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피치료감호자의 수면 특성 및 수면 관련 요인에 대한 비교연구

Comparative Study on the Sleep Characteristics and Associated Factors of the Mentally Disordered Offenders

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참고문헌

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주제분류법학

초록

이 연구는 사법병원에 입원한 피치료감호자의 수면 특성, 그리고 수면과 관련된 임상 증상을 알아보기 위해 실시되었다. 이를 위해 입원한 피치료감호자들의 주요 질환이자 법적 구분인 조현병, 물질사용장애, 정신성적장애 세 집단으로 나누었고, 자발적동의에 의해 연구에 참여한 인원은 111명(조현벙: 69명, 물질사용장애: 21명, 정신성적장애: 21명)이었으며, 이들에게 자기보고 설문지를 실시하였다. 각 집단의 수면 문제의 특성을 분석하기 위하여 공변량분석을 실시하였고, 불면을 예측하는 요인을 알아보기 위해 중다회귀분석을 실시하였다. 첫째 집단간 차이 분석에서, 조현병 집단은물질사용장애 집단에 비해 수면시간이, 정신성적장애 집단에 비해 침대에서 보내는시간이 많았다. 물질사용장애 집단은 조현병 집단과 정신성적장애 집단에 비해 수면효율성인 현저히 낮았다. 조현병 집단과 물질사용장애 두 집단 모두 정신성적장애 집단에 비해 수면제를 더 많이 복용하였다. 둘째, 전체 피치료감호자의 수면 문제를 예측하는 정서적 변인은 불안이, 수면 관련 변인에서는 수면제 사용으로 나타났다. 이연구 결과를 통하여, 피치료감호자 중 조현병 집단은 침대에서 머무는 시간을 줄이기위한 여가 활동 계획하기, 물질사용장애 집단은 수면 압축을 초점으로 하는 자극 조절을 제공할 필요성을 확인하였었다. 전체 피치료감호자의 수면 문제에 영향을 미치고있는 불안에 대해 걱정일기 작성하기와 이완훈련을 제공하고, 수면 문제 개입 시 수면제 사용 이외의 심리치료 모델로 CBT-I를 제시하였다.

Abstract

This study was conducted to investigate the sleep characteristics and sleep-related clinical symptoms of mentally disordered offenders hospitalized in forensic hospital. Mentally disordered offenders were divided into three groups: schizophrenia, substance use disorder, and psychosexual disorder, which are the major diseases and legal categories of hospitalized offenders, and a total of 111 patients (schizophrenia patients: 69 people, substance use disorder patients: 21 people, psychosexual disorder patients: 21 people) completed a self-report questionnaire. Analysis of Covariance to analyze the types of insomnia in each diagnosis, and multiple regression analysis to determine insomnia predictive factors were performed. First, in the analysis of differences among groups, the schizophrenia group spent more sleep time than the substance use disorder group and more time in bed than the psychosexual disorder group. The substance use disorder group had significantly lower sleep efficacy than the others. Both schizophrenia group and substance use disorder group took more hypnotic drugs than the psychosexual disorder group. Second, the emotional variable predicting sleep problems was anxiety, and the sleep related variable was the use of hypnotic drugs. Each group needs different interventions; leisure activities to reduce the time spent in bed for schizophrenia group and stimulation control focusing on sleep compression for substance use disorder group were efficient. For all groups, writing a worry diary about anxiety affecting sleep problems, relaxation training were effective. CBT-I intervention was also suggested as a psychological model that can substitute to the use of hypnotic drugs.

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