양극성 장애에서 Longitudinal Interval Follow-up Evaluation-Range of Impaired Functioning Tool(LIFE-RIFT)의 신뢰도 및 타당도

국소담,유빈,김우정,김경란,이은,김세주,전덕인,조현상 대한우울조울병학회 2010 우울조울병 Vol.8 No.2

Background and Objectives:In this study, we assessed reliability and validity of Longitudinal Interval Followup Evaluation-Range of Impaired Functioning Tool (LIFE-RIFT) with study samples consisted of Korean bipolar disorder patients, and evaluated its availability as a tool for reflecting psycho-social functioning. Materials and Method:The subjects consisted of 28 acute manic or depressive bipolar patients, 72 euthymic bipolar patients,and 69 normal control groups. We compared and supervised Korean version of LIFE-RIFT first. Then we measured its concurrent validity of it by conducting LIFE-RIFT and GAF on patient groups and normal control groups. We also measured discriminative validity by comparing three groups described above. Inter-rater reliability and testretest reliability were analyzed on 17 patients and 14 patients, respectively, and internal consistency of each item was evaluated. Results:Internal consistency of each item of LIFE-RIFT obtained was high with Cronbach’s α=0.75. The correlation between LIFE-RIFT and GAF was negative to a reasonable degree with r=-0.623, p<0.001. The discriminative validity showed significant difference to a reasonable degree among three groups (acute manic/depressive patient group, euthymic patient group and control group) with p<0.001. This phenomenon was also observed between euthymic state patient group and control group with p<0.001. Test-retest reliability and interrater reliability was high with intraclass coefficient (ICC)=0.85 and ICC=0.98, respectively. Conclusion:Korean version of LIFE-RIFT showed significant reliability and validity in evaluating Korean bipolar disorder patients. Therefore,as proven in other countries, this system can be a useful tool for the assessment of psycho-social functioning in Korea.

주의력 결핍 과잉 행동 환자에서 OROS-Methylphenidate 투여 후 신경심리학적 변화에 대한 개방 연구

국소담(So-Dahm Kook),김주영(Joo-Young Kim),천근아(Keun-Ah Cheon),정경운(Kyungun Jhung),송동호(Dong-Ho Song) 대한소아청소년정신의학회 2013 소아청소년정신의학 Vol.24 No.3

Objectives:Previous studies reported that attention-deficit hyperactivity disorder (ADHD) resulted from a deficit of selective attention and sustained attention. In this study, we assessed the result of methylphenidate-induced changes of the cerebral frontal executive functions in patients with ADHD. Methods:The subjects in this study consisted of 16 ADHD patients whose age ranged from 7 to 12. We used ADHD Diagnostic System (ADS) for the attention improvement, and the Stroop Test for the executive function response to pharmacotherapy with MPH. Results:After pharmacotherapy with methylphenidate for 12 weeks, the study group showed improvement in the clinical aspects through Clinical Global Impression-Severity, ADHD-rating scale and Inattention/Overactivity With Aggression Conner’s Parents Rating Scale. In the ADS test, only in auditory task there was a decrease of both the response time and the standard deviation of the response time significantly. In the Stroop Test, there was a decrease in the word task, color task and color-word task significantly. Conclusion:Our results show that psychostimulant medication improves neuropsychological function, including the cerebral frontal executive function. This study implies that we have to consider the improvement of executive function, as well as attention when evaluating the efficacy of treatment.

일 지역사회 독거노인의 삶의 질과 관련된 우울 및 인구사회적 요인

유성원,김현수,손상준,배활립,국소담 대한노인정신의학회 2014 노인정신의학 Vol.18 No.1

Objective:This study is to suggest the plans for improving the quality of lives of the solitary old people by evaluating the effects of depression, social supports, and activity of daily living to the quality of life. Methods:The subjects of this research were 329 elderly people who lived alone in Gangseo-gu, Seoul, Korea. They were recruited and underwent the questionnaire including their sociodemographic data, Activities of Daily Living/Instrumenal Activities of Daily Living scale (ADL/IADL) and the Korean version of the Short Geriatric Depression Scale (SGDS-K). Statistical analyses including Pearson’s correlation test, Multiple regression were performed in this study. Results:They were composed of 83.6% females and 16.4% males and almost age was between 70 and 84 years old. House welfare availability (p<0.05), subjective economic status (p<0.05), and SGDS-K score (p<0.01) had a negative correlation with Quality of life. Multiple regression analysis revealed that Quality of life correlates to SGDS-K score (p<0.05). Conclusion:The quality of life of elderly living alone was related with depression. Early detection and management for depression may need to be considered for quality of life of community dwelling elderly living alone.

일 지역사회 독거노인의 자살사고와 관련된 인구사회학적 및 임상적 요인

이재원,김현수,손상준,배활립,국소담 대한노인정신의학회 2014 노인정신의학 Vol.18 No.1

Objective:The purpose of this study was to examine the relationship between suicidal ideation and the associated with sociodemographic and clinical factors in community dwelling, elderly living alone in Korea. Methods:A total of the 329 community-dwelling elderly aged 65 years or older who lived alone were recruited and they underwent the questionnaire including their sociodemographic data, Activities of Daily Living/Instrumental Activities of Daily Living scale (ADL/IADL) and the Korean version of the Short Geriatric Depression Scale (SGDS-K). Suicidal ideation was evaluated by using the “suicidal thought” item of the Beck Depression Inventory (BDI). Results:According to the result of our sample of elderly living alone, 22.8% of the subjects reported their suicidal ideation. ADL/IADL score (p<0.01), subjective economic status (p<0.05), and subjective health status (p<0.05) had a negative correlation with suicidal ideation. SGDS-K score (p<0.05) had positive correlations with suicidal ideation. Multiple regression analysis revealed that suicidal ideation correlates to ADL/IADL score (p=0.025). Conclusion:This study exhibit that ADL/IADL is significantly associated with suicidal ideation.

정신병적 증상 동반 여부에 따른 1형 양극성장애 환자의 정동기질 특성

김우정,김경란,유빈,국소담,하라연,이경수,이은,석정호,전덕인,조현상 대한우울조울병학회 2010 우울조울병 Vol.8 No.2

Objectives:It has been known that in bipolar I disorder, there are some clinical and neurobiological differences between patients with or without a history of psychotic symptoms. This study aimed to investigate the differences of affective temperaments measured by the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) between bipolar I disorder patients with and without psychotic symptoms. Methods:52 bipolar patients with bipolar I disorder and 32 normal controls were enrolled in this study. Except for irritable temperaments which was tested by Kruskal-Wallis test, one-way ANOVA were used to compare each subscale of TEMPS-A among psychotic bipolar patients (N=23), nonpsychotic bipolar patients (N=29), and normal controls. Then post-hoc analyses were done. Results:When compared among the 3 groups, cyclothymic temperament scores were significantly higher in nonpsychotic patients than normal controls. And irritable temperament scores in nonpsychotic patient group were significantly higher than the other groups. There were no significant differences in depressive, hyperthymic, and anxious temperament scores among the 3 groups. Conclusion:We found that bipolar I disorder patients without psychotic symptoms have some different affective temperaments compared with psychotic bipolar patients and normal controls. These results suggest that even a same diagnostic group,bipolar I disorder, may have differences in their temperaments across the subgroups.

군 병사들에서 인터넷 중독 경향에 따른 입대 후 심리특성 변화

강현묵,김현수,조현상,안석균,오병훈,이강수,홍창형,배활립,국소담,손상준,Kang, Hyun Mook,Kim, Hyun Soo,Cho, Hyun Sang,An, Suk Kyoon,Oh, Byoung Hoon,Lee, Kang Soo,Hong, Chang Hyung,Bae, Hwallip,Kook, So Dahm,Son, Sang Joon 대한생물정신의학회 2013 생물정신의학 Vol.20 No.3

Objectives The aim of this study was to find out the psychological changes associated with internet addiction between before and after the military drill among the young male army recruits. Methods All 1091 participants were army recruits aged from 19 to 22 years who participated in the 5-week military drill. They were assessed with some self-reported questionnaires [Sociodemographic questionnaires, Young's Internet Addiction Scale (IAS), the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory (BDI), the Barratt Impulsiveness Scale (BIS), the Attention-Deficit/Hyperactivity Disorder Self-Rated Scale (ASRS)]. They were divided into two groups, One is the internet addiction tendency group and the other is non-addiction group according to the IAS score. And the severity of the internet addiction tendency, depression, anxiety and impulsiveness were evaluated by the IAS, the STAI, the BDI, the BIS, the ASRS before and after military drill. Results The result of the paired t-test shows that the IAS, the STAI, the BDI, the BIS, the ASRS scores decreased after military drill in both non-addiction group and internet addiction tendency group. The result of the repeated measures ANOVA shows that there is an interaction effect between the changes of ASRS-hyperactivity (F = 23.437, p < 0.001), ASRS-impulsiveness (F = 4.896, p = 0.027), BIS-total (F = 4.057, p = 0.044), BIS-motor impulsiveness (F = 13.609, p < 0.001) scores and groups. The result of the generalized estimating equation shows that internet addiction tendency is associated with ASRS-inattention (${\beta}=0.075$, p < 0.001), ASRS-hyperactivity (${\beta}=0.092$, p = 0.002), STAI-trait anxiety (${\beta}=0.046$, p < 0.001), BIS-motor impulsiveness (${\beta}=0.119$, p = 0.028). Conclusions The results show that psychopathologies such as internet addiction tendency, depression, anxiety, impulsiveness may improve after military drill regardless of the groups. Internet addiction tendency may be related to the ASRS-inattention, ASRS-hyperactivity, STAI-trait anxiety, motor-impulsiveness. So these findings may be considered in the treatment of internet addiction in terms of the impulsiveness control.

조현병 환자의 항정신병 약물에 대한 부정적 태도 및삶의 질에 미치는 영향

한창우(Changwoo Han),신경민(Kyoung Min Shin),손상준(Sang Joon Son),국소담(Sodahm Kook),배활립(Hwallip Bae),정경희(Kyung Hi Jung),김현수(Hyun Soo Kim) 대한사회정신의학회 2013 사회정신의학 Vol.18 No.2

목 적 : 조현병은 다양한 정신병적 증상과 함께 인지능력 감소와 사회적 기능저하 등을 초래하여 일상생활에 장애를 일으킨다. 조현병 환자들이 삶의 질에 영향을 미치는 요인들은 다양한데, 그 중 환자들이 항정신병 약물에 대해서 갖는 태도는 조현병 환자들의 삶의 질을 떨어뜨릴 수 있는 주요 원인으로 알려져 있다. 따라서 본 연구에서는 조현병 환자들의 항정신병 약물에 대해서 갖고 있는 주관적 태도를 확인하고, 이것이 환자들의 삶에 질에 어떠한 영향을 주는 지를 알아보고자 하였다. 방 법 : 정신보건 센터에 등록된 조현병 환자 248명을 대상으로 구조화된 설문지를 사용하여 자기 기입 방식으로 정보를 수집하였다. 우선, 참가자들의 동반된 비정신과적 신체질환을 조사하였다. 신체질환이 있는 조현병 환자들을 대상으로 한국판 약물태도 검사(Korean version of Drug Attitude Inventory-10)을 사용하여 항정신병 약물에 대한 태도를 확인하였으며, 이것을 신체질환 약물에 대한 태도와 paired t-test를 실시하여 비교 분석하였다. 또한 조현병 환자들의 약물에 대한 태도가 삶의 질에 미치는 영향을 확인하기 위하여, 항정신병 약물에 대해서 한국판 세계보건기구 삶의 질 척도 단축형(WHOQOL-BREF)을 시행하고, Pearson 상관분석을 통해서 비교하였다. 결 과 : 조현병 환자들 중 신체 질환이 있는 환자들은 43.9%에 해당하는 107명 이었다. 신체질환이 있는 조현병 환자들의 항정신병 약물에 대한 태도 및 반응과 신체질환 약물에 대한 태도는 긍정적 태도 점수 및 전체 점수에서 유의한 차이가 나타나지 않았으나, 부정적 태도 점수에서는 유의미한 차이를 보였다. 삶의 질과 약물 태도의 상관관계를 분석해본 결과, 항정신병 약물에 대한 주관적인 긍정적 태도는 삶의 질 척도의 심리건강, 환경, 전체 평균 영역과 유의한 정적 상관관계를 보였으나 항정신병 약물에 대한 부정적 태도는 삶의 질 척도의 모든 영역과 유의미한 정적 상관을 보였다. 결 론 : 조현병 환자들은 항정신병 약물에 대해서 신체질환 약물보다 부정적인 태도를 보였다. 또한 조현병 환자들의 이러한 항정신병 약물에 대한 태도는 다양한 영역에서 환자들의 삶의 질에 영향을 미치는데, 항정신병 약물에 대한 부정적인 태도가 긍정적인 태도에 비해 다양한 영역에서 관련성이 있는 것으로 조사되었다. 따라서 조현병 환자들은 항정신병 약물에 대해서 부정적인 태도를 보이며, 이러한 항정신병 약물에 대한 태도는 조현병 환자들의 삶의 질에 영향을 미치는 중요한 요인이 될 수 있다. Objectives : The aim of this study was to examine the drug attitude toward antipsychotics in schizophrenic patients. This study also evaluated the relationship between drug attitude and quality of life in patients with schizophrenia. Methods : The study was carried out on the 248 patients with schizophrenia attending a Community Mental Health Center in Gangdong-gu. This study protocol included sociodemographic variables, information about physical health, Korean version of Drug Attitude Inventory-10 (KDAI-10), and World Health Organization Quality of Life (WHOQOL-BREF). Data were analyzed using One way ANOVA, χ 2 -test, paired t-test, and Pearson correlation coefficients with SPSS 17.0 program. Results : The participants showed significantly more negative attitude toward antipsychotics than somatic medicines. The nega-tive attitude toward antipsychotics was correlated with all domain of quality of life and the positive drug attitude toward antipsychotics was correlated with some domain of quality of life. Conclusion : The results of this study suggest that schizophrenic patients have the negative attitude toward antipsychotics. And the subjective attitude toward antipsychotics seems to be correlated with quality of life in schizophrenic patients.