Aggression ; Humans ; Schizophrenia ; Schizotypal Personality Disorder ; Violence

Although serotonin reuptake inhibitors (SRIs) are the primary therapeutic drugs for obsessive compulsive disorder (OCD), as many as 40% (up to 60%) of OCD patients do not show an adequate response to these drugs. SRI-refractory patients with OCD may have abnormalities in their central dopaminergic system as well as serotonergic system. The combination therapy with SRIs and antipsychotic drugs is considered to be effective especially for treatment-refractory OCD patients who have comorbid tic disorders or schizotypal personality disorder. Recently, the augmentation of atypical antipsychotics has been suggested to be effective in treating SRI-refractory OCD patients, and risperidone and olanzapine could be promising drugs for SRI-refractory OCD patients. We reviewed recent literatures regarding the clinical efficacy of atypical antipsychotics for treatment-refractory OCD patients.
Antipsychotic Agents* ; Humans ; Obsessive-Compulsive Disorder* ; Risperidone ; Schizotypal Personality Disorder ; Serotonin Uptake Inhibitors ; Tic Disorders

OBJECTIVE: The identifying schizotypal trait in obsessive-compulsive disorder (OCD) patients is important to predict clinical course, since those patients are hardly overcome through conventional intervention methods. This paper presents the trial of classification method of obsessive-compulsive disorder with schizotypal trait using Frontal Lobe Function Test (FLFT). METHODS: 110 OCD patients are divided into two groups:27 pure OCD patients, and 83 non-pure OCD patients. After training artificial neural network (ANN) using frontal-lobe function test data of train data (schizophrenia, pure OCD, and normal group), we classify test data (non-pure OCD patients) into one of the three groups. RESULTS: Among the total 83 test data (non-pure OCD patients), 44 patients were classified as schizophrenia, 32 patients as normal, and 7 patients as pure OCD. With respect to the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) data of those classified patients, ordering score in compulsion was significantly different between three groups. Moreover, cluster A socre (Schizoid, Schizotypal) of Personality Diagnostic Questionnaire (PDQ) data showed significant difference between them. CONCLUSION: The results presented that those OCD patients who are classified as schizophrenia using generated model with machine learning technique is tend to have compulsive symptom of arrangement and schizotypal personality disorder.
Machine Learning ; Classification* ; Frontal Lobe* ; Humans ; Obsessive-Compulsive Disorder* ; Surveys and Questionnaires ; Schizophrenia ; Schizotypal Personality Disorder

This study examined the clinical features of patients with obsessive-compulsive disorders who had been admitted to the Department of psychiatry, Seoul National Univ. Hospital from 1980 to 1995, using retrospective investigation of medical records. The subjects were 26 patients(male 22, female 4) who were compatible with the criteria of OCD by DSM-III-R. The results were as follows: 1) The most common obsessive thinking was pathologic doubt, followed by contamination, need for symmetry, somatic and sexual obsession, religious and aggressive obsession in descending order. Twenty three percent of patients had multiple obsessions. 2) The most common compulsive ritual was checking, followed by washing, need to ask and confess, symmetry and precision, counting in descending order. Thrity nine percents of patients had multiple rituals. 3) Depression, schizophrenia, Tourette's syndrome and tic disorder were the co-existing disorder with obsessive compulsive disorder. Cormorbid personality disorders in OCD were obsessive personality disorder, borderline personality disorder, schizotypal personality disorder and passive-aggressive personality disorder. 4) The course in OCD with co-existing disorder was worse than that in pure OCD. 5) The verbal IQ was significantly higher than the performance IQ checked by KWIS in obsessive compulsive disorder.
Borderline Personality Disorder ; Ceremonial Behavior ; Compulsive Behavior ; Depression ; Female ; Humans ; Inpatients* ; Medical Records ; Obsessive Behavior ; Obsessive-Compulsive Disorder* ; Passive-Aggressive Personality Disorder ; Personality Disorders ; Retrospective Studies ; Schizophrenia ; Schizotypal Personality Disorder ; Seoul ; Thinking ; Tic Disorders ; Tourette Syndrome

In order to product and develop questionnaire which can assess the schizotypal personality by model of criteria in DSM-III-R it was presented 1311owing questions in this study. First, far the validation and manufacture of scale and sub-subscale that assess overall feature, nine characteristics of the schizotypal personality disorder, this study was concerned with validity, reliability and factor-analysis results of schizotypal personality questionnaire. Second, we would be present how schizotypal personality disorder trend is connected with trait-anxiety, hopelessness and self-concept. Also the difference Is compared with. Finally, 396(male 216 Ss/53,8%, female 180 Ss/45.5%) college students with mean age 21.2 years were sampled. Raine's schizotypal personality questionnaire(SOQ) which assess nine characterisitics of schizotypal personality disorder in DSM-III-R was translated and used. In this results, Raine's schizotypal personality questionnaire was appeared to have high internal validity, split-half reliability and test-retest reliability Also, 6 factors were affirmed by empirical confirmation through factor-analysis. 6 factors have been very reliable internal validity that ranges from .78 to .83. In these 6 factors, idea of reference, odd or eccentric behavior and odd speech were corresponded to the category model after DSM-III-B in Raine's scale. 'Cognitive, perceptive' dimension was centered of factor 1, 'Emotive, affective' dimension was centered of factor 2, social anxiety and constricted affect were constituted to 2nd factor. No close friends, schizoid trend and suspiciousness of schizotypal characteristics were constituted to 3rd factor by' interpersonal relationship' dimension. These empirical outcomes which confirmed through factor-analysis were very valid and connected much to Raine's scale which assessed schizotypal personality disorder, thus possibility of development and manufacture of schizotypal personality disorder scale through item revision was lighten. In 2nd study the higher schizotypal personality disorder trend, trait-anxiety and hoplessness were higher. But on the contrary, self-concept was lower. The group of high score in schizotypal personality questionnaire had more trait-anxiety and hopelessness than the group of low score in schizotypal personality questionnaire. Contrastly, positive self-concept was high in the group of low score. Also, the most predictable variable to the trait-anxiety was factor 2, predictable power R2 of factor 2 was 29.1%. To the hopelessness, factor 2 was the most powerful predictable variable. Predictable power of factor 2 was 11.2%, also. In self-concept, factor 2 explained 20.8% of self-concept, thus it was presented that factor 2 had the most powerful explanatory quantity. In these consequences, the factors which have meaningful connection to the trait-anxiety, hopelessness and low self-concept within 6 factors were really factor 2, 3, 1. Among these factors, 'Emotive' feature of factor 2 including social anxiety and constricted affect have the most effect on trait-anxiety, hopelessness and serf-concept. And next to factor 2, the isolated interpersonal relation which include no close friends and schizoid trend was some influential variable. Also peculiar, unusual perceptual experience, eccentric belief and magical thinking had some effect though small. The college students who had strong schizotypal personality trend had more social anxiety and more constricted emotional empathic ability, less self-expression, less social skill than common college students. These elements threaten, interrupt and retard identity establishment and intimacy-seeking which are important developmental tasks within this period. These experiences is accepted to ego-dystonic to schizotypal college students who have some or moderate reality testing, adaptive ability. Moreover, These peoples would feel locus of control externally, not internally and would have more control-failure experiences. All these elements elevate anxiety level, give rise to low self-concept and low expectation to the future. These outcomes all confirmed questions which presented in this study.
Anxiety ; Female ; Friends ; Humans ; Internal-External Control ; Interpersonal Relations ; Magic ; Surveys and Questionnaires ; Reality Testing ; Schizotypal Personality Disorder ; Thinking

The average age of frontotemporal dementia onset is much younger than that of the Alzheimer's disease. Behavioral disturbances occur at the early stage of frontotemporal dementia, and social dysfunction and personality deterioration may ensue. For this reason, it may be misdiagnosed as other psychiatric disorders. Therefore, more careful observation and concern is required for proper diagnosis. This report is about the case of a patient who had been misdiagnosed of disorders like schizotypal personality disorder, schizophrenia, obsessive compulsive disorder etc., and therefore have been treated for those. We reviewed this case based on the data of neuropsychiatric history, family history, neuropsychological test, brain MRI, and SPECT, and considered this case as frontotemporal dementia with family history. This is the first frontotemporal dementia case with family history in Korea, so hereafter we may discover the gene locus associated with this case. This study can be very useful for the following frontotemporal dementia studies in Korea.
Alzheimer Disease ; Brain ; Dementia ; Diagnosis ; Frontotemporal Dementia* ; Humans ; Korea ; Magnetic Resonance Imaging ; Neuropsychological Tests ; Obsessive-Compulsive Disorder ; Schizophrenia ; Schizotypal Personality Disorder ; Tomography, Emission-Computed, Single-Photon

Although obsessive-compulsive disorder (OCD) is recognized as a major psychiatric illness, few studies have investigated obsessive-compulsive symptoms in patients with schizophrenia. Recent increases in dual diagnosis due to changes to the DSMIV diagnostic criteria, findings of obsessive-compulsive symptoms (OCS) after administration of atypical antipsychotics, increased reports of co-occurrence of schizophrenia and OCD have increased the interest in OCS in schizophrenia. The incidence of OCS in patients with schizophrenia is reported to be 3-59%; however, the rate of progression to schizophrenia from OCD is not higher than in the general population. Level of insight, which differentiates obsessions from delusions, can be confounded by the specifier 'with poor insight' in OCD. OCD with schizotypal personality disorder or poor insight differs from pure OCD in that it responds poorly to treatment, has a poor prognosis, leads to deficits in cognitive functioning similar to those observed in schizophrenia, and responds well to low-dose antipsychotics. In the past, it was believed that OCS could prevent or delay the deteriorative course of schizophrenia. However, recent studies have shown that co-occurrence of OCD and schizophrenia increases the severity of symptoms, delays the treatment response, and reduces socio-occupational functions. Schizophrenia and OCD share the same pathophysiology in that both diseases have defects in the fronto-basal functional circuitry of the brain. The use of serotonin and dopamine has been addressed in schizophrenia due to the use of atypical antipsychotics in patients with schizophrenia. The finding of drug-induced OCS suggested that the two diseases share a similar pathogenesis involving neurotransmitters. Further studies are needed to make an exact diagnosis between the two diseases and to determine the common pathophysiology between OCD and schizophrenia.
Antipsychotic Agents ; Anxiety ; Brain ; Delusions ; Diagnosis, Dual (Psychiatry) ; Dopamine ; Humans ; Incidence ; Neurotransmitter Agents ; Obsessive Behavior ; Obsessive-Compulsive Disorder ; Prognosis ; Schizophrenia ; Schizotypal Personality Disorder ; Serotonin

OBJECTIVETo explore the clinical efficacy and safety of three-step acupuncture (TSA) combined with small dosage antipsychotic in treating incipient schizophrenia (IS).

METHODSSixty IS patients were randomly assigned to the test group and the control group equally. Patients in the test group received the combined therapy of TSA and antipsychotic, while patients in the control group were treated by full-dose antipsychotic, all for 8 weeks. The clinical efficacy was assessed by the positive and negative syndrome scale (PANSS), and the adverse reaction was evaluated by treatment emergent symptom scale (TESS).

RESULTSThe clinical efficacy in the two groups showed insignificant difference at the end of the 8-week treatment (P > 0.05), but the total scores of PANSS evaluated at the end of the 2nd and 4th week in the test group (74.26 +/- 9.54, 56.33 +/- 10.12) were significantly higher than those in the control group (85.56 +/- 9.73, 70.57 +/- 9.62), respectively (P < 0.05), furthermore, TESS analysis showed that the incidence of adverse reactions in nervous system and autonomic nervous system in the test group were also lesser than in the control group (P < 0.05).

CONCLUSIONThe combined therapy of TSA and small dose antipsychotic shows an efficacy equivalent to that of full-dose antipsychotic, but with shorter initiation time and less side effects.

Acupuncture Therapy ; methods ; Adolescent ; Adult ; Antipsychotic Agents ; administration & dosage ; Combined Modality Therapy ; Female ; Humans ; Male ; Psychiatric Status Rating Scales ; Schizotypal Personality Disorder ; therapy ; Young Adult