한국어판 매일 스트레스 평가서 개발을 위한 예비연구

조숙행,이현수,곽동일,남민,Joe, Sook-Haeng,Lee, Hyeon-Soo,Kwak, Dong-Il,Nam, Min 한국정신신체의학회 1997 정신신체의학 Vol.5 No.1

As a preliminary step to develop the Daily stress Inventory(DSI) for assessing minor stressors frequently experienced in everyday lift. We examined the reliability and validity of the DSI. The Daily Stress Inventory(DSI), the Beck Depression Inventory(BDI), the State-Trait Anxiety Inventory(STAI), the Social Readjustment Rating Scale(SRRS) and the Minnesota Multiphasic Personality Inventory(MMPI) were administered to 111 college students. Compared with the weekly DSI Event, Impact and I/E ratio scores of the American college students, the weekly event and I/E ratio scores of the Korean college students were significantly higher but weekly Impact score was lower. The internal consistency reliability of the DSI as computed by Cronbach alpha was .98. The DSI I/E ratio scores were significantly correlated with the scores of State Anxiety$({\gamma}=.27)$ and Trait Anxiety${\gamma}=.24)$, but not with BDI scores. And the SSRS scores were not significantly correlated to the DSI Event or Impact and In ratio scores. Significant correlations were revealed between the DSI Impact scores and the Sc and Ma scales of the MMPI. And the correlation between the DSI I/E ratio scores and the L, D, Hy, Pd and Pa scales of the MMPI was also significant. But no significant correlation was found between the DSI Event scores and all the scales of the MMPI. This study suggests that the DSI can be a reliable and valid tool to assess the minor stress frequently experienced in everyday life future study should be directed to obtain normative data based on more varied and larger population. Especially gathering additional evidences for the validity of the DSI using other minor stressor scale will be required.

후기황체기 불쾌기분장애(LLPDD) 환자의 광선치료 1례

조숙행,Joe, Sook-Haeng 대한수면의학회 1994 수면·정신생리 Vol.1 No.2

The author reports a 32 years old female patient with late luteal phase dysphoric disorder who received evening bright light treatment for 7 consecutive days during the late luteal phase of menstrual cycle. After the treatment, beneficial clinical effects were observed. This result suggests that bright light can be an alternative treatment for LLPDD. However, the placebo effects should be ruled out completely. Further controlled studies with more patients will be needed.

내분비질환에 영향을 미치는 심리적 요인

조숙행,Joe, Sook-Haeng 한국정신신체의학회 1998 정신신체의학 Vol.6 No.2

Although there has been a considerable research in psychoneuroendocrinology, particularly in relation to the biology of mood disorders, there has been a paucity of research regarding the effects of psychological factors on endocrine diseases. Of the existing literature, the most research is focused on diabetes mellitus, graves' disease. Especially diabetes appears to be the only endocrine disease that has been the focus of recent research studies. Most of the studies had retrospective designs or several methodological flaw. There has been no consistent results demonstrating that psychological factors affect the onset of diabetes mellitus. Several studies have suggested that psychological factors affect the course of diabetes. A small number of studies showed some evidence that psychological stress was associated with changes in glucose regulation in a subset of diabetic patients. There was also evidence to suggest that some temperament and coping skill influence glycemic control in child, adolescent diabetics. Studies of behavioral or psychosocial intervention on diabetic control have been small and have produced mixed results. There was a few controlled study suggested that stressful life events might be a causal role in Cushing's disease and Graves'disease, but there is no presently sufficient evidence to suggest that psychological factors affect the onset and the course of Cushing's disease and Graves' disease. In future, there is need for a well-designed biopsychosocial research with prospective designs, well defined patient population and control groups to study the relationship between psychological factors and endocrine diseases.

월경전 불쾌기분장애 환자의 광치료 임상 시도

조숙행,김진세,김승현,김린,Joe, Sook-Haeng,Kim, Jin-Se,Kim, Seung-Hyun,Kim, Leen 대한수면의학회 1999 수면·정신생리 Vol.6 No.1

목 적 : 광치료는 계절성 기분장애, 약간의 비계절성 주요 우울장애 및 월경전우울증 등의 치료에 이용되고 있다. 저자들은 일중주기리듬의 장애가 병인론으로 제시되고 있는 월경전 불쾌기분 장애에 대한 광치료 효과를 평가하기 위하여 광치료의 임상시도를 하였다. 방 법 : DSM-IV의 월경전 불쾌기분장애 진단기준에 충족되는 4명의 환자에서 광박스(light box,Apolo bright lite III)를 이용한 저녁 광치료(6:30-8:00pm) 시도하였다. 결 과 : 연구대상은 광치료 후, 그 정도에는 차이가 있으나, 월경전기 증상과 더불어 우울기분과 불안이 감소하는 변화를 보였다. 본 연구는 임상시도로 연구대상이 적고, 위약 효과의 통제가 없으며, 증상 평가 방법에 있어 어려움 등 한계가 있으나, 이러한 변화는 특히 비정형 우울증상이 있는 환자에서 두드러졌으며, 신체증상보다는 심리증상에 보다 효과적인 결과를 보였다. 결 론 : 광치료는 월경전불쾌기분 장애 환자의 약물학적 치료에 대안적 방법으로 볼 수 있겠다. 향후 보다 많은 수의 환자를 대상으로, 위약대조 교차연구(아침, 저녁 광치료)가 필요할 것으로 사료된다. Objectives: Patients with premenstrual dysphoric disorder(or PMDD) have impairments of the social, occupational or academic function due to psychological or somatic symptoms, which have the characteristic pattern of symptom exacerbation in the week before menses begin and remission shortly after the onset of menses. In the chronobiological view, many researchers have assumed that the etiology of PMDD is the advanced circadian rhythm. It has been suggested that light has a therapeutic effect on PMDD, because evening light results in phase delay of circadian rhythm through the biochemical changes including melatonin. Methods: The authors investigated the therapeutic effect of light therapy on four patients with prospectively diagnosed PMDD by DSM-IV criteria using clinical psychiatric interview, Premenstrual Assessment Form(PAF) and Daily Rating Form(or DRF). In the evening(6:30pm-8:00pm), the 2,500 lux light administered for seven consecutive days during the symptomatic late luteal phase of menstrual cycle. Beck Depression Inventory(or BDI), Hamilton Rating Scale for Depression(or HAM-D), Spielberg State Anxiety Inventory(or SA), and DRF were evaluated before and after seven days of light therapy. Results: Premenstrual symptoms of PMDD could be effectively treated with the evening bright light therapy, especially in PMDD patients with atypical symptoms. In addition, the light therapy seemed to more effective on the psychologic symptoms than the somatic symptoms of PMDD. There was no significant side-effect of light therapy, except the transient and mild eye-strain in one case. Conclusions: In spite of the results of limited data from our clinical trial, the authors suggest that the potential use of light therapy as an alternative to the pharmacological management of patients with PMDD.

갑상선 기능 저하증에 수반된 정신병에 대한 Levothyroxine(^(�)Synthyroid) 단독치료 1예

조숙행,정인과,곽동일 최신의학사 1990 最新醫學 Vol.33 No.3

청소년의 월경전기 변화

조숙행,Joe, Sook-Haeng 한국정신신체의학회 1996 정신신체의학 Vol.4 No.2

To assess premenstrual changes in adolescents, a self rating retrospective premenstrual assessment from(PAF) and a prospective daily rating form(DRF) were administered to 230 high school students who reported premenstrual changes. The results were as follows 1) According to typological categories of retrospective premenstrual assessment form, the most commonly reported changes in mood and behavior were major depressive syndrome(40.0%), impulsive syndrome(20.9%). Especially among the subtype of depressive syndrome, hostility feature and withdrawal feature were most frequent. The most commonly reported changes in physical condition were general discomfort(73.5%), fatigue(33.9%). 50.9% of all subjects reported impaired social function. 2) 41.2% of the subjects who met the criteria for typological categories of retrospective premenstrual assessment form were confirmed by prospective daily rating form. 3) According to different criteria of percent change method of assessing symptom change, 38.7% of all subjects had at least one mild premenstrual change and 23.5% had at least one moderate premenstrual change. 4) Using prospective daily rating form, overall psychological changes were confirmed more frequently than physical changes. Of the mild premenstrual changes, 'low energy, tired & weak', 'less or impaired work' were most common changes. Of the moderate premenstrual changes, the most common change was 'low energy, tired & weak'. 5) As attitude toward menstruation, 44.9% of the subjects with confirmed premenstrual changes had more negative attitude(disgusted) toward menstruation. 6) The subjects with confirmed mild or moderate premenstrual changes had only dysphoric mood changes or both physical and dysphoric mood changes, but did not have only physical changes. These results suggest that retrospective reports of premenstrual changes were partially confirmed by daily prospective ratings. A substantial number of adolescents appeared to experience premenstrual changes, and the most common confimed premenstrual change of mild or moderate severity was 'low energy, tired and weak'.

스트레스 평가와 관리

조숙행 대한의사협회 2004 대한의사협회지 Vol.47 No.3

임신 및 출산 후의 우울증

조숙행 대한가정의학회 2002 Korean Journal of Family Medicine Vol.23 No.4

자가 면역성 갑상선 질환이 수반된 단기 순환형 정서장애

조숙행,이민수,정인과,곽동일 대한신경정신의학회 1989 신경정신의학 Vol.28 No.4

The authors experienced one case of rapid cycling affective disorder with autoimmune thyroiditis. The case was a 28-year-old female patient who showed rapid cycling with only recurrent manic attacks and poor response to conventional treatment of bipolar disorder. We observed that overt clinical hypothyrodism with high titer of thyroid autoantibodies (antimicrosomal and antithyroglobulin) occured during treatment with lithium, chlorpromazine and carbamazepine. Although hypothyroidism returned to euthyroid state with the use of replacement L-thyroxine, manic attack recurred, so we suggested that the course of rapid cycling has no relation with thyroid dysfunction. However, further evaluation of the relationship between rapid cycling affective disorder and thyroid dysfunction will be required. Recent studies have suggested that rapid cycler have higher prevalence of both clinical hypothyroidism and abnormal thyroid function test than non-rapid cycler, and especially in presence of latent autoimmune thyroiditis, lithium likely to cause clinical hypothyroidism. Therefore we considered that both baseline and periodic asessment of thyroid function and monitoring antithyroid antibodies during lithium treatment should be required.

과수면을 수반한 계절성 정동장애 1례 -광치료 전후의 수면다원검사 소견을 중심으로-

조숙행,김인,서광윤,Joe, Sook-Haeng,Kim, Leen,Suh, Kwang-Yoon 대한수면의학회 1998 수면·정신생리 Vol.5 No.2

Authors report the findings of nocturnal polysomnography and multiple sleep latency test(MSLT) before and after morning light treatment in a winter depressive patient with hypersomnia. On polysomnographic recordings, the sleep pattern of this case before light treatment was similar to that of narcolepsy exhibited, sleep onset REM period(SOREMP). After treatment, the shortened REM latency changed to normal condition, but, deep sleep percentage did not changed, and stage 4 sleep percentage was decreased. Depressive symptoms were improved on clinical interview with Hamilton Depressive Rating Scale. Sleep log showed shortened sleep latency and reduced sleep duration. These findings suggest that although light treatment could alter the sleep structure in seasonal affective disorder with hypersomnia, it does not necessarily imply that antidepressant response of light treatment is result of change of sleep structure.