http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
윤도준,Yoon, Doh-Joon 대한생물정신의학회 1994 생물정신의학 Vol.1 No.1
I will try to serve as the basis for the development of a clinical therapeutic guideline of antipsychotic drugs. Knowing that many patients fail standard treatment recommendations, either because of insufficient efficacy or intolerance to adverse effects, led us to emphasize the importance of the guideline. The clinicians continually assimilate new information about recent advances, including : novel agents targeted to impact specific components of various neurotransmitter systems ; combination strategies ; alternative uses of existing agents ; and specialized requirements of a growing number of identified diagnostic subtypes. The cost to benefit ratio must always be considered when developing a therapeutic guideline.
정신의학(精神醫學)에서 행동모형(行動模型)(I) : 우울증과 불안
윤도준,Yoon, Doh Joon 대한생물정신의학회 1995 생물정신의학 Vol.2 No.1
Behavioral models are used very widely to investigate or illuminate aspects of human psychopathology. However, the extent to which it is possible to extrapolate from animals to people, and, therefore, the value of information derived from a behavioral model, will depend to a large extent on the validity of the models. This article outlines some behavioral models of depression and anxiety.
윤도준,Yoon, Doh Joon 대한생물정신의학회 1997 생물정신의학 Vol.4 No.2
To examine the double-faced thymoleptic(antidepressant and antimanic) effects of risperidone in mood disorders, this article reviews the psychotropic-induced mania, thymoleptic effects of antipsychotics, therapeutic effects of risperidone and risperidone(RIS)-induced mania(RIM) in mood disorders, risk factors of RIM, possible neurochemical mechanism of these thymoleptic effects, pathophysiological and clinical significance of thymoleptic effects, and suggestive clinical guideline of RIS in mood disorders. RIS appeared effective for bipolar disorder at a lower dose than that recommended for schizophrenia, especially in the cases of maintenance of mood stabilizers, and gradual titration from low doses. Manic induction/exacerbation can occur by chance during RIS treatment in mood disorders, schizoaffective disorders, and schizophrenias. The possible risk factors for RIM are refractory mood disorder, especially in bipolar I disorder with poor initial response ; refractory schizoaffective disorders, especially in bipolar type with poor initial response ; refractory chronic schizophrenias, especially with initial responses ; psychotic features ; higher initial doses ; rapid titration ; combined therapy with antidepressants in refractory depression ; and RIS monotherapy in mania/hypomania. RIS is a drug that preferentially block 5-HT2 receptors. The effects of low dose are due mainly to the blockade of 5-HT2 receptors. There are more gradual increase in D2 blockade with increasing dose and this D2 blocking properties become apparent at higher doses. This may be related to a modulation of dopaminergic transmission by 5-HT2 antagonism at lower doses with the direct action of RIS on DA receptors coming into play at higher dose. The serotonergic antagonistic effect may be important for its effects on depressive symptoms. This, together with adequate blo-ckade of D2 receptors, may not necessarily lead to destabilization of mood disorder, but rather to more therapeutic effects. Therefore, this dose-receptor affinity relationship with both antidepressant and antimanic effects according to treatment duration can explain a continuum of antidepressant effect, antimanic effect, behavioral stimulation, and manic/hypomanic induction/exacerbation. It was the recognition of a useful psychiatric side effects by a thoughtful observer with fertile minds that led to their ultimate utilization as psychotropic drugs, i.e., phenothiazine, MAOI, TCA, and lithium. And, in vivo pharmacological challenge by novel psychotropics, as a neurochemical probe, with more specific actions is a useful tool to select pharmacologically homogeneous subgroup of the same phenotypical(clinical) condition, to further study the unknown underlying pathogenesis of various mental illnesses. Finally, RIS may be a useful alternative or adjunctive drug for patients with mood disorders without psychotic features or refractory to treatment with standard antipsychotic drugs. The more conservative doses(tirated slowly from 1-3 mg/d) of RIS, and maintenance of mood stabilizer in the cases with risk factors of RIM are recommended in mood disorder.
박종득,윤도준,Park, Jong Deuk,Yoon, Doh Joon 대한생물정신의학회 1995 생물정신의학 Vol.2 No.2
Late-onset schizophrenia(LOS) is a controversial entity. It has been thought that onset of schizophrenia is limited to early adulthood, but many European psychiatrists have reported on the occurrence of schizophrenia in late life. DSM-III restricted the diagnosis of schizophrenia to patients with onset of illness before age 45 years. But, DSM-III-R, DSM-IV, and ICD-10 recognize no upper limit to the age at onset of schizophrenia. Patients with LOS have more visual, tactile, and olfactory hallucinations. Patients with LOS have more persecutory delusions, premorbid schizoid personality traits, and less affective blunting. The course of illness was favorable in LOS. We present four cases of LOS. Their detailed clinical features are reported hear with brief review.
이장호,윤도준,Yi, Jang Ho,Yoon, Doh Joon 대한생물정신의학회 1995 생물정신의학 Vol.2 No.1
Tardive dyskinesia(TD), typically appearing as an undesirable side effect of a long term antipsychotic drug treatment has gained increased attention in recent times due to the discovery of many TD variants. This is a single case study of a patient who has undergone more than 8 years of high dosage antipsychotic treatment. After altering the type and dosage of antipsychotic medication 3 months prior to visit, the patient showed relatively abrupt onset symptoms of severe tremor and dystonia. These symptoms, appearing in clear consciousess, got better to a certain degree after 48 hours, worsened for 12 hours, and then improved again. Subsequently there was no continuing movement disorder. Several tests and consultation were carried out. However except for the medication factor, no other possible causes for such disabling symptoms were found. This clinical condition was thought to be akin to tardive tremor, a variant of TD. Furthermore, the course was atypical.
동통을 가진 신체형장애 환자에서 감정표현능력과 압통역치
송지영,김태수,오동재,윤도준,염태호,Song, Ji-Young,Kim, Tae-Soo,Oh, Dong-Jae,Yoon, Doh-Joon,Yum, Tae-Ho 한국정신신체의학회 1994 정신신체의학 Vol.2 No.1
저자들은 동통을 가진 신체형장애 환자들에서 물리적인 외부자극에 대한 지각과 외부자극에 따른 언어행동의 관계성을 파악하기 위해서 본 연구를 시행하였다. 환자 34명 (남 10, 여 24)과 건강대조군 37명 (남 19, 여 18)을 대상으로, 물리 적 자극에 대한 지각도의 측정은 압통역치 측정기(algometer)를 이용하였으며, 감정표현능력의 측정은 Toronto Alexithymia Scale을 이용하였다. 한편 신체증상의 정도와 부모-자녀 결합형태검사를 시행하였다. 전체환자의 81.4%는 6개월이상 증상을 지속적으로 많이 호소하는 만성화 특성을 보였다. 그리고 alexithymia의 정도, 신체증상 호소정도, 압통역치가 모두 환자군에서 유의하게 높았다. 그리고 환자군의 44.1%는 alexithymia라고 할 수 있었다. 한편 압통역치와 alexithymia간에 유의한 상관성은 없었다. 결론적으로, 동통을 가진 신체형장애환자들이 정상인에 비해 외부 동통자극에 덜 민감하며, 이는 병의 만성화와 관련되는 것 같다. 이들은 또 외부자극에 따른 적절한 감정표현능력도 떨어져 있는 경우가 많은데, 이것은 신체화의 한 조건이 되며, 한편으로는 정신치료적 접근을 방해하는 한 요소가 될 수 있음을 시사한다. The authors investigated the relationship between the response to the external stimulation and ability of verbal behavior in the patients with somatoform disorder who have pain. The subjects consisted of 34 patients(male 10, female 24) and 37 normal controls(male 19, female 18). Pressure pain thesholds were measured by algometer and alexithymia was assessed by Toronto Alexithymia Scale(TAS). Somatization Scale of SCL-90R and Parental Bonding Instrument were also used. It was shown that 82.4% of the patients had chronic somatic complaints. The mean values of TAS, degree of somatic symptoms and pressure pain thresholds were significantly higher in the patient group than in the normal controls. 44.1% of the patients was considered alexithymia group and there was no correlation between scores of alexithymia and value of pressure pain thresholds. In conclusion, the patients with somatoform disorder who had pain were dull in pain perception to external physical stimulation. This result suggested that their low perception of pain could be closely related with chronicity of illness. And the Poverty of verbal expression of inner emotion was suggested to be one of the factors affecting somatization and difficulty in psychotherapy.