성격장애 부모를 가진 아동의 정신과적 문제들

강제욱 대한소아청소년정신의학회 2018 대한소아청소년정신의학회 학술대회논문집 Vol.2018 No.5

궤양성 대장염과 연관된 자가면역 췌장염 1예

강제욱,이영수,김유정,김봉선,김주성,박진웅,이광재,현선아 중앙대학교 의과대학 의과학연구소 2015 中央醫大誌 Vol.40 No.1

A 28-year-old man was admitted to our hospital because of left upper quadrant abdominal pain, diarrhea, bloody stool, and weight loss for 5 months. He had been diagnosed with ulcerative colitis (UC) at age 15, but without medication, the disease has been in remission since then. On admission, patient complained left upper quadrant pain and serum amylase was checked 594 U/L. For evaluation, we performed colonoscopy and abdominal computed tomography. Colonoscopy showed diffuse active inflammation on entire colon and rectum. And, pancreas was diffuse enlarged and looked like sausage shape in abdominal computed tomography. On the basis of abdominal CT findings and the patient's history, ulcerative colitis accompanied by autoimmune pancreatitis was doubted. So we checked serum IgG4 level and magnetic resonance cholangiopancreatography (MRCP). Although, narrowing of the main pancreatic duct was not detected by MRCP, the serum levels of pancreatic enzyme and IgG4 were elevated. Based on these findings, he was given a diagnosis of autoimmune pancreatitis (AIP) associated with UC. Both diseases improved with using steroids. After discharge, UC symptoms and the serum levels of pancreatic enzymes has been improved.

COVID-19 대유행 이후 청소년의 정신건강문제 변화양상 비교: 2020, 2021년 청소년건강행태조사 기반

강제욱 대한신경정신의학회 2022 신경정신의학 Vol.61 No.4

Objectives This study aimed to investigate the changes in the mental health of adolescents after the coronavirus disease 2019 (COVID-19) pandemic. Methods The data for the study were obtained from the Korea Youth Risk Behavior Web-based Survey (KYRBWS), 2020–2021. Overall, the data of 88184 students were included. The data were analyzed using multiple logistic regression analysis with complex sampling using weighted values. The odds ratios (ORs) with 95% confidence intervals (CIs) for subjective stress perception, loneliness, pan-anxiety disorder scale, suicide-related indicators, and high-risk smartphone usage groups were used as major variables. Results The results suggest that the mental health of adolescents deteriorated in 2021 compared to 2020. Adolescents experiencing stress (OR=1.18; 95% CI, 1.08–1.16; p<0.01) and reporting loneliness were also higher (OR=1.07; 95% CI, 1.02–1.12; p<0.01). The high-risk group for pananxiety disorders also increased more than in 2020 (OR=1.05; 95% CI, 1.00–1.11; p<0.01). It was also found that adolescents experiencing suicide accidents increased (OR=1.09; 95% CI, 1.04–1.16; p<0.01). In addition, the high-risk group for smartphone use also increased compared to 2020 (OR=1.17; 95% CI, 1.12–1.23; p<0.01). On the other hand, there was no statistically significant difference in depression, suicide plans, and suicide attempts. Conclusion This study found that the mental health problem of adolescents, which had temporarily decreased after the COVID-19 pandemic, was deteriorating again. These findings suggest that it is necessary to follow up and closely monitor the mental health problems of adolescents from the longitudinal perspective during the COVID-19 pandemic

재난의 연대기

강제욱(姜帝旭) 새얼문화재단 2020 황해문화 Vol.108 No.-

주의력결핍 과잉행동장애에서 파탄적 행동장애의 공존과 약물치료

강제욱(Je Wook Kang),박은진(Eun Jin Park),김성찬(Seong Chan Kim),신의진(Yee-Jin Shin),신윤미(Yun-Mi Shin),정재석(Jaesuk Jung),천근아(Keun-Ah Cheon),육기환(Ki-Hwan Yook) 대한소아청소년정신의학회 2012 소아청소년정신의학 Vol.23 No.S

Disruptive behavioral disorders [oppositional defiant disorder (ODD) and conduct disorder (CD)] are common comorbid disorders in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). ODD/CD may be comorbid up to 60% of children and adolescents with ADHD. Comorbid ODD and CD symptoms can have a significant impact on the course and prognosis o f patients with ADHD. Stimulant medications have shown effectiveness in treating both core ADHD symptoms and oppositional symptoms. Assessment and management of comorbid disruptive behavioral symptoms is an essential part in evaluation and treatment of ADHD patients. Further research is needed to investigate the efficacy and safety of various behavioral and medication regimens for ADHD, comorbid ODD and CD and to examine the relationships between ADHD, comorbid ODD and CD.

청소년의 스마트폰 사용시간과 우울증상 및 자살의 관계

강제욱(Je-Wook Kang) 대한사회정신의학회 2019 사회정신의학 Vol.24 No.2

연구목적 : 본 연구에서는 스마트폰 과의존이 청소년기의 우울감과 자살사고에 미치는 영향을 알아보고자 하였다. 방 법 : 2017년에 실시한 제 13차 청소년 건강행태 온라인조사의 원시자료를 사용하여 54,603명의 자료를 최종 분석하였다. 사회인구학적 정보와 정신사회적 요인을 평가하기 위해 우울감, 자살생각과 계획, 시도 등을 주요 변수로 사용하였다. 그리고 스마트폰 사용 시간을 주중과 주말로 나누어 각각의 특성을 분석하였다. 결 과 : 주중 스마트폰 사용시간이 300분이상인 청소년은 14.4%, 주말 스마트폰 사용시간이 480분 이상인 청소년의 비중이 18.2%로 나타 났다. 또한 주중 300분 이상 스마트폰을 사용하는 청소년의 경우 60분 이하로 사용하는 집단보다 우울증상의 위험성이 1.56배(OR= 1.56 ; 95% CI, 1.43~1.71 ; p<0.01) 높게 나타났으며, 자살사고도 유의하게 높아지는 것으로 나타났다(OR=1.23 ; 95% CI, 1.08~ 1.39 ; p<0.01). 주말 스마트폰 사용의 경우 480분 이상 스마트폰을 사용하는 경우, 우울증상의 위험성이 1.41배 증가하였고(OR= 1.41 ; 95% CI, 1.30~1.53 ; p<0.01), 자살사고도 유의하게 증가하는 것으로 나타났다(OR=1.16 ; 95% CI, 1.03~1.31 ; p=0.02). 반면 주중 평균 120~180분 사용하는 청소년의 경우에는 자살계획의 위험성이 감소하였으며(OR=0.84 ; 95% CI, 0.70~1.00 ; p=0.05), 주말 평균 240~300분 사용하는 경우에도 자살 사고의 위험성이 낮아지는 결과를 보였다(OR=0.87 ; 95% CI, 0.78~0.98 ; p=0.02). 결 론 : 본 연구의 결과를 토대로 살펴 볼 때 스마트폰 사용은 청소년기의 우울감과 자살사고에 긍정적, 부정적인 영향을 미치는 것으로 나타났다. 이러한 결과를 통해서 적절한 청소년기의 스마트폰 사용시간에 대한 합리적인 가이드라인을 세우는 데 도움이 될 것으로 생각된다. Objectives : The purpose of this study was to investigate the effects of smartphone dependence on adolescent depression and suicide. Methods : Data from 54,603 people were finally analyzed using raw data from ‘the 13th Korea Youth Risk Behavior Web-based Survey (KYRBWS)’ conducted in 2017. In order to evaluate psychosocial factors, depression, suicidal idea, planning and attempts were used as the main variables. The characteristics of each smartphone were analyzed by dividing smart-phone usage time into weekdays and weekends. Results : Adolescents who used smartphones for 300 minutes or more during the week showed 1.56 times higher risk of depression (OR=1.56 ; 95% CI, 1.43-1.71 ; p<0.01) than those who used less than 60 minutes. Incidents of suicide idea were also significantly higher (OR=1.23 ; 95% CI, 1.08-1.39 ; p<0.01). In the case of weekend smartphone use, the risk of depression increased by 1.41 times (OR=1.41 ; 95% CI, 1.30-1.53 ; p<0.01). Incidents of suicide idea were also significantly higher (OR=1.16 ; 95% CI, 1.03-1.31 ; p=0.02). On the other hand, adolescents who used 120-180 minutes on weekdays, had a lower risk of suicide planning (OR=0.84 ; 95% CI, 0.70-1.00 ; p=0.05). Also, risk of suicide idea was also lower when using the weekend for 240-300 minutes (OR=0.87 ; 95% CI, 0.78-0.98 ; p=0.02). Conclusion : This study provide mixed results between smartphone use time and mental health problem. This findings can offer better understanding and providing guideline to adolescent with using smartphone.

독립형 DC 마이크로그리드 내 SoC-V droop 기반의 BESS간 에너지 분배 기법 검토

강제욱(Jeuk Kang),김윤수(Yun-Su Kim) 대한전기학회 2021 대한전기학회 학술대회 논문집 Vol.2021 No.7

다발골수종 환자에서 병기체계에 따른 임상적 결과 비교

현선아,강제욱,류형규,김유정,박진웅,노충균,이영수,박준성 중앙대학교 의과대학 의과학연구소 2015 中央醫大誌 Vol.40 No.4

its simplicity compared with Durie-Salmon system (DSS) for myeloma. However, accurate clinical outcome should be clarified when a patient presents different stage according to the two different staging system. Method: A total of 85 consecutive myeloma patients were evaluated their clinical outcomes after treatment at Ajou University Hospital between 2004 and 2013. Result: Among ISS I patients, the overall survival (OS) of DSS II and DSS III was 51.2 and 52.2 months, respectively. In ISS-II patients, the OS of DSS I and DSS III was 48.1 and 38.7 months, respectively. In ISS III patients, the OS of DSS I and DSS II was 8.2 and 17.1 months, respectively. All of the values were not significant. Conclusion: Our data indicated that subdivision by DSS did not affect survival outcomes of patients who presented same stage by ISS. Enough sample size with homogenous treatment is necessary in order to support this result.

주의력결핍 과잉행동장애 아동의 타이밍과 운동기능 및 실행기능의 상관관계

이수민,강제욱,장문영,김경미 대한작업치료학회 2018 대한작업치료학회지 Vol.26 No.3

목적 : 본 연구는 주의력결핍 과잉행동장애 아동(Attention Deficit Hyperactivity Disorder; ADHD)의 타이밍과 운동기능 및 실행기능의 상관관계를 알아보고자 하였다. 연구방법 : 연구 대상은 부산 지역에 거주하며, ADHD 진단을 받은 만 6~12세 아동 32명을 대상으로 하였다. 연구도구는 타이밍 기능 평가를 위해 상호작용식 메트로놈, 운동기능을 평가하기 위해 Bruininks-Oseretsky Test of motor proficiency, Second edition(BOT-2), 그리고 실행기능 평가를 위해 스트룹 아동 색상 단어 검사와 아동 색 선로 검사를 실시하였다. 타이밍과 운동기능 및 실행기능과의 상관관계를 알아보기 위해 상관분석을 사용해 분석하였다. 결과 : ADHD 아동의 타이밍과 운동기능과의 상관관계를 알아본 결과, 타이밍과 BOT-2 영역 중 미세한 손의 조절, 신체 협응에서 음의 상관관계가 있었다. BOT-2 하위 영역에서는 미세 운동 정확성, 양측 협응과 음의 상관관계가 있었다(p<.05). ADHD 아동의 타이밍 기능과 실행기능과의 상관관계를 알아본 결과, 타이밍과 스트룹 아동 색상 단어 검사의 단어 점수와 아동 색 선로 검사의 Children’s Color Trails Test(CCTT)-1 점수에서 음의 상관관계가 있었다(p<.05). 결론 : 본 연구의 결과를 통해 타이밍과 운동 및 실행기능의 상관관계를 확인할 수 있었다. 따라서 타이밍 평가를 통해 ADHD 아동의 운동기능과 실행기능을 예측할 수 있을 것이다. Objective: The purpose of this study was to examine the relationship between timing and motor function and between timing and executive function in children with Attention Deficit Hyperactivity Disorder(ADHD). Methods: The subjects were 32 children with ADHD aged between 6 and 12. The study tool used Interactive Metronome(IM) for the timing, Bruininks-Oseretsky Test of motor proficiency, Second edition(BOT-2) for the motor functions, and STROOP color and word test and Children’s Color Trails Test(CCTT) for the executive functions. A correlation analysis was conducted to analyze the relationship between timing and motor function and between timing and executive function. Results: Examining the correlation between the timing and the motor functions of the ADHD children, there was a negative correlation between the fine manual control and the body coordination of composite in the BOT-2 (p<.05). And there was a negative correlation between the fine motor precision and bilateral coordination of subtest in the BOT-2. Examining the correlation between the timing and the executive functions of the ADHD children, there was a negative correlation between the word score in the STROOP color and word test (p<.05), and CCTT-1 in the Children’s color trails test (p<.05). Conclusion: The results of this study confirmed the relationship between timing and motor function and between timing and executive function. Timing evaluation can predict the motor functions and executive functions of children with ADHD.

상호작용식 메트로놈 중재가 주의력결핍과잉행동장애의 행동증상, 타이밍 및 운동기능에 미치는 효과

구기쁨,강제욱,이수민,김경미 대한감각통합치료학회 2017 대한감각통합치료학회지 Vol.15 No.2

Objective : The purpose of this study is to investigate the effect of modified Interactive Metronome (IM) program which is applicable to clinical practice based on the IM protocol on the behavioral symptoms, timing and motor function of children with Attention Deficit Hyperactivity Disorder (ADHD). Method : This study used one-group pretest-posttest research design. 13 ADHD children aged 7-12 years in Busan were participated in this study. The participants were underwent 24 sessions of 30 minutes intervention, 3 times a week. Evaluations were performed before- and after the intervention. Measurements used in this study were Korean-ADHD Rating Scale for behavior symptom, Long Form Assessment (LFA) for the timing, and second version of Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) for the motor function. Results : There was a significant improvement in hyperactivity / impulsivity among the behavioral symptoms, and there was a statistically significant improvement in timing, hand coordination, and body coordination. Conclusion : Modified IM program for clinical application has significant effect on improving behavioral symptoms, timing and motor function of children with ADHD 목적 : 본 연구는 주의력결핍과잉행동장애(Attention-Deficit/Hyperactivity Disorder; ADHD) 아동에게 사용되는 상호작용식 메트로놈(Interactive Metronome; IM) 프로토콜을 기반으로 임상에 적용 가능하도록 수정된 IM 프로그램이ADHD 아동의 행동증상, 타이밍 및 운동기능에 미치는 효과를 알아보고자 한다. 연구방법 : 본 연구는 부산 소재의 기초정신건강증진센터 내에 있는 7-12세의 ADHD 아동 13명을 대상으로 단일 집단사전-사후 설계(one group pretest-posttest design)를 사용하였다. 중재는 회당 30분, 주 3회, 24회기 동안 실시하였으며, 중재 전과 후의 행동증상, 타이밍 및 운동기능 변화를 비교하기 위해 부모보고형 한국어판 ADHD 평정척도, IM의Long Form Assessment(LFA), Bruininks–Oseretsky Test of Motor Proficiency 2판(BOT-2)을 사용하였다. 결과 : 행동증상 중 과잉행동/충동성에서 유의미한 향상이 있었고, 타이밍과 손의 협응 및 신체협응에서 통계적으로 유의미한 향상이 있었다. 결론 : 임상에 적용 가능하도록 수정된 IM 프로그램이 ADHD 아동의 행동증상을 개선하고, 타이밍 및 운동기능 향상에유의한 효과가 있다.