비혼과 사별 노인에서 우울증의 특징과 극복방안

명우재 한국노년학회 2017 한국노년학회 학술발표논문집 Vol.2017 No.3

Serum Cytokine Levels in Major Depressive Disorder and Its Role in Antidepressant Response

명우재,임신원,우혜인,박진홍,심상홍,Soo-Youn Lee,김도관 대한신경정신의학회 2016 PSYCHIATRY INVESTIGATION Vol.13 No.6

ObjectiveaaCytokines have been reported to have key roles in major depressive disorder (MDD). However, much less is known about cytokines in MDD and antidepressant treatment due to the diversity of cytokines and the heterogeneity of depression. We investigated the levels of cytokines in patients with MDD compared with healthy subjects and their associations with antidepressant response. MethodsaaWe investigated the changes of several cytokines (eotaxin, sCD40L, IL-8, MCP-1alpha, TNF-alpha, INF-gamma and MIP-1alpha) by Luminex assay in 66 patients with MDD and 22 healthy controls. The antidepressant response was assessed by 17-item Hamilton Rating Scale for Depression. ResultsaaWe found the levels of sCD40L (p=0.001), IL-8 (p=0.004) and MCP-1 (p=0.03) of healthy controls were significantly higher than those of depressive patients. However, the level of eotaxin and TNF-alpha were not associated with MDD. In addition, we found the level of MCP-1 was significantly changed after antidepressant treatment (p=0.01). ConclusionaaThese findings suggest the roles of cytokines in MDD are complex, and could vary according to the individual characteristics of each patient. Further studies regarding the relationship between cytokines and MDD will be required.

Serotonin Transporter Gene Polymorphisms and Chronic Illness of Depression

명우재,임신원,김진우,이유진,송지혜,장기원,김도관 대한의학회 2010 Journal of Korean medical science Vol.25 No.12

Clinical course of depression is variable. The serotonin transporter gene is one of the most studied genes for depression. We examined the association of serotonin transporter gene polymorphisms with chronicity and recurrent tendency of depression in Korean subjects. This cross-sectional study involved 252 patients with major depression. Patients were genotyped for s/l polymorphisms in 5-HTT promoter region (5-HTTLPR), s/l variation in second intron of the 5-HTT gene (5-HTT VNTR intron2). Chronicity was associated with 5-HTTLPR. Patients with l/l had higher rate of chronicity than the other patients (l/l vs s/l or s/s; odds ratio, 4.45; 95% confidence interval, 1.59-12.46; P=0.005; logistic regression analysis). Recurrent tendency was not associated with 5-HTTLPR. Chronicity and recurrent tendency were not associated with 5-HTT VNTR intron2. These results suggest that chronic depression is associated with 5-HTTLPR.

다양한 신체증상을 주소로 내원한 부종양성 근강직증후군 1예

명우재,강은호,유범희 대한신경정신의학회 2009 신경정신의학 Vol.48 No.5

Stiff-person syndrome (SPS) is an unusual autoimmune neurological disease. We report a woman who developed stiff-person syndrome associated with thymoma. A 42-year-old woman visited a general hospital complaining of progressive rigidity in her neck and both lower legs. She also had other symptoms including whole body pruritus, dysphargia, dysarthria, diplopia, and a visual hallucination-like symptom. Emotional distress preceded her symptoms. After a extensive neurologic workup, she was transferred from the neurologic ward to the psychiatric ward under the impression of conversion or somatoform disorder. During her psychiatric admission, we found a prolonged involuntary MUAP discharge on her electromyograph, and positive anti-GAD and anti-GQ1b antibodies. In addition, a chest CT scan revealed a thymic epithelial tumor. We report a case of stiff-person syndrome presenting multiple unexplained somatic symptoms, which was initially diagnosed as a conversion or somatoform disorder. 근강직증후군은 드문 자가면역성 신경계 질환이다. 저자들은 흉선종과 동반한 근강직증후군 증례를 경험하여 보고하였다. 환자는 42세 여자 환자로 진행하는 경부와 양하지의 강직을 주소로 내원하였다. 환자는 전신 소양감, 연하곤란, 조음장애, 체간 강직, 복시 등의 증상을 보였으며, 또한 환각으로 의심되는 증상까지 있었다. 이런 증상은 감정적 스트레스 후에 발생하였기에 신체형 장애나 전환장애 같은 정신과적 질환의 가능성이 높다고 생각되어 신경과에서 정신과로 전과되었다. 그러나 정신과에서 시행한 근전도 검사상 지속 불수의적 근단위활동전위가 나타나고 항GAD 항체와 항GQ1 항체 양성을 보였기에 근강직증후군으로 진단하게 되었다. 흉부 방사선단층촬영상 흉선 상피종이 발견되었으며, 흉선절제술 후 임상증상이 호전되었다.

알츠하이머 치매 환자에서 교육 수준과 우울증의 연관성 : CREDOS(Clinical Research Center for Dementia of South Korea) 연구의 결과

송지혜,명우재,이유진,김상하,윤혜연,최준배,강효신,임신원,나덕렬,김성윤,이재홍,한설희,최성혜,김상윤,김도관 대한노인정신의학회 2012 노인정신의학 Vol.16 No.1

대학생 집단에서의 불안증상 차원과 아동기 외상 종류의 특이 관련성 및 회복탄력성의 매개효과

박광호,명우재,하태현 대한불안의학회 2022 대한불안의학회지 Vol.18 No.2

Objective : Childhood trauma is a risk factor for and resilience is a protective factor against later affective symptoms. The current study aimed to explore the relation between childhood trauma and anxiety symptoms and the mediating effect of resilience in a sample of college students. Methods : Data from 238 subjects who completed the Beck Anxiety Inventory (BAI), the Childhood Trau- ma Questionnaire (CTQ) and the Connor-Davidson Resilience Scale (CD-RISC) were analyzed. Predictors for BAI score and factor analyzed anxiety symptom dimensions were examined using regression models. Path an- alytic models were applied to test the mediating effect of the CD-RICS score on BAI score. Results : The CTQ score was significantly associated with the BAI score and the mediating effect of CD- RISC was significant as well. The cognitive dimension of anxiety was related to emotional abuse while the so- matic dimension of anxiety to physical neglect. The CD-RISC score did not mediate those relations between anxiety dimensions and individual types of childhood trauma. Conclusion : Our data suggest that childhood trauma contributes to adult anxiety symptoms. There may be specific relations between types of childhood trauma and anxiety symptoms dimensions. (Anxiety and Mood 2022;18(2):48-55)

알츠하이머 치매 환자에서의 병식과 신경정신행동과의 연관성 : A Clinical Research Center for Dementia of South Korea (CREDOS) Study

윤혜연,명우재,송지혜,최준배,강효신,나덕렬,김성윤,이재홍,한설희,최성혜,김상윤,김도관 대한신경정신의학회 2013 신경정신의학 Vol.52 No.1

Objectives The aim of this study was to identify the association between insight and neuropsychiatric symptoms in patients with Alzheimer’s dementia (AD). Methods We examined 2607 patients with AD in the Clinical Research Center for Dementia of South Korea study and designed a cross-sectional study. Each patient underwent psychiatric,neurological, and medical examination, interview for caregivers, laboratory tests, neuropsychological tests, and brain MRI. Cognitive function was measured using the Korean version of the Mini-Mental State Examination, Global Deterioration Scale, and Clinical Dementia Rating. Behavioral and psychological symptoms were measured using the Korean version of the Neuropsychiatric Inventory. Daily Living was measured using the Barthel Index for daily living activities and Seoul-Instrumental Activities of Daily Living. Insight was classified according to ‘with insight’,‘partial insight’, and ‘without insight’ by interview with caregivers. Results Among the 2607 patients, 990 were included in the ‘with insight’ group, 1191 were included in the ‘Partial insight’ group, and the ‘without insight’ group included 426 patients. The ‘without insight’ group had a significantly higher aggression level than the ‘with insight’ group, but not the ‘partial insight’ group [odds ratio (OR)=1.46, 95% confidence interval (CI) : 1,14-1.88]. A significantly lower prevalence of depression was observed in the ‘Partial insight’ group and the ‘without insight’ group, compared to the ‘with insight’ group (OR=0.51, 95% CI : 0.43-0.61/OR=0.61, 95% CI : 0.48-0.78). The ‘partial insight’ group showed a lower anxiety level than the ‘with insight’ group (OR=0.63, 95% CI : 0.53-0.75). Conclusion Findings of this study confirmed that insight level was associated with aggression,depression, and anxiety in patients with Alzheimer’ dementia.

건강보험심사평가원 자료를 이용한 국내 비결핵항산균 감염증의 역학적 특성분석

전병우,이혜원,명우재,고원중 대한결핵 및 호흡기학회 2018 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.126 No.0

목적: 비결핵항산균 감염증은 전세계적으로 증가하고 있고, 지역과 국가에 따라서 다양한 역학적 특성을 보인다. 본 연구는 국내에서 발생하는 비결핵항산균 감염증의 역학적 특성에 대해서 분석하였다. 방법: 2007년부터 2016년도까지 건강보험심사평가원 자료에서 상병코드(ICD10th, A31)를 이용하여 비결핵항산균 감염증을 선별하였고, 유병률, 발생률, 그리고 지역 분포 및 인구통계적 특성을 분석하였다. 성적: 연구기간 동안 비결핵항산균 감염증의 유병률(/100,000명)은, 2007년 6.7명, 2012년 24.5명, 그리고 2016년에 39.6명으로 5배 이상 증가함을 보였다. 발생률(/100,000명/년)은 2008년 6.0명, 2012년 12.3명, 그리고 2016년 19.0명으로 3배이상 증가하였다. 전체 기간유병률(/100,000명, 2007-2016)은 연령에 따라서 증가하였고, 20-29세에서 9.3명, 50-59세에서 107.1명, 그리고 70-79명에서 306.9명 이었다. 기간유병률의 성별비교 결과, 여성이 73.9명으로, 남성(61.3명)보다 높았다. 또한, 기간유병률의 지역별비교 결과, 서울특별시와 광역시 (부산, 대전, 광주, 대구, 인천, 울산)들이, 도 지역에 비해서 높은 경향을 보고, 제주도가 가장 낮은 값을 보였다. 가장 흔한 호흡기 동반질환은, 천식(53.0%), 기관지확장증(43.6%), 그리고 만성 폐쇄성 폐질환(32.3%)이었고, 악성질환은 23.0%에서 동반되었다. 결론: 국내 비결핵항산균 감염증은 증가하고 있는 추세이며, 성별, 연력, 지역별로 다양한 분포를 보인다.

Differentially expressed genes related to major depressive disorder and antidepressant response: genome-wide gene expression analysis

우혜인,임신원,명우재,김도관,이수연 생화학분자생물학회 2018 Experimental and molecular medicine Vol.50 No.-

Treatment response to antidepressants is limited and varies among patients with major depressive disorder (MDD). To discover genes and mechanisms related to the pathophysiology of MDD and antidepressant treatment response, we performed gene expression analyses using peripheral blood specimens from 38 MDD patients and 14 healthy individuals at baseline and at 6 weeks after the initiation of either selective serotonin reuptake inhibitor (SSRI) or mirtazapine treatment. The results were compared with results from public microarray data. Seven differentially expressed genes (DEGs) between MDD patients and controls were identified in our study and in the public microarray data: CD58, CXCL8, EGF, TARP, TNFSF4, ZNF583, and ZNF587. CXCL8 was among the top 10 downregulated genes in both studies. Eight genes related to SSRI responsiveness, including BTNL8, showed alterations in gene expression in MDD. The expression of the FCRL6 gene differed between SSRI responders and nonresponders and changed after SSRI treatment compared to baseline. In evaluating the response to mirtazapine, 21 DEGs were identified when comparing MDD patients and controls and responders and nonresponders. These findings suggest that the pathophysiology of MDD and treatment response to antidepressants are associated with a number of processes, including DNA damage and apoptosis, that can be induced by immune activation and inflammation.

경도인지장애에서 성별에 따라 교육 성취도가 영역별 인지기능에 미치는 영향

이춘수(Chunsoo Lee),명우재(Woojae Myung),이경상(Kyung Sang Lee),이준노(Jun Ro Lee),강효신(Hyo Shin Kang),임신원(Shin Won Lim),나덕렬(Duk L. Na),김성윤(Seong Yoon Kim),이재홍(Jae-Hong Lee),한설희(Seol-Heui Han),최성혜(Seong Hye Choi) 대한노인정신의학회 2016 노인정신의학 Vol.20 No.2

Objective:This study aimed to find the sex differences of the way how educational attainment influence on cognitive function in the mild cognitive impairment patients. Methods:A total of 1,704 patients were recruited from a large hospital-based multi-center cohort. Cognitive subdomains were evaluated using the Seoul Neuropsychological Screening Battery-Dementia version. We employed multiple linear regression analysis to compare the score of cognitive subdomains between the groups with high versus low educational attainment based on the high school graduate. Interaction between educational attainment and sex was also included in the analysis Results:High and low educational attainment group had 41.2% and 58.8% of patients in the study population. In the multiple regression analysis, score of all cognitive subdomains were significantly higher in the high educational attainment group. The score of attention, language, and visuospatial function were also significantly affected by interaction between educational attainment and sex. Conclusion:In the female patients, educational attainment showed higher influence on the attention, language, and visuospatial function score.