• Journal of Pharmaceutical Investigation
• /
• 제41권1호
• /
• pp.31-36
• /
• 2011

$5HT_{2C}$ receptor among fourteen 5-HT subtypes plays important roles in several disorders such as depression, anxiety, epilepsy, schizophrenia and sleep disorders. The purpose of the study is to investigate pharmacokinetic parameters and bioavailability of a newly synthesized selective agonist of $5-HT_{2C}$ receptor, KOPC-20010 (KP10) in rats after intravenous and oral administration for the development of therapeutic anti-obesity agents. KP10 was administered orally (40 mg/kg) or intravenously (20 mg/kg), blood was collected via a catheter, and analyzed by GC/MSD. The calibration curve of KP10 in plasma and urine showed high linearity ($r^2$ >0.999). The retention times of KP10 in plasma and urine were 8.7 and 9.7 min, respectively. After oral administration of 40 mg/kg, pharmacokinetic parameters were calculated as follows; $C_{max}$ value was $1242.9{\pm}1195.5$ ng/mL at $1.1{\pm}0.6$ hr ($T_{max}$). $AUC_{0->24hr}$ and $AUC_{0>{\infty}}$ were $8034.2{\pm}960.7$ and $10464.1{\pm}681.5\;ng{\cdot}hr/mL$, respectively. The terminal half-life was $21.9{\pm}7.6$ hr. $AUC_{0->24hr}$ and $AUC_{0>{\infty}}$ were $4292.4{\pm}523.0$ and $6111.2{\pm}756.2\;ng{\cdot}hr/mL$, respectively, after 20 mg/kg of intravenous administration. The terminal half-life after intravenous administration was $25.1{\pm}9.4$ hr. Bioavailability of KP10 was determined to 86%. The excretion amount into the urine within 48 hr was approximately 4.7 to 6.7% of the dose administered. These data may be beneficial to the anti-obesity drug development of KP10.

• 한국콘텐츠학회논문지
• /
• 제13권10호
• /
• pp.113-122
• /
• 2013

론 하워드 감독의 <뷰티플 마인드>는 세계적인 천재 수학자인 존 내쉬의 삶을 영화화 한 것이다. 주인공 존 내쉬는 환각과 망상이 동반된 정신분열병 환자이고 뚜렷한 3사람의 환상으로 나타난다. 이 3인에 대한 해석이 그동안 연구자들에 의해 서로 다른 주장을 해 왔지만 그 주장이 일관성을 상실하고 있는 부분이 많다. 특히 소녀에 대한 해석이 아예 없거나 늙지 않는 인물이어서 주인공이 환각속의 인물임을 인정하는 것으로 해석하고 있다. 이 영화에서 환상인물을 론 하워드 감독은 많이 알아야 많이 본다는 올더스 헉슬리의 이론을 채용하지는 않았지만 독특한 방법으로 이 인물들에 대한 해석을 해 놓음으로서 관객의 수준에 맞는 해석을 해도 무방하다는 태도이다. 환상인물은 주인공 존 내쉬의 머릿속에서 나온 가상의 인물이며 그가 갈망하고 원하는 인물로 표현된다. 인간의 가장 기본적인 욕망인 물욕, 성욕, 명예욕이 바로 그것이며 명석한 내쉬는 그 세 가지 욕망을 가상의 세계를 통하여 치밀하게 3인을 투영한다. 그 동안 논란이 되어온 3인의 환상의미에 대해서 명쾌하게 해석함으로 영화 속에 등장하는 환상인물들의 상징의미를 새롭게 제시하고자 한다.

• 생물정신의학
• /
• 제7권2호
• /
• pp.191-197
• /
• 2000

Objectives : Risperidone is a new antipsychotic drug developed to overcome the therapeutic limitation of conventional antipsychotics. It responses to negative as well as positive symptoms by blocking both dopaminergic and serotonergic receptors, causing no significant side effects such as agranulocytosis and seizure. It is, however, not known whether it induces any serious cardiovascular side effects as evoked by other conventional antipsychotic drugs. The aims of this study were to evaluate the effect of risperidone on cardiovascular function, and to discuss the factors affecting the cardiovascular function. Methods : For 42 patients(22 males and 20 females) diagnosed as schizophrenia, schizophreniform disorder or schizoaffective disorder according to the DSM-IV classification, the cardiovascular fuctions such as heart rate, systolic and diastolic blood pressure, PR interval, QRS interval and QT interval were successively checked before and after 2 weeks and 4 weeks risperidone administration. Furthermore, variables such as body weight, Brief Psychiatric Rating Scale(BPRS), Clinical Global Impression(CGI), Extrapyramidal Symptom Rating Scale(ESRS), Anticholinergic Rating Scale(ARS), serum cholesterol level, serum triglyceride level, serum high-density-lipoprotein level, serum WBC, serum Hb, serum platelet level, prothrombin time and partial thromboplastin time were also analyzed before and after 2 weeks and 4 weeks risperidone administration. Results : 1) Risperidone treatment resulted in a significantly decreased heart rate and increased QT interval after 4 weeks administration(p<0.005 respectively). 2) The scores of BPRS and CGI were significantly decreased after 2 weeks and 4 weeks risperidone administration as compared with baseline(p<0.001 respectively). The scores of ESRS and ASRS were significantly increased after 2 weeks and 4 weeks risperidone administration as compared with baseline(p<0.001 respectively). 3) There were positive correlations between heart rate after 4 weeks and total dose(P<0.05). Blood pressure was significantly(p<0.05) correlated with sex(higher in male) and significantly(p<0.05) positive correlated with body weight. QT interval was significantly(p<0.05) correlated with sex(longer in female) and smoking history(shorter in smokers). Conclusions : Risperidone could induce significant change in heart rate and Q-T interval. Therefore, the cardiovascular safety for risperidone should be reconsidered according to the duration and dosage increase.

• 생물정신의학
• /
• 제4권2호
• /
• pp.198-210
• /
• 1997

To examine the double-faced thymoleptic(antidepressant and antimanic) effects of risperidone in mood disorders, this article reviews the psychotropic-induced mania, thymoleptic effects of antipsychotics, therapeutic effects of risperidone and risperidone(RIS)-induced mania(RIM) in mood disorders, risk factors of RIM, possible neurochemical mechanism of these thymoleptic effects, pathophysiological and clinical significance of thymoleptic effects, and suggestive clinical guideline of RIS in mood disorders. RIS appeared effective for bipolar disorder at a lower dose than that recommended for schizophrenia, especially in the cases of maintenance of mood stabilizers, and gradual titration from low doses. Manic induction/exacerbation can occur by chance during RIS treatment in mood disorders, schizoaffective disorders, and schizophrenias. The possible risk factors for RIM are refractory mood disorder, especially in bipolar I disorder with poor initial response ; refractory schizoaffective disorders, especially in bipolar type with poor initial response ; refractory chronic schizophrenias, especially with initial responses ; psychotic features ; higher initial doses ; rapid titration ; combined therapy with antidepressants in refractory depression ; and RIS monotherapy in mania/hypomania. RIS is a drug that preferentially block 5-HT2 receptors. The effects of low dose are due mainly to the blockade of 5-HT2 receptors. There are more gradual increase in D2 blockade with increasing dose and this D2 blocking properties become apparent at higher doses. This may be related to a modulation of dopaminergic transmission by 5-HT2 antagonism at lower doses with the direct action of RIS on DA receptors coming into play at higher dose. The serotonergic antagonistic effect may be important for its effects on depressive symptoms. This, together with adequate blo-ckade of D2 receptors, may not necessarily lead to destabilization of mood disorder, but rather to more therapeutic effects. Therefore, this dose-receptor affinity relationship with both antidepressant and antimanic effects according to treatment duration can explain a continuum of antidepressant effect, antimanic effect, behavioral stimulation, and manic/hypomanic induction/exacerbation. It was the recognition of a useful psychiatric side effects by a thoughtful observer with fertile minds that led to their ultimate utilization as psychotropic drugs, i.e., phenothiazine, MAOI, TCA, and lithium. And, in vivo pharmacological challenge by novel psychotropics, as a neurochemical probe, with more specific actions is a useful tool to select pharmacologically homogeneous subgroup of the same phenotypical(clinical) condition, to further study the unknown underlying pathogenesis of various mental illnesses. Finally, RIS may be a useful alternative or adjunctive drug for patients with mood disorders without psychotic features or refractory to treatment with standard antipsychotic drugs. The more conservative doses(tirated slowly from 1-3 mg/d) of RIS, and maintenance of mood stabilizer in the cases with risk factors of RIM are recommended in mood disorder.

• 생물정신의학
• /
• 제21권1호
• /
• pp.21-27
• /
• 2014

Objectives The aim of the present study was to investigate gender difference in empathic ability and recognition of facial emotion expression in schizophrenic patients. Methods Twenty-two schizophrenic outpatients (11 men and 11 women) and controls (10 men and 12 women) performed both the scale of Empathic Quotient (EQ) and facial emotion recognition test. We compared the scores of EQ and the facial emotion recognition test among each group according to diagnosis and gender. Results We found a significant sex difference in the scores of EQ and the facial emotion recognition test in the schizophrenic patients. And there were significantly negative correlation between the score of the facial emotion recognition test and the scores of Positive and Negative Symptom Scale (PANSS) in female schizophrenic patients. However, in male schizophrenic patients, there were no significant correlations between the score of each test and the scores of PANSS. Conclusions This study suggests that the sex difference in empathic ability and facial emotion recognition would be very important in chronic schizophrenic patients. Investigation of sex effects in empathic ability and facial emotion recognition in chronic schizophrenic patients would present an important solution for constructing optimal rehabilitation program.

• 한국콘텐츠학회논문지
• /
• 제17권7호
• /
• pp.579-591
• /
• 2017

회복지향질병관리(Illness Management and Recovery: IMR) 프로그램은 정신과 환자의 질병에 대한 자가 관리 및 회복을 촉진하기 위해 개발되었다. 본 연구에서는 한국판 IMR 프로그램이 입원한 만성 중증정신과 환자의 회복, 정신질환 지식, 희망에 미치는 영향을 살펴보았다. 연구 대상자는 조현병, 양극성장애, 조현형정동장애로 진단 받은 사람들로 실험군(51명)은 IMR 프로그램에 참여하였으며, 대조군(41명)은 기존의 치료를 유지하였다. 자료 수집은 2015년 5월부터 2016년 12월까지 이루어졌다. 정신건강회복척도, 정신장애 지식척도, 한국판 희망척도를 사전과 중재 이후에 실시하였다. 연구결과 IMR 프로그램에 참여한 사람들이 기존 치료를 유지한 대조군에 비해 자신의 회복 추구와 정신장애에 대한 지식이 향상하였다. 그러나 두 그룹 모두 희망에 대한 변화는 유의하지 않았다. 본 연구는 한국에서 처음 시행된 IMR 프로그램의 효과성 연구이다. 본 연구 결과는 한국판 IMR 프로그램이 우리나라 정신보건 임상에서 만성 정신과 환자의 회복을 촉진시키는 효과적인 중재로 활용될 가능성을 지지한다.

• 한국의료질향상학회지
• /
• 제8권2호
• /
• pp.208-217
• /
• 2001

Background : The objective of this study is proving the basic data for developing a management system for the discharges against medical advice(AMA) by identifying the characteristics of the AMA patients of an university hospital for 10 years. Methods : By using discharge abstract data base, we divided the total discharges(435,254) into two groups, discharge against medical advice and discharge with discharge order. We confirmed the characteristics of AMA group by analyzing discharge abstract data of the both groups by SAS software V6.12 and $x^2$ test. Medical records of AMA patients in the year 2000 were reviewed to identify the reasons for AMA which we couldn't extract from discharge abstract DB. Result : The total number of AMA for 10 years were 9,358(2.15%) and the AMA rate has been continuously decreased for 10 years. Male, admission through emergency room, discharges admission via other hospital, patients without operation during hospitalization, discharges in hopeless or not improved condition showed higher AMA rate. The AMA rate was higher as the age of the patients was higher, and the average length of stay was longer in AMA patients than in those with discharge order. The AMA rate in psychiatry was highest(14.3%) and it was higher in surgery departments than those of medical or other sections. The AMA rate varied by attending physicians even in the same department and it was statistically significant. Patients with the principal diagnosis of "medical observation and evaluation for suspected diseases" showed the highest AMA rate(15.5%), and that of schizophrenia or psychosis was the nest. One hundred twenty-one patients(19.5%) out of 622 AMA in 2000 discharged against medical advice for transfer to order health care facilities. Among them 71 patients(58.7%) discharged with their medical care information, such as copies of medical record, medical certificates, summaries, etc. Written oath of the patients discharged AMA was filed in their medical records in 466 cases(74.9%) although some of them were incomplete. Conclusion : Characteristics of AMA discharge could be used as the basic data in developing a system to manage the patients who have risk factors to leave the hospital against medical advice. By reducing number of patients leaving the hospital against medical advice we can increase satisfaction of medical providers and consumers.

• 대한불안의학회지
• /
• 제2권1호
• /
• pp.50-55
• /
• 2006

Objectives : In the psychiatry, structured interview is very important tool to be used in epidemiological or psychopharmacological studies. However, investigators often find that the administration of comprehensive diagnostic interviews is time-consuming and expensive to be used in clinical or research settings. Considering these points, Sheehan and his colleagues developed MINI (Mini International Neuropsychiatric Interview) to meet the need for a brief, reliable, and valid structured diagnostic interview for psychiatric disorders. The MINI has been translated into many languages and used in many countries. Therefore, we translated the MINI into Korean and determined its validity in this study. Methods : Twohundred seventy patients and normal subjects participated in the validation of the MINI versus an expert's professional opinion. Schizophrenia and other psychotic disorders, mood disorders including major depressive disorder and bipolar disorder, anxiety disorders including panic and other phobic disorders, and alcohol dependence were included in this study. The validity was obtained by examination whether MINI based diagnoses were compatible with diagnoses by expert psychiatrists. Results : The range of Kappa values was 0.22 (somatoform disorder) to 0.93 (bipolar disorder - past). Overall agreement between MINI and expert's diagnoses were good. The Kappa values for anxiety disorders seemed to be higher than those for other disorders. Conclusion : The MINI Korean version has the good validity. It also has potential applications as a diagnostic tool for psychiatric disorders.

• 정신신체의학
• /
• 제6권2호
• /
• pp.147-154
• /
• 1998

본 연구에서는 공황장애 환자에 대한 인지행동치료의 효과에 영향을 미치는 환자 특성을 확인하기 위하여 다면적 인성검사를 사용하여 환자의 특성을 측정하고 이들 환자 특성 중 어떤 변인이 치료결과를 예측하는데 도움이 되는지를 알아보았다. 31명의 공황장애 환자를 대상으로 11주의 공황장애 인지행동치료 프로그램을 실시하였고, 치료전에 다면적 인성검사를 실시하였으며, 치료 전 후에 Beck Depression Inventory(BDI), Spielberger State-Trait Anxiety Inventory의 상태 불안 질문지(STAI-State), Agoraphobic Cognition Questionniaire(ACQ), Body Sensation Questionnaire(BSQ)의 질문지와 환자의 자기보고 등 5가지를 실시하여 치료 성과의 지표로 사용하였다. 최종상태 기능 (End-State Functioning) 에 따라 치료 결과가 좋은 집단(상위 최종상태 집단)과 치료 결과가 나쁜 집단(하위 최종상태 집단)을 구분하여 두 집단의 특성용 비교 분석하여 다음과 같은 결과를 얻었다. 1) 다면적 인성검사의 건강염려증 척도(Hs), 우울증 척도(D), 히스테리 척도(Hy), 강박증 척도(Pt), 정신분열증 척도(Sc), 그리고 타당도 척도인 F 척도에서 하위 최종상태 집단이 상위 최종상태 집단에 비해 유의미하게 높은 점수를 보였다. 하지만 이러한 차이는 치료 효과에 영향을 미치는 환자 변인이라고 하기보다는 단순히 환자가 가진 증상의 심한 정도를 반영하는 것으로 보인다. 2) 치료 전에 실시한 다섯 가지 평가 지표에서 기본적으로 하위 최종상태 집단이 상위 최종상태 집단보다 증상의 정도가 심했지만, 두 집단 모두 치료를 통하여 비슷한 수준의 치료적 변화를 보인 결과는 1)의 해석을 지지해준다. 이상의 결과를 종합할 때, 다면적 인성검사는 인지행동 치료 결과에 영향을 미치는 환자의 특성을 파악하는데는 효과적이지 못한 방법으로 생각되며, 추후 연구에서는 보다 직접적으로 성격 특성을 측정할 수 있는 방법을 사용하여 환자 변인을 찾아 볼 필요가 있을 것으로 생각된다.

• Journal of Yeungnam Medical Science
• /
• 제5권2호
• /
• pp.141-150
• /
• 1988

1988년 1월부터 동년 2월까지 영남대학교 신입생중 본조사에 응한 3792명(남학생 : 2586명, 여학생 : 1206명)을 대상으로 Zung의 자가평가 불안척도와 자가평가 우울척도, Derogatis등이 고안한 SCL-R중 정신증척도등의 고득점자 392명(10.3%)에서 2차 조사에 응답한 신입생은 156명(69.9%), 여대생은 47명(30.1%)이었다. 이들에게 실시한 MMPI의 결과는 Lachar의 분류법을 이용하였다. 1) MMPI 결과 신경증적경향 24명(15.4%), 정신병적경향 20명(12.8%), 행동장애경향 7명(4.5%)으로 이는 전체 사례수의 약 1.4%이었다. 2) MMPI의 세부조사 결과 정서장애 8명, 불안장애 6명, 정신분열증 9명, 인격장애 3명 등으로 이들 26명은 총 신입생의 0.7%이었다. 3) 사회정신의학적 요인분석에서 자기집 가족 분위기에서 불만인 경우, 부모상호간의 친숙정도에서 불만인 경우, 나와 아버지 사이의 갈등정도에서 심각한 경우, 나와 어머니 사이의 갈등정도에서 심각한 경우 등에서 공통적으로 정신분열증 척도가 높았다. 4) 건강상태가 허약할 경우, 정신과 입원한 경험이 있는 경우, 최근 3년동안의 신체적 질환이 있는 경우 등에서 건강과 관계된 성적은 섬기증척도가 공통적으로 높았다.