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.

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.

Clozapine으로 인한 야뇨증에서 Oxybutynin Hydrochloride 사용 3례

지익성,박철범,이선우,왕성근,신석철 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.5

Clozapine은 치료 저항성 정신분열병의 치료에 있어서의 우수한 효과에도 불구하고, 야뇨증과 같은 환자를 곤란하게 하는 부작용을 유발한다. 야뇨증은 발견 즉시 처리되야 할 부작용 중의 하나이다. 저자들은 oxybutynin hydrochloride가 일일 용량 5∼10mg의 소량으로, 별다른 부작용 없이 빠르게 항 야뇨증 효과가 나타남을 알 수 있었고, clozapine으로 인한 야뇨증 치료의 대안으로 만족할 만한 것이었다. 중심단어:Oxybutinin hydrochloride·Clozapine·야뇨증·정신분열병증. Nocturnal enuresis has been recognized as an adverse effect of clozapine treatment. We re-ported 3 chronic schizophrenic patients who had showed nocturnal enuresis following clozapine treatment. Oxybutynin hydrochloride on clozapine-induced enuresis was very effective in 3 patients. The dose in our patients was 5 to 10mg/day. This medication was well tolerated. It is suggested that oxybutynin hydrochloride is a effective therapeutic option in clozapine-induced nocturnal enuresis. KEY WORDS:Oxbutynin hydrochloride ·Clozapine·Nocturnal enuresis·Schizophrenia.

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.

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

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

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.

정신분열증의 상태 변화에 따른 갑상선 기능의 변화

지익성 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

Thyroid function and BPRS were measured at the day of admission and 2-week later during the course of hospitalization in Schizophrenia. The results were as follows. 1. There was significant difference in BPRS score between the day of admission and 2week later (P<0.05). 2. There was no significant change in thyroid fuction with the change of BPRS score between the day of admission and 2-week later

Risperidone으로 호전된 Capgras' Syndrome

지익성,배경도,이선우 충남대학교 의과대학 지역사회의학연구소 1996 충남의대잡지 Vol.23 No.2

A case of Capgras' syndrome in a 19-year-old girl who improved on Atypical antipsychotics, Risperideone is described. The patient's delusion of misidentification (She believed that her parents are not truly her parents and even she herself is not she) was treated with Risperidone. She showed significantly improvement. Authors believe Risperidone's antipsychotic effect in the treatment of schizophrenia warrants its consideration in alleviating other delusions of various psychotic disoreders, including the dedusion of doubles.