• Title/Summary/Keyword: Psychotic disorder

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El Ser Fronterizo como un yo Fracturado en Instrucciones para Cruzar la Frontera de Luis Humberto Crosthwaite

  • Michel, Gerardo Gomez
    • Iberoamérica
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    • v.23 no.2
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    • pp.179-208
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    • 2021
  • Luis Humberto Crosthwaite, as a witness to the accelerated changes in Tijuana since the 80's, has built a chronicle of the city based on nostalgia, fantasy, popular language, music, and criticism of the inequality between both sides of the border, but above all, on humour and irony. Among the gallery of characters that populate his stories, the common resident of the border has a special place. Here we are not talking about the passing person or newcomers, but of those who have shaped their social and personal identity from a long every day relationship with the city and the borderline, which makes up what we will call the border-being. In this work, we dialogue with the psychoanalytic concept of border personality or borderline disorder, which refers in a general way to subjects with a deep fracture between the self and the being, which prompts a psychotic search to reconcile this division. In addition, we will engage in an interdisciplinary dialogue to analyse how Crosthwaite characterises the fracture of the border-subjects in some of the stories of the book Instrucciones para cruzar la frontera, to point out the psychosis caused by the sociocultural tensions of life in a border city like Tijuana.

Validity of Korean Version of the Mini-International Neuropsychiatric Interview (한국판 Mini International Neuropsychiatric Interview 타당도 연구)

  • Yoo, Sang-Woo;Kim, Young-Shin;Noh, Joo-Sun;Oh, Kang-Seob;Kim, Chan-Hyung;NamKoong, Kee;Chae, Jeong-Ho;Lee, Gi-Chul;Jeon, Seong-Ill;Min, Kyung-Jun;Oh, Dong-Jae;Joo, Eun-Jung;Park, Hyun-Ju;Choi, Young-Hee;Kim, Se-Joo
    • Anxiety and mood
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    • v.2 no.1
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    • pp.50-55
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    • 2006
  • Objectives : In the psychiatry, structured interview is very important tool to be used in epidemiological or psychopharmacological studies. However, investigators often find that the administration of comprehensive diagnostic interviews is time-consuming and expensive to be used in clinical or research settings. Considering these points, Sheehan and his colleagues developed MINI (Mini International Neuropsychiatric Interview) to meet the need for a brief, reliable, and valid structured diagnostic interview for psychiatric disorders. The MINI has been translated into many languages and used in many countries. Therefore, we translated the MINI into Korean and determined its validity in this study. Methods : Twohundred seventy patients and normal subjects participated in the validation of the MINI versus an expert's professional opinion. Schizophrenia and other psychotic disorders, mood disorders including major depressive disorder and bipolar disorder, anxiety disorders including panic and other phobic disorders, and alcohol dependence were included in this study. The validity was obtained by examination whether MINI based diagnoses were compatible with diagnoses by expert psychiatrists. Results : The range of Kappa values was 0.22 (somatoform disorder) to 0.93 (bipolar disorder - past). Overall agreement between MINI and expert's diagnoses were good. The Kappa values for anxiety disorders seemed to be higher than those for other disorders. Conclusion : The MINI Korean version has the good validity. It also has potential applications as a diagnostic tool for psychiatric disorders.

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CLINICAL CHARACTERISTICS OF CHILD AND ADOLESCENT PSYCHIATRIC INPATIENTS WITH MOOD DISORDER (입원한 기분장애 소아청소년의 임상특성 - 주요 우울증과 양극성장애의 우울삽화 비교를 중심으로 -)

  • Cho, Su-Chul;Paik, Ki-Chung;Lee, Kyung-Kyu;Kim, Hyun-Woo;Hong, Kang-E;Lim, Myung-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.2
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    • pp.209-220
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    • 2000
  • The purpose of this study is to find out the characteristics of depressive episode about major depression and bipolar disorder in child and adolescent. The subjects of this study were 34 major depression patients and 17 bipolar disorder patients hospitalized at child and adolescent psychiatry in OO university children's hospital from 1st March 1993 to 31st October 1999. The method of this study is to review socio-demographic characteristics, diagnostic classification, chief problems and symptoms at admission, frequency of symptoms, maternal pregnancy problem history, childhood developmental history, coexisting psychiatric disorders, family psychopathology and family history and therapeutic response through their chart. 1) The ratio of male was higher than that of female in major depressive disorder while they are similar in manic episode, bipolar disorder. 2) Average onset age of bipolar disorder was 14 years 1 month and it was 12 years 8 months in the case of major depression As a result, average onset age of major depression is lower than that of bipolar disorder. 3) The patients complained of vegetative symptoms than somatic symptoms in both bipolar disorder and depressive disorder. Also, the cases of major depression developed more suicide idea symptom while the case of bipolar disorder developed more aggressive symptoms. In the respect of psychotic symptoms, delusion was more frequently shown in major depression, but halucination was more often shown in bipolar disorder. 4) Anxiety disorder coexisted most frequently in two groups. And there coexisted symptoms such as somartoform disorder, mental retardation and personality disorder in both cases. 5) The influence of family loading was remarkable in both cases. Above all, the development of major depression had to do with child abuse history and inappropriate care of family. It is apparent that there are distinctive differences between major depression and bipolar disorder in child and adolescent through the study, just as in adult cases. Therefore the differences of clinical characteristics between two disorders is founded in coexisting disorders and clinical symptoms including onset age, somatic symptoms and vegetative symptoms.

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Prognostic Factors in Postpsychotic Depressive Disorder of Schizophrenia (정신분열증의 정신증 후 우울장애의 예측인자)

  • Kim, Jin-Sung;Lee, Jong-Bum;Seo, Wan-Seok;Koo, Bon-Hoon;Bae, Dae-Seok;Kim, Yi-Youg;Kim, Jung-Youp
    • 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.

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Personality Assessment Inventory Profiles of Patients with Mild and Severe Traumatic Brain Injury (경증 및 중증 외상성 뇌손상 환자의 성격평가 질문지 프로파일)

  • Kweon, Seok-Joon;Rho, Seung-Ho
    • Korean Journal of Biological Psychiatry
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    • v.12 no.1
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    • pp.20-31
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    • 2005
  • Objectives:This study was designed to investigate the characteristics of personality changes and emotional distress using the Personality Assessment Inventory (PAI) in patients with traumatic brain injury(TBI), divided into mild (MTBI) and severe (STBI) groups according to the severity of injury. Methods:The subjects were consisted of 25 patients with MTBI, 25 patients with STBI, and 25 normal controls. They were interviewed with the PAI. The data were analyzed by ${\chi}^2$ test, analysis of variance and Tukey test. Results:The results were the followings. First, Negative Impression in validity scales was elevated above cutoff point(T score 70) in both MTBI and STBI groups. Second, the clinical scales of which scores elevated above the cutoff point were Somatic Complaints, Anxiety, Anxiety-Related Disorders, Depression, and Schizophrenia in the MTBI, and Somatic Complaints and Depression in the STBI. Third, the clinical subscales above the cutoff point were Conversion, Somatization, Health Concerns, Affective Anxiety, Physiological Anxiety, Traumatic Stress, Cognitive Depression, Affective Depression, Physiological Depression, Thought Disorder, and Affective Instability in the MTBI, and Health Concerns, Cognitive Depression, Affective Depression, and Physiological Depression in the STBI. Fourth, Suicide Ideation in treatment scales was the only scale above the cutoff point in the MTBI and the others of the treatment and interpersonal scales in the MTBI and all of these scales of the STBI were not elevated above the cutoff point. Fifth, the scales of which scores showed significant difference between the MTBI and the STBI were Somatic Complaints, Anxiety, Depression, and Suicide Ideation, the subscales were Conversion, Somatization, Health Concerns, Affective Anxiety, Physiological Anxiety, Physiological Depression, and Psychotic Experiences. Conclusion:These results suggest that the patients with MTBI had more somatic and anxiety symptoms, depressed mood, and suicidal ideation than the patients with STBI. These characteristics are generally consistent with clinical observation and findings from previous studies of the patients with TBI, and the PAI seems to be a beneficial adjunctive assessment tool for the evaluation of patients with traumatic brain injury.

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Serum Brain-Derived Neurotrophic Factor in Schizophrenia (정신분열병 환자의 혈청에서 Brain-Derived Neurotrophic Factor 증가)

  • Kim, So Youn;Min, Kyung Joon;Kee, Baik Seok;Park, Doo Byung;Kim, Joo Hee
    • Korean Journal of Biological Psychiatry
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    • v.11 no.2
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    • pp.104-109
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    • 2004
  • Objectives:Abnormalities in neurotrophic factors that regulate neuronal development and synaptic plasticity are often implicated as some causes of schizophrenia. In previous studies, researchers reported that brain and serum BDNF levels underwent similar changes during maturation and aging processes in rats. They also found a positive correlation between serum and cortical BDNF levels. In this study, we investigated whether the serum levels of BDNF in Korean schizophrenic patients would be different from those of healthy controls. Methods:Using an ELISA kit, serum BDNF levels were assessed in schizophrenic group(N=49) and control group(N=50). Results:Serum BDNF levels in the schizophrenic group($36.29{\pm}19.78$ng/ml) were significantly higher than those in control group($22.4{\pm}14.4$ng/ml). The BDNF levels did not correlate with duration of treatment, age or daily dose of antipsychotics in patients with schizophrenia. Conclusions:This result suggests that schizophrenia is characterized by high serum BDNF levels and supports the hypothesis of neurotrophic factor involvement in psychotic disorder. Serum BDNF level is likely to be one of the possible biological markers for schizophrenia.

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SEX DIFFERENCES IN BEHAVIOR PROBLEM PATTERNS (문제행동 양상에서의 성차이)

  • Oh, Kyung-Ja;Lee, He-Len;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.2 no.1
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    • pp.125-134
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    • 1991
  • In an attempt to study sex differences in child behavior disorders, 834 clinic-refered children(582 boys and 252 girls) between the ages of 6 to 11 were assessed using CBCL parental form and the data were factor analysed to form empirically derived syndromes for each sex. The analyses yielded eight behavior disorder syndromes for boys and ten, for girls. Six syndromes(aggressive, hyperactive, delinquent, social withdrawal, emotional lability, physical complaints) were found in both sexes while obsessive, depressive and psychotic syndromes were organized differently in boys and girls. There were also considerable differences in item composition of the six syndromes common to box sexes, suggesting that clinical features of common behavior disorders such as aggression and hyperactiveity might be different for boys and girls despite their apparent similarity. The results were discussed in terms of culturally shared attitudes and beliefs concerning sex differences in behaviors.

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Loss of Hfe Function Reverses Impaired Recognition Memory Caused by Olfactory Manganese Exposure in Mice

  • Ye, Qi;Kim, Jonghan
    • Toxicological Research
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    • v.31 no.1
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    • pp.17-23
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    • 2015
  • Excessive manganese (Mn) in the brain promotes a variety of abnormal behaviors, including memory deficits, decreased motor skills and psychotic behavior resembling Parkinson's disease. Hereditary hemochromatosis (HH) is a prevalent genetic iron overload disorder worldwide. Dysfunction in HFE gene is the major cause of HH. Our previous study has demonstrated that olfactory Mn uptake is altered by HFE deficiency, suggesting that loss of HFE function could alter manganese-associated neurotoxicity. To test this hypothesis, Hfe-knockout ($Hfe^{-/-}$) and wild-type ($Hfe^{+/+}$) mice were intranasally-instilled with manganese chloride ($MnCl_2$ 5 mg/kg) or water daily for 3 weeks and examined for memory function. Olfactory Mn diminished both short-term recognition and spatial memory in $Hfe^{+/+}$ mice, as examined by novel object recognition task and Barnes maze test, respectively. Interestingly, $Hfe^{-/-}$ mice did not show impaired recognition memory caused by Mn exposure, suggesting a potential protective effect of Hfe deficiency against Mn-induced memory deficits. Since many of the neurotoxic effects of manganese are thought to result from increased oxidative stress, we quantified activities of anti-oxidant enzymes in the prefrontal cortex (PFC). Mn instillation decreased superoxide dismutase 1 (SOD1) activity in $Hfe^{+/+}$ mice, but not in $Hfe^{-/-}$ mice. In addition, Hfe deficiency up-regulated SOD1 and glutathione peroxidase activities. These results suggest a beneficial role of Hfe deficiency in attenuating Mn-induced oxidative stress in the PFC. Furthermore, Mn exposure reduced nicotinic acetylcholine receptor levels in the PFC, indicating that blunted acetylcholine signaling could contribute to impaired memory associated with intranasal manganese. Together, our model suggests that disrupted cholinergic system in the brain is involved in airborne Mn-induced memory deficits and loss of HFE function could in part prevent memory loss via a potential up-regulation of anti-oxidant enzymes in the PFC.

The Electroconvulsive Therapy in the Prevention of Suicide Risks and Attempts (자살 위험성 및 자살 시도 방지에 대한 전기경련치료의 역할)

  • Kim, Hee Cheol;Jeong, Seong Hoon;Ahn, Yong Min;Park, Seung Hyun;Kim, Yong Sik;Chung, In Won
    • Korean Journal of Biological Psychiatry
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    • v.27 no.2
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    • pp.64-73
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    • 2020
  • Suicidality is the most serious complication of mood disorders and psychosis; effective treatment should reduce suicide rates. The Organization for Economic Cooperation and Development age-standardized suicide rate in Korea was 22.6 in 2018, much higher compared to other countries worldwide. As mental and psychiatric problems are the main reasons for suicide attempts, accounting for 31.6% in 2018, targeting such problems should be the focus of efforts to reduce suicide rates. However, the ability of current pharmacotherapeutic and psychotherapeutic interventions to reduce suicide rates is limited due to their delayed effects. Therefore, electroconvulsive therapy (ECT) has been proposed as an alternative treatment. This approach is effective for treating most mental disorders associated with high suicide rates, including severe depression, bipolar disorder, and intractable psychotic disorders; ECT is also effective for Parkinson's disease, which has the highest suicide rate among all disorders in Korea. The acute, long-term, and prophylactic effects of ECT on suicidality have been reported in the literature, and treatment guidelines outside of Korea recommend that ECT be used at an early stage for rapid reduction of suicide rates, as opposed to being applied as a treatment of last resort. However, only ~0.092 of every 10000 members of the Korean general population received ECT in 2018; this is much lower than the average rate worldwide, of 2.2 per 10000. Elimination of obstacles to the use of ECT, early crisis intervention involving administration of ECT for rapid stabilization, and maintenance ECT to prevent recurrence should reduce suicide rates.

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.