No abstract available.
Diagnostic and Statistical Manual of Mental Disorders ; Korea

OBJECTIVES: The diagnosis and assessment of personality disorders are crucial for research, as well as for clinical practice. The Structured Interview for the DSM-IV Personality (SIDP-IV) is a structured diagnostic interview for DSM-IV personality disorders (PD). This study aimed to develop the Korean version of the SIDP-IV and to test its inter-rater reliability. METHODS: A panel consisting of 7 psychiatrists translated the SIDP-IV into Korean. Six psychiatrists and 1 psychiatric nurse, all trained to apply the SIPD-IV, interviewed 70 inpatients (male, 30;female, 40) using this translation, two joint-examiners per patient interview. We used kappa coefficients to test diagnosis agreement, the Pearson correlation coefficient to test K-SIDP-IV total score agreement, and percent agreement to test the agreement on the number of DSM-IV criteria met. RESULTS: The kappa coefficients for most of the PDs, such as paranoid, borderline, histrionic, narcissistic, avoidant, dependent, and obsessive-compulsive, were excellent (> or =0.80). Moreover, the kappa coefficients for schizoid and antisocial PD were acceptable (k=0.66). The Pearson correlation coefficient for the K-SIDP-IV total scores were high for all personality disorders (r=0.91-0.97). Percent agreement regarding the number of DSM-IV criteria met varied from 92.9% to 100%. CONCLUSION: The Korean version of the SIDP-IV is a reliable instrument for the assessment and diagnosis of personality disorders.
Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Inpatients ; Personality Disorders ; Psychiatry

OBJECTIVES: Despite stockpiled case reports of obsessive-compulsive symptoms (O-C symptoms) in schizophrenic patients associated with clozapine, it is still difficult to explain the complex interplay between psychotic symptoms, O-C symptoms and clozapine. The main difficulty lies in building an integrated hypothesis for a complex manifestation as O-C symptoms accompanied by psychotic symptoms. Thus we assumed that O-C symptoms shown in schizophrenic patients have diverse mechanisms in symptom formation, and that O-C symptoms developed after clozapine administration have various mechanisms as well. METHODS: We reviewed charts of all the DSM-IV schizophrenic patients from the Refractory Schizophrenia Clinic of Seoul National University Hospital, who are currently using clozapine or has previously used clozapine. Then, we classified the patients into four types implicating different mechanisms of O-C symptom formation. RESULTS: O-C symptoms of first two cases implicating diverse mechanisms in symptom formation clearly showed clinical discrepancies, mainly the relationship with psychotic symptoms, responsiveness to clozapine use and therapeutic approach to O-C symptom per se. And the other two cases implying various mechanisms in O-C symptoms newly developed during clozapine use, also showed obvious differences in the relationship with psychotic symptoms, dose-dependent pattern of O-C symptom during clozapine use and timing of onset of O-C symptom after clozapine administration. CONCLUSIONS: In order to explain the diversity of clinical manifestations of these 4 cases, we have paid attention to inherent characteristics reflecting the differentiation process of symptom structure rather than the complex phenotype of O-C symptoms, and made explanatory model by applying and integrating several useful concepts, the 'symptom conceptualization' proposed by Berrios, 'personal illness hierarchy' proposed by Foulds and 'structural dynamics of O-C phenomena' proposed by Shoda. By proposing this model, we intend to describe the interplay between O-C symptoms, psychotic symptoms and clozapine treatment. This study is based on interpretations of the cases selected out of a great number of patients, and so it is hard to generalize. But we think it is worthwhile to build a hypothetical model for understanding the intricate manifestations of O-C symptoms in light of not only the phenotype but also the internal symptom structure.
Clozapine* ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Phenotype ; Schizophrenia* ; Seoul

OBJECTIVES: Kyung Hee-Frankfurter Beschwerde-Fragebogen(K-FBF) is a representative subjective symptom measuring tool of schizophrenic patients. We performed psychopathology measurements using K-FBF, Positive and Negative Syndrome Scale(PANSS) and Symptom Checklist-90-Revised(SCL-90-R) in patients with schizophrenia and then compared the results of these three examinations one another, in order to examine which psychopathologic aspects K-FBF might reflect and to measure the possibility whether this instrument reflect the negative symptoms or cognitive impairments, which are difficult to measure by conventional objective instruments measuring psychopathology. METHODS: All 66 patients satisfying DSM-IV criteria for schizophrenia, were approached. Their education level was more than high school and they were not in the acute stage of schizophrenia. They performed K-FBF and SCL-90-R, and at the same day, they were interviewed by one of both psychiatirsts using PANSS. We examined the patterns of K-FBF response and performed facor analysis about 10 subscales. We examined the correlation between K-FBF and age, sex and insight. Also, we performed correlation analysis among the K-FBF, PANSS and SCL-90-R. RESULTS: As for K-FBF, with increasing age, the number of positive response items and the symptom severity were decreased. Even when controlling prevalence period as control variable, the correlation remained unchanged. Performing factor analysis to the K-FBF subscales, we created 2 factors, ie summation subscales. We named those recognized distress(RD) and perceptual alteration(PA) each. Using K-FBF standardized total scores as controlling variable, we performed partial correlation between PA and PANSS negative symptom scale. The result was PA and PANSS have statistically significant correlation. This correspons with the view that Huber's basic symptoms are reflecting subjective approach of negative symptoms of schizophrenia. While K-FBF standardized total scores and PANSS total scores had statistically strong correlations, SCL-90-R total scores and PANSS total scores had statistically significant, but very mild correlations. So, we had the judgement that the correlations among the psychopathology measurement tools are more influenced by the rater than the contents of tools. CONCLUSION: We concluded that Huber's basic symptoms, measured by K-FBF, reflect more negative symptoms of schizophrenia than other symptoms. And K-FBF has more correlation with the PANSS, objective psychopathology measuring tool, than the SCL-90-R, self-report quetionnaire. But, more studies using patients with another disease stages and another demographic variables are needed in order to generalize the results of this study.
Diagnostic and Statistical Manual of Mental Disorders ; Education ; Humans ; Prevalence ; Psychopathology* ; Schizophrenia*

No Abstract Available.
Alcoholism* ; Diagnostic and Statistical Manual of Mental Disorders* ; Mass Screening* ; Sensitivity and Specificity*

INTRODUCTION: Attention-deficit hyperactivity disorder (ADHD) was a newly coined term for a disease that existed prior to its naming in the mid 20th century. The issue about whether ADHD is a new disorder or merely a new name for an existing disorder is still controversial. The authors tried to find the clues to the answer for this question through reviewing historical documents for traces of ADHD. CONTENTS: We could find literatures and medical records that contain possible ADHD symptoms. In particular, in 1845, Heinrich Hoffmann's 'fidgety Philip' or 'Johnny Look-in-the-air' nearly satisfies today's criteria for ADHD. Methylphenidate was approved as a promising chemical for inattention in 1957 before the establishment of the concept of ADHD. In 1968, ADHD was first officially introduced as "Hyperactivity Reaction of Childhood" by DSM-II. In 1980, DSM-III, 'Attention Deficit Disorder (ADD)' was adopted as an official diagnostic term and changed to 'ADHD' since the creation of DSM-III-R in 1987. CONCLUSION: As stated above, ADHD has existed since long ago and became familiar via an advanced diagnostic system and therapeutic options.
Diagnostic and Statistical Manual of Mental Disorders ; Medical Records ; Methylphenidate ; Numismatics

OBJECTIVES: This study was conducted to investigate the association between the symptoms of boys with attentiondeficit hyperactivity disorder (ADHD) and the attention-deficit hyperactivity symptoms, temperament and character patterns of their parents. METHODS: Forty-five boys with ADHD and who met the DSM-IV criteria were evaluated by using the ADHD rating scale (ADHD-RS), and their parents completed the Korean Adult ADHD scale (K-AADHDS) and the Temperament and Character Inventory (TCI). RESULTS: The parental K-AADHDS scores were not associated with the ADHD-RS total score and the subscale scores of their siblings. The most potent variable related to the ADHD-RS total score was the maternal self-directedness, and the second was the maternal persistence. The maternal self-directedness was the variable that was most correlated with the hyperactivity/impulsivity subscale scores of the ADHD-RS. CONCLUSIONS: The results suggest that the paternal ADHD symptoms may not be related to the ADHD symptoms of boys with ADHD. Higher maternal self-directedness and persistence may decrease overall the ADHD symptoms of these boys, and higher maternal self-directedness itself may predict lower hyperactivity/impulsivity symptoms of the boys with ADHD.
Adult ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Parents ; Siblings ; Temperament

OBJECTIVES: The aim of this study was to compare endogenous plasma lithium concentrations among schizophrenic patients classified by DSM-IV subtype and control groups and to investigate the correlation of endogenous plasma lithium concentration and psychotic symptoms in schizophrenia. METHODS: Schizophrenic patients were selected among psychiatric inpatients without lithium medication and then classified by DSM-IV schizophrenia subtype. Schizophrenic patient groups were composed of 15 disorganized type, 15 paranoid type and 15 undifferentiated type schizophrenic patients. The control group was composed of 15 healthy subjects without any psychiatric disease. Endogenous plasma lithium concentrations were estimated by inductively coupled plasma atomic emission spectrometer. The psychotic symptoms in schizophrenic patients were classified as positive symptoms, negative symptoms and disorganized symptoms according to andreasen classification1 about SANS and SAPS items. Endogenous plasma lithium concentration among three subtypes of schizophrenia and control group was compared, and correlation between endogenous plasma lithium concentrations and psychotic symptoms was examined. RESULTS: 1) Schizoprenic patients showed higher endogenous plasma lithium concentration than control groups (p=0.033). Endogenous plasma lithium concentrations were significantly different among three subtypes of schizophrenia (p=0.001). Compared with the control group, disorganized type showed higher endogenous plasma lithium concentration, but paranoid type and undifferentiated type were not significantly different. 2) Disorganized symptoms correlated with endogenous plasma lithium concentration (r=0.416, p=0.004), but negative symptom and positive symptom did not significantly correlate with endogenous plasma lithium concentration (r=0.202, p=0.184. r=-0.216, p=0.155). CONCLUSION: These results suggested that schizophrenic patients with disorganized symptom show the differences in utilization or distribution of endogenous lithium.
Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Inpatients ; Lithium* ; Plasma* ; Schizophrenia*

OBJECTIVE: The aim of this study was to explore the factor structure of a novel, 10-item rating scale, the Targeted Inventory on Problems in Schizophrenia (TIP-Sz). Determining the factor structure will be useful in the brief evaluation of medication and non-medication treatment of the disease. METHODS: An exploratory factor analysis was performed on TIP-Sz scores obtained from 100 patients who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for schizophrenia. RESULTS: The factor analysis extracted four factors that were deemed clinically pertinent, which we labeled: disorganization, social cooperativeness, functional capacity, and emotional state. The items exhibited cross-loadings on the first three factors (i.e., some items loaded on more than one factor). In particular, the 'behavioral dyscontrol and disorganization,' 'insight and reality testing,' and 'overall prognostic impression' items had comparable cross-loadings on all of the first three factors. The emotional state factor was distinct from the other factors in that the items loading on it did not cross-load on other factors. CONCLUSION: The TIP-Sz scale comprises factors that are associated with the psychosocial functioning and emotional state of patients, which are important outcome parameters for successful treatment of the disease.
Anomie ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Schizophrenia

OBJECTIVE: This study was carried out to investigate the clinical availability of event related potential (ERP) P300, N100 and QEEG as biological markers in schizophrenia (SPR) patients. METHODS: The 23 SPR patients who met Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) criteria of SPR and age and sex matched 23 normal controls (NC) were recruited. Positive and Negative Syndrome Scale (PANSS) was used to evaluate the clinical symptoms. The three electrodes (Cz, CPz, Pz) were used to measure the amplitude and latency of each ERP components. The qEEG was analyzed by the ranges of Hz: delta (1-3 Hz), theta (4-7 Hz), alpha (8-12 Hz), beta (13-30 Hz) and gamma (30-50 Hz). RESULTS:P300 amplitudes of SPR patients were reduced across Cz, CPz and Pz (F=5.81, p<0.05). There was no difference in P300 latency, N100 amplitude and N100 latency between SPR and NC. P300 amplitudes were not influenced by demographic characteristics and PANSS scores in SPR patients. The PANSS positive, negative, general subscale scores were positively correlated with N100 latency at Cz, CPz. SPR patients showed significantly decreased alpha activity (SPR vs. NC=24.44+/-6.98% vs. 29.55+/-6.74%, p<0.05) and increased gamma activity (SPR vs. NC=19.48+/-5.47% vs. 16.42+/-4.69%, p<0.05) compared with those of NC. CONCLUSION: The results suggest that the amplitude of P300 and alpha activity can be considered as a biological marker of SPR. And there is a possibility that the latency of N100 may reflect symptom severity of schizophrenia patients.
Biomarkers ; Diagnostic and Statistical Manual of Mental Disorders ; Electrodes ; Humans ; Schizophrenia