Effects of Psychosocial Factors and the Genotypes of Aldehyde Dehydrogenase II and Tryptophan Hydroxylase on the Alcohol Use in Freshmen of a University / 대한정신약물학회지

OBJECTIVE: This study was done to investigate the genetic polymorphism of Aldehyde Dehydrogenase (ALDH) II and Tryptophan Hydroxylase (TPH) and examine effects of socio-demographic, psychological and genetic factors on the alcohol use in freshmen of a university in Korea. METHODS: ALDH II (N=534) and TPH (N=504) genotypes of 551 subjects were analyzed using polymerase chain reaction and restriction fragment length polymorphism method. The severity of alcohol drinking was assessed by average alcohol use per drinking episode and frequency of drinking per month. Characteristics of alcohol related behaviors, socio-demographic information, and motives and expectancies of drinking in the subjects, were assessed by designed questionnaires and selfreport scales. RESULTS: The frequencies of NN, ND, and DD genotype of ALDH II (N=534) were 64.0%, 30.1%, and 5.8%, while those of AA, AC, and CC genotypes of TPH (N=504) were 31.7%, 48.4%, 19.8% respectively. The distribution of ALDH II genotypes was not correlated with that of TPH genotypes. Subjects with D (-) (NN) genotype showed more average alcohol use per drinking episode (chi2 trend=29.42, p=0.001) and higher severity index of alcohol drinking (F=9.36, df=2, p=0.000) compared with those with D (+) (ND or DD) genotypes. Subjects with D (-) genotype showed higher frequency of heavy drinking behavior (chi2 trend=5.25, p=0.022) and blackout episode (chi2 trend=17.84, p=0.001). Socio-demographic, psychological, and genetic factors seemed to contribute to the severity of alcohol drinking in the subjects. CONCLUSIONS: C allele of TPH genotypes is important in determining the severity of drinking in subjects with NN genotype of ALDH II. Social motive, gender, and D allele of ALDH II genotype are contributing factors to determine the severity of drinking in total subjects. D allele of ALDH II genotypes plays an important role in determining the severity and motives of drinking, and other alcoholrelated behaviors.

CAG Repeats of KCNN3 Gene in the Patients with Schizophrenia / 신경정신의학

OBJECTS:We investigated a possible association between the polymorphic trinucleotide repeat(TNR) expansion in neuronal potassium channel gene KCNN3 and schizophrenia. METHODS: CAG/CTG repeat distribution in KCNN3, CTG18.1 and ERDA1 was examined and the copy number of ligation product in repeat expansion detection(RED) was measured in Korean patients with schizophrenia(n=245) and ethnically matched healthy controls(n=116). RESULTS: Longer alleles in the KCNN3 gene were over-represented in patients. The frequency of alleles with CAG repeats longer than 19 copy in the KCNN3 gene was higher in the patients with schizophrenia as compared to controls(73.3% vs. 65.1%;p=0.029, Fisher's exact test). And this difference was more prominent in schizophrenic patients with familial background(p=0.03, Fisher's exact test). We found no difference in the frequency of longer alleles between negative and positive subtypes of schizophrenia. Ligation product size in RED and alleles with CAG repeat number in the CTG18.1 gene was not increased in the patients. The copy number of ligation product in RED was highly correlated with CAG/CTG copies of ERDA1 in the patient group(r=0.45, p<0.001) as well as in the control group(r=0.44, p<0.001). However, CAG repeat length in the KCNN3 gene was not correlated with ERDA1 score. CONCLUSIONS: Our results support the hypothesis that the longer allele of KCNN3 may be considered as a candidate gene for schizophrenia, especially in the case with familial background. And the RED assay results was affected by the CAG copy number of ERDA1.

Antipsychotics Maintenance Therapy of Schizophrenic Patients: A Survey on the Psychiatrists' Practice in Extended Seoul Metropolitan Areas / 신경정신의학

We investigated the actual status of antipsychotics maintenance therapy(AMT) for schizophrenic patients through a mail survey sent to psychiatrists practicing in Seoul and Kyonggj province who had no less than two years of psychiatric expertise and who were below fifty years of age. Out of 453 questionnaires sent, 215 completed questionnaires were returned (response rate 47%). The majority of respondents considered pharmacotherapy as the most important longterm treatment strategy for schizophrenia. Haloperidol was selected by the majority as their first choice neuroleptics. The proposed mean daily maintenance dosage was 383+/-229(75-1250)mg in chlorpromazine equivalent. The mean duration of AMT was 1.8+/-1.0(0.25-7.5)years after the first episode and 3.6+/-1.8(0.5-10)years after multi-episodes. Psychotherapy was regarded as more important by the resident psychiatrists group than by the certified psychiatrists. There were preferential differences for a particular treatment strategy, dosage and duration of AMT among the different clinics. A great number of respondents(93%) regarded long-term continuous maintenance as their major AMT policy, Only a few respondents(4.3%) were satisfied with the established guidelines for AMT in treatment of schizophrenia. The results show considerable variations in psychiatrists opinions on AMT which was influenced by grades of expertise of the clinician and the working environment of the clinic or the hospital. To decrease these variabilities and make clinically useful guidelines, it will be necessary' to do further pharmacoepidemiological studies as well as other types of related clinical research.

Acute PTSD in Survivors of a Building Collapse Accident in Seoul: A Preliminary Study on Incidence, Predictors and Pattern of Symptom Changes / 신경정신의학

OBJECTIVE: This is a prospective clinical study on survivors of the collapse accident of a major department store building occurred in Seoul in lune 1995 to investigate the incidence of acute PTSD, to identify risk factors affecting the severity of PTSD symptoms, and to evaluate the pattern of symptom changes over time. METHOD: Thirty-two victims were interviewed with modified Korean version of the PTSD-I(DSM-III-R) to determine the severity of symptoms and diagnosis of PTSD. Degrees of anxiety and depression were measured with Hamilton's Anxiety Scale(HAS) and Depression Scales(HDS) respectively. Subjects were assessed in series at one month(time point 1) and three month(time point 2) from the time the accident occurred. RESULTS: The incidence of PTSD in the subjects over the 3 months was 41% using by full criteria and 48% by partial criteria. Regression analysis at the time point 1, the HDS score, which was partially related with death of accompanied persons(friends/relatives/colleagues), contributed significantly to the PTSD-I variances. At the time point 2, loss of consciousness contributed significantly to the variance of the PTSD-1, HDS and HAS scores. Between tire point 1 and time point 2, the overall severity of PTSD symptoms far all the subjects has remained almost unchanged. However, re-experience and hyperarousal symptoms were improved in comparison with avoidance symptoms, although not statistically significant. CONCLUSIONS: This study result show a high risk of developing PTSD and partial PTSD among the building collapse victims. The death of accompanied person, severity of depression and loss of consciousness are all regarded as major factors affecting the severity of PTSD. Of PTSD symptom clusters, avoidance symptoms are likely to be less changeable than reexperience and hyperarousal symptoms over time.