A Naturalistic Study of Risperidone Treatment in Affiliated University Hospitals: Focus on Clinical Characteristics / 신경정신의학

OBJECTIVE: This retrospective naturalistic study was designed to compare the clinical characteristics including psychopathology of two groups of patients, long-term maintenance group and short-term drop-out group, who were taking risperidone. METHOD: Datas were collected for 210 schizophrenic patients with complete medical records among 580 patients who were enrolled with risperidone administration from January 1996 to December 1996 in 8 affiliated hospital of the Catholic University. The short-term drop-out patients group were assigned to whom treatment period was less than 6 month, and the long-term maintained patients group, treatment period was more than 2 years. We assessed demographics, psychopathology, and other variables related with medication based on past medical records. RESULTS: Among subjects of 210, short-term drop-out patients group were 67(31.9%) and long-term maintained patients group were 143(68.1%). Demographics and psychopathology were not significantly different between two groups. The starting and maximal dosage of risperidone was not significantly different between two groups but the maintenance dosage of risperidone was lower in long-term medicated patients group than short-term drop-out patients group(t=3.698, p<0.05). Additionally, the result of this study showed differences in experiences of past antipsychotic use as following. The number of no previous use of antipsychotic was 39(58.2%), the number of high potency antipsychotic use was 27(40.3%), and the number of low potency antipsychotic use was 1(1.5%) in short-term drop-out group. The number of no previous use of antipsychotic was 58(40.6%), the number of high potency antipsychotic use was 77(53.8%), the number of low potency antipsychotic use was 8(5.6%) in long-term maintained group(X 2=6.559, df=2, p<0.05). CONCLUSION: According to these results, administration of low therapeutic dosage should be recommended for long-term maintenance as if possible. Multi-center based retrospective naturalistic study like this would be useful for getting informations about efficacy and some other aspects of antipsychotic administration in practical field.

Gene Polymorphism of Tumor Necrosis Factor Beta in Major Depressive Disorder / 신경정신의학

OBJECTIVE: Major depressive disorder is known to have high genetic predisposition and the main focus of recent genetic studies in major depressive disorder has been concentrated on association studies between genetic polymorphism and disease, since molecular genetic methods have been developed. This study was designed to investigate the relationship between major depressive disorder and immunogenetic influences by analyzing polymorphism of TNFB gene, which is involved in interaction of immune system and CNS. METHOD: 95 persons who had been diagnosed of major depressive disorder were assigned as patient group and, 202 data obtained from Catholic hemopoietic stem cell bank, College of medicine, the Catholic University of Korea, were used as normal controls in this study. DNA was extracted from whole blood, thereafter amplified by polymerase chain reaction, and digested by NcoI. After that procedure, we obtained and assessd restriction fragment length polymorphism of two alleles, TNFB*1 which has 555bp and 185bp fragments and carries the NcoI restriction site, and TNFB*2 of 740 bp fragment lacks the NcoI restriction site. All data were analyzed by x2 test with two-tailed Fisher's exact test. RESULTS: 1) The frequencies of TNFB*1/1, TNFB*1/2, and TNFB*2/2 were not statistically different between major depressive disorder patients and control group. 2) The frequencies of TNFB*2 and TNFB*1 were not statistically different between major depressive disorder patient group and normal control group. CONCLUSION: We did not verified the differences of frequency in TNFB*1/TNFB*2 gene between the major depressive disorder and normal controls, respectively. Consequently, there is no genetic relationship between major depressive disorder and gene polymorphism of TNFB. We do suggest that further systematic studies including various clinical variables should be conducted.

Results of 1998 Korean Depression Screening Day and Sociodemographic Characteristics of Participants / 신경정신의학

OBJECTIVES: This study was performed to analyze the sociodemographic characteristics of participants in '1998 Korean Depression Screening Day' and to evaluate the results of the screening test. METHODS: By using the survey results of 619 volunteers from 8 hospitals, the authors examined the prevalence of depression detected at the screening test and sociodemographic characteristics and the psychiatric treatment history of respondents. The assessment measure was the Zung Self-Rating Depression Scale. RESULTS: The mean depression score of all participants was 57.5+/-13.8 and it came under mild depression. Of all participants, 69.5% (N=430)had at least mild depressive symptoms, 43.1% (N=267)had at least moderate symptoms, and 18.4% (N=114)had severe symptoms. Never have 56.8% of respondents in the severely depressed range and 63.9% of those in the moderately depressed range had psychiatric treatment. The results suggest that the age group of 29-year-old or younger (relative to 60-year-old or older group)and full-time employment status (relative to unemployment)are protective factors of depression. CONCLUSIONS: By '1998 Korean Depression Screening Day', many depressed patients were detected and their depressive symptoms had statistically significant relationships with some sociodemographic characteristics. The results suggest that the education and screening test programs for depressive illness facilitated by Depression Screening Day are useful to the patients regardless of being under current treatment or not.

Cognitive Function and Its Clinical Significance in Schizophrenic Patients / 신경정신의학

OBJECTIVES: This study was designed to evaluate the cognitive function in schizophrenic pathents. We also examined the correlation of cognitive imparirment with other clinical variables. METHODS: A total of 25 partients and 19 normal controls completed Vienna Test System, a computerized neuropsychological test. These included Cognitrons test, continuous attention test, standard progressive matrices. We separately assessed the patient group on the positive and Negative Syndrome Scale(PANSS) and Extrapyramidal Symptom Rating Scale(EPS scale). The other clinical variables included in this study were age, sex, education level, disease duration, clinical subtype, medication state and genetic factor. RESULTS: Schizophrenic patients had poorer performance than normal controls on the tests of cognitrone, continous attention, and stand progressive matirces, independent of sex, genetic factors, EPS scale scores, PANSS scores, disease duration. The cognitive impairment in schizophrenics was mainly associated with their education levels and clinical subtypes. CONCLUSION: Inlight of our results, it seemd that some schizophrenics perform poorly on cognitive tsasks, and this poor performance may be associated with education levels and clinical subtypes. The more careful evaluation of cognitive function in schizophrenic patients would be needed for their proper management.