Polydipsia in schizophrenic patients is not uncommon, but a frequently underdiagnosed condition. The etiology of polydipsia remains unclear, and its complications can be life-threatening, while often being difficult to manage it. We report a case of a successfully treated chronic schizophrenic patient with polydipsia. The patient was male, 47-year-old, suffering 27-years of residual schizophrenia who had been consuming more than 10 L of water per day, and is complicated by hyponatremia. He was treated with irbesarten 300 mg and naltrexone 50 mg in the setting of closed ward. He consumed less than 3.5 L of water per day and serum sodium levels seemed to be stable following discharge from the closed ward. We suggest that irbesartan and naltrexone may have beneficial effects for treating polydipsia, and future prospective and well-controlled studies are to be performed.
Humans ; Hyponatremia ; Male ; Middle Aged ; Naltrexone* ; Polydipsia* ; Prospective Studies ; Schizophrenia* ; Sodium ; Water

OBJECTIVE: The purpose of this study is to evaluate the relationship of insight with socio-demographic, clinical, and cognitive parameters in schizophrenic patients. METHODS: Seventy-seven patients with schizophrenia were recruited. All subjects completed the Korean version of the revised Insight Scale of Psychosis (KISP) and Multidimensional Scale of Perceived Social Support (MSPSS). Positive and Negative symptom scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Neurocognitive function tests were also administered. RESULTS: Patients that are married or currently living together showed significantly higher levels of insight than those who are divorced, separated, or single. Insight showed positive correlations with CDSS and emotional discomfort factor of PANSS. Insight also had negative correlations with age of onset and family, friend subscales of MSPSS. Total scores of PANSS and neurocognitive functions showed no significant correlations with insight. More severe depressive symptoms, lower perceived social support from friends and family, and younger age of onset were predictor of higher insight. CONCLUSION: The study suggest that impaired insight might be independent from general psychopathology and cognitive function and more influenced by emotional status and social environment.
Age of Onset ; Depression ; Divorce ; Friends ; Humans ; Psychology* ; Psychopathology* ; Psychotic Disorders ; Schizophrenia* ; Social Environment

OBJECTIVES: The close relationship between impaired self-referential processing and intrinsic motivation in schizophrenia has been suggested, but is not investigated yet. The purpose of this study was to explore the characteristics of self-referential processing and its relationship with intrinsic motivation in patients with schizophrenia. METHODS: Nineteen patients with schizophrenia and 24 healthy controls performed a self-referential processing task, in which a face (self, familiar other, or unfamiliar other) and three words (positive, neutral, and negative nouns) were presented. Participants were asked to indicate which word is relevant to the face. Intrinsic motivation and basic psychological needs affecting intrinsic motivation were assessed using self-reports. RESULTS: Compared to healthy controls, the relevance rating between self-face and neutral word was significantly lower in patients with schizophrenia (p=0.02). In patients with schizophrenia, it was negatively correlated with intrinsic motivation (r=-0.47, p=0.04) and competence (r=-0.47, p=0.05) which is known to influence intrinsic motivation. CONCLUSION: These results suggest that there is an impairment in self-referential processing in schizophrenia and it is associated with an impairment in intrinsic motivation. In particular, amotivation in patients with schizophrenia may represent a facet of selfdisorder.
Humans ; Mental Competency ; Motivation* ; Schizophrenia*

OBJECTIVES: The purpose of this study is to investigate the factors affecting recurrence in patients with schizophrenia received more than 10 years of long-term treatment. METHODS: The medical records of long-term follow-up patients with the diagnosis of schizophrenia from department of psychiatry, Inha university hospital for more than 10 years were reviewed. The recurrence was defined as the re-emergence or aggravation of psychotic symptoms after maintenance treatment during 6 months. RESULTS: Of the 110 patients who were included in the study, 78 patients were recurred. Half of the patients were experiencing at least 1 recurrence within six years. After adjustment of sociodemographic variables, female, poor drug compliance, younger baseline age, shorter duration of illness and longer duration of hospitalization at first admission were significantly related to an increased likelihood of recurrence. The most common stressor of recurrence was irregular drug taking (61.73%). CONCLUSION: The results show the importance of gender, drug compliance, baseline age, duration of illness, and duration of hospitalization at first admission in predicting recurrence of long-term follow-up patients with schizophrenia.
Compliance ; Diagnosis ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Medical Records ; Recurrence* ; Schizophrenia*

OBJECTIVES: Schizophrenia patients are known to be more prone to metabolic disease than normal people. This study aimed to identify the changes in metabolic parameters of schizophrenia patients using atypical antipsychotic drugs for 1 year. METHODS: A total of 200 schizophrenia patients were recruited and categorized into the aripiprazole-treatment group and control group taking 5 atypical antipsychotic drugs. Comparative analysis were between groups. The prescriptions of psychotropic drugs were collected by a review of medical records. Blood was collected after fasting for 12 hours at the starting point of treatment and the 12th month, and patient medical records were evaluated for basici nformation and treatment history. Physical measurement, the prevalence of metabolic syndrome and metabolic parameters were studied using ATP-III diagnostic criteria. RESULTS: From the study, the aripiprazole-treatment group had a mean weight increase of 0.6 kg and the control group had a mean weight increase of 6.5 kg at the 1 year follow-up, showing a significant difference between the two groups. There were also significant differences between the two groups in waist size, systolic and diastolic blood pressure, fasting blood sugar, total cholesterol, triglyceride, HDL-choleseterol and prolactin level. Along with meaningful improvement of the symptoms, aripiprazole-treatment group showed less effect on in abdominal obesity, diabetes, blood pressure, cholesterol and prolactin than other atypical antipsychotic drugs. CONCLUSION: Therapeutic intervention such as diagnosis, treatment, weight management and diet improvement is necessary for schizophrenia patients. Psychiatric symptoms as well as internal meicine-related problems such as metabolic disease need to be addressed in case management.
Antipsychotic Agents ; Blood Glucose ; Blood Pressure ; Case Management ; Cholesterol ; Diagnosis ; Diet ; Fasting ; Follow-Up Studies ; Humans ; Medical Records ; Metabolic Diseases ; Obesity, Abdominal ; Prescriptions ; Prevalence ; Prolactin ; Prospective Studies* ; Psychotropic Drugs ; Schizophrenia ; Triglycerides

OBJECTIVES: Our study aimed to present the distinctive correlates of disorganized speech in patients with schizophrenia, using the Scale for the Assessment of Thought, Language and Communication (TLC scale). METHODS: We compared the formal thought and other clinical characteristics between schizophrenia inpatients with (n=82) and without (n=80) disorganized speech. Psychometric scales including the TLC scale, Brief Psychiatric Rating Scale (BPRS), Young Mania Rating Scale (YMRS), Calgery Depression Scale for Schizophrenia (CDSS) and Word Fluency Test (WFT) were used. The presence or absence of disorganized speech was established using transformed dummy variable of score on the Clinician-Rated Dimension of Psychosis Symptom Severity (CRDPSS). RESULTS: After adjusting the effects of age, sex and total scores on the BPRS, YMRS and WFT, the subjects with disorganized speech presented significantly higher score on the poverty of contents of speech (p=0.001), distractible speech (p<0.0001), tangentiality (p<0.0001), derailment (p<0.0001), incoherence (p<0.0001), ilogicality (p<0.0001), word approximations (p=0.003), loss of goal (p<0.0001), blocking (p=0.006) and self-reference (p=0.002) items than those without disorganized speech. With defining the mentioned item scores as covariates, binary logistic regression model predicted that derailment (p=0.0001) and poverty of contents of speech (p<0.0001) were significant independent-correlates of disorganized speech in patients with schizophrenia. CONCLUSION: Our findings suggest that derailment and poverty of contents of speech are significant correlates of disorganized speech in patients with schizophrenia. Our findings might be used to evaluate disorganized speech in patients with schizophrenia efficiently.
Bipolar Disorder ; Brief Psychiatric Rating Scale ; Depression ; Humans ; Inpatients ; Logistic Models ; Poverty ; Psychometrics ; Psychotic Disorders ; Schizophrenia* ; Weights and Measures

Intensive case management provided at the critical period following the onset of schizophrenia is crucial for early social and vocational recovery. We report the young schizophrenia patient who had been treated for 2 years but frequently relapsed and attempted suicide. After receiving cognitive behavioral case management from community mental health center, she has functionally recovered without recurrence for 4 years. Collaboration between psychiatrists of hospital and case manager of community mental health center was very important factor that contributed to her functional recovery. Cognitive behavioral case management promoting coping skills and reducing perceived stress was effective on successful social adaptation even during the stressful situations. In conclusion, psychosocial management including cognitive behavioral case management at the early stage of schizophrenia is crucial to prevent the relapse and to recover patients' function.
Adaptation, Psychological ; Case Management* ; Cooperative Behavior ; Critical Period (Psychology) ; Early Intervention (Education) ; Humans ; Mental Health ; Psychiatry ; Recurrence ; Schizophrenia* ; Suicide, Attempted

OBJECTIVES: There exists only a limited number of studies on the people's perception of criminality of people with mental illness. People's fear of the dangerousness of people with mental illness may have been exaggerated, and yet there are few studies exploring whether people's view of the crime rates of mentally ill people are correct or not. METHODS: A total of 363 college students participated in the present study. The present study first compared the official statistics of the crime rates of the mentally ill with the public perception. In addition, the rates of mentally ill offenders with previous convictions across crime types are compared with people's perception. RESULTS: Compared to the official crime statistics, people's estimates of crime rates of mentally ill offenders were grossly exaggerated across crime types, including fraud, assault, rape, robbery, theft, homicide, and arson. Furthermore, the rates of mentally ill offenders with previous convictions across all crime types on the official crime statistics were actually higher than people's estimates. CONCLUSION: The present findings reveal that people's view of the crime rates of mentally ill people is considerably distorted. There is an urgent need to clarify these prejudices in order to help people with mentally illness adjust to society and to prevent them from committing crime.
Crime* ; Criminals ; Dangerous Behavior ; Firesetting Behavior ; Fraud ; Homicide ; Humans ; Mentally Ill Persons ; Prejudice ; Rape ; Theft

OBJECTIVES: Approximately 30% of individuals diagnosed with schizophrenia suffer from treatment-resistant schizophrenia. Clozapine is underutilized in the management of treatment-resistant schizophrenia. To understand contributing factors, we analyzed the time course and causes of clozapine discontinuations that occurred over a 20-year period in a clinical setting. METHODS: The reasons for discontinuation and duration of clozapine treatment from a retrospective database of 138 patients with schizophrenia who had prescribed clozapine at least a month were reviewed, with the motives for discontinuation coded. The causes for termination were analyzed. RESULTS: Over two-thirds of the patient had ceased clozapine. The two most common causes for discontinuation were side-effects (50%), and own decision (30%). Somnolence accounted for 34% of all side-effects induced discontinuations. Hematological problems accounted for 23% of side-effect. The Maximal treatment dose of clozapine was higher in continuation group (442.36 mg) than in discontinuation group (397.26 mg). The CGI-S score when prescribing clozapine last was higher in discontinuation group than in continuous group. The patients who took atypical antipsychotics before clozapine tended to cease clozapine because of side-effects than who took typical agent. CONCLUSION: Future studies should seek various methods to relieve side-effects of clozapine. Prospective researches using more objective tools are needed to clarify the reason for clozapine discontinuation.
Antipsychotic Agents ; Clozapine* ; Humans ; Prospective Studies ; Retrospective Studies ; Schizophrenia

OBJECTIVES: This article aims to describe the development of smartphone application for the case management of patients with schizophrenia. METHODS: Gwangju Bukgu-Community Mental Health Center developed and launched a smartphone application (HYM) for cognitive-behavioral case management and symptom monitoring. The development of the application involved psychiatrists, nurses, social workers, psychologists, and software technicians from a software development company (Goosl Corp.). RESULTS: The HYM application for clients includes six main modules including Thought record, Symptom record, Daily life record, Official notices, Communication, and Scales. The key module is the 'Thought Record' for self-directed cognitive-behavioral treatment (CBT). When the client writes and sends the self-CBT sheet to the case manager, the latter receives a notification and can provide feedback in real time. 'Communication' and 'Official notices' are useful for promoting communication between case managers and clients with schizophrenia. Ratings in 'Symptom record', 'Daily life record', and 'Scales' modules are stored in graphic or table form representing changes in them and shared with case managers. CONCLUSION: The interactive function of this application is the key characteristics that distinguishes it from other mobile self-treatment tools. This smartphone application may contribute to the development of a youth- and customer-friendly case management system for individuals with early psychosis.
Case Management* ; Cognitive Therapy ; Early Intervention (Education) ; Gwangju ; Humans ; Mental Health ; Psychiatry ; Psychology ; Psychotic Disorders ; Schizophrenia* ; Smartphone* ; Social Work ; Social Workers ; Weights and Measures