Effects of Emotional Management Training in Schizophrenic Patients / 신경정신의학

OBJECTIVES: Schizophrenic patients having a disturbance of cognition and emotion are least likely to identify emotional (especially negative) stimuli and cue in tense background stimuli. Also, schizophreinic patients tend to experience relapse if they are exposued to a situation which is emotionally laden. Although emotion itself is important, emotional processing has not been a therapeutic target and skill trainig which improves social competence has provided patients with emotional load. Therefore, we introduced Emotional Management Trainig (EMT) which deal with indirect and direct emotional processing, applied it to schizophrenic patients, and investigated the therapeutic effects. METHODS: We applied the Emotional Management Training (EMT) to 30 schizophrenic patients for 12 weeks, 2 times every week and psychoeducation to 23 schizophrenic patients as control group attention-placebo for 12 weeks, during the same period. Before and after treatment, we used the Trait Meta Mood Scale-short form (TMMS-S) as emotional proper, Social Perception Scale, Verbal Fluency Test, Verbal Paired Associates, and Similarities for cognitive functions. We also used Positive And Negative Syndrome Scale (PANSS) as psychopathology measurement and Social Problem Solving Scale (SPSI) as various kinds of social problem solving function measurement before and after treatment. RESULTS: The results showed that EMT group appeared to be more effective in improving the visual perception of social perception scale, verbal fluencies, positive symptoms, general psychopathology, and total score in PANSS than the control group. Also EMT group seemed to be more effective in total score and Problem Orientation score in SPSI than the control. But there were no differences in abstract function and verbal memory, negative symptoms, and Problem-Solving Skill score between the two groups. CONCLUSION: This study suggests that despite the limitations of the generalizability and the questions for the persistence of effectiveness, EMT might help schizophrenics get the motivational aspects, the familiarity with emotional-loaded situation, and initial processes, for social problem-solving.

Predictability of Neurocognitive Functions on the Treatment Effect in Schizophrenia / 신경정신의학

OBJECTIVES: This study was to investigate a wider range of neurocognitive function tests to find out how accurately each subtest could predict the outcomes of treatment in schizophrenics. METHODS: The subjects were 33 inpatients diagnosed as schizophrenia according to DSM-IV. Each subject had a drug wash-out period of at least 1 week, and had been given K-WAIS, WMS-R, and Signal Detection, Decision Reaction Timer, and Motor Performance Series in Vienna Test System just before drug administration. Treatment response was evaluated with BPRS and CGI scales before and 8 weeks after drug treatment. We divided the subjects into responders and non-responders according to the outcomes of the above clinical scales in week 8. The responder group was defined with having 20% increase in BPRS score and a CGI score of less than 3. Then we compared the neuropsychological test results between the two groups. RESULTS: Significantly different results between responders and non-responders were Verbal IQ and Full Scale IQ in K-WAIS, the number of correct responses in Signal Detection and Decision Reaction Timer in Vienna Test System. In discrimination analysis of the two groups using these subtests as variables, we could predict the responders with 66.7% accuracy, even though statistically non-significant. CONCLUSION: Although discriminating between responders and non-responders using neurocognitive function tests were proven to be statistically non-significant, the possibility that neurocognitive function tests can be utilized to predict the treatment outcome in schizophrenia cannot be completely ruled out.