• 생물정신의학
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• 제20권4호
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• pp.179-186
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• 2013

Objectives This study is designed to compare the clinical characteristics of patients with early onset schizophrenia to those of adult onset schizophrenia patients in first episode. Methods Authors reviewed medical records of 16 early-onset schizophrenia patients and 22 adult-onset schizophrenia patients who had been admitted in the psychiatric ward and diagnosed as schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders, fourth Edition (DSM-IV) at Eulji University Hospital during 2004-2008. Socio-demographic data and clinical characteristics such as duration between onset and active phase, number of significant positive and negative symptoms, positive and negative symptom scores of Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity (CGI-S) scores, duration from onset to admission, duration of admission, and equivalent dose of antipsychotics were reviewed. These clinical characteristics of early-onset group were compared to those of adult-onset group. Correlation between age of onset and other clinical characteristics was also analyzed. Results Early-onset group showed more insidious onset pattern and had longer duration of hospitalization than adult-onset group. Early onset group also exhibited more negative symptoms, higher negative symptom scores, and higher CGI-S scores than adult-onset group after treatment. However, there were no significant differences in family history of psychosis, positive symptom frequency at discharge and equivalent dose of antipsychotics between two groups. Conclusions This study revealed that patients with early-onset schizophrenia exhibited more insidious onset, more negative symptoms, and more severe symptoms than those with adult-onset schizophrenia after treatment.

• Biomolecules & Therapeutics
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• 제20권1호
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• pp.1-18
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• 2012

Schizophrenia is a devastating psychiatric illness that afflicts 1% of the population worldwide, resulting in substantial impact to patients, their families, and health care delivery systems. For many years, schizophrenia has been felt to be associated with dysregulated dopaminergic neurotransmission as a key feature of the pathophysiology of the illness. Although numerous studies point to dopaminergic abnormalities in schizophrenia, dopamine dysfunction cannot completely account for all of the symptoms seen in schizophrenia, and dopamine-based treatments are often inadequate and can be associated with serious side effects. More recently, converging lines of evidence have suggested that there are abnormalities of glutamate transmission in schizophrenia. Glutamatergic neurotransmission involves numerous molecules that facilitate glutamate release, receptor activation, glutamate reuptake, and other synaptic activities. Evidence for glutamatergic abnormalities in schizophrenia primarily has implicated the NMDA and AMPA subtypes of the glutamate receptor. The expression of these receptors and other molecules associated with glutamate neurotransmission has been systematically studied in the brain in schizophrenia. These studies have generally revealed region- and molecule-specifi c changes in glutamate receptor transcript and protein expression in this illness. Given that glutamatergic neurotransmission has been implicated in the pathophysiology of schizophrenia, recent drug development efforts have targeted the glutamate system. Much effort to date has focused on modulation of the NMDA receptor, although more recently other glutamate receptors and transporters have been the targets of drug development. These efforts have been promising thus far, and ongoing efforts to develop additional drugs that modulate glutamatergic neurotransmission are underway that may hold the potential for novel classes of more effective treatments for this serious psychiatric illness.

• 생물정신의학
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• 제28권2호
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• pp.70-77
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• 2021

Objectives Our study aimed to present the distinctive correlates of formal thought disorder in patients with schizophrenia, using the Clinical Language Disorder Rating Scale (CLANG). Methods We compared clinical characteristics between schizophrenia patients with (n = 84) and without (n = 82) formal thought disorder. Psychometric scales including the CLANG, the Brief Psychiatric Rating Scale (BPRS), the Young Mania Rating Scale (YMRS), the Calgery Depression Scale for Schizophrenia (CDSS) and the Word Fluency Test (WFT) were used. Results After adjusting the effects of age, sex and total scores on the BPRS, YMRS and WFT, the subjects with disorganized speech presented significantly higher score on the abnormal syntax (p = 0.009), lack of semantic association (p = 0.005), discourse failure (p < 0.0001), pragmatics disorder (p = 0.001), dysarthria (p < 0.0001), and paraphasic error (p = 0.005) items than those without formal thought disorder. With defining the mentioned item scores as covariates, binary logistic regression model predicted that discourse failure (adjusted odds ratio [aOR] = 5.88, p < 0.0001) and pragmatics disorder (aOR = 2.17, p = 0.04) were distinctive correlates of formal thought disorder in patients with schizophrenia. Conclusions This study conducted Clinician Rated Dimensions of Psychosis Symptom Severity (CRDPSS) and CLANG scales on 166 hospitalized schizophrenia patients to explore the sub-items of the CLANG scale independently related to formal thought disorders in schizophrenia patients. Discourse failure and pragmatics disorder might be used as the distinctive indexes for formal thought disorder in patients with schizophrenia.

• 대한조현병학회지
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• 제24권1호
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• pp.8-16
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• 2021

Objectives: Although the characteristics of different aggression subtypes provide important information in establishing treatment and prevention strategies in schizophrenia patients, limited information is available about the characteristics of the aggressive subtype in schizophrenia patients in South Korea. The present study was designed to compare the demographic and psychological characteristics across the impulsive and premeditated aggression subtypes in schizophrenia patients in South Korea who had committed a crime. Methods: We enrolled 116 schizophrenia spectrum disorder patients who were admitted to the National Forensic Psychiatric Hospital. Using the criminal and interview records, the study subjects were divided into 83 impulsive and 33 premeditated aggression groups. The subjects' demographic and psychological characteristics were summarized and compared across aggression subtypes. Results: Compared to the premeditated aggression group, the impulsive aggression group had a higher intelligent quotient and a lower rate of physical and sexual abuse experience. Conclusion: To our knowledge, this is the first study to describe the characteristics of aggression subtypes in schizophrenia patients in South Korea who had committed a crime. Our results suggest that different treatment and prevention strategies should be considered for each aggression subtype.

• 대한조현병학회지
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• 제20권2호
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• pp.55-60
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• 2017

Objectives : Severe mental illness is a major risk factor for suicide. This study aimed to identify characteristics of patients who died by suicide among subjects who had been received service from a community mental health center. Methods : We searched individuals who had committed suicide in Gwangju Bukgu Community Mental Health Center since 2006. Sociodemographic and clinical data were gathered from medical records and their case managers and they were compared with those of general members in the center. Characteristics of schizophrenia patients who died by suicide were particularly summarized. Results : Twelve person committed suicide between 2006 and 2016. The characteristics of those who died by suicide were male (67%), diagnosis of schizophrenia (75%), aged below 50 (83%), unemployed (92%), past history of psychiatric hospitalization (100%), recent admission within 3 months (67%), past history of suicidal attempt (78%), family history of schizophrenia (58%), poor adherence to medication (58%), and use of daily rehabilitation program (42%). Ten out of twelve (83%) showed warning sign for suicide. All identified method of suicide in patients with schizophrenia was jumping from high building. Many patients with schizophrenia, who committed suicide, suffered from comorbid depressive symptoms (67%) and auditory hallucination (78%). Conclusion : Case managers should pay attention to and carefully manage individuals who showed suicidal warning, particularly with risk factors for suicide, such as unemployment, admission state or recent discharge from psychiatric hospital, poor adherence to medication, family history of schizophrenia, and a history of suicidal attempt.

• 생물정신의학
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• 제19권4호
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• pp.211-218
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• 2012

Objectives Body image distortion is found in eating disorder and obesity and there are some evidence that schizophrenia is associated with body image distortion. This study sought to find whether schizophrenic patients report more body image distortion than healthy individuals and whether it is related with symptomatology. Methods A total of 88 inpatients with schizophrenia and 88 healthy controls were recruited. Weight, height, and body image accuracy were assessed in all participants, and assessment of mood, psychotic symptom severity and self-esteem, and personal and social performance scale were conducted. Results The patients with schizophrenia had higher Body Mass Index (p < 0. 001) and underestimated their body size more than controls (26.14% vs. 5.13%, p < 0.001). Multiple regression analysis showed that lower depressive symptoms and higher scores of general psychopathology predicted underestimation of body size. Conclusion Weight gain and metabolic syndrome are common adverse events of pharmacological treatment of schizophrenia. Thus, underestimation of body size among patients with schizophrenia may interfere with effort to lose weight or seek weight reduction programs. Clinicians need to consider possible unterestimation of underestimation of body size in patients whose general symptomatology is severe.

• 생물정신의학
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• 제13권1호
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• pp.26-31
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• 2006

Object : To evaluate how the therapeutic factors affect post-discharge course of patients with schizophrenia, we analyzed relationship between each therapeutic factor and outcome of inpatients with schizophrenia in Hanyang University Hospital. Methods : This study is a retrospective report. Subjects were schizophrenic inpatients who were discharged from Hanyang University Hospital from January 1, 2003 through December 31, 2004. We obtained demographic and clinical data from review of inpatient and outpatient charts. Results : We analyzed the records of 104 patients with schizophrenia(44 males and 60 females). Patients who had longer first admission days have fewer number of readmission. There were no significant correlation between psychiatric rehabilitation and course of schizophrenia. Courses, such as duration of outpatient department follow-up and number and duration of rehospitalization, did not differ according to the existence of extrapyramidal symptoms or types of antipsychotics prescribed. Conclusion : Among the therapeutic factors, longer duration of the first admission only affected better post-discharge course of patients with schizophrenia.

• 대한조현병학회지
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• 제24권1호
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• pp.17-25
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• 2021

Objectives: To examine the opinions regarding recovery and assess their will to recover in outpatients with schizophrenia. Methods: Total 98 stable outpatients with schizophrenia were enrolled. To investigate the outpatients' opinions regarding recovery, we asked the subjects to write down the ways they could think they had recovered from their current disease. We classified their answers and chose final 39 statements. Using this questionnaire, they were asked to what extent they agreed with each statement. Moreover, the Recovery Assessment Scale (RAS) was used to measure the subjects' will to recover. Results: Many of the 39 subjects who were surveyed about their opinions on recovery agreed on 11 statements about taking medicine, social life, daily life, social functioning, positivity about life (happiness, hope, confidence, and tranquility), symptoms, occupation, and self-control. The RAS score showed a significant correlation with age (r=-0.26, p<0.01), age at onset (r=0.26, p<0.01), duration of illness (r=-0.52, p<0.01), and number of hospitalization (r=-0.46, p<0.01). Conclusion: This study shows that positivity about life is an important part of the patients' subjective recovery criteria in schizophrenia. Therefore, if clinicians pay more attention to this part of subjective recovery, it would strengthen the patients' will for recovery.

• 한국콘텐츠학회논문지
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• 제22권9호
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• pp.510-519
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• 2022

본 연구는 두 영화 <더 보이스>, <블랙 스완>에서 조현병의 증상 중 대표적으로 망상과 환청을 어떻게 표현하는지 살펴 보고자 한다. 두 영화에서 보여주는 조현병 환자의 외모 및 전반적인 이미지, 조현병 환자의 감정표현 그리고 조현병 환자의 증상에 대해 가족과 동료들이 인식하는 내용을 어떻게 표현하는지 살펴본다. 마지막으로 조현병의 치료대책에 대한 인식 또한 살펴볼 것이다. 종합적으로 이런 과정을 통해 두 영화가 표현하는 조현병 증상이 조현병에 대한 사회적 인식에 어떤 영향을 미치며 조현병 회복을 위한 치료적 개입에 남기는 사회적 함의를 고찰해보고자 한다.

• 신경정신의학
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• 제57권3호
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• pp.235-243
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• 2018

Treatment of schizophrenia has as its ultimate goals, the functional recovery of the patients and improvement of their quality of life. While antipsychotic medication is the fundamental method for treating schizophrenia, it has certain limitations in terms of treating the illness beyond its positive symptoms. Therefore, psychosocial intervention should be used in tandem with pharmacological methods in treating schizophrenia. The efficacy of several modes of psychosocial intervention for improving outcomes in schizophrenia is well attested. Approximately 10 modes of psychosocial intervention have been recommended based on existing evidence, including family intervention, cognitive behavioral therapy, supported employment, early intervention services, lifestyle intervention for physical health enhancement, treatment of comorbid substance abuse, assertive community treatment, cognitive remediation, social skills training, and peer support. Ideally, these interventions are offered to patients in combination with one another. Over the last decade, increased emphasis has been placed on early detection and intervention, with particular focus on long-term recovery. Early intervention with comprehensive psychosocial interventions should be enacted promptly from the initial detection of schizophrenia.