• Korean Journal of Psychosomatic Medicine
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• v.8 no.1
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• pp.122-140
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• 2000

Somatization disorder is a chronic condition characterized by multiple somatic complaints that are not due to any apparent organic illness. Somatization disorder is related historically to hysteria and hysteria has been defined by the existence of somatic complaints for which no organic reason can be found. Therefore most theories of somatization have focused on the psychodynamic and sociological perspectives. However, the concept that the somatic presentation of emotional distress or psychiatric illness might have a neurobiological basis has also aroused considerable interest. Relative to this perspective, the case of Anna O. which has been considered the prototype of hysteria, was reformulated from a neuropsychological perspective. Several neurophysiological and neuropsychological studies, studies concerning hemispheric differences in symptom presentation of the patients with hysteria have been shown the evidences for the biological basis of somatization. Moreover, recent neuroimaging studies in somatization disorder also show that brain dysfunction in somatization. The author reviewed several candidate theories which could help to explain the process of somatization in the perspective of biological basis and proposed the new neuropsychological model of somatization. The author also examined the possible application of this model to the treatment of somatization disorder and discussed it's limitation and the future directions in this field.

• Korean Journal of Biological Psychiatry
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• v.3 no.1
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• pp.57-65
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• 1996

The Evaluation of patients complaining of psychiatric symptoms following head injury is much affected by the results of various tests. The objecive of this paper is to investigate the effectiveness of each lest by comparing the structual and fuctional brain studies. The subjects were 93 organic menial disorder in and out patients at the Dept. of Neuropsychiatry of the Kyung Hee University Hospital. After carrying out MRI, CT, SPECT, EEG, the results of each were analysed for the sesitivity and ability to detect focal lesion. The degree of inter-test correlations of lest results were also investigated. Furthermore, the characteristic features of psychological tests were studied and the relationship between each of above mentioned tests and psychological test was examined. As for the test sensitivity to diagnosis, the SPECT was the most superior followed by MRI, CT, EEG in thai order. In the case of abnormality, SPECT ranked 1st in detection of focal lesion, followed by MRI, CT in that order. In the inter-test result correlation, the correlation of SPECT-MRI was statistically significant. When mare than moderate abnormality EEG finding was reported, it correlated significantly with that of MRI findings. In the MMPI, the average scores on F, Hs, D, Hy, Pa, Pt, Sc subscales were above 60. Abnormal SPECT group scored significantly high on the F, Pd, Pa, Sc, Ma scales and therefore in comparison ot the SPECT normal group, displayed more psychotic features. In K-WAIS, the mean full scale IQ was down to 77. 23(Verbal IQ : 78.76, Performance IQ : 77.44) but there was no characterogic significant relationship between the lowered to and abnormal SPECT, MRI, CT and EEG results. In conclusion, 1) The SPECT was mast superior in sensitivity and detection of focal lesions. In comparision with other tests, the results of SPECT correlated well with MRI had thus is thought to be very usefull testing method in the evaluation of organic mental disorder patients. 2) The MRI had relatively high sensitivity, ability to detect focal lesion and superior correlation with other test. 3) Although EEG fared less an sensitivity in comparison to other tests, the results of above moderate abnormal grade group and that of MRI correlated significantly. 4) In the MMPI highly scored in F, Hs, D, Hy, Pa, Pt, Sc subscales and abnormal SPECT patients were shown to display more sever psychotic features. There was no significant character relationship between the lowered IQ(in K-WAIS) and abnormal findings on MRI, CT, SPECT, EEG.

• Korean Journal of Biological Psychiatry
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• v.2 no.2
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• pp.281-286
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• 1995

Objects : Manic phase of bipolar disorder is treated with a combination of mood stabilizer and antipsychotic drug, especially in the acute phase. Such combined treatment is often required for the clinical management of manic symptoms until therapeutic effects of mood stabilizer become evident. The present study was the first open trial to evaluate the efficacy of risperidone, and safety of the combination of mood stabilizer and risperidone in the treatment of acute manic patients. Method : This study was performed as an open clinical study. The subjects of this study were 42 patients who had been admitted with first manifestations or acute exacerbations of illness were selected, using DSM-III-R criteria for bipolar disorder, manic episode. Patients were rated using the the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI), Extrapyramidal Symptom Rating Scale(ESRS). Other adverse events were assessed by a symptom checklist and by observation by medical personnel. Vital signs were monitored in a standard way and electrocardiography, routine laboratory analysis were performed. Results : Thirty patients(67%) completed the 12-week trial period. The CGI showed a good therapeutic effect with a minimal incidence or severity of side effects. The majority of patients showed a continuos reduction in their BPRS scores. The extrapyramidal symptoms assessed on ESRS generally showed mild to moderate degree. laboratory porameters showed no significant changes during the course of treatment. Conclusion : The results of the study showed a good efficacy of the risperidone in manic patients and further controlled studies are warranted.

• Korean Journal of Biological Psychiatry
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• v.12 no.2
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• pp.207-215
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• 2005

Objectives:This study was to compare verbal memory ability among patients with schizophrenia, bipolar manic patients and unipolar depressive patients, and to understand their charicteristics of memory process. Methods:All subjects were hospitalized patients and had been interviewed by using the Structured Clinical Interview for DSM-IV(SCID). Schizophrenic patients(N=40), bipolar manic patients(N=17), and unipolar depressive patients(N=20) were assessed with K-AVLT for verbal memory and with K-WAIS for verbal IQ. Three groups were compared regarding total immediate recall, delayed recall, delayed recognition, learning curve, memory retention, and retrieval efficiency under controlled verbal IQ. Multiple regression analysis was performed to find which clinical factors have an influence on verbal memory ability. Results:In MANCOVA, differences of verbal memory test scores among the groups were statistically significant(F=1.800, p<.05). In post hoc analysis, Patients with schizophrenia and bipolar mania showed poorer performance in immediate recall, delayed recall, delayed recognition, retrieval efficiency than unipolar depres- sive patients. And schizophrenics performed poorly in delayed recall, delayed recognition, retrieval efficiency than nonpsychotic affective disorder group, but no difference in total immediate recall, delayed recall, delayed recognition, retrieval efficiency between the schizophrenic group and the psychotic affective group. Conclusions:These results partially confirm previous reports of verbal memory ability among major psychiatric disorders. Our results showed that psychotic symptoms were related with verbal memory, and longer duration of illness was related with poorer performance in schizophrenia and unipolar depression.

• Anxiety and mood
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• v.13 no.2
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• pp.141-147
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• 2017

Objective : This study aimed to evaluate the relationship between comorbid obsessive compulsive disorder (OCD) and quality of life in stable patients with schizophrenia. Methods : We interviewed 162 symptom-stable inpatients who have been on a constant dose of antipsychotics for at least 3 months prior and diagnosed as chronic schizophrenia. Subsequently, patients were classified according to the existence of OCD as evaluated using the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). Further, all clinical and demographic data were collected and evaluated. To investigate potential interrelationships, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Korea-Positive and Negative Symptom Scale (K-PANSS), Korean Modification of the Scale to Measure Subjective Well-Being under Neuroleptic Treatment (KmSWN) and Korean Version Quality of Life Scale (K-QOLS) were performed. Independent t-test and Chi-square test were used to compare groups and regression analysis was done to assess the relationship between the Y-BOCS and quality of life. Results : Schizophrenia patients with OCD showed significantly earlier onset of schizophrenia, more severe psychiatric symptoms and lower quality of life, compared to those without comorbid OCD. OCD might be associated with lower quality of life in schizophrenia. Conclusion : Schizophrenia patients with OCD showed lower quality of life than those without OCD. In the treatment for schizophrenia, evaluation of OCD might be needed to improve their quality of life and social function.

• Sleep Medicine and Psychophysiology
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• v.12 no.2
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• pp.144-147
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• 2005

Objective: The authors would like to find the relationship between zolpidem and nocturnal eating episodes in diverse psychiatric patients. Method: We evaluated case series of 6 patients who showed nocturnal eating episodes after takine zolpidem. Results: We have experienced 6 cases who showed nocturnal eating behavior after taking zolpidem. They included 3 patients with schizoprenia, a patient with major depressive disorder, a patient with PTSD and a patient with bipolra I disorder. With reducing or discontiuation of zolpidem, their nocturanl eating resolved. Conclusion: This finding strongly suggests the relationship between zolpidem and the nocturnal eating episode. Physicians should be aware that zolpidem might induce nocturnal eating behaviors.

• Sleep Medicine and Psychophysiology
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• v.3 no.2
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• pp.65-76
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• 1996

Natural sleep pattern and its physiology in childhood are much different from those in adulthood. Several aspects of clinical evaluation for sleepiness in childhood are more difficult than in adulthood. These difficulties are due to several factors. First, excessive sleepiness in childhood do not always develop functional impairments. Second, objective test such as MSLT may not be reliable since it is hard to be certain that the child understand instructions. Third, sleepiness in children is often obscured by irritability. paradoxical hyperactivity, or behavioral disturbances. Anseguently, careful clinical evaluation is needed for the sleepy children. Usual causes of sleepiness in children are the disorders that induce insufficient sleep such as sleep apnea syndrome, schedule disorder, underlying medical and psychiatric disorder, and so forth. After excluding such factors, we can diagnose the hypersomnic disorders such as narcolepsy, Kleine-Levin syndrome, and idiopathic central nervous system hypersomnia. Among the variety of those causes of sleepiness, I reviewed the clinical difference of narcolepsy and obstructive sleep apnea syndrome in childhood compared with in adulthood. Recognition of the childhood narcolepsy is difficult because even severely sleepy children often do not develop pathognomic cataplexy and associated REM phenomena until much later. Since childhood narcolepsy give srise to many psychological, academical problem. Practicers should be concerned about these aspects. Childhood obstructive sleep apnea syndrome is different from adult obstructive sleep apnea syndrome too. Several aspects such as pathophysiology. clinical feature, diagnostic criteria, complication, management, and prognosis differ from those in the adult syndrome. An important feature of childhood obstructive sleep apnea syndrome is the variety of severe complications such as behavioral disorders, cognitive impairment, cardiovascular symptoms, developmental delay, and ever death. Fortunately, surgical interventions like adenotosillectomy or UPPP are more effective for Childhood OSA than adult form. CPAP is a "safe, effective, and well-tolerated" treatment modality too. So if early detection and proper management of childhood OSA were done, the severe complication would be prevented or ever cured.

• Anxiety and mood
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• v.16 no.1
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• pp.32-40
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• 2020

Objective : The purpose of this study was to investigate the cognitive performance of major depressive disorder (MDD) in military service/conscription personnel who visited the psychiatric clinic for a medical certificate to consider the situation from the perspective of Korea's unique compulsory military system. We used the Korean Wechsler Adult Intelligence Scale-IV (K-WAIS-IV) as the test for verifying the suitable level of cognitive functioning for military service and as the embedded measure with reflecting suboptimal effort. Methods : The study was conducted on 56 (28 males, age 19-34) in/out-patients admitted to the psychiatry department and diagnosed with MDD (DSM-IV). All participants completed a structured clinical interview (MINI-Plus), as well as self-report questionnaires related to demographics and severity of clinical symptoms. K-WAIS-IV was administered to each subject to assess cognitive characteristics. Results : Military group showed significantly lower processing speed index (PSI) score including subtests of symbol search (SS) and coding (CD) score, compared to the control group. There was no other significant differences in the Full Scale IQ (FSIQ), Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI) scores including sub-tests comprised of the above indices, and Reliable Digit Span (RDS), Enhanced-RDS-Revised (E-RDS-R) between the study and control groups. Conclusion : This study was the first effort to verify the characteristics of Korea's military group with MDD and suggest the applicability of PSI and processing speed of K-WAIS-IV as an embedded performance index to test sub-optimal effort or low motivation beyond the purpose of testing cognitive deficits.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.3
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• pp.217-225
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• 2015

Objectives : The objective of this study was to compare the Korean Personality Rating Scale for Children (K-PRC) profile between children with attention-deficit hyperactivity disorder (ADHD) and typically developing children. We also aimed to investigate the association of K-PRC and ADHD symptoms. Methods : Ninety-nine youth (age $8.3{\pm}2.4$ years, 72 boys) with ADHD and 84 controls (age $9.2{\pm}2.5$ years, 43 boys) were recruited from the Department of Pediatric Psychiatry of the Asan Medical Center Children's Hospital. Diagnoses of ADHD and comorbid psychiatric disorders were confirmed with the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). The parents of the subjects completed the ADHD rating scale, and K-PRC. Independent t-tests, analysis of covariance, partial correlation analyses, and Mc Nemar test were used for analysis. Results : Children and adolescents with ADHD showed higher K-PRC scores in verbal development, physical development, depression, delinquency, hyperactivity, family dysfunction and psychoticism. Delinquency and hyperactivity were significantly correlated with parent-rated ADHD rating scales and ADHD scores on K-SADS-PL. The hyperactive/impulsive and combined subtypes showed higher scores on hyperactivity and delinquency than the inattentive subtype, and the inattentive subtype showed higher scores on depression and social dysfunction of the K-PRC. Conclusion : Our results suggest that K-PRC could be used to comprehensively evaluate symptoms, combined psychopathologies, developmental delay and family dysfunction of children with ADHD.

• Molecules and Cells
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• v.40 no.7
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• pp.450-456
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• 2017

Mammalian physiology and behavior are regulated by an internal time-keeping system, referred to as circadian rhythm. The circadian timing system has a hierarchical organization composed of the master clock in the suprachiasmatic nucleus (SCN) and local clocks in extra-SCN brain regions and peripheral organs. The circadian clock molecular mechanism involves a network of transcription-translation feedback loops. In addition to the clinical association between circadian rhythm disruption and mood disorders, recent studies have suggested a molecular link between mood regulation and circadian rhythm. Specifically, genetic deletion of the circadian nuclear receptor Rev-$erb{\alpha}$ induces mania-like behavior caused by increased midbrain dopaminergic (DAergic) tone at dusk. The association between circadian rhythm and emotion-related behaviors can be applied to pathological conditions, including neurodegenerative diseases. In Parkinson's disease (PD), DAergic neurons in the substantia nigra pars compacta progressively degenerate leading to motor dysfunction. Patients with PD also exhibit non-motor symptoms, including sleep disorder and neuropsychiatric disorders. Thus, it is important to understand the mechanisms that link the molecular circadian clock and brain machinery in the regulation of emotional behaviors and related midbrain DAergic neuronal circuits in healthy and pathological states. This review summarizes the current literature regarding the association between circadian rhythm and mood regulation from a chronobiological perspective, and may provide insight into therapeutic approaches to target psychiatric symptoms in neurodegenerative diseases involving circadian rhythm dysfunction.