• Korean Journal of Biological Psychiatry
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• v.25 no.2
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• pp.38-43
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• 2018

Objectives Dopamine dysregulation has been regarded as one of the core pathologies in patients with schizophrenia. Since dopamine synthesis capacity has found to be inconsistent in patients with schizophrenia, current classification of patients based on clinical symptoms cannot reflect the neurochemical heterogeneity of the disease. Here we performed new subtyping of patients with first-episode psychosis (FEP) through biotype-based cluster analysis. We specifically suggested basal ganglia structural changes as a biotype, which deeply involves in the dopaminergic circuit. Methods Forty FEP and 40 demographically matched healthy participants underwent 3T T1 MRI. Whole brain parcellation was conducted, and volumes of total 6 regions of basal ganglia have been extracted as features for cluster analysis. We used K-means clustering, and external validation was conducted with Positive and Negative Syndrome Scale (PANSS). Results K-means clustering divided 40 FEP subjects into 2 clusters. Cluster 1 (n = 25) showed substantial volume decrease in 4 regions of basal ganglia compared to Cluster 2 (n = 15). Cluster 1 showed higher positive scales of PANSS compared with Cluster 2 (F = 2.333, p = 0.025). Compared to healthy controls, Cluster 1 showed smaller volumes in 4 regions, whereas Cluster 2 showed larger volumes in 3 regions. Conclusions Two subgroups have been found by cluster analysis, which showed a distinct difference in volume patterns of basal ganglia structures and positive symptom severity. The result possibly reflects the neurobiological heterogeneity of schizophrenia. Thus, the current study supports the importance of paradigm shift toward biotype-based diagnosis, instead of phenotype, for future precision psychiatry.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.18 no.1
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• pp.49-57
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• 2007

Objectives : The research is designed in order to know how much Traumatic Symptom Checklist fur Children(TSCC) is effective in the case of child abuses, especially in the estimation of the psychopathology of child sexual abuse. Methods : A sample includes a group of thirty children of 4th, 5th and 6th grade whose sexual abuse have confirmed and also a group of thirty four normal kids who have no abuse. Along with TSCC, Children's Depression Inventory (CDI) and Revised Children's Manifest Anxiety Scale (RCMAS) were used to children and child behavior checklist (K-CBCL), sexual behaviors (CSBI), and Kiddie-Schedule for Affective Disorder and Schizophrenia-Present and Lifetime version (K-SADS-PL) record sheets were used to kids' parents. Results : In case of the sexual abuse group, the most meaningful difference from the analyzed result is shown at sexual concerns scale which is one of the clinical scale in TSCC (p<.01). Also, the sexual abuse group has the meaningful higher score than the general group's one in the stress scale after the other anxiety, depression, anger and dissociation (p<.01). Conclusion : The scale of TSCC has relatively shown the characteristic symptom and severity which were gained from the children who have experienced trauma, especially sexual abuse.

• The Journal of Korean Academic Society of Nursing Education
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• v.15 no.2
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• pp.285-292
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• 2009

Purpose: This study was to examine the effect of a web-based education program for schizophrenic patients in order to identify symptoms, facilitate medication and prevent recurrence. Method: The design of this study was a quasi experimental research with nonequivalent control group, pretest-posttest design. The subjects of this study were inpatients in the psychiatric day hospitals in Busan; 14 schizophrenic patients for the web-based education group (Exp.I); 14 schizophrenic patients for the web-based education with face -to- face education (Exp.II); and 16 schizophrenic patients for the face -to- face education as control group (Con. G). The data were collected from November 5th 2007 to January 28th 2008 and were analyzed with $\chi^2$-test, ANOVA, ANCOVA and Bonferroni test in SPSS Win 11.0. Results: After receiving education, each with different methods, the Exp.I group attained the highest learning achievement in the knowledge of medication and symptom management. In addition, the Exp.I group and Exp.II group attained the lower scores in the relapse warning symptoms than the control group. There were significant differences among the three groups. Conclusions: A web-based learning program for medication and symptom management education is an effective rehabilitation program that reduces the relapse rate of schizophrenic patients.

• Korean Journal of Psychosomatic Medicine
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• v.5 no.1
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• pp.31-42
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• 1997

This study was aimed to investigate dysfunctional attitudes, stress coping strategies and depressive symptoms in psychiatric patients. The subjects of this study consisted of 210 patients(138 schizophrenic patients, 29 depression patients, 43 alcohol dependence patients) according to DSM-IV criteria. Futhermore, the instruments were K-BDI(Beck Depression Inventory-Korean version), DAS(Dysfunctional Attitude Scale) and multidimensional coping strategy scale. The results were the following. 1) There were statistically significant correlations between depressive symptoms and dysfunctional attitudes in psychiatric patients. 2) In terms of coping strategies, there were positive correlations between depressive symptoms and focus on and venting emotions, accommodation, active forgetting, self-criticism, positive comparison, fatalism, passive withdrawal. Whereas, there was significant negative correlation between depressive symptom and active coping. 3) In terms of coping strategies, there were significant correlations between dysfunctional attitudes and focus on and venting emotions, active forgetting, self-criticism, positive comparison, fatalism, passive withdrawal. 4) Depression groups reported significantly higher BDI scores than schizophrenia groups. 5) In depression groups, DAS scores were significantly higher than those in schizophrenia groups. 6) In terms of coping strategies according to diagnosis, there were significant differences in venting emotions, active forgetting and self-criticism. As for venting emotions, alcoholic groups were scored significantly higher than schizophrenic groups. As for active forgetting, depression groups were scored significantly higher than schizophrenic groups. In self-criticism, depression groups and alcohol dependence groups reported significantly higher scores than schizophrenic groups.

• Korean Journal of Biological Psychiatry
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• v.14 no.3
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• pp.184-193
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• 2007

Objectives:There is increasing evidence that the cerebellum plays an important role in cognition and psychiatric symptoms as well as motor coordination. The concept of cognitive dysmetria has been making cerebellar function in schizophrenia the focus of current studies. In other words, disruption in the corticocerebellum-thalamic -cortical circuit could lead to disordered cognition and clinical symptoms of schizophrenia. The purposes of this study were to determine cerebellar dysfunction in male schizophrenic patients semiquantitatively with ICARS and to investigate the clinical and cognitive correlates of ICARS in patients. Methods:We compared the scores of cerebellar neurologic sign using ICARS in 47 male patients with a DSM-IV-TR diagnosis of schizophrenia with 30 gender and age-matched healthy control subjects. The semiquantitative 100-point ICARS consists of 19 items divided into 4 unequally weighted subscores:posture and gait disturbances, kinetic functions, speech disorders and oculomotor disorders. All subjects were also assessed with cognitive function test. Cognitive functions were evaluated by Korean-Mini Mental Status Examination (K-MMSE), Verbal fluency test, and Clock drawing test. The patients were administered Korea version of Positive and Negative Symptom Scale(K-PANSS) to assess the symptom severity. Results:Schizophrenic patients had significantly higher scores on the ICARS than control subjects with posture and gait disturbances, kinetic functions, and oculomotor disorders. They also showed more significant impairments in cognitive function tests than control subjects. There was a significant correlation between ICARS and negative symptoms of patients. In cognitive function test, Clock drawing test was significantly associated with negative symptoms. In addition, Clock drawing test was negatively correlated with the total score of ICARS. Conclusion:In this study, we confirmed that schizophrenic patients have significant impairments in cognitive and cerebellar function, and that those were related with negative symptoms of schizophrenic patients. These results support a role of the cerebellum in schizophrenia. It is meaningful that we used a structured, and reliable procedure for rating neurological soft signs, ICARS. We hope that future prospective studies using a similar design help that rate of neurological sign should have been visible with the progression of illness.

• Korean Journal of Biological Psychiatry
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• v.6 no.2
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• pp.189-192
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• 1999

The genetically determined CYP2D6 activity may be considered to be associated with antipsychotic induced extrapyramidal side effects with interindividual variation. Genetic polymorphism of CYP2D6 was determined by polymerase chain reaction(PCR) and MspI restriction fragment length polymorphisms(RFLP) for 194 schizophrenics. Subjects with a 334bp band were classified a1a1, those with 229bp and 105bp bands a2a2, and those with all three bands a1-a2. We did not identify schizophrenic subject with poor metabolizer. 194 schizophrenic patients previously treated neuroleptic medication, were assessed by Extrapyramidal Symptom Rating Scale(ESRS).The cases were composed of 33 akathisia, 47 parkinsonism, 21 tardive dyskinesia. These results are similar to the previous understanding that the poor metabolizer is very rare in Orientals compared to Caucasians, therefore, it considered that CYP2D6 genotypes have maybe no association with schizophrenia and extrapyramidal side effects in Koreans.

• Journal of the Korea Computer Graphics Society
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• v.24 no.4
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• pp.1-9
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• 2018

We propose an emotional training framework that can determine the initial symptom of schizophrenia by using emotional analysis method through facial expression change. We use Emotion API in Microsoft to obtain facial expressions and emotion values at the present time. We analyzed these values and recognized subtle facial expressions that change with time. The emotion states were classified according to the peak analysis-based variance method in order to measure the emotions appearing in facial expressions according to time. The proposed method analyzes the lack of emotional recognition and expressive ability by using characteristics that are different from the emotional state changes classified according to the six basic emotions proposed by Ekman. As a result, the analyzed values are integrated into the image color transfer framework so that users can easily recognize and train their own emotional changes.

• Korean Journal of Biological Psychiatry
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• v.5 no.1
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• pp.122-128
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• 1998

Objective : This study was a open clinical trial aimed at exploring the effectiveness of combined treatment with estrogen and antipsychotics to the chronic female schizophrenics. Method : 40 female patients who met DSM-VI criteria for schizophrenia who were chronically ill were randomly assigned to estrogen group(EG) and control group(CG). EG patients were received estrogen 1.25mg for 8weeks in addition to their routine antipsychotic regimens. CG patients were received their routine antipsychotic regimens only. Both groups were evaluated by PANSS(Postive and Negative Syndrome Scale), CGI(Clinical Global Impression) at 0, 4, 8 week during the trial period and compaired with each other. Results : 40 female patients have completed the study during 8weeks. EG was significantly improved in PANSS and CGI scores than CG during the 8weeks. In EG patients, all symptom subtypes(positive symptoms, negative symptoms, general psychopathology symptoms) of PANSS were significantly improved and positive symptoms were most significantly improved at 8week. Conclusions : This results support the clinical value of combined estrogen therapy among chronic female schizophrenics.

• Korean Journal of Biological Psychiatry
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• v.17 no.3
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• pp.127-135
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• 2010

Objectives : This study was conducted to compare between hallucination group and delusion group in patient with schizophrenia, using Brain $^{99m}Tc$-ECD PECT. Methods : Among 16 patients with less than 3 schizophrenic episodes, 8 patients whose initial symptom was hallucination were assigned to the hallucination group, and other 8 patients with initial sumptom of delusion were assinged to the hallucination group. All of the patients clinically evaluated using the PANSS and BPRS. Both groups of patients and 8 healthy subjects underwent $^{99m}Tc$-ECD PECT. Results : Score of thinking disturbance subscale of BPRS were significantly lower in the hallucination group than the delusion group. In SPECT analysis, the hallucination group showed significantly increased perfusion in some areas of the right temporal lobe, bilateral limbic lobes and left parietal lobe compared to delusion group. Both group had a reduced rCBF in some areas of the frontal lobe. Conclusion : The hallucniation group, compared with the delusion group, showed significantly increased regional cerebral blood flow in some regions. Therefore, this data suggests that different neural substrates may affect the process of auditory hallucination and delusion.

• Korean Journal of Biological Psychiatry
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• v.6 no.1
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• pp.111-118
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• 1999

Objectives : There have been several evidences that the central nervous system defect is one of the etiologic factors in schizophrenia and high nailfold plexus visibility can reflect these defects indirectly. These are particularly related to the negative symptoms of schizophrenia. In this study, we examined the relationship between nailfold plexus visibility and various clinical variables in schizophrenia. Methods : Forty patients(20 males, 20 females) satisfying the DSM-lV criteria for schizophrenia and forty normal controls(20 males, 20 females) were measured for Plexus Visualization Score (PVS) by using capillary microscopic examination. We used Positive and Negative Syndrome Scale(PANSS), Ulmann-Giovannoni Process-Reactive Questi-onnaire(PRQ), Phillips Premorbid Adjustment Scale(PAS), Continuous Performance Test, and Backward Masking for psychopathology and clinical variables. Results : There was no significant relationship between schizophrenic subjects and normal controls in PVS. PVS was correlated with PANSS positively except negative symptom subscore. PVS was correlated with PRQ score negatively, and with PAS score positively. Conclusions : This study shows high PVS are associated with more severe psychotic symptoms and with clinical variables, such as disease process and premorbid adjustment, in some schizophrenics.