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자살시도로 응급실에 내원한 환자의 자살 위험성과 양극성 장애 가능성의 연관성
허량,김건형,전진호,박영민,김영훈,이봉주,Huh, Lyang,Kim, Kun Hyung,Chun, Jin Ho,Park, Young Min,Kim, Young Hoon,Lee, Bong Ju 한국정신신체의학회 2015 정신신체의학 Vol.23 No.2
연구목적 본 연구는 자살 시도자를 대상으로 자살 생각의 심각성과 관련된 요인들을 찾아보고자 하였다. 방 법 일 대학병원 응급실에 자살 시도로 내원한 환자 중 50명을 대상으로 임상가가 면담, Columbia Suicide Severity Rating Scale(C-SSRS), Beck Depression Inventory(BDI), Korean Version of Mood Disorder Questionnaire(K-MDQ), Bipolar Spectrum Diagnostic Scale(BSDS)를 시행하였다. 결 과 자살 경향이 높은 고위험군은 C-SSRS의 자살 생각의 심각성 점수와 BDI 점수가 높았고(p<0.001), MDQ에서 양극성 장애 가능성의 양성으로 판정된 자는 자살생각의 심각성 점수가 높았다(p=0.033). 결 론 자살 시도자의 자살 생각의 심각성과 양극성 장애의 가능성은 서로 연관성이 있을 것으로 생각된다. Objectives : The aim of this study was to investigate the factors including possibility of bipolar disorder that are related to intensity of suicidal idea. Methods : The study subjects consisted of 50 patients who did suicidal attempt and treated at the Inje University Haeundae Paik Hospital Emergency Room. All participants underwent psychiatric interview and underwent Columbia Suicide Severity Rating Scale(C-SSRS), Beck Depression Inventory(BDI), Korean Version of Mood Disorder Questionnaire(MDQ) and Bipolar Spectrum Diagnostic Scale(BSDS) to evaluate patient's suicide attempt, severity of depression and possibility of bipolar disorder. Results : Compared to non-high risk group, suicide high risk group showed significantly higher BDI(p<0.001) and intensity of ideation(IOI) in C-SSRS(p<0.001). Also intensity of ideation(IOI) was correlated with Mood Disorder Questionnaire(MDQ) bipolarity positive(p=0.033). Conclusions : The present study indicated that possibility of bipolar disorder plays a significant role in suicide attempters. Assessment of suicide ideation severity and possibility of bipolar disorder should be considered when suicide attempters come to emergency room.
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기억성 경도인지장애 및 알츠하이머 치매 환자에서 해마, 편도체, 뇌들보, 내후각 피질과 혈중 지질, 호모시스테인, 엽산 농도와의 연관성
이상준,김태형,허량,최승은,이봉주,김경미,이정구,김홍대,문치웅,김영훈,Lee, Sang Jun,Kim, Tae Hyung,Huh, Lyang,Choi, Seung Eun,Lee, Bong Ju,Kim, Gyung Mee,Lee, Jung Goo,Kim, Hong Dae,Mun, Chi Woong,Kim, Young Hoon 대한생물정신의학회 2015 생물정신의학 Vol.22 No.4
Objectives In this study, the authors evaluated the correlation between levels of serum lipid, homocysteine, and folate with volumes of hippocampus, amygdala, corpus callosum, and in patients with amnestic mild cognitive impairment (aMCI) or Alzheimer's disease (AD) type. Methods The study recruited patients who visited the dementia clinic of Haeundae Paik Hospital in Korea between March 2010 and June 2014. Among those, patients who had taken the neurocognitive test, brain magnetic resonance imaing, tests for serum lipid, homocysteine, folate, and apolipoprotein E (APOE) genotyping and diagnosed with aMCI or AD were included for analysis. Bilateral hippocampus, entorhinal cortex, amygdala and corpus callosum were selected for region of interest (ROI). The cross-sectional relationships between serum lipid, homocysteine, folate and ROI were assessed by partial correlation analysis and multiple linear regression analysis. Results In patients with aMCI, old age (> 80) and APOE ${\varepsilon}4$ carrier were associated with AD [odds ration (OR) : 12.80 ; 95% confidence interval (CI) : 2.25-72.98 and OR : 4.48 ; 95% CI : 1.58-12.67, respectively]. In patients with aMCI or AD, volumes and thickness of ROI were inversely correlated with levels of serum lipid and homocysteine. In multiple linear regression analyses, higher total cholesterol level was related to lower left, right hippocampus volume and left amygdala volume ; higher low-density lipoprotein cholesterol was related to lower right entorhinal cortex thickness ; higher homocysteine level was related to lower corpus callosum volume. Conclusions Higher serum lipid and homocysteine levels are associated with decreased volume of hippocampus, amygdala, corpus callosum and entorhinal cortex thickness in patients with aMCI or AD. These findings suggest that serum lipid and homocysteine levels are associated with AD as a modifiable risk factor.
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