일차성 및 이차성 불면증 환자에서의 개별 인지행동치료의 임상적 효능

신윤미,차보석,임채미,신홍범,Shin, Youn-Mi,Cha, Bo-Seok,Lim, Chae-Mi,Shin, Hong-Beom 대한수면의학회 2010 수면·정신생리 Vol.17 No.1

목 적: 본 연구는 일차성 및 이차성 불면증 환자에서 인지행동치료(Cognitive Behavioral Therapy, 이하 CBT)의 임상적 효능을 평가하고자 하였다. 방 법: 2008년 1월부터 2009년 6월까지 일차의료기관 수면클리닉에 방문한 환자들을 대상으로 하였다. 전체 64명의 외래 환자가 모집되었으며, DSM-IV에 의거하여 진단 된 일차성 불면증 환자는 30명, 이차성 불면증 환자는 34명이었다. 환자들은 CBT 전후로 수면 일지, 수면에 대한 역기능적 신념 및 태도 척도(Dysfunctional Beliefs and Attitudes about Sleep Scale-16, 이하 DBAS) 및 상태-특성 불안척도(State-Trait Anxiety Inventory, 이하 STAI)를 각각 시행하였다. CBT는 1주 간격으로 7회, 1회당 40~50분 동안 개별적으로 진행하였다. 결 과: 일차성, 이차성 불면증 환자군 모두 입면 잠복기, 총 수면 시간, 수면 효율과 같은 수면 지표와 DBAS 점수의 유의한 호전을 보였다. 반복측정 분산분석에서는 두 군간에 시간에 따른 DBAS와 수면 지표의 유의한 차이는 없었다. 이차성 불면증에서의 CBT의 효과는 일차성 불면증에서의 효과와 동등하였다. 결 론: 이번 연구는 CBT가 일차의료 환경에서 일차성 및 이차성 불면증의 치료에 있어 효과적이라는 것을 시사한다. Objectives: This study aimed to evaluate the clinical efficacy of individual cognitive behavioral therapy (CBT) for Patients with Primary or Secondary Insomnia. Methods: Participants were recruited from a primary care sleep clinic from January 2008 to June 2009. The study sample included 64 outpatients with primary insomnia (n=30) and secondary insomnia (n=34) according to the criteria of DSM-IV. Participants completed sleep diaries, Dysfunctional Beliefs and Attitudes about Sleep Scale-16 (DBAS), State-Trait Anxiety Inventory (STAI) before CBT and shortly after completion of CBT. CBT was provided in 7 weekly, 40-50-minute individual therapy sessions. Results: Both groups of patients with primary and secondary insomnia showed significant improvement in the DBAS and sleep parameters including sleep onset latency, total sleep time, and sleep efficiency. Repeated-measures ANOVA of the DBAS and sleep parameters showed no significant group-by-time interactions between patients with primary and secondary insomnia, suggesting the efficacy of CBT for patients with secondary insomnia was equivalent to that of CBT for patients with primary insomnia. Conclusion: This study suggests that CBT is effective for the management of primary and secondary insomnia in a primary care setting.

비정형 항정신병약물 복용 중인 과체중 환자에서 체중 감량을 위한 행동수정요법의 개발 - 예비연구 -

신홍범,박종호,차보석,김병수,이숙경,김학령,김용식,안용민,강웅구,Shin, Hong Beom,Park, Jong Ho,Cha, Bo Seok,Kim, Byung Soo,Lee, Suk Kyung,Kim, Hak Lyung,Kim, Yong Sik,Ahn, Young Min,Kang, Ung Gu 대한생물정신의학회 2003 생물정신의학 Vol.10 No.2

Objects:The authors devebped a behavioral modification program for oveweight outpatients with schi-zophrenia and bipolar disorder will had teen treated with atypical antipsychotics, and evaluated the applicability of this program to outpatients Methods:Two men and nine women who had been treated with atypical antipsychotics and will had gained at least 5 percent of their pre-treatment body weight for 10 weeks, attended a behavioral modification program. The patients' weight, body mass index and the diet-activity scale were assessed and were compared with those of a matched comparison group will dd not attend the behavioral modification program Results:The body weight of patients who attended the behavioral modification program reduced with statistical significance, The treatment group showed significant improvement in diet-related items but not in activity-related items of the diet-activity scale Conclusions:This study suggested the applicability of a eehavioral mcdification program on weight reduction to overweight patients taking atypical antipsychotics for the frrst time in Korea Additional large scale studies are needed to validate the effectiveness of this program.

학교폭력 가해자에서 외상후 스트레스 증후군의 증상과 휴대폰 중독적 사용과의 관계

서지영,박철수,김봉조,차보석,이철순,이소진,Seo, Ji-Yeong,Park, Chul-Soo,Kim, Bong-Jo,Cha, Bo-Seok,Lee, Cheol-Soon,Lee, So-Jin 대한불안의학회 2012 대한불안의학회지 Vol.8 No.2

Objective : This study aims to investigate the relationship between addictive mobile phone use and post-traumatic stress disorder (PTSD) symptoms in bullies who experienced school violence. Methods : The study subjects consisted of 97 adolescents in The Foundation for Preventing Youth Violence after school violence. The participants conducted self-report questionnaire for addictive mobile phone use and Impacted Event Scale-revised-Korean version (IES-R-K). Partial correlation and multiple logistic regressions were performed. Results : The scores related to addictive mobile phone use were correlated with total score (r=0.21, p=0.04), avoidance score (r=0.21, p=0.04) and intrusive score (r=0.26, p=0.01) related to PTSD symptoms on the IES-R-K. Intrusive score related to PTSD symptoms on the IES-R-K were significant risk factor for addictive mobile phone use (O.R=1.25, 95% CI=1.12-1.39). Conclusion : This data supports that PTSD intrusive symptoms could be predictable factor of addictive mobile phone use. An appropriate intervention about PTSD symptoms might play a useful role in preventing addictive mobile phone use in bullies of school violence.

군인들에서 성인 주의력 결핍 과잉 행동 장애 증상이 스트레스와 우울증에 미치는 영향

서지영,박철수,김봉조,차보석,이철순,이소진,방수영,Seo, Ji-Yeong,Park, Chul-Soo,Kim, Bong-Jo,Cha, Bo-Seok,Lee, Cheol-Soon,Lee, Sojin,Bhang, Soo Young 대한불안의학회 2011 대한불안의학회지 Vol.7 No.2

Objectives : The aim of this study was to investigate whether and how the symptoms of adult attention deficit hyperactivity disorder (ADHD) affect the stress and depressive symptoms in Korean soldiers. Methods : Data were collected on 131 subjects through self-report using the Korean Adult Attention-Deficit/Hyperactivity Disorder Scale (K-AADHDS), Center for Epidemiological Studies Depression Scale (CES-D), Korean Wender Utah Rating Scale (K-WURS), and the Brief Encounter Psychosocial Instrument (BEPSI-K). Student t-tests, Pearson Correlation, Logistic regression, and Path analysis were performed. Results : The scores related to adult ADHD symptoms on the K-AADHDS and K-WURS were correlated with stress scores on the BEPSI-K (r=0.529, p<0.001 and r=0.484, p<0.001) and with depressive symptoms on the CES-D (r=0.686, p<0.001 and r=0.628, p<0.001). Scores related to adult ADHD on the K-AADHDS were the most significant risk factors for stress (O.R=1.198, 95% CI=1.104-1.299), and depressive symptoms (O.R=1.306, p95% CI=1.112-1.534). Path analysis on depressive symptoms showed that adult ADHD symptoms affected stress and depressive symptoms. Conclusion : The results suggest that it may be important to consider the evaluation and treatment of adult ADHD in soldiers. Prospective studies with larger numbers of subjects are warranted to further explore the relevance of the present results.

의학전문대학원 학생들의 일주기 선호와 방어기제

이소진,박철수,김봉조,이철순,차보석,강효승,Lee, So-Jin,Park, Chul-Soo,Kim, Bong-Jo,Lee, Cheol-Soon,Cha, Bo-Seok,Kang, Hyoseung 대한수면의학회 2013 수면·정신생리 Vol.20 No.2

목 적 : 방어기제는 성격의 영향을 받으며, 방어기제로부터 파생된 행동들을 관찰함으로써 추정 및 측정이 가능하다. 현재까지 방어기제와 일주기 선호 사이의 관계에 대해서는 밝혀진 바가 없었다. 본 연구에서는 일 의학전문대학원 학생들을 대상으로 방어기제와 일주기 선호 사이의 관계를 알아보고자 했다. 방 법 : 일 의학전문대학원 학생 148명을 대상으로 자가설문조사를 시행하였다. 아침형-저녁형 질문지, Beck 우울 척도-2, 한국판 방어유형질문지를 이용하였다. 결 과 : 저녁형과 아침 중간형은 공상, 수동 공격, 소비, 승화, 억제의 방어기제들에서 유의한 차이를 보였다(p<0.05). 다중회귀분석에서 소비가 높을 수록(beta=-0.262, p= 0.001), 승화가 적을 수록(beta=0.185, p=0.023), 여자보다는 남자(beta=0.175, p=0.031)가 저녁형을 유의하게 예측하였다. 결 론 : 본 연구에서는 일 의학전문대학원 학생들에서 소비와 승화의 방어기제가 일주기 선호와 관계된다는 것이 밝혀졌다. 그러나 단면 연구로부터의 결과이므로 둘 사이의 인과 관계에 대해서는 알 수가 없다. 환경 요인을 조정하여 일주기 선호가 바뀔 때 방어기제의 변화가 동반되는지에 대한 후속 연구가 가능할 것이다. Objectives: Previous studies have reported an association between circadian preference and personality. Defense mechanism is unconscious ego process which deals with an individual's anxiety and is closely associated with one's personality. Our aim is to investigate the association between defense mechanism and circadian preference in medical students. Methods: One hundred forty eight medical students (70 males, 78 females), aged 22 to 30, answered the Beck Depression Inventory-II, Morningness-eveningness Questionnaire, and Korean version of Defense Style Questinnaire. Results: Consumption (beta=-0.262, p=0.001) and being a male (beta=0.175, p=0.031) were significant positive predictors of eveningness, while sublimation (beta=0.185, p=0.023) was a significant negative predictor of eveningness. Conclusion: Our study showed a relationship between specific defense mechanisms (i.e., consumption and sublimation) and eveningness in medical students, but it did not address whether the relationship is a causal one.

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.

IEEE 802.15.4a채널환경하에서의 저간섭 Chaotic OOK 무선통신기술의 BER 성능분석에 관한 연구

정재호(Jeong, Jae-ho),박구만(Park Goo-man),전태현(Jeon Tae-hyun),서보석(So Bo-seok),곽경섭(Kwak Kyung-sup),차재상(Cha Jae-sang) 한국방송·미디어공학회 2006 한국방송공학회 학술발표대회 논문집 Vol.2006 No.-

현재 WPAN(Wireless Personal Area Network) 전송기술의 하나인 IEEE 802.15.4a의 저속형 UWB(Ultra Wide Band) 기술이 활발하게 연구되어지고 있다. 하지만 IEEE 802.15.4a에서 제시된 WPAN 전송채널의 경우에는 심각한 멀티패스 간섭성분이 존재하여 이에 대한 해결방안이 절실히 요구되어지고 있다. 따라서 본 논문에서는, WPAN환경에서 전송채널의 심각한 멀티패스 성분을 물리계층(Physical layer) 레벨에서 근원적으로 해결하여 높은 QoS(Quality of Service)를 확보하게 해줄 수 있는 단극형 ZCD(Zero Correlation Duration)확산코드 기반의 Chaotic-OOK (On-Off Keying) 무선통신기술을 제안하고 IEEE 802.15.4a 채널 환경하에서의 모의실험을 통한 성능평가를 통해 제안한 무선통신기술의 유용성을 입증하였다.

노인 뇌졸중 환자에서 수면의 질과 연관된 임상 특징들

오민균(Min Kyun Oh),이철순(Cheol Soon Lee),박철수(Chul Soo Park),김봉조(Bong Jo Kim),차보석(Bo Seok Cha),김선미(Sun Mi Kim),이소진(So Jin Lee),신희석(Hee Suk Shin),김아람(A Ram Kim) 대한노인정신의학회 2011 노인정신의학 Vol.15 No.1

Objectives:Although sleep problem is a common complaint in stroke survivors, there is paucity of studies on quality of sleep in old patients with stroke. The purpose of this study was to investigate the clinical characteristics associated with quality of sleep in old patients with stroke. Methods:A comprehensive clinical and psychiatric assessments was performed in 30 patients who were admitted in rehabilitation department. Quality of sleep was evaluated with the Pittsburgh sleep quality index (PSQI). Other rating scales such as Modified Barthel Index, Korean mini mental state examination, Hamilton rating scale for anxiety, and Hamilton rating scale for depression were also performed to evaluate the clinical characteristics. Results:Thirteen patients (43%) were ‘poor sleeper’ defined as a global PSQI score 〉5. In the partial correlation test, poor sleeper group were significantly associated with anxiety (r=0.69, p〈0.01) and depression (r=0.76, p〈0.01). In the multivariate logistic regression analysis, depression symptoms (OR=1.51, p=0.01) were only significant predictor of ‘poor sleep’ compared with other factors including age, sex, stroke type, stoke location, stroke site, past medical history, anxiety, and cognitive function. Conclusion:The results may suggest that it is important to assess depression when old patients with stroke show decreased quality of sleep. Further following studies will be needed for finding relation with other clinical factors.

군인들에서 성인 주의력결핍 과잉행동장애, 우울 그리고 자살 사고의 관계

이동윤(Dong-yun Lee),이철순(Cheol-Soon Lee),박철수(Chul-Soo Park),김봉조(Bong-Jo Kim),차보석(Bo-Seok Cha),이소진(Sojin Lee),서지영(Ji-Yeong Seo) 대한생물치료정신의학회 2012 생물치료정신의학 Vol.18 No.2

Objectives:The aim of this study was to evaluate the relationship among adult Attention Deficit and Hyperactivity Disorder(ADHD) symptoms, depressive symptoms, anxiety symptoms and suicide idea in Korean soldiers. Methods:We investigated past and present symptoms of ADHD(Korean-Wender Utah rating scale and Korean adult attention-deficit/hyperactivity disorder scale), depression(Beck’s Depression Inventory), anxiety(Beck’s Anxiety Inventory) and suicide idea(Beck Suicide Ideation Scale) in 92 Korean soldiers who had been experienced maladjustment and had visited in the medical unit of Army. Pearson correlation analysis, path analysis and structured equation model were used to find the relationship among these factors using SPSS 18.0 and AMOS 19.0 program. Results:There were significant relationships among past and present symptoms of ADHD and depression, anxiety and suicide idea(p<0.01). The regression analysis revealed that depression affected suicide idea(β=0.64, p<0.01). The path analysis showed that the impact of past and present symptoms of ADHD affected on suicide idea via depression( p<0.05, CFI=0.92, TLI=0.62, IFI=0.92, NFI=0.91). Conclusion:The symptoms of ADHD might make a fundamental role in development of suicide ideation via emotion like depression in Korean soldiers.

한국 한 중소 도시 지역의 우울 장애의 유병률 및 관련 요인

이동윤(Dong-Youn Lee),이철순(Cheol-Soon Lee),박철수(Chul-Soo Park),한규희(Kyu-Hee Hahn),손진욱(Jin-Wook Shon),차보석(Bo Seok Cha),김봉조(Bong-Cho Kim) 대한사회정신의학회 2008 사회정신의학 Vol.13 No.2

목 적 중소도시 진주에 거주하는 일반인구를 대상으로 하여 우울 장애의 유병률과 관련 인자를 조사하기 위해 본 연구를 시행하였다. 방 법 중소도시 진주에 거주하는 남자 528명(39.3%), 여자 815명(60.7%), 총 1,343명을 연구대상으로 하였고 자기 보고 형태인 K-CES-D를 사용하여 우울 장애의 유병률과 관련 인자를 조사였다. 결 과 대상군 중 19.6%가 우울 장애로 진단 되었는데, 연령, 경제 수준, 결혼 상태에 따라 유병률의 차이를 보였으며, 그 외 성별, 교육 수준에 따른 유병률의 차이는 통계적으로 유의하지 않았다. 연령과 결혼 상태가 우울 장애의 관련 인자로 조사 되었다. 이중 연령은 남, 녀 모두에서 유의한 관련이 있었지만, 결혼 상태의 경우 남자에서만 우울 장애의 관련 인자로 조사되었다. 고 찰 본 연구는 일반 인구의 우울 장애 유병률을 알아 볼 수 있었고, 우울 장애와 관련된 여러 가지 역학적 정보는 효과적인 보건 정책의 수립에 다양하게 사용될 수 있을 것이다. Objectives:The objective is to investigate the prevalence and correlates of depression in the population at a smallmedian city, Jinju. Method:Total numbers of this study subjects were 1343. Male were 528(39.3%) and female were 815(60.7%) living in a small-median city, Jinju. The data was collected through self reports in 2007. We investigated the prevalence and correlates of depression using a cut-off score of 21 by K-CES-D. Results:19.6% of samples(20% in female and 19.1% in male) were diagnosed as depression. Although the prevalence of depression was not different by sex and educational level, it was different by age, monthly income and marital status. Multivariate logistic regression analysis showed that the risk factor for depression was age and marital status. Age was significantly associated with depression both in men and women, but marital status was associated with depression only in men. Conclusion:This study revealed the prevalence of depression on the general population-base. This epidemiological information should be used to inform and implement equitable and effective health policies.