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박두병 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.3
저자는 DSN-IV진단기준에 의거해 검사전 2주간 약물을 복용한 적이 없는 주요우울 장애 및 정신분열증으로 진단된 환자 각 15명씩을 대상으로 면역기능의 변화를 알아보기위하여 혈중 백혈구수, 총임파구 수 및 %, CD3+세포 수 및 %, B세포수 및 %, CD4+세포수 및 %, CD8+세포수 및 %, CD4+/CD8+ 비율을 측정하였다. 정상 대조군은 신체적으로 건강한 성인 남녀 16명을 대상을 면역기능에 영향을 줄 수 있는 질병이나 약물 복용경험이나 정신질환의 현병력이나 기왕력이 있을 경우 조사대상에서 제외시켰다. 이들을 각 군간에 비교한 결고 다음과 같은 결론을 얻었다. 1)주요우울장애 환자군에서 대조군에 비해 CD8+세포수와 백분율(각각 p<.05)이 저하되어 있었고 정신 분열증군에서는 CD8+ 세포수(P<.05)가 대조군에 비해 저하되어 있었다. 성별로는 남성 주요우울장애 환자의 CD8+ 세포수(p<.05)가 남성대조군에 비해 낮았고 남성우울증환자의 B세포수(p<.05)는 여성우울환자에 비해 저하되어 있었다. 2) 양성정신분열증 환자군에서 T세포백분율과 세포수(각각 p<.05)가 대조군에 비해 저하되어 있었고 B세포 백분율(p<.05)은 대조군에 비해 증가되어 있었다. 3) 정신분열증 환자준에서 BPRS와 임파구 백분율(p<.01), CD8+ 세포수(p<.05), 총임파구수(p<.05)간에 부적 상관관계가 있었고, GP와 임파구 백분율(p<.05)간에도 부적 상관관계가 있었다. 주요우울장애 환자군에서는 연령과 임파구 백분율(p<.05)간에 상관간계가 있었다. An association between immunity and psychiatric diseases such as depression and schizophrenia has been suggested but ha not been consistently demonstrated. In the present study immune status of major depressive disorder and schizophrnia has compared with normal controls by investigating the changes in lymphocyte subpopulation. The number of lmphocyte subpopulation was determined y monoclonal antibody staining in conjunction with flow cytometry, and following surface antigens were determined : CD3+(pan T), CD7+(pan B), CD4+(T helper/inducer) and CD8+(T suppressor/cytotoxic). Fifteen untreated depressive patients and schizophrenic patients were examined along with the control who consisted of sixteen healthy volunteers matched by sex and age. The result showed that in the depression patients, number and percent of CD8+ cells were reduced(p<.05) as compared to control, while in the schizophrenic patients number of CD8+ cells were increased(p<.05) as compared to control. The result also showed variation between sex where in male depressives, the number of CD8+ cells was reduced as compared with male control, while female patients did not show such correlation. In addition, male depressives showed decrease in the number of B cell, compared with female depressives. In the patient group with positive symptoms as measured by PANSS, number and percentage of T cells decreased(p<.05 respectively) while percentage of B cells increased(p<.05) both as compared to control. Furthermore, in contrast with positive correlation found in depression between percentage of lymphosytes and age, a negative correlation was noted in schizophrenias between BPRS and the percentage of lymphocytes, number of CD8+ cell, and the total number of lymphocytes.
朴斗秉 大韓神經精神醫學會 1977 신경정신의학 Vol.16 No.2
For the epidemiologic evaluation of the hospitalized senile mental disorders, it was attempted to reveal the characteristics of the senile psychiatric patients as to their admission rates, mean hospital days, diagnostic classification by age and sex, personal status, personality traits, precipitating factors, hospital status, clinical manifestations and their management. The ninety cases of senile mental disorders who had been admitted to the department of Neuropsychiatry, Chung-Ang University, College of Medicine, from June 1968 to July 1975 were selected for this study, and the results were as follows: 1. The ninety cases of the senile mental disorders showed the following characteristic pictures comparing with the 3,886 case of total hospitalized psychiatric patients. a. Majority of the subjects (85.5%) were distributed in the decade of their sixties, and their mean age was 64.3 years. b. In the diagnostic distribution, 44.4% of the subjects were categorized as affective disorders, 33.4% as organic brain syndrome, 11.1% as psychoses, and 10.0% as neurosies. c. In the personal history, they showed lower educational level, higher rate of unemployment and middle class socioeconomic level. d. In the family history, they showed lesser cases of the first child (16.7%), and more cases of being widowed(33.3%). e. Majority of the senile cases were treated by herb drug (36.7%) or hospital management (35.6%) prior to hospitalization. 2. They were also exhibited following clinical pictures: a. Many of them were categorized as obsessive-compulsive (31.1%), schizoid (14.4%) or passive-aggressive (12.3%), but only 16.7% of them was stable in their premorbid personality. b. In the analysis of the precipitating factors, the intrafamilial problems (16.7%), physical illness (16.7%), changes in health (12.2%), or bereavement (11.1%) were more significant factors. c. 8.9% of them were living alone or with non-relatives. d. Majority of them had been suffered from cardio-vascular diseases (63.2%) and complained of insomnia (51.1%), cardiac symptoms (45.6%), depressive symptoms (30.0%), gastrointestinal symptoms (27.8%), anxiety (27.8%), or headache (25.6%), whereas 21.1% of them were free from any noteworthy associated physical illnesses. 3. 31 case of senile mental disorders showed the following characteristic pictures according to the diagnostic categories: a. In affective disorder, they were relatively younger, higher socioeconomical level, more obsessive compulsive, and frequently complaining insomnia, feelings of depression and gastrointestinal symptoms, but their rate of recurrence were relatively higher in spite of favorable improvement. b. In organic brain syndrome, they were relatively lower socioeconomical level, earlier hospitalization, and their effect of treatment was relatively worse. c. In psychoses, most of them were male, lower educational level, tended to have no religion and they frequently breakdown due to their intrafamilial problems, especially in the case of schizoid or paranoid personality. d. In neuroses, they breakdown due to sudden change of financial state, more complaining cardiac symptoms, occasionally having musculoskeletal disease, and their effect of treatment was not so good as other groups, probably due to earlier discharge against medical advices. 4. In the epidemiological studies, it was revealed that the admission rate of senile psychiatric in-patients among total psychiatric in-patients were relatively lower as 2.6% than 5.5% of senile non-psychiatric in-patients among total non-psychiatric in-patients and also it was extremely lower than the reports from Western countries, while the mean duration of hospitalization in senile psychiatric in-patients was also shorter as 12.0 days than 24.4 days in the total psychiatric in-patients. It was suggested that this lower rate and shorter period of hospitalization in this study was probably due to socio-cultural difference such as the respect for the aged in our traditional customs, popular opinions for senile mental disorders as normal aging process, psychiatrist's avoidance to hospitalization of the aged person due to high risk of mortality, and the trends of the aged persons highly inclining to herb medicine or superstitions belief.