강박증 환자에서의 Mismatch Negativity 이상에 관한 연구

장준환,신경순,손준희,권준수,Jang, Joon-Hwan,Shin, Kyung-Soon,Son, June-Hee,Kwon, Jun-Soo 대한불안의학회 2010 대한불안의학회지 Vol.6 No.1

Objective : Mismatch negativity (MMN) provides an electrophysiological index of an involuntary attention switching process. This study investigated MMN anomalies and their relationship to clinical variables in patients with obsessive-compulsive disorder (OCD). Methods : Study participants were 29 OCD patients and 24 normal controls. We used a 128-channel EEG to measure MMN during a passive oddball paradigm. Then we assessed the correlations between MMN amplitudes and clinical measures. Results : The OCD patients exhibited significantly greater MMN amplitude compared to the controls. Also, the right frontal lobe MMN amplitudes correlated significantly to the OCD patients' Yale-Brown Obsessive Compulsive Scale total scores (r=-0.520, p=0.005). Conclusion : These results suggest that MMN anomalies in OCD patients reflect a monitoring circuit dysfunction, raising the possibility that the OCD's pathophysiology includes glutamatergic dysfunction.

강박장애 환자에서의 안와전두피질 용적의 2년 추적 연구

김성년,강도형,유소영,노규식,장준환,최정석,하태현,권준수,Kim, Sung-Nyun,Kang, Do-Hyung,Yoo, So-Young,Roh, Kyu-Sik,Chang, Joon-Hwan,Choi, Jung-Seok,Ha, Tae-Hyon,Kwon, Jun-Soo 대한불안의학회 2006 대한불안의학회지 Vol.2 No.2

Objective : This study was designed to examine the volumetric abnormality of orbitofrontal cortex (OFC) and its change after 2 years of pharmacotherapy in obsessive compulsive disorder (OCD) patients. Method : Volumetric magnetic resonance imaging studies were conducted in 15 OCD patients and 13 normal volunteers. For 2 years, all patients took at least one serotonin reuptake inhibitor and atypical antipsychotics were used as an augmentation therapy in most patients. The follow-up MRI studies were conducted after the pharmacotherapy and OFC volumes were measured by the manual region of interest method. Results : Bilateral OFC volumes of 15 OCD patients were significantly greater than those of the normal volunteers before the treatment. After 2 years of the treatment, significant decrease was observed in bilateral OFC volumes of OCD patients to the extent that left OFC volume of OCD patients was not different from that of the normal volunteers. Conclusion : This finding suggests that OFC is directly related to the pathophysiology of obsessive compulsive disorder.

강박장애 환자에서의 성격 5요인 모델 분석

허민정,변민수,김성년,김의태,장준환,권준수,Huh, Min Jung,Byun, Min Soo,Kim, Sung Nyun,Kim, Euitae,Jang, Joon Hwan,Kwon, Jun Soo 대한불안의학회 2012 대한불안의학회지 Vol.8 No.2

Objective : The aim of this study is to evaluate the five-factor model of personality in patients with obsessive-compulsive disorder (OCD) related to obsessive-compulsive symptom severity and the distinct symptom subgroups. Methods : We recruited 95 patients with OCD and 116 normal controls in the study. We used the short version of Revised NEO Personality Inventory and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) for the assessment. Results : Patients with OCD showed significantly higher scores in neuroticism than normal controls. On multiple linear regression analysis, we found that agreeableness and conscientiousness were associated with the total Y-BOCS scores. On subscale analysis, agreeableness and neuroticism were associated with the obsession subscale scores and only conscientiousness was associated with the compulsion subscale scores. Furthermore, we found that patients who have contamination/cleaning or symmetry/ordering/counting/arranging as a main symptom presentation had significantly higher mean scores in conscientiousness than patients who have harm due to injury/violence/aggression as a main symptom presentation. Conclusion : In this study, we found that specific personality factors are associated with the obsessive-compulsive symptom severity. In addition, this is the first study to investigate the relationship between the personality factors in the five-factor model and the distinct symptom subgroups in OCD.

병적 도박 환자에서의 회백질 부피 변화 분석 : 화소 기반 형태분석 방법을 이용한 예비 연구

최정석,신영철,정위훈,정명훈,장준환,강도형,최치훈,권준수,이준영,Choi, Jung-Seok,Shin, Young-Chul,Jung, Wi Hoon,Jung, Myung Hun,Jang, Joon Hwan,Kang, Do-Hyung,Choi, Chi-Hoon,Kwon, Jun Soo,Lee, Jun-Young 대한생물정신의학회 2009 생물정신의학 Vol.16 No.3

Objectives : The purpose of this study was to examine structural abnormalities of brain in patients with pathological gambling(PG) using voxel-based morphometry. Methods : We compared gray matter(GM) volumes between 10 patients with PG and 14 age- and IQ-matched healthy controls and examined the relationship of GM volumes with clinical variables in patients with PG. Results : We found significant increase of GM volume in the superior, middle, and inferior frontal gyri, the midbrain, the middle temporal gyrus, the precuneus, and the fusiform gyrus of patients with PG. A significant decrease of GM volume was observed in the parahippocampal gyrus and the lingual gyrus of the patient group. In addition, GM volumes in some of these regions were positively associated with South Oaks Gambling Screen score and negatively with age of onset in patients with PG. Conclusion : Current findings indicate that structural abnormalities in the fronto-temporal cortex, the midbrain, and the precuneus might be involved in the pathophysiology of PG, and contribute to some of the behavioral changes observed in patients with PG.

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.

뇌과학의 발전과 형법적 패러다임 전환에 관한 연구(II)

탁희성(Tak Hee Sung),이인영(Lee In Young),권준수(Kwon Jun Soo),강도형(Kang Do Hyung),장준환(Jang Joon Hwan),박상옥 한국형사법무정책연구원 2014 형사정책연구원 연구총서 Vol.- No.-

음성 증상이 주된 조현병 환자에서 Aripiprazole의 효과에 대한 52주의 전향적 연구

김혜수,김성년,장준환,권준수 대한생물치료정신의학회 2011 생물치료정신의학 Vol.17 No.2

p<.0001), and 41.03% of patients appeared to respond according to CGI-I. Conclusion:Aripiprazole may be as much efficacious against negative symptoms as positive symptoms in schizophrenia. This suggests the possibility clinicians can consider aripiprazole as a drug of choice in the chronic schizophrenic patients with prominent negative symptoms before trying switching other antipsychotics with clozapine. 본 연구는 aripiprazole이 만성 조현병 환자의 선택 약제로 사용될 수 있는 작은 가능성을 제시하였다고 평가할 수 있겠다. 많은 종류의 항정신병약물이 조현병의 치료를 위해 쓰여지고 있는 현 상황에서, 병의 경과 상 다양한 시점에 놓인 각각의 환자군에 대한 보다 많은 종류의 항정신병약물 효과에 대한 비교 연구가 축적된다면, 임상의사의 약물 선택에 대한 시행착오가 지금보다는 줄어들 수 있을 것이다. Objectives:This study was done to evaluate the efficacy of aripiprazole in the schizophrenic patients with prominent negative symptoms. Methods:This study was a prospective, multicenter, single-group, 52-week open study of patients with schizophrenia, schizophreniform disorder and schizoaffective disorder. A total of 300 Korean patients participated in the study. Among them, 39 patients with prominent negative symptoms were initially administered 15mg/day of aripiprazole for the first 2 weeks, and then treated with 10-30mg/day. The efficacy measures included the Positive and Negative Syndrome Scale(PANSS) total, positive and negative subscale scores, the Clinical Global Impression-Severity of Illness(CGI-S), and the CGI-Global improvements(CGI-I). Results:The significant improvements were observed in all 3 PANSS parameters total(-35.72 p<.0001), positive subscale(-7.41 p<.0001), and negative subscale scores(-11.56 p<.0001). The difference between positive and negative subscale scores was significantly decreased from baseline to week 52. CGI-S was also decreased (-1.67

최근 발병한 정신분열병 환자의 증상 관해 및 정신사회적 기능 : 1년 전향적 추적 관찰 연구

정석훈,박원명,권준수,박지홍,안준호,고진경,김창윤 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.5

Objectives : The long-term outcome of schizophrenia is still considered vahable and inconclusive. We perfonned a one-year prospective observational study to investigate the longitudinal outcomes in patients with recent-onset schizophrenia. The primary purpose was to determine the descriptive outcomes in tenns of symptom remission and psychosocial function. The secondary purpose was to identify predictor variables associated with the outcomes. Methods : Patients experiencing their first episode ofpsychosis or hospitalization within the past 2 years with a diagnosis of DSM-IV schizophrenia were included. Clinical symptoms were assessed monthly using Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS) and Clinical Global Impression (CGI) scale. Psychosocial function was measured using PSYCH-UP (Psychosocial symptoms you currently have, follow-up version) and Heinrichs' Quality of Life Scale (QLS) at baseline, 6, and 12 months and Global Assessment of Functioning (GAF) monthly. Remission was defined on the basis of overall, and psychotic core symptoms as having 1) BPRS total score ≤ 36, and 2) Each individual item score of core psychotic items (conceptual disorganization, suspiciousness, hal-lucinatory behavior, unusual thought content) ≤3, and 3) CGI severity score ≤3, and 4) Duration of remission at least for 2 consecutive months. To identify the predictive variables for the outcome, relationships between time to remission and various clinical variables were examined using Cox proportional hazards model. Results : A total of 49 patients with schizophrenia were enrolled in this study. The proportions of patients with symptom re-mission were 54.5% (24/44, drop outs=5) at 3 months, 55.3% (21/38, drop outs=11) at 6 months, and 64.3% (18/28, drop outs=21) at 12 months. Mean time to remission was 3.76±2.43 (s.d.) months, and the mean duration of remission was 7.54±2.99 months. Significantly longer time to remission was predicted by higher SANS total score at baseline in various predictor variables (p=0.01). Impairments of psychosocial function measured using PSYCH-UP and QOL were significantly improved at the end of this study, but still remained at mild to moderate level. SANS total score and GAF score significantly correlated with most ofthe items related to psychosocial fimction at 12 months. The proportion of the patients with GAF score ≥60 increased from 6.1% at baseline to 85.8% at 12 months. Of the patients who were in remission at 12 months, 95.5% obtained GAF score ≥60. Conclusion : This study showed 64.3% of symptom remission rate in patients with recent-onset schizophrenia. Symptom re-mission was accompanied by significant improvement ofglobal function. The severity of negative symptom at baseline appeared to be a significant predictor for time to remission. Psychosocial function was improved at the end of this study, but impainnents still remained at mild to moderate level. GAF score and negative symptoms significantly correlated with psychosocial function.