• Title/Summary/Keyword: Treatment response

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Physiological Predictors of Treatment Response to Biofeedback in Patients With Panic Disorder

  • Seongje Cho;In-Young Yoon;Ji Soo Kim;Minji Lee;Hye Youn Park
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.1
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    • pp.19-24
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    • 2023
  • Objectives : Biofeedback is a useful non-pharmacological treatment for panic disorder (PD), but no studies have identified physiological markers related to the treatment response. This study investigated predictors of the treatment response for biofeedback in patients with PD. Methods : A retrospective study based on the electronic medical records of 372 adult patients with PD was performed. Patients received biofeedback treatment at least once, and physiological markers including heart rate, heart rate variability, respiratory rate, skin conductance, skin temperature, and electromyography were collected before the treatment began. The patients were classified as responders or non-responders based on the change in Clinical Global Impression-Severity (CGI-S) score. Results : The response rate to biofeedback treatment was 30.4%. Multivariable logistic regression analysis revealed that a higher CGI-S score at baseline and fewer benzodiazepine prescriptions were associated with a better response to biofeedback treatment. According to subgroup analyses, the baseline CGI-S score, dose of benzodiazepines, and skin conductance are candidate predictors of the response to biofeedback treatment in men, while only baseline disease severity was associated with the treatment response in women. Conclusions : The present results suggest that skin conductance may be target marker and predictor for biofeedback in male patients with PD.

The Association between the Dopamine $D_5$ Receptor Genotype and Treatment Response for Korean Schizophrenic Patients (정신분열병 환자의 도파민 $D_5$ 수용체 유전자형과 치료반응과의 연관)

  • Kang, Sung Min;Lee, Min Soo;Rhee, Choong Soon
    • Korean Journal of Biological Psychiatry
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    • v.7 no.2
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    • pp.159-163
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    • 2000
  • Background : Dopamine receptors are strong candidates for involvement in schizophrenia and are target of a wide variety of antipsychotics. Dopamine $D_5$ receptor(DRD5) gene polymorphisms may be associated with various treatment response. The purpose of our study was define to what significance can be held as a predictor of treatment response in this polymorphism. Method : The total number of 116 Korean chronic schizophrenic patients was assessed after 48 weeks treatment. The Positive and Negative Syndrome Scale(PANSS) was rated for the clinical response to various antipsychotics. With the use of polymerase chain reaction amplification, we assessed this dopamine $D_5$ receptor polymorphism in schizophrenic patients who had been treated with antipsychotics, and related genotype with treatment response, to test the hypothesis that DRD5 polymorphism may lead to varying response to antipsychotics. Result : DRD5 polymorphism was not associated with treatment response to a variety of antipsychotics in chronic schizophrenic patients. Conclusion : Genetic variation of $D_5$ receptors do not predict treatment response to antispychotics.

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Hypothesis Proposal about Predictive Factors and Optimal Age for Response to Herbal Medicine Treatment for Height Gain in Children: a Retrospective Review

  • Leem, Jungtae;Kim, Jeeyeun;Suh, Kyeungsuk;Lim, Youngkwern;Lee, Junhee
    • The Journal of Korean Medicine
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    • v.39 no.4
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    • pp.16-29
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    • 2018
  • Introduction: We aimed to investigate the predictive factors and optimal age for response to herbal medicine treatment for height gain in children. Methods: This retrospective chart review included 61 children (age range, 5-16 years) treated for height gain between 2011 and 2015. A predictive model was established by multiple linear regression analysis. Dependent variables were defined by the differences in percentile before and after herbal medicine treatment. The optimal cutoff value of patient age was determined by receiver operating curve analysis. Results : The age of initiation of herbal medicine therapy (p = 0.012) and administration of Forsythiae fructus (p = 0.002) were significant variables for treatment response. The adjusted R2 value was 0.231. The mean ages of the responder and non-responder groups were significantly different (p = 0.023). The optimal cutoff value of age for predicting treatment response was 9.75 years. Treatment response was better among children below 9.75 years of age. Conclusions: Patient age and administration of Forsythiae fructus were identified as determinants of response to herbal medicine treatment. Treatment of rhinitis and initiation of height gain treatment at an early age are critical for better response. These findings will provide fundamental data for further research.

Effect of Delayed Clozapine Initiation on Acute Treatment Response in Treatment-Resistant Schizophrenia (클로자핀의 지연된 사용이 치료저항성 조현병 환자의 급성기 약물 반응에 미치는 영향)

  • Yang, So Yung;Choi, Jung-Kyu;Park, Sunyoung;Park, Jaesub
    • Korean Journal of Schizophrenia Research
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    • v.24 no.2
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    • pp.52-59
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    • 2021
  • Objectives: Recent studies have reported that delayed initiation of clozapine can affect clinical response in patients with treatment-resistant schizophrenia (TRS). This study aimed to explore the relationship between delayed initiation of clozapine and acute treatment response. Methods: Sixty-five inpatients with TRS who started clozapine for the first time were included through a retrospective chart review. Acute treatment response was defined as a 30% reduction in the Positive and Negative Syndrome Scale score or a Clinical Global Impression of Improvement score of 1 (very much improved) or 2 (much improved) at 4 weeks after initiating clozapine. Results: After meeting the TRS criteria, the mean delay for initiating clozapine was approximately 13.8 months. The delay was shorter in patients who showed a better response to clozapine in logistic regression analysis (p=0.037). Conclusion: Our findings suggest that reducing the delay in initiating clozapine increases the effectiveness of clozapine in patients with TRS.

Long-Term Treatment Response to Lithium and Valproate in Patients with Bipolar 1 Disorder Treated More Than 2 Years : A Retrospective Study (1형 양극성 장애 환자에서 리튬과 발프로산의 장기간 치료 효과에 대한 후향적 평가 : 2년 이상 치료받은 환자의 효과 비교)

  • Ahn, Sung Woo;Yang, So-Yung;Choi, Yujin;Hong, Kyung Sue
    • Korean Journal of Biological Psychiatry
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    • v.23 no.4
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    • pp.185-192
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    • 2016
  • Objectives Treatment response of bipolar disorders (BDs) to long-term mood stabilizers maintenance has not been well explored because of complicated clinical and treatment courses. This study aims at investigating long-term clinical response of BDs to lithium and/or valproate in a naturalistic setting of a tertiary-care university-affiliated hospital. Methods Subjects were 65 patients with bipolar I (BD-I) disorders who had been treated with lithium and/or valproate for more than two years at single bipolar disorder clinic. Long-term response to the best treatment based on treatment algorithms and the current clinical standard of care was retrospectively evaluated using the Alda Scale and the Clinical Global Impression Scale for use in bi-polar illness (CGI-BP). Patients were classified into full responder and partial/non responder groups based on the total score of the Alda Scale with the cut-off score generated from the frequentist mixture analysis of the authors' previous study. Results The mean duration of treatment with the index medication was 69.2 months. Baseline demographic and clinical characteristics were not different among three mood stabilizer groups (valproate, lithium, and combination groups). Twenty-one subjects were classified into full responder group (32.3%). Treatment response assessed by the Alda Scale and CGI-BP scores was not different between lithium and valproate groups. The Alda Scale scores were well correlated with the CGI-BP scores (p < 0.05). Conclusions One third of the patients showed a full response to the long-term lithium and/or valproate treatment in BD-I. The degree of response was similar between lithium and valproate groups.

Clinical Course of Infliximab Treatment in Korean Pediatric Ulcerative Colitis Patients: A Single Center Experience

  • Kim, Jong Min;Lee, Yoo Min;Kang, Ben;Choe, Yon Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.1
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    • pp.31-36
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    • 2014
  • Purpose: Infliximab (IFX) is considered safe and effective for the treatment of ulcerative colitis (UC) in both adults and children. The aim of this study was to evaluate the short- and long-term clinical course of IFX in Korean children with UC. Methods: Pediatric patients with UC who had received IFX infusions between November 2007 and May 2013 at Samsung Medical Center were retrospectively investigated. The clinical efficacy of IFX treatment was evaluated at 8 weeks (short term) and 54 weeks (long term) after the initiation of IFX treatment using the Pediatric Ulcerative Colitis Activity Index (PUCAI). The degree of response to IFX treatment was defined as complete response (PUCAI score=0), partial response (decrement of PUCAI score${\geq}20$ points), and non-response (decrement of PUCAI score <20 points). Adverse events associated with IFX treatment were also investigated. Results: Eleven pediatric patients with moderate to severe UC had received IFX. The remission rate after IFX treatment was 46% (5/11) and 82% (9/11) at 8 weeks and 54 weeks after IFX treatment, respectively. All patients who were steroid-dependent before treatment with IFX achieved remission at 54 weeks and were able to stop treatment with corticosteroids, while all steroid-refractory patients failed to achieve remission at 54 weeks after treatment with IFX. Conclusion: Response to IFX treatment after 8 weeks may predict a favorable long-term response to IFX treatment in Korean pediatric UC patients.

R347C Polymorphisms in ADRA1A Genes and Mirtazapine Treatment Response in Koreans with Major Depression

  • Koo, Jahyun;Lee, Min-Soo;Ham, Byungju;Won, Eun-Soo
    • Korean Journal of Biological Psychiatry
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    • v.22 no.4
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    • pp.179-186
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    • 2015
  • Objectives Adrenergic alpha 1 and 2 receptors work as pathways to control the serotonergic neuron moderation and mirtazapine acts as antagonist of these receptors. The adrenoreceptor alpha 1a (ADRA1A) gene, which encodes adrenergic alpha 1 receptor, has Arg-347Cys genetic polymorphism and the polymorphism has strong relationship with many neuro-psychiatric diseases. In this study, we explored the relationship between ADRA1A R347C polymorphism and mirtazapine treatment response in Koreans with major depression. Methods 352 patients enrolled in this study, and the symptoms were evaluated by 17-item Hamilton Depression Rating (HAMD-17) scale. After 1, 2, 4, 8, and 12 weeks of mirtazapine treatment, the association between ADRA1A R347C polymorphism and remission/response outcomes was evaluated. Results Treatment response to mirtazapine was significantly better in T allele carriers than C allele homozygotes after 12 weeks of mirtazapine monotherapy. The percentile decline of HAMD-17 score in T allele carriers was larger than that of C allele homozygotes. ADRA1A R347C genotypes were not significantly associated with remission. Conclusions The result showed that treatment response to mirtazapine was significantly associated with ADRA1A R347C genetic polymorphism. T allele carriers showed better treatment response than C allele homozygotes. It can be supposed that T allele carriers have a trend of better treatment response to mirtazapine monotherapy.

Delayed treatment-free response after romiplostim discontinuation in pediatric chronic immune thrombocytopenia

  • Lim, Hyun Ji;Lim, Young Tae;Hah, Jeong Ok;Lee, Jae Min
    • Journal of Yeungnam Medical Science
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    • v.38 no.2
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    • pp.165-168
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    • 2021
  • We report the case of a 16-month-old patient with chronic immune thrombocytopenia (ITP) patient who experienced delayed treatment-free response (TFR) after romiplostim treatment. He received intravenous immunoglobulin every month to maintain a platelet count above 20,000/µL for 2 years. Thereafter, he received rituximab and cyclosporine as second-line therapy, with no response, followed by romiplostim. After 4 weeks of treatment, the platelet count was maintained above 50,000/µL. Following 7 months of treatment, he discontinued romiplostim, and the platelet count decreased. His platelet counts remained above 50,000/µL, without any bleeding symptoms, 2 years after romiplostim discontinuation. This is the first report of TFR after romiplostim treatment in pediatric chronic ITP.

Analysis of related factors for dental treatment of fear and distrust of dentists (치과치료 공포감 및 치과의사 불신감의 관련요인 분석)

  • Choi, Sung-Suk
    • Journal of Korean society of Dental Hygiene
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    • v.12 no.6
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    • pp.1148-1157
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    • 2012
  • Objectives : The purpose of this study is to analyze factors impacting dental treatment of fear and distrust of dentists. The subjects of this study consists of 720 middle & high school students in Daegu area. Methods : The data were collected from June 1, 2009 to September 30, 2009 by self-administrative questionnaires. The data received was analyzed using the descriptive statistic, t-test, ANOVA, and multiple linear regression analysis with level of significance as p<0.05 stimulus response factors in oral health education, often highly-experienced, and distrust of the dentists of factors the lower stimulus response factors are highly. Results : A female dental treatment of fear and distrust of dentists showed higher than male. Showed higher dental treatment of fear and the higher distrust of dentist. Showde the treatment-avoidance factors the higher patient of negligence factors and distrust of dentists factors are highly statistically significant. Showed the stimulus response factors in oral health education, often highly-experienced, and distrust of the dentists of factors the lower stimulus response factors are highly. Showed the similar results physiological arousal factors and the stimulus response factors. Conclusions : The results suggest that oral health status of improve adolescent before treatment of patients identify biological characteristics and personality can decrease dental treatment of fear and distrust of dentist.

Association of Therapeutic Response and Change of Mismatch Negativity in Schizophrenia Patients (조현병 환자의 치료 반응에 따른 Mismatch Negativity 변화)

  • Lee, Soyoen;Rhie, Eui Hyeok;Kim, Jong Woo;Kang, Won Sub
    • Korean Journal of Biological Psychiatry
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    • v.24 no.4
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    • pp.188-195
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    • 2017
  • Objectives Schizophrenia is characterized by disturbances in perception and cognition. Attenuated mismatch negativity (MMN) reflects central auditory dysfunction in schizophrenia. The aim of this study is to compare MMN changes before and after treatment in schizophrenia patients and to assess their association with treatment response. Methods Twenty-three schizophrenia patients underwent an oddball paradigm. MMN was calculated by the difference waveforms of the event-related potentials (ERPs) elicited by subtracting standard from deviant stimulus. The clinical symptoms were measured by the Positive and Negative Syndrome Scale (PANSS), the Psychotic Symptom Rating Scale (PSYRATS). Follow-up evaluation was conducted when the PANSS total score decreased by 30% or more (treatment response group) or before discharge (non-response group). Results The treatment response group showed significantly larger MMN amplitude improvement and latency reduction than the non-response group after treatment (Fz ; mean amplitude p = 0.035, FCz ; p = 0.041). The auditory hallucination group showed shorter latency than that of the group without hallucinations. Additionally, auditory hallucination was associated with prolonged MMN latency and shortened after treatment in the auditory hallucination response group (Fz ; p = 0.048). Conclusions These results suggest that the attenuated MMN amplitude reflects the progression of the disease. The increment of MMN amplitude and shortening of latency after treatment may reflect cognitive functional recovery of central auditory sensory processing.