• Korean Journal of Biological Psychiatry
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• v.15 no.3
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• pp.219-223
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• 2008

Refeeding syndrome is a life-threatening but treatable condition occurring in any patients with starvation. Electrolyte imbalance, especially hypophosphatemia and fluid shift result in metabolic changes in various systems. The authors reported a case of refeeding syndrome associated with prolonged starvation due to delusion and hallucination in a 38-year-old schizophrenia patient. Hypophosphatemia, hypokalemia, edema and elevation of liver enzyme was occurred despite careful treatment. The symptoms were improved after consistent electrolyte supplement. Close observation and repetitive monitoring are important to prevent refeeding syndrome.

• Korean Journal of Social Welfare
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• v.45
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• pp.374-399
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• 2001

Experiences of the subjective burden and its determinants were analyzed in a sample of 110 primary family caregivers of adult schizophrenic patients. The subjects reported varying amount of subjective burden and its mean score was 17.84 that meant considerably high level of subjective burden. Reports of subjective burden were high in the items of 'pity', 'frustration and resentment', 'regret'. The result of factor analysis revealed that subjective burden consisted of four factors such as 'hopelessness', 'frustration and resentment', 'fear', and 'pity and anxiety'. The results about the determining variables of subjective burden indicated that the prognosis of patient, perceived stigma, the number of previous hospitalization, the availability of secondary caregiver, primary caregiver's age, and family income were predictive of primary caregivers' subjective burden. The result examining the multivariate relationship among subjective burden, stressors, social support, family demographic and socioeconomic characteristics revealed that the more important determinants of subjective burden were the prognosis of patient, perceived stigma, and the number of previous hospitalization, Implications for intervention to help with primary caregivers' subjective burden were discussed.

• Journal of Korean Academy of Nursing
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• v.37 no.1
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• pp.26-34
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• 2007

Purpose: This study was aimed at understanding the nature of the suffering of families with patients in mental health nursing homes and hoped to contribute to the rehabilitation process of those with a chronic mental disorder. Method: Research methodology was based upon Parse's human becoming research methodology. Results: a) Despite the despair the family feels by the violence caused by their now-institutionalized relative, they also realize anew the importance of their role as protectors b) Although they fear social stigmatization they also try to be supportive, out of guilt feelings; c) They regret their severe rearing style and wish to be more sympathetic, d) They find courage and hope through family therapy, which leads to a better understanding of the illness, e) With hopes of rehabilitation, the family members feel happy and go through an emotional release, by sharing the pain with each other. Conclusion: Families of nursing home residents share a focus on the process of human-health-universe. This is a positive,'human-becoming' process with which, based on past feelings of despair, fear, resignation, and pain, one can render meaning into his or her experiences in the present in the pursuit of love, conquest, hope, liberty and success.

• 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.26 no.1
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• pp.14-21
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• 2019

Objectives Thyroid hormone deficiency during the neurodevelopmental period can impair brain development and induce psychiatric symptoms. This study examined the association between thyroid dysfunction and the severity of symptoms in schizophrenia patients, and the treatment response of patients with schizophrenia. Methods Three hundred thirty-eight schizophrenia patients, with no prior history of thyroid disease or taking medication associated with it, were studied. We assessed the blood thyroid hormone level, the Brief Psychiatric Rating Scale (BPRS) scores on the day of admission and discharge, admission period, dose of administered antipsychotics, and the number of antipsychotic combinations. The collected data were subsequently analyzed using the Kruskal-Wallis test and Pearson's chi-square test. Results The percentage of schizophrenia patients who presented with abnormal thyroid hormone level was 24.6%. High total triiodothyronine (TT3) (p = 0.003), low TT3 (p = 0.001), and high free thyroxine (fT4) (p < 0.001) groups showed a higher BPRS score on admission than did the normal thyroid hormone group, while thyroid stimulating hormone (TSH) levels were not significantly correlated with the severity of symptoms. Furthermore, thyroid hormone was not associated with the treatment response assessed by the rate of BPRS score reduction, admission days, use of clozapine, and dose of antipsychotics. Conclusions The TT3 and fT4 hormone levels were significantly associated with the severity of symptoms in schizophrenia patients. These relations suggested that thyroid dysfunction may be associated with the severity of schizophrenia. And hence, further analysis of the results of the thyroid function test, which is commonly used in cases of psychiatric admission, is required.

• Journal of Yeungnam Medical Science
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• v.11 no.2
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• pp.338-351
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• 1994

This study was to find out whether there were differences in the levels of depressions between positive and negative schizophrenics. This research was derived from the fact that negative schizophrenics show higher levels of depression than positive schizophrenics. This study also examined the levels of psychomotor dysfunction in positive and negative schizophrenics. For this study, there were 453 subjects. They consisted of 119 positive schizophrenics, 122 negative schizophrenics and 212 normal people. They were asked to complete Zung's Self-Rating Depression Scale(SDS) and to perform one subtest, Digit Symbol of KWIS(Korean Wechsler Intelligence Scale). Subjects' levels of depression were measured by the SDS. the level of psychomotor dysfunction was measured by Digit Symbol subtest of Korean Wechsler Intelligence Scale. ANOV A and Duncan's multiple comparison analysis were used to examine whether there were differences of depression and psychomotor dysfunction among the normal people, positive and negative schizophrenics. The results were as follows: It was found that the depression level was higher in the negative schizophrenic patients than positive schizophrenic patients. Levels of depression were significantly higher in negative schizophrenics than positive schizophrenics. Psychomotor retardation symptom was the most effective variable that discriminates between the normals and the schizophrenics. And it would be concluded that the psychomotor dysfunction was more severe in negative schizophrenics than positive schizophrenics.

• Analytical Science and Technology
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• v.11 no.3
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• pp.161-166
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• 1998

Analytical method of haloperidol (HAL) in serum which has been widely used in therapy of schizophrenic disorders is developed. Gas chromatography/nitrogen-phosphorus detection (GC/NPD) was used for this study. Bromoperidol was used as an internal standard and diethylether as a solvent of three-step extraction. The extraction yield in this procedure was $67.5{\pm}1.9%$ at 15 ng/mL. A good linear response in the range of 1~40 ng/mL was obtained with correlation coefficient of $r^2=0.999$. Detection limit was 0.5 ng/mL when 2 mL of serum was used. This method was applied for the analysis of HAL in serum of schizophrenic patients. After HAL decanoate (HD) was intaken as intramuscular route, HAL levels were determined at second week and forth week. From the result, the concentration of HAL at forth week appeared to 29.6% lower than those at second week. The present method showed low detection limit and high selectivity. Therefore it can be applied for the trace analysis of HAL in serum and the monitoring.

• Korean Journal of Biological Psychiatry
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• v.11 no.1
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• pp.54-60
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• 2004

Objectives:Tardive dyskinesia(TD) is a serious side effect associated with long-term antipsychotic treatments. Some candidate genetic polymorphisms were reported to be associated with TD and possible involvement of serotonergic receptors in the pathophysiology of TD has been suggested. In the present study, we investigated the association between $5-HT_6$ receptor gene polymorphism and TD with schizophrenia. Methods:To investigate the relationship between $5-HT_6$ receptor gene polymorphism and TD, 60 patients with TD were compared with 60 patients without TD. The 267C/T allele of $5-HT_6$ receptor gene was genotyped by means of polymerase chain reaction method. TD was evaluated using the Abnormal Involuntary Movement Scale(AIMS). Results:The patients with the three 267C/T genotype showed no significant differences in age, gender, and duration of illness. No significant difference in genotype frequencies was observed between schizophrenic patients with and without TD. In addition, there was no difference in allele frequencies. Further analysis with an measure of AIMS scores showed that these scores were not significantly influenced by the $5-HT_6$ receptor gene polymorphism. Conclusion:These results suggest that 267C/T polymorphism of $5-HT_6$ receptor gene is not significantly associated with susceptibility to TD in schizophrenia.

• Korean Journal of Biological Psychiatry
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• v.14 no.3
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• pp.167-176
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• 2007

Objectives:A considerable number of pharmacogenetic studies have been performed in recent years to define the association of antipsychotic drug response with dopamine receptor polymorphisms. The purpose of this study was to investigate the relationship between the therapeutic response to antipsychotic drugs and the polymorphisms of the dopamine D2, D3, and D4 receptor genes(DRD2, DRD3 and DRD4, respectively). Methods:We conducted retrospective chart review of 200 consecutively hospitalized patients with the diagnosis of schizophrenia(DSM-IV) who were treated with various antipsychotics(94% atypical antipsychotics) at Bugok National Hospital, Korea. The patients were divided into two groups, responders and non-responders, by responsiveness to antipsychotic drugs according to a four-point scale used in previous studies; responders included moderate to marked responded patients and non-responders included none to minimal responded patients. We analyzed the Ser311Cys polymorphism in the DRD2, the Ser9Gly polymorphism in the DRD3, and the exon III 48 bp repeat polymorphism in the DRD4. Results:Among the total patients of 200, 141(70.5%) were categorized as responders. There were no significant differences in the frequencies of the DRD2, DRD3, and DRD4 alleles and genotypes between responders and non-responders. Conclusion:These results suggest that the Ser311Cys polymorphism in the DRD2, the Ser9Gly polym- orphism in the DRD3, and the exon III 48bp repeat polymorphism in the DRD4 are not associated with the therapeutic response to antipsychotic drugs in Korean schizophrenic patients. A larger prospective study is needed to elucidate the association between antipsychotic response and dopamine receptor gene polymorphism.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.3
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• pp.147-151
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• 2015

The difficult oral healthcare in intellectually disabled patients with poor behavioral control has led to debate over the cost-effectiveness and validity of implant treatment in these patients. The patient in the present report had schizophrenia that had led to poor oral care and severe dental caries in the full mouth. Tooth extraction and a removable prosthesis were planned, but the guardian wanted an implant procedure. Since the guardian showed strong will and cooperation with regard to the patient's oral healthcare, extraction followed by immediate implant placement was performed across two rounds of general anesthesia. Since the outcome appears successful, we present this case report. Immediate implant placement after tooth extraction requires fewer surgeries and rounds of general anesthesia, reduces horizontal bone resorption, and can achieve better esthetic results. Therefore, as long as a certain degree of oral care is possible, this can be a positive option for restoration of a partially edentulous mouth, even in intellectually disabled patients.