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  • 발행기관: 대한신경정신의학회
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신경정신의학(Journal of Korean Neuropsychiatric Association)

  • 발행기관 : 대한신경정신의학회
  • 출처구분 : 학회
  • 간행물유형 : 학술저널
  • 발행주기 : 계간 (발행월:2,5,8,11)
  • Print ISSN : 1015-4817
  • Online ISSN : 2289-0963
  • 등재정보 : KCI 등재
신경정신의학
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폐비 윤씨와 양극성 장애
폐비 윤씨와 양극성 장애
서혜진(Hye-Jin Seo);김창윤(Changyoon Kim)
대한신경정신의학회 / 신경정신의학 제60권 제3호 / 2021 / 159-166 (8 pages)
의약학>정신과학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 신경과학
초록보기
Deposed Queen Yoon was sentenced to death by her husband, King Seongjong, on account of extreme jealousy and inappropriate behaviors. It remains unclear whether her unusual behavior resulted from a psychiatric disorder. In this study, we addressed the issue of whether deposed Queen Yoon suffered from bipolar disorder. We reviewed Seongjong Sillok (Veritable Records of King Seongjong), Joseon Wangjo Sillok (Veritable Records of the Joseon Dynasty), and the available literature on deposed Queen Yoon. A review of the literature showed that deposed Queen Yoon might have experienced depressive and manic episodes. Her symptoms of episodic course, familial tendency of mood symptoms, and postpartum onset suggest that she might have suffered from bipolar disorder. Her symptoms and clinical course suggest that deposed Queen Yoon might have suffered from bipolar disorder. To the best of our knowledge, this is the first report suggesting that deposed Queen Yoon might have suffered from bipolar disorder.
유럽인 자료로 산출된 양극성 장애 다유전자 위험 점수의 한국인 양극성 장애 환자에의 적용
유럽인 자료로 산출된 양극성 장애 다유전자 위험 점수의 한국인 양극성 장애 환자에의 적용
최민준(Min Jun Choi);이동빈(Dong Bin Lee);조윤지(Yunji Cho);조은영(Eun Young Cho);홍경수(Kyung Sue Hong);백지현(Ji Hyun Baek)
대한신경정신의학회 / 신경정신의학 제60권 제3호 / 2021 / 167-173 (7 pages)
의약학>정신과학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 신경과학
초록보기
Objectives This study examined whether the polygenic risk score (PRS) calculated from the most recent genome-wide association study for bipolar disorder (BD) of European ancestry patients is significantly associated with BD diagnosis in the Korean population. Methods The study included 417 Korean patients with BD and 497 healthy controls. Genotyping was performed using the Korean Biobank Array. Summary statistics of the European samples from the Psychiatric Genomic Consortium were used as base data to generate the PRS for each individual. The program PRSice-2 was used to calculate the PRS. Logistic regression was conducted to determine the association between BD diagnosis and PRS for BD after adjusting for age and sex. Results PRS for BD was significantly higher in patients diagnosed with BD compared to healthy controls. The PRS at the p-value threshold of 0.01 best explained the variance of BD after adjusting for age and sex (R2=0.0061, p=0.039). Subgroup analyses were performed for bipolar I and II subgroups. In bipolar I patients, the PRS at the p-value threshold of 0.01 best explained the diagnosis (R2=0.0165, p=0.0055), whereas no significant result was found for bipolar II patients. Conclusion PRS for BD calculated for the Korean sample showed a significant association with the BD diagnosis. This result suggests an overlapping genetic risk for BD between the European and Korean populations.
한국형 우울장애 약물치료 알고리듬 2021 (I)
한국형 우울장애 약물치료 알고리듬 2021 (I)
우영섭(Young Sup Woo);박원명(Won-Myong Bahk);서정석(Jeong Seok Seo);박영민(Young-Min Park);김원(Won Kim);정종현(Jong-Hyun Jeong);심세훈(Se-Hoon Shim);이정구(Jung Goo Lee);장승호(Seung-Ho Jang);왕성민(Sheng-Min Wang);정명훈(Myung Hun Jung);성형모(Hyung Mo Sung);추일한(IL Han Choo);윤보현(Bo-Hyun Yoon);이상열(Sang-Yeol Lee);전덕인(Duk-In Jon);민경준(Kyung Joon Min)
대한신경정신의학회 / 신경정신의학 제60권 제3호 / 2021 / 174-185 (12 pages)
의약학>정신과학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 신경과학
초록보기
Objectives The Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) is a consensus-based medication guideline. To reflect advances in pharmacotherapy for depressive disorders, we have undertaken a fourth revision of the KMAP-DD. Methods The review committee for the new version of the KMAP-DD (KMAP-DD 2021) included 143 Korean psychiatrists with clinical experience in the field of depressive disorders. Each treatment strategy or treatment option was evaluated with an overall score of nine, and the treatment option was categorized into the three levels of recommendation of primary, secondary, and tertiary. Results The first-line pharmacotherapeutic strategy for mild to moderate major depressive episodes (MDE) was antidepressant (AD) monotherapy. For severe MDE without psychotic features, AD monotherapy or the combination of AD and atypical antipsychotics (AAP) was the first-line strategy. The combination of AD and AAP was recommended as the first-line for the MDE with psychotic features as well. When treatment response to initial AD monotherapy was insufficient, a combination of AAP or another AD was recommended. In the case of unsatisfactory response to initial treatment with an AD and AAP combination, switching to another AAP or adding another AD was recommended. Conclusion Generally, there were no significant changes in the recommendations for MDE management in the KMAP-DD 2021 compared to previous versions. However, it was notable that the preference for the use of AAP and AD with the novel mechanism of action including vortioxetine and agomelatine increased.
한국형 우울장애 약물치료 알고리듬 2021 (II)
한국형 우울장애 약물치료 알고리듬 2021 (II)
박영민(Young-Min Park);서정석(Jeong Seok Seo);우영섭(Young Sup Woo);박원명(Won-Myong Bahk);김원(Won Kim);정종현(Jong-Hyun Jeong);심세훈(Se-Hoon Shim);이정구(Jung Goo Lee);장승호(Seung-Ho Jang);왕성민(Sheng-Min Wang);정명훈(Myung Hun Jung);성형모(Hyung Mo Sung);추일한(IL Han Choo);윤보현(Bo-Hyun Yoon);이상열(Sang-Yeol Lee);전덕인(Duk-In Jon);민경준(Kyung Joon Min)
대한신경정신의학회 / 신경정신의학 제60권 제3호 / 2021 / 186-192 (7 pages)
의약학>정신과학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 신경과학
초록보기
Objectives The Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) was developed in 2002 and revised in 2006, 2012, 2017. In 2021, the fifth edition was published. This edition reflected new findings and the latest trends in the areas of pharmacological treatment. The aim of this study is to present strategies and treatment options according to the subtype of depression using data from the KMAP-DD-2021. Methods Ninety-seven psychiatrists with clinical experience in depressive disorder were selected. The questionnaires for KMAP-DD 2021 were sent to participants via mail. KMAP-DD 2021 consists of overall treatment strategies and treatment options under specific circumstances. Each treatment strategy or treatment option was evaluated with an overall score of nine and was divided into the three phases of recommendation that include primary, secondary, and tertiary. Results For persisting depressive disorder, antidepressant monotherapy including selectiveserotonin reuptake inhibitor (SSRI) (escitalopram, fluoxetine, sertraline, paroxetine), serotoninnorepinephrine reuptake inhibitor (SNRI) (desvenlafaxine, venlafaxine, duloxetine, milnacipran), vortioxetine, and mirtazapine, was recommended as first-line medications. For melancholia of major depressive disorder, SSRI, SNRI, vortioxetine, and mirtazapine also were recommended as first-line medications. For mixed features, SSRI, bupropion, mirtazapine, SNRI, except for duloxetine, and milnacipran were recommended as first-line medications. For anxious distress, SSRI, mirtazapine, and SNRI, except milnacipran, were recommended as first-line medications. Conclusion The preferences of antidepressants by experts differed according to the subtype of depression. These findings suggest that experts treat patients with a major depressive disorder after considering the subtype of depression involved.
한국형 우울장애 약물치료 알고리듬 2021 (III)
한국형 우울장애 약물치료 알고리듬 2021 (III)
양찬모(Chan-Mo Yang);심세훈(Se-Hoon Shim);박원명(Won-Myong Bahk);우영섭(Young Sup Woo);정종현(Jong-Hyun Jeong);왕성민(Sheng-Min Wang);김원(Won Kim);서정석(Jeong Seok Seo);이정구(Jung Goo Lee);박영민(Young-Min Park);장승호(Seung-Ho Jang);정명훈(Myung Hun Jung);성형모(Hyung Mo Sung);추일한(IL Han Choo);윤보현(Bo-Hyun Yoon);이상열(Sang-Yeol Lee);전덕인(Duk-In Jon);민경준(Kyung Joon Min)
대한신경정신의학회 / 신경정신의학 제60권 제3호 / 2021 / 193-203 (11 pages)
의약학>정신과학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 신경과학
초록보기
Objectives The Korean Medication Algorithm Project for Depressive Disorder 2021 (KMAP-DD 2021) was a revision of previous works. The main purpose of the current study was to amend guidelines for the treatment of a major depressive disorder (MDD) for children and adolescents. Methods The survey consisted of 21 questionnaires for children and adolescents. A total of 33 of the 46 experts in child and adolescent psychiatry answered the survey. Results Antidepressant (AD) monotherapy was selected as the 1st line option for MDD with mild to moderate severity. As the 1st line of treatment for MDD severe without psychotic features in children and adolescents, AD monotherapy and AD augmented with atypical antipsychotics (AAP) were recommended. For MDD with psychotic features, AD augmented with AAP was preferred as the 1st line of treatment. Conclusion We developed an algorithm for child and adolescent populations with depressive disorders, more specifically than the KMAP-DD 2017. We expect this algorithm will provide clinicians useful information and help in the treatment of children and adolescents with depressive disorders.
북한이탈주민 임상군의 정신건강지표 및 신체활동지표와의 연관성 연구: 예비연구
북한이탈주민 임상군의 정신건강지표 및 신체활동지표와의 연관성 연구: 예비연구
심성수(Sung Soo Shim);이소희(So Hee Lee);이정빈(Jung Been Lee);서예은(Yae Eun Seo);이헌정(Heon Jeong Lee)
대한신경정신의학회 / 신경정신의학 제60권 제3호 / 2021 / 204-212 (9 pages)
의약학>정신과학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 신경과학
초록보기
Objectives This study is designed to extract a representative variable that distinguishes psychiatric patients of North Korean Defectors and a control group by using machine learning based on measured mental health variables and physical activity variables. Methods The physical and mental activity variables of 17 North Korean defectors that previously were hospitalized or received psychiatric outpatient treatment and a control group were compared. The survey focused on mental health variables that included contents related to depression, suicidal risks, post-traumatic stress disorder, anxiety, insomnia, physical symptoms, quality of life, coping skills, social support, and drinking. Physical activity variables included the number of steps walked per day, sleep time, and sleep efficiency were measured by Fitbit. Results The 7th question of the Patient Health Questionnaire-9, “Trouble concentrating on things, such as reading the newspaper or watching television over the past two weeks,” showed the highest gain ratio by 84 percent. Based on the result of the decision tree, this single index may distinguish between the clinical and control groups. Conclusion A clinician may conduct a more effective interview with a North Korean defector by identifying in the early stages whether the patient has been having difficulty concentrating on daily tasks during the past two weeks.
공황 발작으로 인한 응급실 내원과 대기 오염의 연관성
공황 발작으로 인한 응급실 내원과 대기 오염의 연관성
문영경(Young Kyung Moon);이원윤(Wonyun Lee);오세현(Sehhyun Oh);김호(Ho Kim);명우재(Woojae Myung);이혜원(Hyewon Lee);김도관(Doh Kwan Kim)
대한신경정신의학회 / 신경정신의학 제60권 제3호 / 2021 / 213-222 (10 pages)
의약학>정신과학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 신경과학
초록보기
Objectives This study investigates the association between short-term exposure to air pollutants and panic attacks requiring emergency department (ED) visits. Methods We identified 1926 patients who visited EDs in Seoul with panic attacks as the primary cause during the period from 2008 to 2014. We estimated short-term exposure to particles <2.5 μm (PM2.5), particles <10 μm (PM10), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), ozone (O₃), and carbon monoxide (CO). We applied a time-stratified case-crossover study design and conducted a conditional logistic regression analysis to assess the association between air pollutants levels and ED visits due to panic attacks. Results Increasing O₃ concentration was significantly associated with an increased risk of panic attacks requiring ED visits (odds ratio: 1.15; 95% confidence interval: 1.04-1.27) on the same day of exposure. This association was robust to the sensitivity analysis using two pollutant models. Conclusion Our results show that short-term exposure to elevated O₃ concentration is associated with the exacerbation of panic attacks. This finding strongly suggests the detrimental effects of O₃ on major public health problems and provides insights for further research to investigate the causal associations between air pollution and poor mental health.
정신치료 수련의 질과 역량에 관한 정신건강의학과 전공의 인식도 조사
정신치료 수련의 질과 역량에 관한 정신건강의학과 전공의 인식도 조사
김예지(Ye Ji Kim);견영기(Yeong Gi Kyeon);이승재(Seung Jae Lee);전명욱(Myong-Wuk Chon);이상원(Sang Won Lee);정성원(Sung Won Jung);이강욱(Kang Uk Lee);대한신경정신의학회 수련위원회(The Committee of Residency Training of the Korean Neuropsychiatric Association)
대한신경정신의학회 / 신경정신의학 제60권 제3호 / 2021 / 223-231 (9 pages)
의약학>정신과학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 신경과학
초록보기
Objectives This study surveyed the quality of psychotherapy training and psychotherapy competencies during residency in Korea. Methods A questionnaire developed by The Committee of Residency Training of the Korean Neuropsychiatric Association was completed by fourth-year residents of Korean psychiatry (n=120). The questionnaire examined their demographic characteristics, their experience of clinical psychotherapy training, their degree of satisfaction in the quality of psychotherapy training, and self-rated competence regarding the six types of psychotherapies, including supportive psychotherapy, cognitive behavioral therapy, interpersonal psychotherapy, psychoanalytic psychotherapy, group psychotherapy, and family psychotherapy. Results The degree of satisfaction of the residents with the psychotherapy training was diverse among the types of psychotherapy and contents of training. Across all types of psychotherapies, the satisfaction levels of the quantity and quality of supervision education were low, except for psychoanalytic psychotherapy. Overall, more than 70% of residents were not satisfied with the theoretical education, clinical practice, and supervision education in three types of psychotherapies, including interpersonal psychotherapy, group psychotherapy, and family psychotherapy. A positive correlation was found between the degree of satisfaction with the quality of training experience and self-rated competence of psychotherapy. Specifically, the self-rated competence of psychotherapy was more highly correlated with the experience of clinical cases and supervision than theoretical education Conclusion This study showed the quantitative and qualitative status of psychotherapy training in Korean psychiatry residency programs, and the satisfaction level of psychotherapy education was low except for psychoanalytic psychotherapy. There is a strong need for the improvement of psychotherapy training programs in Korea.
자살과 알코올 사용장애를 동반한 기분장애와의 연관성
자살과 알코올 사용장애를 동반한 기분장애와의 연관성
조용혁(Yong Hyuk Cho);이은영(Eunyoung Lee);허은실(Eun Sil Her);황규범(Gyubeom Hwang);임기영(Ki-Young Lim);노재성(Jai Sung Noh);신윤미(Yunmi Shin);홍창형(Chang Hyung Hong);노현웅(Hyun Woong Roh);이동윤(Dongyun Lee);이혜림(Heirim Lee);김도엽(Doyeop Kim);박래웅(Rae Woong Park);박범희(Bumhee Park);손상준(Sang Joon Son)
대한신경정신의학회 / 신경정신의학 제60권 제3호 / 2021 / 232-239 (8 pages)
의약학>정신과학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 신경과학
초록보기
Objectives This study determines the effects of comorbidity of mood disorder and alcohol use disorder on suicide behavior. Methods We converted data from the electronic medical records of one university hospital into a common data model and utilized it in our analysis. We selected 9551 patients with diagnosis codes of mood disorders or alcohol use disorders and divided them into three groups: mood disorder (MD) only, alcohol use disorder (AUD) only, and comorbidity of mood disorder and alcohol use disorder (MD+AUD). The mood disorder group was also subgrouped with depressive (DD) or bipolar affective disorder (BD) groups, and the comorbidity group was classified in the same way. Then, we applied logistic regression analysis to assess the risk of suicide attempts between the diagnostic groups. Subgroup analysis according to age also was conducted. Results The MD+AUD group had 2.7 (odd ratio [OR]=2.70, 95% confidence intervals [CI]=1.91- 3.81, p<0.0001) and the DD+AUD group had 2.78 (OR=2.78, 95% CI=1.95-3.98, p<0.0001) times higher risk of suicide attempts than the MD only and DD only group, respectively. Furthermore, according to the age subgroup, the risk of suicide attempts was the highest (OR=5.17, 95% CI=2.35-11.40, p<0.0001) in the DD+AUD group for those aged 40-59. There were no significant results in BD. Conclusion The results showed that the comorbidity of mood disorder and alcohol use disorder could increase suicide risk. This study suggested that alcohol use behavior needs to be assessed as well as mood symptoms for suicide prevention.