기억력과 정신질환

홍경수,연병길,Hong, Kyung Sue,Yeon, Byeong Kil 대한생물정신의학회 1997 생물정신의학 Vol.4 No.1

Disturbances in memory are the most common problem in patients with an organic mental syndrome. Other patients with significant psychiatric disorders also often have difficulty with memory. So it is very important in the clinical practice of psychiatry to understand the biological and neurocognitive mechanisms of memory proessing, and to develop the assessment tools with which memory function can be evaluated reliably and validly. Moreover, memory researches provide an important viewpoint from which we can understand the pathophysiological mechanisms of major neuropsychiatric illnesses. This article focuses on our understanding of memory functions in clinical and neurobiological aspects. The relevant material will be presented in four parts : 1) terminologies needed in defining major stages of various types of memory processing : 2) neurochemical and neuroanatomical basis of memory processing : 3) brief bed-side screening tests and more comprehensive neuropsychological tests for the evaluation of memory function : 4) the characteristics of memory dysfunction in several major psychiatric illnesses.

정신분열병과 양극성장애에서 뇌파 동시성의 비교분석

김용규,신재공,박종원,홍경수,이승연,오홍석,이용석,곽용태,장재승,이유상,Kim, Yong-Kyu,Shin, Jae-Kong,Park, Chong-Won,Hong, Kyung Sue,Lee, Seung-Yeoun,Oh, Hong-Seok,Lee, Yong-Suk,Kwak, Yong-Tae,Chang, Jae Seung,Lee, Yu-Sang 대한생물정신의학회 2005 생물정신의학 Vol.12 No.2

Objectives:EEG coherence could imply the connectivity between two different areas of the brain, which is known to be important in the pathophysiology of bipolar I disorder(BPD I) and schizophrenia. The authors investigated EEG coherence in patients with BPD I and schizophrenia to examine the connectivity of the neural circuit. Methods:EEGs were recorded in 15 schizophrenia and 14 bipolar disorder patients, and 14 age-matched normal control subjects from 16 electrodes with linked-ear reference. Spectral parameters and coherence were calculated for the alpha bandwidth(8-13Hz) by a multi-channel autoregressive model using 20 artifact-free 2-seconds epochs and the differences were compared among three groups by two different statistical methods;F-test and Kruskal-Wallis test. Furthermore, when there were significant differences among three groups, Scheffe's multiple comparison tests were provided and Jonckheere-Terpstra tests for the ordered alternative were given. Results:In the intra-hemispheric comparison, left frontal coherence was increased in order of control, BPD I and schizophrenia. In the inter-hemispheric comparison, 1) inter-prefrontal coherence in BPD I was signifi- cantly higher than in normal controls, and 2) inter-prefrontal coherence in schizophrenia was significantly lower than in controls. Conclusion:These results suggest that 1) both schizophrenia and BPD I are diseases having the abnormality of neural circuit connectivity in both frontal and prefrontal lobes, and 2) the abnormality is more severe in schizophrenia than in BPD I. Furthermore, the data support that a common pathogenetic process may reside in both schizophrenia and BPD I.

불안신경증과 알코올남용·의존 환자에서 Tofisopam의 항불안 및 항우울 효과 검증

김승태(Seungtai. Peter Kim),홍경수(Kyung-Sue Hong),김도관(Doh Kwan Kim),홍성도(Sungdo David. Hong),유범희(Bum-Hee Yu) 한국중독정신의학회 1997 중독정신의학 Vol.1 No.1

The study aims at evaluating antianxiety and antidepressant effects of tofisopam, a benzodiazepine-related chemical substance with some variations in its nitrogen number and positions. The study subjects were 27 adult outpatients, namely, 11 anxiety neurosis patients(M 6, F 5) and 16 alcohol abuse or alcohol dependence patients(M 13, F 3), diagnosed according to DSM-IV. Tofisopam, doses ranging 100-150mg per day, was administered to each patient in an open clinical trial, over a period of 6-8 week. Each patient was administered with Hamilton Anxiety Scale(HAS) and Hamilton Depression Scale(HDS) twice, before the initiation of tofisopam admininistration and at the completion of 6-8 weeks of the medication administration, to assess the degree and extent of improvements of anxiety and depression symptoms. The following results were obtained from the study: (1) Tofisopam showed noticeably significant antianxiety effects and less significant antidepressant effects. (2) There were no clinically observable or reported untoward CNS effects(e.g. drowsiness, impaired memory, disturbance in attention, etc.) by tofisopam. (3) The more significant improvements among the anxiety symptom clusters were physical(musculomotor and sensory) and autonomic nervous system symptoms. (4) During and immediately after the completion of 6-8 weeks of tofisopam adminstration, alcoholic patients reported of significantly reduced or extinct alcohol cravings. However, it remains to be carefully evaluated whether anticraving effects of tofisopam is transient, long lasting, or psychogenic, etc. The study results warrants further careful revalidations by use of a longitudinal double-blind crossover design and on a large number of patients.

1형 양극성 장애 환자에서 리튬과 발프로산의 장기간 치료 효과에 대한 후향적 평가 : 2년 이상 치료받은 환자의 효과 비교

안성우,양소영,최유진,홍경수,Ahn, Sung Woo,Yang, So-Yung,Choi, Yujin,Hong, Kyung Sue 대한생물정신의학회 2016 생물정신의학 Vol.23 No.4

Objectives Treatment response of bipolar disorders (BDs) to long-term mood stabilizers maintenance has not been well explored because of complicated clinical and treatment courses. This study aims at investigating long-term clinical response of BDs to lithium and/or valproate in a naturalistic setting of a tertiary-care university-affiliated hospital. Methods Subjects were 65 patients with bipolar I (BD-I) disorders who had been treated with lithium and/or valproate for more than two years at single bipolar disorder clinic. Long-term response to the best treatment based on treatment algorithms and the current clinical standard of care was retrospectively evaluated using the Alda Scale and the Clinical Global Impression Scale for use in bi-polar illness (CGI-BP). Patients were classified into full responder and partial/non responder groups based on the total score of the Alda Scale with the cut-off score generated from the frequentist mixture analysis of the authors' previous study. Results The mean duration of treatment with the index medication was 69.2 months. Baseline demographic and clinical characteristics were not different among three mood stabilizer groups (valproate, lithium, and combination groups). Twenty-one subjects were classified into full responder group (32.3%). Treatment response assessed by the Alda Scale and CGI-BP scores was not different between lithium and valproate groups. The Alda Scale scores were well correlated with the CGI-BP scores (p < 0.05). Conclusions One third of the patients showed a full response to the long-term lithium and/or valproate treatment in BD-I. The degree of response was similar between lithium and valproate groups.

양극성 장애 환자에서 나타나는 식욕 및 섭식 행동의 특성 : 일반적 음식갈망-특질척도(G-FCQ-T)와 약물 관련 섭식행동 설문지(DR-EBQ)를 이용한 평가

이선이,류승형,고효정,홍경수,남희정,Lee, Sunny,Ryu, Seung-Hyong,Ko, Hyo-Jung,Hong, Kyung-Sue,Nam, Hee-Jung 대한생물정신의학회 2011 생물정신의학 Vol.18 No.4

Objectives In the current study, we quantitatively estimated changes in appetite and eating behavior of bipolar disorder patients during the pharmacotherapy. We also investigated their contribution to the weight gain and their association with specific food-craving characteristics of the patients. Methods Subjects included forty-one bipolar disorder patients and fifty-six controls. Currently sustained natures of food craving were assessed using the General-Food Craving Questionnaire-Trait (G-FCQ-T) and changes in appetite and eating behavior were measured using the Drug-Related Eating Behavior Questionnaire (DR-EBQ). Results Compared to the control group, the patients' group showed significantly higher body mass index (t=2.028, p=0.045). The patients' group had significantly higher 'Preoccupation with food' factor score of G-FCQ-T (p=0.016) than that of the control group. Hierarchical multiple regression analysis showed that only 'preoccupation with food' factor independently predicted psychotropic medication-induced appetite change. Conclusions Appetite change while receiving psychotropic medication seems to be related to the weight-gain and associated with craving natures of 'preoccupation with food' in bipolar disorder. Appetite and/or eating behavioral changes measured by G-FCQ-T and DR-EBQ could be regarded as an important mediating factor in future studies exploring biological mechanisms of weight gain related with pharmacotherapy for bipolar disorder.

양극성 장애 환자에서 비정형 항정신병약물 치료 후에 나타나는 지연성 운동장애와 지연성 근긴장이상의 유병률 및 위험요인

이아람,김주현,백지현,김지선,최미지,윤세창,하규섭,홍경수,Lee, Ahram,Kim, Joo Hyun,Baek, Ji Hyun,Kim, Ji Sun,Choi, Mi Ji,Yoon, Se Chang,Ha, Kyooseob,Hong, Kyung Sue 대한생물정신의학회 2015 생물정신의학 Vol.22 No.4

Objectives Second-generation antipsychotics (SGAs) are frequently used in the treatment of bipolar disorder. However, there is still no consensus on their risk of tardive movement syndromes especially for first-generation antipsychotics (FGAs)-naive patients. This study aimed to investigate the prevalence and associated factors of SGAs-related tardive dyskinesia and tardive dystonia in patients with bipolar disorder, in a naturalistic out-patient clinical setting. Methods The authors assessed 78 non-elderly patients with bipolar (n = 71) or schizoaffective disorder (n = 7) who received SGAs with a combined use of mood stabilizers for more than three months without previous exposure to FGAs. Multiple direct assessments were performed and hospital records longer than one recent year describing any observed tardive movement symptoms were also reviewed. Results The prevalence rates of tardive dyskinesia and tardive dystonia were 7.7% and 6.4%, respectively. These patients were being treated with ziprasidone, risperidone, olanzapine, quetiapine, or paliperidone at the time of the onset of the movement symptoms. Tardive dyskinesia was mostly observed in the orolingual area, and tardive dystonia was most frequently detected in oromandibular area. A past history of acute dystonia was significantly associated with presence of both tardive movement syndromes. Conclusions Our findings suggest that SGAs-related tardive movement syndromes occur in a substantial portion of bipolar disorder patients. Acute dystonia, a reported risk factor of tardive movement syndromes in the era of FGAs is confirmed as a risk factor of both tardive dyskinesia and tardive dystonia that were induced-by SGAs.

한국인 남자에서 Synapsin III 유전자의 D22S280 표지자와 정신분열병의 연합연구

이유상,박종원,이승연,이석진,박용범,신윤식,유장근,홍경수,양병환,Lee, Yu-Sang,Park, Chong-Won,Lee, Seung-Yeoun,Lee, Suk-Jin,Park, Yong-Bum,Shin, Yoon-Sik,Yoo, Jang-Keun,Hong, Kyung Sue,Yang, Byung-Hwan 대한생물정신의학회 2006 생물정신의학 Vol.13 No.4

Objectives : Synapsin III near VCFS region on chromosome 22q affects. It could be an interesting candidate gene for schizophrenia. D22S280 is a highly polymorphic genetic marker residing in synapsin III. We examined association of D22S280 marker on synapsin III with Korean patients with schizophrenia. Methods : The subjects were 46 male Korean patients with schizophrenia and 60 male normal controls. Using polymerase chain reaction, gel electrophoresis, ABI 310 genetic analyzer, and GeneScan Collection 3.1 software, we confirmed genotypes of D22S280 marker. We examined Hardy-Weinberg equilibrium and case-control association using SAS/Genetic 9.1.3. Results : Genotypes of both schizophrenia and control groups were in Hardy-Weinberg equilibrium. We could not find any significant statistical differences in allele-wise(${\chi}^2$=10.4, df=6, p=0.098) and genotype-wise (${\chi}^2$=22.1 df=19, p=0.258) analyses of D22S280 marker between schizophrenia and normal controls. Individual allele analyses with df=1 showed significant differences in A1(p=0.025) and A7(p=0.034) allele, which were not significant following Bonferroni corrections(A1:p=0.177, A7:p=0.235). Conclusion : We couldn't find any association between schizophrenia and the synapsin III gene. Given the small number of subjects studied, further investigations are needed.

ANK₃ 유전자 다형성과 조현병의 연관성에 대한 연합연구

양소영,허익수,조은영,최미지,박태성,이유상,홍경수,Yang, So Yung,Huh, Ik-Soo,Cho, Eun Young,Choi, Mi Ji,Park, Taesung,Lee, Yu-Sang,Hong, Kyung Sue 대한생물정신의학회 2015 생물정신의학 Vol.22 No.4

Objectives Previous genome-wide association studies have indicated the association between ankyrin 3 (ANK3) and the vulnerability of schizophrenia. We investigated the association between single nucleotide polymorphisms (SNPs) covering the whole ANK3 locus and schizophrenia in the Korean population. Methods The study subjects were 582 patients with schizophrenia and 502 healthy controls. Thirty-eight tag SNPs on ANK3 and five additional SNPs showing significant association with schizophrenia in previous studies were genotyped. Results Three (rs10994181, rs16914791, rs1938526) of 43 SNPs showed a nominally significant association (p < 0.05) with at least one genotype model. But none of these associations remained significant after adjusting for multiple testing errors with Bonferroni's correction. Conclusions We could not identify a significant association between ANK3 and schizophrenia in the Korean population. However, three SNPs showing an association signal with nominal significance need to be investigated in future studies with higher statistical power and more specific phenotype crossing the current diagnostic categories.

양극성 장애 환자와 정상인에서 계절성의 양상과 관련 요인 탐색

최정미,백지현,김지선,최지선,노지혜,남희정,이동수,홍경수,Choi, Jungmi,Baek, Ji Hyun,Kim, Ji Sun,Choi, Ji Sun,Noh, Jihae,Nam, Hee Jung,Lee, Dongsoo,Hong, Kyung Sue 대한생물정신의학회 2010 생물정신의학 Vol.17 No.3

Objectives : Recurrence of mood episodes associated with a specific season has been described in various mood disorders. Seasonal change in mood and behavior as a lifetime trait is also observed in healthy individuals. This study aimed at comparing the lifetime trait of seasonal variations of mood and behavior between bipolar disorder patients and controls as well as investigating associated factors of seasonality. Methods : Subjects were ninety-four clinically stable patients with bipolar disorder and 188 age- and sex-matched healthy controls. Seasonality of mood and behavior was assessed retrospectively on lifetime basis using Seasonal Pattern Assessment Questionnaire(SPAQ). Results : The patient group showed a higher median global seasonality score(GSS) of SPAQ and a higher rate of seasonal affective disorder(SAD) compared to the control group(p < 0.0001). For subjects showing prominent seasonality, the seasonal symptom profile and seasonal pattern was similar in both patient and control groups. In addition to the diagnosis, female gender was shown to be a predictor of seasonality in the multiple linear regression analysis(p = 0.045). Conclusion : This study suggests that lifetime trait of seasonality may be related to the susceptibility of bipolar disorder.

한국 조현병 환자에서 검지-약지 길이비와 발병 연령 및 대사 장애와의 연관성

김홍래,이중선,주연호,원승희,류승형,홍경수,권준수,이승연,오홍석,최준호,이유상,Kim, Hong Rae,Lee, Jung Sun,Joo, Yeon Ho,Won, Seunghee,Ryu, Seunghyong,Hong, Kyung Sue,Kwon, Jun Soo,Lee, Seung Yeoun,Oh, Hong Seok,Choi, Joon Ho,Lee, Yu Sa 대한생물정신의학회 2017 생물정신의학 Vol.24 No.3

Objectives The ratio of second to fourth digit length (2D : 4D) could be a potential epigenetic marker of sexual dimorphism reflecting prenatal testosterone exposure. Testosterone is known to affect the development of the brain through an epigenetic mechanism. The purpose of this study was to investigate the effects of exposure to fetal testosterone on the metabolic syndrome based on 2D : 4D of schizophrenia patients and the relationship with the age of onset of schizophrenia. Methods A total of 214 schizophrenia patients participated in this study. The participant's physical and blood tests were performed according to the American National Cholesterol Education Program's Third Amendment of the Metabolic Syndrome Diagnostic Criteria, and the 2D : 4D was measured by the method designed by McFadden. Data were statistically analyzed by t-test, Pearson's correlation analysis and multiple regression model analysis. Results 2D : 4D was significantly higher in female than male in both hands, and there was a statistically significant negative correlation between 2D : 4D and the age of onset of schizophrenia in male. However, 2D : 4D did not show statistically significant correlation with metabolic factors. Conclusions Fetal testosterone suggests the possibility of affecting the age of onset of schizophrenia through the epigenetic mechanism, but there is no clear relationship with metabolic factors.