• 대한조현병학회지
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• 제22권2호
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• pp.21-33
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• 2019

Objectives: The current study covers a secondary revision of the guidelines for the pharmacotherapy of schizophrenia issued by the Korean Medication Algorithm for Schizophrenia (KMAP-SCZ) 2001, specifically for co-existing symptoms and antipsychotics-related side-effects in schizophrenia patients. Methods: An expert consensus regarding the strategies of pharmacotherapy for positive symptoms of schizophrenia, co-existing symptoms of schizophrenia, and side-effect of antipsychotics in patients with schizophrenia was retrieved by responses obtained using a 30-item questionnaire. Results: For the co-existing symptoms, agitation could be treated with oral or intramuscular injection of benzodiazepine or antipsychotics; depressive symptoms with atypical antipsychotics and adjunctive use of antidepressant; obsessive-compulsive symptoms with selective serotonin reuptake inhibitors and antipsychotics other than clozapine and olanzapine; negative symptoms with atypical antipsychotics or antidepressants; higher risk of suicide with clozapine; comorbid substance abuse with use of naltrexone or bupropion/varenicline, respectively. For the antipsychotics-related side effects, anticholinergics (extrapyramidal symptom), propranolol and benzodiazepine (akathisia), topiramate or metformin (weight gain), change of antipsychotics to aripiprazole (hyperprolactinemia and prolonged QTc) or clozapine (tardive dyskinesia) could be used. Conclusion: Updated pharmacotherapy strategies for co-existing symptoms and antipsychotics-related side effects in schizophrenia patients as presented in KMAP-SCZ 2019 could help effective clinical decision making of psychiatrists as a preferable option.

• 수면정신생리
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• 제2권2호
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• pp.105-114
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• 1995

Schiophrenia is characterized by a variety of cognitive dysfunctions. A number of research findings suggest that schizophrenic patients have global deficits in cognitive functions, such as attention, memory, executive functions, and motor functions. These cognitive deficits, once they arise, tend to become relatively stable. In spite of much efforts to search for the cognitive dysfunctions in schizophrenia, there are no specific deficits or localizations found. It is necessary that future neuropsychological research of schizophrenia should include relationships between symptoms and cognitive dysfunctions and their relationships to treatment.

• The Korean Journal of Physiology and Pharmacology
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• 제12권4호
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• pp.205-209
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• 2008

Recently, Sun et al (2008) reported that the IL6R polymorphism is associated with schizophrenia. Therefore, to detect the association between polymorphisms of interleukin 31 receptor A (IL31RA) and schizophrenia, we genotyped 9 SNPs [rs9292101 (intron 1), rs1009639 (exon 2, Pr043Pro), rs2161582 (intron 2), rs68761890 (intron 5), rs16884629 (intron 6), rs11956465 (intron 12), rs12153724 (intron 12), and rs16884641 (intron 14)] using the Golden Gate assay on Illumina BeadStation 500 GX. Two hundred eighteen patients with schizophrenia and 379 normal subjects were recruited. Patients with schizophrenia were diagnosed according to DSM-IV, and control subjects without history of psychiatric disorders were selected. We used SNPStats, Haploview, HapAnalyzer, SNPAnalyzer, and Helixtree programs for the evaluation of genetic data. Of nine polymorphisms, three SNPs (rs9292101, rs1009639, and rs11956465) were associated with schizophrenia. The rs9292101 and rs11956465 showed significant associations with the risk of schizophrenia in the codominant [rs9292101, odds ratio (OR)=0.74, 95% confidence interval (CI)=0.58${\sim}$0.95, p=0.017] and recessive (rs11956465, OR=0.64, 95% CI=0.42${\sim}$0.96, p=0.034) models, respectively. The rs1009639 also was statistically related to schizophrenia in both codominant (OR=0.76, 95% CI=0.60${\sim}$0.97, p=0.025) and dominant (OR=0.66, 95% CI=0.44${\sim}$0.98, p=0.035) models. Two linkage disequilibrium (LD) blocks were made. In the analysis of haplotypes, a haplotype (GCT) in block 1 and a haplotype (CCACAG) in block 2 showed significant associations between schizophrenia and control groups (haplotype GCT, frequency=0.509, chi square=4.199, p=0.040; haplotype CCACAG, frequency=0.289, chi square=5.691, p=0.017). The results suggest that IL31RA may be associated with risk of schizophrenia in Korean population.

• 대한조현병학회지
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• 제24권1호
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• pp.26-35
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• 2021

Objectives: Social function deficit is known as a core feature of schizophrenia. This study aimed to investigate differences in empathic tendencies and theory of mind (ToM) skills between healthy controls and young individuals with schizophrenia, and to examine the associations between empathic tendencies, ToM skills and schizotypy, and executive function in schizophrenia. Methods: Thirty patients with schizophrenia and 30 healthy controls were enrolled and assessed using the interpersonal relationship index (IRI; perspective taking, fantasy, empathic concern, and personal distress subscales), ToM-Picture Story Task (ToM-PST; sequence and cognitive questionnaire), Wisconsin schizotypy scale (revised physical anhedonia and perceptual aberration), and Stroop tests for empathic tendencies, ToM skills, schizotypy, and executive function. Results: In individuals with schizophrenia, the IRI for perspective taking and ToM-PST score for cognitive function were lower, and the IRI for personal distress was higher than those in healthy controls. The IRIs for perspective taking and fantasy were related to revised physical anhedonia, and that for empathic concern was associated with revised physical anhedonia and perceptual aberration. The ToM-PST score for sequence was associated with the Stroop test score for schizophrenia. Conclusion: These findings indicate deficits in empathic tendencies and ToM skills, which may be independently and primarily associated with schizotypy and executive function in young individuals with schizophrenia.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제9권2호
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• pp.190-197
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• 1998

본 연구에서는 소아 및 청소년 환자군(정신분열증 집단, 우울증 집단, 우울증적 품행장애 집단)을 대상으로 Rorschach검사 SCZI, DEPI, CDI의 진단적 유용성을 살펴보았다. 정신분열증 집단(18명), 우울증 집단(20명), 우울증적 품행장애 집단(19명)을 대상으로 Rorschach 검사를 실시하고 SCZI, DEPI, CDI 점수를 비교하였다. SCZI에서만 세집단간 유의미한 차이가 있었으며 정신분열증 집단이 우울증 집단과 우울증적 품행장애 집단에 비해서 유의미하게 큰 SCZI점수를 보였다. SCZI는 4점을 임계치로 했을 경우에 진단정확율이 96.5%였고, DEPI는 3점을 임계치로 했을 경우에 진단정확율이 57.9%로 저조하였으며, CDI는 4점을 임계치로 할 경우 66.6%의 진단정확율을 보였다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제16권2호
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• pp.173-182
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• 2005

소아기 발병 정신분열병(COS)은 비록 흔하지는 않지만 성인 발병 정신분열병에 비해 보다 동질적인 집단이며 질병의 진행과정을 추적할 수 있다는 면에서 정신분열병 연구자들의 관심의 대상이 된다. COS 환자에대한 기존의 연구 결과들은 소아에서도 성인 진단기준에 의거한 구조적면담을 통해 객관적으로 타당성 있는 정신분열병 진단이 가능하다는 것이다. 또한 소아와 성인 발병 정신분열병이 동일한 임상양상과 질병 진행과정을 보이며 생물학적 여러분야(신경심리, 신경생리, 뇌 구조, 뇌 생화학, 유전 및 염색체)의 연구결과들 역시 성인 발병 정신분열병과 동일한 소견을 보인다는 것이다. 다만 차이점은 COS의 경우 치료 약물반응이 상대적으로 떨어지고, 임상경과 및 예후가 나쁘고, 발병전 발달(언어, 인지, 섬세운동)에 문제가 심각하고, 염색체 이상, 정신분열병이나 정신분열병 스펙트럼 장애의 가족력이 흔하여 유전적 부하가 높다는 것이다. 향후 COS 환자를 대상으로한 유전연구 및 뇌발달 영상 추적연구는 정신분열병의 뇌 신경발달에 관한 기초적인 지식을 확대시킬 것이다. 즉 뇌 발달을 조절하는 유전자의 기능과 발현 시기에 대한 좀 더 명확한 지식을 제공할 것이며 이를 토대로한 위험군에 대한 조기발견 및 치료방안이 강구되어야 하겠다.

• 생물정신의학
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• 제15권3호
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• pp.211-218
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• 2008

Objectives : The purpose of this study is to compare the ability of facial affect perception among schizophrenia patients, their first degree relatives, and normal control subjects. Methods : Thirty five patients with schizophrenia, 22 first degree relatives, and 34 normal control subjects were recruited in this study. All three groups were matched for age and education levels. The facial affect identification test(FAIT), and neurocognitive test were applied. In the FAIT, the correct response rate, perceived intensity, and sensitivity for 6 kinds of affects were compared among three groups. Results : We found that correct response rate of sadness and anger were decreased in the schizophrenia patients compared with the normal control group. Also the schizophrenia patients showed reduced sensitivity for all six affects compared with the normal control group. The ability of facial affect perception in first degree relatives of schizophrenia patients was decreased but there were not any significant differences compared with normal control group. Conclusion : This study confirmed significantly reduced ability of facial affect perception in schizophrenia patients compared with normal control. Decreased ability of facial affect perception in first degree relatives suggests that affective sensitivity can be influenced by genetic predisposition.

• Molecular & Cellular Toxicology
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• 제5권2호
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• pp.160-164
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• 2009

Notch signaling plays a crucial role in development of the nervous system. Neurodevelopmental hypothesis on etiology of schizophrenia has been implicated. The aim of this study is to determine whether single nucleotide polymorphisms (SNPs) of Notch homolog 4 (Drosophila) (NOTCH4) gene are associated with schizophrenia. This study included 283 schizophrenia patients diagnosed according to DSM-IV and 301 normal control subjects. Control subjects without history of psychiatric disorders were recruited. Four missense SNPs [rs915894 (exon 3, Lys117Gln), rs2071282 (exon 4, Pro204Leu), rs422951 (exon 6, Thr320Ala), and rs17604492 (exon 18, Gly942Arg)] of NOTCH4 gene were genotyped by the direct sequencing method. Multiple logistic regression models (codominant, dominant, and recessive models) were employed to evaluate odds ratio, 95% confidence interval, and p value. For analysis of genetic data, SNPStats, Haploview, HapAnalyzer, SNPAnalyzer, and Helixtree programs were also used. Of 4 SNPs, rs2071282 was weekly associated with schizophrenia in two alternative models (codominant model, P=0.049; dominant, P=0.041). However, these associations were not significant after Bonferroni correction. At 4 SNPs, one linkage disequilibrium (LD) block was made. This block consisted of rs915894 and rs2071282. In haplotype analysis, AC haplotype was weakly associated with schizophrenia (dominant, P=0.04). This association was disappeared after Bonferroni correction. Our result shows possibility that some SNPs of NOTCH4 gene may be weekly associated with development of schizophrenia in Korean population. However, replication result by other population will be needed.

• 생물정신의학
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• 제25권2호
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• pp.31-37
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• 2018

Objectives The aim of this study was to evaluate the psychopathological features such as depression and anxiety in schizophrenics with obsessive-compulsive symptoms (OCS) as well as the severity of OCS according to duration of schizophrenia. Methods We randomly selected sixty four inpatients with schizophrenia. We classified the patients into two groups (OCS group, non-OCS group) according to the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Clinical and demographic features were evaluated. To assess OCS, Y-BOCS were performed. The Korean version of the Positive and Negative Syndrome Scale(K-PANSS), the Brief Psychiatric Rating Scale (BPRS), the Korean version of the Calgary Depression Scale for Schizophrenia (K-CDSS), the Beck Anxiety Inventory (BAI) and the Satisfaction With Life Scale (SWLS) were conducted. Independent t-test and chi-square test were conducted to compare the two groups. Pearson correlation analysis was performed to examine the relationship between the duration of schizophrenia and the Y-BOCS score. Results The Y-BOCS, K-CDSS, and BAI scores were higher in the OCS group. There was a significant correlation between the duration of schizophrenia and the Y-BOCS score. Conclusions Anxiety and depression symptoms were severe in the OCS group. In addition, the results of this study indicate that the longer duration of schizophrenia, the more severe the OCS. Therefore, the evaluation of OCS in schizophrenics should be accompanied by treatment intervention.

• 생물치료정신의학
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• 제24권3호
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• pp.202-208
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• 2018

Objectives : The purpose of this study was to investigate the differences in forensic demographic characteristics, interpersonal problems and personality disorder between early and late onset criminal patients with schizophrenia. Methods : The participants included 187 inpatients with schizophrenia who had committed crimes. They filled out the Korean Inventory of Interpersonal Problem Personality Disorder Scales and Psychopathic Personality Inventory-Revised. They were divided into early onset group and late onset group according to onset age of schizophrenia at 26 years old(under 26 versus 26 and older) and forensic demographic characteristics, interpersonal problem and personality disorders including psychopathy were compared between two groups. Results : There were no differences in gender, education years and family history between the two groups. Early onset group was associated with lower age, earlier onset of age and earlier age at the time of the crime. Duration from onset to diagnosis was not different between the two groups. Duration from onset to crime and after diagnosis to crime was shorter in late onset group. There were no differences between the two groups in the interpersonal problems, personality disorder and psychopathic personality evaluation. Conclusion : These results suggested that there may be forensic demographic differences related to crime between early and later onset schizophrenia. Psychiatrists should consider the age at onset of schizophrenia when assessing the risk of violence in patients with schizophrenia. In the future. it will be needed other study of age classification such as admixture analysis.