정신분열증에서 심리기능장애와 예후와의 관계에 관한 임상적 고찰

신석철 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

To investigate the effects of psychological Impairments on the prognosis in schizophrenia, 148 schizophrenic patients on Screening Schedule were applied 10 items of Psychological impairment Rating Schedule. The author devided the long-term prognosis of Diagnostic and Prognostic Schedule into the group of good prognosis (85 cases) and the group of poor prognosis (63 cases) and to find out the difference of symptom structure between two groups, tried factor analysis using SPSS/PC+ based on the scores of each subitems. The results of factor analysis were as follows: 1. In the group of good prognosis, 3 factors were extracted as disordered communication factor, attention withdrawal and loss of initiative factor, and psychic slowness factor. In the group of poor prognosis, 3 factors were extracted as disordered communication by expression factor, fatigue factor, and psychic slowness factor. 2. Generally, disordered communication was common in both groups but, in the group of poor prognosis attention withdrawal, loss of initiative, disordered self-expression were the additional symptoms and subjective fatigability was characteristic, and psychic slowness was common symptom in both groups.

두부손상 환자의 정신과적 합병증에 관한 장애 감정례의 일반 사항에 관한 분석

신석철,왕성근,신윤오,김덕호,김상국,강동숙 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

Authorst ried retrospective analysis to find out general characteristics of the patients undergoing disability evaluation at the department of psychiatry Chungnam National University Hospital from 1986 to 1990. The subjects, who were suffered from psychiatric complications due to head trauma by traffic accident, were 66 patients and they were classified depending on the demographic status, situations of traffic accident, evalaution periods, whether or not perform operation, and rates of evaluated disability and diagnosis. The results were summarized as follows. 1. General background of the subjects were as follows. 1) The frequency order of request were court(59 %) and insurance company(19.7%). 2) The place of accident was more common in large city, common accident vehicle were bus, truck, and cabs. 3) The season of accident were more common in Spring and Autumn. 2. Male(71.2%) was more common than in female and more common in the age group of 5-19 years old(37.9%). The most frequent job of the patients was labour, and the education level was more common in the graduates of elementary school(47.9% ). 3. The interval between accident and evaluation was most frequent in 12-23 months(47.5%), and duration of evaluation was mostly 14 to 21 days. Performed brain operation was 31.8% and non-operated patients was 50.0%. The rates of disability according to the McBride's disability evaluation were mostly belonged to the group of beow 40%(74.1%). 4. The final diagnosis after evaluation were organic personality disorder(45.5%) and dementia(31.8%).

정신분열병에 대한 Risperidone의 효과 및 안전성에 관하여

신석철,왕성근,지익성,이선우,이규광,이봉희,이진영,황선희,신용재,배경도,김정란 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

In order to evaluate the efficacy and safety of risperidone, 10 patients with chronic schizophrenia were examined for 8 weeks in a silgle-open study. After the wash-out period of 1 week, risperidone was administered. Efficacy was evaluated by means of Positive and Negative syndrome Scale for Schizophernia(PANSS) and Clinical Global Impression(CGI). Safety assessment included the Extrapyramidal Symptom Rating Scale(ESRS), vital signs, body weight, ECG, and laboratory tests. The results were as follows 1) On the PANSS total score, there was significant improvement of total score after 1 week (P<.05) of administratiom. 2) On the PANSS positive and negative subscal, there were significant improvement of posotive and negative scores after 2 weeks (P<.05) of administration. 3) On the PANSS general psychopatholgy subscals, there were significant improvement of general psychopathologyscores after 1 week (P<.05) of administratiom. 4) On the CGI, there was significant decreasement of clinical impression of severity of schizophrenia score after 2 week (P<.05) of administration. 5) A statistically significant increase in body weight (P<.05) was observed after 8 weeks of administration. 6) EPS reached the peak at the end of the 1st week of administration of risperidone (11.8± 24.25) but they were easily relieved by addition of benztropine and clonazepam. There was not significant change in laboratory tests, vital sign, ECG after 8 weeks of administration. These results suggest that Risperidone is an effective antipsychotics and clinically safe except for increased body weight in chronic schizophrenia.

뇌경색후에 발생한 이차성 조증

신석철,이충숙,지익성,이선우 충남대학교 의과대학 지역사회의학연구소 1996 충남의대잡지 Vol.23 No.2

Mania is a rare complication of stoke. The clinical features and response to treatment are usually the same as mania without brain injury. Post-stroke mania strongly associated with both a right hemisphere lesion in a limbic-connected area and a second predisposing factor, such as genetic loading for a affective disorder, pre-existing subcortical atrophy or seizure disorder. It may be mediated through frontal lobe dysfunction. We report a case of secondary mania in 65-year old man who showed multiple lacunar infarction left thalamus and right periventricular area.

DSM-Ⅲ-R에 의한 정신분열증의 예후 판정을 위한 요인에 관한 연구

신석철 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

To investigate the prognostic determinats in schizophrenia, the author aplied Psychological Impairment Rating Scale(PIRS) and Diagnostic and Prognostic Schedule to 140 schizophrenic patients on Screening Schedule diagnosed by DSM-III-R, and the patients were devided into 2 groups as the group of under 6 months of expected duration of hospitalization and the group of over 6 months of expected duration of hospitalization. Based on the scores of PIRS, tried t-test and factor analysis between 2 groups. The results were summarized as follows. 1. The mean scores of 10 items of PIRS were higher in the poor prognostic group. 6 items (attention withdrawal, psychic tempo, facial expression, body language, conversation skill, and selfexpression) were statistically significant between 2 groups. 2. The results of factor analysis were: (1) In the group of expected duration of hospitalization is under 6 months, 3 factors were extracted as active expression, body language and psychic tempo. (2) In the group of expected duration of hospitalization is over 6 months, 3 factors were extracted as communication, cooperation, and psychic tempo.

정신분열증의 갑상선기능

신석철,지익성 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

The purpose of this study is to investigate the thyroid function in Schizophrenia. The serum levels of T_3, T_4, TSH were measured in schizophrenias(n=93) and in normal controls(n=16). The results were as follows. 1. There was no significant difference in mean serum levels of T_3 and TSH between schizophrenia and normal control. 2. The mean serum level of T_4 in schizophrenia was significantly lower than that of normal control (P<0.05).

정신분열증과 기질성뇌증후군 환자에 있어서 소인식 기능검사와 Tachistoscope에 관한 연구

신석철 충남대학교 의과대학 지역사회의학연구소 1982 충남의대잡지 Vol.9 No.2

Author tested mini mental state and tachistoscope of normal, schizophrenic and organic brain syndrome patients who was selected by research criteria of Feighner etc. And data was analyzed with stastical method. Result was summarized as followings; 1. Tachistoscope was not difference between normal and schizophrenic patients, but mini mental state was more impaired in schizophrenic patients than in normal persons. 2. Items of calculation and recall of mini mental state was more impaired in schizo-phrenic patients than in normal persons. 3. Tachisoscope. and toatal score and each item score of mini mental state was more impaired in organic brain syndrome group than in schizophrenic patients. And there was correlation between mini mental state and tachstoscope in organic brain syndrome patients.

기질성 정신장애환자에서 불안과 우울

신석철,왕성근,강민희,신윤오 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

Atuhors applied the self-rating anxiety scale(SAS) and the self-rating depression scale(SDS) devised by Zung to 95 psychiatric outpatients with organic mental disorder in order to investigate about anxiety and depression manifest in organic mental disorder and tried factor ananlysis using both test scores. 1. In SAS, 4 factors were extracted as paresthesia & facial flushing, fear & dizziness, palpitation & urinary frequency, and nervousness & fatigability. 2. In SDS, 4 factors were extracted as depressed affect & suicidal rumination, dissatisfaction & indecisiveness, fatigability & sleep distrubance, and emptiness & hopelessness.

기억력장애 환자에 대한 PSDM(Morex^(�))의 임상효과

신석철,왕성근,신윤오 최신의학사 1991 最新醫學 Vol.34 No.7

Late-Onset Schizophrenia (Paraphrenia) 1례

신석철,이봉희,지익성 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

We experienced a case of late onset-schizophrenia in 83 year-old woman who was involuntary admitted by sons. She showed florid psychotic symptoms of persecutory delusion, auditory and visual hallucination, somatic passivity experiences, idea of reference, self-talking, anhedonia, poverty of speech, flattening & restricted affect, irritable tense and anxious mood, insomnia. aggression, poor of eye contact, poor of personal hygiene, social withdrawal, impairment of role functioning from 2 months ago. Other personality problems showed odd belief and magical thinking influence behavior, paranoid ideation, peculiar behavior. General condition was poor because she refused the food and lost the ability of caring herself. Past histroy reported previous psychotic episodes (1986, 1991) and family history reported the mental disorder of her brother. She was diagnosed as late-onset schiaophrenia, paranoid, episodic with interepisode residual symptoms (Paraphrenia) and schizotypal personality trait. During the hospitalization, she had been studied ; brain MRI was nonspecific, brain SPECT showed the hypoperfusion of frontal lobe. She was treated with high-potency antipsychotic (haloperidol) and a supportive psychotherapy. She improved and was discharged with clear sensorium without any psychotic symptoms but no insight.