범법 알코올 중독 환자의 개인적 특성, 알코올 중독의 정도 및 단주교육이 병식에 미치는 영향에 관한 연구

김재훈,이미경,박희석,김선범 한국중독정신의학회 1999 중독정신의학 Vol.3 No.1

This study investigated the effectiveness of Alcohol Abstinence Education Program in Patient’s insight, and how other factors such as individual characteristics, crime, and severity of alcoholism affected the insight. The subjects were 44 alcoholic patients (43 were males;1 was female), currently admitted for treatment at National Forensic Psychiatric Hospital, who were given either single or dual diagnosis according to DSM-IV. Alcohol Abstinence Education Program was 24-session, semiweekly program, lasting 3 months, including lectures, visual-audio education, autobiography, 12-step, group psychotherapy, and others. MAST was administered to measure severity of alcoholism, and HAIS was given to measure improvement of the insight in general, including both intellectual and emotional insights. The results are as follows:1) Patients who had been holding a job showed higher severity of alcoholism than those without occupation. 2) No significant difference was found in insight in general, intellectual insight, and severity of alcoholism between single-diagnosed and dualdiagnosed alcoholic patients, but single-diagnosed alcoholic patients showed higher emotional insight than the other group. 3) Those with history of previous hospitalization due to alcoholism showed higher insight in general, higher intellectualinsight, and also more severity of alcoholism. 4) Those with more severity of crime showed significant improvement of emotional insight after finishing the program twice, whereas those with less severity of crime showed no significant difference after finishing the program once nor after finising the program twice. In conclusion, there were factors affecting insight and degree of alcoholism among criminal alcoholic population, such as occupation status, diagnosis type, history of previous hospitalization and severity of crime.

알코올중독에 대한 포괄적 치료 체계의 개발

이해국(Hae Kook Lee),이명수(Myung-Soo Lee),기선완(Seon Wan Ki),최삼욱(Sam-Wook Choi),조근호(Keun Ho Joe),박애란(Aeran Park),정인원(In-Won Chung),김석범(Seok Beom Kim),이정태(Chung Tai Lee),권용실(Yong Sil Kweon) 대한사회정신의학회 2007 사회정신의학 Vol.12 No.2

Alcoholism is complex primary physiological disease with unique therapeutic interventions, and neither a primary behavior disorder nor ay symptomatic manifestation of any other disease process. And, it is highly prevalent disease with important impact on public health perspective. Therapeutic approach for alcoholism need to be organized by integrative and comprehensive systems, because that development and course of alcoholism are influenced by complex interaction between biological and environmental factors. We tried to developing effective intervening systems for alcoholism in seoul by evaluating the current state of service for alcoholism and referring to advanced treatment system in other countries. The problems of current state are lack of public awareness for seriousness of alcoholism, difficult access to treatment system and weak capacities to managing alcoholic patients in the community. Integrative and comprehensive intervening system for alcoholism are accomplished by developing system of matching services to alcoholic subjects in the community level based on seriousness and needs of alcoholic subjects. Referring to current state of alcoholism service in Seoul, treatment system should be developed based on continuum of care system in which the different intensity of service is placed and organized in the community level. First, the rehabilitation centers for chronic alcoholics and intensive outpatients centers should be newly established. Second, it is needed to strengthen the function of alcohol counseling centers and community mental health centers as coordination centers for alcoholics. Third, legal and political support should be established to induce improvement of inpatient and outpatient treatment service quality. Finally, setting up a committee to support and organize these integrative treatment systems is needed.

중도이주민의 알코올중독에 관한 생애사적 연구

안영규 한국중독범죄학회 2019 한국중독범죄학회보 Vol.9 No.4

이 연구는 중도이주민 알코올중독자의 회복요인을 확인하고 중도이주민 알코올중독 회복을 위한 치유적 개입방안을 제시하기 위한 것이다. 세평적 사례선택(reputational case selection)을 통해 선별된 중도이주민 알코올중독자 1명을 심층 면담하였고, 수집된 자료는 생애사 연구방법으로 분석하였다. 연구참여자의 생애사를 분석한 결과 및 제언은 다음과 같다. 첫째로 중도이주민의 알코올중독은 다양한 원인이 복합적으로 작용한다는 점이다. 둘째로 알코올중독의 회복을 위해서는 알코올중독자임을 스스로 자각하는 것이 중요하다. 셋째로 직업적 안정과 생애과정상의 결혼⋅출산 등도 단주를 유지하는 데에 필요한 요소로 보인다. 넷째로 알코올중독으로부터 회복된 중도이주민은 한국인으로서의 삶을 살기 위한 심리적 준비가 선행되어야 한다. 이와 같은 논의를 기반으로 중도이주민 알코올중독자의 회복을 위한 개입방안을 다음과 같이 제시할 수 있다. 첫째로 중도이주민의 알코올중독은 다양한 원인이 복합적으로 작용한다. 그중 기본적으로 가정의 안정이 최우선 과제로 꼽힌다. 둘째로 알코올중독자임을 스스로 자각할 수 있는 기회를 제공하는 것이 중요하므로 정책적 차원에서 시설수용에 앞서 알코올중독자임을 자각하는데 도움을 줄 수 있는 프로그램을 마련할 필요가 있다. 셋째로 직업적 안정이 단주의 주요한 요인이므로 직업을 선택하는데 어려움이 없도록 중도이주민에 대한 한국어 교육을 강화하고 직업훈련 기회를 제공하여야 한다. 넷째로 알코올중독으로부터 회복된 중도이주민이 단주상태를 유지하고 한국인으로서 동화되어 살 수 있도록 심리적 지지와 지원을 해야 하겠다. The purpose of this study is to identify the recovery factors of alcoholics among migrants and to suggest a therapeutic intervention for the recovery of alcoholism. In-depth interview with alcoholics who were selected through reputational case selection were conducted and the collected data were analyzed by life history research method. The results and suggestions are as follows. First, migrants' alcoholism is caused by a combination of various causes. Second, it is important to be aware of alcoholism in order to recover from alcoholism. Third, occupational stability and lifelong marriage and childbirth seem to be necessary factors for maintaining quitting alcohol Fourth, migrants who recover from alcoholism must be prepared psychologically to live their lives as Koreans. Intervention measures for the recovery of alcoholic migrants can be suggested as follows. First, migrants' alcoholism is caused by a combination of various causes. The stability of the family is the top priority among them. Second, it is important to provide them with the opportunity to recognize themselves as alcoholics, so it is necessary to prepare a program that can help them to recognize that they are alcoholics before accepting facilities from a policy level. Third, occupational stability is important for quitting alcohol. Korean language education should be strengthened and vocational training opportunities should be provided to migrants so that there is no difficulty in choosing a career. Fourth, psychological support and physical support should be provided for Migrants recovering from alcoholism to remain quitting alcohol and assimilate as Koreans.

비예약 접속 시스템을 위한 딥러닝 기반 프리엠블 설계

한민식(Min S. Han),Ameha T. Abebe,강충구(Chung G. Kang) 한국통신학회 2022 한국통신학회 학술대회논문집 Vol.2022 No.11

입원 남성 및 여성 알코올리즘 환자의 인구학적, 임상적 및 인격적 특성비교

정원후,김성부,장기용,손진욱,박철수 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.4

저자들은 1996년 5월 1일부터 1996년 7월 15일까지 부산·경남·대구 소재의 대형정신병원과 종합병원에 입원해 있는 여성 알코올리즘을 대상으로 하고, 또한 같은 기간에 국립부곡정신병원에 입원한 남성 알코올리즘을 비교군으로 해서 사회인구학적 특성, 음주양상, 음주와 관련된 문제점, 성격 및 정신병리등을 비교하여 남녀 알코올리즘에서의 원인과 임상적 특성에서의 차이점을 알고자해서 본 연구를 하게 되었다. 저자들이 작성한 반구조화된 설문지, MAST(Michigan alcoholism screening test). Zung의 SAS(Self-rating anxiety scale)과 SDS(Self-rating depression scale). MMPI(Minnesota Multiphasic Personality Inventory), SCL-90-R(Symptom checklist-90-revision) 및 EPQ(Eysenck personality questionnaire)등의 검사도구를 이용하였고, 그 결과를 독립표본 t-test(independent-samples t-test)와 χ²-test로 검정하여 다음과 같은 결론을 얻었다. 1) 여성 알코올리즘에서 남성 알코올리즘보다 더 낮은 교육 수준을 보였으며 초등학교수준 이하가 52.4%를 차지하였다. 반면에 남성 알코올리즘에서는 중학교·고등학교 수준이 76.7%였다.(p〈0.01). 2) 여성 알코올리즘에서 형제들 중에서 더 낮은 서열을 보였으며 세째딸이 1/3로 가장 많았고 다음이 외동딸로써 23.8%를 차지하였다. 반면 남성 알코올리즘에서는 장남이 46.7%였다.(p〈0.01). 3) 여성 알코올리즘이 사회경제적 수준에서 더 낮았다(p〈0,01). 4) 여성 알코올리즘의 음주시작동기는 대인관계를 위한 사교목적, 심리적 갈등이나 다른 정신적인 문제, 가족들과의 갈등 등이 비슷하게 많았다. 그러나 남성 알코올리즘에서는 대인관계를 위한 사교목적으로 음주하는 경우가 절대적으로 많았다.(p〈0.05). 5) 처음으로 음주를 시작한 연령은 여성 알코올리즘보다는 남성 알코올리즘에서 유의하게 더 어린 연령에서 시작하였다.(p〈0.001). 6) 1일 평균 음주량은 여성 알코올리즘에서 유의하게 더 적었다.(p〈0.01). 7) 금단증상경험, 알코올성 신체장애 및 음주로 인한 법적 처벌경험도 남성 알코올리즘보다는 여성 알코올리즘에서 유의하게 더 낮았다.(p〈0.05). 8) SCL-90-R에서 PSY척도에서 유의하게 여성 알코올리즘군에서 더 높았고, EPQ에서는 L척도에서 유의하게 여성 알코올리즘이 더 높았다(p〈0.05). 결론적으로 본 연구는 심리적 요인과 사회적 요인이 남녀 알코올리즘간에서 많은 차이가 있는 것을 알 수 있었으며, 여성 알코올리즘의 원인에는 심리적 또는 사회인구학적 요인이 더 밀접하게 연관이 되어 있음을 알 수 있었다. Objective : This study was designed to compare the characteristics of demographic data, clinical features, and personality in male and female alcoholics and to identify the clinically meaningful differences in the etiologies and the clinical features between the two groups. Methods : The study group was composed of 30 males and 21 females who were recruited into the impatient treatment. The researchers used self-reporting questionnaire composed of demographic data and drinking patterns, Michigan alcoholism screening test(MAST), self-rating anxiety scale(SAS) and self-rating depression scale(SDS) of Zung, Minnesota Multiphasic Personality Inventory(MMPI), symptom Checklist-90-revision(SCL-90-R), and Eysenck personality questionnaire(EPQ). The differences between the two groups were tested by chi-square test and independent-sample t-test. Result : 1) Education level of the female alcoholics was significantly less than that of male alcoholics(p〈0.05) and the birth order the female alcoholics was significantly higher than that of male alcoholics(p〈0.05). 2) The level of socioeconomic status of female alcoholics was significantly lower than that of male alcoholics(p〈0.01). 3) The initial motivations of female alcoholics were mainly due to social, psychological, and intrafamilial problems while those of male alcoholics were due to social problems. There were significant difference between the two groups(p〈0.05). 4) The onset of initial drinking in female alcoholics was significantly earlier than that of male alcoholics(p〈0.001). 5) The average amount of daily drinking in female alcoholics was significantly less than that of male alcoholics(p〈0.01). 6) Withdrawal symptoms, physical disorder, and social or legal problems induced by alcohol drinking in female alcoholics were significantly less than those of male alcoholics(p〈0.05). 7) The mean scores of PSY scale of SCL90R and of L scale of EPQ in female alcoholics were significantly higher than those of male alcoholics(p〈0.05). Conclusion : Demographic and psychosocial factors differed to a significant degree between male and female alcoholism. We suggest that these factors are more important in female alcoholism than in male one in the etiologies and the clinical features. These differences are due to more complex factors rather than simple ones, thus the further evaluations are needed to elucidate the differences in the etiologies between male and female alcoholism.

한국판 치료용 변화준비척도에 대한 신뢰도와 타당도 검증

이태경,황재연,김설연,정영철,강웅구 대한신경정신의학회 2011 신경정신의학 Vol.50 No.2

Objectives The purpose of this study was to evaluate the psychometric properties of the Korean version of the Readiness to Change Questionnaire-Treatment version (RCQTV-K). Methods The participants were 92 patients who were seeking treatment of alcoholism in two hospitals for alcoholism. A confirmatory factor analysis was performed to test whether the factor structure of the RCQTV-K was consistent with the English version. Convergent validity was assessed by correlating the scores on the RCQTV-K with those on other scales (Alcohol Abstinence Self-Efficacy Scale, Beck Depression Inventory, Korean Version of Alcohol Use Disorders Identification Test). Results The factor structure of the RCQTV-K was consistent with the three-factor structure established for the original RCQTV. Cronbach’s α was high, indicating that the reliability of the items for each subscale was satisfactory. Allocated stage of change showed significant differences among the scores on the other scales. Conclusion The results of the present study indicate that the RCQTV-K is an effective and valid scale for evaluating the stage of readiness to change in patients seeking treatment for alcoholism. The findings suggest that the RCQTV-K is a promising assessment tool for use in the treatment and study of alcoholism. Objectives The purpose of this study was to evaluate the psychometric properties of the Korean version of the Readiness to Change Questionnaire-Treatment version (RCQTV-K). Methods The participants were 92 patients who were seeking treatment of alcoholism in two hospitals for alcoholism. A confirmatory factor analysis was performed to test whether the factor structure of the RCQTV-K was consistent with the English version. Convergent validity was assessed by correlating the scores on the RCQTV-K with those on other scales (Alcohol Abstinence Self-Efficacy Scale, Beck Depression Inventory, Korean Version of Alcohol Use Disorders Identification Test). Results The factor structure of the RCQTV-K was consistent with the three-factor structure established for the original RCQTV. Cronbach’s α was high, indicating that the reliability of the items for each subscale was satisfactory. Allocated stage of change showed significant differences among the scores on the other scales. Conclusion The results of the present study indicate that the RCQTV-K is an effective and valid scale for evaluating the stage of readiness to change in patients seeking treatment for alcoholism. The findings suggest that the RCQTV-K is a promising assessment tool for use in the treatment and study of alcoholism.

The Current Situation of Treatment Systems for Alcoholism in Korea

김지욱,이병철,강태천,최인근 대한의학회 2013 Journal of Korean medical science Vol.28 No.2

Alcoholism is becoming one of the most serious issues in Korea. The purpose of this review article was to understand the present status of the treatment system for alcoholism in Korea compared to the United States and to suggest its developmental direction in Korea. Current modalities of alcoholism treatment in Korea including withdrawal treatment,pharmacotherapy, and psychosocial treatment are available according to Korean evidencebased treatment guidelines. Benzodiazepines and supportive care including vitamin and nutritional support are mainly used to treat alcohol withdrawal in Korea. Naltrexone and acamprosate are the drugs of first choice to treat chronic alcoholism. Psychosocial treatment methods such as individual psychotherapy, group psychotherapy, family therapy, cognitive behavior therapy, cue exposure therapy, 12-step facilitation therapy,self-help group therapy, and community-based treatment have been carried out to treat chronic alcoholism in Korea. However, current alcohol treatment system in Korea is not integrative compared to that in the United States. To establish the treatment system, it is important to set up an independent governmental administration on alcohol abuse, to secure experts on alcoholism, and to conduct outpatient alcoholism treatment programs and facilities in an open system including some form of continuing care.

Biological Studies on Alcohol-Induced Neuronal Damage

Masaru Tateno,Toshikazu Saito 대한신경정신의학회 2008 PSYCHIATRY INVESTIGATION Vol.5 No.1

Alcohol is a well-known cytotoxic agent which causes various kinds of neuronal damage. In spite of thousands of published studies, the true mechanism of alcohol-induced neuronal damage remains unclear. Neurogenesis is the generation of neurons from neural stem cells (NSCs) and occurs in predominantly two regions of the brain, the subventricular zone and the dentate gyrus of the hippocampus. NSCs are the self-renewing, multipotent precursor cells of neurons, strocytes, and oligodendrocytes in the central nervous system. Recent studies have begun to illuminate the role of neurogenesis in the biological and cellular basis of psychiatric disorders and several clinical symptoms seen in alcoholism such as depression, cognitive impairment, underlying stress and brain atrophy have been linked to impaired neurogenesis. Heavy alcohol consumption decreases neurogenesis in animals, while in vitro studies have shown decreased generation of new neurons after alcohol exposure. These findings suggest that decreased neurogenesis is important in the pathophysiology of alcoholism. Neurogenesis can be divided into four stages; proliferation, migration, differentiation and survival. Our in vitro studies on NSCs showed that alcohol decreased neuronal differentiation at doseslower than those that affected cell survival and suggested that neuron-restrictive silencer factor, or repressor element-1 silencing transcription factor (NRSF/REST) could be involved in alcohol-induced inhibition of neuronal differentiation. In an animal model of fetal alcohol effects behavioral symptoms improved after NSC transplantation. Neurogenesis could be the target for new strategies to treat alcohol related disorders. Alcohol is a well-known cytotoxic agent which causes various kinds of neuronal damage. In spite of thousands of published studies, the true mechanism of alcohol-induced neuronal damage remains unclear. Neurogenesis is the generation of neurons from neural stem cells (NSCs) and occurs in predominantly two regions of the brain, the subventricular zone and the dentate gyrus of the hippocampus. NSCs are the self-renewing, multipotent precursor cells of neurons, strocytes, and oligodendrocytes in the central nervous system. Recent studies have begun to illuminate the role of neurogenesis in the biological and cellular basis of psychiatric disorders and several clinical symptoms seen in alcoholism such as depression, cognitive impairment, underlying stress and brain atrophy have been linked to impaired neurogenesis. Heavy alcohol consumption decreases neurogenesis in animals, while in vitro studies have shown decreased generation of new neurons after alcohol exposure. These findings suggest that decreased neurogenesis is important in the pathophysiology of alcoholism. Neurogenesis can be divided into four stages; proliferation, migration, differentiation and survival. Our in vitro studies on NSCs showed that alcohol decreased neuronal differentiation at doseslower than those that affected cell survival and suggested that neuron-restrictive silencer factor, or repressor element-1 silencing transcription factor (NRSF/REST) could be involved in alcohol-induced inhibition of neuronal differentiation. In an animal model of fetal alcohol effects behavioral symptoms improved after NSC transplantation. Neurogenesis could be the target for new strategies to treat alcohol related disorders.

가족력 유무에 따른 알코올중독환자의 임상적 특성

오동훈(Dong-Hoon Oh),김길숙(Gil-Sook Kim),오동열(Dong-Yul Oh) 한국중독정신의학회 1997 중독정신의학 Vol.1 No.1

Object:We attempted to clarify the clinical characteristics of alcoholics according to family history of alcoholism. Method:We examined 51 men alcoholics who had been admitted to alcoholic open ward in Seoul National Mental Hospital from June 1st 1996 to June 30th 1996 according to their family history of alcoholism. We perfomed semi-structured interview for demographic data, drinking history, and social consequences. Self-report questionnaires for severity of alcoholism(Alcoholism Screening Test of Seoul National Mental Hospital;NAST), depression(Korean Version Beck Depression Inventory;K-BDI) and anxiety(State-Trait Axiety Inventory;STAI-trait and state) were given to all subjects at least 2 weeks later after admission. Result: 1) The number of familial alcoholics were 22 and those of non familial alcoholics were 29. 2) Mean age on admission(p<0.05) and age when first diagnosed as alcoholism(p<0.05) was significantly younger in familial alcoholics than in non-familial alcoholics. 3) Familial alcoholics were scored significantly higher than non-familial alcoholics in Alcoholism Screening Test of Seoul National Mental Hospital(p<0.05), Korean Version Beck Depression Inventory(p<0.05), and State-Trait Anxiety Inventory(p<0.05). Conclusion:Therefore special attention is needed for familial alcoholics due to above clinical characteristics.

한국판 TCI를 사용한 알코올 의존 환자의 인격 특성 연구

이정식(Jung-Sik Lee),김홍관(Hong-Kwan Kim) 한국중독정신의학회 2002 중독정신의학 Vol.6 No.1

Alcoholism is a complex disease which has underlying biopsychosocial factors. So, we can make prevention and treatment plan with understanding of alcoholic’s biopsychosocial background. Personality factor is one of the important factors for occurrence, prevention and treatment of alcoholism. Recently, It is increasing the research of personality traits using of Temperament and Character Inventory (TCI), one of the dimensional personality models, which is based on biopsychosocial model. We compared personality traits of alcoholic patients and normal controls with TCI. We divided alcoholic patients into subgroups according to age at onset of problem drinking and family history of alcoholism and compared the personality traits of the subgroups with TCI. We chose 50 male alcoholic patients admitted to Yong-In mental hospital as case and 93 male people who visited Han gang Sacred Heart hospital to exam their health or who work in the hospital as normal controls. We took demographic data and TCI scores from patients and normal controls and got clinical characteristics such as drinking frequency, acute psychological and physiological response after alcohol ingestion, Buss-Durkee Hostility Inventory (BDHI) and Michigan Alcohol Screening Test (MAST) from alcoholics. Alcoholic patients show higher novelty seeking, higher harm avoidance and lower self-directedness than normal controls. In alcoholics, early onset (onset before 25 year old) patients show higher novelty seeking and have more drinking problems and show more spontaneous aggression. Patients with family history show higher novelty seeking and more drinking problems. There are significant differences in personality traits according to age at onset, family history of alcoholism. This study suggested the necessity to build different treatment and prevention plan of alcoholics according to TCI personality traits.