정신과 입원환자의 집단정신치료에 대한 小考

반건호,장환일 慶熙大學校 醫科大學 1988 慶熙 醫大 論文集 Vol.13 No.1

영유아건강검진 사업에서 소아정신과 전문의의 역할

반건호 대한신경정신의학회 2020 신경정신의학 Vol.59 No.3

Given that many adult mental disorders begin in childhood, an assessment of infants’ and children’s cognitive, social, emotional, and behavioral problems can lead to early detection and intervention. Among the national life-cycle health policies in Korea, the first assessment was the National Health Screening Program for Infants and Children (NHSPIC) under the age of six since 2007, which was led by the Korean Center for Disease Control and Prevention and Korean Pediatric Society. Since 2012, the target has been expanded to infants aged 66–71 months, and seven checkups were conducted on each child with a medical examination and health education for parents. Pediatric translational specialists, including language pathologists and pediatric psychiatrists, collaborated on the NHSPIC. The Korean Developmental Screening Test (K-DST) is applicable from the second examination (9–12 months after birth). This test evaluates six categories: gross motor, fine motor, cognition, communication, social interaction, and self-control. Each category consists of eight questions. Caregivers check the assessment questions according to the age group, and physicians classify the developmental levels into three stages: peer and high, follow-up evaluation, and further evaluation. The Korean Academy of Child and Adolescent Psychiatry was incorporated to develop electronic media exposure, emotional and social skills, and pre-school preparation items for health education for parents. An advanced assessment with psychiatrists may occur in the cognitive/lingual/social/self-help areas of the K-DST area. A collaboration of psychiatrists in NHSPIC will reduce the incidence and progression of neurodevelopmental disorders.

민간건강보험에서 정신과 질환에 대한 보험비 지급 관련 약관 현황과 문제

반건호,김종우,조아랑,박진경,김영종,박준헌 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.4

Objectives : Recently, Korean psychiatrists have noticed the complaints from probands and family members that private health insurance companies do not pay for most psychiatric disorders. Furthermore, Probands cannot even apply for insurance because of their medical record of psychiatric disorders. Authors investigated and reviewed contracts of Korean private insurance companies to find reasons for banning psychiatric disorders from insurance policies. Methods : Authors reviewed more than 800 contracts from 48 insurance companies. Results : Among all the psychiatric diagnoses, few of them-dementia and some other organic mental disorders-are guaranteed to be paid from insurance companies. Less then 10 contracts say they pay for psychiatric illnesses. Most insurance companies have contracts prohibiting F codes ; however, there are not enough reasons in these contracts. Conclusions : In the private health insurance system, Psychiatric illnesses have almost no rooms. It is very urgent to add space for patients with psychiatric illnesses and psychiatrists in the insurance policies.

청소년기: Granville Stanley Hall부터 Emerging Adulthood까지

반건호 한국정신분석학회 2020 精神分析 (Psychoanalysis) Vol.31 No.4

Adolescence is known as the transition stage between childhood and adulthood. Stanley Hall described the emotional turmoil during adolescence as ‘storm and stress’ with the biological changes of puberty. Establishing identity and achieving secondary separation and individuation are the main development tasks. The innovative development in the field of biology has enabled us to explain the imbalance between adolescents’ emotion and thinking ability due to the difference in the speed of development of the brain in adolescence, rapid changes in the limbic circuitry, and relative slow progress of the prefrontal lobe circuit. The tremendous changes in social culture have changed the definition of the developmental stages and the developmental goals in adolescence. Teenagers in the 21st century prefer living in cyberspace to the real world, and digital communication is more convenient than speaking in language. While the theory of sexual development that Sigmund Freud was concerned about was based on sex as the unitary sense, people perceive sex and gender separately and can change biological sex through surgery according to the gender they prefer. The diversity of gender identity emerged as a new adolescent development task. The classical psychoanalytic development theory is linear, and stage-based. The socio-demographic changes cause responsibility as an adult to be delayed in the late 20s. As a result of the complex interaction studies of the brain, body and environment, a new developmental stage, and emerging adulthood, are being highlighted.

성폭행 피해 여아들에 대한 정신과 자문 경험

반건호 釜山醫師會 1995 釜山醫師會誌 Vol.31 No.3

영유아보육이 아동의 정신건강에 미치는 영향

반건호 대한소아청소년정신의학회 2019 대한소아청소년정신의학회 학술대회논문집 Vol.2019 No.11

정신지체의 대체의학적 치료접근

반건호 경희대학교 2001 慶熙醫學 Vol.17 No.1

주의력결핍-과잉운동장애의 비중추신경흥분제 치료의 최신지견

반건호,손소정,이서경,강원섭,조아랑,박진경 경희대학교 2006 慶熙醫學 Vol.22 No.1

Methylphenidate (MPH), amphetamine, and pemoline are cerebrostimulants that have been commonly prescribed for more than half century in the treatment of attention-deficit/hyperactivity disorder (ADHD). The use of such drugs, however, is often followed by untoward effects such as loss of appetite, insomnia, nausea, abdominal pain, vomiting, irritability, and etc. There are also debates about decrements in height and weight percentiles and drug dependency. Thus, in this study, we discussed new therapeutic drugs, non cerebro-stimulants, with possibly less adverse effects and more efficacies. Atomoxetine, highly selective inhibitor of the presynaptic noradrenaline transporter with little or no affinity for other neurotransmitter transporters and receptors, is a non-excitatory drug with a strong possibility to replace CNS excitatory drugs. It is also safer in relation to drug dependency since it does not affect nucleus accumbens or the striatum. Atomoxetine, therefore, can be used in patients who do not respond to the CNS excitatory drugs. Tricyclic antidepressants, imipramine and desipramine are also most extensively studied drugs as ADHD treatment modalities. They also exert inhibitory effect on the reuptake of norepinephrine. The use of these drugs in children, however, is limited because of cardiovascular effects. Bupropion is one of promising drugs in treating prepubertal children with ADHD. It is also useful for comorbid depression and conduct problems. Increasing attention is being given to a narcolepsy drug, modafinil. Modafinil acts on histamine pathway resulting in wakefulness. This effect is similar to that of neuropeptide orexin. Since the effect of modafinil is independent of catecholamine, drug dependency adverse effect is not expected. Recently, some new drugs, such as reboxetine, are reported as safe and efficacious for children with ADHD, but they need long-term safety and controlled studies.

임상적 평가 및 감별진단

반건호 대한소아청소년정신의학회 2017 대한소아청소년정신의학회 학술대회논문집 Vol.2017 No.2

What Psychotherapy Do Centenarians Need?

반건호 한국정신분석학회 2018 精神分析 (Psychoanalysis) Vol.29 No.2

The life expectancy of human beings exceeds 80 years in Korea. Due to the low birthrate, the proportion of aged individuals, including centenarians (aged 100 years and above), is increasing rapidly. While the life span increases, the available socioeconomic and psychological support system for the elderly is not adequate. Developmental milestones for such aged individuals have yet to be established. The most formidable physical challenge of the elderly is cognitive deficit, such as dementia, due to deterioration of the brain. The elderly suffer from psychological ailments, especially depression and suicide. On the other hand, although centenarians comprise a very old age group, they live long without suffering from illness. Even a few late nonagenarians are healthier than early nonagenarians. Although physical and mental symptoms can be handled with medications, we need additional interventions to enhance mental health, such as psychotherapy and lessons from centenarians. Performance in developmental tasks during psycho- therapy is an important criterion for mental health assessment. Therefore, the authors reviewed emotional, behavioral, and lifestyle patterns of centenarians to design appropriate developmental tasks. Common health tips for centenarians include “stay active, interact with relatives, and follow a balanced diet.” The major difference in psychotherapy between the elderly and the younger population is the multigenerational transference. The most difficult concern in the psychotherapy of the elderly, compared with younger individuals, is coping with death. Sex imbalance-more women than men-is a unique phenomenon that should be addressed in psychotherapy.