• Korean Journal of Biological Psychiatry
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• v.5 no.2
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• pp.248-252
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• 1998

Object : This study was performed in order to examine the correlation between acute neuroleptic-induced dystonic reactions and serum iron level. Method : Serum iron levels were measured in psychiatric inpatients who had developed acute neuroleptic-induced dystonia(N=41) and in control patients with no history of acute dystonic reactions(N=37). Serum iron levels were compared in acute dystonic inpatients before starting treatment with neuroleptics and after acute dystonic reaction. Results : The patients exhibiting acute dystonic reactions had significantly lower serum iron levels than the patients without acute dystonic reactions. Conclusion : This result supports an association between low serum iron and the occurrence of neuroleptic-induced acute dystonic reactions.

• The Korean Journal of Nuclear Medicine
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• v.31 no.3
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• pp.310-319
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• 1997

This study investigated regional blood flow changes of frontal, temporal, and basal ganglia in eleven schizophrenic patients on DSM-IV criteria to examine the relationship between rCBF and clinical improvement of symptoms. Single-photon emission computed tomography imaging with $^{99m}Tc$-HMPAO was peformed in baseline and sixth weeks after the treatment, and concurrently psychopathology was assessed by PANSS. Antipsychotics wash-out period was more than 2 weeks, and three patient were drug naive. All patients were finally divided into two groups, the improved or not improved. We examined the difference of the amount of rCBF changes between two groups. Finally, frontal activity shows no significant difference between two groups but both groups show decreased frontal blood flow after antipsychotic treatment. However, the change of right temporal rCBF had positive correlation with the change of the total PANSS score, and the change of left temporal lobe activity was greater in the improved group than in the not improved group. Our results suggest that the temporal lobe activity has relation to the underlying schizophrenic symptoms.

• Journal of Korean Public Health Nursing
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• v.16 no.1
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• pp.95-104
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• 2002

Purpose : This study was conducted to investigate the extent to which the professional self concept between the psychiatric mental health nurse practitioner (PMHNP) and general nurse in psychiatric ward was comparable. The results were expected to provide basic data for developing the construct of professional self concept and making awareness of the importance of the program increasing professional self concept. Method : The subjects of this study were 227 PMHNP and 436 general nurse in psychiatric ward. The instruments used for this study were PSCNI by Arthur (1990), PSI by Heppner and Peterson(1982) and the index of work satisfaction by Slavitt et al.(1978). With the aid of the SAS, t-test. two-way ANOVA and stepwise multiple regression were conducted. Result : 1. The average item score of PSCNI of PMHNP was $2.82\pm0.27$. and that of general nurse was $2.66\pm0.27$. Statistically significant difference between two groups was found(p=0.0000) 2. There was statistically significant difference between two groups in the score of professional practice(p=0.0000), satisfaction(p=0.0024), leadersbip(p=0.0000) , flexibility(p=0.0000) and skill (p=0.0000). 3. Statistically significant differences between the two groups were observed in terms of age(p=0.0003), marital status(p=0.0001). education(p=0.0005), religion(p=-.0144), motive (P=-.0001), length of service as a nurse(p=0.0121), the length of service in psychiatric unit(p=0.0143). However there were no significant interaction effect with group and age, marital state. education, religion, motive, length of service as a nurse, length of service in psychiatric unit. 4. Job satisfaction (JS) and problem solving inventory score(PS) were found to be the highest factor predicting the professional self concept between the PMHNP and general nurse. JS and PS accounted for $43.4\%$ in the professional self concept of PMHNP, whereas PS, JS, age and religion accounted for $53\%$ in the professional self concept of general nurse in psychiatric ward. In conclusion, this study suggested that we need to develop programs and polices to increase the professional self concept of nurse, particularly of psychiatric mental health nurse practitioners.

• Korean Journal of Biological Psychiatry
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• v.3 no.1
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• pp.121-126
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• 1996

Objects : There is considerable interest in the role of serotonin(5-HT) in the pathophysiology of schizophrenia. Cimetidine, $H_2$ antagonist, produces transient increase in serum prolactin(PRL) levels by indirect serotonergic mechanism in man following intravenous administration. Therefore the authors investigated the effects of cimetidine on serum PRL levels of male unmedicated schizophrenics. Method : Baseline serum prolactin level and psychopathology were measured at 9:00 AM. in the two groups(12 positive schizophrenics, 7 negative schizophrenics) and $T_{30}$ levels were measured 30 minutes after intravenous injection of cimetidine (ie, 9:30 AM) Results: 1) Baseline prolactin levels were not different in the three groups. 2) Prolactin levels of 30 minutes after intravenous injection of cimetidine($T_{30}$) compared with baseline prolactin levels were increased all in the three groups. 3) Degrees of interval change from baseline to $T_{30}$ were significantly different between normal control and negative schizophrenics(p<0.05). Conclusion : The prolactin response to cimetidine was significantly blunted in negative male schizophrenics than normal control. These data are consistent with the hypothesis of an abnormality of serotonergic activity, including down-regulation $5-HT_2$ receptors, in male negative schizophrenics.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.3 no.1
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• pp.73-83
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• 1992

The purpose of this study was to undrstand the emotional and behavioral sequela in the abused child caused by phygical abuse. To achieve the purpose. the emotional and behavioral differences between not or less abused children group and severely abused children group were compared in this study. The subjects in this study were 61 male children who were selected among children under custody at 4 child-welfare institutions in Seoul. A violence scale in CTS(Conflict Tactics Scale) developed by Straus(1979) was modified and used as a research tool to measure the children's physical abuse. The Korean text of Child Behavior Checklist(CBCL) was also used to measure the emotional and behavioral problems of abused children. The results of this study were as follows : 1) The total scores of behavioral problems in physically abused children were significantly higher than those in control group. 2) The comparison of behavioral problems has shown significant differences between two groups in social withrawal. somatic symptom, emotional disturbance, obsessive-depressive behavior, hyperactivity and psychotic-sexual factors. However. there were no differences in aggressive and delinquent factors. The above results presents us the profile of children's emotional and behavioral problems caused by physical abuse, and can be used as a framework for the treatment protection and preservation of abused children in the course of social work practice.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.1
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• pp.152-158
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• 2016

Glutamate is one of the major excitatory neurotransmitters in the central nervous system of vertebrates. Human GDH (hGDH) is the enzyme that regulates the glutamate metabolism and its expression is higher in the brains of schizophrenia patients than in normal subjects. This study examined the changes in the hGDH enzymatic activity caused by antipsychotic drugs (haloperidol, risperidone, (${\pm}$)-sulpride, chlopromazine hydrochloride, melperone, (${\pm}$)butaclamol, domperidone, clozapine) related to schizophrenia. First of all, hGDH isozymes (hGDH1, hGDH2) were synthesized by genetic recombination. As a result of the enzyme assay, haloperidol, (${\pm}$)-sulpride, melperone and clozapine had an inhibitory effect on the hGDH isozymes. In addition, haloperidol showed a non-competitive inhibition against the substrate, 2-oxoglutarate. In contrast, it showed an uncompetitive inhibition against another substrate, NADH. The inhibitory effect of haloperidol on hGDH2 was abolished by the presence of L-leucine, an allosteric effector of hGDH, but by not other antipsychotic drugs. These results revealed the inhibition of enzyme activity by psychotropic drugs in hGDH isoenzymes (hGDH1 and hGDH2) and the possibility that haloperidol may be used to regulate the GDH activity and glutamate concentration in the central nervous system.

• Anxiety and mood
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• v.4 no.1
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• pp.42-48
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• 2008

Objective : Due to a better understanding of the pathophysiology of posttraumatic stress disorder (PTSD) and the relative limitations in the treatment of patients with PTSD, a variety of medications and treatment algorithms for PTSD have been investigated. This study was conducted to investigate the trends in the pharmacotherapy used in the treatment of inpatients with PTSD at a single university hospital in Korea. Methods : Data from 75 patients diagnosed with PTSD according to the DSM-IV criteria from January 1998 to December 2007 were collected. Demographic data and clinical data, including medications prescribed, were investigated. Results : Thirty-three of the 75 subjects included in this study were male, and 42 were female. Considering psychiatric comorbidity, depressive disorder, cognitive disorder, psychotic disorder and anxiety disorder were reported in order. Approximately 97% of the subjects were treated with antidepressants, including paroxetine in 54.7%, and 24% of the subjects were treated with two different kinds of antidepressants. In addition, atypical antipsychotics were prescribed in 33.3% of patients, mood stabilizers in 17.3%, and anxiolytics in 94.7% of the subjects. Conclusion : In our study, various kinds of antidepressants were prescribed for most patients with PTSD. Antipsychotics and mood stabilizers were added to the treatment regimens of some subjects, and anxiolytics were added to the treatment regimens of most subjects. Despite its many limitations, this study shows the prescription pattern and trends in PTSD treatment in Korea. We hope that these preliminary data would be helpful for the development and integration of a practical guideline for the treatment of PTSD in Korea.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.2
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• pp.217-226
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• 2016

Objectives : To investigate changes in, and predictors of, metabolic syndrome(MetS) status over a 5-year period in chronic schizophrenic patients and to identify factors associated with the prevention of or recovery from MetS. Methods : In total, 107 patients, all of whom provided written informed consent, were followed from 2011 to 2016 at Naju National Hospital for this study. MetS was defined according to the revised National Cholesterol Education Program-Adult Treatment Panel III guidelines. Results : During follow-up period, 22(20.5%) patients were newly diagnosed to MetS, 14(13.1%) were disappeared, 77(66.4%) were not changed[MetS : 34(31.8%), No MetS 37(34.6%)]. Common significant factors in the two changed groups were triglyceride and waist circumference, not dose and type of antipsychotic medication. Multiple logistic regression analysis revealed that female gender(odds ratio[OR]=2.846, 95% confidence interval[CI] : 1.020-7.942), attending two or more outpatient visits per month(OR=3.155, 95% CI : 1.188-8.379) and taking antidepressant medication(OR=3.991, 95% CI : 1.048-15.205) were significantly associated with MetS after controlling for other confounding variables. Type and dose of antipsychotic medication were not significantly associated with MetS. Conclusions : Triglyceride and waist circumference were important manageable indicator of MetS. Adoption of a healthy lifestyle is more important than adjusting the dose or type of antipsychotic medication in the treatment of chronic schizophrenia patients with MetS.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.207-212
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• 2021

Anti-N-methyl-D-aspartate receptor (Anti-NMDAR) encephalitis is a neuroinflammatory disease mediated by autoantibodies to NMDAR. In the initial clinical stages of anti-NMDAR encephalitis, psychiatric symptoms like delusions, perceptual disturbances, and disorganized speech or behaviors are pronounced even without obvious neurological symptoms. Early treatments like immunotherapy and/or tumor removal are central to good clinical outcomes. Hence, it is important to diagnose early anti-NMDAR encephalitis, distinguishing it from mental disorder. In the present case study, the authors described psychiatric symptoms assessed with Positive and Negative Syndrome Scale (PANSS) of Ms. A, a 26-year-old woman, in the early phase of anti-NMDAR encephalitis. We will discuss the characteristic psychopathology of anti-NMDAR encephalitis toward prompt diagnosis and treatment. Ms. A showed a higher negative subscale score than positive one on the PANSS. Compared with mental disorder, negative symptoms and cognitive impairment would be more prominent in the early stage of anti-NMDAR encephalitis. Rituximab and teratoma removal were effective, and quetiapine showed good tolerability. It is recommended to evaluate anti-NMDAR encephalitis when negative symptoms, cognitive impairment, catatonia, changes in consciousness level, and neurological symptoms are observed, especially in young women.

• Korean Journal of Biological Psychiatry
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• v.28 no.2
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• pp.50-57
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• 2021

Objectives Clozapine is the most effective atypical antipsychotic agent for the treatment-resistant schizophrenia (TRS), however, only 40%-70% of TRS patients respond to clozapine. Moreover, TRS encompasses various symptom dimensions. Therefore, augmentation with other medications for clozapine is frequently applied. However, the prescription pattern of clozapine and combined medications in Korea is yet to be examined. This study aims to investigate the maintenance treatment pattern of clozapine and augmentation agents in one Korean tertiary hospital. Methods The patients with schizophrenia spectrum disorders under clozapine maintenance, defined as one-year clozapine continuation, were subjected for analysis. Medication data at one-year time-point after clozapine initiation was extracted and analyzed. Results Among total 2897 patients having clozapine prescription experience from January 2000 to December 2018, 1011 patients were on clozapine maintenance. The mean age of clozapine initiation was 30.2 ± 11.3 years, and the maintenance dose of clozapine was 217.8 ± 124.3 mg/day. Combination rate of antipsychotics, mood stabilizers, and antidepressants were 43.5%, 25.3%, 38.6%, respectively. Most frequently prescribed drugs in each category were aripiprazole, valproate, and sertraline. Olanzapine equivalent dose of combined antipsychotics was 10.4 ± 7.7 mg/day. Male patients were prescribed higher dose of combined antipsychotics and higher rate of antidepressants. Female patients had later onset of clozapine prescription. Patients with two or more combined antipsychotics were prescribed higher dose of clozapine and higher rate of antidepressants compared to patients with one combined antipsychotic. Conclusions Taken together, among the patients taking clozapine, a substantial rate of patients were under polypharmacy. The present findings based on the real-world prescription pattern could provide the valuable clinical information on the treatment of TRS-related conditions.