OBJECTIVES: This study compared attitudes toward antipsychotic treatment according to awareness of the name of their illness in patients with schizophrenia. METHODS: Information on sociodemographic and clinical characteristics, including awareness of the importance of antipsychotic treatment, was obtained through a self-report questionnaire. The Drug Attitude Inventory (DAI) was administered. The data were compared according to awareness of the name of their illness. RESULTS: The study analyzed data for 199 patients with schizophrenia. Of these, 115 patients (57.8%) were aware that their illness was called schizophrenia, while 84 patients (42.2%) knew it by their psychotic symptoms or as another mental illness, such as depression. The patients aware of the name of their illness had significantly longer durations of illness and higher scores on the DAI. They were significantly more likely to have stopped taking medication on their own accord and to agree with the importance of antipsychotic treatment. Statistical significance was sustained in a logistic regression analysis after adjusting for the duration of illness and study site, except for the DAI score, which had borderline significance (p=0.055). In subjects with duration of illness > or =5 years, patients aware of the name of their illness had significantly higher scores on the DAI. CONCLUSION: Awareness of the name of their illness was associated with awareness of the importance of, and a positive attitude toward, antipsychotic treatments in patients. Psycho-education, including telling the patient the correct name of his or her illness, might be needed for maintaining antipsychotic treatment in patients with chronic schizophrenia.
Antipsychotic Agents ; Depression ; Humans ; Logistic Models ; Surveys and Questionnaires ; Schizophrenia

OBJECTIVES: This study aimed to compare psychomotor performance related with automobile driving in patients with schizophrenia under the treatment of a typical antipsychotic agent, haloperidol, or an atypical antipsychotic agent, aripiprazole. METHODS: We evaluated driving ability of schizophrenia patients by using the cognitive perceptual assessment for driving (CPAD). Twelve patients receiving haloperidol monotherapy and 18 taking aripiprazole monotherapy participated in this study and the results of CPAD were compared with each other. RESULTS: Of 30 participants, 15 (50%) of the patients passed the CPAD to be regarded as competent to drive, 3 (10%) of the patients failed the CPAD considered to be severely impaired. Controlling for sex, age, education, duration of illness, there were no significant differences in the CPAD results between two treatment groups. We observed a trend that patients who received aripiprazole showed a higher total score of the CPAD than haloperidol-treated patients (55.2+/-4.9 vs. 45.7+/-8.4, p=0.080). CONCLUSION: There were no significant differences in the psychomotor performance relevant to driving ability between haloperidol and aripiprazole groups. But our results suggest that aripiprazole might have the neurocognitive advantage over haloperidol. Future study with a large sample size and diverse antipsychotics is warranted.
Antipsychotic Agents ; Automobile Driving ; Haloperidol ; Humans ; Imidazoles ; Nitro Compounds ; Piperazines ; Psychomotor Performance ; Quinolones ; Sample Size ; Schizophrenia ; Aripiprazole

OBJECTIVES: People at ultra-high risk for psychosis have heterogenous character and different long-term outcomes. We divided ultra-high risk subjects into two subgroups by presence of familial history and tried to find different pattern of functional connectivity of the default mode network (DMN) between the two groups in order to examine the effects familial loading. METHODS: Eleven subjects at clinical-high risk (CHR) group with familial history of psychiatric illness and nineteen subjects of CHR group without familial history were recruited. All the subjects were scanned using resting-state functional magnetic resonance imaging. A posterior cingulate cortex was the seed region of the analysis, and the DMN of the both high risk group were analyzed with voxel-wise two sample T test. RESULTS: The CHR group with familial history showed greater functional connectivity in the precuneus area in contrast with the other high risk subjects (peak-level t=5.49, p<0.001). There were no significant differences in total score on the Positive and Negative Syndrome Scale and Scales of Psychosis-risk Syndrome between the two groups. CONCLUSION: The study suggests that the abnormalities of functional connectivity between precuneus and posterior cingulate area may be associated with the genetic vulnerability of high risk trait.
Gyrus Cinguli ; Magnetic Resonance Imaging ; Pilot Projects ; Psychotic Disorders ; Seeds ; Weights and Measures

OBJECTIVES: Differential diagnosis based on descriptive psychopathology between bipolar and unipolar depression in the clinical setting is a still huge challenge. Projective psychological tests might provide additional clues. This study aimed to find distinct Rorschach test characteristics of bipolar depression in comparison with unipolar depression. METHODS: Medical records and raw data of the Rorschach Inkblot test applied using standardized procedure for the Exner Comprehensive System were retrospectively reviewed for patients with bipolar disorder or unipolar depression. Individual variables of the Rorchach test were compared among three groups, i.e., (hypo) mania (n=59), bipolar depression (n=56) and unipolar depression (n=25). RESULTS: Bipolar depression group, in accordance with (hypo) manic group, showed more color reponses (WSumC), more extroverted and intuitive decision-making (EBright), and higher emotional expression (CF+C) and instability (ebright), compared to unipolar deperssion group. On the contrary, the (hypo) mania group displayed more cognitive errors (Sum6, WSum6) compared to both depression groups. CONCLUSION: This study suggests that Rorchach test might provide valuable markers for differential diagnosis between bipolar and unipolar depression, and that some of those markers could be regarded as trait markers of bipolar disorder.
Bipolar Disorder ; Depression ; Depressive Disorder ; Diagnosis, Differential ; Humans ; Medical Records ; Psychological Tests ; Psychopathology ; Retrospective Studies ; Rorschach Test

OBJECTIVES: Previous studies have suggested that some personality characteristics are associated with the onset, prognosis and social function in schizophrenia patients. However few is known about the personality and affective characteristic of genetic high risk group (GHR) for schizophrenia. This study aimed to investigate the personality and the affective characteristic of GHR group for schizophrenia. METHODS: Participants were 54 healthy controls (HC), 26 subjects with GHR for schizophrenia and 28 subjects with first episode psychosis (FEP). We performed three self-report questionnaires; NEO-Personality Inventory-Revised, State and Anger Expression Inventory and Positive Affect and Negative Affect Schedule. RESULTS: The GHR group showed higher score in agreeableness item than the HC (p=0.028). In extraversion item, the FEP group showed significantly lower scores than the HC (p=0.001). The GHR group showed lower scores in neuroticism item compared with FEP group in trend level. The FEP group showed higher trait-anger, lower positive affect and higher negative affect compared with the others. CONCLUSION: The GHR group seem to share certain vulnerable personality and affective characteristics for schizophrenia with the FEP group. On the other hands, the GHR group appeared to be more agreeable than the other groups, which might act as the compensation for other impaired functions.
Anger ; Anxiety Disorders ; Compensation and Redress ; Extraversion (Psychology) ; Hand ; Humans ; Polytetrafluoroethylene ; Prognosis ; Psychotic Disorders ; Schizophrenia

OBJECTIVES: The aim of this study was to investigate whether verbal and spatial working memory functions were impaired not only in patients with schizophrenia but also in people at ultra-high risk for first-episode psychosis. METHODS: Twenty-five patients (M 13, F 12) with schizophrenia (SPR), 21 people at ultra-high risk for psychosis (UHR)(M 10, F 11) and 19 normal controls (NC)(M 10, F 9) were recruited. The working memory was assessed by using the verbal and spatial n-back test. The working memory load increased incrementally from the 0-back to the 3-back condition. RESULTS: SPR performed significantly lower than NC and UHR in terms of hit rates of verbal and spatial n-back test. UHR subjects conducted significantly lower than NC and higher in trend-level than SPR in terms of hit rates of verbal and spatial n-back test. These differences were derived from the high working memory load (2-back and 3-back), not from the low working memory load (0-back and 1-back). There was no significant difference between the verbal and spatial n-back test across the three groups. CONCLUSION: These findings suggest that verbal and spatial working memory dysfunction may be general rather than differential in terms of stimuli modality, and this working memory deficit may be an important trait factor in schizophrenia.
Humans ; Memory, Short-Term ; Psychotic Disorders ; Schizophrenia

OBJECTIVES: Schizophrenia patients have deficits of prediction and learning related to dopaminergic dysfunction. It is hypothesized that there would be different characteristics in associative learning of reward approach and loss aversion between controls and patients. METHODS: Participants were 23 healthy participants and 20 out-patients fulfilling criteria for schizophrenia according DSM-IV-TR. Using a monetary incentive contingency reversal task, successful learning rates, numbers of trials and errors till learning, numbers of trials of maintaining learning, response times were measured. Characteristics of learning were compared between controls and patients. RESULTS: Physical anhedonia and PANSS negative symptom scores correlated with the number of trials while loss aversion was maintained. Overall correct response rates were decreased in patient group, particularly during reward approach learning. Patients required more trials and errors to learn reward approach than controls. There were no significant differences in learning performance and reaction times between groups during loss avoidance learning. CONCLUSION: These results support previous reports of deficits in reward-driven learning in schizophrenia. However, anhedonia and negative symptoms were associated with the preserved function of loss avoidance learning.
Anhedonia ; Avoidance Learning ; Humans ; Learning ; Motivation ; Outpatients ; Reaction Time ; Reinforcement (Psychology) ; Reward ; Schizophrenia

OBJECTIVES: The previous genome-wide association studies have revealed several candidate genes for restless legs syndrome (RLS). The PTPRD (protein tyrosine phosphatase receptor type delta) gene is one of the candidate genes for RLS. The occurrence of antipsychotic-related RLS could also be attributable to differences in genetic susceptibility. This study aimed to investigate whether PTPRD polymorphism is associated with antipsychotic-related RLS in schizophrenia. METHODS: We assessed symptoms of antipsychotic-induced RLS in 190 Korean schizophrenic patients and divided the subjects into two groups according to the International Restless Legs Syndrome Study Group diagnostic criteria : (i) subjects that met all of the criteria (n=44) and (ii) the remaining subjects who were not considered to be RLS patients (n=146). PTPRD rs462664 was genotyped by PCR in 190 individuals. The chi2-test was performed to compare differences between two groups. RESULTS: The frequencies of genotype (chi2=1.31, p=0.519) of the PTPRD rs462664 did not differ significantly between schizophrenic patients with and without RLS. The difference of allele frequencies (chi2=1.30, p=0.25) of the PTPRD rs462664 between the schizophrenic patients with and without RLS were not significant. CONCLUSION: These results suggest that PTPRD gene polymorphism does not play a major role in susceptibility to antipsychotic-related RLS in schizophrenia. This finding suggests that antipsychotic-induced RLS may have a different pathogenesis compared to primary RLS.
Gene Frequency ; Genetic Predisposition to Disease ; Genome-Wide Association Study ; Genotype ; Humans ; Polymerase Chain Reaction ; Restless Legs Syndrome* ; Schizophrenia* ; Tyrosine*

OBJECTIVES: The dysfunctional neural networks underlying self-evaluation in schizophrenia are overlapped with the neural structures involved in emotion regulation. The purpose of this study was to investigate the influence of anhedonia on the self-evaluation attitude of patients with schizophrenia. METHODS: Twenty healthy controls and twenty patients with schizophrenia performed a self-evaluation task, presenting a pair of the face (self, familiar other, and unfamiliar other) and word (negative, neutral, and positive noun) at the same time. Participants were asked to evaluate relevance between the pairs by pressing a corresponding button. Relevance rating scores were compared between the groups and were correlated with the severity of physical and social anhedonia. RESULTS: Patients evaluated the condition of a self face with a negative word and a familiar face with a negative word to be more relevant than healthy controls. In the patient group, the scores of relevance rating in the condition of an unfamiliar other face with a negative word were positively correlated with the anhedonia scale scores (physical : r=0.486, p=0.030 ; social : r=0.499, p=0.025). There was no correlation between the self-evaluation attitude and the severity of anhedonia. CONCLUSION: Patients with schizophrenia evaluate themselves badly in only negative circumstances, and anhedonia is not related to self-evaluation, but rather other-evaluation.
Anhedonia* ; Diagnostic Self Evaluation ; Humans ; Schizophrenia*

OBJECTIVES: It has been constantly reported that mismatch negativity (MMN) is impaired in patients with schizophrenia. However, the mechanism which relates impaired MMN and schizophrenia is not clear yet. The aim of this study is to investigate the association between MMN and clinical variables including functional status in patients with schizophrenia. METHODS: The present study assessed MMN using passive auditory oddball task in 26 patients with schizophrenia and 48 healthy controls. Repeated measures Analysis of Variance with age as a covariate was carried out for comparing peak amplitude and latency of MMN at 8 central line electrodes (FPz, Fz, FCz, Cz, CPz, Pz, POz, Oz) across groups. Pearson's correlation was performed to reveal the relationship between MMN and clinical variables including neurocognitive test results and the Global Assessment of Functioning score. RESULTS: MMN amplitude was significantly reduced in patients with schizophrenia compared with healthy controls. Pearson's correlation showed that subsets of short form of Korean Wechsler Adult Intelligence Scale scores and GAF scores were associated with MMN amplitude in patients with schizophrenia. CONCLUSION: These findings suggest that MMN amplitude is associated with current functional status including cognitive function in patients with schizophrenia.
Adult ; Analysis of Variance ; Electrodes ; Humans ; Intelligence ; Schizophrenia*