Peripheral edema is observed as an adverse effect of the usage of antipsychotics in the literature. This case report describes a 36-year-old female patient with the diagnosis of paranoid schizophrenia who presented with pretibial edema following initiation of long-acting injectable paliperidone palmitate. Pretibial edema developed within the second week of treatment and completely disappeared after its discontinuation.
Adult ; Antipsychotic Agents ; Diagnosis ; Edema* ; Female ; Humans ; Paliperidone Palmitate* ; Schizophrenia, Paranoid

BACKGROUND: Psychogenic non epileptic seizures (PNES) are characterized by repeated seizures that are typically caused by stress and psychologic problems such as anxiety and depression. This contrasts with epileptic seizures (ES), which are transient and caused by irregular excitement of nerve cells. PNES can be found in patients with ES, but due to their differing etiologies, it is important to determine the psychologic characteristics that differentiate PNES from ES. METHODS: This study identified psychopathologic and personality traits in 137 patients with PNES (n=7, 49.3% female) or ES (n=0, 35.7% female) using MMPI. The diagnosis was based on a medical history of seizures and the clinical examination in patients who visited the epilepsy clinic. Statistical analyses for comparing MMPI differences between the two groups were conducted using the t-test, chi-square test, and analysis of covariance. RESULTS: We analyzed the frequency of individuals who exhibited a T score of ≥5 on the MMPI, and the results indicated that there were significantly more patients in the PNES group than in the ES group who had elevated scores on the hypochondriasis (Hs) scale and hysteria (Hy) scale. The mean scores of Hs, Hy, paranoia scale and schizophrenia scale were significantly higher in the PNES group than in the ES group. CONCLUSIONS: These results suggest that patients with PNES have greater psychologic problems than ES patients. Differences in MMPI profile patterns between patients with PNES and ES may be helpful in tailoring appropriate therapeutic interventions for the two groups.
Anxiety ; Depression ; Diagnosis ; Epilepsy* ; Humans ; Hypochondriasis ; Hysteria ; MMPI* ; Neurons ; Paranoid Disorders ; Schizophrenia ; Seizures*

This study aimed 1) at determining the seasonal pattern of the first onset and 2) at examining different demographic and clinical factors by the seasonality of first onset, for shizophrenia, mood disorder and subtypes of each diagnosis. Finally, the 52 subjects with paranoid schizophrenia were selected from all patients who fulfilled DSM-IV criteria far schizophrenia who had been admitted to the National Seoul Mental Hospital from March 1994 to February 1995. And the 44 subjects with bipolar I disorder were selected from all patients who fulfilled DSM-IV criteria for mood disorder who had been admitted to the hospital from March 1994 to February 1996. This study was done by reviewing the hospital records about season of the first outset, demographic factors(sex, age, occupation, educated period, religion, marital status, residence and socioeconomic status) and clinical factors(age at the first onset, duration of illness, family history, length of admission, frequency of admission and treatment result). The seasonal pattern of the first onset and the different demographic and clinical factors by the season of the first onset in paranoid shizophrenia and I disorder were analyzed. The results were as follows: 1) There was no significant seasonal variation of the first onset for paranoid schizophrenia. 2) There was a significant seasonal variation of the first onset with a maximum in spring for bipolar I disorder. 3) There was no significant seasonal variation of the first onset in case of bipolar I disorder that began with the manic episode. 4) There was nonsignificant seasonal tendency to peak in spring/summer in the case of the first manic episode for bipolar I disorder. 5) There were no significant differences in demographic and clinical factors by the season of the first onset for paranoid schizophrenia and bipolar I disorder.
Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Hospital Records ; Hospitals, Psychiatric ; Humans ; Marital Status ; Mood Disorders* ; Occupations ; Schizophrenia* ; Schizophrenia, Paranoid* ; Seasons ; Seoul

OBJECTIVE: To explore the current situation and tendency of the forensic psychiatric examination of the cases of labor disputes. METHODS: This study reviewed 156 cases examined during the period of 1990-2001, analyzing some related factors. RESULTS: It was shown that most of these cases were related to the termination and interruption of labor contracts, while the quantity of cases related to labor pay increased considerably. The intervals between the beginnings of disputes to examinations were prolonged, while 69.2% of the intervals were within 12 months. 91.2% conclusions of the examinations were consistent with the diagnosis of psychiatric history. The rates of limited civil capability and incapability were 23.1% and 52.6%. CONCLUSION The quantity, type and interval of the cases of labor disputes were changing greatly during recent years. More attention should be paid to this kind of cases.
Adolescent ; Adult ; Aged ; Collective Bargaining/legislation & jurisprudence* ; Expert Testimony/legislation & jurisprudence* ; Female ; Forensic Psychiatry ; Humans ; Intellectual Disability/diagnosis* ; Male ; Mental Disorders/diagnosis* ; Middle Aged ; Retrospective Studies ; Schizophrenia/diagnosis* ; Schizophrenia, Paranoid/diagnosis*

OBJECTIVES: Obstructive sleep apnea-hypopnea syndrome (OSAHS) and insomnia are two of the most common sleep disorders in the general population. Because OSAHS patients with insomnia may have difficulty in adapting to the sleep breathing medical equipment, it is necessary to pay special attention to the diagnosis and treatment of comorbid insomnia. This study is to investigate the emotion and personality in OSAHS patients with insomnia complaints by using Minnesota Multiphasic Personality Inventory-2 (MMPI-2). METHODS: We reviewed the results of the standardized questionnaires assessing sleep-related variables, MMPI, and polysomnographic findings of the patients diagnosed as OSAHS. RESULTS: 145 subjects were 49.05+/-11.83 years of age. The mean Respiratory Disturbance Index was 33.57+/-19.91 and the mean score of Insomnia Severity Index (ISI) was 11.52+/-6.49. The mean scores of the Beck Depression Inventory (BDI) and MMPI-2 were within normal ranges. We divided the patients into two groups based on the scores of the ISI, OSAHS with insomnia (n=109) and OSAHS without insomnia (n=36). OSAHS patients with insomnia symptoms had significantly higher scores of hypochondriasis, hysteria, psychasthenia, schizophrenia, paranoia and psychopathic deviate scales and BDI than those without insomnia. CONCLUSIONS: Our results suggest that insomnia complaints are very common in OSAHS patients and the psychological problems are more frequently found in OSAHS patients with insomnia symptom than those without it.
Depression ; Diagnosis ; Humans ; Hypochondriasis ; Hysteria ; Minnesota* ; MMPI* ; Paranoid Disorders ; Polysomnography ; Reference Values ; Respiration ; Schizophrenia ; Sleep Apnea, Obstructive* ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders* ; Weights and Measures

OBJECTIVE: Differential diagnosis between post-traumatic stress disorder (PTSD) and adjustment disorder (AD) is rather difficult, but very important to the assignment of appropriate treatment and prognosis. This study investigated methods to differentiate PTSD and AD. METHODS: Twenty-five people with PTSD and 24 people with AD were recruited. Memory tests, the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and Beck's Depression Inventory were administered. RESULTS: There were significant decreases in immediate verbal recall and delayed verbal recognition in the participants with PTSD. The reduced memory functions of participants with PTSD were significantly influenced by depressive symptoms. Hypochondriasis, hysteria, psychopathic deviate, paranoia, schizophrenia, post-traumatic stress disorder scale of MMPI-2 classified significantly PTSD and AD group. CONCLUSION: Our results suggest that verbal memory assessments and the MMPI-2 could be useful for discriminating between PTSD and AD.
Accidents, Traffic* ; Adjustment Disorders* ; Depression ; Diagnosis, Differential ; Hypochondriasis ; Hysteria ; Memory Disorders ; Memory* ; MMPI ; Paranoid Disorders ; Prognosis ; Schizophrenia ; Stress Disorders, Post-Traumatic*

OBJECTIVE: Accurate diagnosis and assessment for psychiatric disorders is crucial for research, as well as for clinical practice. Structured Clinical Interview for DSM-IV(SCID-RV) is a less time-consumimg and more accurate structured diagnostic interview form. It can be used by clinical professions and is known for a reliable diagnostic tool. Present study was conducted to develop Korean version of SCID-RV and to test the inter-rater reliability. METHOD: The authors have translated original SCID-RV into Korean, and revised in parallel with sociocultural background of Korea. Ninety patients from two psychiatric hospitals, both outpatient and inpatient, were interviewed and rated independently by three raters. RESULT: The kappa coefficients for most of illnesses, such as major depressive disorder, dysthymia, schizophrenia, alcohol abuse and dependency, anxiety disorder and eating disorder were excellent (>0.70) in the evaluation of current disorders. And the kappa coefficients for bipolar disorder, delusional disorder, agoraphobia, undifferentiated somatoform disorder, and hypochondriasis were acceptable (>0.40) in the evaluation of current disorders. In the evaluation of lifetime disorders, the concordant rates of all the diagnoses except bipolar disorder and undifferentiated somatoform disorder were excellent. Lack of hierarchy in DSM-IV allows for multiple Axis I diagnoses. Mean numbers of Axis I diagnoses per subject assigned by the three raters were 1.5-1.7. CONCLUSION: Our findings confirm that SCID-RV yields highly reliable diagnoses. SCID-RV is recommended for accurate diagnosis in clinical practice and research on psychiatric disorders.
Agoraphobia ; Alcoholism ; Anxiety Disorders ; Appointments and Schedules* ; Axis, Cervical Vertebra* ; Bipolar Disorder ; Depressive Disorder, Major ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders* ; Feeding and Eating Disorders ; Hospitals, Psychiatric ; Humans ; Hypochondriasis ; Inpatients ; Korea ; Outpatients ; Schizophrenia ; Schizophrenia, Paranoid ; Somatoform Disorders

The nationwide spreaded institutionalized mental disordered offenders admitted in the several mental hospitals were transfered in one time after opening in November 3, 1987 until the end of 1988. In 1989, new admitted MDOs were 5.8%, 107 among total 1849, 203 MDOs(11%) were admitted newly in 1997. The new admitted MDOs were increased every year. The diagnosis of total 1849 mental disordered offenders to be admitted during 11 years from November 3, 1987 to December 31, 1997.Schizophrenia is 69.8%, Epilepsy 0%, Personality disorders 4.0%, Mental Retardation 4.0%, Alcohol-related disorder 3.0%, Substance-related disorder(other than alcohol) 2.0%. The crimes of total 1849 MDOs for 11 years are as follows; Homicide 33.2%, Violence 19.2%, Manslaughter 12.5%, Stealing 8.1%, Arson 6.4%, Robbery 2.5%, Rape 2.2%,II-legal Substance Abuse 1.6%. Year average recidivism of MDOs for 11 years are as follows:1st crime 70.6%, 2nd crime 12.3%, 3rd crime 4.9%, 4th crime 3.7%, 5th crime 8.5%. The number 77(6.8%) among 1141 total discharged MDOs are admitted again after discharge from the Forensic Psychiatric Hospital. The readmitted 77 MDOs for 11 years according to crimes are as follows: Stealing 30(38.9%), Substance Abuse 14(18.2%), Violence 11(14.3%), Arson 5(7.8%), Robbery 5(6.5%), Rape 5(6.5%), Homicide 4(5.2%). The readmitted 77 MDOs for 11 years according to crimes are as follows:Stealing 30(38.9%), Substance Abuse 14(18.2%), Violence 11(14.3%), Arson 6(7.8%), Robbery 5(6.5%), Rape 5(6.5%), Homicide 4(5.2%). The readmitted 77 MDOs for 11 years according to diagnosis are as follows: Schizophrenia 36(46.7%), Substance Abuse 15(19.5%), Kleptomaina 6(7.8%), Mental Retardation 4(5.2%), Personality disorders 4(5.2%), Epilesy 1(1.3%), Delusional disorder 2(2.6%), Bipolar Disorder 2(2.6%), Alcohol dependency 1(1.3%). II. Mental evaluation for Criminal Responsibility The diagnostic classification of total 1422 Mental Evaluation for 11 years are as follows: Schizophenia 431(30.3%), Alcohol-related disorder 205(14.4%), Mood disorder 188(13.2%), Personality disorders 124(8.7%), Mental retardation 108(7.6%), Delusional disorder 67(4.7%), and mental disorder due to general medical condition 42(3.0%). The number sentenced to insanity are 597(44.9%) among total 1331, diminished capacity 546(41%), and 'normal' 188(14.1%).
Alcohol-Related Disorders ; Bipolar Disorder ; Classification ; Crime ; Criminals* ; Diagnosis ; Epilepsy ; Firesetting Behavior ; Homicide ; Hospitals, Psychiatric* ; Humans ; Intellectual Disability ; Korea* ; Mental Disorders ; Mood Disorders ; Personality Disorders ; Rape ; Schizophrenia ; Schizophrenia, Paranoid ; Substance-Related Disorders ; Theft ; Violence

INTRODUCTIONIn tandem with our ageing population, it is observed there is a growing trend of elderly patients presenting for the first time with psychotic symptoms. Clinical experience suggests differences in the phenomenology of late-onset psychosis in our Asian context compared to studies done in the West. This study aimed to analyse the characteristics and psychopathology of first presentation psychosis in our local elderly and to determine the treatment outcome over a 12-month period.

METHODSA total of 64 subjects with first presentation psychosis were consecutively recruited. Those with a non-affective, non-organic psychotic disorder were evaluated using the Positive and Negative Symptoms Scale, the Clinical Global Impression Scale, Mini-Mental State Examination and the Beck's Depression Inventory.

RESULTSOf the 64 subjects recruited, 55 were enrolled in the study. 59.3% (n = 32) of the subjects were diagnosed to be suffering from very-late-onset schizophrenia-like psychosis, followed by delusional disorder in 31.5% (n = 17). The remaining 11.1% (n = 6) were diagnosed to have late-onset schizophrenia. The sample showed a high preponderance of women, with 88.9% reporting persecutory-type delusions. The majority of them were married and 80% of the subjects were living with relatives. Treatment was effective in ameliorating symptoms, but there was a high loss to follow-up of male subjects (81.8%).

CONCLUSIONThis descriptive study found sociodemographic and phenomenological similarities to other studies of late-onset psychosis in the West, except that social isolation and partition delusions were not prominent.

Age of Onset ; Aged ; Aging ; Female ; Geriatrics ; methods ; Humans ; Male ; Mental Status Schedule ; Psychometrics ; methods ; Psychotic Disorders ; diagnosis ; epidemiology ; Schizophrenia, Paranoid ; diagnosis ; epidemiology ; Schizophrenic Psychology ; Sex Factors ; Singapore ; Social Class ; Time Factors ; Treatment Outcome

OBJECTIVES: This study investigated the prevalence of traumatic events and posttraumatic stress disorder (PTSD) in an admission cohort of schizophrenic patients from two university affiliated psychiatric units in Korea. Differences in symptomatology between those with and without trauma were also assessed. METHODS: The consecutive sixty one inpatients (32 women and 29 men), who were diagnosed with schizophrenia by SCID-I, completed the Clinician-Administered PTSD Scale (CAPS), the Positive and Negative Syndrome Scale (PANSS), Symptom Checklist-90-Revised (SCL-90-R), Beck Depression Inventory, and State-Trait Anxiety Inventory. RESULTS: Forty patients (66%) had at least one traumatic event in their life time. The most common traumatic event was child physical abuse (34%), followed by accidents (21%), traumatic loss (18%), witnessing violence (15%), child sexual abuse (10%), natural disaster (8%), adult physical assaults (8%), adult sexual assaults (5%), and psychotic symptoms (5%). Only one patient (2%), however, was diagnosed with current PTSD. Patients with traumatic events compared to those without traumatic events demonstrated significantly higher scores on State anxiety scale (p=.006) and several subscales of SCL-90-R including paranoia, anxiety, phobia, interpersonal sensitivity, and degree of psychosis. No differences of sociodemographic and clinical background variables were found between the two groups. CONCLUSION: Low rate (2%) of current PTSD found in this study is comparable to North American literature reporting 10-46% of PTSD within the schizophrenic population. Absence of substance abuse or homelessness and low rate of sexual violence in these Korean patients may explain the discrepant rates. However, distinct symptom profiles of patients with trauma may suggest that PTSD diagnosis runs short of describing such patients. The results from this study imply that schizophrenia per se may not be associated with increased prevalence in current PTSD diagnosis.
Adult ; Anxiety ; Child ; Child Abuse, Sexual ; Cohort Studies ; Comorbidity ; Depression ; Diagnosis ; Disasters ; Female ; Homeless Persons ; Humans ; Inpatients* ; Korea ; Paranoid Disorders ; Phobic Disorders ; Prevalence* ; Psychotic Disorders ; Schizophrenia* ; Sex Offenses ; Stress Disorders, Post-Traumatic* ; Substance-Related Disorders ; Violence