• Journal of Medicine and Life Science
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• v.18 no.3
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• pp.49-55
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• 2021

Atypical antipsychotics are more effective than typical antipsychotics and have fewer side effects such as tardive dyskinesia and extrapyramidal symptoms; therefore, prescriptions of atypical antipsychotics are increasing. However, recently, it has been reported that atypical antipsychotics have a higher incidence of diabetes, hyperglycemia, and obesity than typical antipsychotics. Atypical antipsychotics induce obesity-inhibiting appetite-related receptors such as serotonin and dopamine. Decreased exercise due to improving psychotic symptoms, and genetic characterictics can also cause weight gain. Hyperglycemia and hypoglycemia were another metabolic problem related to treatment with atypical antipsychotics. The mechanisms of hyperglycemia were mainly related obesity, decreased anorexigenic hormones, and increased insulin resistance in multiple organs. There are also reports that genes related to diabetes have an effect on the incidence of diabetes mellitus treated with atypical antipsychotics. On the other hand, although it is not clear why hypoglycemia occurs, it documented in case reports all over the world. There are more reports of atypical antipsychotics than typical antipsychotics and these are frequently reported in Asians. Further research on the mechanism of hypoglycemia related to atypical antipsychotics is strongly recommended.

• Korean Journal of Biological Psychiatry
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• v.19 no.4
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• pp.193-198
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• 2012

Objectives Despite the growing research interest in the role of immunological markers in schizophrenia, a few studies, with conflicting results, have focused on the association between high sensitivity C-reactive protein (hs-CRP) levels and clinical characteristics in schizophrenia. The aim of the present study was to examine the association of serum hs-CRP with psychopathology in schizophrenia. Methods Fifty-five inpatients with schizophrenia or schizoaffective disorder were enrolled. Serum levels of hs-CRP were measured, and each patient was assessed with the Korean version of the Positive and Negative Syndrome Scale (PANSS). Results In correlation analysis of hs-CRP with PANSS subscales, positive subscale score has significant positive correlation (r = 0.271, p = 0.046). In independent t-test analysis, subjects with hs-CRP > 0.3 mg/dL (elevated CRP group, n = 43) had significantly higher PANSS positive subscale score (t = -3.273, df = 24.107, p = 0.003) than those with hs-CRP ${\leq}$ 0.3 mg/dL (normal CRP group, n = 12). Conclusions Elevated serum levels of high sensitivity C-reactive protein in schizophrenia are associated with the severity of psychotic symptoms.

• Korean Journal of Biological Psychiatry
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• v.13 no.3
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• pp.191-201
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• 2006

Objectives : The purpose of this study was to investigate whether the cognitive functions would be correlated with psychotic symptoms and whether antipsychotic treatments would affect the cognitive functions after 8 weeks. Methods : The thirty-five schizophrenic patients were conducted in this study. The psychopathology was measured using PANSS. The memory function, executive function, and sustained attention were measured using Memory Assessment Scale(MAS), Wisconsin Card Sorting Test(WCST), and Vigilance(VIG) and Cognitrone(COG) in Vienna Test System. After 8 weeks of antipsychotic treatment, we retested the cognitive tests. Results : 1) The cognitive tests after the 8 week's treatment showed significant improvements in memory and executive function in the schizophrenic patients. On the other side, sustained attention did not show improvement. 2) The change of PANSS were correlated with perseverative response, perseverative error and total correct in WCST at baseline. WCST scores at baseline were correlated with negative symptoms, but not positive ones. Conclusion : These study suggests that 1) the impaired sustained attention could be a vulnerability marker in schizophrenia, 2) memory & executive function deficit could be reversible after treatment, and 3) medication might have a benefit in improving the cognitive functions in schizophrenia. Furthermore, the data supports that the better premorbid executive function was, the more favorable was the treatment response in schizophrenic patients. Finally, this study indicates that executive function might be an index of treatment improvement.

• Korean Journal of Biological Psychiatry
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• v.3 no.1
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• pp.37-45
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• 1996

Recent studies on long-term outcome of schizophrenia revealed that schizophrenic symptoms recover in more than 50%, while it remains severe in less than 20% after 20 years or more from the onset. Psychopharmacological studies indicate that 75% of remitted schizophrenics may recur within 2 years after discontinuation of maintenance pharmacotherapy. In addition, family studies revealed that schizophrenic decompensation may occur significantly more frequent in discharged patients with high expressed emotion family than in low expressed emotion family. These findings strongly support a clinical validity of stress-vulnerability concept of schizophrenia which open a new viewpoint to two central problems in schizophrenia treatment, i.e. psychotic relapses and chronification of the fist episode schizophrenia. Moreover, recent psychopathological studies argue that schizophrenic symptoms are manifestations of psychological reaction secondary to a primary cognitive impairment(neurobiological vulnerability), which is originated in neurobiological changes in the brain. Recent approaches to the vulnerability to schizophrenic symptoms or schizophrenic decompensation are reviewed.

• Korean Journal of Schizophrenia Research
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• v.23 no.2
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• pp.45-50
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• 2020

Schizophrenia is one of serious mental illnesses and is often described as a heterogeneous disorder. Approximately one-third of schizophrenia cases are treatment-resistant schizophrenia (TRS). The aim of this study was to review the definitions and clinical features of TRS. Though it was found that the criteria for TRS were considerably diverse, the Treatment Response and Resistance in Psychosis (TRRIP) consensus criteria were recently introduced. According to the TRRIP criteria, TRS should be suspected if symptoms persist alongside psychotic symptoms despite sufficient treatment for ≥12 weeks, or two or more symptoms persist significantly for ≥6 weeks. The clinical characteristics of TRS includes an earlier age of onset, more severe and familial form, possibly more rural residence, unlikely association with male sex, and an increase in cognitive deficits.

• The Korean Journal of Rehabilitation Nursing
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• v.7 no.1
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• pp.58-67
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• 2004

Behavioral symptoms are frequent and problematic components of dementia. The aim of this study was to detect behavioral problem of the 25 item of dementia problem behaviour(DPB)assesment scale for demented older adults. Seventy-three patients with dementia staying in the day care center, group home, dementia hospital, nursing home were recruited data on problematic behavior obtained through interviews with their caregiver during 2 months from March to May 2004. Results shows that problematic behaviors common occurring in 95% of subjects. The most frequently exhibited problematic behaviors were repetitive movement(1.05), repetitive questions(1.03), restlessness(1.0). indifference(0.97). shouting/screaming(0.92). Problematic Behaviors of the demented older adults were closely associated to the distress for caregiver. Most distressful ones for caregivers were repetitive questions(1.46), repetitive movement(1.42), shouting/screaming (1.42), indifference(1.41). restlessness(1.41). Problematic Behaviors of the demented older adults were divided into six subdivisions, among those restless behavior was positively correlated with aggressive behavior, nervous symptom and psychotic symptom. and then nervous symptom was interrelated to psychotic symptom(P<0.01). This study has limitation that field study data were derived from various primary caregivers.

• Journal of Yeungnam Medical Science
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• v.39 no.1
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• pp.58-61
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• 2022

Mega cisterna magna (MCM), one of the members of the Dandy-Walker complex, is a developmental malformation of the posterior fossa that is larger than 10 mm but morphologically does not affect the vermis and cerebellar hemispheres. Reports of psychiatric disorders associated with this anomaly are rare. We present the case of a patient with MCM who presented with a psychotic manic attack and was diagnosed with bipolar disorder. A 28-year-old female, single housewife, university graduate, presented with irritability, decreased sleep and appetite, distraction, and agitation. The patient also had a delusion of reference. In the clinical follow-up, an increase in energy and an increase in the amount of speech were observed. Her neurological examination was normal, and cranial magnetic resonance imaging revealed an MCM. The relationship and clinical significance of MCM with psychosis and mood disorders have not yet been fully elucidated. It is not known whether this association is accidental or based on etiological commonality. The purpose of this case report is to review the relationship between the cerebellum and psychiatric symptoms and to contribute to the literature.

• Korean Journal of Biological Psychiatry
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• v.10 no.2
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• pp.177-185
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• 2003

Object:We investigated the relationship between prolactin response to antipsychotics and clinical courses of psychotic symptoms and DAT gene polymorphisms. Method:Twenty-four acute psychotic inpatients completed the 12-week trial of risperidone. Serum prolactin, BPRS, ESRS and hyperprolactinemia-related symptoms were measured at baseline, 2, 4, 8 and 12 weeks after medication. The DAT gene polymorphisms were analyzed. Results:The serum prolactin was significantly increased over time. According to the prolactin level at 2-week, the subjects were divided into the severe group(serum prolactin>60ng/mL, N=15) and the mild group (serum prolactin<60ng/mL, N=9). The prolactin levels of the mild group didn't increase beyond 60ng/mL throughout 12 weeks. Severe group had slower decrement of BPRS scores than those of mild group. Six females in severe group complained of irregular menstruations, but no female in mild group. Most patients had 10 allele of DAT gene. Conclusion:This study suggests that the magnitude of prolactin elevation at the 2-week of risperidone medication is correlated with severity of hyperprolactinemia throughout treatments. Our results did not show the relationship between prolactin responses and DAT gene polymorphisms.

• Korean Journal of Biological Psychiatry
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• v.21 no.1
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• pp.28-35
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• 2014

Objectives This study aimed to identify the relationship between quality of life (QoL) and psychosocial factors of schizophrenia patients registered in a community mental health center. Methods The ninety patients with schizophrenia, diagnosed by Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revision, registered in a community mental health center were studied cross-sectionally. Four trained personnels interviewed each subject individually for the assessment of QoL, psychopathology, severity of depressed mood, insight of illness, attitude toward drugs, social function, degree of social supports and conflicts. Results QoL was significantly related to the psychopathology, depressed mood, social conflict, social support; and other aspects of QoL were slightly differently related to depressed mood, social conflict, social support and attitude toward drug by scales. In multiple regression analysis, depressed mood (20.0%) and social conflict (10.3%) were contributed to QoL assessed by Korean version of 4th revision of Schizophrenia Quality of Life. Social support (21.4%), social conflict (20.9%) and depressed mood (3.1%) were contributed to QoL assessed by Korean modification of the Scale to measure Subjective Well-being under Neuroleptic treatment. Conclusions These findings demonstrated that QoL of schizophrenia patients in a community is affected by depressed mood, social support and conflict rather than psychotic symptoms, insight and attitude toward drugs. And this result suggests the necessity of approaching not only to the psychotic symptoms but also to the psychosocial characteristics in caring schizophrenia patients in the community.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.437-441
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• 2010

Toxic epidermal necrolysis (TEN) and Stevens Johnson syndrome (SJS) are rare, life-threatening mucocutaneous -diseases, usually attributable to drugs and infections. Corticosteroids have been used in the management of TEN for the last 30 years. This remains controversial and is still much debated. TEN can occur despite administration of high doses of systemic corticosteroids. The psychiatric side effects of corticosteroids can include headache, insomnia, depression, and mood disorders with or without psychotic episodes. Steroid-induced psychosis is dealt with by tapering or discontinuing the steroid; antipsychotics are also sometimes used. We report a case of an 11-year-old boy who was admitted with TEN. He had also been diagnosed as having nephrotic syndrome in the past. Remission was achieved through induction therapy and by maintaining the use of steroids. After a full-dose intravenous dexamethasone for TEN, he showed psychotic symptoms. We diagnosed him as having steroid-induced psychosis. We tapered the steroid use and initiated an atypical antipsychotic medication, olazapine and intravenous immunoglobulin (IV-IG). His symptoms dramatically improved and he was discharged.