Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.16
no.2
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pp.239-250
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2005
Objective : The purpose of this study was obtaining data on the efficacy and safety of risperidone in child and adolescent psychiatric patients. Method : Thirty one children and adolescents (males n=18, females n=13, age ranged from 5.4 to 17.3 years) treated with risperidone were selected among child and adolescent psychiatric inpatients of Seoul National University Hospital from January, 2001 to June, 2002, and charts for them were reviewed retrospectively. Results : The primary psychiatric disorders treated with risperidone were schizophrenia and other psychosis, bipolar I disorder with psychotic features, Tourette's disorder, autism spectrum disorders, mixed receptive and expressive language disorder, attention deficit-hyperactivity disorder, conduct disorder and obsessive-compulsive disorder. twelve of these had comorbid mental retardation. Primary target symptoms of risperidone were psychotic symptoms (n=13 or $41.9\%$), behavioral symptoms (n=10 or $32.3\%$) including aggression, impulsivity, hyperactivity, stereotypy nonresponsive to other psychiatric treatments, and chronic and severe tics (n=8, $25.8\%$). The efficacy of risperidone was measured by clinical global improvement (CGI) for target symptoms, $67.7\%$ of subjects showed moderate or marked improvements and its therapeutic effect appeared to be maintained during at least 7.5 months. Mean daily dosage of risperidone was $0.05{\pm}0.01mg/kg$, the group with psychotic symptoms had significantly higher mean daily dosage (0.07mg/kg) compared with other two groups (0.04mg/kg) with behavioral symptoms or tics. A variety of adverse events were reported in this study : weight gain (n=23) most commonly reported, extrapyramidal symptoms (n=15), autonomic symptoms (n=6), sedation (n=5) and symptoms related to hyperprolactinemia (n=2) etc. Although there was no drug change related to the adverse events of risperidone, and $90\%$ of subjects at their last visits were maintained on it, thus its tolerability appeared good. Conclusions Results suggest that risperidone may be relatively safe and effective drug in managing a wide variety of child and adolescent psychopathologies such as psychotic symptoms, behavioral symptoms including aggression, impulsivity, hyperactivity and stereotypy nonresponsive to other psychiatric treatments, and chronic and severe tics. Controlled and long-term studies of efficacy and safety of risperidone treatment for children and adolescents are recommended in the future.
Objective : We explored the meaning of "Pyo (表)" in Gangpyeong-Shanghanlun through two cases. Methods : We analyzed the original form of 表 and its context in Shanghanlun. We also analyzed 2 clinical cases of bipolar disorder treated with Mahwang-tang (麻黃湯) according to the newly deduced definition of 表. Results : 表 can be interpreted as "pursuing something high-class seen from the outside." Both cases had various psychological symptoms including insomnia, mood swings, anxiety, and depression. We determined that the diseases in both cases occurred when 表 had not been achieved. We also found that 麻黃湯 can improve psychological status. Conclusions : 表 is different from "surface," which is the most widely used definition. After diagnosing these two patients with bipolar disorder using the Diagnostic and Statistical Manual of Mental Disorders (5th edition), we found that symptoms could be improved by administration of 麻黃湯 (46條). Although its potential for neuropsychiatric diagnosis has been suggested through etymological interpretation of 表 and analysis of two cases, more advanced clinical studies are needed in the future.
Bipolar disorder is a mental illness characterized by extreme mood and behavioral swings, such as highs of euphoria and lows of depression. It is a socially significant disorder in which people with the disorder experience intense mood swings and, for those with severe bipolar disorder, it is even difficult leading a normal life. High stress levels in people with mental illness can lead to neuroendocrine disruption, and it is strongly linked to aging. When the neuroendocrine system becomes vulnerable to these mental illnesses and stress, it is likely to accelerate aging. And it's the epigenetic clock that can measure the extent of this accelerated aging. The Epi clock, a pan tissue clock, measures aging through DNA methylation, and the degree of methylation is modified and changed by environmental conditions in the body. Therefore we wanted to check the changes in the epigenetic age of the patients with bipolar disorder. While we found no significant differences in epigenetic age, we did confirm the possibility that people with bipolar disorder have different methylation than normal people. We also found that the EPIC array data fit better on the Epi clock than on the Horvath clock with age-accelerated data from normal people.
The debate about whether depressive disorders should be divided into categories or arrayed along a continuum has gone for decade, without resolution. In our review, there is more evidence consistent with the spectrum concept than there is with the idea that depressive disorders constitute discrete clusters marked by relatively discontinuous boundaries. First, "depression spectrum", "is there a common genetic factors in bipolar and unipolar affective disorder", "threshold model of depression" and "bipolar spectrum disorder" are reviewed. And, a new subtype of depression is so called SeCA depression that is a stressor-precipitated, cortisol-induced, serotonin-related, anxiety/aggression-driven depression. SeCA depression is discussed. But, there is with the idea that depressive disorders constitute discrete subtypes marked by relatively discontinuous boundaries. This subtypes of depressive disorder were reviewed from a variety of theoretical frames of reference. The following issues are discussed ; Dexamethasone suppression test(DST), TRH stimulation test, MHPG, Temperament Character Inventory(TCI), and heart rate variability(HRV).
The purpose of this study is to examine the patterns of the keywords in journals in the field of Cognitive Behavioral Therapy (CBT) to identify the knowledge structure of CBT studies in Korea. To compare CBT studies from Korea and abroad, 234 articles (2008-2019) published on "Cognitive Behavior Therapy in Korea" and 2,316 articles (1977-2019) published on "Cognitive Therapy and Research" were collected. The data were analyzed using NetMiner 4.3. The co-word analysis was done by calculating the cosine similarity matrix of major keywords, followed by visualizing the network. The results of this study identified the main interests of Korean CBT scholars, and categorized the knowledge structure of CBT in Korea into 9 research areas: "scale validation"; "perfectionism and entrapment"; "cognitive, emotional, and relationship characteristics of schizophrenic patients"; "cognitive characteristics and treatment of borderline personality disorder and depression/bipolar disorder patients"; "adaptation and psychological health"; "cognitive characteristics and treatment of patients with social anxiety disorder"; "causes and co-morbidities of depression"; "acceptance and commitment therapy"; and "understanding and the treatment of binge eating disorder patients." This study is meaningful in that it has reviewed the accumulated knowledge in the CBT field in Korea for the past 11 years, and suggests future tasks for development to improve the standards of CBT practice.
Kim, Yong Ku;Lee, Heon Jeong;Kim, Ji Yeon;Choi, So Hyun;Lee, Min Soo
Korean Journal of Biological Psychiatry
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v.6
no.2
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pp.227-234
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1999
An association of low total cholesterol in blood with psychiatric diseases and suicidal behavior has been suggested. As part of an attempt to further explore this relationship, we examine first, whether serum cholesterol levels in psychiatric patients with suicidal attempt would be lower than in non-suicidal psychiatric inpatients or normal controls, second, whether such significant difference of cholesterol levels would be present when the diagnostic groups are analyzed separately, third, whether low cholesterol level would be associated with a history of serious suicidal attempts, and finally, whether low cholesterol level in suicide attempters is a state or a trait marker. We determined the serum cholesterol levels in 231 patients admitted to an emergency room following an suicidal attempt, in the same numbers of age-, sex- and diagnosis- matched non-suicidal psychiatric controls, and in the same numbers of age-, sex matched normal controls. The seriousness of an attempt was divided into 5 grades according to the degree of the resulting medical injury. Total cholesterol levels in suicide attempters were significantly lower compared with both psychiatric and normal controls, when sex, age, and nutritional status (i.e., body mass index) were controlled for. This significant relationship was observed in major depressive disorders and personality disorders, but not in schizophrenia and bipolar type I disorders. The severity of suicide by a lowering of blood cholesterol was related to the magnitude of the cholesterol reduction. After treatment of their psychiatric ailments, the cholesterol levels in suicide attempters were significantly increased. This result suggests that low cholesterol level in psychiatric patients might be a potential biological marker of suicide risk. It is hypothesized that low cholesterol levels is associated with the suicide by modifying the serotonin metabolism, the production of interleukin-2 and melatonin metabolism in psychiatric patients.
Kim, Soo Young;Kim, Tae-Suk;Kim, Dai-Jin;Chae, Jeong-Ho;Lee, Chang Uk;Joo, Soo Hyun
Korean Journal of Biological Psychiatry
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v.29
no.1
/
pp.22-31
/
2022
Objectives Recently, weight loss has emerged as a national concern in South Korea, and this has resulted in an increase in the frequency of use of central nervous system (CNS)-stimulating appetite suppressants. This study aimed to collect cases of psychotic disorders and bipolar disorders triggered by phentermine and phendimetrazine and explore the clinical features and courses. Methods In this retrospective study, we analyzed the electronic medical records of patients and selected eight patients who developed psychotic symptoms and manic symptoms for the first time after taking phentermine and phendimetrazine. All cases were reviewed, and their clinical features and course were summarized. Results All eight patients developed psychotic symptoms, and one had accompanying manic symptoms. The final diagnosis was appetite-suppressant-induced psychotic disorder in four patients, schizophrenia in three, and appetite-suppressant-induced bipolar disorder in one. In addition, three patients were diagnosed as having substance-use disorder. The key psychotic symptoms of these patients were hallucinations and paranoia. Conclusions These case findings suggest that phentermine and phendimetrazine can cause psychotic disorder, bipolar disorder, or substance use disorder and that medical professionals and the public should practice caution when prescribing and using these drugs.
Paik, In Ho;Lee, Chang Uk;Lee, Chul;Lee, Soo Jung;Kim, Jae Hyun
Korean Journal of Biological Psychiatry
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v.2
no.2
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pp.281-286
/
1995
Objects : Manic phase of bipolar disorder is treated with a combination of mood stabilizer and antipsychotic drug, especially in the acute phase. Such combined treatment is often required for the clinical management of manic symptoms until therapeutic effects of mood stabilizer become evident. The present study was the first open trial to evaluate the efficacy of risperidone, and safety of the combination of mood stabilizer and risperidone in the treatment of acute manic patients. Method : This study was performed as an open clinical study. The subjects of this study were 42 patients who had been admitted with first manifestations or acute exacerbations of illness were selected, using DSM-III-R criteria for bipolar disorder, manic episode. Patients were rated using the the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI), Extrapyramidal Symptom Rating Scale(ESRS). Other adverse events were assessed by a symptom checklist and by observation by medical personnel. Vital signs were monitored in a standard way and electrocardiography, routine laboratory analysis were performed. Results : Thirty patients(67%) completed the 12-week trial period. The CGI showed a good therapeutic effect with a minimal incidence or severity of side effects. The majority of patients showed a continuos reduction in their BPRS scores. The extrapyramidal symptoms assessed on ESRS generally showed mild to moderate degree. laboratory porameters showed no significant changes during the course of treatment. Conclusion : The results of the study showed a good efficacy of the risperidone in manic patients and further controlled studies are warranted.
This study was designed to investigate the relationship between changes in manic symptoms and in thyroid hormone level in manic patients. Thyroid hormones(T3, T4) and TSH were measured, and Young's Mania Rating Scale(YMRS) was scored in twenty manic inpatients, at the time of admission and 6 weeks later. Mean value of T3 was slightly increased(increase : 9, decrease : 11). Mean value of T4 was fairly decreased(increase 4, decrease 16), while that of TSH was increased(increase 14, decrease : 6). Mean total score of YMRS was fairly decreased and mean values of each eleven subscales were decreased. Subjects were classified as increased, decreased and unchanged group for each thyroid hormones. for T3, there was statistically significant differences in YMRS subscale of 6(speech : speed/amount), 7(language, thought disturbance) and 10(appereance) between 3 groups. With the above results, the changes of manic symptom during the course of illness could probably be indicated by the thyroid hormon change, and manic symptoms could be classified as subtypes in terms of thyroid hormone change.
The object of this study is to apply a chaotic signal analysis method to the EEG research, especially in the aspect of neuropsychiatry, and to get some inspection of the chaotic phenomena according to the brain sites and subjects. We have acquired 21 channel EEG data and one EOG according to the international 10-20 system and calculated the correlation dimension. The subject groups are schizophrenics, bipolar disorder, major depression and normal control. They were all awoke and eye-closed. We have found no distinctive features from our experiments except temporal regions have slightly higher correlation dimension. There is also no specific distinctions between groups. We conjecture that these results are mainly because the subjects were not well controlled. EEG dimension may change in accordance with to the age, sex, medication and the time data were selected to calculate. We have also considered some conditions for a better and more objective research of chaotic analysis to EEG research. Better conditioning and standardizing the calculation of correlation dimension is necessary for the application of the chaotic analysis to neuropsychiatry.
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