Background: Schizophrenia is a chronic, severe psychotic disease with high incidence. Treatment of schizophrenia with neuroleptic is a major medical advance, but sometime its result is still limited. Objective: To study the effect of electroconvulsive therapy (EC) in treatment of paranoid schizophrenic patients. Subject and methods: 101 paranoid schizophrenic patients treated by neuroleptic alone or neuroleptic combined EC, were treated in the Mental Department of Hospital 103 and Nam Dinh Mental Hospital from May, 2006 to June, 2007. Results and Conclusion: All 100% of the patients had a positive response to EC; the mean times of EC were 7.63\xb11.4 times for one. The regression of hallucination was observed after 4.6\xb11.49 times of EC; delusion after 4.96\xb11.4 times; suicide attempt after 3.25\xb10.96 times and refusing to eat after 4.96\xb12.1 times of EC; insomnia disappeared after 4.96\xb12.1 times of EC. Some side effects of the EC therapy: 100% of patients had orientation disorder; headache with light and moderate level accounted for 69.65% and 26.79%, respectively. Combination therapy made patients more stable, compared to neuroleptic therapy alone (p<0.05).
paranoid schizophrenia ; electroconvulsive therapy

60 patients with schizophrenia type paranoid treated in the Central hospital of Psychology were randomly divided into 2 groups: group I (30 patients): intensive intervention; group II (30 patient): control. The results have shown that the ages which starts suffering the disease were about 20-35; after 4 months of research on progress of the schizophrenia type paranoid and after chomotherapy and training for family in the publicity, the correct awareness, attitude for disease and ability of the social reintegration in the intervented group were better than these in the control
Schizophrenia, Paranoid ; Drug therapy

Patients were divided into 2 groups, one involved 30 patients who have recurrence within 10 years, and the other involved 20 patients without recurrence. All patients were diagnosed with schizophrenia type paranoid using ICD-10 criteria. The result showed that to lower the recurrence of schizophrenia patients, the education and communication measures are needed in the first place so that the patients’ family accept and tolerate them. Try to limit adverse effects such as psychological trauma and stress. Especially, the medical intervention is very important soon after this detecting this condition
Schizophrenia, Paranoid ; Recurrence

We report the first two cases of manic and hypomanic episodes respectively induced by risperidone treatment done to schizophrenics in Korea. One case was a 22-year-old woman with catatonic schizophrenia. Since 3 years ago, she had shown psychotic symptoms, but with was poor treatment compliance. She had mainly negative symptoms such as social withdrawal, decreased flood intake, mutism, and symptoms had been worsened since last 4-5 months. Prior to closed ward admission, she was prescribed 2mg/d of risperidone far a week at OPD. Two days after taking medicine totally 6-8mg, she revealed manic features. After hospitalization, risperidone was discontinued and then, lithium 900mg/d and high dosage of conventional antipsychotics(chlorpromazine 1200mg/d or haloperidol 20mg/d) were prescribed. About on the l0th day of hospitalization, there was limited improvement of her manic symptoms. The other case was a 29-year-old man with a 3-year history of paranoid schizophrenia. He was never exposed to antipsychotics before. His main symptoms were delusions of being poisoned and of persecution. His positive and also negative symptoms were alleviated by 38 days of risperidone 2mg/d trial. However, one week after dosage increment to 3mg/d, hypomanic symptoms appeared. Risperidone medication was discontinued and was replaced by chlorpromazine 300mg/d. The hypomanic episode was resolved over 5 days. In both of the two cases, manic episodes occurred by monotherapy of risperidone without mood stabilizer, and there were no history of substance abuse and other psychiatric disorders, family history of psychiatric disorders, and comorbid physical illnesses. It is hypothesized that the potent blockade effect on serotonin(5-HT2) receptor of risperidone causes antidepressant effect, as well as therapeutic effect for negative and affective symptoms in schizophrenia. Risperidone would induce manic or hypomanic features in schizophrenic patients. And there are few case reports of risperidone-induced mania or exacerbation of preexisting manic symptoms by risperidone treatment in mood disorder and schizoaffective disorder. Risperidone is being used more widely, even for obsessive-compulsive disorder and other psychiatric disorders. It is necessary for clinicians to recognize manic switch, one of psychiatric side effects by risperidon trial. It is recommended that the combination of mood stabilizer with risperidone or usage of the minimum effective dose of risperidone may bewefal especially in the patients with mood disorders or schizoaffective disorders. Clozapine which has mood-stabilizing properties is also beneficial in risk groups of risperidone-induced mania.
Adult ; Affective Symptoms ; Antipsychotic Agents ; Bipolar Disorder* ; Chlorpromazine ; Clozapine ; Compliance ; Delusions ; Female ; Haloperidol ; Hospitalization ; Humans ; Korea ; Lithium ; Mood Disorders ; Mutism ; Obsessive-Compulsive Disorder ; Psychotic Disorders ; Risperidone ; Schizophrenia ; Schizophrenia, Catatonic ; Schizophrenia, Paranoid ; Substance-Related Disorders ; Young Adult

Clozapine is a gold standard medication and drug of choice in refractory schizophrenia. Among many of its fatal side effects, delirium is less reported and inconsistently recognized by clinicians. We here present a case of delirium which emerged during retreatment with clozapine in a patient of paranoid schizophrenia. A patient diagnosed with paranoid schizophrenia, was restarted on clozapine after he left medications and became symptomatic. He was delirious on 22nd day after clozapine was restarted. Clozapine was stopped and the patient was managed with standard treatment for delirium. After one week interval, clozapine was restarted. Delirium was not noted till 6 weeks of his hospital stay. Clozapine induced central anticholinergic toxicity or clozapine induced seizure might cause delirium in index case. Limited literature exist delirium with clozapine. Clinicians must have high index of suspicion to detect delirium during clozapine therapy. More researches should focus to explore the association between delirium and clozapine.
Clozapine* ; Delirium* ; Humans ; Length of Stay ; Retreatment ; Risk Factors ; Schizophrenia ; Schizophrenia, Paranoid ; Seizures

The purposes of this study were to test the negative association between schizophrenia and rheumatoid arthritis(RA) and to clarify the role of prolactin and estrogen as protective factors in this association. The author compared the prevalence rate of RA between 561 patients with schizophrenia and 222 patients with mood disorder. For investigating the role of estrogen and prolactin, the author checked the plasma prolactin and estradiol level in 80 patients with paranoid schizophrenia and 77 patients with RA. The results were as follows. 1) Epidemiological data The prevalence rate of RA in the schizophrenic group was 0/561 and that of RA in the mood disorder group was 2/222. To compare these results between two groups, the author applied the Binomial test using the average prevalence rate of RA(0.8%) in the general population as a reference rate. The prevalence rate of RA in the schizophrenic group was significantly lower than that of RA in the general population. However, the prevalence rate of RA in the mood disorder group was not significantly different to that of RA in the general population. 2) Comparison of plasma prolactin and estradiol level between two groups. The plasma level of prolactin in the schizophrenic group was significantly higher than that of prolactin in th RA group(p=0.000). However, the plasma level of estradiol in the schizophrenic group was significantly lower than that of estradiol in the RA group(p=0.017). These results were not consistent across gender. To contrast with the results in the female group, which were consistent with the results in the total subjects, for the male group, the plasma levels of prolactin and estradiol in the schizophrenic group were significantly higher than those of prolactin and estradiol in th RA group. These results support the results of previous studies which confirm the negative association between schizophrenia and RA. These results also suggest that the elevation of plasma prolactin level in the patient with schizophrenia has a antirheumatic effect while the elevation of plasma estradiol level in the patients with RA has a anti-schizophrenic effect, and that these effects act as a possible mechanism in the negative association between two disorders. However, these results suggest that this association is specific to female patients.
Arthritis, Rheumatoid* ; Epidemiology* ; Estradiol ; Estrogens* ; Female ; Humans ; Male ; Mood Disorders ; Plasma ; Prevalence ; Prolactin* ; Schizophrenia* ; Schizophrenia, Paranoid

The purposes of this study were to compare the difference of prolactin responses to risperidone and haloperidol, the sex difference in prolactin responses to each drug and the difference of prolactin responses to both drug in each sex. METHODS: The patients with schizophrenia, schizophreniform disorder, schizoaffective disorder, delusional disorder, brief psychotic disorder diagnosed by the criteria of DSM-IV were randomly assigned to risperidone group (n=18) or haloperidol group (n=15). Prolactin levels were measured before drug administration and at week 1, 2, 3, 4, 6 after drug administration by immunoradiometric assay. RESULTS: Prolactin levels after risperidone administration were significantly (p<0.05) higher than those after haloperidol. There was no sex difference in the prolactin responses to haloperidol administration. As for risperidone administration, female showed significantly (p<0.05) higher prolcatin levels than male. There was no difference of prolactin responses to both drugs in male, but in female, prolactin levels after risperidone administration were significantly (p<0.05) higher than those after haloperidol. CONCLUSION: Compared to haloperidol, risperidone can cause significantly higher prolactin response in female than male. Therefore one should consider whether there is a sexual side effects related to the elevated prolactin level especially in female during risperidone administration.
Diagnostic and Statistical Manual of Mental Disorders ; Female ; Haloperidol* ; Humans ; Immunoradiometric Assay ; Male ; Prolactin* ; Psychotic Disorders* ; Risperidone* ; Schizophrenia* ; Schizophrenia, Paranoid ; Sex Characteristics

BACKGROUND: Psychogenic non epileptic seizures (PNES) are characterized by repeated seizures that are typically caused by stress and psychologic problems such as anxiety and depression. This contrasts with epileptic seizures (ES), which are transient and caused by irregular excitement of nerve cells. PNES can be found in patients with ES, but due to their differing etiologies, it is important to determine the psychologic characteristics that differentiate PNES from ES. METHODS: This study identified psychopathologic and personality traits in 137 patients with PNES (n=7, 49.3% female) or ES (n=0, 35.7% female) using MMPI. The diagnosis was based on a medical history of seizures and the clinical examination in patients who visited the epilepsy clinic. Statistical analyses for comparing MMPI differences between the two groups were conducted using the t-test, chi-square test, and analysis of covariance. RESULTS: We analyzed the frequency of individuals who exhibited a T score of ≥5 on the MMPI, and the results indicated that there were significantly more patients in the PNES group than in the ES group who had elevated scores on the hypochondriasis (Hs) scale and hysteria (Hy) scale. The mean scores of Hs, Hy, paranoia scale and schizophrenia scale were significantly higher in the PNES group than in the ES group. CONCLUSIONS: These results suggest that patients with PNES have greater psychologic problems than ES patients. Differences in MMPI profile patterns between patients with PNES and ES may be helpful in tailoring appropriate therapeutic interventions for the two groups.
Anxiety ; Depression ; Diagnosis ; Epilepsy* ; Humans ; Hypochondriasis ; Hysteria ; MMPI* ; Neurons ; Paranoid Disorders ; Schizophrenia ; Seizures*

Conventional neuroleptic treatment of organic delusional disorder can induce many serious side effects including extrapyramidal symptoms, sedation and tardive dyskinesia, especially in elderly patients. Risperidone is an atypical neuroleptics that is lack of severe extrapyramidal symptoms. This 68-year-old male case demonstrated that elderly patients with organic delusional disorder could be treated with risperidone without serious side effects.
Aged* ; Antipsychotic Agents ; Delusions* ; Humans ; Male ; Movement Disorders ; Risperidone* ; Schizophrenia, Paranoid*

Reduplicative paramnesia (RP) is one of delusional disorders characterized by false belief that a familiar place, person, or object had been duplicated. There have been several hypotheses about anatomical basis of RP, and right hemispheric pathology combined with or without diffuse bifrontal pathology is commonly accepted. We report a 74-year-old man who developed reduplication of place and person after right frontoparietal cerebral infarction. On the neuropsychological examination, the patient showed marked deficit in several parts of cognition including attention, memory and execution. In accordance with the literature, our clinical report suggests that RP is associated with right parietal and frontal lesion which causes deficits of visuospatial attention, memory and integration, and also emotional confusion during hospitalization.
Cerebral Infarction ; Cognition ; Delusions ; Hospitalization ; Humans ; Hypogonadism ; Infarction ; Memory ; Mitochondrial Diseases ; Ophthalmoplegia ; Schizophrenia, Paranoid