Attention Deficit Hyperactivity Disorder Like Behavioral Problems and Parenting Stress in Pediatric Allergic Rhinitis

OBJECTIVE: Previous studies have reported comorbidity of attention deficit and hyperactivity disorder (ADHD) and allergic diseases. The current study investigated ADHD like behavioral symptoms and parenting stress in pediatric allergic rhinitis. METHODS: Eighty-seven children (6-13 years old) with allergic rhinitis and 73 age- and sex-matched children of control group were recruited. Diagnosis and severity assessments of allergic rhinitis were determined by a pediatric allergist. The Parenting Stress Index-Short Form (PSI-SF), ADHD Rating Scale (ARS), and Child Behavior Checklist (CBCL) were completed by their mothers. RESULTS: In the allergic rhinitis group, the total PSI-SF score (p<0.01), ARS score (p<0.01), the subscale scores of the CBCL including somatization, attentional problems and emotional instability (p=0.01; p<0.01; p<0.01) and prevalence of ADHD (p=0.03) were significantly higher than those of the control group. Among mothers of children with allergic rhinitis, those of children with comorbid ADHD demonstrated significantly higher parenting stress than those without comorbid ADHD (p<0.01). Parenting stress was correlated with severity of child's allergic symptoms and the ARS total score (beta=0.50, p<0.01; beta=0.39, p<0.01). There was a significant correlation between allergic symptom severity and the ARS total score (B=8.4, SD=2.5, t=3.3, p<0.01). CONCLUSION: This study demonstrated that ADHD symptoms were common in children with allergic rhinitis, and this factor increased parenting stress and disrupted the parent-child relationship. Routine evaluation and early management of ADHD symptoms in pediatric allergic rhinitis may benefit families of children with allergic rhinitis.

Treatment Options of Metastatic Brain Tumors from Hepatocellular Carcinoma: Surgical Resection vs. Gamma Knife Radiosurgery vs. Whole Brain Radiation Therapy

OBJECTIVE: Although metastasis of hepatocellular carcinoma to the brain is uncommon, it is associated with a very high mortality rate and most patients usually expire within 1 year after brain metastasis. The aim of this study is to identify the effectiveness of the active interventions such as gamma knife radiosurgery or surgical intervention for these patients. METHODS: We retrospectively reviewed the medical records and imaging data of 59 patients with metastatic brain tumors from hepatocellular carcinoma from May 2004 to September 2012. The study included patients with available clinical and radiological data who had been diagnosed with metastatic hepatocellular carcinoma of the brain, confirmed by magnetic resonance imaging. The overall survival time was analyzed and compared according to each risk factor. RESULTS: The mean age at diagnosis of metastatic brain tumor was 52.2 years (14-77). The mean follow-up duration was 13.3 weeks (0.1-117.6). Overall median survival was 4.3 weeks (95% confidence interval, 2.2-6.4). The results from an analysis of clinical factors related to survival revealed that treatment modalities were significantly related to the patient's survival (log rank, p=0.006). Twenty patients (32.8%) experienced tumor bleeding, and the survival time of the patients with tumor bleeding tended to be shorter, although the result was not statistically significant (log rank, p=0.058). Hepatic reserve, by Child-Pugh classification, was grade A in 38 patients (64.4%), grade B in 16 patients (27.1%), and grade C in 5 patients (8.5%), and was significantly related to the patient's survival (log rank, p=0.000). CONCLUSION: Although patients with metastatic brain tumors from hepatocellular carcinoma showed poor survival, active intervention including surgical resection or gamma knife radiosurgery may result in better survival, especially if patients have preserved liver function.

Comparison of Effect of SSRIs, SNRIs, and NaSSA on Pain / 대한정신약물학회지

OBJECTIVE: Selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and noradrenergic and specific serotonergic antidepressant (NaSSA) are extensively used to treat the patients with depression. Although depressed patients are complaining of somatic pain as a complication of depression, there has not been any straight-forward comparative data of the effect of SSRIs, SNRIs, and NaSSA on pain. Therefore, in this study, we tried to figure out the effect of each drug i.e.SSRIs, SNRIs, and NaSSA, on pain by administrating each drug to three different groups of patient with depression. METHODS: We conducted a chart review of patients, who visited a university hospital. From January, 2010 to February, 2012, total 150 inpatients who had been diagnosed as major depression by Diagnostic and Statistical Manual of Mental Disorders-4th edition criteria, and administered any of three drugs [SSRIs (n=50), SNRIs (n=50), and NaSSA (n=50)] at least for fore weeks in the department of psychiatry in Chung-Ang University Hospital, were enrolled for this study. We compared and analyzed depressive symptoms and pain between three groups. Depressive symptoms and pain were evaluated by Korean version of the Hamilton Depression Rating Scale and visual analogue scale at baseline and fore weeks later. RESULTS: There was no difference in the age, gender, severity of depression and pain among three groups. However, there was difference in 50% depressive symptomatic improvement rate in the following four weeks among three groups. The number of patient found to achieve 50% symptomatic improvement in SSRIs, SNRIs, and NaSSA group was 17 (34%), 20 (40%), and 34 (54%) in each group, respectively, indicating significantly higher improvement rate in NaSSA compared to SSRIs. During four weeks of administration period, significant difference in 50% pain improvement rate was observed among three groups. The number of patient found to achieve 50% pain improvement in SSRIs, SNRIs, and NaSSA group was 14 (28%), 20 (40%), and 27 (54%) in each group, respectively, showing twice higher pain improvement rate in NaSSA compared to SSRIs. CONCLUSION: This result indicates better efficacy of NaSSA on pain improvement compared to SSRIs, and SNRIs in depressed patients. Although the effect of pain improvement has been mainly focused on SNRIs, result from this study suggests the need for further research and validation on the effect of NaSSA for pain control.

Growth Characteristics and Physiological Functionality of Yeasts in Pear Marc Extracts

Kluyveromyces fragilis KCTC 7260 and Saccharomyces cerevisiae KCTC 7904, which both grew well in pear marc extract, were selected and their growth profiles and physiological functionalities were determined. Both of the selected yeasts established maximal growth by 20 hr of cultivation at 30degrees C in pear marc extract. The cell-free extracts showed high antihypertensive angiotensin I-converting enzyme inhibitory activity of 68.9% and 52.1%, respectively. The extracts also displayed 9.2 U/mL and 12.0 U/mL of protease activity, respectively.

Multicenter Clinical Trials for Efficacy and Safety of Mirtazapine in Moderate-to-Severe Major Depressive Patients / 대한정신약물학회지

OBJECTIVE: The purpose of this study is to evaluate the efficacy and safety of mirtazapine treatment in multicenter population consisting of Korean patients suffering from moderate-to-severe depression. METHODS: Total 163 of in and outpatients with a diagnosis of major depressive disorder (DSM-IV) and 18 or over scores of 17-items Hamilton Rating Scale for Depression (HAMD) received treatment with mirtazapine (15-45 mg/day) for 6 weeks. Efficacy was assessed by HAMD, Montgomery and Asberg Depression Rating Scale (MADRS), Beck's Depression Inventory (BDI), and Clinical Global Impression (CGI) scales and statistical analyses were performed on the intent-to-treat sample (143 patients) using the last-observation-carried-forward method. In addition, reported adverse events, routine laboratory parameters, and vital signs were investigated to evaluate the safety of mirtazapine. RESULTS: Mean daily dose of mirtazapine was 28.4 mg. At the end of the study, the response rate (50% or more reduction from baseline in HAMD scores) was 75.5% and the remission rate (7 or less in HAMD score) was 42.7%. Mirtazapine treatment induced significant reduction in depressive symptoms at the 4(th) day and substantial reduction along the treatment period, as assessed by changes in HAMD, MADRS, BDI, and CGI scales. At the 4(th) day and first week of mirtazapine treatment, the mean HAMD-17 total score was significantly reduced compared that of the baseline and the response rates were 11.9% and 28.7%, respectively. Mirtazapine was well tolerated in general, and somnolence and sedation were the most common adverse events reported. In addition, there were no clinically relevant changes in laboratory parameters and vital signs, although body weight was increased. CONCLUSION: Although this trial had many limitations of open non-comparative study, mirtazapine was demonstrated to an effective treatment for moderate to severe major depressive disorder and was well tolerated. A potentially rapid onset of overall therapeutic efficacy of mirtazapine was suggested by significant changes in all major variables of efficacy after 4(th) day of treatment.

Early Treatment Response of Bupropion SR in Smoking Cessation according to Genetic Polymorphism and Temperamental Characteristics / 대한정신약물학회지

OBJECTIVE: Bupropion is an antidepressant with proven efficacy for smoking cessation, however the response rate is some limited. With this background, the authors investigated the difference of early bupropion response in smoking cessation according to individual genetic polymorphism and temperamental characteristics. METHOD: Subjects were 113 Korean male volunteers who were nicotine dependent and wanted to quit smoking. Authors compared 6 candidate genes (DRD2, DRD4, dopamine transporter, norepinephrine transporter, serotonin transporter, COMT), and Temperament Character Inventory (TCI) between response group and non-response group after 3 weeks bupropion treatment. RESULT: Among 6 candidate genes, DRD2 homozygotes (A2/A2+A1/A1), COMT H/H genotype and H allele carriers showed high rate of smoking cessation by bupropion. NET-8 GG genotype and G allele carriers showed low rate of smoking cessation by bupropion. Persistence score in TCI was significant between two groups. CONCLUSION: DRD2, COMT, NET-8 genetic polymorphisms and some temperamental characteristics could predict success of smoking cessation by early treatment response of bupropion.

Relationship between Alcohol Withdrawal Symptoms and Dopaminergic Gene Polymorphisms(DRD2, DAT, COMT) in Alcohol Dependence Patients

with DAT-9 gene allele. And The total score of CIWA-Ar scale in the subject without DAT-9 gene allele was significantly higher than in the subject with DAT-9 gene allele. COMT: The total score of CIWA-Ar scale in heterozygote was significantly higher than in homozygote. CONCLUSION: Our results suggest the relationship between specific genetic factors and the withdrawal symptoms of alcohol dependent patients. As the candidate gene of the severity of alcohol withdrawal syndrome, DRD2 Taq1 gene was recommended.

Serum Homocysteine Level and MTHFR C677T, A1298C Gene Polymorphism in Korean Schizophrenics

OBJECTIVES: Recently in schizophrenia high incidence of MTHFR(methylenetetrahydrofolate reductase), which is a main relating enzyme that reduce homocysteine level, genetic variations were reported. So we examined serum homocysteine level and MTHFR gene polymorphism in Korean schizophrenics. METHOD: We compared serum homocysteine level and MTHFR polymorphism between 235 schizophrenics (100male, 135female) and 235 normal controls(100male, 135female). C677T and A1298C polymorphism of MTHFR gene were analyzed. RESULTS: 1) C677T genetic mutation(CT and TT) were more frequent in schizophrenia group than normal control group(p<0.01). But the difference of A1298C mutation frequency was not found between two groups. 2) In schizophrenia patients, TT genotype of C677T mutation showed significantly higher homocysteine level (29.99uM/L) than other group(CT : 13.34uM/L, CC : 9.34uM/L p<0.01). 3) MTHFR 677 TT homogeneous mutation genotype showed two times more risk(odds ratio=2.15) than 677CC normal genotype in schizophrenia. CONCLUSION: Some schizophrenia patients with high homocysteine serum level may have C677T TT genotype. In that case, folate ingestion could be a good management for clinical improvement.

Comparison of Serum Homocysteine, Folate and Vitamin B12 Level in Korean Schizophrenics

OBJECTIVE: There have been a kind of transmethylation theory that high homocysteine serum concentration affects schizophrenia by neurotoxic mechanism and clinical reports that some schizophrenic patients with high homocysteine were improved by high folate ingestion. This study was done to confirm previous research results and find the clinical characteristics of schizophrenia showing high serum homocysteine and low folate. METHOD: We compared the serum levels of homocysteine, folate and vitamin B12 level between 234 schizophrenic patients(male 99, female 135) group and 234 normal controls(male 99, female 135) group. The subjects of two groups were age and sex matched. The evaluated clinical characteristics items were sex, age, onset of disease, hereditary loading, disease course, hallucination and subtype of schizophrenia. RESULTS: 1) Homocysteine level of the schizophrenia group was significantly higher than the normal control group and folate level of the schizophrenia group was significantly lower than the normal control group. Homocysteine level was more negatively correlated with folate level in the schizophrenia group than the normal control group. 2) The percentage of high homocysteine(above 12.46umol/L;90 percentile of normal control) was 33.8% of schizophrenia patients and 51.5% of male schizophrenia. The percentage of low folate(below 3.8nM/L;bottom tertile of normal control) was 66.2% of schizophrenia. 3) In low folate group and not-low folate group, schizophrenia showed significantly higher homocysteine level than normal control. Especially, low folate schizophrenia group showed significantly higher homocysteine level than low folate normal control group. CONCLUSIONS: Some schizophrenia patients with high serum homocysteine may be genetic defector and having low folate serum level. In that case, folate ingestion could be a good management for clinical improvement.

Changes of Smoking Urge and Endogenous Opioids, Prolactin, ACTH, Cortisol Levels in Nicotine Dependents with Naltrexone Pretreatment / 신경정신의학

OBJECTIVES: There is a controversy on the mechanism of nicotine dependence. Some suggest that the negative reinforcement such as withdrawal symptoms plays an important role, but others suggest that the positive reinforcement through the opioid-dopamine system plays an important role. Under the assumptions that the positive reinforcement and the opioid-dopamine interaction to have an important role in nicotine dependence, this study examined the effects of chronic naltrexone treatment on smoking behaviors, smoking urges to smoking cues and neuroendocrine responses to smoking. METHODS: In a randomized, placebo-control, double-blind design, voluntarily admitted regular smokers who wanted to quit smoking received naltrexone (13 persons) or placebo (12 persons) treatment for 2 weeks. Each week, naltrexone side effects, discomforts after the reduction of cigarette smoking, smoking urges to smoking cues, daily cigarette smoking amount, and expiratory carbon monooxide levels were checked. Also blood beta-endorphin, dynorphin, prolactin, ACTH, and cortisol levels were measured before and after smoking. RESULTS: Naltrexone treatment group showed significantly reduced smoking urges to smoking cues (p=0.036 at 2nd week), daily cigarette smoking amount (p=0.027 at 1st week), and expiratory CO levels (p=0.002 at 1st week, p=0.039 at 2nd week). Naltrexone treatment group also showed significantly increase cortisol level after smoking during the 1st week (p=0.048), and ACTH and prolactin level during the 2nd week (respectively p=0.010, p=0.009). But, the levels of beta-endorphin and dynorphin A were not different between the two groups. Discomfort profiles after the reduction of cigarette smoking, systolic and diastolic BP, and pulse rates were not different between the two groups. CONCLUSION: Longterm naltrexone treatment could be an effective tool used for the cessdtion of smoking. It was suggested that naltrexone blocks the positive reinforcement effects of smoking rather than the negative reinforcement effects of nicotine withdrawal.

Depression in Schizophrenia / 신경정신의학

OBJECTIVE: The heterogeneity of symptomatology within the group of schizophrenias is still a major obstacle for defining clinically useful subgroups of these disorders. One of these symptoms is depression. Recently there is a growing evidence suggesting that depressive symptoms and related mood disturbances are important in treating schizophrenia. This is so because of the improvement of such side effects as extrapyramidal symptoms with increasing use of atypical antipsychotics. Although depression is known to be a serious problem of many schizophrenic patients, the nature and course of depression in schizophrenia remain unknown. METHODS: The author examined the depressive features in 31 patients with schizophrenia. Ratings on the PANSS, BDI and HDRS were obtained. Eighteen percent of the total patients had BDI score above 21, considered depressed. RESULTS: There were no differences in BDI, HDRS and PANSS-D between positive symptom group and negative symptom group. There was also no correlation between subject scale(BDI) and objective scales(HDRS, PANSS-D). CONCLUSIONS: Depression in schizophrenia needs intensive studies. It is also considered as another heterogeneous domain beside negative or positive symptom domains. Out of respect for the high prevalence and serious outcome of depression in schizophrenia, a more differentiated assessment, analysis, and treatment of depressive symptom is recommended.

A Pilot Study for Genetic Polymorphism of Catechol-O-Methyltransferase (COMT) in Panic Disorder / 신경정신의학

OBJECTIVES: Catecholamine metabolism has been thought to be related to the pathophysiology of panic disorder. There are two human COMT alleles, coding for a low activity enzyme, COMT L(L), and a high activity enzyme, COMT H(H), respectively. We examined the distribution of COMT genotypes and the relationship between COMT genetic polymorphism and some clinical characteristics in patients with panic disorder. METHOD: We recruited 51 patients who met the DSM-IV criteria for panic disorder, and 45 normal control subjects who had neither medical nor psychiatric illnesses. Genetic polymorphism of COMT was identified in all subjects using PCR-based restriction fragment length polymorphism(RFLP) analysis. We assessed some clinical variables including treatment responses in panic patients and measured anxiety and depression levels in normal control subjects using Spielberger State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI). RESULT: The frequency of the homozygous LL genotype was higher in panic patients than that in control subjects (19.6% vs. 2.2%). We found that panic disorder was significantly associated with L allele (x2=8.66, p=0.003) and LL genotype(x2=8.45, p=0.015). Panic patients with LL genotype showed poorer treatment response than those with other genotypes (F=4.98, p=0.011). CONCLUSION: These results suggest that LL genotype of the COMT gene may be related to the pathophysiology and clinical courses in some patients with panic disorder.

Alcohol Urge and Plasma beta-endorphin Change after Alcohol Challenge in Naltrexone Pretreated Social Drinker / 신경정신의학

OBJECTIVES: The present study was performed to evaluate whether naltrexone treatment are effectively lowering the urge of alcohol drinking, and to investigate the its mechanism of action. METHODS: 15 healthy male social drinkers were voluntarily participated. The experimental method was double-blind placebo-controlled cross over design. Subjects ingested a naltrexone (50mg)/day or placebo for 1 week. Plasma beta-endorphin, plasma ACTH and serum cortisol levels were measured before, at 20 minutes and at 60 minutes after alcohol exposure. Subjects completed self-report questionnaires such as the visual analog scales of drink urge and the alcohol sensation scales at regular intervals. RESULTS: 1) During naltrexone pretreatment period, subjects reported more headache, dizziness, nervousness, fatigue, day somnolence, nausea, and decreased appetite than placebo pretreatment period. But serum GOT/GPT levels were not significantly different between two pretreatment periods. 2) In case of naltrexone pretreatment, subjects reported significantly less urge to alcohol drink on the self-reporting urge scales, especially at post-drinking 20 minutes and 60 minutes than placebo pretreatment. 3) After alcohol challenge, subjects reported significantly more dizziness on the alcohol sensation scales in case of naltrexone pretreatment, and reported less mood elevation trend though it was not statistically significant. Other scores were not significantly different between two pretreatments. 4) Plasma beta-endorphin levels were significantly different when treated with naltrexone. In case of naltrexone-pretreatment, the increasing degree of plasma beta-endorphin during 20 minutes after alcohol challenge was significantly higher than placebo pretreatment. 5) Basal plasma ACTH level and basal serum cortisol level were not significantly different between two pretreatments. After alcohol challenge, only the decreasing degree of plasma ACTH levels during 20 minutes was significantly lowered in the naltrexone pretreatment than placebo pretreatment. CONCLUSIONS: Naltrexone reduced urge to alcohol drinking in social drinker. The action mechanism of naltrexone may be partially blocking opioid positive reward system and partially alcohol mimicking its property.

Plasma Beta-Endorphin, Adrenocorticotropic Hormone and Cortisol Change in Alcohol Abstinent Patients / 신경정신의학

OBJECTIVES: The present study was performed to evaluate the change in releasing action of hypothalamus-pituitary-adrenal axis after alcohol abstinence in patients with alcohol dependence, and to identify the etiologic mechanism of alcohol dependence indirectly. METHODS: Plasma beta-endorphin, cortisol and ACTH level was measured in 14 alcohol dependent patients and in 14 healthy persons after 7 days and 28 days of alcohol abstinence at 08: 00h and 12: 00h, twice a day. RESULTS: 1) There was no significant difference in plasma beta-endorphin, cortisol and ACTH level measured at 08: 00h and 12: 00h between patients and control group after 7days of alcohol withdrawal. 2) Plasma beta-endorphin level measured at 08: 00h in patients was significantly elevated comparing with control group after 28days of alcohol withdrawal. But, there was no significant difference in plasma beta-endorphin level measured at 12: 00h and in plasma cortisol and ACTH level measured at both 08: 00h and 12: 00h between two groups after 28days of alcohol withdrawal. 3) In the patient group, there was no significant difference between patients after 7days and 28 days of alcohol withdrawal in plasma beta-endorphin, cortisol and ACTH level measured at 08: 00h and ACTH level measured at 12: 00h. But, beta-endorphin and cortisol level measured at 12: 00h were significantly lowered in patients after 28days of alcohol withdrawal than after 7days of withdrawal. 4) In decreasing rate of beta-endorphin production from 08: 00h to 12: 00h, there was significant difference between patients and controlled group after 28days of alcohol withdrawal. CONCLUSION: In alcohol dependent patients, lower level of beta-endorphin and increased reducing rate in diurnal variation of beta-endorphin after alcohol withdrawal are evident, which in turn may elevate craving for alcohol intake, and there findings support the opioid compensation theory in the development of alcohol dependence.

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.

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.

Temporal Lobe Volume Measurement in Mood Disorder Using Magnetic Resonance Imaging / 신경정신의학

OBJECTS: This study was performed to investigate neuroanatomical change in the temporal lobe in the patients with mood disorder. METHODS: The study groups were consisted of 13 patients with major depressive disorder with psychotic feature,23 patients with major depressive disorder without psychotic feature, 13 patients with bipolar disorder and 50 age-matched control group. We used DSM-III-R criteria far classifying our patients. We estimated the area and volume of the left, right and total temporal lobe In selected 6-8 coronal MR images including the boundary of the temporal lobe. We compared the results of both patients with mood disorder and control group. RESULTS: There was no significant difference in the volume of total and right temporal lobe between the patients with mood disorder and control group. But the average volume of the left temporal lobe was significantly smaller than that of the control group. After patients were divided according to subtype, the patient group was compared with control group. The average volume of the left temporal lobe in the patients with depressive disorder was smaller than that of control group, however there were no significant difference In between the patients with bipolar and control group. Among the subtype of depressive diseases, the patients with psychotic feature was significantly smaller than control subjects in the volume of left temporal lobe. CONCLUSION: Finally, we could find that there was significantly smaller volume in left temporal lobe only in the patients with major depressive disorder with psychotic feature. This findings support the previous hypothesis that in contrast to other subtype of mood disorder, major depressive disorder with psychotic feature should be classified to be the spectrum disease lying between schizophrenia and mood disorder.

Case formulation of psychiatric patients with temporomandibular pain and dysfunction / 신경정신의학

No abstract available.

The measurements of ventricular size of brain CT in mood disorder / 신경정신의학

No abstract available.

Two cases of psychiatric patients with basal ganglia lesion / 신경정신의학

No abstract available.