정신분열병에서 도파민 D4 수용체(DRD4) 유전자의 다형성

이홍석,이민수,한덕정,이헌정,Lee, Hong Seock,Lee, Min Soo,Han, Deock-Jeong,Lee, Heon-Jeong 대한생물정신의학회 2000 생물정신의학 Vol.7 No.2

Background : No association between schizophrenia and dopamine D4 receptor polymorphisms have been reported. Despite these results, it is premature to exclude the association. It has been suggested that the susceptibility to develop schizophrenia could result from variation at a number loci which may interact or coact with each other. Therefore, we investigated a possible association of combinations of exon III 48bp polymorphism[D4E3] and exon I 12bp polymorphism of the DRD4 gene [D4E1] with schizophrenia. Methods : 207 unrelated Korean schizophrenic patients and 191 healthy controls were recruited. DRD4 genotype was established using the polymerase chain reaction. Statistical analysis consisted of ${\chi}^2$ tests for Hardy-Weinberg proportions and genotypic and allelic frequencies in the patients and control groups. Results : There were no statistically significant differences in the each polymorphisms between schizophrenics and controls. And all genotype frequencies were within Hardy-Weinberg expectations. When the combinations of the polymorphism in schizophrenia and controls were compared, however, there were significant differences at $A1A2^*2/4$ in the distributions of the combinations of D4E1 and D4E3(p<0.01). Conclusions : These findings suggest that the certain combination of D4E1 and D4E3($A1A2^*2/4$) has the protective role to a susceptibility for schizophrenia. 정신분열병과 DRD4 다형성이 연관이 없다는 보고들이 있어왔다. 그러나 지금까지의 결과로부터 정신분열병과 DRD4가 연관이 없다고 결론 내리는 것은 성급한 것일 수도 있다. 정신분열병의 유전적 취약성은 여러 유전자좌(locus)들이 같이 상호작용(interaction) 또는 공작용(coaction)에 의한 것일 가능성이 크다. 저자들은 DRD4 유전자의 exon III 48-염기쌍 다형성 [D4E3]과 exon I 12-염기쌍 다형성[D4E1]의 조합과 정신분열병의 연관성에 관하여 연구하였다. 207명의 친척이 아닌 한국인 정신분열병 환자와 191명의 정상 대조군이 연구에 참여했다. DRD4 유전자형을 중합효소연쇄반응을 통하여 확인하였으며, 정신분열병 환자군과 정상 대조군의 유전자형과 대립유전자의 빈도간의 차이를 연구하였다. 두 군간에 다형성에 있어 통계적 유의한 차이는 보이지 않았으며, 모든 유전자형의 빈도는 Hardy-Weinberg equilibrium에서 예상되는 분포와 유의한 차이가 없었다. 정신분열병 환자군과 정상 대조군에서 DRD4 유전자의 다형성을 조합하여, D4E1과 D4E3 다형성의 조합의 분포에 있어 비교하였을 때, $A1A2^*2/4$의 분포에 있어 두 군간에 유의한 차이가 있었다(p<0.01). 이러한 소견은 D4E1과 D4E3 다형성의 조합중 하나인 $A1A2^*2/4$이 정신분열병의 취약성에 있어 방어적인 역할을 할 가능성을 시사하는 것이다.

알코올 중독자 자녀의 기질 성격 특성과 음주 효과 기대

이홍석(Hong-Seock Lee),이상규(Sang-Kyu Lee),김형태(Hyung-Tae Kim),손봉기(Bong-Ki Son) 한국중독정신의학회 2008 중독정신의학 Vol.12 No.2

Objectives:Alcohol dependence has been known to be a disease affecting family members, especially children as well as patients themselves. This research was designed to assess the temperament, character patterns, drinking expectancies, and problematic drinking behaviors in adolescents of alcoholics. Methods:Data from 1087 middle school students was collected to analysis. All subjects completed the questionnaire asking the history of experience with alcohol, two screening tests for children of alcoholics (CAST-K and F-CAGE), temperament and character inventory for junior (JTCI), problem oriented screening instrument for teenagers (POSIT-alcohol), and alcohol expectancy questionnaire (AEQ). ANOVA and Chi-square test were used to analyze the data. Results:1) The children of alcoholics (CAST-K score ≥13 & F-CAGE ≥2) were 111 (10.2%), problematic (7≤CAST-K <13 or CAST-K score ≥13 & F-CAGE <2) were 232 (21.3%) and normal parents (CAST-K ≤6) were 744 (68.4%). 2) The POSIT score was highest in the children of alcoholics, and lowest in the children of normal. 3) The children of alcoholics had higher novelty seeking (NS), harm avoidance (HA), self-transcendence (ST) and lower reward dependence (RD), self-directedness (SD) and reported more the positive expectancies for their drinking behaviors than the other groups (normal or problematic drinking parent’s children). Conclusion:The children of alcoholics would have more likelihood of similarity in temperament character pattern with the addictive personality and this result suggested that we should take into consideration in the development of prevention and intervention focused in the adolescents of alcoholics. The preventive program should include some different methods of strengthening some character factors (self directedness and cooperativeness), and education for lessening alcohol expectancies.

외상 후 병리에서 성장으로: 외상 후 성장 시계

이홍석(Hong-Seock Lee) 한국인지과학회 2016 인지과학 Vol.27 No.4

인간 정신은 외상 자극에 역동적으로 반응하여 다차원적 위계를 따라 진화적으로 발전하는 시스템이다. 평형상태에서 일원화되어 있는 정신 내에 외상 자극이 유입되면 그에 반대 쌍이 되는 반응 극성이 형성되어 이원화된다. 그 반대 쌍 사이에 초월적 상호작용이 일어나면 상위 차원에 제3의 극성이 출현하게 되어 정신은 삼위구조로 변형된다. 삼위 구조화된 정신에서는 비평형 상태가 극대화되어 가소성이 최대화됨에 따라 삼위 요인이 같은 기능을 하게 되는 동기화가 가능해지며 이로 인해 정신은 상위차원에서 다시 일원화된다. 만약 정신이 또 다시 새로운 자극을 받아들이게 되면 정신은 위의 위계적 변형과정을 따라 성장하게 된다. 이를 정신의 기본삼위체계의 동기화를 통한 순환적 성장과정이라 한다. 이번 이론 연구에서는 이 개념을 외상 후 성장 과정에 적용하여 외상 후 성장 시계를 제안하였다. 외상 후 성장 시계는 7개의 위계적 단계로 구성되어있으며 처음 6개의 단계들은 충격 대 마비, 공포 대 침습, 편집 대 회피, 강박 대 폭발, 불안 대 우울, 허무 대 의미추구 단계 등의 12분기로 구성되어 있고 마지막 7번째 단계에서는 이들 모든 단계들의 기능들이 동기화되는 거대 동기화 단계가 나타나게 된다. 거대 동기화 단계에서는 이전의 6 단계들로 구성된 개인 내의 생리-사회-실존 차원들 뿐 아니라 자아와 타아도 동기화를 통해 일원화됨으로써 자신의 외상경험 뿐 아니라 타인의 고통도 자신의 실제적 외상경험으로 작용하게 되어 정신은 상위 차원에서 또 다른 성장과정을 반복한다. 이 논문에서 제안된 외상 후 성장 시계의 변형과정에 대한 타당성을 Horowitz의 외상반응과정과 비교하여 논의하였다. The human mind is a self-evolving system that develops along a multidimensional hierarchical pathway in response to traumatic stimulus. In absence of trauma, a mind integrated in conflict-free state is called monistic. When the monistic mind responses to a traumatic stimulus, a response polarity forms toward stimulus polarity within the mind, turning it into a bipartite structure. Dialectical interaction between the two opposites, originating from their incompatibility, creates a new third polarity in the upper dimension. Thereby, the mind turns into a trinity structure. When the interaction among the three polarities becomes optimized, the plasticity of the mind gets maximized into the “far-from-equilibrium state,” and the function of three polarities is synchronized. Through this recalibration, the mind returns back to its monistic structure. If the mind with the recurred monistic structure responds to another traumatic stimulus, this cycle of hierarchical transformation repeats itself in this cyclical and fractal growth process through synchronization of basic trinity system. Applying this concept to the process of post-traumatic growth (PTG), this paper explores how the mind transforms traumatic experiences into PTG and proposes a ‘PTG Clock’ that shows a fundamental sequence in the development of the human mind. The PTG Clock consists of seven hierarchical phases, and each of the first six phases has two opposite sub-phases: shocked/numbed, feared/intrusive, paranoid/avoidant, obsessional/explosive, dependent/depressive, and meaningless/searching for meaning. The seventh, the synchronization phase, completes one cycle of the mind’s transformation, realizing a grand trinity system, where the mind synchronizes its biological, social, and existential dimensions. At that point, the mind becomes more susceptible to not only the stimulus of its own traumatic experience but also the pain of others. Thereby, the PTG Clock sets out on a journey to another cycle of transformation in higher dimensions. The validity of this transformational process for the PTG Clock will be examined by comparing it to Horowitz’s theory of stress response syndrome.

종설 : 당뇨병, 우울증, 그리고 환자-의사관계

이홍석 ( Hong Seock Lee ),이중서 ( Joong Seo Lee ),이흥표 ( Heung Pyo Lee ),전철은 ( Chul Eun Jeon ) 대한당뇨병학회 2009 Diabetes and Metabolism Journal Vol.33 No.3

Although diabetes mellitus (DM) is treatable, it is still not curable. Its chronicity is associated with a high prevalence of psychiatric disorders, especially depression in type 2 DM and learned helplessness in type 1 DM. In turn, this depression and helplessness may affect a patient`s adherence to medical appointments, compliance to treatment, and effective doctor-patient relationships, which are vital to promising outcomes. This study reviews the existing literature regarding the interactional relationships between depression, DM and the doctor/patient relationship, and also suggests certain aspects of the doctor/patient relationship which can contribute to more successful treatment outcomes. (Korean Diabetes J 33:178-182, 2009)

일 도시 직장인의 문제성 음주에 영향을 미치는 요인들

이홍석(Hong-Seock Lee),이상규(Sang-Kyu Lee),손봉기(Bong-Ki Son) 한국중독정신의학회 2009 중독정신의학 Vol.13 No.1

Objectives:Drinking problems among employees cause decreased productivity, injuries, and increased health insurance claims. In this study the relationships between 7 measures of alcohol-related psychosocial factors and employee’s drinking problems were investigated. Methods:Cross-sectional data were collected from 898 employees living in Chuncheon. Data from 678 employees were subjected to final analysis. All subjects completed a set of self-report questionnaires that included the demographic data, problematic drinking behavior (AUDIT-K), expectations about the effect of drinking (Alcohol Belief Scale), a job stress questionnaire (Korean Occupational Stress Scale), and questions about the workplace drinking environment (e.g., the workplace subculture about drinking), social support, and self- esteem. Results:The AUDIT-K score was significantly and positively correlated with alcohol withdrawal experiences, expectations about the effect of drinking, workplace drinking environment, social support, and self-esteem. Analysis by binary logistic regression showed that sex, the amount of daily drinking, expectations about the effect of drinking, and characteristics of the subculture about drinking predicted problem drinking. How-ever, job stress, which had been known to be a contributing factor for employee drinking problem was not related to problem drinking behavior in this study. Conclusion:Previous evidence indicates that job stress can contribute to alcohol problems among employed persons. However, this study does not support this linkage between job stress and alcohol problems. Instead, positive expectations about the effects of drinking and the degree of positive environment about drinking in work-place contributed to the severity of employee alcohol problems in this study. These results, have important implications for the development of preventive programs for employee alcohol abuse by changing the office subculture through educational programs that correct distorted expectations about the effects of alcohol.

불법도박의 빈도와 도박중독 심각도에 대한 도박 동기의 차이

이홍석(Hong-Seock Lee),이흥표(Heung-Pyo Lee),윤장순(Jang-Soon Yoon),김형태(Hyung-Tae, Kim),전철은(Chul-Eun, Jeon),이상규(Sang-Kyu Lee) 한국중독정신의학회 2009 중독정신의학 Vol.13 No.2

Objectives:This study compared differences in gambler’s motivations according to the type of gambling (illegal vs. legal gam-bling) and the severity of pathological gambling (pathological vs. problematic vs. social gambler). Methods:We sampled 890 adults. They were divided into those gambling in both legal and il-legal gambling places (n=217), those gambling only in legal gambling places (n=119) and those gambling only in illegal gambling places (n=124). Also, their 5 gambling motives (avoidance, amusement, monetary, excitement, and socialization) and severity of gambling behavior were measured. We conducted multiple regression analysis to identify the motives associated with increased frequency of gambling in illegal gambling places and severity of gambling behavior. Results:The results revealed that avoidance, socialization, and monetary motives were contributing factors for increased frequency of gambling in illegal pl-aces, but monetary, avoidance, and amusement were the significant contributing factors for high severity of gambling behaviors.Conclusion:Contributing factors of motives for gambling were different according to frequency of illegal gambling behavior and to severity of gambling.

가시광 및 근적외선 전투과 스펙트럼을 이용한 갈색 혈란 비파괴선별 방법 개발

이홍석(Hong-Seock Lee),김대용(Dae-Yong Kim),라리트 칸드팔(Lalit Mohan Kandpal),이상대(Sang-Dae Lee),모창연(Changyeun Mo),홍순중(Soon-Jung Hong),조병관(Byoung-Kwan Cho) 한국비파괴검사학회 2014 한국비파괴검사학회지 Vol.34 No.1

본 논문에서는 가시광 및 근적외선(VIS/NIR) 분광기술을 이용하여 혈란을 비파괴적으로 검출할 수 있는 측정방법을 개발하고자 하였다. 실험에 사용된 혈란 시료는 0.1 mL, 0.07 mL, 0.04 mL, 0.01 mL의 닭의 혈을 인공적으로 노른자 주변에 주입하여 제작하였다. 분석을 위해 사용된 스펙트럼 영역은 471 ~ 1154nm이었으며, 스펙트럼 해상도는 1.5 nm이었다. 혈란 측정을 위한 두 개 광원의 각도는 30도이었으며 광원과 시료간 거리는 100 mm로 설정하였다. 또한 광원의 열로 인해 시료가 손상되지 않도록 측정을 위한 노출시간은 30 ms으로 설정하였다. 측정된 스펙트럼에 부분최소자승 분류방법(PLS-DA)을 적용하여 선별모델을 개발하였다. 개발된 모델들로 분석한 결과 혈란의 선별 정확도는 0.1 mL, 0.07 mL 0.04 mL, 0.01 mL 혈란 시료에 대해 각각 97.9%, 97.9%, 94.8%, 86.5% 이었다. 가시광 및 근적외선 스펙트럼 기술은 0.04 mL 이상의 혈점이 포함된 혈란을 비파괴적으로 선별 할 수 있는 가능성을 보여 주었다. The aim of this study was the non-destructive evaluation of bloody eggs using VIS/NIR spectroscopy. The bloody egg samples used to develop the sorting mode were produced by injecting chicken blood into the edges of egg yolks. Blood amounts of 0.1, 0.7, 0.04, and 0.01 mL were used for the bloody egg samples. The wavelength range for the VIS/NIR spectroscopy was 471 to 1154 nm, and the spectral resolution was 1.5nm. For the measurement system, the position of the light source was set to 30º, and the distance between the light source and samples was set to 100 mm. The minimum exposure time of the light source was set to 30 ms to ensure the fast sorting of bloody eggs and prevent heating damage of the egg samples. Partial least squares-discriminant analysis (PLS-DA) was used for the spectral data obtained from VIS/NIR spectroscopy. The classification accuracies of the sorting models developed with blood samples of 0.1, 0.07, 0.04, and 0.01 mL were 97.9%, 98.9%, 94.8%, and 86.45%, respectively. In this study, a novel nondestructive sorting technique was developed to detect bloody brown eggs using spectral data obtained from VIS/NIR spectroscopy.

인천 화재사건 청소년 생존자를 대상으로 한 PTSD 하위유형간 증상, 기능 및 기질성격 특성 비교연구

황서현,이홍석,이상규,이흥표,전철은,이소영,김용구,Hwang, Seo Hyun,Lee, Hong Seock,Lee, Sang Kyu,Lee, Heung Pyo,Jeon, Chul Eun,Lee, So Young,Lee, Yong Ku 대한불안의학회 2011 대한불안의학회지 Vol.7 No.2

Objectives : The aim of this study was to investigate Post Traumatic Stress Disorder (PTSD)-related symptom severity, level of functional impairment and personality profiles between full-blown PTSD, partial PTSD and non-PTSD groups among 59 adolescent survivals from the Incheon fire disaster. Method : Using Short Screening Scale for DSM-IV PTSD, victims of the disaster were assigned to a full-blown PTSD group (n=18), a partial PTSD (n=22), or a non-PTSD group (n=19). Assessments included the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Impact of Event Scales (IES), the McBride's Degree of General Labor Loss, and the Korean Version of Temperament and Character Inventory (K-TCI). Results : Significantly severe PTSD symptoms (F=4.832, df=2, p<.05) and functional impairment (F=12.144, df=2, p<.01) were demonstrated by PTSD groups as compared to the non-PTSD group. Interestingly, full and partial PTSD did not differ in these comparisons. Similarly, the subtypes of PTSD did not differ with respect to personality profiles using the K-TCI ; however, personality profiles were sharply differentiated between the PTSD and non-PTSD group. Conclusion : Although high subject homogeneity and small sample size may limit the results of this study, the present results highlight the possibility of the underestimation as well as the insufficient, treatment and compensation of partial vs full PTSD.

정신분열증, 알코올중독, 약물중독에서 도파민 $D_2$ 수용체 유전자의 조절유전자(modifying gene)로서의 역할 - 충동적.강박적.탐닉적 행동을 나타내는 정신질환들에서 도파민 $D_2$ 수용체의 조절유전자로서의 역할 -

정현모,이홍석,장동원,이민수,Jung, Hyun-Mo,Lee, Hong-Seock,Chang, Dong-Won,Lee, Min-Soo 대한생물정신의학회 1997 생물정신의학 Vol.4 No.2

The authors attempted to examine the allelic association between the A1 allele of Dopamine $D_2$ receptor and schizophrenia, alcoholism, drug addiction in Koreans. Schizophrenic patients(n=31), alcoholism(n=65), drug addiction(n=18) and controls(n=52) were examined by case-control study for distribution of the TaqI polymorphism of the dopamine $D_2$ receptor gene in Korean population to minimize the effect of racial differencies in gene frequencies. In schizophrenics, the numbers of schizophrenics with A1A1, A1A2, A2A2 were 9(29.0%), 15(48.4%) and 7(22.6%) respectively and in alcoholics with A1A1, A1A2, A2A2 were 14(21.5%), 36(55.4%) and 15(23.1%) respectively and in drug addiction with A1A1, A1A2, A2A2 were 2(11.1%), 10(55.6%) and 6(33.3%) respectively and in controls with A1A1, A1A2, A2A2 were 4(7.6%), 24(46.2%) and 24(46.2%) respectively. The prevalence of the A1 allele in schizophrenics, alcoholics, drug addiction and controls were 77%, 76.9%, 67% and 53.8% respectively. And the frequency of the A1 allele in schizophrenics, alcoholics, drug addiction and controls were 0.53, 0.49 0.39 and 0.31 respectively. There was significant difference in the frequency of the A1 allele between schizophrenics, alcoholics and controls. We also classified our alcoholic population. For classification by severity, we used the median MAST score 30 in our samples. There was also significant difference in the frequency of the A1 allele between less severe group(0.42) and more severe group(0.57). This data suggest that the A1 allele is associated with schizophrenia and alcoholism in Koreans. Furthermore the prevalence of the A1 allele increassed in more severely affected alcoholics. The authors conclude that our data support an allelic association between the A1 allele at dopamine $D_2$ receptor and schizophrenia, alcoholism. These results suggest the A1 allele of the $DRD_2$ gene is associated with a number of behavior disorders in which it may act as a modifying gene rather than as the primary etiological agent.

공황장애 환자의 초기부적응 심리도식의 특성

우나영,이병욱,이홍석,정명훈,이중서,Woo, Na Young,Lee, Byung Wook,Lee, Hong Seock,Jung, Myung Hoon,Yi, Jung Seo 대한불안의학회 2011 대한불안의학회지 Vol.7 No.2

본 연구에서는 공황장애 환자의 심리도식 특성을 조사하였다. 대조군에 비해 환자군은 상태 및 특성불안, 우울 점수가 유의하게 높았으며 YSQ 중에서는 유기/불안정, 위험/질병에 대한 취약성 도식 점수가 유의하게 높았다. 환자군에서 ST-AI로 평가한 불안 수준은 모든 심리도식과, BDI로 평가한 우울 수준은 특권의식/과대성을 제외한 14개 도식과 상관관계가 있었으나 대조군에서는 훨씬 적은 수의 도식만이 상관관계를 보였다. 환자군에서 위험/질병에 대한 취약성, 유기/불안정 도식이 특성불안 수준을 가장 잘 예측하였으며 의존/무능, 유기/불안정 도식은 상태불안 수준을, 결함/수치심, 복종 도식은 우울 수준을 가장 잘 예측하였다. 이를 종합할 때, 초기부적응 심리도식은 공황장애의 발병과 경과 그리고 치료 반응에 영향을 미칠 가능성이 있다. 향후 대규모 집단을 대상으로 공황장애 환자의 심리도식 특성을 파악하고 치료에 접목시키는 작업이 필요할 것으로 생각된다. Objective : This study aimed to investigate the characteristics of the early maladaptive schemas in patients with panic disorder. Methods : Patients (n=35) included people who had met the DSM-IV-TR criteria for panic disorder. The normal control group (n=35) were those people who had no psychiatric disorder and had never experienced panic attack. The early maladaptive schemas and the severity of depression and anxiety were assessed by the Young Schema Questionnaire Short-form (YSQ-SF), the Beck Depression Inventory (BDI), and the Spielberger State-Trait Anxiety Inventory (STAI). Results : The scores on the STAI-S, STAI-T, and BDI were significantly higher in the patient group. Compared to the control group, the scores of vulnerability to harm and illness, and abandonment/instability schemas were significantly higher in the patient group. In the patient group, defectiveness/shame and subjugation schemas were found to predict BDI, dependent/incompetence, abandonment/instability schemas were found to predict STAI-S, and vulnerability to harm and illness, and abandonment/instability schemas were found to predict STAI-T. In normal controls, failure and insufficient self-control/self-discipline, failure, and emotion inhibition schemas were found to predict BDI, STAI-T, and STAI-S. Conclusions : Vulnerability to harm and illness and abandonment/instability schemas may be characteristic schema in patients with panic disorder.