• 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.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.2
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• pp.217-226
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• 2016

Objectives : To investigate changes in, and predictors of, metabolic syndrome(MetS) status over a 5-year period in chronic schizophrenic patients and to identify factors associated with the prevention of or recovery from MetS. Methods : In total, 107 patients, all of whom provided written informed consent, were followed from 2011 to 2016 at Naju National Hospital for this study. MetS was defined according to the revised National Cholesterol Education Program-Adult Treatment Panel III guidelines. Results : During follow-up period, 22(20.5%) patients were newly diagnosed to MetS, 14(13.1%) were disappeared, 77(66.4%) were not changed[MetS : 34(31.8%), No MetS 37(34.6%)]. Common significant factors in the two changed groups were triglyceride and waist circumference, not dose and type of antipsychotic medication. Multiple logistic regression analysis revealed that female gender(odds ratio[OR]=2.846, 95% confidence interval[CI] : 1.020-7.942), attending two or more outpatient visits per month(OR=3.155, 95% CI : 1.188-8.379) and taking antidepressant medication(OR=3.991, 95% CI : 1.048-15.205) were significantly associated with MetS after controlling for other confounding variables. Type and dose of antipsychotic medication were not significantly associated with MetS. Conclusions : Triglyceride and waist circumference were important manageable indicator of MetS. Adoption of a healthy lifestyle is more important than adjusting the dose or type of antipsychotic medication in the treatment of chronic schizophrenia patients with MetS.

• Korean Journal of Biological Psychiatry
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• v.19 no.4
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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.

• Journal of Korean Academy of Nursing
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• v.46 no.4
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• pp.583-597
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• 2016

Purpose: The study was done to evaluate the effects a Stress Management Program (SMP) on stress, problem solving skills, and quality of life for hospitalized patients with Schizophrenia. Methods: A mixed method design was used: a combination of a repeated-measure design with a non-equivalent control group and qualitative data collection. The participants were 40 patients with schizophrenia admitted in three psychiatric hospitals. The experimental group (n=20) received the SMP twice a week for a total of 8 weeks. Results: Study results revealed that the SMP was effective for stress (F=321.02, p<.001), problem solving ability (F=246.28, p<.001), and quality of life (F=63.35, p<.001) for hospitalized persons with schizophrenia. Conclusion: The results suggest that a SMP can be an effective strategy to reduce patients' hospitalization stress, and improve problem solving skills and quality of life. Therefore, it is recommended that mental health nurses use this stress management program in clinical practice to assist adaptation to hospitalization for persons with schizophrenia.

• Korean Journal of Biological Psychiatry
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• v.11 no.2
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• pp.94-103
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• 2004

Objective:There have been a kind of transmethylation theory that high homocysteine serum concentration affects schizophrenia by neurotoxic mechanism and clinical reports that some schizophrenic patients with high homocysteine were improved by high folate ingestion. This study was done to confirm previous research results and find the clinical characteristics of schizophrenia showing high serum homocysteine and low folate. Method:We compared the serum levels of homocysteine, folate and vitamin B12 level between 234 schizophrenic patients(male 99, female 135) group and 234 normal controls(male 99, female 135) group. The subjects of two groups were age and sex matched. The evaluated clinical characteristics items were sex, age, onset of disease, hereditary loading, disease course, hallucination and subtype of schizophrenia. Results:1) Homocysteine level of the schizophrenia group was significantly higher than the normal control group and folate level of the schizophrenia group was significantly lower than the normal control group. Homocysteine level was more negatively correlated with folate level in the schizophrenia group than the normal control group. 2) The percentage of high homocysteine(above 12.46umol/L;90 percentile of normal control) was 33.8% of schizophrenia patients and 51.5% of male schizophrenia. The percentage of low folate(below 3.8nM/L;bottom tertile of normal control) was 66.2% of schizophrenia. 3) In low folate group and not-low folate group, schizophrenia showed significantly higher homocysteine level than normal control. Especially, low folate schizophrenia group showed significantly higher homocysteine level than low folate normal control group. Conclusions:Some schizophrenia patients with high serum homocysteine may be genetic defector and having low folate serum level. In that case, folate ingestion could be a good management for clinical improvement.

• Sleep Medicine and Psychophysiology
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• v.11 no.1
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• pp.44-49
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• 2004

Objectives: The purpose of this study was to investigate whether longitudinal changes in positive and negative symptoms affect cognitive functioning in chronic schizophrenia. Methods: Sixty-eight patients diagnosed with DSM-IV schizophrenia were examined on two occasions over 6 months for symptoms and cognitive changes. Symptoms were measured by PANSS. Cognitive functions were examined for sustained attention, executive function, concentration and attention, and verbal memory and learning using Degraded Stimulus Continuous Performance Test, Wisconsin Card Sorting Test, Digit Span, and Rey Auditory Verbal Learning Test, respectively. Twenty control subjects were assessed to compare the cognitive scores of remitted schizophrenic patients. Results: Patients showed significant improvement in symptoms and all cognitive tests after 6 months treatments. Significant improvements in positive and negative symptoms did not predict improvements in any aspect of cognitive functioning measured. Normal controls performed significantly better than remitted schizophrenic patients on all cognitive tests. The results show no relationship between change in symptoms and change in cognition in chronic schizophrenia. Conclusion: We suggest that symptomatic and cognitive impairment may be a distinct construct. These findings highlight the importance of treating cognitive impairment in addition to the clinical symptoms of schizophrenia.

• Korean Journal of Biological Psychiatry
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• v.15 no.2
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• pp.83-91
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• 2008

Objectives : Neurological soft signs have been regarded as endophenotypes associated with the genetic basis of schizophrenia. This study was to investigate the intra-familial correlations of the neurological soft signs according to their genetic loading. Methods : Schizophrenic patients(N=14) were included, who had one parent with a family history of schizophrenia and the other without it. Genetic loading was determined by the patient's family history of schizophrenia using the Family Interview for Genetic Studies(FIGS). These parents were subdivided into two groups. The first group was designated as 'presumed carriers'(N=9) of genetic loading, who had one or more schizophreic firstor second-degree relatives. The second group was designated as 'presumed non-carriers'(N=11) of genetic loading, who had no schizophrenic first- or second-degree relatives. Normal controls(N=12) consisted of people without schizophrenic relatives. NSS were evaluated using the Neurological Evaluation Scale-Korean Version (NES-K), and the intra-familial correlations of NSS were tested using the Intra-Class Coefficients(ICC) method. Results : The scores of Motor Coordination subdimension of NES-K were significantly correlated between the patients and their presumed carriers(ICC=.804, p=.016), but not significantly correlated between the patients and their presumed noncarriers. In other subdimensions of NES-K, no significant correlation were found between the patients and their parents regardless of the genetic loading. But, there were no statistically significant differences in the scores of Motor Coordination subdimension of NES-K between the patients and controls. Conclusion : This study did not prove that the neurological soft signs might be an endophenotype of schizophrenia that cosegregate with the genetic loading. The future study using more subjects than this would be needed.

• Korean Journal of Biological Psychiatry
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• v.7 no.2
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• pp.152-158
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• 2000

Background : No association between schizophrenia and dopamine D4 receptor polymorphisms have been reported. Despite these results, it is premature to exclude the association. It has been suggested that the susceptibility to develop schizophrenia could result from variation at a number loci which may interact or coact with each other. Therefore, we investigated a possible association of combinations of exon III 48bp polymorphism[D4E3] and exon I 12bp polymorphism of the DRD4 gene [D4E1] with schizophrenia. Methods : 207 unrelated Korean schizophrenic patients and 191 healthy controls were recruited. DRD4 genotype was established using the polymerase chain reaction. Statistical analysis consisted of ${\chi}^2$ tests for Hardy-Weinberg proportions and genotypic and allelic frequencies in the patients and control groups. Results : There were no statistically significant differences in the each polymorphisms between schizophrenics and controls. And all genotype frequencies were within Hardy-Weinberg expectations. When the combinations of the polymorphism in schizophrenia and controls were compared, however, there were significant differences at $A1A2^*2/4$ in the distributions of the combinations of D4E1 and D4E3(p<0.01). Conclusions : These findings suggest that the certain combination of D4E1 and D4E3($A1A2^*2/4$) has the protective role to a susceptibility for schizophrenia.

• Korean Journal of Psychosomatic Medicine
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• v.5 no.2
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• pp.143-150
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• 1997

This study was performed to evaluate the characteristics of smoking behavior and the effects of smoking on clinical symptoms and level of serum prolactin in schizophrenic patients. Methods : 76 male schizophrenic patients answered the questionnaire about the characteristics of smoking patterns. And patients were assessed by brief psychiatric rating scale(BPRS), positive and negative syndrome scle(PANSS), Hamilton rating scale for depression(HAM-D), assessment for involuntary movement scale(AIMS) and symptom checklist 90 R(SCL-90-R). Serum prolactin levels were measured by enzymeimmunoassay. Results: 1) The frequences of drinking coffee were significantly higher in smokers. The reasons for smoking were to relieve tension, to avoid boredom, due to habit and to do with friends. 80.1% of smokers tried quitting, but smoking was relapsed due to craving and withdrawal symptoms. 2) No significant difference was seen in mean neuropeltic doses, scores of PANSS and AIMS. But as for BPRS, scores of anxiety/depression subscale were significanly lower in smokers. Scores of HAM-D and scores of interpersonal sensitivity and phobia among SCL-90-R were significantly lower. 3) Levels of serum prolactin were significanlty lower in smokers. Conclusion : These findings suggest that in schisophrenia smoking relieves anxiety and depression subjectively But decreased prolactin levels may suggest that the possibility of increased dopamine in CNS.

• 대한임상약리학회:학술대회논문집
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• 2001.12a
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• pp.42-43
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• 2001