• 대한불안의학회지
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• 제7권1호
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• pp.40-47
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• 2011

Objective : This study aimed to investigate the prevalence of obsessive-compulsive disorder (OCD) in schizophrenia, and the relationship among OCD, severity of psychopathology, and social function in stable patients with chronic schizophrenia. Methods : We interviewed 138 symptom-stable inpatients who had been on a constant dose of antipsychotics for at least 1 month prior and diagnosed as chronic schizophrenia. Subsequently, patients were classified according to the existence of OCD as investigated using the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Further, all clinical and demographic data was investigated. To investigate potential interrelationships, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Korea-Positive and Negative Symptom Scale (K-PANSS), and the Korean Personal and Social Performance (K-PSP) were used. An independent ttest and Chi-square test were used to compare groups and a Pearson's correlation coefficient was used to assess the relationship between the Y-BOCS and other clinical rating scales. Results : The prevalence of OCD in schizophrenia patients was 18.1%. Patients with schizophrenia and OCD exhibited significantly earlier onset of schizophrenia, more severe psychiatric symptoms, and lower personal and social performance ability as compared to those without OCD. There was no significant relationship among Y-BOCS, K-PANSS, and K-PSP. Conclusion : We found that comorbid OCD was relatively more frequent in patients with schizophrenia. An investigation involving larger samples of schizophrenia patients with OCD with respect to social function and thus, the effect on quality of life is required.

• 동의신경정신과학회지
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• 제26권4호
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• pp.349-356
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• 2015

Objectives: Schizophrenia is difficult to treat effectively and the antipsychotics used have many side effects. However, few studies have focused on the combined treatment of Korean and Western medicine as an alternative. In this study, we reported an inpatient with chronic schizophrenia who was treated by a combination of Korean and Western medicine. Methods: We experienced a case of a diagnosed schizophrenia patient as whose chief complaint was avolition, diminished emotional expression and hallucination. The patient was treated with Western medicine and Korean traditional treatment including acupuncture, moxa and herbal medicine. The Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale (PANSS) were used for assessment. Results: After treatment, symptoms involving avolition, diminished emotional expression and hallucination were improved; furthermore, the scores of the BPRS and the PANSS were decreased by approximately 50%, respectively. In addition, there were no notable side effects. Conclusions: The combined treatment of Korean and Western medicine can be an effective and well-tolerated treatment modality for patients with chronic schizophrenia.

• 대한조현병학회지
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• 제23권1호
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• pp.15-28
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• 2020

Objectives: This study investigated the relationship between clock-drawing test (CDT) performance and neuropsychological functions in patients with chronic schizophrenia. Methods: Thirty-one patients with schizophrenia and 30 healthy controls participated in this study. The CDT was administered in three conditions and analyzed using both quantitative and qualitative scoring systems. Comprehensive neuropsychological tests were administered. Results: The results of the quantitative analysis showed that the schizophrenia group performed significantly worse in all three conditions of the CDT compared with the control group. However, no significant differences were observed between the two groups, when the IQ and educational level were controlled. The qualitative analysis showed that the schizophrenia group exhibited significantly more errors in "graphic difficulty" compared with the control group. In addition, CDT quantitative scores were significantly correlated with visuospatial function, memory, attention and executive functions in patients with schizophrenia. Conversely, each qualitative error type was correlated with specific cognitive domains. Furthermore, "graphic difficulty" and "spatial/planning deficit" were identified as predictors of depression symptoms in patients with schizophrenia. Conclusion: The present study demonstrated that the CDT is useful for assessing cognitive dysfunctions in patients with schizophrenia, while qualitative analyses provide more specific information about cognitive deficits compared with quantitative analyses.

• 대한불안의학회지
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• 제13권2호
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• pp.141-147
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• 2017

Objective : This study aimed to evaluate the relationship between comorbid obsessive compulsive disorder (OCD) and quality of life in stable patients with schizophrenia. Methods : We interviewed 162 symptom-stable inpatients who have been on a constant dose of antipsychotics for at least 3 months prior and diagnosed as chronic schizophrenia. Subsequently, patients were classified according to the existence of OCD as evaluated using the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). Further, all clinical and demographic data were collected and evaluated. To investigate potential interrelationships, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Korea-Positive and Negative Symptom Scale (K-PANSS), Korean Modification of the Scale to Measure Subjective Well-Being under Neuroleptic Treatment (KmSWN) and Korean Version Quality of Life Scale (K-QOLS) were performed. Independent t-test and Chi-square test were used to compare groups and regression analysis was done to assess the relationship between the Y-BOCS and quality of life. Results : Schizophrenia patients with OCD showed significantly earlier onset of schizophrenia, more severe psychiatric symptoms and lower quality of life, compared to those without comorbid OCD. OCD might be associated with lower quality of life in schizophrenia. Conclusion : Schizophrenia patients with OCD showed lower quality of life than those without OCD. In the treatment for schizophrenia, evaluation of OCD might be needed to improve their quality of life and social function.

• 대한간호학회지
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• 제35권3호
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• pp.555-564
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• 2005

Purpose: This study was done to uncover the nature of hope experienced by clients with chronic schizophrenia. Method: A phenomenological approach developed by Van Manen was adopted. Data was collected from intensive interviews on 7 clients with chronic schizophrenia and the expatients' biographies and arts. A phenomenological reflection was done in terms of the four life world existentials. Result: Corporeality: Perceiving the body feeling better, proudness of self, accepting their own ill body and transcending the limitation of the body, expressing self, and staying within the boundary of a healthy body were disclosed as the body's experience of hope. Spatiality :A place with safety, freedom, peace, and sharing was the space of hope. Temporality :The essential experience of time with hope was the continuity of moving forward amid cycling and moments being filled up with something. Relationality : Connecting with someone, having someone who is dependable, understandable and exchanging interest and love were identified as the relationships of hope with others. Conclusion: The results of this study show that chronic schizophrenic patients always strive hard to keep hope and they really need someone who can support them.

• 대한간호학회지
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• 제35권6호
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• pp.1125-1134
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• 2005

Purpose: This research investigated the daily experiences of patients' lives to develop a formal theory that explains the lives of schizophrenic patients. Method: A grounded theory method(Strauss & Corbin, 1998) guided the data collection and analysis. Thirteen patients who were diagnosed with schizophrenia in regional communities participated. Result: The experiences of chronic schizophrenic patients are defined as "escaping from a fallen mine" comparing their suffering to that of entrapped miners trying to free themselves from a collapsed mine tunnel with much difficulty and without hope. In observing participant's time lines of having lived with chronic schizophrenia, it advances with 'surrender', 'collapse', 'reaching out', 'rising', 'preparing to spring up', and 'starting anew'. Conclusion: The results of this study indicate that the experience of a chronic schizophrenic patient is like that of a miner caught under a fallen mine channel, who, without external help cannot escape the depths 'Of the mine, but at the same time must have conviction and hope of rescue and avert fear to cooperate with outside help. The result indicates that family members, doctors and nurses as well as an institute's persistent and active support is most critical for the patient's adjustment to social life.

• 수면정신생리
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• 제18권2호
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• pp.67-71
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• 2011

Schizophrenia is a chronic, currently incurable, and devastating syndrome. Although sleep disturbances are not primary symptoms of schizophrenia, they are important aspects of schizophrenia. Difficulties initiating or maintaining sleep are frequently encountered in patients with schizophrenia. Many schizophrenics report low subjective sleep quality. Measured by polysomnography, increased sleep latency as well as reduced total sleep time, sleep efficiency, slow wave sleep, and rapid eye movement sleep latency (REM latency), are found in most patients with schizophrenia and appear to be an important aspect of the pathophysiology of this disorder. Some literatures suggest that worsening sleep quality precedes schizophrenic exacerbations. Co-morbid sleep disorders such as obstructive sleep apnea (OSA) and restless legs syndrome (RLS), and sleep-disrupting behaviors associated with schizophrenia may lead to sleep disturbances. Clinicians should screen the patient with sleep complaints for primary sleep disorders like OSA and RLS, and carefully evaluate sleep hygiene behaviors of all patients with schizophrenia who complain of sleep disturbances.

• 생물정신의학
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• 제4권1호
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• pp.127-131
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• 1997

Objective : To evaluate the clinical efficacy of adjuvant sertraline treatment in chronic schizophrenic patients, we carried out a double-blind, placebo controlled study. Method : Thirty six inpatients who fulfilled DSM-III-R criteria for chronic schizophrenia were randomly assigned to sertraline and placebo groups in a double-blinded fashion. A history of at least 2 years of illness and at least six months of hospitalization were prerequisities for inclusion in the study. Patients were received sertraline 50mg or placebo for 8 weeks in addition to their routine haloperidol regimen. Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression(CGI), Simpson-Angus Scale(S-A) were evaluated at 5 points ; baseline, 2, 4, 6, and 8 weeks of treatment. Results : The groups were controlled for age, gender, and length of illness. There were no significant differences in three PANSS factros(positive, negative, general), CGI, and S-A scale scores at any between sertaline and placebo treatment. Conclusion : This placebo controlled study showed no significant effects of sertraline on negative and positive symptoms in chronic schizophrenic patients.

• Journal of Korean Biological Nursing Science
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• 제19권3호
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• pp.158-169
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• 2017

Purpose: The purpose of this study was to identify the effects of the Gratitude Enhancement Program on self-esteem, interpersonal relationships, gratitude disposition, subjective happiness, stress index in patients with chronic schizophrenia. Methods: The research was designed for a nonequivalent control group before and after the test design. The subjects of this study were 29 patients in the experimental group and 28 patients in the control group. The Gratitude Enhancement Program was conducted three times a week for a total of nine sessions. Data were collected with questionnaires and measured with autonomic nervous system response (stress index) and was analyzed by t-test, chi-square test, Fisher's exact, and repeated measures ANOVA with the SPSS/WIN 23.0 program. Results: There are no significant differences in the homogeneity test of a dependent variable between groups. The experimental group showed significant higher scores of self-esteem, interpersonal relationships, gratitude disposition, and subjective happiness than the control group. There was no significant difference in the stress index between two groups. Conclusion: Based on the results of this study, this Gratitude Enhancement Program can be a good nursing intervention to improve self-esteem, interpersonal relationship, gratitude disposition, and subjective happiness for chronic schizophrenia patients.

• 생물정신의학
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• 제8권1호
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• pp.140-146
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• 2001

In clinical setting, treatment-refractoriness, medication induced tardive dyskinesia and amenorrhea in chronic schizophrenia are frequently problematic. However, there are few guideline solving these problem available to clinicians. The goal of this study was collecting clinical data on clinical effectiveness and predictors of response of switching to olanzapine. We attempted to switch to olanzapine from risperidone and clozapine in chronic 31(risperidone 17, clozapine 14) schizophrenia and schizoaffective disorder patients suffering from sustained symptoms, weekly blood monitoring, medication induced tardive dyskinesia and amenorrhea. Previous antipsychotics dosage was gradually decreased for 2 or 3weeks, at the same time olanzapine dosage was gradually increased. At baseline, after 1 week, after 2 weeks and after 4 weeks we checked Brief Psychiatric Rating Scale, Clinical Global Impression Scale, Sympson-Angus Rating Scale, Barnes Akathisia Rating Scale and followed up after 12 months. Successful switch after 4 weeks was achieved in 25 patients(clozapine 9(64.2%), risperidone 16(94.1%)). Overall, mean BPRS and CGI scores increased significantly. Successful maintenance after 12 months was achieved in 17 patients(clozapine 5(35.7%), risperidone 12(70.5%)). Overall, mean BPRS and CGI scores increased significantly too. Switching to olanzapine from other atypical antipsychotics is recommendable in chronic schizophrenia with treatment refractoriness and drug induced side effect.