관상동맥질환 환자들에서 스트레스와 관상동맥 협착 간의 관계

노규식,고경봉,Roh, Kyu-Sik,Koh, Kyung-Bong 한국정신신체의학회 1998 정신신체의학 Vol.6 No.2

The object of this study was to investigate the relationship between stress and the extent of coronary artery stenosis in 101 patients with coronary artery diseases. Global assessment of recent stress(GARS) scale and perceived stress response inventory were used to measure perception for stressors and stress responses. Biological variables such as the extent of coronary artery stenosis, the number of the affected lesions on coronary angiography, serum Low Density Lipoprotein(LDL)-cholesterol, High Density Lipoprotein(HDL)-cholesterol, and total cholesterol were measured in all the subjects. Scores of perceived stress related to changes in relationship and overall global scores on GARS scale had significantly positive correlation with the extent of coronary artery stenosis. On the other hand, scores of percieved stress related to changes in relationship and changes or no changes in routine had significantly positive correlation with the number of the lesions. Scores of perceived stress related to change or no change in routine also positively correlated with serum level of LDL-cholesterol and total cholesterol. In contrast, general somatic symptoms negatively correlated with the extent of coronary artery stenosis. Impulsive-aggressive behavior negatively correlated with the number of the lesions. However, impulsive-aggressive thinking positively correlated with LDL-cholesterol. The above results suggest that perception for stressors may negatively affect the extent of coronary artery stenosis, the number of the lesions, serum LDL-cholesterol and total cholesterol. However, some stress responses showed inconsistent effect on the above biological variables. Thus, strategies designed to modify perception for stressors and some stress responses are likely to help the patients minimize the extent of coronary artery stenosis and prevent the diseases.

일개 전방사단 신세대 장병들의 스트레스 지각 및 대응전략

노규식 ( Kyu-sik Roh ),신동수 ( Alexander D. Shin ) 국군의무사령부 2000 대한군진의학학술지 Vol.31 No.1

강박장애 환자에서의 안와전두피질 용적의 2년 추적 연구

김성년,강도형,유소영,노규식,장준환,최정석,하태현,권준수,Kim, Sung-Nyun,Kang, Do-Hyung,Yoo, So-Young,Roh, Kyu-Sik,Chang, Joon-Hwan,Choi, Jung-Seok,Ha, Tae-Hyon,Kwon, Jun-Soo 대한불안의학회 2006 대한불안의학회지 Vol.2 No.2

Objective : This study was designed to examine the volumetric abnormality of orbitofrontal cortex (OFC) and its change after 2 years of pharmacotherapy in obsessive compulsive disorder (OCD) patients. Method : Volumetric magnetic resonance imaging studies were conducted in 15 OCD patients and 13 normal volunteers. For 2 years, all patients took at least one serotonin reuptake inhibitor and atypical antipsychotics were used as an augmentation therapy in most patients. The follow-up MRI studies were conducted after the pharmacotherapy and OFC volumes were measured by the manual region of interest method. Results : Bilateral OFC volumes of 15 OCD patients were significantly greater than those of the normal volunteers before the treatment. After 2 years of the treatment, significant decrease was observed in bilateral OFC volumes of OCD patients to the extent that left OFC volume of OCD patients was not different from that of the normal volunteers. Conclusion : This finding suggests that OFC is directly related to the pathophysiology of obsessive compulsive disorder.

관상동맥질환 환자들과 정상인 간 분노의 비교

고경봉,이상혁,김장우,노규식,Koh, Kyung-Bong,Lee, Sang-Hyuk,Kim, Jang-Woo,Roh, Kyu-Sik 한국정신신체의학회 2004 정신신체의학 Vol.12 No.1

본 연구의 목적은 관상동맥질환 환자들과 정상인 간의 분노수준을 비교하고자 하는 것이었다. 233명의 관상동맥질환 환자들과 215명의 정상대조군을 대상으로 조사하였다. 분노수준을 평가하기 위해서 분노표현척도, 스트레스반응척도의 분노 및 공격성 하위척도, SCL-90-R의 적대감 하위척도를 사용하였다. 관상동맥질환 환자군은 정상대조군보다 분노표현 하위척도점수 및 분노전체 하위척도 점수, 스트레스반응척도의 분노 및 공격성 하위척도 점수가 각각 유의하게 더 높았다. 협심증 환자들은 심근경색증 환자들보다 분노표현 하위척도점수 및 분노전체 하위척도 점수가 유의하게 더 높았다. 환자군에서 남자는 여자보다 분노억제 하위척도 점수가 유의하게 더 높은 반면, 여자는 남자보다 분노표현 하위척도 점수가 유의하게 더 높았다. 이상의 결과는 관상동맥 질환 환자들이 정상인들보다 분노수준, 특히 분노표현의 정도가 더 높다는 것과 성별에 따라 분노표현에 차이가 있음을 시사해 준다. 또한 환자들의 높은 분노 수준은 병의 경과에 나쁜 영향을 미칠 수 있다는 점에서 관상동맥질환 환자들에 대한 분노관리의 필요성이 강조된다. The objective of this study was to make a comparison on anger level between patients with coronary artery diseases and healthy individuals. 233 patients with coronary artery diseases and 215 normal controls were enrolled in this study. The Anger Expression Scale, the anger and aggression subscales of the Stress Response Inventory(SRI) and the hostility subscale of the Symptom Checklist-90-revised(SCL-90-R) were used to assess the level of anger. The patients with coronary artery diseases scored significantly higher on the anger-out and anger total subscales of the anger expression scale, the anger and aggression subscales of the SRI than the normal controls. The patients with angina pectoris had significantly higher scores in the anger-out and anger-total subscale than those with myocardial infarction. Male subjects scored significantly higher on the anger-in subscale than females, whereas female subjects scored significantly higher on the anger-out subscale than male subjects. These results suggest that patients with coronary artery diseases are likely to have a higher level of anger or anger expression than normal controls and that there may be difference in anger expression between male and female patients. It is emphasized that anger management is needed to prevent the coronary artery disease patients from aggravating the illness.

강박장애에서 LORETA 영상을 이용한 P300 국소원의 통계적 분석

박성근,최정석,유소영,이보름,강승석,노규식,하태현,권준수,Park, Sung-Kun,Choi, Jung-Seok,Yu, Soh-Young,Lee, Bo Reom,Kang, Seung-Suk,Roh, Kyu Sik,Ha, Tae-Hyun,Kwon, Jun Soo 대한생물정신의학회 2003 생물정신의학 Vol.10 No.2

Objectives:We investigated the characteristics of P300 generators in obsessive-compulsive disorder(OCD) patients by using voxel-based statistical parametric mapping of current density images. Methods:P300 generators, produced by a rare target tone of 1500Hz under a frequent non-target tone of 1,000Hz, were measured in 15 right-handed OCD patients and 15 controls. Low Resolution Electromagnetic Tomography(LORETA), using a realistic head model of the boundary element method based on individual MRI, was applied to the 128-channel EEG. Statistical parametric mapping(SPM) was applied for the statistical analysis. Results:We found that both groups had the mean current density of P300 in the parietal, temporal and prefrontal lobe. There was a trend for decreased current density in the prefrontal area in OCD patients. The statistical comparison showed current density increase in the supraparietal area, a statistically significant longer P300 latency and a trend for reduced P300 amplitude in OCD patients. Conclusion:It suggests that P300 source of both groups exists in multiple brain regions at the same time. And both groups had no statistically significant differences in the current density of P300 except for increased current density in the supraparietal area in OCD patients. But, considering the statistically significant longer P300 latency, a trend for reduced P300 amplitude and relative mean current density reduction in the prefrontal area in OCD patients, this study suggests that the frontal lobe may have a reduced normal inhibitory process in OCD patients.

강박장애 환자의 인지기능이상에 대한 2년 추적 연구

노규식,신민섭,박희수,하태현,신용욱,김명선,권준수 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.5

Objectives : The purpose of this study was to investigate the changes of cognitive dysfunctions in patients with Obsessive-compulsive disorder (OCD) over the two-year of pharmacological treatment. Methods : The thirty-three OCD patients and thirteen normal subjects were administered the neuropsychological tests and clinical evaluations twice (at the baseline and two-year). Results : In spite of the two-year treatment, the accuracy of delayed recall on the Rey-Osterrieth Complex Figure Tests (RCFT), the numbers of responses on the category and letter test of Controlled Oral Word Association Test (COWA), the response time on the Trail Making Test part A (TMT-A) remained significantly impaired in the OCD patients compared with the normal controls. Conclusion : These findings suggest that the cognitive dysfunctions such as visuospatial memory and verbal fluency might be the underlying persisting neuropathophysiology of OCD.

만화 과제를 이용한 정신분열병 환자의 사회인지 능력의 측정

오정은,나명현,하태현,신용욱,노규식,홍순범,이경진,신민섭,이영호,권준수 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.3

Objectives : This study is to investigate the hypothesis that schizophrenic patients have difficulty in inferring mental state of others. Methods : Twenty schizophrenic patients and twenty normal subjects were administered to the Cartoon Task required inferring the character's intention in a given context. Results : The schizophrenic patients showed a statistically significant impairment in the Cartoon Task. Both groups chose the card depicting a frequent everyday action significantly more rather than the similar card to the last picture in each story for wrong answers. Conclusion : These preliminary results suggest that schizophrenia is associated with a specific deficit of the cognitive ability referred to as social cognition, and this deficit can be detected not only in the acute phase as found in previous research studies, but also in remission. Also when subjects fail to appreciate what is going on in the minds of other people, they seem to rely on a socially familiar experience.

통합심리치료의 인지분화훈련이 정신분열병 환자의 기초 인지기능에 미치는 영향

이희상,현명호,조현상,이연희,김태용,장순아,노규식,정기립,이만홍,유계준 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

연구목적 : 정신분열별 환자들을 대상으로 통합심리치료의 소프로그램인 인지분화훈련을 실시하여 실행기능, 개념형성능력, 언어능력 및 추론력에 대한 훈련이 보다 더 하위단계의 인지기능인 주의력, 기억력, 반응시간 등을 호전시킬 수 있는 지를 알아보고자 하였다. 연구방법 : DSM-IV상 정신분열병으로 진단된 24명의 입원환자를 무작위로 양분하여 한 군은 인지분화훈련군으로 다른 한 군은 대조군으로 나누었다. 훈련군은 4주동안 1주일에 3회(매회 60분간)로 총 12회의 통합심리치료의 인지분화훈련을 받았으며 대조군은 동일한 시간동안 정신건강교육을 받았다. 훈련전후에 훈련군과 대조군을 대상으로 개정판 Wechsler 기억검사로 주의집중력, 장·단기 기억력을 측정하였고 Vienna test system중 결정반응시간검사로 반응시간, 반응결정시간, 반응운동시간을 평가하였다. 연구결과 : 1) 주의집중력에서는 훈련군과 대조군사이에 집단간 효과, 집단내 효과 및 상호작용 효과가 없었다. 2) 단기기억력에서는 훈련군과 대조군사이에 집단내 효과는 있었으나(F(1,24)=10.46. p〈.05). 집단간 효과, 상호작용 효과는 없었다. 3) 장기기억력에서는 훈련군과 대조군사이에 집단내 효과는 있었으나(F(1,24)=15.09. p〈.05). 집단간 효과, 상호작용 효과는 없었다. 4) 반응시간에서는 상호작용 효과(F(1,24)=5.18, p〈.05)가 있었다. 5) 반응운동시간에서는 집단간 효과, 집단내 효과 및 상호작용 효과가 없었다. 6) 반응결정시간에서는 상호작용 효과(F(1.24)=6.00, p〈.05)가 있었다. 결 론 : 통합심리치료의 인지분화훈련은 정신분열병 환자에서 하위단계의 인지기능 중 반응시간(특히 반응결정시간)을 단축시키는 효과가 있었다. Objectives : The purpose of this study was to investigate the effects of cognitive differentiation training of Integrated Psychological Therapy(a training program of executive function, concept formation, language, and abstraction) on micro-level cognitive function such as attention, memory and reaction time in patients time in patients with schizophrenia. Methods : Twenty-four inpatients diagnosed as schizophrenia using DSM-IV were randomly assigned to 2 groups. The training group went through a total of 12 sessions of cognitive differentiation training for 4 weeks. The control group received psychoeducation program during the same period. Wechsler Memory Scale-Revised and Decision-Reaction Timer of Vienna Test System were administered to all patients, both before and after the training program. Results : 1) In the attention and concentration scores of Wechsler Memory Scale-Revised, between group, within group and interaction effects of training were not significant. 2) In the short-term memory scores of Wechsler Memory Scale-Revised, within group effect of training was significant(F(1,24)=10.46, p〈0.05), but the between group and interaction effects did not reach significance. 3) In the long-term memory scores of Wechsler Memory Scale-Revised, within group effect of training was significant(F(1,24)=15.09, p〈0.05), but the between group and interaction effects did not reach significance. 4) In the reaction time scores of Decision-Reaction Timer, interaction effect of training was significant(F(1,24)=5.18, p〈0.05). 5) In the motor time scores of Decision-Reaction Timer, between group, within group and interaction effects of training were not significant. 6) In the decision time scores of Decision-Reaction Timer, interaction effect of training was significant(F(1,24)=6.00, p〈0.05). Conclusion : Our findings suggest that cognitive differentiation training of Integrated Psycho-logical Therapy is partly effective on improving micro-level cognitive functions such as reaction time(especially, decision time) in patents with schizophrenia.

정신분열병 환자의 사회인지 손상이 사회적 기능손상에 미치는 영향

나명현,오정은,강도형,노규식,이영호,권준수 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.1

Objectives : Both story and cartoon task are sensitive to evaluate social cognition deficit m schizophrenia. However it is unclear whether social cognition deficits indexed by these tasks of schizophrenia reflect social functioning in their real life. To this purpose, we investigated the effect of social cognitive deficits detected in schizophrenic patients on social functioning. Methods : Our investigation involved twenty-two schizophrenic patients and normal subjects. The story and cartoon tasks as mental state reasoning tasks and the 'Social Functioning Scale (SFS)' as a social functioning measure were administered for all subjects. Results : The schizophrenic patients with average level of intelligence and mild psychotic symptoms, regarded as almost remitted, showed significantly poor performance on all ofstory task, cartoon task, and SFS. However, after controlling IQ's effects, only the performances on the story task were significantly contributed to the performances on the SFS, especially on subscales of 'Withdrawal', 'Independence performance' and 'Independence competence'. Conclusion : These findings indicate that perfonnance of the story task is considered as a good predictor of social functioning for the schizophrenic patients in remission.