OBJECTIVE: Weight gain is a commonly encountered problem associated with atypical antipsychotics, especially olanzapine. To investigate the weight reducing effect of amantadine, we conducted an prospective open label study. METHODS: We started amantadine treatment in outpatients who had gained weight during olanzapine treatment (mean dose of 11.94 mg/day, mean weight gain of 6.33 kg). Data were collected at St. Mary's Hospital, College of Medicine, The Catholic University of Korea. The add-on treatment of amantadine was given at a mean dose of 161.9 mg/day with mean duration of administration for 110.2 day. Brief Psychiatric Rating Scale (BPRS), Extrapyramidal Symptom Scale were checked to evaluate the tolerability of amantadine. RESULTS: Before administration of amantadine, the mean dose of olanzapine was 11.94+/-4.58 mg and mean duration of administration was 123.1+/-174.6 days. Body weight and BMI during this period was significantly increased mean 6.33+/-4.45 kg (Z=-3.839, p<0.001), 4.94+/-0.75 (Z=-3.724, p<0.001) respectively. Amantadine was administered mean dose of 161.90+/-58.96 mg for mean 110.2+/-78.7 days. Body weight and BMI was decreased mean 0.96+/-3.44 kg, 0.71+/-2.7, respectively. There was no deterioration in psychiatric symptoms, as shown in BPRS score decrement and no adverse effects were reported. CONCLUSION: The present data suggests that amantadine does not significantly decrease weight gain experienced by some patients during olanzapine treatment and does not worse psychotic symptoms. Randomized placebo-controlled trial should be needed to confirm these findings.
Amantadine* ; Antipsychotic Agents ; Body Weight ; Brief Psychiatric Rating Scale ; Humans ; Korea ; Outpatients ; Prospective Studies ; Weight Gain*

OBJECTIVE: Recently, the domestic use of risperidone and the studies of risperidone administration in naturalistic setting have been increased. This retrospective naturalistic study was designed to evaluate the prescription trend and related variables in risperidone administered-psychiatric inpatients at a university hospital, and to compare with those of a university hospital in USA, simultaneously. METHODS: Data of 42 psychiatric inpatients with first administration of risperidone at St. Mary's Hospital from Oct 1999 to Mar 2000 and 61 of McLean Hospital, Harvard Medical School, USA from Mar 1998 to Jun 1998, were collected, respectively. Data on patient's age, sex, number of past admission, diagnosis distribution, duration of hospitalization, multiple antipsychotic therapy, combined psychotropics, initial, maximal, and discharge dosage of risperidone were analyzed and compared. RESULTS: In forty-two patients of St. Mary's hospital, 17 were male and 25 were female, among sixty-one patients of McLean hospital, 23 were male and 38 were female. The mean age and number of past admission were significantly higher at St. Mary's hospital than McLean hospital. In terms of diagnosis, risperidone was most widely prescribed to psychotic disorder, nextly to mood disorder and other psychiatric disorder at St. Mary's hospital, but in order of mood disorder, other psychiatric disorder, and psychotic disorder at McLean hospital, these diagnostic distribution was significantly different. The mean initial dose, maximal dose, and discharge dose of risperidone were significantly higher at St. Mary's hospital than McLean hospital. In aspects of psychotropic combination, these were significantly different, anxiolytic was most highly used at St. Mary's hospital but antidepressant at McLean hospital, additionally, the two hospital have tendency to take a polypharmacy. CONCLUSION: Prescription trend of risperidone in psychiatric inpatient between two hospital was different, St. Mary's hospital prescribed risperidone by diagnosis but McLean hospital did by symptomatic management. In furture, further systematic study should be conducted to refine these differences including various clinical variables.
Diagnosis ; Female ; Hospitalization ; Humans ; Inpatients* ; Korea* ; Male ; Mood Disorders ; Polypharmacy ; Prescriptions* ; Psychotic Disorders ; Retrospective Studies ; Risperidone* ; Schools, Medical

OBJECTIVE: This study was designed to identify the role of serotonin and cortisol in the pathophysiology of schizophrenia by measuring quantitative change of serum cortisol levels after risperidone(5HT2 antagonist) administration. METHOD: Subjects included 10 male and 7 female patients who met DSM-IV criteria for schizophrenia(n=17). Blood samples(4ml/sample) were taken at the baseline, 1st, 2nd, 3rd, 14th, 28th and 42nd days, twice, at 8:00 AM and at 10:00 AM in the morning after an overnight fast. The daily medication was administered after the first blood sampling at 8:00 AM. After baseline sampling, the same dose of risperidone was administered to each patient until the end of the 3rd day. The dose of risperidone was then decided by clinical evaluation. Serum cortisol concentrations were measured by standard double-antibody radioimmunoassay. RESULT: 1) Administration of risperidone significantly decreased serum cortisol levels(p<0.05). 2) There were significant reductions in positive symtom scores(21.7+/-3.8, vs 14.3+/-4.1) and negative symptom scores(20.5+/-5.2, vs 15.2+/-3.2), general symptom scores(44.3+/-5.4, vs 32.9+/-4.2) of PANSS after risperidone administration(p<0.05). 3) There were no significant differences in baseline serum cortisol levels and the reductions of serum cortisol levels after administration of risperidone between males and females. 4) There were no significant differences in baseline serum cortisol levels and the reductions of serum cortisol levels after administration of risperidone between positive symptom subgroup and negative symptom subgroup. CONCLUSION: These results suggest risperidone decreases serum cortisol levels in s chizophrenic patients and the reduction of cortisol by risperidone administration might be important factor in the treatment of schzophrenics, in contrast with typical antipsychotics.
Antipsychotic Agents ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Hydrocortisone* ; Male ; Radioimmunoassay ; Risperidone* ; Schizophrenia ; Serotonin

OBJECTIVE: Schizophrenia is known to have high genetic influences. Recently, the main focus of etiologic study in schizophrenia has been concentrated on molecular genetic approach including polymorphism analysis. This study was designed to investigate the relationship between schizophrenia and immunologic influences by analyzing polymorphism of TNFB that is involved in interaction between immunologic system and CNS. METHOD: 146 schizophrenic patients diagnosed by DSM-IV criteria were included and data of 206 normal population from the Catholic Hemopoietic Stem Cell Information Bank(Seoul, Korea) were used as a control group in this study. DNA was extracted from whole blood, thereafter amplified by polymerase chain reaction, and digested by NcoI. We obtained and assessd RFLP of two alleles, TNFB1 which has a NcoI restriction site generating 555bp and 185bp fragments, and TNFB2 which lacks the NcoI restriction site. All data were analyzed by K 2 test. RESULTS: There were no significant differences in frequency of TNFB1/1, TNFB1/2, and TNFB2/2 between the schizophrenic patient and the control group. Alleric frequencies of TNFB1 and TNFB2 were significantly different between schizophrenic patient and control group. CONCLULSION: We found the possible association between alleles of TNFB and schizophrenia in this study. To clarify the influences of TNFB on schizophrenia, further systematic studies should be conducted.
Alleles ; Diagnostic and Statistical Manual of Mental Disorders ; DNA ; Humans ; Molecular Biology ; Necrosis* ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length* ; Schizophrenia* ; Stem Cells

PURPOSE: People with a family history of mood disorder are more likely to have depression. This study compared the characteristics of non-psychotic major depression disorder according to family history of depression. METHOD: Subjects were total of 817 persons recruited for the CRESCEND-K multicenter trial. Characteristics of depression and suicide history of patients with and without a family history of depression were assessed. Family history was determined through self-report. RESULTS: Of 817 participants, 12.4% had a positive family history of depression. Those with family history of depression reported an earlier age at onset of MDD, and more psychiatric comorbidity. Severity of depression and anxiety were not different according to family history of depression. There were no difference in attempted suicide history, number of attempted suicide and age at onset of 1st attempted suicide according to such a family history. CONCLUSION: Patients with family history of depression reported earlier onset of MDD and more history of psychiatric comorbidity.
Anxiety ; Comorbidity ; Depression ; Depressive Disorder, Major ; Humans ; Mood Disorders ; Suicide ; Suicide, Attempted

Purpose: We hypothesized that a radiomics approach could be employed to classify children with growth hormone deficiency (GHD) and idiopathic short stature (ISS) on sella magnetic resonance imaging (MRI). Accordingly, we aimed to develop a radiomics prediction model for differentiating GHD from ISS and to evaluate the diagnostic performance thereof. Materials and Methods: Short stature pediatric patients diagnosed with GHD or ISS from March 2011 to July 2020 at our institution were recruited. We enrolled 312 patients (GHD 210, ISS 102) with normal sella MRI and temporally split them into training and test sets (7:3). Pituitary glands were semi-automatically segmented, and 110 radiomic features were extracted from the coronal T2-weighted images. Feature selection and model development were conducted by applying mutual information (MI) and a light gradient boosting machine, respectively. After training, the model’s performance was validated in the test set. We calculated mean absolute Shapley values for each of the selected input features using the Shapley additive explanations (SHAP) algorithm. Volumetric comparison was performed for GHD and ISS groups. Results: Ten radiomic features were selected by MI. The receiver operating characteristics curve of the developed model in the test set was 0.705, with an accuracy of 70.6%. When analyzing SHAP plots, root mean squared values had the highest impact in the model, followed by various texture features. In volumetric analysis, sagittal height showed a significant difference between GHD and ISS groups. Conclusion Radiomic analysis of sella MRI may be able to differentiate between GHD and ISS in clinical practice for short-statured children.

OBJECTIVE: Major depressive disorder is known to have high genetic predisposition and the main focus of recent genetic studies in major depressive disorder has been concentrated on association studies between genetic polymorphism and disease, since molecular genetic methods have been developed. This study was designed to investigate the relationship between major depressive disorder and immunogenetic influences by analyzing polymorphism of TNFB gene, which is involved in interaction of immune system and CNS. METHOD: 95 persons who had been diagnosed of major depressive disorder were assigned as patient group and, 202 data obtained from Catholic hemopoietic stem cell bank, College of medicine, the Catholic University of Korea, were used as normal controls in this study. DNA was extracted from whole blood, thereafter amplified by polymerase chain reaction, and digested by NcoI. After that procedure, we obtained and assessd restriction fragment length polymorphism of two alleles, TNFB*1 which has 555bp and 185bp fragments and carries the NcoI restriction site, and TNFB*2 of 740 bp fragment lacks the NcoI restriction site. All data were analyzed by x2 test with two-tailed Fisher's exact test. RESULTS: 1) The frequencies of TNFB*1/1, TNFB*1/2, and TNFB*2/2 were not statistically different between major depressive disorder patients and control group. 2) The frequencies of TNFB*2 and TNFB*1 were not statistically different between major depressive disorder patient group and normal control group. CONCLUSION: We did not verified the differences of frequency in TNFB*1/TNFB*2 gene between the major depressive disorder and normal controls, respectively. Consequently, there is no genetic relationship between major depressive disorder and gene polymorphism of TNFB. We do suggest that further systematic studies including various clinical variables should be conducted.
Alleles ; Depressive Disorder* ; Depressive Disorder, Major ; DNA ; Genetic Predisposition to Disease ; Humans ; Immune System ; Immunogenetics ; Korea ; Lymphotoxin-alpha* ; Molecular Biology ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length ; Stem Cells ; Tumor Necrosis Factor-alpha*

OBJECTIVES: This study was conducted to evaluate the prescription patterns, overall efficacy, and safety of atypical antipsychotics for inpatients with bipolar I disorder. METHODS: Inpatients with bipolar I disorder, who had received adjunctive treatment with olanzapine or risperidone, beyond 1 month, along with mood stabilizers were selected for a retrospective study. The charts of those patients(N=56) were reviewed for the details of efficacy, safety, and other pharmacological variables of the two drugs. RESULTS: Olanzapine and risperidone showed equivalent efficacy by the evaluation in accordance with clinical global impression scale (CGI) and global assessment of functioning scale(GAF) score. Different side effect profiles were noted between two drugs. CONCLUSION: These limited results suggested that the efficacy and safety of risperidone and olanzapine were similar for the treatment of inpatients with bipolar I disorder. Prospective controlled study for efficacy and safety of risperidone and olanzapine in the treatment of bipolar I disorder should be conducted in future.
Antipsychotic Agents ; Humans ; Inpatients* ; Prescriptions ; Retrospective Studies ; Risperidone

OBJECTIVE: This retrospective naturalistic study was designed to compare the clinical characteristics including psychopathology of two groups of patients, long-term maintenance group and short-term drop-out group, who were taking risperidone. METHOD: Datas were collected for 210 schizophrenic patients with complete medical records among 580 patients who were enrolled with risperidone administration from January 1996 to December 1996 in 8 affiliated hospital of the Catholic University. The short-term drop-out patients group were assigned to whom treatment period was less than 6 month, and the long-term maintained patients group, treatment period was more than 2 years. We assessed demographics, psychopathology, and other variables related with medication based on past medical records. RESULTS: Among subjects of 210, short-term drop-out patients group were 67(31.9%) and long-term maintained patients group were 143(68.1%). Demographics and psychopathology were not significantly different between two groups. The starting and maximal dosage of risperidone was not significantly different between two groups but the maintenance dosage of risperidone was lower in long-term medicated patients group than short-term drop-out patients group(t=3.698, p<0.05). Additionally, the result of this study showed differences in experiences of past antipsychotic use as following. The number of no previous use of antipsychotic was 39(58.2%), the number of high potency antipsychotic use was 27(40.3%), and the number of low potency antipsychotic use was 1(1.5%) in short-term drop-out group. The number of no previous use of antipsychotic was 58(40.6%), the number of high potency antipsychotic use was 77(53.8%), the number of low potency antipsychotic use was 8(5.6%) in long-term maintained group(X 2=6.559, df=2, p<0.05). CONCLUSION: According to these results, administration of low therapeutic dosage should be recommended for long-term maintenance as if possible. Multi-center based retrospective naturalistic study like this would be useful for getting informations about efficacy and some other aspects of antipsychotic administration in practical field.
Demography ; Hospitals, University* ; Humans ; Medical Records ; Psychopathology ; Retrospective Studies ; Risperidone*