한국어판 백 우물 설문지 2판의 신뢰도 및 타당도 연구

성형모(Hyung-Mo Sung),김정범(Jung-Bum Kim),박영남(Young-Nam Park),배대석(Dai-Seok Bai),이선희(Sun-Hee Lee),안현의(Hyun-Nie Ahn) 대한생물치료정신의학회 2008 생물치료정신의학 Vol.14 No.2

Objectives : This study was performed to standardize the Korean version of Beck Depression Inventory Ⅱ(BDI-Ⅱ) , self-rating scale to assess severity of depressive symptoms. Also, this study was performed to determine psychometric properties and clinical usefulness of the BDI-Ⅱ. Methods : 31 patients diagnosed as major depressive disorder or dysthymic disorder by DSM-Ⅳ criteria and 77 normal persons were recruited in this study. All subject completed BDI, BDI-Ⅳ, SCL -90-R and MMPI. Then, Hamilton rating scale for depression (HAMD) were administrated by a psychologist. Results : Internal consistency using Cronbach α was 0.834 in depressive patient group and 0.880 in normal control group. In addition, 8DI-Ⅱ showed a very good criterion validity with very strong correlations with BDI, SCL-90-R, MMPI and HAMD. The area under the ROC curve was 0.992. With cut-off point of 22, the korean version BDI-Ⅱ had a sensitivity .935, specificity .981. And discriminant ability was 95.4% Conclusion : Korean version of the 8DI-Ⅱ is considered as a short and valid tool to identify, also to asses severity of depressive symptoms in patients and normal population.

Neurofeedback의 이해와 임상적용

박형배,성형모,Park, Hyung-Bae,Sung, Hyung-Mo 한국정신신체의학회 2006 정신신체의학 Vol.14 No.1

뉴로피드백(neurofeedback)은 EEG biofeedback, neurotherapy 등의 이름으로 불리기도 하는 새로운 치료법으로, 뇌파를 이용하고 뇌(brain) 자체와 뇌 기능(brain function)을 대상으로 한다는 점에서는 일반적인 바이오피드백(biofeedback)과는 차이가 있다. 따라서 바이오피드백의 한 형태로 출발을 하였지만, 현재는 독자적이고 전문화된 방식의 새로운 치료법으로 자리 메김을 하고 있다. 뉴로피드백에 대한 이해를 도우기 위해 뉴로피드백의 역사와 이론적 배경을 우선 알아본 후, 실제 임상에서 어떻게 사용되고 있는 지를 알아보고자 한다. 뉴로피드백은 임상분야에서 간질(epilepsy)의 치료에 처음으로 도입된 이후 그 효과가 입증되었으며, 주의력결핍과잉행동장애(attention deficit hyperactivity disorder, ADHD), 불안 및 우울장애, 수면장애, 물질의존 등의 많은 정신과 질환에 효과적으로 사용되고 있다. 정신과 질환이외에도 두통, 만성통증, 만성피로증후군 등 많은 다양한 영역에 걸쳐 적용되고 있다. 최근에는 질환들 뿐 만이 아니라, 스포츠와 예술 활동에서의 수행능력(peak performance)의 향상, 인지기능의 향상 등의 분야로 활용범위가 확대되고 있어 뉴로피드백의 효용성과 그 가능성에 대한 기대가 더욱 높아지고 있다. Neurofeedback, also known as EEG biofeedback or neurotherapy, is a new therapy differentiated from biofeedback in that brain waves are monitored to study brain itself as well as its functions. Needless to say, it has originated from biofeedback, however it has established itself as an independent and specialized therapy in the field of neurotherapy. In order to have a better understanding of neurofeedback we are going to have a look into its historical and theoretical background first and then we will explain how it can be used clinically. Neurofeedback was clinically introduced for epilepsy for the first time and its effect was proved. Since then it has been used successfully for a number of psychiatric disorders, such as attention deficit hyperactivity disorder(ADHD), anxiety, anxiety and mood disorder, sleep disorder, substance dependency, etc. Furthermore, it has been used for non-psychiatric or psychosomatic symptoms, such as headache, chronic pains, chronic fatigue symptoms, etc. Recently, it has been also used for non-medical areas, such as improvement of peak performance for sports and art activities, enhancement of cognitive function, etc, making the neurofeedback a very promising field for its potential and effectiveness.

우울증의 진단평가 지침 -우울증 평가도구를 중심으로-

정성원 ( Sung Won Jung ),이은정 ( Eun Jung Lee ),최윤경 ( Yun Kyeung Choi ),성형모 ( Hyung Mo Sung ),김대현 ( Dae Hyeon Kim ),최정식 ( Jeong Shik Choi ),김정범 ( Jung Bum Kim ) 한국정신병리진단분류학회 2009 精神病理學 Vol.18 No.1

Depression is the second most common chronic disease in primary care. However, depression is commonly misdiagnosed, or though diagnosed properly, it is easy to treat inadequate doses or duration of antidepressants. It is of importance to diagnose and treat properly. Because of a wide range of symptoms and comorbidities, it is difficult to make a diagnosis of depression. Rating scales can be useful for the diagnosis of depression. It is feasible that the clinicians assess the patients with depression appropriately and determine therapeutic strategies by rating scales for depression. We have reviewed the purpose of rating scales for depression, including screening, ratings of symptoms, diagnosis, the progress, and the results of treatment. We also have described the actual condition of rating scales in Korea, which were performed by clinical research center for depression. It is restricted within marrow limits to select certain rating scale for depression and poorly known that some scales have been developed. Therefore, it is important task to announce the rating scales for depression so that the clinicians and researchers can be familiar with these scales. It is also important to develop a diversity of scales so that the clinicians can select appropriate scales.

한국 아동의 수면시간과 체질량지수

최성민(Sung-Min Choi),서완석(Wan-Seok Seo),성형모(Hyung-Mo Sung),구본훈(Bon-Hoon Koo),김경근(Kyung-Keun Kim),김소연(So-Yeun Kim),최소정(So-Jeong Choi),이종훈(Jong-Hun Lee) 대한소아청소년정신의학회 2009 소아청소년정신의학 Vol.20 No.3

Objectives:We conducted this study to investigate the relationship between sleep duration and body mass index (BMI), in Korean children. Methods:We performed a cross-sectional analysis of data collected on 3,639 boys and girls (aged 7-12) in Daegu, Korea. The data included each child’s age, sex, weight, height, extracurricular activities, bedtime, wake-up time, sleep latency, total sleep duration, parents’ occupations, and parents’ educational levels. The relationship between sleep duration and each variable was examined via analysis of variance (ANOVA). Results:The analysis showed an association between short sleep duration and high BMI. Boys showed a graded inverse relationship between sleep duration and BMI. However, there was no significant corresponding result for girls. In the total sample, hours of computer use, time when the computer was turned off, time when the television was turned off, mother’s bedtime, and hours of extracurricular activity were associated with longer sleep duration. No association was found between sleep duration and hours of watching television, child’s wake-up time, or educational level of the parents. Conclusion:The results of this study show an inverse relationship between a child’s sleep duration and BMI;thus, children with shorter sleep duration tend to have higher BMIs.

주의력 저하 아동에 대한 뉴로피드백 치료의 주의집중력 향상

신기석,이영진,이용호,성형모,서호석,Sin, Ki-Seok,Lee, Young-Jin,Lee, Yong-Ho,Sung, Hyung-Mo,Suh, Ho-Suk 한국정신신체의학회 2009 정신신체의학 Vol.17 No.1

Objectives : This research is to figure out the neurofeedback treatment for the inattentive children is effective in improving attention deficit and furthermore, in relieving hyperactivity and impulsivity. Methods : 20 children subjects participated for this study. C3-A1 protocol neurofeedback was given 15 to 20 times to each child, it is carried out to compare the degree of attention in each case every 5 times of neurofeedback by using ADHD Rating Scale-IV : Parent Version(ARS) and Attention Deficit Disorder Evaluation Scale-Home Version(ADDES-HV). Results : The subscale of mean inattention score of ARS was reduced from 14.2 to 8.8 significantly(p<0.05) after 20 sessions of neurofeedback treatment, also the subscale of mean impulsivity/hyperactivity score of ARS from 13.3 to 7.1. The subscales of mean inattention, impulsivity and hyperactivity score of ADDES-HV was also reduced significantly(p<0.05) after 20 sessions of neurofeedback treatment. The changes of scores appeared significantly(p<0.05) from 10-15 sessions of neurofeedback treatment. Conclusion : The results of this study suggest that neurofeedback can improve children's attention deficit, hyperactivity and impulsivity, there exists the possibility of being a method to treat ADHD. 연구목적 : 본 연구에서는 주의집중력이 저하된 아동에게 뉴로피드백 훈련이 주의집중력의 향상에 효과가 있는가를 알아보고, 더 나아가 과잉행동(hyperactivity)과 충동성(impulsivity)의 호전에 효과가 있는가를 알아보고자 하였다. 방법 : 본 연구에서는 주의집중력이 저하된 아동 20명을 대상으로 각 아동별로 뉴로피드백 C3-A1 프로토콜을 15~20회 시행하였으며, 뉴로피드백 시행 전과 후의 주의집중력 정도를 ADHD Rating Scale-IV : Parent Version(ARS)과 Attention Deficit Disorder Evaluation Scale-Home Version(ADDES-HV)을 이용하여 비교하였다. 결과 : ARS 점수는 뉴로피드백 시행 전 inattention 소척도 평균 점수 14.2점에서 20회 시행 후의 평균 점수 8.8점으로 유의하게(p<0.05) 감소하였으며, impulsivity/hyperactivity 소척도의 평균 점수는 13.3점에서 7.1점으로 유의하게 감소하였다. ADDES-HV의 경우는 뉴로피드백 시행 전 inattention 소척도 평균 점수 34.8점에서 20회 시행 후의 평균 점수 20.7점으로 유의하게 감소하였으며(p<0.05), impulsivity 소척도는 22.5점에서 12.7점, hyperactivity 소척도는 18.8점에서 9.9점으로 유의하게 감소하였다. 이 점수들은 대개 10~15회 시점부터 유의하게 변화하기 시작하였다. 결론 : 뉴로피드백 치료를 통하여 아동의 주의집중력, 과잉행동, 충동성이 호전되었으며, 이는 뉴로피드백이 주의력 향상, ADHD의 치료에 한 방법이 될 수 있는 가능성을 시사하고 있다.

우울증 환자 가족들의 심리적 스트레스에 관한 연구 : 정신분열병 환자 가족과 비교

김진희,이은정,정성원,성형모,사공정규,김정범,Kim, Jin-Hee,Lee, Eun-Jeong,Jung, Sung-Won,Sung, Hyung-Mo,SaKong, Jeong-Kyu,Kim, Jung-Bum 대한불안의학회 2010 대한불안의학회지 Vol.6 No.1

Objective : This study compared the psychological stresses of depressed patients' families with those of schizophrenic patients' families. We investigated the influence of depressive patients' clinical features and their families' demographic characteristics on the families' depressive symptoms and stresses. Methods : Participants were 23 family members of depressed patients and 20 family members of schizophrenic patients. We measured the patients' clinical features (duration of illness, number of previous hospitalizations, and satisfaction with medication), and each family member's socioeconomic status and psychological characteristics (depressive mood, anxiety, family stress, and stress response), analyzing the data via independent t-test, chi-square test, and correlation and hierarchical multiple regression analyses. Results : The depressed patients' average clinical global impression (CGI) was significantly higher than that of the schizophrenic patients. The depressed patients' family members showed stress responses significantly higher than those of schizophrenic patients' family members. Furthermore, in depressed patients, frequency of hospitalization was positively correlated with family members' stat anxiety. For both patient types, family stress was positively correlated with the patient's severity of illness and the family's state anxiety, trait anxiety, and stress response ; socioeconomic status was positively correlated with the family's depressive symptoms ; the family's state anxiety positively correlated with the family's trait anxiety and stress response ; and the family's trait anxiety positively correlated with the family's stress response. Socioeconomic status predicted the family's depressive symptoms, and socioeconomic, illness severity and stress response predicted family stress. Conclusion : These findings suggest that both depressed patients' families and schizophrenic patients' families suffer from psychological stress. The study data also have important clinical implications, in that families of depressed patients need psychiatric intervention, as well as the patients themselves. In particular, family intervention should focus on psycho-education and stress coping strategies.

세로토닌 재흡수 억제제에 대한 아리피프라졸 및 부프로피온 부가요법의 우울증 세부증상에 대한 효과 비교 : 다기관, 개방표지, 무작위 연구

이가원,이광헌,박영우,이종훈,구본훈,이승재,성형모,천은진,Lee, Ga-Won,Lee, Kwang-Hun,Park, Young-Woo,Lee, Jong-hun,Koo, Bon-Hoon,Lee, Seung-Jae,Sung, Hyung-Mo,Cheon, Eun-Jin 대한불안의학회 2017 대한불안의학회지 Vol.13 No.2

우울증은 높은 유병률을 가지며 심각하고 만성화 될 수 있는 질병이다. 환자가 증상 없이 기능적 회복이 되어 일상을 영위하기 위해 임상가는 단독요법 이상의 치료 전략이 필요하다. 본 연구에서 SSRI와 aripiprazole 또는 bupropion 부가 요법은 우울증의 증상 호전을 보였다. SSRI와 aripiprazole 부가 요법은 우울증의 전반적 점수의 호전뿐 아니라 세부척도의 핵심 증상에서 bupropion 병합 요법에 비해 더 의미 있는 변화를 보였다. 또한 두 약제 모두 핵심 우울증상이라 할 수 있는 개별증상(우울한 기분, 일과 활동, 정신적 불안)에서 가장 큰 변화를 보였다 Objective : The purpose of this study was to examine the effects of adjunctive aripiprazole versus bupropion on specific symptoms of depression. Methods : Data were from 6-week, randomized, prospective, open-label multi-center study in 103 patients with major depressive disorders. Participants were randomized to receive aripiprazole (2.5-10 mg/day) or bupropion (150-300 mg/day) for 6 weeks. Change in four subscales of the 17-item Hamilton Depression Rating Scale (HAM-D17) that capture core depression symptoms was determined, and change in individual HAM-D17 items was also assessed. Changes in three composite subscales-anxiety, insomnia, and drive were also examined. Results : Within-group change in the four core subscales was large [effect size (ES)=1.30-1.47] and it was similar to that in the HAM-D17 total score. Differences between aripiprazole and bupropion were significant for each of the four core subscales and the HAM-D17 total score favored aripiprazole (p<0.001). On three composite scales, both treatments caused substantial changes in anxiety (within-group ES=1.10 (aripiprazole) vs. 1.00 (bupropion)], insomnia (ES=0.75 vs 0.50), and drive (ES=1.17 vs 1.15). Conclusion : This results suggested that both aripiprazole and bupropion adjunctive therapies with selective serotonin reuptake inhibitors resulted in significant and clinically meaningful changes in core symptom subscales for depression.

ADHD 혼합형 남아에서 정서인식 결함

박현진(Hyun Jin Park),서완석(Wan Seok Seo),성형모(Hyung Mo Sung),배대석(Dai Seg Bai) 대한생물치료정신의학회 2012 생물치료정신의학 Vol.18 No.2

Objectives:This study had explored emotional recognition defects in boys with Attention Deficit Hyperactivity Disorder, Combined Type(ADHD-C). Methods:30 boys with ADHD-C were selected and 30 normal boys were selected of matching age and intelligence with ADHD-C under a guideline of IRB for a retrospective study. All of participants were examined intelligence, behavioral symptoms, neurocognitive functions and web based emotional recognition test(ERT). Web based ERT was developed for examine the emotional recognition ability as emotional recognition, emotional discrimination and contextual understanding. Results:In correct response ratio analyses at ERT, boys with ADHD-C showed not any significant differences between groups except for fear at contextual understanding, but in decision making speed at correct response analyses, boys with ADHD-C was slowed significantly than normal group at total mean, and expecially, emotional recognition of positive emotion, and contextual understanding of happy and sickening. Correlational trends between correct response ratio and decision making speed at correct response were significantly different between groups. Finally, for a evaluation emotional recognition defects in boys with ADHD-C, a using of both correct response ratio and decision making speed at correct response are proper than a using each index, separately. Conclusions:This result had replicated emotional recognition defects at ADHD-C in researches using physiological indices or parameters as MEG, fMRI, and ERP, and showed characteristic emotional recognition defects at ADHD-C and usability of ERT for a evaluation of ADHD-C.

아동 수면 양상과 관련된 지역별 사회, 환경적 요인들

최용락(Yong-Lak Choi),서완석(Wan-Seok Seo),성형모(Hyung-Mo Sung),구본훈(Bon-Hoon Koo),김경근(Kyung-Keun Kim),김소연(So-Yeun Kim),최소정(So-Jeong Choi),이종훈(Jong-Hun Lee) 대한생물치료정신의학회 2009 생물치료정신의학 Vol.15 No.1

Objectives:This study was conducted to investigate various social and environmental factors related to children’s sleep and to know how these factors may affect sleep duration and patterns. Methods:Total 2,958 students of three elementary school in Daegu, Korea were enrolled in this study. We investigated various factors related to children’s sleep using Sleep questionnaires for Korean Children(SKC) for two days. The factors that we investigated were classified into sleep-related factors, daily life factors, environmental factors. We also evaluated correlations between these factors and children’s sleep duration. Results:When identifying various factors related to children’s sleep in three elementary school groups, group A showed significantly later bedtime(F=103.683, p<.001), longer sleep latency(F=6.30, p<.05), shorter total sleep duration(F=5.93, p<.05), and shorter nap duration(F=141.94, p<.001) compared to other group B and C. Also, group A showed significantly earlier time of returning home(F=71.073, p<.001), shorter amount of TV viewing (F=108.45, p<.001), earlier time of stopping TV viewing(F=24.01, p<.001), shorter amount of computer use(F=67.10, p<.001), earlier time of attending school(F=5.40, p<.05), longer hours in private institute(F=15.57, p<.001), smaller number of family(F=11.00, p<.001), longer father’s years of education(F=311.82, p<.001), and longer mother’s years of education(F=334.87, p<.001) compared to other two groups. Conclusion:Group A was associated with late bedtime, long sleep latency, short total sleep duration despite relatively short nap duration, short amount of TV viewing, short amount of computer use, early time of stopping TV viewing, small number of family, long mother’s years of education. This result suggests that total amount of hours in private institute and parents’ academic demands might be a contributing factor for children’s sleep duration.

한국판 정신과적 진단 선별 질문지(Psychiatric Diagnostic Screening Questionnaire; PDSQ)의 진단적 타당도

최정식 ( Jeong Shik Choi ),김희철 ( Hee Cheol Kim ),정성원 ( Sung Won Jung ),이은정 ( Eun Jung Lee ),성형모 ( Hyung Mo Sung ),사공정규 ( Jung Kyu Sakong ),신임희 ( Im Hee Shin ),김정범 ( Jung Bum Kim ) 한국정신병리진단분류학회 2009 精神病理學 Vol.18 No.1

Objectives: Although many tools have been developed to diagnose mental disorders so far, it has not been easy to administer because it is necessary to undergo training for the professionals as well as time required to administer those tools. The Psychiatric Diagnostic Screening Questionnaire; PDSQ, developed by Zimmerman et al, 2001, is self-reporting test for screening DSM-IV axis I disorders in clinical settings, and it is well known for its simplicity and availability. This study compared Korean PDSQ with Mini-International Neuropsychiatric Interview(M.I.N.I.-Plus) for their diagnostic availability, as a part of standardization of Korean version. Methods: The samples were 320 patients, who were selected from 3 university hospitals in Daegu and Kyoungbook for K-PDSQ and Mini-International Neuropsychiatric Interview(M.I.N.I.-Plus). The diagnostic correspondence, sensitivity, specificity and administering time were evaluated for PDSQ as well. Results: For the diagnostic correspondence of PDSQ, Cohen`s kappa coefficient was .69 between PDSQ and MINI-Plus. The administering time was 19.3±12.9min, which was similar to the M.I.N.I.-Plus` minutes. The sensitivity was higher than 90% in most of the 13 PDSQ subscales(MDD; 100%, PTSD; 75%, Bulimia Nervosa; 100%, OCD; 68%, Panic Disorder; 93%, Psychosis; 59%, Social Phobia; 98%, Alcohol Dependence/Abuse; 94%, Drug Dependence/Abuse; 100%, Agoraphobia; 83%, GAD; 88%, Somatoform Disorder; 100%, Hypochondriasis; 96%), and the AUC(area under the curve) values of them were above 0.79(MDD; 0.91, PTSD; 0.82, Bulimia Nervosa; 1.00, OCD; 0.80, Panic Disorder; 0.94, Psychosis; 0.79, Social Phobia; 0.87, Alcohol Dependence/Abuse; 0.96, Drug Dependence/Abuse; 1.00, Agoraphobia; 0.92, GAD; 0.81, Somatoform Disorder; 0.99, Hypochondriasis; 0.97). Conclusion: PDSQ showed significant diagnostic correspondence. time-efficiency and high level of sensitivity and specificity. PDSQ is considered to be useful diagnostic tool before the first interview of the patients for the screening of DSM-IV Axis I diagnosis because it is simplicity and reliability.