Objectives This study is designed to compare the clinical characteristics of patients with early onset schizophrenia to those of adult onset schizophrenia patients in first episode. Methods Authors reviewed medical records of 16 early-onset schizophrenia patients and 22 adult-onset schizophrenia patients who had been admitted in the psychiatric ward and diagnosed as schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders, fourth Edition (DSM-IV) at Eulji University Hospital during 2004-2008. Socio-demographic data and clinical characteristics such as duration between onset and active phase, number of significant positive and negative symptoms, positive and negative symptom scores of Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity (CGI-S) scores, duration from onset to admission, duration of admission, and equivalent dose of antipsychotics were reviewed. These clinical characteristics of early-onset group were compared to those of adult-onset group. Correlation between age of onset and other clinical characteristics was also analyzed. Results Early-onset group showed more insidious onset pattern and had longer duration of hospitalization than adult-onset group. Early onset group also exhibited more negative symptoms, higher negative symptom scores, and higher CGI-S scores than adult-onset group after treatment. However, there were no significant differences in family history of psychosis, positive symptom frequency at discharge and equivalent dose of antipsychotics between two groups. Conclusions This study revealed that patients with early-onset schizophrenia exhibited more insidious onset, more negative symptoms, and more severe symptoms than those with adult-onset schizophrenia after treatment.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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제25권4호
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pp.209-216
/
2014
Objectives : Alcohol use disorder (AUD) is often comorbid with adult attention-deficit hyperactivity disorder (ADHD) and other psychiatric illnesses. When associated with other mental problems, the prognosis of the AUD can be more serious. This study shows research on the clinical and neuropsychological characteristics according to whether or not ADHD symptoms and AUD were comorbid. Methods : A total of 64 adult inpatients who completed AUD scales about adult ADHD, alcohol dependence, depression, anxiety, and impulsiveness. They also completed neuropsychological tests about attention and executive function. According to the Adult ADHD Self-Report Scale score, patients were categorized into two groups (ADHD symptom positive/negative group). Results : Fourteen among the 64 subjects were part of the ADHD symptom positive group (21.9%). They had statistically significant shorter abstinence periods and a higher rate of history of 'rule violation during school' and 'physical damage in childhood' compared to the ADHD symptom negative group. Conclusion : The comorbidity rate with ADHD symptom in adult AUD is higher than the general population. The ADHD symptom positive group suffered from more severe and refractory AUD. Considering the more frequent history of rule violation during school in the ADHD symptom positive group, the association between ADHD and AUD may be mediated by conduct disorder. Therefore we suggest the necessity of careful evaluation and intervention in children and adolescents with ADHD and conduct disorder.
This study examined the relationship between family support and symptom of depressive among married working women, using the dataset of the Korean Longitudinal Survey of Women & Family (KLoWF 4th). There were 1,875 subjects. A multiple regression model was used to study the association between family support and symptom of depressive, controlling for economic-socio characteristics, health status and health behavior. Additionally, this study ran three subgroup regression models based on hierarchical model. From the results, there was a negative relationship between marriage happiness (b=-0.369, p<0.001), spouse satisfaction (b=-0.143, p=0.010), frequency of meeting with the wife's family (once a month: b=-0.952, p=0.012) and symptom of depressive (model 3). This negative relationship was also seen in the two subgroup regression models (models 1, and 2). The results of this study show the importance of family support for promoting mental health among married working women.
Purpose: The purpose of the study was to investigate symptom clusters experienced by patients on hemodialysis and to identify relations between symptom clusters and quality of life. Methods: Data were collected from 127 patients at 10 local hemodialysis clinics. Symptoms were measured using 10-item physical symptom checklist as well as the Hospital Anxiety depression Scale. Quality of life was measured with the Satisfaction with Life Scale. Data were analyzed using factor analysis, Pearson correlation, and stepwise multiple regression. Results: The most frequently reported symptoms included fatigue, itching, depression, numbness/tingling, and insomnia. Four distinct symptom clusters were identified: cluster 1 was comprised of dry mouth, headache, nausea (gastrointestinal); cluster 2 of decreased appetite, insomnia (basic need); cluster 3 of itching, numbness/tingling (sensory-comfort); and cluster 4 of fatigue, depression (mood-vitality). Among the clusters, the 'basic need' cluster and 'mood-vitality' cluster had a significant negative association with quality of life. The 'mood-vitality' cluster, explained 17.4% of the variance in quality of life. Conclusion: The results of the study indicate that comprehensive symptom assessment provides better symptom management for patients on hemodialysis. Further studies are needed to verify symptom clusters identified in this study.
Purpose : It is widely accepted that addressing multiple symptoms together is the preferred approach in assessment and intervention and results in reduced negative patient outcomes. Yet, there are few studies examining symptom clusters and their impacts on quality of life longitudinally in patients after heart valve surgery. Methods: A total of 101 patients were recruited from a tertiary hospital and were administered questionnaires (at 3, 6, and 10 weeks after the surgery) assessing participants' characteristics, cardiac symptoms, and quality of life. Factor analysis was used to identify symptom clusters. Hierarchical multiple linear regression was used to predict quality of life. Results: Participants were predominantly 70-years old or more with a mean age of 64.34. The two symptom clusters at 3 weeks after the surgery with education, gender, and occupation accounted for 76.3% of variance in quality of life. Conclusion: Symptom clusters containing various physical and psychological symptoms in patients after the surgery affected quality of life, and the relationship was significant at 3 weeks after the surgery. Because symptom clusters were identified in all three recovery periods, nurses need to acknowledge these clusters, rather than each symptom separately, and to utilize these in providing care and education and in promoting quality of life in these patients.
Conventional high-dose antipsychotics tend to result in more side effects, negative symptoms and dysphoria, and at the same time lower the cognitive function which is already impaired in most schizophrenics. Florid psychotic symptoms, negative symptoms and cognitive impairment greatly impede psychosocial performance and eventual reintegration into society. The reduction of symptom and the improvement of cognitive funtions and social skills are therefore central to the psychiatric rehabilitation process. The purpose of this study was to evaluate the dose-reduction effects of antipsychotics on chronic schizophrenics prescribed conventional high-dose antipsychotics more than 1,500mg equivalent of chlorpromazine. Fifty-one chronic schizophrenics who maintained high-dose antipsychotics for more than three months were randomly assigned to two groups : 20 patients comprised the dose-maintaining group and 31 patients made the dose-reduction group. Over a sixteen weekperiod Positive and Negative Syndrome Scale(PANSS), Extrapyramidal Symptom(EPS), Nurses' Observation Scale for Inpatient Evaluation(NOSIE-30), Continuous Performance Test(CPT), Quality of Life(QOL), and haloperidol/reduced haloperidol blood levels were determined at the base line and after 2, 4, 6, 8, 12, 16 weeks to evaluate the dose reduction effects of high-dose antipsychotics. The results were as follows : 1) Dose-reduction is highly effective in reducing positive and negative symptoms, and general psychopathology. Effects were most prominent at 8, 12, 16 weeks. Among the dose reduction group, positive symptoms in positive symptom group and negative symptoms in negative symptom group were more reduced. 2 Extrapyramidal symptoms showed no significant difference between two groups. But the EPS was reduced time after time within two groups. 3) Hit rates of Continuous Performance Test, which indicate attentional capacity, increased significantly after dose reduction. 4) Haloperidol and reduced haloperidol blood levels decreased until the 4th week, after which they were constant. 5) Total scores of Nurses' Observation Scale for Inpatient Evaluation were unchanged between the two groups. But among the indices, social interest and personal neatness were improved in the dose-reduction group and retardation was aggrevated in the dose-maintaining group. 6) Total quality of life scores were unchanged between two groups. But in the dose maintaining group, satisfaction scores of attention, autonomy, and interpersonal relationship decreased progressively. These findings suggest that the dose reduction of antipsychotics for chronic schizophrenics on programs of high-dose antipsychotics were effective. Dose reduction should therefore be implemanted to spread the rehabilitation and improve quality of life for chronic schizophrenics.
The purpose of this study was to identify the relationship of symptom distress and natural killer cell cytotoxicity in breast cancer patients who had been radiation therapy and/or chemotherapy after surgery. Symptom distress measured by modified Lee's(1994) physical symptom questionnaire. For measuring the natural killer cell cytotoxic activity. 8ml to 10ml blood was collected from the subjects. Mononuclear cell was isolated by centrifuge of the blood and cultured by putting $Cr^{51}$, and reacted with target cell, K562 cell. Amount of $Cr^{51}$ was measured, and %lysis was calculated. The results were as follows. 1) Symptom distress score was 42.18, which is moderate symptom distress. 2) Natural killer cell cytotoxic activities were 42.18%lysis(effector : target cell ratio=100 : 1) and 28.05%lysis(effector : target cell ratio=50 : 1). 3) Correlation coefficients of symptom distress and natural killer cell cytotoxic activity were $-.134{\sim}-.461$. Though significant correlation was not found between total score of symptom distress and natural killer cell cytotoxic activity, 3('pain' 'feel hot on radiation site' and 'difficulty in breathing') of 19 symptom distress items and natural killer cell cytotoxic activity showed significant negative correlation(p<.05). These findings suggest that 1) breast cancer patients who had been radiation therapy and/or chemotherapy after surgery have moderate symptom distress and decreased natural killer cell cytotoxic activity. 2) The symptom distress was not related to natural killer cell cytotoxic activity.
This study examine the relationship between the intake of food conformable to each Sasang constitution and the recognition of irregular symptoms of health condition. The study subjects were 362 university students nationwide, classified by heir Sasang constitution. In terms of the intakes of conformable food and the symptom recognition, the number of multiple subjective symptoms tended to rise as the Soeum type digested the conformable food. As for the kinds of food, the Soyang type showed a significant positive correlation between the intake of cucumber namul and the symptoms of eyes and skin, but a negative correlation between the intake of Chongak Kimchi and the symptoms of the digestive system The Soeum type showed a significant positive correlation between multiple subjective symptoms and the intake of Gatkimchi, fernbrake namul, naeng-i soup, naeng-i namul, Korean leek Kimchi, crown daisy namul, and curled mallow soup, a significant positive correlation between the symptom recognition of the respiratory system and the intake of fried flatfish, and chicken gomtang but a negative correlation between the symptom recognition of the eye and skin and the intake of boiled eel. The Taeum type presented the a sigmificant positive correlation between multiple subjective symptoms and the intake of spaghetti, a positive correlation between the symptoms of the respiratory system and the intake of tuna salad, a positive correlation between the symptoms of the eye and skin and the intake of mafa tofu, spaghetti, and tuna salad, a negative correlation between the symptoms of the mouth and anus and the intake of codfish jiri, and a negative correlation between the symptoms of the respiratory system and the intake of tuna salad.
Objectives : To investigate the effect of overtime work on fatigue symptoms among Korean female workers. Methods : A total of 1,875 subjects were analyzed using the structured questionnaire, which was composed of overtime work, fatigue symptom, and background characteristics. Data analysis included multiple regression to test for a relationship of overtime work with fatigue symptom while statistically controlling for demographic and occupational variables. Results : Overtime work was more common in those with shorter work years of 3 or less than in those with longer work years. Overtime work was more popular in day workers than in shift workers. No significant difference of smoking and drinking state was observed between two groups. Subjective fatigue symptoms were significantly higher in overtime workers than in workers without overtime work. In a multiple regression analysis with significant control variables, overtime work was associated with 0.31 more fatigue symptom(p<0.001). Conclusion : Our findings suggest that overtime work may increase risks for fatigue symptom. Therefore, preventive strategies will be needed to control the negative effect of overtime work on health status of female workers.
Purpose: This study was conducted to identify the impact of the symptom cluster of pain, fatigue, sleep disturbance, depression on the quality of life (QOL) among breast cancer patients receiving chemotherapy. Methods: One hundred and thirteen patients were recruited from five hospitals in Korea. The instruments used in this study were the fatigue, depression, sleep disturbance, pain and the quality of life scale for patients with breast cancer. The influence of the symptom cluster on patients' QOL was analyzed by using multiple regression. Results: Most patients reported a moderate level of pain, fatigue, sleep disturbance and depression. Eighty percent of patients reported three of the four symptoms. Among the four symptoms, there was no correlation between pain and sleep disturbance. Quality of life was negative correlated with the four symptoms in the cluster. Symptom cluster of pain, fatigue, and depression accounted for 51.2% of variance in QOL. Conclusion: The findings supported that there is a symptom cluster that negatively influences quality of life and needs to be addressed as we are caring for patients and are promoting quality of life.
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