• Title/Summary/Keyword: Psychotic disorders

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Childhood Onset of Anti-N-Methyl-D-Aspartate Receptor Encephalitis Without Teratoma Masquerading as a Psychotic Disorder

  • Yeum, Tae-Sung;Lee, Jung;Park, Sung-Yeol;Joen, Yaelim;Kim, Bung-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.30 no.3
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    • pp.127-131
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    • 2019
  • Many neurologic disorders manifest as psychiatric symptoms. Anti-N-Methyl-D-Aspartate (NMDA) receptor encephalitis is an autoimmune disease of the brain characterized by numerous neurological and psychiatric features. Despite being rare, its prevalence is rapidly increasing and early management is critical in ensuring successful and sustainable recovery. Therefore, the illness should be considered as a differential diagnosis when clinically assessing patients. This report presents a case of a female child who was hospitalized for acute psychiatric manifestations, which was later confirmed as anti-NMDA receptor encephalitis. She recovered relatively successfully after combined neurological and psychiatric treatment. This report provides information on the clinical course of early onset anti-NMDA receptor encephalitis, including treatment strategy and prognosis.

Current Situation of Psychiatry in North Korean : From the Viewpoint of North Korean Medical Doctors (북한 의사들이 바라보는 북한의 정신의학 현황)

  • Kim, Seog-Ju;Park, Young-Su;Lee, Hae-Won;Park, Sang-Min
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.1
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    • pp.32-39
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    • 2012
  • Objective : Psychiatry in North Korea is believed to seem very different from psychiatry in South Korea. However, there is nearly no information regarding psychiatry in North Korea until now. Our study aimed to get information about North Korean psychiatry. Methods : Three North Korean defectors in South Korea, whose clinical experience as medical doctors in North Korea was over 10 years, were recruited. They underwent the semi-structured interview, content of which included the clinical experience with psychiatric patients, the details of psychiatry, the treatment of psychiatric patients, the stigma of mental illness, and the suicide, in North Korea. Results : In North Korea, psychiatric department was called as 49th(pronounced as Sahsip-gu-ho in Korean). Only patients with vivid psychotic symptoms came to psychiatric department. Non-psychotic depression or anxiety disorders usually were not dealt in psychiatry. The etiology of mental illness seemed to be confined to biological factors including genetic predisposition. Psychosocial or psychodynamic factors as etiology of mental illness appeared to be ignored. Psychiatry was apparently separated from political or ideological issues. The mainstay of psychiatric treatment is the inpatient admission and out-of-date therapy such as insulin coma therapy. Stigma over mental illness was common in North Korea. Suicide is considered as a betrayal to his/her nation, and has been reported to be very rare. Conclusion : The situation of psychiatry in North Korea is largely different from that of South Korea. Although some aspects of North Korean psychiatry are similar to psychiatry in former socialist countries, North Korean psychiatry is considered to have also its unique characteristics.

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Functional Dyspepsia (기능성 소화불량증)

  • Song, Kyung Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.3-8
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    • 2016
  • Functional dyspepsia is one of the most common bowel disorders as prevalent of 7.7% Korean population. The cardinal manifestations include bothersome postprandial fullness, early satiation, epigastric burning or pain. These features are chronic and should be presented recurrently with no other compatible organic disease to explain the symptoms. Even though it is not life-shortening, functional dyspepsia usually make the health-related quality of life worse especially if other functional bowel disorder coexist. The coexistence of functional bowel disorders is called as 'overlap syndrome'. Anxiety, somatization and insomnia is more prevalent in overlap syndrome compared with sole functional bowel disorder. Therefore, it is worthwhile that physician interviews and elucidates whether the dyspeptic patient had other kinds of functional bowel disorders, and manages the underlying psychotic pathology. Placebo effect is large in functional dyspepsia, and there is only four kinds of prokinetics that is proven to be superior to placebo. Adverse events relating prolonged administration of prokinetics sometimes fatal or irreversible, physician willing to describe prokinetics should be familiar to the possible adverse effects and the relating risk factors. Pathologic acid reflux is not uncommon in functional dyspepsia, and acid-suppressant is equivalent to the prokientics in most of dyspeptic patients.

THE PRELIMINARY STUDY OF THE QUANTITATIVE MORPHOLOGIC ANALYSIS USING MRI OF THE LATERAL VENTRICLE IN EARLY-ONSET PSYCHOTIC DISORDER (조기 발병한 정신증적 장애에서 자기공명영상을 이용한 측뇌실에 대한 구조적인 예비연구)

  • Lee, Youn-Hee;Kang, Min-Hee;Kim, Chul-Eung;Bae, Jae-Nam;Hong, Kang-E;Lee, Jeong-Seop
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.2
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    • pp.256-262
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    • 2001
  • Objective:The enlargement of the lateral ventricle is well established finding in adult-onset schizophrenia, but in the patients with early-onset psychotic disorder(EOPD) is still controversal. To identify structural abnormalities of the lateral ventricle in patients with EOPD and difference of the brain developmental course in EOPD group, planimetrical assessment of the lateral ventricle was conducted by means of retrospective quantitative neuroimaging. Methods:The brain MR images of 14 patients with EOPD(mean age $14.0{\pm}2.1$ years) who met the DSM-III-R diagnostic criteria for schizophrenia and bipolar disorder and 24 control subjects with simple headache(mean age $10.0{\pm}2.1$ years) were collected. Single best view for the lateral ventricle, one axial slice was selected for analysis. MR images were redigitalized with flatbed scanner and data were analyzed with NIH IMAGE software. Results:In the patients with EOPD, there were significant correlations between aging and lateral ventricular sizes and between aging and ventricular brain ratio(VBR). The statistical significance of normal asymmetry of the lateral ventricle was not observed for the EOPD group. The EOPD group had larger lateral ventricular sizes and VBR than control group, but these results were not statistically significant. Conclusion:These findings suggest that the brain abnormalities in patients with EOPD progress from the earlier course of the disorders and the course of brain development in EOPD group is different from control group.

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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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Nine cases of strongyloidiasis in Korea (분선충의 인체 감염 9례)

  • 이상금;신보문
    • Parasites, Hosts and Diseases
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    • v.32 no.1
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    • pp.49-52
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    • 1994
  • Nine cases of human infection with Strongyloines stercornlis are reported among patients admitted to the Seoul Paik and Sang-Kye Paik Hospitals, Inje University, from April 1990 to Junuary 1992. The Patients, 7 males and 2 females acted between 50 and 70, either had the history of long term use of steroids for management of arthritis, or were complicated with other chronic diseases such as hypertension, liver diseases, psychotic disorders, and gastrointestinal problems. All of the nine patients revealed rhabditoid larvae of S. stercorolis in fecal examination. A 57-year-old woman who complained of arthritis and abdominal discomfort, was treated with albendazole and mebendazole, and on the 4th and 5th treatment day 220 parasitic adult females were collected from the diarrheal stool. The patient had a long history of administration of steroids for treatment of arthritis, and seems to have suffered from hyperinfection syndrome due to autoinfection with S. stercordis. This is the 3rd report on the recovery of parasitic adult females of S. stercoraLis in Korea.

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Is catechol-o-methyltransferase gene polymorphism a risk factor in the development of premenstrual syndrome?

  • Deveci, Esma Ozturk;Incebiyik, Adnan;Selek, Salih;Camuzcuoglu, Aysun;Hilali, Nese Gul;Camuzcuoglu, Hakan;Erdal, Mehmet Emin;Vural, Mehmet
    • Clinical and Experimental Reproductive Medicine
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    • v.41 no.2
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    • pp.62-67
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    • 2014
  • Objective: The objective of this study was to investigate whether there was a correlation between catechol-o-methyltransferase (COMT) gene polymorphism, which is believed to play a role in the etiology of psychotic disorders, and premenstrual syndrome (PMS). Methods: Fifty-three women with regular menstrual cycles, aged between 18 and 46 years and diagnosed with PMS according to the American Congress of Obstetrics and Gynecology criteria were included in this study as the study group, and 53 healthy women having no health problems were selected as the controls. Venous blood was collected from all patients included in the study and kept at $-18^{\circ}C$ prior to analysis. Results: There was no significant difference between the groups in terms of demographic features such as age, body mass index, number of pregnancies, parity, and number of children. No statistically significant difference was observed in terms of COMT gene polymorphism (p=0.61) between women in the PMS and the control groups. However, a significant difference was found between arthralgia, which is an indicator of PMS, and low-enzyme activity COMT gene (Met/Met) polymorphism (p=0.04). Conclusion: These results suggested that there was no significant relationship between PMS and COMT gene polymorphism. Since we could not find a direct correlation between the COMT gene polymorphism and PMS, further studies including alternative neurotransmitter pathways are needed to find an effective treatment for this disease.

Acute kidney injury in pediatric patients with rhabdomyolysis

  • Lim, Young Shin;Cho, Heeyeon;Lee, Sang Taek;Lee, Yeonhee
    • Clinical and Experimental Pediatrics
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    • v.61 no.3
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    • pp.95-100
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    • 2018
  • Purpose: This study aimed to evaluate the clinical findings in pediatric rhabdomyolysis and the predictive factors for acute kidney injury (AKI) in Korean children. Methods: Medical records of 39 Korean children, who were newly diagnosed with rhabdomyolysis from January 2008 to December 2015, were retrospectively analyzed. The diagnosis was made from the medical history, elevated serum creatinine kinase level >1,000 IU/L, and plasma myoglobin level >150 ng/mL. Patients with muscular dystrophy and myocardial infarction were excluded. Results: The median patient age at diagnosis was 14.0 years (range, 3-18 years), and the male to female ratio was 2.5. The most common presenting symptom was myalgia (n=25, 64.1%), and 14 patients (35.9%) had rhabdomyolysis-induced AKI. Eighteen patients (46.2%) had underlying diseases, such as epilepsy and psychotic disorders. Ten of these patients showed rhabdomyolysis-induced AKI. The common causes of rhabdomyolysis were infection (n=12, 30.7%), exercise (n=9, 23.1%), and trauma (n=8, 20.5%). There was no difference in the distribution of etiology between AKI and non-AKI groups. Five patients in the AKI group showed complete recovery of renal function after stopping renal replacement therapy. The median length of hospitalization was 7.0 days, and no mortality was reported. Compared with the non-AKI group, the AKI group showed higher levels of peak creatinine kinase and myoglobin, without statistical significance. Conclusion: The clinical characteristics of pediatric rhabdomyolysis differ from those observed in adult patients. Children with underlying diseases are more vulnerable to rhabdomyolysis-induced AKI. AKI more likely develops in the presence of a high degree of albuminuria.

Effect of Oral Water Intake to Globus Pharyngeus with Non-Organic Diseases (인후두 이물감을 호소하는 환자에서 경구 수분섭취가 증상 호전에 미치는 영향)

  • Kim, Hak Geon;Kim, A Young;Cha, Eunjoo;Lee, GilJoon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.28 no.1
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    • pp.38-42
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    • 2017
  • Background and Objectives : Globus pharyngeus is a sensation of foreign body in the throat. There are many studies evaluate relationships between globus pharyngeus and organic diseases such as laryngopharyngeal reflux, esophageal motility disorders as well as psychotic causes. But, Also many patients without etiologic causes complain of globus sensation. The authors performed a study that evaluate association between oral water intake and symptoms of globus sensation on the basis of a belief that pharyngeal dehydration due to lack of oral water intake causes globus sensation. Materials and Methods : A survey using visual analogue scale to evaluate symptoms was performed with 73 patients with globus pharyngeus. Results : Patients who drink water less than 500 mL per day (p=0.04) and less than five times per day (p=0.02) were improved after 6 months due to education and doctor's recommendation. Conclusion : Frequent and enough water intake should be recommended to resolve symptoms of globus sensation.

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MMPI Characteristics of the Sexual Offender (성적 가해자에서 MMPI 특성)

  • Kim, Hyun-Sic;Lim, Myung-Ho;Do, Jin-A;Lee, Jae-Woo;An, Jin-Hyung;Lee, Tae-Jun;Paik, Ki-Chung
    • Anxiety and mood
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    • v.8 no.1
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    • pp.16-21
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    • 2012
  • Objectives : The current study investigated the personality characteristics of the sexual offender using the Minnesota Multiphasic Personality Inventory (MMPI) test commonly used in clinical medicine. Methods : 30 sexual offenders (30 male) completed the Korean version of the MMPI. 20 of the 30 sexual offenders were patients with paraphilia. The sexual offenders had been admitted to the Institute of Forensic Psychiatry Ministry of Justice, Gongju, for sexual violence. Results : The MMPI scores of the sexual offenders were significantly higher on the psychopathic deviate (Pd), masculinity-feminity (Mf), paranoia (Pa), psychasthenia (Pt), schizophrenia (Sc) than the comparison group. And The MMPI scores of the sexual offenders had higher values for hypochondriasis (Hs), depression (D), hysteria (Hy), hypomania (Ma), social introversion (Si) than the comparison group, but were not significantly higher. Conclusion : Sexual offenders may be antisocial, paranoid, schizoid or psychasthenic. They seem to have psychotic psychopathology rather than neurotic psychopathology. These results suggested that the psychopatholgy of sexual offenders may be different to the control group.