• 대한불안의학회지
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• 제6권1호
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• pp.17-23
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• 2010

Objective : This study compared the psychological stresses of depressed patients' families with those of schizophrenic patients' families. We investigated the influence of depressive patients' clinical features and their families' demographic characteristics on the families' depressive symptoms and stresses. Methods : Participants were 23 family members of depressed patients and 20 family members of schizophrenic patients. We measured the patients' clinical features (duration of illness, number of previous hospitalizations, and satisfaction with medication), and each family member's socioeconomic status and psychological characteristics (depressive mood, anxiety, family stress, and stress response), analyzing the data via independent t-test, chi-square test, and correlation and hierarchical multiple regression analyses. Results : The depressed patients' average clinical global impression (CGI) was significantly higher than that of the schizophrenic patients. The depressed patients' family members showed stress responses significantly higher than those of schizophrenic patients' family members. Furthermore, in depressed patients, frequency of hospitalization was positively correlated with family members' stat anxiety. For both patient types, family stress was positively correlated with the patient's severity of illness and the family's state anxiety, trait anxiety, and stress response ; socioeconomic status was positively correlated with the family's depressive symptoms ; the family's state anxiety positively correlated with the family's trait anxiety and stress response ; and the family's trait anxiety positively correlated with the family's stress response. Socioeconomic status predicted the family's depressive symptoms, and socioeconomic, illness severity and stress response predicted family stress. Conclusion : These findings suggest that both depressed patients' families and schizophrenic patients' families suffer from psychological stress. The study data also have important clinical implications, in that families of depressed patients need psychiatric intervention, as well as the patients themselves. In particular, family intervention should focus on psycho-education and stress coping strategies.

• 생물정신의학
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• 제12권2호
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• pp.107-113
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• 2005

Purpose:In an attempt to predict the interpersonal differences of therapeutic response to antipsychotic drugs on pharmaco-genetic bases, this study was designed to investigate the relationship between the therapeutic response to antipsychotic drugs and Taq I A dopamine $D_2$ receptor polymorphism in schizophrenic patients. Methods:The subjects were 158 patients diagnosed with schizophrenia(DSM-IV). The therapeutic response to antipsychotic drugs was evaluated using the Treatment Response Scale(TRS) retrospectively. Patients were divided into two groups, dopamine receptor antagonist responders, and serotonin-dopamine antagonist responders. The patients' Taq I A dopamine $D_2$ receptor polymorphism was determined by polymerase chain reaction(PCR) and restriction fragment length polymorphism(RFLP). Results:The dopamine receptor antagonist responders had the A1 allele in significantly higher incidences (${\chi}^2$(1)=4.875, p=0.027, two-tailed). No significant difference was found among the serotonin-dopamine antagonist responders between those with or without the A1 allele. Conclusions:The patients with the A1 allele responded better to dopamine receptor antagonists than those with no A1 allele. Based on these results, it is suggested that the pharmacological effect of dopamine receptor antagonists can be predicted depending on the presence of the A1 allele in schizophrenic patients.

• 동의생리병리학회지
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• 제18권4호
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• pp.1218-1224
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• 2004

Tardive Dyskinesia(TD) may be defined as a syndrome consisting of abnormal, stereotyped involuntary movements, which occurs relatively late in the course of drug treatment and in the etiology of which the drug treatment is a necessary factor like schizophrenia, The frequently involved parts of the body in the schizophrenic patients who have TD were tongue, upper extremity, lips and perioral area, jaws, lower extremity, muscle of facial expression, trunk respectively. The last few years have seen a number of well-conducted clinical, biochemical, neuropathological, and therapeutic studies in patients with TD, but there is no satisfactory treatment for the majority of patients with TD. I used herb medicines and some acupoints like GV20(百會), Extra-point(鎭靜), Extra-point(間谷), Liv20(行間), of the chennel of Gall bladder to treated 2 schizophrenic patients with TD from December 2003 to May 2004. The patients with TD were somewhat improved. Nonetheless for just 2 cases, I might thought that this acupuncture therapy could be helpful to treat schizophrenic patients with TD.However, further studies should be followed.

• 생물정신의학
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• 제3권1호
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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.

• 정신신체의학
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• 제5권1호
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• pp.31-42
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• 1997

This study was aimed to investigate dysfunctional attitudes, stress coping strategies and depressive symptoms in psychiatric patients. The subjects of this study consisted of 210 patients(138 schizophrenic patients, 29 depression patients, 43 alcohol dependence patients) according to DSM-IV criteria. Futhermore, the instruments were K-BDI(Beck Depression Inventory-Korean version), DAS(Dysfunctional Attitude Scale) and multidimensional coping strategy scale. The results were the following. 1) There were statistically significant correlations between depressive symptoms and dysfunctional attitudes in psychiatric patients. 2) In terms of coping strategies, there were positive correlations between depressive symptoms and focus on and venting emotions, accommodation, active forgetting, self-criticism, positive comparison, fatalism, passive withdrawal. Whereas, there was significant negative correlation between depressive symptom and active coping. 3) In terms of coping strategies, there were significant correlations between dysfunctional attitudes and focus on and venting emotions, active forgetting, self-criticism, positive comparison, fatalism, passive withdrawal. 4) Depression groups reported significantly higher BDI scores than schizophrenia groups. 5) In depression groups, DAS scores were significantly higher than those in schizophrenia groups. 6) In terms of coping strategies according to diagnosis, there were significant differences in venting emotions, active forgetting and self-criticism. As for venting emotions, alcoholic groups were scored significantly higher than schizophrenic groups. As for active forgetting, depression groups were scored significantly higher than schizophrenic groups. In self-criticism, depression groups and alcohol dependence groups reported significantly higher scores than schizophrenic groups.

• 생물정신의학
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• 제6권1호
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• pp.125-134
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• 1999

The purposes of this study were to test the negative association between schizophrenia and rheumatoid arthritis(RA) and to clarify the role of prolactin and estrogen as protective factors in this association. The author compared the prevalence rate of RA between 561 patients with schizophrenia and 222 patients with mood disorder. For investigating the role of estrogen and prolactin, the author checked the plasma prolactin and estradiol level in 80 patients with paranoid schizophrenia and 77 patients with RA. The results were as follows. 1) Epidemiological data The prevalence rate of RA in the schizophrenic group was 0/561 and that of RA in the mood disorder group was 2/222. To compare these results between two groups, the author applied the Binomial test using the average prevalence rate of RA(0.8%) in the general population as a reference rate. The prevalence rate of RA in the schizophrenic group was significantly lower than that of RA in the general population. However, the prevalence rate of RA in the mood disorder group was not significantly different to that of RA in the general population. 2) Comparison of plasma prolactin and estradiol level between two groups The plasma level of prolactin in the schizophrenic group was significantly higher than that of prolactin in the RA group(p=0.000). However, the plasma level of estradiol in the schizophrenic group was significantly lower than that of estradiol in the RA group(p=0.017). These results were not consistent across gender. To contrast with the results in the female group, which were consistent with the results in the total subjects, for the male group, the plasma levels of prolactin and estradiol in the schizophrenic group were significantly higher than those of prolactin and estradiol in the RA group. These results support the results of previous studies which confirm the negative association between schizophrenia and RA. These results also suggest that the elevation of plasma prolactin level in the patients with schizophrenia has a antirheumatic effect while the elevation of plasma estradiol level in the patients with RA has a anti-schizophrenic effect, and that these effects act as a possible mechanism in the negative association between two disorders. However, these results suggest that this association is specific to female patients.

• 생물정신의학
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• 제7권1호
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• pp.74-79
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• 2000

본 연구의 목적은 치료 용량의 비정형적 항정신병 약물(risperidone, olanzapine)의 성 호르몬(prolactin과 testosterone)에 대한 효과를 알아보기 위해 총 91명의 정신분열병 환자들의 혈청에서 prolactin과 testosterone의 농도를 측정하였다(haloperidol 28명, 4~20mg/day ; risperidone 31명, 2~6mg/day ; olanzapine 32명, 5~20mg/day). 그 결과 남자 환자에서 olanzapine 복용자의 혈청 prolactin 농도가 risperidone이나 haloperidol 복용자의 혈청 농도보다 낮았으나 risperidone 복용자와 haloperidol 복용자의 혈청 prolactin 농도는 상호 유의한 차이가 없었다. 여자 환자에서는 olanzapine 복용자의 혈청 prolactin 농도가 risperidone이나 haloperidol 복용자의 혈청 농도보다 낮았으며 risperidone 복용자의 prolactin 농도는 haloperidol 복용자보다 낮았다. 또한 남자, 여자 환자 모두에서 haloperidol, risperidone, olanzapine을 각각 복용한 사람들의 혈청 testosterone 농도는 유의한 차이가 없었다. 위의 결과로 저자는 치료 용량에서 risperidone은 혈청 prolactin 농도를 haloperidol 만큼이나 증가시키지만 olanzapine의 경우 혈청 prolactin 농도에는 영향을 끼치지 않으며 비정형적 항정신병 약물은 testosteron의 농도에는 영향을 끼치지 않는다는 것을 알 수 있었다.

• 동서간호학연구지
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• 제23권1호
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• pp.86-95
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• 2017

Purpose: This study was conducted to investigate the effects of forest walking program on stress and recovery among schizophrenic patients in a closed ward. Methods: A non-equivalent control group pre-posttest design was used. The participants were composed of 36 patients with schizophrenia admitted in two psychiatric hospitals. The experimental group (n = 18) received the forest walking program twice a week with a total of 6 weeks. Results: The study results revealed that the forest walking program was effective on stress(${\chi}^2=34.11$, p<.001), subjective recovery(${\chi}^2=22.40$, p<.001) and clinical recovery(F=28.34, p<.001) of hospitalized patients with schizophrenia. Conclusion: The findings indicate that the forest walking program for schizophrenic patients in the closed ward can be an effective nursing intervention to reduce stress and improve recovery ability. We suggest that mental health nurses may adapt this program to help patients with schizophrenia in a closed ward.

• 생물정신의학
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• 제6권1호
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• pp.119-124
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• 1999

This study was done to examine whether cigarette smoking improved smooth pursuit eye movement(SPEM) abnormalities in chronic schizophrenic inpatients. Fifteen schizophrenic and twelve alcoholic subjects abstained from their usual cigarette smoking for a minimum of nine hours and their baseline performances during the constant velocity smooth pursuit tasks were assessed. Then, the subjects smoked as much as they desired in a 10 minutes period and were retested immediately after smoking and 15 minutes after smoking. Electrooculographic recordings during the eye movements were converted and saved as digitized files. Power spectral density curves and natural logarithm value of signal/noise(Ln S/N) ratios were computed from them. In the schizophrenic patients, Ln S/N ratios increased significantly immediately after smoking compared to baseline. But, Ln S/N ratios showed no statistically significant changes after 15 minutes compared to baseline. In alcoholic subjects, Ln S/N ratios showed no statistically significant changes immediately after smoking and after 15 minutes compared to baseline. In conclusion, SPEM was improved in schizophrenic patients immediately after smoking and we hypothesized that nicotinic receptor dysfunction maybe a candidate mechanism for smooth pursuit eye movement abnormalities in schizophrenia.

• 동의신경정신과학회지
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• 제20권2호
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• pp.229-242
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• 2009

Objectives : This article aims to find how effective the art therapy is on the improvement of the self expression and the interpersonal relations with others, as medium for verbal communication of schizophrenic patients. Methods : The subject of this study was one schizophrenic patient who had been treated with drugs for five years in W university hospital, as well as counseled by an art therapy oo counsel office in J city. The art therapy had been performed the total 25 sessions, fifty minute per session, one session per week, from November 28 in 2008 to April 27 in 2009. The test was by HTP. Results : The results of this study are as follows: First, in the pretest of HTP, the subject showed a little lethargy, painting very simple house-shaped figures and too simple rectangular figures corresponding to those painted by 4 or 5-year-old children. In the post-test, however, the structures of houses were described concretely and three-dimensionally, and the descriptions of people were changed into concrete figure, by which we could see the improvement effect on the self expression and the interpersonal relations. Second, in the earlier stage, there was little verbal self expression, and little self respect, staring into space and showing passive attitude without positive assertion and expression. In the later stage, however, there were positive assertion and expression, even showing sense of humor. Lastly, in the earlier stage, there were few interpersonal relations. In the later stage, however, eye contacts and the interpersonal relations were increased during conversation and in the art work process, respectively. Conclusions : These results suggest that the art therapy can be effective on improvement of the self expression and the interpersonal relations with others, as medium for verbal communication of schizophrenic patients.