장신분열증 환자의 현상태에 관한 인자분석 연구

지익성,신석철 대한신경정신의학회 1988 신경정신의학 Vol.27 No.3

This study attempted to investigate the components of schizophrenic phenomenology systematically and objectively. 153 schizophrenic patients on Screening Schedule were given Present State Examination. Factor analysis was based on the scores of each item using SPSS/PC+, and following 4 factors were extracted. The results of factor analysis were summarised as follows. Factor 1 was composed of neurotic symptoms and Schneider’ s first rank symptoms, and was named neurotic symptom and Schneider’ s first rank symptom factor. Factor 2 was composed of speech, affect and behavior during interview and lack of insight, and was named negative symptom factor. Factor 3 was composed of obsession, derealization and depersonalization, and was named obsession and depersonalization factor. Factor 4 was composed of hallucinations, and was named hallucination factor. From the above results, it was shown that these factors were the concentration of the phenomenological symptoms of schizophrenia.

정신과에서 Carbamazepine의 사용

지익성 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

Carbamazepine, known as anticonvulsant, has recently been reported to have therapeutic effect in psychiatric disorder. To investigate the use of Carbamazepine in psychiatry, author evaluate 26 patients with psychiatric disorders who had been improved with carbamazepine. The results were as follows : 1. Of 26 patients, bipolar disorder and organic affective disorder manic state were 17, schizophrenias were 4 and atypical psychosis, schizoaffective disorder, organic personality disorder, borderline personality disorder, dementia was 1, respectively. 2. The mean Carbamazepine dosage was 801.9 ± 379.1 mg, and the serum level of carbamazepine was 7.94 ± 2.49ug/ml of 26 patients. 3. Transient decrease of white blood cells in 3 patients and transient decrease of platelet in 2 appeared. 6 patients showed dry mouth, mild dizzness, nausea but they were recovered without specific measures. Further study about the mechanism of action and psychotropic effect of carbamazepine in psychiatric disorder will be required and carbamazepine may prove to be a useful drug for diverse psychiatric disorders without specific side effects in the therapeutic dosage range

우울증 환자에서 성기능 장애

지익성,김영란,김정란 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2

There are several possible causes of sexual dysfunction in depressed disorder. However, patients will rarely report sexual problem spontaneously. Therefore, it is very difficult to determine a cause of sexual dysfunction in depressive patients, and the differential diagnosis must include primary sexual dysfunction, sexual dysfunction associated with general medical and psychiatric disorder, and sexual dysfunction associated with treatment for psychiatric disorder. Various strategies are recommended to manage antidepressant-induced sexual dysfunction in depression, including waiting, reducing the antidepressant dosage, use of drung holidays, use of adjunctive pharmacotherapy, and switching antidepressant. Use of an antidepressant with a low prevalence of sexual side effects, such as bupropion, nefazodone, and mirtazapine, may be the best way to avoid sexual dysfunction.

Clozapine으로 인한 경련

지익성,조현 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

Clozapine, an atypical antipsychotic drug, is widely used in treatment-resistant schizophrenia. In addition to agranulocytosis, an increased susceptibility to epileptic seizures during clozapine treatment has previously been described. The authors describe 2 patients who developed epileptic seizure during clozapine treatment and provide recommendation for clinical management of this problem.

정신분열증에서 공존하는 신체질환에 대하여

지익성,왕성근,신석철,이선우,황선희,신용재,김정란,배경도 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

In order to determine the frequency of physical illness in schizophrenia, 107 schizophrenics were assessed with physical exam and routine laboratoy test. The results were as follows 1) Among the total number of 107 schizophrenics, 31 had the physical illness(29%), and among the schizophrenics with physical illness, female outnumbered male at the rate of 17:14. 2) There was no difference between schizophrenics with physical illness and schizophrenics without physical illness in demographic characteristics. 3) Classification of physical illness were disease of skin 7 (22.6%), musculoskeletal system 5(16. 1%), ENT(ear nose throat) 3(9.7%), endocrine system 3(9.7%), circulatory system 2(6.5%), respiratory system 2(6.5%), digestive system 1(3.2%), genitourinary system 1(3.2%), infection 1(3. 2%), eye 1(3.2%) respectively Authors suggest that physical exam and routine laboratory test should be done for all hospitalized psychiatric patients

치료저항 정신분열병환자에서 Clozapine의 효과 및 안전성

지익성,김영희,신석철,왕성근,신윤오,이선우,김정란 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2

In order to assess the efficacy and safety of clozapine, 50 in-patients with treatment-resistanat schizophrenia were evaluated using PANSS(Positive and Negative Symptome Scale for Schizophrenia), CGI(Clinical Global Impression), AMS(Abnormal Involuntary Movement Scale), Adverse Event-Somatic Symptoms, Neurological Rating Scale for EPS before and during treatment. Mean daily dosage of clozapine was 344.15±123.43mg at 12th week. A clinically significant improvement in positive, negative, and general psychopathology was noted as early as week 2 through 12 week. The tolerability of clozapine was generally found to be good. Drowsiness/sleepiness, Hypersalivation, and Constipation were the most common side effects. There was no neutropenia, and 3 patients suffered from seizures. These results suggest that clozapine is worth considering for the treatment-resistant patients

정상인에서 부분적 수면박탈이 수면구조및 졸리움과 피로감에 미치는 영향

지익성,신석철 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

The author studied the effects of Partial Differential REM Deprivation(PDRD) on the sleep structure, sleepiness and fatigue with polysomnography and visual analogue test. The subject were 9 healthy male students, ranging in age from 20 to 25 years without personal histories of medical, neurological, or psychiatric illness and current sleep disturbance or parasomnias. Sleep records were analyzed according to the criteria of Rechtschaffen and Kales's manual. The results were as follows. 1. Stage 1 sleep(%) decreased significantly during the PDRD and recovery period. Stage 2 sleep (%) also significantly decreased during the PDRD nights, and there was no significant difference between the baseline and recovery period in both of stage 1 sleep(%) and stage 2 sleep(%). 2. Slow wave sleep(%o) significantly increased during the PDRD period, and there was no difference in the recovery period. Between slow wave sleep(%) in the PDRD and recovery period, there was significantly decreased in the recovery period. 3. REM sleep(min) of PDRD periods significantly decreased, and there was no significant difference between the baseline and recovery period, but REM(%) significantly increased in the recovery period(REM rebound) compared with baseline. 4. There was no correlation between the increase rate of REM % in the baseline and that of recovery nights, and also no correlation was observed between the decrease rate of REM % in the PDRD nights and the increase rate of REM % in the recovery nights. 5. Sleepiness was prominent in the PDRD nights and significantly recovered in the recovery nights, Fatigue was also prominent in the PDRD nights and significantly recovered in the recovery nights.

기분장애의 갑상선기능

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

The purpose of this study is to investigate the thyroid function in mood disorders. The levels of T_3, T_4, TSH were measured in normal conrol(n=16) and mood disorders(n=81) who divided into 3 different diagnostic subgroups by DSM-III-R criteria : major depression (n = 29), bipolar depression(n=5) bipolar mania(n = 47). The results were as follows. 1. The mean serum level of T_4 in mood disorders(n = 81) was significantly lower than that of normal control group (n = 16) (P<0.05). 2. When major depression (n=29), bipolar depression (n=5), bipolar mania(n=47), and normal control(n=16) were compared each other, the mean serul level of T_4 in bipolar depression was significantly lower than that of normal control group(P<0.05). 3. There was no significant difference in mean serum levels of T_3 T_4, and TSH between depressive patients(n=34) and manic patients.

살인을 범한 여성 범법정신분열증환자에 대한 정신의학적 고찰

지익성 최신의학사 1992 最新醫學 Vol.35 No.10

만발성 근긴장증과 지연성 운동장애가 병발한 만성 정신분열증 환자에서 clozapine 치료 1례

지익성,이선우 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Tardive dystonia and Tardive dyskinesia have been the most persistent problem of classical antipsychotics because of their potential irreversibility. No effective treatment for them have been found to date. The author report a case of tardive dystonia and tardive dyskinesia in one woman patient with schizophrenia that has successfully responded to clozapine. Treatment with diazepam, lithium, valproate were ineffective in this patient. Thus, clozapine was tried and the effect was markedly improved. The author recommend treatment with clozapine in patient with antipsychoticinduced tardive dystonia or tardive dyskinesia.