No abstract available.

Therapeutic social environments contribute to the successful treatment and rehabilitation for patients with schizophrenia. However, social stigmata of psychiatric disorder in our society have kept away schizophrenic patients from their recovery and adaptation. Many persons have thought that psychiatric patients are more violent and criminal because of overwhelming prejudice on untreated or mistreated patients with schizophrenia. The purpose of this review is to propose the new and updated fundamentals of our knowledge on the relationship between schizophrenia and violence. In 1980s, many researchers have a belief that rates of criminal behavior vary independently on the rates of mental disorders. The following scientific studies on various population and meta-analyses of relevant data, overall violence rate have been higher in patients with schizophrenia and other psychotic disorders than in healthy controls. Even though schizophrenia and other psychotic disorders are associated with increased risk of homicide, the association has been not attributed to the psychopathology limited to schizophrenia. Most of all, co-occurrence of substance abuse has played an important role in increasing the possibility of violent behavior. The severe violent offending has been inclined to occur during the early period of psychotic episode before beginning the psychiatric treatment. Thus, most of the violent offending of schizophrenia patient can be prevented by prompt therapeutic interventions and treatments.
Christianity ; Criminals ; Homicide ; Humans ; Mental Disorders ; Prejudice ; Psychopathology ; Psychotic Disorders ; Rehabilitation ; Schizophrenia* ; Social Environment ; Social Stigma ; Substance-Related Disorders ; Violence*

Methods: Patients were recruited from the department of psychiatry at a university hospital.Participants were diagnosed using DSM-5 criteria by board certified psychiatrists. Their medical records were reviewed, and participants were put into three groups (Depression with suicide attempt, Depression with suicide ideation, and Normal as a control group). For statistical comparison, MANCOVA with gender as a covariate was used. Results: Similar to pervious research, the two Depression groups with high suicide risk showed significantly higher Emotional/Internalizing Dysfunction, Negative Emotionally/Neuroticism-Revised, Demoralization, Dysfunctional Negative Emotions, Suicidal/Death Ideation, Helplessness/ Hopelessness, Self-Doubt, Stress/Worry, and Cognitive complaints than the normal group. In the Depression with suicide attempt group, Behavioral/Externalizing Dysfunction scales were significantly higher than the Depression with suicide ideation group. Conclusion The results show the significant prediction of MMPI-2-RF scales for suicide risk.Severity of mental pain (EID) and impulsive acting-out tendency of mental pain (BXD) were identified as important psychological characteristics of depression patients with suicide risk. The limitations of this study and suggested directions for future research are also discussed.

The Illness Intrusiveness Rating Scale (IIRS) measures illness-induced disruptions to 13 domains of lifestyles, activities, and interests. A stable three-factor structure has been well documented; however, the cross-cultural validity of this scale needs to be tested. This study investigated the factor structure of the Korean version of IIRS in 712 outpatients at a university medical center. A predominant diagnosis of the patients was rheumatoid arthritis (47%). The Center for Epidemiological Studies-Depression Scale (CES-D), and Health Assessment Questionnaire (HAQ) were also administered. Exploratory Principal Component Analysis identified a two-factor structure, "Relationships and Personal Development (RPD)" and "Instrumen-tal", accounting for 57% of the variance. Confirmatory analyses extracted an identical factor structure. However, a goodness-of-the fit test failed to support two-factor solution (X2 =138.2, df=43, p<.001). Two factors had high internal consistency (RPD, alpha=.89; Instrumental, alpha=.75) and significantly correlated with scores of HAQ (RPD, r=.53, p<.001; Instrumental, .r=44, p<.001) and CES-D (RPD, .r=55, p<.001; Instrumental, .r=43, p<.001). These findings supported construct validity of the Korean version of IIRS, but did not support cross-cultural equivalence of the factor structure.
Adult ; Aged ; Asian Continental Ancestry Group ; *Cross-Cultural Comparison ; Factor Analysis, Statistical ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; *Sickness Impact Profile

No abstract available.
Humans ; Psychotic Disorders* ; Schizophrenia*

A chronic psychological disorder is often encountered in adult survivors of severe and repeated child abuse. We report a case of successful Eye Movement Desensitization and Reprocessing (EMDR) treatment in a multiply traumatized survivor whose previous treatments with psychotropic medication and supportive psychotherapy were unsuccessful. A series of consecutive six weekly sessions of EMDR were given. The patient completed Symptom Checklist-90-Revised. Dissociative Experiences Scale. State and Trait Anxiety Inventory, Beck Depression Inventory and Impact of Event Scale-Revised at four points; at two months and a week before EMDR, a week and six months after EMDR. After EMDR, the patient improved on all the measures of scales. These gains were maintained at six months after the termination of treatment. This case suggests a possible application of EMDR with for chronic difficult-to-treat post traumatic conditions.
Adult ; Anxiety ; Child ; Child Abuse ; Depression ; Eye Movement Desensitization Reprocessing ; Eye Movements* ; Humans ; Psychotherapy ; Stress Disorders, Post-Traumatic ; Survivors ; Weights and Measures

OBJECT: To evaluate how the therapeutic factors affect post-discharge course of patients with schizophrenia, we analyzed relationship between each therapeutic factor and outcome of inpatients with schizophrenia in Hanyang University Hospital. METHODS: This study is a retrospective report. Subjects were schizophrenic inpatients who were discharged from Hanyang University Hospital from January 1, 2003 through December 31, 2004. We obtained demographic and clinical data from review of inpatient and outpatient charts. RESULTS: We analyzed the records of 104 patients with schizophrenia(44 males and 60 females). Patients who had longer first admission days have fewer number of readmission. There were no significant correlation between psychiatric rehabilitation and course of schizophrenia. Courses, such as duration of outpatient department follow-up and number and duration of rehospitalization, did not differ according to the existence of extrapyramidal symptoms or types of antipsychotics prescribed. CONCLUSION: Among the therapeutic factors, longer duration of the first admission only affected better post-discharge course of patients with schizophrenia.
Antipsychotic Agents ; Follow-Up Studies ; Humans ; Inpatients ; Male ; Outpatients ; Rehabilitation ; Retrospective Studies ; Schizophrenia*

Over the last decade, EMDR(Eye Movement Desensitization and Reprocessing) has emerged as a promising new treatment for trauma and other anxiety-based disorders. However, neurobiological mechanism of EMDR has not been well understood. Authors report SPECT findings of two patients of PTSD before and after EMDR. Brain 99mTc-ECD-SPECT was performed before and after EMDR treatment. To evaluate the significance of changes in the regional cerebral perfusion, t-test was conducted on the resulting images using SPM99. In addition, clinical scales(CAPS, CGI, STAI) were employed to asses the changes in the clinical symptoms of the patients. After EMDR treatment, each showed significant improvement in clinical symptoms. The cerebral perfusion increased in bilateral dorsolateral prefrontal cortex, and decreased in the temporal association cortex. The differences in the cerebral perfusion between patients after treatment and normal controls decreased. These changes appeared mainly in the limbic area the and the prefrontal cortex. These results suggest that EMDR may show the therapeutic effect through 1) improvement in the emotional control by increased activity in the prefrontal cortex, 2) inhibited hyperstimuli on amygdala by deactivation of the association cortex, 3) inhibition on past trauma related memory, and 4) keeping the functional balance between the limbic area and the prefrontal cortex. This case report needs further replication from studies with larger sample.
Amygdala ; Brain ; Equidae ; Eye Movement Desensitization Reprocessing ; Eye Movements* ; Humans ; Memory ; Perfusion* ; Prefrontal Cortex ; Stress Disorders, Post-Traumatic ; Tomography, Emission-Computed, Single-Photon*

Objectives: ：This study was designed to investigate the effect of sleep quality on depression symptoms and the mediating effect of interpretation bias and anxiety symptoms in psychiatric patients. Methods: ：Data accumulated for outpatients and inpatients in the Department of Mental Health Medicine at Hanyang University Guri Hospital were used. The measurement tools were Pittsburgh Sleep Quality Index (PSQI), Ambiguous/Unambiguous Situations Diary-Extended Version (AUSD-EX), Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II). Correlation analysis and bootstrapping analysis were conducted using SPSS 25.0 and SPSS Macro based on 162 patient data. Results: ：As a result of the study, the double mediating effect of interpretation bias for Ambiguity and anxiety symptoms was significant in the relationship between sleep quality and depression symptoms. Conclusions ：In this study, it was confirmed that low sleep quality sequentially affects anxiety and depression symptoms through interpretation bias for ambiguity. Based on this, it is expected that the development of other psychiatric symptoms can be prevented by preferentially performing therapeutic intervention on preceding symptoms.

Background: Effective treatment of Graves’ disease during pregnancy is important because uncontrolled hyperthyroidism is associated with increased fetal and maternal morbidity and mortality. While there have been case reports of patients with Graves’ disease who failed to achieve euthyroid state during pregnancy, anesthesiologists rarely encounter patients with uncontrolled hyperthyroidism undergoing urgent Cesarean section.Case: A 31-year-old pregnant patient had uncontrolled hyperthyroidism due to Graves’ disease despite medical treatment. Her signs and symptoms suggested fetal distress and aggravation of the disease, leading to hospitalization. After a failed induction for vaginal delivery, an urgent Cesarean section was performed under spinal anesthesia via an interlaminar approach using 9 mg of 0.5% heavy bupivacaine and 20 μg of fentanyl. It resulted in successful delivery, with no perioperative complications for the mother and neonate. Conclusions This case demonstrates that spinal anesthesia may provide clinical stability to patients with uncontrolled hyperthyroidism undergoing urgent Cesarean section.