지연성 운동장애(Tardive Dyskinesia)의 최근 견해

김용식,강웅구,주연호,Kim, Yong-Sik,Kang, Ung-Gu,Joo, Yeon-Ho 대한생물정신의학회 1996 생물정신의학 Vol.3 No.1

Tardive dyskinesia is a syndrome of involuntary hyperkinetic abnormal movements that occurs during or shortly after the cessation of neuroleptic drug treatment. Typically, the movements are choreoatheoid. Other movements such as tics and dystonia may be present. Nonetheless, any dyskinesia seen in a neuroleptic-treated patient is not always neuroleptic-induced tardive dyskinesia. The prevalence of tardive dyskinesia varies widely, which reflects many methodological problems, such as differential diagnosis. symptom fluctuation, masking effect of neuroleptics, validated diagnostic criteria. Of suggested risk factors, only old age has been consistently found to be associated with an increased frequency of tardive dyskinesia. Many hypotheses about the pathophysiolgy of tardive kinesia are proposeed, but time-honored ones are not present. No consistently safe and effective treatments are found. Various treatment modalities signifies the general ineffectiveness of these agents for most patients. In general, reduction or cessation of neuroleptics, if possible, is recommended. Remission or improvemets of tardive dyskinesia after neuroleptics withdrawal usually occurs among most patients within three months.

한국 조현병 환자에서 검지-약지 길이비와 발병 연령 및 대사 장애와의 연관성

김홍래,이중선,주연호,원승희,류승형,홍경수,권준수,이승연,오홍석,최준호,이유상,Kim, Hong Rae,Lee, Jung Sun,Joo, Yeon Ho,Won, Seunghee,Ryu, Seunghyong,Hong, Kyung Sue,Kwon, Jun Soo,Lee, Seung Yeoun,Oh, Hong Seok,Choi, Joon Ho,Lee, Yu Sa 대한생물정신의학회 2017 생물정신의학 Vol.24 No.3

Objectives The ratio of second to fourth digit length (2D : 4D) could be a potential epigenetic marker of sexual dimorphism reflecting prenatal testosterone exposure. Testosterone is known to affect the development of the brain through an epigenetic mechanism. The purpose of this study was to investigate the effects of exposure to fetal testosterone on the metabolic syndrome based on 2D : 4D of schizophrenia patients and the relationship with the age of onset of schizophrenia. Methods A total of 214 schizophrenia patients participated in this study. The participant's physical and blood tests were performed according to the American National Cholesterol Education Program's Third Amendment of the Metabolic Syndrome Diagnostic Criteria, and the 2D : 4D was measured by the method designed by McFadden. Data were statistically analyzed by t-test, Pearson's correlation analysis and multiple regression model analysis. Results 2D : 4D was significantly higher in female than male in both hands, and there was a statistically significant negative correlation between 2D : 4D and the age of onset of schizophrenia in male. However, 2D : 4D did not show statistically significant correlation with metabolic factors. Conclusions Fetal testosterone suggests the possibility of affecting the age of onset of schizophrenia through the epigenetic mechanism, but there is no clear relationship with metabolic factors.

양극성 경향과 스트레스 취약성:기분장애설문지 양성 반응군과 음성 반응군에서 지각된 스트레스, A형 행동, 그리고 생활습관의 비교

김병수,김성윤,최재원,주연호,윤대현,한내진,김유신,김선옥,Kim, Byung-Su,Kim, Seong-Yoon,Choe, Jae-Won,Joo, Yeon-Ho,Yoon, Dae-Hyun,Han, Nae-Jin,Kim, Yoo-Shin,Kim, Seon-Ok 한국정신신체의학회 2010 정신신체의학 Vol.18 No.1

연구목적 : 본 연구를 통해 양극성 장애 I형 혹은 II형 진단 기준에는 부합하지 않지만, (경)조증적 성향 혹은 기분 불안정성 등의 양극성 경향(bipolar tendency, bipolarity)을 가진 사람에게서, 주관적으로 지각하는 스트레스 수준, 스트레스 취약성을 반영하는 것으로 알려진 A형 행동 유형(Type A Behavior Pattern, TABP), 그리고 건강하지 못한 생활습관의 위험이 증가되어 있는지 확인하고자 한다. 방 법 : 정신과적 병력이 없는 30세 이상의 1987명의 연구 대상군이 분석에 포함되었다. 이들 중에서 기분장애설문지 (Mood Disorder Questionnaire, MDQ)의 (경)조증적 증상 경험에 대한 13개 항목 중에서 7개 항목에 "예"라고 응답한 사람들을 양극성 경향군으로 분류하였다. 양극성 경향군과 비양극성 경향군 사이에서 지각된 스트레스 척도(Perceived stress scale, PSS), TABP를 반영하는 A/B 생활 습관 설문(A/B Lifestyle ques-tionnaire) 점수와, 음주, 흡연, 불규칙적인 식사, 운동 부족 등의 생활 습관 변인을 비교하였다. 결 과 : 양극성 경향군(329명, 16.6%)은 비양극성 경향군에 비해 TABP를 반영하는 A/B 생활 습관 설문의 총 점수가 유의미하게 높았으며(125.4점 vs. 115.9점, p<0.001), TABP로 판정(총 점수 135점 이상)된 비율도 양극성 경향군에서 유의미하게 높은 것으로 관찰되었다(41.3% vs. 30.1%, p<0.001). 주관적으로 지각하는 스트레스 수준의 비교에서도, 양극성 경향군이 비양극성 경향군에 비해 유의미하게 높았다(18.5 vs. 16.5, p<0.001). 생활습관의 비교에서 '불규칙적인 식사'(20.1% vs. 14.3%, p=0.002), '주 4회 이상 음주'(29.8% vs. 16.5%, p<0.001), '현재 흡연'(41.9% vs. 23.0%, p<0.001), '주 2회 이하 운동'(63.2% vs. 55.1%, p=0.007) 이라고 응답한 사람의 비율이 양극성 경향군에서 유의미하게 높았다. 결 론 : 양극성 경향을 가진 경우는 스트레스에 취약한 행동 양상이 높게 관찰되고, 주관적으로 지각하는 스트레스 수준도 높고 흡연, 음주, 불규칙한 식사와 운동 부족과 같은 건강하지 못한 생활 습관을 가지고 있을 위험도 높은 것으로 확인되었다. 이러한 위험 요소들은 비만, 대사증후군, 당뇨, 그리고 심혈관계 질환의 발병 위험을 높일 수 있으므로, 양극성 경향을 가진 사람들은 스트레스 관리 및 건강한 생활 습관을 유지하기 위한 보다 적극적인 노력이 필요하다. Objectives:Authors hypothesized that bipolar tendency of non-psychiatric person would be associated with stress vulnerability. To test the hypothesis, we compared perceived stress level, Type A Behavioral Pattern (TABP) and unhealthy lifestyle between person with and without bipolar tendency. Methods:The study cohort consisted of 1987 subjects without past and current psychiatric history. In this study, bipolar tendency was determined by MDQ response which requires endorsement of at least 7 of the 13 "yes or no" questions. We compared the scores of Perceived Stress Scale, A/B lifestyle questionnaire, and unhealthy lifestyle(alcohol, smoking, lack of exercise, irregular meal) between MDQ positive and negative respondents. Results:We identified the bipolar tendency group determined by the MDQ positive response were 329 subjects(16.6%). The overall score of the bipolar tendency group was significantly high on the A/B lifestyle questionnaire compared to the non-bipolar tendency group(125.4 vs. 115.9, p<0.001), and the rate of the subjects defined as TABP was also significantly high(41.3% vs. 30.1%, p<0.001). In comparison of subjectively perceived stress level, the bipolar tendency group was observed to be significantly higher than the non-bipolar tendency group (18.5% vs. 16.5%, p<0.001). The bipolar tendency group was significantly higher than the non-bipolar tendency group on the rate of answering:'irregular eating habit' (20.1% vs. 14.3%, p=0.002), '4-or-more-times alcohol intake per week' (29.8% vs. 16.5%, p<0.001), 'currently smoking' (41.9% vs. 23.0%, p<0.001), '2-or-less-times physical exercises per week' (63.2% vs. 55.1%, p=0.007). Conclusion:By clinical diagnosis, even a person who does not meet the criteria of bipolar disorder has a high risk of stress-related behavioral pattern, and perceived stress when possessing bipolar tendencies such as the (hypo) maniac tendency or affective instability. Such individual has significantly higher risk of having unhealthy life-style such as smoking, drinking, irregular eating habit and lack of exercise compared to non-bipolar tendency group. Since these risk factors lead to increase the risk of obesity, metabolic syndrome, diabetes, and cardiovascular diseases, the individual with the bipolar tendency requires a more effort to manage stress and to maintain healthy lifestyle.

정신질환의 진단 및 통계 편람(DSM) 조현병 진단 개념의 변천 : 1980년에서 2013년까지

조영탁(Young Tak Jo),주연호(Yeon Ho Joo) 대한신경정신의학회 2021 신경정신의학 Vol.60 No.4

Schizophrenia has been conceptualized as a biologically caused mental disease. However, its causes and pathophysiology have not yet been clearly defined. Unlike physical diseases that are defined using specific biomarkers, mental disorders, such as schizophrenia, are usually diagnosed using the diagnostic criteria established by the consensus of a professional committee. The Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association is widely used as the authoritative guide for the diagnosis of mental disorders, including schizophrenia. If the cause and pathophysiology of a disease are uncertain, a diagnostic concept should be considered valid only when the course, prognosis, or treatment response is generally predictable and consistent. However, patients with schizophrenia who are diagnosed based on the criteria defined by the DSM frequently display varied disease courses and outcomes. This strongly suggests that the current diagnostic concept of schizophrenia in the DSM fails to meet the standards for a valid diagnosis. Although this limitation has been recognized since the DSM-III was published, many psychiatrists today mistakenly believe that the diagnostic concept in the DSM looks at schizophrenia as an explicit disease rather than as a concept. In this review article, we analyze the historical changes in the concepts and diagnostic criteria of schizophrenia. We believe that this will help us to better understand the nature of the current diagnostic approach and also improve our understanding of how the DSM should be used in research and everyday clinical practice.

단기 정신병적 장애로 진단된 환자들의 임상적 특성

정석훈 ( Suk Hoon Jung ),주연호 ( Yeon Ho Joo ),고진경 ( Jin Kyung Goh ),김창윤 ( Chang Yoon Kim ) 한국정신병리진단분류학회 2003 精神病理學 Vol.12 No.1

주의력결핍 과잉행동장애의 산전 및 주산기 위험인자

여진영(Jin-Young Yeo),최세진(Sejin Choi),주연호(Yeon Ho Joo),김효원(Hyo-Won Kim) 대한소아청소년정신의학회 2015 소아청소년정신의학 Vol.26 No.2

Objectives:The purpose of this study was to examine the prenatal, perinatal and developmental risk factors of attention-deficit hyperactivity disorder (ADHD), compared to unaffected siblings (SIB), and typically developing children (TC). Methods:Subjects with ADHD, their SIB, and TC were recruited from the child psychiatry outpatient clinic of the Asan Medical Center Children’s Hospital. The parents of the children completed questionnaires on perinatal and developmental risk factors. Results:Fifty-eight subjects with ADHD (41 boys, 7.7±1.3 years), 21 SIB (8 boys, 8.2±1.8 years), and 22 TC (8 boys, 8.5±2.1 years) were included. The ADHD group showed higher rates of maternal stress during pregnancy than the SIB group (p=.002), and the ADHD group showed higher rates of familial psychiatric history than the TC (odds ratio, 8.76 ; 95% confidence interval, 1.69 to 45.45). Conclusion:These findings suggest that among perinatal and developmental factors, maternal stress during pregnancy contribute to the development of ADHD. Future prospective studies will be needed in order to determine the causal relationship between perinatal risk factors and development of ADHD.

한국판 기질성격검사와 아이젱크 성격검사의 관계

정준규(Joon-Gyu Jeong),고진경(Jin-Kyung Goh),주연호(Yeon-Ho Joo),김창윤(Chang-Yoon Kim),이철(Chul Lee) 대한사회정신의학회 2004 사회정신의학 Vol.9 No.1

목 적: 기질성격검사(Temperament and Character Inventory, TCI)는 Cloninger의 생물 사회학적 모델을 바탕으로 만들어진 자기 보고형 인격 검사이다. 본 연구의 목적은 TCI와 유사한 생물학적 근거 및 요인수를 가진 한국판 아이젱크 성격검사(Eysenck Personality Questionnaire, EPQ)와의 비교를 통해 TCI의 준거타당도를 평가하고 두 검사 간의 상관관계를 알아보는 것이다. 방 법: 서울 시내 종합병원 간호사 및 대학생 총 207명을 대상으로 한국판 TCI와 한국판 EPQ 제 Ⅰ 부와 제 Ⅲ 부를 시행하였다. Cron-bach α를 통해 척도들의 내적 일치도를 조사하였다. TCI 척도들을 피어슨 상관분석법을 통해 EPQ 척도들과의 관계를 조사하 였고, EPQ 척도들과 함께 연합요인분석을 실시하였다. 결 과: TCI 척도들의 내적 일치도는 기질 차원의 경우는 0.58-0.87, 성격 차원의 경우는 0.84-0.86의 값을 보였다. 한국판 TCI의각 차원마다 대개 2개 이상의 EPQ의 척도가 상관을 보였으며, TCI와 EPQ의 모든 척도들의 연합요인분석 결과는 크게 불안, 충동성, 합동의 3가지 요인구조를 나타냈다. 결 론: 한국판 TCI는 충분한 준거타당도를 가지고 있으며, TCI와 EPQ의 연합요인분석 결과는 3차원 인격모델을 지지한다. Objectives:This study was intended to evaluate the correlations between the Korean version of the Temperament and Character Inventory(TCI) and the Korean version of the Eysenck Personality Questionnaire(EPQ). Methods:The TCI & EPQ were administered to 207 Korean students and nurses. Internal consistency was calculated by Cronbach α. Correlations between the TCI and the EPQ scales were analyzed by Pearson correlation method and Joint factor analysis was performed to examine the concurrent validity of the TCI. Results:Cronbach values for the TCI scales ranged from 0.58 to 0.87 for the temperament scales and from 0.84 to 0.86 for the character scales. Correlations between the TCI scales and the EPQ scales were observed on several aspects. The result of Joint factor analysis showed the three factor solution(impulsivity, anxiety, affiliation). Conclusion:Most of the TCI scales were correlated with about two of the EPQ scales. Joint factor analysis of the TCI and EPQ scales supported big three dimensional personality model. In general, the TCI is a valid instrument, but it needs some refinement on several aspects.

리튬을 사용한 병력이 없는 양극성장애 환자에서의 갑상선기능저하증

김소희(So Hee Kim),하규섭(Kyoo Seob Ha),원승희(Seong Hee Won),주연호(Yeon Ho Joo),안준호(Joon Ho Ahn),조수현(Soo Hyun Joe) 대한생물치료정신의학회 2015 생물치료정신의학 Vol.21 No.3

Coil embolization으로 치유된 십이지장 dieulafoy 병변 출혈 1예

정승욱 ( Seung Wook Jung ),손혁수 ( Hyuk Soo Son ),김준형 ( Jun Hyung Kim ),장성훈 ( Seong Hoon Jang ),이주형 ( Joo Hyung Lee ),박종호 ( Jong Ho Park ),주연호 ( Yeon Ho Joo ) 대한내과학회 2006 대한내과학회지 Vol.70 No.2S

소화성궤양 환자에서 저용량 clarithromycin 3제요법의 Helicobacter pylori 제균효과

정명아 ( Myeong A Cheong ),김태헌 ( Tae Hun Kim ),박영숙 ( Young Sook Park ),이진혁 ( Jin Hyuk Lee ),주연호 ( Yeon Ho Joo ),최일주 ( Il Ju Choi ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-

<목적> 우리나라에서는 H. pylori의 첫 치료로 PPI, amoxacillin과 clarithromycin의 3제요법이 추천되고 있다. Clarithromycin의 용량은 500mg을 하루 2회 복용하는 것이 추천되나, 250mg을 하루 2회 복용하는 저용량 Clarithromycin 3제요법의 H. pylori 제균 효과에 대하여는 아직 논란이 있는 실정이다. Omeprazole을 사용한 3제요법에 대한 국내의 보고에서 clarithromycin