스트레스 대응전략 -생물학적 접근-

정영조,Chung, Young-Cho 한국정신신체의학회 1995 정신신체의학 Vol.3 No.1

Because the origins of stress are various, complex, and often indirectly-causing, reactions to stress are also various according to it's psychopathologies and mechanisms. For a proper management of stress, first of all accurate evaluation and diagnosis must be done. Then, treatment against the stress also can be considered, if necessary. In case of extreme stress, psychotropic drugs such as short-term anxiolytics or antidepressants can be used according to it's specific target symtoms. But long-term treatment of stress must be directed by increasing the individual's usual coping strategy or decreasing the externally causing stresses. Reactions to stress and drug interactions. which are not the whole of the biologic treatment strategy, are very important As a results, in our discussions, we ought to describe the issues by focusing the interactions between the drug and it's reaction to stress rather than the reaction to stress or drug itself and aimed at helping the proper treatment against the stress.

정신분열병환자의 언어지각 능력 - 우울증 환자군, 정상인과의 비교 연구 -

정영조,이순정,이승환,Chung, Young-Cho,Lee, Soon Jeong,Lee, Seung-Hwan 대한생물정신의학회 2002 생물정신의학 Vol.9 No.2

Object:This study was to investigate the difference of speech perception ability in schizophrenic patients, and depression patients in order to explore trait-dependent speech perception ability of each disorder. Methods:The speech perception ability was assessed with masked speech tracking test(MST) in schizophrenic patients(N=31), depression patients(N=25), and normal controls(N=21). The continuous performance test(CPT) and sentence repetition test(SRT) were also used for assessment of attention and working memory. Results:The schizophrenic patients showed significant impaired MST performance, compared with depressive patients and normal controls. The performances of CPT and SRT were also more impaired in schizophrenic patients. The difference of MST performances between two patient group was cancelled out after consideration of differences in CPT & SRT performances. Conclusions:These results imply that schizophrenic patients have the impaired speech perception ability compared with depressive patients and normal controls. But speech perception ability was significantly influenced with CPT and SRT. For evaluation of pure speech perception ability, the more elaborate controlled study that excluded factors such as attention, working memory and intelligence is needed.

말라리아 후유증으로 초래된 피질하성 치매 1례

정효경,이영호,정영조,김수지,박병관,Chung, Hyo-Kyung,Lee, Young-Ho,Chung, Young-Cho,Kim, Su-Sie,Park, Byoung-Kwan 대한생물정신의학회 1995 생물정신의학 Vol.2 No.2

Subcortical dementia may occur as a complication of cerebral malaria via deep white matter demyelination with encephalitis and diffuse small vessel vasculitis. In subcortical dementia, impairment in attention and frontal executive function are predominant. Patients are often inert, indifferent, and uninterested. They appear characteristically 'slowed up' with a marked deficit in the retrieval of information. Changes in mood, personality, and social conduct are very common. We describe a case of subcortical dementia, who has definite changes in brain MRI after cerebral malaria.

알쯔하이머 질환의 신경생물학

정영조,서승우,이승환,Chung, Young-Cho,Seo, Seung-Woo,Lee, Seung-Hwan 대한생물정신의학회 2001 생물정신의학 Vol.8 No.1

Alzheimer's disease(AD) is associated with a characteristic neuropathology. The major hallmarks of AD are senile plaques (SPs) and neurofibrillary tangles(NFTs). ${\beta}$-amyloid protein($A{\beta}$) is derived from the proteolysis of amyloid precursor protein(APP) and then converted to SPs. Mature SPs produce cytotoxicity through direct toxic effects and activation of microglia and complement. NFTs are composed of paired helical filaments(PHFs) including abnormally phosphorylated form of the microtubule-associated protein(MAP) tau and increased tau level in cerebrospinal fluid may be observed in most AD. The aggregation of $A{\beta}$ and tau formation are thought to be a final common pathway of AD. Acetylcholine, dopamine, serotonin, GABA and their receptors are associated with AD. Especially, decreased nicotinic acetylcholine receptors(nAChRs) in AD are reported. Genetic lesions associated with AD are mutations in the structural genes for the APP located on chromosome 21, presenilin(PSN)1 located on chromosome 14 and PSN2 located on chromosome 1. Also, trisomy 21, Apo-E gene located on chromosome 19, PMF locus, low density lipoprotein receptor-related protein and ${\alpha}$-macroglobulin increase risk of AD. In this article, we will review about the neurobiology of AD and some newly developed research areas.

당뇨성 신경병환자들에서 우울증상

정영조,이영호,한기석,권오영,임경호,Chung, Young-Cho,Lee, Young-Ho,Han, Ki-Seok,Kwon, Oh-Young,Lim, Kyung-Ho 한국정신신체의학회 1993 정신신체의학 Vol.1 No.1

Before studying the effectiveness of amitriptyline in alleviating the pain of diabetic neuropathy, this study was designed to compare the severity and nature of depressive symtoms of diabetic patients with neuropathy with those of diabetic patients without neuropathy and patients with somatoform disorder whose complaints were mainly somatic pain, respectively. The authors administered Beck Depression Inventory(BDI) to the three groups of patients. The mean total scores of BDI were relatively low in all groups and not significantly different among the three groups. The mean scores of four subscales of BDI were also not significantly different among the three groups. These results might suggest that the pain of diabetic neuropathy did not influence on the severity and the nature of depressive symptoms of preexisting diabetes.

Lithium 투약도중 과나트륨혈증과 섬망을 동반한 신장성 뇨붕증 환자 1례

정효경,이영호,정영조,Chung, Hyo-Kyung,Lee, Young-Ho,Chung, Young-Cho 한국정신신체의학회 1996 정신신체의학 Vol.4 No.1

Lithium is a widely used important drug in the treatment of manic-depressive illness and its prevention of relapse. However, this drug has a Low therapeutic index, therefore, it has many attendant side effects. The most prevalent renal effect of lithium is impairment of concentrating ability and this defect appeared into overt polyuria. A renal lesion is confined to the collecting tubule and 12-20% of patients taking lithium suffer from nephrogenic diabetes insipidus. This nephrogenic diabetes insipidus causes the states of extracellular fluid depletion, hypernatremia and precipitates lithium intoxication. In such situation, symptoms of nephrogenic diabetes insipidus and lithium intoxication are very similar, so we should be very cautious to discriminate them. We herein report a patient characterized by a prolonged stuporous state, hypernatremia and severe nephrogenic diabetes insipidus during lithium therapy.

한국판 Beck 우울척도의 표준화 연구 1 : 신뢰도 및 요인분석

정영조(Young Cho Chung),이민규(Min Kyu Rhee),이영호(Young Ho Lee),박세현(Se Hyun Park),손창호(Chang Ho Sohn),홍성국(Sung Kook Hong),이병관(Byung Kwan Lee),장필립(Phi Lip Chang),윤애리(A Rhee Yoon) 한국정신병리진단분류학회 1995 精神病理學 Vol.4 No.1

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정신분열병 환자에서 항정신병 약물로 발생한 체중 증가의 유전적 원인 : 연합 연구를 중심으로

박영민(Young-Min Park),정영조(Young-Cho Chung),이헌정(Heon-Jeong Lee) 대한생물치료정신의학회 2007 생물치료정신의학 Vol.13 No.2

항정신병 약물로 인한 체중 증가는 장기적인 건강 상태와 치료 순응도에 부정적인 영향을 많이 끼치게 된다. 2세대의 비전형 항정신병 약물이 개발되었으나 여전히 체중 증가에서 자유로울 수는 없었다. 항정신병 약물에 의한 체중 증가는 약물의 중단 혹은 순응도 감소의 가장 큰 이유가 되고 있다. 성인에서의 비만과 체중 증가는 고혈압, 2형 당뇨병, 관상동맥 질환, 뇌혈관 질환, 담낭질환, 퇴행성 관절염, 수면 무호흡증, 호흡기 질환, 악성 종양 등의 건강에 심대한 손상을 주는 질환들과 관련이 되어 있다. 더구나 체중 증가는 자존감 저하, 사회적 기능 장애, 활동성 감소 등과 같은 심리적인 부분과 삶의 질에도 많은 영향을 주게 된다. 현재까지 많은 연구들이 진행되어왔다. 비록 연관 연구에서는 성과가 적었지만 연합 연구에서는 항정신병 약물에 의한 체중 증가와 관련된 후보 유전자들이 많이 발견되었다. 후보 유전자에는 5-hydroxytrptamin 2C(HTR2C), adrenergic adrenergic α2a(ADR2α) receptor gene, leptin, guanine nucleotide binding protein(GNB3), synaptomal-associated protein 25kDa(SNAP25) genes 등을 들 수 있다. 향후 연구는 더 많은 표본 수를 이용하여 더 긴 기간의 연구가 이루어져야 할 것이다. 나아가 밝혀지지 않은 새로운 유전자에 대한 연구와 유전자와 유전자간의 상호 작용 및 유전자와 환경간의 상호 작용에 대한 연구들이 이루어져야 할 것이다. Antipsychotic-induced weight gain is a major reason for discontinuation of and noncompliance with antipsychotics. Obesity and weight gain in adulthood have been associated with significant health complications, such as type II diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, respiratory problems, and some types of cancer. Weight gain may also adversely affect self-esteem, social functioning, and physical activity. Futhermore, medication -induced weight gain has been associated with a lower quality of life, and is a leading barrier to continued compliance with psychiatric medications. An individual’s propensity to develop weight gain largely depends on genetic factor. Candidate gene studies have produced significant findings in the 5-hydroxytrptamin 2C(HTR2C), adrenergic α2a(ADR2α), receptor gene, as well as in the leptin, guanine nucleotide binding protein(GNB3) and synaptomal-associated protein 25kDa(SNAP25) genes in the association studies, although there have been short of positive results by the linkage studies. Future studies should employ larger samples. In addition, the possible involvement of as-yet-uncovered gene(s) that influence susceptibility to antipsychotic-induced weight gain should be evaluated, as well as the possibility of gene-gene and geneenvironment interactions.

운동선수에 있어 체중조절필요성에 따른 식사특성, 성격특성, 우울성향 및 기타병리의 차이에 대한 연구

이영호,박세현,정영조,Lee, Young-Ho,Park, Se-Hyun,Chung, Young-Cho 한국정신신체의학회 1995 정신신체의학 Vol.3 No.1

This study was designed to investigate the role of weight control in the formation of underlying pathology in eating disorder or eating related problems. The subjects were 304 college athletes(Male : 187. Female: 121) and they were divided into two groups according to need for weight control(Weght control group: 110, Weght non control group: 194). The authors used self report questionnaire which was composed of epidemiologic data, food habit scale, eating attitude test, scale for locus of control for weight, scale for food preference and eating behavior. And we also used Eysenck Personality Questionnaire of Korean standardized edition for assessment of personality characteristics, Beck depression inventory, and the scale of hypochondriasis. The results were as follows: 1) Body mass index and the amount of cigarrette smoking and alcohol drinking showed significant differences by sex but not by need for weight control. 2) Eating habit of female athletes was the worst in all athletes. The score of eating attitude test of female athletes was higher than that of male athletes but there was no significant difference by need for weight control. Food preference and eating related behavior was also different by sex. 3) There were no significant differences in all subscales of Eysenck Personality Questionnaire, Beck depression inventory, and the scale of hypochondriasis between two groups which were divided by need for weight control. Neuroticism score was higher in female atheletes and psychoticism score was the highest in weight control male atheletes. 4) There was no significant difference in number of population with abnormal EAT score(to-tal score$\geq$26) between two groups which were divided by need for weight control. 5) The score of eating attitude test had positive correlation with the score of psychoticism and the tendency of depression in weight control male athletes but not in non-weight control male athletes. In non-weight control male athletes, the score of eating attitude test had positive correlation with the score of lie scale. so its correlation is different from those of weight control male athletes. But in female athletes, the score of eating attitude test had significant positive correlation with the score of psychoticism in both groups. In conclusion, these results suggest that the differences of eating traits in athletes are depend upon the sex difference, not upon the need for weight control. and that the role of weight control in eating disorder or abnormal eating attitude differs according to sex.

정신분열병과 P50

이승환,서형석,정영조,Lee, Seung-Hwan,Seo, Hyung-Seok,Chung, Young-Cho 대한생물정신의학회 2006 생물정신의학 Vol.13 No.3

One of the most widely recognized neurophysiologic endophenotypes for schizophrenia is deficient gating or inhibition of the P50 component of the auditory event-related potential(ERP). A deficit in P50 sensory gating refers to a dysfunction in the mechanism responsible for modulating the brain's sensitivity of filtering out irrelevant or background stimuli, perhaps as a result of dysfunction in inhibitory neural circuits. In this paper, we review the neuronal and genetic aspects as well as medication effects on P50 in schizophrenia.