Changes of Functional MRI Findings in a Patient Whose Pathological Gambling Improved with Fluvoxamine

Legalized gambling is a growing industry, and is probably a factor in the presently increasing prevalence of pathological gambling. We present a case of a 36-year-old pathological gambler who was treated with fluvoxamine, a selective serotonin reuptake inhibitor, and who was assessed by functional MRI before and after drug administration. During activation periods, the pathological gambler was shown cards as stimuli, and fMRI results in several brain regions showed differential effects before and after medication and a maintenance period. This case demonstrates that the treatment response to fluvoxamine in a pathological gambler was observed not only by subjective self-report, but also by objective fMRI results. Therefore, fMRI may be a useful tool in the diagnosis and prediction of treatment response in patients afflicted with pathological gambling.

Hyponatremia with Neurological Symptom in Patients with Chronic Schizophrenia : Five Cases / 대한정신약물학회지

Hyponatremia frequently occurs in patients with chronic schizophrenia and has various causes such as compulsive drinking, neuroleptics, and physical illness. If not corrected immediately, it leads to severe problems such as seizures, change in mental status, and even death. We detected five cases of hyponatremia with neurological symptoms in patients with chronic schizophrenia. One case had a long history of primary polydipsia, whereas the other four cases had no history of polydipsia. We speculated that the cause in these latter four cases was neuroleptics or physical illness. All five cases improved with conservative treatment. Possible implications and the need for future study are discussed.

A Case of Single Photon Emission Computerized Tomographic Finding in Patient with Acquired Deafness and Musical Hallucinosis after Viral Encephalitis / 대한정신약물학회지

OBJECTIVE: Musical hallucinosis is uncommon symptom in the province of neuropsychiatry. Musical hallucinosis is often accompanied with hearing impairment caused by physical illness and is characterized by no psychotic symptoms. In the previous study, musical hallucinosis is related with secondary language center which paly a important roll in cognition and imagination of music and also related with activation of temporal lobe and frontal lobe. METHODS: We report the case of musical hallucinosis with hearing impairment subsequent viral encephalitis. RESULTS: This case is activated both inferior temporal lobe and borderline of left temporal lobe and occipital lobe in the Single Photon Emission Computerized Tomography (SPECT). CONCLUSION: We predict that the result should be helpful to understand musical hallucinosis and auditory hallucination of schizophrenia.

Treatment Response, Remission and Recovery in Schizophrenia: Definition and Criteria / 대한정신약물학회지

Understanding the definition of treatment response, remission and recovery is very critical in terms of investigating the course of schizophrenia and planning treatment strategies accordingly. In this article, we reviewed various definitions and criteria used in previous studies. Based on this, several limitations and new proposals are discussed. Clear establishment of the criteria for treatment response, remission and recovery for schizophrenia would help clinicians to make a time-appropriate decision for medication plan and to set up the long-term treatment goal in people with schizophrenia.

Genetic Polymorphism of Endothelial Nitric Oxide Synthase in Korean Schizophrenic Patients / 신경정신의학

OBJECTIVES: Although genotype of endothelial nitric oxide synthase has been investigated in many neuropsychiatric disorders, results were controversial and even contradictory. The purpose of this study was to investigate the nature of endothelial nitric oxide synthase in Korean schizophrenic patients, and compare it with healthy control group in terms of distribution of e genotype and allele frequency of endothelial nitric oxide synthase. METHODS: Using polymerase chain reaction and amplified refractory mutation system, endothelial nitric oxide synthase genotypes were identified in 77 schizophrenics and 121 healthy controls. RESULTS: 1) When genotypes of endothelial nitric oxide synthase were classified as a/a, a/b, b/b, there was no statistical difference in genotypes between the two groups. 2) In terms of allele frequency, there was also no statistical difference between the two groups. CONCLUSION: These results suggest that endothelial nitric oxide synthase gene seem to be unrelated to the pathogenesis of schizophrenia in Korean population.

Genetic Polymorphisms of Apolipoprotein E in Korean Schizophrenic Patients

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 epsilon2/2, epsilon2/3, epsilon2/4, epsilon3/3, epsilon3/4, epsilon4/4 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.