제 2 회 선원자녀작품 당선작 발표 : 동시 금상 ; 꿈속의 바다

윤해주 한국해사문제연구소 1977 (月刊)海洋韓國 Vol.50 No.-

이상의 『12월 12일』에 나타난 운명에 대한 인식

윤해주 서울대학교 국어국문학과 2015 冠嶽語文硏究 Vol.40 No.-

알코올 중독 환자들의 성격 특성에 관한 탐색

윤해주(Hai-Joo Yoon),이민규(Min-Kyu Rhee),이태경(Tae-Kyung Lee),이종일(Jong-Il Lee) 한국중독정신의학회 2004 중독정신의학 Vol.8 No.2

The purpose of this study was to explore the influences of personality trait and behavioral aspects in alcoholics. A shorter version of Tridementional Personality Questionnaire, Aggression Questionnaire, Beck Depression Inventory-Korean version were administered to 156 male alcoholics. In doing so, this participants were distinguished by a difference of means from normal norms. In increasing age, sensation seeking tendency or behavioral undercontrol was on the decrease, and direct aggression showed a tendency to decrease, but overall aggressive level didn’t show significant relation with age. Using the K-means Cluster Analysis, four subgroups were extracted;that is, a depressiondirect aggression-verbal aggression-anger-hostility profile (n= 30), a depression-hostility profile (n=44), a verbal aggressionanger-hostility profile (n=44), a normal profile (n=41). At the conclusion, implication and limitations of this study were discussed.

조현병 환자에서 비전형항정신병약물 사용시 대사지표에 미치는 영향 조사 : 3년 추적연구

배하현,윤해주,박은경,이종일 대한조현병학회 2017 대한조현병학회지 Vol.20 No.1

Objectives : Pharmacological treatment is critical on relapse prevention in patients with schizophrenia. However, atypical antipsychotic agents are known to cause weight gain more than typical agents despite their various effects. In addition, they are known to affect blood sugar, blood pressure, cholesterol, cardiac function, and sexual function. This study was designed to examine the effects on metabolic parameters when schizophrenic patients have been taken atypical antipsychotic agents. Methods : This was a trial in 137 patients with DSM-IV-TR schizophrenia who were admitted or treated in mental hospital. Anthropometric measurement and blood testing were conducted at baseline, 12 month, 36 month, and sociodemographic and treatment history were collected from medical records. We conducted height, weight, waist circumference, blood pressure, FBS, total cholesterol, HDL, triglyceride, and QTc interval. Metabolic syndrome was diagnosed by ATPIIIa criteria. Results : Aripiprazole showed the significant difference in the impact on weight, blood pressure, waist circumference, total cholesterol, HDL, triglyceride than paliperidone and olanzapine at 1-year and 3-year period. Olanzapine showed the significant increase of weight and triglyceride than paliperidone at 3-year period. The prevalence of metabolic syndrome increased in paliperidone at 1-year and in olanzapine at 3-year period compared to aripiprazole significantly. Conclusion : We concluded that aripiprazole has less impact on the abdominal obesity, FBS, blood pressure, and cholesterol than paliperidone and olanzapine. Olanzapine showed the increase of long-term metabolic risk than other agents. There was needed the routine screening and multidisciplinary management of medical problems in schizophrenic patients for the prevention of metabolic syndrome.

조현병 환자에서 항정신약물이 대사지표에 미치는 영향 조사 - 1년 추적연구

정선화,임선진,윤해주,박은경,이종일 대한조현병학회 2015 대한조현병학회지 Vol.18 No.2

Objectives : Schizophrenia patients are known to be more prone to metabolic disease than normal people. This study aimed to identifythe changes in metabolic parameters of schizophrenia patients using atypical antipsychotic drugs for 1 year. Methods : A total of 200 schizophrenia patients were recruited and categorized into the aripiprazole-treatment group and controlgroup taking 5 atypical antipsychotic drugs. Comparative analysis were between groups. The prescriptions of psychotropic drugswere collected by a review of medical records. Blood was collected after fasting for 12 hours at the starting point of treatment andthe 12th month, and patient medical records were evaluated for basici nformation and treatment history. Physical measurement,the prevalence of metabolic syndrome and metabolic parameters were studied using ATP-III diagnostic criteria. Results : From the study, the aripiprazole-treatment group had a mean weight increase of 0.6 kg and the control group had amean weight increase of 6.5 kg at the 1 year follow-up, showing a significant difference between the two groups. There were alsosignificant differences between the two groups in waist size, systolic and diastolic blood pressure, fasting blood sugar, total cholesterol,triglyceride, HDL-choleseterol and prolactin level. Along with meaningful improvement of the symptoms, aripiprazoletreatmentgroup showed less effect on in abdominal obesity, diabetes, blood pressure, cholesterol and prolactin than other atypicalantipsychotic drugs. Conclusion : Therapeutic intervention such as diagnosis, treatment, weight management and diet improvement is necessary forschizophrenia patients. Psychiatric symptoms as well as internal meicine-related problems such as metabolic disease need to beaddressed in case management.

조현병 환자에서 항정신병약물 유지치료 시 치료결과에 대한 연구

배하현,나의현,윤해주,박은경,이종일 대한조현병학회 2017 대한조현병학회지 Vol.20 No.2

Objectives : Relapse prevention is a major therapeutic goal in the treatment of schizophrenia. However, many patients experience multiple functional impairments and treatment resistance due to recurrence. This study was designed to investigate the follow-up of patients with using antipsychotic drugs and to compare the total treatment failure rate, withdrawal reasons, and duration period of antipsychotic drugs. Methods :IThe subjects were 1963 patients who taking antipsychotic drugs under the diagnosis of schizophrenia. We selected 1836 patients using 10 antipsychotic drugs according to frequency of using. The rate of total treatment failure of them was divided into 6-month, 1-year, 2-year, 3-year, and 5-year according to the time of drug withdrawal. We compared the total treatment failure rate at 1 and 3-year between 10 antipsychotic drugs. Results : The total treatment failure rate of clozapine was lowest compared with the other 9 antipsychotic drugs in all the surveyed periods. When evaluating actual number of subjects, olanzapine, sulpiride, risperidone, aripiprazole, amisulpride, and haloperidol were lower significantly compared with ziprasidone at 1-year in the total treatment failure rate, but there was no significant difference between them except clozapine at 3-year. The results of the analysis based on the number of prescriptions showed that the total treatment failure rate of the atypical antipsychotic drug was lower than that of the typical antipsychotic drug at 1-year, but the difference was decreased over time except quetiapine and ziprasidone. Conclusion : In conclusion, although there is some controversy about which drug to prescribe to the patient, the clinician needs a proper prescription considering various factors such as efficacy, side effects, price, and formulations of each drug.

조현병 환자에서 항정신병약물 병용요법 분석 : 임상적관련인자 및 처방현황 조사

최진영,강시현,이종일,하유정,윤해주,박은경,박동연 대한신경정신의학회 2014 신경정신의학 Vol.53 No.6

Objectives Despite increasing use of antipsychotic polypharmacy (APP), few studies have investigatedAPP for Korean patients with schizophrenia. The aim of this study was to identify thesociodemographic and clinical correlates and recent prescription profiles of APP in schizophreniapatients. Methods A total of 297 schizophrenia patients were recruited and interviewed using standardizedassessment instruments in Seoul National Hospital. Differences in demographic and clinicalcharacteristics between APP and antipsychotic monopharmacy (APM) groups were analyzed. The prescriptions of psychotropic drugs were collected by a review of medical records. ResultsIn comparison with the APM group, the APP group showed association with earlieronset, lower employment rate, and higher scores for Clinical Global Impression-Severity andBrief Psychiatric Rating Scale (BPRS) (p<0.001). In particular, the BPRS positive (p<0.001) andaffective symptom scores (p<0.001) of the APP group were higher those of the APM group. Themost frequent combination pattern of APP was second generation antipsychotics (SGA)+SGA,followed by SGA+first generation antipsychotics (FGA), and SGA+SGA+FGA. For antipsychotics,it was risperidone+quetiapine, followed by clozapine+risperidone, risperidone+sulpiride, andrisperidone+haloperidol. Conclusion The current study suggests that the usage of APP for schizophrenia could be relatedto symptom severity affected by positive and affective symptoms. The prescription profilereflects that the proportion of atypical antipsychotics on APP has increased. 2000년대 이후로 조현병 환자에게 더욱 다양한 약물 치료가 적용되고 있음에도 불구하고, 항정신병약물 병용요법과관련된 정신병리, 사회적 기능, 부작용 등 임상적인 모든 영역을 다루는 총체적인 연구 결과가 없는 상황이고, 현재의항정신병약물 병합요법의 처방 조합 및 경향에 대한 구체적자료가 필요한 시점이다. 본 연구는 국내 조현병 환자를 대상으로 병용요법군과 단독요법군의 사회 인구학적 자료와 CGI, BPRS, AIMS, SAS척도 점수를 비교 분석하였고, 최근 병합요법의 구체적인 처방 현황을 알아보았다. 연구결과, 항정신병약물 병합요법군은 단독요법군에 비해 BPRS 총점이 높았으며, 항목별 비교에서는 양성 증상, 정동 증상 세부 항목에서 점수가 유의하게높았다. 병합요법군은 단독요법군에 비해서 발병나이가 유의하게 어리고, CGI 점수가 유의하게 높았다. 또한 학력에차이가 없음에도 병용요법군에서 직업을 가진 비율이 유의하게 낮았다. 단독요법군에 비해서 병용요법군에서 항콜린성약제와 벤조다이아제핀계의 높은 처방률을 보여주었지만,MSQ로 측정한 약물만족도와 AIMS와 SAS로 평가한 약물부작용 비교 결과 두 군 간의 유의한 차이가 없었다. 가장 흔히 처방되는 항정신병약물 병합요법의 패턴은 두 가지 비정형 항정신병약물의 병합요법이었으며, 구체적 약물조합은risperidone-quetiapine으로 나타났다. 본 연구를 통해, 조현병 환자들은 정신증적 증상, 특히 양성 증상과 정동 증상이 심할수록 항정신병약물을 병용 처방받는 것으로 해석된다. 병용요법시 추체외로부작용이 증가되는 것으로 추정되나 부작용 조절약물을 통해 실제 부작용은 완화될 수 있으며, 환자들의 주관적 만족도도 단독요법을받는 환자들과 차이가 없음을 알 수 있었다. 또한, 항정신병약물 병용요법에서 비정형 항정신병약물의 비율이 증가하고 있음을 관찰할 수 있었다.

성인 인터넷 중독자의 기질 특성

임선진,김진훈,장동원,정은기,윤해주,김의정 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.6

Objectives : Since mid-90s there have been numerous studies to understand and establish the concept of internet addiction as one of diagnostic classifications in psychiatry. Among them, many studies on the personality characteristics of internet addiction have been conducted. Recently, interests are expanding to temperament characteristics of internet addictors but the subjects have been limited to adolescents, In this study, the temperament characteristics of internet addiction in adults were investigated using Tridimensional Personality Questionnaire (TPQ). Methods : 430 participants (189 males, 241 females) answered the on-line and off-line questionnaires from January to December in 2005. Participants completed questionnaires on demography and the onset of internet use, Young's Internet Addiction Scale and Korean Contracted Version of Cloninger's Tridimensional Personality Questionnaire (TPQ). Rcsults : There were statistically significant differences in age, marital status, occupation, psychiatric history, smoking history, alcohol history and onset age of internet use among non-addiction, overuse and addiction groups by Young's scale. Of the TPQ items harm avoidance (HA) scores were significantly higher in addiction and overuse groups than non-addiction group. Reward dependence (RD) scores were significantly lower in addiction group than non-addiction group. Novelty seeking (NS) scores were significantly higher in addiction group than non-addiction group. Conclusion : This study suggests a significant difference of novelty seeking in temperament characteristics between adults and adolescents with internet addiction. Further studies are expected for profound understanding of internet addiction.

전자의무기록 보급 및 활용에 대한 정신건강의학과 전문의의 인식

조근호(Keun-Ho Joe),윤해주(Haijoo Yoon),이수정(Soojung Lee),박종익(Jong-Ik Park) 대한사회정신의학회 2019 사회정신의학 Vol.24 No.1

목 적 : 전자의무기록의 보급이 확대되고 있으나, 정신건강의학과는 다른 전문과목과 활용도에 차이가 있을 것으로 추정된다. 이에 정신 건강의학과 전문의들을 대상으로 전자의무기록의 경험 정도를 확인해보고자 하였으며, 현행 전자의무기록의 의미 및 향후 확대 보급하기 위한 조건에 대한 의견을 조사해 보고자 하였다. 방 법 : 수련병원, 정신병원 및 정신건강의학과 의원 등으로 의료기관의 유형을 분류한 후, 유형별로 각각 150기관을 무작위로 선별하였다. 이후 각 기관 마다 1명씩의 정신건강의학과 전문의를 무작위로 추출하여 총 450명에게 이메일 설문을 배포하였다. 설문 수거 또한 온라인으로 진행하였다. 전자의무기록의 사용 경험에 대해서 교차분석을 시행하였으며, 사용경험 여부 및 소속 의료기관에 따라 전자의무기록의 의미 및 향후 확대 조건에 대한 의견에 차이가 있는 지 여부를 분석하였다. 결 과 : 설문에 응답한 112명의 정신건강의학과 전문의 중 87.5%에서 처방전달시스템을 사용한 경험이 있다고 하였으며, 84.8%에서 전산 화된 경과기록을 사용한 경험이 있다고 하였다. 전자의무기록의 도입은 병원의 경영효율화 및 의료진간의 의사소통에 도움이 되는 측면이 있다는 응답에 동의한 전문의들이 많았으며, 상대적으로 의료질 향상이나 의사결정에 도움이 된다는 응답은 적었다. 전자의 무기록의 확대를 위해서는 수가를 통한 보상이 필요하다는 응답이 많았으며, 상담 내용의 비밀 보장을 위한 별도의 메뉴가 필요하 다는 응답이 많았다. 그에 비해 표준화된 전자의무기록의 보급이나 지역사회와의 정보교류 네트워크 확보 등에 동의한 비율은 상대 적으로 낮았다. 결 론 : 우리나라에서도 전자의무기록의 도입은 급속히 이루어지고 있지만, 병원의 경영 효율성 증대 및 병원 내 직원 들 간의 의사소통 수준에 머물러 있으며, 의료질 향상이나 업무 표준화 및 지역사회 기관들과의 연계체계, 진료 시 의사결정지원 등의 차원까지 발전 되지는 못하였다. 향후 전자의무기록의 변화에 대해 정신건강의학과 전문의들의 관심이 더 필요한 시점이다. Objectives : Even though the adoption of electronic medical record in hospital increases nowadays but certain hurdles might exist in the department of psychiatry. Therefore, we performed this study to evaluate the experiences of electronic medical record in psychiatrists and invested that the opinions of psychiatrists on the current applying electronic medical record and the necessary conditions to disseminate it more in the future. Methods : Hospitals were divided into three groups as training hospital, mental hospital, and private clinics and randomly selected 150 hospitals/clinics of each group. Request for participation on this survey was sent via e-mail to the 1 psychiatrist of each hospital/clinics who extracted randomly also. The answers were collected by on-line. The cross analysis or nonparametric comparison were done to identify the statistical significances of the responses by the experiences of elec-tronic medical record or by the affiliated hospitals types of the subjects. Results : 87.5% of 112 responded psychiatrists reported their experiences on the order communication system and 84.8% reported their experiences on the electronic progress note. The responded psychiatrists strongly agreed that the adoption of electronic medical record will be helpful for hospital management but weakly agreed that the positive effects on the clinical quality improvement and decision making. They said that the additional reimbursement should be provided to disseminate more in clinical situation and building up special menu to ensure the patients’ privacy. However, the psychiatrists showed slight agreement on the necessary of standard electronic medical record and organizing systemic network between community and hospital through electronic medical record. Conclusion : Despite the rapid spread of electronic medical record in Korea, the psychiatrists' recognition on electronic medical record remains within the boundary of individual hospital. They regarded that the electronic medical record has benefits on hospital management rather than on the communication between the all involved facilities, clinical performance indicator, or assistant for clinical decision. More attentions of psychiatrists should be needed on the evolution of electronic medical record.

노화기대가 성인의 건강증진행위에 미치는 영향

배혜영,김아란별,남수진,윤지아,윤해주,김가영,장다혜,김수현,Bae, Hyeyoung,Kim, Aranbyeol,Nam, Soojin,Youn, Jia,Youn, Haeju,Kim, Gayoung,Jang, Daehyae,Kim, Su Hyun 한국데이터정보과학회 2014 한국데이터정보과학회지 Vol.25 No.1

본 연구의 목적은 우리나라 성인층을 대상으로 연령대별 노화에 대한 기대수준과 건강증진행위 정도를 파악하고, 노화기대가 개인의 건강증진행위에 미치는 영향에 대해 확인하기 위함이다. 연구대상자는 대구 경북지역의 지역사회에 거주하는 만 20~50대 성인 233명으로, 직접 접촉을 통한 설문 조사로 자료를 수집하였으며, 위계적 회귀분석을 이용하여 자료 분석하였다. 연구결과, 대상자의 노화기대 점수는 연령대가 높을수록 낮게 나타나, 노화에 대해 부정적인 생각을 가지고 있는 것으로 나타났다. 대상자의 노화기대 점수는 신체건강 영역에서 가장 낮았고 정신건강 영역에서 가장 높았다. 각 연령대별로 건강증진행위는 유의한 차이가 없었다. 20~30대 대상자에서는 노화기대가 건강증진행위에 유의한 영향을 미치는 것으로 나타났으나, 40~50대 집단에서는 유의한 영향이 없었다. 따라서 노화를 긍정적이며 능동적이고, 자연스러운 자기선택적인 변화로 바라볼 수 있도록 인식의 전환을 유도 할 필요가 있겠으며, 특히 20~30대의 건강증진행위를 증진하기 위한 전략으로서 긍정적인 노화기대를 가지도록 지지할 필요가 있겠다. The purpose of the current study was to identify expectations regarding aging and health-promoting behaviors and to examine whether expectation regarding aging was associated with health-promoting behaviors among community-residing Korean adults. Data were collected from 233 adults dwelling in the community of Daegu and Kyungpook province. The influence of expectations regarding on health-promoting behaviors was analyzed through hierarchical multiple regression controlling for sociodemographic variables. As a result, the mean score of expectations regarding aging was significantly lower in 40s and 50s than 20s and 30s. The participants had the lowest expectations regarding aging in terms of physical health domain and the highest expectations in terms of mental health domain. No significant differences were found in health-promoting behaviors among different age groups. After controlling for sociodemographic variables, expectations regarding aging were independently associated with health-promoting behaviors in adults in 20s~30s but not in those in 40s~50s. The findings suggest the need for encouraging Korean adults to strive for having positive and active perspective on aging and for getting higher expectations regarding aging, in particular, for 20s and 30s, as a health-promoting strategy.