• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제25권1호
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• pp.14-19
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• 2014

Objectives : This study was conducted in order to describe prescribing practices in treatment of pediatric bipolar disorder in a Korean inpatient sample. Methods : We performed a retrospective chart review of 66 youths who had been hospitalized and diagnosed with bipolar disorder according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria. Demographics, clinical characteristics, medications used, doses, and related adverse events were examined. Results : Mood stabilizers and/or atypical antipsychotic medications were the primary treatment. Risperidone, valproate, and lithium were the most commonly used. Thirty seven patients (58.1%) were treated with combination therapy of an atypical antipsychotic and mood stabilizer for improvement of manic/mixed symptoms. Conclusion : Combination pharmacotherapy was necessary for most patients in this admission sample group. Conduct of further studies will be needed for evaluation of treatment response according to the clinical characteristics, and the safety and efficacy of treatment for child and adolescent bipolar disorder.

• 생물정신의학
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• 제1권1호
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• pp.40-59
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• 1994

The introduction of lithium salts for the treatment of mood disorder by Code in 1949 was a major therapeutic breakthrough. Yet it is far from the universal therpeutic agent in the treatment of mood disorders. Indeed, some acutely manic patients do not respond adeqately to lithium and some individuals experience breakthrough affective episodes during lithium maintenance. In the last decode, it has become c1ear that a significant number of patients with more highly recurrent disorders may require alternative or enhanced forms of prophylactic treatment. For these reasons, a variety of other drugs hove been employed for the treatment and prophylaxis of mood disorders. Efforts to develop new pharmacologic strategies for mood disorder hove included a diverse array of medications, ranging from potent benzodiazepines to novel neuroleptics and from anticonvulsants to calcium channel blockers. The anticonvulsants appear particularly useful in cases of dysphoric mania and rapid cycling state, subforms of bipolar disorder that respond quite poorly to conventional treatments. Among all of these new pharmacologic strategy, carbamazepine and sodium valproate have received the broadest clinical applications as maintenance therapies. The data documenting the short-term antimanic effectiveness of the calcium channel blocker verapamil and benzodiazepins such as clonazepam and lorazepam appear also promising. A number of other theoretically interesting, as well as clinically relevant therapies, which are not presently employed routinly, hove also been studied, including 2 blocker clonidine, atypical antipsychotic clozapine, cholinomimetics, 5-HT enhancers, thyroid and magnesium preparations. Now prophylaxis in mood disorder remains a considerable therapeutic challenge. Controlled testing of the prophylactic efficacy of compounds such as carbamazepine, valproic acid, and the calcium channel blockers represent important next step in the clinical trials for mood disorder.

• Parasites, Hosts and Diseases
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• 제21권2호
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• pp.280-285
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• 1983

본 연구는 우리나라에서의 정신질환 환자에 관한 Toxoplasma 항체 가의 분포를 조사한 성적이다. 대상은 국립서울정신병원에 입원중인 환자 573명이며 대조군은 울산중공업의 근로자중 신체검사로 건강인으로 판점된 76명이 다. 검사시기는 1983년 7월~8월이 었으며 검사방법으로는 간접 Latex응집반응용 kit("Eikon" E-ST 06)을 입수해서 사용하였다. 1. 대조군에서는 76명중 항체가 1 : 64 1예(1.3%)가 있었다. 2. 정신과환자는 573명 중 양성반응자 11예 (1.9%)이었으며 이중에서 정신분열환자군은 495명 중 3예(1.8%), 그리고 우울중환자 27명 중 2예(7.4%)가 양성이었다. 3. 실험군의 양성반응자중 남자는 367명 중의 8예(2.2%). 그리고 여자는 206명 중 3예(1.5%)애서 양성반응을 나타내었다. $\ulcorner$본 연구를 수행함에 있어서 여러가지 지도를 아끼지 않으셨던 일본 Jikei 의과대학 소림교수와 항원을 제공해주신 "Eikon" 회사측에 심심한 사의를 표합니다. $\lrcorner$

• 동의생리병리학회지
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• 제28권3호
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• pp.251-262
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• 2014

This article is for understanding dementia with the perspective of Korean Medicine through research on syndrome differentiations of dementia clinically applied and relations between modern diseases and Korean Medicine pattern types of dementia. clinical papers were searched in China Academic Journals(CAJ) of China National Knowledge Infrastructure(CNKI) from 2012 to 2013. Conclusions are as follows. First, dementia was expressed in many ways such as imbecility, stupidity, fatuity, idiocy, vacuity, etc and was related with amnesia, forgetfulness, speech not in the right order, depressive psychosis(quiet insanity), manic psychosis, depression syndrome. Second, prescriptions such as QiFuYin and ZuoGuiWan from JingYueQuanShu, XiXinTang and ZhiMiTang from BianZhengLu, TongQiaoHuoXueTang, XueFuZhuYuTang and BuYangHaiWuTang from YiLinGaiCuo, HaiShaoDan from YiFangJiJie, HuangLianJieDuTang from WaiTaiMiYao were suggested for dementia. Third, syndrome differentiation pattern types of dementia are kidney deficiency and marrow decrease, qi-blood depletion, liver-kidney depletion, spleen-kidney depletion, heart-spleen deficiency as deficiency patterns and effulgent heart-liver fire, ascendant hyperactivity of liver yang, qi stagnation and blood stasis, phlegm turbidity obstructing orifice, phlegm-blood stasis obstructing orifice, intense heat toxin as excess patterns and qi deficiency with blood stasis, yin deficiency with yang hyperactivity as deficiency-excess complex patterns. Major pattern types are kidney deficiency and marrow decrease, phlegm-blood stasis obstructing orifice, qi stagnation and blood stasis, liver-kidney depletion, phlegm turbidity obstructing orifice.

• 대한불안의학회지
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• 제9권2호
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• pp.101-105
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• 2013

Objectives : This study was conducted to evaluate the association between first episode polarity of pediatric bipolar disorder and prognosis. Methods : We analyzed the clinical records of 66 inpatient subjects with DSM-IV defined pediatric bipolar disorder. The patients were split into 2 groups according to the polarity of the illness onset [depressive onset (DO) vs. manic/hypomanic/mixed onset (MO)]. Clinical feature and prognosis were compared between the two groups of patients. Results : In our sample, 68% of patients experienced a depressive onset. In DO patients, rates of suicidal attempt, episodic illness course and comorbid disruptive behavior disorder were higher than rates in MO patients. Conclusion : Findings from this study suggest that polarity of illness onset may be useful in predicting the prognosis of pediatric bipolar disorder.

• 사상체질의학회지
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• 제23권1호
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• pp.33-43
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• 2011

1. Objectives: This study is aimed to develop the algorithm, which can help clinicians diagnose Soeumin's symptomology, based on the indexes such as dry mouth, water drinking, sweat, urine, appetite, digestion, and stool, etc. 2. Methods: This research analyzes the items of "Donguisusebowon(東醫壽世保元)" to reveal the inevitable and sequential indexes of Soeumin's symptomology diagnosis, in order of exterior-interior pattern differentiation, favorable-unfavorable pattern differentiation, and mild-severe-dangerous-urgent pattern differentiation. 3. Results and Conclusions: 1) 1st step: Soeumin's exterior pattern and interior pattern are differentiated in terms of heat and cold, respectively. Stool and digestion are used to confirm the difference. 2) 2nd step: The existence of sweat is used to find out that an exterior pattern is with or without favor, while the indexes of stool, dry mouth, and generalized pain are used to identify an interior pattern with or without favor. 3) 3rd step: The favorably exterior-heat pattern can be either mild or severe by the indexes of cold-heat, stool, tidal fever, and manic raving, panting and straight looking, while the unfavorably exterior-heat pattern can be either dangerous or urgent by the ones of cold-heat, stool, and urine. And, the favorably interior-cold pattern can be either mild or severe by the indexes of stuffiness and fullness, jaundice, and edema, while the unfavorably interior-cold pattern can be either mild or severe by the ones of vexation level.

• 생물정신의학
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• 제9권2호
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• pp.129-139
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• 2002

Objective:This study was performed to investigate the prescribing patterns of antimanic agents in the treatment of acute bipolar disorder inpatients in Korea from 1990 through 2000. The results will serve as the basic data for the practice guideline for the pharmacotherapy of bipolar disorder patients in Korea. Method:Retrospective chart review of bipolar disorder inpatients of Soonchunhyang Medical Center in Seoul and Chun-An was conducted for each of the year 1990, 1995, and 2000. The following data are collected ; 1) demographic data, 2) history of bipolar disorder, 3) length of hospital stay, 4) detailed drug titration records of antimanic agents and antipsychotic agents. Results:During the last decade, the frequency of lithium monotherapy was decreased obviously. Instead, more than half of the patients in 2000 were on combination therapy of lithium and anticonvulsants. Lithiumvalproate combination was the preferred strategy and the use rate of carbamazepine has been decreased. In addition, most of the patients were given antipsychotic agents during the last 10 years. And recently, atypical antipsychotics were increasingly prescribed. These changes in the field of pharmacology of bipolar disorder have resulted neither in shorter hospital stays nor lower dosages of concurrent neuroleptics. Conclusions:The results indicate the trends in the prescribing of antimanic agents for the treatment of bipolar disorder in Korea across the past 10 years. Mostly, the change seems to correspond to the international practice guideline. More systematic research is needed to find out the clinical benefits of the anticonvulsants in the real practice of treatment of bipolar disorder.

• 대한임상독성학회지
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• 제11권2호
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• pp.130-132
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• 2013

Distinguishing wild plants in spring from ingestible plants is difficult. Differentiation of budding plants from other plants is particularly difficult. Many people want to find edible plants for health during the spring season. Scopolia japonica can cause symptoms of mania. The author experienced three cases of poisoning by Scopolia japonica. We reported on the cases with literature reviews.

• Clinical Psychopharmacology and Neuroscience
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• 제16권4호
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• pp.376-382
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• 2018

We reviewed clinical studies investigating the pharmacological treatment of major depressive episodes (MDEs) with mixed features diagnosed according to the dimensional criteria (more than two or three [hypo]manic symptoms+principle depressive symptoms). We systematically reviewed published randomized controlled trials on the pharmacological treatment of MDEs with mixed features associated with mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD). We searched the PubMed, Cochrane Library, and ClinicalTrials.gov databases through December 2017 with the following key word combinations linked with the word OR: (a) mixed or mixed state, mixed features, DMX, mixed depression; (b) depressive, major depressive, MDE, MDD, bipolar, bipolar depression; and (c) antidepressant, antipsychotic, mood stabilizer, anticonvulsant, treatment, medication, algorithm, guideline, pharmacological. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We found few randomized trials on pharmacological treatments for MDEs with mixed features. Of the 36 articles assessed for eligibility, 11 investigated MDEs with mixed features in mood disorders: six assessed the efficacy of antipsychotic drugs (lurasidone and ziprasidone) in the acute phase of MDD with mixed features, although four of these were post hoc analyses based on large randomized controlled trials. Four studies compared antipsychotic drugs (olanzapine, lurasidone, and ziprasidone) with placebo, and one study assessed the efficacy of combination therapy (olanzapine+fluoxetine) in the acute phase of BD with mixed features. Pharmacological treatments for MDEs with mixed features have focused on antipsychotics, although evidence of their efficacy is lacking. Additional well-designed clinical trials are needed.

• 한국임상약학회지
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• 제33권3호
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• pp.153-167
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• 2023

Objective: Bipolar disorder displays a spectrum of manifestations, including manic, hypomanic, depressive, mixed, psychotic, and atypical episodes, contributing to its chronic nature and association with heightened suicide risk. Creating effective pharmacotherapy guidelines is crucial for managing bipolar disorder and reducing its prevalence. Treatment algorithms grounded in science have improved symptom management, but variations in recommended medications arise from research differences, healthcare policies, and cultural nuances globally. Methods: This study compares Korea's bipolar disorder treatment algorithm with guidelines from the UK, Australia, and an international association. The aim is to uncover disparities in key recommended medications and their underlying factors. Differences in CYP450 genotypes affecting drug metabolism contribute to distinct recommended medications. Variances also stem from diverse guideline development approaches-expert consensus versus metaanalysis results-forming the primary differences between Korea and other countries. Results: Discrepancies remain in international guidelines relying on meta-analyses due to timing and utilized studies. Drug approval speeds further impact medication selection. However, limited high-quality research results are the main cause of guideline variations, hampering consistent treatment conclusions. Conclusion: Korea's unique Delphi-based treatment algorithm stands out. To improve evidence-based recommendations, large-scale studies assessing bipolar disorder treatments for the Korean population are necessary. This foundation will ensure future recommendations are rooted in scientific evidence.