A Randomized Controlled Pilot Study of Cognitive Behavioral Social Skills Training (Korean version) for Middle- or Older-Aged Patients with Schizophrenia : A Pilot Study / 신경정신의학

OBJECTIVES: Cognitive behavioral therapy and social skills training have been proposed as a promising modality for treatment of patients with schizophrenia. The objective of this study was to evaluate the effectiveness of Cognitive Behavioral Social Skill Training (CBSST) in patients with chronic schizophrenia. METHODS: Twenty six middle- or older-aged hospitalized patients with schizophrenia were selected in a mental hospital. Eleven participants were randomly assigned to undergo treatment with CBSST and 15 participants were assigned to receive the usual treatment. CBSST was administered in a single group over 12 sessions for a period of weeks, and the participants were assessed by blinded raters at base line and end point, and end of treatment. RESULTS: Compared to patients who received the usual treatment, those who received treatment with CBSST showed a significant reduction of Hamilton Rating Scale for Depression score, however, scores for other psychiatric symptoms did not differ significantly. In terms of Quality of life (QoL) analysis, scores for overall quality of life showed a more significant increase in the CBSST group, compared with the group of patients who received the usual treatment. According to results of the Independent Living Skill Survey, patients receiving CBSST showed significantly greater involvement in social activities than patients receiving usual treatment group. CONCLUSION: Psychosocial intervention for patients with chronic schizophrenia is very important, not only for management of primary psychiatric symptoms, but also for QoL and social rehabilitation. The results of this study, showing improvement of depressive mood, overall life quality, and social activities, suggest that CBSST could be an effective treatment for these patients. This study is a pilot study performed in an inpatient treatment setting. Further studies are required in order to clarify the advantage of CBSST in treatment of patients with chronic schizophrenia, esp. under outpatient settings.

Study on the P50 Auditory Evoked Potential in Mood Disorder Subjects / 신경정신의학

OBJECTIVES: Diminished suppression of the P50 response, a consistent finding in schizophrenia, has also been reported in patients with bipolar disorder. It is a promising endophenotype for schizophrenia, but its relationship to genetic liability in mood disorder is controversial. The present study investigated event-related brain potential (ERP) indices of auditory processing and sensory gating in mood disorder and subgroups of patients with bipolar disorder with or without a history of psychosis using the P50 dual-click procedure. METHODS: The P50 auditory evoked potential response to paired stimuli was measured in 77 subjects with mood disorder (58 with bipolar disorder and 19 with major depressive disorder) and 28 healthy controls. P50 parameters were compared between groups. RESULTS: P50 suppression in patients with mood disorder did not differ from that in the healthy subjects. Except for S1 latency, there were no significant differences in P50 parameters between the diagnosis groups. In patients with bipolar disorder, a history of psychosis made no difference to P50 parameters. CONCLUSION: P50 was not significantly impaired in patients with mood disorder. There has been much debate on the meaning of P50, and more studies including longitudinal within-subjects studies are warranted to clarify the meaning and mechanisms of P50.