• Title/Summary/Keyword: 생물정신의학

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Electroconvulsive Therapy in Major Depressive Disorder (주요우울장애에서의 전기경련요법)

  • Lee, Hwa-Young;Kang, Rhee-Hun;Lee, Min-Soo
    • Korean Journal of Biological Psychiatry
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    • v.15 no.2
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    • pp.75-82
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    • 2008
  • Major depressive disorder(MDD) is one of the most common diseases with serious health consequences such as increased morbidity, disability, and mortality. Electroconvulsive therapy(ECT) has been used as a treatment for mental disorder since the 1930s. A growing number of recent publications support the conclusions that ECT is an effective and safe treatment for depressed patients. Dosing strategies, frequency, safety, side effects and efficacy of ECT in MDD will be considered. ECT may be an alternative to treatment with antidepressants.

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A Case of Risperidone-induced Neuroleptic Malignant Syndrome (리스페리돈으로 인한 신경이완제 악성 증후군 1례)

  • Kang, Hwa-Yeon;Kim, Yong-Ku;Lee, Min Soo
    • Korean Journal of Biological Psychiatry
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    • v.5 no.1
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    • pp.138-141
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    • 1998
  • Neuroleptic malignant syndrome (NMS) is an uncommon but potentially fatal idiosyncratic reaction to neuroleptics, characterized by muscular rigidity, fever, autonomic dysfunction, and altered consciousness. The major theories to explain NMS is central dopaminergic blockade, but it is unclear. Risperidone is a new antipsychotic drug, a benzisoxazole derivative that blocks dopamine $D_2$ receptor and serotonin type 2 receptor. The comparatively greater serotonin-blocking activity is believed to give risperidone the specific property of not causing any more extrapyramidal side effects than conventional antipsychotics at the optimal dose of 4-8mg/day. It is postulated that risperidone is unlikely to cause NMS. Here, we report a case of risperidone induced neuroleptic malignant syndrome.

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Behavioral Toxicity of Psychotropic Drugs (향정신성약물의 행동학적 독성)

  • Yoon, Jin-Sang
    • Korean Journal of Biological Psychiatry
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    • v.5 no.1
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    • pp.46-55
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    • 1998
  • Any compound which disrupts the integrity of psychological aspects of performance, in particular, cognitive ability and psychomotor function analogous to the psychological behaviors of routine life, is known to be behaviorally toxic. A significant level of behavioral toxicity will interfere with patient safety and quality of life, and also may be counter-therapeutic by exacerbating the condition that the drug was prescribed for. Now, behavioral toxicity of psychotropic drugs has become one of the main growth areas of psychopharmacological research. Evaluation of the potential of drug-induced behavioral toxicity is important not only to the experimental researcher involved in human psychopharmacology, but also to the clinical practitioner treating psychiatric patients. This article attempts to describe behavioral toxicity of the three classes of psychotropic drugs - benzodiazepines, antidepressants and neuroleptics. After a brief discussion of some methodological issues arising in the investigation of behavioral toxicity, each of these drug classes is reviewed in the context of practical importance rather than purely scientific concern. The last session summarizes some suggestions for future studies on drug-induced behavioral toxicity.

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Therapeutic Drug Monitoring (TDM) of Psychotropic Drugs (향정신성약물의 치료적 약물농도 검사)

  • Yang, Byung-Hwan
    • Korean Journal of Biological Psychiatry
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    • v.5 no.1
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    • pp.56-65
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    • 1998
  • Clinicians can use therapeutic drug monitoring(TDM) to optimise dosage decisions with psychotropic drugs, in order to maximize efficacy and prevent toxicity, especially when individuals are nonresponsive to treatment or vulnerable to adverse reactions with standard doses because age, disease states or drug interactions. Currently, therapeutic drug concentrations have been established for the TCA and lithium. There is also evidence for the usefulness of TDM with carbamazepine, valproic acid and some antipsychotic drugs. However for most psychotropic drugs this approach remains experimental. TDM-assisted psychiatric treatment is potentially useful and cost effective, particularly when applied by psychiatrists who are knowledgeable of pharmacokinetics and pharmacodynamics.

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Biomarkers for Alzheimer's Dementia : Focus on Neuroimaging (알츠하이머 치매의 바이오마커-뇌영상 연구를 중심으로)

  • Won, Wang-Youn;Lee, Chang-Uk
    • Korean Journal of Biological Psychiatry
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    • v.18 no.2
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    • pp.72-79
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    • 2011
  • Recent advances in brain imaging research are remarkable. Among them, many results from a variety of neuroimaging modalities in Alzheimer's dementia accompanied by the development and growing of imaging techniques have been presented in the research field. In this review we are focused on the imaging biomarkers for the Alzheimer's dementia to investigate the pathophysiologic mechanism. Future research on biomarkers for Alzheimer's dementia will provide more diverse and complex mechanisms or hypotheses than have been proposed in the current hypothesis about the pathogenesis of Alzheimer's dementia.

Neural Circuit and Mechanism of Fear Conditioning (공포 조건화 학습의 신경회로와 기전)

  • Choi, Kwang-Yeon
    • Korean Journal of Biological Psychiatry
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    • v.18 no.2
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    • pp.80-89
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    • 2011
  • Pavlovian fear conditioning has been extensively studied for the understanding of neurobiological basis of memory and emotion. Pavlovian fear conditioning is an associative memory which forms when conditioned stimulus (CS) is paired with unconditioned stimulus (US) once or repeatedly. This behavioral model is also important for the understanding of anxiety disorders such as posttraumatic stress disorder. Here we describe the neural circuitry involved in fear conditioning and the molecular mechanisms underlying fear memory formation. During consolidation some memories fade out but other memories become stable and concrete. Emotion plays an important role in determining which memories will survive. Memory becomes unstable and editable again immediately after retrieval. It opens the possibility for us of modulating the established fear memory. It provides us with very efficient tools to improve the efficacy of cognitive-behavior therapy and other exposure-based therapy treating anxiety disorders.

Evolutionary Meaning of Sadness, Depression, and Suicide (슬픔과 우울, 그리고 자살의 진화적 의미)

  • Shin, Chul-Jin
    • Korean Journal of Biological Psychiatry
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    • v.23 no.4
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    • pp.123-129
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    • 2016
  • Depression has a relatively high lifetime prevalence rate in spite of a genetic influence on its etiology and a high mortality rate in untreated cases. This suggests the possibility that depression gives us evolutionary benefits which we do not exactly know yet. There have been several hypotheses which tell us what evolutionary advantages depression could give us. The psychic pain hypothesis considers sad or depressed mood as a negative reward just like physical pain which we have to avoid for our protection and survival. The social rank hypothesis holds that depressed mood is very similar to the emotional state of the defeated in social competition which prevents him from further protesting or fighting that might cause additional damage to him. The inclusive fitness hypothesis views suicide as a sacrifice phenomenon to contribute to inclusive fitness. These hypotheses gives us new insights into mood disorders and also some suggestions about the conditions in which depressed mood or suicidal behaviors increase and the ways to reduce them.

Basic Concept of Gene Microarray (Gene Microarray의 기본개념)

  • Hwang, Seung Yong
    • Korean Journal of Biological Psychiatry
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    • v.8 no.2
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    • pp.203-207
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    • 2001
  • The genome sequencing project has generated and will continue to generate enormous amounts of sequence data including 5 eukaryotic and about 60 prokaryotic genomes. Given this ever-increasing amounts of sequence information, new strategies are necessary to efficiently pursue the next phase of the genome project-the elucidation of gene expression patterns and gene product function on a whole genome scale. In order to assign functional information to the genome sequence, DNA chip(or gene microarray) technology was developed to efficiently identify the differential expression pattern of independent biological samples. DNA chip provides a new tool for genome expression analysis that may revolutionize many aspects of biotechnology including new drug discovery and disease diagnostics.

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Interictal EEG in Diagnosis and Assessment of Epilepsy (간질의 평가와 진단 - 발작간 뇌파소견을 중심으로 -)

  • Park, Kun-Woo
    • Korean Journal of Biological Psychiatry
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    • v.8 no.2
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    • pp.233-238
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    • 2001
  • The routine interictal electroencephalogram(EEG) continues to play an important role in the diagnosis and treatment of epilepsy. The clinical investigation of brain disease in the last decade has been marked by dramatic advances in functional imaging, magnetic resonance scanning and digitized EEG. Epilepsy is a disorder of electrical hyperirritability of cerebral cortex and the interictal EEG remains the most convenient means available to demonstrate cortical hyperirritability. The sensitivity and specificity of the EEG in the diagnosis of epilepsy have been disputed. In this review, the type of EEG findings in epilepsy are reviewed and the sensitivity and specificity of interictal epileptiform discharge are discussed. And also the role of EEG in various clinical situations are summarized.

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Drug Augmentation Strategies in the Treatment of Mood Disdorder (기분장애의 치료에 있어서 약물의 Augmentation Strategies)

  • Chung, Young In
    • Korean Journal of Biological Psychiatry
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    • v.5 no.2
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    • pp.155-161
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    • 1998
  • Mood disorder is a medical illness resulting from the disorder of CNS neurotransmission and its principal therapeutic tool is pharmacotherapy. Psychotherapeutic drugs for mood disorder have some clinical limitations which are due to no or partial response, decreased compliance for drug by the side effects, and delayed therapeutic effects. So, general hope of all clinicians that mood diorder will respond to a single psychotherapeutic agent may be the exception rather than the rule. Recently, combined drug treatments have become increasingly popular to overcome the clinical limitations of individual agent in mood disorder. Combined treatments are usually used for augmenting or initiating rapidly the effect of drug, and for treating different target symptoms or drug side effects. When combined treatments being tried, knowledge of the action mechanism, pharmacokinetics, and pharmacodynamics is crucial to cope with the possible adverse reactions of drugs.

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