The Relationship of Alcohol Withdrawal Delirium and Alcohol Withdrawal Symptoms in Patients with Alcohol Dependence

OBJECTIVE: This study was performed to analyze the clinical variables associated with occurrence of delirium tremens (DT) in inpatients with alcohol dependence initially admitted with diseases unrelated to alcohol. METHODS: This study included 132 inpatients seeking treatment for medical problem with acute alcohol withdrawal. The cases were divided into two groups : with DT group (n=44), without DT group (n=88). We compared the epidemiologic data, alcohol withdrawal symptoms and serum analysis data between two groups. We used the logistic regression to predict risk factors for DT. RESULTS: The DT group had more severe alcohol withdrawal symptoms, more amount of drinking alcohol, more number of drinking per month, higher blood urea nitrogen (BUN), creatinine, amylase, C-reactive protein and lower serum total protein than the without-DT group. According to the result of a logistic regression, occurrence of DT showed correlation with the following factors : sweating, hallucination, agitation, amount of alcohol consumption, number of drinking per month. CONCLUSION: Our study suggests development of DT was correlated with severe alcohol withdrawal symptoms, high BUN, creatinine and low total serum protein. Therefore, during assessment of alcohol dependent patients, clinicians should keep these parameters in mind in order to prevent DT.

Electroconvulsive Therapy for Patients with Treatment-Resistant Schizophrenia Patients : A Retrospective Study / 신경정신의학

OBJECTIVES: This study analyzes the effect of electroconvulsive therapy (ECT) by predicting the factors contributing to the effectiveness of ECT and evaluating the persistency of ECT effect in patients with treatment-resistant schizophrenia. METHODS: Using retrospective review of the charts of 24 schizophrenic inpatients who were admitted to Busan Paik Hospital between March 1, 2005 and December 31, 2009. We compared the pre-ECT Clinical Global Impression (CGI) scores and post-ECT CGI scores among these patients. We evaluated the differences in the ECT responses by sex, age, duration of illness and dose of antipsychotic agents, and investigated the rate of continuation of out-patient treatment and readmission, and the change of the CGI score for 12 months after the ECT. RESULTS: ECT resulted in an overall clinical improvement as measured on the CGI scale. 15 (62.50%) patients were good responders, while 9 (37.50%) were poor responders. There was no significant difference between sex, age, duration of the illness, and dose of antipsychotics taken by the patient before the ECT. 21 (87.50%) patients continuously visited the outpatient department for 12 month, and 14 (66.67%) of them maintained the ECT effect with medical treatment only and without readmission. CONCLUSION: This study showed that the ECT could be a useful treatment option for schizophrenic patients who are resistant to antipsychotics.

Effects of Antipsychotics-Induced Amenorrhea on Attitudes Toward Treatment and Quality of Life in Women with Schizophrenia / 대한정신약물학회지

OBJECTIVE: This study was aimed to identify the correlation between antipsychotics-induced amenorrhea, and attitudes toward treatment and quality of life in women with schizophrenia. METHODS: Twenty female schizophrenic patients with antipsychotics-induced amenorrhea and thirty female schizophrenic patients without antipsychotics-induced amenorrhea were evaluated. Attitudes toward treatment were assessed by the Korean version of Drug Attitude Inventory (KDAI-10) and quality of life was assessed by the Korean version of World Health Organization Quality of Life Assessment Instrument-BREF (WHOQOL-BREF). The psychopathology of each patient was assessed by the Positive and Negative Syndrome Scales and the Clinical Global Impression-Severity. Adverse effects were evaluated using the Drug-Induced Extrapyramidal Symptoms Scale. Correlation analysis and multiple linear regression were conducted. RESULTS: The KDAI-10 score was not significantly correlated antipsychotics-induced amenorrhea. In WHOQOL-BREF score, social relation domain only showed significant correlation with antipsychotics-induced amenorrhea. Multiple linear regression analysis revealed that the number of family members contributed significantly to the Positive Subjective Feelings Scores of KDAI-10 and marital status contributed significantly to the social relation domain of WHOQOL-BREF in amenorrhea group. CONCLUSION: The results of present study suggest that antipsychotics-induced amenorrhea lower part of the quality of life domain in women with schizophrenia. Clinicians must pay attention to treatment of amenorrhea and various factors that correlated with attitudes toward treatment and quality of life in women with schizophrenia.