정신과 여자 입원 환자의 체중 증가

서동향,박기창,신정호,Seo, Dong-Hyang,Park, Ki-Chang,Shin, Jong-Ho 한국정신신체의학회 1998 정신신체의학 Vol.6 No.2

Objectives : The purposes of present study were to identify weight increment in female psychiatric patients during hospitalization and to evaluate the relationship between weight gain and daily calorie intake, daily activity and other variables of disease itself. Methods : 20 patients were studied. Body weight were measured once a week, and daily activity(total amounts of walking/day) and total amount of daily calorie intake were measured twice a week. We examined psychiatric and medical illness history, eating disorders' history and family history of eating disorders and obesity. Results: Mean body weight and Body Mass Index(BMI) at admission are 49.40kg and 19.59kg/$m^2$. Mean weight increment during hospital stays of mean 65 days is 4.90kg. Mean amounts of daily calorie intake and daily activity(daily walks) were increased during hospital stays, but not statistically significant. The degree of weight increment is higher in longer hospital stay group, but not statistically significant. Mean body weight at admission of mood disorder group is higher than that of schizophrenia group, but not statistically significant. Conclusion : This results suggested that weight increment in female psychiatric hospitalized patients is present. However, it is not resulted by amount of calorie intake and daily activity level.

肝炎의 鑑別과 投藥 : 주증상은 지속적인 發熱 페니실린 과감히 투여

金在完,李祥鍾,徐東昶,徐仁享,金京玉,金瀉洙 藥業新聞社 1988 (月刊) 醫藥情報 Vol.1988 No.6

급성기 뇌졸중 환자 자살 사고

김세주,김영신,최낙경,서동향,이병철,이만홍 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.2

연구목적: 일반적으로 자살과 자살 사고의 가장 주된 위험 인자는 우울증, 불안장애와 같은 정신과적 질환의 동반 유무이다. 그러나 정신과적 질환 외에 신체적 질환의 동반 유무 또한 자살 및 자살 사고에 영향을 미치는 것으로 알려져 있다. 일반적인 신체 질환과 마찬가지로 뇌졸증 환자들에 있어 자살율이 증가한다는 몇몇의 보고들이 있다. 그러나 우리나라에서는 뇌졸중 환자의 자살 사고에 대한 연구가 보고된 바가 없다. 따라서 본 연구에서는 급성기 뇌졸중 환자들을 대상으로, 자살 사고의 발현율을 조사하고, 자살 사고 유무에 따른 사회문화적 변인 및 신경과적, 정신과적 임상 양상에 있어서의 차이에 대해 알아보고자 하였다. 방법: 1999년 7월부터 2000년 6월까지 한림대학교 성심병원 뇌졸중 센터에 입원한 77명의 급성기 뇌졸중 환자를 대상으로 하였다. Beck Suicidal Ideation Scale(BSIS)을 이용하여 자살 사고를 평가하였고, 우울 증상과 불안 증상은 각각 Beck Depression Inventory(BDI)와 Beck Anxiety Inventory(BAI)를 사용하였다. 사회적 지지체계의 정도는 사회적 지지체계 척도(Social Support Scale)를 사용하였으며, 뇌졸중 후 신경학적 장애의 정도는 National Institutes of Health Stroke Scale(NIHSS)와 Barthel's Index를 사용하였다. 결과: 약 35%의 뇌졸중 환자들이 심한 자살 사고를 보고하였다. 심한 자살 사고군에서 심하지 않은 자살 사고군에 비해 BDI, BAI 그리고 사회적 지지체계 척도 점수가 높은 반면, Barthel's index와 NIHSS는 두 군간에 유의한 차이를 보이지 않았다. 심한 자살 사고를 지닌 뇌졸중 환자의 대부분은 우울 증상이나 불안 증상을 가지고 있었으나, 일부의 환자들은 우울 증상이나 불안 증상 없이 자살 사고를 보고하였다. 결론: 급성기 뇌졸중 환자들의 많은 수가 정신과적 평가와 개입이 필요한 자살 사고를 가지고 있었다. 따라서 모든 급성기 뇌졸중 환자들을 대상으로 정기적으로 불안 및 우울 증상에 대한 평가와 더불어 직접 또는 간접적인 방법을 통한 자살 사고의 평가가 반드시 필요할 것으로 생각된다. Objective: The presence of psychiatric disorders including depression and anxiety disorders is considered to be the most important risk factor of suicide. Also, suicidal risk is known to be increased in patients who have serious medical illnesses. Like in patients with other medicalillness, some authors reported that suicidal risk is increased in patients with stroke. But there have been no reports with korean patients. The aim of this study is to investigate the frequency of suicidal ideation of patients in the acute stage of stroke, and to examine the demographic characteristics, and psychiatric and neurological symptoms between the patients with and without suicidal ideation. Method: Seventy seven hospitalized stroke patients at the Hallym Stroke Center from July of 1999 to June of 2000 were included in this study. Beck Suicidal Ideation Scale(BSIS) was used to evaluate suicidal ideation. Beck Depression Inventory(BDI) and Beck Anxiety Inventory(BAI) for depression and aniety, and Social Support Scale(SSS) for social support system of the stroke patients were used. Neurologic disabilities were rated with National Institutes of Health Stroke Scale(NIHSS) and Barthel's Index. Results: Thirty five percent(N=27) of the stroke patients reported severe suicidal ideation. Scores of BDI, BAI and SSS were higher in the patients with severe suicidal ideation than their counterpart. There were no differences in Barthel's index score and NIHSS between two groups. Most patients with severe suicidal ideation had depressive or anxiety symptoms. But patients without depressive or anxiety symptoms also reported severe suicidal ideation. Conclusions: Thirty five percent of stroke patients in acute stage of their illness have severe suicidal ideation that requires careful psychiatric evaluation and intervention. Inclusion of routine assessment of suicidal ideation in these patients is recommended.

초등학생에서 집단따돌림의 유병률과 이와 관련된 정신병리현상

김영신,고윤주,노주선,박민숙,손석한,서동향,김세주,최낙경,홍상의 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.5

연구목적 : 학교폭력의 가장 흔한 형태인 집단따돌림은 피해아동 및 가해아동 모두에서 다양한 행동, 정서 및 사회적 문제와 연관되어 있는 것으로 알려져 있다. 본 연구에서는 지역사회내의 초등학교 고학년 학생들을 대상으로 집단따돌림의 유병률과 집단따돌림과 관련되어 아동에게 나타나는 정신병리 현상에 대하여 조사하고자 한다. 방 법 : 안양지역의 두 초등학교에서 무선으로 선출된 두 학급의 4, 5, 6학년 학생들이 본 연구의 연구대상이었다. 학생들은 한국형 또래지명설문지(K-PNI)를 완성하였고, 교사 및 부모는 ADHD Rating Scale(ARS)과 Conners 척도를 완성하였으며 부모들은 추가로 아동행동조사표를 완성하였다. 통계방법으로는 기술적 통계, 다중회귀분석 및 다중로지스틱 회귀분석을 사용하였다. 결 과 : 총 532명의 학생들이 본 연구에 참여하였다. 집단딸돌림의 피해자, 가해자 및 피해자 겸 가해자의 유병률은 각각 48%, 45%, 30%로 나타났다. 심한 집단따돌림의 유병률은 2.1∼4.1% 사이였다. 집단따돌림의 피해아동와 피해자 겸 가해아동들은 교사와 부모에 의해 부주의하고 수동적이며 사회적으로 미성숙하고 공격성이 있는 것으로 평가되었으며 학년이 올라 갈수록 피해자가 되는 경향이 적은 것으로 나타났다. 가해 아동은 행동문제와 관련되어 있었으며 남아에게 많은 것으로 나타났다. 결 론 : 집단따돌림은 한국 초등학교 고학년 학생들 사이에서 매우 흔하게 일어나는 현상으로 보인다. 집단따돌림의 경험을 한 아동은 그렇지 않은 아동에 비해 더 많은 정신병리 현상을 보였다. 이러한 정신병리와 집단따돌림과의 인과관계를 밝히기 위해서는 집단따돌림을 경험한 아동에 대한 추적 조사가 필요할 것이다. Objective : School bullying, the most prevalent type of school violence, is Know related to various behavioral, emotional and social problems both in victims and per The purpose of the present study is to investigate the prevalence of school bullying psychopathology in a community sample of elementary school students. Method : Fourth to 6^th graders of two randomly selected classes in two elementary Anyang City participated in a cross-sectional study. Study subjects completed Nominating Inventory(K-PNI). Parents completed Korean-Child Behavior Checklist(KADHD Rating Scale(ARS) and Conners Scales for parents, and teachers completed Conners Scales for teachers. Descriptive statistics, multiple linear and logistic regress performed. Results : A Total of 532 students participated in this study. Prevalence of victims, and victim-perpetrators were 48%, 45%, and 30% respectively. Extreme victims and of school bullying ranged from 2.1∼4.1%. Inattention-passivity in teachers' Conn social immaturity or aggression in K-CBCL were positively associated with victims perpetrators, and grade was negatively related to school bullying. Conduct problem in Scale for teachers and emotional instability in K-CBCL, and male gender were positively with perpetrators. Conclusion : School bullying is very common in Korean children of elementary Those who had experienced school bullying, either as victims or as perpetrators, cantly more psychopathology than their counterparts. To clarify a causal relationship psychopathology and school bullying, a longitudinal follow-up study is suggested.

The Reliability and Validity of Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version (K-SADS-PL-K)

김영신,천근아,김붕년,장순아,유희정,김재원,조수철,서동향,배명옥,소유경,노주선,고윤주,Keith McBurnett,Bennett Leventhal 연세대학교의과대학 2004 Yonsei medical journal Vol.45 No.1

In order to develop a structured and objective diagnostic instrument, authors completed: (1) the translation and back translation of the Korean version of the Kiddie-Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (K-SADS-PL) and (2) the examination of its validity and reliability of the K-SADS-PL-Korean version (K-SADS- PL) when used with Korean children. A total of 91 study subjects were recruited from child and adolescent psychiatry outpatient clinics. Clinical diagnoses were used as a gold standard for the examination of validity of K-SADS-PL-K. Consensual validity of threshold and sub-threshold diagnoses were good to excellent for attention-deficit/hyperactivity disorder (ADHD), fair for tic and oppositional defiant disorders, and poor to fair for anxiety and depressive disorders. Inter-rater and test-retest reliabilities were fair to excellent for ADHD and tic disorder. The significant correlations between the K-SADS-PL-K and Korean Child Behavior Checklist (K-CBCL) were found, which provided additional support for the concurrent validity of the K-SADS-PL-K. Sensitivities varied according to the diagnostic categories, but specificities remained high over all diagnoses, suggesting that the K-SADS-PL-K is a desirable confirmatory diagnostic tool. The results of this study suggest that the K-SADS-PL-K is an effective instrument for diagnosing major child psychiatric disorders, including ADHD, behavioral disorders and tic disorders in Korean children. Future studies will examine the validity and reliability of the K-SADS-PL-K in larger samples, including adolescents and community samples on a variety of child and adolescent psychiatric disorders.