Clozapine, on atypical antipsychotic drug, has been estimated to be a major improvement in the treatment-refractory schizophrenic patients. We evaluated the clozapine efficacy in the treatment of schizophrenic patients who are refractory to classic neuroleptics. The patients were assigned in a prospective, open, comparative trial for 12 weeks. Following an dose titration, 33 inpatients with treatment-refractory schizophrenia diagnosed according to DSM-III-R were given a clozapine(N=17, approximate 300-600mg/day) or haloperidol(N=16, approximate 20-30 mg/day) for 12 weeks. The clinical state was assessed before treatment, and 1st, 4th, 8th and 12th week during treatment using Brief Psychiatric Rating Scale(BPRS) and Positive and Negative Syndrome Scale(PANSS). Assessment of side effects were mode weekly using Simpson-Angus Scale for Extrapyramidal Side Effects and Adverse Events-Somatic Symptoms. Clozapine produces significant improvement than haloperidol on the BPRS and PANSS scores. 77% (13/17) of the clozapine-treated patients were categorized as responders, who showed at least 20% decrease in total BPRS scores, compared with 31% (5/16) of haloperidol-treated patients. Extrapyramidal side effects occurred in only one patient in clozapine group, but nine patients in haloperidol group. Salivation, sleepiness, constipation and hypotension were most frequent adverse effects observed in clozapine group. There was no significant changes in total WBC and neutrophil during clozapine treatment. These findings suggest that clozapine is on effective antipsychotic drug for the Korean treatment-refractory schizophrenic patients, who are nonresponsive to or unable to tolerate classcal antipsychotic drugs due to extrapyramidal side effects.
Ha, Eun-Hye;Lee, Soo-Jung;Oh, Kyung-Ja;Hong, Kang-E
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.9
no.1
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pp.3-12
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1998
The present study compared the self report and parental report on the behavior problems of adolescents as a way to explore similarities and differences in the ways that adolescents and their parents conceptualize behavior problems of adolescents. Specifically, K-CBCL and YSR data from 3271 adolescents between the ages of 12 and 17 were subjected to factor analyses. Five factors;Depression/Anxiety/Withdrawal, Aggressiveness, Somatic Symptom, Disruptiveness, Attention Getting were obtained from the YSR data with the first factor, Depression/Anxiety/Withdrawal explaining 14.23% of the total variance. K-CBCL data yielded somewhat different factor structure with Aggression/Delinquency as the first factor explaining 14.08% of the total variance, followed by Somatic Symptoms, Social Withdrawal, Disruptiveness, and Depression/Anxiety. Total K-CBCL and YSR score showed a moderate correlation(r=.51), and correlation between pairs of comparable K-CBCL and YSR factor scores were also moderate. Regression analyses of the variables contributing to the total problem score of the K-CBCL and YSR suggested that social competence and academic achievement are two important sources of influence on the evaluation of behavior problems both in self-report and parental report. However, externalizing problems such as aggressiveness/delinquency appeared to be more salient for parents, while adolescents themselves appeared to be more concerned with internalizing problems such as depression/anxiety. Implications of these subtle differences for assessment of adolescent behavior problems were discussed.
Joe, Sook-Haeng;Kim, Jin-Se;Kim, Seung-Hyun;Kim, Leen
Sleep Medicine and Psychophysiology
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v.6
no.1
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pp.46-51
/
1999
Objectives: Patients with premenstrual dysphoric disorder(or PMDD) have impairments of the social, occupational or academic function due to psychological or somatic symptoms, which have the characteristic pattern of symptom exacerbation in the week before menses begin and remission shortly after the onset of menses. In the chronobiological view, many researchers have assumed that the etiology of PMDD is the advanced circadian rhythm. It has been suggested that light has a therapeutic effect on PMDD, because evening light results in phase delay of circadian rhythm through the biochemical changes including melatonin. Methods: The authors investigated the therapeutic effect of light therapy on four patients with prospectively diagnosed PMDD by DSM-IV criteria using clinical psychiatric interview, Premenstrual Assessment Form(PAF) and Daily Rating Form(or DRF). In the evening(6:30pm-8:00pm), the 2,500 lux light administered for seven consecutive days during the symptomatic late luteal phase of menstrual cycle. Beck Depression Inventory(or BDI), Hamilton Rating Scale for Depression(or HAM-D), Spielberg State Anxiety Inventory(or SA), and DRF were evaluated before and after seven days of light therapy. Results: Premenstrual symptoms of PMDD could be effectively treated with the evening bright light therapy, especially in PMDD patients with atypical symptoms. In addition, the light therapy seemed to more effective on the psychologic symptoms than the somatic symptoms of PMDD. There was no significant side-effect of light therapy, except the transient and mild eye-strain in one case. Conclusions: In spite of the results of limited data from our clinical trial, the authors suggest that the potential use of light therapy as an alternative to the pharmacological management of patients with PMDD.
The purpose of this study was to investigate the relationship among the stress on clinical practice, stress coping method and the somatization symptom of dental hygiene students and propose strategies for effective instruction of clinical practice. The survey was performed by self-reported questionnaires for 268 dental hygiene students who have recently experienced clinical practice. Collected data were analyzed using by t-test and Pearson correlation coefficient with the SPSS Win 12.0 program. Its results are as follows. 1. In the satisfaction of clinical practice, 'Satisfaction', 'Average' and 'Unsatisfactory' were 32.5%, 42.2% and 25.4%, respectively. The reason for dissatisfaction of clinical practice were 'insufficient education of college'(29.8%), 'environment of clinical practice institute'(23,4%), 'interpersonal relationship'(21.3%) in order. 2. Somatization symptoms was positive correlation(0.307, p < 0.01) associated with stress of clinical practice. Also it was negative correlation associated with satisfaction level of the subjects and stress of clinical practice. Correlation coefficient of the interpersonal relation factor was found the most significantly high as much as 0.331, according to the analysis carried out between subordinate factors of clinical practice stress and somatization. 3. According to stress coping method. Subjects were distributed into two group of active method and passive method. Thereafter as a result of verifying the difference of somatization symptoms, there was statistically significant difference between active method group and passive method group. Based on the study results, we suggests that effective management program of clinical practice should be developed and applied to the dental hygiene students to make them cope with stress and somatic symptom during their clinical practice.
Objectives : This study aims to identify various psychiatric symptoms and psychosomatic symptoms caused by COVID-19 infection and investigate their long-term impact. Methods : A systematic literature review was conducted, selecting papers from domestic and international databases using keywords such as "COVID-19" and "psychosomatic." A total of 16 papers, including those using structured measurement tools for psychosomatic symptoms, were included in the final analysis. Results : Psychiatric symptoms such as anxiety, depression, and somatic symptoms have been reported in acute COVID-19 infection, while long-term post-COVID symptoms include chest pain and fatigue. The frequency of long-term psychosomatic symptoms has been estimated to be 10%-20%. Factors contributing to these symptoms include psychological and social stress related to infectious diseases, gender, elderly age, a history of psychiatric disorders, and comorbid mental illnesses. It is suggested that systemic inflammation, autoimmune responses, and dysregulation of the autonomic nervous system may be involved. Conclusions : Psychosomatic symptoms arising after COVID-19 infection have a negative impact on quality of life and psychosocial functioning. Understanding and addressing psychiatric aspects are crucial for symptom prevention and treatment.
Objectives There is a controversy regarding the construct validity of anxiety and depression. Some believe that these two symptoms are basically the same construct, that is, both measure what is called 'general distress' or two phenomena are distinct experiences which often coexist. To further understand relationship between anxiety and depressive symptoms, we investigated the factor structure of a combined anxiety and depression scale among psychiatric outpatients. Methods Data of Zung's Self-Rating Depression and Anxiety Scales were gathered from 401 newly visiting psychiatric outpatients at a university-affiliated hospital. We performed a component analysis on the 40 items from two scales. Results Exploratory factor analysis revealed a seven factor structure explaining 56% of total variance. Overall finding indicated that depression and anxiety scales consisted of four symptom domains : mainly depressive symptoms, mainly anxiety symptoms, common somatic symptoms, and others. Conclusions Our results suggest that the construct of self-reported depressive and anxiety symptoms are more complex than previously thought, i.e., either one or two factor theories. These findings also support that anxiety and depression can be better modeled by dimensional approach. Clinicians may be alert for the fact that both depression and anxiety scales measure distinct and also common aspects. Further researches on other scales especially, interview based instruments are needed.
Hong, Min Ah;Kim, Min Kyung;Kim, Jung Bum;Jun, Tae Youn;Yim, Hyeon Woo;Lee, Min Soo;Kim, Jae Min
Anxiety and mood
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v.11
no.1
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pp.3-11
/
2015
Objective : The aim of this study was to find associations between specific symptoms and suicidal behavior by using global severity on depression scales. Methods : Data were obtained from 1,183 patients of CRESCEND study. Factor analysis of the 17-item Hamilton Rating Scale for Depression (HAM-D) and the Beck Depression Inventory-II (BDI-II) was used to compare symptom clusters between the past suicide attempters and the non-suicide attempters, among the patients with depressive disorders. Results : Factor analyses of HAM-D and BDI-II extracted three factors. Suicide attempters had significantly higher scores on core factor of HAM-D, including depressed mood, feeling of guilt, suicide, work, and activities. The higher scores on all factors of BDI-II or scores correlated with a total of 7 suicide attempts and with known risk factors for suicidal behavior. Conclusion : These findings suggest that the suicide attempters complained of more cognitive, affective, somatic symptoms on BDI-II, but the core factor on HAM-D was the only differentiated factor between the two groups. Clinician-rated scales as well as self-reported questionnaires were valid in measuring suicidal attempts, and the clinical profile may help in guiding the studies of biological correlates and the treatments to reduce suicide risk.
Journal of the Korean Data and Information Science Society
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v.26
no.2
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pp.429-440
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2015
This study was to investigate factors influencing the school adjustment according to gender and body mass index (BMI) of middle school students who participated in the 2nd-wave Korea Children and Youth Panel Study (KCYPS). This study used a crosssectional design with secondary analysis with KCYPS. The variables were parental interest, behavioral problem, aggression, attention problem, somatic symptom, social withdrawal, depression, and academic achievement. The data were analyzed with descriptive statistics, Pearson's correlation coefficients, and multiple regressions. School adjustment was significantly associated with academic achievement high, explaining 11.3~19.1% of the variance in boys. School adjustment was significantly associated with attention problem, explaining 14.9~42.4% of the variance in girls. Factors influencing school adjustment were significantly different according to gender and BMI. To improve the school adjustment, it is necessary to develop gender-specific school adjustment promotion programs according to BMI.
Purpose: The aim of this study was to translate the original English version of tampa scale for kinesiophobia for temporomandibular disorders (TSK-TMDs) for cultural equivalency into Korean language and to evaluate the reliability of the Korean version of the TSK-TMD among symptom free subjects. Methods: The original version of TSK-TMD was translated and cross-culturally adapted following international guidelines. A total 90 subjects (50 women, 40 men) were participated to fill out the questionnaire. The internal consistency and test-retest reliability with a one- or two-week time interval were evaluated. Results: The internal consistency of TSK-TMD of the original and the modified 12-item TSK-TMD were 0.866, and 0.858, respectively using the Cronbach's alpha coefficient. And the internal consistency of activity avoidance (AA) and somatic focus (SF) subscale were 0.838 and 0.807 assessed with Cronbach's alpha indicating excellent reliability. Test-retest reliability of the original TSK-TMD measured by the intra-class correlation coefficient (ICC) was 0.764, and coefficients value of the 12-question TSK-TMD was 0.752. Test-retest reliability of AA subscale was 0.722 and SF subscale was 0.677 measured by ICC. Conclusions: The Korean version of the TSK-TMD questionnaire was found to be a reliable instrument and successfully translated to Korean language. There are no significant differences between overall and modified version of TSK-TMD. It can be used as a valuable instrument for the analyses of the psychosocial aspects of the TMD patients in Korea.
Background and Objectives: Embryologically, mesodermal development is closely related to the development of various organs such as muscles, blood vessels, and hearts, which are the main organs that make up the body. However, treatment for mesoderm developmental disorders caused by congenital or acquired factors has so far relied on surgery and drug treatment for symptom relief, and more fundamentally, treatment for mesoderm developmental disorders is needed. Methods and Results: In our study, microRNA (miRNA), which plays an important role in the mesoderm development process, was identified and the developmental function was evaluated. miRNAs consist of small nucleotides, which act as transcription factors that bind to the 3' untranslated region and suppressed target gene expression. We constructed the human embryonic stem cell (hESC) knockout cell line and analyzed the function and characteristics of miR-5739, which plays an important role in mesoderm lineage. miR-5739 acts as a transcription factor targeting SMA, Brachyury T, Hand1, which controls muscle proliferation and differentiation, and KDR gene, which regulates vessel formation in vitro. In vivo results suggest a role in regulating muscle proliferation and differentiation. Gene ontology analysis confirmed that the miR-5739 is closely related to genes that regulate muscle and vessel proliferation and differentiation. Importantly, abnormal expression of miR-5739 was detected in somatic cells derived from patients with congenital muscle disease. Conclusions: Our study demonstrate that miR-5739 gene function significantly affects transcriptional circuits that regulate muscle and vascular differentiation during embryonic development.
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