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논문검색은 역시 페이퍼서치

정신병리학검색

The Korean Journal of Psychopathology


  • - 주제 : 의약학분야 > 정신과학
  • - 성격 : 학술지
  • - 간기: 연간
  • - 국내 등재 : -
  • - 해외 등재 : -
  • - ISSN : 1225-5300
  • - 간행물명 변경 사항 :
논문제목
수록 범위 : 18권 1호 (2009)

종설 : 치매의 신경심리학적 접근

김태호 ( Tae Ho Kim ) , 문석우 ( Seok Woo Moon )
4,000
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It is increasingly apparent that each form of dementia has a distinct cognitive profile, and that this reflects the pattern of underlying neuropathological change. Advance in the understanding of the neuropsychology of the dementias has led to a greater role for neuropsychological assessment in the diagnosis and treatment of the various neurodegenerative diseases. A full neuropsychological battery produces a much wider range of scores and taps more cognitive domains, making early detection possible and providing differential diagnosis within the dementias. It is non-invasive, well tolerated by patients, relatively inexpensive, and most importantly, it may be sensitive to the prodromal phase often seen in dementia. In this review, a brief outline of the rationale for neuropsychological assessment is given, together with a description of what a detailed neuropsychological assessment can offer a clinician over and above simple rating scales such as MMSE and ADAS-cog.

종설 : MRI로 측정한 해마로 경도인지장애에서 알츠하이머병을 예측

최진영 ( Jin Yong Choi ) , 한상돈 ( Sang Don Han ) , 문석우 ( Seok Woo Moon )
4,000
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MCI is an intermediate cognitive state between normal aging and dementia. Most MCI patients transition to AD, but some remain stable and others improve. Hippocampal volume measures are sensitive to early brain change, therefore hippocampal atrophy correlates strongly with pathological staging and cognitive decline, and predates conversion of MCI to AD in the old. MRI-based volumetric measurements of hippocampus are being used clinically with increasing frequency, because of it accurately depicts the structural-functional relationships between memory loss and hippocampal damage across the spectrum from MCI to AD. Smaller hippocampi and specifically CA1 and subicular involvement are associated with increased risk for conversion from MCI to AD and these quantitative, dynamic visualizations of hippocampal atrophy rates in MCI and AD may provide a promising measure to track AD progression in drug trials.

종설 : 경도인지장애에서 알츠하이머병의 경과와 연관된 신경정신학적 증상의 고찰

최진영 ( Jin Yong Choi ) , 문석우 ( Seok Woo Moon ) , 남범우 ( Beom Woo Nam )
4,000
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Mild Cognitive Impairment(MCI) often represents a transitional stage betweeen normal aging and Alzheimer`s Disease(AD). Review of many studies of MCI and AD, The overall pattern of neuropsychiatric symptoms in MCI is similar to that seen in mild AD, with depression, apathy, agitation, anxiety, and irritability among the most commonly exhibited symptoms. Several longitudinal studies of MCI suggest that depression and apathy in particular may represent prodromal symptoms of AD that are indicative of subsequent development of dementia, althougth not all investigators have confirmed these findings. These symptoms have serious adverse consequences and should be inquired about and treated as necessary.

종설 : 우울증의 진단평가 지침 -우울증 평가도구를 중심으로-

정성원 ( Sung Won Jung ) , 이은정 ( Eun Jung Lee ) , 최윤경 ( Yun Kyeung Choi ) , 성형모 ( Hyung Mo Sung ) , 김대현 ( Dae Hyeon Kim ) , 최정식 ( Jeong Shik Choi ) , 김정범 ( Jung Bum Kim )
5,300
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초록보기
Depression is the second most common chronic disease in primary care. However, depression is commonly misdiagnosed, or though diagnosed properly, it is easy to treat inadequate doses or duration of antidepressants. It is of importance to diagnose and treat properly. Because of a wide range of symptoms and comorbidities, it is difficult to make a diagnosis of depression. Rating scales can be useful for the diagnosis of depression. It is feasible that the clinicians assess the patients with depression appropriately and determine therapeutic strategies by rating scales for depression. We have reviewed the purpose of rating scales for depression, including screening, ratings of symptoms, diagnosis, the progress, and the results of treatment. We also have described the actual condition of rating scales in Korea, which were performed by clinical research center for depression. It is restricted within marrow limits to select certain rating scale for depression and poorly known that some scales have been developed. Therefore, it is important task to announce the rating scales for depression so that the clinicians and researchers can be familiar with these scales. It is also important to develop a diversity of scales so that the clinicians can select appropriate scales.

원저 : 정신과 외래 환자에서 우울증상과 무감동의 관계

박정원 ( Jung Won Park ) , 이문수 ( Moon Soo Lee ) , 양재원 ( Jae Won Yang ) , 김승현 ( Seung Hyun Kim ) , 조숙행 ( Sook Haeng Joe ) , 정인과 ( In Kwa Jung )
4,000
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초록보기
Introduction: Apathy was found in patients with disorders seemingly unrelated with depression such as dementias, stroke, Parkinson`s disease, Alzheimer`s disease, and schizophrenia. As apathy is common in depressive patients and depressive patients with apathy have poorer prognosis than depressive patients without apathy, it might be important that we evaluate the relationship between apathy and depressive symptoms in clinical practice. Therefore, we evaluated the relationship between apathy and depressive symptoms in patients using Hamilton Rating Scale for depression(HRSD), Beck depression inventory(BDI), and apathy evaluation scale-clinician version(AES). Method: This study was performed in Korea university medical center, Guro hospital. Outpatients diagnosed as currently having depressive disorders or have achieved state of remission were enrolled (n=70). We translated AES into Korean and performed a cross-sectional assessment using HRSD, BDI and AES. Results: There was a positive correlation between total score of HRSD and the total score of AES (R=0.757, p<0.001). The AES score was higher correlated with subtotal scores of the four apathyrelated items from HRSD; loss of interest, psychomotor retardation, loss of energy, and loss of insight (R=0.827, p<0.001). Moreover, there was a positive correlation between total score of BDI and the total score of AES(R=0.552, p<0.001). In high BDI score group(n=33), 32 patients showed apathy syndrome. However, there was not a positive correlation between total score of BDI and the total score of AES. In low BDI group(n=37), 21 patients showed apathy syndrome. There was not a positive correlation between total score of BDI and the total score of AES. In high HRSD group(n=21), all patients had clinically meaningful apathy syndrome. There was not a positive correlation between total score of HRSD and the total score of AES. On the other hand, in low HRSD group(n=49), 32 patients had apathy syndrome. There was a statistically significant positive correlation between total score of HRSD and the total score of AES(R=0.720, p<0.001). Moreover, there was also a significant correlation between subtotal scores of the four apathy-related items from HRSD and the total score of AES(R=0.793, p<0.001). Conclusion: This cross-sectional study shows that apathy symptoms are different from the depression. However, apathy symptoms frequently coexist with depression. Even if the depressive patients scored below cut-off value in HRSD or BDI as they are in clinically remission state, we should consider the possibility of apathy syndrome.

원저 : 대학생에서 해리와 NEOPI-R로 측정한 성격특성과의 관계

이정식 ( Jung Sik Lee ) , 이우경 ( Woo Kyeong Lee ) , 박상준 ( Sang Jun Park )
4,000
초록보기
Objectives: Dissociative experiences are conceptualized as existing on a continuum raging from relatively common everyday occurrences to more pathological forms of dissociation. Although dissociative experiences are often precipitated by stress or trauma, there may be an underlying vulnerability or diathesis for experiencing dissociation. Previous research investigating personality traits and dissociative experience in non-clinical samples reported significant relationships of dissociation with Neuroticism and Openness of NEOPI-R. The present investigation sought to explore the relationship between dissociation and personality dimensions. Methods: The relationship between dissociative experiences and personality dimension was investigated in a sample of 214 undergraduate students. Personality characteristics was measured by the NEOPI-R, dissociative experiences by the DES-K(Dissociation Experience Scale-Korean version), and pathological dissociation by DES-T(Dissociation Experience Scale-Taxon). We divided the students into two groups according to DES-K (DES-K≥20, N=60; DES-K<20 N=154) and DES-T scores(DES-T≥20, N=21; DES-K<20 N=193) to evaluate differences in personality domains of NEOPI-R. Chi-square test and t-test was used for differences in personality domains of NEOPI-R and demographic variables according to variable. Pearson correlation test was used for relationship among the NEOPI-R, DES-K and DES-T. We also used stepwise and logistic regression analysis to evaluate accountability of personality domains for dissociative experiences. Results: In high DES-K group, scores of Neuroticism(t=4.404, p=.000) and Openness(t=2.334, p=.021) domain was higher and score of Conscientiousness(t=-2.468, p=.014) was lower than low DES-K group. DES-T groups also had similar results in the t-test. In the total samples, score of DES-K was correlated with scores of Neuroticism(r=.206, p<.01) and Openness(r=.237, p<.01). In high DES-K and DES-T samples, there was no correlation between DES and NEOPI-R. But in low DES-K and DES-T samples, there was a correlation between DES and Neuroticism. In the stepwise regression analysis, scores of DES-K were explained partly by Neuroticism and Openness and DES-T by Openness and Neuroticism. In the logistic regression analysis, DES-K group was explained partly by Neuroticism and Openness and DES-T by Openness and Conscientiousness. Conclusion: As hypothesized, The Neuroticism and Openness domain accounted for the great portion of variance in the dissociative experiences. Compared DES-K, there were some differences in case of DES-T. This result suggested that there were some differences between normative dissociation and pathological dissociation. Extensive study is needed in dissociative disorder patients for investigating the pathological dissociation.

원저 : 한국판 정신과적 진단 선별 질문지(Psychiatric Diagnostic Screening Questionnaire; PDSQ)의 진단적 타당도

최정식 ( Jeong Shik Choi ) , 김희철 ( Hee Cheol Kim ) , 정성원 ( Sung Won Jung ) , 이은정 ( Eun Jung Lee ) , 성형모 ( Hyung Mo Sung ) , 사공정규 ( Jung Kyu Sakong ) , 신임희 ( Im Hee Shin ) , 김정범 ( Jung Bum Kim )
4,000
초록보기
Objectives: Although many tools have been developed to diagnose mental disorders so far, it has not been easy to administer because it is necessary to undergo training for the professionals as well as time required to administer those tools. The Psychiatric Diagnostic Screening Questionnaire; PDSQ, developed by Zimmerman et al, 2001, is self-reporting test for screening DSM-IV axis I disorders in clinical settings, and it is well known for its simplicity and availability. This study compared Korean PDSQ with Mini-International Neuropsychiatric Interview(M.I.N.I.-Plus) for their diagnostic availability, as a part of standardization of Korean version. Methods: The samples were 320 patients, who were selected from 3 university hospitals in Daegu and Kyoungbook for K-PDSQ and Mini-International Neuropsychiatric Interview(M.I.N.I.-Plus). The diagnostic correspondence, sensitivity, specificity and administering time were evaluated for PDSQ as well. Results: For the diagnostic correspondence of PDSQ, Cohen`s kappa coefficient was .69 between PDSQ and MINI-Plus. The administering time was 19.3±12.9min, which was similar to the M.I.N.I.-Plus` minutes. The sensitivity was higher than 90% in most of the 13 PDSQ subscales(MDD; 100%, PTSD; 75%, Bulimia Nervosa; 100%, OCD; 68%, Panic Disorder; 93%, Psychosis; 59%, Social Phobia; 98%, Alcohol Dependence/Abuse; 94%, Drug Dependence/Abuse; 100%, Agoraphobia; 83%, GAD; 88%, Somatoform Disorder; 100%, Hypochondriasis; 96%), and the AUC(area under the curve) values of them were above 0.79(MDD; 0.91, PTSD; 0.82, Bulimia Nervosa; 1.00, OCD; 0.80, Panic Disorder; 0.94, Psychosis; 0.79, Social Phobia; 0.87, Alcohol Dependence/Abuse; 0.96, Drug Dependence/Abuse; 1.00, Agoraphobia; 0.92, GAD; 0.81, Somatoform Disorder; 0.99, Hypochondriasis; 0.97). Conclusion: PDSQ showed significant diagnostic correspondence. time-efficiency and high level of sensitivity and specificity. PDSQ is considered to be useful diagnostic tool before the first interview of the patients for the screening of DSM-IV Axis I diagnosis because it is simplicity and reliability.

원저 : 노인병원 근무자의 강박에 대한 인식도 예비조사

윤종철 ( Jong Chal Youn ) , 이남진 ( Nam Jin Lee ) , 이소애 ( So Ae Lee )
4,000
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초록보기
Aim: This study aimed to investigate the awareness of staffs in elderly hospital on mechanical restraint use. Methods: A questionnaire on attitude and opinions regarding restraints was distributed to a convenience sample of 71 nurses and 149 care workers in elderly hospital, 93 nurses in mental hospital and 50 families of dementia patients. Results: In general, staffs in elderly hospital frequently involved in restraints. They held rather neutral opinions regarding the use of restraints. But, care workers insist on the positive effect of restraint. Staffs in elderly hospital thought that restraints were needed when patients had risk of fall, poor medical condition and many behavioral problems. About 40% of care worker in elderly hospital did not think that chest belt is a restraint. Conclusion: In general, staffs in elderly hospital especially for care worker had low level of awareness on restraint. Structured education program might be helpful for reducing restraint use in elderly hospital setting.
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