OBJECTS: The purpose of this study was to present a model of inpatient group psychotherapy led by a doctor in charge, to evaluate this model in practice, and to give a effective inpatient treatment by application of this model. METHODS: The subject composed of 25 psychiatric inpatient. The authors performed this model of group psychotherapy for 6 months and evaluate this model by objective data. Also we analyzed this model globally to get comprehensive understandings. RESULTS: The results of the objective data were as follows: 1) This model was effective to subside patients' symptoms. And the patients estimated this model to be important and helpful to them. 2) Identification with therapist' among therapeutic factors was high rank. This meant that therapist him- or her-self is a important tool for therapy. 3) Therapeutic factors in upper level group was much different from those in lower level group. And various therapeutic factors was used complementarily between two groups. 4) To check '13 therapeutic factors' repeatedly made the patients acquire therapeutic factors spontaneously. And to check 'the most important event' repeatedly gave the opportunity of self-reflection. The results of global analysis to this model were as follows: 1) This group psychotherapy gave a field in which a therapist met patients as human being. 2) This model was easy to perform, and helpful to a comprehensive therapeutic approach. 3) This model was able to make the basis of continuous outpatient and day hospital treatment, and the basis of outpatient group psychotherapy or individual psychotherapy. 4) In this model, social workers, nurses, or students in practice played a role of the healthy ego. Therefore they were able to activate group psychotherapy. 5) This model was a practical and useful tool of the education for psychiatric residents, medical students, social works, and other students. CONCLUSION: This model of group psychotherapy was useful f3r inpatient treatment and easy to perform in general.
Education ; Ego ; Humans ; Inpatients* ; Outpatients ; Psychiatry* ; Psychotherapy ; Psychotherapy, Group* ; Social Workers ; Students, Medical

OBJECTIVES: Regarding the relationship between the laterality of seizure focus and depression in temporal lobe epilepsy (TLE), previous studies reported inconsistent results. The role of frontal function as moderating variable between laterality and depression had been proposed. We attempted to replicate functional involvement of frontal lobe (FIFL) and, as an effort to extend previous findings, to test the functional involvement of parietal lobe (FIPL) to prove the hypothesis derived from Heller's valencearousal theory of emotion. METHODS: In study 1, patients with TLE (right 19, left 17) performed MMPI-D as a depression measure, Wisconsin Card Sorting Test (WCST) as a frontal function measure, and block design (BD) as a parietal function measure in the course of pre-operation assessment. Multiple regression model of depression which includes the interaction terms both between laterality and WCST and between laterality and BD were tested. In study 2, patients underwent anterior temporal lobectomy (ATL;right 20, left 25) were assessed and analyzed in the same way as study 1. RESULTS: In study 1, contrary to the FIFL and FIPL prediction, interaction of laterality with WCST or BD were not significant. In study 2, the interaction with frontal function was significant. Consistent with FIFL prediction, depression came to be evident when seizure focus was lateralized to the left side and simultaneously frontal function declined. But the interaction with BD remained insignificant, which suggests the invalidity of FIPL hypothesis. CONCLUSION: We replicated the FIFL hypothesis in the depression of ATL patients. The relation of depression with frontal function was more evident in post rather than pre operation sample. This pattern may be due to the inter-hemispheric interference of frontal functions in pre-operation sample and to the release-of-function phenomenon in post-operation sample. On the other hand, we did not succeed in confirming the role of parietal function in depression. Intactness of the parietal function in TLE was considered as the main cause of the negative finding.
Anterior Temporal Lobectomy ; Depression* ; Epilepsy, Temporal Lobe* ; Frontal Lobe ; Hand ; Humans ; Parietal Lobe* ; Rabeprazole* ; Seizures ; Temporal Lobe* ; Wisconsin

Objectives: Aripiprazole is an antipsychotic that functions as a partial agonist in hypodopaminergic states and a dopamine antagonist in hyperdopaminergic states. Methods: This paper reports a series of five clinical cases of worsening psychotic symptoms in schizophrenic patients related to the initiation of aripiprazole, oral and injection, as combination therapy. Results: In all five cases, the switching of aripiprazole improved the psychotic symptoms. Conclusion Even with the suggestive relationship between aripiprazole therapy and the worsening of psychotic symptoms, further research is needed.

Patients with hypertrophic cardiography often complain of chest pain and have electrocardioagrams suggesting myocardial damage or ischemia. Some of three patients have associated coronary arterial atherosclerosis. Transmural myocardial infarction may occur in patients with hypertrophic cardiomyopathy in the absence of significant atherosclerosis of the extramural coronary arteries, about which several pathophysiologic exlpanations were discussed. Presented here, a case of 49-year-old man with hypertrophic cardiomyopathy accompanied with myocardial infarction and angiographically normal coronary arteries is reported. Asymmetric septal hypertrophy, characteristic morphologic abnormality of hypertrophic cardiomyopathy, was progressed to dilated cardiomyopathy after the occurrence myocardial infarction.
Atherosclerosis ; Cardiomyopathy, Dilated ; Cardiomyopathy, Hypertrophic* ; Chest Pain ; Coronary Vessels ; Humans ; Ischemia ; Middle Aged ; Myocardial Infarction*

No abstract available.
Leukemia, Lymphocytic, Chronic, B-Cell*

OBJECTIVES: We investigated the effectiveness and safety when treated in schizophrenics with paliperidone palmitate, a long acting injectable antipsychotic. METHODS: This was a 24-week open-label study, performed at one center in Korea. The eligible patients with schizophrenia diagnosed by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria were enrolled. Patients received long-acting paliperidone palmitate injection (234 mg, baseline; 156 mg, week 1 ; then once 4 weeks flexible dosing). Effectiveness assessments were measured by the Positive and Negative Syndrome Scale (PANSS), The Clinical Global Impression Severity Scale (CGI-S), The Personal and Social Performance (PSP) at baseline, week 1, every 4 weeks untill 24 weeks or endpoint. Safety assessments were measured by The Extrapyramidal Symptom Rating Scale (ESRS), body weight (BW) and incidence of adverse events. Oral antipsychotics were stopped or tapered off within next 14 days. RESULTS: Of 20 patients recruited, 9 patients (45%) completed the study. Paliperidone palmitate produced a significant improvement in PANSS total score from baseline to endpoint. The response rate was 75% [mean change (+/- SD) -25.9 +/- 14.4, all p < 0.001]. The CGI-S and PSP total scores significantly improved during 24 weeks (All p < 0.001). Eighty percent of patients reported adverse events and most common adverse events (> or = 10%) in paliperidone palmitate were anticholinergic adverse event, extrapyramidal symptoms, weight gain, akathisia, insomnia, headache, agitation, anxiety and GI trouble. ESRS score is not statistically significant, but tends to get better at the end of the study when compared to baseline. CONCLUSIONS: Our study results demonstrated maintained effectiveness and safety of paliperidone palmitate treatment in schizophrenics. And provides both clinicians and patients with a new choice of treatment that can improve the outcome of long term therapy. Their potential effectiveness and safety should be better addressed by future randomized-controlled trials.
Antipsychotic Agents ; Anxiety ; Body Weight ; Diagnostic and Statistical Manual of Mental Disorders ; Dihydroergotamine ; Headache ; Humans ; Incidence ; Korea ; Psychomotor Agitation ; Schizophrenia ; Sleep Initiation and Maintenance Disorders ; Weight Gain ; Paliperidone Palmitate

OBJECTIVES: The second to fourth digit ratio (2D : 4D) is known to reflect testosterone level during intrauterine period. Testosterone is essential for masculinization of brain. Cloninger's type II alcoholism is characterized by early age at onset and largely limited to males. Compared with type I alcoholism, type II alcoholism is thought to be masculine. There is a possibility that the digit ratio of type II alcoholism is low compared with type I. We examined digit length ratio in Cloninger's type I and II alcoholism to understand the effects of intrauterine testosterone on the development of alcoholism. METHODS: The participants were 87 alcohol dependent patients. We divided two subtypes of patients by Irwin's symptom list, based on Cloninger's concept. We captured the images of both palms by the scanner and measured the lengths of digits by the graphic program. Then we analyzed the digit ratios by independent-sample t-test. RESULTS: The mean 2D : 4D of type I was 0.942 (right), 0.952 (left). The mean 2D : 4D of type II was 0.927 (right), 0.940 (left). In both hands, 2D : 4D of type II was significantly lower than type I. CONCLUSIONS: Type II alcoholism showed masculine type of digit length ratio compared with type I. It suggests the exposure of testosterone during intrauterine period might play an important role in determining the course and feature of alcoholism.
Alcoholism ; Brain ; Hand ; Humans ; Male ; Testosterone

OBJECTIVES: The Mood Disorder Questionnaire (MDQ) has been validated as a diagnostic screening instrument for the detection of patients with bipolar disorder, but some patients with bipolar disorder obtain false negative screens. So we investigated demographic and clinical characteristics in false-negative MDQ in bipolar patients. METHODS: The participants were 60 DSM-IV bipolar outpatients in remission. All completed the Korean version of the Mood Disorder Questionnaire (K-MDQ) and the Korean version of the Beck Cognitive Insight Scale (K-BCIS) and were assessed by a trained clinician on the Young Mania Rating Scale, the Hamilton Depression Rating Scale and the Global Assessment of Functioning scale. The patients were categorized into two groups according to their K-MDQ score excluding further two questions (MDQ > or =7 : K-MDQ-positives and MDQ <7 : K-MDQ-negatives). Differences in demographic and clinical characteristics between these two groups were analyzed. RESULTS: There were no statistically significant differences between K-MDQ-positives and K-MDQ-negatives on the demographic and clinical variables, except on the K-BCIS where K-MDQ-negatives reported significantly lower scores on the K-BCIS composite index and self-reflectiveness subscale. CONCLUSION: These results suggest that lack of insight is a confounding factor in screening for bipolar disorder using the K-MDQ.
Bipolar Disorder ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Mass Screening ; Mood Disorders ; Outpatients ; Surveys and Questionnaires

OBJECTIVES: This study was performed to make a model of large group psychodrama suitable for Korean inpatients and easy for psychiatrists trained in the individual psychotherapy and the group psychotherapy to use, to investigate the therapeutic factors after applying this model to inpatients, and then to contribute to the treatment of inpatients. METHODS: The study subjects were all the inpatients and the therapists(the auxiliary ego's) who participated in psychodrama from March 1998 to September 1998. The subjects were composed of 346 inpatients(152 males, 194 females) and 60 therapists. To the inpatients 13-Therapeutic Factors Scale, Scale of General Attitude to Psychodrama, and the Questionnaire describing helpful things in psychodrama were administered. To the therapists 13-Therapeutic Factors Scale and the Questionnaire describing helpful things in psychodrama were administered. The inpatient group were divided into 4 groups(the audience, the auxiliary ego's, the participants in sharing, the protagonists). The therapeutic factors among 4 groups were compared. RESULTS: First, the therapeutic factors described by the inpatient group were as follows: 1) Most inpatients made great account of 'existential factor' and 'the corrective recapitulation of the primary family group' regardless of their roles in psychodrama. 2) The inpatients who participated in psychodrama directly as the protagonists, the auxiliary ego's, or the participants in sharing made much account of 'development of socializing techniques'. The inpatients who participated in psychodrama more directly as the protagonists or the auxiliary ego's made much account of 'catharsis'. 3) All the inpatients except the protagonists made much account of 'instillation of hope'. 4) The audience made much account of 'identification' and 'universality'. Especially, 'identification with members' was much accounted of by the participants in sharing. 'Universality' also was much accounted of by the auxiliary ego's. Next, when we compared the therapeutic factors in the inpatient group with those in the therapist group, the therapist group made much account of 'group cohesiveness' which the inpatient group made little account of. And the therapist group made no account of 'development of socializing techniques' which the inpatient group made much account of. CONCLUSION: By dividing the inpatient group according to their roles, we found the characteristics of the inpatient large group psychodrama and of the therapeutic factors according to the roles of the inpatients. This model could be applied to the treatment for the inpatients easily and was helpful to many inpatients on the whole.
Humans ; Inpatients* ; Male ; Psychiatry ; Psychodrama* ; Psychotherapy ; Psychotherapy, Group ; Surveys and Questionnaires

OBJECTIVES: A day hospital has been remodeled after a vision to help psychotic patients quickly recover their psychological and social functions and lessen their induced regressions caused by long-term hospitalization, thereby enhancing their social abilities. The authors concerned once developed a day hospital model of an integrated therapy for psychotic patients suitable for Korean situation in their previous paper. Based on it, the present study was to determine how effective a day hospital would be, in comparison of the following two paired groups: day hospital group with experience of hospitalization(hereinafter abbreviated as DH group) & day hospital parents group with experience of hospitalization(hereinafter abbreviated as DH parents group) and OPD group with experience of hospitalization(hereinafter abbreviated as OPD group) & OPD parents group with experience of hospitalization(hereinafter abbreviated as OPD parents group). METHODS: During the 18-month long research period(from May to 1996 October 1997), 17 day hospital patients with experience of hospitalization & their parents and the same number of OPD patients with experience of hospitalization & their parents were corespondingly paired with at random, who identified themselves closest in the following categories: diagnosis, age, sex and function. All of them were asked to check questionnaires on their respective quality of life, insight, and their attitude about drug. Day hospital patients with experience of hospitalization and their parents were checked from the first day they were treated while OPD patients with experience of hospitalization and their parents were examined after discharge from hospital, commonly at the interval of 2 weeks, 3 months, 6 months, 12 months, and 18 months. RESULTS: 1) The quality of life scored higher in DH group than in OPD group. It turned increased significantly at the 3rd month and continued the same until the 12th month. At the 18th month, it showed a significant downturn. Meanwhile, DH group showed a significant upturn at the 3rd month and it turned down at 12 month. 2) The insight of DH group and DH parents group scored higher compared with OPD group and OPD parents group between the 3rd and 18th month, with the 3rd and 6th month showing a particular strength as well. Meanwhile, it continued unchanging for day DH group and DH parents group from the date on, of their discharge from hospital. 3) Attitude towards drugs scored higher in DH group than in OPD group at the 3rd and 6th month. It continued unchanging between the 6th and 18th month. It didn't score significantly higher in DH parents group than in their counterparts. 4) Satisfaction on the therapy started upward in DH group at the 3rd and 6th month, and scored higher in them than in their counterparts during the period form the 6th and 18th month. It started upward as well in DH parents group at the 3rd and 6th month, and scored higher in them than in their counterparts during the period form the 6th to the 18 month. 5) Number, and duration of DH group totalled lower than those by OPD group during the research period. CONCLUSION: The day hospital model, developed by the authors concerned, has proved a highly effective treatment for psychotic patients, as the data scored higher in the day hospital patients and their parents than in the OPD patients with experience of hospital and their parents in terms of "quality of life" by patients, insight, attitude toward drugs and satisfaction on its therapy.
Diagnosis ; Hospitalization ; Humans ; Parents ; Quality of Life ; Surveys and Questionnaires