1.Eveningness, Sleep Patterns, Daytime Sleepiness and Fatigue in Korean Male Adolescents.
Shi Hyun KANG ; Hanik K YOO ; Seockhoon CHUNG ; Chang Yoon KIM
Sleep Medicine and Psychophysiology 2012;19(2):89-96
OBJECTIVES: Individuals differ in their biological rhythms. This study investigated the association between the morningness-eveningness and sleep patterns, daytime sleepiness and fatigue in Korean male adolescents. METHODS: Participants were 501 eleventh grade male students (16.9+/-0.2 years of age) in one male high school in Seoul. Each student completed the Korean translation of composite scale (KtCS), Epworth sleepiness scale (ESS), Fatigue Severity Scale (FSS) and a questionnaire about their sleep schedule. RESULTS: The evening group had shorter weekday sleep time than the intermediate (p<0.001) or morning group (p=0.029). The evening group had more daytime napping (16.8%, p<0.001), high rate of caffeine use (58.8%, p<0.001) and snoring (18.5%, p=0.037). The evening group showed more daytime sleepiness (8.7, SD=3.2, p<0.001) and severe fatigue (4.4, SD=1.2, p<0.001) than the intermediate or morning group. CONCLUSION: Adolescents with eveningness have higher problems in weekday sleep, daytime sleepiness and fatigue. An intervention program for sleep problem in these adolescents should be considered.
Adolescent
;
Caffeine
;
Fatigue
;
Humans
;
Male
;
Surveys and Questionnaires
;
Snoring
2.Eveningness, Sleep Patterns, Daytime Sleepiness and Fatigue in Korean Male Adolescents.
Shi Hyun KANG ; Hanik K YOO ; Seockhoon CHUNG ; Chang Yoon KIM
Sleep Medicine and Psychophysiology 2012;19(2):89-96
OBJECTIVES: Individuals differ in their biological rhythms. This study investigated the association between the morningness-eveningness and sleep patterns, daytime sleepiness and fatigue in Korean male adolescents. METHODS: Participants were 501 eleventh grade male students (16.9+/-0.2 years of age) in one male high school in Seoul. Each student completed the Korean translation of composite scale (KtCS), Epworth sleepiness scale (ESS), Fatigue Severity Scale (FSS) and a questionnaire about their sleep schedule. RESULTS: The evening group had shorter weekday sleep time than the intermediate (p<0.001) or morning group (p=0.029). The evening group had more daytime napping (16.8%, p<0.001), high rate of caffeine use (58.8%, p<0.001) and snoring (18.5%, p=0.037). The evening group showed more daytime sleepiness (8.7, SD=3.2, p<0.001) and severe fatigue (4.4, SD=1.2, p<0.001) than the intermediate or morning group. CONCLUSION: Adolescents with eveningness have higher problems in weekday sleep, daytime sleepiness and fatigue. An intervention program for sleep problem in these adolescents should be considered.
Adolescent
;
Caffeine
;
Fatigue
;
Humans
;
Male
;
Surveys and Questionnaires
;
Snoring
3.Eosinophilia, Pleural Effusion, Hepatitis, and Jaundice Occurring Early in Clozapine Treatment.
Clinical Psychopharmacology and Neuroscience 2013;11(2):103-105
Clozapine use is associated with various adverse events, some of which have received little attention, including eosinophilia, pleural effusion, and hepatitis. Because of the fatality of jaundice with hepatitis, it is necessary to understand the course and management of clozapine-induced eosinophilia and hepatitis. We report on a case in which the eosinophil count began to increase shortly after clozapine use, and pleural effusion and fever then developed at the time eosinophilia was at its peak level. Jaundice with hepatitis consecutively developed when all the above symptoms subsided. The liver function recovered rapidly after clozapine was discontinued. We recommend that patients who develop rapid eosinophilia at the beginning of clozapine treatment should be monitored with LFTs, chest X-rays, and urine analysis tests.
Clozapine
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Eosinophilia
;
Eosinophils
;
Fever
;
Hepatitis
;
Humans
;
Jaundice
;
Liver
;
Pleural Effusion
;
Thorax
4.Metabolic Disturbances Independent of Body Mass in Patients with Schizophrenia Taking Atypical Antipsychotics.
Psychiatry Investigation 2015;12(2):242-248
OBJECTIVE: Atypical antipsychotic (AAP) treatment is associated with weight gain and metabolic disturbances such as dyslipidemia and dysglycemia. The metabolic disturbances are usually considered to develop secondary to weight gain. We performed the comparison of metabolic disturbances of three AAP group with different risk of metabolic side effect after adjusting for body mass to investigate whether any metabolic disturbances develop independently from body mass index (BMI). METHODS: This cross-sectional study included 174 subjects with schizophrenia who were on 1) monotherapy with clozapine (CL), olanzapine (OL), or quetiapine (QT) (n=61), 2) monotherapy with risperidone (RSP) (n=89), or 3) monotherapy with aripiprizole (ARP), or ziprasidone (ZPS) (n=24) more than 1 year. Association between the prevalence of metabolic disturbances and groups were analysed using logistic regression after adjusting confounding variables including BMI. Analysese of covariance were used to compare the AAP groups in terms of the levels of metabolic parameters. RESULTS: There were significant differences among groups in terms of the prevalence of hypertriglyceridemia (p=0.015), low HDL-cholesterol (p=0.017), and hyperglycemia (p=0.022) after adjusting for BMI. Triglyceride level (p=0.014) and the ratio of triglyceride to HDL-cholesterol (p=0.004) were significantly different among groups after adjusting for BMI. CONCLUSION: In conclusion, metabolic disturbances are significantly different in AAP groups even after adjusting BMI. AAPs may have direct effect on metabolic parameters. Blood lipid and glucose levels should be monitored regularly regardless of whether patients tend to gain weight.
Antipsychotic Agents*
;
Body Mass Index
;
Clozapine
;
Confounding Factors (Epidemiology)
;
Cross-Sectional Studies
;
Dyslipidemias
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Glucose
;
Humans
;
Hyperglycemia
;
Hypertriglyceridemia
;
Logistic Models
;
Prevalence
;
Risperidone
;
Schizophrenia*
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Triglycerides
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Weight Gain
;
Quetiapine Fumarate
5.Cognitive Behavioral Therapy for Psychosis
Korean Journal of Schizophrenia Research 2022;25(1):10-16
Cognitive behavioral therapy for psychosis (CBTp) is recommended by the National Treatment Guidelines in both the U.K. and the U.S. Consistent reports of moderate effect sizes have led to such interventions being suggested as part of routine clinical practice. However. Access to CBTp is poor due to a variety of factors, including training and resources. Therapeutic developments should be based on the theoretical understanding of cognitive models and psychological process associated with stress-vulnerability model. Cognitive models of psychosis incorporate the role of negative core beliefs, hypervigilance for threat, scanning for confirmatory evidence and safety behavior. The current evidence about CBTp is reviewed regarding various methods such as low-intensity of CBTp, different formats of therapy (e.g., individual or group), and phase of illness (e.g., acute or treatment-resistant) of subjects. This review suggests that that patients with psychosis with various disease phase need to be derived more benefit from appropriate adjunctive CBTp.
6.Change of Prescribing Pattern after Clozapine Discontinuation: A Retrospective Chart Review
Korean Journal of Schizophrenia Research 2021;24(1):36-43
Objectives:
Despite the high discontinuation rate of clozapine in refractory schizophrenia, there is limited evidence regarding the suggested treatment after clozapine discontinuation.
Methods:
The medical records of 37 patients who discontinued clozapine were retrospectively reviewed. The prescription patterns of antipsychotics, mood stabilizers, and antidepressants were compared at three points before and after clozapine treatment and at the most recent visit.
Results:
After clozapine discontinuation, 75.6% of the subjects were receiving antipsychotic polypharmacy, and 32.4% were taking more than 3 antipsychotics. The frequently used antipsychotics were olanzapine (21.5%), quetiapine (21.5%), and paliperidone (12.7%). The rates of augmentation with mood stabilizers and antidepressants were 43.2% and 29.7%, respectively. Furthermore, valproate was the most commonly used mood stabilizer (87.5%).
Conclusion
Antipsychotic polypharmacy and augmentation are inevitable in schizophrenia patients for whom clozapine has been discontinued. Further research is required to improve the outcomes of polypharmacy and augmentation in schizophrenia patients.
7.Change of Prescribing Pattern after Clozapine Discontinuation: A Retrospective Chart Review
Korean Journal of Schizophrenia Research 2021;24(1):36-43
Objectives:
Despite the high discontinuation rate of clozapine in refractory schizophrenia, there is limited evidence regarding the suggested treatment after clozapine discontinuation.
Methods:
The medical records of 37 patients who discontinued clozapine were retrospectively reviewed. The prescription patterns of antipsychotics, mood stabilizers, and antidepressants were compared at three points before and after clozapine treatment and at the most recent visit.
Results:
After clozapine discontinuation, 75.6% of the subjects were receiving antipsychotic polypharmacy, and 32.4% were taking more than 3 antipsychotics. The frequently used antipsychotics were olanzapine (21.5%), quetiapine (21.5%), and paliperidone (12.7%). The rates of augmentation with mood stabilizers and antidepressants were 43.2% and 29.7%, respectively. Furthermore, valproate was the most commonly used mood stabilizer (87.5%).
Conclusion
Antipsychotic polypharmacy and augmentation are inevitable in schizophrenia patients for whom clozapine has been discontinued. Further research is required to improve the outcomes of polypharmacy and augmentation in schizophrenia patients.
8.Attitude Toward Illness and Treatment in Adherent Schizophrenia Patients: A Qualitative Study
Journal of Korean Neuropsychiatric Association 2020;59(2):159-165
Objectives:
The adherence to antipsychotics is essential for relapse prevention in schizophrenia. Although 40–60% of schizophrenia patients suffer from non-adherence problems, some patients had consistently good adherence. They are clinically desirable examples of non-adherent patients. This qualitative study aimed to explore the actors influencing medication adherence in people with schizophrenia with good adherence to the patients’ perspectives.
Methods:
In-depth semi-structured interviews were conducted with 23 subjects with schizophrenia. Narratives were elicited on the attitudes toward illness and treatment, familiar support for treatment, and perceived stigma about psychosis over time.
Results:
In the process of changing from non-adherence to adherence, symptomatic relapse, involuntary treatment, and familial support played leading roles. The patients’ experiences on their own made them accept the illness and necessity of medications. Once the patients accepted the need for treatments, side effects and social stigma did not influence their adherence. Reducing psychotic symptoms was the priority of the treatment effects on the patients’ perspectives.
Conclusion
Adherence in schizophrenia requires multiple factors that affect the attitude toward illness and medication over time. Therefore, it is necessary to understand the specific process of adherence and develop the relevant interventions to facilitate those processes over time.
9.Therapeutic effect of gabexate mesilate as therapy for childhood DIC.
Jo Won JUNG ; Sook Hyun PARK ; Shi Hey KANG ; Chuhl Joo LYU ; Chang Hyun YANG ; Kir Young KIM
Korean Journal of Hematology 1991;26(1):93-101
No abstract available.
Dacarbazine*
;
Gabexate*
10.Two Cases of Reversible Neutropenia Associated with Olanzapine-Valproate Combination Treatment.
Shi Hyun KANG ; Jung Keun OH ; Jong Il LEE ; An Kee CHANG
Journal of Korean Neuropsychiatric Association 2010;49(6):653-656
The novel antipsychotic, olanzapine, has structural and pharmacological properties similar to clozaine. Antipsychotic drugs, as well as mood stabilizers, can cause neutropenia, which can progress to life-threatening agranulocytosis if the medication is not discontinued. We report two cases of reversible neutropenia associated with a olanzapine-valproate combination treatment. This report suggests that patients treated with the combination of olanzapine and valproate should be monitored for the occurrence of leukopenia and neutropenia.
Agranulocytosis
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Antipsychotic Agents
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Benzodiazepines
;
Humans
;
Leukopenia
;
Neutropenia
;
Valproic Acid