Catechol-O-Methyltransferase Gene Polymorphism of Attention Deficit Hyperactivity Disorder in Korean Population / 신경정신의학

OBJECTIVE: Attention-deficit hyperactivity disorder is a highly heritable psychiatric condition of early childhood onset characterized by marked inattention, hyperactivity and impulsiveness. Genes involved in catecholamine pathways, including catechol-O-methyltransferase (COMT), represent potential candidates, given that around 70% of children with ADHD show a symptomatic improvement when treated with methylphenidate, a psychostimulant. This study was designed to investigate the association of COMT polymorphism with ADHD in Korean population. METHOD: In this study, we used both family-based (the haplotype relative risk & the haplotype-based haplotype relative risk design) and case-control approaches to examine COMT polymorphism. The sample included 31 Korean children (25 males, 6 females) diagnosed as ADHD by DSM-IV, their 31 families with 31 mothers and 27 fathers and 106 normal controls. RESULTS: There were no differences of COMT genotype and allele frequencies between ADHD patients and control subjects. Also, there was no difference of COMT genotype between ADHD patients and HRR controls. The COMT1 allele frequencies of normal control group in Korean population (75%) was significantly different with that frequency of Caucasian population (50%). CONCLUSION: These results suggest that COMT polymorphism is not associated with ADHD in Korean population. However, the possibility of interacting effects of COMT with other genes or environment should be investigated.

Changes in Serum Cortisol Levels and Clinical Symptoms after the Administration of Risperidone in Schizophrenic Patients / 신경정신의학

OBJECTIVE: This study was designed to identify the role of serotonin and cortisol in the pathophysiology of schizophrenia by measuring quantitative change of serum cortisol levels after risperidone(5HT2 antagonist) administration. METHOD: Subjects included 10 male and 7 female patients who met DSM-IV criteria for schizophrenia(n=17). Blood samples(4ml/sample) were taken at the baseline, 1st, 2nd, 3rd, 14th, 28th and 42nd days, twice, at 8:00 AM and at 10:00 AM in the morning after an overnight fast. The daily medication was administered after the first blood sampling at 8:00 AM. After baseline sampling, the same dose of risperidone was administered to each patient until the end of the 3rd day. The dose of risperidone was then decided by clinical evaluation. Serum cortisol concentrations were measured by standard double-antibody radioimmunoassay. RESULT: 1) Administration of risperidone significantly decreased serum cortisol levels(p<0.05). 2) There were significant reductions in positive symtom scores(21.7+/-3.8, vs 14.3+/-4.1) and negative symptom scores(20.5+/-5.2, vs 15.2+/-3.2), general symptom scores(44.3+/-5.4, vs 32.9+/-4.2) of PANSS after risperidone administration(p<0.05). 3) There were no significant differences in baseline serum cortisol levels and the reductions of serum cortisol levels after administration of risperidone between males and females. 4) There were no significant differences in baseline serum cortisol levels and the reductions of serum cortisol levels after administration of risperidone between positive symptom subgroup and negative symptom subgroup. CONCLUSION: These results suggest risperidone decreases serum cortisol levels in s chizophrenic patients and the reduction of cortisol by risperidone administration might be important factor in the treatment of schzophrenics, in contrast with typical antipsychotics.

Changes in Serum Prolactin Levels after the Administration of Risperidone in Schizophrenic Patients: Gender Difference / 대한정신약물학회지

OBJECTIVE: In spite of being an atypical antipsychotic which has serotonergic(5HT2) biocking activity in addition to the dopaminergic(D2) antagonistic action, risperidone elevates serum prolactin level. Hyperprolactinemia secondary to neuroleptic treatment have an obvious impact on fertility. We investigated the prolactin response after oral administration of risperidone and compared the prolactin responses between male and female subjects. METHOD: Subjects included 10 male and 7 female patients who met DSM-IV criteria for schizophrenia(n=17), Blood samples(4 ml/sample) were taken on the 1st, 2nd, 3rd, 14th, 28th and 42nd days, twice, at 8:00 AM and at 10:00 AM in the morning after an overnight fast. The daily medication was administered after the first blood sampling at 8:00 AM. After baseline sampling, the same dose of risperidone was administered to each patient until the end of the 3rd day. The dose of risperidone was then decided by clinical evaluation. Serum prolactin concentrations were measured by standard double-antibody radioimmunoassay. RESULTS: Administration of risperidone significantly increased serum prolactin levels (p<0.05). After administration of risperidone, the elevations of serum prolactin level in women was significantly higher than those in men (p<0.05). There were significant reductions in positive symptom stores (21.7+/-.8, vs 11.4+/-.0) and negative symptom score (20.5+/-.2, vs 14.6+/-.8), general symptom store (44.3+/-.4, vs 30.9+/-.0) of PANSS by risperidone administration for 6 weeks(p<0.05). All patients developed hyperprolactinemia and one of the ten men developed women developed menstrual disturbance during observation period. CONCLUSIONS: This study suggests that administration of risperidone results in a significant increase of prolactin and the elevation of serum prolactin levels were significantly higher in women, therefore clinicians should be vigilant to possible reactions in female patients with psychotic symptoms upon treatment with risperidone.

Altered Auditory Event Related Potentials Following Administration of Methylphenidate in Children with Attention Deficit Hyperactivity Disorder / 신경정신의학

OBJECTS: Event related potential(ERF) has been recently applied to examine the neurophysiological disturbance in attention deficit hyperactivity disorder(ADHD), particularly with regard to N100 and P300 which are known as one of ERP components closely linked with cognitive function. On the basis of these aspects, this study was designed to evaluate electrophysiologic characteristics and its availability for diagnosis and treatment of ADHD children by comparison of ERP between normal controls and ADHD children before and after methylphenidate (MFD) administration. METHODS: We examined the topographic auditory ERF and T.O.V.A.(Test of variables of attention), a standardized computerized visual continuous performance test following administration of stimulant drug, MPD 10mg in 13 ADHD children and compared these results with those of 11 normal controls. RESULTS: The results were as follows: 1) Thought the difference was not spastically significant(P=0.0548), N100 latencies seemed to be longer in ADHD children than in normal controls. N100 amplitudes also seemed to be larger in ADHD children than in normal controls(P=0.0629). 2) The F300 latencies significantly shortened after MFD administration when compared with those before MPD administration in ADHD group(P<0.01). 3) ADHD group performed significantly less well than normal controls in T.O.V.A.(P<0.05). And T.O.V.A. scores significantly improved after MFD administration in ADHD group(P<0.01). 4) The N100 and P300 latencies and the T.O.V.A. scores were significantly correlated before MPD administration in ADHD group(P<0.05). 5) The F300 latencies before MFD administration were significantly correlated with the amplitudes of changes of T.O.V.A. scores after MFD administration(P<0.05). CONCLUSION: It seems that prolonged N100 latency of ADHD children can be regarded as a relatively enduring trait marker and that F300 latency may reflect attentional response ability along with therapeutic effect by stimulant.

Correlation between Naturally Occurring Hypnotic Experiences and Hypnotic Induction Profile Scores in Korean Medical Students / 신경정신의학

OBJECTIVE: We attempted to investigate the relation between naturally occurring hypnotic experiences and hypnotizability. We examined the correlations among hypnotic induction profile scores, natural hypnotic scores, induction scores and MBTI personality types. METHODS: Sixty-three medical students completed NHQ(natural hypnotic questionnaire) developed from a list of naturally occurring hypnotic-like experiences and MBTI(Myers-Briggs Type Inventory), HIF(Hypnotic Induction Profile) was also administered to all the subjects. HIF score and IND(induction score) were obtained. RESULTS: 1) The NHS(natural hypnotic score) was significantly correlated with IND in all the subjects. The IND also showed significant correlation with HIF score. 2) There was no significant correlation between NHS and HIP scores. 3) HIF scores were positively correlated with induction scores in all types of MBTI. 4) Natural hypnotic scores were positively correlated with HIF scores and induction scores in introvert and thinking types. 5) There were positive correlations between natural hypnotic scores and induction scores in intuition and judgment types. CONCLUSION: The natural hypnotic scores were correlated with induction scores. It is suggested that the more the naturally-occurring hypnotic experience is experienced, the better the hypnotic induction is induced In introvert and thinking types of MBTI personality types.

Atenolol Induced Visual Hallucination in Patients with Underlying cerebral Infarction / 대한정신약물학회지

Atenolol is a beta1-selective adrenoreceptor blocking agent which is generally thought of as cardioselective, with little CNS action, because it has hydrophilic solubility rather than lipophilic. But recently, it has been reported that atenolol also can cause CNS side effect, especially in the patient with past neuropsychiatric history, old age, or underlying cerebral lesion. This 59-year-old female case demonstrated that atenolol could be an etiological agent of visual hallucination in a elderly patient with cerebral infarction.