• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.16 no.2
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• pp.173-182
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• 2005

This review is a clinical and research update of recent literature related to childhood onset schizophrenia (with an onset of psychosis by age 12). Childhood onset schizophrenia(COS) is a rare disorder, but that may represent a more homogeneous patient population in which to search for risk or etiologic factors of schizophrenia. These overview data show that COS shares the same clinical and neurobiological features as later onset forms of the disorder. Compared with later onset schizophrenia, however, this subgroup of patients appear to have more severe premorbid neurodevelopmental abnormalities, more cytogenic abnormalies, poor outcome, and potentially greater family histories of schizophrenia and associated spectrum disorders. Future studies of this subgroup may provide important clues as to the genetic basis for schizophrenia and how gene products influence certain feature of the disease, such as age of onset and mode of inheritance.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.11 no.2
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• pp.262-281
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• 2000

We focused on the peer relationship of adolescent patients with schizophrenia, which usually occurs around puberty. Reviewing cases with schizophrenia and the literature extensively, we had come to the conclusion as follows；1) the most robust predictors among factors influencing the prognosis of schizophrenia are premorbid interpersonal relationship and adaptive functions. 2) Especially teachers’ reports about school life and peer relationship during school life are useful for predicting the occurrence of schizophrenia in adolescents. We described characteristic and behavioral childhood features which are important in pathogenesis of schizophrenia, based on high-risk studies and long term follow-up studies. Also, pathological profiles of the interpersonal relationship and pathology in adulthood were presented. We tried to integrate various aspects of interpersonal and social weaknesses of schizophrenics applying 'primary and secondary socialization' concept. Finally, five cases of adolescent schizophrenics were described briefly and proposal for the early detection and intervention for risk factors was introduced.

• Korean Journal of Biological Psychiatry
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• v.6 no.1
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• pp.111-118
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• 1999

Objectives : There have been several evidences that the central nervous system defect is one of the etiologic factors in schizophrenia and high nailfold plexus visibility can reflect these defects indirectly. These are particularly related to the negative symptoms of schizophrenia. In this study, we examined the relationship between nailfold plexus visibility and various clinical variables in schizophrenia. Methods : Forty patients(20 males, 20 females) satisfying the DSM-lV criteria for schizophrenia and forty normal controls(20 males, 20 females) were measured for Plexus Visualization Score (PVS) by using capillary microscopic examination. We used Positive and Negative Syndrome Scale(PANSS), Ulmann-Giovannoni Process-Reactive Questi-onnaire(PRQ), Phillips Premorbid Adjustment Scale(PAS), Continuous Performance Test, and Backward Masking for psychopathology and clinical variables. Results : There was no significant relationship between schizophrenic subjects and normal controls in PVS. PVS was correlated with PANSS positively except negative symptom subscore. PVS was correlated with PRQ score negatively, and with PAS score positively. Conclusions : This study shows high PVS are associated with more severe psychotic symptoms and with clinical variables, such as disease process and premorbid adjustment, in some schizophrenics.

• Korean Journal of Biological Psychiatry
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• v.14 no.3
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• pp.177-183
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• 2007

Objectives:Previous studies have suggested that S100B protein play an important role in the pathogenesis and progress of schizophrenia. In the present study, we evaluate the serum levels of S100B in the patients with schizophrenia, and compare them with those of healthy controls. Method:The serum S100B levels were measured by lectrochemiluminescence immunoassay in 21 schizophrenic patients (8 males, 13 females) and 27 normal controls(11 males, 16 females). The Positive and Negative Syndrome Scale(PANSS) was used to evaluate the symptoms of the patients with schizophrenia, and the correlation between PANSS subscale scores and serum S100B levels was examined. Results:No significant difference was found between the serum S100B levels of the schizophrenic patients($0.074{\pm}0.039$ng/ml) and those of the normal controls($0.072{\pm}0.030$ng/ml)(p=0.925). Correlationships between the high serum S100B level with high negative symptom scores(p=0.065) or with the low positive symptom scores(p=0.080) did not exist. Conclusion:The relation between serum S100B level and schizophrenia was not found in the present study. However, to confirm this result, further studies, such as measurement of S100 protein level in CSF, postmortem study, long-term follow-up study, and studies with other neurotrophic proteins are needed.

• Korean Journal of Biological Psychiatry
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• v.8 no.1
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• pp.123-130
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• 2001

Objective : Asymmetries in evoked potential P300 topography of schizophrenia and bipolar disorder are still controversial. The purpose of this study was to examine the difference in P300 topography between schizophrenia and bipolar disorder. Method : P300 was recorded from 16 schizophrenic, 15 bipolar manic, and 16 control subjects. All were right-handed. Subjects silently counted target stimuli(2.0kHz) among trains of standard stimuli(1.0kHz). Averages were constructed from brain responses to target stimuli. Results : 1) Schizophrenics displayed significantly smaller peak amplitude of P300 over Cz, Pz, T3 than controls. 2) Schizophrenics displayed significantly smaller peak amplitude of P300 over T3 than bipolar manics. 3) Schizophrenics displayed significantly smaller peak amplitude of P300 over T3 than their T4. 4) Schizophrenics displayed significantly delayed latency of P300 over T3 than bipolar manics. 5) Schizophrenics displayed significantly delayed latency of P300 over T3 than their T4. Conclusions : Left-sided P300 abnormality, especially left superior temporal gyrus, in schizophrenics relative to bipolar manics and controls suggests that psychophysiological cause of schizophrenia and bipolar disorder is different and P300 asymmetry is specific to the psychophysiological cause of schizophrenia.

• Korean Journal of Biological Psychiatry
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• v.6 no.2
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• pp.153-160
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• 1999

Animal models can provide a useful tool for the study of some aspects of psychiatric disorders and their treatment. The four criteria for the evaluation of animal models of psychiatric disorders are as following : 1) similarity of inducing conditions 2) similarity of behavioral state 3) common underlying neurobiological mechanisms 4) reversal by clinically effective treatment techniques. Several animal models have been proposed for schizophrenia : phenylethylamine model, L-dopa model, hallucinogen model, cocaine model, amphetamine model, phencyclidine model, noradrenergic reward system lesion model, reticular stimulation model, social isolation model, conditioned avoidance reaction, catalepsy test, paw test, self-stimulation paradigms, latent inhibition paradigms, blocking paradigms, prepulse inhibition of the startle reflex, rodent interaction, social behavior in monkeys, hippocampal damage, high ambient pressure, and models using selective breeding. Among them, animals with bilateral lesion of the hippocampus may provide an adequate animal model for several symptoms of schizophrenia, and ketamine model can reproduce negative symptoms and cognitive deficits as well as positive symptoms of schizophrenia. In conclusion, no model of schizophrenia is entirely representative of the disease, and findings gleaned from model systems must be cautiously interpreted. Furthermore, the process of developing and validating animal models must work in concert with the process to identify reliable measures of human phenomenology.

• Korean Journal of Biological Psychiatry
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• v.7 no.2
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• pp.152-158
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• 2000

Background : No association between schizophrenia and dopamine D4 receptor polymorphisms have been reported. Despite these results, it is premature to exclude the association. It has been suggested that the susceptibility to develop schizophrenia could result from variation at a number loci which may interact or coact with each other. Therefore, we investigated a possible association of combinations of exon III 48bp polymorphism[D4E3] and exon I 12bp polymorphism of the DRD4 gene [D4E1] with schizophrenia. Methods : 207 unrelated Korean schizophrenic patients and 191 healthy controls were recruited. DRD4 genotype was established using the polymerase chain reaction. Statistical analysis consisted of ${\chi}^2$ tests for Hardy-Weinberg proportions and genotypic and allelic frequencies in the patients and control groups. Results : There were no statistically significant differences in the each polymorphisms between schizophrenics and controls. And all genotype frequencies were within Hardy-Weinberg expectations. When the combinations of the polymorphism in schizophrenia and controls were compared, however, there were significant differences at $A1A2^*2/4$ in the distributions of the combinations of D4E1 and D4E3(p<0.01). Conclusions : These findings suggest that the certain combination of D4E1 and D4E3($A1A2^*2/4$) has the protective role to a susceptibility for schizophrenia.

• Korean Journal of Biological Psychiatry
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• v.14 no.3
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• pp.184-193
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• 2007

Objectives:There is increasing evidence that the cerebellum plays an important role in cognition and psychiatric symptoms as well as motor coordination. The concept of cognitive dysmetria has been making cerebellar function in schizophrenia the focus of current studies. In other words, disruption in the corticocerebellum-thalamic -cortical circuit could lead to disordered cognition and clinical symptoms of schizophrenia. The purposes of this study were to determine cerebellar dysfunction in male schizophrenic patients semiquantitatively with ICARS and to investigate the clinical and cognitive correlates of ICARS in patients. Methods:We compared the scores of cerebellar neurologic sign using ICARS in 47 male patients with a DSM-IV-TR diagnosis of schizophrenia with 30 gender and age-matched healthy control subjects. The semiquantitative 100-point ICARS consists of 19 items divided into 4 unequally weighted subscores:posture and gait disturbances, kinetic functions, speech disorders and oculomotor disorders. All subjects were also assessed with cognitive function test. Cognitive functions were evaluated by Korean-Mini Mental Status Examination (K-MMSE), Verbal fluency test, and Clock drawing test. The patients were administered Korea version of Positive and Negative Symptom Scale(K-PANSS) to assess the symptom severity. Results:Schizophrenic patients had significantly higher scores on the ICARS than control subjects with posture and gait disturbances, kinetic functions, and oculomotor disorders. They also showed more significant impairments in cognitive function tests than control subjects. There was a significant correlation between ICARS and negative symptoms of patients. In cognitive function test, Clock drawing test was significantly associated with negative symptoms. In addition, Clock drawing test was negatively correlated with the total score of ICARS. Conclusion:In this study, we confirmed that schizophrenic patients have significant impairments in cognitive and cerebellar function, and that those were related with negative symptoms of schizophrenic patients. These results support a role of the cerebellum in schizophrenia. It is meaningful that we used a structured, and reliable procedure for rating neurological soft signs, ICARS. We hope that future prospective studies using a similar design help that rate of neurological sign should have been visible with the progression of illness.

• Korean Journal of Biological Psychiatry
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• v.9 no.1
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• pp.62-67
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• 2002

Objective:There is increasing evidence that free radical-mediated CNS neuronal dysfunction is involved in the pathophysiology of schizophrenia. This study was performed to examine the relationship between antioxidant defense system and schizophrenia by analyzing polymorphism of catalase gene, an antioxidant enzyme. Method:Genotype and allele frequencies in the promoter region in the catalase gene using restriction fragment length polymorphism were studied, comparing 155 Korean controls with 167 Korean schizophrenics. Results:No difference was found between the schizophrenics and the controls in genotype and allele frequencies of HinfI polymorphism in the catalase gene. Significant difference was found between the female schizophrenics and the female controls in the genotype distribution(${\chi}^2$=11.096, df=2, p=0.004). Conclusions:The results do not support an association between polymorphism of catalase gene and schizophrenia. However, this study suggests that HinfI polymorphism in the catalase gene could be associated with female schizophrenics.

• Korean Journal of Biological Psychiatry
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• v.4 no.1
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• pp.74-83
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• 1997

With increasing tendency of incidence and interest for the late onset schzophrenia, concerns about whether this disorder is etiologically or phenomenogically distinctive entity or not have increased also. To clarify the disease entity of the late onset schzophrenia and the role of structural brain changes in its etiology, authors tried to prove following hypothesis : Are there any evidences of structural brain changes in the lateonset schizophrenia? ; If present, are they not different from those of the early-onset schizophrenia or progressive schizophrenia? ; And are they not different from those of senile dementia? Subjects were 6 patients with the late-onset schizophrenia, 6 patients with the early-onset schizophrenia, 6 patients with progressive schizophrenia, 6 patients with Alzheimer's dementia, and 6 controls. We measured regions of interest of the magnetic resonance images by computer assisted planimetry using the AutoCad and digitizer. Our study results may suggest that the third ventricular enlargement and a reversal of normal difference between left and right temporal lobe and left-right difference in posterior lateral ventricle are common brain pathology for all types of schizophrenia including the late onset schzophrenia. And also suggest that brain structural changes of the late onset schizophrenia are related with neurodevelopmental abnormality rather than degenerative change.