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.

High-Dose Zolpidem Dependence and Detoxification from Withdrawal Symptoms Using Diazepam / 신경정신의학

Zolpidem is a nonbenzodiazepine hypnotic for the treatment of insomnia, and known as a relatively-safe medication. However, there have been several case reports of zolpidem abuse aand dependence these days. Even though some withdrawal symptoms like seizures can occur, there has not been any standard detoxification method until now. A high dose of zolpidem has similar pharmacological properties as the rest of the benzodiazepines, even though the usual dose of zolpidem has a selectivity to the type 1 benzodiazepine receptors. We report a rare case of high-dose addiction and successful detoxification by cross-titration with diazepam.