길고도 험해지는 기분 순환 : 안정화에 이르는 길은 어디에?

하라연,조현상,전덕인,하규섭 대한신경정신의학회 2010 신경정신의학 Vol.49 No.3

젊은 성인에서 중립 얼굴표정 인식과 관련된 심리적 요인들

하라연,강지인,안석균,조현상 대한신경정신의학회 2009 신경정신의학 Vol.48 No.6

Objectives Previous studies have shown the relationship between recognition of facial expressions and psychiatric symptoms. This study investigated how healthy young adults recognize neutral faces and which psychological distresses and symptoms relate to their recognition of neutral faces. Methods One hundred forty-three healthy volunteers participated in this study. We used neutral facial pictures, selected from the Japanese and Caucasian Facial Expressions of Emotion (JACFEE) photo set, to evaluate participants’ facial expression recognition and the State-Trait Anxiety Inventory, Beck Depression Inventory, Toronto Alexithymia Scale, Conner-Davidson Resilience Scale, and Temperament and Character Inventory (TCI) to measure and examine their psychological characteristics. Results There were significant positive correlations between the recognition rate of neutral expressions as contempt and trait-anxiety level (r=0.21;p=0.01) and depression (r=0.20; p=0.02). This contempt-recognition was significantly negatively correlated with resilience score (r=-0.22; p=0.01) and the TCI self-directedness subscale (r=-0.29;p=0.00). Also, the TCI’s harm avoidance subscale score was significantly positively correlated with the contempt recognition rate (r=0.21; p=0.01). Conclusion These finding suggests recognition of neutral faces as contempt may be related to psychological distress, including trait and temperament characteristics. This negative bias toward neutral emotion (expressions) may affect interpersonal relations and social functioning in a healthy population.

정신과 연구에서 다양한 임상연구방법의 장단점

하라연,조현상,Ha, Ra Yeon,Cho, Hyun-Sang 대한생물정신의학회 2012 생물정신의학 Vol.19 No.4

An appropriate research design for hypotheses and purposes leads to a good quality of research results. In this review article, we summarized the types of research methods and described the characteristics of clinical trials. Research designs are categorized into observational studies and experimental ones, depending on data collecting methods. In an observational study, there are cross-sectional, cohort and case-control studies. Parallel groups design and crossover trial studies are representative designs in a randomized controlled trial study, a kind of experimental study. Clinical researchers should understand the characteristics of clinical research designs including advantages and disadvantages and choose the suitable design according to their study purposes and the nature of collected data or subjects.

백인과 일본인의 얼굴정서 자극에 대한 한국인의 인식 차이

하라연,강지인,박지인,안석균,조현상 대한우울조울병학회 2011 우울조울병 Vol.9 No.1

Objectives : We compared recognition of emotional expression from Japanese faces with Caucasian faces in Korean healthy volunteers. Methods : From Jan. 1992 to Aug. 2001, we analysed 25 cases (23 patients) of stapedotomy operated by one surgeon for stapedial fixation at Asan Medical Center. The clinical features, preoperative and postoperative audiologic findings, postoperative complication and factors affecting the results were analysed. Results : There were no differences in recognition rates of anger, contempt, sadness, and surprise between Caucasian and Japanese expressions. The expressions of fear and happiness were better recognized from Japanese faces while the expression of disgust was better recognized from Caucasian faces. Conclusion : Our study demonstrates substantial accuracy in categorizing emotional faces regardless of culture differences but also recognition differences according to ethnic faces in some emotional expressions. We suggest that further researches involved in facial emotional expression paradigm will have to consider cultural differences. (J of Kor Soc for Dep and Bip Disorders 2011;9:17-23)

Clinical Case Conference 길고도 험해지는 기분 순환 : 안정화에 이르는 길은 어디에?

조현상,하라연,하규섭,전덕인 대한신경정신의학회 2010 신경정신의학 Vol.49 No.3

Effects of Color Temperature and Brightness on Electroencephalogram Alpha Activity in a Polychromatic Light-emitting Diode

박진영,하라연,유빈,김어수,정영철 대한정신약물학회 2013 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.11 No.3

Objective: It has been reported that working and learning efficiency might be increased through artificially controlling the color temperature and brightness of light. However, the neurological bases of these outcomes are not well established. Our study was designed to observe whether electroencephalogram (EEG) alpha frequency, as a candidate biological marker, demonstrates significant changes in response to alterations of specific light parameters. Methods: Thirty-two healthy subjects performed cognitive tasks under four different polychromatic light conditions: a combination of two different levels of color temperature (2766K vs. 5918K) and brightness (300 lux vs. 600 lux). Spectrum analyses were performed on alpha frequency. Results: Subjects reported that they felt more pleasant in bright conditions and more relaxed in warm color temperature conditions. Our findings indicate that alpha power increases in warm, low-light and cool, high-light conditions, and there is a significant interaction between color temperature and brightness. Conclusion: EEGs might serve as a useful biological marker for further research related to the effects of polychromatic light on cognitive function.

양극성 장애 환자의 자서전적 기억

선자연,하라연,이수진,유빈,하규섭,조현상,Sun, Ja-Yeun,Ha, Ra-Yeon,Lee, Su-Jin,Ryu, Vin,Ha, Kyoo-Seob,Cho, Hyun-Sang 대한생물정신의학회 2012 생물정신의학 Vol.19 No.1

Objectives : Autobiographical memory (ABM) is a special type of episodic memory, containing events that have occurred in a personal life. Overgeneral tendency of ABM refers to the retrieval of memory with only general and categorical descriptions rather than specific events. ABM specificity in depression and posttraumatic stress disorder is a robust finding with relation to cognitive vulnerability, affect regulation, problem-solving ability. It is also implicated in bipolar disorder with frequent relapses. In this study, we investigated whether ABM specificity was related to manic or euthymic mood states in patients with bipolar disorder. Methods : Forty bipolar patients with manic and euthymic episodes and 25 healthy controls participated in this study. Prompted by 5 positively and 5 negatively valenced emotional cue words, each participant was instructed to recall positive or negative memories and describe them in detail. The One-way ANOVA was used to compare ABM scores and post-hoc analyses were done. Results : Comapred to the healthy persons, the bipolar patients reported significantly more general than specific negative memories in both manic and euthymic episodes (p = 0.003). However, there was no significant difference between manic and euthymic patients (p = 0.074). Conclusions : These results suggest that overgeneral tendency of negative ABM may be a trait abnormality in bipolar disorder. Moreover, this phenomenon might be related to underlying cognitive deficits or affect regulation irrespective of the mood state.

확률적 보상과제를 이용한 기분안정기 양극성 장애 환자의 보상학습 특성

김태영,유빈,하라연,이수진,하규섭,조현상 대한정신약물학회 2012 대한정신약물학회지 Vol.23 No.1

본 연구는 확률적 보상과제를 이용하여 양극성 장애 안정기에 있는 환자에서 보상학습특성을 살펴보았다. 그 결과 양극성 장애 환자는 안정기 상태에서 정상인에 비해 반응편향의 감소가 관찰되었다. 그 외 두 군 간에 변별력, 정답률 및 반응시간에는 차이가 없어 과제 수행능력에는 차이가 없는 것으로 나타났다. 본 결과는 양극성 장애 기분안정기 환자들의 보상학습에 문제가 있음을 시사하는 것으로 보인다. Objective: Bipolar disorder patients often show excessive goal-directed and pleasure-seeking behavior during manic episodes and reduced hedonic capacity during depressive episodes, indicating that bipolar disorder might involve altered reward processing. As such, bipolar disorder subjects have been reported to show impaired reward learning in situations requiring integration of reinforcements over time. In this study, we examined characteristics of reward learning in euthymic patients with bipolar disorder using a probabilistic reward task. Methods: We recruited 23 euthymic patients with bipolar disorder and 47 healthy subjects for the probabilistic reward task. This task is a reward-based paradigm to produce a response bias, in which correct identifications of two ambiguous stimuli are differently rewarded. The other dependent measures were the discriminability, hit rate and reaction time. Results: Relative to comparison subjects, bipolar patients showed a reduced acquisition of response bias toward the more frequently rewarded stimulus (p<0.01). The overall reward learning was positively correlated with state and trait anxiety levels in bipolar patients (p<0.01). No significant differences of discriminability, hit rates, and reaction time were found between bipolar patients and controls. Conclusion: These findings suggest that euthymic patients with bipolar disorder may have deficits in reward learning related to anxiety.

제1형 양극성장애 환자의 신경인지검사 수행에서 나타나는 개인 내 변산성

김상현,김성화,하라연,유지수,유빈,안석균,조현상 대한우울조울병학회 2015 우울조울병 Vol.13 No.3

Objectives: Intra-individual variability (IIV) represents the degree to which a given individual’s performance varies relative to his or her own mean level of performance across neuropsychological tasks. IIV across neuropsychological tasks has received recent attention to risk for developing psychiatric illnesses. The present study investigated the IIV across different cognitive domains in patients with bipolar I disorder compared to healthy controls. Methods: Sixty bipolar I patients and 50 healthy controls were evaluated for comprehensive neuropsychological battery, including tests of attention and working memory, visual memory, verbal memory, and executive function. IIV was computed from factor-based cognitive scores in each four cognitive domain and across the cognitive domains. Results: Higher IIV was observed from across-domains (p<0.001) and executive function (p <0.05), and close to the boundary of statistical significance from verbal memory (p=0.06), but not from attention and working memory (p=0.61) and visual memory (p=0.22) in bipolar patients compared to healthy controls. Conclusion: These findings suggest that bipolar patients have distinct feature of increased IIV of across-domains and executive and verbal memory functions. Comprehensive application of IIV in various cognitive domains may be helpful in understanding of neuropsychological problems and potential cognitive interventions for bipolar disorder.

일 대학병원에 입원하는 알코올 의존 환자에서 동반되는 베르니케 뇌병증의 선별 및 치료

이서정,이수영,하라연,김어수,정영철,남궁기 대한신경정신의학회 2011 신경정신의학 Vol.50 No.4

Objectives The purpose of this study was to investigate the prevalence and clinical characteristics of Wernicke’s encephalopathy (WE) patients in alcoholics and to evaluate the utility of Caine’s criteria as a screening test. Methods We made an admission note including Caine’s criteria and applied it to patients who were admitted to an alcohol treatment unit. Demographic, clinical, and laboratory data were collected on 204 alcoholics. Our alcoholics who met more than one of Caine’s criteria were considered at risk for WE and were given high-dose thiamine IV therapy. Results WE was diagnosed in 15.2% of the alcoholic patients. Age and head trauma history were risk factors of WE. The sensitivity of Caine’s criteria was 97% and specificity was 54%. High-dose thiamine IV therapy appeared to be a safe and cost-effective method to prevent the serious complications of WE. Conclusion Caine’s criteria is useful as a screening test for WE among alcoholic patients. High-dose thiamine IV therapy is cost-effective for alcoholic patients who are considered to be at risk for WE.