• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.30 no.1
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• pp.42-44
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• 2019

Hashimoto's encephalopathy (HE) is a rare and underdiagnosed neuropsychiatric illness. We present the case of a 17-year-old girl who was admitted to a tertiary-care psychiatric center with acute onset psychosis and fever. Her psychotic symptoms were characterized by persecutory and referential delusions, as well as tactile and visual hallucinations. Her acute behavioral disturbance warranted admission and treatment in a psychiatric setting (risperidone tablets, 3 mg/day). She had experienced an episode of fever with a unilateral visual acuity defect approximately 3 years before admission, which was resolved with treatment. Focused clinical examination revealed an enlarged thyroid, and baseline blood investigations, including thyroid function test results were normal. Abnormal laboratory investigations revealed elevated anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) levels (anti-TPO of 480 IU/mL; anti-TG of 287 IU/mL). Results of other investigations for infection, including cerebrospinal fluid examination, electroencephalography, and brain magnetic resonance imaging were normal. She was diagnosed with HE and was treated with intravenous corticosteroids (methylprednisolone up to 1 g/day; tapered and discontinued after a month). The patient achieved complete remission of psychotic symptoms and normalization of the anti-thyroid antibody titers. Currently, at the seventh month of follow-up, the patient is doing well. This case highlights the fact that in the absence of well-defined clinical diagnostic criteria, a high index of suspicion is required for early diagnosis of HE. Psychiatrists need to explore for organic etiologies when dealing with acute psychiatric symptoms in a younger age group.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.6
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• pp.375-384
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• 2021

This study explored the change in keywords and topics in newspaper articles related to schizophrenia after the Gangnam murder case. The study examined newspaper articles related to schizophrenia for five years before and after the Gangnam murder case. A semantic network analysis was conducted using the NetMiner 4.4.1 program. 610 articles between 2013 and 2018 were retrieved from 8 national newsletters. The most frequent core keyword was 'treatment' before the murder case, but 'incidents' after the case. Four topics were identified: 'becoming chronic if missing the time of treatment due to prejudice', 'being curable with early treatment', 'living an ordinary life with medication', 'being indicted as a murderer while impaired by a mental disorder' before the murder case. After the case, four topics were identified: 'committing murder for delusions, not misogyny', 'medication non-adherence leads to more impulsive behavior', 'claiming leniency for criminals due to the mental impairment', 'killing the police who were mobilized to stop stabbing rampage'. These findings suggest that newspaper articles should provide accurate information about schizophrenia to reduce prejudice and stigma toward patients with schizophrenia and other forms of mental illness.

• Journal of the Korean Society of Radiology
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• v.83 no.4
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• pp.945-950
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• 2022

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a common autoimmune encephalitis that is noted to be a severe but treatable disease entity. Patients with anti-NMDAR encephalitis often develop psychotic symptoms, including delusions, hallucinations, and paranoia, as well as memory impairment and persistent loss of attention. However, MRI findings in such patients show no abnormalities in most cases. Although typical brain abnormality features, known as T2 hyperintensities, involve the brain parenchyma and contrast enhancement at the cerebral cortex or overlying meninges, isolated leptomeningeal enhancement has been rarely reported in anti-NMDAR encephalitis. Herein, we report a patient with anti-NMDAR encephalitis who presented with isolated leptomeningeal enhancement, additionally showing the diagnostic value of contrast-enhanced fluid-attenuated inversion recovery imaging.

• 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.

• Industry Promotion Research
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• v.6 no.2
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• pp.37-46
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• 2021

The purpose of this study is to examine the necessity of providing new perspectives by conveying the various psychological changes and realities experienced by victims of incest sexual violence after the incident, And it is meaningful to understand and record it through. The results of the analysis through the phenomenological methodology are as follows: First, participants were disturbed by the emotional neglect of their parents and forced violence, threats, and silence by their family members, resulting in disbelief in interpersonal relationships and low self-esteem and suffered constant difficulties in daily life. Second, the suffering and aftereffects of sexual violence experienced the conflict of roles by repeating the real maladjustment and social activity avoidance as the fear of being informed about the event, the negative thought about oneself, and the difficulty of interpersonal relationship. Third, the aftereffects of incest sexual violence in childhood·adolescence were found to be extreme with regard to PTSD. The PTSD experience has become a factor that forces participants to rely on substances, such as psychiatric medications and alcohol, and further avoids external activities with hallucinations and delusions. Fourth, the change through the adaptation process is a new perspective on life, facing and separating the events. During the adaptation program, they tried to express their words and feelings that they could not express because of the past hurts, to set goals for living their life, and to move forward. The experience of overcoming reality has enhanced participants' confidence in self-esteem, self-efficacy, and healthy self-control ability. In this study, it is meaningful to suggest a model in which the incest sexual violence trauma is reexperienced through the new daily crisis and the new adaptation process is repeated for each process.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.10 no.1
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• pp.91-99
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• 1999

Objects：It is difficult to differentiate between attention deficit hyperactivity disorder(ADHD) and mania because of similar symptoms and atypical symptoms of mania in children and adolescents. The purpose of this study is to identify the characteristics and to clarify the relationship by comparing the clinical features and comorbidities of ADHD and manic patients. Methods：The subjects consisted of 35 patients with ADHD and 19 manic patients. To Compare the characteristic symptoms between the two disorders, we selected 29 patients with ADHD and 14 patients with manic disorders. 6 ADHD patients who had manic disorders as comorbid disorder, and 5 manic patients who had ADHD as comorbid disorders were manic disorders were excluded. Results：1) There were significant differences in ages of onset and state anxiety scale scores, birth weights, numbers of perinatal problem, gestational ages, school behavioral problems between ADHD patients and manic patients(p<0.01). 2) There were significant differences in loses things(p<0.05) of ADHD-symptoms and grandiosity(p<0.01), decrease in sleep(p<0.05), delusions(p<0.01), hallucinations(p<0.05) of mania-symptoms between ADHD patients and manic patients. 3) The comorbid disorders of ADHD patients are significantly high(p<.05) than that of manic patients in major depression. 4) The familial loading of manic patients are significantly high(p<.05) than that of ADHD patients in mood disorder. Conclusions：The above results suggest that ADHD and mania are different disorders, considering the significant differences of clinical features and characteristics, familial loadings of the two disorders.