• Korean Journal of Biological Psychiatry
• /
• v.2 no.1
• /
• pp.3-19
• /
• 1995

Numerous investigators have conducted extensive investigation in the search for biological markers in psychiatric illness. There are, as a test of q biological approach to the diagnosis of the psychiatric illness, tests for the neurotransmitters, their metabolites, and related enzymes, the neurotransmitter receptors, the neuroendocrine output and response, the membrane transport, peptides and eletrolytes. They are called the biological markers, and they are helpful for the diagnosis or differential diagnosis, choice of treatment or drugs, symptom improvement, predictor of recurrence and anticipation of suicidal attempt. These studies are among the main purposes that are pursued in the neuroscience and based on the potential utility of the biological markers mentioned above. Since 1970's, lots 01 biological markers' studies for the diagnosis, differential diagnosis or subtypes differentiation have been done but varieties of different opinions have been drawn since then through they could explain the charaters of main psychiatric illness(especially schizophrenia and mood disorder). But, the search for biological markers, including displines of neuroendoclinology and neurochemistry(neurotransmitter and thair metabolite), has yielded a number of putative trait merkers and state markers for psychayric illness. This paper aims to anticipate or evaluate the good response to the therapy(Therpeutic response) with lots of markers. Acoording to the diagnosis of lots of diseases or subtypes, we are going to review the papers, mainly concern with 'Is there any Marker' or 'Is any test possible to detect the improvement clinically?' 'Is it possible to predict the recurrence or good prognsis?' or 'Is it possible to select any drug or therapy to bring the good response?' The biological tests to review are mainly the metabolites of catecholamine neurotransmitter, and especially neuroendocrine test based on the knowledge that hormons of the adenohypophysis are influenced by activity of the cerebral or limbic neurons as well as the hypothalamus ones. Among them, author introduced some clinically available tests that are DST, TRH stimulation test(TRHST), GH stimulation test, and the urine MHPG test that can give us the evaluation of the treatment response, the predictor for recurrence or choice of drug that can bring a good response. So author discussed thair potential utility in clarifying, therapeutic, and prognostic issues in psychatric illness. We hope they'll be used and look forward to more active study on the different opinion.

• Korean Journal of Psychosomatic Medicine
• /
• v.9 no.2
• /
• pp.164-173
• /
• 2001

Objectives : Fatigue is a common symptom in primary medical care and has nonspecific and highly subjective features. So it has been difficult to define and measure fatigue, especially those present without any organic diseases. This study was conducted to evaluate the validity of the Fatigue severity scale(FSS) in patients with persistent fatigue who were free of any organic diseases or psychiatric disorders of depression or anxiety. Methods : Subjects consisted of 45 controls, 44 fatigued patients and 43 psychiatric patients with depression or anxiety. They all completed the fatigue severity, modified Bepsi stress, and Hospital anxiety and depression scales. Chalder fatigue scale was administrated randomly in 30 of them. Data were analyzed for reliability and validity of the FSS. Results: Cronbach's a coeffient of FSS was 0.929, and the Pearson correlation coefficient for test-retest was 0.916(p<0.01). ANCOVA for discriminant validity revealed that there were significant differences in mean FSS values among the three groups. The fatigue group had significantly higher FSS value than the other two groups. The psychiatric group also had significantly higher FSS value than the control group. The Pearson correlation coefficient for convergent validity by comparing FSS with Chalder fatigue scale was 0.782(p<0.01). Using FSS index 3.22 as the cut-off point, sensitivity was 84.1% and specificity was 85.7% for the fatigue and control groups, respectively. Conclusion : Results suggested the clinical application of the FSS to be a useful measurement for distinguishing fatigue between patients with physiologic fatigue and psychiatric patients with depression or anxiety.

• Korean Journal of Psychosomatic Medicine
• /
• v.7 no.2
• /
• pp.174-183
• /
• 1999

Objective : This study was designed to evaluate the incidence and characteristics of posttraumatic stress disorder(PTSD) after motor vehicle accidents(MVA) in 44 consecutive MVA victims referred to psychiatry for the diagnosis, treatment and psychiatric assessment. Method : The diagnosis of posttraumatic stress disorder was made on the basis of DSM-IV criteria, and posttraumatic stress symptoms were assessed by the Clinician-Administered PTSD Scale(CAPS). Correlation between the extent of physical injury and the severity of PTSD symptoms using the Abbreviated Injury Scale(AIS) was analyzed and the frequency of psychiatric comorbidity of PTSD was invested. Result : Twenty-two(45.5%) MVA victims met DSM-IV criteria for PTSD, while thirteen(29.5%) showed a subsyndromal form of it. AIS scores significantly related with the development of posttraumatic stress symptoms(r=0.565, p=0.0001). PTSD group showed high percentages of each of the 17 symptoms(criterion B, C, D), while subsyndromal PTSD group showed relatively high percentages of criterion Band D. The most frequent symptom was 'distressing dreams' of criterion B in both group. A high percentages(56%) of the MVA-PTSD group also met the criteria for current major depression. Conclusions : These findings suggest that there is apparently a high likelihood of developing all or part of the PTSD syndrome after motor vehicle accidents. So it does appear that for those MVA victims who seek medical attention and eventually need psychiatric referral, diagnostic possibility of PTSD should be taken into account in treatment planning and early intervention.

• Korean Journal of Psychosomatic Medicine
• /
• v.3 no.2
• /
• pp.115-125
• /
• 1995

Reports about the prevalence of premenstrual symptoms state that occurs in 20 to 100% of most reproductive-age women. There is a close association between premenstrual syndrome and affective disorders as well as same some other psychiatric disorders. Late luteal phase dysphoric disorder (LLPDD) is a premenstrual condition defined in DSM-III-R by severe mood changes and other symptoms that repeatedly occur only in the luteal phase of the menstrual cycle. However, DSM-III-R does not specify how to compute the change from the follicular to the luteal phase or how to determine when the amount of change is great enough to warrant the diagnosis nor how to determine occupational or social functional impairment. This study was conducted to evaluate the nature, severity and magnitude of premenstrual syndrome in women with current psychiatric disorders by using prospective Daily Rating Form(DRF), and to measure symptom changes according to three scoring methods for diagnosing LLPDD. Our study obtains the data about premenstrual changes estimated by DRF from 22 women with psychiatric disorders who had met criteria for major depressive syndrome on the Premenstrual Assessment Form (PAF). The data was scored by each three methods and was determined to meet criteria A for LLPDD. The results are as follows: 1) the subjects, when scored according to the percent change method, effect size method and absolute severity method, met the DSM-III-R criteria A for LLPDD in 36.4% (8 subjects), 14% (3 subjects) and 4.5% (1 subject) of the cases respectively. 2) The items of irritability, anger and impatience were occurred most frequently on the DRF, when it was scored according to the three scoring methods. And the item of breast pain was next frequent according to the effect size method and the percent change method but according to the absolute severity method. 3) The PAF item of impaired social functioning was reported by 16 (73%) of the subjects. 4) 4 (18%) of the subjects met criteria A for LLPDD and reported impaired social functioning. The prevalency of LLPDD according to each method varied. The percent change method yielded the greatest (36.4%), and the absolute seventy method yielded the laest (4.5%), The effect size method yielded an intermediate frequency (14%). Therefore, for maximizing the diagnostic accuracy of LLPDD, a diagnostic procedure including a measure of change (e.q., effect size method, percent change method) as well as confirmed diagnosis by DRF, will be needed. Also, an accurate tool to evaluate impaired social functioning will be required.

• Korean Journal of Psychosomatic Medicine
• /
• v.29 no.2
• /
• pp.207-212
• /
• 2021

Anti-N-methyl-D-aspartate receptor (Anti-NMDAR) encephalitis is a neuroinflammatory disease mediated by autoantibodies to NMDAR. In the initial clinical stages of anti-NMDAR encephalitis, psychiatric symptoms like delusions, perceptual disturbances, and disorganized speech or behaviors are pronounced even without obvious neurological symptoms. Early treatments like immunotherapy and/or tumor removal are central to good clinical outcomes. Hence, it is important to diagnose early anti-NMDAR encephalitis, distinguishing it from mental disorder. In the present case study, the authors described psychiatric symptoms assessed with Positive and Negative Syndrome Scale (PANSS) of Ms. A, a 26-year-old woman, in the early phase of anti-NMDAR encephalitis. We will discuss the characteristic psychopathology of anti-NMDAR encephalitis toward prompt diagnosis and treatment. Ms. A showed a higher negative subscale score than positive one on the PANSS. Compared with mental disorder, negative symptoms and cognitive impairment would be more prominent in the early stage of anti-NMDAR encephalitis. Rituximab and teratoma removal were effective, and quetiapine showed good tolerability. It is recommended to evaluate anti-NMDAR encephalitis when negative symptoms, cognitive impairment, catatonia, changes in consciousness level, and neurological symptoms are observed, especially in young women.

• Korean Journal of Psychosomatic Medicine
• /
• v.4 no.2
• /
• pp.262-268
• /
• 1996

It is important not only understanding the underlying psychodynamic mechanism of the somatization but also understanding the somatization as a process where biological and sociocultural factors are acting as maintaining and exaggerating the primary vague somatic symptoms. Recently, among mechanisms of the somatization biological and cognitive aspect became more important than psychodynamics. When the doctors see patients complain physical discomforts without organic foundation, they should give attention to the mechanism of symptom amplification, misinterpretation, individual cognitive characteristics and learned behavior. Psychiatric disorders which show somatic symptoms should be also evaluated. Autonomic dysfunctions linked with stress would give some clues of the mystery of the mind-body relationship.

• Korean Journal of Psychosomatic Medicine
• /
• v.3 no.1
• /
• pp.91-97
• /
• 1995

Pain is a complex symptom consisting of a sensation underlying potenial disease and associated emotional state. Acute pain is a reflex biological response to injury, in contrast, chronic pain consists of pain of a mininum of 6 months duration and associates with physical, emotional past experience, economic resources of the patient, family and society. Moreover, chronic pain is characterized by physiological affective and behavioral responses that are quite different than those of acute pain. The different type of stimuli exciting pain receptor are mechanical, thermal and chemical stimli and chronic pain are concerned with three of all stimli. The major three components of pain central(Analgesia) system in the brain and spinal cord are 'periaqueductal gray area of the mesencephalon', 'the raphe magnus nucleus' and 'pain inhibitory complex located in the dorsal horns of the spinal cord'. But unfortunately, the central biochemical mechanisms of chronic pain are not clearly defined. To proper management of chronic pain, comprehensive urderstanding as a psychosomatic aspect and multidisciplinary therapeuti-team approach must be emphasized.

• Korean Journal of Psychosomatic Medicine
• /
• v.6 no.2
• /
• pp.228-234
• /
• 1998

The importance of psychological factors in dermatologic disorders has been recognized for several decades. However, there have been few reports on the management of psychodermatologic disorders. Psychodermatologic conditions can be divided into three broad subgroup in the dermatologic point of view ; first, psychiatric disorders manifesting as dermatological symptom, second, dermatoses mainly caused by emotional factors, i.e., stress, or determined by complex psychophysiological mechanism, and third, psychological symptoms secondary to dermatological conditions, i.e., anxiety or depression. This article describes first two major categories of psychodermatologic disorders and attempts to provide brief guideline for each psychodermatologic condition in view of the clinical interface between dermatology and psychiatry.

• Korean Journal of Psychosomatic Medicine
• /
• v.1 no.1
• /
• pp.101-108
• /
• 1993

A case of a 38 year-old woman with histrionic personality who had chronic epigastric pain, dyspepsia and alternating bowel habit for more than 10 years was presented in detail on its course of two times of admission and follow-up. The diagnosis was thought as psychophy-siological disorder or gastrointestinal motility disorder of undefined etiology rather than hypo-chondriasis or Briquet's syndrome. She was characterized by sustained illness behavior and combined several physical illnesses. i.e. tuberculosis. anemia and hepatic stone. These physical diseases led to a blurring of psychological and physical boundaries regarding symptom formation. The points on consultation from medical part to psychiatric department were discussed and the supposed causal mechanisms in non-organic functional gastrointestinal disturbances were also reviewed. Physical and psychological modalities for the treatment and the abnormal illness behavior were mainly emphasized in this case.

• Journal of Korean Academy of Nursing
• /
• v.36 no.3
• /
• pp.542-550
• /
• 2006

Purpose: This study investigated the effects of a recovery education program on rehabilitation motivation, symptoms, and function for schizophrenic patients. Method: The study employed a quasi-experimental design. Participants for the study were 27 patients with schizophrenia, 14 in the experimental group and the other 13 in the control group. Data were analyzed by using the SPSS/WIN 11.5 program with Fisher's exact test, t-test, and Repeated measures ANOVA. Results: After a 7 week intervention, participants in the recovery education program group reported increased rehabilitation motivation and function scores, which was significantly different from those in the control group. Conclusion: A recovery education program was effective improving rehabilitation motivation and function for schizophrenic patients. Therefore, this program is recommended as a rehabilitation strategy for schizophrenic patients.