• Journal of Ginseng Research
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• 제31권3호
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• pp.117-126
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• 2007

Ginseng, the root of Panax species, a well-known herbal medicine has been used as a traditional medicine for thousands of years and is now a popular and worldwide used natural medicine. Ginseng has been used primarily as a tonic to invigorate weak bodies to help the restoration of homeostasis in a wide range of pathological conditions such as cardiovascular diseases, cancer, immune deficiency and hepatotoxicity. Although conclusive clinical data in humans is still missing, recent research results have suggested that some of the active ingredients ginseng exert beneficial effects on central nervous system (CNS) disorders and neurodegenerative diseases, suggesting it could be used in treatment of psychotic disorders. Data from neural cell cultures and animal studies contribute to the understanding of these mechanisms that involve inhibitory effects on stress-induced corticosterone level increasing and modulating of neurontransmitters, reducing $Ca^{2+}$ over-influx, scavenging of free radicals and counteracting excitotoxicity. In this review, we focused on recently reported medicinal effects of ginseng and summarized the possibility of its applications on psychotic disorders.

• 생물정신의학
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• 제24권3호
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• pp.134-141
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• 2017

Objectives A retrospective case series study was conducted to investigate the clinical characteristics of psychotic disorders induced by appetite suppressants, phentermine and phendimetrazine. Methods A retrospective electronic medical record review identified 5 admitted patients who had psychotic symptoms after taking phentermine or phendimetrazine. Clinical information was reviewed and summarized in each case. Results Hallucinations were reported in all cases, including auditory, visual, olfactory and somatic hallucinations. After discontinuation of phentermine or phendimetrazine, the symptoms rapidly improved with low dose of antipsychotics. Patients tended to have less prominent negative symptoms and higher insight into illness, and often showed depressive mood. These clinical characteristics were similar to psychosis induced by amphetamines. Two patients developed stimulant use disorder while using phentermine. Conclusions These findings call for awareness of the risks associated with use of appetite suppressants. Prescription of phentermine or phendimetrazine should be accompanied by close monitoring of mental status, and suspicion for substance/medication-induced psychotic disorder.

• 생물정신의학
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• 제29권1호
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• pp.22-31
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• 2022

Objectives Recently, weight loss has emerged as a national concern in South Korea, and this has resulted in an increase in the frequency of use of central nervous system (CNS)-stimulating appetite suppressants. This study aimed to collect cases of psychotic disorders and bipolar disorders triggered by phentermine and phendimetrazine and explore the clinical features and courses. Methods In this retrospective study, we analyzed the electronic medical records of patients and selected eight patients who developed psychotic symptoms and manic symptoms for the first time after taking phentermine and phendimetrazine. All cases were reviewed, and their clinical features and course were summarized. Results All eight patients developed psychotic symptoms, and one had accompanying manic symptoms. The final diagnosis was appetite-suppressant-induced psychotic disorder in four patients, schizophrenia in three, and appetite-suppressant-induced bipolar disorder in one. In addition, three patients were diagnosed as having substance-use disorder. The key psychotic symptoms of these patients were hallucinations and paranoia. Conclusions These case findings suggest that phentermine and phendimetrazine can cause psychotic disorder, bipolar disorder, or substance use disorder and that medical professionals and the public should practice caution when prescribing and using these drugs.

• 생물정신의학
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• 제13권4호
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• pp.234-243
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• 2006

정신병적 우울증의 심한 정도와 나쁜 예후, 그리고 현재까지의 연구 실적을 고려했을 때, 임상의사들은 정신병적 증상을 동반한 우울증과 정신병적 증상을 동반하지 않는 우울증을 구분하여 치료계획을 수립하는 것이 바람직하다. 저자들은 체계적인 검색을 통해 광범위하게 조사를 하였으나, 정신병적 우울증 환자의 약물치료에 대한 근거는 아직 부족한 것으로 생각한다. 소수의 연구 결과들이지만 현재까지 발표된 근거에 의하면, 항우울제와 항정신병약물의 병합치료와 전기충격요법이 그 효과에 대한 근거 수준이 가장 높아서 정신병적 우울증 환자를 위한 일차적 치료법으로 생각된다. 그러나 최근에 항우울제 단독치료가 항우울제와 항정신병약물의 병합치료에 비해 효과 면에서 떨어지지 않는다는 분석 결과가 발표되면서 항우울제-항정신병약물 병합치료법과 항우울제를 사용하다가 필요시에 항정신병약물을 추가하는 방법 둘 다 권고된 바 있다. 이는 기존 치료 권고 사항과 대조가 되기 때문에, 향후 이러한 관점에서 기존의 치료 전략들이 어떻게 영향을 받을지 주목된다. 그러나 적어도 정신병적 우울증 환자에게 항정신병약물을 단독으로 사용하는 것은 항우울제와 병합하였을 때 보다 덜 효과적이므로 항정신병약물 단독으로 시작하는 것은 바람직하지 않다는 데에는 연구자들 간에 의견이 일치하고 있다. 항우울제 중에서는 삼환계 항우울제에 대한 근거 수준이 가장 높고 선택적 세로토닌 재흡수 차단제의 경우 현재는 근거가 부족하나 앞으로 유망할 것으로 보인다. 항우울제와 항정신병약물 병합 치료에 반응이 없거나 부작용으로 인해 투여할 수가 없을 경우에는 항우울제의 종류를 바꾸거나 lithium을 강화하는 방법을 고려할 수 있다. 실제 임상에서는 환자 개개인의 위험과 이득을 고려하여 약물을 선택하는 것이 중요하다. 또한 선택된 약물을 충분한 양, 그리고 충분한 기간 동안 시도했는지도 중요하다. 이와 함께 부작용의 출현에 대해 잘 모니터링을 해야 하고, 특히 우울증 자체가 악화되는 것과 구분해야 한다. 결론적으로, 임상의사들은 정신병적 증상을 동반하는 우울증 환자의 치료 전략을 현재까지 수행된 연구 근거의 양과 수준을 감안하여 받아들여야 하고, 아직까지 명백한 결론을 이끌어내기에는 부족하기 때문에 향후 이에 대한 많은 체계적 연구들이 필요할 것이다.

• Journal of Yeungnam Medical Science
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• 제39권1호
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• pp.58-61
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• 2022

Mega cisterna magna (MCM), one of the members of the Dandy-Walker complex, is a developmental malformation of the posterior fossa that is larger than 10 mm but morphologically does not affect the vermis and cerebellar hemispheres. Reports of psychiatric disorders associated with this anomaly are rare. We present the case of a patient with MCM who presented with a psychotic manic attack and was diagnosed with bipolar disorder. A 28-year-old female, single housewife, university graduate, presented with irritability, decreased sleep and appetite, distraction, and agitation. The patient also had a delusion of reference. In the clinical follow-up, an increase in energy and an increase in the amount of speech were observed. Her neurological examination was normal, and cranial magnetic resonance imaging revealed an MCM. The relationship and clinical significance of MCM with psychosis and mood disorders have not yet been fully elucidated. It is not known whether this association is accidental or based on etiological commonality. The purpose of this case report is to review the relationship between the cerebellum and psychiatric symptoms and to contribute to the literature.

• 생물정신의학
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• 제3권2호
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• pp.156-161
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• 1996

Many pregnant women have to receive psychotropic medication during pregnancy and lactation period, despite the proven and assumed risks to the fetus ar neonate. A brief summary of drug metabolism and pharmacodynamics is given. Principles and quidelines of using psychotropic agents during pregancy and lactation period are presented for psychotic disorders, bipolar affective disorders. depression and anxiety disorders, with due consideration for relative benefits and risks of choosing among psychotropic drugs and alternative treatments.

• 대한조현병학회지
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• 제21권2호
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• pp.74-80
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• 2018

Objectives : This study investigated whether long-acting injectable (LAI) paliperidone is different from its oral form in terms of the effect on cognitive function in schizophrenia spectrum and other psychotic disorders. Methods : We reviewed the medical records of patients in Seoul National University Bundang Hospital who were diagnosed as having schizophrenia and/or other psychotic disorders based on DSM-5 from 2016 to 2017. Seven patients were treated with oral paliperidone and 11 were treated with paliperidone palmitate. All patients underwent clinical and neuropsychological assessment, including the Korean version of the MATRICS Consensus Cognitive Battery (MCCB) at their first visit or within one month of their initial treatment. MCCB was repeated within three to 12 months after the initial assessment. Results : There was no significant difference between the two groups in most cognitive domains including speed of processing, attention and vigilance, working memory, verbal learning, visual learning and reasoning and problem solving domain. However, patients treated with paliperidone palmitate showed better improvement in social cognition domain than those taking oral paliperidone. The standardized values of social cognition domain scores had significantly improved over time in patients under paliperidone palmitate, demonstrating a significant time-by-group interaction. Conclusion : Our results show that long-acting injectable paliperidone could be helpful in some aspects of improving cognitive function in schizophrenia spectrum and other psychotic disorders. Further studies with other antipsychotics are necessary to generalize the results.

• 대한간호학회지
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• 제53권1호
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• pp.69-86
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• 2023

Purpose: This study aimed to evaluate the effects of digital health interventions on the psychotic symptoms among people with severe mental illness in the community. Methods: A systematic review and meta-analysis were conducted in accordance with the Cochrane Intervention Research Systematic Review Manual and PRISMA. A literature search was conducted of published randomized controlled trials (RCTs) for digital health interventions from January 2022 to April 2022. RevMan software 5.3 was used for quality assessment and meta-analysis. Results: A total 14 studies out of 9,864 studies were included in the review, and 13 were included in meta-analysis. The overall effect size of digital health interventions on psychotic symptoms was - 0.21 (95% CI = - 0.32 to - 0.10). Sub-analysis showed that the reduction of the psychotic symptoms was effective in the schizophrenia spectrum group (SMD = - 0.22; 95% CI = - 0.36 to - 0.09), web (SMD = - 0.41; 95% CI = - 0.82 to 0.01), virtual reality (SMD = - 0.33; 95% CI = - 0.56 to - 0.10), mobile (SMD = - 0.15; 95% CI = - 0.28 to - 0.03), intervention period of less than 3 months (SMD = - 0.23; 95% CI = - 0.35 to - 0.11), and non-treatment group (SMD = - 0.23; 95% CI = - 0.36 to - 0.11). Conclusion: These findings suggest that digital health interventions alleviate psychotic symptoms in patients with severe mental illnesses. However, well-designed digital health studies should be conducted in the future.

• Journal of Hospice and Palliative Care
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• 제10권3호
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• pp.120-127
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• 2007

Bereavement is the state of loss resulting from death. Grief is the emotional response associated with loss, intense and acute sorrow resulting from loss. Complicated grief represent a pathological outcome involving social, physical, emotional, cognitive, spiritual morbidity. The common psychiatric disorders associated complicated grief or abnormal grief responses include clinical depression, anxiety disorders, alcohol abuse or other substance abuse, and dependence, psychotic disorders, and post-traumatic stress disorder (PTSD). Grief tasks involve a series of stage or phases following an important loss that gradually permit adjustment and recovery. Three phases of grief involve phase 1 (walking the edges), phase 2 (entering the depths), and phase 3 (reconnecting the world). For intervention to be effective they need to be individually tailored to abnormal grief reaction or unresolved grief reaction. Clear understandings of complicated grief, abnormal responses, factors increasing risk after bereavement will often enable us to prevent psychiatric disorders in bereaved patients.

• 생물정신의학
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• 제17권3호
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• pp.119-126
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• 2010

Synaptic adhesion molecules mediate synapse formation, maturation and maintenance. These proteins are localized at synaptic sites in neuronal axons and dendrites. These proteins function as a bridge of synaptic cleft via interaction with another synaptic adhesion molecules in the opposite side. They can interact with scaffold proteins via intracellular domain and recruit many synaptic proteins, signaling proteins and synaptic vesicles. Scaffold proteins function as a platform in dendritic spines or axonal terminals. Recently, many genetic studies have revealed that synaptic adhesion molecules and scaffold proteins are important in neurodevelopmental disorders, psychotic disorders, mood disorders and anxiety disorders. In this review, fundamental mechanisms of synapse formation and maturation related with synaptic adhesion molecules and scaffold proteins are introduced and their psychiatric implications addressed.