In order to study the relations between attentional deficits and social functioning of the schizophrenia, 83 stable outpatients with DSM-IV schizophrenia and matched 60 normal controls were examined for their sustained attention, sensory register, and social functioning by means of Continuous performance test(CPT), Span apprehension task(SPAN), and Korean version of Social Adjustment Scale II-Revised Version(KSAS II-RV) respectively. Psychopathology was assessed using the Positive and Negative Syndrome Scale(PANSS). The results were as follows. 1) Schizophrenic patients showed a significant deficit in the sustained attention and sensory register as manifested in the data of CPT and SPAN, compared with the matched normal controls. Schizohrenic patients also showed a significantly poor social functioning in measure of KSAS II-RV compared with the matched normal controls. 2) There was no correlation between three type of symptoms(positive/negative/general) and total scores of social functioning. But negative symptoms was correlated with the social leisure subarea of KSAS II-RV. 3) CPT was correlated with total scores of social functioning including the instrumental role and friend relation subareas of KSAS II-RV, whereas SPAN was only correlated with the instrumental role subarea of social functioning. 4) In the relations between attention and symptoms, CPT was correlated with negative symptoms. These results suggest that the deficit of the sustained attention may be a predictive factor of social functioning in the schizophrenic outpatients.
Diagnostic and Statistical Manual of Mental Disorders ; Friends ; Humans ; Leisure Activities ; Outpatients* ; Psychopathology* ; Schizophrenia ; Social Adjustment

OBJECTIVES: The purpose of this study is to examine differences of treatment responses and cognitive functions between typical antipsychotics and Olanzapine in schizophreniac inpatients. METHODS: Ninety-nine patients with schizophrenia treated by Olanzapine (n=56) or typical antipsychotics (n=43) by their attending were included in this study. Prior to entering the study, all subjects did not take any antipsychotics for at least 4 weeks. Cognitive and psychopathological evaluations were carried out on three times: prior to drug assignment immediately after admission (baseline), 3 months and 6 months after starting medications. Cognitive assessments were blinded to medication and psychopathological status. Cognitive functions were examined for sustained attention, sensory register, executive function, concentration and attention, and verbal memory and learning using Degraded Stimulus Continuous Performance Test, Span Apprehension Task, Wisconsin Card Sorting Test, Digit Span, and Rey Auditory Verbal Learning Test. RESULTS: The Olanzapine group presented a significantly greater improvement in the perseverative response, perseverative errors, number of completed categories of Wisconsin Card Sorting Test, forward Digit Span, immediate recall of Rey Auditory Verbal Learning Test, and positive and negative symptomatology than the typical antipsychotic group in the repeated-measures of ANCOVA among baseline, 3 month and 6 month assessments. These cognitive differences remained statistically significant after covarying out changes in symptomatology except forward Digit Span, which was affected by positive symptom in 3 month assessments. CONCLUSION: These data suggest that Olanzapine is associated with significantly greater symptomatic improvement and less cognitive than typical antipsychotics, and its benefits continued after 3 and 6 months of treatment in patients with schizophrenia.
Antipsychotic Agents ; Cognition* ; Executive Function ; Humans ; Inpatients ; Learning ; Memory ; Memory, Short-Term ; Schizophrenia* ; Verbal Learning ; Wisconsin

OBJECTIVE: The development of metabolic disorders including diabetes mellitus and hyperlipidemia has been reported among schizophrenia patients treated with atypical antipsychotic drugs. The role of antipsychotic drugs in the development of this condition has not been proven yet. This study was conducted to investigate whether antipsychotic drugs that often induce weight gain influence glucose and lipid metabolism including insulin resistance and serum leptin level. METHODS: The study population consisted of 63 patients (all meeting DSM-IV criteria for schizophrenia), who were divided into 3 treatment groups: haloperidol (N=21), risperidone (N=21), and olanzapine (N=21) monotherapy, and 31 healthy control subjects. Fasting blood samples for glucose, insulin, leptin and lipids were analysed. In addition, insulin resistance (IR) was calculated through the homeostatic model assessment (HOMA) and body mass index (BMI) was also calculated. RESULTS: In patients receiving olanzapine, significant increases in BMI (p<0.01) and lipid profiles including LDL-cholesterol (p<0.05), triglyceride (p<0.01) and leptin levels (p<0.001) were found in comparison with the normal control group. A significantly higher degree of IR, as measured with the HOMA index, was found in patients receiving olanzapine than in patients receiving haloperidol (p<0.01) and risperidone (p<0.05), and in the normal control group (p<0.01). After removal of the impacts of BMI on the degree of HOMA-IR and serum leptin levels, the degree of HOMA-IR (p<0.05) and serum leptin levels (p<0.001) was also higher in patients receiving olanzapine than in the normal control group. CONCLUSION: The results of this study suggest that olanzapine has more significant influence on metabolic complications than haloperidol and risperidone and the characteristics of antipsychotic drug per se may be involved in the development of metabolic complication as well as weight change.
Antipsychotic Agents* ; Body Mass Index ; Diabetes Mellitus ; Diagnostic and Statistical Manual of Mental Disorders ; Fasting ; Glucose* ; Haloperidol ; Humans ; Hyperlipidemias ; Insulin ; Insulin Resistance ; Leptin ; Lipid Metabolism* ; Risperidone ; Schizophrenia* ; Triglycerides ; Weight Gain

It was aimed to investigate the effect of 5-HT2C receptor modulation on the rat behavioral responses induced by 1-(m-chlorophenyl) piperazine(mCPP), a major metabolite of trazodone. The animal activities(ambulation, stereotypy and total activity) were measured for 3 hours following mCPP administration, using an animal activity meter which accumulates the frequency of light beam interruption. mCPP(1-10 mg / kg, i.p.) induced dose-dependent decreases in ambulation and stereotypy, consequently leading to hypoactivity. The hypoactivity induced by mCPP(1mg / kg, i.p.) was significantly inhibited by pretreatment with mianserin(1mg / kg, i.p.), an antagonist with high affinity for 5-HT2C receptor, whereas pretreatment with 5-HT2 antagonists, ketanserin and ritanserin(1mg / kg, i.p., respectively) was without effect. Furthermore, long-term pretreatment with imipramine(10mg / kg, i.p., b.i.d. for 2 weeks) markedly attenuated the mCPP-induced hypoactivity. Mianserin and imipramine in the absence of mCPP did not increase the animal activity. Taken together, these results indicate that the mCPP-induced hypoactivity is mediated by 5-HT2C receptor, and that selective 5-HT2C antagonists and down regulation of 5-HT2C receptor might be useful for inhibiting the mCPP-induced hypoactivity.
Animals ; Down-Regulation ; Imipramine ; Ketanserin ; Mianserin ; Rats ; Receptor, Serotonin, 5-HT2C* ; Serotonin 5-HT2 Receptor Antagonists ; Trazodone ; Walking

In order to investigate the factors associated with family burdens of schizophrenics, 92 primary caregivers and 68 siblings of 92 persons with schizophrenia were examined by means of self-report scales about the effect of positive and negative symptom behaviors, clinical and sociodemographic variables, and guilty feelings toward patient on the objective and subjective burden. The results were as follows. 1) There was no difference in the objective and subjective burden scores between the primary caregivers and siblings, even though the former showed a higher scores compared to the latter. 2) Burden scores were significantly affected by the factors such as age of patients, duration of illness, total duration of hospitalizations, monthly family income, and the experience of family education in the primary caregivers or siblings of schizophrenics. 3) Objective and subjective burden were related to both the severity of positive, negative, and the other symptom behaviors in the primary caregivers and siblings. The positive and negative symptom behaviors were more related to subjective burdens compared to objective burdens in the primary caregivers and siblings. The positive symptom behaviors were more related to perceived objective and subjective burdens compared to negative symptom behaviors in the siblings. 4) The correlations between guilty feelings toward patient and burden scores was significant only in the primary caregivers. These results could be used as useful datas to develop the more effective family intervention for reducing family burden.
Caregivers* ; Education ; Hospitalization ; Humans ; Schizophrenia ; Siblings* ; Weights and Measures

In order to evaluate whether Wisconsin Card Sorting Test(WCST) could be used to detect the vulnerability markers of schizophrenia, three groups such as offsprings of schizophrenic patients(n=28), offsprings of alcoholic patients(n=18), and offsprings of psychiatrically normal persons(n=41) were examined for their concept formation and abstract thinking by means of WCST.The results were as follows; 1) No significant differences were noted in all variables of the WCST such as number of totol administered trials, total correct response %,total error response $,perseverative response %,perseverative error response %,nonperseverative error response %,conceptual level response %,number of completed category,number of trials to complete 1st category,number of failure to maintain a set,and learning to learn among three groups. 2) There was no difference in the number of cases with extreme low WCST total correct % of lower 10% of the normal controls among three groups. These results suggest that Wcst could be an ineffective instrument for using to detect the vulnerability markers of schizophrenia.
Alcoholics ; Concept Formation ; Humans ; Learning ; Schizophrenia ; Thinking ; Wisconsin*

OBJECTIVES: Psychotic Symptom Rating Scale (PSYRATS) is an assessment tool to measure the severity of different dimensions of auditory hallucinations and delusions. The reliability and validity of the Korean version of PSYRATS (K-PSYRATS) were examined in Korean patients with major psychosis. METHODS: The inter-rater reliability of the K-PSYRATS was determined from the videotaped interviews of the five schizophrenic patients. To measure validity and internal consistency reliability, the 109 patients with auditory hallucinations or delusions were assessed using the K-PSYRATS, Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression-Severity (CGI-S) scale. RESULTS: K-PSYRATS was found to have excellent inter-rater reliability (intra-class correlation coefficient of auditory hallucination= 0.81, p<.001, intra-class correlation coefficient of delusion=0.97, p<.001) and internal consistency reliability (Cronbach's alpha of auditory hallucination=0.77, Cronbach's alpha of delusion=0.76). Significant correlation was found between K-PSYRATS and positive syndrome subscale of PANSS and CGI. CONCLUSION: K-PSYRATS is a useful assessment instrument for psychotic symptoms in Korea.
Delusions ; Hallucinations ; Humans ; Korea ; Psychotic Disorders ; Reproducibility of Results*

OBJECTIVE: The purpose of this study was to evaluate the validity and reliability of Korean version of Addiction Severity Index for the systematic diagnosis and evaluation of alcoholism. METHODS: The authors selected 65 alcoholic patients with the criteria of DSM-VI. RESULTS: The results were as follows: 1) The exception of the significant correlation between psychiatric and the family/social problem area, the 6 sections of ASI were mutually independent. 2) There was significant inter-rater reliability in all sections of ASI. 3) In medical, alcohol use, family/social and psychiatry section, the calculation of composite score showed reasonable level of item consistency. In all sections, there was significant correlation between composite scores and severity ratings of corresponding section. 4) The important items of each section were most highly correlated with their corresponding severity ratings except two sections. 5) In the multiple regression analysis, the amount of variance accounted far by the most important 4 items were 83% in medical section, 45% in employment/support,43% in alcohol use section, 55% in legal section,53% in family/social section and 84% in psychiatric section. 6) Severity rating of psychiatric section was significantly correlated with the scores of MMFI, MAST and SCL-90-R. CONCLUSION: The result suggests that Korean version of the ASI showed relatively reasonable reliability and validity and it can be used in treatment and study of alcoholic patients.
Alcoholics* ; Alcoholism ; Diagnosis ; Humans ; Reproducibility of Results*

In order to study the possible vulnerability in the markers of schizophrenia, offsprings of the schizophrenic parents(n=28), offsprings of the alcohol dependent parents(n=18), and offsprings of the psychiatrically normal persons(n=41) were examined for their sustained attention and sensory register by means of Continuous performance test(CPT) and Span apprehension task(SPAN) respectively. The results were as follows: 1) The offsprings of the schizophrenic parents showed a significant deficit in the sustained attention as manifested in the data of CPT by significantly lower hit rate and sensitivity, compared with the offspring of the alcohol dependent parents and those of the psychiatrically normal persons. No difference was evident in the false alarm rate and response bias among three groups. There was no difference in all variables of the CPT between the offsprings of the alcohol dependent parents and those of the psychiatrically normal persons. 2) The deficit in the sustained attention as revealed by lower hit rate and sensitivity was not apparent in the first part of the CPT. However it emerged and aggravated itself as the test continued in the offsprings of the schizophrenic parents only. 3) Proportion of subjects falling in the extreme low sensitivity of lower 10% of the normal controls was significantly higher in the offsprings of the schizophrenic parent group as compared with the offsprings of the alcohol dependent parents and those of the psychiatrically normal persons with a rate of 29%, 17%, and 10% respectively. 4) No significant difference was noted in all variables of MMPI among normal controls, index group, and the extreme low CPT sensitivity subgroup of index group. 5) The offsprings of the schizophrenic parents showed a significantly delayed response in the time to correct and incorrect response in SPAN compared to offsprings of the alcohol dependent parents and those of the psychiatrically normal persons. No difference was evident in the number of correct response, number of incorrect response, and number of no response among three groups. There was no difference in all variables of the SPAN between the offsprings of the alcohol dependent parents and those of the psychiatrically normal persons. These results suggest that a subgroup of the offsprings of schizophrenic parents may suffer from the deficit in the sustained attention which may be a vulnerability marker of schizophrenia.
Automatic Data Processing ; Bias (Epidemiology) ; Humans ; MMPI ; Parents* ; Schizophrenia

OBJECTIVES: Previous studies have shown that the endogenous opioid system, which plays an important role in drinking behavior, might be related to the genetic etiology of alcohol dependence. And a recent study reported that the affinity of micro opioid receptor, which is closely related to the endogenous opioid system activity, is affected by the genotype of micro opioid receptor gene (OPRM1) A118G. To investigate the gender difference in genetic etiology of alcohol dependence, this study examined the association of the genotype of OPRM1 A118G with female alcohol dependence in Koreans. METHODS: The author studied the genotype of OPRM1 A118G in 106 male and 35 female Korean with alcohol dependence and 80 male and 60 female healthy Koreans as control. RESULTS: 1) A statistically significant increase in A/G or G/G (G+) genotype of OPRM1 A118G was observed in women with alcohol dependence compared to the controls. 2) Among men with alcohol dependence, no significant difference in OPRM1 A118G polymorphism was observed relative to the age at which drinking started, age of onset of alcohol-related problems, age of first admission to psychiatric hospital for alcohol-related problems, drinking days per month, drinks per drinking day, family history of alcohol dependence in the first-degree relatives or history of severe alcohol withdrawal symptoms. But the drinking days per month is significantly less in those who have A/G or G/G genotypes of OPRM1 A118G. CONCLUSION: These results suggest that G+ genotypes of micro opioid receptor gene A118G are important genetic factors in the etiology of female alcohol dependence.
Age of Onset ; Alcoholics* ; Alcoholism ; Drinking ; Drinking Behavior ; Female* ; Genotype* ; Hospitals, Psychiatric ; Humans ; Male ; Receptors, Opioid* ; Substance Withdrawal Syndrome