금단증상을 가진 알코올리즘 환자에 대한 임상적 고찰

이귀행,유세종 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.3

1994년 6월 1일부터 1995년 5월 31일까지 원광대학교 부속병원 신경정신과에 알코올관련 장애로 입원한 144명을 대상으로 하였다. 대상을 무금단군과 금단군 및 금단섬망군으로 분류하여 대상환자들을 나이 및 성, 교육 년수, 음주 진행가정, 음주빈도, 동반된 신체질환, 단주의지, 전반적 기능 평가 척도(GAF), 금단증상 분포를 비교하였다. 1) 교육 년수는 무금단군(10.3년)이 다른 두 군〔금단군(7.8년), 금단섬망군(8.4년)〕보다 길었다(p<0.05). 2) 매일 술을 마시는 경우는 금단섬망군(96%), 금단증후군(80.3%), 무금단군(67.9%) 순으로 많았다(p<0.05). 3) 동반된 신체질환은 금단섬망군(72.0%), 금단군(43.9%), 무금단군(34.0%) 순으로 많았다(p<0.05). 4) 단주에 대한 의지는 무금단군(67.9%), 금단군(56.1%), 금단섬망군(28.0%) 순으로 많았다(p<0.05). 5) 현재 기능척도, 지난 해 최고 기능척도(current GAF), (past year highest GAF) 모두는 무금단군(31.6±11.5), (71.6±9.1), 금단군(27.1±9.0), (66.9±10.8), 금단섬망군(20.2±3.7), (65.6±8.0)의 순으로 높았다(p<0.01, p<0.05). 입원한 알코올 환자에서 금단과 섬망에 따라 집단을 나누고, 이를 금단이나 섬망이 없는 집단과 비교하였다. 무금단군 및 금단군 보다 금단섬망군에서 교육기간이 짧고, 술을 매일 마시며, 금단의지가 약하고, 기능수준이 떨어지며, 동반된 신체질환이 많은 경향을 보였다. The authors surveyed the basic demographic data, diagnostic distribution, progression and frequency of alcohol drinking, associated physical diseases, patient's abstinence will, global assessment of functional scales, distribution of alcohol withdrawal symptoms for 144 admitted alcoholic patients, which had performed at the department of neuropsychiatry, Wonkwang University, College of medicine, from June 1, 1994 to May 31, 1995. They were divided into three groups, which were those without alcohol withdrawal symptoms(group A), those with alcohol withdrawal symptoms(group B) and those with alcohol withdrawal delirium(group C). The results were as follows : 1) The mean period of education showed a difference between group A(10.3 years) and other two groups, group B(7.8 years) and C(8.4 years)(p<0.05). 2) Daily alcohol drinking appeared 96% in group C, 80.3% in group B and 67.9% in group A(p<0.05). 3) Physical diseases associated with alcohol drinking appeared 72.0% in group C, 43.9% in group B and 34.0% in group A(p<0.05). 4) The abstinence will appeared 67.9% in group A, 56.1% in group B and 28.0% in group C(p<0.05). 5) Current GAF and past year highest GAF were 31.6±11.5, 71.6±9.1, in group A, 27.1±9.0, 66.9±10.8 in group B and 20.2±3.7, 65.6±8.0 in group C(p<0.01), (p<0.05). The results impressed us that group C, assumed as the most severe group, had less educational period, more daily drinking, weaker abstinence will, lower general function, more associated physical diseases than other groups.

家兎의 前庭眼球反射에 대한 Amphetamine 및 Diazepamdm의 影嚮

이귀행,박병림,류성훈 大韓神經精神醫學會 1990 신경정신의학 Vol.29 No.4

The effects of amphetamine and diazepam on the control of body posture were examined in unanesthetized rabbits. Vestibuloocular reflex(VOR) was elicited by rotation of whole body at frequency of 0.1, 0.2, 0.3Hz by means of sinusoidal rotator in the dark. The following results were obtained. 1) In normal VOR, the frequency and the velocity of nystagmus were increased by increasing the frequency of stimulus rotation from 0.1Hz to 0.3Hz. 2) In amphetamine treated VOR, the frequency and the velocity of nystagmus were increased at all of 3 stimulus frequencies, but any significant differences of the velocity of nystagmus between different stimulus frequencies were not observed. 3) In diazepam treated VOR, the frequency and the velocity of nystagmus were decreased at all of 3 stimulus frequencies, but any significant differences of the frequency and the velocity of nystagmus between different stimulus frequencies were not observed. 4) The actions of amphetamine and diazepam on the VOR were contradictory. These data suggest that amphetamine and diazepam may impair the control of body posture by increasing or decreasing the VOR respectively, through their action on the central nervous system but not on the vestibular system.

정신과자문에 대한 임상적 고찰

이귀행,노승호,박남진 圓光大學校 醫科學硏究所 1989 圓光醫科學 Vol.5 No.1-2

A clinical survey was performed on the cases of cosultations to psychiatry from March, 1988 to January, 1990 at Won Kwang University Hospital. The results were as follows : 1. The consultations were requested from Internal Medicine (43.1%), Neurosurgery (12. 5%), General Surgery (7.8%), Orthopedic Surgery (7.2%), Urology (5.4%), Pediatrics (4.8%), Chest Surgery (3.6%), Dermatology (3.6%), Otorhinolaryngology (3.0%), Plastic Surgery (3.0%), Emergency Room (3.0%), Ophthalmology (1.2%), Oral Surgery (1.2%) and Intensive Care Unit (0.6%). The numbers between parentheses represent the component ratios of the consultations. 2. Memory disturbance (8.6%), Behaviour disturbance (7.8%), Consciousness disturbance (7.6%), Sensory disturbance (7.6%) and Sleep disturbance (7.0%) had higher frequences than others in the consulted symptoms from the referral departments. 3. Memory disturbance (12.3), Behaviour disturbance (9.4%), Sleep disturbance (8.5%), Sensory disturbance (7.4%) and Headache (6.4%) had higher frequences than others in the consulted symptoms checked by psychiatrist. 4. Organic mental disorder (23.8%), Somatoform disorder (18.4%), Epilepsy (9.4%), Mood disorder (5.8%) and Brief reactive psychosis (5.8%) had relatively higher frequences than others in the psychiatric diagnosis of the consulted cases. 5. The cases of Organic mental disorder showed delayed consultations. 6. The psychiatric answers were composed of Psychiatric recommendation (34.1%), Referal to psychiatry (25.1%), Drug prescription (18.0%), Reevaluation for physical condition (12.0%), Observation (10.2%) and Psychitric follow-up (0.6%).

망상형 정신분열증 환자의 지적 능력에 대한 고찰 : K-WAIS를 중심으로 based on K-WAIS

이귀행,오기모,한평주 圓光大學校 醫科學硏究所 1997 圓光醫科學 Vol.13 No.1-2

The authors surveyed 42 paranoid types, 38 undifferentiated types of schizophrenia and 47 neurosis by the K-WAIS to evaluate the intelligence state of the paranoid type of schizophrenia. The results were as follows. 1. Information scale made significant difference between the neuroses and the paranoid types of schizophrenic patients (P<0.1). 2. There were significant differences between the neurotic patients and the schizophrenic patients on all the scores of K-WAIS except information scale(P<0.05). 3. No differences were found between the paranoid and the undifferentiated types of the schizophrenic patients on the intelligence. 4. The paranoid types of schizophrenic patients showed significant difference between the verbal and the performance scale(P<0.1) According to above results, there was the difference of intelligent ability between the schizophrenic patients and the neuroses patients but not between the paranoid types and the undifferentiated types of schizophrenic patients.

Moclobemide의 항우울 효과에 대한 평가

이귀행,박민철,노승호,백영석,이상열,김재현 圓光大學校 醫科學硏究所 1996 圓光醫科學 Vol.12 No.2

Eighteen patients took Moclobemide for 6 weeks, who had been diagnosed as major depression based on DSM-Ⅲ-R and had had more than 16 points on the Hamilton Depression Rating Scale. After medication of Moclobemide, they were evaluated by the Hamilton Depression Rating Scale and in terms of sleep, vigilance, performance, social interactions and drive. The results were as follows ; 1. The average dosage of Moclobemide was 400±89 ㎎. 2. Antidepressant effect were checked on the all items of the Hamilton Depression Rating Scale and prominent on the items of work and activities, insomnia, suicide, somatic symptoms. 3 There were obvious changes of the antidepressive effect by the evaluation of the doctors and patients at 4 weeks after the medication of Moclobemide. 4. In the patients, 61% had positive effects on the sleep. 94% no negative effects on the vigilance. Nobody has negative effects on the social interactions and drive. 5. Side effects or physical disturbances induced by Moclobemide were not found. According to these results, it seemed that Moclobemide had clear antidepressant effects, few negative effects on the life of day time, positive effects on the sleep and somatic symptoms.

정신과 입원환자의 공격행동에 대한 연구

이귀행,김상원 大韓神經精神醫學會 1992 신경정신의학 Vol.31 No.2

This study was performed to evaluate the episodic aggressive behaviors of psychiatric patients who had admitted at Wonkwang University hospital from March 20. 1990 to March 19. 1991. The staffs assessed these episodic aggressive behaviors by Yudofsky's Overt Aggression Scale treanslated into korean. The results were estimated acceding to demographic aspects and diagnostic criterias. During the period of this research, for about 1 year. episodic aggressive behaviors occured in 211(22.5%) patients of the 938 admitted patients and in 745(1.2%) cases of the 64021 inpatients. 49.8% of total aggressive behaviors appeared within one month after admission. 37% from 12 to 18 o'clock during a day, 76.8% in patients with enduring illness more than 25 months. Means of postadmission day of aggressive behaviors for manic episodes. paranoid schizophrenics, personality disorder, and nonparanoid schizophrenics were 18.64, 58, 38, 87.61 and 109.51 days, respectively. Patients of coerced admission, in close ward. readmission. or history of violence before admission made more frequent aggressive behaviors than patients of voluntary admission. in open ward. first admission or no history of violence before admission. In order of frequency, aggressive behaviors occured in corridor, own room, nursing room and were discovered by other patients, nurse, attendant and doctor. Although most aggressive behaviors appeared in schizophrenia, the patients with schizoalfective disorder, manic episode and organic mental disorder were more aggressive than the patients with schizophrenia, alcohol abuse and dependency according to ratio of frequency of aggressive behavior to the number of patients. In major diagnostic categories, the patients with manic episodes was more aggressive than the patient with nonparanoid schizophrenia or personality disorder, and the patients with schizophrenics paranoid type was more aggressive than the patient with nonparanoid type according to total aggression score.

精神分裂症患者의 幻覺에 對한 精神病理學的 考察 : Hun Adaptation of Bender-Gestalt Test 및 Mini-Mental Test를 중심으로

오상우,이귀행,박종호 大韓神經精神醫學會 1992 신경정신의학 Vol.31 No.2

To evaluate the state of perceptual distortion experienced by Schizophrenic hallucinations the Hutt Adaptation of the Bender-Gestalt test(HABGT) and Mini-mental test were performed on two subgroups of schizophrenics. 28 hallucinated schizophrenics(hallucinated group) and 28 nonhallucinated schizoprirenicsCcontrolled group). Psychopathology scale. Adience-abience scale. Regression level were applied to the results of HABGT of both groups. The results of Mini-mental test suggested that hallucinated group had less organic brain damage than controlled group. The results of HABGT suggested that hallucinated group had better ability in external object perception, reasonable ego function, adaptation and emotional control than controlled group. The clinical and psychopathological meanings of these findings were discussed.

攻擊行動을 보이는 精神分裂病 患者의 臨床樣相 및 知能의 特徵

임승한,이귀행,오소영 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.1

Objective : This study was performed to evaluate the clinical and intelligent characteristics of the schizophrenia patients with aggressive behaviors in wards. Subjects and Methods : 112 schizophrenic patients were selected among the patients admitted to the department of neuropsychiatry, Wonkwang University, school of medicine, from January, 1997 to December, 1999. The selected schizophrenic patients were divided into two groups(a group with aggressive behavior, a group without aggressive behavior). We assessed these aggressive behaviors by Yudofsky's Overt Aggression Scale. Clinical features and results of Korean-Wechsler Adult Intelligence Scale(K-WAIS) in each group were compared. Results : 1) The aggressive group showed higher past year highest global assessment of functioning(GAF) & current GAF than the non- aggressive group. 2) The aggressive group had more positive symptoms and less negative symptoms than the non-aggressive group. 3) The aggressive group showed higher scores of picture arrangement, block design, object assembly and digit symbol on the performance scale and vocabulary, comprehension on the verbal scale than the non-aggressive group. 4) The aggressive group showed higher scores of total intelligence Quotient(IQ), performance IQ and verbal IQ than the non- aggressive group. Conclusions : The aggressive schizophrenia patients showed better adjustment and intelligence, especially the performance intelligence than the other schizophrenia patients without aggression . The aggression in schizophrenia seemed to have some reactive component.

색채단어 간섭검사로 본 정신분열증 환자의 주의력 장애

이상렬,이귀행,오상우 大韓神經精神醫學會 1991 신경정신의학 Vol.30 No.1

This study was conducted to investigate the attention span of positive and negative schizophrenic patients. The subjects of consisted of 3 groups : 32 positive schizophrenics, 32 negative shiczophrenics and 32 normal controls. Stroop Color Word Test were adminstered to each group after they were evaluated according to age, educational level, duration of current admission, information scores of KWIS, daily dose of antipsychotics, and state-trait anxiety scores of Spielberger. The results were as follows ; 1) For the word card, the reaction time was significantly different between the schizophrenic group and normal group(P〈.01), and number of errors were significant between the schizophrenic group and normal(P〈0.05). But, there was no significant difference between the two schizophrenic groups in reaction time and number of errors, and between the negative schizophrenic group and control group in number of errors. 2) Fro the color card, the reaction time was significantly different between the schizophrenic group and normal group(P〈0.01), and among the three groups(P〈0.05). The number of errors were significantly different among the three groups(P〈0.01). 3) For the attention to word on incongruent color-word, the reaction time and number of errors were significantly different between the two schizophrenic groups and normal group(P〈.01), but there was no significant difference between the positive and negative schizophrenic group in reaction time, and the negative schizophrenic group have significantly more number of errors than the positive schizophrenic group and control group. 4) For the attention to color on incongruent color-word card, the reaction time was significantly different among the three groups(P〈0.01), and the number of errors were significantly different between the positive and negative schizophrenic group, and between control group and the negative group(P〈0.01) 5) In relative comparision, there were significantly longer reaction time and more errors in the negative than in the positive schizophrenic group to attention to color on incongruent color-word card than to the attention to word on same card(P〈.01). 6) In relative comparision, there were significantly longer reaction time and more errors in the negative than in the positibe schizophrenic group at to the attention to color on incongruent color-word card than to the color card(P〈.01).

알콜 및 임신오조에 의한 Wernicke-Korsakoff 증후군 2례

김훈,이귀행,박민철 圓光大學校 醫科大學 神經精神科學敎室 1994 圓光精神醫學 Vol.10 No.1

We reported a case of Wernicke-Korsakoff's syndrome which was consultated due to psychiatric symptoms by severe hyper-emesis gravidarum and a case of Wernicke-Koraskoff's syndrom which was diagnosed and treated due to chronic alcohol drinking. Wernicke-Korsakoff's syndrome is not rarely experienced in psychiatric settings, and early diagnosis and adequate treatment is much important in clinical prognosis of that illness. His detailed clinical features, etiologies and treatments are reported here with a brief review of literatures.