甲狀腺機能亢進症의 精神醫學的 硏究

姜秉祚 慶北大學校 醫科大學 1978 慶北醫大誌 Vol.19 No.2

The author performed the Self-Rating Anxiety and Depression Scale of W.W.K. Zung on 70 female toxic goiters, 68 female non-toxic goiters and 86 normal females from Mar. 1977 to Step 1977. Also the author briefly interviewed 62 toxic goiter patients during the same stdudy period. The results were as follows: 1. In both anxiety and depressive scores, toxic goiters were singificantly higher than non-toxic goiters, and non-toxic goiters were singificantly higher than normal females. 2. The mojority of toxic goiters had emotional traumas during th 2 year prior to the onset of symptoms. Death of a close family member, financial loss, change in residence, personal illness, argument with spouse, death of spouse, marriage, pregnancy and trouble with in-laws were important emotional factors.

Alprazolam과 Fluoxetine이 기억력과 인지 기능에 미치는 영향

박용진,강병조 대한생물치료정신의학회 1996 생물치료정신의학 Vol.2 No.2

Alprazolam이 기억력과 인지기능에 장애를 초래한다는 많은 보고들이 있고, fluoxetine이 기억력 장애를 초래한다는 일부 보고가 있다. 그래서 저자는 정신과 외래에서 가장 널리 사용되는 약 중 하나인 alprazolam과 fluoxetine이 환자의 기억력과 인지기능에 미치는 영향을 평가하고자 본 연구를 수행하였다. 최근 2개월 이상 정신과 약을 비롯한 어떠한 약도 복용한 적이 없는 환자 9명을 대상으로 약을 투여 하기 전에 기억력 검사와 인지기능 검사를 수행하였고, alprazolam과 fluoxetine을 각각을 8주 동안 치료 용량으로 투여후, 기억력 검사와 인지기능 검사를 다시 시행하였다. 그리고 대조군을 두어 동일 검사를 두 번 시행함에 있어서 발생할 수 있는 학습 효과를 평가하였다. 결과는 다음과 같았다. 1) Alprazolam을 투여 한 군에서 투약전 투약후 검사간의 0.05 수준에서 유의한 차이는 없었다. 2) Fluoxetine을 투여한 군에서도 투약전 투약후 검사간에 0.05 수준에서 유의한 차이는 없었다. 3) 대조군에서 8주간격으로 실시한 두 검사간에 0.05 수준에서 유의한 차이는 없었다. 4) Alprazolam을 투여 한 군, fluoxetine을 투여 한 군, 그리고 대조군 사이에서 투약전 및 투약후 검사간에 0.05 수준에서 유의한 차이는 없었다. The benzodiazepines have been reported to cause anterograde amnestic effects. There are also some report that the fluoxetine may be the cause of amnestic effects. The aim of this study was to investigate the effect of alprazolam and fluoxetine on memory and cognitive function. Alprazolam is popular intermediate-acting benzodiazepines and fluoxetine is one of SSRI which is being used most frequently. The subjects were 9 outpatients who visited to Psychiatry Department of Kyungpook National University Hospital. Some patients were under alprazolam medication(N=5, dosage:0.75-1.5㎎) and the others were under fluoxetine medication(N=4,dosage:20㎎-40㎎). The control group(N=6) was formed by normal volunteers, To measure the subjects' memory and cognitive functions, the Wechsler Memory Scale(WMS) and the Computerized Neuropsychological Test(STIM system, neuroscan Inc, 1990) were used. The groups were examed by the WMS and the STIM before medication and after 8 weeks of taking medication. The data were analysed by Wilcoxon Matched-pairs Signed-ranks Test and Kolmogrov-Smirnov 2-Sample Test. The result of this study were as follows: 1) There was no significant difference between pretreatment and posttreatment in alprazolam medication group. 2) There was no significant difference between pretreatment and posttreatment in fluoxetine medication group. 3) There was no significantdifference between pretest and posttest in control group. 4) There was no significant difference between pretreatment and posttreatment among above three groups. In Summary, the effect of alprazolam and fluoxetine on memory and cognitive function has no statistical significance after 8 weeks treatment by therapeutic dosage.

Alcoholics 환자와 Alcohol Dehydrogenase

정태호,신창규,이종학,강병조 경북대학교 병원 1998 경북대학교병원의학연구소논문집 Vol.2 No.1

저자들은 만성알콜중독의 원인으로 음주자의 성격, 사회요인 등 여러가지 문제들이 게재되어 있지만 유전적 요인도 중요하리라고 생각되어 만성알콜중독자로 진단되어 국립부곡정신병원에 입원가료 중인 환자 30명을 대상으로 ADH2의 다형현상(polymorphism)을 조사하여 알콜중독자가 아닌 건강한 한국인의 유전자형과 비교한 결과 다음과 같은 결과를 얻었다. 만성알콜중독자 30명 중 ADH2-1/ADH2-1 형을 갖는 사람이 27명이었으며 ADH2-1/ADH2-2를 갖는 사람이 3명이었다. ADH2¹의 gene frequencies는 0.68이었으며 ADH²의 gene frequencies는 0.32로서 정상 한국인과 비교하여 유의한 차이가 없었다. This study was performed to know the gene polymorphism of alcoholic dehydrogenase(ADH)-2 in 30 Korean alcohol addicted patients who were admitted at Bugok National Mental Hospital. The results were as follows ADH-2/ADH2-1 type among 30 alcohol addicts were 27 and ADH2-1/ADH2-2 type were 3. Gene frequencies of ADH2-1 were 0.68 and gene frequencies of ADH2-2 were 0.32 These results were not different from the gene polymorphism of ADH2 in non-alcoholic Korean healthy adults.

월경전기우울증상 유무에 따른 월경상태 및 월경전기증상의 비교

이제영,강병조 大韓神經精神醫學會 1987 신경정신의학 Vol.26 No.3

As a part of the study for the relationship between affective disorder and premenstrual depressive syndrome, the authors surveyed the characteristics of menstrual condition and frequencies of the premenstrual syndromes in 167 women with major depressive syndrome (MDS) and 342 women without MDS in Taegu, Korea during 4 months from Aug 1, 1985 to Nov, 30, 1985. The results were as follows: 1) In women with MDS, the duration of menstrual flow, dysmenorrhea and mittelschmerz were significantly longer and higher than women with MDS. 2) Among the premenstrual syndromes, impaired social functioning (ISF) was most frequent, 87.4%, followed by general discomfort syndrome (GDS) 83.2%, fatigue syndrome (FS) 67.1%, autonomic physical syndrome (APS) 53.3%, impulsive syndrome (IS) 50.3%, water retention syndrome (WRS) 35.9%, organic mental syndrome (OMS) 33.5% and increased well-being (IWB) 26.3% in women with MDS. In women without MDS, GDS was most frequent, 46.8%, followed by ISF 24.6%, minor depressive syndrome 19.9%, FS 13.2%, anxiety syndrome 8.8%, APS 8.5%, WRS 7.6%, IS 7%, IWB 5%, OMS 1.5% and irritable/angry syndrome 0.3%. 3) IWB, IS, WRS, GDS, APS, FS, ISF and OMS were significantly more frequent in women with MDS than women without MDS.

Lepromin 反應의 再檢討

姜秉祚,金在植,金重明 慶北大學校 醫科大學 1975 慶北醫大誌 Vol.16 No.1

癩腫樣癩(L型) 532例, 非癩腫樣癩(nL型) 177例 都合 709例의 癩患者에 Mitsuda (M)抗原과 Dharmendra (D)抗原에 依한 皮膚反應을 實施하여 그 成績을 다음과 같이 要約할 수 있었다. 1. 早期反應에서는 理用의 判定規準으로 病型判定이 可能하다. 2. M抗原에 依한 晩期反應에서는 理用判定規準에 依하면 L型에서 陽性率이 너무 높았다. 3. M抗原에 依한 晩期反應에 있어서 陽性의 判定規準은 6~7mm 以上이 適當하였다. 4. M反應과 D反應의 48時間値는 매우 有意的 相關性이 있었고, L反應의 48時間値와 14日値도 亦是 有意 的인 相關性이 있었다. In the study of the lepromin reaction with 709 Leprosy patients consisting of 532 cases of lepromatous type and 177 cases of nonlepromatous type, the author has attempted a reevaluation of the lepromin reaction because of the likely disagreement of the present interpretation in the aspects of the determination of the type of leprosy. It was found that the lepromin reaction seemed to be reliable for the determination of the type of leprosy by the early reaction but was unable to determine by the delayed reaction because of the high positivity in the lepromatous leprosy with the Mistuda antigen. Hence in the delayed reaction it is thought to be necessary to increase the range of the diameter of the skin reaction to 6~7㎜. There were apparent correlations between the Mistuda and Dharmendra reaction in the early reaction and also between the early and delayed reactions with the Mistuda antigen.

Clozapine에 의한 야뇨증 1례

강병조 대한생물치료정신의학회 1996 생물치료정신의학 Vol.2 No.2

저자는 만성정신분병을 앓고 있는 17세 여고생에게 haloperidol을 일일 20㎎씩 1년 이상 투여하여도 음성증상이 호전되지 않아 clozapine으로 바꾸었다. Clozapine을 증량하여 2개월째 일일용량 200㎎까지 올렸을 때 야뇨증이 생겼으며 150㎎으로 낮추니 소실되었다. 다시 200㎎ 올렸더니 역시 야뇨증이 재발하여 150㎎으로 낮추니 야뇨증이 다시 소실되는 것을 경험하여서 사례보고 하였다. 저자는 이 사례보고와 더불어 이와 유사한 외국 사례 몇례를 소개하였고 그들의 치료법도 소개하였다. The author reported a 17 year-old-schizophrenic high school Korean girl who developed an enuretic episode with daily dose 200㎎ of clozapine and ceased the enuretic episode at 150㎎ per day. The author also reviewed the literatures about clozapine induct enuresis and urinary incontinence and the treatment involved therein.

정신과와 신경과

강병조 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.3

항우울제 치료에 의한 성기능 부작용 : Serotonin-Specific Reuptake Inhibitor 중심으로 Focused on Serotonin-Specific Reuptake Inhibitors

이승재,강병조 대한생물치료정신의학회 1999 생물치료정신의학 Vol.5 No.2

There are many causes of sexual dysfunction in depression, including primary sexual dysfunction, sexual dysfunction associated with general medical and psychiatric disorders, and sexual dysfunction associated with treatments for psychiatric disorders. But antidepressant-induced sexual dysfunction has emerged as a particular problem in treatment of depression, because depression often requires long-term treatment and anything that interferes substantially with sexual functioning will contribute to noncompliance. The author reviewed the prevalence, potential mechanisms and update treatments of antidepressant-induced sexual dysfunction, focused on serotonin-specific reuptake inhibitors(SSRIs).

糖尿病 患者의 正神科的 症狀

姜秉祚,朴宗漢,丁海翼,尹榮佶 慶北大學校 醫科大學 1979 慶北醫大誌 Vol.20 No.2

著者들은 1979年 8月에서 11월까지 慶北醫大 附屬病院에 入院한 糖尿病 患者 110名(男=61, 女=49)과 對照群 110名(男=61, 女=49)에게 SCL-90을 使用하여 精神科的 症狀을 比較調査하여 본 結果 다음과 같은 結果를 얻었다. 1. 糖尿病 患者群은 對照群 보다 睡眼障碍, 憂鬱症, 罪意識, 强迫症, 不安症, 身體化의 順으로 有意하게 높았고, 對人 敏感性, 編執症 思考, 恐怖不安, 敵愾心, 죽음에 대한 生覺의 順으로 有意하게 낮았으며, 精神症에서는 아무런 差異도 없었다. 2. SCL-9이 糖尿病을 비롯한 韓國人 精神身體疾患者들의 精神科的 病理所見을 알아내고 다루는데 상당한 價値가 있다고 生覺한다. The present study was conducted to investigate the difference of psychiatric symptoms between 110 diabetic group admitted in Kyungpook National University Hospital and 110 control group by SCL-90 from August, 1979 to November, 1979. The results obtained are summarized as follows. Diabetic patients group has significantly higher levels of sleep disturbance, depression, feelings of guilt, obsessive compulsive, anxiety and somatizatization, but lower levels of interpersonal sensitivity, paranoid ideation, phobic anxiety, hostility and thought of death or dying than those levels of contral group. There are no difference between diabetic patients group and control group in psychoticism. The use of this kind of self-administered symptom inventory can be a valuable adjunct to the identification and management of psychiatric pathology in psychosomatic patients such as diabetics in Korea.

정신분열병 환자에서 Olanzapine이 인지기능에 미치는 영향

강병조,김양태,김문두,이승재,박영우 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.1

Objects : The purpose of this study was to test the effects of olanzapine on cognitive functions in schizophrenic patients. Methods : The subjects were 16 haloperidol-medicated schizophrenic patients and 15 risperidone-medicated schizophrenic patients, who participated in an eight-week crossover study from haloperidol and risperidone to olanzapine. Results : The patients in the group of crossover from haloperidol to olanzapine showed significant improvement in Parkinson scale of ESRS and other cognitive functions except for verbal fluency. Negative scale of PANSS and cognitive functions such as verbal memory, verbal fluency, visual memory and executive function were significantly improved in patients In the group of crossover from risperidone to olanzapine. Conclusions : These data suggest that olanzapine has some superior cognitive benefits relative to haloperidol and risperidone, but a larger sample replication study is necessary.