갑상선 기능 저하증에 수반된 정신병에 대한 Levothyroxine(^(�)Synthyroid) 단독치료 1예

조숙행,정인과,곽동일 최신의학사 1990 最新醫學 Vol.33 No.3

계절성 우울증 환자의 아침 광치료 1례

조숙행,이헌정 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.3

저자들은 겨울에 반복적으로 우울 삽화가 발생하고, 봄 또는 여름에 자연적으로 회복되는 전형적인 계절성 정동장애 환자 1례를 경험하였다. 최근에 많은 연구들에서 광치료가 계절성 정동장애에 효과적임을 보고하고 있다. 그러나 광치료의 작용기전과 빛의 밝기와 치료기간, 치료시기 등의 치료변인에 관하여는 아직 많은 논란이 있는 상태이다. 저자들은 2500 lux의 광상자를 이용하여 본 증례의 환자에게 아침 광치료를 시도하여 임상적 증상의 호전을 경험하였기에 관련 문헌의 검토와 함께 보고하고자 한다. The authors identified a patient with typical seasonal affective disorder, characterized by recurrent depression in the winter with remission in the spring or summer. Many studies reported that bright light therapy was effective in seasonal affective disorder, but the mechanism of bright light therapy and the therapeutic parameters of light therapy including intensity, duration, timing are still debated. We treated the patient with morning light treatment using 2500 lux light box, the clinical symptoms in this case were improved. The authors suggest that seasonal affective disorder can be effective treated with morning light treatment.

Flutoprazepam (Restas^(�))의 임상적 효과

조숙행,정인과,곽동일 최신의학사 1989 最新醫學 Vol.32 No.8

스트레스 평가와 관리

조숙행 대한의사협회 2004 대한의사협회지 Vol.47 No.3

Haloperidol과 Benztropine의 과량복용에 인한 항콜린성 증후군 치험 1례

조숙행,김형섭 大韓神經精神醫學會 1988 신경정신의학 Vol.27 No.5

The authors experienced an acute anticholinergic intoxication syndrome in a 17 year-old female schizophrenic patient who had taken overdose of haloperidol(??) and Benztropine (??). This patient showed restless agitation, confusion, disorientation, hallucination, purposeless overactivity, tarchycardia, urinary retention, pupil dilatation and reduced bowel motility. For the management of the patient, physostigmine(??) had been tried and proved to be dramatically effective.

정신과 환자군에서 경한 스트레스요인(Minor Stressor)의 평가 : 불안, 우울장애 환자 중심으로 for the Patient with Anxiety or Depressive Disorder

이봉현,조숙행,곽동일 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.5

본 연구는 1995년 3월 2일부터 1995년 9월 2일까지 약 6개월에 걸쳐 고려대학교 의과대학부속 구로병원 정신과에 내원한 환자중 DSM-IV 진단기준상 불안장애, 우울장애(주우울장애와 불쾌기분장애 포함)에 부합되는 환자들과 신체적 질환 및 정신적 질환이 없는 건강한 일반인을대상으로, 경한 생활사건스트레스를 측정하는 매일 스트레스평가서(DSI), 주요 생활사건척도, 우울척도(BDI), 불안척도(STAI)등을 사용하여 측정후 비교분석하여 다음과 같은 결과를 얻게 되었다. 1) 경한 생활사건스트레스는 사회인구학적 변인에 따라 차이를 보이지 않았다. 2) 경한 생활사건의 빈도, 경한 생활사건으로 인한 스트레스의 지각정도 및 취약성은 환자군이대조군보다 높은 경향을 보였고 특히, 불안장애군에서 가장 높았으나 통계적 유의성은 보이지 않았다. 3) 경한 생활사건스트레스중 불안장애군은 개인능력 요인에서, 우울장애군은 환경스트레스요인에서 대조군에 비해 유의하게 높은 취약성을 보였다. 4) 경한 생활사건스트레스는 주요 생활사건스트레스와 관련이 없었다. 5) 경한 생활사건스트레스는 주요 생활사건스트레스보다 우울, 불안점수와 더욱 높은 상관관계를 보였다. The purpose of this study was to evaluate the effect of minor stressor to the patients with the psychiatric disorders[depressive disorder(major depressive disorder and dysthymic disorer),anxiety disorders according to the criteria of DSM-IV]and control group(N=40). Minorstressor was measured by the Daily stress inventory(DSI) and major life event stress was measured by the Major life event stress inventory. The severity of anxiety and depression were measured by the Beck Depression Inventory(BDI), State-Trait Anxiety Inventory(STAI). The one week DSI impact/event ratio(I/E ratio ; the index of vulnerability to stressful events) score was not affected by the demographic factors. There was no significant difference on DSI scores(event, impact, impact/ event ratio) in minor stressor between the depressive disorder, anxiety disorder and control group, but the anxiety group had the highest DSI scores. The one week DSI scores were not correlated with the score of major life event stress, but positively correlated with the score of BDI, STAI(p<.001) in patient group. And the scores of BDI, STAI were positively more correlated with DSI score than the stress of major life events. The authors concluded that the minor life event as well as the major life event were closely associated with the anxiety and depressive symptoms of patient group. So the DSI seems to be very effective tool to evaluate the minor life event stress. Using a stable baseline of at least 1week and recording DSI scores throughout treatment would provide a potentially useful measure of the course and impact of various interventions, such as medication effects, stress management gainsand response to biofeedback.

간질환자의 출생 순위에 관한 임상적 연구

이민수,조숙행,한선호,서광윤,이병윤 大韓神經精神醫學會 1981 신경정신의학 Vol.20 No.2

To provide data on the clinical issues related to the birth order and other characteristic background in epilepsy, 331 idiopathic epileptic patients were evaluated and analyzed phenomenologically. The patients had been treated at the neuropsychiatric department of the Korea University Hospital during 1974 to 1980. The age at onset ranged from 1 to 45 years, with the mean age of 16.65 years. Males were 1.36 times more than females. Seventeen (5.13%) of the subjects had the family history of epilepsy. Attacks in the daytime only occurred in 67.67% (N=224) of the subjects, while 23.56% (N=78) had their seizures only at night, and 8.77% (N=20) had their seizures both at daytime and night. Grand mal was the most frequent type of seizure, followed by psychometer and petit mal. There was a higher incidence among the first born than the subsequent siblings and the children born second had a somewhat higher frequency of epilepsy than the subsequent children.

월경 전기 변화 여성에서 월경 전기 증상의 양상과 스트레스 대처 방식

류영민,조숙행 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구배경 : 월경 전기 변화의 원인으로써 많은 가설들이 제시되어 왔는데, 이중 환경적인 스트레스와 월경 전기변화의 관련성에 관한 보고가 있다. 즉, 월경 전기 변화을 보이는 여성은 스트레스 상황에서 그것을 평가하고 대처하는 양식이 월경 전기 변화를 유발하거나 악화시킬 수 있다. 이에 본 연구에서는 정상 성인 여성에서 월경 전기 변화군을 선별하여, 월경 전기 변화의 증상 양상과 스트레스 대처방식 사이의 연관성을 알아보고자 하였다. 방 법 : 고려대학교 부속의료원과 부산 동인 병원의 간호사 및 직원과 그 가족 중의 20세 이상의 건강한 성인 여성 51명을 대상으로 하여 대처 방식 체크리스트를 작성하고 1회의 월경 주기 동안 전향적으로 DSM-IV월경전 불쾌 기분 장애의 진단 기준에 기초한 매일 평가서와 매일 지각하는 스트레스의 정도를 작성하도록 하였다. 결 과 : 50% 변화 기준으로 월경 전기 변화를 확인하였으며, 월경 전기 변화가 있는 군과 없는 군에서 인구 통계학적인 요인과 위험 인자들에서 유의한 차이를 보이지 않았다. 월경 전기 변화로 확인된 군은 확인되지 않는 군에 비해서 월경 전기에 스트레스의 지각이 유의하게 높은 것으로 나타났다. 또한 스트레스에 대한 대처 방식의 4가지 요인은 두 군 사이에 유의한 차이가 없었다. 그러나 월경 전기 변화가 확인된 군에서는 월경 전기 증상과 정서 중심 대처와 소극적 대처가 유의미한 상관 관계를 보였던 반면에 월경 전기 변화가 없는 군은 상관관계를 보이지 않았다. 즉, 월경 전기 변화군은 월경 전기 변화가 없는 군에 비해 월경 전기 스트레스를 더 많이 지각하며 소극적 대처방식과 월경 전기 증상이 상관관계를 보이고 있다. 결 론 : 월경 전기 변화가 확인된 군은 월경 전기에 스트레스를 더 많이 지각하며, 월경 전기 변화가 확인된 군과 확인되지 않는 군 사이에 대처 방식이 유의한 차이를 보이지는 않고 있지만 월경 전기 변화군에서 월경 전기 증상들이 정서 중심 대처 및 소극적 대처와 상관관계를 보이고 있다. 이와 같은 결과을 월경전기 변화에 대한 치료에서는 스트레스에 대한 대처 방식에의 접근과 이완 요법이나 인지-행동 치료 등과 같은 스트레스 관리가 도움이 될 수 있음을 제시한다. This study was designed to compare the relationships of premenstrual symptom patterns, stress perception, and coping style between women with premenstrual change and women without premenstrual change, using prospective methods, Fifty one women older than 20 years and in healthy state were asked to complete the Daily Rating Form and Daily Stress Scale(6-point Likert scale) during one menstrual cycle. They were also instructed to respond to the Ways of Coping Checklist. Fifty-percent-change method was used to identify women with premenstrual change, and methods of chi-square, t-test, paired t-test, and correlation were employed to analyze their responses. The results are as follow. 1) 47.1% of the subjects were classified into premenstrual change group. 2) No significant difference between women with premenstrual change and women without premenstrual change was found in demographic characteristics(e.g., age, education, job, marriage)and menstrual chara-cteristics(e.g., ages of menarche, regularity of menstruation, interval and duration of menstru-ation, amount of menstruation, dysmenorrhea). 3) There was no significant difference in coping style between women with premenstrual change and women without premenstrual change. However, we observed relationships between some of premenstrual sym-ptoms(i.e., depressed mood, lability, difficulty in concentrating, change during premenstrual phase. No association was observed between premenstrual symptoms and coping style among women without premenstrual change. 4) Women with premenstrual change reported more stressfulness premenstrually than postmenstrually(t=5.09, df=22, p=.000) as compared to women without premenstrual change(t=0.59 df=26, p=.56). Our findings suggest that, among women with premenstrual change, there exists significant relationship between premenstrual symptom patterns and coping style. Also, the ways stressors are perceived are likely to be affected by the menstrual cycle phase, only among women with premenstrual change. These findings are consistent with the state-dependent model of premenstrual syndrome. Therefore, we should consider stress management as an important therapeutic strategy for those with premenstrual change, because of their high vulnerability to stressors.

기혼 여성의 부부 적응도와 성격 차워난의 연관성

이효근,조숙행,김정웅 한국정신신체의학회 2003 정신신체의학 Vol.11 No.2

위내시경 검사환자에 대한 정신의학적 연구 : BDI와 STAI를 중심으로

신동균,조숙행,이성근 大韓神經精神醫學會 1991 신경정신의학 Vol.30 No.6

The authors studied the emotinal status of the medical outpatient who underwent gastroscopy for gastrointestinal complaints by means of BDI(Beck Depression Inventory) and STAI(State-Trait Anxiety Inventory). Also, the authors compared the degree of anxiety and depression according to each factors of demographic and other data which might influence emotional status. The subjects were 674 patients who underwent gastroscopy at Guro Hospital, College of Medicine, Korea University. from March 1 to September 30, 1986. The results are as follows : 1) There were no statistically significant differences in BDI and STAI between the negative group and positive group, and between the ulcer group and gastritis group. 2) There were no statistically significant differences in BDI and STAI between the gastric ulcer group and duodenal ulcer group, and among the chronic superficial group and erosive gastritis group and atrophic gastritis group. In atrophic gastritis group, there was no statistically significant difference in BDI and T-A among patients with mild, moderate or severe pathology. But in S-A, patients with severe pathology showed higher degree of anxiety than patients with mild or moderate pathology. 3) 25% of the positive group and 13% of the ulcer group and 23% of the gastritis group were rated as depressed by BDI(a score of 21 was used as criterion). 4) In the negative group, according to sex, there was significant difference in BDI and STAI. According to economic state, there was significant difference in BDI, but not in STAI. According to sleep pattern, there were significant difference in BDI and S-A, but not in T-A. 5) In the ulcer group, according to sex, education level, and sleep pattern, there were significant differences in BDI and S-A, but not in T-A. According to economic state, there was significant differences in T-A, but not in BDI or S-A. 6) In the gastritis group, according to age, there was significant differences in BDI but not in STAI. According to marital state, there was significant differences in BDI and T-A, but not in S-A. According to sex, economic state, educational level, early parental death, and sleep pattern, there was significant differences in BDI and STAI.