한국 정신장애의 역학 조사 연구[I] : 각 정신장애의 유병률

조맹제,함봉진,김장규,박강규,정은기,서동우,김선욱,조성진,이준영,홍진표,최용성,박종익,이동우,이기철,배재남,신정호,정인원,박종한,배안,이충경 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). Methods : Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November30,2001. Results : Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major de-pressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. Conclusion : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.

정신보건관련시설 입원(소)자의 주요 정신장애 유병률 : 전국 20개 시설의 입원(소)자를 대상으로

조성진,조맹제,서동우,함봉진,홍진표,배재남,이준영,이동우,박종익,전홍진,김성주,김용익 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.6

Objectives : One of the objectives of this study is to estimate the prevalence rates of psychiatric diagnoses in the combined populations of psychiatric hospitals, psychiatric nursing facilities and homeless asylums using the Korean version of the Composite International Diagnostic Interview (K-CIDI), which is a comprehensive and fully standardized interview schedule to assess psychiatric disorders for diagnosis. The Other objective is to compare with previously studied prevalence rates of Psy-chiatric diagnoses using the results of this study. Methods : The study subjects, aged from 181o 64 years, were randomly selected from 64,582 institutionalized population of psychiatric hospitals, Psychiatric nursing facilities and homeless asylums as of 30, June, 2001. Twelve trained interviewers administered the K-CIDI to the selected respondents. A total of 1,875 respondents (male 1,194, female 681) completed the interview. Results : The lifetime and one year prevalences of any diagnosis excluding nicotine dependence · withdrawal, anxiety disorder, eating disorder, somatoform disorder were 88.2% (male 88.1%, female 88.3%), and 65.8% (male 62.7%, female 73.7%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were 78.5% (male 75.3%, female 83.7%), and 56.8% (male 51.9%, female 64.8%), respectively. The lifetime and one year prevalences of alcohol use disorder (dependence/abuse) were 26.7% (male 37.9%, female 8.3%), and 8.7% (male 12.8%, female 2.1%), respectively. The lifetime and one year prevalences of mood disorder were 18.1% (male 13.5%, female 25.8%), and 10.4% (male 7.2%,female 16.9%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were comparable with the 2001 community survey by 1.19% to 1.32%, and 0.51% to 0.61%, respectively. The lifetime and one year prevalences of schizophrenia were also comparable by 0.16% to 0.28%, and 0.16% to 0.25%, respectively. There were no significant changes of prevalence rates when correction were applied to other psychiatric diagnosis. Conclusion : The results of this study could be used for evaluating the distribution of psychiatric diagnoses in mental health related facilities and for planning mental health policies.

한국어판 Composite International Dianostic Interview(K-CIDI)의 개발

조맹제,함봉진,서동우,홍진표,배재남,김장규,이동우,조성진 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.1

연구목적 : 본 연구는 국제적인 정신장애 진단도구인 Composite International Diagnostic Interview(CIDI)를 한국의 사회문화적 상황에 적합하게 번역하고 신뢰도 및 타당도를 평가하여 한국어판으로 개발하기 위한 것이다. 방 법 : CIDI는 정신장애를 평가하고 진단할 수 있는 포괄적이고, 완전히 표준화된 진단도구로 훈련받은 일반인들이 적용할 수 있기 때문에 대규모 역학조사에 적합하다. 세계보건기구에서 제공하는 CIDI 번역 지침에 따라 한국어판 CIDI(K-CIDI)를 제작하였다. 영어권과 한국의 언어 및 사회문화적 차이를 고려하여 번역 및 개정을 하였고 역번역을 통하여 원본의 의미와 일치하는지를 확인하였다. 임상환자를 135명과 일반인 5명을 대상으로 신뢰도와 타당도 검사를 실시하였다. 두 명의 평가자가 K-CIDI를 이용하여 동일한 대상자를 동시에 면담하고 일주일 뒤에 재검사를 실시하였다. K-CIDI로 검사를 받은 대상자들을 정신과 전공의와 임상심리사가 한국어판 Structured Clinical Interview for DSM-Ⅳ를 이용하여 진단을 내렸다. 두 가지 진단의 일치도에 대한 kappa값을 산출하였다. 결 과 : CIDI의 번역에서 한국어 표현이 복잡하고 긴 문항은 두 개의 문장으로 분리하였고, 성과 관련된 표현과 의료체계 및 의료추구행태에서 사회문화적 차이를 반영하였다. 공포장애의 대상과 알코올 및 물질의 종류도 한국의 실정에 맞게 조정하였다. 현장 검사와 역번역 과정에서 K-CIDI가 적절하게 제작된 것으로 평가되었다. K-CIDI의 평가자간 신뢰도 검사는 140명에 대하여 이루어졌고 kappa값은 진단에 따라 0.86∼1.00범위였다. 검사/재검사 신뢰도 검사는 47명에 대해 이루어졌고 kappa값은 진단에 따라 0.42∼0.89였다. K-CIDI의 타당도 검사는 50명에 대해 이루어졌고 kappa값이 진단에 따라 0.50∼1.00의 범위였다. 결 론 : K-CIDI는 한국의 사회 문화적 배경에 적합하게 제작되었고 신뢰도 및 타당도 검사에서 역학연구에 적절한 진단도구로 평가되었다. Objectives : This study aims to develop a Korean version of the Composite International Diagnostic Interview(K-CIDI). Methods : The Composite International Diagnostic Interview(CIDI) is a comprehensive, fully standardized interview that can be used to assess psychiatric disorders and provide diagnoses. The K-CIDI was developed according to the guidelines provided by the WHO. The reliability and validity of the K-CIDI was evaluated by examining 135 psychiatric patients and five community residents. Subjects were jointly interviewed twice with a one-week interval. A psychiatric resident and clinical psychologist jointly determined clinical diagnoses using the Structured Clinical Interview for DSM-Ⅳ. Results : Notable modifications were done on sex-related expression, health system and help seeking behavior, subjects for phobic disorder, and kinds of alcohol and substance. Long and complex questions were divided into two or more questions. Field test and back-translation of the K-CIDI confirmed the appropriateness of the translation of the CIDI. The inter-rater reliability, test/retest reliability, and validity of the K-CIDI indicated kappa values ranging from 0.86-1.00, 0.42-0.89, and 0.50-1.00, respectively. Conclusion : The K-CIDI was deemed to be appropriate for the sociocultural background of Koreans. The reliability and validity of the K-CIDI were judged to be exceptionally acceptable.

노사학파 심포(心圃) 문형(文炯)의 학술 관계망

조우진 ( Cho Woo-jin ) 전남대학교 호남학연구원 2023 호남학 Vol.- No.74

본 논문은 노사학파 재전문인 심포(心圃) 문형(文炯)의 학술 관계망을 살펴보는 데 목적이 있다. 문형은 전남 화순 청풍면 출신으로 개항기와 일제강점기를 걸쳐 살았던 성리학자이다. 어려서는 민우식(閔佑植)에게 13년 동안 유학을 배웠으며, 민우식이 죽기 직전 정의림(鄭義林)을 찾아가 9년 동안 기정진(奇正鎭)의 이론을 수학하였다. 정의림이 죽자, 『노사집(蘆沙集)』을 스승으로 삼아 노사학의 정수를 확인하였다. 문형은 영ㆍ호남의 노사학파와 화서학파의 재전문인 뿐만 아니라 영남의 한주 학파의 재전문인 및 당대 최고의 문장가 등과 교류를 확대하면서 학문적 유대와 사상적 통합을 이루고자 했다. 이것이 바로 지역과 사상을 횡단하는 문형의 학술 관계망의 특징이다. 특히 문형은 자신의 호를 ‘심포(心圃)’라고 했던 것처럼 성리학의 핵심 개념인 심(心)을 바탕으로 자신의 철학 체계를 완성하였다. 그는 화서학파 김평묵(金平默) ㆍ최익현(崔益鉉)의 문인들과 교유하면서 이항로(李恒老)의 심주리(心主理)에 대한 견해를 적극적으로 옹호하였으며, 한주학파 곽종석(郭鍾錫)의 문인들과 소통하면서 이진상(李震相)의 심즉리(心卽理)를 비판적으로 수용하였다. 더불어 문형은 리(理) 중심의 사유체계를 바탕으로 <성사심제변(性師心弟辨)>을 지어 간재(艮齋) 전우(田愚)가 심을 주기적(主氣的) 입장으로 보는 병폐를 지적하였다. 문형의 위상은 다양한 학파와 심을 중심으로 한 학술 관계망을 형성하여 당시의 성리학적 문제의식을 통합하고자 했다는 점이고, 그의 역할은 화순 노사 학맥을 이어 확산을 주도했을 뿐만 아니라, 화순 노사학파의 중심에 서 있었다는 점이다. 문형은 정주학을 토대로 노사학을 전수하여 화순 근현대 유학을 정립하는 데 중추적인 역할을 하였으며, 미래지향적 지역학으로써 화순학(和順學)을 수립할 수 있는 학술적 기반을 제공하였다. This paper aims to explore the academic network of Shimpo[心圃] MunHyeong(文炯, 1882-1936), a redeliver disciple[再傳門人] of Nosa School[蘆沙學派]. MunHyeong is a Neo-Confucian scholar who was born in Cheongpung-myeon[淸風面], Hwasun, Jeollanam-do, and lived during the opening period and Japanese colonial era. When young, he learned to study Neo-Confucianism from MinWoosik[閔佑植] for 13 years, and just before Min Woo-sik died, he visited JungEuirim[鄭義林] and studied KiJeongjin[奇正鎭]’s theory for 9 years. When JungEuirim died, he confirmed the essence of Nosahak[蘆沙學] regarding 『Nosajip[蘆沙集]』 as his teacher. MunHyeong sought to achieve academic ties and ideological integration by expanding exchanges with not only redeliver disciples[再傳門人] of Nosa School[蘆沙學派] and Hwaseo School[華西學派] in YeongnamㆍHonam but also redeliver disciples[再傳門人] of the Hanju School[寒洲學派] and Good writers[文章家] of the time. This is the characteristic of academic network of MunHyeong that crosses regions and ideas. In particular, MunHyeong completed his philosophical system based on the core concept Shim[心] of Neo-Confucianism, as he called his pen name ‘Shimpo’. He actively advocated IHanglao [李恒老]’s view of Shimjuli[心主理] while interacting with the writers of the Hwaseo School of KimPyeongmuk[金平默] and ChoeIckhyun[崔益鉉], and critically accepted IJinsang[李震相]’s Shimjeukli[心卽理] while communicating with the writers of KwakJongseok[郭鍾錫] of the Hanju School. In addition, Moon Hyung wrote < Seongsashimjebyeon[性師心弟辨] > based on the Li[理]-centered thinking system and pointed out the problem of Ganje[艮齋] JeonWoo[田愚]'s view of Shim[心] as Jugi[主氣] position. MunHyeong's status was to form an academic network centered on various schools and Shim and to integrate the Neo-Confucian problem consciousness of the time, and his role was not only to lead the spread of Hwasun Nosahakmaek, but also to be at the center of Hwasun Nosa School. MunHyeong played a pivotal role in establishing modern and contemporary Hwasun Confucianism by transferring Nosahak based on ChéngZhūxué[程朱學], and provided an academic foundation for establishing Hwasunhak[和順學] as a future-oriented regional studies.

한국어 판 구조화 임상면담도구 개발 : 신뢰도 연구

한오수,안준호,송선희,조맹제,김장규,배재남,조성진,정범수,서동우,함봉진,이동우,박종익,홍진표 대한신경정신의학회 2000 신경정신의학 Vol.39 No.2

연구목적: 정신장애의 정확한 진단과 평가는 임상에서뿐만 아니라 신뢰성 있는 연구를 위해서도 매우 중요하다. Structured Clinical Interview for DSM-IV(SCID)는 임상전문가들이 사용하는 진단도구로서, 비교적 짧은 시간에 정확한 진단을 내릴 수 있다. 본 연구는 한국어판SCID를 개발하고 그 신뢰도를 평가하기 위해 수행되었다. 방법: 국문학자가 포함된 번역위원회를 통하여 연구용판 SCID를 번역한 후, 정신과 의사 2인과 임상심리학자 1인에게 한국어판SCID 실시방법을 교육시킨 뒤 한국어판SCID를 이용한 면담의 평가자간 신뢰도 (interrater reliability)를 검증하였다. 면담 대상은 1999년 2월에서 3월까지 2개 병원 정신과에 치료중인 환자 90명(남:41명, 여:29명)이었다. 결과: 현재 장애(current disorder) 평가에서 주요 우울장애, 기분부전장애, 정신분열병, 알코올 남용 및 의존, 기타 물질 남용 또는 의존, 여러 불안장애들 및 섭식장애 등과 같은 대부분 장애의 kappa값은 .70이상으로 매우 높았다. 그 이외의 양극성 장애, 망상장애, 광장공포증, 감별 불능 신체화 장애 및 건강염려증의 kappa값도 .69에서 .40사이로 수용할 수 있는 정도였다. 평생 장애(lifetime disorder)에서는 양극성 장애(k=.69)와 감별 불능 신체화장애(k=.59)를 제외한 다른 모든 장애의 kappa값이 .70이상이었다. K-SCID 면담시 Ⅰ축 질환에 대하여 흔하게 다중 진단이 내려졌으며, 평균 진단 수는 1.5∼1.7개로 나타났다. 결론: 한국어판 SCID는 신뢰도가 높은 진단도구로 생각되며, 향후 정신질환의 정확한 진단과 임상연구에 유용하게 사용될 수 있다. Objectives: Accurate diagnosis and assessment for psychiatric disorders is crucial for research, as well as for clinical practice. Structured Clinical Interview for DSM-Ⅳ(SCID-RV) is a less time-consumimg and more accurate structured diagnostic interview form. It can be used by clinical professions and is known for a reliable diagnostic tool. Present study was conducted to develop Korean version of SCID-RV and to test the inter-rater reliability. Methods: The authors have translated original SCID-RV into Korean, and revised in parallel with sociocultural background of Korea. Ninety patients from two psychiatric hospitals, both outpatient and inpatient, were interviewed and rated independently by three raters. Results: The kappa coefficients for most of illnesses, such as major depressive disorder, dysthymia, schizophrenia, alcohol abuse and dependency, anxiety disorder and eating disorder were excellent(>0.70) in the evaluation of current disorders. And the kappa coefficients for bipolar disorder, delusional disorder, agoraphobia, undifferentiated somatoform disorder, and hypochondriasis were acceptable(>0.40) in the evaluation of current disorders. In the evalua-tion of lifetime disorders, the concordant rates of all the diagnoses except bipolar disorder and undifferentiated somatoform disorder were excellent. Lack of hierarchy in DSM-Ⅳ allows for multiple Axis I diagnoses. Mean numbers of Axis I diagnoses per subject assigned by the three raters were 1.5-1.7. Conclusions: Our findings confirm that SCID-RV yields highly reliable diagnoses. SCID-RV is recommended for accurate diagnosis in clinical practice and research on psychiatric disorders.

우리나라 法院의 建築計劃的 特性에 관한 硏究

조영태,이진우,양동양 대한건축학회 2003 대한건축학회논문집 Vol.19 No.4

Despite a hundred year long history of the planning and construction of modern courthouse in Korea, the adequate evaluations thereof are overdue. This study aimed to prevent uniformity in courthouse designs and to suggest desirable direction of planning for the public-use, through the investigation of the domestic(including Seoul District Court Complex) and 27 foreign instances. Architectural factors were analyzed in 1)site plans and outdoor space, 2)external appearance, 3)internal space program, 4)circulations. Especially, internal space program of floor with courtrooms and circulations of users are important analysing factors in this paper. As the result of this study, most of domestic courthouses are very much similar in site planning, massing, appearance, and judge oriented circulation plans. These characteristics of planning are purposed to express the equity and dignity of law. But the instances of European and USA have various type of spatial composition and the general public-oriented planning.

야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 행동 및 정서 문제를 중심으로

조수철,김재원,신민섭,황준원,한상원,박관현,이상돈,김경도,김건석,서홍진,이유식,정재용,김영균,문두건,남궁미경,한창희,조원열,김영식,배기수,이종국,정우영,신의진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. Results : Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.

비탈형 거푸집의 경제성 향상에 관한 연구

조규현,김제섭,전판근,김우재,정상진 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1

The purpose of this study is to improve the productivity and constructability of permanent forms. The permanent forms will cut down the cost of production and make easier to install in the field; hence increase the use of forms in the today's market. The permanent form is produced in the factory and built in field. So this study is in two parts. The one is the productivity in factory, the other is constructability in the field. This study is the designing a new mold system as a solution to existing mold system's problems.

성인의 복잡성 복강내 감염증의 치료에서 Ertapenem 단독투여와 Ceftriaxone과 Metronidazole 병용투여의 안전성과 유효성 평가를 위한 다기관, 공개, 무작위, 비교 임상연구

조용균,이정남,서성옥,김선회,장진영,김상걸,윤영국,이우정,김민자 대한감염학회 2005 감염과 화학요법 Vol.37 No.6

Background : Ertapenem, a novel β-lactam agent with a wide range of activity, has a pharmacokinetic profile and antimicrobial spectrum that support its potential use as a once-a-day agent for the treatment of common mixed aerobic and anaerobic pathogens encountered in intraabdominal infections. Materials and Methods : The prospective, randomized, controlled, open, and multicenter trial was conducted to compare the clinical efficacy and safety of ertapenem with ceftriaxone plus metronidazole as therapy before or following adequate surgical management of complicated intraabdominal infections. Results : One hundred sixty-three patients were included in the modified intent-to-treat population, of which 134 were clinically evaluable. Patients with a wide range of infections were enrolled; perforated appendicitis or periappendiceal abscess were most common. As for the modified intent- to-treat groups, 71 of 72 (98.6%) patients treated with ertapenem and 73 of 80 (91.3%) treated with ceftriaxone/metronidazole showed favorable clinical response. Conclusion : In this study, the efficacy of ertapenem was equivalent to ceftriaxone plus metronidazole in the treatment of complicated intraabdominal infections. Ertapenem was generally well tolerated and had a similar safety and tolerability profile compared to ceftriaxone plus metronidazole. The results of this trial suggest that ertapenem could be considered as a useful option that could eliminate the need for combination and/or multi-dosed antibiotic regimens for the empiric treatment of complicated intraabdominal infections.

급성충수돌기염으로 발현된 방선균증 2예

조진원,송진영,김창억,민영훈,최창순,우흥정,현인규,김종현,유기철,채승완,손진희 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.1

The Actinomyces species are normal flora of oral cavity and upper intestine characterized as gram-positive, non-spore-forming anaerobic or mjcroaerophilic rods. Actinomycosis is a chronic suppurative and granulomatous disease characterized by abscess, sinus, abundant granulation and mass. The appendix is the commonly involved site among abdominal actinomycosis. Abdominal actinomycosis is often difficult to diagnose before operation because of no reliable clinical features and infrequency of the disease. We report two cases of abdominal actinomycosis which were manifested as acute appendicitis. Those were detected Incidentally tv the pathologist after routine appendectomy. Both patients were successfully treated with appendectomy followed by proper antibiotics use.