북한 이탈주민의 외상후 스트레스장애에 대한 3년 추적연구

홍창형,유정자,조영아,엄진섭,구현지,서승원,안은미,민성길,전우택 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.1

Objective : This study is a follow-up of a first survey of 200 North Korean defectors who entered South Korea in 2001. The purpose of this study is to examine changes in the current prevalence of partial PTSD and full PTSD after 3 years and to evaluate related factors. Methods : This study followed up on 151 of the 200 North Korean defectors from our first survey. 20 interviewers conducted face-to-face interviews and assisted defectors in completing a self-report assessment. The traumatic events which participants with chronic PTSD and delayed onset PTSD experienced were then examined. Results : Over the 3 years, the current prevalence rate of partial PTSD was reduced from 31.8% to 5.3%, and the current prevalence rate of full PTSD was reduced from 27.2% to 4.0%. Of particular interest was that 88.8% of those diagnosed with full or partial PTSD in the first survey had recovered after 3 years. Conclusion : The current prevalence rate of partial and full PTSD rapidly decreased during 3 years.

노인인구에서 대사증후군과 인지기능간의 연관성

홍창형,김은아,정해관,이동우,차경렬,이강수,오병훈 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.4

Objective : The purpose of this study is to find out the effect of ApoE genotype in correlation between metabolic syndrome and cognition of the elderly in the community. Methods : A total of 1,305 subjects (440 men and 865 women) aged 60-98 years were analyzed from preliminary data of Gwangju Dementia and MCI Study (GDEMCIS). The metabolic syndrome was assessed as defined by the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). The study questionnaire consisted of demographic characteristics, current and past illness history, drug history, family history of dementia and stroke, and Korean version-Mini Mental State Examination (K-MMSE). We also examined ApoE genotype and analyzed associated factors with metabolic syndrome. Results : Metabolic syndrome was present in 28.6% of the subjects (13.4% of men and 36.3% of women). On multiple logistic regression analysis, low serum HDL cholesterol was associated with an increased risk for cognitive impairment (K-MMSE score≤17) adjusted by age, sex, educational level, and smoking in the presence of ApoE ε 4 allele (OR 0.95, 95% CI 0.92-0.99). Conclusion : These results suggest that serum HDL cholesterol may affect cognitive function in the elderly in the presence of ApoE ε 4 allele.

지역사회 기반의 정신건강 프로그램

홍창형 한국보건행정학회 2016 한국보건행정학회 학술대회 논문집 Vol.2016 No.1

북한이탈주민들의 외상경험과 외상 후 스트레스장애와의 관계

홍창형,전우택,이창호,김동기,한무영,민성길 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : The purpose of this study is to find out the relationship between the traumatic experiences and the prevalence of PTSD among North Korean refugees in South Korea. Methods : Two hundred North Korean refugees in South Korea were voluntarily participated. Researchers conducted face-to-face interviews and assisted defectors in performing a self-report assessment of this survey. The study questionnaire consisted of demographic characteristics, Traumatic Experiences Scale for North Korean Defectors, and PTSD part of the Stmctured Clinical Interview for DSM-III-R Korean version. Results : Prevalence rate of PTSD in defectors was 29.5%, with a higher rate for women. In factor analysis, the 25 items of traumatic events experienced in North Korea were divided into three factors: physical trauma, Political-ideological trauma, and family-related trauma. In addition, the 19 items of traumatic events during defection were grouped into four factors : physical trauma, discovery and capture-related trauma, family-related trauma, and betrayal-related trauma. In multi-factorial logistic regression analysis, family-related trauma in North Korea had a significant odds ratio. Conclusion : Family-related trauma experienced in North Korea is related to the prevalence of PTSD among North Korean refugees in South Korea.

노인 환자에서의 부적절한 약물처방

홍창형,오병훈 대한의사협회 2009 대한의사협회지 Vol.52 No.1

In older people, medicines are considered appropriate when they have an evidence-based indication, are well-tolerated and cost-effective. However, inappropriate prescribing (IP) is a common and significant healthcare problem in elderly people in Korea as well as in the world. IP in old people is highly prevalent but preventable. Screening for IP is highly desirable, since detection and correction are simple and worthwhile. Until now, Beers’ criteria for IP dominate the international literatures, although they have some defects. The 2002 version of Beers’ criteriaindependent of diagnosis includes 48 different categories of either single medications or multiple medications of a similar class identified as IP, and the 2002 version of Beers’ criteria-considering diagnosis contains 19 different categories containing possible drug-disease interaction. Successful approaches to optimizing prescribing have been either educational or administrative. More research specially focused on the IP in the elderly is needed.

전측두엽 치매 증례

홍창형(Chang Hyung Hong),차경렬(Kyung Ryeol Cha),오병훈(Byoung Hoon Oh) 대한노인정신의학회 2003 노인정신의학 Vol.7 No.2

Frontotemporal lobe dementia have been underevaluated because of various clinical features, changing diagnostic criteria, and indifference of clinicians. It is important that frontotemporal lobe dementia patient showing behavioral and lingual problems should be early diagnosed and treated. Because frontotemporal lobe dementia patients often confused with Alzheimer's disease, senile depression, schizophrenia, drug abuse. We have presented a case of frontotemporal lobe dementia. He had typical clinical history and symptoms which deserve to be considered frontotemporal lobe dementia. He showed appropriate findings of frontotemporal lobe dementia in the neuropsychological tests and brain magnetic resonance imaging and single photon emission computed tomography. This case is thought to be helpful for clinicians to give attention to early diagnosis and appropriate treatment of frontotemporal lobe dementia.

한국 전통의약물로부터의 신경정신계 신약개발

민성길,홍창형 대한정신약물학회 2007 대한정신약물학회지 Vol.18 No.1

This paper reviews history of new drug development in Korea as well as the world and researchs on development of new psychotherapeutic drug from traditional medicines or natural products in Korea. Korea has a long history of traditional medicine and accumulated knowledge of natural resources. However, only a few new drug have been developed from those natural products. Now many researchers in Korea are devoting themselves to test the possibility of natural products as antipsychotic drugs, antidepressants, anxiolytic drugs and cognitive enhancers. However, only a few graduates from traditional medical schools in Korea are engaging in research on developing new drug from natural products and they are not familiar to research methods of western medicine and pharmacology. For research and development of new drug from natural products or traditional medicines, many researchers should be trained for methodology of basic medicine, pharmacology, pharmacognosy, and oriential pharmacy. Government and pharmaceutical companies need to provide more investment for R&D for new drug from natural products including establishment of data base for component of traditional medicines and natural products, system development integrating information technology, bio-technology and nanotechnology, and international collaboration with advanced countries which have common interest in new drug development from natural products. 외국 및 국내의 천연물 신약 개발의 역사와 현황과 그리고 신경정신질환을 대상으로 한 국내 천연물 신약 개발 현황에 대해 조사 기술하였다. 현재 우리나라는 오랜 전통의학의 역사와 풍부한 천연물 자원을 가지고 있으나 개발된 천연물신약은 많지 않은 편이다. 국내에서는 최근 한약재 및 전통의학에서 사용되어온 재료 또는 기타 천연물을 이용하여 신경정신질환을 대상으로 한 항불안, 항정신병, 항우울, 항치매 약효의 가능성을 연구 중에 있다. 그러나 한국전통의학을 연구하는 한의대에서 많은 인재를 배출하고 있지만 연구분야에 종사하는 경우가 드물 뿐 아니라 서양의학적 내지 약리학적 연구 방법에도 익숙치 않은 형편이다. 앞으로 한국전통의학에 기반을 둔 천연물 신약개발을 위해서는 서양의학, 약리학, 생약학 및 한약학 등에 익숙한 기초의약학 연구자들이 많이 배출되어야 할 것이다. 특히, 정부와 제약회사는 연구개발에 많은 투자를 해야 하며, 천연물과 한약재의 특성에 대한 데이터베이스 구축뿐 아니라 정보기술(information tech-nology), 생명공학기술(bio-technology), 나노기술(na -notechnology)를 통합할 수 있는 시스템구축과, 한국전통의약물을 이용한 천연물 신약개발에 관심이 있는 선진국과 국제적 협력 교류에도 많은 관심을 가져야 할 것이다.

주요우울장애 노인에 대한 Internet of Things 기반 행동 중재 : 예비연구

한효진,홍창형,김재훈,노현웅,손상준 대한노인정신의학회 2019 노인정신의학 Vol.23 No.1

Objective:To assess the effectiveness of Internet of Things (IoT)-based behavioral intervention for reducing depressive symptom of older adults with major depressive disorder. Methods:A 12-week randomized cross-over controlled study was conducted at community mental health center. We recruited 39 participants with major depressive disorder aged 60 years or older. As a multidomain intervention, four evidence-based therapeutic factors (physical activity, healthy diet, social activity, and emotional regulation) were approached. To maintain motivation of participants, we applied contingency management using IoT device based on operant conditioning theory. Results:The primary outcome was change of depressive symptom measured by Montgomery-Asberg Depression Rating Scale (MADRS). Mixed-effect model compared the effectiveness of intervention and usual care management (intervention by time and period interaction, p=0.017). And during the study period consisting of a total of visit 8, significant group difference was shown in post hoc test at visit 4 (MADRS score of intervention group : MADRS score of control group=7.7±3.4 : 21.1±11.5, p=0.008). Conclusion:Community-implementable IoT-based behavioral intervention resulted in greater reduction of depressive symptom of elderly with major depressive disorder

탈북자들을 통하여 본 북한주민 의식 조사

전우택,홍창형,엄진섭 대한신경정신의학회 2003 신경정신의학 Vol.42 No.5

Objectives:North Korean people’s thought and opinions on their contry, society, and economy were studied through North Korean defectors. Methods:At Hanawon, 163 defectors were surveyed with 2 questionnaires in May 2002. Results:North Koreans believe that socialism it was a right choice for North Korea. Because of the gap between the ideal and economic reality, however admitted sense of frustration. They think that the communist value system and the communal consciousness have been shrinking gradually, and their attitude to South Korea was one of ambivalence. Peoples views are different according to age and institutional education they received. Conclusion:For the day of unification, we suggest the followings. First, South and North Korea should put in more effort for building a common nationalistic consciousness. Second, reasonable criticism against communism and the advantages of alternative systems which are expected to be accepted by North Koreans through education after unification, need to be prepared. Third, the development of psychological conflicts and the frustration of North Korean people after unification are anticipated and their solutions must be saught after. Fourth, continuos studies for the understanding of North Korean people’s psychological characteristics and it’s change is needed.

Tri-phase Data Mining Modeling for Dementia Diagnosis

방선주,손상준,홍창형,신현정 한국경영과학회 2016 한국경영과학회 학술대회논문집 Vol.2016 No.4

환자의 치매 진단을 위해서 환자의 의학정보와 보호자설문조사 및 다양한 의료진 검사로 이루어진 약 480여 개의 진단기준을 사용한다. 의료진의 진단을 보조할 수 있는 예측 모델이 개발된다면 의료진과 환자의 시간 및 경제적 비용, 더 나아가서는 사회적 비용을 줄일 수 있다. 또한, 분야의 특성상 예측 모델의 결과에 대한 설명이 반드시 동반되어야 의미 있는 활용이 가능하다. 본 연구에서는 이를 반영한 세 모듈로 구성된 3상(tri-phase) 데이터마이닝 모델링방법을 제안한다. Proposer Module에서는 진단에 유효한 변수들을 스크리닝하며, Predictor Module에서는 치매를 예측, 진단한다. Descriptor Module에서는 예측 결과를 해석하여 진단 원인과 치매 유형 등을 파악한다. 제안한 모델은 노인임상시험연구센터(CREDOS)에서 구축한 2만 명의 치매환자에 대한 코호트 연구 데이터베이스에 적용되었다.