날씬해지려는 욕망이 유발하는 신경성 식욕 부진증과 탐식증

한오수 사회발전연구소 1995 한국인 Vol.14 No.5

혼재성 불안 및 우울장애

한오수 약업신문사 1998 의약정보 Vol.1998 No.5

백서 뇌에서 선택적 세로토닌 재흡수 차단제인 Sertraline이 Serotonin Transporter mRNA의 조절에 미치는 영향

김창윤,김성윤,홍진표,이철,황온유,한오수 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

연구목적 : 항우울제인 sertraline이 전사 수준에서 serotonin transporter의 유전자 발현에 어떤 영향을 주는 지에 대해 상반된 결과가 보고되고 있어 이를 확인하고자 본 연구를 시행하였다. 방 법 : 각 군 당 백서 5마리를 대상으로 처치군에는 sertraline 10mg/kg을, 대조군에는 생리적 식염수를 복강내에 매일 일회 2주간 투여하였다. 마지막 약물 투여 후 24시간 뒤 고정액으로 관류하여 뇌를 적출한 뒤 raphe 부위를 냉동 절삭하여 얻은 절편들에 대해 미리 준비된 ³(???)S-dATP가 부착된 780bp serotonin transporter cDNA probe와 보합결합(in situ hybridization)을 시행하고, 슬라이드에 부착시킨 다음 X-선 필름에 노출시켜 나타난 serotonin transporter mRNA 신호를 image analyzer로 정량 분석하였다. 통계 자료 분석은 대응되는 절편에 대해 paired t-test를 적용하였다. 결 과 : Sertraline 투여 시 serotonin transporter mRNA 농도가 증가하는 경향을 보였다(p<0.05). 결 론 : 이러한 연구 결과는 sertraline 투여에 따라 시냅스 내 serotonin이 증가함에 따라 이를 보상하기 위해 감소시키는 방향으로 serotonin transporter의 유전자 발현이 조절되는 것으로 해석할 수 있다. The knowledge of gene regulation of serotonin transporter mRNA may provide clues to understanding how antidepressants affect their therapeutic actions. Recently, the effects of antidepressants on the serotonin transporter have been investigated but yielded controversial results. To study this further, we performed in situ hybridization for serotonin transporter mRNA in rats(treatment group, n=5)receiving long term(14 days) treatment with a selective serotonin reuptake inhibiting antidepressant, sertraline(10mg/kg, i.p). Following sertraline treatment, a significant(P<0.05)increase in hybridization of serotonin transporter mRNA was observed compared to that observed in vehicle-treated rats(control group, n=5). This result may be interpreted as a compensatory mechanism to reduce synaptic levels of serotonin which were increased by long term sertraline treatment.

콤퓨터에 依한 精神科 疾患의 診斷

韓五洙 서울대학교 의과대학 정신과학교실 1978 精神醫學報 Vol.2 No.1-12

홧병 경험군과 홧병 비경험군간의 홧병의 질병개념에 대한 비교연구

홍진표,김창윤,이창화,김성윤,박인호,이철,한오수 울산대학교 의과대학 1995 울산의대학술지 Vol.4 No.2

Objective The concept of Hwa-byung in terms of illness entity remains vague. In order to clarify such illness entity, this study was conducted to find out differences and similarities in subjects who experienced Hwa-byung and those who did not experienced Hwa-byung from a wide distribution within the general population. Method (1) Test Material The questionnaires were made up with reference to previously published articles on Hwa-byung, to SCL-90-R and to diagnostic criteria of DSM-Ⅲ-R. The questionnaires included the subject's demographic variables, their awareness of Hwa-byung, their experience of Hwa-byung, and also their opinions about its possible causes, precipitating factors, symptomatology, effective treatment modalities, course and prognosis of Hwa-byung. Such questionnaires were given to 50 subjects, all of whom are psychiatric out-patients at Asan Medical Center, for determining its validity and reliability before selecting 27 questionnaires. (2) Subject Subjects were recruited from among patients and their family members who visited the out-patient clinics of seven different departments at Asan Medical Center in Seoul a large metropolis (N=334), the out-patient clinics of seven different departments of Hae Sung General Hospital in the industrial city of Ulsan, Korea (N=299) and the seven branches of the public health center of Yeonchun county, Korea (N=262), a rural area. From these 895 subjects, 67 subjects who don't know about Hwa-byung and 34 subjects who didn't answered to the question on experience were eliminated from study subjects. The final number of study subjects was 794. (3) Methods of analysis The subjects were divided into the Hwa-byung experienced group and the Hwa-byung inexperienced group. The demographic data and the concepts of Hwa-byung were statistically analyzed by the student t-test or the chi-sq test. Results and Discussion The mean age of the Hwa-byung experienced group is significantly higher than that of the Hwa-byung inexperienced group. MOre women experienced Hwa-byung than men and lesser educated subjects experienced significantly more Hwa-byung. The place of residence, the place of upbringing and socioeconomic status have no significant difference statistically between the two groups. Both groups considered the primary cause of Hwa-byung as being psychological origin. However in the Hwa-byung experienced group, more subjects considered that the supernatural factor was the primary cause of Hwa-byung. One of the primary precipitating events causing Hwa-byung in both groups is conflict in interpersonal relationships ; however, the Hwa-byung inexperienced group exhibited more experiences in the realm of economical losses such as "failure of business" or "loss of capital" as precipitating factors causing Hwa-byung. Both groups consider that the symptoms of Hwa-byung are a combination of multiple physical and mental symptoms. With particular respect to in mental symptoms, such as depressive symptoms, anxiety symptoms and hostility are thought to be prominent features. As effective treatment modalities, subjects in both groups consider that both himself and his family members should make effort to resolve intrafamilial conflicts. But in contrast with the Hwa-byung inexperienced group, the Hwa-byung experienced group requires more concrete and more attention-giving modalities as important treatment strategies. The Hwa-byung experienced group considers its prognosis more grave than the Hwa-byung inexperienced group.

측두엽간질 환자에서 보이는 정신병리의 특성

김창윤,이철,안준호,박인호,한오수 울산대학교 의과대학 1995 울산의대학술지 Vol.4 No.2

The diagnostic tools and treatment modalities for epilepsies are growing in recent years. Therefore many investigators are studying the relationship of ipilepsy and psychopathology. These efforts are not only for the understanding of and therapeutic approach to psychiatric disorder in epileptic patients but also seeking the etiological basis of psychopathologies. Method 45 patients who were diagnosed as temporal lobe epilepsy by brain MRI and EEG etc were investigated, and offered psychiatric diagnosis. Also we took detailed psychiatric histories and investigated the characteristic features of psychiatric disorders in temporal lobe epilepsy. We evaluated several variables, i.e., age, sex, duration of epilepsy, age at first seizure, age at onset of epilepsy, time between first seizure and onset of epilepsy, seizure frequency, history of febrile convulsions, history of clustering seizures, and laterality of focus of these 45 subjects. Futher investigations divided 45 subjects into a group without psychiatric disorder, a group with mood disorder and a group with psychotic disorder. And we compared those variables among these 3 groups. Among 45 subjects, nine were diagnosed as psychotic disorders, five were mood disorders, and two were anxiety disorders. Among 9 subjects with psychotic disorders, six were diagnosed as psychotic disorder NOS, and the other three were schizophrenia. And they manifested unique clinical features in relations to epileptic seizures. Among 5 subjects with mood disorders, 4 subjects were diagnosed as dysthymia with chronic depression and 1 subject were major depression. We compared all variables between the group without psychiatric disorder and the group with psychotic disorder however we can't find any statistically significant differences except one variable. In the group with psychotic disorder, all subjects had the history of clustering of seizures in the rate of 100% of cases, but 54.6% of cases of the group without psychiatric disorder. The statistical difference was significant(p=0.016). It is a preliminary study in this field in Korea. However this study will help to understand the various psychiatric symptoms of the patients with temporal lobe epilepsy and will help to promote further investigations in this field.

대체의학 선택에 영향을 미치는 일반인들의 심리사회적 특성

유희정,노은여,이철,한오수 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.4

본 연구의 목적은 대체의학을 선택하는 사람들의 심리사회적 변인을 다차원상에서 분석해 봄으로써 이 요인들이 어떤 방식으로 선택 과정에 영향을 미치는가를 살펴보고, 대체의학을 선호하는 사람들의 특성을 탐색해 보는 것이다. 서울시에 거주하는 일반인 200명(남 92명, 여 108명)을 대상으로 인구 통계학적 특성, 대체의학에 대한 인지도, 정통의학 기법과 대체의학 기법의 특성, 경험한 대체의학 기법의 종류, 성격변인, 대처방식, 건강에 대한 통제감, 사회적 지지를 측정하였다. 본 연구결과, 연구대상 중 약 80%는 한약을 포함한 대체의학적 치료법을 경험해본 것으로 드러났다. 또한, 대체의학적 기법을 선호하는 사람들일수록 대체의학에 대한 인지도가 높고, 연령수준이 높으며, 적극적-행동적 대처방식을 지니고 있고, 건강에 대한 내적 통제감을 지닌 것으로 드러났다. 대체의학에 대한 관심이 급격히 증가하고, 정통의학 기법과는 달리 대체의학적 치료법의 선택에는 심리적인 요인의 영향이 크다는 점을 감안할 때 앞으로 이 분야에 대한 연구가 보다 폭넓게 진행되어야 하겠다. This study examined the characteristics of people who have preference for complementary medicine and also the psychosocial factors that are related to the selection of complementary medicine. Two-hundred subjects recruited from the community were included in this study. Demographic variables, medical service characteristics, health locus of control, social support, coping style, and personality characteristics such as self-esteem, neuroticism, and hypochon-driasis were measured. It turned out that nearly 80% of the subjects had already experienced at least one alternative therapy in the past. However, past experience was not significant in predicting future complementary medicine usage. People who were older in age, had more information about complementary medicine, used active-behavioural coping styles, and had internal locus of control were more likely to use complementary medicine in the future. Recommendations for furthur research is indicated.

과민성 대장 증후군 환자의 심리적 특성

이성동,민영일,한오수 大韓神經精神醫學會 1993 신경정신의학 Vol.32 No.2

In order to evaluate psychological characteristics of the patients with irritable bowel syndrome, 60 adult patients with irritable bowel syndrome, 14 cases of ulcerative colitis and 45 controls were assessed with Symptom Checklist-90-R(SCL-90-R), Eysenk Personality Questionaire(EPQ) and Global Assessment of Recent Stress Scale(GARS). The results were as follows ; 1) In the symptom dimensions assessed with SCL-90-R, score of the phobic anxiety was higher in the patients with irritable bowel syndrome than in the controls. No significant differences in symptom dimensions were proved between irritable bowel syndrome and ulcerative colitis, and between ulcerative colitits and the controls. 2) In the personality trait assessed with EPQ, the neuroticism score was higher in the patients with irritable bowel syndrome than the controls. No significant differences were manifested between the groups of irritable bowel syndrome and ulcerative colitis, and between the group of ulcerative colitis and the controls. 3) In the stress area assessed with GARS, the patients with ulcerative colitis manifested higher score in the sickness or the injury, compared to the controls, and the patients with irritable bowel syndrome showed higher scores in the scales of work, job and school and unusual happenings, compared to controls.

정상 건강인에서 파록세틴이 인지 및 정신운동기능에 미치는 영향

김창윤,최명기,이창화,안준호,이 철,한오수 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: SSRI 하나인 paroxetine이 정상건강인에서 인지 및 정신운동기능에 미치는 영향을 객관적으로 알아보고자 이 연구를 시행하였다. 방 법: 연구대상은 20세에서 40세 사이의 건강한 남녀 총 10명이었고 그 평균연령은 26.5±5.9세였다. Paroxetine이 인지 및 정신운동기능에 미치는 영향을 기존의 삼환계 항우울제인 amitriptyline과 비교하여 연구를 하였으며 double-blind, two-way, single dose, crossover design에 따라 연구를 시행하였다. 약물은 amitriptyline 50㎎ 또는 paroxetine 40㎎을 일회투여하였으며 두번째 약물은 최초 약물투여 후 1주간의 washout기간이 지난 후 투여하였다. 평가에는 Vienna Determination Unit, Vienna Reaction Unit, Vienna Signal Detection, Grooved Pegboard Test 및 Finger Tapping Test를 이용하였으며 약물투여 전, 약물투여 3시간 후 및 6시간 후 등 3회에 걸쳐서 평가하였다. Crossover model에 따라 반복측정을 고려한 이원분산분석을 시행하여 자료를 분석하였고 다중비교는 Fisher의 최소자승차이법(Least square difference, LSD)을 이용하여서 각 투약군마다 1회 검사(baseline)와 2회, 3회 검사와의 차이를 비교검증하였다. 결 과: 시행된 거의 모든 검사에서 amitriptyline 투여군에서는 대부분 현저한 기능의 저하를 보인 반면 paroxetine 투여군에서는 정신운동기능의 유의한 감소가 관찰되지 않았다. 결 론: Paroxetine은 주간에 주의집중이나 정교한 운동기능을 요하는 일을 하는 환자들에게 보다 적절한 약물이 될 것으로 생각되어지며 이러한 환자들에게서 기존의 삼환계 약물보다 높은 순응도를 보일 것으로 생각된다. 아울러 본 연구는 중추신경계에 작용하는 약물에 관한 임상 연구 분야에서 통상적으로 측정하기 어려운 것으로 알려진 미세한 인지 및 정신운동기능의 변화를 객관적으로 정교하게 평가하여 약물에 따른 차이를 객관적으로 입증하였다는 점에서 의미있는 연구라고 생각된다. Objectives: Paroxetine is known to have fewer cognitive side effects than older antidepressants such as amitriptyline. To confirm this objectively, we compared the effects of paroxetine on the psychomotor performance with those of amitriptyline in 10 healthy volunteers. Method: Paroxetine and amitriptyline were administered orally in a double-blind, two-way, single dose, crossover design. Assessments of psychomotor performances were carried out before and 2 and 6 hours after administration of single dose of paroxetine(40㎎) or amitriptyline (50㎎). Each treatment day was separated by 1 week of washout period. The psychomotor performances were measured using Vienna Determination Unit, Vienna Reaction Time, Vienna Signal Detection, Grooved Pegboard Test and Finger Tapping Test. The data were analyzed using two-way, repeated measures ANOVA on a crossover model. Results: The results showed that paroxetine 40㎎ produced no significant performance decrements on the every test of psychomotor performances, whereas amitriptyline 50㎎ produced markedly impaired performance on most of the psychomotor tests. Conclusion: This study confirmed pervious findings that paroxetine is generally devoid of adverse, side effects on psychomotor performance.

만성 B형 간염 환자의 심리특성에 관한 연구

이민규,이영상,한오수 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.2

The authors investigated the psychological impact of chronic viral B hepatitis on the patients. Ninety-four patients and 100 normal controls who had visited the Health Promotion Center participated in the study. The authors used SCL-90-R for the measurement of psychiatric symptoms, GARS(Global Assessment of Recent Stress Scale) for the measurement of stress perception and the Weisman Coping Strategy Scale for measuring coping ability and efficacies. The results of subjective psychiatric symptoms, stress perception and coping strategy were compared between patient group and control group. To reveal the psychological aspect of infectivity on patients, those scales were compared between 56 HBeAg positive group and 38 negative group. The following results were obtained : 1) The subscale scores of psychoticism, depression, anxiety and positive symptom distress index(PSDI) in chronic viral B hepatitis patients was significantly higher than in control group. The subscale scores of sickness or injury stress perception and financial stress perception in chronic viral B hepatitis patient group was significantly higher than in control group. Patient group used more passive and inflexible coping strategy than control group. 2) No significant difference in stress perception and coping strategy were found between HBeAg positive group and negative group. But the coping strategy of confrontation and 'flexibility' were used more frequently in HBeAg negative group than in positive group. 3) HBeAg positive patients showed less active coping style than HBeAg negative patients in problem-solving. We suggest that chronic viral B hepatitis patients may show inactive, ineffective coping strategy compared to normal controls.