Effectiveness of a Qigong-based Stress Management Program in Patients with Anxiety Disorder / 신경정신의학

OBJECTIVES: The object of this study was to examine the effectiveness of Qigong-based stress management program in patients with anxiety disorder. METHODS: An 8-week controlled clinical trial compared 24 patients with anxiety disorder assigned to a Qigong-based stress management program with 22 patients with anxiety disorder assigned to an education control program. Beck depression inventory (BDI), Spielberger trait state anxiety inventory (STAI), Hamilton depression rating scale (HAM-D), Hamilton anxiety scale (HAM-A), and Symptom checklist-90-revised (SCL-90-R) were used to assess the effectiveness of Qigong-based stress management program. RESULTS: Qigong-based stress management group showed significant improvement compared to the education control group on anxiety symptoms and hostility, but Qigong group showed inconsistent findings on depressive symptoms. Qigong-based stress management group did not show significant improvement on somatization, obsessive-compulsive symptoms, interpersonal sensitivity, or phobic anxiety subscale of SCL-90-R compared to the education control group. CONCLUSION: This study showed that Qigong-based stress management program can be an effective method for patients with anxiety disorder in relieving anxiety symptoms. However, well-designed randomized controlled trials are needed before these kind of interventions.

Adolescents' Exposure to Violence and It's Associated Psychiatric Symptoms / 신경정신의학

In this research, we examined the frequency of exposure to violence in the home, school and neighborhood among middle school students as well as its related psychiatric symptoms. A total of 1,345 students from 5 middle schools in Seoul participated in this study: 670 were male, 675 were female. We administered self-reported questionaires including discriptions of exposure to violence and a trauma symptom checklist(TSC)(Singer 1995). 1) The total frequency of exposure to any type of violence was 45% in our sample. The frequency of girls' being hit in home was 22.8%, which was significantly higher than it was for boys(p<0.001). The frequency of boys' exposure to violence in school and in the neighborhood was 22.1% and 10.1% respectively, which was higher than it was for girls(p<0.005). 2) In factor analysis of TSC, 4 factors were identified. TSC including depression-anxity, PTSD, dissociation and anger was correlated with violence exposure variables. Multiple regression analysis revealed that TSC is related with violence victimization in life(R2=0.18), sexual assault(R2=0.12), recent victimization in the home(R2=0.08), recent witness to violencein the home(R2=0.07), recent victimization in school(R2=0.08) and all violence exposures(R2=0.29). 3) Among the demographic variables, sex, parental alcohol problem and student alcohol-smoking-drug problems influenced the TSC(p<0.005). TSC could be result of witness to violence as well violence victimization. And the risk factors for violence-related psychiatric symptoms were mainly seen in females, who have parents with alcohol problems or who themselves have alcohol-substance problems. So intervention programs for violence victims should be focused on the these high risk group.

Efficacy of Risperidone in Treatment-Resistant Patients with Chronic Schizophrenia / 대한정신약물학회지

OBJECTS: This open study was designed to investigate the efficacy and safety of risperidone in the treatment-resistant patients with chronic schizophrenia. 24 patients were entered on the 8-week open trial. A total of 3 patients discontinued risperidone treatment before the end of the study. METHODS: We investigated risperidone's efficacy and its side effects in 21 patients with treatment-resistant chronic schizophrenia, who had previously been treated with different kinds of classical antipsychotic drugs but with insufficient clinical effect or distressing extrapyramidal side effects, over a 8-week period. After 3- 7 days of placebo wash-out period, patients were assigned to receive risperidone. The overall clinical efficacy was assessed at the 1st, 2nd, 4th, and 8th week of the treatment using the PANSS and the CGI. Safety and tolerability were assessed by the ESRS, the UKU side effect rating scale, the vital signs, and the laboratory tests including CBC, urinalysis, liver function test, and ECG. RESULTS: Clinically PANSS total score and CGI severity score on the end study point showed a significant improvement compared with baseline state. Significant improvements in both PANSS positive and negative subscale scores was as early as week 1 through week 8. Nine(43%) among of the 21 patients showed at least a 20% decrease in total PANSS scores. The tolerability of risperidone was geneally found to be good. Insomnia(52%), fatigue(52%), and sedation(52%) were the most common side effects. CONCLUSION: These results suggest that risperidone may be a effective antipsychotic agent in the treatment of refractory schizophrenia. However, double-blind comparative trial between risperidone and clozapine should be performed to further clarify the efficacy of risperidone in treatment-resistant patients with chronic schizophrenia.