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      • KCI등재

        정신과 자문환자의 정신과에 대한 인식 및 수용도

        고경봉 大韓神經精神醫學會 1987 신경정신의학 Vol.26 No.1

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

        This survey was done to investigate the effect of concept and acceptability of psychiatry in the patients referred for psychiatric consultation on their resistance to psychiatric approach. They were compared with each of the psychiatric outpatients and the general public. In general, the concept of psychiatry in the former is similar to that in both the latter. In its degree, however, such concept in the former is reiatively lower than in the outpatients. It means that motivation of psychiatric treatment and prior contact with psychiatry could highly influence such concept. Those patients consulting a psychiatrist show less acceptability in psychiatric treatment of somatic symptoms than the general public. They also tend to consider primarily their psysicians' recommendation for psychiatric treatment in comparison with the outpatients. So it can be said that their acceptability of psychiatry depends upon their physicians' attitude. In each of three groups of subjects, the concept of psychiatry os markedly different from the concept of mental disorder: a large proportion of people still view psychiatry as dealing with only psychoses, while they view mental disorder as including little psychoses. It suggests that their resistance to psychiatric approach might arise from the misconception of psychiarty rather than of mental disorder. In addition, both the patients consulting a psychiatrist and the general pubic do not understand distinctly the difference between psychiatry and neurology. Thus, it is emphasized that education and guidance are necessary to make them understand psychiatry correctly.

      • 정신신체장애, 불안장애 및 우울장애 환자들 간의 Alexithymia의 비교

        고경봉,Koh, Kyung-Bong 한국정신신체의학회 1994 정신신체의학 Vol.2 No.1

        본 연구는 정신신체장애, 불안장애 및 우울장애 환자들 간에 alexithymia의 정도를 비교하기 위해서 실시되었다. 연구대상은 정신과 외래에 내원 하였거나 타과에서 정신과에 자문의뢰된 정신신체장애 환자 100명(긴장성 두통환자 47명 포함), 불안장애환자 52명, 우울장애환자 50명으로 하였다. 조사방법은 반체계적 면담용 평가도구인 Alexithymia provoked Response Questionnaire(APRQ)를 사용하였다. 정신신체장애환자들은 불안장애 및 우울장애환자들보다 alexithymia의 정도가 더 낮았으나 세 군간에 유의한 차이는 없었다. 반면 긴장성 두통환자들은 불안장애 및 우울장애환자들에 비해 alexithymia의 정도가 각각 유의하게 더 높았다. 우울장애환자들이 불안장애환자들보다 aluithymia의 정도가 더 높았으나 양군간에 유의한 차이는 없었다. 성별, 연령, 교육수준, 종교 및 직업유무와 같은 인구학적 특징들은 조사대상 모든 군에서 alexithymia와 유의한 관계가 없었다. 이 결과들은 일반적으로 정신신체장애환자들이 alexithymia를 보인다는 기존 보고와 다르게 정신신체장애 중 긴장성 두통과 같은 특정 정신신체장애환자들에서 alexithymia가 현저함을 시사한다. 따라서 긴장성 두통환자들에서의 치료전략으로 감정표현을 유도하는 특수한 형태의 면담방법이 개발될 필요가 있다. A comparison was made regarding the degree of alexithymia among patients with psychosomatic disorders, anxiety disorders and depressive disorders. The author examined the degree of alexithymia in three groups : 100 psychosomatic patients(including 47 patients with tension headache), 52 outpatients with anxiety disorden, and 50 outpatients with depressive disorders. Alexithymia was assessed by Alexithymia provoked Response Questionnaires(APRQ) developed as a semi-structured interview form. No significant difference was found in the degree of alexithymia among Patients with Psychosomatic disorders, anxiety disorders, and depressive disorders. On the other hand, patients with tension headache were significantly more alexithymic than patients with anxiety disorders and depressive disorders, respectively. However, there was no significant difference in degree of alexithymia between patients with anxiety disorders and those with depressive disorders. Multiple regression analysis revealed that demographic variables such as set age, education level, and marital status did not make a significant influence on alexithymia scores. These results suggest a greater degree of alexithymia in patients with a specific group of psychosomiatic disorders such as tension headache than in patients with emotional disorders, unlike the previous report that in general, psychosomatic patients are alexithymic. Thus, it is necessary to develop special forms of interview which can induce and encourage expression of emotion as a therapeutic strategy for patients with tension headache.

      • SCOPUSKCI등재
      • KCI등재

        The Relationship of Anger Expression and Alexithymia with Coronary Artery Stenosis in Patients with Coronary Artery Diseases

        고경봉,조승연,김장우,노규식,이상혁,박일호 연세대학교의과대학 2004 Yonsei medical journal Vol.45 No.2

        This study examined the relationship between anger expression or alexithymia and coronary artery stenosis in patients with coronary artery diseases. 143 patients with coronary artery diseases (104 males and 39 females) were enrolled in this study. The severity of their coronary artery stenosis was measured by angiography. The Anger Expression Scale and the Toronto Alexithymia Scale were used to assess the level of anger expression and alexithymia. The more stenotic group (occluded by 75% or more) exhibited a significantly higher level of alexithymia than the less stenotic group (occluded by less than 25%). Multiple regression anaylsis on the extent of stenosis also revealed that regardless of gender and age, the coronary artery disease patients with higher alexithymia were likely to show a greater level of stenosis. However, no significant differences were found on either the anger-in or anger-out subscale scores between the two groups. These results suggest that alexithymia is associated with the severity of coronary artery stenosis in patients with coronary artery disease. However, both anger expression and anger suppression were not shown to be associated with the severity of coronary artery stenosis.

      • KCI등재후보

        분노대응 척도의 개발

        고경봉,박중규 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.4

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

        Objectives : The purpose of this study was to develop the Anger Coping Scale (ACS). Methods : First, a preliminary survey was conducted for 123 healthy adults to obtain 23 response items. Second, a Preliminary questionnaire was completed by 258 healthy subjects. Third, a comparison was made regarding anger coping between 72 depressive disorder patients and 258 healthy subjects. Results : Factor analysis yielded 5 subscales : behavioral aggression, problem-solving coping, verbal aggression, tension-releasing coping and anger suppression. Reliability was computed by administering the ACS to 53 healthy subjects during a 2-week interval. Test-retest reliability for 5 subscales was significantly high, ranging between .39-.78. Cronbach's α for 5 subscales ranged between .58-.86. Convergent validity was computed by correlating the 5 subscales score with the total score of the Aggression Questionnaire, the State Trait Anger Expression Inventory, the anger and aggression subscale of the Stress Response Inventory and the hostility subscale of the Symptom Checklist-90-Revised. The depressive disorder group scored significantly higher on the anger suppression subscale than the control group. However, the normal control group scored significantly higher on the behavioral aggression and tension-releasing coping subscale than the depressive disorder group. Conclusion : These results indicate that the ACS is highly reliable and valid. In addition, depressive disorder patients are more likely to use anger suppression than healthy individuals, whereas healthy individuals are more likely to use both behavioral aggression and tension-releasing coping than depressive disorder patients. Further transcultural study on anger coping is required.

      • 신체질환 환자들에서 우울증의 평가 및 치료

        고경봉,Koh, Kyung-Bong 한국정신신체의학회 2001 정신신체의학 Vol.9 No.2

        신체질환 환자들에서의 우울증은 일차진료의나 정신과자문의가 흔히 부딪치는 임상적 문제들이다. 본 저자는 이런 환자들을 효과적으로 평가하고 치료하기 위한 방법들을 알아보고자 하였다. 첫째, 환자의 의학적 및 정신과적 상태를 동시에 평가해야 한다. 둘째, 신체질환 환자에서 우울의 평가는 다면적인 접근을 고려하는 것이 바람직하다. 때로는 심리적 도구를 이용하는 것도 좋은 평가 방법이다. 치료는 첫째, 기질적 원인을 찾아서 제거하는 일이 무엇보다 중요하다. 둘째, 정신사회적 치료로는 정신과적 치료에 대한 저항을 다루어야 하고 심한 신체적 질환에 따른 낙담 반응을 처리해 주는 일이다. 셋째, 생물학적인 치료방법으로는 적절한 항우울제를 선택하는 것이 중요하다. 선체질환 환자들에서 항우울제의 선택은 환자의 일차적인 우울증상, 약물역학 및 약물역동, 항우울제의 부작용을 평가한 후 고려한다. 이 외에도 약물-질병 및 약물-약물 상호작용의 가능성에 관해 각별히 주의를 기울일 필요가 있다. SSRI약물, bupropion, venlafaxine과 같은 새로운 항우울제들이 신체질환 환자들의 우울증 치료에 효과적이나 삼환계 항우울제는 통증장애 환자들에서는 아직도 효과적으로 사용될 수 있는 약물이다. 신체질환 환자들에서 항우울제로 우울증이 잘 치료되지 않는 경우에는 전기충격요법의 사용을 고려해 본다. Depression in the medically ill is a common clinical problem that primary physicians and psychiatric consultants encounter. Treatment of such patients begins with a careful evaluation of the patient's medical and psychiatric conditions. The assessment of depression in the medical patients requires a multidimensional approach. Psychological instruments are also used as a method of assessment in these patients. First of all, what the therapists have to do is to find and remove organic causes. Psychosoical treatment includes dealing with the patient's resistance and despondency relevant to physical diseases. For biological treatment, it is important to select appropriate antidepressants. Therapists should be familiar with the side effects of the antidepressants as well as the patient's primary depressive symptoms, pharmacokinetics and pharmacodynamics of the available agents. In addition, special attention should be paid to the potential for drug-illness and drug-drug interactions. Tricyclic antidepressants can be still effectively used for patients with pain disorder, although a variety of new antidepressants such as selective serotonin reuptake inhibitors (SSRI), bupropion and venlafaxine could have more benefits in depression of the medically ill. However, electroconvulsive therapy can be recommended for refractory cases of depression in patients with medical illness.

      • 신체형장애, 정신신체장애 및 우울장애 환자들간의 가족지지도지각의 비교

        고경봉,우용일,Koh, Kyung-Bong,Woo, Yong-Il 한국정신신체의학회 1999 정신신체의학 Vol.7 No.1

        본 연구는 신체형장애, 정신신체장애 및 우울장애 환자들 간의 가족지지도지각을 비교하기 위해서 시행되었다. 연구대상은 정신과 외래에 내원한 신체형장애 환자 49명, 정신신체장애 환자 43명, 우울장애 환자 50명이었다. 연구방법은 가족지지도 지각척도를 사용하였다. 신체형장애환자들은 정신신체장애환자들에 비해 가족지지도의 접수가 유의하게 더 낮았다. 그러나 신체형장애환자들과 우울장애환자들 간, 정신신체장애환자들과 우울장애환자들 간에 가족지지도점수는 각각 유의한 차이가 없었다. 이들 전체 환자들에서 연령이 많을수록 가족지지도점수가 유의하게 더 높았고, 기혼자들이 미혼자들보다 가족지지도점수가 유의하게 더 높았다. 결론적으로 신체형장애 환자들에서 낮은 가족지지도가 신체화의 원인 및 후유증일 가능성이 시사된다. 따라서 신체형장애 환자 들에 대한 평가 및 치료에 있어서 가족지지의 역할의 중요성이 강조된다. 앞으로 가족지지도가 신체화의 원인인지를 규명하기 위해서는 일정한 기간을 두고 종적인 연구를 시행해야 할 필요가 있다. A comprison was made regarding perceived family support among patients with somatoform disorders, psychosomatic disorders and depressive disorders. The subjects included 49 patients with somatoform disorders, 43 patients with psychosomatic disorders, and 50 patients with depressive disorders. Perceived social support-family scale was used to measure the extent of family support. The patients with somatoform disorders were significantly lower in family support than the patients with psychosomatic disorders. However, no significant differences were found between patients with somatoform disorders and those with depressive disorders, as well as between patients with psychosomatic disorders and those with depressive disorders. Patients with older age had significantly higher scores on family support than those with younger age. Married patients were significantly higher in family support than unmarried ones. These results suggest that low family support may be associated with either the etiology or the sequelae of somatization. Thus, it is emphasized that the role of family support is essential in evaluation and treatment of somatization. In addition, longitudinal studies will be required to investigate the causative role of low family support in somatization.

      • KCI등재

        Medazepam 및 Cloxazolam 이 가토혈중 주정농도에 미치는 영양에 관한 실험적 연구

        高京鳳 大韓神經精神醫學會 1978 신경정신의학 Vol.17 No.4

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

        Medazepam is a diazepam analogue with a 2-ketone omitted, and is used as an antianxiety agent. The drug shows the charateristic taming effect, muscle relaxant and anticonvulsant properties with minimal side effects and low toxicity. The pharmacodynamic aspects of the drug indicated rapid onset of absorption and rapid biotransformation of oral medazepam in men and dogs, with little acumulation in the plasma. It is also found that diazepam is an important metabolite of medazepam in rats and men, showing a major potency in clinical actions. Cloxazolam is a newer menmber of the benzodiazepine derivatives, which possess considerable calming effects. It is suggested that the potentiation of alcohol by some psychotropic drugs may, among other things, increase the risk of traffic accidents. Hence, it is necessary to test all psychotropic drugs for their interaction with alcohol. It has been recently reported that many psychotropic drugs including chlorpromazine and lithium, elevated the blood alcohol level in rabbits. In view of these findings, the author conducted an animal experiment to investigate the efect of medazepam and cloxazolam on blood level of alcohol in rabbits. Material and Method 1. The experimental work was done on mature rabbits of both sexes, weighing about 2 to 3kg. 2. The experimental animals were divided into two groups; the control and the experimental group. 3. The control group was given alcohol alone. 4. The experimental group was divided into 4 subgroups ; a) alcohol plus medazepam, 5mg/kg of body weight, b) alcohol plus medazepam, 10 mg/kg of body weight, c) alcohol plus cloxazolam, 1mg/kg of body weight , and d) alcohol plus cloxazolam, 2mg/kg of body weight. 5. These above groups were further divided into 2 subgroups in which one subgroup was given these drugs respectively for 5 days and another for 5 days and another for 10 days. 6. Each medazepam or cloxazolam was orally given in a single does at a fixed time. The last dose was given one hour and a half before alcohol administration. 7. In all groups 20 vol. % ethanol solution was slowly given in a dose of 5.0ml/kg of body weight for 5 minutes by intravenous route. 8. All of the blood specimens were obtained by cardiac puncture at both 15 and 45 minutes after alcohol administration. 9. The determination of blood alcohol level was made by Cavett's method. Results 1. Alcohol plus medazepam, 5mg/kg of body weight for 5 days. Medazepam caused no significant change in the blood alcohol level at both 15 and 45 minutes after alcohol administration (P>0.05) 2. Alcohol plus medazepam, 5mg/kg of body weight for 10 days. In this group, no significant change was shown in the blood alcohol level at 15 minutes (P>0.05) but significant elevation of blood alcohol level was noted at 45 minutes (P<0.01) after alcohol administration. 3. Alcohol plus medazepam, 10mg/kg of body weight for 5 days. In this group, medazepam elevated the blood alcohol level significantly at 15 minuts (P<0.05) but caused no significant change in the blood alcohol level at 45 minutes (P>0.05) after aslcohol administration. 4. Alcohol plus medazepam, 10mg/kg of body weight for 10 days. In this group, medazepam elevated the blood alcohol level significantly at both 15 (P<0.01)and 45 mimutes (P<0.05) after alcohol adnimistration. 5. Alcohol plus cloxazolam, 1mg/kg of body weight for 5 days. Cloxzolam caused no significant change in the blood alcohol level at both 15 and 45 minutes after alcohol administration(P>0.05) 6. Alcohol plus cloxazolam , 1mg/kg of body weight for 10 days. In this group, no significant change in the blood alcohol level 1 was also shown at both 15 and 45 minutes after alcohol administration(P>0.05) 7. Alcohol plus cloxazolam, 2mg/kg of body weight for 5 days. In this group, significant elevation of the blood alcohol level was noted at both 15 (P<0.005) and 45 minutes(P<0.001)after alcohol administration. 8. Alcohol plus cloxazolam, 2mg/kg of body weight for 10 days. In this group, cloxazolam also caused significant elevation in the blood alcohol level at both 15 (P<0.025) and 45 minutes (P<0.001) after alcohol administration. 9. No statistical significance was obtained in the difference of the blood alcohol level between 5 and 10 day groups when the dose was fixed (P> 0.005). Conclusions 1. Medazepam, when administered orally in a dose of 5mg/kg of body weight daily for 5 or 10 days, did not elevate the blood alcohol level significantly at both 15 and 45 minutes after alcohol administration except for the group administered for 10 days in which significant elevation was noted in the blood alcohol level at 45 minutes. 2. Medazepam, when administered orally in a dose of 10mg/kg of body weight daily elevated the blood alcohol level significantly at both 15 and 45 minutes except for the group administered for 5 days in which there was no significant elevation at 45 minutes. 3. Cloxazolam, when administered orally in a dose of 1mg/kg of body weight daily for 5 or 10 days, did not elevate the blood alcohol level 1significantly at both 15 and 45 minutes after alcohol administration. 4. Cloxazolam, when administered orally in a dose of 2mg/kg of body weight daily for 5 or 10 days, elevated the blood alcohol level significantly at both 15 and 45 minutes after alcohol administration. 5. There was no significant different in the blood alcohol level between 5 and 10 day groups in which a fixed dose of either medazepam or cloxazolam was administered.

      • 여자 고등학생들의 월경주기에 따른 스트레스인자 지각 및 정신병리

        고경봉,현태영,구민성,Koh, Kyung-Bong,Hyun, Tae-Young,Koo, Min-Seong 한국정신신체의학회 1999 정신신체의학 Vol.7 No.2

        본 연구는 청소년 여성에서 월경전기, 월경기, 월경후기간 스트레스인자 지각 및 정신병리를 비교하기 위해 시행되었다. 여자 고등학생 341명(인문계 164명, 예능계 177명)을 대상으로 하였고, 평가도구는 스트레스인자 지각 및 정신병리를 평가하기 위해 global assessment of recent stress(GARS) scale과 symptom checklist-90-revised(SCL-90R)를 이용하였다. 월경기보다 월경전기 및 월경후기 중에 관계의 변화에 관련된 스트레스인자 지각점수가 각각 유의하게 더 높았다. 그러나 세 기간 중 정신병리는 유의한 차이를 보이지 않았다. 한편 인문계 학생들이 예능계 학생들보다 일상생활의 변화유무에 관한 스트레스인자 지각점수는 물론 강박증 척도접수와 positive symptom total(PST) 점수가 유의하게 더 높았다. 결론적으로 일부 스트레스인자지각이 월경기보다 월경전기 및 월경후기 중에 더 현저할 가능성이 높으나 정신병리는 월경주기와 관계가 없는 것으로 나타났다. 이 결과는 청소년 여성들의 정신병리가 월경주기 이외의 다른 변수들의 영향을 받을 가능성이 있음을 시사하였다. The purpose of this study was to make a comparison in perceived stressor and psychopathology among premenstrual, menstrual and postmenstrual phases, in high school girls. Three hundred forty-one high school girls(164 academic school girls, 177 art school girls) participated in this study. Global assessment of recent stress(GARS) scale and symptom checklist-90-revised(SCL-90R) were used to measure perceived stressors and psychopathology. The scores of perceived stressor relevant to change in relationships were significantly higher during the premenstrual and the postmenstrual phases than during the menstrual phase. However, no significant differences were found in psychopathology among three mentstrual phases. Scores of perceived stressor relevant to change or no change in routine were significantly higher in academic school girls than in art school girls. The scores of obsessive-compulsion subscale and positive symptom total were significantly higher in academic school girls than in art school girls. In conclusion, a perceived stressor was higher during the premenstrual and the postmenstrual phases than during the menstrual phase in adolescents, but psychopathology was not related to the menstrual cycle. These results indicated that the psychopathology in adolescent girls might be influenced by other factors than menstrual cycle.

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