Objective: New drugs are needed to treat antipsychotic-resistant schizophrenia, especially those with clozapine-resistant schizophrenia. Atypical antipsychotics have predominantly 5-HT2A and dopaminergic antagonism, but also require investigation of other receptors. Methods: In this study, the binding affinities between clozapine, olanzapine, and quetiapine with neuropharmacological, immunological, and metabolic receptors were measured using GNINA (Deep Learning Based Molecular Docking) and AlphaFold (Predicted Protein Structures). Results: Through this study, it was determined that these antipsychotics showed high binding affinity to a variety of receptors, such as CB2, 5-HT1BR, NPYR4, and CCR5. Cyclosporin A and everolimus which show high affinities with those receptors could be used for the development of new antipsychotic drugs based on these drugs. Conclusion In the future, the method used in this study will be applied to the development of new antipsychotic drugs, including drug repositioning, and to the discovery of the pathophysiology of schizophrenia.

Psychosis is a symptom of functional decline due to hallucinations, delusions, and the resulting behavior, and it appears in several psychiatric conditions including schizophrenia and severe mood episodes of bipolar affective disorder. Psychosis is influenced by environmental factors, including childhood stress, as well as genetic predisposition. People with psychosis are known to have more insecure attachments than the general population, and are particularly more likely to display dismissive attachment styles. Attachment behavior is related to stress-induced CRH secretion, CRH suppression by oxytocin, and dopamine release in the brain. Imbalances of CRH, oxytocin, and dopamine are expected in psychotic patients with unstable attachments, requiring tailored treatment for this condition. Therefore, this review intends to investigate the effects of insecure attachment in individuals with psychosis.

Schizophrenia is a syndrome involving positive symptoms, negative symptoms, and cognitive decline due to several causes. The neuropathological findings of schizophrenia are unclear, but the age of onset of schizophrenia is consistent from the late teens to twenties, and patients with schizophrenia usually have prodromal symptoms. Research on schizophrenia is ongoing according to the neurodevelopmental hypothesis. Neural stem cell abnormalities are suggested to affect the pathophysiology of schizophrenia through brain imaging studies, genomic studies, and postmortem brain studies in patients with schizophrenia and are consistent with the existing striatumcentered dopamine hypothesis. This paper briefly introduces neural stem cells, particularly adult neural stem cells, and striatal abnormalities and explains their effects on the pathophysiology of schizophrenia.

Objective: To compare the clinical characteristics, support system, and personality traits of cannabis and stimulant users in South Korea. Methods: This study was based on electronic medical records. Among a total of 152 subjects who suspected of drug use and who underwent six types of urine-based drug screening tests at the National Center for Mental Health, 104 people who underwent both an interview with a psychiatrist and a psychological test were selected and classified according to the type of substance used. Psychological and personality characteristics were examined through the National Center for Mental Health psychological test battery for addiction. The differences in characteristics between cannabis (n=60) and stimulant (n=18) users were analyzed by an independent t-test for parametric data and chi-square test or Fisher’s exact test for nonparametric data, and analysis of covariance for psychological tests. Results: The average age of cannabis users was lower than that of stimulant users and they were more often single. Substance cravings were higher in stimulant users, who more often had a psychiatric history than cannabis users. Moreover, stimulant users had higher clinical scale scores for depression and anxiety. Among the Minnesota Multiphasic Personality Inventory-II clinical scale scores, there was a significant difference in social introversion scores between groups. Conclusion We found differences in demographic, psychological, and personality characteristics between cannabis and stimulant users in South Korea. Considering the recent increase in illegal drug use in South Korea, further follow-up and policy research on drug users are needed.

Objective: We aimed to determine the overall profile of patients in a psycho-oncology clinic and the differences in their characteristics according to the cancer site. Methods: The charts of 740 patients aged under 81 years were reviewed. The data from 586 completed questionnaires were subjected to multiple comparison analyses using one-way analysis of variance to examine the demographic and clinical differences according to the cancer site. Results: Most (n=532, 71.9%) patients were referred. Most new patients (n=426, 96.6%) received a psychiatric diagnosis; the most common diagnosis was depressive disorder (n=234, 31.6%). Likewise, depressive disorder accounted for the majority of diagnoses in all groups except for the digestive system cancer group in which sleep-wake disorder was the most prevalent. The female genital cancer group showed a higher level of anxiety symptoms than other groups, except for breast and haematolymphoid cancer groups, and psychological distress than all other groups. Conclusion There appear to be delays in the referral of cancer patients seeking psychiatric help to a psycho-oncology clinic. Along with tailoring approaches by cancer site, thorough evaluation and appropriate management of sleep-wake and anxiety symptoms are important for digestive system and female genital cancer patients, respectively.

Objective: We aimed to determine the overall profile of patients in a psycho-oncology clinic and the differences in their characteristics according to the cancer site. Methods: The charts of 740 patients aged under 81 years were reviewed. The data from 586 completed questionnaires were subjected to multiple comparison analyses using one-way analysis of variance to examine the demographic and clinical differences according to the cancer site. Results: Most (n=532, 71.9%) patients were referred. Most new patients (n=426, 96.6%) received a psychiatric diagnosis; the most common diagnosis was depressive disorder (n=234, 31.6%). Likewise, depressive disorder accounted for the majority of diagnoses in all groups except for the digestive system cancer group in which sleep-wake disorder was the most prevalent. The female genital cancer group showed a higher level of anxiety symptoms than other groups, except for breast and haematolymphoid cancer groups, and psychological distress than all other groups. Conclusion There appear to be delays in the referral of cancer patients seeking psychiatric help to a psycho-oncology clinic. Along with tailoring approaches by cancer site, thorough evaluation and appropriate management of sleep-wake and anxiety symptoms are important for digestive system and female genital cancer patients, respectively.

OBJECTIVES: The aim of this study was to estimate the prevalences of electroencephalographic (EEG) abnormalities and epilepsy in children and adolescents with autism spectrum disorder (ASD). In addition, we intended to identify demographic and clinical correlates of epilepsy in ASD. METHODS: A total of 140 children and adolescents (age 7.3+/-4.8 yrs, 106 boys) with ASD underwent EEG from January 2010 to December 2013 at Asan Medical Center. Medical records were reviewed for demographic information, clinical characteristics, psychiatric diagnoses and comorbidities, EEG findings and neurological diagnoses. RESULTS: The prevalences of EEG abnormalities and epilepsy in children and adolescents with ASD was 62.1% and 38.6%, respectively. In subjects with seizure-like movements, EEG abnormalities and epilepsy were more frequent than those without seizure-like movements (EEG abnormalities : 92.5% vs. 43.7%, p<.001 ; epilepsy : 90.6% vs. 5.7%, p<.001). ASD subjects who had epilepsy were older (p=.001), had lower full scale intelligence quotient (p<.001) and took more antipsychotics (p=.006) than those who did not. CONCLUSION: The prevalences of EEG abnormalities and epilepsy in our sample were similar to those from Western countries. Our results suggested a possible association of older age, lower intelligence quotient, and antipsychotics use with epilepsy in ASD. Conduct of further prospective study in a larger sample is needed.
Adolescent* ; Antipsychotic Agents ; Autism Spectrum Disorder* ; Child* ; Chungcheongnam-do ; Comorbidity ; Diagnosis ; Electroencephalography ; Epilepsy ; Humans ; Intelligence ; Medical Records ; Prevalence

Antidepressant prescription for youths has recently been on the increase. There is a growing concern over the increasing off-label usage of antidepressants. Current data on off-label antidepressant usage vary across countries and healthcare systems. Therefore, we examined the extent and pattern of antidepressant prescription for Korean children and adolescents using population-based data. Our data was retrieved from the Korean National Health Insurance Service National Sample Cohort of the year 2013. Among 0.2 million children and adolescents aged 6–18 years from the cohort, subjects who had received any antidepressant medication in the year 2013 were investigated for the prescribed medication, concomitant psychotropic medication, and the associated diagnosis. A total of 2,190 children and adolescents (boys, 55.4%) received antidepressant medication. The most common diagnosis was depressive disorders (n = 469, 21.4%), followed by attention-deficit/hyperactivity disorder (n = 442, 20.2%). Among the prescriptions (n = 3,370), escitalopram (n = 650, 24.1%) and fluoxetine (n = 553, 20.5%) were the two most frequently prescribed drugs. A majority of prescriptions (n = 2,039, 60.5%) included concomitant psychotropic agents, consisting of antipsychotics (n = 901, 26.7%), sedatives (n = 263, 26.3%), medication for attention-deficit/hyperactivity disorder (n = 822, 24.4%), and some others. Our study shows the prescription pattern of antidepressants for children and adolescents in Korea, of which a large proportion is off-label. The results call for close monitoring by clinicians treating this population.
Adolescent* ; Antidepressive Agents* ; Antipsychotic Agents ; Child* ; Citalopram ; Cohort Studies ; Delivery of Health Care ; Depressive Disorder ; Diagnosis ; Fluoxetine ; Humans ; Hypnotics and Sedatives ; Korea* ; National Health Programs ; Off-Label Use ; Prescriptions*

Objectives: We investigate relationship between suicide attempts and peripheral blood inflammatory markers in patients visiting the emergency department (ED) for psychiatric consultations, aiming to identify potential biomarkers for predicting suicide risk. Methods: We retrospectively reviewed medical records of 569 patients who were referred to psychiatric consultation at the ED from January 1, 2022 to December 31, 2022. Demographic and clinical characteristics and various blood test markers were analyzed. Analyses were performed to compare differences in blood markers between suicide attempters and non-attempters and among those with varying histories of suicide attempts. Results: Among 569 patients, 398 (69.9%) had attempted suicide. Significant differences in leukocytes, lymphocytes, eosinophils, red blood cells (RBCs), lactate dehydrogenase (LDH), and ketone bodies were observed between suicide attempters and non-attempters. Further analysis revealed that patients with a history of suicide attempts had higher lymphocyte and eosinophil counts but lower LDH and ketone body levels. An increasing frequency of past suicide attempts correlated with higher lymphocyte and eosinophil count and lower neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune inflammatory index, glucose, LDH, and ketone body levels. Conclusions We identify blood markers associated with suicide attempts, indicating that leukocyte, lymphocyte, eosinophil, RBC count, LDH, and ketone body levels could serve as potential biomarkers for assessing suicide risk. Findings underscore importance of biological assessments in conjunction with psychological evaluations in predicting and preventing suicide attempts. Further research is needed to validate these biomarkers and understand mechanisms.

Objectives: We investigate relationship between suicide attempts and peripheral blood inflammatory markers in patients visiting the emergency department (ED) for psychiatric consultations, aiming to identify potential biomarkers for predicting suicide risk. Methods: We retrospectively reviewed medical records of 569 patients who were referred to psychiatric consultation at the ED from January 1, 2022 to December 31, 2022. Demographic and clinical characteristics and various blood test markers were analyzed. Analyses were performed to compare differences in blood markers between suicide attempters and non-attempters and among those with varying histories of suicide attempts. Results: Among 569 patients, 398 (69.9%) had attempted suicide. Significant differences in leukocytes, lymphocytes, eosinophils, red blood cells (RBCs), lactate dehydrogenase (LDH), and ketone bodies were observed between suicide attempters and non-attempters. Further analysis revealed that patients with a history of suicide attempts had higher lymphocyte and eosinophil counts but lower LDH and ketone body levels. An increasing frequency of past suicide attempts correlated with higher lymphocyte and eosinophil count and lower neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune inflammatory index, glucose, LDH, and ketone body levels. Conclusions We identify blood markers associated with suicide attempts, indicating that leukocyte, lymphocyte, eosinophil, RBC count, LDH, and ketone body levels could serve as potential biomarkers for assessing suicide risk. Findings underscore importance of biological assessments in conjunction with psychological evaluations in predicting and preventing suicide attempts. Further research is needed to validate these biomarkers and understand mechanisms.