우울, 불안장애 환자에서 폐경에 대한 태도 및 인식과 폐경기 증상

최인광,이문수,함병주,이화영,고영훈,조숙행,Choi, In Kwang,Lee, Moon-Soo,Ham, Byung-Joo,Lee, Hwa-Young,Ko, Young-Hoon,Joe, Sook-Haeng 한국정신신체의학회 2010 정신신체의학 Vol.18 No.2

연구목적 본 연구의 목적은 정신과 중년여성 외래환자를 폐경기 상태에 따라 폐경전기, 폐경주위기, 폐경후기의 3집단으로 세분화하여 폐경기 증상을 비교하고, 폐경에 대한 태도 및 인식과 폐경기 증상 간의 연관성을 조사하며, 우울증상 및 특성불안의 심각도에 따른 폐경기 증상의 심각도를 평가하고자 하였다. 방 법 2009년 8월 17일부터 2009년 11월 28일까지 고려대학교 구로병원 신경정신과 외래를 방문하여 우울장애와 불안장애로 진단받은 40~64세의 여성 환자 152명을 대상으로 연구를 하였다. 폐경기 증상의 심각도를 평가하기 위해 폐경평가척도(Menopause Rating Scale, MRS)를 이용하였고, 폐경기에 대한 태도를 평가하기 위하여 11항목으로 구성된 자기보고식 설문지를 사용하였다. 또한 대상자의 우울, 불안증상을 평가하기 위해 Beck 우울 척도(Beck Depression Inventory, BDI), 상태특성 불안 척도(State-Trait Anxiety Inventory, STAI)가 사용되었다. 폐경기 상태에 따른 각 그룹에서의 폐경기 증상의 차이가 있는지 비교하였고, 폐경에 대한 태도 및 인식과 폐경기 증상 간의 연관성을 조사하였다. 우울증상, 특성불안의 심각도와 폐경기 증상의 관계를 살펴보았다. 결 과 폐경기 상태에 따른 폐경기 증상은 유의한 차이를 보이지 않았다. 그러나 '폐경기는 노화의 증후; 배우자들은 폐경기 여성을 매력이 없다고 느낌'의 항목에 동의할수록, '임신을 하지 않아 홀가분함'의 항목에 동의하지 않을수록 일부 폐경기 증상을 심하게 호소하여, 부정적인 폐경에 대한 태도와 폐경기 증상의 심각도 간에 유의한 연관성을 보여주었다. 그리고 우울증상과 특성불안의 수준이 높은 경우 폐경기 증상이 심한 것으로 나타났다. 결 론 본 연구에서 폐경에 대한 부정적 태도 및 우울증상, 불안은 폐경기 증상의 심각도 간에 상호연관성을 보여주었다. 따라서 임상에서 폐경기 증상에 대해 평가하고 교육을 통하여 환자들로 하여금 폐경에 관한 긍정적 태도를 갖고 폐경기 증상에 적절히 대처하도록 하는 것이 필요하다. 향후 임상에서 많은 중년여성 정신과 환자를 대상으로 하여, 정신과 치료를 지속하면서 우울증상, 불안의 호전 정도에 따라 폐경기 증상의 변화를 살펴보는 전향적인 연구가 필요할 것으로 사료된다. Objectives : The purpose of this study was to explore attitude and belief about menopause and severity of menopausal symptoms according to menopausal status. This study conducted a cross-sectional assessment of the effects of depressive symptoms and the severity of trait anxiety on the severity of menopausal symptoms. Methods : Participants were all outpatients at the psychiatric outpatient clinic of Korea University Guro Hospital. All participants, aged 40 to 64, had depressive or anxiety disorders and were divided into the premenopause, perimenopause, premenopause, and postmenopause groups. Menopause Rating Scale(MRS) was used to measure the severity of menopausal symptoms. The attitude toward menopause was examined by a self-report questionnaire regarding menopause. Beck Depression Inventory(BDI) and State-Trait Anxiety Inventory(STAI) were used to assess depressive symptoms and anxiety. Results : The severity of menopausal symptoms was not different among the groups according to menopausal status. There was a significant correlation between a negative attitude toward menopause and the severity of menopausal symptoms. Patients with moderate to severe depressive symptoms and trait anxiety had more severe menopausal symptoms. Conclusion : Negative attitude toward menopause, depressive symptoms, and anxiety had a significantly negative impact on the severity of menopausal symptoms. The results of this study suggest that treatment to relieve depressive symptoms and anxiety and intervention to reduce negative attitude toward menopause are required. Further studies with larger sample size are needed to evaluate potentially effects of depressive symptoms and anxiety on severity of menopausal symptoms in middle-aged female psychiatric patients.

인간의 성 반응에 대한 모델

최인광,Choi, In Kwang 대한생물정신의학회 2013 생물정신의학 Vol.20 No.3

Sexual behavior is crucial in life, yet comparatively little is known about the mechanisms in the sexual response in humans. A lot of theories and models have been developed to explain about the process of the sexual response in humans. The first model of sexual function was described by Masters and Johnson, defined the four-phase model (phases of excitation, plateau, orgasm and resolution). Helen Kaplan proposed a slightly different model of human sexual response by adding the conception of the desire phase. Some years later, a new model of circular sexual response pattern was described by Whipple and Brash-McGreer, who acknowledged the cyclic nature of women's sexual response. Basson presented an alternative model of women's normative sexual function, which featured a responsive form of desire in women's sexual response. Bancroft developed a new theoretical model, the Dual Control Model, which postulates sexual response and arousal is ultimately determined by the balance between the sexual activation or excitation system and the sexual inhibition system. The Sexual Tipping Point is a model created by Perelman, suggesting that a sexual response is determined by a balance between excitatory or inhibitory factors that may be psychological, organic, psychosocial, or cultural. A comprehensive understanding of sexual response and function is of paramount importance for the psychiatrist to study sex, offer counseling to the patient on sex, and practice sex therapy. In this literature, models of sexual response would be reviewed to understand the knowledge of the sexual functioning in humans.

수면의 정신역동 정신분석 관점에서 고찰한 수면의 의의

최인광 ( In Kwang Choi ) 한국정신병리진단분류학회 2010 精神病理學 Vol.19 No.1

Sleep is a natural state of bodily rest and an indispensable part during the lifetime. Sleep is important for restoration, energy preservation, brain development and memory processing. Sleep can be understood differently in psychoanalysis. It depends on how the psychoanalyst explores the psychodynamics of sleep. The significances of sleep from a psychoanalytic perspective are as follows: 1) the acquisition of affection and interest from motherhood in the period of pre-oedipal stage; 2) the reflection of desire to relieve the stress by throwing external difficulties into the unconscious and changing it to the reemergence of Oedipus complex; 3) the process that eros leads a life against the force of thanatos. Dreams help sleep achieve its own purposes by playing the role of a field of conflict resolution and functioning as a source of energy for eros. The comprehension of sleep from a psychoanalytic viewpoint breaks new ground because it promotes the psychiatrist to feel empathy for people who complain of sleep disturbances.

전기차 클러스터 인터페이스 트렌드 분석

최인광(Ingwang Choi),한자령(Jaryeong Han),김지은(Jieun Kim),김승민(Seungmin Kim) 한국디자인학회 2021 한국디자인학회 학술발표대회 논문집 Vol.2021 No.5

감정표현불능증 특성을 보이는 건강한 여성의 화소 기반 형태분석 방법을 통한 회백질 용적 감소의 정량적 분석

한규만,최인광,한명일,이민수,함병주 대한우울조울병학회 2012 우울조울병 Vol.10 No.3

Objectives : Alexithymia is a condition characterized by impaired ability to identify and describe subjective feelings. In this study, we aimed to investigate whether an alexithymic trait is associated with structural abnormalities in cerebral cortex in healthy adults with voxel-based morphometry (VBM). Method : 71 healthy women were enrolled in this study and the Korean version of 20-item Toronto Alexithymia Scale (TAS-20) was carried out to determine their alexithymic traits. Gray matter (GM) volume was assessed with a VBM protocol from magnetic resonance images acquired on a 1.5 T scanner. We compared GM volumes between subjects with alexithymic traits and non-alexithymic subjects. Results : In the reigion-of-interest (ROI) analysis of both frontal lobes and hippocampal regions, the subjects with alexithymic traits showed a trend of smaller GM volume in the superior frontal gyrus (Talairach coordinate=-12, 23, 53 ; cluster size=47 ; Z-score=3.26), parahippocampalgyrus (24, -34, -9 ; 38 ; 2.95) and middle frontal gyrus (42, 50, 17 ; 22 ; 2.87). Conclusion : Our results suggest that the subjects with alexithymic traits would have a trend of smaller GM volumes in the superior frontal gyrus, parahippocampalgyrus and middle frontal gyrus.

CYP2D6 P34S Polymorphism and Outcomes of Escitalopram Treatment in Koreans with Major Depression

한규만,장헌수,최인광,함병주,이민수 대한신경정신의학회 2013 PSYCHIATRY INVESTIGATION Vol.10 No.3

Objective Cytochrome P450 (CYP) enzymatic activity, which is influenced by CYP genetic polymorphism, is known to affect the inter-individual variation in the efficacy and tolerability of antidepressants in major depressive disorder (MDD). Escitalopram is metabolized by CYP2D6, and recent studies have reported a correlation between clinical outcomes and CYP2D6 genetic polymorphism. The purpose of this study was to determine the relationship between the CYP2D6 P34S polymorphism (C188T, rs1065852) and the efficacy of escitalopram treatment in Korean patients with MDD. Methods A total of 94 patients diagnosed with MDD were recruited for the study and their symptoms were evaluated using the 21-item Hamilton Depression Rating scale (HAMD-21). The association between the CYP2D6 P34S polymorphism and the clinical outcomes (remission and response) was investigated after 1, 2, 4, 8, and 12 weeks of escitalopram treatment using multiple logistic regression analysis and χ2 test. Results The proportion of P allele carriers (PP, PS) in remission status was greater than that of S allele homozygotes (SS) after 8 and 12 weeks of escitalopram treatment. Similarly, P allele carriers exhibited a greater treatment response after 8 and 12 weeks of escitalopram treatment than S allele homozygotes. Conclusion Our results suggest that the P allele of the CYP2D6 P34S polymorphism is a favorable factor in escitalopram treatment for MDD, and that the CYP2D6 P34S polymorphism may be a good genetic marker for predicting escitalopram treatment outcomes.