• Title/Summary/Keyword: 생물정신의학

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Psychotic Disorder Induced by Appetite Suppressants, Phentermine or Phendimetrazine : A Case Series Study (식욕억제제 Phentermine, Phendimetrazine으로 유발된 정신병적 장애 증례군 연구)

  • Kwak, Sookyoung;Youn, Tak;Lee, Nam Young;Chung, In Won;Kim, Se Hyun
    • Korean Journal of Biological Psychiatry
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    • v.24 no.3
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    • pp.134-141
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    • 2017
  • Objectives A retrospective case series study was conducted to investigate the clinical characteristics of psychotic disorders induced by appetite suppressants, phentermine and phendimetrazine. Methods A retrospective electronic medical record review identified 5 admitted patients who had psychotic symptoms after taking phentermine or phendimetrazine. Clinical information was reviewed and summarized in each case. Results Hallucinations were reported in all cases, including auditory, visual, olfactory and somatic hallucinations. After discontinuation of phentermine or phendimetrazine, the symptoms rapidly improved with low dose of antipsychotics. Patients tended to have less prominent negative symptoms and higher insight into illness, and often showed depressive mood. These clinical characteristics were similar to psychosis induced by amphetamines. Two patients developed stimulant use disorder while using phentermine. Conclusions These findings call for awareness of the risks associated with use of appetite suppressants. Prescription of phentermine or phendimetrazine should be accompanied by close monitoring of mental status, and suspicion for substance/medication-induced psychotic disorder.

Association of Tardive Dyskinesia with Cognitive Deficit in Schizophrenia (정신분열병에서 지연성 운동장애와 인지결함의 연관성)

  • Jang, Tae-Seob;Oh, Byoung-Hoon;Cheon, Jin-Sook
    • Korean Journal of Biological Psychiatry
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    • v.6 no.1
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    • pp.89-95
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    • 1999
  • To understand a mechanism of underlying cognitive deficit in schizophrenia, the risk factors, cognitive function, blood dopamine concentrations and glutamate dehydrogenase activities of male schizophrenics with tardive dyskinesia(N=30) were compared with those of schizophrenics without tardive dyskinesia(N=30). The results were as following ; 1) The age, duration of illness and duration of medication were significantly more in schizophrenics with tardive dyskinesia than schizophrenics without tardive dyskinesia(respectively p<0.005, p<0.0001, p<0.0001). 2) The scores of MMSE, TIQ, VIQ and PIQ were significantly lower in schizophrenics with tardive dyskinesia than schizophrenics without tardive dyskinesia (rspectively p<0.0001). 3) Plasma dopamine concentrations were tended to be higher, and serum glutamate dehydrogenase activities were tended to be lower in schiz-ophrenics with tardive dyskinesia than schizophrenics without tardive dyskinesia. 4) The cognitive deficit seemed to be negatively correlated with duration of illness and duration of medication(respectively ${\gamma}$=-0.496, ${\gamma}$=-0.615).

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Genetic Polymorphisms of Apolipoprotein E in Korean Schizophrenic Patients (한국인 정신분열병 환자에서 Apolipoprotein E 유전자의 다형성)

  • Cho, Gwang-Hyun;Chung, Sang-Geun;Hwang, Ik-Keun
    • Korean Journal of Biological Psychiatry
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    • v.10 no.2
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    • pp.116-120
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    • 2003
  • Objectives:Although polymorphisms of apolipoprotein E have been investigated in many neuropsychiatric disorders, results were controversial and even contradictory. The purpose of this study was to investigate the genotypes of apolipoprotein E in schizophrenia and healthy controls, and to compare them in two groups in terms of distribution of apolipoprotein E genotype and allele. Method:Using polymerase chain reaction and amplified refractory mutation system, apolipoprotein E genotypes were identified in 77 schizophrenics and 115 healthy control persons. Results:The results were as follows 1) When genotypes of apolipoprotein E were classified into ${\varepsilon}2/2$, ${\varepsilon}2/3$, ${\varepsilon}2/4$, ${\varepsilon}3/3$, ${\varepsilon}3/4$, ${\varepsilon}4/4$ according to phenotypes, there were no statistical differences in genotypes between two groups 2) In terms of allele frequency, there were also no statistical differences between two groups Conclusion:These results suggest that genotypes and alleles of apolipoprotein E seem to be unrelated to the pathogenesis of schizophrenia.

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Three Cases of Typical Clinical Characteristics and Overview of Neuroleptic Malignant Syndrome (항정신병약물성 악성증후군에 관한 3증례 및 개관)

  • Lee, Kyung-Kyu;Kim, Hyun-Woo
    • Korean Journal of Biological Psychiatry
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    • v.4 no.1
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    • pp.136-145
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    • 1997
  • We are report on three cases of typical clinical characterstics and treatment response in neuroleptic maligant syndrome(NMS), and reviewed the literatures of NMS. NMS was first recognized as a life-threatening complication of dopamine receptor antagonists, and defined as a catatonic-like states associated with fever, obtundation, muscle rigidity, and unstable vital sign in patients taking neuroleptic agents. Concepts of NMS have changed because medications other than classic neuroleptic drugs have been implicated as triggering agents and syndromes identical to NMS have been observed in other conditions. The important neurochemical features are probably functional dopamine deficiency and ensuing hyperactivity of excitatory amino acid neurotransmission in the basal ganglia and hypothalamus. Recognition of NMS and early discontinuation of neuroleptics are the most important step in its management. Supportive care includes management of hyperthermia and fluid replacement. Controversial therapeutic measures include the application of dopamine receptor agonists, excitatory amino acid antagonists, or dantrolene. Psychiatric patients with a history on NMS and psychotic relapse necessitating antipsycotics do not commonly redevelop NMS.

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Adjuvant Sertraline Treatment for Chronic Schizophrenia : A Randomized, Double Blind, Placebo-Controlled Study (만성 정신분열증환자에 대한 Sertraline병합치료 효과)

  • Lee, Min-Soo;Kim, Yong-Ku;Lee, Sang-Kyu;Suh, Kwang-Yoon
    • Korean Journal of Biological Psychiatry
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    • v.4 no.1
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    • pp.127-131
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    • 1997
  • Objective : To evaluate the clinical efficacy of adjuvant sertraline treatment in chronic schizophrenic patients, we carried out a double-blind, placebo controlled study. Method : Thirty six inpatients who fulfilled DSM-III-R criteria for chronic schizophrenia were randomly assigned to sertraline and placebo groups in a double-blinded fashion. A history of at least 2 years of illness and at least six months of hospitalization were prerequisities for inclusion in the study. Patients were received sertraline 50mg or placebo for 8 weeks in addition to their routine haloperidol regimen. Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression(CGI), Simpson-Angus Scale(S-A) were evaluated at 5 points ; baseline, 2, 4, 6, and 8 weeks of treatment. Results : The groups were controlled for age, gender, and length of illness. There were no significant differences in three PANSS factros(positive, negative, general), CGI, and S-A scale scores at any between sertaline and placebo treatment. Conclusion : This placebo controlled study showed no significant effects of sertraline on negative and positive symptoms in chronic schizophrenic patients.

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The CDH2 Gene Polymorphism in Schizophrenia (정신분열병의 CDH2 유전자 다형성)

  • Lee, Won Seok;Kim, Mi Kyung;Jung, Han Yong;Woo, Sung Il;Kwon, Young Joon;Kim, Jong Woo;Lee, Hee Je
    • Korean Journal of Biological Psychiatry
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    • v.12 no.1
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    • pp.62-67
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    • 2005
  • Objective:There has been increasing evidence that neurodevelopmental dysfunction is involved in the pathophysiology of schizophrenia. Cadherin is known to be one of the important molecules in neurodevelopment. This study was performed to examine the relationship between T816C polymorphism of CDH2 gene and schizophrenia. Methods:Genoytypes of T816C polymorphism of CDH2 gene were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 156 Korea patents with schizophrenia and 170 controls. Results:No difference was found between the patients with schizophrenia and the controls in genotype and allele frequencies of T816C polymorphism of CDH2 gene. Conclusion:The results of this study do not support an association between T816C polymorphism of CDH2 gene and schizophrenia. However, it is necessary to investigate other polymorphic regions of CDH2 in schizophrenia.

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The Association between the Dopamine $D_5$ Receptor Genotype and Treatment Response for Korean Schizophrenic Patients (정신분열병 환자의 도파민 $D_5$ 수용체 유전자형과 치료반응과의 연관)

  • Kang, Sung Min;Lee, Min Soo;Rhee, Choong Soon
    • Korean Journal of Biological Psychiatry
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    • v.7 no.2
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    • pp.159-163
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    • 2000
  • Background : Dopamine receptors are strong candidates for involvement in schizophrenia and are target of a wide variety of antipsychotics. Dopamine $D_5$ receptor(DRD5) gene polymorphisms may be associated with various treatment response. The purpose of our study was define to what significance can be held as a predictor of treatment response in this polymorphism. Method : The total number of 116 Korean chronic schizophrenic patients was assessed after 48 weeks treatment. The Positive and Negative Syndrome Scale(PANSS) was rated for the clinical response to various antipsychotics. With the use of polymerase chain reaction amplification, we assessed this dopamine $D_5$ receptor polymorphism in schizophrenic patients who had been treated with antipsychotics, and related genotype with treatment response, to test the hypothesis that DRD5 polymorphism may lead to varying response to antipsychotics. Result : DRD5 polymorphism was not associated with treatment response to a variety of antipsychotics in chronic schizophrenic patients. Conclusion : Genetic variation of $D_5$ receptors do not predict treatment response to antispychotics.

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Association between the Alleles of the Dopamine $D_1$ Receptor and Schizophrenia (정신분열증환자와 도파민 $D_1$ 수용체 대립유전자 연합)

  • Kim, Jeong Il;Lee, Min Soo;Kwak, Dong Il
    • Korean Journal of Biological Psychiatry
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    • v.4 no.2
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    • pp.218-224
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    • 1997
  • The results regarding an association between the polymorphism sites in the dopamine $D_1$ receptor gene and schizophrenia compelled us to study the distribution of the polymorphism in Korean schizophrenia and controls. Eighty-eight schizophrenic patients and normal controls were examined by case-control study for distribution of the polymorphism of the dopamine $D_1$ receptor gene in Korean popualtion to minimize the effect of racial differencies in gene frequencies. The frequencies of the $B_1$ and $B_2$ in schizophrenic patients were 0.11 and 9.89, respectively. And 0.10 and 0.90 in normal control. Ther was no significant differences in the frequencies in the allele $B_1$ and $B_2$between schizophrenic patients and normal controls. The author present here the evidence of a lack of alleic association between the polymorphism of the dopamine $D_1$ receptor gene and Korean schizophrenic patients. The assumption that the dopamine $D_1$ receptor gene has a genetic role in the development of schizophrenia was not suppoorted by this case-control study.

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Prevalence and Risk Factors of Polydipsia and Water Intoxication in Psychiatric Inpatients (정신과 입원 환자에서의 다음증 및 물중독 유병률 및 위험인자에 관한 연구)

  • Cho, Ae-Hwa;Cho, Yeon-Soo;Roh, Jaewoo
    • Korean Journal of Biological Psychiatry
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    • v.16 no.4
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    • pp.246-255
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    • 2009
  • Objectives : The aims of this study are to estimate the prevalence of polydipsia and water intoxication and to identify risk factors of polydipsia and water intoxication in psychiatric inpatient. Methods : 1,108 Psychiatric inpatients at 2 mental hospitals in Yongin city were studied from September, 2008 to January, 2009. We diagnosed 'polydipsia' using staff reports(fluid intake>3L/day) or by specific gravity of urine(SPGU<1.008) and diagnosed 'at risk for water intoxication' using normalized diurnal weight gain (NDWG>4%). We attempted to identify clinical characteristics of patients by reviewing their medical records. Results : Two hundred forty seven patients(22.3%) were polydipsic. Sixty eight patients(6.1%) were at risk for water intoxication. The factors associated with polydipsia were lithium, smoking, younger age and increased smoking amounts. The factors associated with risk for water intoxication were valproic acid and polydipsia. Conclusion : Polydipsia and water intoxication in psychiatric inpatients are not rare conditions. Therefore, clinicians' attention should be paid to these conditions.

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A Preliminary Study of Childhood Trauma and Patterns of Psychotropic Medication Use in Patients with Schizophrenia (조현병 환자의 아동기 외상과 정신작용약물 사용 경향에 대한 예비 연구)

  • Kim, Chonggi;Kim, Daeho;Lee, Hyunji;Kim, Yangsuk
    • Korean Journal of Biological Psychiatry
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    • v.23 no.3
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    • pp.116-121
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    • 2016
  • Objectives Experience of early childhood abuse elevates the risk of developing schizophrenia in later period of life, incidence of psychiatric comorbidity, symptomatic severity and complexity. In this context, we hypothesized that the pattern of psychotropic medication used would reflect this; those with childhood trauma will received more types and higher doses of psychotropic medication. Methods From our database of 102 outpatients diagnosed with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) schizophrenia, we analyzed experiences of childhood trauma measured by the Childhood Trauma Questionnaire-Short Form and types and dose of prescribed psychotropic medication. Results We found significant positive correlations between child sexual abuse and the number of psychotropic medications (p = 0.029) and between child emotional neglect and the number of psychotropic medications other than antipsychotics (p = 0.045). Conclusions This preliminary study suggests that the pattern of psychotropic use may be affected by types of childhood trauma. Further studies will have to shed light on mediating factors such as symptoms or comorbid conditions that lead to prescription of certain psychotropic class.