1.Association between Type D Personality and the Somatic Symptom Complaints in Depressive Patients.
Korean Journal of Psychosomatic Medicine 2013;21(1):18-26
OBJECTIVES: Type D personality was originally introduced to study the role of personality in predicting outcomes of heart disease. However, researches showed that other medical conditions are also affected by this personality. The purpose of this study was to evaluate the relationship between type D personality and somatic symptom complaints in depressive patients. METHODS: Eighty-two individuals diagnosed with depressive disorder were included. Type D personality was measured with DS14. Patient Health Questionnaire(PHQ) 9 and 15 were used to measure depression severity and somatization tendencies. For alexithymia, TAS-20 was used. Student T-test and linear regression analysis were performed. The best regression model was determined by stepwise variable selection. RESULTS: More than half of the subjects(56%) complained at least medium degree somatic symptoms according to PHQ-15 criteria. Two-thirds of the subjects were classified as Type D personality(63.4%). The mean PHQ-15 score of the Type D individuals was significantly higher than the remaining subjects(PHQ-15 mean=12.7, p=8.2x10-7). The best regression model included age, PHQ-9 score and NA subscale score as predictor variables. Among these, only the coefficients of age(p=1.5x10(-3)) and NA score(p=1.5x10(-7)) were found to be statistically significant. CONCLUSIONS: The result showed that Type D personality was one of the strong predictors of somatic complaints among depressive individuals. The finding that negative affectivity rather than social inhibition was more closely associated with somatization tendencies does not fully agree with the traditional explanation that inability to express negative emotion predispose the individuals to somatic symptoms. The finding that alexithymia was not shown to be a significant predictors also substantiated this discrepancy. However, it might be possible that the high correlation between NA and SI subscore(r=0.65) and between NA and TAS-20 score(r=0.44) hid the additional effects of social inhibition and alexithymia. Further research with a larger sample would be needed to investigate the effects of the latter two components over and above the effect of negative affectivity on the somatic complaints in depressive patients.
Affective Symptoms
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Depression
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Depressive Disorder
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Heart Diseases
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Humans
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Linear Models
2.A Case of Amisulpride Induced Tardive Blepharospasm in Schizophrenia.
Wu Ri PARK ; Sung Whoi KONG ; Je Chun YU ; Chang Hwa LEE ; Kyeong Sook CHOI
Korean Journal of Psychopharmacology 2012;23(3):122-125
Tardive blepharospam is characterized by repetitive, forceful, and sustained involuntary contractions of the orbicularis oculi. We report here one case of neuroleptic-induced tardive blepharospasm that developed during high-dose amisulpride treatment and was treated with clozapine. The patient was a 29-year-old man with a 6-year history of schizophrenia. After 33 months of amisulpride treatment (1200 mg/day), involuntary eye-blinking had developed. Following exclusion of all other possible etiopathological causes of the blepharospasm, we decided to switch the drug treatment from amisulpride to clozapine. On the fourteenth day of clozapine (250 mg/day) treatment, we observed significant improvements in eye-blinking and psychotic symptoms. Four months later, the eye-blinking had remitted completely. We suggest that amisulpride may cause blepharospasm and lead to an impaired ability to perform daily activities. Therefore, we recommend that clinicians regularly monitor involuntary movements in patients receiving antipsychotic treatment, especially when high doses of amisulpride are involved.
Adult
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Blepharospasm
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Clozapine
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Contracts
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Dyskinesias
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Humans
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Organothiophosphorus Compounds
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Schizophrenia
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Sulpiride
3.A Case of Phendimetrazine Induced-Psychotic Disorder and Dependence.
Ji Ae YUN ; Wu Ri PARK ; Je Chun YU ; Kyeong Sook CHOI
Journal of Korean Neuropsychiatric Association 2013;52(5):402-405
Phendimetrazine and related amphetamine-like compounds are used widely as appetite suppressants in Korea. We report on a patient who developed psychotic disorder and dependence while using phendimetrazine. A 25-year-old female with no psychiatric history began experiencing hallucination of bugs after using phendimetrazine for weight loss for five months. She was admitted and the drug was stopped. Three days later, her psychotic symptoms had subsided and she returned home. Two months after discharge, against medical advice, she returned to a clinic to obtain phendimetrazine for its anorectic effect. She continued using phendimetrazine because she had developed withdrawal symptoms and experienced cravings for it. Within two months of restarting the drug, she had developed paranoid delusions, auditory and olfactory hallucinations. She was readmitted, and was confirmed to have a dependence on phendimetrazine. This case provides a warning that amphetamine-related anorectics can cause psychotic disorder and dependence.
Adult
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Appetite Depressants
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Delusions
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Female
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Hallucinations
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Humans
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Korea
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Morpholines
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Psychotic Disorders
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Substance Withdrawal Syndrome
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Weight Loss
4.A Case of Pituitary Mucormycosis in Diabetic Patient with Acromegaly and Gastric Cancer.
Pyoung Rak CHOI ; Hong Jun YU ; Seung Wu YANG ; Gyu Jong KIM ; Hark RIM ; Yu Ri KIM ; Young Sik CHOI ; Yo Han PARK ; Bong Kwon CHUN
Journal of Korean Society of Endocrinology 2006;21(3):245-250
Rhino-orbito-cerebral mucormycosis (ROCM) is an uncommon, acute, and aggressive fungal infection occurring in several immunocompromised states including poorly controlled diabetes. ROCM causes a very high residual morbidity and mortality due to the angioinvasion property of the fungus. Acromegaly is a chronic condition resulting from the excessive secretion of growth hormone, generally from pituitary adenoma. Although it has been demonstrated that acromegalic patients have an increased risk of neoplasm, gastric cancer with acromegaly is very rare. We experienced a case of pituitary mucormycosis in the diabetic patient with acromegaly and gastric cancer. The patient was treated successfully with subtotal gastrectomy for early gastric cancer, transsphenoidal surgery for pituitary adenoma, and a systemic application of amphotericin B for the mucormycosis.
Acromegaly*
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Amphotericin B
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Fungi
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Gastrectomy
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Growth Hormone
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Humans
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Mortality
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Mucormycosis*
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Pituitary Neoplasms
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Stomach Neoplasms*
5.The Effects of Mental Fitness, Social Support and Psychological Distress on Suicidal Idea of People with Schizophrenia Using Community Mental Health Services.
Dong Dae SEO ; Kyeong Suk CHOI ; Wu Ri PARK ; Mi Rim LEE ; Do Yun KIM ; Je Chun YU
Journal of Korean Neuropsychiatric Association 2014;53(6):364-369
OBJECTIVES: The objective of this study was to analyze the relationships of psychological distress, social support, mental fitness and suicidal idea among patients of chronic schizophrenia using community mental health services. METHODS: This study was conducted in patients who visited the mental health services in Daejeon from October to December 2011. In total, 395 chronic schizophrenic patients were evaluated using Mental Fitness Scale (MFS), Kessler Psychological Distress Scale (K10), and Multidimensional Scale of Perceived Social Support (MSPSS). RESULTS: Results showed that 37% (n=146) of patients had suicidal ideas and 63% (n=249) of patients did not have suicidal ideas. The group that had suicidal ideas showed significantly lower scores on MFS, K10, and MSPSS than the group with no suicidal ideas (p=0.000). Logistic regression analysis showed a significantly lower score on MFS, K10 for the suicidal ideation group than the group with no suicidal ideas. CONCLUSION: These results suggest that health care providers should consider mental fitness and psychological distress, in order to prevent suicidal idea of schizophrenic patients.
Community Mental Health Services*
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Health Personnel
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Humans
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Logistic Models
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Mental Health Services
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Schizophrenia*
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Suicidal Ideation