While the therapeutic efficacy of antipsychotic drugs is not in doubt, a variety of undesirable side effects are common. They can be a disincentive to good compliance with treatment, resulting in increased possibilities for relapse and hospitalization. They can be distressing and disabling and thus interfering with patient safety and quality of life. Furthermore, they may be counter-therapeutic by exacerbating the condition that the drug was prescribed for. In this article, we will provide an overview of management of antipsychotic-induced side effects, with a particular emphasis on the most common side effects as well as less common but serious side effects. In addition, some practical issues regarding the management of side effects will b discussed.
Antipsychotic Agents ; Compliance ; Hospitalization ; Motivation ; Patient Safety ; Quality of Life ; Recurrence

OBJECTIVE: This study aimed to investigate the pattern of psychiatric consultation-liaison in a new general hospital over a 5-year period. METHOD: Retrospective chart review was conducted for psychiatric consultations performed from May 2004 to December 2008 in a new general hospital in Hwasun, Korea. RESULTS: A total of 1,852 patients who were referred to the Department of Psychiatry for consultation were included in the analysis. The main reasons for psychiatric consultation were changes in mental status(20.5%), depression(16.8%), insomnia(12.8%), and anxiety(7.9%). Psychiatric consultations were conducted with diagnoses of delirium(39.7%), depressive disorder(28.2%), adjustment disorder(7.9%), and anxiety disorder(4.1%). Patients with delirium were significantly older than were those with other psychiatric diagnoses(p<0.001). Delirium was more common in male patients than in female patients(47.1% vs. 29.9%, respectively), and depression was more common in female patients than in male patients(48.3% vs. 33.9%, respectively)(p<0.001). Delirium was more common in patients who underwent surgical operation than those who did not(p=0.010). CONCLUSION: Delirium was the most common diagnosis for psychiatric consultation followed by depression in a university hospital. Delirium was more prevalent in men than in women, while depression was more common in women.
Anxiety ; Delirium ; Depression ; Female ; Hospitals, General ; Humans ; Male ; Referral and Consultation ; Retrospective Studies

OBJECTIVE: This study was done to explore the determinants of care burden of Korean caregiver in patients with dementia. METHODS: For the seventy-nine patients with dementia and their caregivers, data on Caregiver Burden Inventory Korean version, and various patient- and caregiver related factors potentially related to care burden were investigated. Uni- or bi-variate analyses were performed to measure the relationships between individual factors and care burden, and then stepwise multiple linear regression tests were used to determine the independent risk factors. RESULTS: Two determinants of care burden were identified: 'severer depressive symptoms in patient' and 'lower spontaneous care motivation in caregiver'. Of the patient related factors, 'shorter disease duration', 'severer behavioral and psychotic symptoms' and'severer anxiety symptoms', and of the caregiver related factors,'women','having household responsibility', 'shorter free time' and'worse subjective health state' were related to care burden, although these were not identified as independent risk factors. CONCLUSION: To mitigate the care burden of Korean caregivers in patients with dementia, therapeutic interventions focused on the behavioral and psychological symptoms of patients would be essential in terms of patient related factors. With respect to caregiver related factors, in addition to the succession of the philosophy of filial piety, establishment of multi-modal services and facilities suitable for the caregivers vulnerable to care burden would be needed.
Anxiety ; Caregivers* ; Dementia* ; Depression ; Family Characteristics ; Humans ; Linear Models ; Motivation ; Philosophy ; Risk Factors

Frontotemporal lobar degeneration (FTLD) is a progressive dementia with prominent neuropsychiatric features, aphasia or both. FTLD predominantly affects the frontal and anterior part of temporal cortex. FTLD is classified into frontotemporal dementia (FTD), progressive nonfluent aphasia (PA), and semantic dementia (SD). FTLD is estimated to account for 20% of cases of degenerative dementia with presenile onset. This disease typically has onset in the mid- or early fifties. FTD is characterized by behavioral change and executive dysfunction, PA features a progressive nonfluent aphasia. SD is characterized by a progressive semantic aphasia and associative agnosia. Structural imaging shows atrophy of the frontal lobe and the anterior portion of the temporal lobe, bilaterally symmetric or asymmetric. Pathologically, FTLD can be classified into tau-positive pathology, tau-negative, ubiquitin positive pathology, dementia lacking distinctive histology. At present, there are no specific pharmacological therapies approved for use in any of the FTLD syndrome.
Agnosia ; Aphasia ; Atrophy ; Dementia ; Frontal Lobe ; Frontotemporal Dementia ; Frontotemporal Lobar Degeneration* ; Pathology ; Primary Progressive Nonfluent Aphasia ; Temporal Lobe ; Ubiquitin

11,609 of childhood new outpatients seen in Department of Dermatology of Seoul National University Hospital from 1975 to 1984 were analyzed statistica,lly. The study results were summarized as follows: l. 11, 609 out of 48, 188 new outpatients were under 15 years old age, amounting to 24. l %. 2. The 10 most common dermatoses were atopic dermatitis, vitiligo, urticari, hemangiorna, contact dermatitis, fungal disease, molluscum contagiosum, scabies, impetigo and nevocellular neuvs. The most freguent age groups were 2 to 6 years amounting to 47 2p, af total outpatients. 4. The peak incidence occurred in August, while the lowest incidence occurred in November and October. 5. Dermatoses which showed increasing tendency were nevocellular nevus and vitiligo, those of decreasing tendency were contact dermatitis and impetigo,
Adolescent ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatology ; Humans ; Impetigo ; Incidence ; Molluscum Contagiosum ; Nevus ; Outpatients ; Scabies ; Seoul ; Skin Diseases* ; Statistics as Topic* ; Vitiligo

OBJECTIVES: Daytime drowsiness or sedation and changes in night sleep are commonly seen in patients treated with clozapine. There is, however, very limited informatio on their degree and nature during the course of treatment. The purpose of this study was to understand the sleep patterns in chronic schizophrenic patients with clozapine treatment over a period of 24 weeks. METHOD: The sleep pattern was evaluated using a set of 5-point scale questionnaire, to record subjective impressions of the night sleep induction, maintenance and quality, and daytime drowsiness and fatigue. In addition, unusual experiences associated with night sleep were recorded. The sleep questionnaire was repeatedly administered at baseline and at 1, 2, 4, 8, 12 and 24 weeks of drug treatment. At present, data on 12 patients has been collected. RESULTS: All the components of night sleep were significantly improved in th 1st through the 12 th week after treatment with clozapine. Daytime drowsiness was significantly higher in the 1st to the 2nd week after the treatment and fatigue was also significantly higher in the 1st to the 4th week after the treatment. Eight patients experienced noticeable increases in salivation during night sleep, and of these, one also reported frequent nocturnal urination and even enuresis. However, all these adverse factors did not affect the major sleep patterns. CONCLUSIONS: These finding suggest that the beneficial effects of clozapine on night sleep might last much longer than the undesirable effect of daytime drowsiness and fatigue. In other words, tolerance of the hypnotic action of clozapine might develop late and tolerance of the daytime drowsiness and fatigue might be evident earlier.
Clozapine* ; Enuresis ; Fatigue ; Humans ; Surveys and Questionnaires ; Salivation ; Sleep Stages ; Urination

Objectives: This study aimed to investigate factors associated with depression among elderly living alone and those living with a spouse in an urban area. Methods: This study was a community-based, cross-sectional study that included 384 elderly aged 60 years or older.The subjects completed a questionnaire that covered sociodemographic characteristics and chronic medical illnesses.The Korean version of the Short Form of the Geriatric Depression Scale, the Korean version of the Quality of Life-Alzheimer’s Disease (KQOL-AD), and the Korean Mini Mental State Examination in the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease assessment packet were also performed. Results: The participants were divided into two groups: 137 elderly individuals living alone and 247 elderly individuals living with a spouse. Heart disease (odds ratio [OR]=13.099, 95% confidence interval [CI]=1.892-90.697, p=0.009) was identified as a risk factor for depression, while the religion (OR=0.137, 95% CI=0.028-0.668, p=0.014) was found to be a protective factor against depression among elderly individuals living alone. Higher scores on the KQOL-AD scale were found to be protective factors against depression for both elderly individuals living alone (OR=0.742, 95% CI= 0.636-0.867, p<0.001) and those living with a spouse (OR=0.664, 95% CI=0.573-0.771, p<0.001). Conclusions Among elderly living alone in an urban area, heart disease, religion, and the quality of life appear to have an impact on depression. To reduce the risk of depression in the elderly, it is necessary to properly manage heart disease, encourage religious participation, and enhance the quality of life.

OBJECTIVE: This study aimed to investigate the effects of alcohol on daytime sleepiness, psychomotor performance, and subjective response in healthy young men with different ALDH2 genotypes. METHODS: A total of 24 males, half with the active ALDH2*1/*1 and the rest with inactive the ALDH2*1/*2, were selected through genotyping. In a double-blind, placebo-controlled crossover design, each subject consumed either a 0.5 g/kg dose of alcohol or placebo in the morning on two separate occasions, a week apart. Multiple Sleep Latency Test, a battery of psychomotor tests (Critical Flicker Fusion Threshold, Choice Reaction Time, Compensatory Tracking Task, Digit Symbol Substitution), questionnaire for subjective response and modified Epworth Sleepiness Scale were administered. RESULTS: Daytime sleep latency was significantly decreased after alcohol intake in the morning compared to placebo, and the decrease was much greater in subjects with ALDH2*1/*2 than in subjects with ALDH2*1/*1. Psychomotor function was significantly impaired after alcohol intake in the morning compared to placebo, in subjects with ALDH2*1/*2. Subjective response was significantly negative or intense after alcohol intake in the morning, compared to placebo, in subjects with ALDH2*1/*2. Subjective daytime sleepiness was significantly increased after alcohol intake compared to placebo, in subjects with ALDH2*1/*2. CONCLUSION: These results supported that ALDH2 polymorphism might be one of important factors in determining the effects of alcohol on the various psychobehavioural functions as well as on patterns of alcohol use.
Cross-Over Studies* ; Flicker Fusion ; Genotype* ; Humans ; Male ; Psychomotor Performance* ; Surveys and Questionnaires ; Reaction Time

The case of a 66-year-old woman with coexisting idiopathic basal ganglia calcification(IBGC) and dementia was presented. The calcification was detected in bilateral basal ganglia, dentate nucleus, and thalamus by brain imaging. Serum calcium and phosphorus levels were normal. The underlying diseases of calcification of basal ganglia such as parathyroid dysfunction and other infectious, toxic, or metabolic illness were excluded. The patient had memory impairment and frontal executive dysfunction without aphasia, agnosia, apraxia, and visuospatial impairment in neuropsychological test. It suggested that the cognitive impairment might be due to the dysfunction of frontal-subcortical circuit.
Aged ; Agnosia ; Aphasia ; Apraxias ; Basal Ganglia* ; Calcium ; Cerebellar Nuclei ; Dementia* ; Female ; Humans ; Memory ; Neuroimaging ; Neuropsychological Tests ; Phosphorus ; Thalamus

No abstract available.
Dyspnea* ; Humans