No abstract available.
Diabetes Mellitus* ; Obesity*

The authors have compiled the available references on the use of risperidone in 'non-psychotic conditions', not including schizophrenia and bipolar disorders. In addition, information was gathered on the mechanism of action of risperidone in this diverse disorders. Atypical antipsychotics are known to have fewer adverse effects seen with typical antipsychotics, such as tardive dyskinesia (TD), neuroleptic malignant syndrome (NMS), and cognitive disturbances, and they possess a 'broad range of therapeutic efficacy.' The broad psychotropic effects, apart from the antipsychotic action, of risperidone are attributed to their particular pharmacological properties, which differ greatly from those of typical antipsychotics. Risperidone has a greater affinity for the dopamine D2 receptor than for the D1 receptor, but its D2/5-HT2 affinity ratio is low. This fixed D2/5-HT2 ratio may bring about significantly different clinical effects depending on the dosage. The dose-dependent pharmacologic properties of risperidone, in the form of the effects of blocking the 5-HT2 receptors, which are observed at smaller doses, and the effects of D2 blockade, which are manifested progressively with increasing dosage, may be the basis of the efficacy of risperidones in non-psychotic conditions at smaller doses than in psychoses. The authors have also ascertained that risperidone may be of efficacy in the treatment of non-psychotic conditions other than the major psychoses. The authors consider the different dosages depending on the diagnoses to be reflective of differences in the etiopathophysiology between the conditions. In addition, the authors have noted that risperidone, at small doses, shows efficacy in the treatment of a wide variety of disorders other than psychotic disorders, including obsessive symptoms, anxiety. This also demonstrates the greater range of therapeutic efficacy of risperidone other than typical antipsychotics. Despite the fact that risperidone possesses such various therapeutic actions, the first-line drugs in the treatment of non-psychotic conditions are and should be non-antipsychotic psychotropics;risperidone is still an antipsychotic drug, with all the entailing characteristics, and it is not completely free of the side effects common in typical antipsychotics, such as EPS. Wisdom is called for in the appropriate application of risperidone in the treatment regimen of suitable patients following treatment with other non-antipsychotic psychotropics. It seem to review all non-psychotic psychiatric disorders via the clinical applications of risperidone. Through expansion of the indications for risperidone, further insight will be gained on its previously unknown psychotropic effects and the etiopathophysiology of the indicated conditions.
Antipsychotic Agents ; Anxiety ; Bipolar Disorder ; Diagnosis ; Humans ; Movement Disorders ; Neuroleptic Malignant Syndrome ; Psychotic Disorders* ; Receptors, Dopamine D2 ; Risperidone* ; Schizophrenia

BACKGROUND: Obesity is associated with a variety of diseases and increases cardiovascular morbidity and mortality. The purpose of this study is to examine the relationship between the obesity index and diastolic function parameters of the left ventricle. We use body mass index (BMI) and waist circumference (WC) as the obesity index. METHODS: From January 2010 to December 2012, 390 cases (283 men, 109 women) were enrolled in this study. The blood pressure, height, weight, blood test, personal habits questionnaire, and echocardiographic indices were obtained. We analyzed the echocardiographic indices of left ventricular diastolic function with BMI and WC. RESULTS: The left ventricle (LV) mass index (P=0.007), LV dimension (P<0.01), A (P<0.01), A' (P=0.030), and E/E' (P=0.006) were higher, and E (P=0.003), E' (P<0.01), E/A (P<0.01) were lower in the overweight and obese groups than in the normal group. On multiple linear regression analysis, E/E' correlated positively with age, gender, BMI and systolic blood pressure. In men, E/E' correlated positively with age and BMI or WC. In women, only age had a positive correlation with E/E'. CONCLUSION: In men, increased BMI or waist circumference are associated with an increase in E/E', which surrogates left ventricular diastolic dysfunction. In women, obesity and abdominal obesity have no correlation with E/E'.
Blood Pressure ; Body Mass Index ; Echocardiography ; Female ; Heart Ventricles ; Hematologic Tests ; Humans ; Linear Models ; Male ; Mortality ; Obesity ; Obesity, Abdominal ; Overweight ; Waist Circumference

No abstract available.
Body Mass Index ; Echocardiography ; Waist Circumference

OBJECTIVES: Electroconvulsive therapy (ECT) is the important treatment method which has a good effect on refractory depression, schizophrenia at acute stage, patients with suicidal ideation. Although ECT results in better effects and less adverse effects in acute stage of illnesses as compared with pharmacotherapy, clinical implications are decreasing. Thus, authors surveyed a view of Korean psychiatrists about ECT to find whether there are prejudices and/or misconceptions for ECT. METHODS: Authors made survey questionaire for the attitudes of ECT, based on the APA task force 14, a clinical study in Korea, Hermann et al's report, and questioned Korean psychiatrists on their opinions for ECT through the internet E-mail, who are the members of Korean Neuropsychiatric Association (KNPA) serving in hospitals with psychiatric inpatient units. RESULTS: 122 psychiatrists answered to survey questionnaire. 89.4% have positive attitude about ECT. They thought that ECT has relatively safe and potent therapeutic effects, and less adverse effects. The rate of psychiatrists who have been no experience to perform ECT was 13.9% (n=16). Interestingly all of them had been trained serve in university hospitals now. The rate of psychiatrists who had experienced practicing ECT past but, not experienced within 2 years recently was 48.7% (n=56). While psychiatrists who have been no experience of ECT were more worried about adverse effects, doctors who experienced practicing ECT thought preferably the aspect of safety and potent effects of ECT. Psychiatrists who prefer psychotherapy were more likely to concern about adverse effect of ECT, but there were no differences in other aspects when compared with others. Most psychiatrists participated in this survey had positive attitudes about application of ECT to geriatric patients, but negative at child&adolescent patients. CONCLUSION: Authors recognized that many Korean psychiatrists agreed with performing ECT, and expected good results, but in reality, it is difficult to expect for them to perform ECT. Several factors may be associated for that: the changes in trend of psychiatric treatment, production of novel psychotropic drugs, researches trends which pharmacotherapy is prevailing in the fields of psychiatry, and problems of education, that is, lack of standard educational curriculums and systemic training course at residency for ECT.
Advisory Committees ; Curriculum ; Depressive Disorder, Treatment-Resistant ; Drug Therapy ; Education ; Electroconvulsive Therapy* ; Electronic Mail ; Hospitals, University ; Humans ; Inpatients ; Internet ; Internship and Residency ; Korea ; Prejudice ; Psychiatry* ; Psychotherapy ; Psychotropic Drugs ; Surveys and Questionnaires ; Schizophrenia ; Suicidal Ideation

OBJECT: The study was performed to examine the psychotrophic drugs used in psychiatric out-patients in which neutropenia developed and current state of consultation and to confirm the importance of complete blood count and differential count (CBC/DC). SUBJECTS AND METHODS: The subjects were 60 patients of our university hospital in which neutropenia developed in out-patient department (OPD) of psychiatry during recent three years. The absolute neutrophil counts of patient were below 2,000/mm3. RESULTS: The reasons why exam was performed were mainly to follow-up exam during medications. Mood stabilizers such as carbamazepine, phenytoin, sodium valproate were identified to cause neutropenia in the group using multiple drugs, and clozapine was highly related in the group using single drug. But many kinds of drugs were related with neutropenia. We have not checked well enough the CBC/DC and have not consulted well to hematologist in OPD of neuropsychiatry. CONCLUSIONS: It is important to find neutropenia in the psychiatric out-patients using psychotropic drugs. We had better check CBC/DC routinely and consult to hematologist.
Blood Cell Count ; Carbamazepine ; Clozapine ; Follow-Up Studies ; Humans ; Neuropsychiatry ; Neutropenia* ; Neutrophils ; Outpatients* ; Phenytoin ; Psychotropic Drugs ; Valproic Acid

OBJECTIVES: Patients with poor insight are commonly observed among schizophrenics and they show poor drug compliance and prognosis. This study aimed at examining the characteristics of psychopathology in patients with schizophrenia who have no insight. Understanding the features of inner psychopathology in schizophrenic patients with poor insight, we assumed, could lead to insight-promoting clues. METHODS: The subjects consisted of 69 patients with schizophrenia diagnosed by DSM-IV criteria. For identifying insight level in the patients, Scale to Assess Unawareness of Mental Disorder(SUMD) was applied. After subjects were divided into two groups depending upon insight level, psychopathological differences were evaluated by Kyung Hee-Frankfruter Beschwerde Fragebogen(K-FBF), which was known as one of the subjective psychological tests for the schizophrenics. RESULTS: There was no significant differences in demographic variables, duration of illness, and dose of medication between two groups. However, significantly high rate of involuntary admission and tendency of high frequency of admission were revealed in schizophrenic patients with poor insight. And, also poor insight group showed significantly high scores in the factors of sensorimotor disorder(subscales of psychomotor disorder, perceptual disorder and blocking symptoms included) and in language-cognitive disorder factor(subscales of language disorder and cognitive floating included) compared with patients who have insight. CONCLUSION: We was assumed that lack of insight in schizophrenics could include one of the symptoms based on neuropsychological or neurobiological abnormalities in brain. Moreover, it was revealed that patients with poor insight evaluated themselves as having more serious psychopathologies than patients who had insight. It has been already known that schizophrenic patients who lack in insight are reluctant to taking psychiatric care and lack in awareness of their illness. However, this study suggests that their inner psychopathology associated with insight can be understood with the use of subjective psychological test, i.e. K-FBF. For understanding the schizophrenic patients who lack in insight, not only checking the insight but also applying the subjective test such as K-FBF seems to be helpful.
Brain ; Compliance ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Language Disorders ; Perceptual Disorders ; Prognosis ; Psychological Tests ; Psychopathology* ; Schizophrenia

Trichotillomania (TTM) is a disorder characterized by repetitive hair pulling, frequently from the scalp and/or eyebrows, leading to noticeable hair loss and functional impairment. TTM remains a poorly understood and inadequately treated disorder despite increased recognition of its prevalence. We review available neuroimaging studies conducted in patients with TTM, covering structural and functional neuroimaging in turn. Data from patients' structural and functional neuroimaging results enabled us to identify the neural circuitry involved in the manifestation of hair pulling. Finally, we highlighted the future importance of neuroimaging studies in children and adolescents with TTM.
Adolescent ; Brain ; Child ; Eyebrows ; Functional Neuroimaging ; Hair ; Humans ; Neuroimaging ; Prevalence ; Scalp ; Trichotillomania

OBJECTIVES: To identify the factors affecting long-term adherence to methylphenidate treatment in children with attention-deficit hyperactivity disorder (ADHD). METHODS: A retrospective medical record review of 239 ADHD patients (mean age 9.3+/-2.6 years, range 6.0-17.4 years) who had visited the child and adolescent psychiatry clinic at a university hospital, in Seoul, Korea from March 2005 to February 2008. Subjects were diagnosed as ADHD based on the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision version (DSM-IV-TR) and underwent neuropsychological tests including the continuous performance test (CPT). Treatment discontinuation was defined as the last prescription date when the medication possession rate (MPR) became less than 0.80. Subjects were divided into three groups and labeled as Group I, non-adherence without pharmacotherapy, Group II, non-adherence with short-term pharmacotherapy, and Group III, adherence with long-term pharmacotherapy. RESULTS: Ninety (37.7%) patients were grouped as non-adherent (Groups I+II) and 149 (62.3%) as adherent (Group III). The adherence group exhibited lower intelligence, higher symptom severity, and a higher number of comorbid psychiatric disorders than controls. The use of stimulants was significantly associated with long-term adherence to treatment. Additionally, the duration of interval between the date of the first visit and the date of the first prescription was positively associated with long-term adherence. CONCLUSION: About two-thirds of patients diagnosed as ADHD adhered to the treatment six months after the first visit. With respect to patient evaluation and the development of treatment strategies, factors affecting early drop-out and longer follow-up must be considered.
Adolescent ; Adolescent Psychiatry ; Child ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Intelligence ; Korea ; Medical Records ; Methylphenidate ; Neuropsychological Tests ; Prescriptions ; Retrospective Studies

PURPOSE: To investigate the correlations between Seoul Neuropsychological Screening Battery (SNSB) scores and the gray matter volumes (GMV) in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) and cognitively normal (CN) elderly subjects with correcting the genotypes. MATERIALS AND METHODS: Total 75 subjects were enrolled with 25 subjects for each group. The apolipoprotein E (APOE) epsilon genotypes, SNSB scores, and the 3D T1-weighted images were obtained from all subjects. Correlations between SNSB scores and GMV were investigated with the multiple regression method for each subject group using both voxel-based and region-of-interest-based analyses with covariates of age, gender, and the genotype. RESULTS: In the AD group, Rey Complex Figure Test (RCFT) delayed recall scores were positively correlated with GMV. In the MCI group, Seoul Verbal Learning Test (SVLT) scores were positively correlated with GMV. In the CN group, GMV negatively correlated with Boston Naming Test (K-BNT) scores and Mini-Mental State Examimation (K-MMSE) scores, but positively correlated with RCFT scores. CONCLUSION: When we used covariates of age, gender, and the genotype, we found statistically significant correlations between some SNSB scores and GMV at some brain regions. It may be necessary to further investigate a longitudinal study to understand the correlation.
Aged ; Alzheimer Disease ; Apolipoproteins ; Brain ; Genotype* ; Humans ; Mass Screening* ; Methods ; Mild Cognitive Impairment ; Seoul* ; Verbal Learning