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韓國成人男子 알코올중독환자의 Aldehyde Dehydrogenase-I 遺傳子 變異에 따른 性格特性의 差異 比較
백기청 大韓神經精神醫學會 1995 신경정신의학 Vol.34 No.1
Objects : Since it has been supposed that unpleasant flushing reaction in Orientals after alcohol ingestion is probably arised from the deficiency of ALDH-I(aldehyde dehydrogenase-Ⅰ), the enzyme working on the 2nd step of alcohol metabolism, the deficiency of this enzyme are inclined to be aversive to alcohol beverage and have few chance of being alcoholics, But in the previous study done by the author and his colleagues. a few alcoholics in Korea are proven to have atypical ALDH-Ⅰ genotypes ie, to be deficient of this enzyme. And in many of them. life event stressor played a role as precipitator of being alcoholics. Also they were more of late onset type and had more tissue damages induced by alcohol and physical dependence and deteriorating course than those who had normal ALDO-I genotype. In this study, by comparing personality trait among different ALDO-Ⅰ genotype, the author wants to elucidate the necessity of the different approach especially in psychological aspect in the prevention and treatment of alcoholism in terms of ALDO-Ⅰ genotype. Methods : We analysed the ALDO-Ⅰ genotype with 102 admitted Korean adult male primary alcoholics by DAM Ⅲ-R criteria and compared the personality trait between different ALDH-Ⅰ genotypes, For the evaluation of the personality trait, five established scales were used : EPQ, Locus of Control, 16PF, TPQ and Spielberger's Trait Anxiety Scale. Results : In ALDH-Ⅰ genotype assay among 102 alcoholic subjects, 85 one(83.3%) had the usual NN type, 17 one (16.67%) had atypical ND type and no one(0.00%) had DD type, so we compared the personality trait between NN and ND type. As a result, those who have ND type compared to NN type were proven to had more introverted, dependent and serious character trait. Conclusion : Those who had atypical ND type ALDH-Ⅰ gene had introverted, dependent, serious personal character and lack of self confidence. So instead of confronting external stressor, they passively use alcohol as a more easily defense arms. We could say that it's similar to the Schuckit's ‘milieu limited’ ‘type 1’ ; in a sense that onset is late, it's external stress related, has more passive and evasive character triat, high psychological dependence. In this context, dealing with those who have atypical ALDH-Ⅰ genotype, we should consider this psychological aspect in the prevention and treatment of alcoholism.
백기청 대한정신약물학회 2005 대한정신약물학회지 Vol.16 No.3
Up to now, it has been a prevailing concept that psychotherapy rather than pharmacotherpy is the main treatment modality for personality disorders. The use of medication to treat personality disorders has been derived from the recent confluence of anecdotal experience, a growing body of controlled studies and emerging evidence of the presence of psychobiological traits that may underlie personality disorders. Antipsychotics may be helpful for cluster A personality disorders, while antiserotonergic agents may be useful in improving mood and impulsivity for cluster B personality disorders. However data on the utility of antipsychotics and mood stabilizers are inconsistent. There have been very few studies done for cluster C personality disorders. The big problem lies in the fact that there is no consensus yet on the more fundamental areas of therapy such as classification of personality disorders, reliable measuring instruments, the relationship between axis I and axis II disorders, ruling out the effect of psychotherapy, and so on. This study reviewed the principal problems regarding the results of pharmacological treatment research of personality disorders in order to shed light on the future research directions in this area.