Background: Pediatric alopecia areata (AA) can affect the quality of life (QoL) of patients and their family members. Research on the QoL and burden on family members in pediatric AA is limited. Objective: This nationwide multicenter questionnaire study described the QoL and burden of the family members of patients with pediatric AA. Methods: This nationwide multicenter questionnaire study enrolled AA patients between the ages of 5 and 18 years from March 1, 2017 to February 28, 2018. Enrolled patients and their parents completed the modified Children’s Dermatology Life Quality Index (CDLQI) and the modified Dermatitis Family Impact (mDFI). The disease severity was measured using the Severity of Alopecia Tool (SALT) survey scores. Results: A total of 268 patients with AA from 22 hospitals participated in this study. Our study found that the efficacy and satisfaction of previous treatments of AA decreased as the severity of the disease increased. The use of home-based therapies and traditional medicines increased with the increasing severity of the disease, but the efficacy felt by patients was limited. CDLQI and mDFI scores were higher in patients with extensive AA than those with mild to moderate AA. The economic and time burden of the family members also increased as the severity of the disease increased. Conclusion The severity of the AA is indirectly proportional to the QoL of patients and their family members and directly proportional to the burden. Physicians need to understand these characteristics of pediatric AA and provide appropriate intervention to patients and their family members.

OBJECTIVE: As the limitation of lithium that is representative of the treatment in bipolar disorder is known, the use of other mood stabilizers such as carbamazepine, valproate have been increased. And with the development of pharmacotherapy, combinations of atypical antipsychotics and other drugs are a general tendency in the treatment of bipolar disorder. This study was to investigate the prescription trends in psychiatric inpatients with bipolar disorder at a university hospital and to put knowledge to practical use. METHODS: Data of 118 cases with a diagnosis of bipolar disorder according to DSM-IV from January 1998 to December 2001 were collected. Data on demographic data, duration of hospitalization, and kinds and dosages of mood stabilizers and antipsychotics were analyzed. RESULTS: In 118 subjects, 52 were male and 66 were female. In term of diagnosis, subjects with bipolar I disorder were 116 (98.3%) and subjects with bipolar II disorder were 2 (1.7%). And subjects with manic episode were 96 (81.4%), subjects with depressive episode were 17 (14.4%), subjects with hypomanic episode were 3 (2.5%) and subjects with mixed episode were 2 (1.7%). From 1998 to 2001, 95.8% of total cases were treated with the combination therapy of mood stabilizers and antipsychotics, and only 4.2% were treated with the monotherapy of a mood stabilizer. Considering mood stabilizers, the use of single mood stabilizer was 54.2% and two or more mood stabilizers combination was 45.8%. Lithium was the most commonly used mood stabilizer, and the combination of lithium and carbamazepine was the second. The mean dosage was 1060+/-207 mg/day for lithium, 665+/-131 mg/day for carbamazepine, 1056+/-258 mg/day for valproate. There was no significant change in terms of dosages used in every year. Comparing year 1998 to year 2001, the combination of mood stabilizers and antipsychotics has been increased from 90.3% to 100%. The ratio of using two or more antipsychotics decreased from 38.7% to 10.3%, but the ratio of single antipsychotics use increased from 54.8% to 89.7%. Considering the ratio of antipsychotics, typical antipsychotics decreased from 38.7% to 6.9%, but atypical antipsychotics increased from 61.3% to 93%. CONCLUSION: With the rapid and dramatic progress of psychopharmacology, the prescription trend of the pharmacotherapy in the bipolar disorder has been changed. This study suggest that the use of atypical antipsychotics has increased profoundly. We think it reflects the current progress of the treatment in the bipolar disorder.
Antipsychotic Agents ; Bipolar Disorder* ; Carbamazepine ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Drug Therapy ; Female ; Hospitalization ; Humans ; Inpatients* ; Lithium ; Male ; Prescriptions ; Psychopharmacology ; Valproic Acid

OBJECTIVES: Since the efficacy is similar among different antidepressants, side effects, costs, and overdose toxicity are considered preferentially as factors to choose antidepressant. Recently, selective serotonin reuptake inhibitors (SSRIs) are more frequently prescribed than tricyclic antidepressants because of their less frequent side effects. Also the use of noradrenergic and specific serotonergic antidepressants (NaSSA) are increasing. These new antidepressants have characteristic side effect profiles in terms of gastrointestinal side effects, weight gain and sexual dysfunction which serve as direct cause of noncompliance. In the present study, we compared the drug side effects of patients with major depressive disorder who have taken either mirtazapine or SSRIs. METHODS: Among those patients who were treated at Department of Psychiatry, St. Mary's Hospital, The Catholic University of Korea, from Jun, 2002 to July, 2002, we included patients who met DSM-IV criteria for major depressive disorder. Patients who reveive either mirtazapine or SSRIs (fluoxetine, paroxetine) monotherapy as an antidepressant were enrolled. Patients with physical illnesses or poor drug compliance were excluded. A self-rating questionnaire was used to assess the drug side effects. RESULTS: Total 86 patients (mirtazapine;24, SSRIs;62 (fluoxetine 18, paroxetine 44)) were participated in this study. There was no difference at age (mirtazapine;48.0+/-14.0 years, SSRIs;43.3+/-15.6 years), sex ratio (mirtazapine;male 12: female 12, SSRIs;male 24: female 38), and mean duration of administration (mirtazapine;20.2+/-21.5 weeks, SSRIs;32.1+/-50.9 weeks) between two groups. Patients taking mirtazapine have significantly less side effects in terms of decreased appetite, yawn, decreased libido, and anorgasmia. Patients taking SSRIs have significantly less side effects in terms of peripheral edema than mirtazapine. CONCLUSION: Mirtazapine and SSRIs showed differences in some side effects. Mirtazapine showed more favorable side effect profiles in the gastrointestinal and sexual side effects than SSRIs. This data was thought to be useful guidelines in selecting antidepressants hereafter.
Antidepressive Agents ; Antidepressive Agents, Tricyclic ; Appetite ; Compliance ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Edema ; Female ; Humans ; Korea ; Libido ; Paroxetine ; Surveys and Questionnaires ; Serotonin Uptake Inhibitors* ; Sex Ratio ; Weight Gain

OBJECTIVE: As the limitation of lithium that is representative of the treatment in bipolar disorder is known, the use of other mood stabilizers such as carbamazepine, valproate have been increased. And with the development of pharmacotherapy, combinations of atypical antipsychotics and other drugs are a general tendency in the treatment of bipolar disorder. This study was to investigate the prescription trends in psychiatric inpatients with bipolar disorder at a university hospital and to put knowledge to practical use. METHODS: Data of 118 cases with a diagnosis of bipolar disorder according to DSM-IV from January 1998 to December 2001 were collected. Data on demographic data, duration of hospitalization, and kinds and dosages of mood stabilizers and antipsychotics were analyzed. RESULTS: In 118 subjects, 52 were male and 66 were female. In term of diagnosis, subjects with bipolar I disorder were 116 (98.3%) and subjects with bipolar II disorder were 2 (1.7%). And subjects with manic episode were 96 (81.4%), subjects with depressive episode were 17 (14.4%), subjects with hypomanic episode were 3 (2.5%) and subjects with mixed episode were 2 (1.7%). From 1998 to 2001, 95.8% of total cases were treated with the combination therapy of mood stabilizers and antipsychotics, and only 4.2% were treated with the monotherapy of a mood stabilizer. Considering mood stabilizers, the use of single mood stabilizer was 54.2% and two or more mood stabilizers combination was 45.8%. Lithium was the most commonly used mood stabilizer, and the combination of lithium and carbamazepine was the second. The mean dosage was 1060+/-207 mg/day for lithium, 665+/-131 mg/day for carbamazepine, 1056+/-258 mg/day for valproate. There was no significant change in terms of dosages used in every year. Comparing year 1998 to year 2001, the combination of mood stabilizers and antipsychotics has been increased from 90.3% to 100%. The ratio of using two or more antipsychotics decreased from 38.7% to 10.3%, but the ratio of single antipsychotics use increased from 54.8% to 89.7%. Considering the ratio of antipsychotics, typical antipsychotics decreased from 38.7% to 6.9%, but atypical antipsychotics increased from 61.3% to 93%. CONCLUSION: With the rapid and dramatic progress of psychopharmacology, the prescription trend of the pharmacotherapy in the bipolar disorder has been changed. This study suggest that the use of atypical antipsychotics has increased profoundly. We think it reflects the current progress of the treatment in the bipolar disorder.
Antipsychotic Agents ; Bipolar Disorder* ; Carbamazepine ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Drug Therapy ; Female ; Hospitalization ; Humans ; Inpatients* ; Lithium ; Male ; Prescriptions ; Psychopharmacology ; Valproic Acid

OBJECTIVES: Since the efficacy is similar among different antidepressants, side effects, costs, and overdose toxicity are considered preferentially as factors to choose antidepressant. Recently, selective serotonin reuptake inhibitors (SSRIs) are more frequently prescribed than tricyclic antidepressants because of their less frequent side effects. Also the use of noradrenergic and specific serotonergic antidepressants (NaSSA) are increasing. These new antidepressants have characteristic side effect profiles in terms of gastrointestinal side effects, weight gain and sexual dysfunction which serve as direct cause of noncompliance. In the present study, we compared the drug side effects of patients with major depressive disorder who have taken either mirtazapine or SSRIs. METHODS: Among those patients who were treated at Department of Psychiatry, St. Mary's Hospital, The Catholic University of Korea, from Jun, 2002 to July, 2002, we included patients who met DSM-IV criteria for major depressive disorder. Patients who reveive either mirtazapine or SSRIs (fluoxetine, paroxetine) monotherapy as an antidepressant were enrolled. Patients with physical illnesses or poor drug compliance were excluded. A self-rating questionnaire was used to assess the drug side effects. RESULTS: Total 86 patients (mirtazapine;24, SSRIs;62 (fluoxetine 18, paroxetine 44)) were participated in this study. There was no difference at age (mirtazapine;48.0+/-14.0 years, SSRIs;43.3+/-15.6 years), sex ratio (mirtazapine;male 12: female 12, SSRIs;male 24: female 38), and mean duration of administration (mirtazapine;20.2+/-21.5 weeks, SSRIs;32.1+/-50.9 weeks) between two groups. Patients taking mirtazapine have significantly less side effects in terms of decreased appetite, yawn, decreased libido, and anorgasmia. Patients taking SSRIs have significantly less side effects in terms of peripheral edema than mirtazapine. CONCLUSION: Mirtazapine and SSRIs showed differences in some side effects. Mirtazapine showed more favorable side effect profiles in the gastrointestinal and sexual side effects than SSRIs. This data was thought to be useful guidelines in selecting antidepressants hereafter.
Antidepressive Agents ; Antidepressive Agents, Tricyclic ; Appetite ; Compliance ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Edema ; Female ; Humans ; Korea ; Libido ; Paroxetine ; Surveys and Questionnaires ; Serotonin Uptake Inhibitors* ; Sex Ratio ; Weight Gain

OBJECTIVE: The atypical antipsychotics are being increasingly used to control acute episode of bipolar disorder, and data are emerging to support their mood-stabilizing and antidepressant properties. This study investigated the short-term efficacy of quetiapine as a combination therapy in the treatment of acute bipolar I disorder. METHODS: This study was a 4-week, open-label, combination, prospective investigation using quetiapine in addition to mood stabilizers. Data of 18 patients fulfilling DSM-IV diagnostic criteria for bipolar I disorder were analyzed. The Young Mania Rating Scale (YMRS), the Hamilton Scale for Depression (HDRS), the Brief Psychiatric Rating Scale (BPRS) and the Extrapyramidal Symptom Rating Scale (ESRS) were applied at baseline and at week 1, 2 and 4. The Clinical Global Impression Scale (CGI) was evaluated at baseline and week 4. RESULTS: The addition of quetiapine produced a statistically significant improvement on the YMRS, HDRS, BPRS and CGI score at week 4 from baseline (p<0.01). Significant improvement on the ESRS-Parkinsonism subscore was observed at week 1, 2 and 4 from baseline (p<0.05). Quetiapine was well tolerated, with no subjects discontinuing because of side effects. CONCLUSION: This study suggests that combination of quetiapine was an effective and safe treatment in patients with acute episode of bipolar disorder. Randomized placebo-controlled prospective studies with increased sample size are needed.
Antipsychotic Agents ; Bipolar Disorder* ; Brief Psychiatric Rating Scale ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Drug Therapy ; Humans ; Prospective Studies ; Sample Size ; Quetiapine Fumarate

OBJECTIVE: Immediate early gene (IEG), c-fos is known to encode a 62 kDa nuclear protein (Fos) which has a critical role in the stimulus response process of many cells. c-fos can be activated in the central nervous system by a variety of physiological and pharmacological treatment. Recently evidences has been reported suggesting that glucocorticoid hormones, which are released from adrenal cortex in response to stress, may regulate IEG expression. We observed whether immobilization stress or corticosterone altered the induction of c-fos by haloperidol in the nucleus accumbens, lateral striatum, and prefrontal cortex. METHODS: Twenty-four healthy Wistar rats of male sex, weighing 300-450 g, were divided into 6 groups according to injection agents [vehicle (1 mg/kg), haloperidol (1 mg/kg), corticosterone (1 mg/kg), immobilization stress, haloperidol (1 mg/kg) and corticosterone (1 mg/kg), haloperidol (1 mg/kg) and immobilization stress] respectively. Fos-immunoreactivity was measured by counting of Fos-positive neurons in the nucleus accumbens, lateral striatum, and prefrontal cortex. RESULTS: (1) The number of Fos-positive neurons in the nucleus accumbens was significantly decreased in the haloperidol plus immobilization stress group and haloperidol plus corticosterone group compared with that in the haloperidol group (p<0.05). (2) The number of Fos-positive nurons in the lateral striatum was significantly decreased in the haloperidol plus corticosterone group compared with that in the haloperidol group, but the number of Fos-positive neurons in the lateral striatum was not significantly different between the haloperidol plus immobilization stress group and the haloperidol group (p<0.05). (3) The number of Fos-positive neurons in the prefrontal cortex was significantly increased in the haloperidol plus immobilization stress group and haloperidol plus corticosterone group compared with that in the haloperidol group (p<0.05). CONCLUSION: These results suggest that regulatory process exerted by corticosterone may alter the antipsychotic effect of haloperidol.
Adrenal Cortex ; Animals ; Antipsychotic Agents ; Brain* ; Central Nervous System ; Corticosterone* ; Haloperidol ; Humans ; Immobilization* ; Male ; Neurons ; Nuclear Proteins ; Nucleus Accumbens ; Prefrontal Cortex ; Rats* ; Rats, Wistar

OBJECTIVES: This study was conducted to evaluate the prescription patterns, overall efficacy, and safety of atypical antipsychotics for inpatients with bipolar I disorder. METHODS: Inpatients with bipolar I disorder, who had received adjunctive treatment with olanzapine or risperidone, beyond 1 month, along with mood stabilizers were selected for a retrospective study. The charts of those patients(N=56) were reviewed for the details of efficacy, safety, and other pharmacological variables of the two drugs. RESULTS: Olanzapine and risperidone showed equivalent efficacy by the evaluation in accordance with clinical global impression scale (CGI) and global assessment of functioning scale(GAF) score. Different side effect profiles were noted between two drugs. CONCLUSION: These limited results suggested that the efficacy and safety of risperidone and olanzapine were similar for the treatment of inpatients with bipolar I disorder. Prospective controlled study for efficacy and safety of risperidone and olanzapine in the treatment of bipolar I disorder should be conducted in future.
Antipsychotic Agents ; Humans ; Inpatients* ; Prescriptions ; Retrospective Studies ; Risperidone

OBJECTIVE: Schizophrenia is known to have high genetic influences. Recently, the main focus of etiologic study in schizophrenia has been concentrated on molecular genetic approach including polymorphism analysis. This study was designed to investigate the relationship between schizophrenia and immunologic influences by analyzing polymorphism of TNFB that is involved in interaction between immunologic system and CNS. METHOD: 146 schizophrenic patients diagnosed by DSM-IV criteria were included and data of 206 normal population from the Catholic Hemopoietic Stem Cell Information Bank(Seoul, Korea) were used as a control group in this study. DNA was extracted from whole blood, thereafter amplified by polymerase chain reaction, and digested by NcoI. We obtained and assessd RFLP of two alleles, TNFB1 which has a NcoI restriction site generating 555bp and 185bp fragments, and TNFB2 which lacks the NcoI restriction site. All data were analyzed by K 2 test. RESULTS: There were no significant differences in frequency of TNFB1/1, TNFB1/2, and TNFB2/2 between the schizophrenic patient and the control group. Alleric frequencies of TNFB1 and TNFB2 were significantly different between schizophrenic patient and control group. CONCLULSION: We found the possible association between alleles of TNFB and schizophrenia in this study. To clarify the influences of TNFB on schizophrenia, further systematic studies should be conducted.
Alleles ; Diagnostic and Statistical Manual of Mental Disorders ; DNA ; Humans ; Molecular Biology ; Necrosis* ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length* ; Schizophrenia* ; Stem Cells