조현병과 치유환경

이해경,이명수,노재성,Lee, Hae Kyung,Lee, Myung Soo,Noh, Jai Sung 대한생물정신의학회 2015 생물정신의학 Vol.22 No.3

Treatment of schizophrenia is one of the most challenging areas in the field of psychiatry. There has been much improvement in psycho-pharmacotherapy, and at present, psycho-pharmacotherapy along with milieu therapy and social rehabilitation is the standard first-line treatment for schizophrenia. Healing environment, a concept which has arisen from the architectural field, has similarities in meaning to milieu therapy in psychiatry. In other words, healing environment may be an encountering point between psychiatry and architecture. In this encountering, each field can understand each other and expand its concept to aid the treatment of schizophrenia and to plan the build-up of the entire environment considering its social and psychological effects. In this paper, we aim to establish the basic concept of healing environment to alleviate the psychopathologies in schizophrenic patients. We worked under the premise that physical setting affects human behavior and mind, and that physical setting should play a role as a medium with therapeutic potential for patients with medical problems. The aims of this paper are as follows. First, theoretical discussion of the concept and the constructs of healing environment : second, understanding of the schizophrenic symptoms that may be affected by supporting environment : and third, discussion of supporting environment that may alleviate the symptoms of schizophrenia.

Clozapine에 의한 심근염 1예

조우동,최병주,노재성,Jo, Woo-Dong,Choi, Byoung-Joo,Noh, Jai-Sung 대한생물정신의학회 2012 생물정신의학 Vol.19 No.3

Clozapine is an atypical antipsychotic agent that is more effective than the typical neuroleptics in the treatment of refractory schizophrenia. Recently, there has been an increased recognition of the association of clozapine with myocarditis and cardiomyopathy. Commonly used diagnostic tests have limited sensitivity in diagnosing this potentially life-threatening complication. Here we report a case of 36-year-old male patient who developed fever, tachycardia, and dyspnea after introduction of clozapine. By clinical evaluation and laboratory test we diagnosed the patient with myocarditis and treated him successfully. To our knowledge this is the first case report of clozapine-induced myocarditis in Korea.

일반 여자 대학생 군에서의 공황발작의 특성 및 증상의 요인 분석

고정선(Jung Seoun Ko),노재성(Jai Sung Noh),신광철(Kwang Cheol Shin) 한국정신병리진단분류학회 1995 精神病理學 Vol.4 No.1

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한국 지역사회 노인의 사회적 활동과 인지기능의 연관성

조우동(Woodong Jo),손상준(Sang Joon Son),이윤환(Yunhwan Lee),백종환(Joung Hwan Back),노재성(Jai Sung Noh),고상현(Sang Hyun Koh),김현정(Hyun Chung Kim),김진주(Jinju Kim),박미애(Mi Ae Park),홍창형(Chang Hyung Hong) 대한노인정신의학회 2012 노인정신의학 Vol.16 No.1

Objectives:Among non-pharmaceutical measures for preventing cognitive impairment, involving in social activities is known to be very effective. We tried to examine the correlation between social activity and cognitive function. Methods:This study was based on the Suwon Project, a cohort comprising of non-random convenience samples of ethnic Koreans aged 60 years and above. All the subjects completed the study questionnaire which included demographic characteristics, current and past history of illnesses, drug history, Korean version of Mini Mental State Examination (K-MMSE), Korean version of Short Form Geriatric Depression Scale, and Beck Anxiety Inventory. We checked the time consumed in each 9 social activities through the checklist. Results:On multiple logistic regression analysis, the total time spent in social activities wasinversely associated with the K-MMSE score after adjusting confounding variables like age, sex, education level, depression, anxiety and vascular risk factor (β= -0.041, p=0.024). On the other hand, correlation was found between K-MMSE score and time spent in participating in religious party (β=0.053, p=0.003) as well as time spent in elder’s university (β=0.040, p=0.025) after adjustingage, sex, education, depression, anxiety and vascular risk factor. Conclusion:Our results suggest that involving in quality social activities might be more effective in improving cognitive function than spending longer total time in any social activity.

독일 정신보건의료서비스체계에 관한 연구

문하늬 ( Ha Ni Moon ),노재성 ( Jai Sung Noh ),채철균 ( Choul Guun Chai ) 한국의료복지건축학회 2014 의료·복지 건축 Vol.20 No.3

Purpose: Mental health facilities are facing a new social environment. To provide appropriate patient care environment, mental health and mental healthcare is changing the paradigm. In this situation, this study research and analysis mental healthcare service system and mental healthcare facility in Germany. The reason is that Germany has cosistently been building mental healthcare service system and mental healthcare facility for patient. Therefore, it aims to suggest a fundamental resource for amental healthcare service system and mental healthcare facility for mental healtn. Methods: This study was conducted literature researches and field studies. Literature researches for mental healthcare service system and facilities. Field study is to identify the characteristic and configuration of mental healtncare facilities. Results: Findings of this study can be summerrized inth three points. First, In Germany, Mental healthcare facility is critical environment in the community. And, the facilities are being turned into reasonable and alternative environment. Second, Facilities of Mental healthcare and service system designed by various level and configurations that can be providing places for people with mental problems. Third, Mental healthcare facilities consist of healing environment for patient. Implications: The future study on finding of the specific environment planning citeria in mental healthcare facility on the basis of findings of present study.

노인에서 주관적으로 지각한 신체 및 정신건강수준이 인지감퇴에 미치는 영향

권윤영(Yunyoung Kwon),손상준(Sang Joon Son),이윤환(Yunhwan Lee),백종환(Jong Hwan Back),노재성(Jai Sung Noh),고상현(Sang Hyun Koh),김현정(Hyun Chung Kim),김진주(Jinju Kim),박미애(Mi Ae Park),홍창형(Chang Hyung Hong) 대한노인정신의학회 2013 노인정신의학 Vol.17 No.1

Objectives:The aim of this study was to describe subjective physical and mental health assessed by the single item self-rated physical health (SRPH), and self-rated mental health (SRMH) had influence on the cognitive decline in community-dwelling elderly. Methods:This study was based on the Suwon Project, a cohort comprising of non-random convenience samples of ethnic Koreans aged 60 years and above. 1,356 individuals were assessed at 2 time points 2 years apart for questionnaire which included demographic characteristics, medical history, Korean Mini-Mental State Examination (K-MMSE), Korean version of Geriatric Depression Scale (SGDS-K), SRPH, and SRMH. Multiple logistic regression was used to assess K-MMSE score change from the SRPH, and SRMH. Results:At baseline, both SRPH (β=0.18, p<0.01) and SRMH (β=0.19, p<0.01) score positively associated with the K-MMSE score. At follow-up, subjects with baseline lower SRMH score had significantly greater decline in K-MMSE score (β=0.09, p=0.007). However, baseline SRPH score showed no effect to follow up K-MMSE score before and after adjusting age, sex, education, number of chronic disease, SGDS-K, and baseline K-MMSE score (p=0.89). Conclusion:Brief and easily collected subjective mental health may predict the risk of cognitive decline, but subjective physical health may not.

종합병원 외래진료부문 정신건강의학과의 공간구성 및 이용현황에 관한 연구

문하늬 ( Ha Ni Moon ),노재성 ( Jai Sung Noh ),채철균 ( Choul Gyun Chai ) 한국의료복지건축학회 2015 의료·복지 건축 Vol.21 No.1

Purpose : This study examined the social and environmental change in the outpatient department of psychiatry, were analyzed disease characteristics and using characteristics of the mental illness. Thus, this aims to provide a material that can be used for efficient spatial composition of psychiatry. Methods : This study was conducted through a literature review, observation surveys, interviews. Results : Psychiatry is aware of the need to respond to the current needs of ambulatory space, there are concerns that the spatial configuration for your needs. In accordance with the results of studies conducted are as follows: 1) Specialty care programs and space needs based on segmentation and specialization of the disease 2) Considered in conjunction with the layout of essential space and other departments 3) Spatial composition and furnishings for characteristic of psychiatry 4) Spatial configuration taking into account the patient``s characteristic. Implications : This study looked at the change of social change and the environment related to psychiatry. Grasp the present state of spatial composition in psychiatry. And the use characteristics of patients and guardians were investigated. Meanwhile, studies of psychiatric outpatient department is still lacking. As a result, its significance is to analyze the spatial composition requirements.

지역사회 노인에서의 머리둘레와 인지기능의 연관성

백혜원(Hye Won Baek),손상준(Sang Joon Son),이강수(Kang-Soo Lee),김현정(Hyun Jung Kim),장기중(Ki Jung Chang),노현웅(Hyun Woong Roh),이윤환(Yunhwan Lee),백종환(Jong Hwan Back),노재성(Jai Sung Noh),정영기(Young Ki Chung),임기영(Ki Young 대한노인정신의학회 2014 노인정신의학 Vol.18 No.2

Objective:Head circumference (HC) has been reported to be an index of cognitive functioning in the elderly and in Alzheimer’s patients. The object of the study is to find the relationship between HC and cognition. Methods:A total of 7,603 subjects over 60 years of age were analyzed from preliminary data of Gwangju Dementia and Mild Cognitive Impairment Study. HC was manually measured and cognitive functioning was assessed by the Korean version of the Mini Mental State Examination (K-MMSE). Results:Correlational analysis showed that HC was associated with age (r=-0.14, p<0.01), education (r=0.33, p<0.01), height (r=0.26, p<0.01), and K-MMSE (r=0.28, p<0.01). Also, even after adjusting for confounding variables (age, education, height, gender) the positive association between HC and K-MMSE score remained significant (β=0.18, p<0.001). Conclusion:The results suggest that HC may play an important role in predicting cognitive impairment in the elderly.

[프로젝트 리포트] 정신건강증진환경디자인

채철균(Chai, Choul-Gyun),이해경(Lee, Hae-Kyung),노재성(Noh, Jai-Sung) 대한건축학회 2013 建築 Vol.57 No.11

1인 가구의 연령계층별 자살 생각 비교연구

송나경(Na Kyoung Song),박향경(Hyang Kyung Park),노재성(Jai Sung Noh) 연세대학교 사회복지연구소 2019 한국사회복지조사연구 Vol.61 No.-

본 연구는 1인 가구 형태에 주목하여 연령에 따라 청년, 중ㆍ장년, 노년층으로 집단을 나누고, 집단별 자살 생각에 영향을 미치는 요인에 대해 파악하고자 하였다. 연구 분석을 위해 2017년 지역사회 건강조사 자료를 활용하였다. 연구결과, 혼자 사는 청년보다 중ㆍ장년과 노년의 자살 생각 경험비율이 높은 것으로 나타나 연령계층에 따라 자살 생각에 차이가 있으며, 연령계층별 자살 생각 영향요인도 다른 것으로 나타났다. 연령집단에 따라 공통으로 자살 생각에 가장 큰 예측력을 갖는 변수는 우울감, 일상생활 스트레스, 주관적 건강 순으로 나타났다. 청년 1인 가구에서는 공통요인을 제외하고 걷기운동 빈도가 자살 생각과 연관이 있었다. 중ㆍ장년 1인 가구의 경우 배우자, 경제적 특성, 흡연, 그리고 사회활동참여 및 가족, 이웃, 친구와의 연락 빈도가 자살 생각에 통계적으로 유의한 영향력이 있었으며, 65세 이상 노년 1인 가구의 경우 소득과 직장 유무의 경제적 특성과 고위험 음주, 걷기운동의 빈도 및 사회활동참여빈도가 유의하게 관련이 있는 것으로 나타났다. 본 연구의 결과를 토대로, 1인 가구의 비율이 점차 증가하고 있는 지금 이들의 정신건강 문제를 해결하고 건강한 삶을 영위할 수 있도록 1인 가구의 연령계층별 특성 및 욕구를 고려한 사회복지 차원의 예방, 관리 대책의 필요성에 대한 함의를 논의하였다. The purpose of this study was to identify the factors affecting the suicidal thoughts of single person households aged 19 and older. Using 2017 Community Health Survey, grouping them into young, middle-aged, and elderly, it analyzed the differences and effects of related variables on suicidal thoughts by age groups. Suicidal thoughts rate of middle-aged and elderly people was higher than that of young adults. Also, according to age group, logistic regression results showed that there were similarities and differences in suicidal thoughts associated factors. Depression, daily life stress, and subjective health were the most significant predictors of suicidal thoughts regardless of the age group. Except the common factors, the frequency of walking exercise was associated with suicidal thoughts for young single-person households. Among middle-aged people in single-person households, spouse, economic status, smoking, participation in social activities and frequency of contact with family, neighbors, and friends were statistically related to suicidal thoughts. In case of the elderly over 65 years old, income, employment status, high risk drinking, the frequency of walking exercise, and the participation in social activities were found to be associated suicidal thoughts. This study finding shed light on single-person household s psychological difficulties. It also discusses social health and welfare policy implications for improving their psychological well-being.