주의력 결핍 과잉행동 장애 아동에서의 집단 프로그램의 치료 효과

심세훈,오창근,권자영,정유숙,홍성도 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Background : The authors attempted to introduce group program for improving interpersonal relationship and evaluate the effects of that program. Material and Methods : This program had been held twice a week for 8 weeks for children and parents training had been for times on the treatment and continued from 2001 to 2002. Twenty-five ADHD children in school age were selected as subjects from child psychiatric clinic of a general hospital in Seoul. Treatment outcomes were evaluated by comparing at pre- and post- treatment using the various rating scale. Result : According to the results of statistical analysis, paired t-test, the score of total self-concept including popularity was increased and family environment and parenting stress were improved significantly. These results suggest that this program is useful for its orginal goal. The parents evaluated also that children's total problem behaviors were decreased. Conclusion : These results suggest that the designed and performed group program in this study would be effective in facilitating ADHD children's emotional and interpersonal growth, and decreasing their parents stress. Finally they would have healthy interpersonal reationship.

우울장애 환자에서 자살 시도와 트립토판 수산화 효소(Tryptophan Hydroxylase) A218C 유전자 다형성과의 관련성

심세훈,황보영,권영준,정희연,이분희,김용구 대한신경정신의학회 2008 신경정신의학 Vol.47 No.2

Objectives : Several lines of evidence suggest the serotonergic dysfunction involved in the biological susceptibility of suicide. Tryptophan hydroxylase (TPH), the rate-limiting enzyme in the biosynthesis of serotonin, Plays a vital role in serotonin metabolism. In a case-control study, we investigated whether the TPH gene was a susceptible factor for suicidal behavior in depressive patients. Methods : The subjects were 218 depressed patients who attempted suicide and visited emergency rooms in multi-medical centers. One hundred thirty hospitalized non-suicidal depressed patients and the 161 normal controls were matched with the suicidal group. Individuals in all 3 groups were evaluated independently by a Structured Clinical Interview for the purpose of establishing a DSM-IV criteria diagnosis (SCID). The severity of depressive symptoms was evaluated using Hamilton depression rating scale (HDRS). Results : There was no significant difference in genotype distributions and allele frequencies of TPH intron 7 A218C polymorphisms among 3 groups. Furthermore, no significant difference in genotype counts and allele frequencies of the polymorphisms was found among lethal suicidal depressed patients, non-suicidal depressed patients and the normal controls. Conclusion : This study suggests that the A218C polymorphism of the TPH gene is unlikely to have a major effect on the susceptibility of suicidal behaviors in depressive patients.

한국인 주요우울장애 환자에서 혈중 ACTH, Cortisol 농도와 해밀턴 우울 평가 척도의 신체증상 항목과의 상관관계

여혜빈,김린,함병주,심세훈,권영준,정희연,정한용,한상우,이민수,이화영 대한생물치료정신의학회 2011 생물치료정신의학 Vol.17 No.2

Objectives:Hypothalamic-Pituitary-Adrenocortical(HPA) system dysregulation plays an important role in the pathophysiology of major depressive disorder. Medically unexplained somatic symptoms comprised the predominant complaints of korean patients with major depressive disorder. It might be related to dysregulation of HPA system and somatic symptoms. The aim of this study was to investigate the association between Hamilton Depression Rating Scale severity and the Plasma Adrenocorticotropic Hormone(ACTH) & Serum Cortisol level in Korean patients with major depressive disorder. Methods:Our study design was prospective. A total 111 hospitalized patients with major depressive disorder (DSM-IV) at Anam Hospital, Korea University Medical Center between Jan 2009 and May 2011 were selected. Hamilton Depression Rating Scale was measured by psychiatrist. Plasma ACTH, Serum Cortisol levels were analyzed at the time of admission. Results:There are significant correlations(p<0.05) between Hamilton Depression Rating Scale of somatic component(HAM-D 11-15 item) and Plasma ACTH and Serum Cortisol level. However, other HAM-D sub items were not significantly correlated with Plasma ACTH and Serum Cortisol level except somatic component. Conclusion:Our Study results suggest that hyperactivity of HPA axis might be correlation with somatic symptoms in korean patients with major depressive disorder.

자살 시도에 영향을 미치는 정신사회적 요인

허지원,최광연,이분희,심세훈,양종철,김용구 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.2

Objectives : A lots of studies have investigated the psychosocial characteristics of suicidal attempters in order to find eff-cient coping strategy and treatment intervention. The purpose of this study was to examine the psychosocial factors affecting the suicide attempt in psychiatric patients. Methods : Two hundred eighty patients who attempted suicide and admitted in the emergency room in 3 university hospitals from December 2003 to May 2006 were recruited in this study. The patients were interviewed using Structured Clinical Inter-view for DSM-IV Axis I disorder (SCID-RV), Lethality of Suicide Attempt Ratings Scale (LSARS) and Risk-Rescue Rating system (RRR). Results : The suicide attempters have psychosocial characteristics of female preponderance, age 20-39, high school in educational level, married in marriage condition, inoccupation, house makers in occupation. Most of attempters used the non-severe methods such as drug ingestion or wrist cutting, and selected home as the place of attempt. The delay until discovery was less than 4 hours for most suicide attempters, and the rate of asking for help directly or dropping clues were high. Major depressive disorder was the most common psychiatric illness among attempters. Conclusions : The present study would be the early stage to explore the risk factor and protect factor of suicidal attempt. This study suggests that the closed observation to potential-suicidal attempter in daily life is critical to protect against the fatal results due to suicidal attempts.

주의력결핍 과잉행동장애 아동에서 틱 장애 동반 여부에 따른 확산 텐서 영상 비교 연구

최지욱,임명호,이창화,박진균,손정우,심세훈,유인규,강현수,정범석 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.5

Objectives : Diffuse tensor imaging (DTI) was applied to explore the difference in regional distribution and extent of white matter (WM) abnormalities in boys with Attention-deficit/hyperactivity disorder (ADHD) versus boys with comorbid ADHD and tic disorders. Methods : Fifteen boys with ADHD (mean age 9.3 +1.8), 24 ADHD boys with chronic tic disorder or Tourette's disorder(9.9 =b 1.2) and 9 age-, gender-matched controls (9.2 d= 1.8) received DTI assessments. Fractional Anisotropy (FA) maps of WM were compared between groups with a voxel-wise analysis after intersubject registration to MNI space. Results : Bo groups, ADHD group and ADHD with tic disorder group, commonly showed decreased FA than healthy control group in left cerebellar middle peduncle and right frontal lobe, increased FA in right middle occipital WM. In the common areas of left cerebellar middle peduncle and right middle occipital WM, comorbid group showed broader areas of significant FA. The comorbid group also showed increased FA in right cerebellar peduncle, additionally. Conclusion : The findings in ADHD group support previous ADHD hypothesis of the functional abnormalities in corticocerebellar circuit, and suggest that ADHD might have more complicated pathology of neuronal circuit including occipital visual system. The comorbid group showed common areas of overlapping but more extensive abnormalities and also had additional WM abnormalities. ADHD with chronic tic disorders may represent a severe form of ADHD with additional regions of abnormal connectivity.

Impact of Interpersonal Relationships and Acquired Capability for Suicide on Suicide Attempts: A Cross-Sectional Study

Se-Hoon Shim,Young Joon Kwon,Dongwook Lee,Ho Sung Lee,Min Jin Jin,Ji Sun Kim 대한신경정신의학회 2022 PSYCHIATRY INVESTIGATION Vol.19 No.5

Objective This study examined the path model predicting suicide attempts (SA) by interpersonal need for suicide desire, acquired capability for suicide, the emotion dysregulation, and depression symptoms in people admitted to hospitals for medical treatment.Methods A total of 344 participants (200 depressed patients with attempted suicide, 144 depressed patients with suicidal ideation) were enrolled for this study. Depression, anxiety, emotion regulation, interpersonal needs, and acquired capability for suicide were evaluated. A model with pathways from emotion regulation difficulties and interpersonal needs to SA was proposed. Participants were divided into two groups according to the presence of SA or suicidal ideation.Results Acquired capability for suicide mediated the path from depression to SA. In the path model, difficulties in emotion regulation and interpersonal needs predicted depression significantly. Although depression itself was not significantly related to acquired capability for suicide, depression was significantly related to acquired capability for suicide in suicide attempter group.Conclusion Interventions with two factors affecting SA will clarify the suicide risk and contribute to finding risk factors.

Screening with the Korean Version of the Mood Disorder Questionnaire for Bipolar Disorders in Adolescents: Korean Validity and Reliability Study

Se-Hoon Shim,Jong-Hun Lee,Jye-Heon Song,Beomwoo Nam,Bo-Hyun Yoon,Ha-young Jin,Hyung-Mo Sung,Jong Hyun Jeong,Sae-Heon Jang,Duk-In Jon,Young Sup Woo,Won-Myong Bahk 대한정신약물학회 2018 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.16 No.3

Objective: This study aimed to evaluate the validity and reliability of a Korean version of the Mood Disorder Questionnaire-Adolescent version (K-MDQ-A) as a screening instrument for bipolar disorders in adolescents. Methods: One hundred two adolescents with bipolar disorders and their parents were recruited from November 2014 to November 2016 at 7 training hospitals. One hundred six controls were recruited from each middle school in two cities of South Korea. The parent version of the original MDQ-A was translated into Korean. The parents of all participants completed the K-MDQ-A. The diagnoses of bipolar disorders were determined based on the Korean version of K-SADS-PL. The test-retest reliability with a 10-month interval was investigated in 33 bipolar adolescents. Results: K-MDQ-A yielded a sensitivity of 0.90 and a specificity of 0.92 when using a cut-off score of endorsement of 5 items, indicating that symptoms occurred in the same time period and caused moderate or serious problems. The internal consistency of the K-MDQ-A was good. The correlations between each item and the total score ranged from 0.40 to 0.76 and were all statistically significant. Factor analysis revealed 3 factors that explained 61.25% of the total variance. The mean total score was significantly higher in bipolar adolescents (7.29) than in controls (1.32). The Pearson correlation coefficient for the total test-retest score was 0.59 (p<0.001). Conclusion: The K-MDQ-A completed by parents showed the excellent validity and reliability and may be a useful screening tool for adolescents with bipolar disorders attending in- and outpatient psychiatric clinics.

The Relationship between Plasma Erythropoietin Levels and Symptoms of Attention Deficit Hyperactivity Disorder

Se-hoon Shim,Yong-Ku Kim,Young Hwangbo,Hee-jung Yoon,Ji Sun Kim,Youn Jung Lee,Young Sup Woo,Won-Myong Bahk 대한정신약물학회 2021 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.19 No.2

Objective: There are animal models associating dopamine dysfunction with behavioral impairments that model attention deficit hyperactivity disorder (ADHD). Erythropoietin (EPO) has trophic effects on dopaminergic neurons. The aim of this study was to examine the EPO plasma levels and determine whether there was any correlation between plasma EPO levels and clinical characteristics of ADHD. Methods: Plasma EPO levels were measured in 78 drug-naïve children with ADHD and in 81 healthy children. The severity of ADHD symptoms was determined by scores on the Korean ADHD Rating Scale (K-ARS) in ADHD children and healthy controls. Results: The difference between median plasma EPO levels in ADHD children and in healthy controls was not statisti-cally significant. Adjusting for age and sex, a linear regression analysis showed that inattention score was significantly higher in the second highest tertile of plasma EPO compared to those in the lowest tertile. Hyperactivity-impulsivity score was significantly higher in the highest tertile of plasma EPO compared to those in the lowest tertile. Moreover, total K-ARS scores were significantly higher in the second highest tertile of plasma EPO compared to those in the lowest tertile. Conclusion: These findings suggest that plasma EPO levels were related to some ADHD symptoms, which could be used in the monitoring of the disorder.

Comparison between Atomoxetine and OROS Methylphenidate as an Adjunctive to SSRIs in Attention-deficit/Hyperactivity Disorder Adults with Comorbid Partially Responsive Major Depressive Disorder: A Head-to-head, 12-week, Randomized, Rater-blinded Clinical

Se-hoon Shim,Young Sup Woo,Ji Sun Kim,In Soo Heo,Hee-jung Yoon,Hyung Mo Sung,Jonghun Lee,Won-Myong Bahk 대한정신약물학회 2022 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.20 No.1

Objective: This study aimed to compare the efficacy and safety of atomoxetine (ATX) and OROS methylphenidate (MPH) as adjunctive to selective serotonin reuptake inhibitors (SSRIs) in adults with attention-deficit hyperactivity disorder (ADHD) with comorbid partially responsive major depressive disorder (MDD). Methods: Sixty Korean adults with ADHD and comorbid partially responsive MDD were recruited in a 12-week, randomized, rater-blinded, active-controlled trial and were evenly randomized to ATX or OROS MPH treatment. Results: Depressive symptoms measured using the Hamilton Depression Rating Scale and Clinically Useful Depression Outcome Scale, and ADHD symptoms measured using the Adult ADHD Self-Report Scale, as well as the Clinical Global Impression-Severity, Clinical Global Impression-Improvement, and the Sheehan Disability Scale scores were significantly improved in both groups during the 12 weeks of treatment. The changes in all outcome measures during the 12-week treatment were not significantly different between the two groups (all p > 0.05). No serious adverse events were reported and there were no significant differences in systolic and diastolic blood pressure, pulse rate, weight, or body mass index between the ATX and MPH groups. Conclusion: Our findings suggest that ATX and MPH can be used as adjunctive treatments in adults with ADHD and comorbid partially responsive MDD. The efficacy and tolerability of ATX and MPH in adults with ADHD did not differ significantly. Further studies should be conducted to draw a definitive conclusion.

만성 정신분열병 환자에서의 강박증상에 대한 연구

심세훈(Se Hoon Shim),정한용(Han Yong Jung),한선호(Sum Ho Han) 한국정신병리진단분류학회 2000 精神病理學 Vol.9 No.1

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