• Title/Summary/Keyword: Psychosis

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A Case of Central Nervous System Toxicity Associated with Cyclosporine (Cyclosporine에 의한 중추신경계 독성 1례)

  • Lee Do-Yoon;NamGoong Mee-Kyung;Kim Hwang-Min;Lim Baek-Keun
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.179-182
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    • 1997
  • Cyclosporine is an immunosuppressant usually used to prevent renal transplantation rejection. Nephrotoxicity and hypertension are considered as the most frequent side effects of cyclosporine treatment. The neurotoxic effects of cyclosporine such as agitation, anxiety, delirium, depression and psychosis have recently been found. Methylprednisolone may increase as well plasma concentration of cyclosporine, which leads to side effects. Here we report a $Henoch-Sch\"{o}nlein$ nephritis patient treated with cyclosporine and methylprednisolone who has experienced psychosis including visual and auditory hallucination and convulsion.

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Pattern Analysis of Volume of Basal Ganglia Structures in Patients with First-Episode Psychosis (초발 정신병 환자에서 기저핵 구조물 부피의 패턴분석)

  • Min, Sally;Lee, Tae Young;Kwak, Yoobin;Kwon, Jun Soo
    • Korean Journal of Biological Psychiatry
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    • v.25 no.2
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    • pp.38-43
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    • 2018
  • Objectives Dopamine dysregulation has been regarded as one of the core pathologies in patients with schizophrenia. Since dopamine synthesis capacity has found to be inconsistent in patients with schizophrenia, current classification of patients based on clinical symptoms cannot reflect the neurochemical heterogeneity of the disease. Here we performed new subtyping of patients with first-episode psychosis (FEP) through biotype-based cluster analysis. We specifically suggested basal ganglia structural changes as a biotype, which deeply involves in the dopaminergic circuit. Methods Forty FEP and 40 demographically matched healthy participants underwent 3T T1 MRI. Whole brain parcellation was conducted, and volumes of total 6 regions of basal ganglia have been extracted as features for cluster analysis. We used K-means clustering, and external validation was conducted with Positive and Negative Syndrome Scale (PANSS). Results K-means clustering divided 40 FEP subjects into 2 clusters. Cluster 1 (n = 25) showed substantial volume decrease in 4 regions of basal ganglia compared to Cluster 2 (n = 15). Cluster 1 showed higher positive scales of PANSS compared with Cluster 2 (F = 2.333, p = 0.025). Compared to healthy controls, Cluster 1 showed smaller volumes in 4 regions, whereas Cluster 2 showed larger volumes in 3 regions. Conclusions Two subgroups have been found by cluster analysis, which showed a distinct difference in volume patterns of basal ganglia structures and positive symptom severity. The result possibly reflects the neurobiological heterogeneity of schizophrenia. Thus, the current study supports the importance of paradigm shift toward biotype-based diagnosis, instead of phenotype, for future precision psychiatry.

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Antipsychotics for patients with pain

  • Shin, Sang Wook;Lee, Jin Seong;Abdi, Salahadin;Lee, Su Jung;Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • v.32 no.1
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    • pp.3-11
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    • 2019
  • Going back to basics prior to mentioning the use of antipsychotics in patients with pain, the International Association for the Study of Pain (IASP) definition of pain can be summarized as an unpleasant experience, composed of sensory experience caused by actual tissue damage and/or emotional experience caused by potential tissue damage. Less used than antidepressants, antipsychotics have also been used for treating this unpleasant experience as adjuvant analgesics without sufficient evidence from research. Because recently developed atypical antipsychotics reduce the adverse reactions of extrapyramidal symptoms, such as acute dystonia, pseudo-parkinsonism, akathisia, and tardive dyskinesia caused by typical antipsychotics, they are expected to be used more frequently in various painful conditions, while increasing the risk of metabolic syndromes (weight gain, diabetes, and dyslipidemia). Various antipsychotics have different neurotransmitter receptor affinities for dopamine (D), 5-hydroxytryptamine (5-HT), adrenergic (${\alpha}$), histamine (H), and muscarinic (M) receptors. Atypical antipsychotics antagonize transient, weak $D_2$ receptor bindings with strong binding to the $5-HT_{2A}$ receptor, while typical antipsychotics block long-lasting, tight $D_2$ receptor binding. On the contrary, antidepressants in the field of pain management also block the reuptake of similar receptors, mainly on the 5-HT and, next, on the norepinephrine, but rarely on the D receptors. Antipsychotics have been used for treating positive symptoms, such as delusion, hallucination, disorganized thought and behavior, perception disturbance, and inappropriate emotion, rather than the negative, cognitive, and affective symptoms of psychosis. Therefore, an antipsychotic may be prescribed in pain patients with positive symptoms of psychosis during or after controlling all sensory components.

Predicting Prognosis in Patients with First Episode Psychosis Using Mismatch Negativity : A 1 Year Follow-up Study (초발 정신증 환자에서 Mismatch Negativity를 이용한 1년 간의 예후 예측 연구)

  • Jang, Moonyoung;Kim, Minah;Lee, Tak Hyung;Kwon, Jun Soo
    • Korean Journal of Schizophrenia Research
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    • v.20 no.1
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    • pp.15-22
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    • 2017
  • Objectives : It has been shown that early intervention is crucial for favorable outcome in patients with schizophrenia. However, development of biomarkers for predicting prognosis of psychotic disorder still requires more research. In this study, we aimed to investigate whether baseline mismatch negativity (MMN) predict prognosis in patients with first episode psychosis (FEP). Methods : Twenty-four patients with FEP and matched healthy controls (HCs) were examined with MMN at baseline, and their clinical status were re-assessed after 1 year. Repeated-measures analysis of variance was performed to compare baseline MMN between the two groups. Multiple regression analysis was used to identify factors predicting prognosis in FEP patients during the follow-up period. Results : MMN amplitudes at baseline were significantly reduced in patients with FEP compared to healthy controls. In the multiple regression analysis, baseline MMN amplitude significantly predicted later improvement of performances on digit span and delayed recall of California Verbal Learning Test. However, baseline MMN did not predicted improvement of clinical symptoms. Conclusion : These results indicate that MMN may be a possible predictor of improvement in cognitive functioning in patients with FEP. Future study with larger sample and longer follow-up period would be needed to confirm the findings of the current study.

A SURVEY OF THE PSYCHOSIS AMONG SCHOOL VIOLENCE VICTIMS (학교폭력 피해자의 정신병 실태 조사)

  • Kwon, Seok-Woo;Shin, Min-Sup;Cho, Soo-Churl;Shin, Sung-Woong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.124-143
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    • 2000
  • Objectives:The primary purpose of this study is to understand the psychopathology of the victims of school violence in terms of early psychosis. By doing this, the early detection of psychosis among the victims is possible, and early detection may lead to early intervention. Methods:Two-thousand and nine-hundred seventy two students from 16 middle schools in Seoul were asked to fill out questionnaire comprised of popularity and intellectual and school status of Piers-Harris Children's Self Concept Inventory, Symptom Check List-90-Revised, and Ostracism Scale. The subjects whose scores upon Ostracism Scale were higher than average by two standard deviation were labeled as ‘Repelled and Isolated group', and subjects whose scores on popularity were significantly lower than average and whose scores on psychoticism of SCL-90-R were higher than average were defined as 'tentative early psychosis group'. Odds ratios were calculated from the numbers of subjects with and without high psychoticism scores and high ostracism scores. On the subjects of 'tentative early psychotic group', we examined every clinical characteristic and conducted correlation analysis and regression analysis in order to find out the risk factors and to construct theoretical model that explains the psychoticism scores. Results:The results were as follows:1) Total 157(5.3%) subjects were rated significantly higher on ostracism scale, and among them, 47 subjects(29.9%) were rated significantly higher than average on psychoticism scale, while only 50 subjects among 2,135 students who were rated within normal range showed significantly higher score on psychoticism scale. Odds ratio for psychotic group of isolated group were 17.82 and it was statistically significant. 2) Forty-seven subjects(31 boys, 16 girls) who were rated as they were unpopular and rejected from peers had significantly higher psychoticism scores. They were not significantly different from simply high psychoticism subjects in anxiety, social anhedonia scale, magical thinking, obsessivecompulsive symptoms, phobic anxiety, psychoticism, somatization, but showed higher ostracism scores and paranoid tendencies. Among school violence victims, who rated themselves unpopular and showed higher psychoticism scores, the psychoticism scores were mainly explained by anxiety, depression, hostility, interpersonal sensitivity, obsessive-compulsive symptoms, paranoid tendency, somatization scales($r^2=0.93$). Conclusion:Thus, it can be concluded that the subjects with higher ostracism score have the substantially high risk for psychosis development. By these results, we propose that school violence victims with anxiety, depression, hostility, interpersonal sensitivity, obsessive-compulsive symptoms, paranoid tendency, somatization should be tested individually considering school adjustment, attentional deficit, concept formation problems.

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A Study on the correlation between the lunar cycle and M. M. P. I (우주변화(宇宙變化)와 인성(人性)과의 관련성(關連性)에 관한 조사연구(調査硏究))

  • Lee Seok-Jun;Yu Yeong-Su
    • Journal of Oriental Neuropsychiatry
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    • v.3 no.2
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    • pp.87-96
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    • 1992
  • In order to see the variation of human nature, M.M.P.I. was carried on 2, April 1992 (the last day of the second lunar month) and 15, June 1992 (the fifteenth day of the fifth lunar month). These experiments took male and female students who were in Won kwang University as subjects (108 students on 2, April, 105 students on 15, June). The results of it suggested the followings. 1) Every students' average of T-grades on each measure were in a normal scope. 2) There were no significant differences in comparison between the fifteenth day and the last day of the month. 3) On every measure except L, Mf, Si, the female students showed higher grade in the fifteenth day than the last day of the month. But there was no significant difference in male students. Both male and female students didn't show the significant one. 4) On the fifteenth day of the month, the female students showed higher T-grade then male did on every measure except Mf, Ma, Si. There was a significant difference on D, Pd, Mf(P<0.05) measure. 5) On the last day of the month, male students showed higher T-grade then female did on every measure except L, K, Hy, Pt. There was a significant difference on L(P<0.001), K(P<0.01). 6) On experiments about female students, there was no symptom of neurosis and psychosis on the last day of the month. But three of sixteen students(18.7%) showed symptom of neurosis, one of thirteen(6%) showed symptom of psychosis on the fifteenth day of the month. On experiments about male students, eleven of ninety-two(11.9%), four of ninety-two(4.3%) showed symptom of neurosis and psychosis respectively on the fifteenth day of the month. Ten of ninety-two(10.8%), six of ninety-two(6.5%) showed symptom of neurosis and psychosis respectively on the last day of the month. As the results of the above, human nature changes to some extend according to lunar cycle. And there are many changes in female than male. But it is difficult to generalize this fact by limited subject and only one experiments. So the controlled studies are needed on the basis of this result and have to take many person as a subject.

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Working Memory Deficits in Ultra-High Risk for Psychosis and Schizophrenia (조현병 및 정신증 고위험군에서의 작업기억 손상)

  • Jeon, Im Hong;Park, Jong Suk;Park, Jin Young;Cho, Hye Hyun;Koo, Se Jun;Lee, Eun;An, Suk Kyoon;Yoo, Sun Kook
    • Korean Journal of Schizophrenia Research
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    • v.15 no.2
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    • pp.66-72
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    • 2012
  • Objectives : The aim of this study was to investigate whether verbal and spatial working memory functions were impaired not only in patients with schizophrenia but also in people at ultra-high risk for first-episode psychosis. Methods : Twenty-five patients (M 13, F 12) with schizophrenia (SPR), 21 people at ultra-high risk for psychosis (UHR)(M 10, F 11) and 19 normal controls (NC)(M 10, F 9) were recruited. The working memory was assessed by using the verbal and spatial n-back test. The working memory load increased incrementally from the 0-back to the 3-back condition. Results : SPR performed significantly lower than NC and UHR in terms of hit rates of verbal and spatial n-back test. UHR subjects conducted significantly lower than NC and higher in trend-level than SPR in terms of hit rates of verbal and spatial n-back test. These differences were derived from the high working memory load (2-back and 3-back), not from the low working memory load (0-back and 1-back). There was no significant difference between the verbal and spatial n-back test across the three groups. Conclusion : These findings suggest that verbal and spatial working memory dysfunction may be general rather than differential in terms of stimuli modality, and this working memory deficit may be an important trait factor in schizophrenia.

A Case of Transient Psychosis Suspected to be Induced by Arachnoid Cyst, Which was Responsive to Risperidone (거미낭으로 일과성 정신병 유발이 의심되고 리스페리돈 치료에 효과적이었던 증례)

  • Bahk, Won-Myong;Pae, Chi-Un;Jun, Taeyoun;Kim, Kwang-Soo;Lew, Tae-Yul
    • Korean Journal of Biological Psychiatry
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    • v.8 no.1
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    • pp.153-155
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    • 2001
  • There had been few reports of arachnoid cyst accompanying psychiatric disturbance and no report treated with low-dose risperidone administration. We report a patient, developed first-transient psychotic episode considered to be provoked by an arachnoid cyst, responsive to risperidone, which was found in the middle cranial fossa as follows. A 57-year-old man was admitted by suddenly developed headache, auditory hallucination, delusion of persecution and, an arachnoid cyst in the anteromedial aspect of middle cranial fossa was found on MRI after admission. The psychotic episode was first to him and he was also negative to other clinical evaluation including endocrine abnormality, his psychotic symtom was suspected to be induced by arachnoid cyst and was well controlled to low-dose risperidone administration. He left hospital free from psychotic symptoms on 14 hospital days.

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