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Review of Sexual Dysfunction in Male Schizophrenics (남자 정신분열병 환자에서 성기능장애에 대한 검토)

  • Choi, Yeong Tae;Cheon, Jin Sook;Oh, Byoung Hoon
    • Korean Journal of Biological Psychiatry
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    • v.7 no.1
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    • pp.85-98
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    • 2000
  • Objective : There are four possible explanations for the sexual dysfunction of schizophrenics. The first is the possibility of a real structural aspect. The second possibility is that sexual function changes secondary to the illness. The third possibility is that there are medical and sociocultural barriers to sexual expression for chronic schizophrenics. The fourth possibility is that sexual dysfunction due to antipsychotic medication. However, we didn't know the precise cause of sexual dysfunction in schizophrenics. Therefore, the purpose of this study was to explore the mechanism of illness itself and antipsychotics on sexual dysfunction in male schizophrenics. Methods : The serum prolactin(PRL), testosterone(TST), and the plasma serotonin(5-HT) concentrations were measured by radioimmunoassay and high performance liquid chromatography method for 100 healthy male schizophrenics according to the DSM-IV. Concomitantly, the severity of psychotic symptoms using Clinical Global Impression(CGI), Brief Psychiatric Rating Scale(BPRS), Positive and Negative Syndrome Scale(PANSS), and the severity of side effects for antipsychotics using Extrapyramidal Side Effects Scale(EPSE), Anticholinergic Side Effects Scale(ACSE), the cognitive function using PANSS-Cognitive Function(PANSS-CF), Mini Mental State Exam-Korean(MMSE-K), and the sexual dysfunction using Sexual Functioning Questionnaire(SFQ), Questionnaire for Sexual Dysfunction in Men were assessed. The PRL, TST, and 5-HT levels of 50 healthy male controls who had no medical, neurological, and psychiatric illnesses were evaluated. The sexual function using SFQ(items FGa, FNa) were also assessed. Furthermore, the correlation with age, education, religion, economic status, age at onset, duration of illnesses, duration of admission, levels of PRL, TST, 5-HT, antipsychotic dosages, potency, benztropine, total duration of medication, EPSE, ACSE, CGI, BPRS, PANSS, PANSS-CF, MMSE-K and sexual dysfunctions were identified in male schizophrenics. Results : 1) The frequencies of sexual dysfunctions for schizophrenics(80%) were significantly(p<0.001) higher than those for controls(42%). The sexual dysfunctions according to sexual response cycle were 'low sexual desire' 76%, 'impairment of achieving erection' 75%, 'impairment of maintaining erection' 75%, 'impairment of obtaining orgasm' 32%, 'impairment in the quality of orgasm' 61%, 'impairment in quantity of ejaculate' 44%, 'premature ejaculation' 15%, and 'delayed ejaculation' 50%. 2) The PRL, 5-HT levels of schizophrenics($28.5{\pm}20.6ng/ml$, $298.5{\pm}89.1ng/ml$) were significantly(p<0.001) higher than those of controls($10{\pm}5.6ng/ml$, $169.2{\pm}37.8ng/ml$), while the TST levels of schizophrenics($4.3{\pm}1.5ng/ml$) and controls($4.5{\pm}1.2ng/ml$) were not significantly different. The sexual dysfunctions of schizophrenics who had abnormal 5-HT levels($4.7{\pm}1.3$ scores) were significantly(p<0.05) higher than those of who had normal 5-HT levels($3.8{\pm}1.6$ scores) on item D7. 3) The sexual dysfunctions of unmarried schizophrenics were significantly(p<0.01 : p<0.05) higher than those of married schizophrenics($6.1{\pm}2.8$ scores, $4.7{\pm}1.3$ scores on item FGa : ${\beta}$=-0.211 on item FNa). The sexual dysfunctions were positively correlated with the rise of 5-HT levels(r=0.209, p<0.05 on item D4 and r=0.241, p<0.05 on item D7), the higher age at onset(r=0.275, p<0.01 on item FNa : r=-0.202, p<0.05 on item FDa), the longer duration of illnesses(r=0.237, p<0.05 on item D6), the longer duration of admission(r=0.234, p<0.05 on item D4 : r=0.328, p<0.05 on item D6), the longer total duration of medication(r=0.237, p<0.05 on item D6). However, age, education, religion, economic status, PRL, TST levels, antipsychotics dosage, potency, benztropine, ACSE, CGI, BPRS, PANSS, PANSS-CF, MMSE-K scores were not correlated with increased sexual dysfunctions. Conclusions : Male schizophrenics have significantly more sexual dysfunction to compare with controls. The higher frequencies of sexual dysfunctions were low sexual desire and erectile disorder. The unmarried, higher age at onset, and longer duration of diseases were positively correlated with increased sexual dysfunctions. Also high 5-HT levels were positively correlated with increased sexual dysfunctions. This means that studies of plasma 5-HT levels, albeit questionable indicators of central 5-HT function, offer some additional support for the association of sexual dysfunction with excess 5-HT activity as primary pathology of schizophrenia. Our findings suggest that excess 5-HT activity seems to affect the patient's sexual function.

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An Exploratory Study on the Effects of Relational Benefits and Brand Identity : mediating effect of brand identity (관계혜택과 브랜드 동일시의 역할에 관한 탐색적 연구: 브랜드 동일시의 매개역할을 중심으로)

  • Bang, Jounghae;Jung, Jiyeon;Lee, Eunhyung;Kang, Hyunmo
    • Asia Marketing Journal
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    • v.12 no.2
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    • pp.155-175
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    • 2010
  • Most of the service industries including finance and telecommunications have become matured and saturated. The competitions have become severe while the differences among brands become smaller. Therefore maintaining good relationships with customers has been critical for the service providers. In case of credit card and debit card, the similar patterns are shown. It is important for them to maintain good relationships with customers, and therefore, they have used marketing program which provides customized services to customers and utilizes the membership programs. Not only do they build and maintain good relationships, but also highlight their brands from the emotional aspects. For example, KB Card or Hyundai Card uses well-known designers' works for their credit card design. As well, they differentiate the designs of credit cards to stress on their brand personalities. BC Card introduced the credit card with perfume that a customer would like. Even though the credit card is small and not shown to public easily, it becomes more important for those companies to touch the customers' feelings with the brand personalities and their images. This is partly because of changes in consumers' lifestyles. Y-generations becomes highly likely to express themselves in many different ways and more emotional than X-generations. For the Y-generations, therefore, even credit cards in the wallet should be personalized and well-designed. In line with it, credit cards with good design can be seen as an example of brand identity, where different design for each customer can be used to recognize the membership groups that customers want to belong. On the other hand, these credit card companies offer the special treatment benefits for those customers who are heavy users for the cards. For example, those customers who love sports will receive some special discounts when they use their credit cards for sports related products. Therefore this study attempted to explore the relationships between relational benefits, brand identification and loyalty. It has been well known that relational benefits and brand identification lead to loyalty independently from many other studies, but there has been few study to review all the three variables all together in a research model. Furthermore, as reviewed above, in the card industry, many companies attempt to associate the brand image with their products to fit their customers' lifestyles while relational benefits are still playing an important role for their business. Therefore in our research model, relational benefits, brand identification, and loyalty are all included. We focus on the mediating effect of brand identification. From the relational benefits perspective, only special treatment benefit and confidence benefit are included. Social benefit is not applicable for this credit card industry because not many cases of face-to-face interaction can be found. From the brand identification perspective, personal brand identity and social brand identity are reviewed and included in the model. Overall, the research model emphasizes that the relationships between relational benefits and loyalty will be mediated by the effect of brand identification. The effects of relational benefits which are confidence benefit and special treatment benefits on loyalty will be realized when they fit to the personal brand identity and social brand identity. In the research model, therefore, the relationships between confidence benefit and social brand identity, and between confidence benefit and personal identity are hypothesized while the effects of special treatment benefit on social brand identity and personal brand identity are hypothesized. Loyalty, then, is hypothesized to have positive relationships with personal brand identity and social brand identity. In addition, confidence benefit among the relational benefits is expected to have a direct, positive relationship with loyalty because confidence benefit has been recognized as a critical factor for good relationships and satisfaction. Data were collected from college students who have been using either credit cards or debit cards. College students were regarded good subjects because they are in Y-generation cohorts and have tendency to express themselves more. Total sample size was two hundred three at the beginning, but after deleting those data with many missing values, one hundred ninety-seven data points were remained and used for the model testing. Measurement items were brought from the previous literatures and modified for this research. To test the reliability, using SPSS 14, chronbach's α was examined and all the values were from .874 to .928 exceeding over .7. Using AMOS 7.0, confirmatory factor analysis was conducted to investigate the measurement model. The measurement model was found good fit with χ2(67)=188.388 (p= .000), GFI=.886, AGFI=.821, CFI=.941, RMSEA=.096. Using AMOS 7.0, structural equation modeling has been used to analyze the research model. Overall, the research model fit were χ2(68)=188.670 (p= .000), GFI=.886, AGFI=,824 CFI=.942, RMSEA=.095 indicating good fit. In details, all the paths hypothesized in the research model were found significant except for the path from social brand identity to loyalty. Personal brand identity leads to loyalty while both confidence benefit and special treatment benefit have a positive relationships with personal and social identities. As well, confidence benefit has a direct positive effect on loyalty. The results indicates the followings. First, personal brand identity plays an important role for credit/debit card usage. Therefore even for the products which are not shown to public easy, design and emotional aspect can be important to fit the customers' lifestyles. Second, confidence benefit and special treatment benefit have a positive effects on personal brand identity. Therefore it will be needed for marketers to associate the special treatment and trust and confidence benefits with personal image, personality and personal identity. Third, this study found again the importance of confidence and trust. However interestingly enough, social brand identity was not found to be significantly related to loyalty. It can be explained that the main sample of this study consists of college students. Those strategies to facilitate social brand identity are focused on high social status groups while college students have not been established their status yet.

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On the Bibliographies of Chinese Historical Books - Classifying and cataloguing system of six historical bibliographies - (중국의 사지서목에 대하여 -육사예문$\cdot$경적지의 분류 및 편목체재 비교를 중심으로-)

  • Kang Soon-Ae
    • Journal of the Korean Society for Library and Information Science
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    • v.24
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    • pp.289-332
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    • 1993
  • In china, six bibliographies of offical historical books are evaluated at the most important things among the systematically-editing bibliographies. These bibliographies would be usful to study the orign of classical sciences and their development, bibliographic research of Chinese classics, bibliographic judgement on genuine books, titles, authors, volumes. They could be refered to research into graving, correcting, and existence of ancient books. therefore, these bibliographies would be applied to estimation the phase of scientific and cultural development. The study of these bibliographies has been not yet made in Korea. This thesis lays its importance on the background of their appearance, their classification norms, organizing system of their catalogue, and comparison between their difference. 1. Editing and compiling of Chilyak (칠약) by Liu Chin (유흠) and official histories played an important role of entering an apperance of historical book's bibliographies. Chilyak has been lost. However, its classification and compiling system of classical books would be traced by Hansoyemunji(한서예문지) of which basic system is similar to Chilyak. It classified books according to their scientific characteristic. If a few books didn't have their own categories, they were combined by the circles parallel to the books' characteristic. With the books classified under the same scientific characteristic, they were again divided into the scientific schools or structures. It also arranged the same kinds of books according to the chronology. The some books wi th duplicate subjects were classified multiplely by their duplicate subject. 2. Ssu-ma Chon's (사마천) The Historical Records (Saki, 사기) and Pan Ku's (반고) The History of the Former Han Dynasty (Hanso, 한서) has also took effects on appearance of historical books' bibliographies. Covering overall history, Saki was structured by the five parts: The basic annals(본기), the chronological tables (표), the documents (서), the hereditary houses (세가), biographies (열전). The basic annals dealt with kings and courts' affairs according to the chronology. The chronological tables was the records of the annals. The documents described overall the social and cultural systems. The hereditary houses recorded courts' meritorious officials and public figures. The biographies showed exemplars of seventy peoples selected by their social status. Pan Ku(반구)'s The History of the Former Han Dynasty(한서) deserved to be called the prototype for the offical histories after Saki's (사기; The Historical Records) apperance. Although it modelled on Saki, it had set up its own cataloguing system. It was organized by four parts; the basic annals (본기), the chronological tables (표), treatises(지), biographies (열전). The documents in the Hanso(한서) was converted into treatises(지). The hereditary houses and biographies were merged. For the first time, the treatise with The Yemunji could operate function for historical bibliographies. 3. There were six historical bibliographies: Hansoyemunji(한서예문지), Susokyongjeokji (수서경적지), Kudangsokyongjeokji(구당서경적지), Shindangsoyemunji (신당서예문지), Songsayemunji (송사예문지), Myongsayemunji (명사예문지). 1) Modelling on Liu Chin's Chilyak except Chipryak(집략), Hansoyemunji divided the characteristic of the books and documents into six parts: Yukrye(육예), Cheja(제자), Shibu(시부), Pyongsoh(병서), Susul(수술), Pangki(방기). Under six parts, there were thirty eight orders in Hansoyemunji. To its own classification, Hansoyemunji applied the Chilyak's theory of classification that the books or documents were managed according to characteristic of sciences, the difference of schools, the organization of sentences. However the overlapped subjects were deleted and unified into one. The books included into an unsuitable subject were corrected and converted into another. The Hansoyemunji consisted of main preface (Taesoh 대서), minor preface (Sosoh 소서) , the general preface (Chongso 총서). It also recorded the introduction of books and documents, the origin of sciences, the outline of subjects, and the establishment of orders. The books classified by the subject had title, author, and volumes. They were rearranged by titles and the chronological publication year. Sometimes author was the first access point to catalogue the books. If it was necessary for the books to take footnotes, detail notes were formed. The Volume number written consecutively to order and subject could clarify the quantity of books. 2) Refering to Classfication System by Seven Norms (칠분법) and Classification System by Four Norms(사분법), Susokyongjeokji(수서경적지) had accomplished the classification by four norms. In fact, its classification largely imitated Wanhyosoh(완효서)'s Chilrok(칠록), Susokyongjeokji's system of classification consisted of four parts-Kyung(경), Sa(사), Cha(자), Chip(칩). The four parts were divided into 40 orders. Its appendix was again divided into two parts, Buddihism and Taiosm. Under the two parts there were fifteen orders. Totally Susokyongjeokji was made of six parts and fifty five orders. In comparison with Hansoyemunji(한서예문지), it clearly showed the conception of Kyung, Sa, Cha, Chip. Especially it deserved to be paid attention that Hansoyemunji laied history off Chunchu(춘추) and removed history to Sabu(사부). However Chabu(사부) put many contrary subjects such as Cheja(제자), Kiye(기예), Sulsu(술수), Sosol(소설) into the same boundary, which committed errors insufficient theoretical basis. Anothor demerit of Susokyongjeokji was that it dealt with Taiosm scriptures and Buddism scriptures at the appendix because they were considered as quasi-religion. Its compilation of bibliographical facts consisted of main preface(Taesoh 대서), minor preface(Sosoh 소서), general preface (Chongsoh 총서), postscript (Husoh 후서). Its bibliological facts mainly focused on the titles. Its recorded authors' birth date and their position. It wrote the lost and existence of books consecutive to total number of books, which revealed total of the lost books in Su Dynasty. 3) Modelling on the basis of Kokumsorok(고분서록) and Naewaekyongrok(내외경록), Kudangsokyongjeokji(구당서경적지) had four parts and fourty five orders. It was estimated as the important role of establishing basic frame of classification by four norms in classification theory's history. However it had also its own limit. Editing and compling orders of Kudangsokyongjeokji had been not progressively changed. Its orders imitated by and large Susokyongjeokji. In Its system of organizing catalogue, with its minor preface and general preface deleting, Kudangsokyongjeokji by titles after orders sometimes broke out confusion because of unclear boundaries between orders. 4) Shindangsoyemunji(신당서예문지), adding 28,469 books to Kudangsokyongjeokji, recorded 82,384 books which were divided by four parts and fourty four orders. In comparison with Kudangkyongjeokj, Sindangsoyemunji corrected unclear order's norm. It merged the analogical norms four orders (for instance, Kohun 고훈 and Sohakryu 소학류) and seperated the different norms four orders (for example, Hyokyong 효경 and Noneuhryu 논어류, Chamwi 참위 and Kyonghaeryu 경해류, Pyonryon 편년 and Wisaryu 위사류). Recording kings' behaviors and speeches (Kikochuryu 기거주류) in the historical parts induced the concept of specfication category. For the first time, part of Chipbu (집부) set up the order of classification norm for historical and literatural books and documents (Munsaryu 문사류). Its editing and compiling had been more simplified than Kudangsokyongjeokji. Introduction was written at first part of bibliographies. Appendants except bibliographic items such subject, author, title, volume number, total were omitted. 5) Songsayemunji(송사예문지) were edited in the basis of combining Puksong(북송) and Namsong(남송), depending on Sabukuksayemunji(사부국사예문지). Generally Songsayemunji had lost a lot of bibliographical facts of many books. They were duplicated and wrongly classified books because it committed an error of the incorrectly annalistic editing. Particularly Namsong showed more open these defaults. Songsayemunji didin't include the books published since the king Youngchong(영종). Its system of classification was more better controlled. Chamwiryu(참위류) in the part of Kyongbu(경부) was omitted. In the part of history(Sabu 사부), recordings of kings' behaviors and speeches more merged in the annals. Historical abstract documents (Sachoryu 사초류) were seperately arranged. In the part of Chabu(자부), Myongdangkyongmaekryu(명당경맥류) and Euisulryu(의술류) were combined. Ohangryu(오행류) were laied off Shikuryu(시구류). In the part of Chipbu(집부), historical and literatural books (Munsaryu 문사류) were independentely arranged. There were the renamed orders; from Wisa(위사) to Paesa(패사), Chapsa (잡사) to Pyolsa(열사), Chapchonki(잡전기) to Chonki(전기), Ryusoh(류서) to Ryusa(류서). Introduction had only main preface. The books of each subject catalogued by title, the volume number, and author and arranged mainly by authors. Annotations were written consecutively after title and the volume number. In the afternote the number of not-treated books were revealed. Difference from Singdangsohyemunji(신당서예문지) were that the concept and boundary of orders became more clearer. It also wrote the number of books consecutive to main subject. 6) Modelling on Chonkyongdangsomok (경당서목), Myongsayemunji(명사예문지) was compiled in the basis of books and documents published in the Ming Danasty. In classification system, Myongsayemunji partly merged and the seperated some orders for it. It also deleted and renamed some of orders. In case of necessity, combining of orders' norm was occured particulary in the part of Sabu(사부) and Chabu(자부). Therefore these merging of orders norm didn't offer sufficient theretical background. For example, such demerits were seen in the case that historical books edited by annals were combined with offical historical ones which were differently compiled and edited from the former. In the part of Chabu(자부), it broke out another confusion that Pubga(법가), Meongga(명가), Mukga(묵가), Chonghweongka's(종횡가) thoughts were classified in the Chapka(잡가). Scriptures of Taiosim and Buddhism were seperated from each other. There were some deleted books such as Mokrokryu(목록류), Paesaryu(패사류) in the part of history (Sabu 사부) and Chosaryu(초사류) in the part of Chipbu(집부). The some in the each orders had been renamed. Imitating compiling system of Songsayemunji(송사예문지), with reffering to its differ-ence, Myongsayemunji(명사예문지) wrote the review and the change of the books by author. The number of not-treated books didn't appear at the total. It also deleted the total following main subject.

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