Psychiatrists and pharmaceutical industry have a shared interest in advancing medical knowledge. Nonetheless, they also create opportunities for conflict of interests. The primary interest of the psychiatrist is to promote the patient's best interests, while the primary interest of industry is to promote profitability. This paper explores the content of ethical documents most relevant to the biomedical researcher and guidelines related to the ethics of sponsored research. Subsequently, it discusses the ethical quandaries involved and offers solutions for ethical business relationships.
Commerce ; Conflict of Interest ; Drug Industry ; Ethics ; Informed Consent ; Psychiatry ; Psychotropic Drugs

Frontotemporal lobe dementia have been underevaluated because of various clinical features, changing diagnostic criteria, and indifference of clinicians. It is important that frontotemporal lobe dementia patient showing behavioral and lingual problems should be early diagnosed and treated. Because frontotemporal lobe dementia patients often confused with Alzheimer's disease, senile depression, schizophrenia, drug abuse. We have presented a case of frontotemporal lobe dementia. He had typical clinical history and symptoms which deserve to be considered frontotemporal lobe dementia. He showed appropriate findings of frontotemporal lobe dementia in the neuropsychological tests and brain magnetic resonance imaging and single photon emission computed tomography. This case is thought to be helpful for clinicians to give attention to early diagnosis and appropriate treatment of frontotemporal lobe dementia.
Alzheimer Disease ; Brain ; Depression ; Early Diagnosis ; Frontotemporal Dementia* ; Humans ; Magnetic Resonance Imaging ; Neuropsychological Tests ; Pick Disease of the Brain ; Schizophrenia ; Substance-Related Disorders ; Tomography, Emission-Computed, Single-Photon

Evidence-based medicine (EBM) has been defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. EBM could be a meme in medicine that is transferred from one clinical filed to another. The knowledge base that informs clinical decision has been growing with a very rapid pace making it a difficult challenge for the busy clinician to keep up with this growing and high volume of research findings. To keep up to date with the best research evidence, clinicians need a set of strategies. EBM may be the solution of this challenge. The term, Evidence-Based Psychiatry (EBP) was introduced by Elliot Goldner and Dan Bilsker in 1995. The purposes of this review are to introduce EBP and to find the best way to adopt the evidence-based approach to the practice of psychiatry in Korea. For these purposes, we reviewed the practice of EBM and discussed the application of EBP in Korean psychiatric field of medicine.
Clinical Medicine ; Evidence-Based Medicine ; Humans ; Knowledge Bases ; Korea

Virtual reality technology is now being used in neuropsychological assessment and real-world applications of many psychiatric disorders, including anxiety disorders, schizophrenia, child psychiatric disorders, dementia, and substance related disorders. These applications are growing rapidly due to recent evolution in both hardware and software of virtual reality. In this paper, we review these current applications and discuss the future work of clinical, ethical, and technological aspects needed to refine and expand these applications to psychiatry.
Anxiety Disorders ; Child ; Dementia ; Diagnosis ; Humans ; Schizophrenia

OBJECTIVES: This study aimed to compare the behavioral psychological symptoms of dementia by stages and to suggest the proper management treatment plan. METHODS: We examined behaviral psychological symptoms in 17 dementia patients with mild stage (CDR=0.5, 1), 18 dementia patients with moderate stage (CDR=2) and 24 dementia patients with severe stage (CDR=3, 4). We compared the prevalence and the composite scores (frequency X severity) of each behavioral domain in K-NPI among three groups. The MMSE-K, GDS, Barthel ADL were also administrated to evaluate the general cognitive function, severity of the patients and activity of daily living. RESULTS: The most common behavioral disturbances were apathy/indifference, depression/dysphoria, and aberrant motor behavior. The mean composite score of aberrant motor behavior increased by stages of dementia severity with statistical significance. The total score of the K-NPI increased with severer stages of dementia the result didn't show statistical significance. The K-NPI score showed the positive correlation with CDR, GDS and the negative correlation with MMSE-K, B-ADL. But, there was no statistically significant correlation. CONCLUSION: Behavioral and Psychological Symptoms of Dementia (BPSD) change by the stages of dementia. The practical guideline for BPSD management according to dementia stage is needed. Re-evaluation and new therapeutic inter-vention must be considered by the stages of dementia.
Activities of Daily Living ; Dementia* ; Humans ; Prevalence

OBJECTIVES: This study aimed to compare the behavioral psychological symptoms of dementia by stages and to suggest the proper management treatment plan. METHODS: We examined behaviral psychological symptoms in 17 dementia patients with mild stage (CDR=0.5, 1), 18 dementia patients with moderate stage (CDR=2) and 24 dementia patients with severe stage (CDR=3, 4). We compared the prevalence and the composite scores (frequency X severity) of each behavioral domain in K-NPI among three groups. The MMSE-K, GDS, Barthel ADL were also administrated to evaluate the general cognitive function, severity of the patients and activity of daily living. RESULTS: The most common behavioral disturbances were apathy/indifference, depression/dysphoria, and aberrant motor behavior. The mean composite score of aberrant motor behavior increased by stages of dementia severity with statistical significance. The total score of the K-NPI increased with severer stages of dementia the result didn't show statistical significance. The K-NPI score showed the positive correlation with CDR, GDS and the negative correlation with MMSE-K, B-ADL. But, there was no statistically significant correlation. CONCLUSION: Behavioral and Psychological Symptoms of Dementia (BPSD) change by the stages of dementia. The practical guideline for BPSD management according to dementia stage is needed. Re-evaluation and new therapeutic inter-vention must be considered by the stages of dementia.
Activities of Daily Living ; Dementia* ; Humans ; Prevalence

The procedure of the online paper submission to the Journal of Korean Neuropsychiatric Association is consisted of seven steps:entering type, author, title, keyword and abstracts of the paper, author's affiliation, uploading the paper file, and completion of submission. Six steps before the completion of submission could be reversed. But after this, no change will be possible. When editor decide that the paper is eligible, correspondence author will get the acceptance letter. The review of the paper will be done by selective reviewers. They will login to the system for the evaluation. The efficacy and the convenience of this system will be heightened by user's feedback (ex, systemic error, inconvenience, improvements, and ideas).
Peer Review

The aim of the present study was to determine whether oncologic outcomes and adverse events associated with active on/off intermittent antiandrogen monotherapy (daily bicalutamide, 50 mg per day) are comparable with those of standard external beam radiation therapy (EBRT) or combined androgen blockade (CAB) therapy in prostate cancers with positive surgical margins after radical prostatectomy. Two hundred twenty-three patients with positive surgical margins post-radical prostatectomy who underwent active surveillance (AS, n = 32), EBRT without hormone therapy (n = 55), intermittent antiandrogen monotherapy without EBRT (IAAM, n = 50), or CAB without EBRT (n = 86), between 2007 and 2014, were reviewed retrospectively. Pathologic outcomes, biochemical recurrence rates, radiological disease progression, and adverse events were collected from medical records. Biochemical recurrence rates, biochemical recurrence-free survival rates, and radiological recurrence were not different between the groups (P = 0.225, 0.896, and 0.284, respectively). Adverse event rates and severities were lower for IAAM compared with EBRT or CAB (both P < 0.05), but were comparable to those for AS (P = 0.591 and 0.990, respectively). Grade ≥3 adverse events were not reported in the IAAM or AS groups. Erectile dysfunction and loss of libido rates were lower in the IAAM group compared with the EBRT and CAB groups (P = 0.032). Gastrointestinal complications were more frequently reported in the EBRT group (P = 0.008). Active on/off IAAM treatment might be an appropriate treatment option for patients with positive surgical margins after radical prostatectomy. Furthermore, regarding oncologic outcomes, IAAM was comparable to standard EBRT but had a milder adverse event profile.
Aged ; Aged, 80 and over ; Androgen Antagonists/adverse effects* ; Anilides/adverse effects* ; Antineoplastic Agents/adverse effects* ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Chemotherapy, Adjuvant/adverse effects* ; Disease-Free Survival ; Humans ; Male ; Neoplasm Recurrence, Local/blood* ; Neoplasm, Residual ; Nitriles/adverse effects* ; Prostate-Specific Antigen/blood* ; Prostatectomy ; Prostatic Neoplasms/therapy* ; Radiotherapy, Adjuvant/adverse effects* ; Retrospective Studies ; Tosyl Compounds/adverse effects*

BACKGROUND: To evaluate the success rate of balloon dilation and the factors possibly influencing the outcomes of balloon dilation for the ureteric strictured portion of ureteroureterostomy (UUS) site in patients with post-gynecologic surgeries.METHODS: A single institution data base was screened for the patients who received balloon dilation for a treatment of ureteral stricture diagnosed after gynecologic surgery. Overall 114 patients underwent primary intra-operative UUS due to ureteral injury during gynecologic surgery. Among them, 102 patients received balloon dilation, and their medical records were retrospectively reviewed. Success of balloon dilation was defined as the condition that requires no further clinical interventions after 6 months from balloon dilation.RESULTS: The ureter injury rate of women treated with open radical abdominal hysterectomy was highest (32 cases, 31.4%). 60 patients (60.8%) showed successful outcomes regarding dilation. All patients underwent technically successful dilation with a full expansion of balloon during the procedure, but 40 patients (39.2%) were clinically unsuccessful as they showed a recurrence of ureteral stricture on the previous balloon dilation site after the first dilation procedure. Univariate logistic regression analyses showed that stricture length >2 cm was a significant predictor of successful dilation (odds ratio, 0.751; 95% confidence interval, 0.634–0.901; p-value, 0.030), but it failed to achieve independent predictor status in multivariate analysis.CONCLUSION: Balloon dilation can an effective alternative treatment option for strictured portion of the primary UUS in post-gynecologic surgery patients when its length is < 2 cm.
Constriction, Pathologic ; Female ; Gynecologic Surgical Procedures ; Humans ; Hysterectomy ; Logistic Models ; Medical Records ; Multivariate Analysis ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Ureter

BACKGROUND: To evaluate the success rate of balloon dilation and the factors possibly influencing the outcomes of balloon dilation for the ureteric strictured portion of ureteroureterostomy (UUS) site in patients with post-gynecologic surgeries. METHODS: A single institution data base was screened for the patients who received balloon dilation for a treatment of ureteral stricture diagnosed after gynecologic surgery. Overall 114 patients underwent primary intra-operative UUS due to ureteral injury during gynecologic surgery. Among them, 102 patients received balloon dilation, and their medical records were retrospectively reviewed. Success of balloon dilation was defined as the condition that requires no further clinical interventions after 6 months from balloon dilation. RESULTS: The ureter injury rate of women treated with open radical abdominal hysterectomy was highest (32 cases, 31.4%). 60 patients (60.8%) showed successful outcomes regarding dilation. All patients underwent technically successful dilation with a full expansion of balloon during the procedure, but 40 patients (39.2%) were clinically unsuccessful as they showed a recurrence of ureteral stricture on the previous balloon dilation site after the first dilation procedure. Univariate logistic regression analyses showed that stricture length >2 cm was a significant predictor of successful dilation (odds ratio, 0.751; 95% confidence interval, 0.634–0.901; p-value, 0.030), but it failed to achieve independent predictor status in multivariate analysis. CONCLUSION Balloon dilation can an effective alternative treatment option for strictured portion of the primary UUS in post-gynecologic surgery patients when its length is < 2 cm.