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Intensive Cognitive Behavioral Case Management for Functional Recovery of Young Patients with Schizophrenia.

Ga Young LEE ; Hye Young YU ; Min JHON ; Jin Sang YOON ; Sung Wan KIM

Korean Journal of Schizophrenia Research.2016;19(1):32-37. doi:10.16946/kjsr.2016.19.1.32

Intensive case management provided at the critical period following the onset of schizophrenia is crucial for early social and vocational recovery. We report the young schizophrenia patient who had been treated for 2 years but frequently relapsed and attempted suicide. After receiving cognitive behavioral case management from community mental health center, she has functionally recovered without recurrence for 4 years. Collaboration between psychiatrists of hospital and case manager of community mental health center was very important factor that contributed to her functional recovery. Cognitive behavioral case management promoting coping skills and reducing perceived stress was effective on successful social adaptation even during the stressful situations. In conclusion, psychosocial management including cognitive behavioral case management at the early stage of schizophrenia is crucial to prevent the relapse and to recover patients' function.
Adaptation, Psychological ; Case Management* ; Cooperative Behavior ; Critical Period (Psychology) ; Early Intervention (Education) ; Humans ; Mental Health ; Psychiatry ; Recurrence ; Schizophrenia* ; Suicide, Attempted

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A Comparative Analysis of the Official Crime Statistics of People with Mental Illness and Public Perception.

Jisun PARK

Korean Journal of Schizophrenia Research.2016;19(1):25-31. doi:10.16946/kjsr.2016.19.1.25

OBJECTIVES: There exists only a limited number of studies on the people's perception of criminality of people with mental illness. People's fear of the dangerousness of people with mental illness may have been exaggerated, and yet there are few studies exploring whether people's view of the crime rates of mentally ill people are correct or not. METHODS: A total of 363 college students participated in the present study. The present study first compared the official statistics of the crime rates of the mentally ill with the public perception. In addition, the rates of mentally ill offenders with previous convictions across crime types are compared with people's perception. RESULTS: Compared to the official crime statistics, people's estimates of crime rates of mentally ill offenders were grossly exaggerated across crime types, including fraud, assault, rape, robbery, theft, homicide, and arson. Furthermore, the rates of mentally ill offenders with previous convictions across all crime types on the official crime statistics were actually higher than people's estimates. CONCLUSION: The present findings reveal that people's view of the crime rates of mentally ill people is considerably distorted. There is an urgent need to clarify these prejudices in order to help people with mentally illness adjust to society and to prevent them from committing crime.
Crime* ; Criminals ; Dangerous Behavior ; Firesetting Behavior ; Fraud ; Homicide ; Humans ; Mentally Ill Persons ; Prejudice ; Rape ; Theft

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Reason for Clozapine Discontinuation.

Jin Woo CHO ; Won Hyoung KIM ; Jun Hwan SHIN ; Ji Hyun KIM ; Jeong Seop LEE ; Jae Nam BAE ; Chul Eung KIM

Korean Journal of Schizophrenia Research.2016;19(1):17-24. doi:10.16946/kjsr.2016.19.1.17

OBJECTIVES: Approximately 30% of individuals diagnosed with schizophrenia suffer from treatment-resistant schizophrenia. Clozapine is underutilized in the management of treatment-resistant schizophrenia. To understand contributing factors, we analyzed the time course and causes of clozapine discontinuations that occurred over a 20-year period in a clinical setting. METHODS: The reasons for discontinuation and duration of clozapine treatment from a retrospective database of 138 patients with schizophrenia who had prescribed clozapine at least a month were reviewed, with the motives for discontinuation coded. The causes for termination were analyzed. RESULTS: Over two-thirds of the patient had ceased clozapine. The two most common causes for discontinuation were side-effects (50%), and own decision (30%). Somnolence accounted for 34% of all side-effects induced discontinuations. Hematological problems accounted for 23% of side-effect. The Maximal treatment dose of clozapine was higher in continuation group (442.36 mg) than in discontinuation group (397.26 mg). The CGI-S score when prescribing clozapine last was higher in discontinuation group than in continuous group. The patients who took atypical antipsychotics before clozapine tended to cease clozapine because of side-effects than who took typical agent. CONCLUSION: Future studies should seek various methods to relieve side-effects of clozapine. Prospective researches using more objective tools are needed to clarify the reason for clozapine discontinuation.
Antipsychotic Agents ; Clozapine* ; Humans ; Prospective Studies ; Retrospective Studies ; Schizophrenia

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Development of Smartphone Application for Cognitive Behavioral Therapy-Based Case Management in Patients with Schizophrenia.

Sung Wan KIM ; Ga Young LEE ; Hye Young YU ; Ji Hyun PARK ; Yong Sung LEE ; Ju Wan KIM ; Cheol PARK ; Ju Yeon LEE ; Yo Han LEE ; Jae Min KIM ; Jin Sang YOON

Korean Journal of Schizophrenia Research.2016;19(1):10-16. doi:10.16946/kjsr.2016.19.1.10

OBJECTIVES: This article aims to describe the development of smartphone application for the case management of patients with schizophrenia. METHODS: Gwangju Bukgu-Community Mental Health Center developed and launched a smartphone application (HYM) for cognitive-behavioral case management and symptom monitoring. The development of the application involved psychiatrists, nurses, social workers, psychologists, and software technicians from a software development company (Goosl Corp.). RESULTS: The HYM application for clients includes six main modules including Thought record, Symptom record, Daily life record, Official notices, Communication, and Scales. The key module is the 'Thought Record' for self-directed cognitive-behavioral treatment (CBT). When the client writes and sends the self-CBT sheet to the case manager, the latter receives a notification and can provide feedback in real time. 'Communication' and 'Official notices' are useful for promoting communication between case managers and clients with schizophrenia. Ratings in 'Symptom record', 'Daily life record', and 'Scales' modules are stored in graphic or table form representing changes in them and shared with case managers. CONCLUSION: The interactive function of this application is the key characteristics that distinguishes it from other mobile self-treatment tools. This smartphone application may contribute to the development of a youth- and customer-friendly case management system for individuals with early psychosis.
Case Management* ; Cognitive Therapy ; Early Intervention (Education) ; Gwangju ; Humans ; Mental Health ; Psychiatry ; Psychology ; Psychotic Disorders ; Schizophrenia* ; Smartphone* ; Social Work ; Social Workers ; Weights and Measures

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Characteristics of Ambivalence of Self-image in Patients with Schizophrenia.

Byung Hoon KIM ; Yu Bin SHIN ; Sunghyon KYEONG ; Seon Koo LEE ; Eun Joo KIM ; Jae Jin KIM

Korean Journal of Schizophrenia Research.2016;19(1):5-9. doi:10.16946/kjsr.2016.19.1.5

OBJECTIVES: Ambivalence of self-image is considered to be important in patients with schizophrenia since impairment of self-referential processing and increment in ambivalence are illness-related symptoms. This study aimed to evaluate quantitative and qualitative properties of ambivalence of self-image in patients with schizophrenia. METHODS: Twenty patients with schizophrenia and 20 normal controls performed a set of 'self-image reflection task' and then the level of ambivalence towards actual and ideal self-image were numerically scored. Ambivalence scores were compared between groups and correlation analyses with psychometric scales were done in each group. RESULTS: Patients with schizophrenia had higher level of ambivalence towards both actual and ideal self-image (p<0.001). Normal controls showed significant correlations with the scales representing level of self-concept clarity (r=-0.480, p=0.033), depression (r=0.479, p=0.033), and self-esteem (r=-0.555, p=0.011 ; R=-0.600, p=0.005) while the patients did not. CONCLUSION: Ambivalence towards one's self-image is more intense in patients with schizophrenia. This symptom may be considered to exist as an independent symptom in schizophrenia.
Depression ; Humans ; Psychometrics ; Schizophrenia* ; Weights and Measures

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Multidimensional Comparison of Personality Characteristics in Genetic High Risk for Schizophrenia, First Episode Psychosis and Healthy Controls.

Jae Wook HAN ; Sung Nyun KIM ; Jin Woo PARK ; Je Yeon YUN ; Na Young SHIN ; Ji Won HUR ; Seung Won KIM ; Jun Soo KWON

Korean Journal of Schizophrenia Research.2012;15(2):73-80. doi:10.16946/kjsr.2012.15.2.73

OBJECTIVES: Previous studies have suggested that some personality characteristics are associated with the onset, prognosis and social function in schizophrenia patients. However few is known about the personality and affective characteristic of genetic high risk group (GHR) for schizophrenia. This study aimed to investigate the personality and the affective characteristic of GHR group for schizophrenia. METHODS: Participants were 54 healthy controls (HC), 26 subjects with GHR for schizophrenia and 28 subjects with first episode psychosis (FEP). We performed three self-report questionnaires; NEO-Personality Inventory-Revised, State and Anger Expression Inventory and Positive Affect and Negative Affect Schedule. RESULTS: The GHR group showed higher score in agreeableness item than the HC (p=0.028). In extraversion item, the FEP group showed significantly lower scores than the HC (p=0.001). The GHR group showed lower scores in neuroticism item compared with FEP group in trend level. The FEP group showed higher trait-anger, lower positive affect and higher negative affect compared with the others. CONCLUSION: The GHR group seem to share certain vulnerable personality and affective characteristics for schizophrenia with the FEP group. On the other hands, the GHR group appeared to be more agreeable than the other groups, which might act as the compensation for other impaired functions.
Anger ; Anxiety Disorders ; Compensation and Redress ; Extraversion (Psychology) ; Hand ; Humans ; Polytetrafluoroethylene ; Prognosis ; Psychotic Disorders ; Schizophrenia

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Working Memory Deficits in Ultra-High Risk for Psychosis and Schizophrenia.

Im Hong JEON ; Jong Suk PARK ; Jin Young PARK ; Hye Hyun CHO ; Se Jun KOO ; Eun LEE ; Suk Kyoon AN ; Sun Kook YOO

Korean Journal of Schizophrenia Research.2012;15(2):66-72. doi:10.16946/kjsr.2012.15.2.66

OBJECTIVES: The aim of this study was to investigate whether verbal and spatial working memory functions were impaired not only in patients with schizophrenia but also in people at ultra-high risk for first-episode psychosis. METHODS: Twenty-five patients (M 13, F 12) with schizophrenia (SPR), 21 people at ultra-high risk for psychosis (UHR)(M 10, F 11) and 19 normal controls (NC)(M 10, F 9) were recruited. The working memory was assessed by using the verbal and spatial n-back test. The working memory load increased incrementally from the 0-back to the 3-back condition. RESULTS: SPR performed significantly lower than NC and UHR in terms of hit rates of verbal and spatial n-back test. UHR subjects conducted significantly lower than NC and higher in trend-level than SPR in terms of hit rates of verbal and spatial n-back test. These differences were derived from the high working memory load (2-back and 3-back), not from the low working memory load (0-back and 1-back). There was no significant difference between the verbal and spatial n-back test across the three groups. CONCLUSION: These findings suggest that verbal and spatial working memory dysfunction may be general rather than differential in terms of stimuli modality, and this working memory deficit may be an important trait factor in schizophrenia.
Humans ; Memory, Short-Term ; Psychotic Disorders ; Schizophrenia

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The Characteristics of Associative Learning of Reward Approach and Loss Aversion in Schizophrenia.

Sunyoung PARK ; Seok Hyeong KIM ; Il Ho PARK ; Jung Hwan KIM ; Jae Jin KIM ; Min Seong KOO ; Jungeun SONG

Korean Journal of Schizophrenia Research.2012;15(2):59-65. doi:10.16946/kjsr.2012.15.2.59

OBJECTIVES: Schizophrenia patients have deficits of prediction and learning related to dopaminergic dysfunction. It is hypothesized that there would be different characteristics in associative learning of reward approach and loss aversion between controls and patients. METHODS: Participants were 23 healthy participants and 20 out-patients fulfilling criteria for schizophrenia according DSM-IV-TR. Using a monetary incentive contingency reversal task, successful learning rates, numbers of trials and errors till learning, numbers of trials of maintaining learning, response times were measured. Characteristics of learning were compared between controls and patients. RESULTS: Physical anhedonia and PANSS negative symptom scores correlated with the number of trials while loss aversion was maintained. Overall correct response rates were decreased in patient group, particularly during reward approach learning. Patients required more trials and errors to learn reward approach than controls. There were no significant differences in learning performance and reaction times between groups during loss avoidance learning. CONCLUSION: These results support previous reports of deficits in reward-driven learning in schizophrenia. However, anhedonia and negative symptoms were associated with the preserved function of loss avoidance learning.
Anhedonia ; Avoidance Learning ; Humans ; Learning ; Motivation ; Outpatients ; Reaction Time ; Reinforcement (Psychology) ; Reward ; Schizophrenia

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A Study on the Neurobiological Basis of Communicative Intelligence Using Voxel-Based Morphometry.

Joohan KIM ; Shin Ae YOON ; Hae Jeong PARK

Korean Journal of Schizophrenia Research.2015;18(1):35-42. doi:10.16946/kjsr.2015.18.1.35

OBJECTIVES: To develop reliable tools for measuring communication skills in schizophrenia, the present study proposed the concept of communication intelligence, consisting of conversational competence, emotional competence, and empathic competence, and explored its neurobiological underpinnings using regional gray matter volume with healthy people. METHODS: Communicative intelligence scores were obtained from 126 healthy young participants. Correlation analyses between regional volume distributions and communication intelligence subcomponents were conducted using voxel-based morphometry of structural MRI. RESULTS: The significant positive correlations between the regional gray matter volumes with conversational competence were found mainly at the ventromedial frontal gyrus while the negative correlations between the bilateral middle frontal gyrus. With emotional competence, the volume of right superior temporal gyrus was positively and that of bilateral insula was negatively correlated. With empathic competence, the volume of the left middle frontal gyrus was positively and that of the insula was negatively correlated. CONCLUSION: Each of the subcomponents of communicative intelligence scores showed distinctive neurobiological underpinnings. The regions for the subcomponents, which constitute a common network for social cognition and emotion, are highly associated with the regions of the schizophrenia pathology. In conclusion, communicative intelligence scales have neurobiological basis to evaluate social skills of patients with schizophrenia.
Cognition ; Humans ; Intelligence* ; Magnetic Resonance Imaging ; Mental Competency ; Pathology ; Schizophrenia ; Weights and Measures

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A Comparison of Magical Ideation in Nonclinical Adolescent and Adult Groups : An Item Response Theory Based Differential Item Functioning Analysis.

Jung LEE ; Sumi PARK ; Yeni KIM ; Yong Sik KIM ; Hee Yeon JUNG

Korean Journal of Schizophrenia Research.2015;18(1):28-34. doi:10.16946/kjsr.2015.18.1.28

OBJECTIVES: We examined magical ideation in adolescent and adult group by Magical Ideation Scale (MIS). We also explored how adolescents and adults respond differently to each items of MIS. METHODS: 310 nonclinical adults and 310 Year 10 students participated in this study, and completed MIS and Symptom Checklist 90-revision (SCL-90-R). Total scores of MIS were compared between adults and adolescents. The item characteristics of MIS were evaluated by item response theory (IRT). Differential item functioning (DIF) was detected using the parameters of IRT. RESULTS: Total score of MIS was higher in adolescents than in adults, but there was no statistical significance. Item 5, 10, 13, and 16 showed significant difference on item difficulty parameters and were identified as DIF. Among DIF items, item 5 was more difficult for adolescents than adults. Item 10, 13, and 16 were more difficult for adults than adolescents. The modified MIS score excluding 4 DIF items was significantly higher in adolescents than adults. CONCLUSION: The influence of age on response to DIF items should be considered when comparing MIS scores between adolescents and adults.
Adolescent* ; Adult* ; Checklist ; Humans ; Magic*

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