알코올에 대한 생리적 반응이 음주동기와 음주문제에 미치는 효과에 대한 연구

이현정(Hyun-Jeong Lee),기선완(Seon Wan Ki),김지웅(Ji-Woong Kim),김성은(Sung-Eun Kim),송지은(Ji-Eun Song) 한국중독정신의학회 2008 중독정신의학 Vol.12 No.2

Objectives:It has become known that experiencing a low-level of physiological response when consuming alcohol poses a greater possibility of causing more frequent drinking problems. This study was performed to find the causal effects of physio-logical responses arising from consuming alcohol on drinking motivation among college students. Methods:The subject pool consisted of 115 randomly-selected college students. The level of physiological response, degree of drinking motivation, and resulting drinking problems were evaluated according to the Self-Report of the Effects of Alcohol (SRE), the Drinking-Motivation Questionnaire, and the Alcohol Use Disorder Identification Test (AUDIT), in that order. Results:SRE totals and SRE during the heaviest drinking period are associated with AUDIT scores. According to the data acquired by Correlation Analysis, when comparing the levels of the subjects’ incidents of binge drinking and those of the most recent 3-month period of drink-ing, the SRE value showed a connection with enhancement motivation (r=0.278) and coping motivation (r=0.259). Further-more, multiple-regression analysis was executed to elucidate a causal relationship, and the results pointed to the SRE total’s causal influence on the drinking motivation total, enhancement motivation, and coping motivation. Upon measuring motivation, there was a significant disparity of (p<0.05) between the high-risk and low-risk groups. Conclusion:This study was first in the field to shed a light on the effects SRE has on motivations for alcohol consumption. Upon concluding the study, the results clearly indicate that SRE, which has gained consideration as a reliable means of recognizing alcohol abuse problems, has a cogent causal-influence on coping motivation, which is an incontrovertible indicator of alcohol abuse. However, due to the restrictions induced by the inadequate numbers in the subject pool and an abridged methodology which bears the shortcomings that come from lack of precision and sophistication, it is indubitable that the study needs to be improved upon further with more ac-curacy and exactitude on an extensive scale.

월경전 불쾌기분장애 환자에서 증상과 기질과의 관련성

김성은,이정현,김덕만,박진균,기선완,김지웅,Kim, Sung-Eun,Lee, Jung-Hyun,Kim, Deok-Man,Park, Jin-Kyun,Ki, Seon-Wan,Kim, Ji-Woong 한국정신신체의학회 2006 정신신체의학 Vol.14 No.1

연구목적 : 본 연구는 월경전 불쾌기분장애와 기질 특성과의 관련성을 알아봄으로써 월경전 불쾌기분장애의 병태생리 및 관련된 성격 경향을 이해하며 치료 응용의 가능성을 제시해 보고자 하였다. 방법 : DSM-IV 진단기준에 의해 월경전 불쾌기분장애로 진단된 28명을 대상으로 한국어판 TPQ, 축약형 월경전기평가서 등을 작성케 한 후, 이들 사이의 상관관계를 구하였다. 결과 : 기질의 4가지 차원에 해당하는 점수를 독립 변인으로 하고, 축약형 월경전기평가서 점수를 종속 변인으로 하여 표준 중다회귀분석을 시행하였을 때 월경전 불쾌기분장애 증상은 Cloninger가 제시한 성격의 기질을 구성하는 4가지 요인 중 손해 회피(HA) 요인과 보상 의존(RD) 요인에 대하여 유의하였으며, 특히 손해 회피(HA) 요인에 의해 가장 많이 설명될 수 있는 것으로 나타났다. 결론: 월경전 불쾌기분장애의 증상은 높은 손해 회피(HA) 요인과 낮은 보상 의존(RD) 요인에 의해 잘 설명되었다. 월경전기증상 중 특히 정동 증상이 손해 회피(HA) 요인과 상관관계를 갖고 있는데, 이는 월경전 불쾌기분장애가 기질의 특성에 영향을 받음을 의미한다. 이는 향후 월경전 불쾌기분장애의 병태생리의 이해에 도움이 될 것으로 생각한다. Objectives: The study was intended to explore the relationships between temperament and premenstrual dysphoric disorder, to understand symptomatology of premenstrual dysphoric disorder and associated personality trait and to suggest therapeutic availability. Method : Twenty eight women, diagnosed as premenstrual dysphoric disorder by DSM-IV, were asked to complete the Korean version of Tridimensional Personality Questionnaire, and Shortened Premenstrual Assessment Form. The correlations between the severity of premenstrual symptoms and the scores of Tridimensional Personality Questionnaire were calculated. Results : The severity of symptoms of premenstrual dysphoric disorder was best explained by the harm-avoidance factor of the four dimensions of temperament. Conclusion : The symptoms of premenstrual dysphoric disorder are well explained by the harmavoidance factor and the reward-dependence factor of four dimensions of the temperament.

알코올정책의 개념과 효과성

노성원(Sungwon Roh),이해국(Hae Kook Lee),기선완(Seon Wan Ki) 한국중독정신의학회 2009 중독정신의학 Vol.13 No.2

This article describes the concept and efficacy of alcohol po-licy, including a brief historical review of interventions for alcohol-related problems, the basic concept of alcohol-related problems, interventions from a public health perspective, comprehensive prevention, community systems, frameworks, and practical prevention strategies in terms of evidence for their effectiveness, research support amounts, implementation costs, and other feasibility issues. Alcohol-related problems cannot be solved only by treatment models. More comprehensive preventions and interventions are needed, because evidence shows such problems have complicated and diverse characteristics. The prevailing view-point on alcohol-related problems has changed, from its being a sin, in the past, to being a disease, in the 70’s, and, recently, to being a biopsychosocial concept. Prevention frameworks require intervention strategies, establishing the severity of patients’ problems, establishing a concrete target group, and a range of target. Overall, the interventions with the greatest amount of empirical support are (1) low legal limits on blood alcohol concentration levels for driving while intoxicated, (2) controls on alcohol availability, (3) age limits on alcohol purchases, and (4) relatively high alcohol prices. Policy efforts in the developing countries should focus on improving countermeasures against driving while intoxicated, measures that alter the drinking context, and limits on alcohol’s physical availability. For developed countries, the goal should be to prevent any backsliding with regard to current drinking patterns and to reduce the overall volume of alcohol consumed. Many evidence-based policies clearly seem to have the potential for communities to substantially reduce their alcohol-related problems.

알코올중독에 대한 포괄적 치료 체계의 개발

이해국(Hae Kook Lee),이명수(Myung-Soo Lee),기선완(Seon Wan Ki),최삼욱(Sam-Wook Choi),조근호(Keun Ho Joe),박애란(Aeran Park),정인원(In-Won Chung),김석범(Seok Beom Kim),이정태(Chung Tai Lee),권용실(Yong Sil Kweon) 대한사회정신의학회 2007 사회정신의학 Vol.12 No.2

Alcoholism is complex primary physiological disease with unique therapeutic interventions, and neither a primary behavior disorder nor ay symptomatic manifestation of any other disease process. And, it is highly prevalent disease with important impact on public health perspective. Therapeutic approach for alcoholism need to be organized by integrative and comprehensive systems, because that development and course of alcoholism are influenced by complex interaction between biological and environmental factors. We tried to developing effective intervening systems for alcoholism in seoul by evaluating the current state of service for alcoholism and referring to advanced treatment system in other countries. The problems of current state are lack of public awareness for seriousness of alcoholism, difficult access to treatment system and weak capacities to managing alcoholic patients in the community. Integrative and comprehensive intervening system for alcoholism are accomplished by developing system of matching services to alcoholic subjects in the community level based on seriousness and needs of alcoholic subjects. Referring to current state of alcoholism service in Seoul, treatment system should be developed based on continuum of care system in which the different intensity of service is placed and organized in the community level. First, the rehabilitation centers for chronic alcoholics and intensive outpatients centers should be newly established. Second, it is needed to strengthen the function of alcohol counseling centers and community mental health centers as coordination centers for alcoholics. Third, legal and political support should be established to induce improvement of inpatient and outpatient treatment service quality. Finally, setting up a committee to support and organize these integrative treatment systems is needed.

한국인 알코올사용장애 임상경과 및 생물정신사회적 요인 규명을 위한 임상 및지역기관 전향적 연구 : ( I ) CRF 개발과정 및 단면적 조사결과

김홍진(Hong Jin Kim),이수비(Soo Bi Lee),정원미(Won Mi Jung),서정석(Jeong Seok Seo),남범우(Beomwoo Nam),조근호(Keun Ho Joe),이해국(Hae Kook Lee),정슬기(Sulki Chung),기선완(Seon Wan Ki)박일호(Il Ho Park) 한국중독정신의학회 2018 중독정신의학 Vol.22 No.1

Objectives : The purpose of this study was to develop a standard case record form (CRF) and to identify the specific biopsychosocial factors influencing a clinical course of patients with alcohol use disorder in Korea. Methods : The CRF was developed with reference to the six-domain assessment of the American Society of Addiction Medicine, taking account of the need for a multifaceted evaluation of alcohol use disorders. We divided Korea into six regions, and the subjects who registered in the first year will be on surveillance for the next three years. Results : We present epidemiological and clinical data from the CRF completed from March to June 2016. In the CRF registration survey, the total number of eligible patients was 247 in the Medical centers, and 193 in community centers for mental health and addiction. Conclusion : The CRF developed for this surveillance can assess a six-domain model, with information taken from patient’s drinking history to social support and quality of life. To my knowledge, this is the first nationwide survey of AUD patients in Korea as conducted by a naturalistic and prospective framework. These results could be an important basic data to determine the appropriate service and treatment level for AUD pat

만성 정신분열증 환자에 있어 Clozapine 투여에 의한 비정형적 Prolactin반응

이홍식,김찬형,기선완 대한신경정신의학회 1994 신경정신의학 Vol.33 No.3

Objects : Typical antipsychotic drugs robustily increase prolactin both in rodents and in man. Unlike in rodents, Meltzer(1989) found that acutely administered clozapine did not increases serum prolactin levels in schizophrenia and his preliminary data suggested that prolactin levels might even be reduced during clozapine treatment. Methods : We investigated the serum prolactin levels in chronic schizophrenics, who were assigned to clozapine(N=28) or haloperidol(N=20) for eight weeks. Blood samples were obtained biweekly during the study period, and serum prolactin concentrations were measured by standard double-antibody radioimmunoassay. Results : The serum prolactin levels were not changed in the schizophrenic patients to whom clozapine had been administrated, otherwise marked increases in serum prolactin level were observed in the haloperidol treatment group. Conclusion : Our results suggest that clozapine differs from typical antipsychotics(e.g., haloperidol) in its failure to produce serum prolactin elevation in schizophrenic patients.

알코올 의존에 대한 최근 정신사회 치료적 접근

기선완 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.6

Alcohol use disorder is a one of major psychiatric problems in Korea. But after detoxification treatment, relapse is very frequent. Psychosocial therapy is a crucial element in alcoholism treatment and prognosis. There are so many psychosocial treatment modalities, In this article, various psychosocial treatments are explained. The main lists of introduced recent Psychoso-cial treatments on alcoholism are as follows : therapeutic community, cognitive-behavioral therapy, motivation enhancement therapy, twelve step facilitation therapy, network therapy, and other community-based treatment, In Korea, in contrast to the importance of huge alcoholic problems, comprehensive alcoholism treatment system is weak. Therefore well-modified and Korean styled psychosocial treatment programs on alcoholism is requested.

강박장애의 약물 치료

이종섭,기선완 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.1

The author reviewed pharmacotherapy for obsessive compulsive disorder. Serotonin reuptake inhibitors (SRIs) and The tricyclic antidepressant clomipramine are the first line therapies for patients with obsessive compulsive disorder (OCD), with the side-effect profile of selective SRIs (SSRIs) being more favorable than clomipramine. As many as 40% to 60% of patients with OCD may not response to adequate trials of SRIs. Not all patients tolerate SSRIs, and delay in full therapeutic responses often occur. Thus, other pharmacological approaches to treating patients with OCD have been investigated. Augmentation and monotherapy have been explored with serotonergic enhancers, dopamine and 5-HT antagonists , enhancers of second -messenger systems, and GABAergic agents with varying efficacy.

"한국판 학령전기 기질성격검사[K-psTCI]" 의 신뢰도 및 타당도 검사

박진균,김지웅,기선완,신의진 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : The purpose of this study was to evaluate the reliability and validity of the Korean version of Preschool Temperament and Character Inventory (K-psTCI), a questionnaire based on Cloninger's seven-factor model of personality. Methods : The psTCI was translated into Korean and administered to 266 children aged 2-6 years. α test-retest study of the K-psTCI was conducted across a 4-month interval, Internal consistency was calculated by Cronbach a. Test-retest and reliability was analyzed by Pearson correlation analysis. Factor analyses for the temperament and character dimensions were performed using principal component analysis, rotating factors by varimax. The psTCI scores of Korean and United States preschoolers were compared Results : Cronbach α values for the K-psTCI scales ranged from .62 to .78 for each dimensions. Test-retest correlations (r) ranged from .50 to .77 for each dimensions. Explorative factor analysis with the condition of eigenvalue greater than 2 produced four factors for the temperament items and three factors for the character items like the US original version of psTCI. Through factor analyses, five items in the K-psTCI were categorized differently from the US version of psTCI. Korean preschoolers had higher mean scores on Cooperativeness (CO) in males as compared to a sample of US preschoolers. Conclusion : The results of this study suggests that the Korean preschool TCI is satisfactory in reliability and validity.

알코올 금단 증상의 치료에서 Topiramate의 효과 및 안정성

최은애,기선완,김성은,김지웅,박진균 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.3

Objectives : Benzodiazepines are most often used for the treatment of alcohol withdrawal, but they also may result in several adverse consequencies such as sedation, respiratory depression, cognitive impairment, disinhibition, and abuse. New anticonvulsants, topiramate may have a potential to treat alcohol withdrawal effectively. This study compared the therapeutic responses of a benzodiazepine, lorazepam, and an anticonvulsant, topiramate, for the treatment of alcohol withdrawal. Methods : Fifty-two hospitalized patients with the diagnosis of DSM-IV Alcohol dependence, after obtaining written informed consent, were randomely divided into the either lorazepam (N=27) or the topiramate (N=25) groups. Subjects were assessed with CIWA-Ar scores at the time of baseline, 1, 3, 5 day after the last alcohol drinking. Lorazepam was given 4 mg divided by 4 on day 1, tapering to 2 mg divided by 2, and topiramate was given fixed single dose of 50 mg a day. Results : There were no significant differences between two groups in demographic or clinical characteristics except marital status and s-ALT level. Two groups had similar ADS scores and baseline withdrawal severity. There were no significant differences by treatment group in CIWA-Ar scores over time (F=0.883, P>0.05). Conclusion : Efficacy and safety were not different between the two groups. Therefore our results suggest that topiramate is a Promising alternative agent to benzodiazepine for treating alcohol withdrawal.