서울, 천안, 농촌지역 중 고교 학생들의 인터넷 중독에 대한 비교 연구

이석범,이경규,백기청,김현우,Lee, Seok-Bum,Lee, Kyung-Kyu,Paik, Ki-Chung,Kim, Hyun-Woo 한국정신신체의학회 2004 정신신체의학 Vol.12 No.2

연구목적: 인터넷 중독이란 '과도한 인터넷 사용에 의해 현실생활에 어려움을 겪게 되는 경우', '인터넷에 과도한 시간을 사용하거나 현실세계에서의 진정한 인간관계가 가상공간에서의 표면적인 관계로 대치되는 것', '인터넷 사용에 대한 자기조절 능력이 현저히 약하고 사용을 금지할 경우 심리적 혼돈과 무기력에 빠지게 되는 상태' 등으로 정의되는 새로운 형태의 중독 현상을 지칭한다. 본 연구에서는 경제적, 문화적, 지리적 여건이 다른 서울, 천안, 농촌지역 중고교 학생들을 대상으로 인터넷 중독율, 인구학적 변수들, 컴퓨터 사용성향, 불안성향, 우울, 그리고 가상공간을 통한 자기 효능감이 각 지역간에 어떠한 차이가 있는지를 알아보고자 하였다. 방법: 연구대상군은 서울, 천안, 천안근교 농촌 소재의 남녀 중고교생 1718명을 대상으로 하였으며 사회인구학적인 변인에 대한 문항들, the Spielberger State-Trait Anxiety Inventory (STAI)를 김정택이 번안한 한국판 상태-특성 불안척도, Self-Rating Depression Scale (SDS)을 이중훈이 번안한 한국판 자기평가 우울척도, 인터넷 사용 성향을 묻는 문항들, Young, K. S.의 인터넷 중독 진단 척도를 윤재희가 번안하였고 본 연구자가 청소년에 맞게 수정한 인터넷 중독척도, J. W. Henry & R. W. Stone이 개발한 computer self-efficacy and outcome expectancy scale과 Paulhus, Delroy가 개발한 Spheres-of-Control Battery Item을 송원영이 번안, 수정하여 사용한 가상공간 활용에 대한 자기효능감 및 결과기대척도로 구성된 설문지를 해당학교장의 협조를 받아 교실 내에서 학생들이 작성하는 방식으로 연구가 시행되었다. 결과: 연구결과 전체 대상군의 인터넷 중독율은 2.9%였으며 세 지역간에 인터넷 중독율에 있어서 유의한 차이는 발견되지 않았다. 전체 대상군의 경우 농촌이 서울이나 천안에 비하여 높은 불안, 우울정도를 보였고, 서울, 천안, 농촌 순으로 높은 가상공간활용에 대한 자기효능감을 보였으며 천안, 서울, 농촌 순으로 여가생활을 혼자 지내는 비율이 높았으나 중독군 만을 대상으로 하였을 때는 이러한 차이가 없었다. 전체 대상군의 경우 인터넷에 접속하는 장소에 있어서 서울, 천안, 농촌 순으로 가정이 많았으며 인터넷 접속방법에 있어서도 서울, 천안, 농촌 순으로 초고속 인터넷의 사용율이 높았으나 중독군 만을 대상으로 하였을 때는 이러한 차이가 없었다. 인터넷 중독에 대한 인식에 있어서는 전체 대상군의 경우 서울, 천안, 농촌의 순으로 인터넷에 중독되어 있다고 생각하는 비율이 높았으나 중독군 만을 대상으로 하였을 때는 이러한 차이가 없었다. 결론: 이번 연구결과를 보면 인터넷 중독율은 세 지역간에 차이가 없었으며 불안, 우울, 가상공간활용에 대한 자기효능감, 여가형태, 인터넷 접속장소, 인터넷 접속방법, 인터넷 중독에 대한 인식에 있어서 전체 대상군에서는 세 지역간에 차이가 있음에도 불구하고 중독군의 경우에는 이러한 차이가 없어 지역간 중 고교 학생들의 심리적 상태, 여가형태, 인터넷 환경, 인터넷 중독에 대한 인식은 차이가 있으나 인터넷에 중독되면 이러한 차이가 없어지고 비슷한 형태의 중독군을 형성함을 알 수 있었다. Objectives : Internet addiction is a newly appeared addictive phenomenon that is defined as 'difficulty in real life due to internet over-use', 'excessive time spent on the internet or replacement of genuine real relationships with superficial virtual ones' or 'weakness in self-control about internet use and if discontinued, fallen in psychological confusion and anergic state'. This study was aimed to compare the internet addiction rate, demographic factors, computer using patterns, anxiety, depression, and internet self-efficacy and outcome expectancy between Korean middle and high school students in three areas - Seoul, Cheonan, and Rural areas - that were different in economic, cultural, and geographic state. Methods : Subjects are consisted of middle and high school students in Seoul, Chunan, and Rural areas(N=1718). Self-rating questionnaire included demographic data, Korean Spielberger State-Trait Anxiety Inventory, Korean Self-Rating Depression Scale(SDS), questions for internet-using pattern, Korean version of Internet Addiction Scale invented by K. S. Young, Internet Self-efficacy and Out-come Expectancy Scale. Results: In this study, prevalence of internet addiction was 2.9%. There was no significant difference found in prevalence of internet addiction among three areas. In all subjects, there were significant differences in anxiety, depression, internet self-efficacy and outcome expectancy, leisure style, places of internet use, internet connecting method, and insight on internee addiction. But, in addicted group, there was no significant difference among three areas. Conclusion: This study suggested that the difference in economic, cultural, and geographic state was not related to prevalence of internet addiction. Although there were significant differences in anxiety, depression, self-efficacy associated with internee use, leisure style, places of internet use, internet connecting method, insight on internet addiction among three areas, there were no significant difference in addicted group among three areas. So, we concluded that the difference in economic, cultural, and geographic state did not influence the prevalence of internet addiction, and despite the difference in economic, cultural, and geographic state, people in three areas were equally influenced by internet addiction.

알츠하이머병의 최신지견

이정재,이석범,Lee, Jung Jae,Lee, Seok Bum 대한생물정신의학회 2016 생물정신의학 Vol.23 No.2

Alzheimer's disease (AD) is a neurodegenerative disorder in which neuronal loss causes cognitive decline and other neuropsychiatric problems. It can be diagnosed based on history, examination, and appropriate objective assessments, using standard criteria such as the Diagnostic and Statistical Manual of Mental Disorders or the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA). Brain imaging and biomarkers are making progress in the differential diagnoses among the different disorders. The cholinesterase inhibitors, donepezil, rivastigmine and galantamine and N-methyl-D-aspartate receptors antagonist memantine are approved by the US Food and Drug Administration for AD. Recently some acetylcholinesterase inhibitors gained approval for the treatment of severe AD and became available in a higher dose formulation or a patch formulation. Optimal care in AD is multifactorial and it should include early diagnosis and multidisciplinary care with pharmacological and nonpharmacological interventions including exercise interventions, cognitive interventions and maintenance of social networks.

Choline Acetyltransferase 유전자 다형성이 경도인지손상 발현에 미치는 영향

이정재,박준혁,이석범,허윤석,김태희,윤종철,주진형,이동영,박경운,김기웅,Lee, Jung-Jae,Park, Joon-Hyuk,Lee, Seok-Bum,Huh, Yoon-Seok,Kim, Tae-Hui,Youn, Jong-Chul,Jhoo, Jin-Hyeong,Lee, Dong-Young,Park, Koung-Un,Kim, Ki-Woong 대한생물정신의학회 2010 생물정신의학 Vol.17 No.4

Objectives : The potential association between choline acetyltransferase(CHAT) polymorphism and the risk of mild cognitive impairment(MCI) has not been investigated in Korea. We examined the main effect of CHAT polymorphism and its interaction with apolipoprotein E(APOE) polymorphism in the development of MCI in elderly Korean sample. Methods : We analyzed CHAT 2384G > A polymorphism and APOE polymorphism among 149 MCI subjects with MCI and 298 normal controls. We tested the association between MCI and CHAT A allele status using a logistic regression model. In addition, we employed generalized multifactor dimensionality reduction(GMDR) to investigate the interaction between CHAT and APOE with regard to the risk of MCI. Results : The CHAT A allele was associated with AD risk(OR = 1.59, 95% CI = 1.02-2.48, p = 0.042). No significant gene-gene interaction between CHAT and APOE was found in GMDR method(testing balanced accuracy = 0.540, p = 0.055). Conclusion : The CHAT A allele was associated with MCI risk in the Korean elderly. Its interaction with the APOE ${\varepsilon}4$ allele was not significant with regard to the development of MCI.

독거노인의 외로움과 수면의 관계

최유정,이경규,이석범,김경민,김도현,이정재,Choi, Yu Jung,Lee, Kyung Kyu,Lee, Seok Bum,Kim, Kyung Min,Kim, Dohyun,Lee, Jung Jae 한국정신신체의학회 2020 정신신체의학 Vol.28 No.2

연구목적 외로움과 수면의 질 저하는 노인에게서 흔히 나타나는 증상이다. 하지만 우리나라에서 노인의 외로움과 수면의 관계에 대해서는 연구된 바는 거의 없다. 본 연구는 독거노인의 외로움과 수면의 질의 연관성을 보고자 하였다. 방 법 본 연구는 천안 지역에 거주하는 독거노인 1,090명을 대상자로 시행되었다., 훈련된 간호사의 면담과 외로움 척도, 피츠버그 수면의 질 지수(Pittsburgh Sleep Quality Index, PSQI), 인구사회학적 정보, 신체 건강상태(Cumulative illness rating scale, CIRS), 인지기능, 단축형 노인우울척도 등의 자가설문지를 통해 조사하였다. 통계분석은 인구학적 변인과 외로움 척도 간의 관계를 탐색하기 위해 기술적 통계분석을 시행하였으며 외로움과 수면의 질의 연관성을 확인하기 위해 단변량 및 다중회귀분석을 사용하였다. 결 과 외로움군의 평균 PSQI 점수(9.2±4.2)는 정상군(7.3±3.7)에 비해 통계적으로 유의하게 높았다(student-t test, p<0.001). 성별, 기분장애 및 상관분석에서 유의성을 보인 변수를 통제한 다중회귀분석에서 외로움은 전체 PSQI 총점(standardized β=0.065, p=0.025), 수면방해(standardized β=0.086, p=0.005), 수면제 사용(standardized β=0.065, p=0.034)과 유의한 연관성을 보였다. 결 론 외로움은 수면문제와 연관성을 보였으며 이는 독거노인의 수면의 질 저하에 외로움이 위험요인이 될 수 있음을 의미한다. 독거노인의 외로움을 줄이기 위한 개입은 수면의 질을 호전시키고 신체 및 정신 질환을 줄일 수 있을 것이다. 따라서 독거노인의 외로움을 예방하고 줄일 수 있는 지역사회 기반의 보건복지 정책이 필요함을 시사한다. Objectives : Loneliness and poor sleep quality are common phenomena in old age and are associated with negative physical and mental health. However, little is known regarding the relation between loneliness and sleep quality. The aim of this study was to examine the association of loneliness and sleep quality among the elderly living alone. Methods : This is a cross-sectional study that enrolled 1,090 subjects who are the community-residing elderly living alone. Sociodemographic status, medical condition, cognition, mood disorder, sleep quality and levels of loneliness were collected using a self-administered questionnaire and a specific semi-structured interview conducted by trained nurses. Descriptive statistics were used to analyze data regarding sociodemographic variable and loneliness. Univariate and Multivariate regression analyses were applied to examine the association between loneliness and sleep quality after adjustment for multiple confounding variables. Results : The Pittsburgh Sleep Quality Index (PSQI) mean score of "lonely group" (9.2±4.2) was significantly higher than that of "not lonely group" (7.3±3.7) (student-t test, p<0.001). Loneliness was significantly associated with PSQI (standardized β=0.065, p=0.025), sleep disturbance (standardized β=0.086, p=0.005), use of sleep medication (standardized β=0.065, p=0.034) after adjustment for possible confounding variables including sex and mood disorder. Conclusions : Loneliness was associated with sleep disturbance and this finding implied negative impact of loneliness on sleep quality of older adults. Public health promotion efforts to reduce loneliness may improve sleep quality and mental health in the elderly living alone.

당뇨병 환자에서 우울증상 및 불안증상과 혈당조절과의 연관성

전병희,김현우,김희진,임명호,이석범,백기청,이경규,Jeon, Byung-Hee,Kim, Hyun-Woo,Kim, Hee-Jin,Lim, Myung-Ho,Lee, Seok-Bum,Paik, Ki-Chung,Lee, Kyung-Kyu 한국정신신체의학회 2008 정신신체의학 Vol.16 No.2

연구목적 : 당뇨병 환자들은 질환 자체에 대한 부담감과 혈당 관리를 위한 약물 및 식이요법과 운동 요법 등의 유지에 대한 부담감이 스트레스로 작용하고 있으며, 이러한 심리적 스트레스가 혈당조절에 악영향을 줄 수 있다. 당뇨병 환자들은 일반 인구에 비해 우울증 및 불안장애의 유병율이 높으며, 이러한 우울증과 불안장애의 증상은 또 다시 혈당조절에 부정적인 영향을 주게 된다. 이에 본 연구는 우울과 불안증상이 혈당조절에 어떤 영향을 미치는가를 알아보고자 하였다. 방법 : 단국대학교병원 내분비내과에서 외래통원치료 중인 30세 이상의 당뇨병 환자 65명을 대상으로 하여, 정맥 혈액채취로 당화혈색소(Hemoglobin A1c;이하 HbA1c) 수치를 얻었으며, 자가보고식 설문지인 Beck의 우울척도(Beck's Depression Inventory;이하 BDI) 및 Beck의 불안척도(Beck's Anxiety Inventory;이하 BAI)를 시행하여 통계분석을 하였다. 결과 : 65명의 당뇨병 환자 중 경한 우울증상을 보인 환자는 27명(41.5%), 중등도 이상의 우울증상을 보인 환자는 6명으로(9.23%) 일반 인구에 비해 높은 빈도를 보였다. HbA1c와 BDI간에는 유의한 상관관계를 보이지 않았으나 HbA1c와 BAI간에 유의한 상관관계를 보였으며(R=0.567, P<0.001), 다중회귀분석에서 BAI는 혈당조절에 영향을 미치고 있었으나($\beta=0.551$, T=4.912, P<0.001) BDI와 체질량지수, 당뇨병 합병증의 수 및 유병기간은 HbA1c에 유의한 영향을 미치지 않았다. 결론 : 본 연구에서는 일반 인구에 비해 우울증상을 보이는 당뇨병 환자의 빈도가 높았으며, 불안증상을 보이는 당뇨병 환자의 빈도는 높지 않았다. 당뇨병 환자에서 우울증상과 혈당조절간의 유의한 연관성을 보이지 않았으나 불안증상과 혈당조절 간에는 유의한 연관성을 보였다. 결론적으로 우울증상은 혈당조절에 별 영향을 미치지 않으나 불안증상은 혈당조절에 영향을 미치는 것으로 나타났다. Objectives : Diabetes patients suffer from severe stress in maintaining the diet therapy and exercise therapy as well as the disease itself, and this stress has bad effects on controlling the glucose level and causes high prevalence rate of depressive and anxiety disorders. These symptoms again have deleterious effects on blood glucose control. A lot of researches about the relationship between glycemic control and symptoms of depression and anxiety and about the positive effects of the treatments of depression and anxiety disorder on glycemic control in diabetic patients are being performed. In Korea, the research regarding the relationship between glycemic control and depression and anxiety symptoms are seldom performed. In this study, we tried to find out the correlation between the glycemic control and depressive symptom and anxiety symptom. Methods : The study included 65 patients(male 34, female 31) with Diabetes in outpatient clinic of the Department of Endocrinology in Dankook University Hospital. We used the HbA1c levels to check glycemic control through blood sample analysis and used Beck Depression Inventory(BDI) and Beck Anxiety Inventory(BAI). Results : Among the 65 Diabetes patients, 21(32.30%) had mild depressive symptoms, and 6(9.23%) had moderate or severe depressive symptoms. The relation of HbA1c and BDI was not statistically significant, but was significant between HBA1c and BAI, (R=0.567, P<0.001). In the linear regression analysis, BAI had an effect on HbA1c($\beta=0.533$, T=5.012, P=0.00), but BDI, diabetes complications, diabetic morbid period and BMI had no effect on HbA1C. The relationship between HbA1c and BDI was not statistically significant, but the relationship between HbA1c and BAI was statistically significant(R=0.254, P<0.001). Conclusions : In this study, the rates of diabetic patients with depressive symptoms were higher, but those with anxiety symptoms were not higher than the general population. We could not find out significant relationship between depressive symptom and glycemic control, but found the significant relationship between the anxiety symptom and glycemic control in diabetic patients.

분노표현 양식과 스트레스 노출이 심박변이도에 미치는 영향

김현도,임명호,김현우,이석범,이경규,김현주,노상철,백기청,Kim, Hyun-Do,Lim, Myung-Ho,Kim, Hyun-Woo,Lee, Seok-Bum,Lee, Kyung-Kyu,Kim, Hyun-Joo,Rho, Sang-Cheol,Paik, Ki-Chung 대한불안의학회 2009 대한불안의학회지 Vol.5 No.1

Objective : Using patterns of change in heart rate variability (HRV), we investigated the effects of stress exposure and type of anger expression on cardiovascular diseases. Methods : Eighty-nine medical students were evaluated by STAXI-K, BDI, BAI, and measured HRV. According to the scores of anger expression questions in STAXI-K, objects are comparted to three groups. Each group is compared with others on the levels of depression, anxiety and HRV. Additionally objects are divided into two groups of functional anger expression group and dysfunctional anger expression group, and each group also divided into two groups, depending on the exposure of stressful situation or not. Members who took part in the stress exposure groups, they've got a serial arithmetic process for five minutes. We surveyed patterns of HRV in 4 each groups and estimated interactions between existence of stressful situation or type of anger expression and HRV. Results : Irrespective of stress manipulation, the dysfunctional anger expression group showed a marked increase in the LF/HF ratio in comparison to the functional anger expression group. Also, under conditions of stress manipulation, the stress exposure group exhibited a relatively increased level of TP. It can't be discriminated any correlations between stress manipulation and type of anger expression. Conclusion : Both of them, exposure to the stressful situation and type of anger expression, have influence on cardiovascular diseases. By controlling anger and way of express that, it is possible to diminish the incidence of cardiovascular diseases.

노인에서 Coronavirus Disease 2019 낙인의 두려움에 영향을 미치는 요인

최윤성(Yoon Seong Choi),이경규(Kyung Kyu Lee),이석범(Seok Bum Lee),김경민(Kyung Min Kim),김도현(Do Hyun Kim),이정재(Jung Jae Lee) 대한노인정신의학회 2021 노인정신의학 Vol.25 No.2

Objective: The purpose of this study was to investigate the factors associated with the fear of coronavirus disease of 2019 (COVID- 19) stigmatization in the elderly in Chungcheongnam-do, Korea. Methods: This study used data of a survey on depression, loneliness, social support, and fear of COVID-19 of the elderly in a province of Korea in July to November, 2020. The sample consisted of 1,485 (female 1,117); mean age 78.3 (6.5) years old. We administered Korean version of the Geriatric Depression Scale-Short Form, 6-item De Jong Gierveld Loneliness Scale, Medical Outcome Study Social Support Survey and experience about COVID-19 infection or fear of stigmatization. Binary logistic regression analyses were performed for evaluating the association between fear of COVID-19 stigmatization and the factors; gender, education level, living with spouse, socioeconomic status, depression, loneliness, and social support. Results: Socioeconomic status and loneliness are associated with the fear of COVID-19 disease stigmatization, and gender and socioeconomic status are associated with the fear of COVID-19 territorial stigmatization. Conclusion: Gender, socioeconomic status and loneliness are the factors for COVID-19 stigmatization in the elderly in Chungcheongnam- do, Korea.

인지기능이 정상인 노인에게서 주관적 기억력 저하의 위험요인

허승(Seung Huh),이정재(Jung Jae Lee),이석범(Seok Bum Lee),홍민하(Minha Hong),이경규(Kyung Kyu Lee),백기청(Ki Chung Paik) 대한노인정신의학회 2014 노인정신의학 Vol.18 No.2

Objective:We examined the risk factors for subjective memory impairment in cognitively normal elderly. Methods:One hundred fifty five cognitively normal elderly individuals with subjective memory impairment and 126 normal control subjects without subjective memory impairment were selected. All participants underwent clinical evaluation for dementia and clinical psychiatric disorder conformed to the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet and Korean version of Mini-International Neuropsychiatric Interview, respectively. Korean version of Geriatric Depression Scale-Revised was administered to evaluate depression. Subjective memory impairment was defined as 1) subjective memory complaint by the participant and/or the informants and 2) evidence of memory impairment. Results:Depression [odds ratio (OR)=1.07, 95% confidence interval (CI)=1.03-1.10] and female (OR=2.27, 95% CI=1.17- 4.39) significantly increased the risk of subjective memory impairment in cognitively normal elderly. Conclusion:Depression can be a risk factor of subjective memory impairment in cognitively normal elderly. The clinicians should be vigilant regarding the presence of depression when assessing the subjects with subjective memory complaint.

우울증이 치매조기검진에서 간이정신상태검사의 선별검사 예측 정확도에 미치는 영향

김세범(Se Beom Kim),이정재(Jung Jae Lee),이석범(Seok Bum Lee),이경규(Kyung Kyu Lee),백기청(Ki Chung Paik) 대한노인정신의학회 2016 노인정신의학 Vol.20 No.2

Objective:Depression and cognitive impairment are closely associated in old age. In this study, we investigate the influence of depression on the prediction accuracy of Mini-Mental State Examination (MMSE) as screening test for early detection of dementia. Methods:Three hundred and twenty one dementia patients and five hundred and thirty five normal control subjects were enrolled in this study. We administered both the Mini International Neuropsychiatric Inventory and the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet clinical and neuropsychological battery. We diagnosed depressive disorders according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition diagnostic criteria, and evaluated the severity of depressive symptoms using the revised Korean version of the Geriatric Depression Scale. Subjects were divided into two groups : 1) depressed group, 2) non-depressed group. We compared sensitivity, specificity, positive predictive value, negative predictive value, receiver operating characteristic curve, and areas of under the curve (AUC) of MMSE between two groups. Results:AUC of total group was 0.803 [95% confidence interval (CI)=0.774-0.833]. AUC of non-depressed group was the higher (0.855 ; 95% CI=0.823-0.887) than that of depressed group (0.767 ; 95% CI=0.710-0.824, p<0.009). Conclusion:In non-depressed group, diagnostic accuracy and positive predictive value were higher than those of depressed group. Depression should be considered for effective and efficient national dementia screening and registry program.

정신지체 및 자폐스펙트럼장애에서 다양한 치료방법의 사용실태

김경민(Kyung Min Kim),이인철(In Chul Choi),이석범(Seok Bum Lee),이경규(Kyung Kyu Lee),백기청(Ki Chung Paik),이정엽(Jeong Yeob Lee),임명호(Myung Ho Lim) 대한소아청소년정신의학회 2014 소아청소년정신의학 Vol.25 No.2

Objectives:The purpose of this study was to investigate the use of various treatment modalities including pharmacotherapy, education-behavior therapy, and complementary alternative treatment for children with mental retardation (MR) or autism spectrum disorder (ASD) in Korea. Methods:The sample consisted of 50 parents who have children with MR (N=28) or ASD (N=22), 38 boys, 12 girls ; mean age 14.06 (4.14) years old. A questionnaire was composed of the experienced modality, duration, cost, satisfaction etc. Results:According to the results, 56.0%, 100.0%, and 36.0% of children with MR or ASD have experienced pharmacological treatment, educational-behavioral therapy and complementary alternative medicine (CAM), respectively. Children who experienced education-behavioral therapy and CAM experienced 3.52 kinds of education-behavioral therapy and 2.78 kinds of CAM, respectively. Monthly cost of pharmacological treatment was lowest among three modality categories. Regarding treatment satisfaction by parental report, the lowest score was recorded fir CAM. Conclusion:Parents who have a child with MR or ASD are trying many treatment modalities and feeling the burden of their treatment.