• Title/Summary/Keyword: 전기충격요법

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A CASE OF LETHAL CATATONIA IN A 11-YEAR-OLD BOY (11세 남아에서 발생된 치사성 긴장증 1례)

  • Cho, In-Hee;Hong, Sung-Do;Joung, Yoo-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.121-133
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    • 1999
  • Lethal catatonia is one of catatonic spectrum, but it differentiates itself to a separate entity as a syndrome because of its severity and lethality. The prevalence of this disorder may have declined worldwide, coinciding with the advent of modern psychopharmacologic agents and other advances in medical treatment. The patient reported here was an 11-year old boy, showing catatonic excitement and stuporous condition with high fever, autonomic dysfunction and several catatonic symptoms. This is a case of successful treatment by using intensive medical monitoring and conservative treatment in an intensive care unit, combined with pharmacological treatment and electroconvulsive therapy during the early phase of lethal catatonia with mild symptoms.

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P3 in the Auditory Event-Related Evoked Potential of Schizophrenia(I) -P3 in the Schizophrenics- (정신분열증의 사건관련유발전위에 대한 연구(I) -정신분열증 환자의 사건관련유발전위-)

  • Oh, Dong-Jae;Chang, Hwan-Il
    • Sleep Medicine and Psychophysiology
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    • v.1 no.1
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    • pp.87-98
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    • 1994
  • Objectives: To examine a defect in inhibitory gating of auditory evoked response in schizophrenics, to compare P3 latency and amplitude in negative and positive schizophrenics, and to assess the association of P3 with family history of the psychiatric disorders, electroconvulsive therapy, and clinical features. Methods: 54 schizophrenics(male 31, female 23) and 75 controls(male 33, female 42) were tested with event-related potential paradigm designed to elicit P3 response and Frankfurter Beschwerde Fragebogen. Results: In schizophrenics, the latency of P3 was significantly more delayed and the amplitude of P3 was significantly more reduced than in the controls. Significant differences in P3 latency and amplitude between negative and positive schizophrenics were not found. And significant difference in the P3 latency and amplitude between schizophrenics with family histories of psychiatric disorder and those without family histories of psychiatric disorder was not found also. The P3 latency and amplitude was not significantly related with electroconvulsive therapy and other clinical features such as age, duration of illness, onset of inllness, number of admission, and doses of antipsychotics etc. Conclusion: These results suggested that schizophrenics had a dysfunction in the process of selective attention and that P3 was not significantly related with family history of the psychiatric disorders, positive and negative symptoms, electro1convulsive therapy, and clinical features in schizophrenics.

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Influence of Electroconvulsive Shock (ECS) on the Central and Peripheral Opiate System of the Rat (백서의 중추와 말초 Opiate계에 미치는 전기충격의 영향)

  • Kwon, Hyuk-Il;Kim, Kee-Won;Kwak, Yong-Geun;Yang, Won-Mo;Cho, Kyu-Park
    • The Korean Journal of Pharmacology
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    • v.24 no.2
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    • pp.165-178
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    • 1988
  • In this study, the effect of single or repeated (daily for 7 or 14 days) electroconvulsive shock (ECS) on central and peripheral opiate system and modification of the actions of ECS by several psychoactive drugs were investigated in the rat. Repeated ECS caused increase of Met-enkephalin content and decrease of Bmax of specific $[^3H]$imorphine binding in the rat brain. These effects were persisted more than 7 days after the last ECS, but single ECS failed to show these effects. However, ${\beta}-endorphin$ content was decreased in midbrain preparation and increased in plasma by repeated or single ECS. These phenomenon was seen shortly after the last ECS. After ECS-induced seizure was prevented by phenobarbital, ECS-induced increase in Met-enkephalin content was significantly attenuated. Imipramine or pargyline did not affect the action of repeated ECS. On the other hand, reserpine, chlorpromazine or haloperidol which were classified as neuroleptic antipsychotics, augmented the ECS-induced changes of central and peripheral opiate parameters. Furthermore, in groups received repeated ECS, changes of Bmax of specific $[^3H]-morphine binding$ binding was inversely correlated with changes of Met-enkephalin contents, but not with changes of ${\beta}-endorphin$ contents. From these results, it is inferred that the central or peripheral opioidergic system may be involved in the therapeutic and/or adverse effects of ECS which also can be influenced by some psychoactive drugs.

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Assessment and Treatment of Depression in the Medically III (신체질환 환자들에서 우울증의 평가 및 치료)

  • Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.2
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    • pp.111-132
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    • 2001
  • Depression in the medically ill is a common clinical problem that primary physicians and psychiatric consultants encounter. Treatment of such patients begins with a careful evaluation of the patient's medical and psychiatric conditions. The assessment of depression in the medical patients requires a multidimensional approach. Psychological instruments are also used as a method of assessment in these patients. First of all, what the therapists have to do is to find and remove organic causes. Psychosoical treatment includes dealing with the patient's resistance and despondency relevant to physical diseases. For biological treatment, it is important to select appropriate antidepressants. Therapists should be familiar with the side effects of the antidepressants as well as the patient's primary depressive symptoms, pharmacokinetics and pharmacodynamics of the available agents. In addition, special attention should be paid to the potential for drug-illness and drug-drug interactions. Tricyclic antidepressants can be still effectively used for patients with pain disorder, although a variety of new antidepressants such as selective serotonin reuptake inhibitors (SSRI), bupropion and venlafaxine could have more benefits in depression of the medically ill. However, electroconvulsive therapy can be recommended for refractory cases of depression in patients with medical illness.

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Treatment Strategies for Psychotic Depression (정신병적 우울증의 치료 전략)

  • Lee, Soyoung Irene;Jung, Han-Yong
    • Korean Journal of Biological Psychiatry
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    • v.13 no.4
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    • pp.234-243
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    • 2006
  • Objectives : Several factors, such as biological markers, clinical correlates, and course of the depressive disorders with psychotic symptoms differ from those without psychotic symptoms. Therefore, specification of a treatment algorithm for depressive disorder with psychotic symptoms is legitimated. This article provides a systematic review of somatic treatments for depressive disorder with psychotic symptoms. Methods : According to the search strategy of the Clinical Research Center for Depression of Korean Health 21 R & D Project, first, PubMed and EMBASE were searched using terms with regard to the treatment of depressive disorders with psychotic symptoms(until July 2006). Reference lists of related reviews and studies were searched. In addition, relevant practice guidelines were searched using PubMed. All identified clinical literatures were reviewed and summarized in a narrative manner. Results : Treatment options, such as a combination of an antidepressant and an antipsychotic versus an antidepressant or an antipsychotic alone are summarized. In addition, issues regarding the electroconvulsive therapy( ECT), combination therapy, and maintenance treatment are discussed. Conclusion : In former times, the combination of an antidepressant and an antipsychotic or ECT were recommended as the first line treatment for depressive disorder with psychotic symptoms. Recently, however, there was a suggestion that there was no conclusive evidence that the combination of an antidepressant and an antipsychotic drug is more effective than an antidepressant alone. More evidence regarding the pharmacological treatment for depressive disorder with psychotic symptoms is needed.

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Antinociceptive Efficacy of Korean Bee Venom in the Rat Formalin Test (랫드의 포르말린 시험에서 한국산 봉독의 항통각 효과)

  • Lee, Eun-Goo;Kim, Joong-Hyun;Han, Tae-Sung;Cho, Ki-Rae;Kim, Myung-Hwan;Park, Woo-Dae;Han, Hyun-Jung;Kim, Gon-Hyung;Choi, Seok-Hwa
    • Journal of Veterinary Clinics
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    • v.24 no.4
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    • pp.499-502
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    • 2007
  • The study was performed to assess the antinociceptive efficacy of Korean bee venom(BV) in the rat formalin test. Korean BV was collected using BV collector devices in which an electrical impulse is used to stimulate the worker bee(Apis mellifera L.) to sting and release venom. After collection, whole Korean BV was evaporated until dry using BV collector. Experiments were performed on male Sprague-Dawley rats(weighing 260-270, 6 weeks old). Rats divided into 4 groups, each comprising 8 rats. BV was diluted and amounts of 6 mg/kg body weight(BW), 0.6 mg/kg BW and 0.06 mg/kg BW were tested. BV was subcutaneously injected to produce an antinociceptive effect and the antinociceptive efficacy was evaluated using a rat formalin test. BV was subcutaneously injected into an acupoint(Zusanli, ST36) at 15 min prior to 1% formalin($50{\mu}l$) injection. The antinociceptive effect observed during 60 min following formalin administration. BV produced antinociceptive efficacy from 10 to 60 min after formalin injection. The antinociceptive efficacy of Korean BV showed a dose-dependent response. These results suggest that Korean BV may be a suitable and preferred choice for antinociceptive efficacy in pain management.

Depression during Pregnancy and the Postpartum (임신 및 산후 우울증)

  • Kim, Youl-Ri
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.1
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    • pp.22-28
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    • 2007
  • The pregnancy and postpartum period appear to be a time of heightened vulnerability for the development of major depression in some women. Postpartum depression affects 10% of women within a few weeks immediately postpartum. Postpartum depression is associated with disturbances in the mother-infant relationship, which in turn have an adverse impact on the course of child cognitive and emotional development. Depression during pregnancy is also common, although it has been relatively neglected. Psychopathological symptoms during pregnancy have physiological consequences for the fetus. Understanding the aetiology of perinatal depression requires integrating of multiple psychosocial and biological risk factors. The treatment of depressed pregnant women requires skilled decision making by psychiatrists. Risk-benefit analysis is appropriate method for intervention fur depression in pregnancy. Effective treatments for depression in pregnancy include psychotherapy, antidepressant medication and electroconvulsive therapy. In treatment of postpartum depression, the biological, psychological, and social interventions are included. Prescribing antidepressants(such as fluoxetine), estrogen in severe and chronic cases, and counselling can be effective for improving maternal mood and aspects of infant outcome. Ongoing research is directed to further elucidating neurohormonal and psychosocial contributions to depression during pregnancy or postpartum. Screening for risk factors and symptoms for depression need to be incorporated into antenatal and pediatric clinics.

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Treatment Strategies for Depression during Pregnancy and Lactation (임신과 수유기 우울증의 치료 전략)

  • Lee, Soyoung Irene;Jung, Han-Yong
    • Korean Journal of Biological Psychiatry
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    • v.14 no.2
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    • pp.91-98
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    • 2007
  • Objectives : Considering the impact of depressive illness on physical and mental health of both mother and fetus, specification of a treatment algorithm for depressive disorder during pregnancy is legitimated. This article provides a systemic review of treatments for depressive disorder during pregnancy and lactation. Methods : According to the search strategy of the Clinical Research Center for Depression of Korean Health 21 R & D Project, PubMed and EMBASE were searched using terms with regard to the treatment of depressive disorders during pregnancy and lactation. Reference lists of related reviews and studies were searched. In addition, relevant practice guidelines were searched using the PubMed. All identified clinical literatures were reviewed and summarized in a narrative manner. Results : Pharmacotherapy during pregnancy and lactation requires a comprehensive assessment of the risks and benefits of treatment for both mother and fetus or neonate. Recently, there is growing evidence that the use of tricyclic and selective serotonin reuptake inhibitors during pregnancy and lactation does not result in increased risks of teratogenicity. Treatment strategies are described according to the point of time of pregnancy or lactation. FDA categories for antidepressants during pregnancy and lactation are described. In addition, issues regarding to the electroconvulsive therapy and psychosocial treatment are discussed. Conclusion : The treatment option for depressive disorders during pregnancy and lactation depends on the severity of depressive illnesses of the individual patient. For mild to moderate depression, the non-pharmacological treatment should be considered first. For moderate to severe depression, pharmacotherapy should be administered in addition to the psychosocial treatment. ECT is recommended for depressive disorder of severe intensity. As the research knowledge is limited, the recommendations should based on the best judgement of psychiatrists.

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