Recent studies have reported that obsessive-compulsive (OC) symptoms are highly prevalent in schizophrenia, and schizophrenic patients with OC symptoms have a poorer clinical course compared to those without OC symptoms. In spite of many previous case reports, treatment of OC symptoms in schizophrenia has not been systematically studied. We report a patient with chronic schizophrenia who had obsessive symptoms such as bizarre, stereotyped behaviors. Treatment with olanzapine and risperidone, resulted in partial response for his psychotic symptoms, respectively. The obsessive symptoms, however, persisted and fluoxetine was added to the risperidone regimen. After 4 weeks of combination treatment, fluoxetine was titrated up to 80 mg/day and his obsessive symptoms became less in frequency and intensity. After 7 weeks on combination treatment of risperidone and fluoxetine, obsessive symptoms resulted in a significant reduction. On the 20 months of following, he remained in a recovered state and had been treated with risperidone 4 mg/day, and fluoxetine 20 mg/day.
Fluoxetine ; Humans ; Risperidone ; Schizophrenia ; Stereotyped Behavior

Our report focuses on the case of a pregnant woman with bipolar disorder, manic episode. The patient was treated with olanzapine from the 24th gestational week until delivery and during breast feeding. No adverse events occurred during pregnancy, and the outcome was healthy.
Bipolar Disorder* ; Breast Feeding ; Female ; Humans ; Pregnancy ; Pregnant Women*

Our report focuses on the case of a pregnant woman with bipolar disorder, manic episode. The patient was treated with olanzapine from the 24th gestational week until delivery and during breast feeding. No adverse events occurred during pregnancy, and the outcome was healthy.
Bipolar Disorder* ; Breast Feeding ; Female ; Humans ; Pregnancy ; Pregnant Women*

OBJECTIVES: Paroxetine is known to have fewer cognitive side effects than older antidepressants such as amitriptyline. To confirm this objectively, we compared the effects of paroxetine on the psychomotor performance with those of amitriptyline in 10 healthy volunteers. METHOD: Paroxetine and amitriptyline were administered orally in a double-blind, two-way, single dose, crossover design. Assessments of psychomotor performances were carried out before and 2 and 6 hours after administration of single dose of paroxetine (40mg) or amitriptyline (50mg). Each treatment day was separated by 1 week of washout period. The psychomotor performances were measured using Vienna Determination Unit, Vienna Reaction Time, Vienna Signal Detection, Grooved Pegboard Test and Finger Tapping Test. The data were analyzed using two-way, repeated measures ANOVA on a crossover model. RESULTS: The results showed that paroxetine 40mg produced no significant performance decrements on the every test of psychomotor performances, whereas amitriptyline 50mg produced markedly impaired performance on most of the psychomotor tests. CONCLUSION: This study confirmed pervious findings that paroxetine is generally devoid of adverse side effects on psychomotor performance.
Amitriptyline* ; Antidepressive Agents ; Cross-Over Studies ; Fingers ; Healthy Volunteers* ; Paroxetine* ; Psychomotor Performance ; Reaction Time

OBJECTIVES: Although genotype of endothelial nitric oxide synthase has been investigated in many neuropsychiatric disorders, results were controversial and even contradictory. The purpose of this study was to investigate the nature of endothelial nitric oxide synthase in Korean schizophrenic patients, and compare it with healthy control group in terms of distribution of e genotype and allele frequency of endothelial nitric oxide synthase. METHODS: Using polymerase chain reaction and amplified refractory mutation system, endothelial nitric oxide synthase genotypes were identified in 77 schizophrenics and 121 healthy controls. RESULTS: 1) When genotypes of endothelial nitric oxide synthase were classified as a/a, a/b, b/b, there was no statistical difference in genotypes between the two groups. 2) In terms of allele frequency, there was also no statistical difference between the two groups. CONCLUSION: These results suggest that endothelial nitric oxide synthase gene seem to be unrelated to the pathogenesis of schizophrenia in Korean population.
Gene Frequency ; Genotype ; Humans ; Nitric Oxide Synthase Type III* ; Polymerase Chain Reaction ; Polymorphism, Genetic* ; Schizophrenia

Osteomas are benign neoplasms consisting of mature normal osseous tissue. They are common on the long bones of the extremities and found in the sinuses, facial bones, skull and madible in the head and neck region. Much rarer, however, are osteomas arising from subdural space with displacement of the underlying brain. A 42-year-old woman presented with a history of intermittent left frontal headache that was proved to be due to an intracranial lesion. After surgical removal, it was found to be an subdural osteoma. We report this case with pertinent literatual reviews.
Adult ; Brain ; Extremities ; Facial Bones ; Female ; Head ; Headache ; Humans ; Neck ; Osteoma* ; Skull ; Subdural Space

Venlafaxine has a dose-dependant effect on blood pressure that is clinically significant at high dose. But the cases of hypertension associated with low dose venlafaxine have been rarely reported. We experienced a case of low dose venlafaxine-induced hypertension in a 53 year-old woman with major depressive disorder who has never been diagnosed as hypertension and other medical diseases. We started venlafaxine administration at a dose of 37.5 mg/day, and on the first day of venlafaxine administration, her blood pressure was abruptly elevated. Regardless of hypertension, venlafaxine was adjusted up to 112.5 mg/day for her depressive symptoms. Hypertension was continued, but not controlled by antihypertensive medication. We thought that she had a venlafaxine-induced hypertension, so we stopped this medication. Elevated blood pressure was normalized 2 days after stopping venlafaxine administration. Her blood pressure has been within normal range without antihypertensive medication for 9 months. So we report this case with the review of the literatures on the venlafaxine-induced hypertension.
Blood Pressure ; Depression ; Depressive Disorder, Major ; Female ; Humans ; Hypertension* ; Middle Aged ; Reference Values ; Venlafaxine Hydrochloride

OBJECTIVE: The aim of this study was to examine the validity of the Korean version of the Hypomania Checklist-32, second revision (HCL-32-R2) in mood disorder patients. METHODS: A total of 454 patients who diagnosed as mood disorder according to Structured Clinical Interview for DSM-IV Axis I Disorders, clinician version (SCID-CV) (bipolar disorder [BD] I, n=190; BD-II, n=72; and major depressive disorder [MDD], n=192) completed the Korean module of the HCL-32-R2 (KHCL-32-R2). RESULTS: The KHCL-32-R2 showed a three-factorial structure (eigenvalue >2) that accounted for 43.26% of the total variance. Factor 1 was labeled “active/elated” and included 16 items; factor 2, “irritable/distractible” and included 9 items; and factor 3 was labeled “risk-taking/indulging” and included 9 items. A score of 16 or more on the KHCL-32-R2 total scale score distinguished between BD and MDD, which yielded a sensitivity of 70% and a specificity of 70%. MDD and BD-II also could be differentiated at a cut-off of 15 with maximized sensitivity (0.67) and specificity (0.66). Cronbach’s alpha of KHCL-32-R2 and its subsets (factors 1, 2, and 3) were 0.91, 0.89, 0.81 and 0.79, respectively. Correlations between KHCL-32-R2 and Montgomery-Asberg Depression Rating Scale, Young Mania Rating Scale and Korean version of Mood Disorder Questionnaire were −0.66 (p=0.41), −0.14 (p=0.9), and 0.61 (p < 0.001), respectively. CONCLUSION: The KHCL-32-R2 may be a useful tool in distinguishing between bipolar and depressive patients in clinical settings.
Bipolar Disorder ; Depression ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Mood Disorders* ; Psychometrics* ; Sensitivity and Specificity

OBJECTIVES: This study aimed to assess the prevalence of bipolar spectrum disorders among Korean high school students (individuals in late adolescence) using the Korean version of the Mood Disorder Questionnaire (K-MDQ). METHODS: Two thousand male and female participants were proportionately selected from among high school students nationwide. From November 2007 through February 2008, we conducted an epidemiological survey of, and administered the K-MDQ to, these participants, assessed their psychometric properties, and compared characteristics between K-MDQ-positive and K-MDQ-negative participants. RESULTS: The K-MDQ's internal consistency (Cronbach's alpha) was 0.74. The item-total score correlations ranged from 0.35 to 0.57, and all were statistically significant (p<.001). Factor analysis with varimax rotation revealed 3 factors that explained 42.6% of total variance. We found the cutoff endorsement of the K-MDQ score (7 or more in criteria 1) in 1207 students (60.4%) and found 104 (5.2%) subjects were K-MDQ-positive, meeting all 3 K-MDQ criteria. The mean K-MDQ total score was 7.2+/-2.9 and total scores of K-MDQ-positives and K-MDQ-negatives were 9.9+/-1.7 and 7.0+/-2.9, respectively. K-MDQ-positives and K-MDQ-negatives showed no differences in the sociodemographic variables we assessed. Endorsement of items in total subject ranged from 15.7% to 77.7%. All items except item 8 (more energy) differed significantly in endorsement between K-MDQ-positives and K-MDQ-negatives. Items accounting for over 30% of the endorsement differences between K-MDQ-positives and K-MDQ-negatives were"feel so good," "so irritable," and"excessive, foolish, risky behavior." CONCLUSION: The K-MDQ was a relatively valid screening tool for Korean high school students. Per the result of the K-MDQ survey, suspected lifetime prevalence of bipolar spectrum disorders for those in late adolescence (high school students) seems to be 5.2%, suggesting that systemic screening for bipolar spectrum disorder should be required for this age group.
Accounting ; Adolescent ; Bipolar Disorder ; Female ; Humans ; Male ; Mass Screening ; Mood Disorders ; Prevalence ; Psychometrics ; Surveys and Questionnaires

Celiac disease is a chronic absorptive disorder of the small intestine caused by gluten. The prevalence rate of celiac disease is 1% in Western countries. But, it is rare in Asian countries, and there is no celiac disease reported in Korea. Here, we report a case of celiac disease. An 36-years-old woman complained non-specific abdominal pain and diarrhea. She had anemia and was taking medication for osteoporosis. Colonoscopy showed no abnormality except shallow ulcer at the terminal ileum. Gastroduodenoscopy showed micronodularity at the duodenum 2nd and 3rd portion. Capsule endoscopy and enteroscopy showed villous atrophy and blunting of villi from the duodenum. Small intestinal pathology showed villous atrophy with lymphocyte infiltration. After gluten free diet, diarrhea, abdominal pain, anemia and osteoporosis were improved. And, she felt well-being sensation. This is a first case of celiac disease in Korea.
Abdominal Pain/etiology ; Adult ; Anemia/etiology ; Capsule Endoscopy ; Celiac Disease/complications/*diagnosis/diet therapy/pathology ; Diarrhea/etiology ; Diet, Gluten-Free ; Duodenum/pathology ; Endoscopy, Gastrointestinal ; Female ; Humans ; Ileum/pathology ; Intestinal Mucosa/pathology ; Osteoporosis/etiology ; Tomography, X-Ray Computed ; Treatment Outcome