에어로빅 운동이 정신분열증 환자의 체력 및 우울증에 미치는 영향

김윤영,김영준 대한스포츠의학회 1999 대한스포츠의학회지 Vol.17 No.1

The purpose of this study was to investigate effects of an aerobic exercise as a remedy through on schizophrenia patients physical fitness and depression. For this study. 19 patients are selected as samples according to the norm who suffer from schizophrenia at Psychopathic Hospital. The effects of and aerobic exercise on schizophrenia patients during 8 week are measured by the physical fitness test and BDI(Beck Depression Inventory) test is used as the tool of measuring schizophrenia patients depression. The patients' physical fitness increase remarkably in stork stand, trunk flexion and sit-ups, and no significant difference in back strength, sargcnt jump and whole body reaction time. At the result of BDI test, the patients' depression in the exercise group decreases by 13.33 points after an aerobic exercise. while that in the control group shows no significant difference. In this respect, it can be seen that an aerobic exercise has an important effect on schizophrenia patients depression. Consequently, it is known that schizophreniac in the exercise group makes much progress in physical fitness and depression decreases after an aerobic exercise. Therefore, an aerobic exercise can be recommended as a remedy through an exercise suitable to schizophrenia patients physical and psychological characteristics so that schizophrenia patients in the closed hospital can be treated through improvement in his physique.

조현병 진단 후 1년 이내 자살 관련 요인: 국민건강보험공단 자료를 이용한 후향적 코호트 연구

박순주 한국융합학회 2022 한국융합학회논문지 Vol.13 No.2

This study aims to identify factors related to suicide within one year of schizophrenia diagnosis based on data from National Health Information Database. We obtained data of 102,540 patients diagnosed with schizophrenia between 2007 to 2010 from customized database, which was checked using the National Statistics Organization database and schizophrenia cohort was built. The number of suicide within one year of schizophrenia diagnosis was 615(0.60%), and the risk of suicide within one year was high among patients within age group of 25-34 and patients with medium-low to high economic status. The risk of suicide within one year among male patients was high within age group of 45-54 and patients with medium-low to high economic status. The risk of suicide within one year among female patients was high within patients with high economic status. Age and economic status need to be considered during suicide prevention intervention of schizophrenia patients diagnosed within one year and suicide related factors by sex need to be especially considered. 본 연구의 목적은 국민건강보험공단 자료를 이용하여 조현병 진단 후 1년 이내 자살과 관련된 요인을 규명하는 것이다. 연구대상 자료는 맞춤형 데이터베이스에서 2007년부터 2010년 사이에 조현병으로 진단받은 대상자 102,540명으로 통계청 사망자료를 확인한 후 조현병 코호트를 구축하였다. 연구결과 조현병 진단 후 1년 이내 자살사망자는 615명(0.60%)이고, 1년 이내 자살 위험은 25-34세 집단(adjusted OR, 1.40; 95% CI, 1.06-1.86)과 중하(adjusted OR, 1.86; 95% CI, 1.38-2.50)부터 상위(adjusted OR, 1.89; 95% CI, 1.42-2.51)집단의 경제상태에서 높았다. 남성은 45-54세 집단(adjusted OR, 1.60; 95% CI, 1.05-2.43)과 중하(adjusted OR, 2.66; 95% CI, 1.79-3.95)부터 상위(adjusted OR, 2.18; 95% CI, 1.45-3.28)집단의 경제상태에서 자살 위험이 높았다. 여성은 상위집단(adjusted OR, 1.51; 95% CI 1.01-2.27)에서 자살 위험이 높았다. 따라서 조현병 진단 후 1년 이내 자살예방을 위한 중재 시 연령과 경제상태를 고려해야 하며, 성별에 따른 자살 관련 요인에 초점을 두어야 할 것이다.

재가 만성조현병 내담자의 심리상담 경험 연구

노청숙,한재희 한국기독교상담심리학회 2015 한국기독교상담학회지 Vol.26 No.3

The purpose of this study is to analyze the fundamentals of the psychological counseling experience of the patients with chronic schizophrenia. To this end, I selected five non–institutionalized chronic schizophrenia patients with more than a year of counseling experience and analyzed their in–depth interview data according to the phenomenological approach of Giorgi. The patients developed a positive relationship with their counselor and complied with the active therapeutic intervention by the counselor. The patients sought advice from the counselor for difficulties in everyday life. The patients learned how to distinguish the reality from hallucination and they were taught the importance of taking medications. They were given detailed instructions on how to deal with everyday tasks. The participants experienced conflicts at the beginning stage of counseling. However, they soon developed voluntary willingness towards the treatment and remained hopeful by participating in counseling and taking medications. The interventions by the counselor combined with the willingness by the patients resulted in emotional, practical, and subjective effects of counseling. 본 연구의 목적은 재가 만성조현병 내담자의 심리상담 경험의 본질과 의미를 심층적으로 탐구하는 것이다. 이를 위해 전문 심리상담자에게 1년 이상 상담을 받은 재가 만성조현병 환자 5명을 연구 참여자로 선정하여 심층인터뷰한 자료를 Giorgi의 현상학적 연구방법에 따라 분석하였다. 만성조현병 환자인 참여자들은 상담을 받기 시작하면서 상담자와의 따뜻하고 긍정적인 교류를 경험하면서 또한 상담자의 적극적인 치료적 개입을 경험하였다. 참여자들은 상담 초기 상담자와 신뢰관계가 형성되기 전에는 상담에 대한 갈등을 경험하였으나 점차 자발성을 발휘하며 상담에 적극적으로 임하게 되었고, 약물복용과 상담을 꾸준히 병행하면서 자신의 병에 대한 치료적 기대감을 유지하였다. 참여자들은 상담자의 개입과 자신의 자발성 발휘의 순환적 상호작용을 통해 정서적, 현실적, 주관적 측면의 변화를 경험하였다. 참여자들은 심리적 안정감을 갖게 되었고, 현실감을 유지하면서 일상생활이 가능해졌으며, 주변 관계가 이전보다 호전되었다. 또한 참여자들은 장기간의 상담을 통해 자신을 소중히 여기게 되고, 자신의 병을 수용하고 다스리면서 소망을 가지고 살아가는 긍정적인 변화를 경험한 것으로 발견되었다.

빅데이터를 활용한 조현병 인식에 관한 연구

주소희,이경은 한국정신건강사회복지학회 2019 정신보건과 사회사업 Vol.47 No.4

본 연구에서는 빅데이터를 활용하여 조현병에 대한 대중들의 의미 연결 구조를 통해 대중들의 조현병에 대한 인식을 파악해 보고자 한다. 일반 국민들이 조현병에 대해 어떠한 생각들을 가지고 있으며, 이러한 생각이 조현병에 대해 어떠한 이미지 혹은 인식의 틀을 만들어 내는지 확인하고자 한다. 본 연구는 지난 10년 동안 인식된 조현병에 관련된 단어를 맥락(context) 수준에서 의미를 파악하는 텍스트마이닝, 단어 간의 관계를 기반으로 핵심단어를 찾는 의미연결망분석, 그리고 단어와 동시에 연결된 단어들의 그룹을 찾는 CONCOR 분석 방법을 활용하였다. 본 연구결과 첫째, 핵심단어의 빈도가 높은 순은 대중은 정신분열, 환자, 치료, 정신장애, 진단, 약, 환청 망상과 같은 질환과 관련된 단어들이 주로 나타났다. 둘째 네트워크 분석에서는 대중들은 조현병은 환자이면서 동시에 범죄자라는 인과적 인식이 강하게 나타났다. 셋째, I 그룹은 조현병과 관련된 치료와 증상 위주의 단어들이고, II, III 그룹의 단어들은 조현병으로 인해 나타난 범죄와 사건으로 구성되어진다. IV 그룹은 네 번째 그룹은 드라마나 영화에서 나타난 단어들이 중심네트워크를 형성하였다. 본 연구 결과 대중들은 조현과 관련된 인식은 “아프거나 나쁜 사람”들로 인식하고 있었으며 조현병 환자에 대한 인권이나 재활, 사회복귀에 관련된 인식은 나타나지 않았다. 따라서 대중이 조현병에 대해 전인적으로 인식하고 ‘사건중심’이 아닌 ‘사람중심’으로 조현병을 인식할 수 있는 대안을 제시하였다. we want to use big data to understand the public's perception of schizophrenia through the public's semantic connection structure. I want to see what the general public has in mind about schizophrenia and what kind of image or recognition it creates. This study used text mining to grasp meanings of words related to schizophrenia recognized over the past decade at context level, semantic network analysis to find key words based on relationships between words, and CONCOR analysis method to find groups of words connected at the same time as words. The results of this study show that the first, the high frequency of core words, the public, was mainly represented by words related to diseases such as schizophrenia, patients, treatment, mental disorders, diagnosis, medicine, and auditory delusions. Second, network analysis strongly showed that the public has a strong causal perception that schizophrenia is a patient and at the same time Third, Group I is the words for treatment and symptom related to schizophrenia, and the words in Group II and III are composed of the crimes and events resulting from schizophrenia. IV Group 4 formed a central network of words in dramas and movies. The study found that the public recognized Cho-hyeon's perceptions as "sick or bad" and that no human rights, rehabilitation or social return-related perceptions of patients with schizophrenia appeared. Therefore, the public proposed an alternative to recognizing schizophrenia as 'people-centered' rather than 'event-oriented'.

조현병에서 인지행동치료의 적용

이동은 대한신경정신의학회 2012 신경정신의학 Vol.51 No.6

Objectives Cognitive behavioral therapy for treatment of schizophrenia was designed as a psychological therapy for treatment of drug resistant patients with schizophrenia. This therapy is currently being widely applied from early psychosis to chronic condition. The aim of this article is to review the main results of research articles on cognitive behavioral therapy of schizophrenia and prompt practicing the therapy in Korean mental health services. Methods The important original and review articles were referred in order to understand the main results of research from published international books, and the English website Pubmed was searched in order to update recent findings. This article reviewed the results of four areas of different phases and types of cognitive behavioral therapy for treatment of schizophrenia: drug resistant chronic patients, acute psychotic state, prodromal phase, and group cognitive behavioral therapy. Results Cognitive behavioral therapy for treatment of drug resistant patients with schizophrenia can attenuate the positive and general symptoms more than that for patients who receive supportive psychotherapy or treatment as usual. However, the effect appears to be less than previously expected, small to moderate. Cognitive behavioral therapy for patients of acute psychotic state can reduce the time of recovery from acute psychotic symptoms by approximately 25%. The result of cognitive behavioral therapy for patients of prodromal phase shows that the therapy can reduce the rate of transition to schizophrenia by up to one third. Group behavioral therapy has recently been tested. Group therapists have suggested that the therapy should be applied through the way of groups with relatively homogenous symptoms. However, whether the therapy can reduce the severity of hallucination in the voice hearer group is inconclusive. Conclusion Alongside pharmacotherapy for treatment of schizophrenia, cognitive behavioral therapy is a distinct psychological therapy for attenuation of psychotic symptoms. The effect of cognitive behavioral therapy appears to last for one year and requires additional therapeutic sessions after one year. The effect is not still clear in group cognitive behavioral therapy for treatment of schizophrenia. Cognitive behavioral therapy for treatment of schizophrenia should be practiced widely in the Korean mental health system. 조현병의 인지행동치료는 약물치료와 더불어 정신병적증상을 효과적으로 다룰 수 있는 가장 체계적인 심리학적 치료 방법이다. 조현병의 인지행동치료를 통하여 전구기 정신증 환자부터 약물저항성 만성 환자까지 망상과 환청과 같은정신병적 증상에 일정 부분 호전을 가져올 수 있으며 사회적기능 회복에도 도움이 될 수 있다. 인지행동치료의 효과는 약1년 정도 지속되는 것으로 보이며 이후에는 부가적인 치료가필요하다. 집단 인지행동치료의 정신병적 증상에 대한 효과는 명확하지 않지만 비교적 동질적인 증상 집단을 대상으로치료를 시도하였을 때, 사회적 기능 회복에 대한 효과는 있는것으로 보인다. 조현병의 인지행동치료는 국내의 임상과 지역사회에서 활발하게 적용되어야 할 것이다.

항정신병약물 비노출과 비투여 정신분열증 환자의 99m-Tc-ECD SPECT로 측정한 상대적 뇌혈류량 차이

김세주,안석균,전덕인,이종두,민성길 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.6

연구 목적: 정신분열중 환자에서 뇌 혈류량은 나이. 성별, 이환기간, 임상양상 등에 영향을 받는다. 또한 약리학적 상태도 고려해야 할 중요한 요소이다. 그러나 항정신병약물 비투여 (drug-free) 정신분열증 환자군과 전혀 약물을 복용하지 않은 환자군(drug-naive)사이의 상대적 뇌혈류량에 대한 유용한 자료는 거의 없다. 이런 상태에서 많은 연구들이 '항정신병약물 비노출군과 비 투여군의 상대적 뇌혈류량 양상이 동일할 것이다.'라는 가정에서 두 군 모두를 '현재 약물을 복용하고 있지 않은(unmedicated)'정신분열증 환자에 포함시켜 연구하고 있다. 따라서 본 연구에서는 뇌혈류량에 영향을 미칠 것으로 생각되는 나이, 성별. 이환기간, 임상중상(양성증상 및 음성증상) 등의 혼란변수를 통제한 상태에서 항정신병약물 비노출 정신분열증 환자화 비투여 정신분열증 환자의 뇌혈류량이 동일한지 여부를 알아보고자 하였다. 연구방법 : 항정신병약물 비노출(antipsychotic drug-rlaive) 정신분열증 환자 18명과 비투여(drug-free) 환자 15명을 대상으로 안정 상태에서 SPECT를 촬영하여 국소 뇌혈류량을 폭정하였고, 두 군 사이의 상대적 뇌혈류량을 비교하였다. 결 과: 좌측 저측두엽, 우측 저전두엽. 좌 · 우측 기저신경절, 좌 · 우측 시상. 좌 · 우측 고측두엽. 우측 두정-후두염 및 좌 · 우측 고전두엽에서 두 군 사이의 상대적 평균 혈류지표는 유의한 차이를 보이지 않았다. 그러나 우측 저측두엽과 좌측 저전두엽에서의 상대적 평균 혈류지표는 항정신병약물 비투여군에서 비노 출군에 빅해 유의하게 증가되어 있었다. 또한,좌측 두정∼후두엽과 좌·우측 두장엽에서의 상대적 평균 혈류지표는 항정신병약물 비노출군에서 비투여에 비해 유의하게 증가되어 있었다. 결 론; 항정신병약물 비노출 정신분열증 환자군과 비투여 환자군의 상대적 뇌 혈류량은 서로 다름을 알 수 있었다. 그러므로 이전의 항정신병약물 노출여부는 정신분열증 환자의 뇌혈류량 연구에서 반드시 고려되어야 할 중요 요소로 시사된다. 0bjectives : In schizophrenics, regional cerebral blood flow(rCBF) are affected by various confounding variables, i.e., age, sex, duration of illness, and clinical status. The pharmacological condition of patients is also a particular important variable to be taken into consideration. However, few data are available regarding the differences between the relative rCBF findings in drug-free and drug-naive schizophrenic patients. Currently, numerous studies have included drug-free and drug-naive schizophrenic patients in the same'unmedicated'group under the assumption that the rCBF is identical between drug-free and drug-naive cases. Therefore, the aim of this study was to compare the rCBF between a group of drug-free schizophrenic patients and a group of drug-naive schizophrenic patients about the effects of age, sex, duration of illness, and clinical status(positive and negative symptoms) under control. Methods : Eighteen drug-naive schizophrenics and fifteen drug-free schizophrenics were included in the study. Regional cerebral blood flow was studied with the single-photon emission computed tomography(SPECT) under resting state. Symptoms were assessed with Positive and Negative Syndrome Scale(PANSS). Regions of interest were both inferior temporal lobe, inferior frontal lobe, superior temporal lobe, thalamus, basal ganglia, parieto-occipital lobe, superior frontal lobe, and parietal lobe. Results: No significant differences of relative rCBF were found between drug-free and drug-naive schizophrenic patients in left inferior temporal lobe, right inferior frontal lobe, both superior temporal lobe, both thalamus, both basal ganglia, right parieto-occipital lobe, and both superior frontal lobe. But, drug-free schizophrenic patients had a significant increase of perfusion in the right inferior temporal lobe and left inferior frontal lobe and a significant decrease of perfusion in both parietal lobes and left parieto-occipital lobe. Conclusions : Relative rCBF in drug-free schizophrenic patients is different from that in drug-naive schizophrenic patients. So, in the relative rCBF studies of schizophrenic patients, it must be considered whether the patients were previously medicated or not.

Association between Therapeutic Alliance and Adherence in Outpatient Schizophrenia Patients

Jhin Goo Chang,Daeyoung Roh,김찬형 대한정신약물학회 2019 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.17 No.2

Objective: Although various clinical factors that affect medication adherence in schizophrenia have been studied, the role of the therapeutic alliance has not been studied in detail. Accordingly, we investigated the association between medication adherence and therapeutic alliance in patients with schizophrenia treated in a community outpatient clinic in Korea. Methods: In this cross-sectional study, 81 outpatients who met the DSM-IV-TR criteria for schizophrenia were analyzed. Therapeutic alliance was measured via patient-self-report questionnaires consisting of 12 questions, which evaluate both “affective bond” and “collaborative bond” of alliance. We investigated the relationship between medication adherence and therapeutic alliance through correlation and regression analyses. Results: Overall therapeutic alliance was weakly associated with medication adherence (r=0.268, p<0.05). Among two factors of therapeutic alliance, “affective bond” was associated with adherence (r=0.302, p<0.05), but collaborative was not. Regression analysis showed that therapeutic alliance significantly predicted medication adherence even after adjustment for duration of treatment, insight, and symptom severity. Conclusion: Maintaining a favorable therapeutic alliance is associated with medication adherence in schizophrenia. Further, treating patients in a frank and genuine manner might be important to improve adherence.

특수체육 : 댄스스포츠 운동이 정신분열증 환자의 체력에 미치는 영향

홍명엽(HongMyeng-Yeb),어경철(EhKyung-Chel),장성동(ChangSeung-Dong),최진관(ChoiJin-Gwan),김주혁(KimJu-Hyeok),이윤관(LeeYun-Gwan),김영준(KimYoung-Jun) 한국체육학회 2003 한국체육학회지 Vol.42 No.2

The purpose of to study is to analyze the change of body composition physical fitness, and pulmonary function after practicing dance sports of 60 minutes a day in 2 times a week during 12 weeks based on schizophrenia patients (male:5, female:6) who are in 30-60 aged hospitalized in the lunatic hospital. The results of the above study are as follows; % Fat is found to have a significant decrease in the male and female groups after dance sports exercise, Back strength and whole body reaction time are found to have a significant increase in the male group, and then trunk flexion and whole body reaction time are also found to have a significant increase in the female group. Forced vital capacity(FVC) is found to have a significant increase in the female group, and then the rate d forced vital capacity(%FVC) is found to have a significant increase(p<.05) in the male and female groups. But forced expiratory volume of per one second(FEV₁ ) is found to have a significant change in the male and female groups. Therefore, the results of physical test after practicing dance sports show a significant increase, and then dance sports are found to increase and keep the physical fitness, and then some when dance sports are practiced to mental patients who have been hospitalized in the lunatic hospital for a long time, it is recognized that physical fitness gives a significant increase to the above patients.

만성조현병 환자를 대상으로 한 스트레스관리 프로그램의 효과

송예빈,안혜란 전남대학교 간호과학연구소 2022 Nursing and Health Issues(NHI) Vol.27 No.1

Purpose: The purpose of this study was to examine the effects of a stress management program on perceived stress, interpersonal relationship, self-esteem, and problem-solving ability for chronic schizophrenic patients. Methods: The participants comprised 50 male patients recruited from G Metropolitan City, who were divided into two groups of 25 each. They were randomly assigned to test and control groups, respectively, through convenience sampling. A stress management program was provided to the test group in over 11 sessions for six weeks from July 1 to August 5, 2018. Data were analyzed using Kolmogorov-Smirnov test, Chisquare-test, Fisher’s exact test, and independent t-test with the SPSS/ WIN 24.0 Program. Results: There were significant changes in perceived stress score (t=−2.37, p=.013), interpersonal relations score (t=3.44, p=.001) in the experimental group before and after treatment. Self-esteem score (t=1.61, p=.059) and problem solving ability score (t=1.38, p=.091) was no significant difference in score between the test and control groups. Conclusion: The results of this study indicate that the stress management program was effective in reducing perceived stress levels and improving personal relationship ability in patients with chronic schizo-phrenia. The findings suggest that stress management programs can be utilized as an efficient nursing intervention to preventsocial isolation and personal relationship dissolution in patients with chronic schizophrenia by lowering their stress levels and improving their personal relationships.

The Effects of Social Skills Training vs. Psychoeducation on Negative Attitudes of Mothers of Persons with Schizophrenia: A Pilot Study

Chulkwon Kim,Kim T. Mueser 대한신경정신의학회 2011 PSYCHIATRY INVESTIGATION Vol.8 No.2

Objective We compared the effects of two brief psychoeducation programs and social skills training on the negative attitudes of mothers with a son who has schizophrenia. Methods 15 mothers with strong negative feelings towards a sons with schizophrenia were assigned by convenience to participate in one of three brief (5 session) group programs at an outpatient clinic: lecture-based psychoeducation, video-based psychoeducation, or social skills training. Assessments using the Patient Rejection Scale were conducted with the mothers at post-treatment, and 3-, 6-, and 9-months later. Results Mothers in the three groups demonstrated significantly different patterns of changes in their negative attitudes following treatment. Whereas the mothers who received the two psychoeducation interventions showed reductions in rejecting attitudes immediately following the program, their scores gradually increased at the subsequent follow-up assessments. In contrast, the mothers in the social skills training group showed reductions in negative attitudes that were sustained across all of the follow-up assessments. Conclusion Brief social skills training may be more effective than psychoeducation in reducing negative attitudes of parents who have an offspring with schizophrenia. Objective We compared the effects of two brief psychoeducation programs and social skills training on the negative attitudes of mothers with a son who has schizophrenia. Methods 15 mothers with strong negative feelings towards a sons with schizophrenia were assigned by convenience to participate in one of three brief (5 session) group programs at an outpatient clinic: lecture-based psychoeducation, video-based psychoeducation, or social skills training. Assessments using the Patient Rejection Scale were conducted with the mothers at post-treatment, and 3-, 6-, and 9-months later. Results Mothers in the three groups demonstrated significantly different patterns of changes in their negative attitudes following treatment. Whereas the mothers who received the two psychoeducation interventions showed reductions in rejecting attitudes immediately following the program, their scores gradually increased at the subsequent follow-up assessments. In contrast, the mothers in the social skills training group showed reductions in negative attitudes that were sustained across all of the follow-up assessments. Conclusion Brief social skills training may be more effective than psychoeducation in reducing negative attitudes of parents who have an offspring with schizophrenia.