Objective: This study was performed to evaluate the efficacy and safety of lurasidone (160 mg/day) compared to quetiapine XR (QXR; 600 mg/day) in the treatment of acutely psychotic patients with schizophrenia. Methods: Patients were randomly assigned to 6 weeks of double-blind treatment with lurasidone 160 mg/day (n=105) or QXR 600 mg/day (n=105). Primary efficacy measure was the change from baseline to week 6 in Positive and Negative Syndrome Scale (PANSS) total score and Clinical Global Impressions severity (CGI-S) score. Adverse events, body measurements, and laboratory parameters were assessed. Results: Lurasidone demonstrated non-inferiority to QXR on the PANSS total score. Adjusted mean±standard error change at week 6 on the PANSS total score was -26.42±2.02 and -27.33±2.01 in the lurasidone and QXR group, respectively. The mean difference score was -0.91 (95% confidence interval -6.35–4.53). The lurasidone group showed a greater reduction in PANSS total and negative subscale on week 1 and a greater reduction in end-point CGI-S score compared to the QXR group. Body weight, body mass index, and waist circumference in the lurasidone group were reduced, with significantly lower mean change compared to QXR. Endpoint changes in glucose, cholesterol, triglycerides, and low-density lipoprotein levels were also significantly lower. The most common adverse drug reactions with lurasidone were akathisia and nausea. Conclusion Lurasidone 160 mg/day was found to be non-inferior to QXR 600 mg/day in the treatment of schizophrenia with comparable efficacy and tolerability. Adverse effects of lurasidone were generally tolerable, and beneficial effects on metabolic parameters can be expected.

Objective: Clozapine is considered the most reliable drug for treatment-resistant schizophrenia. In 2014, a generic formulation of clozapine (Clzapine) was introduced in Korea. This study was performed to provide clinical information regarding the use of clozapine and to compare efficacy and tolerability when converting from the brand-name formulation (Clozaril) to the generic formulation during longterm maintenance treatment among Korean patients with schizophrenia. Methods: This mirror-image study retrospectively investigated the electronic medical records of patients who had switched from Clozaril to Clzapine with a ≥1-year duration for each formulation. Clinical data were collected, including information regarding clozapine use, psychiatric hospitalization, co-medications, and blood test findings. Data before and after the switch were compared using paired t-tests. Results: Among 332 patients, the mean 1-year dosages were 233.32±149.35 mg/day for Clozaril and 217.36±136.66 mg/day for Clzapine. The mean clozapine concentration-to-dose ratios were similar before and after the switch (Clozaril, 1.33±0.68; Clzapine, 1.26±0.80). Switching from Clozaril to Clzapine resulted in no significant differences in the hospitalization rate, hospitalization duration, or laboratory findings (liver function parameters, serum cholesterol level, and serum glucose level). Equivalent doses of co-prescribed antidepressants were decreased, but concomitant medications otherwise showed no significant differences. Conclusion Clinical efficacy and tolerability appear comparable when switching to Clzapine during clozapine maintenance treatment. This study offers descriptive real-world clinical insights into clozapine maintenance treatment in Korea, thereby providing patients with more treatment options and contributing to the development of maintenance guidelines tailored to the Korean population.

Objectives: To conduct a comparative study of children’s health in South Korea versus North Korea focusing on air pollution. Methods: We used annual mortality rate, prevalence, and environmental indicators data from the World Bank and World Health Organizations (WHO). Trend analysis of the two Koreas was conducted to evaluate changes in health status over time. Spearman’s correlation analysis was used to find out the correlation between environmental indicators and children’s health status. Results: We found a distinct gap in children’s health status between the two Koreas. While North Korea reported a higher death rate of children than South Korea, both showed a decreasing trend with the gap narrowing from 2000 to 2017. The prevalence of overweight and obesity increased and that of thinness decreased in both Koreas. Except PM2.5 exposure, South Korea reported higher figures in most indicators of air pollutant emissions (South Korea, mean (SD)=28.3 (2.0); North Korea, mean (SD)=36.5 (2.8), P-value=0.002). Conclusion This study empirically discovered the gaps and patterns of children’s health between South Korea and North Korea. North Korean children experienced more severe health outcomes than children in South Korea. These findings imply that epigenetic modification caused by environmental stressors affect children’s health in the two Koreas despite similar genetic characteristics. Considering the gaps in children’s health between the two Koreas, more attention and resources need to be directed towards North Korea because the necessary commodities and services to improve children’s health are lacking in North Korea.

Background: In this study, the relationship between depression and stress-coping strategies among public enterprise workers whose workplaces were relocated to a newly-built innovation city was investigated. Methods: This study included a total of 922 public enterprise workers living in Naju Innovation City. Along with their sociodemographic data, each subject was assessed concerning depression, occupational stress, and stress-coping strategies using the Center for Epidemiologic Studies Depression Scale(CES-D), Korean Occupational Stress Scale (KOSS), and stress-coping scale (SCS), respectively. Logistic regression was performed to investigate the impact of the relevant factors on depressive symptoms. Results: The overall prevalence of depressive symptoms was 14%. Some sociodemographic variables, the total scores of the KOSS, and four subscales of the SCS revealed significant differences between the depressed and normal groups. Multivariate regression analysis revealed that the KOSS (odds ratio [OR], 1.17; p<0.001) and SCS, such as problem-solving-focused (OR, 0.75; p<0.001), emotion-focused (OR, 1.15; p<0.05), and wishful-thinking-focused (OR, 1.10; p<0.05), were significantly associated with depression. Conclusion The results indicated that depressive symptoms were highly prevalent among workers whose workplaces were relocated. In addition, these symptoms were found to be related with occupational stress and stress-coping strategies. Our findings also suggest that promoting healthy stress-coping strategies and reducing occupational stress may help in preventing the occurrence of depression and managing depressed workers.

Objectives: Clozapine is the most effective atypical antipsychotic agent for the treatment-resistant schizophrenia (TRS), however, only 40%–70% of TRS patients respond to clozapine. Moreover, TRS encompasses various symptom dimensions. Therefore, augmentation with other medications for clozapine is frequently applied. However, the prescription pattern of clozapine and combined medications in Korea is yet to be examined. This study aims to investigate the maintenance treatment pattern of clozapine and augmentation agents in one Korean tertiary hospital. Methods: The patients with schizophrenia spectrum disorders under clozapine maintenance, defined as one-year clozapine continuation, were subjected for analysis. Medication data at one-year time-point after clozapine initiation was extracted and analyzed. Results: Among total 2897 patients having clozapine prescription experience from January 2000 to December 2018, 1011 patients were on clozapine maintenance. The mean age of clozapine initiation was 30.2 ± 11.3 years, and the maintenance dose of clozapine was 217.8 ± 124.3 mg/day. Combination rate of antipsychotics, mood stabilizers, and antidepressants were 43.5%, 25.3%, 38.6%, respectively. Most frequently prescribed drugs in each category were aripiprazole, valproate, and sertraline. Olanzapine equivalent dose of combined antipsychotics was 10.4 ± 7.7 mg/day. Male patients were prescribed higher dose of combined antipsychotics and higher rate of antidepressants. Female patients had later onset of clozapine prescription. Patients with two or more combined antipsychotics were prescribed higher dose of clozapine and higher rate of antidepressants compared to patients with one combined antipsychotic. Conclusions Taken together, among the patients taking clozapine, a substantial rate of patients were under polypharmacy. The present findings based on the real-world prescription pattern could provide the valuable clinical information on the treatment of TRSrelated conditions.

To examine the effects of Populus tomentiglandulosa (PT) extract on the expressions of antioxidant enzymes and neurotrophic factors in the cornu ammonis 1 (CA1) region of the hippocampus at 5 min after inducing transient global cerebral ischemia (TGCI) in gerbils, TGCI was induced by occlusion of common carotid arteries for 5 min. Before ischemic surgery, 200 mg·kg PT extract was orally administrated once daily for 7 d. We performed neuronal nuclear antigen immunohistochemistry and Fluoro-Jade B staining. Furthermore, we determined in situ production of superoxide anion radical, expression levels of SOD1 and SOD2 as antioxidant enzymes and brain-derived neurotrophic factor (BDNF) and insulin-like growth factor I (IGF-I) as neurotrophic factors. Pretreatment with 200 mg·kg PT extract prevented neuronal death (loss). Furthermore, pretreatment with 200 mg·kg PT extract significantly inhibited the production of superoxide anion radical, increased expressions of SODs and maintained expressions of BDNF and IGF-I. Such increased expressions of SODs were maintained in the neurons after IRI. In summary, pretreated PT extract can significantly increase levels of SODs and protect the neurons against TGCI, suggesting that PT can be a useful natural agent to protect against TGCI.
Animals ; Brain-Derived Neurotrophic Factor ; genetics ; metabolism ; CA1 Region, Hippocampal ; drug effects ; metabolism ; Gerbillinae ; Humans ; Insulin-Like Growth Factor I ; genetics ; metabolism ; Male ; Neuroprotective Agents ; administration & dosage ; Plant Extracts ; administration & dosage ; Populus ; chemistry ; Pyramidal Cells ; drug effects ; metabolism ; Reperfusion Injury ; drug therapy ; genetics ; metabolism ; Superoxide Dismutase ; genetics ; metabolism ; Up-Regulation ; drug effects

We aim to investigate the effect of fronto-temporal transcranial direct current stimulation (tDCS) on the interactions among functional networks and its association with psychotic symptoms. In this pilot study, we will determine possible candidate functional networks and an adequate sample size for future research. Seven schizophrenia patients with treatment-refractory auditory hallucinations underwent tDCS twice daily for 5 days. Resting-state fMRI data and measures of the severity of psychotic symptoms were acquired at baseline and after completion of the tDCS sessions. At baseline, decreased functional network interaction was negatively correlated with increased hallucinatory behavior. After tDCS, the previously reduced functional network connectivity significantly increased. Our results showed that fronto-temporal tDCS could possibly remediate aberrant hallucination-related functional network interactions in patients with schizophrenia.
Hallucinations ; Humans ; Magnetic Resonance Imaging ; Neuroimaging ; Pilot Projects ; Sample Size ; Schizophrenia ; Transcranial Direct Current Stimulation

PURPOSE: The current study was conducted for evaluation and comparison of dietary behavior and food intake in different regions of Lao PDR. METHODS: The survey was conducted on 979 people aged 40~59 years old living in 25 urban provinces and 25 rural provinces in four districts (VTE Capital-Chanthabuly, Xaysetha, VTE Province-Phonhong, and Thoulakhom) of Laos. General demographic information, health status, and dietary behavior were surveyed using a questionnaire. RESULTS: The literacy ratio (p = 0.000), education level (p = 0.000), asset ownership level (p = 0.000), and government and private employee ratio (p = 0.000) were higher in urban subjects compared with rural subjects. The mean value of weight (p = 0.000), waist circumference (p = 0.000), and diastolic blood pressure (p = 0.009) and alcohol consumption (p = 0.000), self-rated health status (p = 0.001), and the rate of obesity (p = 0.000) were significantly higher in urban subjects compared with rural subjects. However, the rate of current smoker was significantly higher in the rural group (p = 0.023). Meals are becoming more westernized by higher frequency of eating out, consumption of fatty meat and fried or stir-fried food in urban areas compared to rural areas. Urban subjects had relatively better balanced meals compared to rural subjects whereas they consumed insufficient meals per day and consumed meals irregularly compared to rural subjects. Intake of fruit and milk was significantly higher in urban subjects compared with rural subjects. However, the intake of vegetables was significantly higher in rural areas than urban areas. CONCLUSION: The result of this study showed that the traditional Lao diet is being replaced by an unhealthy western dietary pattern, which may be a risk factor for increasing development of non-communicable disease (NCD) in Lao PDR. Planning of proper personalized nutritional intervention and education in each area is needed to decrease the health risks of NCD.
Alcohol Drinking ; Blood Pressure ; Diet* ; Eating* ; Education ; Fruit ; Humans ; Laos ; Meals ; Meat ; Milk ; Obesity ; Ownership ; Risk Factors ; Vegetables ; Waist Circumference

OBJECTIVES: Despite the recent emphasis on a patient-centered chronic care model, few studies have investigated its use in older adults in South Korea. We explored how older Korean adults perceive and cope with their chronic illness. METHODS: We conducted focus group interviews in Seoul, Korea in January 2010. Focus groups were formed by disease type (hypertension and type 2 diabetes) and gender using purposive sampling. Inclusion criteria were patients aged 60 and over who had been diagnosed with diabetes or hypertension and received care at a community health center for at least six months prior to participation. Interview data were analyzed through descriptive content analysis. RESULTS: Among personal factors, most participants felt overwhelmed when they received their diagnosis. However, with time and control of their acute symptoms using medication, their worry diminished and participants tended to denying being identified as a patient or sick person. Among socio-familial factors, participants reported experiencing stigma with their chronic illness and feeling it was a symbol of weakness. Instead of modifying their lifestyles, which might interfere with their social relationships, they resorted to only following their medicine regime prescribed by their doctor. Participants also reported feeling that their doctor only prescribed medications and acted in an authoritative and threatening manner to induce and reinforce participants\' compliance with treatment. CONCLUSIONS: For successful patient-centered management of chronic illnesses, supportive environments that include family, friends, and healthcare providers should be established.
Aged ; Chronic Disease ; Community Health Centers ; Diabetes Mellitus, Type 2/*diagnosis ; *Disease Management ; Female ; Focus Groups ; Humans ; Hypertension/*diagnosis ; Interviews as Topic ; Life Style ; Male ; Middle Aged ; *Perception ; Republic of Korea ; Social Support

OBJECTIVES: This study examined the trends in gender disparity in the self-rated health of people aged 25 to 64 in South Korea, a rapidly changing society, with specific attention to socio-structural inequality. METHODS: Representative sample data were obtained from six successive, nationwide Social Statistics Surveys of the Korean National Statistical Office performed during 1992 to 2010. RESULTS: The results showed a convergent trend in poor self-rated health between genders since 1992, with a sharper decline in gender disparity observed in younger adults (aged 25 to 44) than in older adults (aged 45 to 64). The diminishing gender gap seemed to be attributable to an increase in women's educational attainment levels and to their higher status in the labor market. CONCLUSIONS: The study indicated the importance of equitable social opportunities for both genders for understanding the historical trends in the gender gap in the self-reported health data from South Korea.
Adult ; Age Factors ; Data Collection ; Educational Status ; Employment/classification/economics ; Female ; *Health Status Disparities ; Humans ; Male ; Middle Aged ; Republic of Korea ; Sex Factors ; *Social Change ; Social Class ; Women's Health/*trends ; Women's Rights/*trends