糖尿病 患者의 正神科的 症狀

姜秉祚,朴宗漢,丁海翼,尹榮佶 慶北大學校 醫科大學 1979 慶北醫大誌 Vol.20 No.2

著者들은 1979年 8月에서 11월까지 慶北醫大 附屬病院에 入院한 糖尿病 患者 110名(男=61, 女=49)과 對照群 110名(男=61, 女=49)에게 SCL-90을 使用하여 精神科的 症狀을 比較調査하여 본 結果 다음과 같은 結果를 얻었다. 1. 糖尿病 患者群은 對照群 보다 睡眼障碍, 憂鬱症, 罪意識, 强迫症, 不安症, 身體化의 順으로 有意하게 높았고, 對人 敏感性, 編執症 思考, 恐怖不安, 敵愾心, 죽음에 대한 生覺의 順으로 有意하게 낮았으며, 精神症에서는 아무런 差異도 없었다. 2. SCL-9이 糖尿病을 비롯한 韓國人 精神身體疾患者들의 精神科的 病理所見을 알아내고 다루는데 상당한 價値가 있다고 生覺한다. The present study was conducted to investigate the difference of psychiatric symptoms between 110 diabetic group admitted in Kyungpook National University Hospital and 110 control group by SCL-90 from August, 1979 to November, 1979. The results obtained are summarized as follows. Diabetic patients group has significantly higher levels of sleep disturbance, depression, feelings of guilt, obsessive compulsive, anxiety and somatizatization, but lower levels of interpersonal sensitivity, paranoid ideation, phobic anxiety, hostility and thought of death or dying than those levels of contral group. There are no difference between diabetic patients group and control group in psychoticism. The use of this kind of self-administered symptom inventory can be a valuable adjunct to the identification and management of psychiatric pathology in psychosomatic patients such as diabetics in Korea.

Mirtazapine의 작용기전과 임상적 효과

강병조 대한생물치료정신의학회 1998 생물치료정신의학 Vol.4 No.2

Mirtazapine is a Noradrenergic and Specific Serotonergic Antidepressant(NaSSA). It enhances noradrenergic transmission by blocking α2-adrenergic autoreceptors. In addition, mirtazapine enhances serotonergic transmission via two synergistic mechanisms : an increase of 5-HT cell firing and blockade of α2-adrenergic heteroreceptors. Mirtazapine specifically enhances 5-HT1-mediated transmission while 5-HT2 and 5-HT3 receptors are blocked by mirtazapine. Mirtazapine has demonstrated clinical efficacy in the treatment of moderately and severely depressed patients. Mood improvement with mirtazapine is seen within 1 week of tratment, and therapeutic effects are sustained throughout the treatment period. Because of its unique pharmacological profile, mirtazapine is virtually devoid of antichotinergic, adrenolytic, and serotonin-related side effects. The most frequently reported adverse events were transient sedation and weight gain. The recommended dosing schedule is to start treatment with 15mg/day for 4days, followed by 30mg/day for 10 days. Treatment may continue with the unchanged daily(30mg/day) in patients showing a satisfactory therapeutic response, or it can subsequently be raised to 45mg/day in patients assessed as not sufficiently improved after 14 days.

약물치료를 위한 정신치료 : 약물 순응도를 높이기 위한 정신치료 사례

강병조,이양현 대한생물치료정신의학회 2002 생물치료정신의학 Vol.8 No.2

연구목적 : 병식이 없어 약을 잘 복용하지 않는 망상장애 환자에게 약물 순응도를 높이기 위한 정신치료적 접근 방법을 연구함이 목적이다. 방법: 저자가 최근에 치료 경험한 한 사례의 병록지를 검토하여 분석 요약하였다. 결과 : 병식이 없는 망상 및 우울장애 환자가 호소하는 약물 비순응의 이유들을 밝혀서 잘 설명하여 주고, 병의 생물학적인 원인 및 약의 작용과 부작용을 설명하여 주었더니 약물 순응도가 높아 졌다. 망상장애와 우울증이 심하며 약물 순응도가 낮은 이 환자에서는 정신치료자와 약물치료자가 분리되어 치료하는 것이 별로 도움이 되지 않았다. 결론 : 병식이 없는 망상장애 환자에게 병의 생물학적 원인과 약의 작용과 부작용을 설명하여주는 것이 약물 순응도를 높혔다. 또한 이런 약물 순응도가 낮은 환자에게는 정신치료자와 약물치료자가 분리되지 않는 것이 좋았다. Objectives : The aim of this case study was to investigate a kind of psychotherapy fordrug compliance in a delusional disorder patient who is without insight.Methods : The author selected and reviewed one of many medical records of drug noncompliance patients.Results : The author's explanation of biological hypothesis of the disorder, and the efficacy and side effects of the drugs to the patient helped improve the patient's drug compliance. The author also experienced that split between psychotherapist and pharmacotherapist was not helpful to the patient.Conclusions : The results revealed that the explanation of biological hypothesis of the disorder, and the efficacy and side effects of the drugs to the patient who has no insight improved the patient's drug compliance. Split between psychotherapist and pharmacotherapist was not helpful in a delusional disorder patient who is very psychotic.

정신분열병 환자에서 Olanzapine이 인지기능에 미치는 영향

강병조,김양태,김문두,이승재,박영우 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.1

Objects : The purpose of this study was to test the effects of olanzapine on cognitive functions in schizophrenic patients. Methods : The subjects were 16 haloperidol-medicated schizophrenic patients and 15 risperidone-medicated schizophrenic patients, who participated in an eight-week crossover study from haloperidol and risperidone to olanzapine. Results : The patients in the group of crossover from haloperidol to olanzapine showed significant improvement in Parkinson scale of ESRS and other cognitive functions except for verbal fluency. Negative scale of PANSS and cognitive functions such as verbal memory, verbal fluency, visual memory and executive function were significantly improved in patients In the group of crossover from risperidone to olanzapine. Conclusions : These data suggest that olanzapine has some superior cognitive benefits relative to haloperidol and risperidone, but a larger sample replication study is necessary.

Clozapine이 인체내에서 인간조직적합성항원에 미치는 영향

강병조,김문두,곽경필 경북대학교 의학연구소 2000 경북대학교병원의학연구소논문집 Vol.4 No.1

The histocompatibillty antigen (human leukocyte antigen : HLA) has been used for organ transplantation, discrimination of one's real children and transfusion, etc. The objective of this study was to find out how dozapine affects HLA class I and II type in the humanbody when therapeutic doses are applied. The subject consists of 3 persons for lass I and class II They were administered for about 3 months with clozapine 157-250mg/day (mean dally dose 200mg). Analysis of HLA lass I type was the microcytotoxicity test of Terasaki and class II type was PCR method of Erhich. The results were as followings: Two of 3 were changed in HLA-A, B, C type. All three were not chanced in HLA-DR type. In conclusion, the short-term application, about 3 months, of therapeutic dose of clozapine is not considered to bring about changes in DNA level.

정상인의 월경전기증상에 대한 Pyridoxine 과 Lithium의 효과

강병조 大韓神經精神醫學會 1987 신경정신의학 Vol.26 No.4

저자는 1985년 9월부터 12월 까지 ㅇㅇ시에 있는 한 학교 여대생 31명에게 이중검맹법으로 pyridoxine, lithium 그리고 placebo를 투여하여 월경전기증상에 대한 효과를 연구하여 보았다. 월경전기증상은 매일평가서식을 사용하여 투약전 6주간과 투약중 6주간 매일 스스로 기록하게 하였으며, 투약전과 후의 각 증상의변화를 조사하여 다음과 같은 결과를 얻었다. Pyridoxine군과 lithium군은 치료효과는 없이 부종, 피곤, 유방통, 두통, 성욕감퇴의 증상이 유의하게 증가하였으며 lithium이 더욱 심하였다. 한편 placebo군은 오히려 우울감이 유의하게 호전된 결과를 나타내었다. The author carried out a study upon the effects of pyridoxine, lithium and placebo for premenstrual syndrome on 31 college women using the double blind method, from September 1985 to December 1985. Each subject checked her own symptoms on the daily ratings from every day for 6 weeks before and after medication. The author checked changes of symptpms before and after medication. Pyridoxine and lithium groups showed distinct edema, low energy, breast pain, headaches and less sexual interest. On the other hand, placebo group showed improvement of their depressed mood.

看護學生들의 憂鬱症 調査

姜秉祚,朴點姬,姜錫憲 慶北大學校 醫科大學 1975 慶北醫大誌 Vol.16 No.2

The authors, who have been subjected to the nursing education and psychiatric consultation of nursing students for several years, felt recently a pressing need for a preliminary survey of mental health problem of them. The purpose of the present study is twofold; to determine whether the nursing students are more depressive than other general college girl students or not, and to evaluate any difference of depression rate of nursing students among each different school and grade. The total number of subjects studied were 476 nursing students comprising 126 from K. nursing college, 253 from M. nursing school and 97 from T. nursing school, and as a control group 50 from H. women's college were selected randomly. The self-rating depression scale was applied to these subjects separately with the aid of the teachers of respective school with adequate explanation. 1. First of all, as a general overview, there was no significant difference of total depression rate between that of nursing students and control group, and there also showed no significant difference of depression rate among three different nursing school. 2. Regarding so called "problem group" that means meaningfully depressive, there also could be found no significant difference of depression rate among above mentioned four groups, (K-group, M-group, T-group and control group) 3. However, in comparison with each grade of different nursing school the authors could find some interesting results of depression rate of nursing students. In two civilian nursing students(KT group), as the educational year increases, they showed gradually increasing depression rate, while in military nursing students they showed a contrasting reverse traits. 4. Of all nursing students comprising different schools and grades, the senior class of K. nursing college showed most depressive traits. 5. From the above results, the authors analyzed and interpreted them in relation with previous studies done by other authors.

약물치료를 위한 정신치료 : 약물 순응도를 높이기 위한 정신치료 사례 A Case of Psychotherapy for Drug Compliance

강병조,이양현 대한생물치료정신의학회 2002 생물치료정신의학 Vol.8 No.1

甲狀腺機能亢進症의 精神醫學的 硏究

姜秉祚 慶北大學校 醫科大學 1978 慶北醫大誌 Vol.19 No.2

The author performed the Self-Rating Anxiety and Depression Scale of W.W.K. Zung on 70 female toxic goiters, 68 female non-toxic goiters and 86 normal females from Mar. 1977 to Step 1977. Also the author briefly interviewed 62 toxic goiter patients during the same stdudy period. The results were as follows: 1. In both anxiety and depressive scores, toxic goiters were singificantly higher than non-toxic goiters, and non-toxic goiters were singificantly higher than normal females. 2. The mojority of toxic goiters had emotional traumas during th 2 year prior to the onset of symptoms. Death of a close family member, financial loss, change in residence, personal illness, argument with spouse, death of spouse, marriage, pregnancy and trouble with in-laws were important emotional factors.

폐경기 증후군의 생물학적 접근

강병조,이죽내,임효덕,강석헌,Kang, Byung-Jo,Lee, Zuk-Nae,Rim, Hyo-Deog,Kang, Suk-Hun 한국정신신체의학회 1996 정신신체의학 Vol.4 No.1

Hormone replacement therapy in menopausal women has recently been a hot issue in medical fields. The author reviewed the physiology of menopause and discussed the physiological mechanism and biological management of vascular flushing and menopausal depression. The above symptoms are hard to distinguish from those of psychiatric disorders.