• Korean Journal of Biological Psychiatry
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• v.13 no.4
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• pp.234-243
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• 2006

Objectives : Several factors, such as biological markers, clinical correlates, and course of the depressive disorders with psychotic symptoms differ from those without psychotic symptoms. Therefore, specification of a treatment algorithm for depressive disorder with psychotic symptoms is legitimated. This article provides a systematic review of somatic treatments for depressive disorder with psychotic symptoms. Methods : According to the search strategy of the Clinical Research Center for Depression of Korean Health 21 R & D Project, first, PubMed and EMBASE were searched using terms with regard to the treatment of depressive disorders with psychotic symptoms(until July 2006). Reference lists of related reviews and studies were searched. In addition, relevant practice guidelines were searched using PubMed. All identified clinical literatures were reviewed and summarized in a narrative manner. Results : Treatment options, such as a combination of an antidepressant and an antipsychotic versus an antidepressant or an antipsychotic alone are summarized. In addition, issues regarding the electroconvulsive therapy( ECT), combination therapy, and maintenance treatment are discussed. Conclusion : In former times, the combination of an antidepressant and an antipsychotic or ECT were recommended as the first line treatment for depressive disorder with psychotic symptoms. Recently, however, there was a suggestion that there was no conclusive evidence that the combination of an antidepressant and an antipsychotic drug is more effective than an antidepressant alone. More evidence regarding the pharmacological treatment for depressive disorder with psychotic symptoms is needed.

• Korean Journal of Biological Psychiatry
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• v.24 no.3
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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.

• Sleep Medicine and Psychophysiology
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• v.24 no.2
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• pp.97-105
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• 2017

Objectives: To evaluate sleep characteristics and factors associated with sleep disturbance in schizophrenia patients with concurrent active psychotic symptoms and insomnia. Methods: Schizophrenia patients with insomnia and active psychotic symptoms (n = 63) were recruited from community-based mental rehabilitative facilities. Sleep scales such as the Korean version of the Insomnia Severity Index (ISI-K) and the Korean Version of the Pittsburgh Sleep Quality Index (PSQI-K) were evaluated and those with ISI-K >15 were included in the study. Psychotic, anxiety and depressive symptoms were rated with the Brief Psychotic Rating Scale (BPRS), the Korean Version of the Anxiety Sensitivity Index (K-ASI), and the Korean Version of the Beck Depression Inventory-I (K-BDI), respectively. Pearson correlation analyses were performed between the sociodemographic data, ISI-K and PSQI-K. Multiple linear regression analysis was conducted to investigate the factors which affected the ISI-K and PSQI-K. Results: The mean ISI-K and PSQI-K scores were $18.1{\pm}2.6$ and $12.0{\pm}2.2$, respectively. Pearson correlation analysis showed a negative correlation between age of onset and ISI-K score and positive correlations between BRPS and PSQI-K scores and between K-ASI and both ISI-K and PSQI-K scores. Multiple regression analyses for both ISI-K and PSQI-K with K-ASI, age of onset, and BPRS as covariates revealed K-ASI as the only significant remaining factor. Conclusion: Our study suggests that anxiety symptoms are associated with insomnia symptoms in schizophrenia patients regardless of depressive or psychotic symptoms.

• Journal of Korean Academy of Nursing
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• v.53 no.1
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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.

• Korean Journal of Biological Psychiatry
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• v.29 no.1
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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.

• Korean Journal of Biological Psychiatry
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• v.14 no.2
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• pp.122-128
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• 2007

Objectives : The aim of this study was to investigate relationships between psychotic symptoms and cognitive functions in schizophrenia. Methods : The study group was composed of 36 schizophrenic patients. Positive, negative, and disorganization symptoms were assessed using the PANSS. Verbal, visuospatial, attention, memory, and executive functions were assessed using a battery of cognitive tests. Results : Correlation analysis between symptom vs. cognitive measures showed that (a) positive symptoms were significantly correlated with no cognitive measures, (b) negative symptoms were significantly correlated with all cognitive measures, and (c) disorganization symptoms were significantly correlated with executive and memory measures. Correlation analyses between symptom vs. cognitive factors showed that negative-disorganization factor is significantly correlated with executive-memory factor. Conclusion : Significant relationships were confined mostly to frontal symptoms vs. frontal cognitive functions. Thus, the relationships may be mediated mainly by variations in severity of frontal pathology among patients.

• Korean Journal of Biological Psychiatry
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• v.5 no.2
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• pp.149-154
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• 1998

Antipsychotic drugs(APDs) have been effective to alleviate psychotic symptoms of schizophrenia. However, some schizophrenic patients do not respond to APDs. In addition to psychotic symptoms of schizophrenia, negative symptoms, excitement, violence, agitation, depression, and disorganization are frequently noted in patients with schizophrenia. Though APDs are the first line drugs for these symptoms, other drugs than APDs to augment the effects of APDs are efficacious for the treatment of these symptoms. Such augmenting drugs include benzodiazepines, anticonvulsants, antidepressants, lithium, and electroconvulsive therapy. These augmentation strategies can boost the effects of APDs or decrease the requirements of APDs, and consequently decrease the chance of the occurrence of side effects of APDs. Augmenting strategies are revewed for each class of drugs or treatment modality.

• Journal of the Korea Convergence Society
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• v.8 no.2
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• pp.35-42
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• 2017

The purpose of the present study was to explore the features of Emotional Intelligence(EI) in psychiatric patients in terms of the ability model. EI scores of patients, measured by performance-based test and self-report inventory, was compared. The scores of performance-based test(Emotional Literacy Test) and self-report inventory(Trait Meta-Mmood Scale) of patients(30 with psychotic symptoms, 32 without psychotic symptoms) who had a appropriate literacy were analyzed by means of independent t-test. There was a no significant difference of IQ between two groups. Our results indicated that psychotic group had significantly lower EI in performance-based test than non-psychotic group. In contrast, non-psychotic group showed lower EI in self-report inventory than psychotic group. This inconsistent results might be attributable to the differences in method of measurement. Thus, these results suggested that it may be important to adopt a convergent using of both performance-based test and self-report inventory while assessing EI of patients with psychopathology.

• Journal of Oriental Neuropsychiatry
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• v.2 no.1
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• pp.108-121
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• 1991

Deficiency symptom-complex is related to psychotic disease and important concept of Pal Gang(八綱) in oriental Diagnosis. This investigation was carried out to see the effect of disease of deficiency Symptom-Complex upon Symptoms Checklist-90-Revision. The following results were obtained ; 1. Deficiency Symptom-Complex was related to psychoses in the bibliographic study. 2. Dimension #1, #2, #4, #5, #7, #9, were significantly recognized in the deficiency Symptom-Complex. 3. Dimension #1 was significantly recognized in the back pain. 4. Dimension #1 was related to the deficiency of spleen(脾虛). 5. It is suggested that dimension #2, #3, #7, related with phobia were connected with the deficiency of liver, and gall bladder(肝膽虛). Considering the above results, it is thought that deficiency Symptom-Complex was related to psychotic disease, investigation about deficiency Symptom-Complex of viscera &bowels(臟腑虛證) and Symptoms Checklist-90-Revision should be continued.

• Korean Journal of Psychosomatic Medicine
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• v.5 no.1
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• pp.118-122
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• 1997

We experienced a case of 51-year-old female patient who showed symptoms of persecutory delusion, auditory hallucination and hallucinatory behavior, severe insomnia, psychomotor retardation and social withdrawal, along with some clinical signs of the deficiency of various hormones those gradually progressed after massive postpartum vaginal bleeding 13 years ago. She was admitted to a psychiatric ward under the impression of psychotic depression. However careful history taking and evaluation of clinical feature gave rise to the possibility of underlying medical condition. Laboratory work-up revealed panhypopituitarism, hypoglycemia and hyponatremia. After replacement of thyroid hormone and cortisol for 1 week, her clinical symptoms including psychiatric symptoms were improved. Taken together, these findings were compatible with the diagnosis of Sheehan's syndrome. On reporting this case, we would like to emphasize again the importance of differential diagnosis of medical problems causing psychiatric symptoms those are easily neglected in the clinical approach toward psychiatric patients.