PTSD symptoms on blood pressure. Methods : Korean veterans of the Vietnam War with (n=62) or without PTSD (n=87) participated in this study. The clinician administered PTSD scale (CAPS) and alcohol use disorder identification test (AUDIT) were applied. Blood pressure, pulse rate, risk factors of HTN and demographic data of the subjects were collected. Effects of potential explanatory variables on HTN were analyzed with logistic regression. Results : Diastolic blood pressure was significantly higher in PTSD group (p=0.015). However, PTSD subjects showed significantly lower pulse rate than non-PTSD subjects (p=0.004). Logistic regression analysis showed that avoidance symptom might be a predictor for hypertension (OR=1.065, p=0.030). Conclusion : These results suggest that PTSD, especially avoidance symptom, might be a risk factor on HTN in the elderly with PTSD. Further studies are needed to evaluate the change of blood pressure according to the clinical improvement of PTSD.

외상 후 스트레스 장애 환자의 음주와 음주동기

이시은(Shi-Eun Lee),정혜경(Hae Gyung Chung),이수영(Soo Young Lee),소형석(Hyung Seok So),정문용(Moon Yong Chung),최진희(Jin Hee Choi),김태용(Tae Yong Kim) 한국중독정신의학회 2010 중독정신의학 Vol.14 No.2

Objectives:Posttraumatic stress disorder (PTSD) is a mental disorder that develops in response to catastrophic life events. Alcohol abuse or dependence is the most common co-occurring disorder among men with PTSD, and possible functional correlations are suspected. Therefore, we conducted this study to identify the differences in drinking patterns and motives between patients with PTSD and a combat exposed control group. Methods:We recruited 92 veterans patients with PTSD and 79 veterans without PTSD for a control group, who had all experienced combat trauma in the Vietnam War. A detailed history of alcohol use, the Alcohol Use Disorder Identification Test (AUDIT), Clinician-administered PTSD Scale (CAPS), Combat Exposure Scale (CES) and Drink-ing Motive Questionnaire were obtained from all participants. Results:Patients with PTSD consumed alcohol longer and more frequently than those in the control group. In the PTSD group, the AUDIT scores and coping motives were significantly higher than in the control group (p<0.01). The difference in coping motive was still significant after adjusting for AUDIT score using multi-variate analysis of covariance. There were no significant differences in enhancement, social, and conformity motives between groups. Conclusion:Our data support the hypothesis that patients with PTSD drink to cope with the negative affects including symptoms of PTSD. These results suggest that treatment of symptoms of PTSD may be important for optimizing the outcomes for patients with comorbid PTSD and alcohol use disorders.