정신분열병 환자의 면역기능에 관한 연구

은헌정,김미정,김임 대한신경정신의학회 1991 신경정신의학 Vol.30 No.1

This study was done to study immune function in schizophrenia focusing on lymphocyte, its subpopulations, natural killer cell activity and null cell. The subjects were 30 schizophrenic patients (male 19, female 11) according to DSM-III-R criteria, diagnosed by two psychiatrists They were admitted to Department of Neuropsychiatry, Presbyterian Medical Center and Sinsaeng Mental Hospital from February 1,1990 to September 30, 1990. The normal control group was 30 healthy volunteers(male 15, female 15) selected randomly. The results were as follows : 1) There was no significant difference between normal control and schizophrenic group in the number and percentage of lymphocytes (p〉0.05). 2) There was no significant difference between normal control and schizophrenic group in the number and percentage of T lymphocytes (p〉0.05). 3) The number and percentage of B lymphocytes ( t = —2.67,p < 0 .0 0 l) were statistically significant difference between normal control and schizophrenic group. 4) There was statistically significant difference between normal control and schizophrenic group in the number and percentage of null cells(t=2.59, p〈0.001). 5) There was no significant difference between normal control and schizophrenic group in helper to suppressor T cell ra tio (p > 0.05). 6) There was statistically significant difference between normal control and schizophrenic group in natural killer cell activities(t= —2.88, p〈0.05). 7) Sex difference of the number of lymphocyte in schizophrenic group ( t = — 0.30, p>0.05) was not statistically significant and that in normal control group ( t = —2.04,p〉0.05) was also not significant. 8) Positive and negative symptoms were not related in any way to the percentages of lymphocyte subpopulations, null cell and natural killer cell activities. ( p > 0.05). 9) There were inverse correlation between T and B lymphocytes and between T lymphocytes and null cells in both schizophrenic(N=30) and normal control g ro u p(N ^ 30) (p〈0.001). In conclusion, there are significantly different in some kinds of immune cell of the schizophrenic patients such as elevation of null cell and reductions of NK cell activity and B lymphocyte. The reduction of natural-killer cell activities is considerable, so authors feel this could be a biological marker for schizophrenia. However, role of antipsychotic medication in producing these changes is not clear.

간질의 정신의학적 동반이환율

은헌정 대한간질학회 2004 대한간질학회지 Vol.8 No.1

간질 환자의 인구학적 특성, 임상 특성, 정신병리 및 대처방식과 심리사회적 적응과의 관계

은헌정,최관호,이선미,김태형,최말례 대한간질학회 2004 대한간질학회지 Vol.8 No.1

정신건강의학과 의사를 위한 뇌파의 기초

은헌정 대한신경정신의학회 2019 신경정신의학 Vol.58 No.2

In 1924, Hans Berger, a German psychiatrist, recorded the brain waves from a human brain for the first time. Many advances have been made in this field since then. Currently, brain waves are generated by a variety of computer technologies, including brain computer interface technology, and robot or artificial intelligence technology has also made amazing progress. A mental health practitioner who deals with brain-related medicine has an obligation and responsibility to research and find clinical applications of brain waves because they contain a great deal of information hidden in the brain. Therefore, understanding the basics of electroencephalography will contribute to a determination and resolution of various clinical situations. This review discusses basic knowledge before dealing with brain waves. In addition to a visual inspection of general brain waves, quantitative analysis of brain waves is expected to become an important area of interest for mental health practitioners.

일 도시 지역의 외상후 스트레스 장애 역학 조사

은헌정,이선미,김태형 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.4

연구목적 : 이 연구는 DSM-IV에 근거한 외상후 스트레스 장애(Posttrauamatic Stress disorder : 이하PTSD)의 평생 유병률 및 현재 유병률을 평가하고, PTSD와 관련된 외상 사건의 유형과 사회인구학적 특성을 조사하고 한다. 방 법 : 조사를 위해, 전체 인구가 611,921명인 한 도시가 선택되었고, 도시 내 15세에서 65세 이상인 850명을 표집하여, 가정 방문을 통해 외상사건 조사표와 임상가 실시용PTSD척도(CAPS)를 적용하여 실시하였다. 결 과 : 연구 지역내에서 PTSD의 평생 유병률은 4.71%, 현재 유병률은 2.12%이었다. 평생 및 현재 유병률에서 남녀간에 통계적으로 유의한 차이가 없었다. (p>.05). 또한 나이, 교육에 따른 평생 유병률도 통계적으로 유의한 차이가 없었다.(p<.001). 단지 결혼 상태에 따른 평생 유병률에서 통계적으로 유의한 차이가 있었다. 외상사건에 평생 동안 노출될 확률은 78.79%이었다. 갑작스럽고 예기치 않았던 친지의 죽음이 가장 흔히 발생하는 사건이었다(51.06%). 자연재해, 화재 및 폭발, 교통사고, 가정 및 직장에서의 심각한 사고, 신체적폭력, 무기로 공격함, 전쟁, 생명을 위협하는 질병, 누군가를 심하게 다치게 하거나 죽음에 이르도록 함과 같은 사건은 남성에서 여성들보다 더 자주 발생하였고, 여성들에게는 성폭행이 더 자주 발생하였다. PTSD발병과 상관이 높은 외상사건은 자연재해, 화재 및 폭발, 교통사고, 가정 및 직장에서의 심각한 사고, 신체적 폭력, 성폭행, 생명을 위협하는 질병 등 이었다. 결 론 : 조사 지역 내에서 PTSD의 유병율은 다른 대부분의 선행 연구들에 비해 낮았다. 본 연구에서는 성별에 따라 흔히 경험한 외상사건의 유형에 차이가 있으며, PTSD와 관련된 외상사건들도 차이가 있음을 발견했다. 앞으로 역학 연구에서 외상 사건들로부터 PTSD를 일으킬 확률을 알기 위해서는 회고적으로 보고한 제한된 소수의 외상사건들을 조사하기 보다는 평생 경험하는 모든 외상사건들을 평가해야 할 것이며, 전국전인 표집을 해야 할 필요가 있을 것으로 생각된다. Objectives : This study was designed to assess the epidemiology of DSM-IV posttraumatic stress disorder(PTSD), including information on lifetime and current prevalence, the kinds of traumas most often associated with PTSD, and sociodemographic correlates. Method : For this survey, an urban area with total population of 611,921 persons was chosen. Modified version of traumatic event checklist and Clinician Administered PTSD Scale were administrated to a representative sample of 850 persons aged 15 o 65 years above through home visiting. Results : The lifetime and current prevalence of PTSD in survey area was 4.71% and 2.12%. the lifetime and current prevalence in male and female were of no significant statistical differences(p>.05). And the lifetime prevalence by age, and education were of no significant statistical differences. Only the lifetime prevalence by marital status was of significant statistical differences(p<.001). The lifetime prevalence to any traumatic exposure was 78.79%. Sudden unexpected death of a close person was the most prevalent traumatic event(51.06%). Among the traumas, natural disaster, fire and explosion, motor vehicle accident, serious accident at work or home, physical assault, assault with a weapon, combat, life-threatening illness, and serious injury to death you caused to someone else were more commonly associated with male sex, and sexual assault was more commonly associated with female sex. The traumas commonly associated with PTSD were natural disaster, fire and explosion, motor vehicle accident, serious accident at work or home, physical assault, sexual assault, combat, and life-threatening illness. Conclusion : The lifetime and current prevalence in survey area were lower than those of previous studies. This study found differences between men and women on the type of trauma experienced, and the type of trauma associated with PTSD. Future epidemiological studies to assess PTSD from all lifetime traumas rather than from only a small number of retrospectively reported ones will be required, and larger sample size covering the country will be required for better estimation.

한국판 사건충격척도 수정판의 신뢰도 및 타당도 연구

은헌정,권태완,이선미,김태형,최말례,조수진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.3

Objectives : The present study was conducted to explore the reliability and validity of the "Impact of Event Scale-RevisedKorean version" (IES-R-K). Methods : The subjects were college students who visited a college counseling center and patients who were admitted to a general hospital and two orthopedic local clinics.Those subjects who experienced catastrophic traumatic events were tested for CAPS, BDI, STAI-I, II, and MMPI-PTSD scale. Results : The range of correlations between item-total were .45 -.89. The coefficients of internal consistency were .69 -.83, of them were the Split-half reliability was .71 and the test-retest reliability was .89, all within expected ranges. Inter-corre-lations of IES-R-K, CAPS, BDI, STAI-I, II, and MMPI-PTSD scale were high. CAPS showed the highest correlation Coef-ficient. Factor analysis indicated 4 factors in IES-R ; avoidance, hyperarousal, intrusion, and sleep problem & numbness. IES-R-K can be a useful self-rating diagnostic instrument for PTSD symptoms to be a clinical concern by using 24/25 cutoff in total score. The partial PTSD cutoff score is 17/18. Conclusion : The IES-R-K was confirmed in it's reliability and validity. IES-R-K could be applied for screening of PTSD.

한국판 워싱턴 심리사회적 간질 척도(K-WPSI)의 타당도 : 횡문화적 비교 연구 Cross-Cultural Comparisons

은헌정,김현기,이선미,최말례 대한간질학회 2003 대한간질학회지 Vol.7 No.1

전신성 경련발작, 경조증 및 과잉행동증을 보인 뇌실질 스파르가눔증 1례

은헌정,김동인,김임,이광민,최진옥,박경우 예수병원 1992 예수병원학술지 Vol.13 No.-

중년기 우울증 여성의 생활사건, 대처방식, 사회적 지지 및 가족관계

김동인,이진욱,김임,이선미,은헌정 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.4

국문초록본 연구는 중년기 우울증 여성의 생활사건 스트레스, 대처 방식, 사회적 지지, 가족 관계 등의 정신사회적 요인들을 알아보기 위한 것으로 각 변인들이 어떻게 우울과 관계가 있는지를 우울증 환자 집단과 정상인 집단으로 나누어서 비교 연구하였다. 이를 위해 35세 이상 64세 이하의 116명의 우울증 환자와 113명의 정상인을 대상으로 Beck 우울 질문지(BDI), 생활사건 질문지, 대처방식 척도, 대인관계 지지 평가척도(ISEL), 가정환경척도 등의 검사를 하였고 다음과 같은 결과를 얻었다. 1) 최고 스트레스는 환자 집단의 경우 결혼생활 스트레스(42명, 36.2%), 정상인 집단의 경우는 가정생활 스트레스(44명, 38.9%)였다. 2) 소극적 대처(t=0.93, p=.35)만을 제외하고 환자 집단과 정상인 집단에서 BDI 우울 점수(t=15.94, p<.0001), 생활사건 스트레스 점수(t=4.73, p<.0001), 적극적 대처점수(t=6.29, p<.0001), 사회적 지지점수(t=7.20, p<.0001), 가족 관계 점수(t=5.75, p<.0001)에서 유의한 차이를 보였다. 3) 우울증 환자 집단에서 BDI 우울 점수는 생활사건 스트레스(r=.24, p<.01) 변인과 유의한 정적 상관을 보였고, 적극적 대처(r= -.22, p<.01) 변인, 사회적 지지(r= -.35, p<.001) 변인, 가족관계(r= -.30, p<.001) 변인과는 유의한 역 상관을 보였다. 4) 우울증 환자 집단에서 BDI 우울에 대한 각 변인들의 중다회귀분석은 사회적 지지(12.3%, β= -.281, T= -3.162, P=.002, 생활사건 스트레스(5.1%, β=.279, T=3.195, P=.002), 적극적 대처(3.5%, β= -.204, T= -2.225, P=.028) 변인이 합하여 20.9%의 설명력을 나타냈다. 5) 중년기 여성에서 생활사건 스트레스는 가족 관계에서 겪는 스트레스가 가장 큰 스트레스였고, 대처방식은 우울과의 관계에서 일관성이 부족하였으며, 사회적 지지는 우울에 영향을 주는 가장 중요한 요인이었고, 가족관계는 양 집단에서 유의한 차이는 있었으나 우울에 대하여 의미있게 설명하지 못하고 있다. ABSTRACTLife Events, Coping Styles, Social Support, and Family Relationships of Middle-Aged Depressed Women Jin-Wook Lee, M.D., Yim Kim, M.D., Sun-Mi Yi, M.S., Dong-In Kim, M.D., Heon-Jeong Eun, M.D. Department of Neuropsychiatry, Presbyterian Medical Center, Chonju The objective of this study was to explore the psychosocial factors such as life events, coping styles and family relationships in middle-aged depressed women. This study was designed to compare how different variables relate to depression in two different test groups : a depressed patient group and a normal group. The Beck Depression Inventory(BDI), The Ways of Coping Checklist, Interpersonal Support Evaluation List(ISEL), Family Environment Scale were administered to 116 depressed patients and 113 normal persons between the ages of 35 and 64. The results were as follows : 1) The highest stress was marital stress(n=42, 36.2%) in patient group and family stress(n=44, 38.9%) in normal group, respectively. 2) There were significant differences between patient group and normal group in BDI scores(t=15.94, p<.0001), life events(t=4.73, p<.0001), active copinig(t=6.29, p<.0001), social support(t=7.20, p<.0001), and family relationships(t=5.75, p<.0001) except for passive coping(t=0.93, p=.35). 3) In depressed patient group, BDI scores had a significantly positive correlation with the scores of the life events(r=.24, p<.01) and negative correlation with active coping(r= -.22, p<.01), social support(r= -.35, p<.001) and family relationships(r= -.30, p<.001). 4) In depressed patient group, multiple regression analysis showed that social support(12.3%, β= -.281, T= -3.162, P=.002), life events(5.1%, β=.279. T=3.195, P=.002), and active coping(3.5%, β= -.204, T= -2.225, P=.028) had predictability on the BDI scores and the total predictability was 20.9%. 5) Stress experienced in family relationships were highest in life events and there was a lack of consistency(in the BDI scores of the coping styles). Social support was the most important factor and there were no significant differences between the two groups in family relationships.

외상후 스트레스 장애의 다면적 인성검사 특성

은헌정,이선미,장광철 大韓神經精神醫學會 1994 신경정신의학 Vol.33 No.2

본 연구는 외상후 스트레스 장애와 정상인을 의미있게 구별하여 주는 다면적 인성검사 반응 특성을 확인하고, 외상후 스트레스 장애군 내의 다면적 인성검사 프로화일 특성을 분류하고자 시도하였다. 연수 대상은 1991년 1월부터 1993년 3월까지 전주 예수병원에 입원 또는 외래로 내원한 외상후 스트레서 장애 환자 45명과 정상인 55명을 대상으로 하였다. 결과는 다음과 같다: 1) 외상후 스트레스 장애군이 L척도를 제외한 모든 척도에서 정상집단보다 의미있게 더 높은 점수를 보였다. 2) 판별 분석에서 두 집단을 잘 판별해주는 척도는 D, Mf, Pt,Si척도이고, 이 척도들은 외상후 스트레스 장애군을 88.9% 정확헤게 판별해 주었으며, 정상 대조군은 94.5% 정확하게 판별해주었다. 3) 외상후 스트레스 장애군의 다면적 인성검사 반응을 군집 분석한 결과 3개의 하위 집단이 추출되었다. a. 첫번째 집단은(54.3%) L, F, K척도의 프로화일이 역전된 'V' 형태이고 Hs, D, Hy, Pd , Pt, Sc척도의 점수가 60년에서 71점 사이의 점수를 보이고 있다. b. 두번째 집단은(36%) L, F, K척도의 점수가 47점에서 56점 사이의 범위를 보이고 있고, 모든 임상 척도가 42점에서 59점 사이의 점수를 보이고 있는 정상 프로화일이었다. c. 세번째 집단은 (11.1%) L, F, K척도가 56점에서 70점의 점수에 속하고, Mf척도를 제외한 모든 임상척도들이 60점에서 80점의 점수를 보이고 있다. 이러한 결과들은 다면적 인성검사가 외상후 스트레스 장애군을 구별하는데 신뢰할만한 판별력을 가진다는 것을 시사해 준다. This study was attempted to identify MMPI responses which significantly discriminate between the PTSD and the normal on the basis of MMPI scores. And it was designed to classify the types of MMPI profiles in the PTSD. Subjects were 55 healthy control and 45 PTSD who were inpatient or outpatient in Presbyterian Medical Center from January, 1991 to March, 1993. The results were as follows : 1) In MMPI subscales, except L scale, PTSD had significantly higher score than the normal group. 2) In discriminant analysis, it was D, Mf, Pt, ans Si that discriminate these two groups. Also, it classified 88.9% of PTSD group and 94.5% of normal group correctly. 3) Three subgroups were extracted from the PTSD by cluster analysis of MMPI. a. The first subgroups(54.3%) showed a profile which T score of L, F scale configured a reverted "V" pattern, and T scores of Hs, D, Hy, Pd, Pt, and Sc scale belonged to the range of 60 to 71 point. b. The second subgroup(36%) showed a normal profile which had L, F, and K scale with normal range of 47 to 56 T score and all clinical scales with 42 to 59 T score. c. The third subgroup(11.1%) showed a profile which had L, F, and K scale belonged to the range of 56 to 70 T score and all clinical scales belonged to the range of 60 to 80 T score except Mf scale. These findings suggest MMPI has a remarkable discriminant power in PTSD group.