Association between D2 Dopamine Receptor Gene Polymorphisms and Reward Dependence Personality Traits

BACKGROUND: The dopaminergic genes have been implicated with some personality traits. Many recent studies indicated that there is a correlation between D2 dopamine receptor gene(DRD2) polymorphisms and the personality traits. The purpose of this study is to investigate a possible association between DRD2 gene (TaqI A, TaqI B) polymorphism and personality traits. METHODS: The subjects were consisted of 173 blood-unrelated young female Koreans with a mean age(+/-SD) of 13.88(+/-0.29) years. These volunteers were recruited from one of the junior high schools in Seoul and were tested by the Korean version of the Temperament and Character Inventory(TCI). Genotyping of the DRD2 polymorphisms by PCR methods were carried out. Two DRD2 gene polymorphisms were classified and individually assessed as follows: TaqI A1+ vs A1-, TaqI B1+ vs B-. The associations between the TCI scores and TaqI A, TaqI B polymorphisms were assessed by Student's t-test. RESULTS: In the 173 subjects, the allele frequencies of the DRD2 TaqI A1, TaqI B1 alleles ranged from 0.42 to 0.43, and these results are quite different from the ranges of 0.15-0.20 in the case of a Caucasian population. The genotype frequencies of DRD2(TaqI A1, TaqI B1) variants showed no significant deviation from the Hardy-Weinberg equilibrium. RD4(dependence vs. independence) of Cloninger's TCI, a sub-dimension of Reward Dependence, was significantly higher in the subjects having DRD2 less frequent alleles than those without these alleles. CONCLUSION: This study suggests that the female subjects carrying the less frequent DRD2 alleles exhibited higher reward-dependent personality trait compared to those without these alleles.

Neurocognitive Function and Clinical Characteristic in Schizophrenia Patients with Treatment-Resistant Auditory Hallucination / 신경정신의학

OBJECTIVES: The purpose of this study was to investigate the clinical characteristics and neurocognitive functions in schizophrenia patients with treatment-resistant auditory hallucination. METHODS: The 30 patients with treatment-resistant hallucination (hallucinating patients) were compared with 31 patients without hallucination (non-hallucinating patients) and 30 normal controls. The hallucinating patients included the schizophrenic patients who reported not-remitting hallucinations for 2 years in spite of appropriate treatments. The non-hallucinating patients included schizophrenic patients who had chronic illness course, and not reporting hallucination within 2 years. The hallucination characteristics and neurocognitive were measured by self report questionnaires on hallucination: functions Wisconsin card sorting test (WCST), Continuous performance test (CPT) and Sentence repetition test (SRT) among three groups. Psychopathology, depressive symptomps and extrapyramidal symtomps were measured by Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS), Beck depression Inventory (BDI) and Extrapyramidal Symptom Rating Scale (ESRS), separately. RESULTS: The auditory hallucinations 1 or 2 times a day (33%), with the contents of criticising and cursing (26%) were most frequent. Hallucinating patients did not feel uncomfortable with their hallucinations. WCST performances were significantly decreased in hallucinating patients than non-hallucinating patients, especially on total error (35.2+/-7.6 vs 25.3+/-10.0), perseverative error (54.8+/-14.9 vs 38.5+/-13.0). In CPT, hallucinating patients showed more error response (11.9+/-8.1 vs 8.9+/-7.5) and more prolonged reaction time to incorrect answers (552.4+/-433.2 ms vs 492.7+/-358.5 ms). CONCLUSION: Integrating these observations, it can be said that schizophrenic patients with treatment-resistant auditory hallucination have more neurocogntive functional deficits implying frontal lobe dysfunction than non-hallucinating schizophrenic patients.

Prolactin Response to Antipsychotic Drug and Dopamine Transporter Gene Polymorphisms

OBJECT: We investigated the relationship between prolactin response to antipsychotics and clinical courses of psychotic symptoms and DAT gene polymorphisms. METHOD: Twenty-four acute psychotic inpatients completed the 12-week trial of risperidone. Serum prolactin, BPRS, ESRS and hyperprolactinemia-related symptoms were measured at baseline, 2, 4, 8 and 12 weeks after medication. The DAT gene polymorphisms were analyzed. RESULTS: The serum prolactin was significantly increased over time. According to the prolactin level at 2-week, the subjects were divided into the severe group(serum prolactin>60ng/mL, N=15) and the mild group (serum prolactin<60ng/mL, N=9). The prolactin levels of the mild group didn't increase beyond 60ng/mL throughout 12 weeks. Severe group had slower decrement of BPRS scores than those of mild group. Six females in severe group complained of irregular menstruations, but no female in mild group. Most patients had 10 allele of DAT gene. CONCLUSION: This study suggests that the magnitude of prolactin elevation at the 2-week of risperidone medication is correlated with severity of hyperprolactinemia throughout treatments. Our results did not show the relationship between prolactin responses and DAT gene polymorphisms.

Association between Dopamine Receptor D4 Polymorphisms and Novelty Seeking Personality Trait in a Korean Population / 신경정신의학

OBJECTIVES: We investigated the relationship of personality traits with dopamine D4 receptor(DRD4) exon III polymorphism in a Korean population. METHODS: We analysed DRD4 exon III 48-bp repeats polymorphism in 173 Korean healthy female adolescents(age=13.88+/-0.29 years) who also completed Temperament and Character Inventory(TCI). RESULTS: Novelty seeking score of the TCI was significantly higher in the subjects with DRD4 long alleles(>or=5 repeats) compared with the subjects without these(t=2.11, p=0.037). CONCLUSION: The present study supports the previous reports that long repeats of the DRD4-exon III polymorphism are related with Novelty Seeking personality.

The Effects of Total Sleep Deprivation on Neurocognitive Functions / 신경정신의학

OBJECTIVES: The purpose of this study was to investigate the neurocognitive and psycho-physiological effects of total sleep deprivation by using the objective and quantifiable methods of Vienna Test System (Reaction Unit, Cognitrone, Vigilance) and P300 event-related potential. METHODS: Thirty healthy medical students(22 men, 8 women) participated in this study. Subjects remained awake for 38 hours under continuous surveillance. In the morning and the evening of two consecutive study days, the Vienna tests and P300 were performed. RESULTS: In Vigilance test of the Vienna Test System, a significant functional impairment occurred as a result of total sleep deprivation(p<.001). In Reaction unit, reaction time significantly increased (p<.01). However, in Cognitrone, a functional improvement was revealed. The P300 latency was significantly prolonged(p<.001) and amplitudes decreased(p<.01) as a consequence of total sleep deprivation. Comparing the results of Vigilance and Reaction unit each taken in the morning and evening, the performance decrements were prominent in morning sessions. In Cognitrone, evening session result showed the improvemed performance. CONCLUSIONS: The cognitive impairment resulting from 38 hours of sleep deprivation are considerable in alertness and reaction time tests, but not in higher complex cognitive functions such as fine perceptual analyses, visual discrimination, and short term memory. Considering the results with P300 latency and amplitudes, it may be concluded that the P300 changes as a result of total sleep deprivation are due to the decrement in the alertness which prolongs reaction time. More deterioration of cognitive performance shown in the morning, could be explained by considering circadian rhythm.

Efficacy and Safety Profile of Risperidone in Schizophrenia: Long-term Follow-up Study / 신경정신의학

OBJECTIVES: The purpose of this study was to evaluate the long-term efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. METHOD: This multicenter open label study included 116 schizophrenic patients drawn from 19 university hospitals. After a wash-out period of 1 week, the patients were treated with risperidone for 56 weeks and evaluated at 8 points:at baseline, and the 8th, 16th, 24th, 32nd, 40th, 48th, 56th weeks of treatment. The dose was started at 2mg of risperidone on day 1, and increased to 4mg on day 2, and 6mg on day 3,7 and adjusted to a maximum of 16mg/day according to the individual's clinical response. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. RESULTS: Eighty-seven(75%) of 116 patients completed the 56-week trial of risperidone. Clinical improvement(as defined by a 20% of reduction in total PANSS score at end point) was shown by 92.0% of the patients. The mean dose of risperidone was 5.0mg/day in the 56 week follow-up. PANSS total scores showed significant improvements between consecutive two points at baseline, 8th, 16th, 24th, 32nd, and 48th week of treatment. CGI scores showed significant reductions between consecutive two points at baseline, 8th, 16th, 24th, and 48th week of treatment. Three PANSS factors(positive, negative, general) showed a significant improvement from the 8th week of treatment, and, after then, remained improved in the rest of the study period. ESRS showed no significant change during the 56 week trial. Laboratory parameters showed no significant changes during the course of treatment. CONCLUSIONS: This multicenter long-term open study suggests that risperidone is a antipsychotic drug with long term efficacy and safety in the treatment of schizophrenic patients.

An Assiociation Study of Interleukin-2 Receptor beta-Chain Gene Polymorphism on Chromosome 22 in Korean Schizophrenic Patients / 신경정신의학

BACKGROUND: While a significant genetic predisposition to schizophrenia has been proposed, the mode of inheritance or nature of etiological factors is unknown. Previous reports of a genome-wide survey for schizophrenia susceptibility genes have indicated a possible region of linkage on chromosome 22. In order to test the possibility that the interleukin-2 recepto beta chain(IL-2R beta ) gene on chromosome 22 is of etiological importance in schizophrenia, a case-control association study was conducted. METHODS: Subjects were ninety-three schizophrenic patients with a diagnosis of schizophrenia by DSM- III -R criteria and ninety-seven normal controls. Schizophrenic patients were divided by clinical phenotypes such as DSM- III -R diagnostic subtypes, positive and negative symptoms, and family history so as to increase the homogeneity of schizophrenics. Genomic DNA was extracted from whole blood lymphocytes according to standard procedures. The DNA was used to study a dinucleotide repeat in the IL-2R beta gene. To reveal the dinucleotide polymorphism, genomic DNA of subjects was amplified by polymerase chain reactions(PCR). RESULTS: At the IL-2R beta gene locus, all the previously reported alleles (eight different alleles) of a dinucleotide polymorphism were identified. There was no significant difference between number of heterozygosity in schizophrenic patients and in normal controls. There was no significant difference in the distribution of frequencies of alleles between schizophrenics and normal controls. In addition, there was no significant difrfrence in the allele frequencies among subtypes of schizophrenic patients according to DSM- III -R diagnostic subtypes, positive and negative symptoms, and family history. CONCLUSIONS: The present study did not detect a difference in frequencies of alleles of a dinucleotide polymorphism at the IL-2R beta gene locus between schizophrenic patients and normal controls. These results do not support an evidence that IL-2R beta gene plays, a major role in the etiology of schizophrenia.

Interleukin-1 beta , -2, -6 Production, Serum Concentration and Hypothalamic-Pituitary-Adrenal Axis in Patients with Major Depression / 신경정신의학

The present study was carried out in order to investigate the relationship between immune function and the activity of hypothalamic-pituitary-adrenal(HPA) axis in patients with major depression. The subjects were 16 female major depressives and 16 female healthy controls. We measured mitogen-induced production of IL-1 beta, IL-2, IL-6 and serum level of IL-1 beta, IL-2, IL-6 and basal plasma cortisol levels at 8 00 a.m. We measured post-DST(dexamethasone suppression test) cortisol levels in 16 major depressives. The result were as follows : 1) Basal cortisol level was significantly higher in the patients with major depression than in the healthy controls(14.4+/-4.6 microgram/dl, 10.1+/-5.2microgram /dl, respectively, p<0.05). 2) IL-2 production was significantly lower in the patients with major depression than in the healthy controls(1747.3+/-387.9 pg/ml, 2520.2+/-884.1 pg/ml, respectively, p<0.05). There were no significant differences in IL-1 beta and IL-6 production between the patients with major depression and the healthy controls. 3) Serum level of IL-2 was detectable in 12 of 16 patients with major depression and in 10 of 16 healthy controls. There was no significant difference in serum level of IL-2 between two groups. Serum level of IL-1 beta was detectable in 3 of 16 patients with major depression and of 16 healthy controls. We could not detect serum level of IL-6 in both groups. 4) There was significant negative correlation between IL-2 production and post-DST cortisol level(r= -0.89) in the 16 patients with major depression. There was significant negative correlation between serum level of IL-2 and post-DST cortisol level(r= -0.97) in the 12 patients with major depression. There was significant negative correlation between serum level of IL-2 and basal cortisol level(r= -0.65) in the 12 patients with major depression. But there was no significant correlation between IL-2 production and basal cortisol level in the 16 patients with major depression. These findings suggest that immune function is decreased in major depression and the decreased immune function is highly related to the hyperactivity of the HPA axis.

The Effects of Chronic Carbamazepine Administration on Protein Kinase A and Protein Kinase C Activities in Rat Brain

OBJECTIVE: Many evidences suggest that patients with bipolar disorder have functional abnormalities in their postreceptor signal transduction pathways, and mood stabilizing effect of lithium is exerted by modulating this dysfunctioning system. Carbamazepine, an antiepileptic agent, is also known to be effective in the treatment and prevention of bipolar disorder. But the precise mechanism of action of the drug is still poorly understood. This study was performed to elucidate the possible therapeutic mechanism of carbamazepine. METHOD: The effects of chronic carbamazepine administration on protein kinase A and protein kinase C activities in frontal cortex of rat brain after 2 weeks of drug administration were measured and compared with those of control subjects. RESULTS: Mean(+/-SE) value of activity(phosphate transfer micromol/mg of protein, min) or protein kinase A in control and test group was 0.249563+/-0.036 and 0.539853+/-0.078, and that of protein kinase C was 0.654817+/-0.053 and 1.146205+/-0.052 respectively, being increased in test group. And differences between the two groups were statistically significant for both enzymes(protein kinase A ; p<0.01, protein kinase C ;p<0.001). CONCLUSION: These results show that chronic carbamazepine administration increases protein kinase A and C activities, and concerning the possible mode of therapeutic action in bipolar disorder it is suggested that enhanced enzymes phosphorylate receptor-G-protein-effector complexes to dampen hyperfunctioning neuronal activity and thus stabilize the system.

Personality Characteristics of Chronic Insomniacs / 신경정신의학

OBJECTIVES: It is very important to understand the personality characteristics of chronic insomniacs far diagnosis and treatment in clinical practice. The authors investigated the personality factors and the ways of coping to define the personality characteristics which underly the development of insomnia. METHODS: The authors used the diagnostic criteria of International Classification of Sleep Disorders to diagnose chronic insomnia, and performed 16 Personality Factors(PF) test and the Ways of Coping Checklist to both chronic insomniacs and normal controls. The diagnosis of chronic insomnia included psychophysiologic insomnia, poor sleep hygiene, and hypnotics dependent insomnia. The subjects were 21 chronic insomniacs and 26 normal controls. RESULTS: The chronic insomniacs showed significantly lower stableness(C factor ; 4.57 +/-1.89 VS 7.38+/-1.83), intelligence(B factor ; 3.76+/-2.23 VS 6.54+/-1.96), motivation distorsion(B factor ; 3.76+/-2.23 VS 6.54+/-1.96) factor scores, and higher guilt-proneness(O factor ; 6.67+/-2.11 VS 3.81+/-1.65), tension and anxiety(Q4, factor ; 7.57+/-2.29 VS 3.46+/-1.88) factor scores than controls in 16 PF. The chronic insomniacs had significantly higher emotional-focused coping(30.30+/-9.53 VS 24.52+/-5.71) and passive coping pattern scores(50.75+/-13.76 VS 43.26+/-8.73) than controls in the Ways of Coping Checklist. CONCLUSION: The authors suggest that chronic insomniacs are characterized by depressive mood and anxiety-proneness from low ego strength, high levels of anxiety and guilty feelings, and passive and emotion-concentrated coping pattern. This traits are supposed to be factors contributing the state of emotional arousal and resultant physiological activation that has developed and maintained the insomnia.

Efficacy and Safety Profile of Risperidone in Schizophrenia: Open Multicenter Clinical Trial / 신경정신의학

OBJECTIVE: The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. METHOD: This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points: at baseline, and 1,2,4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. RESULTS: 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action: a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. CONCLUSIONS: This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

The Effect of Haloperidol on Serum Levels of Interleukins in Schizophrenic Patients / 신경정신의학

OBJECTIVE: Altered interleukin(IL) regulation has been regarded as an additional proof that schizophrenia has a viral-autoimmunological background. However, it is possible that abnormalities of ILs may represent a neuroleptic artifact rather than a finding intrinsic to the disorder. Therefore, we studied the effect of haloperidol on serum IL level in schizophrenic patents. METHODS: We measured seam levels of IL-1beta, IL-2, and IL-6 using quantitative sandwich ELISA method at the day 0(before-medication), week 4 and week 8 in 20 male schizophrenic patents. RESULTS: There were no significant differences in serum IL-1beta, IL-2, and IL-6 levels between before medication and at either week 4 and week 8 artier haloperidol administration. CONCLUSIONS: These Bindings suggest that at least 8 weeks of haloperidol administration does not affect serum IL-19, IL-2 and IL-6 levels in male schizophrenics.

Adjuvant Sertraline Treallnent for Chronic Schizophrenia :A Randomized, Double Blind, Placeho-Controlled Study

OBJECTIVE: To evaluate the clinical efficacy of adjuvant sertraline treatment in chronic schizophrenic patients, we carried out a double-blind, placebo controlled study. METHOD: Thirty six inpatients who fulfilled DSM-III-R criteria for chronic schizophrenia were randomly assigned to sertraline and placebo groups in a double-blinded fashion. A history of at least 2 years of illness and at least six months of hospitalization were prerequisities for inclusion in the study. Patients were received sertraline 50mg or placebo for 8 weeks in addition to their routine haloperidol regimen, Positive and Negative Syndrome Scale(PANSS), Clinical Global Impression(CGI), Simpson-Angus Scale(S-A) were evaluated at 5 points ; baseline, 2, 4, 6 and 8 weeks of treatment. RESULTS: The groups were controlled for age, gender, and length of illness. There were no significant differences in three PANSS factros(positive, negative, general), CGI and S-A scale scores at any between sertraline and placebo treatment. CONCLUSION: This placebo controlled study showed no significant effects of sertraline on negative and positive symptoms in chronic schizophrenic patients.

The Knowledge and Practice of Sleep Hygiene in Residents of Seoul / 신경정신의학

PURPOSE: Poor sleep hygiene can complicate any other syndrome producing insomnia complaint and must always be considered in any treatment. In clinical situation, it is important for Insomniacs to practice the sleep hygiene rule in treatment strategies. The authors investigated the recognition of sleep hygiene and the practice of it in general population, then provided the data available for physician to educate the sleep hygiene in treatment of insomnia. METHOD: The 330 subjects were at the age above 18 in Seoul, Korea. The questionnaire included the experience of insomnia and knowledge of caffeine, and 4 categories of sleep hygiene instruction, eg, homeostatic drive far sleep, circadian factors, drug effects, and arousal in sleep sleeper. The interview was done face to face by the investigators. RESULTS: In general, the knowledge about the drug effects on sleep was relatively poor. The degree of recognition of each item indicating organization of sleep and arousal in sleep setting was various. Poor sleeper showed no difference in recognition of sleep hygiene categories except drug effects on sleep compared to good sleeper, but they practiced sleep hygiene rules poorly in categories of homeostatic drive and arousal in sleep setting, though various by items. CONCLUSION: The findings, in which the degree of recognition of the items in 4 sleep hygiene categories was venous, indicated that sleep hygiene education should be done in details by each item. It seems like the poor sleeper practiced sleep hygiene poorly in categories of homeostatic drive and arousal in sleep setting compared to good sleeper. this finding suggested that the efforts, which reflected the behavioral patterns of insomniacs shown in clinical setting to get good sleep, frustrated the practice of sleep hygiene actively.

Polysomnographic findings of a case of narcolepsy / 신경정신의학

No abstract available.

Clinical features and polysomnographic findings of sleep apnea syndrome / 신경정신의학

No abstract available.

A study on the sleep patterns of the general adult population in Seoul / 신경정신의학

No abstract available.