• Korean Journal of Biological Psychiatry
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• v.11 no.2
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• pp.94-103
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• 2004

Objective:There have been a kind of transmethylation theory that high homocysteine serum concentration affects schizophrenia by neurotoxic mechanism and clinical reports that some schizophrenic patients with high homocysteine were improved by high folate ingestion. This study was done to confirm previous research results and find the clinical characteristics of schizophrenia showing high serum homocysteine and low folate. Method:We compared the serum levels of homocysteine, folate and vitamin B12 level between 234 schizophrenic patients(male 99, female 135) group and 234 normal controls(male 99, female 135) group. The subjects of two groups were age and sex matched. The evaluated clinical characteristics items were sex, age, onset of disease, hereditary loading, disease course, hallucination and subtype of schizophrenia. Results:1) Homocysteine level of the schizophrenia group was significantly higher than the normal control group and folate level of the schizophrenia group was significantly lower than the normal control group. Homocysteine level was more negatively correlated with folate level in the schizophrenia group than the normal control group. 2) The percentage of high homocysteine(above 12.46umol/L;90 percentile of normal control) was 33.8% of schizophrenia patients and 51.5% of male schizophrenia. The percentage of low folate(below 3.8nM/L;bottom tertile of normal control) was 66.2% of schizophrenia. 3) In low folate group and not-low folate group, schizophrenia showed significantly higher homocysteine level than normal control. Especially, low folate schizophrenia group showed significantly higher homocysteine level than low folate normal control group. Conclusions:Some schizophrenia patients with high serum homocysteine may be genetic defector and having low folate serum level. In that case, folate ingestion could be a good management for clinical improvement.

• Korean Journal of Biological Psychiatry
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• v.3 no.2
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• pp.211-215
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• 1996

The present study investigated the associations between CT measures and obstetric complications and family history of major mental illnesses. We had the hypothesis of diosthesis-stress model in the etiology of schizophrenia. We had the following findings. 1) Family history of major mental illnesses is inversely related to obstetric complications. 2) Prefrontal sulcal widening and family history of schizophrenia. are inversely related. 3) In female but not in male patients those with family history of schizophrenia tended to have less prefrontal sulcal widening and ventricular brain ratio. These results suggest that more genetic factors contribute to structural brain abnormalities in female than in male patients.

• Korean Journal of Schizophrenia Research
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• v.23 no.2
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• pp.45-50
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• 2020

Schizophrenia is one of serious mental illnesses and is often described as a heterogeneous disorder. Approximately one-third of schizophrenia cases are treatment-resistant schizophrenia (TRS). The aim of this study was to review the definitions and clinical features of TRS. Though it was found that the criteria for TRS were considerably diverse, the Treatment Response and Resistance in Psychosis (TRRIP) consensus criteria were recently introduced. According to the TRRIP criteria, TRS should be suspected if symptoms persist alongside psychotic symptoms despite sufficient treatment for ≥12 weeks, or two or more symptoms persist significantly for ≥6 weeks. The clinical characteristics of TRS includes an earlier age of onset, more severe and familial form, possibly more rural residence, unlikely association with male sex, and an increase in cognitive deficits.

• Korean Journal of Biological Psychiatry
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• v.21 no.4
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• pp.151-160
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• 2014

Objectives Prenatal testosterone is known to influence both cerebral laterality and 2nd to 4th digit ratio (2D : 4D). Epigenetic changes are thought to play some role in it. We studied sex-related differences between 2D : 4D and cerebral laterality in patients with schizophrenia and controls to examine the effects of prenatal testosterone in the development of schizophrenia. Methods Forty one men (18 schizophrenic patients and 23 controls) and 40 women (17 schizophrenic patients and 23 controls) were recruited from one psychiatric hospital in Korea. The 2D : 4D and electroencephalographic (EEG) coherence in 19 channels (66 pairs of interhemispheric coherence and 54 pairs of intrahemispheric coherence) were measured. The sex-related statistical analyses between 2D : 4D and EEG coherence in controls and patients with schizophrenia were performed using multiple regression. Results In male patients, the relationship between 2D : 4D and right intrahemispheric EEG coherence showed mainly positive correlation in delta and theta frequency bands, while it showed negative correlation in male controls. In female patients, the relationship between 2D : 4D and interhemispheric EEG coherence showed stronger positive correlation in alpha and beta frequency bands, while it showed weaker positive correlation in female controls. Conclusions Low prenatal testosterone may play certain roles in altered correlation between 2D : 4D and cerebral laterality in schizophrenia and the development of schizophrenia by epigenetic mechanism.

• Korean Journal of Schizophrenia Research
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• v.22 no.2
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• pp.34-41
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• 2019

Objectives: This study was performed to examine the effects of the public attention to 'crime of schizophrenia' on the use of mental health services in patients with schizophrenia using big data analysis. Methods: Data on the frequency of internet searches for 'crime of schizophrenia' and the patterns of mental health service utilization by patients with schizophrenia spectrum disorders by month were collected from Naver big data and the Health Insurance Review and Assessment Services in Korea, respectively. Their correlations in the same and following month for lagged effect were examined. Results: The number of outpatients correlated negatively with public attention to 'crime of schizophrenia' in the same month. The lagged relationship between public attention and the number of admissions in psychiatric wards was also found. In terms of sex differences, the use of outpatient services among female patients correlated negatively with public attention in the same month while the number of male patients' admissions in both same and following month correlated positively with public attention. Conclusion: These findings suggested that public attention to 'crime of schizophrenia' could negatively affect illness behavior in patients with schizophrenia.

• Korean Journal of Biological Psychiatry
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• v.12 no.2
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• pp.114-122
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• 2005

Objectives:Recently in schizophrenia high incidence of MTHFR(methylenetetrahydrofolate reductase), which is a main relating enzyme that reduce homocysteine level, genetic variations were reported. So we examined serum homocysteine level and MTHFR gene polymorphism in Korean schizophrenics. Method:We compared serum homocysteine level and MTHFR polymorphism between 235 schizophrenics (100male, 135female) and 235 normal controls(100male, 135female). C677T and A1298C polymorphism of MTHFR gene were analyzed. Results:1) C677T genetic mutation(CT and TT) were more frequent in schizophrenia group than normal control group(p<0.01). But the difference of A1298C mutation frequency was not found between two groups. 2) In schizophrenia patients, TT genotype of C677T mutation showed significantly higher homocysteine level (29.99uM/L) than other group(CT:13.34uM/L, CC:9.34uM/L p<0.01). 3) MTHFR 677 TT homogeneous mutation genotype showed two times more risk(odds ratio=2.15) than 677CC normal genotype in schizophrenia. Conclusion:Some schizophrenia patients with high homocysteine serum level may have C677T TT genotype. In that case, folate ingestion could be a good management for clinical improvement.

• Korean Journal of Schizophrenia Research
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• v.20 no.2
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• pp.55-60
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• 2017

Objectives : Severe mental illness is a major risk factor for suicide. This study aimed to identify characteristics of patients who died by suicide among subjects who had been received service from a community mental health center. Methods : We searched individuals who had committed suicide in Gwangju Bukgu Community Mental Health Center since 2006. Sociodemographic and clinical data were gathered from medical records and their case managers and they were compared with those of general members in the center. Characteristics of schizophrenia patients who died by suicide were particularly summarized. Results : Twelve person committed suicide between 2006 and 2016. The characteristics of those who died by suicide were male (67%), diagnosis of schizophrenia (75%), aged below 50 (83%), unemployed (92%), past history of psychiatric hospitalization (100%), recent admission within 3 months (67%), past history of suicidal attempt (78%), family history of schizophrenia (58%), poor adherence to medication (58%), and use of daily rehabilitation program (42%). Ten out of twelve (83%) showed warning sign for suicide. All identified method of suicide in patients with schizophrenia was jumping from high building. Many patients with schizophrenia, who committed suicide, suffered from comorbid depressive symptoms (67%) and auditory hallucination (78%). Conclusion : Case managers should pay attention to and carefully manage individuals who showed suicidal warning, particularly with risk factors for suicide, such as unemployment, admission state or recent discharge from psychiatric hospital, poor adherence to medication, family history of schizophrenia, and a history of suicidal attempt.

• Korean Journal of Biological Psychiatry
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• v.13 no.4
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• pp.260-266
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• 2006

Objectives : Synapsin III near VCFS region on chromosome 22q affects. It could be an interesting candidate gene for schizophrenia. D22S280 is a highly polymorphic genetic marker residing in synapsin III. We examined association of D22S280 marker on synapsin III with Korean patients with schizophrenia. Methods : The subjects were 46 male Korean patients with schizophrenia and 60 male normal controls. Using polymerase chain reaction, gel electrophoresis, ABI 310 genetic analyzer, and GeneScan Collection 3.1 software, we confirmed genotypes of D22S280 marker. We examined Hardy-Weinberg equilibrium and case-control association using SAS/Genetic 9.1.3. Results : Genotypes of both schizophrenia and control groups were in Hardy-Weinberg equilibrium. We could not find any significant statistical differences in allele-wise(${\chi}^2$=10.4, df=6, p=0.098) and genotype-wise (${\chi}^2$=22.1 df=19, p=0.258) analyses of D22S280 marker between schizophrenia and normal controls. Individual allele analyses with df=1 showed significant differences in A1(p=0.025) and A7(p=0.034) allele, which were not significant following Bonferroni corrections(A1:p=0.177, A7:p=0.235). Conclusion : We couldn't find any association between schizophrenia and the synapsin III gene. Given the small number of subjects studied, further investigations are needed.

• Korean Journal of Biological Psychiatry
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• v.18 no.1
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• pp.46-54
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• 2011

Objectives : The objective of this study is to assess the prevalence and risk factors of metabolic syndrome (MS) among inpatients with schizophrenia, and to compare with general population. Methods : Nine hundreds seventy inpatients were included to assess the prevalence of MS from two mental hospitals in Yong-in city. Assessment of MS was performed based on modified American Heart Association criteria with abdominal obesity threshold of 90cm for men, 85cm for women. Comparative analysis was performed using age- and gender matched sample from Korea Health and Nutritional Examination Survey III. For evaluating risk factors, analysis included 766 inpatients taking consistent medications at least for 30 days. Results : The prevalence of MS of inpatients with schizophrenia was 26.2%, in females it was 33.2%, compared to 20.2% in males(p < 0.001). Compared to general population, the prevalence of MS was significantly lower in male and higher in female patients. In terms of criteria prevalence, who met abdominal circumference criterion were more prevalent in patient group(p < 0.001). After multivariate analysis, female gender and old age remained as risk factors of MS. Conclusions : The prevalence of MS of inpatients with schizophrenia was 26.2% and significantly low compared to general population. Female gender and old age were risk factors of MS.

• Korean Journal of Schizophrenia Research
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• v.23 no.1
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• pp.38-44
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• 2020

Objectives: Dehospitalization of long-term inpatients with schizophrenia can be difficult because of complex factors such as chronic symptoms and low family and social support. The aim of this study was to identify factors related to dehospitalization and readmission of long-term inpatients with schizophrenia. Methods: This retrospective study reviewed the medical records of patients discharged from a psychiatric hospital in Yongin, South Korea, from February 1, 2016, to July 31, 2017. Patients who were hospitalized for over 3 months were divided into two groups: readmission (n=47) and dehospitalization (n=55). Differences in sociodemographic and clinical factors were analyzed between the two groups. Results: Regarding sociodemographic characteristics, female sex, familylessness, discharge to nursing homes, and discharge after symptom improvement were more prevalent in the dehospitalization group, whereas male sex, having a sibling as next of kin, and discharge because of other problems were more prevalent in the readmission group. Among clinical characteristics, hospital stay was longer in the readmission group. Conclusion: In this study, patients without a family showed a tendency to not be readmitted when they were discharged to nursing homes after symptom improvement. Expansion of social welfare support may encourage dehospitalization of long-term inpatients with schizophrenia.