소방공무원에서 탄력성이 외상후스트레스 증상과 해리에 미치는 영향 : 우울의 매개 효과

권태훈,현소연,정영기,임기영,노재성,강대용,하귀염,김남희,Kwon, Tae Hoon,Hyun, So Yeon,Chung, Young Ki,Lim, Ki Young,Noh, Jae Sung,Kang, Dae Ryong,Ha, Gwiyeom,Kim, Nam Hee 한국정신신체의학회 2016 정신신체의학 Vol.24 No.1

연구목적 본 연구는 소방공무원에서 탄력성이 외상후스트레스 증상 및 해리에 미치는 영향과 함께, 탄력성과 각 외상후스트레스 증상 및 해리의 관계에서 우울의 매개효과에 대해서 알아보고자 하였다. 방 법 총 115명의 소방공무원을 대상으로, 생활사건 체크리스트, 사건충격척도-개정판, 해리경험척도, 벡 우울척도, 코너-데이비슨 탄력성 척도를 시행하였다. 탄력성이 외상후스트레스 증상과 해리에 미치는 영향 및 우울의 매개효과를 확인하기 위해 구조방정식모형(Structural equation modeling)과 경로분석(path analysis)을 실시하였다. 결 과 탄력성이 높을수록 낮은 외상후스트레스 증상과 낮은 해리를 보였으며, 각 탄력성과 외상후스트레스 증상 및 해리의 관계는 우울이 완전 매개를 하는 것으로 나타났다. 즉, 탄력성이 외상후스트레스 증상 및 해리에 대해 직접적인 영향이 아닌 우울을 통해 간접적으로 각 증상을 감소시킴을 보여주었다. 결 론 본 연구는 소방공무원에서 외상후스트레스 증상 및 해리의 예방과 치료에 있어 탄력성 강화와 우울 증상 감소를 목표로 한 임상적 개입이 중요함을 시사한다. Objectives : This study aimed to investigate the effects of resilience on posttraumatic stress symptoms and dissociation and whether depression mediates the relationships between resilience and posttraumatic stress symptoms and dissociation. Methods : A total of 115 firefighters participated in the study. Data were collected via the Life Events Checklist, Impact of Event Scale-Revised, Dissociative Experience Scale, Beck Depression Inventory, and Connor-Davidson Resilience Scale. Structural equation modeling and path analysis were applied to estimate the relationships between resilience, depression, posttraumatic stress symptoms, and dissociation. Results : Greater resilience was associated with lower posttraumatic stress symptoms and dissociation, and the relationship between them was fully mediated by depression. Conclusions : Specific aspects of depression may help explain the relationships between resilience and posttraumatic stress symptoms and dissociation. Tailored prevention programs and treatments based on resilience and depression may prevent posttraumatic stress symptoms and dissociation in firefighters and improve treatments outcomes among firefighters with posttraumatic stress symptoms and/or dissociation.

근로자의 수면문제에 따른 생산성 시간 손실

우종민,현소연,이상학,강승걸,이진성,김린,이유진,유범희,강은호,구정일,신홍범,서완석,박두흠 대한신경정신의학회 2011 신경정신의학 Vol.50 No.1

ObjectivesZZThe daily activities and performance of the working population can be threatened by sleep disturbances, including insomnia. This study evaluated the sleep patterns, sleep problems, daytime sleepiness, and lost productivity time (LPT) resulting from sleep quality and sleep duration issues among workers. MethodsZZThe Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Health and Work Performance Questionnaire (HPQ) were completed by 653 workers in an urban area. Statistical analyses were performed using independent t-tests. ResultsZZThe average sleep duration among the subjects was 6 h 37 min. While 19.6% of the sub-jects complained of poor sleep quality, 53.4% were affected during the day by insomnia. The estimated annual cost of LPT due to presenteeism (\13,892,545 vs. \11,840,140 ; p=0.033) and the total annual cost of LPT (\14,040,968 vs. \11,961,302 ; p=0.032) were higher in poor sleepers than in good sleepers. Furthermore, workers with a shorter sleep duration had a higher annual LPT due to presenteeism (747.83 vs. 648.57 h ; p=0.046) and a higher total annual LPT (754.48 vs. 657.99 h ; p=0.049) than workers with a longer sleep duration. ConclusionZZSleep deprivation among workers caused 1 h 51 min LPT per week. This suggests that sleep disturbance affects workers’ performance in an organization, as well as in terms of individual health. Objectives The daily activities and performance of the working population can be threatened by sleep disturbances, including insomnia. This study evaluated the sleep patterns, sleep problems, daytime sleepiness, and lost productivity time (LPT) resulting from sleep quality and sleep duration issues among workers. Methods The Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Health and Work Performance Questionnaire (HPQ) were completed by 653 workers in an urban area. Statistical analyses were performed using independent t-tests. Results The average sleep duration among the subjects was 6 h 37 min. While 19.6% of the sub-jects complained of poor sleep quality, 53.4% were affected during the day by insomnia. The estimated annual cost of LPT due to presenteeism (\13,892,545 vs. \11,840,140 ; p=0.033) and the total annual cost of LPT (\14,040,968 vs. \11,961,302 ; p=0.032) were higher in poor sleepers than in good sleepers. Furthermore, workers with a shorter sleep duration had a higher annual LPT due to presenteeism (747.83 vs. 648.57 h ; p=0.046) and a higher total annual LPT (754.48 vs. 657.99 h ; p=0.049) than workers with a longer sleep duration. Conclusion Sleep deprivation among workers caused 1 h 51 min LPT per week. This suggests that sleep disturbance affects workers’ performance in an organization, as well as in terms of individual health.

COVID-19 대규모 유행 국가에서 귀국한 격리자의 정신건강문제

이다영,이정현,현소연,김창훈,김우진,김경애,오은혜,하지현,전경선,심민영 대한신경정신의학회 2022 신경정신의학 Vol.61 No.3

Objectives This study aimed to propose an efficient mental health service plan to be implemented during epidemics by identifying the mental health characteristics of people who have returned from countries with large-scale coronavirus disease-2019 (COVID-19) outbreaks. Methods We analyzed the mental health evaluation scale data submitted by 504 quarantined people who had returned from countries hit by the COVID-19 pandemic from January to April 2020 through a government support project. Results The average age of the study group was 35.6±8.72 years, and males accounted for 67.1% and females 32.9% of the total subjects. The screening score for post-traumatic stress disorder was met by 12.1% of the subjects. Moderate to high level of depression and anxiety symptoms were seen in 10.7% and 7.0%, respectively. Also, 2.2% of the group complained of clinical level somatization symptoms, and 1.4% were evaluated as being at a high risk of suicide. The average scores and the proportion of subjects at high risk on all scales were significantly higher in female than in male. In a comparison by age, the average score of post-traumatic stress symptoms was significantly higher in subjects in their 20s than those in their 50s, and the proportion of the subjects at high risk for post-traumatic stress symptoms also showed a significant variation between age groups. However, there were no significant differences by age with respect to depression, anxiety, somatic symptoms, and suicidal tendencies. Conclusion During an epidemic, the mental health problems of people may increase, and the risk appears to be higher in female and young adults. Therefore, in addition to strong protection policies, a customized support system for each target group is required.

Mediating Role of Anxiety and Depression in the Relationship between Posttraumatic Stress Symptoms and Illness Intrusiveness

김남희,김석현,현소연,강대룡,오민정,김대호 대한의학회 2018 Journal of Korean medical science Vol.33 No.45

Background: Posttraumatic stress symptoms (PTSS) in patients with psychological trauma lead to poor health-related quality of life. Understanding of the relationships among PTSS, anxiety, depression, and illness intrusiveness will guide the development of efficient approaches to enhance subjective well-being in patients with psychological trauma. This study investigated whether anxiety and depression mediate the relationship between PTSS and illness intrusiveness in the hope of providing more comprehensive and effective trauma treatment. Methods: Psychiatric outpatients who visited the trauma clinic of a university hospital (n = 260) participated in this study. Assessments were conducted for PTSS, anxiety, depression, and illness intrusiveness. Structural equation modeling and path analysis were performed to analyze the mediating effects of anxiety and depression on the relationship between PTSS and illness intrusiveness. Results: PTSS had both direct and indirect exacerbating effects on illness intrusiveness. Anxiety exhibited the largest direct exacerbating effect on illness intrusiveness. The indirect effects of PTSS on illness intrusiveness through anxiety alone and through a depression-to- anxiety pathway were significant, but the indirect effect through depression alone was not. Conclusion: The findings demonstrate that anxiety, both independently and as part of an interrelated pathway with depression, partially mediates the relationship between PTSS and illness intrusiveness. Appropriate interventions and a comprehensive approach to alleviate anxiety and depression could mitigate the negative effects of PTSS on illness intrusiveness in patients with psychological trauma.

COVID-19 대응 의료인력의 소진과 관련 요인

오현석,곽의현,현소연,이송은,이숙현,오인목,심민영 대한신경정신의학회 2023 신경정신의학 Vol.62 No.4

Objectives This study was conducted to evaluate burnout and its associated factors among coronavirus disease 2019 (COVID-19) frontline healthcare workers. Methods We analyzed the nationwide burnout evaluation scale data collected from 774 COVID- 19 frontline healthcare workers in South Korea from July 1 to 14, 2021. Along with demographic variables and work-related information, the Maslach Burnout Inventory–General Survey and the list of stress factors were used to assess burnout and its associated stressors. Results The study participants were predominantly female (86.2%) and the majority were nurses (78.8%). Among them, 53.0% felt emotionally exhausted, 34.5% were cynical, and 45.5% experienced decreased professional efficacy. The most common stressors were “insufficient rewards” (85.0%) and “excessive workload” (72.5%). Factors such as excessive workload, interpersonal relationships at work, and stress from insufficient rewards were correlated with higher levels of exhaustion and increased cynicism. Insufficient rewards and stress about family infection were associated with increased professional efficacy. Conclusion Stress related to the work environment, rather than that from potential infection, was associated with exhaustion and cynicism in the COVID-19 frontline healthcare workers.

코로나바이러스 감염증-19 대응 의료진의 정신건강 및 소진 연구

정보라,이다영,이정현,현소연,이송은,이숙현,심민영 대한신경정신의학회 2023 신경정신의학 Vol.62 No.3

Objectives This study was conducted to identify the level of mental health and burnout of medical staff at hospitals and public health centers, which responded to the coronavirus disease 2019 (COVID-19) in South Korea and to suggest appropriate management plans. Methods The mental health and burnout levels of medical staff responding to COVID-19 were evaluated through an online survey conducted during the period July 1–14, 2021. To analyze the mental health status of the participants according to their demographic characteristics, the chisquare test, t-test, and an analysis of variance were conducted, followed by Scheffe post-hoc tests for pairwise comparisons. Results A total of 773 participants were included in the study. An analysis of the clinically significant symptoms of the group showed that 29.5% had posttraumatic stress symptoms, 30.6% had depression, 15.8% had anxiety, 39.8% had somatic symptoms, and 4.5% were seen to be at risk of suicide. The average scores for burnout were as follows: 3.55±1.75 for emotional exhaustion, 2.68±1.73 for depersonalization, and 3.89±1.40 for personal accomplishment. Mental health problems and burnout were found to be high in women, those in the 20–39-year age bracket, those with less than 5 years of work experience, and public health center workers. Conclusion The medical staff responding to COVID-19 were observed to experience high levels of mental health and burnout problems. Work-related characteristics, such as younger age, lower work experience, and employment at a public health center, may have a negative impact on mental health and cause burnout. Therefore, individualized and systemic support for mental health and to prevent the burnout of medical staff responding to cases of COVID-19 is needed.

COMT 유전자 다형성이 도박중독 환자의 중증도 및 사회성에 미치는 영향

이재원(Jaewon Lee),현소연(So Yeon Hyun),김대진(Dai Jin Kim),최정석(Jung-Seok Choi),최삼욱(Sam-Wook Choi) 한국중독정신의학회 2015 중독정신의학 Vol.19 No.2

Objectives : The Val158Met polymorphism of Catechol-O-methyltransferase (COMT) gene is known for its role in various mental disorders. Because the COMT polymorphism influences the activity of COMT enzyme which is involved in the degradation of dopamine, its influence in addictive disorder has been paid attention. We investigated the role of COMT polymorphism in gambling disorder. Methods : A total of 55 male participants (aged : 38.3±11.5 years) diagnosed to gambling disorder with DSM-5 criteria for gambling disorder were recruited for this study. Six symptom scales such as Beck depression inventory (BDI), Beck anxiety inventory (BAI), Barrett impulsiveness scale (BIS), Lubben social network scale (LSNS), Wender Utah rating scale (WURS), and Gambling symptom assessment scale (GSAS) were used. Results : There are 7 for LL (MetMet) gen-otype, 26 for HL (ValMet) genotype, and 22 for HH (ValVal) genotype. The significant differences between genotypes were found in the scores of LSNS, WURS, and GSAS. The lower ac-tivity LL genotype showed significantly higher score of LSNS and lower score of WURS and GSAS than other genotypes. Conclusion : The patient with gambling disorder who has LL COMT polymorphism is supposed to have lower gambling symptoms and also maintain more emotionally stable relation ship lasting from childhood to adulthood than other genotypes. To our knowledge, this is the first report for showing the differences in severity and sociality in gambling disorder between COMT genotypes.