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주의력결핍-과잉행동장애를 동반한 알코올 의존환자들의 특성 : 임상적/유전학적 자료분석
김붕년,손기현,전지현,곽욱환,유희정,조수철,박철수 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.3
Objectives : This study was conducted to estimate the comorbidity rate of ADHD in a group of patients with alcohol dependency and to find out the characteristics of alcoholic patients with ADHD using the diverse clinical and genetic variables. Methods : Eighty five patients with alcohol dependency were recruited from 4 mental hospitals in Kyoung-Nam and Kyoung-Ki province. For the evaluation of ADHD symptoms in both childhood and adulthood, the highly structured Diagnostic Interview Schedule for Children-IV (DISC-FV)-ADHD module was used. The various standardized scales and questionnaires were also applied to evaluate the comorbid conditions and psychopathological status. All the subjects' blood was collected and genetic study for the polymorphism of DRD2, TH, 5-HTTLPR, COMT, ALDH2 was performed. Results : 1) The comorbid rate of definite ADHD in alcoholic patients was 38% (28/85). 2) The frequency of unmarried status was significantly higher in ADHD group compared non-ADHD group. 3) The onset of pathologic drinking and auditory hallucination was significantly earlier in ADHD group than non-ADHD alcholic group. 4) In ADHD alcoholic group, antisocial behavior was more frequently reported, and the score of co-dependency scale, depression/anxiety, aggression and obsessive compulsive drinking scales were significantly higher compared to non-ADHD alcoholic group. 5) No signficant difference was found in the frequency of polymorphic alleles in COMT, DRD2, 5-HTTLPR, ALDH2, TH between ADHD and non-ADHD alcoholic group. Conclusion : In alcoholic patients, the rate of adult type ADHD was higher than expected rate in general population. The alcoholic patients with ADHD suffered from more sever degree of alcohol dependency and earlier alcohol related problems. ADHD-alcoholic group showed higher diverse comorbid psychopathology and lower marital status compared to non-ADHD-alcoholic group. No difference, however, was found in genetic data between two groups.
아동기 가정 내 스트레스가 공동의존성에 미치는 영향 및 공동의존성과 정신병리와의 관련성
곽운환,손지욱,한규희,박철수,김장락,김붕년,김봉조,강여화,하형래 대한생물치료정신의학회 2003 생물치료정신의학 Vol.9 No.1
연구목적: 본 연구는 공동의존성에 영향을 미치는 아동기 가정내 스트레스 요인과 공동의존성과 다른 병리와의 연관성을 규명하고자 하였다. 더불어 특정한 질환에서의 공동의존성의 평가가 가지는 의의를 탐색해 보고자 하였다. 방 법: 연구 대상은 정상 일반인 남성집단 88명과 알코올리즘 남성 집단 76명으로 구성되어 있다. 평가도구는 본 저자가 직접 작성한 '아동기 가정내 스트레스 요인 측정용 설문'과 공동의존 척도(RPS), 간이증상 진단검사(SCL-90-R)를 사용하였다. 통계적 분석은 Mann-Whitmey test, Kruskall- Wallis test, Multiple linear regression analysis, Spearman correlation analysis를 이용하였다. 결 과: 1) 정상 일반인 군과 알코올리즘 군의 공동의존성 평균값은 각각 49.12점(표준편차=15.41)과 88.31점(표준편차=17.48)이었다. 2) 정상 일반인 군에서는 '아동기 부모 사별'(p<0.01) '부모의 알코올리즘'(p<0.01) '부모의 상습적 구타'(p<0.01)의 3가지 요인에서, 알코올리즘 군에서는 '어린시절 부모 사별'(p<0.01) '부모의 알코올리즘'(p<0.01) '부모의 상습적 구타'(p<0.01) '부도의 도박'(p<0.01) '사회 병질자 부모의 존재'(p<0.05)의 5가지 요인에서 스트레스 유무에 따라 공동의존성에 유의한 차이를 보였다. 3) 두 집단 동시에 SCR-90-R의 8개 소척도 중 '대인관계 예민성'이 공동의존성과 가장 높은 연관성(rs>0.06, p<0.01)을 보였다. 이외에도 '우울증' '불안증'등이 두 집단 모두에서 통계적으로 유의한 연관성을 보였다. 결 론: 본 연구는 부모의 알코올리즘뿐만 아니라 여러 가정 내 스트레스 요인이 공동의존성의 발생에 영향을 미칠 수 있음과 공동의존성이 높은 집단이 다른 정신과 질환을 동반할 가능성이 높음을 증명한다고 할 수 있다. Objectives : The aim of this study was to examine the relationships of codependency with family stressors in childhood and psychopathology. Methods : Subjects were a group of 88 normal adult males and a group of 76 alcoholic males. The degree of codependency was assessed with the Korean version of Recovery Potential Survey(RPS). All subjects filled out questionnaires regarding demographic information and family stressors. The psychopathology was measured by self-administred questionnaires using Symptom Check List-90-Revision(SCL-90-R). Results : 1) There were no significant differences in codependency levels by sociodemographic characteristics in two groups, but obvious difference in mean of codependency scores(normal group : 49.12±15.41, alcoholism group : 88.31±17.48). 2) There were significant differences in codependency levels between the presence and absence of parental physical abuse, parental death, and parental alcoholism(p<0.01) in both groups. 3) Among family stressors, parental physical abuse had the largest contribution to codependency level in multiple linear regression. 4) There were significant correlations between the codependency levels and the scores of SCL-90-R's subscales of interpersonal sensitivity, depression, and anxiety in both groups. Conclusion : The codependency levels were related to some family stressors such as parental physical abuse, parental death, and parental alcoholism and the high-level codependency was correlated with higher level of psychopathology in both normal and alcoholism group. These results suggested that various family stressors, as well as parental alcoholism may be predictors of codependency, and codependency also may be a predictor of other psychiatric disorders.
주의력결핍과잉행동장애와 Alpha-1C-Adrenergic 수용체 유전자와의 연관성에 대한 연구
조수철,김재원,김붕년,황준원,박미라,김순애,조대연,유희정,정운선,손정우,박태원 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.1
Objectives : Neurobiological and pharmacological research has suggested that the dysregulation of the central noradrenergic systems might be involved in the pathophysiology of ADHD. The aim of this study was to examine the association of the alpha-1C-adrenergic receptor gene (ADRA1C) with ADHD in Korean subjects. Methods : In a case-control study, we assessed 186 DSM-IV ADHD probands and 150 normal controls. One hundred and eight trios were studied in a family-based association analysis. Psychiatric diagnoses were derived through structured diagnostic interviews. For the clinical evaluation of the ADHD subjects, the Child Behavior Checklist (CBCL), the ADHD Rating Scale-IV (ARS) and the Junior Temperament and Character Inventory (JTCI) were administered. A computerized continuous performance test (CPT) was used to measure the inattention and impulsivity of the ADHD children. Results : There were no significant differences in the genotype or allele frequencies of the ADRA1C PstI polymorphism between the ADHD and control group (p>0.05). The transmission disequilibrium test (TDT) analysis observed no evidence for biased transmission of any of the alleles of the PstI polymorphism. There were no significant differences in the CPT or JTCI profiles between those ADHD subjects with the CC genotype and those with the other (CT+TT) genotypes at the PstI polymorphism. Conclusion : The results of this study do not support the ADRA1C as a major genetic susceptibility factor in ADHD.
중추신경자극제를 사용할 수 없는 주의력결핍과잉행동장애 아동에서의 Modafinil 효과 : 예비 연구
유한익,김진용,박수진,전정원,왕희령,김붕년,홍진표,김성윤,김창윤 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.6
Objectives : This study was aimed to examine the efficacy and safety of modafinil in psychostimulant-inapplicable children with attention deficit hyperactivity disorder (ADHD) due to insufficient treatment response or intolerable adverse effects. Methods : Fifteen children (8.8±1.8 years, 14 boys, total IQ 107.22±13.4) were recruited for this study. ADHD was confirmed by K-SADS-PL. The efficacy was assessed by ADHD rating scale (ADHDRS), Conner's parental rating scale-revised(CPRS-R), ADHDRS school version, clinical global impression (CGI) and computerized neurocognitive function test. Mean dose of modafnil was 250. 0±103.3 mg. Results : Total score (p=0.012) and hyperactive/impulsive score (p=0.021) of ADHDRS for investigator, as well as CPRS-R score (p<0.01) and CGI-severity score (p<0.01) were significantly reduced after 39.2±8.7 days of modafmil administration. Response time of word color test was also significantly decreased after medication. Decreased appetite (2 subjects), insomnia (2 subjects), irritability (1 subject) and alopecia (1 subject) were observed during this study period. Conclusion : Modafinil was effective and well-tolerated for the psychostimulant-inapplicable children with ADHD.
박희붕,박찬희,황희성,소의영,김명욱 아주대학교 의과학연구소 1996 아주의학 Vol.1 No.1
Thirty one female patients(age range 23~71 years) with suspicious breast lesions underwent technetium-99m methoxyisobutylisonitrile(Tc-99m MIBI) breast scintigraphy in order to assess the value of this technique in the detection of breast carcinomas and lymph node metastasis. The results of this Tc-99m MIBI scintigraphy were compared with mammography and ultrasonography. The results showed that all cases of breast cancer were detected by Tc-99m MIBI breast scintigraphy. Eight of 15 axillary lymph node metastasis showed positive uptake(53%). The sensitivity of mammography and ultrasonography were 77% and 84% respectively. Every multiple lesions in four patients were detected preoperatively with Tc-99m MIBI scintigraphy. Our results suggest that Tc-99m MIBI scintigraphy may be useful in diagnosis of breast cancer.