The Differences of Suicidal Behavior, Stress, Internet Gaming Disorder-Related Symptoms and Personality Traits between Internet Game Overusers and General Users / 신경정신의학

OBJECTIVES: The purpose of this study was to investigate the differences of the suicidal behavior, stress, internet gaming disorder-related symptoms and personality profiles between online game overusers and general users. METHODS: A total of 460 adult online game users (40 overusers, 420 general users) participated in this study and were asked to complete several self-report measures. Questionnaires included demographic information, suicidal behavior, stress, internet gaming disorder-related symptoms, and big five inventory-10. RESULTS: Compared to the general user group, the overuser group showed statistically significant higher suicide idea, suicidal plan, stress, internet game withdrawal symptoms, online game-related daily life problems and lower extraversion, conscientiousness. Online game overusers showed lower extraversion, decreased conscientiousness, and higher neuroticism compared to the psychiatrically undiagnosed group. CONCLUSION: The current results indicate the possibility that online game overuse may be related to suicidal behavior, stress, and the personality traits of extraversion, conscientiousness, and neuroticism.

Validity of Dementia Screening Test 'Korean Version of the Mini-Cog'

OBJECTIVE: The Mini-Cog, a composite of three word recall and clock drawing, was developed by Soo Borson as a brief test for discriminating demented from non-demented persons in a community sample. This study was conducted to prove the diagnostic validity of the Korean version of Mini-cog. METHODS: All 41 who met the criteria for probable dementia based on informant interviews and 88 with no history of cognitive decline were included. Sensitivity and, specificity of the Mini-Cog were compared with those of the Mini-Mental State Examination in the Korean version of the CERAD assessment packet (MMSE-KC), clock drawing test (CDT) and three word recall. RESULTS: The Mini-Cog had the higher sensitivity (86.11%) than MMSE-KC and fair specificity (72.09%). Cut off points of Mini-Cog was 2/3. AUC of Mini-Cog was 0.819 (p<0.001). The Mini-Cog required minimal training to administer and no test forms of scoring modifications. CONCLUSION: It suggests that the Mini-Cog might be readily incorporated into general practice and senior care setting as a routine cognitive measure.

Use of the Terms "Schizophrenia" and "Schizophrenic" in the South Korean News Media: A Content Analysis of Newspapers and News Programs in the Last 10 Years

OBJECTIVE: In this study, we explored the meaning attributed to the words "jungshinbunyeolbyung" (schizophrenia) and "jungshinbunyeol" (schizophrenic) in South Korean newspapers and news programs in the last 10 years. METHODS: We screened the websites of three national newspapers and the broadcasts of three nationwide television news programs from January 1, 2001, to December 31, 2010. We classified a total of 490 articles and 257 news segments by category and quantitatively and qualitatively analyzed them. The articles and news segments were assigned to one of the following categories based on their use of the term "schizophrenia": 1) negative, 2) neutral or positive, 3) incidental, and 4) metaphorical. RESULTS: The negative viewpoint accounted for 349 incidences (46.7%), while the neutral and positive viewpoints included 225 incidences (30.1%). Incidental uses accounted for 95 incidences (12.7%), and metaphorical uses accounted for 78 incidences (10.4%). The majority of the negative uses focused on violence or dangers posed by patients (137 mentions, 37.8%), while the metaphorical uses mainly focused on the idea of splitting (51 mentions, or 65%). CONCLUSION: This study showed that the South Korean news media do not provide balanced information about schizophrenia to the public. This study also showed that no significant move has been made toward a more positive use of the term since a previous study was conducted on the subject. Although the term schizophrenia has given way to "attunement disorder," it will be difficult to establish the new term as the standard if the South Korean media continue to use the term "schizophrenic symptom." Even though the term has been changed, guidelines are necessary to encourage the mass media to provide balanced articles and reduce prejudice.

The Association of Heavy Metal of Blood and Serum in the Alzheimer's Diseases

This study has attempted to establish an analysis method through validation against heavy metals in the body (Pb, Cd and Hg) using ICP-MS and Gold amalgamation and find out the relevance between heavy metal and Alzheimer's disease after analyzing the distribution of heavy metal concentration (Pb, Cd and Hg) and correlations between a control group and Alzheimer's disease group. In this study, Pb and Cd levels in the blood and serum were validation using ICP-MS. For analysis of Hg levels in the blood and serum, the gold amalgamation-based 'Direct Mercury Analyzer' has been used. According to an analysis on the heavy metal concentration (Pb, Cd and Hg concentration) in the blood, Cd concentration was high in the Alzheimer's disease group. In the serum, on the contrary, Pb and Hg were high in the Alzheimer's disease group. For analysis of correlations between heavy metal levels in the blood and serum and Alzheimer's disease, t-test has been performed. Even though correlations were observed between the blood lead levels and Alzheimer's disease, they were statistically insignificant because the concentration was higher in a control group. No significance was found in Cd and Hg. In the serum, on the other hand, no statistical significance was found between the heavy metal (Pb, Cd and Hg) and Alzheimer's disease. In this study, no statistical significance was observed between heavy metal and decrease in cognitive intelligence. However, it appears that a further study needs to be performed because the results of the conventional studies were inconsistent.

Changes in the Metabolic Parameters and Positive and Negative Syndrome Scale (PANSS) Scores of Patients with Schizophrenia 8 Weeks after Switching to Paliperidone

OBJECTIVES: The purpose of this study was to examine the changes in metabolic parameters and Positive and Negative Syndrome Scale (PANSS) scores of patients previously treated with atypical antipsychotic drugs other than paliperidone, after 8 weeks of treatment with paliperidone. METHODS: Changes in body weight, body mass index, leptin, lipid levels, fasting glucose, and PANSS scores of patients who switched from other atypical antipsychotic drugs to paliperidone were measured after 8 weeks of treatment with paliperidone. We compared these results with those of patients who had not been treated with antipsychotic drugs for at least 2 weeks prior to treatment with paliperidone (antipsychotic drug-free patients). RESULTS: The antipsychotic drug-free group (n = 9) did not show significant changes in metabolic parameters, but showed a significant improvement in total and subscale scores of PANSS. In the group that switched from other atypical antipsychotic drugs to paliperidone (n = 13), body weight, body mass index and fasting glucose level significantly increased, while total and subscale scores of PANSS significantly improved. CONCLUSIONS: Paliperidone treatment will benefit patients with schizophrenia who have been antipsychotic drug-free or who have had difficulty with other atypical antipsychotic drugs, with regard to their psychopathological state. However, if patients have been treated with other atypical antipsychotic drugs before switching to paliperidone, they could gain body weight or their fasting glucose level could increase over a short period because of a change in receptor number and sensitivity caused by the previously prescribed antipsychotic drugs, and hence, paliperidone should be prescribed with caution for these patients.

Validity of the Korean Version of the Executive Interview (K-EXIT25)

OBJECTIVES: This study was conducted to prove the validity of the Korean version of the Executive Interview (K-EXIT) which was developed by Donald Royall as a bed-side test to measure the executive function. METHODS: The K-EXIT was developed and applied to 169elderly people with other executive functiontests.The internal consistency,reliability and the validity of the K-EXIT were analyzed. RESULTS: The K-EXIT showed high internal consistency (Crohnbachalpha= 0.766) and high inter-rater reliability (r=0.997, p<0.01).The K-EXIT total score was well correlated with verbal fluency test (r=-0.460, p<0.001), and the initiation-perseveration-change score (r=-0.598, p<0.005). CONCLUSION: The K-EXIT is a reliable and valid instrument for assessing executive function of the Korean elderly people. It may be also useful for the less well-educated people.

The Relationship between Cognitive Decline Elderly People and Blood Metal Levels : A Systematic Review

OBJECTIVES: There have been several previous studies that the pathology of Alzheimer's disease (AD) might be in part caused or exacerbated by metals. But inconsistent results are often seen in evaluation of levels of metals in Alzheimer's disease patient's blood and control group. So, we conducted a systematic review using a comprehensive search strategy to find out whether there is significant difference between cognitive decline elderly people and normal control group. METHODS: Studies were searched in Pubmed, CINAHL and EMBASE with predefined words according to MeSH and purpose of this study. 996 studies were selected as primary screening, and two reviewers extracted relevant data independent of each other. 172 studies fulfilled the inclusion criteria. 32 studies about aluminum, copper, lead, mercury, cadmium finally selected. The Newcastle-Ottawa Scale (NOS) was used for assessing the quality of studies. To synthesize the results of this study, summarized table was made. RESULTS: In most studies, blood levels of mercury were high in cognitive decline group. But the majority study shows lead was not that different between cognitive decline group and control group. Measurements of other metal levels in whole blood, plasma, serum were inconsistent. However, there are not enough evidences to generalize with just number of studies since the studies have various degrees of validity. CONCLUSION: There is lack of evidences, till now, to use blood levels of metals as diagnostic purpose or predicting prognosis. Further studies which are supplemented limitations of previous studies are needed.

Multicenter Study on the Efficacy and Safety of Intracavernous 'TM' (Standro(R)) for the Treatment of Erectile Dysfunction in Korean / 대한비뇨기과학회지

PURPOSE: To evaluate the efficacy and safety of an intracavernous injection of lyophilized papaverine/phentolamine/alprostadil (Standro(R)) for the treatment of erectile dysfunction (ED) in Koreans. MATERIALS AND METHODS: 249 men (>20 years old), with ED (>6 month duration), were enrolled from 14 clinical centers. The intracavernous 'TMs' were titrated in a stepwise fashion at the clinic, from 0.05-0.25ml (17.64mg papaverine, 0.6mg phentolamine, and 6mug alprostadil per ml), with increment of 0.02-0.05ml, according to the etiology and severity of the ED and the patients' ages. RESULTS: Of the 249 men, 238 completed the dose titration, and progressed to home treatment of 3 months duration. Of these 238, 193 (psychogenic 13.0%, organic 75.5%, mixed 11.5%) completed the home treatment (4 or more self-injections), with the other 45 dropping out (lost to follow-up in 24, patient refusal in 9, no chance to have intercourse in 7 and omitted recording of patient diary in 2). The success rate per trial (a total number of sufficient erection for vaginal intromission/a total number of injections) and per patient (number of patients who had one or more sufficient erections for vaginal intromission/the enrolled patients at beginning or 193 patients), and the satisfaction rate per patient (number of patients who had both patient and partner satisfaction with erection/193 patients) were 74.1, or 91.2 and 75.1%, respectively. The adverse reactions were prolonged erections in 3, urethral pain in 1 and penile skin edema in 2. Three patients complained of penile pain during an erection, but there was no dropout due to the pain. No significant changes in laboratory tests were found after the home treatment. CONCLUSIONS: A 'TM' seems to be effective and safe for an intracavernous injection for the treatment of men with erectile dysfunction.