한국의 일 지역 독거노인에서 종교성 및 영성이 우울 및 삶의 질에 미치는 영향

허윤(Yoon Huh),문유선(Yoo Sun Moon),손봉기(Bong Ki Son),이상규(Sang Kyu Lee),이강(Kang Lee),노현진(Hyun Jin Rho),김도훈(Do Hoon Kim) 대한노인정신의학회 2008 노인정신의학 Vol.12 No.2

Objectives : This study tried to investigate the effects of religiosity and spirituality on depression and quality of life in older people. Methods : This study was conducted by selecting 274 solitary elderly people of over 65 years of age living in Chuncheon city. Symptoms of depression were evaluated by SGDS-K (Short Geriatric Depression Scale of Korean version) and quality of life were measured by GQOL-D (Geriatric Quality of Life-Dementia). We used the Duke Religion Index (DUREL) to assess religiosity and spirituality. Results : There was significant correlation between scales of depression (SGDS-K), quality of life (GQOL-D) and the scale of religiosity, spirituality (DUREL) in older people. Depressed people had lower score in GQOL-D than non-depressed. Among the depressed, people believing in a religion had higher score in GQOL-D than people who have no religion. As a result of multiple regression analysis, we came to know that religiosity and spirituality had significant effects on depression and quality of life in elderly. Interestingly, religiosity and spirituality is not related with depression and quality of life in Buddhism, but in Christian and Catholic. Conclusion : Religiosity and spirituality had significant effects on depression and the quality of life in Korean elderly. However, there are different relationships between depression and religiosity, quality of life and religiosity according to different kinds of religion. In the future, more research is needed.

지역사회에 거주하고 있는 노인의 우울증과 삶의 질을 평가하는 도구로 한국판 WHO-5의 유용성

김현지(Hyun Ji Kim),문유선(Yoo Sun Moon),손봉기(Bong Ki Son),이상규(Sang Kyu Lee),노현진(Hyun Jin Rho),김도훈(Do Hoon Kim) 대한노인정신의학회 2010 노인정신의학 Vol.14 No.2

Background and Objectives : Recently the number of geriatric depressed people has been increasing tremendously. Among many factors affecting depression, quality of life seems to be closely related to depression. Thus, a screening tool for assessing both geriatric depression and quality of life is needed. The purpose of this study is to estimate the utility of the Korean version of the WHO-Five Well-Being Index (WHO-5) in evaluating geriatric depression as compared with SGDS-K (Short Geriatric Depression Scale of Korean version) that is being used widely and quality of life. Methods : A sample of 244 subjects over 65-year old living in Yanggu and Inje area in Gangwon Province, Korea were interviewed and responded to scales, including WHO-5, SGDS-K, MMSE-KC (Mini Mental Status Examination in the Korean version of the CERAD assessment packet) and GQOL-D (Geriatric Quality of Life-Dementia). The total score of WHO-5 below 13 indicates low well-being. Results : The WHO-5 inversely correlated with SGDS-K and positively with GQOL-D, but showed no significant correlation with MMSE-KC. The SGDS-K negatively correlated with WHO-5, MMSE-KC, and GQOL-D. Low well-being group (WHO-5 score<13) had lower GQOL-D score (t=1.9698, p<0.05) and higher SGDS-K score (t=1.9798, p<0.05) than high well-being group. In multiple regression analysis, WHO-5 was significantly associated with GQOL-D and SGDS-K (r2=0.29422, p=0.0000). Conclusion : The Korean version of WHO-5 was very useful to evaluate both depressive symptoms and quality of life in the aged dwelling in community.

종교/영성과 정신건강

김도훈(Do Hoon Kim),문유선(Yoo Sun Moon) 대한사회정신의학회 2021 사회정신의학 Vol.26 No.1

종교와 영성에 관한 많은 경험적 증거와 관련 전문가들의 권고가 있음에도 불구하고, 종교와 영성이 임상적 진료과정에 통합되어 실행되는 것은 큰 도전으로 남아 있다. 이와 같은 맥락에서, 종교와 영성에 관한 근거-기반의 실천적 지침(evidence-based guideline)은 정신건강 전문가들이 이를 더 잘 이해하고, 이러한 정보를 임상적 진료 과정에 통합하는데 도움을 줄 것이다. 본 논문은 정신과 진료에 있어서 종교와 영성의 역할에 대한 연구 결과를 고찰하고, 종교/영적 평가를 하는 실용적 방법에 대한 근거-기반 지침 들을 검토하여 치료현장에서 활용하는데 도움을 주고자 한다. Despite the large amount of empirical evidence on religion and spirituality and recommendations of relevant experts, the integration of religion and spirituality into clinical practice remains a major challenge. In this context, evidence-based practice guidelines on religion and spirituality will help mental health professionals understand better and integrate this information into clinical care processes. This paper seeks to evaluate the results of research on the role of religion and spirituality in psychiatric practice, and to examine the evidence-based guidelines for practical evaluation methods of religion/spirituality and help utilize them in the field of treatment.

Silent stroke 환자의 임상적 특징

김도훈(Kim Do-Hoon),문유선(Moon Yoo-Sun) 대한임상노인의학회 2002 대한임상노인의학회지 Vol.3 No.3

연구배경 : Silent stroke은 흔히 노인에게서 많이 발견된다고 보고되고 있다. Silent stroke은 후에 노인성 우울증, 뇌졸증, 혈관성 치매 등의 질병을 일으킬 수 있는 대뇌 혈관병변의 존재를 의미하기 때문에 그 임상적 중요성에 대한 관심이 증가되고 있다. 본 연구는 정상성인을 대상으로 CT 상에서 silent cerebral infarction(SCI)의 빈도와 그 임상적 특징에 대해 조사하고자 한다. 방법 : 1998년 1월부터 2001년 12월까지 한림대학교 부속 춘천성심병원 건강검진실에서 건강진단을 목적으로 방문한 20세 이상의 연령으로서 컴퓨터 단층촬영 (computed tomography; CT) 촬영을 시행한 193명을 연구대상으로 하였다. 모든 연구대상자는 Zung's depression scale (SDS) 과거 고혈압 경력, 담배사용량, 음주량에 대한 조사와 함께 현재 체중, 키, BMI(body mass index), 혈압을 조사하였으며 공복시 혈당 그리고 혈중지질(cholesterol, triglyceride, HDL-C, LDL-C) 검사을 시행하였다. 분석은 SCI가 있는 군과 SCI가 없는 정상 대조군으로 나누어 변수 척도의 특성에 따라 student t 검정 및 χ² 검정을 시행하였고 유의수준은 p<0.05로 하였다. 결과 및 결론 : CT 상에서 SCI가 있는 군은 정상 대조군에 비해서 상대적으로 고 연령이었고, 고혈압 병력이 많았다. 또한 수축기 혈압, 이완기 혈압, 혈중 LDL-C 이 SCI 군에서 의미있게 높았다. 그외 알코올 섭취양, 흡연양, SDS 점수, BMI 등은 양 군간의 차이가 없었다. CT 상의 SCI을 가진 정상군을 장기 추적조사를 통하여 뇌졸중 발생, 인지기능의 변화, 우울증상의 발생율을 조사하는 것이 필요할 것으로 사료된다. Background : It has been reported that silent stroke has been commonly found in the elderly. Silent cerebral infarction (SCI) implicates the possibility of cerebrovascular lesions, which are also suggestive of having risk factors for geriatric depression, decrease in cognitive function, cerebral infarction and vascular dementia. This study investigated prevalence and clinical characteristics of patients with silent cerebral infarctions on brain CT (computed tomography) in normal healthy adults. Method: 193 adults above age of 20 were studies who took health examinations for the regular health screening from 1998 to 2001 in Chuchon Sacred Heart Hospital. All subjects filled out Zung's depression scale (SDS) for the evaluation of depressive symptoms. Past histories of hypertension, smoking, alcohol drinking, and height, body weight, BMI (body mass index), systolic and diastolic blood pressure, fasting blood sugar, serum lipids (cholesterol, triglyceride, LDL-C, HDL-C) were evaluated in all subjects. The subjects were divided into two group (SCI group and normal control group) and student t test or χ² tests were carried out with the significance level of 0.05. Results and Conclusion : SCI on CT were found in relatively old age groups, and hypertension histories were more frequent in SCI group and systolic and diastolic blood pressures were higher in SCI groups. Serum LDL-C levels were higher in SCI group than normal control group. The amount of alcohol drinking, smoking and BMI index were not significantly different between two groups. Normal healthy adults with SCI on CT should be followed up for long period of time to investigate incidence of clinical infarct and depressive symptoms and change in cognitive function.

정상인의 MRI-T2 영상에서 보이는 고음영의 정도와 임상적 변인과 관계성

김도훈(Do Hoon Kim),문유선(Yoo Sun Moon) 대한노인정신의학회 2002 노인정신의학 Vol.6 No.1

연구배경: 뇌영상 술기의 발달로 백질 변화(white matter changes) 등을 포함하는 silent brain lesion 들이 노인군에서 흔히 발견된다고 보고되고 있다. 이러한 silent brain lesion 은 대뇌 혈관의 병변이 존재할 가능성을 의미하기 때문에 후에 노년기 우울증, 인지기능의 저하, 뇌졸중 그리고 혈관성 치매를 일으킬 수 있는 중요한 위험인자로서 제시되고 있다. 본 연구는 정상성인을 대상으로 MRI T2 영상에서 고음영 빈도와 우울증 및 스트레스 지각 등의 심리적 요인을 포함하는 다양한 임상적 특징에 대해 조사하고자 한다. 방 법: 1998년 1월부터 20001년12월까지 한림대학교 부속 춘천성심병원 건강검진실에서 건강진단을 목적으로 방문한 20세 이상의 연령으로서 뇌자기공명(Magnetic resonance imaging;MRI) 촬영을 시행한 89명을 연구대상으로 하였다. MRI에서 나타나는 고음영은 뇌신경 방사선과 전문의가 Fazekas의 분류에 따라 평가를 하였다. 모든 연구대상자는 zung's depression scale (SDS)과 brief encounter psychosocial instrument (BEPSI)를 시행하였다. 과거 고혈압과 당뇨병 경력, 현재 고혈압약 사용유무, 담배사용량, 음주량에 대한 조사와 함께 현재 체중, 키, 체질량지수, 혈압을 조사하였으며 공복시 혈당 그리고 혈중 지질(cholesterol, triglyceride, HDL-C, LDL-C) 검사을 시행하였다. 분석은 MRI 상의 고음영 평가 척도에 따라 대조군(평가점수 0점) 그리고 고음영군을 심한 정도에 따라 두군(고음영군 1-평가점수 1점군;고음영군 2-평가점수 2점 이상군)으로 나누었다. 분석은 이 세군을 대상으로 변수 척도의 특성에 따라 ANOVA 검정(Post Hoc test;Scheffe) 또는 χ2 검정을 시행 하였고 유의수준은 0.05로 하였다. 결 과: 정상인의 MRI T2 영상에서 나타나는 고음영이 있는 군은 상대적으로 고 연령이었고, 수축기 혈압이 높은 경 향이 있었다. 혈중 지질(cholesterol과 triglyceride)은 고음영이 심할수록 대조군 보다 높은 경향은 있지만 통계적 의미는 없었다. 체질량지수, 알코올섭취양, 흡연양 등은 각군간의 차이가 없었다. 결 론: 대뇌 MRI T2 영상에서 보이는 고음영이 있는 군에서 고혈압과 같은 뇌혈관질환의 위험인자가 동반된다면 후에 lacunar infarct 이나 뇌출혈과 같은 뇌졸중을 일으킬 수 있는 뇌졸중전 시기로 간주하여 더욱 적극적인 치료가 필요할 것으로 사료된다. MRI T2 상의 고음영 을 보이는 정상 성인군을 장기 추적조사를 통하여 뇌졸중 발생, 인지기능의 변화, 우울증상의 발생율을 조사하는 것이 필요할 것으로 사료된다. Background:The brain imaging techniques have developed to detect silent brain lesion in healthy elderly, including white matter changes. These silent brain lesions implicate the possibility of brain cerebrovasculopathy, which are also suggestive of having risk factors for geriatric depression, decrease in cognitive function, cerebral infarction and vascular dementia. This study investigated prevalence and clinical characteristics of patients with hyperintesities on MRI (Magnetic Resonance Imaging) T2 image in normal healthy adults. Method:Eighty-nine adults above age of 20 were studies who took health examinations including brain MRI. Hyperintensities on brain MRI were categorized by a neuroradiologist according to Fazekas classification. All subjects filled out Zung’s depression scale (SDS) and Brief Encounter Psychosocial Instrument (BEPSI). Past histories of hypertension and diabetes mellitus, antihypertensive drug medication history, smoking, alcohol drinking, and height, body weight, BMI (body mass index), systolic and diastolic blood pressure, fasting blood sugar, serum lipids (cholesterol, triglyceride, HDL-C, LDL-C) were evaluated in all subjects. The subjects were divided into three group according to the evaluation scores of hyperintensities on MRI (control group with 0 score, hyperintensity 1 group with evaluation score of 1, hyperintesity 2 group with evaluation score of 2 or 3). ANOVA (Post Hoc test;Scheffe) or χ2 tests were carried out in three groups with the significance level of 0.05. Results:Hyperintensities on MRI T2 image were found in relatively old age groups, and systolic blood pressures were higher in these groups. Serum cholesterol and triglycerides were higher in hyperintensity 1 and 2 group than normal control group, but there was no statistical significance. The amount of alcohol drinking and smoking were not significantly different in three groups. Conclusion:Normal healthy subjects with hyperintensities on MRI T2 image in normal healthy people would need to be treated if they have concurrent risk factors of cerebrovascular disease such as hypertension. Normal healthy adults with hyperintensities on MRI should be followed up for long-term to investigate incidence of clinical infarct and depressive symptoms, change in cognitive function.

가정의학과 외래 우울증환자에서 moclobemide의 안전성 및 유효성 평가를 위한 시판후조사

김영식,이근미,김병성,신호철,성은주,이상엽,문유선,송상욱,김철환,선우성,Kim, Young-Sik,Lee, Keun-Mi,Kim, Byung-Sung,Shin, Ho-Cheol,Sung, Eun-Ju,Lee, Sang-Yeoup,Moon, Yoo-Sun,Song, Sang-Wook,Kim, Cheol-Hwan,Sunwoo, Sung 대한임상약리학회 2002 臨床藥理學會誌 Vol.10 No.1

Background : Depression is quite a common disease in primary care however, studies for the safety and effectiveness of antidepressants in primary care setting are rare in Korea. Objectives : This multi-centered post-marketing study was performed to evaluate the safety and effectiveness of Moclobemide and to find out the factors related to the adherence among patients with depression in family practice. Methods : A total of 386 patients were enrolled from July 1999 to January 2000 by twenty family doctors from fifteen family practice centers. They were prescribed Moclobemide and were reevaluated at the 4th, 8th, and l2th week. Evaluation of compliance, safety and effectiveness were performed with pre-made, structured self-reported questionnaires. Evaluation of effectiveness was also performed utilizing self-rating depression scale (SDS). Results : Among 386 patients, safety was evaluated in 310 patients and effectiveness was evaluated in 239 patients. During the first 12 weeks, the number of subjects continuing with Mocclobemide was 136(37.1%). 141 subjects (38.4%) discontinued taking the drug and 90 subjects (24.5%) dropped out at the 12th week. Considering drop-out patients as ineffective cases, overall effectiveness was estimated to be 84.5%. Symptoms improved with time in patients whose follow-up were completed (P<0.01). The SDS score decreased by an average of ${6.8{\pm}9.1(12.2{\pm}19.1%)}$ after 12 weeks(p<0.01). During the study, 33(10.6%) subjects reported adverse events. The most commonly reported adverse events, in descending order, were dizziness(2.3%), headache(1.6%), insomnia(1.3%), facial edema(1.3%), constipation(1.0%), nausea(1.0%) and tremor(1.0%). The main reasons for discontinuing antidepressants were attributed to improvement of symptoms and manifestation of adverse events. Conclusion : The percentage of adherence at 12th week of Moclobemire among patients suffering from depression in the family practice outpatient clinic was shown to be 49%. The antidepressant effect and safety of Moclobemide was relatively superior.

한국의 일 지역 노인에서 종교성이 자살 생각 및 자살 관련 변인에 미치는 영향

김소연(So Yeon Kim),정재훈(Jae Hoon Jung),문유선(Yoo Sun Moon),전광용(Kwang Yong Jeon),김도훈(Do Hoon Kim) 대한노인정신의학회 2014 노인정신의학 Vol.18 No.2

Objective:This study tried to investigate the effects of religiosity on suicide ideation, depression and well-being in older people. Methods:We analyzed data of 455 subjects over 60-year old who responded to Duke Religion Index, Suicidal Ideation Scale, Short Geriatric Depression Scale of Korean version and WHO-Five Well-Being Index. We compared each score of the scales between religious group and non-religious group and tested the moderating effect of religiosity on the relationship between depression and suicide ideation. Results:Only well-being score of religious group was higher than that of non-religious group. Organizational religious activity had moderating effect on the relationship between depression and suicide ideation. The elderly people who frequently participate in organizational religious activity had low suicide ideation level even if they feel depressed. Conclusion:Religiosity can be a protective factor on suicide in elderly people by giving positive effect on well-being and decreasing suicide ideation.

뇌졸중 후 삶의 질에 영향을 미치는 요인

김현철(Hyon Chul Kim),김도훈(Do Hoon Kim),김세주(Se Joo Kim),문유선(Yoo Sun Moon),김홍철(Heung Cheoul Kim) 대한노인정신의학회 2003 노인정신의학 Vol.7 No.1

Objectives:The cerebrovascular diseases including stroke have become prevalent in Korea, ranking first as the cause of death in the aged. The quality of life (QOL) in stroke patients has been studied with growing interest since every aspect of life after stroke is influenced by the sequelae of this illness. This study aimed at 1) describing QOL of stroke patients and 2) identifying predictors of two month QOL after the event in stroke survivors. Method:WHO QOL scale was used to evaluate two month QOL after the stroke in 69 ischemic stroke patients. Data on age at the stroke event, sex, education level, brain MRI (magnetic resonance imaging) findings, symptoms of depression and anxiety, and neurologic disabilities were collected. Analyses were performed to explore the predictors of two month QOL. Results:Stroke survivors with higher number and volume of frontal cortex lesions had lower two month QOL. Also, patients with more severe subcortical gray matter lesions had significantly lower two month QOL. Stroke patients with depression at the event had lower two month QOL than patients without depression. Conclusion:Lesions in frontal cortex and subcortical gray matter hyperintensities on MRI T2 images and depression in acute phase were of paramount importance in predicting two month QOL. Accurate and prompt neurologic and psychiatric interventions are required to improve QOL after stroke.

생쥐의 골격성장과 Ca대사에 미치는 식이Ca과 칼슘조절 호르몬의 영향

정차권(Cha-Kwan Chung),한은경(Eun-Kyung Han),남상명(Sang-Myung Nam),문유선(Yoo-Sun Moon),최수용(Soo-Yong Choi),하경선(Kyung-Sun Ha) 한국식품영양과학회 1999 한국식품영양과학회지 Vol.28 No.3

본 연구는 생체내에서 Ca대사에 미치는 칼슘조절 호르몬과 식이 Ca 수준의 영향을 조사하였다. BALB/c 생쥐를 high Ca, Medium Ca, 그리고 low Ca군으로 나누고 PTH, CT, Vit D 등의 호르몬을 i.p. injection하여 투여하였다. 5주간의 사육후 생쥐는 에테르 마취후 heart puncture에 의해 희생하였다. Femur의 성장율은 low Ca 군보다는 high Ca군에서 약간 높게 나타났으나 통계적 유의성은 없었다. PTH+CT군에서는 평균 femur 성장율이 가장 높았으며, 식이적인 Ca 공급이 충분할수록 성장률이 높은 경향을 보였다. 식이 Ca 수준은 뼈조직내의 무기물 보유에 가장 큰 영향을 끼쳤다. 전반적으로 모든군에서 high Ca은 혈청 Ca 수준을 상승시켰다. 식이 Ca 수준이 낮은 경우 PTH는 뼈로부터 Ca유출을 증가시켜 혈청 Ca 수준을 높여 주는 것으로 나타났고, 이러한 작용은 CT에 의해 억제되는 것으로 보였다. 대조군에 비해 모든 호르몬을 투여한 군에서는 medium 또는 high Ca 공급시 혈청 Ca 증가가 억제되었다. PTH와 Vit D는 식이 Ca 수준에 관계없이 간의 Ca 저장을 억제시켰으나, 식이 Ca 공급이 적을 경우 뼈에서의 Ca 보유를 촉진시키는 것으로 나타났다. 그러나 식이 Ca 공급이 충분시는 반대의 효과를 나타냈다. 식이 Ca 공급이 높을 때보다 식이 Ca 공급이 낮을 때 PTH, Vit D 및 CT이 공동으로 투여되었을 경우는 뼈의 Ca수준이 크게 증가되었다. 이것은 식이적인 Ca 공급이 부적절한 경우에는 적절한 골밀도를 유지하기 위해 생체내에서 이들 호르몬들이 공동으로 협력하는 작용이 존재한다는 것을 시사한다. This study has dealt the effect of Ca-regulating hormones and dietary Ca levels on Ca metabolism. Animals(BALB/c mice) were divided into three dietary groups(high and medium Ca and Ca-free) and hormones including parathyroid hormone(PTH), calcitonin(CT), cholecalciferol(Vit D) were i.p. injected. After feeding experimental diets for five weeks, mice were anaethetized and sacrificed by heart puncture. We found that femur growth of mouse was slightly increased by high dietary Ca without showing statistical significance comparing to low dietary Ca group. The combination of PTH and CT showed the same effect when dietary Ca was high. At the same time, total mineral retention in bone was most affected by dietary Ca. In general, high Ca diet elevated Ca level in the serum. When dietary Ca was low, PTH stimulated Ca release from the bone into the serum, which was shown to be inhibited by CT treatment. Comparing to the control, PTH, Vit D and CT together tended to inhibit serum Ca level at high and medium dietary Ca. PTH and Vit D inhibited Ca reserve in the liver at all dietary levels of Ca. Both PTH and Vit D stimulated bone Ca retention when dietary Ca was low, but this effect was reversed when dietary Ca was high. When PTH, Vit D and CT were administered together, bone Ca level was greatly enhanced at low dietary Ca than at high dietary Ca, which suggests that these hormonal cooperation is needed for proper bone density maintenance especially when dietary minerals are not sufficient.

패션디자인 캐드 시스템의 현황과 미래 : 패션산업에서 디자인 캐드 시스템의 활용사례와 발전적 사용방안

류성훈 ( Sung Hoon Ryu ),최종문 ( Jong Moon Choi ),변유선 ( Yoo Sun Byun ) 한국의류학회 2007 패션정보와 기술 Vol.4 No.-