• Korean Journal of Biological Psychiatry
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• v.13 no.2
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• pp.82-94
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• 2006

Objectives : In order to explore effects of board-game therapy for cognitive rehabilitation in patients with schizophrenia, we investigated the change of executive cognitive function over a 2-month period of board-game therapy in patients with schizophrenia. Methods : Two groups of chronic schizophrenic inpatients were participated in this study. One group(n=21) were treated with board-game therapy for 2 months and the other control group(n=19) were not treated. For the evaluation of the executive cognitive function, a Wisconsin Card Sorting Test(WCST) was administered before and after the introduction of the board-game therapy. PANSS score change was also evaluated. Result : At the beginning of this study, there was no significant difference in performance of cognitive function tests, demographical data or clinical severity between both patient groups. After 2 months of treatment with the board-game therapy, the board-game therapy group showed significant improvements of executive cognitive function without any significant change of their schizophrenic symptoms. On the contrary, there was no change in control group. Conclusion : This study showed that a board-game therapy is effective for the enhancement of executive cognitive function in patients with chronic schizophrenia. A board-game therapy could be introduced with ease into psychiatric fields, such as inpatients' or outpatients' clinic wards and day hospital. Our result indicates that the board-game therapy is a promising tool for the enhancement of cognitive function, especially executive cognitive function and helpful for cognitive rehabilitation for schizophrenic patients.

• 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.

• Korean Journal of Biological Psychiatry
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• v.20 no.4
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• pp.179-186
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• 2013

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.

• The Korean Journal of Rehabilitation Nursing
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• v.9 no.2
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• pp.109-116
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• 2006

Purpose: This study is a descriptive research in which the pathological syndromes of the schizophrenic patients in the community mental health centers, the degrees of the insights, and the correlations between them were examined. Method: The subjects included 114 SPR pt. people who were enrolled in community mental health centers located in D City. The research was conducted during the period from Aug. 1st, 2002 to Jul. 30th, 2004. The instruments were PANSS developed by Kay(1987) and SUMD developed by Amador(1993). Results: Among the pathological syndromes, positives ones were $12.64{\pm}3.80$ on the average, negative ones were $32.00{\pm}5.36$, and general pathological syndromes were $30.50{\pm}6.24$. In the evaluation of the insights, the mean score was $11.81{\pm}5.09$. There were some significant correlations between positive syndromes and general pathological ones (r=.572, p=.000), and negative syndromes and general pathological ones(r=.262, p=.029), while there was no significant correlation between the insights and the sub-measures of general pathological syndromes. Conclusion: Therefore, the schizophrenic patients taking advantage of the community mental health centers have more negative syndromes than those in hospitalized, and rehabilitation programs are needed to help them continuously. And the further study of the correlations between the pathological syndromes and the degrees of the insights are required, and still, it should be analyzed what effects the insight acquirement brings about to the improvements of the pathological syndromes after the application of the insight-oriented programs.

• Korean Journal of Biological Psychiatry
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• v.17 no.2
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• pp.86-93
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• 2010

Objectives : The aim of this research is to determine the effects of depression and anxiety symptoms of schizophrenic psychopathology on the HPA axis. Methods : Twenty patients with schizophrenia were included and divided into the medication non-exposed group(n = 10) and the medication exposed group(n = 10). Evaluated scales were the Positive and Negative Syndrome Scale(PANSS), Scale for the Assessment of Negative Symptoms(SANS), Scale for the Assessment of Positive Symptoms(SAPS), Hamilton Depression Inventory(HAM-D) and Hamilton Anxiety Inventory (HAM-A), and then the combined Dexamethasone/Corticotropin Releasing Hormone(DEX/CRH) test was conducted to determine the basal level, the peak level and the area under the curve(AUC) of cortisol and adrenocorticotropic hormone(ACTH). Results : When the correlations between each psychopathology and cortisol level or ACTH AUC value were analyzed, HAM-D showed a negative correlation, whereas HAM-A showed a positive correlation. Also, the non-depression group(HAM-D ${\leq}$ 18) showed higher cortisol and ACTH concentrations than the depression group(HAM-D > 18), and the anxiety group(HAM-A ${\geq}$ 14) showed significantly higher concentrations than the non-anxiety group(HAM-D < 14)(p < 0.05). Also, as for the comparison between the medication non-exposed group and the medication exposed group, the non-exposed group showed significantly higher cortisol and ACTH concentration than exposed group(p < 0.05). Conclusion : This study suggest that anxiety symptoms rather than depression symptoms are related to the increased activity of the HPA axis of schizophrenics.

• Korean Journal of Biological Psychiatry
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• v.25 no.2
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• pp.31-37
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• 2018

Objectives The aim of this study was to evaluate the psychopathological features such as depression and anxiety in schizophrenics with obsessive-compulsive symptoms (OCS) as well as the severity of OCS according to duration of schizophrenia. Methods We randomly selected sixty four inpatients with schizophrenia. We classified the patients into two groups (OCS group, non-OCS group) according to the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Clinical and demographic features were evaluated. To assess OCS, Y-BOCS were performed. The Korean version of the Positive and Negative Syndrome Scale(K-PANSS), the Brief Psychiatric Rating Scale (BPRS), the Korean version of the Calgary Depression Scale for Schizophrenia (K-CDSS), the Beck Anxiety Inventory (BAI) and the Satisfaction With Life Scale (SWLS) were conducted. Independent t-test and chi-square test were conducted to compare the two groups. Pearson correlation analysis was performed to examine the relationship between the duration of schizophrenia and the Y-BOCS score. Results The Y-BOCS, K-CDSS, and BAI scores were higher in the OCS group. There was a significant correlation between the duration of schizophrenia and the Y-BOCS score. Conclusions Anxiety and depression symptoms were severe in the OCS group. In addition, the results of this study indicate that the longer duration of schizophrenia, the more severe the OCS. Therefore, the evaluation of OCS in schizophrenics should be accompanied by treatment intervention.

• Journal of Yeungnam Medical Science
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• v.22 no.2
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• pp.150-165
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• 2005

Purpose: This study was conducted to investigate the prognostic factors of postpsychotic depressive symptoms in patients with schizophrenia. Materials and Methods: Eighty patients were selected based on the diagnostic criteria from the DSM-IV, PANSS and ESRS. For all patients information was collected on demographic and clinical characteristics. The subjective depressive symptoms and the objective depressive symptoms, as well as patients insight regarding psychosis were evaluated. The subjective depressive symptoms were evaluated by BDI and ZDS; the objective depressive symptoms were evaluated by HDRS and CDSS, and patient insight into the psychosis was evaluated by KISP. Results: The comparisons using demographic and clinical characteristics showed that HDRS and CDSS had significant difference with regard to gender and suicide attempts; the BDI was associated with difference in education level and age of onset. The patients with scores above cuff-off score for each scale were 20(25.0%) for the BDI, 16(20.0%) for the ZDS, 18(22.5%) for the CDSS and 6(7.5%) for the HDRS. The results of the stepwise multiple regression analysis showed that the scores for the KISP, education levels, gender and suicide attempts were the main prognostic factors in patients with the psychotic depressive disorder of schizophrenia. Conclusion: The main prognostic factors in psychotic depressive disorder of schizophrenia included: insight into psychosis, suicidal attempts. Insight into the psychosis was the most reliable prognostic factor but this characteristic had a negative relationship to the with depressive symptoms.

• Journal of the Korean Society of Radiology
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• v.18 no.2
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• pp.73-81
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• 2024

This study compared the cortical thickness of patients with mood disorders and a control group to assess structural abnormalities. A retrospective study was conducted from September 2020 to August 2022 at the Department of Psychiatry, P Hospital in Yangsan, Gyeongsangnam-do. The study included 44 individuals diagnosed with mood disorders and 59 healthy individuals without any pathological lesions. The 3D-T1 MPRAGE images obtained from magnetic resonance imaging examinations were utilized, and FreeSurfer software was employed to measure cortical thickness. Statistical analysis involved independent samples t-tests to measure the differences in means between the two groups, and Cohen's d test was used to compare the effect sizes of the differences. Furthermore, the correlation between the measured average cortical thickness and Positive and Negative Syndrome Scale scores was analyzed. The research results revealed that patients with mood disorders exhibited decreased cortical thickness compared to the normal control group in both superior frontal regions, both rostral middle frontal regions, both caudal middle frontal regions, both pars opercularis, pars orbitals, pars triangularis regions, both superior temporal regions, both inferior temporal regions, both lateral orbitofrontal regions, both medial orbitofrontal regions, both fusiform regions, both posterior cingulate regions, both isthmus cingulate regions, both superior parietal regions, both inferior parietal regions, both supramarginal regions, left postcentral region, right bank of the superior temporal sulcus region, right middle temporal region, right rostral anterior cingulate region, and right insula region. Among them, regions that showed differences with effect sizes of 0.8 or higher were left fusiform (d=0.82), pars opercularis (d=0.94), superior frontal (d=0.88), right lateral orbitofrontal (d=0.85), and pars orbitalis (d=0.89). Additionally, there was a weak negative correlation between PANSS scores and average cortical thickness in both the left hemisphere (r=-0.234) and right hemisphere (r=-0.230). These findings are expected to be helpful in identifying areas of cortical thickness reduction in patients with mood disorders compared to healthy individuals and understanding the relationship between symptom severity and cortical thickness changes.

• Korean Journal of Biological Psychiatry
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• v.12 no.2
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• pp.189-195
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• 2005

Objects:Some studies have suggested that brain-derived neurotrophic factor(BDNF), one of the most important neurotrophins, is involved in pathophysiology of depression and suicide. This study was performed to determine whether there is an abnormality in plasma BDNF concentration in suicidal attempters. Methods:The subjects were 71 suicidal attempters who visited emergency rooms in multi-medical centers. All subjects had been interviewed by using Structured Clinical Interview for DSM-IV(SCID), Hamilton Depression Rating Scale(HDRS), Young Mania Rating Scale(YMRS), and Positive And Negative Syndrome Scale(PANSS). The severity of the suicidal behavior was measured by Lethality of Suicide Attempt Rating Scale(LSARS) and Risk-Rescue Rating(RRR) system. Seventy-one age, sex, and diagnosis matched non-suicidal psychiatric patients who were consecutively admitted to a psychiatric ward during the same period recruited as psychiatric controls. They were drug-naive or drug-free at least more than 2 months. In addition, 80 healthy controls were randomly selected as normal controls. Plasma BDNF level was measured by the enzyme linked immunosorbent assay(ELISA) methods. Results:In overall F-test, differences of the plasma BDNF levels among the groups were statistically significant(F=20.226, p<0.001). In the multiple comparisons(Scheffe), while mean levels of plasma BDNF between normal controls and non-suicidal psychiatric patients were similar(p=0.984), the BDNF levels of suicidal attempters were lower than those of other two groups(p<0.001). LSARS and RRR did not reveal any significant correlations with BDNF levels in suicidal attempters. Conclusion:These results suggest that reduction of plasma BDNF level is related to suicidal behavior and BDNF level may be a biological marker of suicidal behavior.

• Korean Journal of Biological Psychiatry
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• v.5 no.2
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• pp.263-277
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• 1998

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.