Neurocognitive Functioning in Bipolar Disorder / 신경정신의학

OBJECTIVES: This study was aimed to investigate the neurocognitive functioning of patients with remitted bipolar disorder and compare with schizophrenic patients' neurocognitive functioning. METHODS: This issue was addressed by comparing remitted DSM-IV diagnosed bipolar, schizophrenics patients and controls on several clinical and neurocognitive measures. Clinical state was assessed using the Positive and Negative Syndrome Scale (PANSS), Young Mania Rating Scale (YMRS), and Montgomery-Asberg Depression Rating Scale (MADRS). Neurocognitive measures included the KWIS, WMS-III, Korean California Verbal Learning Test (K-CVLT), Wisconsin Card Sorting Test (WCST), Rey-Osterrieth Complex Test (RCFT), and Color Trails Test (CTT). Thirty-two subjects with remitted bipolar disorder, twenty-four remitted schizophrenia and twelve normal controls were studied. RESULTS: Analysis of variance (ANOVA) revealed no differences across groups on age, education and IQ. With respect to neurocognitive test performance, bipolar disorder patients and schizophrenic patients were similar and both groups were impaired compared to normal controls. Two diagnosed groups have persistent impairments in neurocognitive function, particularly in the domains of declarative memory. CONCLUSION: The results provide support for the view that remitted patients with bipolar disorder suffer cognitive impairment.

Symptom Remission and Functional Outcomes in Patients with Recent-Onset Schizophrenia: A One-Year Prospective Observational Study / 신경정신의학

OBJECTIVES: The long-term outcome of schizophrenia is still considered variable and inconclusive. We performed a one-year prospective observational study to investigate the longitudinal outcomes in patients with recent-onset schizophrenia. The primary purpose was to determine the descriptive outcomes in terms of symptom remission and psychosocial function. The secondary purpose was to identify predictor variables associated with the outcomes. METHODS: Patients experiencing their first episode of psychosis or hospitalization within the past 2 years with a diagnosis of DSM-IV schizophrenia were included. Clinical symptoms were assessed monthly using Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS) and Clinical Global Impression (CGI) scale. Psychosocial function was measured using PSYCH-UP (Psychosocial symptoms you currently have, follow-up version) and Heinrichs' Quality of Life Scale (QLS) at baseline, 6, and 12 months and Global Assessment of Functioning (GAF) monthly. Remission was defined on the basis of overall, and psychotic core symptoms as having 1) BPRS total score or =60 increased from 6.1% at baseline to 85.8% at 12 months. Of the patients who were in remission at 12 months, 95.5% obtained GAF score > or =60. CONCLUSION: This study showed 64.3% of symptom remission rate in patients with recent-onset schizophrenia. Symptom remission was accompanied by significant improvement of global function. The severity of negative symptom at baseline appeared to be a significant predictor for time to remission. Psychosocial function was improved at the end of this study, but impairments still remained at mild to moderate level. GAF score and negative symptoms significantly correlated with psychosocial function.