영아살해와 임신거부증을 주소로 내원한 경계선 인격장애의 치료사례

정세미나,백기청,이준형,김경민,도진아,임명호,Jung, Semina,Paik, Ki Chung,Lee, Jun Hyung,Kim, Kyung Min,Doh, Jin Ah,Lim, Myung Ho 대한불안의학회 2012 대한불안의학회지 Vol.8 No.2

Though infanticide, killing the baby after birth of the neonate and denial of pregnancy, are very rare psychiatric disorder, they have been receiving a lot of social concerns. We report and review infanticide and denial of pregnancy administration in a 19 year-old adolescent with bipolar disorder and borderline personality disorder. Patients with a young age, cognitive immaturity, an unwanted child, hid the pregnancy facts were consistent with the results of previous studies. In addition, the patient's impulsivity and emotional instability is affecting infanticide. After inpatient care with pharmacotherapy (escitalopram 20mg, alprazolam 1.5 mg, clonazepam 0.5 mg, valproate sodium 1,100-1,300 mg, and quetiapine 100-400 mg) and supportive psychotherapy, and there were significant improvement of clinical symptoms.

원형탈모증 환자의 정서상태와 성격특성에 관한 임상적 연구

이경규,백기청,Lee, Kyung-Kyu,Paik, Ki-Chung 한국정신신체의학회 1997 정신신체의학 Vol.5 No.2

Objectives: This study was aimed to investigate the emotional state and personality characteristics of alopecia aerata patient and to determine whether these characteristics are similar with those of neurotic patient. Methods : 20 alopecia aerata patients, 20 neurotic patients, and 20 normal healthy controls were studied. Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI) and Korean standardized edition of Catell's 16 Personality factors Questionnaire(16PF) were used for assessment. Results: 1) Total score of BDI was higher in neurosis group than alopecia aerata group and normal control group(p<0.05). Inspire of statistical non-significance, total score of in alopecia aerata group was higher than normal control group. 2) Total scores of state anxiety and trait anxiety in alopecia aerata and neurosis group were significantly higher than normal control group(p<0.001). 3) In first-stratum source traits of 16PF, normal control group was significantly higher than alopecia aerata group and neurosis group in B-factor(intelligence) and C-factor(ego-strength)(p<0.05). Alopecia aerata group and neurosis group were significantly higher than normal control group in O-factor(guilt-proneness) and $Q_4-factor(tension,\;anxiety)$(p<0.001). 4) In second-stratum source traits of 16PF, alopecia aerata group and neurosis group were significantly higher than normal control group in ANX-factor(anxiety)(p<0.05). Conclusions : These results suggest that emotional state and personality characterstics of patients with alopecia aerata are a distinguishable different to compare with normal control, and are very similar with those of neurotic patients. The authors propose that psychiatric management in patient with alopecia aerata will be more benificial.

기억 및 기억연구 : 개념, 역사, 그리고 과제

양병환,백기청,Yang, Byung-Hwan,Paik, Ki-Chung 한국정신신체의학회 2001 정신신체의학 Vol.9 No.1

오늘날 '기억(memory) '이라는 용어는 일반적인 의미 이외에도, 컴퓨터공학의 메모리, 유전자생물학에서 쓰이는 메모리 등의 예에서 보듯 여러 분야에서 광범위한 의미로도 쓰이고 있다. 영어의 'memory' 라는 용어는 어원적으로는 앵글로-색슨어 'gemund' 에서 유래된 말로 gemund은 원래 mind(마음)의 의미라고 한다. 어떻든 전형적인 의미에서 기억이란 과거에 경험한 일들을 회상하고, 이러한 일들에서 학습된 여러 사실과 관념을 마음속으로 다시 가져와 상기시킬 수 있는 능력을 뜻하는데, 다시 말해 기억이란 현재의 도움으로 과거를 일깨워 주는 것이라고 정의될 수 있겠다. 최근에 이루어진 신경생물학적 연구의 발전은 이런 기억이나 학습이 뇌의 어떤 활동 또는 기능과 관련이 있는가를 어느 정도 밝힐 수 있는 단계로까지 이를 수 있게 해주었는데, 그 결과 기억은 단순히 기계적인 기억을 하는 기능만이 아닌 여러 뇌기능에 작용하는 다양한 인지기능의 핵심적인 요소라는 사실이 밝혀졌다. 오늘날 기억은 진화론적 입장에서 인간존재 자체나, 지(智) 정(情) 의(意)로 대별되는 인간정신세계의 가장 핵심적인 요소로서 관심의 대상이 되고 있다. 본 논문에서는 기억 및 기억연구의 개념, 역사, 그리고 신경생물학적 기억연구를 비롯한 최근의 연구경향을 총괄적으로 살펴보고, 향후 이루어져야 할 기억연구의 과제나 방향을 제시하고자 한다. The term 'memory' has acquired so many meanings today that it is not even confined to the mental domain any longer, although it is etymologically derived from the Anglo-Saxon word 'gemund', meaning mind. In its most typical sense, memory can be defined as 'the reawakening of the past in the service of present'. But in many papers, the term memory has been used in a various different meaning, which made the interpretation of the research result very complicated. Recently there has been tremendous development in the neurobiological researches with regard to the memory. This paper reviewed the concept, history, and current tendencies of the memory and memory researches comprehensively for the purpose of showing future direction of the memory researches.

서울, 천안, 농촌지역 중 고교 학생들의 인터넷 중독에 대한 비교 연구

이석범,이경규,백기청,김현우,Lee, Seok-Bum,Lee, Kyung-Kyu,Paik, Ki-Chung,Kim, Hyun-Woo 한국정신신체의학회 2004 정신신체의학 Vol.12 No.2

연구목적: 인터넷 중독이란 '과도한 인터넷 사용에 의해 현실생활에 어려움을 겪게 되는 경우', '인터넷에 과도한 시간을 사용하거나 현실세계에서의 진정한 인간관계가 가상공간에서의 표면적인 관계로 대치되는 것', '인터넷 사용에 대한 자기조절 능력이 현저히 약하고 사용을 금지할 경우 심리적 혼돈과 무기력에 빠지게 되는 상태' 등으로 정의되는 새로운 형태의 중독 현상을 지칭한다. 본 연구에서는 경제적, 문화적, 지리적 여건이 다른 서울, 천안, 농촌지역 중고교 학생들을 대상으로 인터넷 중독율, 인구학적 변수들, 컴퓨터 사용성향, 불안성향, 우울, 그리고 가상공간을 통한 자기 효능감이 각 지역간에 어떠한 차이가 있는지를 알아보고자 하였다. 방법: 연구대상군은 서울, 천안, 천안근교 농촌 소재의 남녀 중고교생 1718명을 대상으로 하였으며 사회인구학적인 변인에 대한 문항들, the Spielberger State-Trait Anxiety Inventory (STAI)를 김정택이 번안한 한국판 상태-특성 불안척도, Self-Rating Depression Scale (SDS)을 이중훈이 번안한 한국판 자기평가 우울척도, 인터넷 사용 성향을 묻는 문항들, Young, K. S.의 인터넷 중독 진단 척도를 윤재희가 번안하였고 본 연구자가 청소년에 맞게 수정한 인터넷 중독척도, J. W. Henry & R. W. Stone이 개발한 computer self-efficacy and outcome expectancy scale과 Paulhus, Delroy가 개발한 Spheres-of-Control Battery Item을 송원영이 번안, 수정하여 사용한 가상공간 활용에 대한 자기효능감 및 결과기대척도로 구성된 설문지를 해당학교장의 협조를 받아 교실 내에서 학생들이 작성하는 방식으로 연구가 시행되었다. 결과: 연구결과 전체 대상군의 인터넷 중독율은 2.9%였으며 세 지역간에 인터넷 중독율에 있어서 유의한 차이는 발견되지 않았다. 전체 대상군의 경우 농촌이 서울이나 천안에 비하여 높은 불안, 우울정도를 보였고, 서울, 천안, 농촌 순으로 높은 가상공간활용에 대한 자기효능감을 보였으며 천안, 서울, 농촌 순으로 여가생활을 혼자 지내는 비율이 높았으나 중독군 만을 대상으로 하였을 때는 이러한 차이가 없었다. 전체 대상군의 경우 인터넷에 접속하는 장소에 있어서 서울, 천안, 농촌 순으로 가정이 많았으며 인터넷 접속방법에 있어서도 서울, 천안, 농촌 순으로 초고속 인터넷의 사용율이 높았으나 중독군 만을 대상으로 하였을 때는 이러한 차이가 없었다. 인터넷 중독에 대한 인식에 있어서는 전체 대상군의 경우 서울, 천안, 농촌의 순으로 인터넷에 중독되어 있다고 생각하는 비율이 높았으나 중독군 만을 대상으로 하였을 때는 이러한 차이가 없었다. 결론: 이번 연구결과를 보면 인터넷 중독율은 세 지역간에 차이가 없었으며 불안, 우울, 가상공간활용에 대한 자기효능감, 여가형태, 인터넷 접속장소, 인터넷 접속방법, 인터넷 중독에 대한 인식에 있어서 전체 대상군에서는 세 지역간에 차이가 있음에도 불구하고 중독군의 경우에는 이러한 차이가 없어 지역간 중 고교 학생들의 심리적 상태, 여가형태, 인터넷 환경, 인터넷 중독에 대한 인식은 차이가 있으나 인터넷에 중독되면 이러한 차이가 없어지고 비슷한 형태의 중독군을 형성함을 알 수 있었다. Objectives : Internet addiction is a newly appeared addictive phenomenon that is defined as 'difficulty in real life due to internet over-use', 'excessive time spent on the internet or replacement of genuine real relationships with superficial virtual ones' or 'weakness in self-control about internet use and if discontinued, fallen in psychological confusion and anergic state'. This study was aimed to compare the internet addiction rate, demographic factors, computer using patterns, anxiety, depression, and internet self-efficacy and outcome expectancy between Korean middle and high school students in three areas - Seoul, Cheonan, and Rural areas - that were different in economic, cultural, and geographic state. Methods : Subjects are consisted of middle and high school students in Seoul, Chunan, and Rural areas(N=1718). Self-rating questionnaire included demographic data, Korean Spielberger State-Trait Anxiety Inventory, Korean Self-Rating Depression Scale(SDS), questions for internet-using pattern, Korean version of Internet Addiction Scale invented by K. S. Young, Internet Self-efficacy and Out-come Expectancy Scale. Results: In this study, prevalence of internet addiction was 2.9%. There was no significant difference found in prevalence of internet addiction among three areas. In all subjects, there were significant differences in anxiety, depression, internet self-efficacy and outcome expectancy, leisure style, places of internet use, internet connecting method, and insight on internee addiction. But, in addicted group, there was no significant difference among three areas. Conclusion: This study suggested that the difference in economic, cultural, and geographic state was not related to prevalence of internet addiction. Although there were significant differences in anxiety, depression, self-efficacy associated with internee use, leisure style, places of internet use, internet connecting method, insight on internet addiction among three areas, there were no significant difference in addicted group among three areas. So, we concluded that the difference in economic, cultural, and geographic state did not influence the prevalence of internet addiction, and despite the difference in economic, cultural, and geographic state, people in three areas were equally influenced by internet addiction.

백반증 환자의 정서상태와 성격특성

이경규,이종헌,김현우,백기청,김유찬,Lee, Kyung-Kyu,Lee, Jong-Hyun,Kim, Hyun-Woo,Paik, Ki-Chung,Kim, You-Chan 한국정신신체의학회 2000 정신신체의학 Vol.8 No.1

연구목적 : 백반증 환자의 치료에서 간과되어지고 있는 심리적인 요인이 치료에서 중요하게 다루어져야 한다는 것을 제시하기 위하여 첫째 백반증 환자에서의 우울과 불안의 정도 및 성격유형이 어떠한가를 알아보고, 둘째 이 결과를 정상 대조군과 비교함으로써 환자들의 정서상태 및 성격특성을 고려하여 이들의 스트레스나 정신과적인 문제에 어떻게 접근하는 것이 도움이 될 수 있는가를 알아보고자 하였으며, 마지막으로 환자들의 특성에 따른 차이를 알아봄으로써 이를 고려한 치료방법을 모색하고자 하였다. 방법 : 21명의 백반증 환자와 정상인 20명을 대상으로 Beck의 우울 검사, Spielberger의 상태-특성 불안검사 및 염태호와 김정규가 한국판 표준화한 Cattell의 16 성격요인검사를 시행하였다. 결과 : 백반증 환자군과 정상 대조군 간에 우울과 불안에서 차이를 보이지 않았고, 성격특성에서는 백반증 환자군이 정상 대조군보다 소심하지만 고집이 센 것으로 나타났으며 다른 성격특성에서는 차이가 없었다. 그리고 백반증 환자들의 특성에 따른 비교에서는 여성 환자들이 더욱 민감한 것으로 나타났으며 미용 상 문제가 되는 병변 유무와 진행유무는 특별한 영향을 미치지 않는 것으로 나타났지만, 30세 이상의 환자들이 지배적, 도덕적이며 의심이 많고 사변적이며 자가 충족적이고 통제적이고 독립적이며 강한 초자아를 가지고 있으며 창조적인 것으로 나타났다. 그러나 유병기간은 유의한 상관관계를 보이지 않았다. 결론 : 백반증 환자들은 정상인에 비해 대인관계에서 소심하면서 고집이 샌 것으로 나타나 나이에 맞는 성격 발달을 하고 있지만 대인관계에서는 문제점이 있는 것으로 나타났다. 백반증 환자들의 치료에 있어서 대인관계에서의 문제 해결에 도움을 줄 수 있는 정신과적인 접근을 피부과적인 치료법과 병용함이 유익하리라는 것을 제시한다. Objectives : This study was aimed to investigate the emotional state and personality factors of patients with vitiligo, and the impacts of clinical characteristics. Methods : Twenty one patients with vitiligo and 20 normal controls were studied. Beck Depression Inventory(BDI), Spielberg's State and Trait Anxiety Inventory(STAI) and Cattell's 16 Personality Factors Questionnaire(16-PF) were used for assessment. Statistically, t-test, Oneway ANOVA, Mann-Whitney U test and Pearson's correlation test were used. Results : The Results were as follows. 1) The comparison of total score of BDI, state anxiety and trait anxiety between the patients with vitiligo and normal controls were not significantly different. 2) In first-stratum source traits of 16-PF, normal control group was significantly higher than the patients with vitiligo in H-factor(Boldness) and I-factor(Tender-mindedness). In second-stratum source traits of 16-PF, there was no significant difference between the patients with vitiligo and normal control in all factors. 3) According to sex, the comparison of total scores of BDI, STAI between male and female patients with vitiligo were not significantly different. In the comparison of 16-PF, female patients were higher than male patients in I-factor only. 4) As according to age(under and over 30 years of age), the comparison of total scores of BDI, STAI between patients over 30 years of age and under 30 years of age were not significantly different. In the comparison of 16-PF, patients over 30 years of age were higher than patients under 30 years of age in E-, G-, L-, M-, Q2-, Q3-, IND-, SUP-, and CRE-factor. 5) As according to the presence of progression of vitiligo and the presence of visible lesion, the comparison of total scores of BDI, STAI and 16-PF were not significantly different. 6) There were no significant correlation between the duration of the vitiligo and BDI, STAI-S, STAI-T, and 16-PF. Conclusions : There were no significant difference between patients with vitiligo and normal controls on the emotional state and personality characteristics. But patients with vitiligo were more bolder and tender-minded than normal controls on 16-PF. The author propose that methods of treatment to resolve problems of the interpersonal relations will be helpful.

평택시 군용비행장 주변지역 주민건강조사

김현주,노상철,권호장,백기청,이무용,정재윤,임명호,구미진,김창훈,김혜영,임정훈,김동현,Kim, Hyun-Joo,Roh, Sang-Chul,Kwon, Ho-Jang,Paik, Ki-Chung,Rhee, Moo-Yong,Jeong, Jae-Yun,Lim, Myung-Ho,Koo, Mi-Jin,Kim, Chang-Hoon,Kim, Hae-Young,Lim, Je 대한예방의학회 2008 예방의학회지 Vol.41 No.5

Objectives : We conducted an epidemiologic survey to evaluate the effect of the aircraft noise exposure on the health of the residents near the military airbases in Pyeongtaek City. Methods : The evaluation of environmental noise level, questionnaire survey, and health examination were performed for 917 residents. The study population consisted of four groups: subjects who lived in the village close to the fighter airbase (high exposure), subjects who lived along the course of fighters (intermediate exposure), and subjects near a helicopter airbase, and the control group. Results : The prevalence of the aircraft noise related accident and irritable bowel syndrome in the exposure groups were higher than that of the control group. The risks of noise induced hearing loss, hypertension and diabetes mellitus were higher in the exposed groups than in the control group. The prevalence of anxiety disorder and primary insomnia were higher in the exposed groups than in the control group. Prevalence odd ratios of the risk for primary insomnia after adjusting age, sex, agricultural noise, and occupation were 4.03 [95% confidence interval (95% Cl) 1.56-10.47] for the subject near the helicopter airbase, 1.23 (95% Cl 0.40-3.76) for those intermediately exposed to fighter noise, and 4.99 (95% Cl 2.14-11.64) for those highly exposed to fighter noise. Conclusions : The results of the present study suggest that the aircraft noise may have adverse effects on hearing function, cardiovascular health and mental health. Therefore, it seems to be needed to take proper measures including the control of the aircraft noise and the management of the exposed people's health.

한국판 신체 이형장애 자가 평가척도의 표준화 연구 : 대학생들을 대상으로

이혜진,최은영,도진아,임명호,백기청,이경규,김현우,Lee, Hye-Jin,Choi, Eun-Young,Do, Jin-A,Lim, Myung-Ho,Paik, Ki-Chung,Lee, Kyung-Kyu,Kim, Hyun-Woo 대한불안의학회 2009 대한불안의학회지 Vol.5 No.2

Objective : Recently, there is an increasing trend of attachment to physical appearance of individuals in many persons with spread of social concern through mass communication. Domestically, several studies has been performed, but they were limited to obesity mainly for juveniles or female college students. Therefore, purpose of this study were to standardize Body image dysmorphic disorder examination self report with male and female college students in Cheonnan area. Methods : This study were total 825 college students in Cheonan area. Subject group are consist of 393 males (47.6%) and 427 females (51.8%), and the mean age was $22.28{\pm}3.24$ years old. Results : The BDDE-SR had adequate internal consistency (Cronbach's alpha=.93) and test-retest (r=.82) and interator reliability. Four factors were extracted by factor analysis with the Varimax rotation. They were 'the camouflage and comparison factor', 'the self-consciousness and negative self-evaluation factor', 'the avoidance factor', and 'the distressing and embarassment factor'. The total score of BDDE-SR was $50.8{\pm}27.1$, female's score ($59.2{\pm}25.5$) was statistically higher than male's score ($41.85{\pm}25.84$). Conclusion : It is considered that BDDE-SR is reliable instrument for body image dissatisfaction, provided correct information in predicting clinical status of Body dysmorphic disorder that is most largely influenced by individual psychologic factor and family system.

일 도시 여자 고등학생에서 월경전기증후군 및 월경전불쾌장애와 우울, 수면의 질, 수면형태의 연관성

이지연,김석만,강석훈,정혜경,최진희,소형석,김태용,백기청,Lee, JiYeon,Kim, Seok Man,Kang, Suk-Hoon,Chung, HaeGyung,Choi, JinHee,So, HyungSeok,Kim, Tae Yong,Paik, Ki-Chung 대한불안의학회 2016 대한불안의학회지 Vol.12 No.2

Objective : Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) is known to reduce the quality of sleep and is associated with various psychiatric disorders. The aim of this study was to investigate the relationship of PMS with depression, sleep qulity and sleep pattern in Korean female adolescents. Methods : Out of 867 high school female students, 400 female subjects were included in this study. All participants completed self-report questionnaires that included demographic variables, shortened premenstrual assessment form (SPAF), patient health questionnaire-9 (PHQ-9), Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), insomnia severity index (ISI) and Korean translation of composite scale (CS). A total of 394 individuals who completed the questionnaires were analyzed. Results : As score of SPAF, 143 subjects was defined PMDD group. They had more prevalence of eveningness, more depressive symptom, poorer sleep quality, and more excessive sleepiness than non-PMDD groups. Although the PMDD groups showed more menstrual dysmenorrhea, no difference was found in bleeding duration and cycle. PMS symptom had correlations with depression, poorer sleep quality and excessive sleepiness during the daytime. There was no difference in sleep duration between two groups, but PMS might have a relationship with eveningness of chronotype. Conclusions : Among Korean female high school students, the PMS might have an association with depression and poor sleep quality, and it might lead to daytime impairment due to excessive sleepiness. An appropriate evaluation of PMS could be helpful in determining the mental health condition of adolescents.

성적 가해자에서 MMPI 특성

김현식,임명호,도진아,이재우,안진형,이태준,백기청,Kim, Hyun-Sic,Lim, Myung-Ho,Do, Jin-A,Lee, Jae-Woo,An, Jin-Hyung,Lee, Tae-Jun,Paik, Ki-Chung 대한불안의학회 2012 대한불안의학회지 Vol.8 No.1

Objectives : The current study investigated the personality characteristics of the sexual offender using the Minnesota Multiphasic Personality Inventory (MMPI) test commonly used in clinical medicine. Methods : 30 sexual offenders (30 male) completed the Korean version of the MMPI. 20 of the 30 sexual offenders were patients with paraphilia. The sexual offenders had been admitted to the Institute of Forensic Psychiatry Ministry of Justice, Gongju, for sexual violence. Results : The MMPI scores of the sexual offenders were significantly higher on the psychopathic deviate (Pd), masculinity-feminity (Mf), paranoia (Pa), psychasthenia (Pt), schizophrenia (Sc) than the comparison group. And The MMPI scores of the sexual offenders had higher values for hypochondriasis (Hs), depression (D), hysteria (Hy), hypomania (Ma), social introversion (Si) than the comparison group, but were not significantly higher. Conclusion : Sexual offenders may be antisocial, paranoid, schizoid or psychasthenic. They seem to have psychotic psychopathology rather than neurotic psychopathology. These results suggested that the psychopatholgy of sexual offenders may be different to the control group.

분노표현 양식과 스트레스 노출이 심박변이도에 미치는 영향

김현도,임명호,김현우,이석범,이경규,김현주,노상철,백기청,Kim, Hyun-Do,Lim, Myung-Ho,Kim, Hyun-Woo,Lee, Seok-Bum,Lee, Kyung-Kyu,Kim, Hyun-Joo,Rho, Sang-Cheol,Paik, Ki-Chung 대한불안의학회 2009 대한불안의학회지 Vol.5 No.1

Objective : Using patterns of change in heart rate variability (HRV), we investigated the effects of stress exposure and type of anger expression on cardiovascular diseases. Methods : Eighty-nine medical students were evaluated by STAXI-K, BDI, BAI, and measured HRV. According to the scores of anger expression questions in STAXI-K, objects are comparted to three groups. Each group is compared with others on the levels of depression, anxiety and HRV. Additionally objects are divided into two groups of functional anger expression group and dysfunctional anger expression group, and each group also divided into two groups, depending on the exposure of stressful situation or not. Members who took part in the stress exposure groups, they've got a serial arithmetic process for five minutes. We surveyed patterns of HRV in 4 each groups and estimated interactions between existence of stressful situation or type of anger expression and HRV. Results : Irrespective of stress manipulation, the dysfunctional anger expression group showed a marked increase in the LF/HF ratio in comparison to the functional anger expression group. Also, under conditions of stress manipulation, the stress exposure group exhibited a relatively increased level of TP. It can't be discriminated any correlations between stress manipulation and type of anger expression. Conclusion : Both of them, exposure to the stressful situation and type of anger expression, have influence on cardiovascular diseases. By controlling anger and way of express that, it is possible to diminish the incidence of cardiovascular diseases.