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Variables Influencing Subjective Well-Being in Patients with Schizophrenia.

Jinseung OH ; Young Hoon KO ; Jong Woo PAIK ; Moon Soo LEE ; Changsu HAN ; Hyun Ghang JEONG ; Byung Joo HAM ; Yong Ku KIM ; Seung Hyun KIM

Korean Journal of Schizophrenia Research.2014;17(2):93-99. doi:10.16946/kjsr.2014.17.2.93

OBJECTIVES: The purpose of this study was to analyze the relationship between subjective well-being and other clinical parameters such as sociodemographic and clinical variables, which include positive and negative symptoms, depressive symptoms, insight, and side effects. METHODS: Fifty-one outpatients diagnosed with schizophrenia were recruited in this study. Subjective well-being was assessed using a self-rating scale, the Subjective Well-being under Neuroleptics-Short form (SWN-K). Sociodemographic variables were also evaluated and other evaluations were conducted using the Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS), Korean Version of the Revised Insight Scale for Psychosis (KISP), and Multidimensional Scale of Perceived Social Support (MSPSS). The relationship between subjective well-being and these clinical variables was assessed. RESULTS: Education years and social support scores were positively correlated with the total SWN-K scores, but severity of illness, severity of depression, severity of side effect, and the scores on insight were negatively correlated. The stepwise multiple regression analyses indicated that the total SWN-K score of the patients with schizophrenia was associated with negative symptoms and insight. CONCLUSION: Better insight and more severe negative symptoms in patients with schizophrenia may be associated with worse subjective well-being. Results indicate that careful evaluation of subjective well-being is essential for proper management of patients with schizophrenia.
Depression ; Education ; Humans ; Outpatients ; Psychotic Disorders ; Schizophrenia*

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Attitude Toward Psychiatric Medication among College Students Majoring in Nursing Science and Social Welfare.

Cheol PARK ; Sung Wan KIM ; Ju Yeon LEE ; Hyun Ju NA ; Ga Young LEE ; Ji Hyun PARK ; Kyung Yeol BAE ; Jae Min KIM ; Il Seon SHIN ; Jin Sang YOON

Korean Journal of Schizophrenia Research.2014;17(2):86-92. doi:10.16946/kjsr.2014.17.2.86

OBJECTIVES: Nurses and social workers are key persons connecting patients with psychotic disorders to psychiatric treatment. This study investigated the attitude of college students majoring in nursing science and social welfare toward psychiatric medication and stigma toward the mentally ill. METHODS: The study enrolled 553 college students (369 nursing science, 184 social welfare). We administered a five-item questionnaire to assess attitude toward psychiatric medication and a 20-item scale to assess stigma (prejudice regarding the dangerousness of the mentally ill and discrimination against the mentally ill). Factors associated with attitude toward psychiatric medication were identified. In addition, the stigma scale scores were compared with each item on attitude toward psychiatric medication. RESULTS: In the multivariate analysis, students majoring in social welfare had a significantly poorer attitude toward psychiatric medication than those majoring in nursing science. Age, senior grade, and experience to contact the mentally ill were also significantly associated with a good attitude toward medication, while attending psychiatry lectures, having a religion, and gender were not significantly associated with attitude toward psychiatric medication, although they showed relationships in the univariate analyses. For three of the five items, a negative attitude toward psychiatric medication was significantly associated with higher scores on the prejudice and discrimination scales. CONCLUSION: Prejudice toward and discrimination against the mentally ill are closely associated with a negative attitude toward psychiatric medication. An anti-stigma campaign should be developed that includes education to promote knowledge about psychiatric medications and reduce the stigma against the mentally ill. In addition, our findings suggest that experience to contact the mentally ill might improve attitudes toward psychiatric medication.
Dangerous Behavior ; Discrimination (Psychology) ; Education ; Humans ; Lectures ; Mentally Ill Persons ; Multivariate Analysis ; Nursing* ; Prejudice ; Psychotic Disorders ; Surveys and Questionnaires ; Schizophrenia ; Social Welfare* ; Social Workers ; Weights and Measures

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A Case-Controlled Study of Cognitive Behavioral Therapy for Patients with Schizophrenia Having Violence-Related Crime.

Won Young KIM ; Sun Bum KIM ; Myeong Jae KIM ; Jin Young LEE ; Geumsook SHIM ; Mi Kyung RYU

Korean Journal of Schizophrenia Research.2014;17(2):80-85. doi:10.16946/kjsr.2014.17.2.80

OBJECTIVES: Despite remarkable development of pharmacotherapy for schizophrenia, some patients continuously have had violence problems. The violence of psychotic patients is recently becoming the focus of the attention. The aim of this study is to investigate the influence of Cognitive Behavioral Therapy (CBT) on patients with schizophrenia having violence related history. METHODS: 15 Patients with schizophrenia spectrum disorder of crime history were treated with individual CBT for 12 sessions, and assessed with 4 scales (Korean version of Aggression Questionnaire, Korean version of the Barratt Impulsiveness Scale-11-Revised, Beck Cognitive Insight Scale and Positive and Negative Syndrome Scale) to evaluate anger, impulse, insight and clinical symptoms respectively at baseline and post treatment. The comparison group consisted of 15 patients with schizophrenia spectrum disorder of crime history. They were also assessed with the same scales during the same period. RESULTS: Although impulsivity is not changed significantly after treatment, but there was significant improvement in clinical symptom, insight and aggression, especially self-reflectiveness and anger respectively. CONCLUSION: CBT can be one of the good therapeutic tools for patients with schizophrenia having violence problems in that it reduces aggression and enhances insight of patients with schizophrenia spectrum disorder.
Aggression ; Anger ; Case-Control Studies* ; Cognitive Therapy* ; Crime* ; Drug Therapy ; Humans ; Impulsive Behavior ; Surveys and Questionnaires ; Schizophrenia* ; Violence ; Weights and Measures

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Correlation of Lifetime Symptom Dimensions with Cognitive Function and Other Clinical Characteristics in Schizophrenia Patients.

Youngah CHO ; Seunghyong RYU ; Hyeji OH ; Sohee OH ; Taesung PARK ; Se Chang YOON ; Kyung Sue HONG

Korean Journal of Schizophrenia Research.2014;17(2):72-79. doi:10.16946/kjsr.2014.17.2.72

OBJECTIVES: Considering large diversity of clinical presentation of schizophrenia, it is important to identify valid clinical subtypes or dimensions that might have homogeneous biological underpinning. The current study aimed to explore lifetime symptom-based dimensional phenotypes in patients with chronic schizophrenia, and to investigate their correlation with cognitive functions and other clinical characteristics. METHODS: Lifetime-based symptoms and additional clinical variables were measured using the Diagnostic Interview for Genetic Studies and the Schedule for the Deficit Syndrome in 315 clinically stable patients with chronic schizophrenia. Through principal components factor analysis, eight dimensional phenotypes were obtained. Comprehensive neuropsychological tests were administered for 103 out of 315 patients, and domain scores were calculated for cognitive domains defined in the MATRICS consensus battery. RESULTS: 'Non-paranoid delusion factor' including delusions of grandiose or religious nature, showed significant negative correlation with processing speed, working memory, attention/vigilance, and general cognitive ability, and positive correlation with intra-individual variability. 'Negative symptom factor' showed significant negative correlation only with general cognitive ability. Those two factors were also negatively correlated with function levels measured by Global Assessment Scale (GAS), and associated with poor treatment responses. CONCLUSION: Symptom-based dimensional phenotypes of schizophrenia measured on a lifetime basis showed discriminative correlation with cognitive function domains, global functioning level, and overall treatment responses, indicating their possibility as valid phenotype axes of schizophrenia having homogeneous biologic basis.
Appointments and Schedules ; Cognition ; Consensus ; Delusions ; Humans ; Memory, Short-Term ; Neuropsychological Tests ; Phenotype ; Schizophrenia*

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Emotional Dysregulation, Attributional Bias, Neurocognitive Impairment in Individuals at Ultra-High Risk for Psychosis and with Schizophrenia : Its Association with Paranoia.

Nam Wook KIM ; Yun Young SONG ; Jin Young PARK ; Seo Yeon BAEK ; Jee In KANG ; Eun LEE ; Suk Kyoon AN

Korean Journal of Schizophrenia Research.2014;17(2):63-71. doi:10.16946/kjsr.2014.17.2.63

OBJECTIVES: Paranoia is a complex phenomenon, affected by a number of factors such as depression, trait anxiety, and attributional bias in schizophrenia. The aim of this study was to explore whether paranoia within continuum of clinical and subclinical states is associated with emotional dysregulation, attributional bias and neurocognitive impairment in whole individuals of normal controls, ultra-high risk (UHR) for psychosis and schizophrenia. METHODS: 101 normal controls, 50 participants at UHR for psychosis, and 49 schizophrenia patients were recruited. All subjects were asked to complete self-reported paranoia scale and emotional dysregulation scales including Rosenberg's self-esteem, Spielberg's state-trait anxiety inventory and Beck depression inventory. The attributional style was assessed by Ambiguous Intentions Hostility Questionnaire (AIHQ). Participants were also requested to complete the comprehensive neurocognitive battery. RESULTS: Multiple linear regression analysis showed that paranoia were found to be associated with emotional dysregulation (state anxiety, trait anxiety and depression), composite blaming bias in ambiguous situation, impairment of attention and working memory in whole participants [F (9, 190)=34.85, p<0.001, adjusted R2=0.61]. CONCLUSION: The main findings suggest that paranoia is a complex affective and cognitive structure that may be associated with emotional dysregulation, blaming bias and attention and working memory impairment in clinical and non-clinical paranoia.
Anxiety ; Bias (Epidemiology)* ; Depression ; Hostility ; Humans ; Intention ; Linear Models ; Memory, Short-Term ; Paranoid Disorders* ; Psychotic Disorders* ; Surveys and Questionnaires ; Schizophrenia* ; Weights and Measures

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A Case Report: Irbesartan and Naltrexone Treatment of Polydipsia in a Patient with Schizophrenia.

Hyun Seok DONG ; Seung Hyun KIM ; So Young PARK

Korean Journal of Schizophrenia Research.2015;18(2):86-90. doi:10.16946/kjsr.2015.18.2.86

Polydipsia in schizophrenic patients is not uncommon, but a frequently underdiagnosed condition. The etiology of polydipsia remains unclear, and its complications can be life-threatening, while often being difficult to manage it. We report a case of a successfully treated chronic schizophrenic patient with polydipsia. The patient was male, 47-year-old, suffering 27-years of residual schizophrenia who had been consuming more than 10 L of water per day, and is complicated by hyponatremia. He was treated with irbesarten 300 mg and naltrexone 50 mg in the setting of closed ward. He consumed less than 3.5 L of water per day and serum sodium levels seemed to be stable following discharge from the closed ward. We suggest that irbesartan and naltrexone may have beneficial effects for treating polydipsia, and future prospective and well-controlled studies are to be performed.
Humans ; Hyponatremia ; Male ; Middle Aged ; Naltrexone* ; Polydipsia* ; Prospective Studies ; Schizophrenia* ; Sodium ; Water

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Relationship of Insight with Cognitive Function, Psychopathology and Psychosocial Factors in Patients with Schizophrenia.

Dasom UH ; Moon Soo LEE ; Changsu HAN ; Jong Woo PAIK ; Seung Hyun KIM

Korean Journal of Schizophrenia Research.2015;18(2):79-85. doi:10.16946/kjsr.2015.18.2.79

OBJECTIVE: The purpose of this study is to evaluate the relationship of insight with socio-demographic, clinical, and cognitive parameters in schizophrenic patients. METHODS: Seventy-seven patients with schizophrenia were recruited. All subjects completed the Korean version of the revised Insight Scale of Psychosis (KISP) and Multidimensional Scale of Perceived Social Support (MSPSS). Positive and Negative symptom scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Neurocognitive function tests were also administered. RESULTS: Patients that are married or currently living together showed significantly higher levels of insight than those who are divorced, separated, or single. Insight showed positive correlations with CDSS and emotional discomfort factor of PANSS. Insight also had negative correlations with age of onset and family, friend subscales of MSPSS. Total scores of PANSS and neurocognitive functions showed no significant correlations with insight. More severe depressive symptoms, lower perceived social support from friends and family, and younger age of onset were predictor of higher insight. CONCLUSION: The study suggest that impaired insight might be independent from general psychopathology and cognitive function and more influenced by emotional status and social environment.
Age of Onset ; Depression ; Divorce ; Friends ; Humans ; Psychology* ; Psychopathology* ; Psychotic Disorders ; Schizophrenia* ; Social Environment

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Relationship Between Self-Referential Processing and Intrinsic Motivation in Patients with Schizophrenia.

Jung Suk LEE ; Eun Seong KIM ; Eun Joo KIM ; Joohan KIM ; Jae Jin KIM

Korean Journal of Schizophrenia Research.2015;18(2):73-78. doi:10.16946/kjsr.2015.18.2.73

OBJECTIVES: The close relationship between impaired self-referential processing and intrinsic motivation in schizophrenia has been suggested, but is not investigated yet. The purpose of this study was to explore the characteristics of self-referential processing and its relationship with intrinsic motivation in patients with schizophrenia. METHODS: Nineteen patients with schizophrenia and 24 healthy controls performed a self-referential processing task, in which a face (self, familiar other, or unfamiliar other) and three words (positive, neutral, and negative nouns) were presented. Participants were asked to indicate which word is relevant to the face. Intrinsic motivation and basic psychological needs affecting intrinsic motivation were assessed using self-reports. RESULTS: Compared to healthy controls, the relevance rating between self-face and neutral word was significantly lower in patients with schizophrenia (p=0.02). In patients with schizophrenia, it was negatively correlated with intrinsic motivation (r=-0.47, p=0.04) and competence (r=-0.47, p=0.05) which is known to influence intrinsic motivation. CONCLUSION: These results suggest that there is an impairment in self-referential processing in schizophrenia and it is associated with an impairment in intrinsic motivation. In particular, amotivation in patients with schizophrenia may represent a facet of selfdisorder.
Humans ; Mental Competency ; Motivation* ; Schizophrenia*

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Factors Affecting Recurrence in Patients with Schizophrenia Received More Than 10 Years of Treatment.

Min Jae KAL ; Won Hyoung KIM ; Jin Woo CHO ; Ji Hyun KIM ; Jeong Seop LEE ; Jae Nam BAE ; Chul Eung KIM

Korean Journal of Schizophrenia Research.2015;18(2):66-72. doi:10.16946/kjsr.2015.18.2.66

OBJECTIVES: The purpose of this study is to investigate the factors affecting recurrence in patients with schizophrenia received more than 10 years of long-term treatment. METHODS: The medical records of long-term follow-up patients with the diagnosis of schizophrenia from department of psychiatry, Inha university hospital for more than 10 years were reviewed. The recurrence was defined as the re-emergence or aggravation of psychotic symptoms after maintenance treatment during 6 months. RESULTS: Of the 110 patients who were included in the study, 78 patients were recurred. Half of the patients were experiencing at least 1 recurrence within six years. After adjustment of sociodemographic variables, female, poor drug compliance, younger baseline age, shorter duration of illness and longer duration of hospitalization at first admission were significantly related to an increased likelihood of recurrence. The most common stressor of recurrence was irregular drug taking (61.73%). CONCLUSION: The results show the importance of gender, drug compliance, baseline age, duration of illness, and duration of hospitalization at first admission in predicting recurrence of long-term follow-up patients with schizophrenia.
Compliance ; Diagnosis ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Medical Records ; Recurrence* ; Schizophrenia*

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A Study on Changes of Metabolic Parameters with Antipsychotic Treatment in Schizophrenic Patients : 1 Year Prospective Natualistic Study.

Sun Hwa JEONG ; Seon Jin YIM ; Hai Joo YOON ; Eun Kyung PARK ; Jong Il LEE

Korean Journal of Schizophrenia Research.2015;18(2):59-65. doi:10.16946/kjsr.2015.18.2.59

OBJECTIVES: Schizophrenia patients are known to be more prone to metabolic disease than normal people. This study aimed to identify the changes in metabolic parameters of schizophrenia patients using atypical antipsychotic drugs for 1 year. METHODS: A total of 200 schizophrenia patients were recruited and categorized into the aripiprazole-treatment group and control group taking 5 atypical antipsychotic drugs. Comparative analysis were between groups. The prescriptions of psychotropic drugs were collected by a review of medical records. Blood was collected after fasting for 12 hours at the starting point of treatment and the 12th month, and patient medical records were evaluated for basici nformation and treatment history. Physical measurement, the prevalence of metabolic syndrome and metabolic parameters were studied using ATP-III diagnostic criteria. RESULTS: From the study, the aripiprazole-treatment group had a mean weight increase of 0.6 kg and the control group had a mean weight increase of 6.5 kg at the 1 year follow-up, showing a significant difference between the two groups. There were also significant differences between the two groups in waist size, systolic and diastolic blood pressure, fasting blood sugar, total cholesterol, triglyceride, HDL-choleseterol and prolactin level. Along with meaningful improvement of the symptoms, aripiprazole-treatment group showed less effect on in abdominal obesity, diabetes, blood pressure, cholesterol and prolactin than other atypical antipsychotic drugs. CONCLUSION: Therapeutic intervention such as diagnosis, treatment, weight management and diet improvement is necessary for schizophrenia patients. Psychiatric symptoms as well as internal meicine-related problems such as metabolic disease need to be addressed in case management.
Antipsychotic Agents ; Blood Glucose ; Blood Pressure ; Case Management ; Cholesterol ; Diagnosis ; Diet ; Fasting ; Follow-Up Studies ; Humans ; Medical Records ; Metabolic Diseases ; Obesity, Abdominal ; Prescriptions ; Prevalence ; Prolactin ; Prospective Studies* ; Psychotropic Drugs ; Schizophrenia ; Triglycerides

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