정신약물에 의한 피부 부작용

우정민(Jungmin Woo),임효덕(Hyo-Deog Rim),원승희(Seunghee Won),이승재(Seung Jae Lee),김병수(Byung-Soo Kim),장성만(Sung Man Chang) 대한생물치료정신의학회 2017 생물치료정신의학 Vol.23 No.3

Psychotropic drugs are one of the most widely prescribed drugs. Adverse skin reactions are associated with psychotic drugs. These drug side effects occur in about 2% to 5% of patients. Mostly, the prognosis is good. However, some may be life-threatening. Life-threatening side effects are mainly related to mood stabilizers, antidepressants, and antipsychotic drugs. Once these side effects occur, the drug should be discontinued and treated for cutaneous and related symptoms. However, it would be better if prevention could be done before these side effects develop. Interestingly, mild adverse events occur within a few days, and severe adverse events develop after 1-3 weeks. Regardless of its severity, skin adverse effects can cause secondary issues that increase the cost of treatment and lower the patient`s adherence to medications, so clinician should be able to recognize and respond quickly to this problem.

유방암 환자에서 생활사건 스트레스가 치료지연에 미치는 영향

우정민(Jungmin Woo),정재훈(Jaehoon Jeong),임효덕(Hyo-Deog Rim) 대한생물치료정신의학회 2015 생물치료정신의학 Vol.21 No.1

임신과 정신약물

우정민(Jungmin Woo) 대한생물치료정신의학회 2018 생물치료정신의학 Vol.24 No.2

According to the report of World Health Organization, about 10% of pregnant women and 13% of women who have just delivered have a mental illness. Maternal mental illness can affect not only on the mother but also on the fetus mentally and physically. Therefore, active treatments including medication have to be considered. However, a lot of women still refuse to take medications even though their symptoms are not controlled or the risk of relapse is high, due to the fear of fetal malformations when they become aware of their pregnancy. The decision on the administration of medication could be difficult in terms of the conflicting values of maternal illness and fetal safety. The appraisal for drug risk has been based on the pregnancy A, B, C, D, X categories of the United States Food and Drug Administration(FDA) so far. However, it has been criticized for evoking an excessive anxiety for teratogenicity. Fortunately, over time, data on drugs have been accumulated and new FDA pregnancy and lactation labeling rule(PLLR or final rule) was adopted recently. In this historical turning point, the psychotropic treatment for pregnant women would be reviewed.

지연된 유방암 진단을 예측하는 정신사회적 요인 : 부부관계기능의 역할

김지영,우정민,이상신,김혜원,강동우,임효덕,Kim, Ji Young,Woo, Jungmin,Lee, Sang Shin,Kim, Hea Won,Khang, Dongwoo,Rim, Hyo-Deog 한국정신신체의학회 2014 정신신체의학 Vol.22 No.1

연구목적 2001년 이후로 유방암은 한국에서 가장 흔한 여성 암이 되었다. 진행 유방암으로 진단받을 고위험군을 확인하는 것은 유방암 사망률을 줄이기 위한 효과적인 방법 중 하나라고 할 수 있다. 본 연구의 목적은 유방암을 진단 받은 시점에서 진행 유방암과 연관된 사회인구학적, 건강행위 건강특성, 임상적 그리고 정신사회적 요인을 조사하며, 진행 유방암을 예측할 수 있는 요인을 밝히는 데 있다. 방법 경북대학교 병원에서 처음으로 유방암을 진단받고, 수술을 시행한 후 '유방암 환자들을 위한 스트레스 클리닉'에 자문 의뢰되어 정신의학적 면담이 시행된 219명의 환자를 대상으로 하였다. 기본 사회인구학적 자료를 비롯하여, 자가진단 및 유방촬영술의 규칙적 시행여부, 진단 당시의 병기, 유방암 발견 경위 등을 조사하였다. 정신사회적 요인으로는 경제적 및 가족적 부담, 부부관계기능, 가족관계기능 정도 등을 반구조화된 면담을 통해 파악하였다. 교차분석과 로지스틱 회귀분석으로 조기 유방암 환자군과 진행 유방암 환자군 간에 변수를 비교하고 진행 유방암 환자군을 예측할 수 있는 요인을 확인하였다. 결과 유방암을 진단받은 시점에서 120명(54.8%)이 진행 유방암으로 확인이 되었다. 단변량분석을 통하여 조기 유방암을 진단받은 환자군과 진행 유방암을 진단받은 환자군 사이에 통계적으로 유의한 차이가 난 변수는 다음과 같았다. 건강행위 및 특성 변수로는 자가 검진행위(p<0.000), 매년 유방촬영술 시행여부(p<0.000)이었다. 암 관련 임상적 특징으로는 종양 발견경위(p<0.000), 첫 증상의 양상(p<0.000), 첫 증상 발견부터 치료까지 소요된 기간(p<0.000)이었다. 정신사회적 요인으로는 부부관계기능(p<0.000)과 가족관계기능(p=0.000), 과도한 경제적 가족적 부담(p=0.018)이었다. 로지스틱회귀분석을 통하여 매년 비진행 유방암에 영향을 미치는 독립인자로는 매년 유방암 선별을 위해서 실시하는 유방촬영술을 비정기적으로 시행하거나(OR=7.431 ; 95% CI 2.407-22.944), 전혀 시행하지 않는 경우(OR=25.299 ; 95% CI 7.855-81.482)였으며 정신사회적 요인으로는 기능 부전적 부부관계(OR=4.772 ; 95% CI 2.244-10.145)가 유일했다. 결론 본 연구를 통하여 진행 유방암 진단의 위험인자로 널리 알려진 비정기적 검진을 재확인하였으며, 이외에도 정신사회적 요인으로서 '비기능적 부부관계기능'을 밝혀냈다. 이러한 결과는 유방암을 조기에 진단하는데 전통적으로 인정되어 왔던 사회인구학적, 임상적 요인 이외에도 정신사회적 요인이 중요한 영역임을 시사한다. Objectives : Breast cancer has been the most prevalent female cancer in South Korea since 2001. Early detection of this disease is the most effective strategy for reducing mortality. The objective of this study was to identify factors which could predict advanced stage at diagnosis of breast cancer. Methods : Participants who were initially diagnosed with breast cancer and referred to the Stress Clinic of the Breast Cancer Center at Kyungpook National University Hospital were included. Through a semi-structured interview, the authors investigated psychosocial variables such as the extent of marital and family functioning and emotional-economic family burden as well as sociodemographic and health behavior-, health characteristic- and cancer-related variables. Results : Data were collected from 219 participants. One hundred and twenty(54.8%) subjects were diagnosed with advanced-stage breast cancer. Variables that were significantly different between the advanced-stage and early-stage groups included : monthly breast self examination(p<0.000), annual mammographic screening(p<0.000), mode of tumor detection(p<0.000), nature of the first symptoms(p<0.000), time to treatment after diagnosis(p<0.000), overloaded economic and family burden(p=0.018), marital functioning(p<0.000) and family functioning(p<0.00). Logistic regression analysis indicated that irregular annual mammography screening(OR=7.431 ; 95% CI 2.407-22.944) or a lack of screening(OR=25.299 ; 95% CI 7.855-81.482) and a dysfunctional marital relationship(OR=4.772 ; 95% CI 2.244-10.145) were significantly associated with advanced stage at diagnosis of breast cancer. Conclusions : We reconfirmed screening behavior to be a risk factor for delayed diagnosis of breast cancer. Our findings also emphasized the importance of psychosocial factors such as marital functioning in early detection of breast cancer. Psychiatric consultation in the area of martial functioning could be beneficial for increasing early detection in breast cancer.

응급실에서의 노인환자의 섬망

박신율(Sin Youl Park),우정민(Jungmin Woo) 대한생물치료정신의학회 2012 생물치료정신의학 Vol.18 No.2

Objectives:It is known that delirium is common among elder patients and is associated poor clinical outcomes. As elderly patients are increasing in emergency department(ED), the prevalence of delirium should be on the rise. However delirium has been under-recognized by medical team. Our study was designated to evaluate the frequency, the clinical effect and risk factors of delirium of hospitalized elder patients in ED. Methods:We retrospectively reviewed elderly patients admitted to general ward after over 24 hours hospitalization in ED between January 2008 and December 2008. examined the frequency and assessed the clinical effect and risk factors. Results:Among 414 patients, 42 patients(10.1%) developed delirium in ED over 12 month period studied. The development of delirium in ED was associated with significant poor outcomes ; increased hospital mortality and prolonged hospital stays. Independent risk factors of delirium were stroke, metabolic derangements, dementia, hemodynamic instability, depression. Conclusion:ED environment can be important risk factors of delirium, thus ED physician should try to recognize and correct the possible risk factors of delirium earlier and in particular, should try to reduce exposure time to the ED environment in elderly patients.

양극성 I형 장애 환자와 발병하지 않은 일차 친족에서 인지조절의 비교

윤혜림,우선진,이상원,진보현,우정민,원승희,Yun, Hyerim,Woo, Seonjin,Lee, Sang-Won,Jin, Bo-Hyun,Woo, Jungmin,Won, Seunghee 대한생물정신의학회 2018 생물정신의학 Vol.25 No.1

Objectives This study intended to identify the deficits of cognitive control among patients with bipolar I disorder and their first-degree relatives, and identify the possibility of cognitive control as an endophenotype of bipolar disorder. Methods The study included three groups: euthymic states patients with bipolar I disorder (n = 55), unaffected first-degree relatives of probands with bipolar I disorder (n = 30), and a healthy control group (n = 51), that was matched on age, sex, and years of education. The AX version of the continuous performance test (CPT) was used to examine cognitive control. Error rate, correct response times of each subsets (AX, BX, AY, BY), and d' as an indication of accuracy sensitivity index were calculated. Psychopathology, intelligence, and psychomotor speed were also assessed. Results Patients with bipolar I disorder showed significantly worse error rates in the AX (p = 0.01) and BX (p = 0.02) subsets and d' (p = 0.05) than the others. They also showed more delayed correct response times than the healthy control group and first-degree relatives in all subsets (p < 0.01). But first-degree relatives showed neither high error rates nor delayed correct response times than healthy control group. Conclusions These findings suggest that cognitive control is impaired in bipolar I disorder but less likely to be an endophynotype of bipolar I disorder.

아버지의 양육행동이 또래놀이행동을 매개로 아동의 창의적 성향에 미치는 영향

박혜성(Hyesung Park),우정민(Jungmin Woo),이선영(Seon Young Lee) 한국창의력교육학회 2022 창의력교육연구 Vol.22 No.2

본 연구는 아동의 창의적 성향에 영향을 미칠 수 있는 환경요인으로 아버지의 양육행동(온정적, 통제적)을 설정하고, 그 과정에서 또래놀이행동(긍정적 놀이행동, 부정적 놀이행동)의 종단적 매개효과를 확인하고자 하였다. 이를 위해 한국아동패널의 6차(만 4세 아버지 양육행동), 7차(만 5세 또래놀이행동), 12차년도(만 10세 창의적 성향)의 자료를 활용하였으며 구조방정식모형을 적용하여 분석하였다. 연구 결과, 만 4세의 아버지 양육행동은 만 5세의 또래놀이행동을 매개로 만 10세의 창의적 성향에 유의한 영향을 주는 것으로 나타났다. 이 때 아버지의 양육행동이 아동의 창의적 성향에 주는 직접적인 효과는 유의하지 않았으나, 또래놀이행동을 매개로 한 간접효과만이 유의한 것으로 나타났다. 구체적으로 아버지의 온정적인 양육태도는 긍정적인 또래놀이행동을 매개로 창의적 성향에 유의한 영향을 주었으며, 통제적인 양육태도는부정적인 또래놀이행동을 매개로 창의적 성향에 영향을 주는 것으로 나타났다. 나아가 다집단분석을 실시한 결과, 남아와 여아 집단에서 경로계수의 차이가 유의하지 않았다. 연구 결과를바탕으로 아동기의 창의성을 계발하기 위한 실천적인 시사점을 논의하였다. This study aims to identify the mediating role of peer play behaviors (positive peer play, negative peer play) in the relationship between father's two different parenting behaviors (warm, controlled) and children’s creative personalities. The sixth (father's parenting behaviors of a four-year-old), seventh (interactive peer play of a five-year-old), and twelfth (creative personality of a ten-year-old) data from the Korean Children Panel were used. The structural equation model was used for the analysis. Results revealed that the father's parenting behaviors of a 4-year-old indirectly predicted the creative personality of a 10-year-old through interactive peer play of a 5-year-old. However, the direct effects of the father's parenting behaviors on creative personality were not statistically significant. Specifically, the father's compassionate parenting behaviors significantly predicted creative personality through positive interactive peer play, and the controlled parenting behaviors significantly predicted creative personality through negative interactive peer play. In addition, a multi-group analysis was performed to examine the gender differences in respect of the path differences, although no significant gender differences were found. Implications for practice and limitations are discussed.

한국어 개정판 친밀관계경험 척도의 단축형 개발

윤혜림,이원기,배금예,이상원,우정민,원승희,Yun, Hyerim,Lee, Won-Kee,Bae, Geumye,Lee, Sang-Won,Woo, Jungmin,Won, Seunghee 대한불안의학회 2017 대한불안의학회지 Vol.13 No.2

Objective : The experiences in close relationships questionnaire-revised (ECR-R) (Fraley, Waller & Brennan, 2000) is a valuable tool for measuring adult attachment, and its Korean version, the ECRR-K (Kim, 2004), is widely used in Korea. However, given its substantial length, this study was aimed to develop and validate a short version of the ECRR-K called the ECRR-K14. Methods : Two hundred and ninety-four medical students participated in this study in 2016. They completed the ECRR-K, the Perceived Stress Scale (PSS), the Rosenberg Self-Esteem Scale (RSES), and the UCLA Loneliness Scale (UCLA-LS). The study authors applied the Rasch rating scale to check each item's model fit and then performed confirmatory factor analyses (CFAs) to test the new scale's validity. Results : The authors selected seven items each for the anxiety and avoidance subscales, and the ECRR-K14 showed fair to good internal consistency (Cronbach's ${\alpha}=0.93$ and 0.92 for anxiety and avoidance, respectively). The anxiety subscale showed concurrent validity with the PSS and the RSES while the avoidance subscale showed concurrent validity with the UCLA-LS. The CFAs also demonstrated the validity of the model with a goodness-of-fit index of 0.916. Conclusion : The ECRR-K14 showed excellent reliability and validity and appears to be a promising instrument for measuring the two attachment dimensions in adults.

조현병 환자에서 아미설프라이드의 치료반응과 도파민 D3 수용체 유전자다형성의 연관성

강승걸,이헌정,이승재,최태영,우정민,김지현,정성원,구본훈,이광헌,김정란,지익성,이종훈,Kang, Seung-Gul,Lee, Heon-Jeong,Lee, Seung Jae,Choi, Tae Young,Woo, Jungmin,Kim, Jihyun,Jung, Sung-Won,Koo, Bon Hoon,Lee, Kwanghun,Kim, Jeong-Lan,Chee, 대한생물정신의학회 2013 생물정신의학 Vol.20 No.3

Objectives The aim of this study is to evaluate the association between rs6280 and rs905568 genetic polymorphism of DRD3 gene and the treatment response of amisulpride. Methods After six weeks treatment of amisulpride, 125 schizophrenia patients were interviewed based on the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression-Severity (CGI-S). The genotyping for rs6280 and rs905568 was performed using TaqMan single nucleotide polymorphism (SNP) genotyping assay. Results There was no significant difference in the frequency of genotype and allele of rs6280 between the responders and non-responders based on the total, positive, and general score of PANSS and CGI-S score. However, there was a significant association between this SNP and treatment response in the negative score of PANSS (${\chi}^2=5.23$, p = 0.022). There was no significant association between rs905568 and the response in positive, negative, general, and total PANSS score and CGI-S score. Conclusions This is the first positive association study between DRD3 gene and the treatment response of negative symptoms to amisulpride in Korean schizophrenia patients. A larger scale research on more SNP of the DRD3 gene will make a progress in the study of pharmacogenetics on the treatment response of the amisulpride.

코티졸, Dehydroepiandrosterone Sulphate와 우울증상 심각도와의 상관성

장서영(Seoyoung Jang),서민수(Min-Soo Seo),우정민(Jungmin Woo) 대한생물치료정신의학회 2016 생물치료정신의학 Vol.22 No.2

Objectives:Cortisol and dehydroepiandrosterone sulfate(DHEAS) are neuroactive steroids related mood disorder as well as stress response. The purposes of this study are to examine the correlations between cortisol, DHEAS and severity of depressive symptoms and to evaluate the possibility of cortisol and DHEAS as biomarkers for depression. Methods:A total of 60 participants who had no history of psychiatric disease were recruited. We assessed the severity of depressive symptoms using the Beck Depression Inventory(BDI) and the Hamilton Depression Rating Scale(HAMD). The blood samples were collected between 12 PM to 14 PM. We applied an ELISA to measure the level of cortisol and DHEAS. Results:The depressive group showed higher cortisol level(Base on BDI : 13.64±7.91 ug/dL, p<0.001 ; Base on HAMD: 14.14±8.34 ug/dL, p<0.001). Cortisol level showed positive correlation with the severity of depressive symptoms based on BDI (r=0.572 ; p<0.01) and HAMD(r=0.638 ; p<0.01). DHEAS level significantly correlated with BDI score (r=0.398 ; p<0.01) but not with HAMD score. Conclusion:These findings suggest that cortisol and DHEAS may have a role as biomarkers for evaluating depression. DHEAS was associated with only one side of two scales. This may suggest the level of steroid hormone is different depending on specific depressive symptoms.