뇌의 REM 수면 발생기전

손진욱,Sohn, Jin-Wook 대한수면의학회 1995 수면·정신생리 Vol.2 No.2

The author reviews current knowledge about what REM sleep is and where and how it is generated. REM sleep is the state in which our most vivid dreams occur. REM sleep is identified by the simultaneous presence of a desynchronized cortical EEG, an absence of activity in the antigravity muscles(atonia), and periodic bursts of rapid eye movements. Another characteristic phenomena of REM sleep are the highly synchronized hippocampal EEG of theta frequency and the ponto-geniculo-occipital(PGO) spike. All these phenomena can be explained in terms of changes in neuronal activity. Transection studies have determined that the pons is sufficient for generating REM sleep. Lesion studies have identified a small region in the lateral pontine tegmentum corresponding to lateral portions of the nucleus reticularis pontis oralis(RPO) and the region immediately ventral to the locus coeruleus, which is required for REM sleep. Unit recording studies have found a population of cells within this region that is selectively active in REM sleep. Cholinergic neurons of the giant cell field of pontine tegmentum(ETG), which is 'REM a sleep-on cells', has shown to be critically involved in the generation of REM sleep. Noradrenergic neurons of the locus coeruleus and serotonergic neurons of the dorsal raphe, which are called 'REM sleep-off cells', appear to act in a reciprocal manner to the cholinergic neurons. It is proposed that the periodic cessations of discharge of 'REM sleep-off cells' during REM sleep might be significant for the prevention of the desensitization of receptors of these neurons.

일개(一個) 대학병원(大學病院) 초입원환자(初入院患者)의 불면증(不眠症) 유병률(有病率), 원인(原因) 및 약물처방(藥物處方)에 관한 연구(硏究)

손진욱,이태우,Sohn, Jin-Wook,Lee, Tae-Woo 대한수면의학회 1997 수면·정신생리 Vol.4 No.1

The purpose of this study was to investigate the prevalence, primary causes, and management of insomnia newly admitted patients in a university hospital. Subjects consisted of 168 adult patients (95 men and 73 women, 88 medical and 94 surgical patients) newly admitted to Gyeongsang National University Hospital from September 7 through September 27, 1996. Sleep patterns of all subjects in the usual nights before admission(UN), the previous night to admission(PN), the night on admission(ON), and the 5th night after admission(5N) were investigated using the Korean version of the St. Mary's Hospital Sleep Questionaire. In addition, all insomnia patients and their doctors and nurses in charge were interviewed by psychiatric residents. Additionally, their medical records were reviewed. Prevalence of insomnia were 22.6% in the UN, 42.9% in PN, 51.8% in ON, and 43.5% in 5N. The prevalence of insomnia was significantly increased immediately before and after admission. There were no significant differences in the prevalence of insomnia by age and sex. The most ammon primary causes of insomnia were somatic symptoms and psychological factors in PN, somatic symptoms and noise in ON and 5n. Only 17 (10.1%) of insomnia patients took medicstions for insomnia control(analgesics in 15, hypnotics in 2). These results shorred that the prevalence of insomnia was significantly increased on hospitalization due to somatic symptoms, environmental factors, and psychological factors, but nearly none were adequately managed.

Zolpidem, Triazolam 및 위약이 입원한 정신분열병 환자의 불면에 미치는 영향에 대한 비교연구

박소영,손진욱,Park, So-Young,Sohn, Jin-Wook 대한수면의학회 1997 수면·정신생리 Vol.4 No.2

Zolpidem is a relatively new, short-acting, rapid onset, and nonbenzodiazepine hypnotics. Zolpidem selectively binds to the central benzodiazepine 1 (BZI) receptor subtype. The present study was designed to compare the hypnotic effects of zolpidem (10 mg), triazolam (0.25 mg), and placebo in 22 schizophrenic inpatients. Zolpidem, triazolam, and placebo were administered orally in a randomized, double-blind design. Compared with placebo, zolpidem and triazolam significantly decreased sleep latency (p<0.05), increased total sleep time (p<0.05), and increased improvement of satisfaction of sleep (p<0.05). Zolpidem decreased the number of awakenings significantly in comparison with placebo (p<0.05), but triazolam did not. In addition, both drugs were well tolerated and did not produce severe side effects. These results suggest that zolpidem is effective for transient insomnia of schizophrenic inpatients and zolpidem is superior to triazolam in hypnotic effect.

일 부대 현역 사병들에서 입대 전 인터넷 사용 정도와 정신건강과의 관계

김선미,박철수,손진욱,김봉조,차보석,이철순,Kim, Sun-Mi,Park, Chul-Soo,Sohn, Jin-Wook,Kim, Bong-Jo,Cha, Bo-Seok,Lee, Cheol-Soon 대한불안의학회 2010 대한불안의학회지 Vol.6 No.2

Objective : The purpose of this study was to survey the degree to which people use the Internet prior to joining the army and mental health. Methods : The author assessed Internet addiction and mental health using an Internet addiction diagnostic scale for soldiers and the Symptoms Check-list-90. A total of 508 subjects were included in the final analysis. Collected data were analyzed by independent t-test. Results : The Internet addiction risk group (n=19, 3.7%) had significantly higher mean scores for obsessive-compulsion (t=-2.43, p=0.02) and interpersonal-sensitivity subscales (t=-2.30, p=0.03) than the control group. Conclusion : Internet addiction was related to soldiers' mental health. An assessment focused on internet use would be useful in the evaluation of a person potential adaptation to the military.

조증 및 정신분열병 환자에서 덱사메사손/인슐린-유도성 저혈당 병합검사

성시용,박철수,손진욱,Sung, Si Yong,Park, Chul Soo,Sohn, Jin Wook 대한생물정신의학회 1997 생물정신의학 Vol.4 No.2

Many investigators are trying to elucidate the pathogenesis of psychiatric disorders on the basis of neuroendocrine responses to stimulation or perturbation. Dexamethasone(DEX) suppression has been the most widely utilized as the prototypical challenge test. Dexamethasone suppression test(DST) has proven to be valuable in diagnosing the depressive spectrum disorder. Reported specificity of diagnosis of depression is relatively high, but sensitivity is limited. Some researchers used the combination of dexamethasone and corticotropin releasing hormone(CRH) in order to improve the sensitivity. They reported that combined DEX/CRH test is more sensitive than DST alone. In this study the authors modified the DEX/CRH test, i.e., we administered the insulin instead of CRH. Total subjects were 28(7 normal controls, 10 manic patients, 11 schizophrenic patients). Subjects were taken DEX(1.5mg p.o.) at 11 p.m., insulin 16 hours later(0.1 unit/kg i.v.). Five blood samples for the determination of cortisol and ACTH were serially drawn at 15 minute interval. The results are as followings : 1) The cortisol and ACTH levels of manic subjects increased following insulin administration. Manic subjects showed higher levels of cortisol and ACTH than schizophrenic and normal control subjects. The cortisol and ACTH levels of schizophrenic and normal control subjects did not show gross changes. 2) The sensitivity of the test was lower than that of reported DEX/CRH test.

알코올 의존자의 입원경험

이인선(In-Sun Lee),손진욱(Jin-Wook Sohn),배행자(Hang-Ja Bai) 한국중독정신의학회 2007 중독정신의학 Vol.11 No.1

Purpose:This study was to build up a detailed and structural substantive theory on the alcoholics’ hospital experience. Method:It was selected Creswell’s (2002) exploratory mixed method research design applying qualitative research and quantitative research sequentially, and then integrating two studies into one. In the qualitative research, 17 inpatient alcoholics participated. Qualitative data were collected and analyzed by the method of Strauss and Corbin (1998). In the quantitative study (survey), 172 inpatient alcoholics participated. Quantitative data were ana-lyzed with window’s SPSS 11.0 Version. Results:Through the qualitative research, 327 concepts, 81 subcategories, 23 categories, and a tentative conceptual framework were extracted. The tentative conceptual framework was composed with 23 categories including a core phenomenon (“Bridling”), emotional reactions (“Comfort”, “Bluntness”, “Boiling-Heart”), coping strategies (“Accepting”, “Dwindling”, “Standing-Against”), and de-bridling attitudes as result (“Recovering-Effort”, “Tinkering-Effort”, “Cling-Discharge”, “Depending-Hospital”, “Self-Despairing”). Through the quantitative research, significant factors (interventions and contextual conditions) which influence emotional reactions, coping strategies, and de-bridling attitudes of the inpatient alcoholics were founded. In the last phase of this study, the process of the alcoholics’ hospital experience was constructed. The process showed the steps and courses coming to the various de-bridling attitudes. Expecially the pathway to “recovering-effort”, one of the de-bridling attitudes, is expected to be desirable experience process for alcoholics during their hospitalization.

한국인 집단에서 알코올 의존과 Tryptophan Hydroxylase A218C 유전자 다형성의 연관성

이철순(Cheol-Soon Lee),박철수(Chul-Soo Park),이환철(Hwan-Chul Lee),구준(Joon Gu),손진욱(Jin-Wook Sohn),한규희(Gyu-Hee Hahn),윤혁진(Hyuck-Jin Yoon),김봉조(Bong-Jo Kim) 대한생물치료정신의학회 2006 생물치료정신의학 Vol.12 No.1

목적 : 알코올 의존은 환경적 요인과 생물학적 요인이 복합되어 발생하는 것으로 널리 알려진 질환으로 최근 가족, 쌍생아 및 양자 연구에서 유전적 요인의 중요성이 시사되고 있다. 본 연구는 알코올 의존의 유전적 요인을 찾기 위해 세로토닌 합성 조절 효소인 tryptophan hydroxylase(TPH) A218C 유전자 다형성 빈도를 정상 대조군과 비교하였으며 알코올 의존 환자에서 TPH A218C의 유전자 다형성과 임상적 변인과의 관련성을 알아보고자 하였다. 방법 : DSM-Ⅳ 진단 기준에 부합되는 알코올 의존 환자 162명과 정상 대조군 182명을 대상으로 TPH 유전자 분석을 시행하였다. 알코올 의존 환자에서 TPH 유전자 다형성과 임상적 변인간의 관련성을 알아보기 위해서 알코올 의존 환자들을 대상으로 알코올 의존 척도, 불안 척도, 우울 척도, 강박적 음주 척도를 조사하였다. 결과 : 알코올 의존 환자군에서 정상 대조군에 비하여 AA 유전자형과 A 대립 유전자의 빈도가 높게 나타났다. 유전자형에 따른 평균 발병 연령을 조사한 결과 AA, AC, CC에서 각각 25.8세, 30.5세, 33.6세로 조사되어 AA 유전자형을 가진 환자군에서 유의하게 낮은 발병 연령을 보였다(p<0.001). 또한 AA 유전자형을 가지는 환자군에서 CC 유전자형을 보인 환자군에 비하여 알코올 의존 척도에서 유의하게 높은 값을 가지는 것으로 나타났다(p=0.001). 결론 : TPH A218C 유전자 다형성이 알코올 의존의 원인적 요인으로 작용할 있을 뿐만 아니라 발병 연령 및 증상 심각도와 관련이 있다. 이러한 결과는 조기 발병하고 심각한 알코올 의존과 같은 알코올 의존 아형 분류의 생물학적 근거가 될 수 있다. Objective : Family, twin, and adoption studies have demonstrated that genes play an important role in the development of alcoholism. In this study, we explored the genetic causes of alcohol dependence by comparing the frequency of the tryptophan hydroxylase(TPH) A218C between patients with alcohol dependence and control subjects in Korean population. We also explored the association between TPH A218C polymorphism and clinical characteristics in patients with alcohol dependence. Method : The genotype and allele frequencies of TPH were investigated in 182 normal control and 162 male hospitalized patients who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (DSM-Ⅳ) criteria for alcohol dependence. We conducted clinical assessments using Alcohol Dependence Scale(ADS), Beck Depression Inventory, Beck Anxiety Inventory, and Obsessive-Compulsive Drinking Scale. Results : The frequency of AA genotype and A allele is higher in patients with alcohol dependence than in normal control. Alcoholics with the TPH CC or AC genotypes had a later age of disease onset(mean age of onset, 33.6 and 30.5 years, respectively) than those with the AA genotype(mean age of onset, 25.8 years ; p<0.001). Also we found the TPH AA genotype has a higher score on the Korean version of the ADS than those with CC genotypes(p=0.001). Conclusion : Our results suggest that TPH polymorphism may be a crucial factor in the development of alcohol dependence and may explain, in part, the biological basis for these typologies.

고등학생의 인터넷 중독과 주의력결핍과잉행동장애의 관계

유희정 ( Hee Jeong Yoo ),우성일 ( Sung Il Woo ),김재원 ( Jae Won Kim ),하지현 ( Ji Hyun Ha ),이철순 ( Cheol Soon Lee ),손진욱 ( Jin Wook Sohn ) 한국정신병리진단분류학회 2003 精神病理學 Vol.12 No.1

정신분석적 정신치료에서 한국인이 보이는 전이의 특성

손진욱 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.2

저자는 정통정신분석가에게 정신분석적 정신치료를 받은 경험을 보고하여 이를 바탕으로 정신분석적 정신치료에서 한국인이 보일 수 있는 전이의 특성을 살펴보았다. 저자는 한국인이 보이는 전이의 특성으로 다음을 제시하였다. 1) 의사를 존경의 대상인 권위자로 생각하기 때문에 치료초기부터 긍정적 전이를 보인다. 2) 윗사람에 대한 조심성과 감정표현을 꺼리는 문화적 배경 때문에 전이신경증으로의 발전이 힘들다. 3) 아버지에 대한 양가적 갈등이 치료자에게 전이될 때 공격성은 암묵적, 은유적, 간접적으로 표현되는 경향이 강하다. 이는 한국인의 수동의존형성격과 관련될 것이다. 4) 효라는 사회문화적 장치에 의하여 억압 또는 억제되어 있던 미해결된 외디프스적 갈등이 전이 안에서 재현될 가능성이 있다. The author presented the experience in undergoing psychoanalytic psychotherapy focusing the transference. Characteristics of transference of Koreans in psychoanalytic psychotherapy were suggested as follows. 1) Koreans tend to develop initial positive trnasference because they regard the therapist as the respecting authority. 2) Koreans have difficulty in the development of an intense transference because they would not express their thoughts and feelings freely. 3) Koreans tend to express their aggression or hostility toward the therapist implicitly and indirectly because they are passive-dependent. 4) Suppressed or repressed Oedipal conflict by filial piety might be activated in the transference situation.

정신질환자들의 종교적 믿음, 행위 및 체험

하현봉,박철수,손진욱 大韓神經精神醫學會 1993 신경정신의학 Vol.32 No.6

To study the influences of religion on the psychiatric disorders, the authors examined the differences in religious beliefs, practices, and experiences between 60 psychiatric and 43 surgical patients in the Gyeongsang University Hospital using a modified questionnire developed by Littlewood and Lipsedge. The proportion of individuals having beliefs in the existence of Devil, in God's concern with all that is happening, and that dead persons will return were significantly higher in the psychiatric patients than in the surgical ones. The schizophrenics showed the higher rate of beliefs that dead persons will return and in God's concern with all that is happening, the mood disorders showed the higher rate of beliefs that the Scripture refers to daily events, and the neurotics showed the higher rate of beliefs in God, the Devil, and an after life. The proportion of individuals avoiding prescribed foods or drinks, and praying more than once a week were significantly higher in the psychiatric patients than in the surgical ones. The mood disorders showed the higher tendency to regular religious rite and pray daily. The proportion of individuals that have had a personal religious experience, had received a revelation, had the power to heal, and had experienced that God or the Devil have made them do things were significantly higher in the psychiatric than in the surgical patients. The proportion of individuals that attended specific religious meeting more than three times and have experienced that God or he Devil made them do things were high in the schizophrenics. The religious variables had influence on the occurrence of illnesses as precipitating or reinforcing factors in 18.3% patients, and on the symptom formation in 18.3% of psychiatric patients. These variables also had positive effect on the treatment of illnesses in 13.3%, negative effect in 18.3%. The authors concluded that there are some differences in religious beliefs, practices, and experiences and that individual inquiry and systematic research into this neglected area is very important.