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송지영 ( Ji Young Song ) 한국정신병리진단분류학회 2011 精神病理學 Vol.20 No.1
The author have described brief history of the psychiatric classification and diagnostic changes which had been developed since 18th century in Europe. Most parts of the psychiatric diagnostic concepts and classifica tions had been started and developed mainly in France and Germany which had been followed by United States thereafter. Understanding of the old fashioned psychiatric nosology and classifications in psychiatry would not be useless rather give us fertile understandings for the original meaning of the diagnostic terms in psychiatry. Knowledged of the concept and development in diagnoses of the mental illness would be helpful for under standing the pros and cons in psychiatric classifications using at this time. It is expected new revised edition of the ICD and DSM classification published within several years. It seems to be fundamental and necessary task for us understanding not only the background but the trend of the classifications and concepts in metal illness.
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김태호 ( Tae Ho Kim ),문석우 ( Seok Woo Moon ) 한국정신병리진단분류학회 2011 精神病理學 Vol.20 No.1
Maternal psychopathology has been associated with child psychological development. When mother is suffered depression in peripartum period there are excessive activity and growth delays in the fetus as well as prematurity, low birthweight, disorganized sleep and less responsiveness to stimulation in the neonate. Infants of depressed mothers have difficult temperament, attentional, emotional and behavioral problems during childhood and adoles cence as well as adulthood. Potential mediating variables are low prenatal maternal dopamine & serotonin levels and elevated cortisol & norepinephrine levels. The associated intrauterine artery resistance may limit blood flow, oxygen and nutrients to the fetus. Some studies suggest the heritability of developmental problems for the children of depressed mothers, including ADHD and antisocial behavior.
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MMSE와 SIRQD의 조합을 통한 치매선별 정확도 향상
윤제연 ( Je-yeon Yun ),이동영 ( Dong Young Lee ),서은현 ( Eun Hyun Seo ),윤종철 ( Jong Chul Youn ),우종인 ( Jong In Woo ) 한국정신병리진단분류학회 2011 精神病理學 Vol.20 No.1
목 적 본 연구에서는 간이 인지기능 검사인 Mini-Mental Sta-te Examination(MMSE)와 치매선별용 정보제공자 보고용 설문지인 Seoul Informant Report Questionnaire(SI- RQD)의 조합이 개별 도구에 비해 치매 선별 정확도를 향상시킬 수 있는지를 규명하고자 하였다. 방 법 462명의 치매 환자와 423명의 비치매 노인에게 MM-SE in the Korean version of the Consortium to Esta-blish a Registry for Alzheimer’s Disease(CERAD) assessment packet(MMSE-KC) 검사를 시행하였다. 또한, 각 대상자의 정보제공자에게 SIRQD 설문지를 작성하도록 하였다. 이를 통해 얻어진 MMSE-KC 점수와 SI-RQD 점수를 조합하여 조합 점수로서 단순합 점수와 가중합 점수를 구하였다. MMSE-KC 점수와 SIRQD 점수, 두 점수의 제곱 및 두 점수간의 상호작용을 독립 변수로 하는 로지스틱 회귀분석을 통해 치매 여부를 예측하는 회기모형 I을 구하고 이를 이용하여 가중합 I을 산출하였다. 아울러 회기 모형 I에 포함된 독립변수들과 교육 연수를 함께 고려한 회기모형 II를 구하고 이를 이용하여 가중합 II를 구하였다. Receiver Operating Charac-teristics 곡선하 면적 비교를 통해 MMSE-KC 점수, SI-RQD 점수, 단순합, 가중합 I 및 II 간의 치매 선별 정확도를 비교하였다. 결 과 MMSE-KC 점수의 치매 선별 정확도는 SIRQD 점수에 비해 유의하게 높았다. 단순합의 치매 선별 정확도는 MMSE-KC를 단독 사용하였을 때와 비교하여 통계적으로 유의한 차이를 보이지 않았지만, 로지스틱 회기식을 통해 얻은 조합 점수인 가중합 I과 II는 MMSE-KC 점수 단독 사용시에 비해 유의하게 향상된 치매 선별 정확도를 나타냈다. 결 론 본 연구에서 나타난 이러한 결과들은 기존에 서구 노인을 대상으로 보고된 바와 같이 한국 노인에서도 서로 다른 접근 방식을 취하는 대표적인 두 가지 치매 선별 방식에 의한 점수를 적절한 가중치를 주어 조합함으로써 치매 선별 정확도를 향상시킬 수 있음을 지지한다. 아울러 본 연구 결과는 이러한 조합 시 교육 수준을 함께 고려할 경우 선별 정확도를 더욱 높일 수 있음을 시사한다. Objectives:We aimed to investigate whether the combination of a brief cognitive test, the Mini-Mental State Examination(MMSE), and an informant report-based screening questionnaire for dementia, the Seoul Informant Report Questionnaire(SIRQD), can improve the screening accuracy for dementia compared to each individual instrument. Methods:Four hundred and sixty-two dementia patients and 423 non-demented elderly individuals were included in this study. The MMSE in the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet(MMSE-KC) and SIRQD were applied to each subject and his or her reliable informant, respectively. Simple sum(SS) score and two weighted sum(WS) scores, derived from stepwise logistic regression model only including MMSE-KC and SIRQD scores(WS I), or model including both scores and education (WS II), were calculated to combine the contributions of the two instruments to dementia screening. We compared dementia screening accuracy among individual instrument scores and three combination scores by using area under the curve(AUC) of the Receiver Operating Characteristics curves. Results:Both WS I and II showed significantly better dementia screening accuracy than each individual screening instrument score, while SS did not. In addition, WS II demonstrated superior screening accuracy compared to WS I. WS I and WS II predicted dementia clinical diagnosis 62.7% and 64.7%, respectively. Conclusion:The finding from this study indicated that proper combination of brief cognitive test and informant report-based questionnaire can improve the dementia screening accuracy of each individual screening instrument. Moreover, educational level probably contributes to the further improvement of dementia screening ability when added to combination model.
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강원섭 ( Won Sub Kang ),김용희 ( Yong Hee Kim ),장환일 ( Hwan Il Chang ) 한국정신병리진단분류학회 2006 精神病理學 Vol.15 No.1
Objectives: This study was conducted to evaluate the reliability and validity of the Korean Version of the Jefferson Scale of Empathy-HP-version(K-JSE-HP). Method: The subjects were 86 residents who are working at Kyunghee University Hospital. The reliability and validity of K-JSE-HP and the differences on mean empathy scores by physicians` gender, specialty, career, and personality traits were examined. Results: The 20 items(except 2 items) of the K-JSE-HP(emotional empathy, cognitive empathy) was associated with excellent internal consistency(cronbach`s α=0.88) in reliabilities. The correlation coefficient between sum and the general items of the K-JSE-HP showed appropriate scores. Individual items showed good concurrent validity. Empathy scores were inversely correlated with impulsivity. But it were not associated with gender, specialty and career. Conclusion: K-JSE-HP was confirmed in its reliability and validity. It can be a useful scale for evaluating empathy in physician with various specialty.
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이윤나 ( Yunna Lee ),전진숙 ( Jin Sook Cheon ),최영식 ( Young Sik Choi ),오병훈 ( Byoung Hoon Oh ) 한국정신병리진단분류학회 2015 精神病理學 Vol.23 No.1
연구목적 : 자가면역 갑상선장애 환자에서 삶의 질(quality of life, 이하 QoL) 저하 여부와 이들의 QoL에 관계되는 변인을 규명하기 위함이다. 연구방법 : 자가면역 갑상선장애 환자 41명과 건강한 대조군 40명을 대상으로 구조적 면담과 한국판 세계보건기구 삶의 질 간편형 척도(WHOQOL-BREF)를 사용한 QoL 평가 및 한국판 Hamilton 우울증 평가척도(K-HDRS)를 사용한 우울증 평가를 시행하였다. 연구결과 : 1) 자가면역 갑상선장애 환자군은 대조군 보다 유의하게 전체 QoL 점수, 일반적 건강, 영역1(신체적 건강 영역), 영역 2(심리적 영역), 영역 3(사회적 관계 영역) 및 영역 4(환경적 영역) 점수가 낮았다(각각 p<0.001). 2) 전반적 QoL은 K-HDRS 점수 및 경제수준, 일반적 건강은 K-HDRS 점수와 유의한 역상관관계가 있었다(각각 p<0.01). 전체 QoL 점수는 교육수준과 유의한 순상관관계, K-HDRS 점수 및 경제수준과 유의한 역상관관계가 있었다 (각각 p<0.01). 신체적 건강 영역은 K-HDRS 점수(p<0.01)와 유의한 역상관관계, antimicrosomal 항체(p<0.05)와 유의한 순상관관계가 있었다. 심리적 영역은 TSH와 유의한 순상관관계(p<0.05), K-HDRS 점수(p<0.01) 및 T3(p<0.05)와 유의한 역상관관계가 있었다. 사회적 관계 영역은 K-HDRS 점수와 유의한 역상관관계(p<0.01)가 있었다. 환경적 영역은 교육수준과 유의한 순상관관계, 경제수준과 유의한 역상관관계가 있었다(각각 p<0.01).3) 회귀분석에서 antimicrosomal 항체는 전체 QoL 점수에 역의 영향(β=-0.002)을 미쳤으며, 전반적 QoL(β=0.037), 일반적 건강(β=0.023), 신체적 건강 영역(β=0.003), 심리적 영역(β=0.006), 사회적 관계 영역(β=0.013) 및 환경적 영역(β=0.004)에 순의 영향을 미쳤다(각각 p<0.01). 결론 : 본 연구의 결과는 자가면역 갑상선장애 환자에서 삶의 질 저하에 가장 중요한 결정인자는 갑상선항체 (antimicrosomal 항체)임을 시사하였다. Objectives : The aims of this study were to know whether quality of life (QoL) was lowered in patients with autoimmune thyroid disorders, and to identify influencing factors on their QoL. Methods : Demographic and clinical data were obtained by structured interviews for healthy controls (N=40) and patients with autoimmune thyroid disorders (N=41). The measurements of QoL and depression were also performed using Korean Version of WHOQOL-BREF and Korean Version of Hamilton Deression Rating Scale. Results : 1) The total QoL scores, general health, domain 1 (physical health domain), domain 2 (psychological domain), domain 3 (social relationship domain) and domain 4 (environmental domain) were significantly lower in patients with autoimmune thyroid disorder than those of healthy controls (p<0.001, respectively). 2) Overall QoL had negative correlation with K-HDRS and economic status, and general health had negative correlation with K-HDRS (p<0.01, respectively). Total QoL scores had positive correlation with education, and had negative correlation with K-HDRS and economic status (p<0.01, respectively). Physical health domain had negative correlation with K-HDRS (p<0.01), and had positive correlation with antimicrosomal antibodies (p<0.05). Psychological domain had positive correlation with TSH (p<0.05), and had negative correlation with K-HDRS (p<0.01) and T3 (p<0.05). Social relationship domain had negative correlation with K-HDRS (p<0.01). Environmental domain had positive correlation with education, and had negative correlation with economic status (p<0.01, respectively). 3) According to regression analysis, antimicrosomal antibodies influenced negatively on the total QoL scores (β=-0.002), and positively on the overall QoL (β=0.037), general health (β=0.023), physical health domain (β=0.003), psychological domain (β=0.006), social relationship domain(β=0.013) and environmental domain (β=0.004)(p<0.01, respectively). Conclusion : The thyroid antimicosomal antibodies seemed to be the most important determinant of QoL in patients with autoimmune thyroid disorders.
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