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Attitude Toward Antipsychotic Treatment According to Patients' Awareness of the Name of Their Illness in Patients with Schizophrenia.

Ji Eun JANG ; Sung Wan KIM ; Yo Han LEE ; Seon Young KIM ; Kyung Yeol BAE ; Jae Min KIM ; Il Seon SHIN ; Jin Sang YOON

Korean Journal of Schizophrenia Research.2012;15(2):106-113. doi:10.16946/kjsr.2012.15.2.106

OBJECTIVES: This study compared attitudes toward antipsychotic treatment according to awareness of the name of their illness in patients with schizophrenia. METHODS: Information on sociodemographic and clinical characteristics, including awareness of the importance of antipsychotic treatment, was obtained through a self-report questionnaire. The Drug Attitude Inventory (DAI) was administered. The data were compared according to awareness of the name of their illness. RESULTS: The study analyzed data for 199 patients with schizophrenia. Of these, 115 patients (57.8%) were aware that their illness was called schizophrenia, while 84 patients (42.2%) knew it by their psychotic symptoms or as another mental illness, such as depression. The patients aware of the name of their illness had significantly longer durations of illness and higher scores on the DAI. They were significantly more likely to have stopped taking medication on their own accord and to agree with the importance of antipsychotic treatment. Statistical significance was sustained in a logistic regression analysis after adjusting for the duration of illness and study site, except for the DAI score, which had borderline significance (p=0.055). In subjects with duration of illness > or =5 years, patients aware of the name of their illness had significantly higher scores on the DAI. CONCLUSION: Awareness of the name of their illness was associated with awareness of the importance of, and a positive attitude toward, antipsychotic treatments in patients. Psycho-education, including telling the patient the correct name of his or her illness, might be needed for maintaining antipsychotic treatment in patients with chronic schizophrenia.
Antipsychotic Agents ; Depression ; Humans ; Logistic Models ; Surveys and Questionnaires ; Schizophrenia

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Psychomotor Performance Relevant to Driving Ability in Patients with Schizophrenia Treated with Haloperidol and Aripiprazole.

Ji Hyun HAN ; Se Jin PARK ; Jong Il LEE ; An Kee CHANG ; Shi Hyun KANG ; Minah SOH ; Kyung Jin LEE ; Eun Sang KOH ; Sungwon ROH

Korean Journal of Schizophrenia Research.2012;15(2):99-105. doi:10.16946/kjsr.2012.15.2.99

OBJECTIVES: This study aimed to compare psychomotor performance related with automobile driving in patients with schizophrenia under the treatment of a typical antipsychotic agent, haloperidol, or an atypical antipsychotic agent, aripiprazole. METHODS: We evaluated driving ability of schizophrenia patients by using the cognitive perceptual assessment for driving (CPAD). Twelve patients receiving haloperidol monotherapy and 18 taking aripiprazole monotherapy participated in this study and the results of CPAD were compared with each other. RESULTS: Of 30 participants, 15 (50%) of the patients passed the CPAD to be regarded as competent to drive, 3 (10%) of the patients failed the CPAD considered to be severely impaired. Controlling for sex, age, education, duration of illness, there were no significant differences in the CPAD results between two treatment groups. We observed a trend that patients who received aripiprazole showed a higher total score of the CPAD than haloperidol-treated patients (55.2+/-4.9 vs. 45.7+/-8.4, p=0.080). CONCLUSION: There were no significant differences in the psychomotor performance relevant to driving ability between haloperidol and aripiprazole groups. But our results suggest that aripiprazole might have the neurocognitive advantage over haloperidol. Future study with a large sample size and diverse antipsychotics is warranted.
Antipsychotic Agents ; Automobile Driving ; Haloperidol ; Humans ; Imidazoles ; Nitro Compounds ; Piperazines ; Psychomotor Performance ; Quinolones ; Sample Size ; Schizophrenia ; Aripiprazole

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Pilot Study on Resting-State Functional Connectivity under the Effects of Familial Loading in People at Ultra-High Risk for Psychosis.

Beom Jun MIN ; Tae Young LEE ; Sung Nyun KIM ; Hyun Jung HAN ; Da Jung SHIN ; Seo Hyun JO ; Jun Soo KWON

Korean Journal of Schizophrenia Research.2012;15(2):90-98. doi:10.16946/kjsr.2012.15.2.90

OBJECTIVES: People at ultra-high risk for psychosis have heterogenous character and different long-term outcomes. We divided ultra-high risk subjects into two subgroups by presence of familial history and tried to find different pattern of functional connectivity of the default mode network (DMN) between the two groups in order to examine the effects familial loading. METHODS: Eleven subjects at clinical-high risk (CHR) group with familial history of psychiatric illness and nineteen subjects of CHR group without familial history were recruited. All the subjects were scanned using resting-state functional magnetic resonance imaging. A posterior cingulate cortex was the seed region of the analysis, and the DMN of the both high risk group were analyzed with voxel-wise two sample T test. RESULTS: The CHR group with familial history showed greater functional connectivity in the precuneus area in contrast with the other high risk subjects (peak-level t=5.49, p<0.001). There were no significant differences in total score on the Positive and Negative Syndrome Scale and Scales of Psychosis-risk Syndrome between the two groups. CONCLUSION: The study suggests that the abnormalities of functional connectivity between precuneus and posterior cingulate area may be associated with the genetic vulnerability of high risk trait.
Gyrus Cinguli ; Magnetic Resonance Imaging ; Pilot Projects ; Psychotic Disorders ; Seeds ; Weights and Measures

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Comparison of the Rorschach Test Characteristics between Bipolar Disorder and Unipolar Depression.

Mi Jin KIM ; Ju Hyun PARK ; Ji Hyun BAEK ; Eun Ho LEE ; Ji Hae KIM ; Hong CHOI ; Dongsoo LEE ; Kyung Sue HONG

Korean Journal of Schizophrenia Research.2012;15(2):81-89. doi:10.16946/kjsr.2012.15.2.81

OBJECTIVES: Differential diagnosis based on descriptive psychopathology between bipolar and unipolar depression in the clinical setting is a still huge challenge. Projective psychological tests might provide additional clues. This study aimed to find distinct Rorschach test characteristics of bipolar depression in comparison with unipolar depression. METHODS: Medical records and raw data of the Rorschach Inkblot test applied using standardized procedure for the Exner Comprehensive System were retrospectively reviewed for patients with bipolar disorder or unipolar depression. Individual variables of the Rorchach test were compared among three groups, i.e., (hypo) mania (n=59), bipolar depression (n=56) and unipolar depression (n=25). RESULTS: Bipolar depression group, in accordance with (hypo) manic group, showed more color reponses (WSumC), more extroverted and intuitive decision-making (EBright), and higher emotional expression (CF+C) and instability (ebright), compared to unipolar deperssion group. On the contrary, the (hypo) mania group displayed more cognitive errors (Sum6, WSum6) compared to both depression groups. CONCLUSION: This study suggests that Rorchach test might provide valuable markers for differential diagnosis between bipolar and unipolar depression, and that some of those markers could be regarded as trait markers of bipolar disorder.
Bipolar Disorder ; Depression ; Depressive Disorder ; Diagnosis, Differential ; Humans ; Medical Records ; Psychological Tests ; Psychopathology ; Retrospective Studies ; Rorschach Test

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Symptom Remission Related to Increased Drug Response after Conversion Into Schizophrenia in Early Psychosis : A Case Report.

Jung Hoon KIM ; Jong Ik PARK

Korean Journal of Schizophrenia Research.2016;19(2):89-93. doi:10.16946/kjsr.2016.19.2.89

In recent years, early intervention is the paradigm in psychosis treatment. The logic of early intervention paradigm is based on the view that the earliest possible detection and intervention for psychosis will deliver the best outcome for patients. Therefore, in recent decades, most of studies focused on indentifying people with psychosis as early as possible, reducing the duration of untreated psychosis. However, while there are well documented and sometimes serious side effects associated with antipsychotic medication in the short-term, the iatrogenic risks of atypical antipsychotic medication are underscored. Furthermore, against this paradigm, the recent of longitudinal studies of schizophrenia suggest a new paradigm shift in treatment timing of psychosis. In this respect, this case which showed symptom remission after conversion into schizophrenia in early psychosis suggests wondering about the time of treatment. Similar cases have not been reported. And review of the effects of timing, in fact, has yet to be done. If similar cases would be reported in the future more, treatment timing may be the next paradigm shift in the therapeutics of early psychosis.
Antipsychotic Agents ; Early Intervention (Education) ; Humans ; Logic ; Longitudinal Studies ; Psychotic Disorders* ; Schizophrenia*

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Factors Affecting Quality of Life and Family Burden among the Families of Patients with Schizophrenia.

Se Ri MAENG ; Won Hyung KIM ; Ji Hyun KIM ; Jae Nam BAE ; Jeong Seop LEE ; Chul Eung KIM

Korean Journal of Schizophrenia Research.2016;19(2):78-88. doi:10.16946/kjsr.2016.19.2.78

OBJECTIVES: Study aimed to identify factors that may affect family burden and quality of life (QOL) of primary caregivers in schizophrenia family. METHODS: Among outpatients with schizophrenia undergoing treatment at the psychiatric department of a university hospital, 72 patients and their primary caregivers were investigated. Sociodemographic and clinical data were collected and analyzed. RESULTS: As a result of multiple regression of primary caregivers’ family burden (R²=0.284), primary caregiver’s income (p=0.001) and patient’s delusional symptoms (p=0.001) significantly explained the total family burden of primary caregivers. In multiple regression on QOL (R²=0.515), primary caregiver’s income (p=0.033) and education level (p=0.006), patient’s sex (p=0.006), treatment duration (p<0.001), degree of disorganized speech (p=0.008), negative drug attitudes (p=0.026) and the attitude of overcoming stigma against mental patients (p=0.029) all significantly explained the average QOL score. CONCLUSION: Various factors determining primary caregiver’s QOL, including Clinical symptoms such as patient’s disorganized speech and clinically correctable factors such as negative drug attitude and insight into disease. Therefore, provision of education regarding drug and disease for patients and caregivers will be helpful to effectively reduce burden and improve the QOL of primary caregivers.
Caregivers ; Delusions ; Education ; Humans ; Mentally Ill Persons ; Outpatients ; Quality of Life* ; Schizophrenia*

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Prescription Pattern of Atypical Antipsychotics in a University Psychiatric Ward : 11-Year Observational Study.

Sung Yeol PARK ; Sangho SHIN ; Euitae KIM

Korean Journal of Schizophrenia Research.2016;19(2):68-77. doi:10.16946/kjsr.2016.19.2.68

OBJECTIVES: This study investigated the prescribing patterns of atypical antipsychotics for the various psychiatric disorders in the psychiatric ward of a University hospital. METHODS: We reviewed the medical records of patients who were discharged from an open psychiatric ward from May, 2003 through April, 2014. The association between psychiatric disorders and prescription pattern of atypical antipsychotics was analyzed. RESULTS: The study included 3091 patients' prescription of psychiatric medication. 60% of prescription included antipsychotics; quetiapine was the most frequently prescribed antipsychotics, but the average dosage was the lowest among all the atypical antipsychotics. According to the diagnoses, prescription rates and dosage of antipsychotics were different. Prescription rates of antipsychotics were the lowest in patients with anxiety disorders, and the mean dosage were the lowest in those with delirium, dementia, and amnestic and other cognitive disorders. CONCLUSION: This observational study shows prescription patterns of atypical antipsychotics for the treatment of psychiatric disorders in a University hospital; atypical antipsychotics were widely used for the treatment of the various disorders, and there were differences in prescription patterns for each disorders. The results of this study may be used to identify the proper atypical antipsychotics effective on certain psychiatric disorders and to propose expanding the indications of each atypical antipsychotics in the future.
Antipsychotic Agents* ; Anxiety Disorders ; Delirium ; Dementia ; Diagnosis ; Humans ; Medical Records ; Observational Study* ; Prescriptions* ; Quetiapine Fumarate

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Prevalence of Sexual Dysfunction in Schizophrenic Patients Taking Antipsychotic Drugs.

Sun Hwa JEONG ; Shi Hyun KANG ; Dong Yeon PARK ; Hai Joo YOON ; Eun Kyung PARK ; Jong Il LEE

Korean Journal of Schizophrenia Research.2016;19(2):60-67. doi:10.16946/kjsr.2016.19.2.60

OBJECTIVES: Sexual dysfunction is said to affect the compliance of drug and quality of life. This study is a research to investigate the prevalence of sexual dysfunction and affecting factors that can occur when schizophrenic and schizoaffective patients have taken drugs. METHODS: Subjects were 300 patients who have been taken inpatient or outpatient treatment in national seoul hospital. We used UKU-S, ASEX scale for evaluating the prevalence of sexual dysfunction and CGI-S, PANSS negative scale and CES-D for investigating the influence of psychopathology and depressive symptoms on sexual dysfunction. RESULTS: It was reported sexual dysfunction 82.7% in male and 92.2% in female with 7 items of UKU-S. The prevalence of sexual dysfunction with criteria of ASEX was 47.72% in male and 65.05% in female. Sexual dysfunction was more prevalent in patients taking prolactin-elevation drugs. In the factor analysis for the sexual dysfunction it was investigated that age, onset time, CGI-S, PANSS negative scale, and CES-D can affect the sexual dysfunction in both male and female. CONCLUSION: This study reported that many patients complained of sexual dysfunction. On considering the influence of sexual dysfunction to compliance and quality of life, clinicians evaluate sexual side effects more actively because patients are more likely not spontaneously tell the sexual side effects in comparison to others.
Antipsychotic Agents* ; Compliance ; Depression ; Female ; Humans ; Inpatients ; Male ; Outpatients ; Prevalence* ; Psychopathology ; Quality of Life ; Schizophrenia ; Seoul

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Factors Predicting Personal and Social Performance in Schizophrenia Patients.

SuHyuk CHI ; Hyun Ghang JEONG ; Moon Soo LEE ; Seung Hyun KIM

Korean Journal of Schizophrenia Research.2016;19(2):47-59. doi:10.16946/kjsr.2016.19.2.47

OBJECTIVES: Schizophrenia is a chronic psychiatric disorder characterized by its debilitating course. It leads to personal and social dysfunctions, burdening patients and guardians heavily. Enhancing functional outcome is a major treatment goal, but pharmacotherapy alone is usually not enough. Hence, it is important to reveal clinical factors that can predict personal and social performance in schizophrenia patients. Analyze factors influencing personal and social performance in schizophrenia patients. METHODS: 66 schizophrenia patients from three University hospitals in Korea were enrolled, completing clinical scales between January 2008 and December 2009. 38 patients dropped out during follow up. 28 patients were included in the final study. Personal and social performance was measured using the Personal and Social Performance scale (PSP) since January 2015. Correlation and multiple regression analyses were performed to reveal associations between demographic and clinical factors and PSP. RESULTS: Correlation analyses resulted in statistically significant correlations between CGI-S (r=-0.646, p<0.01), PANSS (r=-0.419, p<0.05), KISP (r=-0.523, r<0.01), KmSWN (r=0.388, p<0.05), Trail making B (r=0.608, p<0.01), KDAI (r=0.608, p<0.01), and PSP. Stepwise multiple regression analyses showed significant models with CGI-S (β=-0.485, p<0.01), and KDAI (β=0.423, p<0.01). CONCLUSION: Our results show that attitude toward drugs and symptom severity affect a patient’s personal and social performance most prominently. We advise to focus on patient education to reinforce attitude toward drugs, and to concentrate on reducing symptom severity to enhance personal and social performance in schizophrenia patients.
Drug Therapy ; Follow-Up Studies ; Hospitals, University ; Humans ; Korea ; Patient Education as Topic ; Schizophrenia* ; Weights and Measures

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A Study on Discontinuation Rate on Maintenance Treatment of Antipsychotic Agents in Schizophrenic Patients.

Ha Hyun BAE ; Eui Hyeon NA ; Hai Joo YOON ; Eun Kyung PARK ; Jong Il LEE

Korean Journal of Schizophrenia Research.2017;20(2):69-76. doi:10.16946/kjsr.2017.20.2.69

OBJECTIVES: Relapse prevention is a major therapeutic goal in the treatment of schizophrenia. However, many patients experience multiple functional impairments and treatment resistance due to recurrence. This study was designed to investigate the follow-up of patients with using antipsychotic drugs and to compare the total treatment failure rate, withdrawal reasons, and duration period of antipsychotic drugs. METHODS: The subjects were 1963 patients who taking antipsychotic drugs under the diagnosis of schizophrenia. We selected 1836 patients using 10 antipsychotic drugs according to frequency of using. The rate of total treatment failure of them was divided into 6-month, 1-year, 2-year, 3-year, and 5-year according to the time of drug withdrawal. We compared the total treatment failure rate at 1 and 3-year between 10 antipsychotic drugs. RESULTS: The total treatment failure rate of clozapine was lowest compared with the other 9 antipsychotic drugs in all the surveyed periods. When evaluating actual number of subjects, olanzapine, sulpiride, risperidone, aripiprazole, amisulpride, and haloperidol were lower significantly compared with ziprasidone at 1-year in the total treatment failure rate, but there was no significant difference between them except clozapine at 3-year. The results of the analysis based on the number of prescriptions showed that the total treatment failure rate of the atypical antipsychotic drug was lower than that of the typical antipsychotic drug at 1-year, but the difference was decreased over time except quetiapine and ziprasidone. CONCLUSION: In conclusion, although there is some controversy about which drug to prescribe to the patient, the clinician needs a proper prescription considering various factors such as efficacy, side effects, price, and formulations of each drug.
Antipsychotic Agents* ; Aripiprazole ; Clozapine ; Diagnosis ; Follow-Up Studies ; Haloperidol ; Humans ; Prescriptions ; Quetiapine Fumarate ; Recurrence ; Risperidone ; Schizophrenia ; Secondary Prevention ; Sulpiride ; Treatment Failure

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