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만성 정신분열증 환자에서 Schneider의 일급증상의 예후적 가치에 대한 연구
이영호,김종원,유태익 大韓神經精神醫學會 1993 신경정신의학 Vol.32 No.4
In order to investigate the prognostic values of Schneiderian first-rank symptoms in chronic schizophrenis, the authors divided the subjects, 40 patients with schizophrenia, into two groups according to the presence or absence of Schneiderian first-rank symptoms. We compared the premorbid and morbid factors, which might be associated with long term outcome between two group, and also short term outcome of response to antipsychotics. The results were as follows ; 1) Among total 11 outcome predict factors, only three factors, social-personal adjustment(p<0.05), depression(p<0.05), and duration from onset to first admission(p<0.01), were different between two groups. 2) There was no significant difference in short term treatment responses between two groups. 3) Among four symptomatic prognostic factors, which are depression, guilt, emotional blunting and Schneiderian first-rank symptoms, Schneiderian first-rank symptom was related to BPRS score on admission only, but emotional blunting was related to BPRS score during all periods of assessment. These findings suggest that the prognostic value of Schneiderian first-rank symptoms is not so notable in both long term and short term outcome. Rather emotional blunting is significantly correlated with short term treatment response.
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한국어판 예일 틱 증상 평가척도 : 신뢰도 및 타당도 연구
정선주,이정섭,유태익,구영진,전성일,김봉석,홍강의 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5
목 적 : 틱 증상의 심한 정도를 평가하기 위한 도구인 예일 틱 증상 평가척도(Yale Global Tic Severity Scale)를 한국판 가정 평가용 설문지 및 임상 평가용 척도로 개발하기 위하여 본 연구를 시행하였다. 방 법 : 예일 틱 증상 평가척도는 뚜렛 장애 및 기타 틱 장애에서 나타나는 운동틱과 음성틱 각각의 증상의 수, 빈도, 심한 정도, 복합성, 방해 정도 및 장해도를 포괄적으로 평가하도록 고안되어져 있다. 틱 증상을 주소로 정신과외래를 방문한 만 4.3세에서 19세까지의 100명의 환아 및 부모들을 대상으로 한국어로 번역한 예일 틱 증상 평가척도의 가정평가용 설문지를 평가전에 완료하도록 한 후, 면담을 통한 임상평가용 척도를 실시하였으며 수렴타당도 및 변별타당도의 검증을 위해 총괄적인 임상 인상척도-뚜렛 증후군, 강박장애, 주의력결립/과잉운동장애(Clinical Global Impression-TS, OCD, ADHD)를 시행하였다. 결 과 : 자료분석결과 내적일치도, 수렴타당도, 변별타당도 및 검사자간 신뢰도 모두 매우 높게 나타났으며 요인분석상 전 항목척도와 장해도는 운동틱과 음성틱에 해당하는 2개의 요인으로 묶여졌다. 결 론 : 본 연구결과 한국판 예일 틱 증상 평가척도의 높은 타당도 및 신뢰도가 입증되었으며 이는 향후 틱 증상의 객관적인 평가 및 정량화를 위해 유용하게 사용되어질 수 있을 것이다. Objectives : This study was carried out to develop the Korean form of Yale Global Tic Severity Scale(YGTSS)-family & clinical rating version. The severity of motor and phonic tics was rated according to five separate dimensions : number, frequency, intensity, complexity, and interference. Methods : The Korean form of YGTSS was applied to 100 children who visited psychiatric outpatient clinic with chief complaints of tic symptom. Together with YGTSS, Clinical Global Impression for Tourette's syndrome(CGI-TS), Obsessive-Compulsive disorder(CGI-OCD), Attention-Deficit/Hyperactivity Disorder(CGI-ADHD) were administered to all subjects for examining convergent and discriminant validities. Results : We could confirm high internal consistency, convergent and discriminant validities and interrater reliability of YGTSS by analysing data from 100 children with tic disorder. In factor analysis, items were clustered to 2 factors which were identical to motor and phonic tic subscales. Conclusion : The results of this study indicate the Korean form of YGSS is a reliable and valid rating scale for rating tic symptom severity. It can be used to evaluate tic symptom objectively and to quantify the tic severity in the studies for tic disorder.
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양측 하지마비증상을 동반한 말초신경병증을 보인 알코올의존 환자 치료 1례
김성엽(Sung-Yeop Kim),이요왕(Yo-Wang Lee),유태익(Tae-Ik Yoo),정운섭(Woon-Seop Chung) 한국중독정신의학회 2005 중독정신의학 Vol.9 No.1
Problems related to chronic alcohol use common in neuropsychiatric fields, but the concerns about alcoholic neuropathy is much lower to clinicians than other alcohol related problems. We experienced a 54 year-old male alcohol dependent patient who complained of the weakness in both lower legs. He suddenly could not stand or walk showing the flaccid tetraparesis and areflexia on hospital day 7. We should differentiate alcoholic neuropathy from Guillain-Barre syndrome clinically. He showed abnormal electromyographic finding with predominantly no sensory potential and no sensory nerve conduction velocity in lower legs. We successfully treated alcoholic neuropathic pain with amitryptiline without any side effect. According to this case, Psychiatrists should pay more attention to alcoholic neuropathy in alcohol related patients via detailed physical examination, and treat them more aggressively without any fear.
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