CP 기반 정신 평가 및 진단을 위한 심리검사의 활용 = Utilization of Psychological Tools for Critical Pathway Based Mental Evaluation and Diagnosis

다국어 초록 (Multilingual Abstract)

Objectives: For diagnosis and evaluation, evaluation tools are needed. Various tools can be used to diagnose and evaluate mental disorders. Among them, psychological tests are widely used. For Korean Standard Classification of Diseases (KCD) diagnosis, psychological tests are also required. Currently developed critical pathway (CP) presented tools for diagnosis and evaluation of mental disorders. The CP suggests the use of tools based on the Clinical Practice Guideline (CPG). Therefore, CPG-based tools should be able to be used in the clinical scene of Korean Medicine for diagnosing and evaluating mental disorders according to CP.
Methods: Tools suggested by CPs are summarized. The degree of utilization of tools in CPGs is also summarized. A review was conducted by Korean Medicine neuropsychiatrist experts on tools and user’s usage plan.
Results: As a result, developed CPs suggested using 19 tools for anxiety disorder, 13 tools for insomnia), 12 tools for Hwabyeong, and 9 tools for dementia. In CPG, 48, 34, 44, and 44 tools were used for anxiety disorder, insomnia, Hwabyeong, and dementia, respectively. Among tools presented in CP, HAM-A, HAM-D, CGI, SAS, and TESS for anxiety disorder, CPG, ISI, and PSQI for insomnia disorder, CPG, STAI, and STAXI for Hwabyeong were frequently used in CPG. For dementia CPG, MoCA, MMSE, HDS, ADL, and ADAS-cog were frequently used. Among them, MoCA, ADL, and ADAS-cog were suggested tools in CP.
Conclusions: As a result of analyzing tools suggested and used in the developed CPs and CPGs, it was verified that various tools were used in each study. Most of them were symptom and behavioral evaluation scales. Therefore, symptoms and behavior evaluation scales used more frequently should be able to be used in the clinical scene of Korean Medicine.

참고문헌 (Reference)

1 최우진 ; 이승기 ; 손인봉 ; 선승호, "화병에 대한 사암침 심포정격의 치료 효과 : 환자-평가자 눈가림, 무작위배정 대조군 임상시험" 대한한방신경정신과학회 22 (22): 1-13, 2011

2 임현주 ; 김석환 ; 이상룡 ; 정인철, "화병변증도구 개발 연구" 한의병리학회 22 (22): 1071-1077, 2008

3 강연욱 ; 박재설 ; 유경호 ; 이병철, "혈관성 인지장애 선별검사로서 Korean-Montreal Cognitive Assessment(K-MoCA)의 신뢰도, 타당도 및 규준 연구" 한국임상심리학회 28 (28): 549-562, 2009

4 박수지 ; 박병선, "한국형 일상생활활동 측정도구(K-ADL)의 타당도 및 측정불변성 검증" 한국보건사회연구원 37 (37): 98-124, 2017

5 이중서 ; 배승오 ; 안용민 ; 박두병 ; 노경선 ; 신현균 ; 우행원 ; 이홍식 ; 한상익 ; 김용식, "한국판 Hamilton 우울증 평가 척도의 신뢰도, 타당도 연구" 대한신경정신의학회 44 (44): 456-465, 2005

6 정순민 ; 김미경 ; 이정빈 ; 최진환 ; 정봉주 ; 변원탄, "한국어판 정신증상평가척도의 신뢰도와 타당도" 대한신경정신의학회 46 (46): 201-213, 2007

7 엄정연 ; 최승원, "한국 임상심리학자의 종합심리검사에 대한 견해와 활용 실태" 한국임상심리학회 37 (37): 1-17, 2018

8 류창희 ; 정인철 ; 조성훈 ; 황의완 ; 강위창 ; 이상룡, "치매 한의 평가도구 개발을 위한 기초 연구" 대한한방신경정신과학회 21 (21): 123-135, 2010

9 한지원 ; 김태희 ; 주진형 ; 박준혁 ; 김정란 ; 유승호 ; 문석우 ; 추일한 ; 이동우 ; 윤종철 ; 도연자 ; 이석범 ; 김문두 ; 김기웅, "치매 선별용 간이정신상태검사(Mini-Mental State Examination for Dementia Screening；MMSE-DS)와 단축형 MMSE-DS(SMMSE-DS)의 한국 노인 정상규준 연구" 대한노인정신의학회 14 (14): 27-37, 2010

10 이은희 ; 최우창 ; 정인철, "우울증 변증도구 개발을 위한 기초연구" 대한한방신경정신과학회 24 (24): 435-450, 2013

11 정정엽 ; 김대호, "불안과 우울은 다른가? : Zung 자기보고식 불안 및 우울 척도의 탐색적 요인분석" 대한생물정신의학회 20 (20): 21-27, 2013

12 정진형 ; 이지윤 ; 김주연 ; 김시연 ; 강위창 ; 임정화 ; 김보경 ; 정인철, "불면증 변증도구 신뢰도와 타당도 평가 및 심리검사와의 상관성에 대한 초기연구" 대한한방신경정신과학회 31 (31): 1-12, 2020

13 조용원 ; Mei Ling Song ; Charles M. Morin, "Validation of a Korean Version of the Insomnia Severity Index" 대한신경과학회 10 (10): 210-215, 2014

14 Sohn SI, "The reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index" 16 (16): 803-812, 2012

15 Kim SH, "The effect of Bunsimgi-eum on Hwa-byung : randomized, double blind, placebo controlled trial" 144 (144): 402-407, 2012

16 Hamilton M, "The assessment of anxiety states by rating" 32 (32): 50-55, 1959

17 Tombaugh TN, "The Mini-Mental State Examination : a comprehensive review" 40 (40): 922-935, 1992

18 National Institute of Mental Health, "TESS(Treatment Emergent Symptom Scale-Write-in)" 21 : 1069-1072, 1985

19 Hahn DW, "Standardization of Spielberger State-Trait Anxiety Test" 505-512, 1993

20 National Health for Mental Health, "Standard Guidelines for Mental Health Screening Tools and Use in 2020" National Health for Mental Health 2020

21 Nam HW, "Regional Base Public Hospital CP Development Methodology (version 1.0)"

22 Kim TW, "Quality assessment of outpatient depression care" 14 (14): 56-78, 2020

23 Lee SI, "Overview of Critical Pathway for its successful development and implementation in Korea" 6 (6): 6-11, 1999

24 Hahn DW, "Korean adaptation of the State-Trait Anger Expression Inventory (STAXI-K) : the case of college students" 3 (3): 18-32, 1998

25 National Oriental Medical College Neuropsychology Textbook Compilation Committee, "Korean Neuropsychology" Jipmoondang 2018

26 The Korean Society of Oriental Neuropsychiatry, "Insomnia disorder critical pathway of korean medicine" National Development Institute of Korean Medicine National Agency for Korean Medicine Innovative Technologies Development 2022

27 The Korean Society of Oriental Neuropsychiatry, "Insomnia disorder clinical practice guideline of korean medicine" National Development Institute of Korean Medicine National Agency for Korean Medicine Innovative Technologies Development 2021

28 The Korean Society of Oriental Neuropsychiatry, "Hwabyung clinical practice guideline of Korean medicine" National Development Institute of Korean Medicine National Agency for Korean Medicine Innovative Technologies Development 2021

29 The Korean Society of Oriental Neuropsychiatry, "Hwabyung Critical Pathway of Korean medicine" National Development Institute of Korean Medicine National Agency for Korean Medicine Innovative Technologies Development 2020

30 Gong Y, "Efficacy observation of electroacupuncture combined with duloxetine in the treatment of generalized anxiety" 24 (24): 2877-2899, 2012

31 Feng H, "Effect of acupuncture and estazolam on episodic memory and sleep structure in patients with chronic insomnia disorder : a randomized controlled trial Chinese Full Text" 40 (40): 707-712, 2020

32 Che LN, "Discussion on the effect of acupuncture on patients with generalized anxiety disorder" 8 : 86-87, 2015

33 Youn JC, "Development of the Korean version of Alzheimer’s disease assessment scale (ADAS‐K)" 17 (17): 797-803, 2002

34 The Korean Society of Oriental Neuropsychiatry, "Dementia clinical practice guideline of Korean medicine" National Development Institute of Korean Medicine National Agency for Korean Medicine Innovative Technologies Development 2021

35 The Korean Society of Oriental Neuropsychiatry, "Dementia Critical Pathway of Korean medicine" National Development Institute of Korean Medicine National Agency for Korean Medicine Innovative Technologies Development 2022

36 De Bleser L, "Defining pathways" 14 (14): 553-563, 2006

37 Kang YW, "Comparison of two screening tests in dementia: the Mini-Mental State Examination (MMSE) and the revised Hasegawa’s Demential Scale (HDS-R)" 17 : 82-83, 2009

38 Zhao H, "Clinical research on post-traumatic stress disorder in a sample size of 240 by integrated traditional chinese and western medicine" 2 : 211-212, 2014

39 Deng XY, "Clinical observation on panic disorder treated by integrated traditional Chinese and western medicine(Translated from 中西医结合治疗惊恐障碍症临床观察)" 6 : 1193-1194, 2014

40 Zhao LY, "Clinical observation of modified Liuwei Dihuang decoction in the treatment of vascular dementia with elevated high-sensitivity C-reactive protein" 1 : 73-75, 2017

41 Zhang J, "Clinical observation of 35 cases of insomnia with deficiency of both heart and spleen treated by integrated traditional Chinese and western medicine" 12 : 124-125, 2019

42 Busner J, "Clinical global impressions scale : applying a research tool in clinical practice" 4 (4): 28-37, 2007

43 Meng YZ, "Clinical analysis of panic disorder by tranquilizing therapy combined with traditional Chinese medicine psychotherapy" 13 (13): 114-115, 2016

44 Zhao G, "Clinical Study on Modified Tongqiao Huoxue Tang Combined with Routine Treatment for Vascular Dementia" 2 : 70-72, 2019

45 "Central CP guidelines" National Medical Center

46 Ko YS, "CIST (Cognitive Impairment Screening Test) manual" Ministry of Health and Welfare National Institute of Dementia 2021

47 Lee JY, "Brief screening for mild cognitive impairment in elderly outpatient clinic : validation of the Korean version of the Montreal Cognitive Assessment" 21 (21): 104-110, 2008

48 The Korean Society of Oriental Neuropsychiatry, "Anxiety disorder critical pathway of korean medicine" National Development Institute of Korean Medicine National Agency for Korean Medicine Innovative Technologies Development 2022

49 The Korean Society of Oriental Neuropsychiatry, "Anxiety disorder clinical practice guideline of korean medicine" National Development Institute of Korean Medicine National Agency for Korean Medicine Innovative Technologies Development 2021

50 Gaudry E, "Anxiety and intelligence in paired-associate learning" 61 : 386-401, 1970

51 Li LL, "50 cases of vascular dementia treated by Huiyangjiuzhen Acupuncture" 12 : 1675-1677, 2014