Increased Bone Mineral Density after Abstinence in Male Patients with Alcohol Dependence

OBJECTIVE: This study aimed to compare the bone mineral density of male patients with alcohol dependence with that in healthy controls and to assess changes in bone density after abstinence. METHODS: Forty-four inpatients with confirmed the Diagnostic and Statistical Manual of Mental Disorders, fourth edition diagnosis of alcohol abuse and 42 controls were recruited. Bone density was determined with dual-energy X-ray absorptiometry in the lumbar spine as well as in the femoral neck, trochanter, and Ward’s triangle regions of the proximal right femur. RESULTS: There were no significant differences in age and body mass index between patients with alcohol dependence and healthy controls. In the alcohol dependence group, osteopenia and osteoporosis were found in 54.5% and 34.1% of the patients, respectively, whereas in the control group, the corresponding values were 45.2% and 11.9% (p=0.001). Although the actual bone density in the femur and the corresponding T-scores were significantly lower in the alcohol dependence group, no significant differences were found in the lumbar spine. In both groups, body mass index showed a significant correlation with bone mineral density in all areas. After 3 to 4 years of abstinence, bone density significantly increased in the lumbar and femur. CONCLUSION: We conclude that bone mineral density in patients with alcohol dependence was significantly lower than that in healthy controls, and the rates of osteopenia and osteoporosis are higher. Importantly, abstinence from alcohol increases bone density.

The Korean Version of the University of California San Diego Performance-based Skills Assessment: Reliability and Validity

OBJECTIVE: The study’s aim was to develop and standardize a Korean version of the University of California San Diego Performance-based Skills Assessment (K-UPSA), which is used to evaluate the daily living function of patients with schizophrenia. METHODS: Study participants were 78 patients with schizophrenia and 27 demographically matched healthy controls. We evaluated the clinical states and cognitive functions to verify K-UPSA’s reliability and validity. For clinical states, the Positive and Negative Syndrome Scale, Clinical Global Impression-Schizophrenia scale, and Social and Occupational Functioning Assessment Scale and Schizophrenia Quality of Life Scale-fourth revision were used. The Schizophrenia Cognition Rating Scale, Short-form of Korean-Wechsler Adult Intelligence Scale, and Wisconsin Card Sorting Test were used to assess cognitive function. RESULTS: The K-UPSA had statistically significant reliability and validity. The K-UPSA has high internal consistency (Cronbach’s alpha, 0.837) and test-retest reliability (intra-class correlation coefficient, 0.381–0.792; p<0.001). The K-UPSA had significant discriminant validity (p<0.001). Significant correlations between the K-UPSA’s scores and most of the scales and tests listed above demonstrated K-UPSA’s concurrent validity (p<0.001). CONCLUSION: The K-UPSA is useful to evaluate the daily living function in Korean patients with schizophrenia.

The Korean Version of the Schizophrenia Cognition Rating Scale: Reliability and Validity

OBJECTIVE: This study's aim was to develop and standardize a Korean version (SCoRS-K) of the Schizophrenia Cognition Rating Scale (SCoRS), which is used to evaluate the degree of cognitive dysfunction affecting the everyday functioning of people with schizophrenia. METHODS: Eighty-four schizophrenia patients with stable symptoms who were receiving outpatient treatment and rehabilitation therapy, and 29 demographically matched non-patient controls, participated in the study. Demographic data were collected, and clinical symptoms, cognitive function, and social function were evaluated to verify SCoRS-K's reliability and validity. Clinical symptoms were evaluated using the Positive and Negative Syndrome Scale and the Clinical Global Impression-Schizophrenia Scale. Cognitive function was evaluated using a short form of the Korean Wechsler Adult Intelligence Scale and the Wisconsin Card Sorting Test (WCST). Social function was evaluated using the Social and Occupational Functioning Assessment Scale, the Schizophrenia Quality of Life Scale, and the Social Functioning Scale. RESULTS: Data analysis demonstrated SCoRS-K's statistically significant reliability and validity. SCoRS-K has high internal consistency (Cronbach's alpha; patient 0.941, informant 0.905, interviewer 0.964); test-retest reliability [patient 0.428 (p=0.003), informant 0.502 (p<0.001), interviewer 0.602 (p<0.001); and global rating 0.642 (p<0.001)]. The mean scores of subjects were significantly higher than those of the controls (p<0.001), demonstrating SCoRS-K's discriminant validity. Significant correlations between the total scores and global rating score of SCoRS-K and those of the scales and tests listed above (except WCST) support SCoRS-K's concurrent validity. CONCLUSION: SCoRS-K is a useful instrument for evaluating the degree of cognitive dysfunction in Korean schizophrenia patients.

The Relationship between Language Ability and Cognitive Function in Patients with Schizophrenia

OBJECTIVE: Cognitive dysfunction is common in people with schizophrenia, and language disability is one of the most notable cognitive deficits. This study assessed the use and comprehension ability of the Korean language in patients with schizophrenia and the correlations between language ability and cognitive function. METHODS: Eighty-six patients with schizophrenia and a group of 29 healthy controls were recruited. We assessed both clinical symptoms and cognitive functions including Korean language ability. For clinical symptoms, the Positive and Negative Syndrome Scale, Clinical Global Impression-Schizophrenia Scale, and Social and Occupational Functioning Assessment Scale were used. For the Korean language ability assessment, a portion of the Korean Broadcasting System (KBS) Korean Language Test was used. The Short-form of Korean-Wechsler Adult Intelligence Scale, the Korean version of the University of California San Diego (UCSD) Performance-based Skills Assessment (K-UPSA), and the Wisconsin Card Sorting Test (WCST) were used to assess cognitive functions. RESULTS: Schizophrenic patients had significantly lower scores in the language and cognitive function tests both in the total and subscale scores. Various clinical scores had negative correlations with reading comprehension ability of the KBS Korean Language Test. The WCST and a part of the K-UPSA had positive correlations with multiple domains of the language test. CONCLUSION: A significant difference was found between schizophrenic patients and controls in language ability. Correlations between Korean language ability and several clinical symptoms and cognitive functions were demonstrated in patients with schizophrenia. Tests of cognitive function had positive correlations with different aspects of language ability.

A Review of Pharmacological Strategy for Cognitive Deficits in Schizophrenia / 대한정신분열병학회지

Cognitive deficit is frequently observed in patients with schizophrenia. It is significantly associated with functional outcome. In the past 20 years, due to significant advances on the concept of schizophrenia, cognitive deficit has been accepted as a core feature. In the DSM-5, cognitive deficit does not introduce diagnostic criteria of schizophrenia, but did one dimension of diagnosis of psychosis. Existing schizophrenia drugs are effective in treatment of positive symptoms of schizophrenia, but lack of effectiveness on improving cognitive function. Led by NIMH (National Institute of Mental Health), the MATRICS (Measurement and Treatment Research to Improve Cognition in Schizophrenia) meeting was conducted in order to achieve consensus on measuring tools and neuropharmacological targets for clinical trials for development of new drugs for improvement of cognitive function in schizophrenia. At the MATRICS consensus meeting, glutamatergic modulators and nicotinic and muscarinic agonists are expected to be promising, but should be proven by a double-blind placebo-controlled multicenter study for patients.

Tolerability, Safety and Effectiveness of Paliperidone ER in Patients with Schizophrenia : A 24-Week Interim Analysis of the 48-Week Open-Label, Prospective, Switch Study

OBJECTIVES: We investigated the tolerability, safety, and treatment response to flexible-dose paliperidone ER in patients with non-acute schizophrenia in whom previous antipsychotic drugs were ineffective. METHODS: This 24-week interim analysis of the 48-week multicenter, prospective, open-label study assessed effectiveness using the Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Schizophrenia-Severity (CGI-SCH-S) Scale, Personal and Social Performance (PSP) and Drug Attitude Inventory (DAI). Safety and tolerability were assessed using the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS) and Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS). RESULTS: Effectiveness was assessed in 169 patients. Significant improvement in the PANSS total score was observed by week-1 and continued until week-24. The response rate was 33%. The CGI-SCH-S and PSP total scores significantly improved during 24 weeks ; however, no change occurred in the total DAI. Fifty-nine percent of patients reported adverse events, of which extrapyramidal symptoms were the most frequent (19.0%). The DIEPSS and LUNSERS scores were improved after 24 week. CONCLUSIONS: Switching to the flexible-dose paliperidone ER from an ineffective antipsychotic drug was safe, tolerable, and showed a good treatment response in Korean patients with schizophrenia.

Association of the Neuronal Cell Adhesion Molecule (NrCAM) Gene Variants with Personality Traits and Addictive Symptoms in Methamphetamine Use Disorder

OBJECTIVE: 1) To investigate the relationship between NrCAM polymorphisms and methamphetamine abuse in an ethnically homogenous Korean population. 2) To further support our findings by investigating the association among NrCAM gene variants, certain personality traits, and addictive symptoms of methamphetamine abusers. METHODS: Thirty-seven male methamphetamine abusers (age=43.3+/-7.8) and30 non-users (16 men, 14 women; age=59.8+/-10.4) were recruited. Ten single nucleotide polymorphisms (SNPs) in the NrCAM gene were assayed to compare genotype distributions between the 2 groups. Personality characteristics were measured using the Temperament and Character Inventory (TCI) and the NEO Personality Inventory, Revised (NEO PI-R). Addictive symptoms were assessed using the Diagnostic Interview for Genetic Studies (DIGS) and reviews of the subject's medical records. RESULTS: Among the 10 SNPs in the NrCAM gene, the frequency of the TA genotype at rs1990162 was significantly lower in methamphetamine abusers compared to non-users (p=0.042). In the 3 NrCAM gene SNPs (rs381318, rs2072546, and rs6954366), the distribution of genotypes and alleles were significantly associated with some traits in the TCI and NEO PI-R. Genotypes and alleles at 5 gene SNPs (rs2142325, rs381318, rs1269621, rs1269634, and rs1990162) were associated with certain addictive symptom dimensions in the patients. CONCLUSION: These findings support the idea that NrCAM is associated with genetic susceptibility of methamphetamine abuse and is also associated with certain personality characteristics that may increase disturbed addictive behavior.

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.

The Effect of CYP2D6/3A5 Genotypes on Plasma Concentrations of Haloperidol after Adjunctive Treatment of Aripiprazole

OBJECTIVES: To evaluate the drug interactions between aripiprazole and haloperidol, authors investigated plasma concentrations of those drugs by genotypes. METHOD: Fifty six patients with a confirmed Diagnostic and Statistical Manual of Mental Disorders 4th edition diagnosis of schizophrenia were enrolled in this eight-week, double blind, placebo-controlled study. Twenty-eight patients received adjunctive aripiprazole treatment and twenty-eight patients received placebo while being maintained on haloperidol treatment. Aripiprazole was dosed at 15 mg/day for the first 4 weeks, and then 30 mg for the next 4 weeks. The haloperidol dose remained fixed throughout the study. Plasma concentrations of haloperidol and aripiprazole were measured by high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) at baseline, week 1, 2, 4 and 8. *1, *5, and *10 B alleles of CYP2D6 and *1 and *3 alleles of CYP3A5 were determined. The Student's T-test, Pearson's Chi-square test, Wilcoxon Rank Sum test and Logistic Regression analysis were used for data analysis. All tests were two-tailed and significance was defined as an alpha < 0.05. RESULTS: In the frequency of CYP2D6 genotype, *1/*10 B type was most frequent (36.5%) and *1/*1 (30.8%), *10B/*10B (17.3%) types followed. In the frequency of CYP3A5 genotype, *3/*3 type was found in 63.5% of subjects, and *1/*3 type and *1/*1 were 30.8% and 5.8% respectively. The plasma levels of haloperidol and its metabolites did not demonstrate significant time effects and time-group interactions after adjunctive treatment of aripiprazole. The genotypes of CYP2D6 and 3A5 did not affect the plasma concentration of haloperidol in this trial. No serious adverse event was found after adding aripiprazole to haloperidol. CONCLUSION: No significant drug interaction was found between haloperidol and aripiprazole. Genotypes of CYP2D6 and 3A5 did not affect the concentration of haloperidol after adding aripiprazole.

Adjunctive Treatment with Aripiprazole for Risperidone-Induced Amenrrhea / 대한정신약물학회지

OBJECTIVE: Hyperprolactinemia and associated side effect, amenorrhea, often occur with risperidone treatment. We investigated the effect of adjunctive treatment with aripiprazole on risperidone induced amenorrhea in female patients with schizophrenia. METHODS: A retrospective chart review of 24 female patients with adjunctive aripiprazole treatment for risperidone induced amenorrhea between August 2008 and July 2009 was conducted. The information collected included age, menstrual cycle, duration of no menstruation, prolactin level (before aripiprazole treatment and after regaining menstruation), dose of risperidone and aripiprzole, time from starting aripiprazole adjunctive treatment to regaing menstruation. The Student's t-test, Pearson's Chi-square test were used for data analysis. RESULTS: Mean percent decrease in prolactin level for all aripiprazole-treated patients was 71.4+/-8.6%. 85.7% (18/21) of patients resumed menstruation, while 14.3% (3/21) did not regain. In patients with regaining menstruation, mean time from starting aripiprazole to restarting menstruation was 6.6+/-2.4 weeks, mean dose of aripiprazole was 12.2+/-3.9 mg/day (dose range, 5 mg to 20 mg/day). Aripiprazole dose for regaining menstruation was not significantly correlated with baseline prolactin level. CGI score was not significantly changed after aripiprazole treatment. The cutoff point of prolactin level significantly increasing amenorrhea was 40 ng/mL. CONCLUSION: Adjunctive aripiprazole treatment is very effective to treat risperidone induced amenorrhea in female patients with schizophrenia.

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.

A Correlation of Cognitive Function, Depression, Suicidal Idea and Serum Lipid Levels in the Elderly Over Sixty Years of Age

OBJECTIVES: We investigated a correlation of cognitive function, depression, suicidal idea and serum lipid levels in Korean elderly over 60 years old to find risk factors of deprssion and cognitive decline. METHODS: 834 persons participated in this study. Clinical evaluation was done at a point by using Mini-Mental State Examination in the Korean version of CERAD assessment packet(MMSE-KC). We also evaluated 165 persons that agreed to our exact examination for Geriatric Depression Scale(GDS), Scale for Suicidal Ideation(SSI), Hachinski Ischemic Score and serum lipid profile. Correlation analysis was used to evaluate correlation among serum lipid levels, MMSE-KC and SSI. One-way ANOVA was used for comparison of serum lipid levels and cognitive function, depression and SSI. We did a post-hoc analysis. RESULTS: Depression and suicidal ideation were related with cognitive impairment in Korean elderly over 60 years old. Those who have more severe cognitive impairment and depressive symptom, have higher Hachinski ischemic score. We can see high HDL cholesterol levels only in the normal control group. Low total, HDL, LDL cholesterol were related with depression. CONCLUSION: There was high prevalence of depression in the Korean elderly over 60 years old and low serum lipid level was related with severity of depression and high suicidal ideation. In the normal control group, we can see high HDL cholesterol levels. To confirm this result, we need well-designed and wide range study.

Effects of Psychoeducation Program on Insight and Treatment Attitudes in Patients with Schizophrenia, Schizophreniform Disorder, and Schizoaffective Disorder / 대한정신약물학회지

OBJECTIVE: This study aimed to confirm effectiveness of psychoeducation program on insight and treatment attitudes in patients with schizophrenia, schizophreniform disorder and schizoaffective disorder. METHODS: Seventy eight psychotic patients who were diagnosed as schizophrenia, schizophreniform disorder, and schizoaffective disorder by Diagnostic and Statistical Manual of Mental Disorders 4th edition Text Revision (DSM-IV TR) were included. Subjects who decline more than 30% compared with baseline in Positive and Negative Syndrome Scale (PANSS) scores participated in psychoeducation program. Insight and Treatment Attitudes Questionnaire (ITAQ) and Drug Attitude Inventory (DAI) were assessed at pre-psychoeducation, post-psychoeducation and 2 months after discharge to estimate insight and treatment attitudes. RESULTS:There were significant improvement in ITAQ and DAI scores at post-psychoeducation and 2 months after discharge. Increase in DAI scores related with high ITAQ scores at post-psychoeducation. Small changes in PANSS scores and ITAQ scores at post-psychoeducation had positive relationship. Subjects of late onset of illness and female took better ITAQ and DAI scores after psychoeducation. CONCLUSION: This study showed that psychoeducation program would be effective for insight and treatment attitudes in patients with schizophrenia, schizophreniform disorder, and schizoaffective disorder.

Questionnaire for Developing the Korean Medication Algorithm for the Treatment of Schizophrenia / 대한정신약물학회지

KMAP (Korean Medication Algorithm Project for Major Psychiatric Disorders) was established to develop Korean algorithm for major psychiatric disorders. KMAP developed the draft of Korean medication algorithm for schizophrenia and assessed the level of satisfaction and fitness in the Review Committee using questionnaire about this draft. The members of Review Committee were medical doctors of psychiatry who were interested in the research of psychiatric drugs or were experienced in psychiatric pharmacotherapy in college of medicine, mental hospital or private psychiatric clinic. 57 psychiatrists were appointed as committee of re-examination of algorithm and 48 (84.2%) answered the questionnaire. The Korean medication algorithm draft for schizophrenia was based upon Korean clinical research, clinical experience of Korean professionals and clinical guidelines of other countries. The draft of this algorithm was categorized into 32 items, then we made a questionnaire according to these items. The answers of each question were consist of 5 levels of satisfaction, and the committee members could propose free opinion about these questions. The results of questionnaire were presented and discussed in an open forum. In most items except two, over half of committee members answered that `correction unnecessary of draft'. The 2 items showing low level of satisfaction were `trial of atypical antipsychotics at level 1', `trial of typical antipsychotics at level 4'. These items were revised from the draft after having discussion in an open forum. And then we published the first edition of `Korean Medication Algorithm for Schizophrenia'.

Designs and Methods for the Development of Korean Medication Algorithm for Schizophrenic Patients / 대한정신약물학회지

As a solution about many problems of pharmacotherapy for Korean patients with major psychiatric disorders, Korean Medication Algorithm Project for Major Psychiatric Disorders (KMAP) was launched. Recently, a medication algorithm for schizophrenic patients was developed and distributed. This review article showed the designs, processes and methods for developing this algorithm. Also we compared the development of Korean algorithm for schizophrenics with other foreign representative algorithms or clinical practice guidelines. We hope that this review elicit the productive criticism about the rigour, the system of development and the objectivity of content. The limitations and problems of Korean algorithm are also discussed in this review.

Korean Medication Algorithm Projects for Major Psychiatric Disorders(II): Background, Basic Plan, Organization of KMAP and Principles, Methods of Algorithm Development and Limitation, Caution when sing KMAP / 대한정신약물학회지

In this special article we present Korean medication algorithm development project for major psychiatric disorder (KMAP), basic plan, organization, basic principles of algorithm developments, methods of development, limitations and cautions of using this algorithm. The Korean Society of Psychopharmcology and Korean Academy of Schizophrenia as a co-worker started to make Korean algorithm project that is helpful to treat major mental disorder (schizophrenia, bipolar disorder) patients by the better psychopharmacologic treatments. In spite of many advantages of algorithm, these projects have many limitations and problems simultaneously; we needed to introduce the goal of algorithm, details of development methods in this special article. KMAP have employed the latest survey techniques and reflect only the most current clinical standards. The results are a practical reference tool not only for clinicians but also for mental health educators and other healthcare professionals involved in the care of patients who have major mental disorders. This algorithm projects can have problems and shortcomings. but we will revise this issues by correction and amendment.

Cortisol and Prolactin Responses to Buspirone in Alcoholism / 신경정신의학

OBJECTIVES: The purpose of this study was to evaluate the prolactin and cortisol responses to 5-HT 1A receptor activation by buspirone in alcoholics. METHODS: The subjects were twenty two male alcoholic patients meeting the DSM-IV criteria for alcohol dependency and abstaining for more than 3 months. Patients were free from overt anxiety and depressive symptoms. Controls were fifteen male normal volunteers, with no psychiatric and medical illness. Blood samples for the measurement of serum cortisol and prolactin levels were drawn 0, 30, 60, 90, 120, 150 minutes after oral administration of 30mg buspirone hydrochloride at 9:00 a.m. RESULTS: The baseline cortisol levels were not significantly different between alcoholics and controls. Serum cortisol levels of controls after buspirone administration were significantly increased over time(p<0.01), but those of alcoholics did not increased. After 60 minutes following buspirone administration, cortisol levels were significantly lower in alcoholics than in controls(p<0.05). Prolactin responses to buspirone were not significantly different between the two groups. CONCLULSION: Our results suggested that 5-HT 1A receptor function is decreased in alcoholic patients.

Association between Tardive Dyskinesia and Soft Neurological Signs / 대한정신약물학회지

OBJECTIVE: The goal of this study was to examine association between tardive dyskinesia and soft neurological signs in schizophrenic patients. METHODS: 35 schizophrenic inpatients who met the diagnostic criteria for tardive dyskinesia developed by Schooler and Kane and 30 schizophrenic inpatients without tardive dyskinesia were enrolled in this study. Tardive dyskinesia, soft neurological signs, and cognitive function were evaluated with Abnormal Involuntary Movement Scale (AIMS), Neurological Evaluation Scale (NES), and Mini-Mental State Examination (MMSE) independently by 2 psychiatrists, respectively. Data of the two schizophrenic groups were compared and also those of 31 normal controls. RESULTS: Total schizophrenics scored higher than normal controls in total mean scores of NES (p<0.01), and its three functional area scores, sensory integration (p<0.01), motor coordination (p<0.05), and sequencing of complex motor acts (p<0.05). Patients with tardive dyskinesia showed higher prevalence rates than those without in 5 items-left graphesthesia (p<0.05), right fist-ring test (p<0.05), right fist-edge-palm test (p<0.05), right synkinesis (p<0.05), and left synkinesis (p<0.05). The total scores of NES were not significantly related to the severity of tardive dyskinesia and cognitive dysfunction. CONCLUSION: Schizophrenics had more soft neurological signs than normal subjects. Five items of NES were more impaired in the patients with tardive dyskinesia than in those without tardive dyskinesia.

Effect of a Psychoeducational Family Therapy Model for the Families of Schizophrenic Patients / 신경정신의학

OBJECTIVES: This study was performed to introduce a psychoeducational family therapy model for the families of schizophrenic patient and to investigate the effect of this model on the changes in coping style and depressive symptoms of the family members, and in perception of emotional support by families and depressive symptoms of patients. METHODS: Subjects were schizophrenic out-patients, who fufilled DSM-IV diagnostic criteria, and their families. The members of "education group" were 11 families and patients who participated in more than two thirds of 19 sessions of the program. The members of "non-education group" were 11 families and patients who had no experience of family education and were treated in a general hospital in Pusan. Clinical ratings were performed using by The Ways of Coping Checklist, Family Emotional Support Questionnaire for Transactions, and Beck Depression Inventory. RESULTS: Coping style was changed positively, in education group but not in non-education group. The depressive symptoms of families were decreased in educated group and increased in non-educated group, although there were no statistical significance. In education group, patients felt much better emotional support by their families than patients in non-education group did. At the same time, their depressive symtoms were significantly reduced. The patients from education group were on more successful rehabilitation than those from non-education group were. CONCLUSION: Our results suggest that this psychoeducational family therapy model would be helpful to induce the positive changes in coping styles and reduce the depressive symptoms of family members, and it could also induce the reduction of depressive symptoms of schizophrenic patients and help their rehabilitation.