Journal Detail Information

1

Cite

Share

Atypical Antipsychotic Drug Induced Diabetes Mellitus.

Myoung Sun ROH ; Young Jin KOO ; Yong Min AHN ; Ung Gu KANG ; Yong Sik KIM

Journal of Korean Neuropsychiatric Association.2002;41(5):942-946.

BACKGROUND: Atypical antipsychotics have been reported to affect glucose-insulin homeostasis and possibly induce diabetes mellitus. Here, we present five cases in which clozapine or olanzapine treatment were associated with de novo onset of diabetes mellitus. CASE REPORTS: Three out of the five cases had risk factors for diabetes and developed diabetes during the early phase of treatment with atypical antipsychotics. However, it took longer for the other two patients with no risk factor for diabetes to manifest symptoms of diabetes. In all of the cases, we were able to control their plasma glucose level within clinically tolerable range by applying diverse treatment modalities for diabetes mellitus and continue with antipsychotics treatment. CONCLUSION: These findings suggest that risk factors for diabetes such as family history of diabetes and baseline obesity may be related to development and time of onset of atypical antipsychotic drugs induced diabetes.
Antipsychotic Agents ; Blood Glucose ; Clozapine ; Diabetes Mellitus* ; Homeostasis ; Humans ; Hyperglycemia ; Obesity ; Risk Factors

2

Cite

Share

The Comparison of the Quality of Life and Mental Health in Homosexual Men and Heterosexual Men.

Seong Uk KONG ; Kang Seob OH ; Kyung Sun NO

Journal of Korean Neuropsychiatric Association.2002;41(5):930-941.

OBJECTIVES: The study was performed to compare the quality of life and mental health -depression, suicide etc- in homosexual men with those in heterosexual men and to identify how the quality of life is related with mental health. METHODS: 129 homosexual men and 114 heterosexual men in twenties and thirties were enrolled by crosssectional method. Quality of life, depression, suicidal idea, hopelessness, self esteem, coping strategy, social support, social conflict, familiar adaptability and familiar cohesion were measured by self-report scale to compare the homosexual and the heterosexual groups. RESULTS: The results showed that age, educational level, income, alcohol intake, smoking and reli-gion were not significantly different between homosexual group and heterosexual group. Teased experience about feminity, past psychiatric history, HIV test experience in homosexual group were higher than those in heterosexual group. The self- esteem, hopelessness, coping strategy, familiar ada-ptability and social support-conflict were not significantly different between two groups. Homosexual group had poorer quality of life, lower familiar cohesion, higher depression and higher suicidal idea than heterosexual group. Being alienated from home, social system and interpersonal relationship, which are subscales of the quality of life, scored lower by homosexual group as compared with hete-rosexual group. Therefore, high depression and low familiar cohesion had significant effect on the quality of life in homosexual group. CONCLUSION: Although homosexuality is excluded from DSM, the prevalences of many mental health problems are higher in homosexual group than heterosexual group. It is suggested that the more studies on depression and familiar function related to homosexuality are needed.
Depression ; Emigrants and Immigrants ; Heterosexuality* ; HIV ; Homosexuality* ; Humans ; Male ; Mental Health* ; Prevalence ; Quality of Life* ; Self Concept ; Smoke ; Smoking ; Suicide

3

Cite

Share

Exploring Sources of Life Meaning among Koreans.

Mira KIM ; Hong Seock LEE ; Sang Kyu LEE

Journal of Korean Neuropsychiatric Association.2002;41(5):912-929.

OBJECTIVES: The purpose was to explore sources of Koreans' life meaning and determine its structure that is reflective of Koreans' unique culture and values. METHODS: The study consisted of both qualitative and quantitative research methods. To this end, two sample data sets were collected. Study One was an exploratory study in which the qualitative component was conducted in order to gather all possible attributes of sources of life meaning among Koreans. All possible sources of life meaning were extracted through content analysis. Study Two was a quantitative study using a closed questionnaire and conducted in order to determine the structure of Koreans' life meaning by measuring Koreans' current level of life meaning. For the study, factor analysis was carried out. RESULTS: From Study One, 106 attributes of all possible sources of Koreans' life meaning were extracted. In Study Two, factor analysis with the responses from 638 subjects reduced 106 attributes to 53 attributes and ten factors were extracted as Koreans' sources of life meaning: Achievement, Security, Religion, Acceptance & Affirmation, Relationship, Self-Transcendence, Good Character, Self-Discipline, Physical Health and Intimate Friend. CONCLUSION AND IMPLICIATIONS: Among the ten factors extracted from this study, the factors of Security, Acceptance and Affirmation, Good Character, Self-Discipline, and Physical Health are Koreans' unique factors of Life Meaning, while Achievement, Religion, Relationship, Self-Transcendence and Intimate Friend are comparable to Wong's1) Personal Meaning Profile for Canadians. It implies that it is necessary to develop Koreans' own measurement tool in order to assess their life meaning properly. However, because this study was an exploratory in developing Koreans' life meaning mea-surement and had several limitations, in order to determine structure of Koreans' life meaning, further study must be necessary.
Dataset ; Friends ; Humans ; Surveys and Questionnaires

4

Cite

Share

Item Characteristics of the Hamilton Rating Scale for Depression: Self-Report Inventory.

Chang Yoon KIM ; Jin Kyung GOH ; Eun Yoe RO

Journal of Korean Neuropsychiatric Association.2002;41(5):905-911.

OBJECTIVES: The present study investigates the psychometric adequacy of the Hamilton Depression Scale-Self-Report(HAMD-Self-report) with respect to the measuring the severity of depressive symptom by the use of item-response models(two parameter logistic model). METHODS: 114 patients with depressive disorder as diagnosed by DSM-IV criteria were studied. All depressed patients were aged 22 years or older, with the mean age of 33. They were requested to fill up the questionnaires of Hamilton Rating Scale for Depression-Self-Report. The data was analysed by Bayesian 1.0 for windows for item analysis. RESULTS: 1) Of the 76 items that consist of HAMD-Self-report, only 66 fitted the Item response model. 2)The 66 items reflected the degree of depression necessary for each symptom to shift from 'low intensity' to 'moderate intensity', and from 'moderate' to 'high intensity'. 3) The subscales of feeling of guilty and weight loss were mainly consisted of items with high item severity. Therefore only the severely depressed subjects may response. The subscale work and activities was made of items with low item severity, and the subjects with much less severe may response. CONCLUSION: The 66 items that were fitted to the item response model represented the different level of depressive severity. By weighing each item differently with respect to the symtom severity parameter(item severity), each item on the subscales represents a different level of depressive severity. Therefore the total score computed by summing responses to the highest weighted item of each scale can be used as an adequate index of depressive severity.
Depression* ; Depressive Disorder ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Psychometrics ; Surveys and Questionnaires ; Weight Loss

5

Cite

Share

The Study for Switching Methods to Olanzapine in Korean Schizophrenic Patients Treated with Other Antipsychotics(II): Comparison of Safety.

Yong Min AHN ; Yong Sil KWEON ; Jun Soo KWON ; Seong Ho MIN ; Doo Byung PARK ; Mun Jung YANG ; Hyoung Seok SOH ; Jong Ho SONG ; Yoon Sik SHIN ; Haing Won WOO ; Bum Hee YU ; Hong Seok LEE ; Han Yong JUNG ; Chang Hwan HAN ; Yong Sik KIM

Journal of Korean Neuropsychiatric Association.2002;41(5):890-904.

OBJECTIVES: This multicenter clinical trial involving 13 hospital sites compared the safety of switching to olanzapine between 'direct switching method' and 'start-tapering switching method'. METHOD: This study included both inpatients and outpatients who fulfilled the criteria for schizophrenia as defined in the ICD-10, and were in need to be appropriate for switching antipsychotics. Subjects were randomly assigned to one of the two switching methods. For 'direct switching method' group, previous antipsychotics were abruptly discontinued and 10mg of olanzapine was administered, whereas for 'start-tapering switching method' group, initially 10mg of olanzapine was administered and previous antipsychotics was gradually tapered for 2 weeks. Olanzapine was used for 6 weeks and the dose was adjusted within the range of 5-20mg. The safety of switching to olanzapine was measured with vital signs including body weight, adverse events reported spontaneously, laboratory tests, and various scales such as Simpson-Angus Scale(SAS), Barnes Akathisia Rating Scale(BARS), Abnormal Involuntary Movement Scale(AIMS), and Liverpool University Neuroleptic Side Effect Rating Scale(LUNSERS). RESULTS: 103 patients were switched to olanzapine in this study. The comparison between two switching methods did not show any significant difference in the dosage of olanzapine used, the concomitant use of benzodiazepine, the rate and reasons of drop-out, the adverse events, vital signs, laboratory tests, and most scales for measuring side-effects. However, the decrease in AIMS scores was significantly lower in 'direct switching method' group, and the concomitant use of anticholinergics was comparatively greater in 'start-tapering switching method' group. At baseline, SAS and BARS scores were 3.5 and 1.8 points respectively, and more than 70% of the subjects showed hyperprolactinemia. After switching to olanzapine, SAS, BARS, and AIMS scores were significantly decreased and the proportion of the patients with hyperprolactinemia was also decreased to less than 30%. However significant weight gain after the treatment of olanzapine was observed regardless of switching method. CONCLUSION: This study may suggest that switching to olanzapine can be done with relatively high safety regardless of switching methods and olanzapine can significantly decrease some side-effects induced by other antipsychotics.
Antipsychotic Agents ; Benzodiazepines ; Body Weight ; Cholinergic Antagonists ; Dyskinesias ; Humans ; Hyperprolactinemia ; Inpatients ; International Classification of Diseases ; Outpatients ; Psychomotor Agitation ; Schizophrenia ; Vital Signs ; Weight Gain ; Weights and Measures

6

Cite

Share

The Study for Switching Methods to Olanzapine in Korean Schizophrenic Patients Treated with Other Antipsychotics(I): Comparison of Therapeutic Effecacy.

Yong Min AHN ; Kyung Bong KOH ; Young Jin KOO ; Leen KIM ; Kyung Joon MIN ; Ki Chang PARK ; Ho Suk SUH ; Jong Ho SONG ; Haing Won WOO ; Bum Hee YU ; Dong Woo LEE ; Chung Tai LEE ; Sang Ick HAN ; Sun Ho HAN ; Chang Hwan HAN ; Yong Sik KIM

Journal of Korean Neuropsychiatric Association.2002;41(5):876-889.

OBJECTIVES: This randomized, multicenter, open-label, parallel clinical trial was carried to compare the therapeutic efficacy and the proportion of successful switch between 'direct switching method' and 'start-tapering switching method' when switching an antipsychotic to olanzapine. METHODS: This study included both inpatients and outpatients who fulfilled the criteria for schizophrenia as defined in the ICD-10 from 13 hospitals, and were in need to be appropriate for switching antipsychotics. Subjects were randomly assigned to one of the two switching methods. For 'direct switching method' group, previous antipsychotics were abruptly discontinued and 10mg of olanzapine was administered, whereas for 'start-tapering switching method' group, initially 10mg of olanzapine was administered and previous antipsychotics was gradually tapered for 2 weeks. Olanzapine was used for 6 weeks and the dose was adjusted within the range of 5-20mg. The therapeutic efficacy was measured with PANSS, BPRS, and CGI-Severity. A successful switching was defined as the completion of the 6 week trial without either worsening of the symptom(i.e. CGI-S score becomes worse twice consecutively) or the exacerbation of extrapyramidal symptoms(i.e. Simpson-Angus Scale scores becomes worse). RESULTS: 103 schizophrenic patients were participated in this study. There were no differences in baseline characteristics such as the demographic variables, the severity of symptoms, the history of previous antipsychotics treatments, the dosage of olanzapine used and the compliance between two groups. The proportion of successful switch was 71.1% for "direct switching method" and 82.2% for "start-tapering switching method", and there was no significant difference between the two switching methods. Also response rates to olanzapine based on total PANSS total scores were not different between the two groups(26.9% vs. 31.1%). At the time of completion of the trial, the scores of PANSS total, PANSS subscales, CGI-S and BPRS have significantly decreased after switching to olanzapine. But the changes of all scales measuring therapeutic efficacy in both endpoint and weekly analyses were not significantly different between the two switching methods. CONCLUSION: Although this study trial has many limitations and problems as an open clinical trial, the results may suggest that there were no significant differences between the two switching methods in the therapeutic efficacy. It was also found that the additional therapeutic benefits could be obtained by switching their antipsychotics to olanzapine.
Antipsychotic Agents ; Compliance ; Humans ; Inpatients ; International Classification of Diseases ; Outpatients ; Schizophrenia ; Weights and Measures

7

Cite

Share

Longitudinal Study of Cerebral Blood Perfusion Deficits in 12 Cases of Dementia of Alzheimer's Typer.

Jin Yeong KIM ; Jae Sung LEE ; Dong Woo LEE ; Jang Kyu KIM ; Hong Jin JEON ; Seon Uk KIM ; Dong Soo LEE ; Maeng Je CHO

Journal of Korean Neuropsychiatric Association.2002;41(5):863-875.

OBJECTIVES: The purpose of this study was to investigate the pattern of longitudinal changes in cerebral blood perfusion defects using SPECT in patients with dementia of Alzheimer's type . METHOD: Twelve patients with dementia of Alzheimer's type(10 male, 2 female; mean age 73.25+/- 10.62 years), diagnosed by the criteria of the DSM IV and the NINCDS-ADRDA, and ten normal comparison subjects(7 male, 3 female; mean age 75.10+/-5.76 years) were recruited. They were rated by Mini-Mental Status Examination, Mattis dementia Rating Scale, and Hamilton Depression Rating Scale. rCBF(regional cerebral blood flow) was measured using 99mTc-HMPAO SPECT at the initial study in all subjects, but rCBF was remeasured only in the patients after the follow-up period of average 2 years. SPECT scans of dementia patients and comparison subjects were analyzed by three- dimensional volume of interest method. RESULTS: Results were as follows. 1) There were significant perfusion defects in the bilateral frontal and temporoparietal areas in patients with dementia compared with normal comparison subjects at the baseline evaluation. More extensive perfusion defects including left superior frontal and medial temporal areas were observed in the follow-up SPECT scan compared with baseline scan. 2) There was significant negative correlation between rCBF of bilateral temporal lobe at the baseline scan and the rate of decline of scores of MMSE-K and Mattis dementia rating scale. 3) Various areas of the brain showed correlations between rCBF at the baseline scan and the rate of decline of scores of five subscales of Mattis dementia rating scale. CONCLUSIONS: Three-dimensional VOI approach using SPM analysis showed the characteristic perfusion defects and pattern of longitudinal changes in the patients of dementia of Alzheimer's type, which may be overlooked by the conventional region-of-interest technique. This alteration in rCBF may be closely related to the pathophysiological process of dementia of Alzheimer's type.
Brain ; Dementia* ; Depression ; Female ; Follow-Up Studies ; Frontal Lobe ; Humans ; Longitudinal Studies* ; Male ; Perfusion* ; Technetium Tc 99m Exametazime ; Temporal Lobe ; Tomography, Emission-Computed, Single-Photon

8

Cite

Share

Volumetric Brain MRI Study in Patients with First Episode Schizophrenia.

Sang Eun SHIN ; Min Hee KANG ; Jeong Seop LEE ; Chul Eung KIM ; Jae Nam BAE ; Sung Wook CHOI

Journal of Korean Neuropsychiatric Association.2002;41(5):847-862.

OBJECTIVES: To demonstrate the structural pathogenesis of schizophrenia, this study measures cerebral and cerebellar volumes of antipsychotics-navie and first episode schizophrenic patients. Also this study analyzes morphological character of patients with early schizophrenia. METHODS: Volume segmentation incorporating MRI scanning was performed on 25 patients with schizophrenia(mean age: 31.2+/-7.85yr, ranging: 14-18yr) and a control group of 29 healthy dindividuals(mean age: 29.03+/-7.02yr, ranging: 18-42yr). To carry out segmentation, the cerebrum and cerebellum were partitioned by gray matter, white matter and cerebrospinal fluid using a probabilistic histologic algorithm. These images of the segments were defined as the frontal, parietal, temporal and occipital lobes and cerebellum by using the semi-automated technique based on the atlas developed by Talairach. The area of dimension for each fraction was measured and its symmetry was compared. A statistical analysis was performed using the analysis of covariance by compensating the total brain volume with the level of covariance. RESULTS: The total brain volume of the schizophrenic patient group was significantly smaller than that of the control group(t=-1.986, d.f.=38.97, p=0.05). Female patients with schizophrenia showed a smaller right cerebellar volume than the female controls(F=4.20, d.f.=(1,51), p=0.046). Female with schizophrenia showed a larger left frontal white matter volume than their female controls and male with schizophrenia showed a smaller right frontal white matter volume than their male controls(F=6.89, d.f.=(1,51), p=0.012). Male patients with schizophrenia showed a larger right occipital white matter volume than the male controls. Females with schizophrenia showed a larger left occipital white matter volume than their female controls and male with schizophrenia showed a smaller left occipital white matter volume than their male controls(F=3.97, d.f.=(1,51), p=0.050). Female patients with schizophrenia showed a larger parietal white matter volume than the female controls(F=6.14, d.f.=(1,51), p=0.017). Female patients with schizophrenia also showed a smaller right and left cerebellar gray matter volume than the female controls(F=3.90, d.f.=(1,51), p=0.050). Female patients with schizophrenia also showed a smaller temporal gray matter volume than the female controls(F=4.74, d.f.=(1,51), p=0.034). CONCLUSION: These results demonstrate that the cerebellum and frontal lobe are involved in pathogenesis of schizophrenia, difference of white matter between schizophrenic patient and control is an important finding that suggest the importance of cortical dysconnection syndrome as pathophysiology on schizophrenia, and these findings suggest that pathogenesis of schizophrenia include many areas of brain.
Brain* ; Cerebellum ; Cerebrospinal Fluid ; Cerebrum ; Female ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging* ; Male ; Occipital Lobe ; Rabeprazole ; Schizophrenia*

9

Cite

Share

Interaction between Estrogen Receptor 1 and the Epsilon 4 Allele of Apolipoprotein E in Korean Schizophrenic Patients.

Tae Young CHOI ; Baik Seok KEE ; Mi Kyung LEE ; Ae Ja PARK ; Kyung Hwan KWAK ; Bum Yoo NAM ; Kyung Jun MIN ; Doo Byoung PARK

Journal of Korean Neuropsychiatric Association.2002;41(5):831-846.

OBJECTIVES: Recent studies indicated that estrogen receptor 1 subtype(ESR1) genetic polymorphisms may affect the expression of ESR1, and are associated with Alzheimer's disease. This study was designed to investigate the interaction between ESR1 polymorphism and the epsilon4 allele of apolipoprotein E(ApoE) in Korean schizophrenic patients. METHODS: We studied 46 schizophrenic patients and 40 healthy controls. The ESR1 & ApoE polymorphisms were assessed by PCR-restriction fragment length polymorphism(RFLP) or reverse hybridization. RESULTS: The distribution of the genotype in schizophrenic patients with XX, Xx, xx, PP, Pp, pp were 7(15.2%), 20(43.5%), 19(41.3%), 10(21.7%), 19(41.3%), 17(37%), and the controls were 1(2.5%), 12(30%), 27(67.5%), 7(17.5%), 21(52.5%), and 12(30%). No significant differences for genotype distribution were revealed between controls and schizophrenic patients except Xba I genotype. The genotype frequency of schizophrenia with xx of ESR1 and epsilon4 of ApoE were 58.7%, 6.5% and that of the controls were 58.7%, and 15%, respectively. The ESR1 genotypes and ApoE were not associated with onset age, psychiatric symptoms, familial history, subtype(positive vs negative) of schizophrenic cases. In kappa-square, there is no significant difference between the two groups, and we are with an assum the interaction between the homogenous ESR1 xx genotype and the ApoE epsilon4 allele was not ob-served in schizophrenic patients. CONCLUSION: The ESR1 gene may not appears to interact with the ApoE epsilon4 genotype in determining schizophrenia susceptibility. There was no significant association between schizophrenia and ESR1 & ApoE gene polymorphism. But, Xba I genotype may be closer to schizophrenia than Pvu II genotype.
Age of Onset ; Alleles* ; Alzheimer Disease ; Apolipoproteins E ; Apolipoproteins* ; Estrogen Receptor alpha* ; Estrogens* ; Genotype ; Humans ; Polymorphism, Genetic ; Schizophrenia

10

Cite

Share

Polymorphisms of Interleukin-4 Promoter and Interleukin-4 Receptor Gene in Schizophrenic Patients.

Jin Ouk CHOI ; Tae Youn JUN ; Chi Un PAE ; Kyoung Uk LEE

Journal of Korean Neuropsychiatric Association.2002;41(5):823-830.

OBJECTIVES: Recently, the main focus of etiologic study in schizophrenia has been directed to molecular genetic approach including polymorphism analysis. Abnormal immunoreactivity to IL-4 promoter and IL-4Ralpha has been identified in patients with schizophrenia. This study was designed to investigate the relationship between schizophrenia and immunologic influences by analyzing the polymorphisms of IL-4 promoter and IL-4Ralpha gene that are involved in interaction between immunologic system and CNS. METHODS: 222 schizophrenic patients diagnosed by DSM-IV and data of 165 normal controls obtained from Catholic Hemopoietic Stem Cell Information Bank, College of medicine, the Catholic University of Korea, were used in this study. DNA was extracted from whole blood and the polymorphic loci of IL-4 promoter and IL-4Ralphagene were amplified by polymerase chain reaction. Gene typing was performed by using SSCP and the results were assessed. The frequencies of allele and genotype were compared between patients and normal controls and between paranoid group and non-paranoid group. All data were analyzed chi2-test with two-tailed Fisher's exact test. RESULTS: 1) There were no significant differences in allele or genotype frequencies of IL-4 promoter and IL-4Ralpha between the group of schizophrenic patients and controls. 2) There were no significant differences in allele or genotype frequencies of IL-4 promoter and of IL-4Ralpaha between the group of paranoid schizophrenic patients and non-paranoid schizophrenic patients. CONCLSUION: These results suggest that polymorphisms of IL-4 promoter and IL-4Ralpha genes are unlikely related with the pathogenesis of schizophrenia.
Alleles ; Diagnostic and Statistical Manual of Mental Disorders ; DNA ; Genotype ; Humans ; Interleukin-4* ; Korea ; Molecular Biology ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Schizophrenia ; Stem Cells

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share