Validity and Reliability of the Korean Version of the Hamilton Depression Rating Scale(K-HDRS) / 신경정신의학

OBJECTIVES: The reliability and validity of the Korean version of Hamilton Depression Rating Scale (K-HDRS) were examined in Korean patients depressive symptoms. METHODS: 33 inpatients and 70 outpatients diagnosed as major depressive disorder or depressive episode of bipolar I disorder according to the DSM-IV criteria were assessed with K-HDRS, Clinical Global Impression score(CGI), Beck Depression Inventory (BDI) and Montgomery-Aberg Depression Rating Scale (MADRS). RESULTS: Internal consistency (Cronhach's alpha coefficeint=0.76) and interrater reliability (r=0.94, p<0.001) were statistically significant. Principal axis factoring analysis revealed 4 factors that accounted for 50.4% of the total variance. The correlations of K-HDRS with CGI, BDI and MADRS were 0.84, 0.54, 0.58 respectively. CONCLUSION: These results showed that the K-HDRS could be a reliable and valid tool for the assessment of depressive Korean patients. The K-HDRS will be a useful tool for assessing depressive symptoms in Korea.

Interaction between Estrogen Receptor 1 and the Epsilon 4 Allele of Apolipoprotein E in Korean Schizophrenic Patients / 신경정신의학

OBJECTIVES: Recent studies indicated that estrogen receptor 1 subtype(ESR1) genetic polymorphisms may affect the expression of ESR1, and are associated with Alzheimer's disease. This study was designed to investigate the interaction between ESR1 polymorphism and the epsilon4 allele of apolipoprotein E(ApoE) in Korean schizophrenic patients. METHODS: We studied 46 schizophrenic patients and 40 healthy controls. The ESR1 & ApoE polymorphisms were assessed by PCR-restriction fragment length polymorphism(RFLP) or reverse hybridization. RESULTS: The distribution of the genotype in schizophrenic patients with XX, Xx, xx, PP, Pp, pp were 7(15.2%), 20(43.5%), 19(41.3%), 10(21.7%), 19(41.3%), 17(37%), and the controls were 1(2.5%), 12(30%), 27(67.5%), 7(17.5%), 21(52.5%), and 12(30%). No significant differences for genotype distribution were revealed between controls and schizophrenic patients except Xba I genotype. The genotype frequency of schizophrenia with xx of ESR1 and epsilon4 of ApoE were 58.7%, 6.5% and that of the controls were 58.7%, and 15%, respectively. The ESR1 genotypes and ApoE were not associated with onset age, psychiatric symptoms, familial history, subtype(positive vs negative) of schizophrenic cases. In kappa-square, there is no significant difference between the two groups, and we are with an assum the interaction between the homogenous ESR1 xx genotype and the ApoE epsilon4 allele was not ob-served in schizophrenic patients. CONCLUSION: The ESR1 gene may not appears to interact with the ApoE epsilon4 genotype in determining schizophrenia susceptibility. There was no significant association between schizophrenia and ESR1 & ApoE gene polymorphism. But, Xba I genotype may be closer to schizophrenia than Pvu II genotype.

Depression in Schizophrenia / 신경정신의학

OBJECTIVE: The heterogeneity of symptomatology within the group of schizophrenias is still a major obstacle for defining clinically useful subgroups of these disorders. One of these symptoms is depression. Recently there is a growing evidence suggesting that depressive symptoms and related mood disturbances are important in treating schizophrenia. This is so because of the improvement of such side effects as extrapyramidal symptoms with increasing use of atypical antipsychotics. Although depression is known to be a serious problem of many schizophrenic patients, the nature and course of depression in schizophrenia remain unknown. METHODS: The author examined the depressive features in 31 patients with schizophrenia. Ratings on the PANSS, BDI and HDRS were obtained. Eighteen percent of the total patients had BDI score above 21, considered depressed. RESULTS: There were no differences in BDI, HDRS and PANSS-D between positive symptom group and negative symptom group. There was also no correlation between subject scale(BDI) and objective scales(HDRS, PANSS-D). CONCLUSIONS: Depression in schizophrenia needs intensive studies. It is also considered as another heterogeneous domain beside negative or positive symptom domains. Out of respect for the high prevalence and serious outcome of depression in schizophrenia, a more differentiated assessment, analysis, and treatment of depressive symptom is recommended.