• Korean Journal of Psychosomatic Medicine
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• v.5 no.1
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• pp.73-81
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• 1997

Objects: This study aimed to evaluate the role of somatic delusion on the pain perception in patients with schizophrenia. It was hypothesized that pressure pain thresholds would be rather higher in schizophrenic patients who had somatic delusion than patients with other delusion. Methods The subjects were consisted of 3 groups, 23 men with schizophrenia who had somatic delusion, 25 men with schizophrenia who had other delusion, and 22 normal healthy controls. By using Algometer, pressure pain thresholds were examined to subjects on three non-tender sites with 6 weeks interval. The severity of delusion was evaluated in both patient groups. Statistically, Chi-square test, One-way ANOVA, Multivariate ANOVA, and Scheffe's test were used. Results : 1) There was significant difference between somatic and other delusion groups and normal control group at initial stage. 6 weeks later even when severity of delusion was thought to be ameliorated, this finding were sustained. 2) The severity of the components of delusion, conviction and preoccupation, were significantly decreased in both somatic delusion group and other delusion group according to the time interval. The decrements of the severity of delusion seems to be related with changes in pressure pain thresholds in both patient groups. Conclusions : We re-confirmed that both schizophrenic patient groups showed higher pressure pain thresholds compared to normal healthy control. However we failed to find the role of somatic delusion on pain perception in schizophrenia. Delusion, including somatic delusion, as a whole, seems to affect the increased level of pressure pain threshold due to attention deficit and decreased motivation in patients with schizophrenia.

• Korean Journal of Biological Psychiatry
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• v.17 no.3
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• pp.127-135
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• 2010

Objectives : This study was conducted to compare between hallucination group and delusion group in patient with schizophrenia, using Brain $^{99m}Tc$-ECD PECT. Methods : Among 16 patients with less than 3 schizophrenic episodes, 8 patients whose initial symptom was hallucination were assigned to the hallucination group, and other 8 patients with initial sumptom of delusion were assinged to the hallucination group. All of the patients clinically evaluated using the PANSS and BPRS. Both groups of patients and 8 healthy subjects underwent $^{99m}Tc$-ECD PECT. Results : Score of thinking disturbance subscale of BPRS were significantly lower in the hallucination group than the delusion group. In SPECT analysis, the hallucination group showed significantly increased perfusion in some areas of the right temporal lobe, bilateral limbic lobes and left parietal lobe compared to delusion group. Both group had a reduced rCBF in some areas of the frontal lobe. Conclusion : The hallucniation group, compared with the delusion group, showed significantly increased regional cerebral blood flow in some regions. Therefore, this data suggests that different neural substrates may affect the process of auditory hallucination and delusion.

• Sleep Medicine and Psychophysiology
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• v.7 no.1
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• pp.60-66
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• 2000

Objectives: The Psychopathology of schizophrenia was expected to be related with focal dysfunction of brain while schizophrenia is recognized and studied as the brain disease. Authors studied correlation between neuropsychological tests and delusion which is representative symptom of schizophrenia in patients with head trauma and psychiatric patients in order to explore the functional localization of brain in delusional symptom. Methods: Halstead Reitan Neuropsychological Test Battery and Korean Weschler Intelligent Scale and Minnesota Multiphasic Personality Inventory(MMPI) were administered to one hundred ninteen patients consisted of sixty nine psychiatric patients and fifty patients with brain damage. We tested correlation between results of neuropsychological tests and delusional scale made from twenty four items related with delusion in MMPI. T-test between eighteen higher delusion scorers and twenty one lower scorers was examed in psychiatric group. Results: In brain damage group, signigicant correlations were found in the tests related with function of frontal lobe such as category test, trail making AB test, tactual performance test, digit symbol test and fingertip number writing test, and significant correlations were also noted in the tests related with function of left temporal and parietal lobes such as information, comprehension, vocabulary, similarities and speech sound perception test. The tests related with the function of right hemisphere such as tactual performance test location, picture completion and performance, and the tests related with subcortical function such as arithmetic, digit span, attention, digit symbol test, digit symbol and trail making AB test were signigicantly corelated with delusional scale too. In psychiatric group there were significant difference of delusional score in the tests related with function of left hemisphere such as vocabulary, vocable IQ, comprehension and language, and in the tests related with subcortical function such as N 120 voltage, digit symbol and arithmetic. Conclusions: Delusion seems to be related with function of frontal lobe, left hemisphere and subcortex in both groups. Right hemisphere may be also partially related with delusion.

• Korean Journal of Biological Psychiatry
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• v.15 no.3
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• pp.219-223
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• 2008

Refeeding syndrome is a life-threatening but treatable condition occurring in any patients with starvation. Electrolyte imbalance, especially hypophosphatemia and fluid shift result in metabolic changes in various systems. The authors reported a case of refeeding syndrome associated with prolonged starvation due to delusion and hallucination in a 38-year-old schizophrenia patient. Hypophosphatemia, hypokalemia, edema and elevation of liver enzyme was occurred despite careful treatment. The symptoms were improved after consistent electrolyte supplement. Close observation and repetitive monitoring are important to prevent refeeding syndrome.

• The Journal of Korean Medicine
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• v.34 no.1
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• pp.179-191
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• 2013

Kleine-Levin syndrome is a rare disorder characterized by recurrent episodes of hypersomnia, hyperphagia, hypersexuality and delusion and hallucination with spontaneous recovery. A 17-year-old female suddenly showed hypersomnia, severe fatigue, and compulsive hyperphagia. She was diagnosed with suspected Kleine-Levin Syndrome. The precipitating factor was an upper respiratory tract infection that the patient had undergone 2 weeks prior. Past psychiatric history included somnambulism and ADHD; her symptoms of ADHD included attention deficit, impulsiveness, hyperactivity, and irritability. This was her third episode. Her hypersomnia was longer in duration but lower in frequency compared with usual KLS. Her low LF/HF ratio in heart rate variability measurement showed high parasympathetic nerve activity. A MMPI report showed some psychological problem. The patient was diagnosed of gastric fever by pattern identification. Her hypersomnia episode improved 6 weeks after onset. This is the first reported case of suspected Kleine-Levin Syndrome in the field of Oriental Medicine in Korea.

• Journal of Oriental Neuropsychiatry
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• v.15 no.1
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• pp.247-254
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• 2004

Schizophrenia is a frequent psychotic disorder. Recently many studies raised biochemical theory as a cause of schizophrenia. But in this case, we used psychosocial treatment and oriental medical treatment, without antipsychotic drugs for 4 months, obtained good results. Practicing psychosocial treatment, we were able to remove anxiety and fear of the patient. In addition positive symptoms, for example auditory hallucination and delusion, were improved. Schizophrenia conforms to JEONKWANG(癲狂) in oriental medicine. We concluded this case to JEONJUNG(癲證) due to QIULDAMHWA(氣鬱痰火). So we used herbal medication and acupuncture according to oriental medical theory and these efforts helped the care of disease.

• Journal of Korean Medical Science
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• v.33 no.47
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• pp.300.1-300.17
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• 2018

Parkinson's disease (PD) is the second most common neurodegenerative disorder. Although its major manifestation is motor symptoms, resulting from the loss of dopaminergic neurons in the substantia nigra, psychiatric symptoms, such as depression, anxiety, hallucination, delusion, apathy and anhedonia, impulsive and compulsive behaviors, and cognitive dysfunction, may also manifest in most patients with PD. Given that the quality of life - and the need for institutionalization - is so highly dependent on the psychiatric well-being of patients with PD, psychiatric symptoms are of high clinical significance. We reviewed the prevalence, risk factors, pathophysiology, and treatment of psychiatric symptoms to get a better understanding of PD for improved management.

• Korean Journal of Psychosomatic Medicine
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• v.20 no.2
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• pp.105-111
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• 2012

Objectives : We investigated the prevalence and composite score of the neuropsychiatric symptoms in patients with mild cognitive impairment(MCI), and dementia of Alzheimer's type(AD). The aim of this study is to analyze the correlation between the result of Korean Neuropsychiatric Inventory(K-NPI) and cognitive function. Methods : A total of 163 patients diagnosed with MCI or AD was divided into three groups(55 MCI patients, 56 dementia patients with mild stage, and 52 dementia patients with moderate, severe stage). We examined neuro-psychiatric symptoms by K-NPI and compared the prevalence and composite score of each subdomain in K-NPI among three groups. Results : The most common symptoms in the MCI group were depression/dysphoria, sleep/night-time behavior, anxiety, and irritability/lability. In mild AD group, the most frequent disturbance was agitation/aggression, depression/dysphoria, anxiety, apathy/indifference, and sleep/night-time behavior. In moderate to severe AD group, the most frequent disturbance was apathy/indifference, depression/dysphoria, agitation/aggression, and delusion. The frequencies of delusion, hallucination, agitation/aggression, apathy/indifference, aberrant motor behavior, appetite/eating change were statistically significant. The total NPI score showed a negative correlation with MMSE-KC and a positive correlation with GDS. Conclusions : Neuropsychiatric symptoms are common features of MCI and AD. These symptoms observed in MCI are similar to those of mild AD. Psychosis is most common in moderate to severe AD, leading to a faster rate of cognitive decline. Therefore, proper management according to the neuropsychiatric symptoms of MCI and three stages of dementia is needed.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.2
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• pp.200-207
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• 2016

Objectives : Alzheimer's disease(AD) is characterized by progressive decline of cognitive function and also by various behavioral psychological symptoms of dementia(BPSD) which causes distress to their caregivers. The purpose of this study was to investigate association between each AD patients' behavioral psychological symptoms and their caregivers' burden. Methods : Participants were 80 AD patients and their caregivers. We used Korean neuropsychiatric inventory (K-NPI) to assess the symptoms of patients and Korean version of Zarit Burden Interview(ZBI) to evaluate caregivers' burden. Results : The results showed ZBI score, which is the index for caregivers' burden, had a statistically significant positive correlation with the frequency of delusion, hallucination, agitation/aggression, depression, anxiety, disinhibition and irritability, the severity of hallucination, agitation/aggression, anxiety, disinhibition, aberrant motor, and sleep, and the global score(frequency${\times}$severity) for delusion, hallucination, agitation/aggression, depression, anxiety, disinhibition, aberrant motor, and sleep. There were significant correlations between each scale for cognitive function(i.e. MMSE-KC, CDR, GDS) and ZBI scale. Correlations between each scale for activity of daily living(i.e. Barthel -ADL, K-ADL) and ZBI scale were also significant. Conclusions : There were a significant correlation between BPSD and caregiver burden. Caregiver burden was also correlated with cognitive function and activity of daily living. Early detection and preventive treatment of these symptoms in BPSD might make improvement of caregivers' quality of life as well as AD patients'.

• Journal of Haehwa Medicine
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• v.12 no.2
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• pp.85-103
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• 2004

From the studies on a few specific chapters of Tibetan Medical Painting, following conclusions were obtained. 1. The doctors of Tibet had to be not only academically and morally perfect, but he must show and have respect for his religion and his religous leaders and Gods. 2 The most main causes for all the disease that Tibetan Medicine resumed were hatred, delusion and ignorance of human mind which can make the physiological bile, wind, and phlegm to turn into pathological ones. 3. There is the classification of primary cause, which would be the human mind mentioned above, and the secondary cause which include dietary, behavior, seasonal problems, etc. 4. The Tibetans thought the digestive power is very important in the improvement or degravation of the disease. 5. More chapters were held for explaining the disease of fever, its clssification, stages, and cures which can indirectly show that the Tibetans might have thought it was very serious and could be very harmful. 6. The treatments for all the kinds of disease not only include medication and external therapy but also dietary and behavior regulations.