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E-ISSN : 2733-4538
본 연구는 정신분열병 환자들의 시계 그리기 검사 수행양상을 분석하여 봄으로써 시계 그리기 검사의 임상적 유용성을 확대하는데 목적을 두었다. 정신분열병집단, 성인우울집단, 노인우울집단, 경도치매집단을 대상으로 CDT를 실시하였으며, 정신분열병집단과 성인우울집단에서는 지능검사를 실시하였고, 성인우울집단과 노인우울집단에서는 CDR, MMSE-K를 추가로 실시하였다. 연구결과, 네 집단은 CDT 총점에서 유의미한 차이가 있었고, 오류유형을 분석해본 결과 정신분열병집단이 경도의 치매집단만큼이나 CDT의 수행이 빈약했으며, <너무 큰 시계><원밖에 숫자적기><경도수준의 그리기의 어려움><개념결함><불특정형 배열오류>등의 항목에서 높은 빈도의 오류를 보였다. 따라서 CDT 상으로도 정신분열병 환자들의 현실검증력의 손상 및 시공간적 구성능력 저하, 경직성, 계획력 결여, 실행기능 약화와 같은 인지 및 사고기능의 손상을 확인할 수 있었다. 또한, 상관분석결과, CDT 수행이 연령, 나이, 언어적 기능과는 유의미하지 않으나, 비언어적 기능과 상관이 유의미하였다. 본 연구는 CDT를 통해 정신분열병 환자들의 사고혼란과 인지기능의 손상을 살펴봄으로써 CDT가 치매환자 뿐만 아니라 정신증적 환자들의 사고특성과 인지적 결함을 선별하는데 유용하다는 것을 보여주었다는 것에 의미가 있다. 끝으로 본 연구의 시사점, 제한점, 향후 연구방향을 논의하였다.
The purpose of this study was to expand the clinical utility of CDT by analyzing aspects of CDT in patients with schizophrenia. The CDT was administered to seventy schizophrenics, fifty adult depression patients, thirty elderly depression patients, and thirty mild dementia patients. Additionally, K-WAIS(Korean Wechsler Adult Intelligence Scale) was administered to schizophrenics and adult depression patients, and CDR(Clinical Dementia Rating), and MMSE-K(Mini-Mental State Examination-Korean) were administered to elderly depression patients and mild dementia patients. The results of this study were that the difference of CDT total scores among these four groups was significant statistically. In the error type analysis of CDT, schizophrenic patients showed higher frequency even than mild dementia patients in <big size figure><all numbers in closure figure><conceptual error><spatial and planing error>. It was thought that CDT has ability to measure schizophrenics' cognitive deficits in reality testing, visuo-spatial function, cognitive flexibility, planning, and executive function. These results confirmed that CDT has the clinical utility in differentiating schizophrenic patients as well as mild dementia patients. Additionally, the CDT score was no correlations with age, education, and verbal IQ; however, there were correlations among the CDT score and performance IQ and total IQ. Finally, the suggestions, limitations and further issues for future study were discussed.
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