회복된 기억의 진위에 대한 논쟁

홍계현 ( Kye Hyunn Hong ),손인기 ( Inki Sohn ) 한국정신병리진단분류학회 2012 精神病理學 Vol.21 No.1

The recovery of forgotten memories, especially the recovery of memories of childhood abuse are important from a clinical point of view. However, there is controversy about its authenticity because of the seriousness of its impact. Many retrospective studies support the veracity of the memories, but studies themselves are defective. There are many case reports, but also the problem of not being able to prove its validity. There are also prospective studies to support this, but some are otherwise. Even the possibility of false memories syndrome, therapists argue that they should consider the traumatic experience and the uniqueness of memories of that. There are attempts to compromise this disagreement in rational way. Psychiatric Association and Psychological Society in the United States and the United Kingdom present different guidelines about recovered memories, especially that of childhood abuse. The authors reviewed this controversy and representative guidelines.

입원 치료 중인 조현병 환자의 비만도와 정신병리

송명선,함웅,박성용,홍계현,백인호 대한신경정신의학회 2015 신경정신의학 Vol.54 No.2

Objectives ZZThe aims of this study were to examine the relationship between obesity and psychopathology of inpatients with schizophrenia. MethodsZZEighty four inpatients with schizophrenia and 81 control subjects were recruited. Height and weight were measured for calculation of body mass index (BMI). Symptom severity scales [Positive and Negative Syndrome Scale (PANSS), Brief Psychiatric Rating Scale] and Global Assessment of Functioning Scale (GAF) were conducted in all patients. Comorbid medical conditions, years of education, smoking status, age of onset, duration of illness, and medication history were collected. ResultsZZPatients with schizophrenia had significantly higher BMI and ratio of obesity than control subjects. Among patients, obese patients scored lower on symptom severity scales and better on functional assessment than not obese patients. Multiple regression analysis revealed an association of late onset and being obese with lower PANSS total score and better GAF score in patients. Late onset and being female were inversely related with negative symptom score. The type and dose of antipsychotics showed no association with obesity. ConclusionZZThe results of this study indicate that patients with schizophrenia are likely to be more obese. Some characteristics of patients with less severe psychopathology, such as late onset, being obese, were coincident with the result of previous studies. In addition, the result showing that the heavier the weight of patients, the lower severity of symptoms was repeatedly reported in previous studies. The type and dose of antipsychotics were not associated with obesity. These results prompt further investigation of the relationship among schizophrenia, antipsychotics, and weight gain.

주의력결핍 과잉행동장애의 약물치료에 대한 일반 대중의 인식

김학철,함웅,손인기,서정석,홍계현 대한정신약물학회 2014 대한정신약물학회지 Vol.25 No.3

ObjectivezzThe aim of this study was to examine 1) public knowledge and perceptions about attention-deficit hyperactivity disorder (ADHD) and 2) factors influencing the public’s decisions to adhere to ADHD pharmacotherapy. MethodszzIn this study, 396 participants responded to the internet survey regarding their experiences, beliefs and treatment preferences about ADHD. Resultszz252 respondents (63.6%) were reluctant to pharmacological treatment of ADHD. The respondents chose the functional impairment of the brain as the main cause of ADHD were favorable to pharmacological treatment and scored significantly high on the ADHD Knowledge Questionnaire. On the other hand, the respondents who regarded ADHD as an overly active personality rather than a disease were skeptical to pharmacotherapy and scored significantly low. The respondents who were acquainted with someone who had been diagnosed with ADHD perceived themselves relatively well informed about ADHD. However, the subjective perception of the degree of knowledge of ADHD was not correlated with the objective score of the ADHD Knowledge Questionnaire. ConclusionzzThe public is not well informed about ADHD and its treatments. Culturally appropriate psychoeducational strategies based on the media and the internet are needed. Providing biomedical conceptualization of ADHD to the public may aid with treatment decisions and promote adherence to pharmacological treatment. 본 연구에서는 ADHD에 대한 대중의 인식과 그들이 ADHD의 약물 치료를 선택하는 데 영향을 미치는 인자를 파악하기 위하여 인터넷 설문 조사에 응답한 396명의 자료를 분석하였다. 응답자들이 ADHD에 관한 지식을 얻은 주요 경로는 신문, 방송과 같은 대중 매체와 인터넷으로 나타났다. 3분의 1 이상 (36.6%)의 응답자들이 ADHD의 주요 병인으로 ‘부모의 양육태도’를 선택하였다. ADHD를 진단 받더라도 약물을 사용을 하지 않겠다고 대답한 경우는 63.6%였다. ADHD의 병인으로 ‘뇌기능장애’를 선택한 응답자들은 그 외의 병인을 선택한 경우에 비하여 약물요법에 호의적이었으며 ADHD에 관한 지식을 측정하는 문항에 대한 평균 점수가 유의하게 높았다. 반면에 ADHD는 질병이 아니라 과도하게 활동적인 성격이라고 대답한 응답자들은 약물요법에 비호의적이었으며 지식을 측정하는 문항에 대한 평균 점수가 유의하게 낮았다. 본인이나 주변의 인물 중에 ADHD를 진단 받은 인물이 있는 응답자는 본인이 ADHD에 대하여 비교적 잘 알고 있다고 생각하였다. 그러나 본인이 주관적으로 평가하는 ADHD에 대한 지식의 수준과 객관적으로 평가한 실제 지식의 수준은 상관 관계가 없는 것으로 나타났다. ADHD 아동에게 적절한 진단과 치료를 받을 수 있는 기회를 제공하기 위해서는 대중을 대상으로 ADHD의 생물의학적 병인론을 바탕으로 한 교육이 필요하며 이를 위하여 대중매체와 인터넷을 활용하는 것이 효율적일 것이다

5년 동안 추적한 만성 조현병 환자에서 대사증후군의 예측인자

조재길,윤보현,전봉희,박수희,송제헌,정하란,홍계현,Joe, Jae-Gil,Yoon, Bo-Hyun,Jeon, Bong-Hee,Park, Su-Hee,Song, Je-Heon,Jeong, Ha-Ran,Hong, Kye Hyun 한국정신신체의학회 2016 정신신체의학 Vol.24 No.2

연구목적 본 연구는 대사증후군의 예방과 회복을 위해 5년 동안 추적이 가능한 만성 조현병 환자에서 대사증후군의 변화와 예측인자를 조사하였다. 방 법 2011년부터 2016년까지 추적이 가능하며 동의서에 동의한 107명의 환자가 본 연구에 포함되었다. Revised National Cholesterol Education Program-Adult Treatment Panel III(NCEP-ATP III)를 이용하여 대사증후군을 정의하였다. 결 과 추적 관찰 기간 동안 22명(20.5%)의 환자가 새롭게 대사증후군에 진단되었고 14명(13.1%)는 대사증후군에서 회복되었다. 77명(66.4%)은 변화가 없었다(대사증후군이 있는 환자:34명[31.8%], 대사증후군이 없는 환자 : 37명[34.6%]). 복부둘레와 중성 지방이 대사증후군의 유무가 변화된 환자들에서 중요한 인자였다. 다른 변수를 통제한 다변량 회귀분석에서 여성(OR=2.846, 95% C.I. 1.020-7.942), 1달에 1회 이상 외래 방문(OR=3.155, 95% C.I. 1.188-8.379), 항우울제 병합치료(OR=3.991, 95% C.I. 1.048-15.205)가 대사증후군의 유병률에 유의한 영향을 주었다. 반면에 항정신병 약물의 종류나 용량은 대사증후군의 유병률에 영향을 주지 못했다. 결 론 만성 조현병 환자에서 약제의 변경 및 용량조절보다 증상에서의 회복과 건강한 생활 습관이 대사증후군에 중요하다. Objectives : To investigate changes in, and predictors of, metabolic syndrome(MetS) status over a 5-year period in chronic schizophrenic patients and to identify factors associated with the prevention of or recovery from MetS. Methods : In total, 107 patients, all of whom provided written informed consent, were followed from 2011 to 2016 at Naju National Hospital for this study. MetS was defined according to the revised National Cholesterol Education Program-Adult Treatment Panel III guidelines. Results : During follow-up period, 22(20.5%) patients were newly diagnosed to MetS, 14(13.1%) were disappeared, 77(66.4%) were not changed[MetS : 34(31.8%), No MetS 37(34.6%)]. Common significant factors in the two changed groups were triglyceride and waist circumference, not dose and type of antipsychotic medication. Multiple logistic regression analysis revealed that female gender(odds ratio[OR]=2.846, 95% confidence interval[CI] : 1.020-7.942), attending two or more outpatient visits per month(OR=3.155, 95% CI : 1.188-8.379) and taking antidepressant medication(OR=3.991, 95% CI : 1.048-15.205) were significantly associated with MetS after controlling for other confounding variables. Type and dose of antipsychotic medication were not significantly associated with MetS. Conclusions : Triglyceride and waist circumference were important manageable indicator of MetS. Adoption of a healthy lifestyle is more important than adjusting the dose or type of antipsychotic medication in the treatment of chronic schizophrenia patients with MetS.

입원한 남성과 여성 알코올 의존 환자간의 임상적 특징 및 기질 성격 특성의 차이

이상백(Sang Baek Lee),이정식(Jung Sik Lee),송진우(Jin Woo Song),강상범(Sang Bum Kang),김응조(Eung Jo Kim),홍계현(Kye Hyun Hong),조성민(Sung Min Cho),이석진(Suk-Jin Lee),장순우(Soon Woo Chang) 한국중독정신의학회 2010 중독정신의학 Vol.14 No.1

Objective:Although researchers have performed many stu-dies attempting to understand alcoholics’ characteristics, few have conducted direct comparative studies between male and female alcoholics. This study examined the differences in Temperament and Character Inventory (TCI) scores and in clinical characteristics between male and female alcoholics, to discern new treatment possibilities for both groups. Method:Study participants were 55 male and 49 female patients with alcohol dependence. We obtained their demographic data and TCI scores. Additionally, we identified each group’s clinical characteristics from information on their drinking habits and suicidality histories and from the results of administering the Buss-Durkee Hostility Inventory (BDHI), the Acute Physiological and Psychological Response after Drinking, and the Michigan Alcohol Screening Test (MAST-K) to them. Results:Female patients had higher scores on Harm-Avoidance (HA) and lower scores on Reward-Dependence (RD) and Cooperative (CO) as compared to male patients. Male alcoholics had earlier ages of drinking onset and higher scores on Anger Control. Female alcoholics tended to have more suicidal thoughts and attempts. In the presence of a positive familial history, female alcoholics had higher scores on Spontaneous Aggression and lower scores on Novelty-Seeking (NS) and Reward-Dependence (RD) than did male alcoholics. Conclusion:These results suggest that male alcoholics tend to have more biological traits than female patients have and that female patients have more Editor’s note re highlight: Please clarify. Some information seems to be missing here. psychological problems than male patients have. These differences between male and female alcoholics should be incorporated into treatment processes for patients with alcohol dependence.

한국어판 소아청소년 기질성격검사의 신뢰도 및 타당도 연구

하지현 ( Jee Hyun Ha ),유희정 ( Hee Jeong Yoo ),조인희 ( In Hee Cho ),류인균 ( In Kyoon Lyoo ),신재공 ( Jae Gong Shin ),김지현 ( Ji Hyeon Kim ),홍계현 ( Kye Hyun Hong ),최소현 ( So Hyun Choi ) 한국정신병리진단분류학회 2005 精神病理學 Vol.14 No.1

Objectives: The purpose of this study is to evaluate the reliability and validity of the Junior Temperament and Character Inventory(JTCI), which is a child and adolescent version of Temperament and Character Inventory. Method: JTCI was translated to Korean and applied to 796 children(male=402, female=394, age=11.0±0.9), and their parents. Internal consistency was calculated by Cronbach`s α. A test-retest study was done after 3 months with 115 subjects. Factor analysis for the temperament and character factors were performed using principal component analysis, rotating factor varimax. Results: Cronbach`s α values of the JTCI scales ranged from .52 to .77 for the temperament scales except persistence(.09), and from .47 to .65 for the character scales. Test-retest correlation was relatively low. Factor analysis of temperament showed 3 factors out of 4 temperament scales, but couldn`t extract clear differentiations in character dimension. Intercorrelation between 7 factors were clear each other significantly. Female showed higher reward dependence, persistence, self-directedenss and cooperativeness than male. Discussion: Although reliability is relatively low, this study suggests JTCI is a useful tool to evaluate biosocial model of personality in children population. Character dimension should be assessed with the careful consideration of their development.

여성 알코올 의존 입원환자의 음주 양상 및 기질 성격 특성

이상백(Sang-Baek Lee),이정식(Jung-Sik Lee),송진우(Jin-Woo Song),강상범(Sang-Bum Kang),김응조(Eung-Jo Kim),홍계현(Kye-Hyun Hong),조성민(Sung-Min Cho),이석진(Suk-Jin Lee),장순우(Soon-Woo Chang) 한국중독정신의학회 2009 중독정신의학 Vol.13 No.1

Objective:This study examined the temperament and character inventory (TCI) scores as well as demographic and clinical data of female alcoholic patients, in order to discern new treatment possibilities for them. Methods:Forty-three female patients with alcohol dependence and thirty-two female social drinkers were included in this study. Female patients were divided into subgroups with positive and negative family histories. The presence or absence of drinking problems in the hus-band was also recorded. The demographic data and the TCI scores of groups were obtained. The clinical characteristics of each group were identified by obtaining information about drinking habits and childhood victimization histories, and by administer-ing the Beck Depression Inventory (K-BDI), State-trait Anxiety Inventory (STAI), Buss-Durkee Hostility Inventory (BDHI), Acute Physiological and Psychological Response after Drinking, and the Michigan Alcohol Screening Test (MAST-K). Results:Higher scores of Self-Transcendence (ST) and lower scores of Self-Directedness (SD) were shown in female patients compared to normal controls. Female alcoholics had higher scores on the BDI and STAI, and tended to have more suicidal thoughts and attempts. They also showed higher rates of childhood victimization experiences such as physical abuse. Conclusion:TCI profiles of the female alcoholic patients compared with normal healthy subjects reflected common comorbid psychiatric conditions such as depression, anxiety disorder, and personality dis-order. The evaluation of childhood traumatic experience and suicidal risk should be included in the treatment process for fe-male alcoholics.