DSM-III에 의한 불면증에 관한 연구 : 정신과 외래환자를 대상으로

정한용,이대희,신동균 대한신경정신의학회 1985 신경정신의학 Vol.24 No.3

This investigation was based on the study of 247 Psychiatric patients with insomnia of at least 1 month’s duration, who had visited at the Department of Neuropsychiatry, Korea University Haewha Hospital from January 1983 to December 1983. The results were as follows; 1. There were 101 men ar.d 146 wcmen with the mean age of 38. 9 years. They had occupied 40.4 percent of all psychiatric patients in the same period. 2. The most common diagnoses were, in order, -affective, somatoform , anxiety, schizophrenic, -compulsive personality, and passive-aggressive perscalrity disorder. Also abcut one half of them were in the anxious or fearful cluster. 3. In the duration of insomnia, more than one half had been suffering from insomnia for at least 12 months and there were no statistical significances among diagnoses except subtypes of affective disorder. 4. Difficulty falling asleep was the most common type in this investigation. Difficulty falling asleep was more common in bipolar disorder, mania; V codes; schizophrenic; dysthymic; and compulsive personality disorder, whereas difficulty staying asleep was more common in major depression and bipolar disorder, depressed. 5. Twenty-one patients had axis III diagnoses and also they had axis I diagnosis as principal diagnosis. 6. In the MMPI results, the scales most elevated were, in order, hypochondriasis, conversion hysteria, depression and psychasthenia. These findings suggested that various factors such as somatic concern, depression, anxiety, fear, and obsession were correlated with insomnia.

대한신경정신의학회 발전방향에 대한 고찰

정한용,이강준,이해국,백종우,나경세,최원석 대한신경정신의학회 2014 신경정신의학 Vol.53 No.6

The Korean Neuropsychiatric Association (KNPA) should protect members’ rights, and also plan long-term policy for public activity in a society. In these efforts, creation of mission, vision, and core values is of utmost importance. Second, effective communication among members is important for sharing and discussing the mission, vision, and core values of the KNPA. Third, public relations play a key role in advertising the policy and providing information. Based on the above major issues and results of representatives questionnaire, the authors suggest that careful planning of long-term policy and roles of the KNPA is needed. 대한신경정신의학회의 중장기 발전 방향을 효과적으로 논의하고 설정하여, 이를 바탕으로 실질적으로 학회가 더 나은모습으로 발전하기 위해서는 그 토대가 되는 기본적인 미션과 비전, 핵심가치가 설정되어야 하고 이에 대해 회원들 간의 폭넓고 자유로운 소통이 이루어져야 한다. 본고에서 제시된 내용들이 향후 대한신경정신의학회의 중장기 발전 방향에 대한 논의를 하는 데 초석이 되기를 희망하는 바이다.

급성 조증 입원환자에 대한 항정신병약물의 처방 경향

정한용,이소영,전용호 대한정신약물학회 2004 대한정신약물학회지 Vol.15 No.1

Objective: Antipsychotic drugs are known to be effective in reducing psychotic symptoms and behavioral disruptions, and are mainly used during the first few days of acute manic phases of bipolar disorders. The purpose of this study was to investigate the use patterns of antipsychotics in the treatment of acute bipolar manic patients in a university hospital in Korea during the last decade. Methods: To track the use of antipsychotics from 1990 through 2000, a retrospective chart review was conducted by reviewing the medical records of bipolar disorder inpatients at the department of psychiatry, Soonchunhyang Medical Center in Seoul and Chunan. The following data were collected (1) demographic data, (2) history of bipolar disorder, (3) length of hospital stay, and (4) drug titration records of all prescribed antipsychotic medications. Results: Of the 138 total subjects, 98.5% had been treated with more than one antipsychotics combined with a mood stabilizer for at least one week. Chlorpromazine was found to be the preferred antipsychotic between 1990 and 1995. However, preference of high-potency antipsychotics, such as haloperidol, to low-potency antipsychotics for bipolar disorder patients was observed between 1995 and 2000. The prescription percentage of atypical antipsychotics increased to 16.3% in 2000. The overall mean prescribed daily chlorpromazine equivalents was 669.9mg/day (SD=514.3). Conclusion: In spite of unfavorable side effects and an established guideline for the usage of antipsychotics for bipolar disorder, most bipolar manic inpatients have been prescribed adjunctive antipsychotics at relatively high dosages. The results imply a need to reduce the discrepancy between daily clinical practice and recommended guidelines in the treatment of bipolar patients.

[군사진단Ⅲ] 드골과 아이젠하워 장군의 CIP 리더십-Ⅰ

정한용 월간군사저널 2024 월간군사 Vol.2024 No.4

외상성 뇌 손상이후의 우울증

정한용,한선호,Jung, Han Yong,Han, Sun Ho 대한생물정신의학회 1999 생물정신의학 Vol.6 No.1

외상성 뇌 손상은 다양한 신경행동학적 후유증을 나타낸다. 불안정한 기분, 무감동증, 공격성, 충동성, 과민성 등을 나타내고 기억력 상실, 집중력 장해, 정보처리 지연, 지남력 감소, 자기인식 결여, 및 문제 해결 능력의 결여 등 인지 기능의 손상을 나타낸다. 이러한 신경행동학적 증상은 직업과 가정을 포함하는 개인의 역할 수행에 다양한 충격을 주고 이는 또한 다양한 정도의 감정적 어려움을 더하게 되어, 이러한 생물학적, 심리적, 사회적 요인들이 우울증을 일으킨다. 외상성 뇌 손상이후의 우울증의 발병률은 주요 우울증이 25~50%, 기분저하 장애가 15~30%로 보고되고 있다. 외상성 뇌 손상이후의 우울증의 양상은 근본적으로는 일반적인 우울증의 양상과 별다른 차이가 없는 것으로 보고된 바 있다. 뇌 손상이후의 시간에 따라 우울증 양상에서의 차이를 보여 첫 6개월에 나타나는 경우에는 불안, 초기 불면증, 기분의 조석 변동, 및 식욕 장애 등이, 그리고 12개월의 경우에는 말기 불면증, 성욕 상실, 집중력 저하 등이 각각 두드러진 것으로 보고된 바 있다. 또한 외상성 뇌 손상이후의 급성 기에 발생하는 우울증은 보다 더 생물학적 원인이 관여하는 것으로, 지연성 우울증의 경우에는 심리적인 요인들이 더 많이 관여하는 것으로 보고되고 있다. 좌측전반부 병소와 주요 우울증의 연관성이 여러 연구에서 보고되고 있으며, 특히 불안을 호소하는 우울증은 우반구 병소와 그리고 불안의 호소가 적은 우울증은 좌측 전반부와 연관된다고 보고되었다. 외상성 뇌 손상이후에 우울증을 나타내는 경우의 병리생리학적 변화는 우울증의 원인론과 연관되어 많은 관심을 받고있으나 아직 어떠한 결론을 도출해내기에는 이르다. 치료에는 fluoxetine, desipramine 등 부작용이 적은 항우울제가 선택된다. Traumatic Brain Injury(TBI) of any severity can result in broad and persisting biopsychosocial sequelae. Depression after TBI occur at a greater frequency than in the general population, with estimates approaching 25% to 50% for major depression, and 155 to 30% for dysthmia. Acute onset depressions are related to lesion location and may have their etiology in biological response of the injured brain, whereas delayed onset depressions may be mediated by psychosocial factors, suggesting psychological reactions as a possible mechanism. Anxious depressions are associated with right hemisphere lesions, whereas major depressions alone are associated with left dorsolateral frontal and left basal ganglia lesions. However, there is insufficient information to postulate a specific neuroanatomic model for TBI-related depression.

외상성 뇌손상 환자에서 Amantadine의 치료적 효과 : 2증례 및 고찰

정한용,이소영,김양래,Jung, Han Yong,Lee, Soyoung Irene,Kim, Yang Rae 대한생물정신의학회 2001 생물정신의학 Vol.8 No.1

We reported two cases of amantadine treatment in traumatic brain injury patients and reviewed the literature of amantadine treatment of those patients. Problems with short-term memory, attention, planning, problem solving, impulsivity, disinhibition, poor motivation, and other behavioral and cognitive deficit could occur following traumatic brain injury or other types of acquired brain injury. This report described results of amantadine using in two patients with this type of symptom profile. Patients received neuropsychiatric examination as well as BPRS and Barthel index. These patients were improved, respectively from 57 point to 82 point(case 1), from 85 to 94(case 2) in Barthel index, and from 66 point to 35 point(case 1), from 55 to 32 point(case 2) in BPRS. These two patients did not reveal any other adverse effect. The rationale for using amantadine were discussed. 두부 외상을 받은 환자는 여러 가지 다양한 병태생리학적인 과정을 통해 뇌손상을 받으며 이로 인해 다양한 신경정신과적인 장애를 나타낸다. 두부외상을 받은 두 명의 환자에서 이에 대한 약물학적인 접근으로 amantadine을 사용하였고 증세의 호전을 경험하였다. 이에 대한 이론적인 근거로는 amantadine은 전연접(presynaptic)과 후연접(postsynaptic)에서 도파민 신경전달(dopamine neurotransmission)을 증진시켜 인지기능과 전두엽 기능장애에서 발생되는 특징적인 정신 행동학적인 증상을 호전시키고, NMDA 수용체 길항제(NMDA receptor antagonist)로 작용하여 흥분성 독성물질(excitotoxic substrate)에 의한 이차적인 신경손상을 차단하는 신경보호제(neuroprotective agent)로 작용한다. 이와 같이 amantadine은 급성과 만성 외상성 뇌손상 환자 모두에서 나타나는 인지, 기분과 행동장애의 치료에 효과적이고 안전하며 비싸지 않은 가격으로 사용될 수 있을 것으로 사료된다. 또한 이 영역에서 더욱 많은 대조군 연구가 필요하고, 나아가서 외상성 뇌손상 환자의 인지기능 호전을 위한 약물학적인 개입에 관한 연구가 필요할 것으로 사료된다.

[군사 진단 Ⅱ] 프랑스 드골의 핵개발 2가지 이유

정한용 월간군사저널 2023 월간군사 Vol.2023 No.7.8

외상성 뇌 손상 환자의 신경정신과 영역 치료

정한용,Jung, Han Yong 대한생물정신의학회 1998 생물정신의학 Vol.5 No.1

The neuropsychiatric sequelae of traumatic brain injury are effects on complex aspect of cognition, emotion and behavior. They include problems with attention and arousal, concentration, executive function, intellectual changes, memory inpairments, personality changes, affective disorders, anxiety disorders, psychosis, apathy, aggression, and irritability. There are many useful therapeutic approaches available for people who have been brain injuries. Although a multifactioral, multidisciplinary, collaborative approach to treatment is proposed, for purposes of exposition the author have divided treatment into psychopharmacological, cognitive, behavioral, psychological, and social interventions.

Antipsychotic Drug Use Patterns for In-hospital Treatment of Bipolar Disorder Patients Across A 10-Year Span

정한용,이소영,Yong-Ho Jun 대한정신약물학회 2003 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.1 No.1

Antipsychotic drugs are known to be effective in reducing psychotic symptoms and behavioral disruptions, and are mainly used during the first few days of acute manic phases of bipolar disorders. The purpose of this study was to investigate the use patterns of antipsychotics in the treatment of acute bipolar manic patients in a university hospital in Korea during the last decade. To track the use of antipsychotics from 1990 through 2000, a retrospective chart review was conducted by reviewing the medical records of bipolar disorder inpatients at the department of psychiatry, Soonchunhyang Medical Center in Seoul and Chunan. The following data were collected; 1) demographic data, 2) history of bipolar disorder, 3) length of hospital stay, and 4) drug titration records of all prescribed psychotropic medications. Of the 139 total subjects, 98.5% had been treated with more than one antipsychotics combined with a mood stabilizer for at least one week. Chlorpromazine was found to be the preferred antipsychotic between 1990 and 1995. However, preference of high-potency antipsychotics, such as haloperidol, to low-potency antipsychotics for bipolar disorder patients was observed between 1995 and 2000. The prescription percentage of atypical antipsychotics increased to 16.3% in 2000. The overall mean prescribed daily chlorpromazine equivalents was 669.9 mg/day(SD=514.3). In spite of unfavorable side effects and an established guideline for the usage of antipsychotics for bipolar disorder, most bipolar manic inpatients have been prescribed adjunctive antipsychotics at relatively high dosages. The results imply a need to reduce the discrepancy between daily clinical practice and recommended guidelines in the treatment of bipolar patients.

대한신경정신의학회 정책연구 과제 소개

정한용,이강준,나경세 대한신경정신의학회 2014 신경정신의학 Vol.53 No.2

이상의 8가지 연구 주제들은 이미 2013년 9월에 중간발표및 공청회를 통해서 한 차례 검토를 하고 다듬어야 할 부분에대해서 논의를 거쳤으며, 이를 토대로 지금의 연구 보고서가나올 수 있었다. 정책연구소에서는 이상의 소중한 8개 연구성과들을 우리 회원들과 공유함으로써, 실제 우리가 환자를진료하고 정신건강증진정책을 구현하는 지금 이 순간의 현실에서 변화와 개선이 이루어지기를 기대하는 바이다. Mental health policy influences the mental health system and promotion in the medium and longerterm. Thus, many countries develop a mental health plan suitable for their countries. In 2012,the suicide rate in Korea was 28.1 per 100000 persons, representing a nine-year high amongcountries in the Organization for Economic Co-operation and Development. In addition, suiciderates in Korea increase as a function of age. For example, the prevalence of suicide per 100000persons is 19.3 among people in their 20 s and 83.2 among those in their 70 s, respectively. Anotherimportant mental health issue in Korea is a need for ‘positive psychiatry’, which generallyaims to improve mental health and psychiatric conditions, not only in patients with psychiatric illnessesbut also in the general population. As the definition of mental health is being broadened,psychiatrists should expand their range of activities and collaborate more with other professionaland civic groups. Psychiatrists belonging to various institutions, such as mental health groups,clinics, mental health hospital, and general hospital, also need to find ways to expand the importanceof their roles. Given the growing responsibilities for the mental health policy, the Policy ResearchInstitute of the Korean Neuropsychiatric Association planned eight review articles on themental health of Korea in the medium and longer term.