• Korean Journal of Biological Psychiatry
• /
• v.3 no.1
• /
• pp.37-45
• /
• 1996

Recent studies on long-term outcome of schizophrenia revealed that schizophrenic symptoms recover in more than 50%, while it remains severe in less than 20% after 20 years or more from the onset. Psychopharmacological studies indicate that 75% of remitted schizophrenics may recur within 2 years after discontinuation of maintenance pharmacotherapy. In addition, family studies revealed that schizophrenic decompensation may occur significantly more frequent in discharged patients with high expressed emotion family than in low expressed emotion family. These findings strongly support a clinical validity of stress-vulnerability concept of schizophrenia which open a new viewpoint to two central problems in schizophrenia treatment, i.e. psychotic relapses and chronification of the fist episode schizophrenia. Moreover, recent psychopathological studies argue that schizophrenic symptoms are manifestations of psychological reaction secondary to a primary cognitive impairment(neurobiological vulnerability), which is originated in neurobiological changes in the brain. Recent approaches to the vulnerability to schizophrenic symptoms or schizophrenic decompensation are reviewed.

• Proceedings of the Korean Society for Emotion and Sensibility Conference
• /
• 1999.11a
• /
• pp.356-361
• /
• 1999

본 연구에서는 정신분열증 환자들이 인식하는 타인의 얼굴표정에 관한 정보를 정상집단과 비교해보았다. 정신분열증환자 30명과 정상인 31명을 대상으로 얼굴 계인 검사와 28개의 얼굴표정에 대한 명명과제를 실시하였다. 연구 결과, 얼굴표정에 대한 명명에서 정신분열증 환자집단은 정상집단에 비해 얼굴표정을 명명하는 일치율이 낮았고 흐뭇함과 두려움을 표현하는 표정을 인식하는데 어려움을 나타냈다. 또한, 28개의 얼굴표정들 중, 정신분열증 환자들은 7개의 표정(흐뭇함 3, 두려움 2, 경멸 1, 나른한 1)을 정상집단과 다른 정서로 명명하였다. 연구 결과를 통해, 정신분열증 환자들은 타인의 얼굴정서를 인식하는데 정상인들과 차이를 나타낸다는 것을 알 수 있었으며 이러한 결과를 토대로 정신분열증 환자들의 타인의 정서인식능력의 결핍에 대해서 논의하였다.

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

• Korean Journal of Biological Psychiatry
• /
• v.2 no.1
• /
• pp.57-62
• /
• 1995

Objects : Clozapine, prototype of the atypical neuroleptics, was known to have unique antipsychotic effect with a few extrapyramidal effects. While most typical antipsychotic agents mainly block $D_2$ receptors, clozapine has higher affinity for dopamine $D_4$ receptor than for $D_2$ receptor. Many researchers have tried to find out the relationship between schizophrenia and the abnormality of the genes coding dopamine receptors. But no consistent findings were reported. Recently, dopamine $D_4$ receptor was fully sequenced, and the alleles of dopamine $D_4$ receptor gene was found in unusual form on the 48th base pair. Our study was performed to identify the distribution of the dopamine $D_4$ receptor alleles of schizophrenics and normal controls, and whether any difference between the dopamine $D_4$ receptor alleles of schizophrenics and that of normal controls exists. Methods : DNA was extracted from the blood of schizophrenic patients(N=60) and normal controls(N=60). Part of the dopamine $D_4$ receptor gene was amplified by PCR, and amplified DNA was electrophoresed. Authors compared the distribution of the alleles of dopamine $D_4$ receptor gene of normal controls and that of schizophrenic patients. Results : Six kinds of alleles of $D_4$ receptor were observed both groups. The fourth repeat form of alleles was the most common in both schizophrenic patients(75.8%) and normal controls(70.3%), so there was not significant difference between two groups. Conclusion : The Difference in the distribution of the dopamine $D_4$ receptor gene alleles is not thought to be responsible for the pathophysiology of the schizophrenia. However, the difference in the expression of the dopamine $D_4$ receptor gene between normal and schizophrenia is left to be scrutinized.

• Korean Journal of Biological Psychiatry
• /
• v.1 no.1
• /
• pp.109-116
• /
• 1994

It is not known whether negative symptoms and cognitive functions are dissociable or improvements in symptoms are reflected in improvements in cognitive functions in chronic schizophrenic patients. We administered clozapine to evaluate its effect on cognitive functions in chronic schizophrenic patients and to show correlations between improvement in psychotic symptoms and in cognitive functions. Neuropsychological tests such as Wisconsin Card Sorting Test, Digit Span test and Judgment of Line Orientation Test were applied to 16 chronic schizophrenic patients at baseline and after 9 months of treatment with clozapine. Using BPRS we assessed psychopathology before initiation of clozapine and at 9 months. Clozapine improved both positive and negative symptoms in chronic schizophrenic patients significantly. After nine months of clozapine treatment, significant improvements occurred in attention, short-term memory and visual perception ability. And interestingly we noted the trend of improvement in executive functions even though they were not statistical significant. Any significant correlations between the clinical improvement and change in congnitive functions were not observed. Long-term treatment with clozapine improved parts of cognitive functions of chronic schizophrenics. The results of the study suggest that deficits in simple cognitive functions as well as psychotic symptoms are improved after 3 month period of short-term treatment, but executive functions requiring more sophisticated processing of information could be improved after more than 9 months of long-term treatment.

• Korean Journal of Biological Psychiatry
• /
• v.7 no.2
• /
• pp.140-146
• /
• 2000

P450 CYP2D6 enzyme(=debrisoquine hydroxylase) is known to metabolize many neuroleptics and some genetic polymorphisms in the CYP2D6 gene were reported to be associated with tardive dyskinesia(TD). We investigeted the association of two genetic polymorphisms in the CYP2D6 gene, $CYP2D6^*4$ and $CYP2D6^*10$, with TD in Korean schizophrenic subjects. Subjects consisted of 71 Korean schizophrenics and TD was evaluated using the Abnormal Involuntary Movement Scale (AIMS). There were no statistically significant differences in the demographic variables of age, male to female percentage and the current antipsychotic(CPZ equivalent) dose between the group with TD and the group without TD. But the duration of antipsychotic drug exposure was significantly higher in the group without TD(p=0.000, by independent t-test). The mean AIMS score in the group with TD was $11.2{\pm}6.6$(S.D.). Genotypings for the presence of $CYP2D6^*4$ and $CYP2D6^*10$ were done using PCR amplifications and endonuclease digestions. There were no statistically significant genotypic and alleleic associations between TD and $CYP2D6^*4$(by chisquare tests), and between TD and $CYP2D6^*10$(by chi-square tests). These results indicate that the $CYP2D6^*4$ and $CYP2D6^*10$ polymorphisms have no significant roles in the causation of TD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.9 no.1
• /
• pp.34-46
• /
• 1998

This study was designed to develop the scale of paternal parenting attitudes which has become an area of interest in child fostering study recently. Considering various factors extracted from previous Korean and foreign studies, the authors constructed a questionnaire composed of total 57 questions. It was applied to 126 mothers from families with no psychiatric patient in Seoul and Pusan who had at least onechild older than age 12 by random sampling. Then the authors extracted the factors which were able to compose the scale and evaluated the concurrent reliability. Also the authors selected mothers of 47 schizophrenic patients and 29 bipolar I patients diagnosed with the criteria of DSM-IV who have treated in Seoul National Mental Hospital and 46 controls which consisted of randomly selected mothers from normal families for the discriminative validity test. The results were as follows. The authors extracted 5 subscales of active participation, democratic guidance, warmth, hostility, devotion for education and Cronbach’s ${\alpha}$ value of each subscale which shows its internal consistency was .82, .78, .65, .78, .61 respectively. In the discriminative validity test, all subscales except ‘devotion for education’ subscale significantly discriminated between fathers of schizophrenics and control group. Furthermore ‘active participation’ subscale and ‘warmth’ subscale showed significant difference between fathers of control group and resting both father group of schizophrenics and biopolar I patients.

• Sleep Medicine and Psychophysiology
• /
• v.5 no.2
• /
• pp.185-193
• /
• 1998

Objectives : The hypothesis that the brain is a nonlinear dynamical system exhibiting deterministic chaos has offered new perspectives to the investigation of information processing in the brain of schizophrenic patients. It seemed worthwhile to estimate nonlinear measures of the electroencephalogram (EEG) in positive and negative schizophrenics, because nonlinear measures might serve as indicators of the specific brain function in schizophrenia according to specific psychopathologies. Method : Previous studies which estimated the chaoticity in the brain of schizophrenia with nonlinear methods recorded the EEGs at limited electrodes, so we tried to record EEGs from 16 channels for nonlinear analysis in 8 positive and 9 negative schizophrenics and 8 healthy control subjects. We employed a new method to calculate the nonlinear invariant measures. For limited noisy data, this algorithm was strikingly faster and more accurate than previous ones. Results : Our results showed that the patients with negative schizophrenia had lower the first positive Lyapunov exponents ($L_1$) than the positive schizophrnics and control subjects at $T_3$ lead. Positive symptoms were positively correlated with $L_1$ in $C_3,\;O_1$ leads, and negatively correlated with $C_4$ lead. Conclusion : These results suggest that if clinical variables such as psychopathology or neuroleptic medications would be well controlled, the nonlinear analysis of the EEGs in patients with schizophrenia seems to be a useful tool in analyzing EEG data to explore the neurodynamics.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.10 no.2
• /
• pp.178-185
• /
• 1999

Objective：This study was designed to examine the validity of the Ego Impairment Index(EII) in adolescent psychiatric patients(depression, depressive-conduct disorder, schizophrenia), and to explore the validity of the depressive-conduct disorder as a diagnostic entity. Method：19 depressives, 13 depressive-conduct disordered, and 10 schizophrenics with the age from 12 to 18 were selected based on DSM-IV and ICD-10 criteria, and their responses of the Rorschach and MMPI were analyzed. The EII was empirically developed by Perry and Viglione(1991) in order to assess the degree of ego impairment, and was derived from the Rorschach test. Results：It was founded that a single factor, ego impairment, was derived from the principal component analysis and explained 57.18% of total variances. The degree of ego impairment was grater in schizophrenics than in the other two groups, but there were no difference between depressives and depressive-conducts. Conclusions：These results offered support for the use EII as an empirical means of assessing the degree of ego impairment in adolescent patients. And these results suggest that depressive-conduct disorder group is more similar to the depressive group, implying that depressive-conduct disorder might correspond to so called masked depression. The clinical implication and limitation of present study were discussed.

• Korean Journal of Biological Psychiatry
• /
• v.10 no.2
• /
• pp.116-120
• /
• 2003

Objectives:Although polymorphisms of apolipoprotein E have been investigated in many neuropsychiatric disorders, results were controversial and even contradictory. The purpose of this study was to investigate the genotypes of apolipoprotein E in schizophrenia and healthy controls, and to compare them in two groups in terms of distribution of apolipoprotein E genotype and allele. Method:Using polymerase chain reaction and amplified refractory mutation system, apolipoprotein E genotypes were identified in 77 schizophrenics and 115 healthy control persons. Results:The results were as follows 1) When genotypes of apolipoprotein E were classified into ${\varepsilon}2/2$, ${\varepsilon}2/3$, ${\varepsilon}2/4$, ${\varepsilon}3/3$, ${\varepsilon}3/4$, ${\varepsilon}4/4$ according to phenotypes, there were no statistical differences in genotypes between two groups 2) In terms of allele frequency, there were also no statistical differences between two groups Conclusion:These results suggest that genotypes and alleles of apolipoprotein E seem to be unrelated to the pathogenesis of schizophrenia.