음주관련 범법자 대상 알코올프로그램

민성호(Seongho Min):신정호(Jongho Shin):박새한(Sae-Han Park),안정숙(Joung-Sook Ahn) 한국중독정신의학회 2002 중독정신의학 Vol.6 No.2

In Korea, the alcohol program for alcohol related offenders started in 1997, the model of which was Attendance Centre Orders of U.K that is group-lecture centered with an emphasis on ethics and moral concepts of drinking. The aim of this study was to investigate the effect of our modified alcohol program practiced since February 2001. Our program was long-term follow-up program and emphasized group discussion, which made those offenders get motivation of abstinence and rebuild their attitude toward drinking. We worked with 8-10 offenders each term, total 50 offenders in 6 terms, for 2 hours at once and up to 20 hours for completion of the program. During the program, six scales were used to measure their behavioral change, and expiratory alcohol concentration was tested regularly. The mean age of the subjects was 41 and most of them were married and irreligious. The mean occasion of unearthed driving and other unearthed offence while alcohol intoxication was 2.5 and 1.3, separately. Seventy-six percent of them were suffered with alcohol use disorder and 29% were alcohol dependence. As completing of the program, their amount of alcohol consumed reduced from 1 bottle of Soju before to 0.46 bottle, and the frequency of drinking day lessened from 1 per 2.3 days before to 1 per 4.2 days. But their urge and craving for drinking was not changed significantly, which means the probability of relapse is so high that further long-term followup program is still necessary. From the results of our study, we suggest the alcohol program should be done under the concept of disease of alcohol drinking and treatment order system.

수면 소리 특징과 컨볼루션 신경망을 이용한 상태 분류 모델

민성호(Seongho Min),최예신(Ye Shin Choi),김우제(Woo Jae Kim),이수안(Suan Lee) 한국정보과학회 2023 한국정보과학회 학술발표논문집 Vol.2023 No.12

남자 알코올의존 환자들의 사회지향성과 집단주의적 성향에 대한 단면적 연구

민정원(Jungwon Min),신정호(Jongho Shin),민성호(Seongho Min),안정숙(Joung-Sook),박기창(Ki-Chang Park),김민혁(Min-Hyuk Kim) 한국중독정신의학회 2010 중독정신의학 Vol.14 No.2

Objectives:Previous studies reported that patients with alcohol dependence had low self-esteem, which affect interpersonal relationship. The purpose of this study was to investigate the col-lectivistic and sociotropic tendencies of male patients with alcohol dependence (AD) and it’s relations to self-esteem. Method:The subjects, all male in gender, were 91 patients who met DSM-IV criteria for AD and 97 normal controls. We administered a questionnaire for demographic data, Rosenberg Self-Esteem Scale (SES), Personal Style Inventory-II (PSI-II) for sociotropy-au-tonomy and Individualism-Collectivism (INDCOL). Results: AD patients were lower in education level and more in unmarried status than normal control group (p<0.001, p=0.002, respectively). Self-esteem score was lower in AD patients than in normal controls (t=-9.484, p<0.001). Scores of sociotropy and auton-omy subscale of PSI-II were higher in AD patients (t=3.454;p<0.001, t=3.454;p=0.001, respectively). Self-esteem of AD patients had negative correlations with sociotropy (r=-0.229, p<0.01) and autonomy (r=-0.294, p<0.01) of PSI-II. There was no significant difference in the INDCOL score between two groups. Conclusion:Our study findings show a mixed presentation of heightened sociotropy and autonomy of AD patients. From these findings we suggest that patients with AD may overly in-vest in interpersonal relations as a source of their self-esteem on one hand, and in maintaining a sense of separatedness and independence from others on the other hand.

알코올 사용이 자살시도의 심각성과 치명도에 미치는 영향-성별 차이를 중심으로

이진희,민성호,안정숙,박기창,김민혁,김흥규,Lee, Jinhee,Min, Seongho,Ahn, Joung-Sook,Park, Ki-Chang,Kim, Min-Hyuk,Kim, Heungkyu 한국정신신체의학회 2016 정신신체의학 Vol.24 No.2

Objectives : The aim of this study was to clarify the role of alcohol use disorders and acute alcohol consumption in suicide attempts by gender. Methods : Data of 1,152 suicide attempters(487 males and 742 females) who had visited an emergency center was gathered. Suicide attempts were categorized into three groups according to alcohol use: an alcohol use disorder group(AUD), an acute alcohol use group(AAU), and a no-alcohol use group(NAU). The intent and lethality of suicide attempts were evaluated by Suicidal Intents Scale and Risk-Rescue Rating Scale. Results : For Suicidal Intents Scale score, the male AUD group revealed a significantly lower mean score than the male AAU one. However, there were no statistically significant differences for female subjects across subgroups. With regard to the Risk-Rescue Rating Scale score, there were no significant differences for males, while the AUD group showed both the lowest highest rescue scores and lowest risk-rescue scores within female groups. Conclusions : AUD in females was more likely regarding impulsive suicide attempts with high rescue chances. Consuming alcohol might have different effect on suicide attempts by gender and our study shows that alcohol use is an important risk factor according to gender, particularly with regard to female suicide attempts. 연구목적 본 연구는 자살시도에서 알코올이 자살시도의 심각성 및 치명도에 미치는 영향이 성별에 따라 차이가 있는 지 여부를 확인하고자 하였다. 방 법 총 1,152명의 자살시도자(남성 487명, 여성 742명)를 분석 대상으로 하였으며, 음주 양상에 따라 알코올사용 장애군, 급성알코올사용군, 비알코올사용군으로 나누었다. 자살시도의 심각성과 치명도는 자살의도척도및 위험-구조평가척도로 평가하였다. 결 과 남성에서는 급성알코올사용군에 비해 알코올사용장애군에서 자살의도척도의 총점이 유의하게 낮았지만, 여성에서는 각 군 사이에 유의한 차이가 없었다. 위험-구조평가척도에서 남성은 각 군간에 차이가 없었으나, 여성은 알코올사용장애군에서 가장 높은 구조도와 가장 낮은 위험도 점수를 보였다. 결 론 알코올사용장애가 있는 여성 자살시도자는 구조가 쉬운 상황에서 충동적인 자살 시도를 하는 경향이 있다면, 남성은 알코올 사용장애 환자보다 급성 알코올 중독상태일 때 자살의도가 더 강했다. 자살시도자의 알코올의 사용이 성별에 따라 다른 영향을 미칠 수 있으며, 특히 여성에서 중요한 위험 요인임을 시사하고 있다.

섬망의 운동성 아형에 따른 증상과 임상적 특징

백수현,민성호,안정숙,박기창,김민혁,Paik, Soo-Hyun,Min, Seongho,Ahn, Joung-Sook,Park, Ki-Chang,Kim, Min-Hyuk 한국정신신체의학회 2015 정신신체의학 Vol.23 No.2

연구목적 본 연구에서는 섬망의 운동성 아형 간의 증상과 임상적 특징의 차이를 알아보고자 한다. 방 법 일 대학병원에 입원하여 정신건강의학과에 협진의뢰된 환자 중 일반신체질환에 의한 섬망으로 진단된 256명을 대상으로 후향적으로 의무기록을 검토하였다. 운동성 아형은 Lipowski의 분류 체계에 따라 과활동형, 저활동형 및 혼재형으로 분류하였으며, 섬망평가척도를 이용하여 증상을 평가하였다. 결 과 과활동형이 130명(50.8%), 혼재형은 118명(46.1%), 저활동형은 118명(3.1%)이었다. 과활동형은 평균연령이 혼재형 환자보다 적었으며(p=0.022), 섬망을 치료하기 위해 항정신병 약물을 더 자주 사용하였다(p<0.001). 과활동형은 인지적 및 비인지적 증상 점수가 타 아형에 비해 높았다(각각 p=0.002, p<0.001). 결 론 섬망의 운동성 아형에 따라 증상 및 임상적 특징에서 차이가 있었다. 운동성 아형에 따라 진단 및 치료적 접근 방법을 달리하여, 특정 아형의 섬망 진단이 간과되거나 치료가 지연되지 않도록 관심을 가질 필요가 있다. Objectives : To investigate clinical and symptomatic differences among motoric subtypes of delirium. Methods : A total of 256 patients referred to psychiatric consultation services for delirium due to general medical condition were assessed retrospectively. Motoric subtypes were determined according to Lipowski's criteria for hyperactive, hypoactive and mixed subtypes. All patients were evaluated according to Delirium Rating Scale-Revised-98(DRS-98-R) by trained psychiatrists to obtain symptomatic profiles of delirium. Results : Hyperactive subtype were 50.8%(n=130), mixed 46.1%(n=118) and hypoactive 3.1%(n=8). Hyperactive patients were younger than mixed subtype($69.62{\pm}13.976$ vs. $73.97{\pm}11.569$, p=0.022) and received antipsychotics to manage symptoms of delirium more frequently(83.8% vs. 57.6%, p<0.001). Hyperactive patients had higher DRS-R-98 scores on both noncognitive($7.14{\pm}3.543$ for hyperactive, $5.62{\pm}3.279$ for mixed subtype) and cognitive subscales($10.00{\pm}3.574$ for hyperactive, $6.38{\pm}2.875$ for hypoactive, $7.43{\pm}3.771$ for mixed subtype, p<0.001). Conclusions : We demonstrated that clinical and symptomatic profiles were different across motoric subtypes in delirium. Diagnostic and therapeutic approach should be made differently according to motoric subtypes of delirium and special attention is needed not to underestimate or delay treatment in specific motoric subtype of delirium.

일 대학병원 정신과의 알코올 프로그램- 원주기독병원 알자회를 중심으로 -

신정호(Jongho Shin),민성호(Seongho Min) 한국중독정신의학회 1997 중독정신의학 Vol.1 No.1

Recently some treatment programs for alcohol problem have started to offer services in general hospitals in Korea. Most of them were noted to have system mainly for acute inpatients. And the treatment outcome of them has been studied only in terms of months up to one year. For about seven years we have experienced a treatment program focused on intensive group psychotherapy with cognitive-behavioral orientation which put great stress on follow up case management, and we found this program was very efficient in longer-term outcome over 1 year. Alcohol treatment program of Wonju Christian Hospital consisted of inpatient program, outpatient program and a particular form of group therapy mainly for recovering OPD patients named Alzahoe. Alzahoe is a Korean abbreviation of Alcoholics Self-esteem Recovering Meeting. It is a semi-closed intensive group psychotherapy, and one of its characteristics is the function of linking acute inpatient treatment with out-patient follow up and rehabilitation after discharge. With this modality, the treatment outcome was outstanding; one-year abstinence rate was 77.1%, two-year abstinence 57.7%, and three-year abstinence 30.8%, which was much higher than those of previous studies. One factor of this better outcome seemed to be resulted from individual intensive psychotherapy for personality problems and Alzahoe exposure during admission. Therefore its members were well known to each other and encouraged to have prudent intra- and extrasocial relations and contacts, that was much different from the policy of anonymity in A.A. meeting. We are sure that this treatment approach will be well applied for alcoholic problem in general hospital psychiatry.

오진된 섬망 환자의 임상적 특징

오유진,백수현,김민혁,민성호,박기창,안정숙,Oh, Eugene,Baek, Sue-Hyun,Kim, Min-Hyuk,Min, Seongho,Park, Ki-Chang,Ahn, Jung-Sook 한국정신신체의학회 2014 정신신체의학 Vol.22 No.2

연구목적 본 연구에서는 섬망의 오진과 관련된 임상적 특징 및 임상의를 오진으로 유도할 수 있는 증상적 특징들을 알아보고자 한다. 방 법 일 대학병원에 입원하여 정신과에 협의진료 의뢰된 환자 중, 정신건강의학과 전문의에 의해 섬망으로 진단된 256명을 대상으로 후향적으로 의무기록을 조사하였다. 협진요청서에 명시된 사유를 검토하여, 의뢰의사의 진단이 섬망인 경우 진단일치군으로 섬망이 아닌 경우 진단불일치군으로 구분하였다. 결 과 69명(27%)이 진단불일치군으로, 섬망이 아닌 다른 진단으로 협진이 의뢰되었다. 진단불일치군에서 항정신병약물의 사용, 기질성 정신질환의 과거력이 많았다. Delirium rating scale-Revised-98(DRS-R-98) 중 증상의 변동 항목의 점수가 진단일치군에서 더 높았다. 로지스틱 회귀분석결과 질환의 낮은 심각도, 항정신병약물 사용력, 적은 증상의 변동이 임상의가 섬망 외에 다른 진단을 고려하는 예측인자였다. 결 론 본 연구에서 항정신병약물을 복용중인 경우, 섬망증상의 변동이 적은 경우 오진의 위험이 높았다. 지연된 섬망의 진단과 치료는 환자의 예후에 부정적인 영향을 미칠 수 있으므로 주의 깊은 임상적 관심이 필요하다. Objectives : Delirium of hospitalized patients is common and it is significantly associated with increased mortality rate. Misdiagnosis rates of delirium are reported in a range of 36.7 to 63% in clinical setting. We aimed to identify the clinical features and symptomatic characteristics associated with misdiagnosis of delirium. Methods : Subjects were 256 inpatients who were referred for psychiatric consultation and diagnosed with delirium by a psychiatrist at a university hospital between January 1 and June 30, 2012. Clinical data were obtained with retrospective chart review. Patients were divided into misdiagnosed group and correct diagnosed group, after reviewing the reason which were described in the consultation request form. Results : Sixty nine(27%) subjects of the 256 patients were referred for other reasons(mood, substance, anxiety, dementia etc.) than "delirium/confusion" by clinician(misdiagnosed group). In misdiagnosed group, use of antipsychotics was more common. There were no differences between the two groups in age, gender, and department of referring clinician. Fluctuation score of DRS-R-98 was higher in the correct diagnosed group. Conclusions : In this study, the risk of misdiagnosis was higher when the patients have taken antipsychotics or less symptom fluctuation. Careful clinical attention is needed for diagnosis for delirium in these patients.

고립적 일 산촌 지역사회의 알코올중독과 남용에 대한 실태조사

신정호(Jongho Shin),민성호(Seongho Min),박기창(Kichang Park),이종섭(Jongsub Lee),표진인(Jinin Pyo) 한국중독정신의학회 1999 중독정신의학 Vol.3 No.2

Besides basic epidemiologic data and alcohol behavior, we studied health behaviors such as exercise, smoking, etc. in an isolated mountainous rural community;Guyrae-myeon, Wonjusi, Kangwon-do, Korea. We surveyed 640 (84.4%) of all households and completed the study procedures on 1,058 (58.1%) of all residents. This will be a preparatory step for the future development of community-based program for alcoholism treatment and education. We measured various alcohol use behavior with Alcohol Effect Questionnaire (AEQ), Drinking Restraint Questionnaire (DRS) and Severity of Alcohol Dependence Questionnaire (SADQ) in residents of the community, living there over 18-years. The results were as following;1) The subjects were composed with 578 women (54.6%) and 480 men (43.4%), mean age was 55.0±16.87 years (men;53.0± 16.78yrs, women;56.6±16.78yrs). 2) The subject, drinking alcohol more than once a month was 63.8%, and drinking almost everyday was 22.1%. 3) Mean amount of alcohol consumed was 59.6±81.83 gm in pure form a day in men, 11.1±22.97 gm in women. The percentage of all subjects, which had consumed more than 45 gm alcohol of pure form that accounts one half bottle of regular size Soju, was 15.1% and that of men was 30.3%. 4) With AEQ, ‘alcohol induced social and physical pleasure’ was the most highly responded subscale (66.1%). Items of ‘feel good’ (75.6%) and ‘more interesting’ (68.8%) were most highly responded among this subscale. 5) The subject who showed concern that ideally they should drink much less than present amount was 28.1%, and who accepted the idea that it would be very likely that they soon will have problems from drinking with DRS was 21.1%. 6) With SADQ, average severity of alcohol dependence was 27.4±7.48 in men and 22.8±5.49 in women. Score above 30 was found in 20.2% of men and 2.9% of women. 7) The subject who suffered from insomnia was 27.8%. The insomniac who had drunken alcohol for sleep induction was 27.5%, who had used hypnotics for sleep induction was 7.8%. 8) More men had smoked than women (68.3% Vs 17.5%).

수해지역 주민의 정신건강에 대한 2년 추적조사

조영주(Youngju Cho),김민혁(Min-Hyuk Kim),고상백(Sang-Back Koh),허지훈(Ji-hoon Heo),박준호(Joon-Ho Park),안정숙(Joung-Sook Ahn),박기창(Ki-Chang Park),신정호(Jongho Shin),민성호(Seongho Min) 대한사회정신의학회 2010 사회정신의학 Vol.15 No.2

목 적: 홍수피해를 입은 지역사회 주민의 수해 후 2년간의 정신건강상태 변화와 우울증, 외상 후 스트레스 장애 유병률에 대하여 연구하였다. 방 법: 저자들은 강원도 인제군 가리산리를 농작업 안전관리현황 진단을 위한 코호트로 선정하고, 2006년 4월부터 수해가 일어나기 직전인 7월까지, 83명의 주민들에 대한 사전조사를 마쳤었다. 신체 및 정신 건강상태와 의료 결과 연구 36항목 단축 서식 건강조사-한국판 (36-Item Short-Form Health Survey-Korean version, SF-36), 단축형 사회심리적 스트레스(Psychological Well-being Index, PWI-SF), Beck 우울척도(Beck Depression Inventory, BDI), 사회충격척도-개정판 (Impact of Event Scale-Revised, IES-R) 등의 조사도구를 사용하였다. 수해 후 18개월 후에 1차 조사, 24개월 후에 2차 조사를 시행하였고, 25명의 남자와 32명의 여자가 1차, 2차 조사에 응답하였다. 우울증상, 외상 후 스트레스장애 증상과 일반적 정신건강 상태의 시간에 따른 변화와 관련된 인자들을 조사하였다. 결 과: BDI 16점 이상의 중등도 이상의 우울증상은 1차 조사 에서 36.8%, 2차 조사에서 28.1%로, 2차 조사에서 호전되는 양상이 었다. 반면 PWI-SF는 1차 조사보다 2차 조사에서 증가하여 스트레스에 대한 심각도가 높아졌고, IES-R로 측정된 외상 후스트레스장애 증상의 유병율도 1, 2차 조사에서 각각 29.8%, 38.6%로 증가하였다. SF-36은 고령군에서 유의미하게 감소하였 지만, 보상 만족도가 높은 집단에서는 증가하였다. 결 론: 재해는 2년 이상 장기간 동안 피해자들의 정신건강에 영향을 미치며, 그 영향은 정신병리에 따라 다양하다. 연령, 계절, 보상 수준, 재해 중 경험 등이 재해 후 정신건강의 변화에 조절인자로 작용하는 것으로 보인다. Objective:Eighteen-month and 24-month follow-ups after floods were performed to investigate interval changes of general mental health status and the prevalence of depression and PTSD symptoms in the agricultural population of a mountain village. Method:Garisan-ri of Inje-gun, Gangwon-do was chosen as an associate for evaluating agricultural safety management status. A baseline survey was done among the residents from April to July, 2006 just before flood damage occurred. Among the 83 subjects of the baseline survey before the flood, the primary investigation was implemented 18 months after, and a secondary investigation 24 months after the flood. Twenty five men and 32 women responded to both the primary and secondary investigations. The SF-36, PWI-SF BDI, MMPI-PTSD and IESR were used for this group to examine the prevalence of depression, post-traumatic stress disorder symptoms, and the general status of their mental health. They were also observed regarding changes of time and seasons. Results:Depression of a moderate or higher degree measured with BDI (>16) was shown to be experienced in 36.8% of residents from the primary, and 28.1% from the secondary investigation. It seemed to be improving, but the PWI-SF total score increased in the secondary investigation than that in the primary. The estimated prevalence of post-traumatic stress disorder symptom measured by IES-Rappeared to be increasing, being 29.8% and 38.6% in the primary and secondary investigations, respectively. As for changes in SF-36, the elderly group and the group with high satisfaction showed significant values. Conclusion:The result of the study is that disasters may have long-term effects on victimsfor more than two years, although some of the symptoms improve, other symptoms continue, and there are changes in mental health status depending on age, seasons, level of compensation and other factors.

보상만족도가 수해 후 정신병리와 삶의 질에 미치는 영향

김신(Shin Kim),민성호(Seongho Min),고상백(Sang-Back Koh),신정호(Jongho Shin),박기창(Ki-Chang Park),안정숙(Joung-Sook Ahn),김민혁(Min-Hyuk Kim) 대한사회정신의학회 2011 사회정신의학 Vol.16 No.2

목 적 : 본 연구의 목적은 보상만족도가 재해 후 정신병리와, 삶의 질의 변화에 미치는 영향을 알아보는 것이다. 방 법 : 강원도 인제군 가리산리는 농작업 안전관리현황 진단을 위한 코호트로 선정되어, 2006년 4월부터 수해가 일어나기 직전인 7월까지 주민 83명의 신체적 및 정신적 건강실태에 대한 기초조사가 이루어졌다. 저자들은 수해 후 18개월에 1차 조사, 24개월에 2차 조사를 시행하여, 한국판 36-단축형 건강조사(36-Item Short-Form Health Survey-Korean version, SF-36)를 사용하여 삶의 질을 측정하였고, 단축형 사회심리적 스트레스(Psychological Well-being Index Short form, PWI-SF), 개정판 사건충격척도(Impact of Event Scale-Revised, IES-R), Beck 우울척도(Beck Depression Inventory, BDI) 등을 사용하여 정신병리를 측정하였으며, 보상에 대한 만족도에 대해 조사하였다. 결 과 : 55명 중 보상만족도가 보통 이상은 12명(21.8%), 불만족은 33명(78.2%)이었으며, 두 집단간의 인구사회학적 특징은 차이가 없었다. 보상만족도에 따라 시간에 따른 BDI, IES-R, AUDIT 점수의 변화에는 차이가 없었다. SF-36은 보상만족도가 높은 집단에서 수해 후 18개월에 감소하였다가 24개월 증가하였으며, 보상만족도가 낮은 집단은 수해 후 18개월에 증가하였다가 24개월에 감소하 였다. 결 론 : 수해는 피해자들의 정신건강에 장기간 영향을 미치며 보상만족도는 수해 후 삶의 질 변화에 영향을 미친다. Objectives : This study aims to examine the effects of compensation satisfaction on psychopathology and quality of life following flood. Methods : Garisan-ri of Inje-gun, Gangwon-do was chosen as a cohort regarding evaluating of agricultural safety management status. A baseline survey had been administered just before the flood. A follow-up study was conducted for 24 months. Psychopathology and quality of life were assessed using BDI, IES-R, SF-36 and PWI-SF. Satisfaction with the flood compensation was also evaluated. Results : There was a total of 55 respondents. There was no significant difference between the low satisfaction group (N=43, 78.2%) and middle & high group (N`12, 21.8%) in the sociodemographic factors. There were no significant differences in changes in BDI, IES-R, and AUDIT score over time between the two groups. While SF-36 in the low satisfaction group was increased at 18months after the disaster and decreased at 24months, SF-36 in the middle and high satisfaction group decreased at 18 months after the disaster and increased at 24 months. Conclusion : The flood disaster had a long-term effect on the flood victims’ mental health. Satisfaction with compensation affects changes of quality of life following a flood disaster.