양극성 장애 환자에서 CTLA-4 유전자 다형성

전태연,이경욱,이혁재,배치운,채정호,박원명,김광수,Jun, Tae-Youn,Lee, Kyoung-Uk,Lee, Hyuk-Jae,Pae, Chi-Un,Chae, Jeong-Ho,Bahk, Won-Myong,Kim, Kwang-Soo 대한생물정신의학회 2003 생물정신의학 Vol.10 No.1

Objective : Bipolar disorder is known to have strong genetic background and cellular immune activation. Based on the hypothesis that abnormalities of normal inhibitory control of T cell immunity can contribute to the pathophysiology of bipolar disorder, we investigated the relationship between the first exon at position +49(A/G) polymorphism of cytotoxic T lymphocyte antigen 4(CTLA4) gene and bipolar disorder. Method : Among the Korean patients diagnosed as bipolar disorder according to DSM-IV, 90 patients without serious medical illness, neurologic illness, hormonal disorder, or concomitant mental illness were selected. The normal control group consisted of 149 age-and sex-matched subjects without current or past history of autoimmune diseases or mental disorder. DNA was extracted from whole blood and the exon 1 region of CTLA-4 gene was amplified by polymerase chain reaction. Gene typing was performed using single strand conformation polymorphism. Results : There were no significant differences in genotype frequencies of G/G, G/A, and A/A between the patients with bipolar disorder and the control group(48.9% vs 46.3%, 44.4% vs 39.6%, and 6.7% vs 14.1%, respectively). There were no significant differences in allelic frequencies of G and A between the patients with bipolar disorder and the control group(71.1% vs 66.1%, and 28.9% vs 33.9%, respectively). Conclusion : This study did not show the association of exon 1 polymorphism of CTLA-4 gene with bipolar disorder.

양극성 장애환자에서 HLA 대립형의 빈도와 질병연관성

전태연,Jun, Tae-Youn 대한생물정신의학회 1994 생물정신의학 Vol.1 No.1

For the purpose of evaluating the human leukocyte antigen(HLA) disease-association with bipolar disorder, HLA class I and class II allelic frequencies were assessed in 37 bipolar patients and were compared to the data from normal population. HLA class 1 typing was performed with microlymphocytotoxicity method while class II(DRB1) genotyping with reverse dot blot hybridization and sandwich method. Statistical analysis consisted of relative risk, Haldane's modified relative risk, Fisher's exact test and Bonferoni's corrected P. The results were as follows : 1) Bipolar patients showed increased allelic frequency of HLA A3 which has statistical significance. 2) Allelic frequencies of HLA B7, B14 and B54 were higher, while those of B51 and B55 were lower in bipolar patients, but they were not statistically significant. 3) Both of increased frequencies of DR2 in bipolar patients and DR15 in normal controls had statistical significance. The results of the present study suggested that some of HLA allelic types might be associated with bipolar disorder. To clarify the genetic influence of HLA to bipolar disorder, we should do consecutive study of bipolar disorder with new information about HLA system including alleles.

정신분열병의 미세신체기형과 음성증상

전태연(Tae Youn Jun),도규영(Kyu Young Toh),김석범(Seok Beom Kim),권용실(Yong Sil Kweon) 한국정신병리진단분류학회 1998 精神病理學 Vol.7 No.2

N/A N/A

제1형 양극성 장애와 Lymphotoxin Alpha 유전자 단일염기 다형성 연관 연구

김상하,전태연,Kim, Sang-Ha,Jun, Tae-Youn 대한생물정신의학회 2012 생물정신의학 Vol.19 No.3

Objectives : Proinflammatory process has been implicated as an underlying mechanism of bipolar disorder and schizophrenia. Previous studies have suggested a possible role of lymphotoxin alpha (LTA) gene in the development of schizophrenia and have prompted further investigation in bipolar patients. Association of the LTA +252A/G polymorphism with susceptibility to bipolar I disorder itself as well as with vulnerability among a subset of psychotic bipolar patients were tested. Methods : DNA extraction was done by a standard method and genotyping was carried out by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method in 114 Korean patients with bipolar I disorder and 202 healthy controls. SPSS v18.0 was used for statistical analysis. Comparisons of the genotype and allele distributions in LTA +252A/G polymorphism were made using a chi-square test. The genotype and allele associations were also evaluated using odds ratio (OR) and 95% confidence interval (CI). Statistical significance was accepted when p was < 0.05. Results : No significant association was found between the LTA +252A/G polymorphism and bipolar disorder. However, LTA +252G allele was present with significantly higher frequency among bipolar patients with psychotic features compared to those without (${\chi}^2$ = 4.69, p = 0.034, OR = 2.495, 95% CI = 1.069-5.827). Conclusion : The results suggest that the allele LTA +252G of the polymorphism may be associated with the psychotic subset of bipolar disorder but not with bipolar I disorder itself. Adequately powered subsequent studies should be conducted.

일 대학병원에서 외상 후 스트레스장애 입원환자의 약물 치료 경향

민정아,정영은,서호준,박원명,전태연,채정호,Min, Jung-Ah,Jung, Young-Eun,Seo, Ho-Jun,Bahk, Won-Myong,Jun, Tae-Youn,Chae, Jeong-Ho 대한불안의학회 2008 대한불안의학회지 Vol.4 No.1

현재 PTSD와 관련한 여러 병태생리 기전들이 밝혀지고 있으며 이에 초점을 둔 다양한 약물치료가 행해지고 있다. 본 연구에서는 일 대학병원에서 PTSD로 진단된 환자들의 의무기록을 검토하여 약물치료의 경향에 대해 알아보았다.1998년 1월부터 2007년 12월까지 DSM-IV에 의해 PTSD로 진단된 입원 환자 75명이 대상군이 되었으며, 이들의 인구학적 요인들, 입원기간, 외상의 종류, 외상 후 경과시간 및 정신과적 공존병리 및 처방 받은 약물을 조사하였다. 조사 결과, 75명 중 남자는 33명, 여자는 42명이었다. 정신과적 공존병리는 총 50명(66.7%)에서 존재하였으며, 우울장애, 인지장애, 정신장애 및 불안장애 순이었다.73명(97%)의 대상군은 항우울제를 처방 받았으며, 그 중 paroxetine이 54.7%로 가장 많았고 두 가지 이상의 항우울제를 처방 받은 경우도 24%였다. 또 거의 대부분의 환자에서 비정형 항정신병약물(33.3%), 기분안정제(17.3%),항불안제(94.7%)가 항우울제와 병용 처방된 것으로 조사되었다. 여러 제한점에도 불구하고 본 연구에서 얻어진 약물 처방 경향은 향후 국내 실정에 맞는 치료 지침을 수립하는 데에 하나의 근거 자료가 될 수 있을 것이다. Objective : Due to a better understanding of the pathophysiology of posttraumatic stress disorder (PTSD) and the relative limitations in the treatment of patients with PTSD, a variety of medications and treatment algorithms for PTSD have been investigated. This study was conducted to investigate the trends in the pharmacotherapy used in the treatment of inpatients with PTSD at a single university hospital in Korea. Methods : Data from 75 patients diagnosed with PTSD according to the DSM-IV criteria from January 1998 to December 2007 were collected. Demographic data and clinical data, including medications prescribed, were investigated. Results : Thirty-three of the 75 subjects included in this study were male, and 42 were female. Considering psychiatric comorbidity, depressive disorder, cognitive disorder, psychotic disorder and anxiety disorder were reported in order. Approximately 97% of the subjects were treated with antidepressants, including paroxetine in 54.7%, and 24% of the subjects were treated with two different kinds of antidepressants. In addition, atypical antipsychotics were prescribed in 33.3% of patients, mood stabilizers in 17.3%, and anxiolytics in 94.7% of the subjects. Conclusion : In our study, various kinds of antidepressants were prescribed for most patients with PTSD. Antipsychotics and mood stabilizers were added to the treatment regimens of some subjects, and anxiolytics were added to the treatment regimens of most subjects. Despite its many limitations, this study shows the prescription pattern and trends in PTSD treatment in Korea. We hope that these preliminary data would be helpful for the development and integration of a practical guideline for the treatment of PTSD in Korea.

성매매 피해 여성의 외상 후 스트레스 증상과 정신건강-탈 성매매 후 추적 연구

김성철,이준우,송정민,전태연,채정호,Kim, Seong-Cheol,Lee, Jun-Woo,Song, Jeong-Min,Jun, Tae-Youn,Chae, Jeong-Ho 대한불안의학회 2006 대한불안의학회지 Vol.2 No.1

Objectives : Since prostitution is multitraumatic phenomena, it is known that most women in prostitution have symptoms of posttraumatic stress disorder (PTSD) and other mental illness. In Korea, new anti-prostitution law launched in the year of 2004 imposes protecting prostituted victims at government-supported shelter. The objective of this study was to compare the mental symptoms, especially PTSD features of women who escaped from prostitution with those of control subjects. Methods : We assessed 113 ex-prostituted women who live in shelter for 8 months on the average and 65 normal control subjects. Demographic data, questionnaire for sleep, physical illness, smoking, alcohol and drug use, Stress Response Inventory, Davidson Trauma Scale (DTS), Impact of Event Scale-Revised (IES-R) were used. Results : Ex-prostituted women had significantly higher scores of DTS, IES-R, stress related responses, sleep problems, smoking problems, and alcohol problems than control group. Age and duration of sex trade of the subjects were significantly correlated with the severity or frequency of PTSD symptoms. The degree of smoking, alcohol drinking and sleep problems were also significantly correlated with the PTSD symptoms. Conclusion : These results suggested mental symptoms did not disappear even after women escaped from prostitution.

우울증과 전두엽

채정호,이경욱,양완석,박원명,전태연,김광수,Chae, Jeong-Ho,Lee, Kyung-Uk,Yang, Wan-Seok,Bahk, Won-Myong,Jun, Tae-Youn,Kim, Kwang-Soo 대한생물정신의학회 2002 생물정신의학 Vol.9 No.2

Objectives:Abnormalities in the frontal lobe have been consistently suggested in the pathophysiology of depression. The purpose of this review is to discuss the relationship between the frontal lobe and depression. Methods:Recent researches on the frontal lobe in depression were reviewed and abnormalities in this region were considered within the context of modern functional neuroanatomy. Results:This paper reviewed evidence strongly implicating the frontal lobe as a key brain structure in depression. Conclusion:Taken together, these abnormalities in the function of the frontal lobe implicate interconnected neural circuits in depression and offer suggestions for the themes of future research and treatment. Further research is needed to investigate the association between emotion and the brain in the paradigm of "affective neuroscience".

우울증 자살시도자들에서 표준우울평가척도들의 요인분석 : CRESCEND 연구

홍민아,김민경,김정범,전태연,임현우,이민수,김재민,Hong, Min Ah,Kim, Min Kyung,Kim, Jung Bum,Jun, Tae Youn,Yim, Hyeon Woo,Lee, Min Soo,Kim, Jae Min 대한불안의학회 2015 대한불안의학회지 Vol.11 No.1

Objective : The aim of this study was to find associations between specific symptoms and suicidal behavior by using global severity on depression scales. Methods : Data were obtained from 1,183 patients of CRESCEND study. Factor analysis of the 17-item Hamilton Rating Scale for Depression (HAM-D) and the Beck Depression Inventory-II (BDI-II) was used to compare symptom clusters between the past suicide attempters and the non-suicide attempters, among the patients with depressive disorders. Results : Factor analyses of HAM-D and BDI-II extracted three factors. Suicide attempters had significantly higher scores on core factor of HAM-D, including depressed mood, feeling of guilt, suicide, work, and activities. The higher scores on all factors of BDI-II or scores correlated with a total of 7 suicide attempts and with known risk factors for suicidal behavior. Conclusion : These findings suggest that the suicide attempters complained of more cognitive, affective, somatic symptoms on BDI-II, but the core factor on HAM-D was the only differentiated factor between the two groups. Clinician-rated scales as well as self-reported questionnaires were valid in measuring suicidal attempts, and the clinical profile may help in guiding the studies of biological correlates and the treatments to reduce suicide risk.

양극성 조증 입원 환자에서 과체중, 비만과 연관 인자 : 예비 연구

정영은,서호준,송후림,왕희령,전태연,박원명,Jung, Young-Eun,Seo, Ho-Jun,Song, Hoo-Rim,Wang, Hee-Ryung,Jun, Tae-Youn,Bahk, Won-Myong 대한불안의학회 2010 대한불안의학회지 Vol.6 No.2

Objective : Being overweight or obesity impairs quality of life and often causes treatment noncompliance in patients with bipolar disorder. This preliminary study evaluated the prevalence of overweight and obesity in inpatients with bipolar mania. Methods : Inpatients with bipolar mania, who were treated with adequate medications at least 4 weeks were included in a retrospective study. The body weight of each patient was measured and the body mass index (BMI) was calculated. Results : Of the 80 patients, 16.4% (N=13) were overweight, and 35.0% (N=28) were obese at discharge. Female patients had higher prevalence rates of overweight and obesity. Being overweight or obesity was associated with the number of previous episodes of depression and combination treatment with atypical antipsychotics and mood stabilizers. Conclusions : Being overweight or obesity is highly prevalent in patients with bipolar mania. Clinicians should pay more attention to weight gain and obesity when prescribing combination therapies. More research is required to identify the impact of specific risk factors for overweight and obesity in patients with bipolar mania.

암 환자에서 우울증의 선별도구로서 단축형 에딘버러 우울증 척도의 한국 표준화

이정현,김태석,고윤호,윤수정,류인균,전태연,이철,Lee, Jung Hyun,Kim, Tae-Suk,Ko, Yoon-Ho,Yoon, Sujung J.,Lyoo, In Kyoon,Jun, Tae-Youn,Lee, Chul 대한생물정신의학회 2009 생물정신의학 Vol.16 No.2

Objectives : Depression is a common psychiatric disorder in cancer patients. The Brief Edinburgh Depression Scale(BEDS), which is an abbreviated version of the Edinburgh Depression Scale, may serve as a useful tool in screening for the depression in patients with the medical illnesses. This report investigated the reliability and validity of the Korean Version of the BEDS(K-BEDS) for the depression in cancer patients. Methods : One-hundred cancer patients were enrolled in this study. All subjects completed the K-BEDS, the Hospital Anxiety Depression Scale(HADS), and the Karnofsky Performance Status Scale(KPSS). Reliability, validity and Receiver Operating Characteristic(ROC) curve analysis measures were assessed. Results : The K-BEDS showed good internal consistency(Cronbach ${\alpha}$=0.77) and test-retest reliability(0.94, p<0.001). All item-total correlations were above 0.3. Also, it revealed moderate correlation with the depression subscale of the HADS(r=0.617), but no correlation with the KPSS. Exploratory factor analysis produced only one factor, accounting for 47.1% of the total variance. The most valid cutoff value to screen for depression was a total score of 5 on the K-BEDS, which showed sensitivity of 62.5% and specificity of 86.4% with a positive predictive value of 4.60 and a negative predictive value of 0.43.