새로운 우울증 치료 약물

정희정,문은수,Jeong, Hee Jeong,Moon, Eunsoo 대한생물정신의학회 2016 생물정신의학 Vol.23 No.1

Development of various antidepressants such as monoamine oxidase inhibitors, tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, and noradrenergic and specific serotonergic antidepressant has led to a tremendous progression of pharmaceutical treatment for depression, but still there are some limitations of current antidepressants, such as treatment-resistant depression and delayed onset of antidepressants. The pathogenesis of depression is unclear because depression is a heterogeneous disease state, and the mechanisms of antidepressants remain uncertain as well. Nevertheless, in an attempt to develop novel antidepressants, some trials have been conducted based on the potential biological mechanism discovered in the numerous research results. This review will provide information about the potential novel antidepressants and the current states of clinical studies using them. In particular, some potential novel antidepressants anti-inflammatory agents, antioxidants, anticholinergics, modulators of Hypothalamic Pituitary Adrenal Axis, glutamate, and opioid systems, as well as some neuropeptides such as susbstance P, neuropeptide Y, and galanin will be discussed.

우울장애 환자에서 양극성 성향에 따른 문제음주행동 비교

강태욱(Tae Uk Kang),문은수(Eunsoo Moon),박제민(Je Min Park),이병대(Byung Dae Lee),이영민(Young Min Lee),정희정(Hee Jeong Jeong),이정진(Jeong Jin Lee),최윤미(Yoonmi Choi),이덕기(Duk-Ki Lee) 대한생물치료정신의학회 2015 생물치료정신의학 Vol.21 No.1

정신질환 연구에서의 일주기 리듬 측정

김수연(Soo Yeon Kim),문은수(Eunsoo Moon),정희정(Hee Jeong Jeong) 대한생물치료정신의학회 2020 생물치료정신의학 Vol.26 No.3

The circadian rhythms have been gradually important in psychiatric field. Several studies have shown that major psychiatric disorders, such as schizophrenia, bipolar disorders, and dementia, were highly associated with the abnormalities of circadian rhythms. Circadian rhythms might have an influence on the pathogenesis and prognosis of psychiatric disorders. Understanding the impact of circadian rhythms on psychiatric disorders became crucial to psychiatrists. Therefore, this review investigated the types of the circadian rhythms to be used in psychiatric field. The measurement of circadian rhythms were performed by several ways, such as sleep diary, self-reported scales, heart rate, heart rate variability, polysomnography, electroencephalography, actigraphy, melatonin, cortisol. Using these data related to circadian rhythms might be utilized to evaluate the relevance of the pathogenesis in psychiatric disorders and predict the treatment response and prognosis of illness. Furthermore, if the real-time monitoring of circadian rhythms is possible, the novel diagnostic and therapeutic model using circadian rhythms could be applied in psychiatric area.

양극성장애와 조현병 환자의 분노대응 방식 비교

권민정(Min Jung Kwon),문은수(Eunsoo Moon),박제민(Je Min Park),이병대(Byung Dae Lee),이영민(Young Min Lee),이재민(Jae Min Lee),김정범(Jung Bum Kim) 대한생물치료정신의학회 2012 생물치료정신의학 Vol.18 No.2

Objectives:This study aimed to compare anger coping strategies between bipolar I disorder and schizophrenia, and to explore the relationship between impulsivity and anger coping strategies. Methods:Forty three bipolar patients who met DSM-IV criteria for bipolar I disorder and forty three schizophrenia controls who were matched by age and sex were included. Anger coping strategies were measured by Anger Coping Scale(ACS), and the levels of impulsivity were also measured by Barratt Impulsiveness Scale(BIS). Independent t-test was used to compare anger coping strategies between two groups, and analysis of covariance(ANCOVA) to adjust the influence of impulsivity. Results:Score of problem-solving coping strategy was significantly higher in bipolar I disorder than schizophrenia (t=-2.047 p=.044). Problem-solving strategy was negatively correlated with total impulsivity in both bipolar patients and schizophrenic controls(bipolar I disorder r=-.376 p=.013 ; schizophrenia r=-.395 p=.009). There was no significant difference of problem-solving coping strategy between two groups after adjusting impulsivity(F=2.385 p=.126). Conclusion:These results suggested that bipolar I patients have a tendency to use more problem-solving coping strategy for anger situation than schizophrenia, which can be influenced by the level of impulsivity.

우울과 불안이 흉통 환자의 삶의 질에 미치는 영향

신미희,박숙현,이한철,문은수,이혜원,김보원,Shin, Mi Hee,Park, Sook Hyun,Lee, Han Cheol,Moon, Eunsoo,Lee, Hye-Won,Kim, Bo Won 대한불안의학회 2011 대한불안의학회지 Vol.7 No.2

Objectives : There has been substantial evidence that patients with chest pain have depression and anxiety, and show impaired quality of life (QoL). This study aimed to campare the QoL according to types of chest pain and to examine the impact of depression and anxiety on QoL in patients with chest pain. Methods : Forty-seven patients with chest pain were divided into Cardiac-Typical Chest Pain (CTCP, n=22) and Non-Cardiac-Atypical Chest Pain groups (NCACP, n=25) according to the pain characteristics and cardiovascular disease. Patients were assessed for depression using the Beck Depression Inventory (BDI), for anxiety using the State-Trait Anxiety Inventory (STAI), and QoL was assessed using the Korean version of the SmithKlein Beecham 'Quality of Life' Scale (KvSBQOL). Results : Compared with the CTCP group, the NCACP group reported significantly higher anxiety, and lower QoL. There was no significant difference in QoL between the two groups after adjusting for anxiety. The QoL was associated with depression and trait-anxiety in the CTCP group, and with trait-anxiety in the NCACP group. Conclusion : The findings suggest that there are different effects of depression and anxiety on QoL in individuals with CTCP and NCACP. Understanding about these differences can be important in the treatment of patients with chest pain. A large prospective study is needed to confirm these results.

첫 조증 또는 혼재형 삽화로 입원한 양극성 장애 I형 환자의 유지기 치료중단율 및 관련 위험인자

김수연(Soo Yeon Kim),문은수(Eunsoo Moon),박제민(Je Min Park),이병대(Byung Dae Lee),이영민(Young Min Lee),정영인(Young In Chung),하지경(Ji Kyung Ha) 대한생물치료정신의학회 2012 생물치료정신의학 Vol.18 No.2

Objectives:Dropout is one of the important factors that may hinder successful treatment in the maintenance treatment of bipolar disorder. Dropout rates of bipolar patients have been reported in 32-51%, but there are lack of evidences about risk factors of dropout in bipolar I patients with the first manic or mixed episode. The aim of this study was to investigate the dropout rate and risk factors of dropout in bipolar I patients with the first manic or mixed episode. Method:Fifty eight bipolar I patients with the first manic or mixed episode were included in this study. We examined sociodemographic and clinical variables that may be associated with dropout by chart review retrospectively. Dropout for 2 year maintenance treatment was assessed by telephone interview. Cox proportional hazards regression model was used to assess risk factors affecting the time to dropout. Results:Dropout rate for 2 years in the maintenance treatment of bipolar I patients was 49.8%. Lower socioeconomic status, past impulsive behaviors, and lack of familial support for treatment were significantly associated with time to dropout in bipolar I patients. Conclusion:Dropout rates of bipolar patients with the first manic or mixed episode were high, and these were associated with socioeconomic status, impulsivity, and familial support. For the successful treatment of bipolar disorder patients, it is necessary to detect the high risk group of dropout and do psychosocial treatments in order to reduce dropout. Large-scaled, multicenter, and prospective studies are needed to confirm these results in the near future.

정신질환 연구에서의 일주기 리듬 분석

김수연(Soo Yeon Kim),문은수(Eunsoo Moon),정희정(Hee Jeong Jeong) 대한생물치료정신의학회 2021 생물치료정신의학 Vol.27 No.1

In the field of psychiatry, studies on circadian rhythms are increasing. This research trend is based on the emerging evidence on the relationship between circadian rhythm and pathophysiology and prognosis of psychiatric disorders. As performing the research on this area, the difficulty in analyzing large amount of data that are sequentially collected according to time change exists. In order to properly analyze the data in research on the circadian rhythm, it is necessary to effectively apply analysis methods of time series data. Therefore, this review aimed to summarize the analysis methods of circadian rhythms that show time series data. Understanding the analysis method of circadian rhythm will be useful for utilizing clinical data in the form of a time series data in the smart medical field in the future.

성별과 연령에 따른 음주행동 관련 요인

이정진(Jeong Jin Lee),문은수(Eunsoo Moon),박제민(Je Min Park),이병대(Byung Dae Lee),이영민(Young Min Lee),정희정(Hee Jeong Jeong),최윤미(Yoonmi Choi),정영인(Young In Chung) 대한생물치료정신의학회 2014 생물치료정신의학 Vol.20 No.1

Objectives:It is important to examine factors affecting problem drinking to prevent social drinking from proceeding alcohol addiction. As the factors associated with problematic drinking are various according to age and gender, we aimed to investigate whether several clinical factors are associated with drinking behavior according to age and gender in general population. Methods:291 participants without experience of psychiatric diagnosis and treatment were recruited. Problematic drinking behavior was evaluated by Alcohol Use Disorder Identification Test(AUDIT). Depression, bipolarity, anxiety and impulsivity were measured using Beck Depression Inventory(BDI), Bipolar Spectrum Diagnostic Scale(BSDS), State-Trait Anxiety Inventory(STAI) and Barratt impulsiveness scale(BIS), respectively. The authors analyzed the effects of clinical factors on drinking behavior according to age and gender using univariate linear regression. Results:In younger group, there was no correlation between clinical variables and problematic drinking behavior. In middle aged group, however, BSDS total scores were significantly correlated with AUDIT scores(p=.006). Problematic drinking behaviors in middle-aged men were significantly associated with STAI-state(p=.027), total score and mania subscore of BSDS(p=.006 ; p=.001) and BIS(p=.011), but those in middle-aged women were associated with BDI (p=.022), STAI-state and trait(p=.027 ; p=.010), total score and mania subscore of BSDS(p=.031 ; p=.037), as well as depression subscore of BSDS(p=.012). Conclusion:These results suggest that factors associated with problematic drinking are different according to age and gender. Therefore, consideration on difference of gender and age effect on problematic drinking behavior is important to establish strategies for decreasing problematic drinking.

응급실 방문 자살기도자들의 기도 원인, 방법, 정신과적 진단에 대한 다기관 분석

김혜영,김보라,강승걸,김문두,김민혁,김수인,김재민,문은수,안준호,이경욱,이상혁,이승재,정성훈,정영철,정희연,주가원,차보석,하태현,안용민,Kim, Hyeyoung,Kim, Bora,Kang, Seung-Gul,Kim, Moon-Doo,Kim, Min-Hyuk,Kim, Soo In,Kim, Jae Min,Moon, Eunsoo,Ahn, Joon-Ho,Lee, 대한생물정신의학회 2015 생물정신의학 Vol.22 No.4

Objectives To examine direct causes of attempted suicides, methods adopted to commit suicide, and psychiatric diagnoses among suicide attempters in South Korea. Methods A total of 1359 suicide attempters who had visited emergency department of 17 medical centers due to suicide attempt from May 2013 to Nov 2013 were interviewed using semi-structured questionnaires. Results Psychiatric symptoms were the most common cause of suicide attempts (62.2%), followed by interpersonal relationships (24.4%). Women attempted suicide more often for interpersonal reasons, whereas men were more likely to do so for financial and job-related reasons. Half of participants (55.8%) attempted suicide by drug intoxication, which was more prevalent among females and those who had previous history of psychiatric disease or previous suicide attempt. Men were more likely to use more lethal methods such as pesticide poisoning and gas inhalation than women. Pesticide poisoning was also prevalent among the elderly group and the rural population. Near ninety-five percent (94.5%) of participants received a psychiatric diagnosis : the most frequent diagnosis was depressive disorder. Conclusions This is the first nationwide study of cases of attempted suicide. When stratified by age groups, gender, urbanicity, living alone or not, presence of physical illness, previous psychiatric history, and previous suicide attempt, there were significant differences with respect to causes, methods of attempted suicides and psychiatric diagnoses of suicide attempters.

우울장애 환자에서 Bipolar Spectrum Diagnostic Scale의 선별결과에 따른 생활사건 경험 및 주관적 스트레스 인지 비교

천용준(Yong Jun Cheon),강태욱(Tae Uk Kang),문은수(Eunsoo Moon),박제민(Je Min Park),이병대(Byung Dae Lee),이영민(Young Min Lee),정희정(Hee Jeong Jeong),이강윤(Kang Youn Lee),최윤미(Yoonmi Choi),정봉주(Jeong Bong Joo) 대한생물치료정신의학회 2016 생물치료정신의학 Vol.22 No.1

Objectives:There are some evidences that patients with bipolar depression experience more stressful life events than patients with unipolar depression do. However, there is lack of evidence that bipolarity in depressive patients is associated with more frequent and severe stressful life events. The current study is aimed to compare life events and perceived stress according to the Bipolar Spectrum Diagnostic Scale(BSDS) results in depressive patients. Methods:A total of 102 patients who have experienced major depressive episodes were recruited. Two groups with or without positive screening of Bipolar Spectrum Diagnostic Scale(BSDS) were divided. Stress-related factors were measured by the Life Experiences Survey(LES) and Perceived Stress Scale(PSS). Results:Patients with depressive disorders who screened positive on the BSDS showed more life events(p=.006) and higher impact of life events(p=.005) checked on the LES, and higher score on the PSS negative perception subscale(p=.010) than those who screened negative on the BSDS did. After the adjustment of Beck Depression Inventory(BDI), depressive patients with BSDS(+) experienced more life events(p=.019) and higher impact of life events(p=.029) than those with BSDS(-). However, the difference of PSS negative perception subscale between two groups disappeared after adjusting the effects of depressive symptoms. Conclusion:These results suggest that depressive patients with positive screening of BSDS may response to life events in negative ways and feel more stressful. The positive screening of BSDS in depressive patients can affect their trajectories of depression. Further, large scale and prospective studies are needed to clarify these relationships between bipolar spectrum disorder and stress.