• Korean Journal of Biological Psychiatry
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• v.6 no.1
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• pp.41-48
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• 1999

This review focused on the pharmacological treatment of alcoholism, especially alcoholism-related mental disorder. The pharmacological agent for alcoholism can be divided into the following categories : anticraving agent, aversive agent, agent to treat acute alcohol withdrawal, agent to diminish drinking by treating associated psychiatric pathology, agent to induce sobriety in intoxicated individuals. Following trends are included in new trends of pharmacological treatment of alcoholism. What are precise conditions amenable to pharmacological intervention? ; How can psychosocial and behavioral intervention be integrated with pharmacotherapy to enhance treatment outcome? ; Is the concept of "matching" specific pharmacotherapy treatment to different aspect of alcoholism more efficacious than a more generalized medicational approach to treatment? One of the most important factors for alcoholics treatment is good and proper therapeutic relationship with patients and setting up individually specialized treatment program is also important.

• Korean Journal of Biological Psychiatry
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• v.10 no.2
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• pp.97-106
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• 2003

Criticisms about amyloid cascade hypothesis of Alzheimer's disease(AD) are based on the findings, first, that the degree of dementia does not correlate with the number of plaques, and second, that the neurofibrillary tangle formation seems to predate plaque formation. In addition, neurofibrillary tangle counts correlate well with the degree of cognitive impairment. These findings suggest the independent importance of tau abnormality in AD research which is involved in the neurofibrillary tangle formation. Recently, tau pathology without amyloid deposits and mutations in tau protein gene were reported to be the major pathogenic mechanism in Pick's disease, progressive supranuclear palsy, corticobasal degeneration and FTDP-17(frontotemporal dementia and parkinsonism linked with chromosome 17). These data suggest that understanding the causes and consequences of tau dysfunction might give new clinical and therapeutic solutions to many known tauopathies.

• Korean Journal of Biological Psychiatry
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• v.4 no.1
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• pp.24-28
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• 1997

Visual perception is a complex process engaging many different aspects of brain functioning. Like other cognitive functions, the extensive cortical distribution and complexity of visual perceptional activites make them hihgly vulnerable to brain injury. Dectection and characterization of perceptual disorders require a careful clinical assessment as well as the application of selected neuropsychological tests. In this article we reviewed neuropsychological assessment of visual perception and constructional abilities. And the principal visuospatial disorders are discussed, the associated neuropsychiatric disorders are presented.

• Korean Journal of Biological Psychiatry
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• v.4 no.1
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• pp.116-120
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• 1997

This study investigated the antidepressant efficacy and it's impact on the quality of life of depressed patients. We performed Hamilton Depression Rating Scale(HDRS), and Montgomery-Asberg Depression Rating Scale(MADRS), and Health-related Quality of Life Questionnaire(HQLQ) to both tricyclic antidepressant(TCA) and sertraline groups. There were 16 subjects in this study. The tricyclic group had 9 subjects and the sertraline group had 7. The TCA and sertraline produced a similar degree of response. Both groups experienced a reduction of 70% or more in mean HDRS and MADRS total score after 6wks. In HQLQ, the TCAs group also showed improved bed disability days, alertness behavior, and social interaction, the sertraline group showed improved health perception, alertness behavior, home management, and social interaction. We suggested that the improvement of "Quality of life" were not in proportion to the clinical symptom's improvement. Therefore, clinicians should consider the benefit of antidepressant treatment in terms of quality of life.

• Korean Journal of Biological Psychiatry
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• v.2 no.1
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• pp.20-27
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• 1995

Therapeutic montitoring of drugs is a well established clinical 1001. However, the state of art is somewhat less advanced for psychotrpoic agents than it is for other classes of drugs, for several reasons. Most psychotropics have large volumes of distribution and achieve relatively low plasma concentrations following therapeutic doses. Many have one or more active metabolites. As a consequene, the analytical methodologies are often complex and not always reliable; well-controlled clinical studies are difficult to perform; and therapeutic ranges have been difficult to establish. Despite these limitations, prudent and selective monitoring of serum drug concentrations, particularly of the tricyclic antidepressants can be helpful in clinical management. This paper presents an overview of clinical and mothodological issues surrounding the utility of blood level measurement.

• Korean Journal of Biological Psychiatry
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• v.2 no.1
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• pp.28-37
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• 1995

Clinical neuropsychology which belongs to the necuroscience field is concerned with relationship between human behaviors and the brain structure. Clinical neuropsychology has grown to be a specialized separate field within psychology over the last twenty years. Clinical neuropsychology offers an objective methodology to consider the mind-body interaction and evaluate the behavioral consequences and functional deficits associated with brain lesions. Clinical neuropsychological assessment is composed of cognitive, perceptual, motor and emotional function through various neuropsychological examinations such as Halsted-Reitan and Luria-Nebraska batteries, and computerized neuropsychological test such as PCIS Vienna Test System and Stim. The goals of neuropsychological evaluation are to identify of neuropsychological dysfuncitions, to develop execute and monitor treatment plans, and to make rehabilitation programs. Recently, the neuropsychiatric patients are increasing in number and 15-20% of acute psychiatric patients suffer from organic mental problems. Moreover, clinical neuropsychology has an increasingly important role in both neurobehavioral foundation and clinical application. So, psychiatrists must play a major role in the development of clinical neuropsychology in psychiatry.

• Korean Journal of Biological Psychiatry
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• v.2 no.1
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• pp.140-143
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• 1995

Tardive dyskinesia(TD), typically appearing as an undesirable side effect of a long term antipsychotic drug treatment has gained increased attention in recent times due to the discovery of many TD variants. This is a single case study of a patient who has undergone more than 8 years of high dosage antipsychotic treatment. After altering the type and dosage of antipsychotic medication 3 months prior to visit, the patient showed relatively abrupt onset symptoms of severe tremor and dystonia. These symptoms, appearing in clear consciousess, got better to a certain degree after 48 hours, worsened for 12 hours, and then improved again. Subsequently there was no continuing movement disorder. Several tests and consultation were carried out. However except for the medication factor, no other possible causes for such disabling symptoms were found. This clinical condition was thought to be akin to tardive tremor, a variant of TD. Furthermore, the course was atypical.

• Korean Journal of Biological Psychiatry
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• v.4 no.2
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• pp.179-187
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• 1997

The clinical efficacy of serotonin reuptake inhibitors such as clomipramine in the treatment of obsessive compulsive disorder(OCD) has fueled interest in the neurobiological basis of this illness. OCD is responsive exclucively to potent serotonin reuptake inhibitors clomipramine, fluoxetine, fluvoxamine, sertraline, and paroxetine and this point forms the important evidence supporting a cental role for serotonin in the pathogenesis of the disorder. Other serotonergic medications such as lithium, buspirone, trazodone, or fenfluramine may be useful as adjuvant treatments in treatmentrefractory OCD and adjuvant antipsychotics are useful in tic disorders, personality disorders, and psychotic disorders. This paper reviews results of treatment studies, investigations of biological markers, and neuroendocrine challenges and implications for the role of serotonin in pathophysiology and treatment of OCD.

• Korean Journal of Biological Psychiatry
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• v.4 no.2
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• pp.188-193
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• 1997

Along with psychosocial factors of suicide, biological backgrounds of suicide are explored by extensive works mostly on biological markers, neurobiological models, genetic bases, and relationships with aggression and violence. The biology of suicide confers on neurotransmitters in central nervous system exploring metabolites, receptor binding affinities, neuroendocrine challenge tests in brain, cerebrospinal fluid, blood and etc. The major concerns with suicide are focused mainly on serotonin system : low CSF 5-HIAA concentration, higher $5-HT_2$ receptor binding, and blunt prolactin response to fenfluramine. Postmortem study, in vivo study, genetic contributions, and some other issues such as suicidal methods, serum cholesterol, alcohol, and selective serotonin reuptake inhibitors are reviewed and discussed.

• Korean Journal of Biological Psychiatry
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• v.4 no.2
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• pp.168-178
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• 1997

The serotonin has been known to play important roles in pathology of the mood disorders. We summerize the evidences of serotonin in pathology of the mood disroders in a view of neuroanatomical and neurochemical aspects. Nowaday, the selective serotonin reuptake inhibitors(SSRIs) may be practically the first line of antidepressants with traditional tricyclic antidepressants(TCAs). Authors review the role of serotonin in the treatment of the mood disorders, in a view of the general considerations in selecting antidepressants, pharmacology, therapeutic indications, side effects, doses of medication, drug-discontinuation syndrome, drug-to-drug interactions, and special therapeutic situations.