Association between Dopamine Receptor D4 Polymorphisms and Novelty Seeking Personality Trait in a Korean Population / 신경정신의학

OBJECTIVES: We investigated the relationship of personality traits with dopamine D4 receptor(DRD4) exon III polymorphism in a Korean population. METHODS: We analysed DRD4 exon III 48-bp repeats polymorphism in 173 Korean healthy female adolescents(age=13.88+/-0.29 years) who also completed Temperament and Character Inventory(TCI). RESULTS: Novelty seeking score of the TCI was significantly higher in the subjects with DRD4 long alleles(>or=5 repeats) compared with the subjects without these(t=2.11, p=0.037). CONCLUSION: The present study supports the previous reports that long repeats of the DRD4-exon III polymorphism are related with Novelty Seeking personality.

Postoperative Change in Mood and Cognition of the Elderly Patients

OBJECTIVES: Surgery is being offered to an increasing proportion of the over 60s and postpoerative cognitive dysfunction may occur in the elderly. We investigated that age could be a risk factor. The confounding effects, such as learning effect due to repeated testing and the effect of distress on the test performance, were controlled for by control group. METHOD: Twenty patients aged at least 60 years completed neuropsychological test 1 day before and 1 week after surgery. We measured Mini-Mental Status Examination (MMSE), digit span, 'A' test, similarity test, Digit Symbol Substitution Test (DSST), Beck Depression Inventory (BDI), Montgomery-Asberg Depression Rating Scale (MADRS) and State Anxiety Inventory (SAI). The authors compared postoperative cognitive dysfunction by neuropsychological test in the elderly patients with those in the control group. RESULTS: One week after operation, there was no cognitive impairment compared with before operation. Advanced age might not contribute to cognitive impairment except DSST. And there was an improvement in the scores for BDI and SAI in the control group only. We did not find a significant relation between early postoperative cognitive dysfunction and mood state before operation. Because the elderly patients had lower educational level and more depressive than control group before operation, we thought that the deterioration of DSST did not happened with operation, but by insufficiency of learning effect in the elderly patients. CONCLUSION: Cognition in the elderly patients was not impaired significantly after operation when attention was paid to the known perioperative influences on mental function.

A Case of Risperidone-induced Neuroleptic Malignant Syndrome

Neuroleptic malignant syndrome(NMS) is an uncommon but potentially fatal idiosyncratic reaction to neuroleptics, characterized by muscular rigidity, fever, autonomic dysfunction, and altered consciousness. The major theories to explain NMS is central dopaminergic blockade, but it is unclear. Risperidone is a new antipsychotic drug, a benzisoxazole derivative that blocks dopamine D2 receptor and serotonin type 2 receptor. The comparatively greater serotonin-blocking activity is believed to give risperidone the specific property of not causing any more extrapyramidal side effects than conventional antipsychotics at the optimal dose of 4-8mg/day. It is postulated that risperidone is unlikely to cause NMS. Here, we report a case of risperidone induced neuroleptic malignant syndrome.