알코올리즘 입원치료프로그램 참가자들의 퇴원 후 경과에 대한 연구

최성빈(Sung-Bin Choi),박병권(Byung-Kwon Park),김한오(Han-O Kim),원민혜(Min-Hye Won),손인기(In-Ki Sohn),함 웅(Woong Hahm) 한국중독정신의학회 2006 중독정신의학 Vol.10 No.1

Objectives:The purpose of this study is to evaluate the outcome of alcoholics who participated in an inpatient alcoholism treatment program of a mental hospital. At the same time, We studied the various clinical variables affecting the recovery of alcoholism. Methods:The 261 subjects who were diagnosed as alcohol dependence took part in the treatment program at the alcohol center in Keyo hospital at least for 2 weeks between January 2004 and December 2004. The subjects were followed up by faceto-face or telephone interview, and medical records were reviewed to obtain data on demographic characteristics, alcohol-related clinical characteristics, treatment process, etc. Results:1) the mean follow-up period was 19.67 months. 2) 141 of the 261 subjects were followed up, so the follow-up rate was 54.02% 3) 43 of the 141 subjects (30.5%) were classified into abstinent group, 23 (16.3%) into controlled drinking group, and 75 (53.2%) into relapse group. Abstinent and controlled drinking groups were called recovery group. So 66 (46.8%) of the 141 subjects were classified into recovery group. 4) By the comparison of relapse and recovery groups, education, socioeconomic status, occupation, and marital status are significantly different between groups. 5) Recovery group had a longer duration of abstinence before admission than relapse group. 6) Completion of alcoholism treatment program during admission and a return to work after discharge from hospital were associated with recovery of alcoholism. 7) In a stepwise regression model, four risk factors were significantly correlated with the recovery:a return to work after discharge from hospital, completion of alcoholism treatment program during admission, marital status, and duration of abstinence before admission. Conclusion:The variables above mentioned were thought to be the points to be duly considered for the better outcome of alcoholism.

알코올 의존 환자에서 K-MMSE를 이용한 인지 기능 연구

서승진(Suhng-Jin Suh),최성빈(Sung-Bin Choi),김한오(Han-O Kim),원성두(Sung-Doo Won),손인기(In-Ki Sohn),함 웅(Woong Hahm),신경철(Kyung Chul Shin) 한국중독정신의학회 2009 중독정신의학 Vol.13 No.2

Objectives:This study aimed to characterize the cognitive functions of chronic alcohol dependent patients in their forties as compared to normal controls, via the K-MMSE (Korean version of the Mini-Mental State Examination). Methods:Participants were 25 male volunteers from the curative program at the Keyo hospital alcohol center, recruited from June 2007 to November 2007, and 25 male social drinkers who constituted the normal controls. We compared demographic characteristics, such as age, level of education, occupation, and socioeconomic status, and also K-MMSE results between the two groups. Results:Even though the demographic characteristics showed statistically significant differences between the two groups, their K-MMSE scores were not significantly different. Also, there was no identifiable correlation between demographic variables and K-MMSE total scores and subscales. The alcohol dependent patients varied significantly from the control group with regard to visuospatial area. Conclusion:In this study the cognitive functions and demographical variables such as education, occupation and socioeconomic status were not correlated. The subjects in two groups scored similar on K-MMSE in total score ; they had different scores in the test on their visuospatial area. In conclusion, some specific items of K-MMSE are thought to be applicable to predict whether patients with alcoholic dependence will have disability in their cognitive function.

알코올리즘 입원치료프로그램 참가자들의 퇴원 후 단기경과

성상경(Sang-Kyung Sung),문황선(Whang-Sun Moon),김한오(Han-O Kim),이규항(Kyu-Hang Lee) 한국중독정신의학회 2003 중독정신의학 Vol.7 No.2

The purpose of this study is to examine the short-term course of the alcoholics who participated in an inpatient alcoholism treatment program, and the relationship between the treatment program and the short-term course of alcoholics. The 89 subjects who were diagnosed as alcohol dependence according to DSM-IV diagnostic criteria took part in the treatment program at the alcohol/drug abuse center in Keyo hospital at least for 2 weeks between January 2000 and February 2001. The mean follow-up period was 10.5 months. The subjects or their families were followed up by face-to-face or telephone interview, and medical records were reviewed to obtain the data on demographic characteristics, clinical characteristics, and past alcohol drinking history, etc. The results were as follows:1) 79 of the 89 subjects were followed up, so the follow-up rate was 88.8%. 2) Of the 79 subjects, 19 (24.0%) were classified into abstinent group, 12 (15.2%) into controlled drinking group, and 48 (60.8%) into relapse group. 3) The abstinent group had better attendance at out-patient department program and AA than the relapse group. 4) The difference of the insight assessed by Hanil Alcoholism Insight Scale (HAIS) among the three groups was not statistically significant, but the insight score of the abstinent group was higher than the other groups. 5) The family or patient response about treatment results was significantly different among groups.

입원 및 외래 알코올중독 환자의 병식 차이에 대한 연구

성상경(Sang-Kyung Sung),이학구(Hak-Koo Lee),김한오(Han-O Kim),이규항(Kyu-Hang Lee) 한국중독정신의학회 2003 중독정신의학 Vol.7 No.1

Objectives:The goals of this study were to estimate level of insight in alcoholic patients and provide the fundamental data for which can be used for development of effective treatment programs. With this purpose, we compared insight status between inpatient alcoholics and outpatient alcoholics. Methods:The subjects participated in this study were 65 inpatient alcoholic patients who were admitted to alcohol/drug abuse treatment center in Kyungido between February and June, 2001 and 38 outpatient alcoholics who were undergone outpatient alcohol treatment program after discharge. We investigated demographic data, clinical characteristics, past alcoholic history by questionary survey and measured insight status by NAST (National Alcoholism Screening Test) and HAIS (Hanil Alcohol Insight Scale). Results:The outpatient alcoholic patients showed statistically significant higher NAST numbers, NAST scores and mean HAIS scores than inpatient alcoholics. In addition, outpatient alcoholics were statistically significant higher frequency of past admission, and more recognized addiction and necessary of treatment than inpatient alcoholics. Conclusion: We suggest that the necessity to adjust inpatient alcohol treatment program to insight status of individual alcoholic patient more flexibly. Further studies on correlation among other variables such as the independent program’s impact on each patient, guide goals which can increase insight status through inpatient alcohol treatment program, and development of the level of insight to abstinence may be required.

만성정신병환자의 재활치료를 위한 주간보호 모델

이규항,김한오,이후경,윤성철,성상경,함웅,윤배중 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 본 연구는 전문병원 위탁형 정신보건센터에서 실시한 주간보호의 전체적인 체계, 운영, 프로그램에 관한 모델을 소개하고, 이 모델을 주간보호에서 시행한 후 그 결과와 시행과정에서 나타난 특징을 분석하여, 우리 실정에 맞는 주간보호 모델을 발전시켜 만성정신병환자의 생활유지와 재활을 촉진시키기 위한 목적으로 실시되었다. 방 법 : 본 주간보호 모델(이하 본 모델이라 함)을 1997년 3월부터 1998년 2월까지 의왕시 정신보건센터에서 총 23명의 환자를 대상으로 실시하였다. PANSS, Quality of Life, 삶의 만족 척도를 주간보호 전과 주간보호 실시 3개월 이후에 조사하였다. 프로그램 유익성 척도, 13가지 치료요인 척도를 주간보호 1개월째와 주간보호 실시 3개월 이후에 조사하였다. 결 과 : 1) 본 모델은 만성정신병환자의 증상을 감소시키고 삶의 질을 향상시켜, 환자의 생활유지 및 재활에 도움을 주었다. 2) 본 모델은 다양한 형태의 집단치료들을 사용하여 만성정신병환자에게 유익을 주었으며, 특히 예술치료와 활동치료가 환자의 신체적, 심리적, 사회적 기능회복을 위해 중요한 역할을 하였다. 3) 본 모델에 작용하는 치료요인의 특징을 보면 주간보호 초기와 후기에 모두 중시된 치료요인은 치료자와의 동일시, 치료자의 조언, 일차가족집단의 교정적 감정경험이었다. 주간보호 초기에 중시된 치료요인은 집단응집력, 이타심이었으며, 주간보호 후기에는 희망의 고취가 중시되었다. 4) 본 모델은 여러 분야의 치료자들과 다양한 치료방법들을 전체적으로 통합하여 사용하는데 유용하였다. 결 론 : 본 모델은 만성정신병환자의 생활유지와 재활을 위해 우리 나라에서 효과적이면서 효율적으로 적용될 수 있을 것으로 생각된다. Objectives : The purpose of this study was to present general system, operation, and program of a day care model managed by a psychiatrist, to evaluate the results of performing this model, and thus to develop a day care model applied to Korean situation appropriately for promoting maintenance and rehabilitation of chronic psychotic patients. Methods : We performed this day care model(hereinafter called as this model) from March 1997 to February 1998. The subjects were composed of 23 psychotic patients. PANSS, Quality of Life Scale, Life Satisfaction Self-Rating Scale were used before beginning this model and after three months of performing this model. Program Helpfulness Scale, 13 Therapeutic Factors Scale were used at one months of day care and after three months of day care. Results : 1) This model helped maintenance and rehabilitation of chronic psychotic patients through reducing their symptoms and increasing quality of life. 2) This model used the various group therapy, especially creative art therapy and activity therapy, played an important role for recovering physical, psychological, and social functions. 3) Important therapeutic factors at early and late period of this model were identification with therapists, guidance of therapists, and the corrective recapitulation of the primary family group. Important therapeutic factors at early period were group cohesiveness and altruism, and at late period instillation of hope. 4) This model was useful for integrating the multidisciplinary therapeutic team and the various therapeutic methods. Conclusion : This model would be applied to day care in this country effectively and efficiently for maintenance and rehabilitation of chronic psychotic patients.

한국어판 병동매일행동척도 개발

임호섭,신경철,함웅,채정호,김한오,정찬호 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.2

Objectives : Patient's behavior features are important factors which influences the clinical judgement including diagnosis. However, most psychiatrists build up a picture of patients' behavior from an amalgamation of their own brief observations and nurses' reports, which often lack in the objectiveness. Several behavioral scales have been developed to alleviate this difficulty, but the poor efficiency and reliability of these scales have made them less useful. The recently developed Ward Daily Behavior Scale is an objective tool for evaluating all the daily noteworthy behaviors of patients, and is easily applicable to wide ranges of diagnoses and ages. This study tried to prove the reliability and validity of the Ward Daily Behavior Scale-Korean version. Methods : The 112 patients, 63 males and 49 females, at a chronic psychiatric inpatient ward were selected as subjects. Experienced and unexperienced nurses rated patients' behaviors independently with the Ward Daily Behavior Scale-Korean version, after observing behaviors of subjects for 8 hours during day duty time. And then we tested the inter-rater reliability, internal consistency, and concurrent validity of this scale. Results : The Ward Daily Behavior Scale-Korean version proved to be both reliable and valid for measuring of behaviors of psychiatric inpatients. Conclusions : The Ward Daily Behavior Scale-Korean version will be a valuable tool to observe and quantify patients' behavior in psychiatric wards.