• Korean Journal of Biological Psychiatry
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• v.24 no.4
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• pp.188-195
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• 2017

Objectives Schizophrenia is characterized by disturbances in perception and cognition. Attenuated mismatch negativity (MMN) reflects central auditory dysfunction in schizophrenia. The aim of this study is to compare MMN changes before and after treatment in schizophrenia patients and to assess their association with treatment response. Methods Twenty-three schizophrenia patients underwent an oddball paradigm. MMN was calculated by the difference waveforms of the event-related potentials (ERPs) elicited by subtracting standard from deviant stimulus. The clinical symptoms were measured by the Positive and Negative Syndrome Scale (PANSS), the Psychotic Symptom Rating Scale (PSYRATS). Follow-up evaluation was conducted when the PANSS total score decreased by 30% or more (treatment response group) or before discharge (non-response group). Results The treatment response group showed significantly larger MMN amplitude improvement and latency reduction than the non-response group after treatment (Fz ; mean amplitude p = 0.035, FCz ; p = 0.041). The auditory hallucination group showed shorter latency than that of the group without hallucinations. Additionally, auditory hallucination was associated with prolonged MMN latency and shortened after treatment in the auditory hallucination response group (Fz ; p = 0.048). Conclusions These results suggest that the attenuated MMN amplitude reflects the progression of the disease. The increment of MMN amplitude and shortening of latency after treatment may reflect cognitive functional recovery of central auditory sensory processing.

• Korean Journal of Biological Psychiatry
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• v.22 no.4
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• pp.163-172
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• 2015

Objectives This study was aimed to examine the multidimensional relationship between auditory verbal hallucinations (AVHs) and Positive and Negative Syndrome Scale (PANSS) factors of psychopathology in the patients with schizophrenia. And we explored the differences between assessments to hallucination by the clinicians and patients. Methods 82 patients with schizophrenia who were assessed by the Hamilton Program for Schizophrenia Voices Questionnaire (HPSVQ), Psychotic Symptom Rating Scale-Auditory Hallucination (PSYRATS-AHS), and the PANSS were recruited. Hwang's five-factor model of PANSS, items and total scores of hallucination scales, Kim's and Haddock's factor models of hallucination were applied to examine the correlations between psychopathology and AVHs. AVH-positive patients was 50 in PANSS-HPSVQ group and 24 in PANSS-PSYRATS-AHS. These two groups were separately analyzed. Results Among the five factors of the PANSS, negative and depression/anxiety factors were correlated with the total scores of HPSVQ and PSYRATS-AHS, and positive and autistic preoccupation factors were correlated only with the total score of PSYRATS-AHS. The activation factor was correlated with none of the total scores of HPSVQ/PSYRATS-AHS. These correlation patterns of a total score of HPSVQ/PSYRATS-AHS were same in the emotional factor of HPSVQ and physical factor of PSYRATS-AHS respectively. In the items which showed significant correlations, correlation coefficients of PANSS-PSYRATS-AHS group ranged between 0.406-0.755 and those of PANSS-HPSVQ ranged between 0.283-0.420. Conclusions This study suggested that the psychopathological domains of schizophrenia were differentially correlated with AVHs and the assessment of AVHs by clinicians and patients showed substantial differences which should be integrated into the therapeutic interventions.

• Korean Journal of Biological Psychiatry
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• v.16 no.3
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• pp.170-180
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• 2009

Objectives : To assess clinical improvement and change in plasma brain-derived neurotrophic factor(BDNF) level after repetitive transcranial magnetic stimulation(rTMS) in patients with treatment-resistant schizophrenia. Methods : Seven patients with DSM-IV schizophrenia, who were proven to be treatment-resistant, were treated with 15 sessions of rTMS for three weeks as an adjuvant therapy to antipsychotic treatment. Clinical improvement and change in plasma BDNF level were measured after the treatment period. The symptom severity was assessed with the Positive and Negative Syndrome Scale(PANSS) and the Korean Version of Calgary Depression Scale for Schizophrenia(K-CDSS) at baseline and 7 days after the treatment. Plasma BDNF level was measured by enzyme-linked immunosorbent assay(ELISA) at baseline and 7 days after the treatment. Results : After the rTMS treatment, there was no significant improvement in PANSS total score(Z=-1.693, p=0.090) and no significant change in plasma BDNF was found(Z=-1.183, p=0.237). Negative correlations were found between percentage change in PANSS positive subscale score and duration of illness(rho=-0.991, N=7, p<0.0005, two-tailed), and PANSS negative subscale score at baseline and percentage change in plasma BDNF level(rho=-0.821, N=7, p=0.023, two-tailed). Conclusion : This preliminary study suggests that rTMS didn't make a significant change in clinical symptoms nor in plasma BDNF level in treatment-resistant schizophrenia. Percentage change in plasma BDNF, however, might be correlated with treatment resistance in schizophrenic patients. This is a pilot study with a small sample size, therefore, a further study with a larger sample size is needed.

• Journal of Oriental Neuropsychiatry
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• v.24 no.3
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• pp.257-262
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• 2013

Objectives : Aripiprazole is unique drug among the SGA (Second generation antipsychotics) in its pharmacology and pharmacokinetics,but is similar in clinical efficacy. Aripiprazole acts as a partial agonist at dopamine D2 receptors, activating the receptor but eliciting a reduced response compared to the natural neurotransmitter. There are some side effects of aripiprazole, the most common side effects of aripiprazole are headache, nausea, vomiting, insomnia, tremor, constipation and EPS. Difficulty in opening eyes is not defined EPS yet, but it is a rare but important side-effect symptom of aripiprazole. Methods : This article is about a case of side-effect symptom of aripiprazole, 26-year-old single female suffering from schizophrenia had difficulty in opening eyes while she was taking antipsychotics. During the hospitalization, the relaxation therapy is helpful not only to reduce tension in the eyelids but also to headache. Results : It is important that early recognition of aripiprazole-induced oculogyric dystonia can prevent life-threatening complications. Education medical staff to this easily treatable reaction will improve overall quality of health care. Conclusions : This case notifies the need for awareness of the risk of acute oculogyric dystonia in adolescent female patients receiving aripiprazole.

• Korean Journal of Biological Psychiatry
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• v.3 no.1
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• pp.109-114
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• 1996

We have previously reported that Korean schizophrenic patients hove low production of IL-2 in vitro suggestive of autoimmunity to the pathogenesis of the disorder. In an attempt to further explore this issue, we measured in vivo serum levels of interleukins(IL-$1{\beta}$, IL-2, and IL-6) using a quantitative "sandwich" enzyme immunoassay(ELISA) in 26 male schizophrenic patients and in 26 age-matched normal controls. Patients met DSM-IV criteria for schizophrenia and were drug free for at least six months. The severity of symptoms was assessed by SANS and SAPS. We found a significant increase of IL-2 level(p<0.05) in schizophrenic patients as compared with normal controls. There were significant positive correlations between IL-2, IL-6 levels and negative symptom scores. There were no correlations between age, age at onset, duration of illness and interleukin levels. Our results may support the hypothesis of viral-autoimmune dysfunction in schizophrenia. IL-2 or IL-6 may be associated with specific clinical feature in schizophrenic syndrome, especially negative symptom.

• 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.

• Journal of the Korean Magnetic Resonance Society
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• v.5 no.1
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• pp.56-65
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• 2001

Localized in vivo proton magnetic resonance spectroscopy (MRS) was performed to evaluate metabolic alterations in the right and left frontal lobe before and after neuroleptic treatment of schizophrenic patients (n=24) and a group of healthy normal subjects (n=20). Proton metabolic ratios obtained from the 8㎤ yokels in the right and left frontal lobe were compared with the clinical assessment of PANSS for each subject. There was no significant difference in the metabolic ratios between the right and the left frontal lobes in either the schizophrenic group or the control group, indicating no laterality. Compared with those of the normal control group, NAA/Cr and (GABA+Glu)/Cr ratios of the schizophrenic patients showed significantly lower (p=0.023) and higher (p=0.005) value, respectively. The (GABA+Glu)/Cr ratio of the schizophrenic patients was generally decreased after neuroleptic treatment, while the NAA/Cr ratio was not changed. Significant correlation between the (GABA+Glu)/Cr ratio and the clinical symptom scores assessed by PANSS was established. The present study supports the “hypofrontality” hypothesis of schizophrenia on the basis of the altered metabolic ratios before and after neuroleptic treatment.

• Journal of Korean Academy of Nursing
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• v.36 no.3
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• pp.542-550
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• 2006

Purpose: This study investigated the effects of a recovery education program on rehabilitation motivation, symptoms, and function for schizophrenic patients. Method: The study employed a quasi-experimental design. Participants for the study were 27 patients with schizophrenia, 14 in the experimental group and the other 13 in the control group. Data were analyzed by using the SPSS/WIN 11.5 program with Fisher's exact test, t-test, and Repeated measures ANOVA. Results: After a 7 week intervention, participants in the recovery education program group reported increased rehabilitation motivation and function scores, which was significantly different from those in the control group. Conclusion: A recovery education program was effective improving rehabilitation motivation and function for schizophrenic patients. Therefore, this program is recommended as a rehabilitation strategy for schizophrenic patients.

• Korean Journal of Biological Psychiatry
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• v.8 no.1
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• pp.116-122
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• 2001

Objectives : Schizophrenia manifests a variety of interindividual differences in therapeutic response to antipsychotics. This might be attributable to dopamine and serotonin receptors that a important target for various antipsychotics, and the $D_3$ receptor(DRD3) alleles they carry. The purpose of our study was to investigate whether the plasma levels of homovanillic acid(HVA) and 5-hydroxyindoleacetic acid(HIAA), and the polymorphism of DRD3 can be held as a predictor of treatment response in chronic schizophrenic patients. Methods : Therapeutic response for 116 korean schizophrenia patient treated during 48 weeks were assessed by PANSS used as the clinical symptom rating scales. The levels of concentration of HVA and 5-HIAA were examined by HPLC at baseline and at 48 weeks. We classified the polymorphism of DRD3 receptor using amplifying by polymerase chain reaction(PCR). Results : Neither concentrations of HVA and 5-HIAA nor genotype of dopamine 3 receptor were not significantly associated with the therapeutic response. But, the patients who has A1 alleles of DRD3 gene showed poor therapeutic responses. Conclusion : A1 allele of DRD3 gene is associated with poor prognosis of chronic schizophrenia.

• Korean Journal of Biological Psychiatry
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• v.4 no.1
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• pp.95-101
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• 1997

The recent hypothesis about the pathophysiology of schizophrenia has been centered mainly on two theories, i.e. dopamine hypothesis and serotonin hypothesis. We investigate the correlations between plasma monoamine metabolite concentrations and clinical symptoms in schizophrenic patients. The first purpose of our study was to examine whether the plasma levels of HVA(homovanillic acid) and 5-HIAA(hydroxyindoleacetic acid) are significantly different in schizophrenics, compared to normal controls. And, with the intention of clarifying the interaction between dopaminergic system and serotoninergic system, the ratio of HVA/5-HIAA also was measured. The second purpose was whether the basal(pre-treatment) levels of these metabolites show the correlation with clinical symptoms. Finally, third purpose was whether basal HVA and 5-HIAA levels can be held as a predictor of treatment response. We used Scale for the Assessment of Positive Symptoms(SAPS) and Scale for the Assessment of Negative Symptoms(SANS) as the clinical symptom rating scales. Our results were as followed, 1) only the level of basal plasma HVA was significantly differ in schizophrenics. 5-HIAA and HVA/5-HIAA were not. 2) basal HVA showed significant correlation with SAPS score, especially delusion subscale. 3) the higher was the basal HVA level, the more improvement in clinical symptoms was observed. The basal 5-HIAA level and the HVA/5-HIAA ratio did not show any significant findings. These results support the dopamine hypothesis of schizophrenia, but fail to examine on the possible involvement of serotonin in schizophrenia.