OBJECTIVES: Cognitive psychological models propose that auditory hallucinations arise from a problem with monitoring one's auditory verbal imagery. Most auditory hallucinations are derogatory in content and accompany negative emotions. If auditory verbal imagery plays an critical role in the pathogenesis of auditory hallucination, it must be influenced by negative emotions. This study was aimed at understanding the influence of negative emotions on the development of hallucinations by investigating the way by which negative emotions have influence on cortical activity induced by auditory verbal imagery. METHODS: For both normal subjects and patients with schizophrenia, quantitative electroencephalography(Q-EEG) was applied during the auditory verbal imagery tasks using a two word list. The one word list accompanied negative emotion and the other accompanied neutral emotions. The difference of EEG activity between two tasks was compared by paired t-test. WE also compare the difference of the influence of negative emotions between normal subjects and patients with schizophrenia. RESULTS: In normal subjects, amplitude of beta wave was increased in temporal area such as TCP1, and, the amplitude of theta frequency wave was decreased in right hemisphere such as FP2, F4, C4, CP2, P4, But, in the schizophrenia group, there were no significant differences. CONCLUSION: These results may suggest that auditory verbal imagery with negative emotion requires more activation in left temporal area, but, appropriate activation may not achieved in schizophenia patients. So, the possibility that the resultant disturbance of verbal self monitoring may be related to auditory hallucination is suggested in this study.
Electroencephalography ; Hallucinations ; Humans ; Models, Psychological ; Schizophrenia*

This paper covered a variety of issues that fall under the general rubric of ethical considerations in clinical psychopharmacologic research. The topics of ethical of subject selection and confidentiality, medication-free research. informed consent for those humans exposed to psychotropic drug research, and possible conflicts of interest in medical researcher/pharmaceutical sponsor were reviewed. Beginning with a brief section on the justifications for engaging in research, this review indentified the codflicts that inevitably arise between society's need for reliable and valid research and our obligation to protect subjects. Also author reviewed the patient consent issues, including the essential elements of informed consent, populations requiring surrogate consent, and confidentiality requirements. The paper continued with a discussion of responsible research practices, including the medication-free research, and conflicts of relationship between researcher and sponsor. In spite of a number of ethical dilemmas in clinical trials, the willingness of the scientist to confront the ambiguities of ethical questions in the pursuit of scientific knowledge reveals a basic truth, that is, the ethical characteristics of the scientist who undertakes such a task. Although it would be impossible to assure the general population that all researchers are ethical, it is incumbent on us to educate future researchers and provide practical guidelines for maintaining the primary ethical values of the individual who performs research with humans.
Confidentiality ; Ethics* ; Humans ; Informed Consent

The ventricular septal defect with aortic insufficiency is a relatively uncommon congenital heart disease. Once the prolapse of aortic cusp complicates the ventricular septal defect, the prolapse of the aortic cusp is a progressive, rather than static lesion. With the curent possibility of surgical correction in cases of ventricular septal defect and other abnormalities, the differential diagnosis assumes marked importance. vTwo cases of ventricular septal defect with aortic insufficiency are presented with a review of pertinent literature. These young female patients had long standing palpitation and dyspnea on exertion since childhood. The physical examination showed with pulse pressure, bounding carotid pulsation and a systolic ejection-type murmur and a decrescendo diastolic murmur at the upper left sternal border, which simulated "machinery" type murmur of patent ductus arteriosus. The ventricular septal defect with aortic insufficiency was demonstrated by cardiac catheterization and cineangiocardiography.
Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Diagnosis, Differential ; Ductus Arteriosus, Patent ; Dyspnea ; Female ; Heart Defects, Congenital ; Heart Murmurs ; Heart Septal Defects, Ventricular* ; Humans ; Physical Examination ; Prolapse

BACKGROUND: The number of patients of doxylamine overdose has increased, but there were little clinical reports. The purpose of this study is review the patients of doxylamine overdose for aid clinical decision making of patients disposition. METHODS: We reviewed medical records of patients who ingested doxylamine succinate retrospectively from Jan. 1, 1996 to Dec. 31. 1996. Data that was recorded were followed: age, sex, psychiatric history, amounts of ingestion, time interval from ingestion to arrival to hospital, initial vital signs and symptoms, EKG, chest PA, Lab. findings, treatment, patients disposition, length of hospital stay, complication. RESULTS : 1) Total number of patients was ninety and average dosage of ingestion was 1062mg. 2) Tachycardia was the most frequent anticholinergic symptom(46%). 3) Routine lab. findings was not abnormal except one patient who was diagnosed as Rhabdomyolysis. 4) Gut decontamination was performed in patients who had arrived at hospital in 2-3 hours, and who had ingested large dose of drug. 5) Five patients were admitted to Psychiatric dept. and one patient was admitted to emergency dept. for treatment of rhabdomyolysis. 6) The mean duration of hospital stay was 6.5 hours. CONCLUSION: The patients who ingested overdose of doxylamine was managed safely in emergency department, but we should warn against the possibility of rhabdomyolysis.
Decision Making ; Decontamination ; Doxylamine* ; Eating ; Electrocardiography ; Emergencies ; Emergency Service, Hospital ; Humans ; Length of Stay ; Medical Records ; Retrospective Studies ; Rhabdomyolysis ; Succinic Acid* ; Tachycardia ; Thorax ; Vital Signs

OBJECTIVES: Oriental medicine has affected the way in which Koreans seek psychiatric help and how they understand psychiatric symptoms and mental illnesses. In this study, we investigated the concept of psychosis in traditional oriental medicine and compared it with how modern western medicine understands the same concept. METHODS: We searched for descriptions of psychotic symptoms or illnesses in traditional medical documents of various periods. Four psychiatrists then analyzed the contents of these descriptions in terms of DSM-IV. RESULTS: The concept of psychosis in oriental medicine has two symptom domains: positive and negative symptoms, which are similar to the positive and negative symptoms of schizophrenia in modern psychiatry. However, there were differences in the basic concepts of disease entities and in the approaches to the illness. CONCLUSION: This descriptive study showed that, in oriental medicine, psychopathology is based on oriental philosophy, and that this creates wide differences between oriental and western medicine.
Medicine, East Asian Traditional ; Medicine, Traditional ; Philosophy ; Psychiatry ; Psychopathology ; Psychotic Disorders ; Schizophrenia

No abstract available.
Psychopharmacology*

No abstract available.
Psychopharmacology*

No abstract available.

Although the establishment of appropriate dosage ranges and dose-up strategies for antipsychotic drugs has important ramifications for both short-term treatment and long-term therapeutic outcomes, difficulties in dosing persist. As a matter of fact, drug dosages utilized during controlled clinical trials are not always optimal for patients encountered in day-to-day practice. The original trials of risperidone, a novel antipsychotics, suggested that an initial target dose and dose-up schedule of 6 mg/day within 1week was appropriate, but these trials were necessarily conducted among patients who were chronically impaired, hospitalized, and often partly drug resistant. Relevant data relating to the dosage and dose-up schedule of risperidone identified through a lot of papers published in Korean and other country. On the basis of multicenter studies, naturalistic studies, phase 4 trials and many years of clinical experiences, the curre ntly recommended target dose and their schedule for risperidone treatment is 4-5 mg/day with less-rapid titration than previously recommended. Moreover, a lower dose than this and slower titration may be appropriate for elderly patients and first-episode patients.
Aged ; Antipsychotic Agents ; Appointments and Schedules ; Humans ; Risperidone* ; Schizophrenia

This study was done to examine changes of plasma homovanillic, acid(HVA), 5-hydroxyindoleacetic acid(5-HIAA), and HVA/5-HIAA ratio during an 8-week clozapine trial and to investigate the relationship between the plasma monoamine metabolites and treatment responses. Twenty-seven chronic schizophrenic patients were treated for 8 weeks with clozapine. The psychopathology was assessed at baseline just clozapine trial and then every 2 weeks until the end of 8-week clozapine treatment using the positive and Negative Syndrome Scale(PANSS) and the Clinical Global Impression scale(CGI). The plasma HVA and 5-HIAA levels were measured also biweekly using high preformance liquid chromatography with electrochemical detection method. Plasma HVA and 5-HIAA levels were significantly decreased during a 8-week chozapine treatment, although plasma HVA/5-HIAA ratio showed no significant change. The changes of plasma HVA levels were in significant correlations with the changes of PANSS positive scores, of general psychophathology scores, and changes of total scores. The changes of plasma 5-HIAA levels were in significant correlations with the changes of PANSS negative scores. But the changes of plasma HVA/5-HIAA ratio had no significant correlation with any PANSS subscale score changes. 48% of the patients treated with clozapine was categorized as responders, who showed at least a 20% decrease in PANSS total score and a CGI severity score of mildly ill or less(< or =3) of the end pint of the study. The baseline plasma HVA levels and HVA/5-HiAA) ratio were significantly higher in responders(N=13) than in nonresponders(N=14). But no significant difference in the change of plasma HVA between responders(40.3% decrement) and nonresponders(3.1% increment). But no significant difference in the change of plasma 5-HIAA and the change of plasma HVA/5-HIAA ratio between responders and nonresponders were observed. These results suggest that the antipsychotic effect of clozapine on positive symptoms may be associated with dopaminergic blocking activity, and that on negative symptoms may be associated with serotonergic blocking activity. The baseline plasma HVA levels and the change of HVA levels from baseline may be useful predictors of treatment response with clozapine.
Antipsychotic Agents ; Chromatography, Liquid ; Clozapine ; Homovanillic Acid* ; Humans ; Hydroxyindoleacetic Acid ; Plasma* ; Psychopathology ; Schizophrenia*