Antipsychotic-Induced Oculogyric Crisis and Paroxysmal Perceptual Alteration / 대한정신분열병학회지

During antipsychotic drug treatment, clinicians occasionally encounter sudden attacks of oculogyric crisis (OGC) and/or paroxysmal perceptual alteration (PPA) which occur mostly in the afternoon or early evening lasting for minutes to hours and are eventually remitted with rests or short sleep and/or medications such as benzodiazepines, anticholinergics and so forth. Moreover, these attacks are usually accompanied with psychiatric symptoms such as various modalities of hallucinations and illusions, delusions, obsessive thoughts, panic attacks, agitation as well as autonomic symptoms. These accompanying psychiatric symptoms can be perceived as a worsening of psychiatric symptoms if the clinician does not understand the symptoms due to the side effects of antipsychotic drugs, which may result in increasing the dosage of antipsychotics instead of reducing doses or switching to less offending drugs. On the other hand, patients could easily recognize the symptoms as the adverse effects of drugs. This literature review and case-series study is aimed to raise awareness of OGC and PPA by providing clinical cases and author's views with the literature reviews about concepts, recognitions and managements from the works of Japanese authors who first reported the clinical importance of these attacks, particularly PPA.

Conceptualization of Soliloquy in Patients with Schizophrenia / 신경정신의학

Soliloquy is a significant symptom in schizophrenia and is usually regarded as being related to auditory hallucination. Elucidation of the psychopathology of soliloquy is incomplete. Soliloquy is also a normal human behavior that has multidimensional functions such as guiding internal cognitive processes and managing social interaction. In the young, soliloquy appears as egocentric speech and arises before maturation of the third-person perspective. Soliloquy has been regarded as indicative of an intermediary stage during the transformation of social speech into internalized thinking. Every thought process retains a social dimension because language itself is based on intersubjectively shared meanings, and internal thinking originates from interpersonal communication. Thus, soliloquy can be seen as a kind of thought process that accentuates the social dimension. This approach may help in understanding soliloquy in normal and pathological situations. Soliloquy was actively discussed in the late nineteenth and early twentieth century in European psychiatry. Since then it has received less attention and has been neglected as an academic concern, except in child developmental theory. Recently however, soliloquy has attracted more attention among neuroscientific researchers. To attain an advanced understanding of soliloquy, it is necessary to integrate the early European perception of soliloquy with current developmental theory. In this paper, we review past literature on the conceptualization of soliloquy and integrate those concepts into an explanatory framework. In addition, a case series and a discussion of the applicability of the explanatory framework are presented. Our results may help provide an insight into the contemporary understanding of soliloquy.

Psychiatric Applications of Placebos / 대한정신약물학회지

As the placebo effect is inevitable in almost all types of treatment implemented in the context of the doctor-patient relationship, it would be a wise strategy to try to enhance the treatment effect by understanding its mechanism and applying it clinically. However, for various reasons there is resistance to therapeutical application of placebos. The main reason for this resistance comes from the confusion about the concept of the placebo, and it is necessary to differentiate the placebo response and the placebo effect and understand them clearly. Meta-analytical reviews of clinical studies showed that the placebo effect accounts for part of clinical effect of drugs. Authors reviewed meta-analytic studies dealing with the placebo effect on depression, sleep disorders, dementia, anxiety and addiction. In addition, we discussed the current state of placebo use and also the way to promote the placebo effect.

Gender Difference in Event Related Potentials to Masked Emotional Stimuli in the Oddball Task

OBJECTIVE: We investigated gender differences in event-related potential (ERP) responses to subliminally presented threat-related stimuli. METHODS: Twenty-four participants were presented with threat-related and neutral pictures for a very brief period of time (17 ms). To explore gender differences in ERP responses to subliminally presented stimuli, we examined six ERP components [P1, N170, N250, P300, Early Posterior Negativity (EPN) and Late Positive Potential (LPP)]. RESULTS: The result revealed that only female participants showed significant increases in the N170 and the EPN in response to subliminally presented threat-related stimuli compared to neutral stimuli. CONCLUSION: Our results suggest that female participants exhibit greater cortical processing of subliminally presented threat-related stimuli than male participants.