The Effects of Repeated Electroconvulsive Shock on the Expression of NMDA Receptor Subunits in the Rat Hippocampus / 신경정신의학

OBJECTIVES: The N-methyl-D-aspartate (NMDA) receptor plays an important role in synaptic plasticity. The functional NMDA receptor is an oligomer of several subunits and the most abundant subunits in the brain are NR1, NR2A and NR2B. The function of the NMDA receptor is regulated by protein phosphorylation and by changes in the level of protein expression. The present study examined the effect of repeated electroconvulsive shock (ECS), an effective antidepressant and antipsychotic measure, on the expression of NMDA receptor subunit proteins in the rat hippocampus. METHODS: Male Sprague-Dawley rats were given 1, 5, or 10 consecutive daily ECS and the amounts of NR1, NR2A, and NR2B in the hippocampus were assessed by the immunoblot analysis. RESULTS: The expression levels of NR1 and NR2A subunits were found positively correlated with the number of treatment. However, there was no evidence of NR2B regulation by ECS. CONCLUSION: These findings suggest the action of ECS in the regulation of the NMDA receptor, and hence in the regulation of synaptic plasticity.

Analysis of the Risk Factors and Psychotropics' Role in the Falls of the Dementic Elderlies in a Nursing Home

OBJECTIVE: This study examines the risk factors of the falls of the dementic elderlies in the nursing home. Especially we investigated how the psychotropics affect them in the aspect of the falling tendency. METHODS: We investigated the falls of the 262 patients living in the Seoul JungGae Nursing Home for six month since March 1 1999. Among these we recruited 182 patients whom the exclusion criteria was applied to, and then we measured the relative risks of risk factors known from the previous studies. RESULTS: The incidence rate of falls is 40.1/100person year. The relative risk of gender, age, disease of central nervous system, chronic illness, cognitive function, antipsychotics, antidepressants and anxiolytics had no significance (p>0.05). BADL, mobility, mood stabilizers were related with the falls significantly, and the relative risks were 0.904 (95%CI 0.840-0.973), 1.744 (95%CI 1.064-2.858), 4.683 (95%CI 1.412-15.532) relatively. CONCLUSIONS: The average rate of falling was 40.1/100person year showing less frequent accidents than that of other foreign studies, which was assumed the large number the care-givers and sitting life style on the floor helped preventing the elderlis' falling. Although The gender, age, disease of central nervous system, chronic illness, cognitive function, antipsychotics, antidepressants and anxiolytics did not influence the rate of the falling tendendy of the elderlies, the mobility and impaired activity of daily living increased the rate of their falling. The elderlies taking psychotropics more fell than others not taking pills. The imbalance between the mobile potency and imposed real activity causes the falls. When the psychotropics affect negatively on the mobility, it increases the falling rate of the elderlies. On the other hands, when these affect positively, these prevent elderlies falling.

Reliability and Validity of the Korean Version of the Positive and Negative Syndrome Scale / 신경정신의학

OBJECTIVES: We tested the reliability and validity of the Korean version of the PANSS (PANSS-KV). METHODS: The PANSS ratings were obtained from 101 subjects with DSM-IV diagnoses of schizophrenia or schizophreniform disorder. To study the concurrent validity, the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS) were also administrated in 38 patients. Using these data, inter-rater reliability, test-retest reliability, internal consistency, criterion validity and concurrent validity were evaluated. Factor structure was analyzed by the principal axis factoring. RESULTS: The inter-rater reliability of the Korean version of the PANSS was satisfactory in positive (r=0.92) and negative syndrome subscales(r=0.86), but somewhat low in general psychopathology subscale (r=0.78). The test-retest correlations for the 3 PANSS subscales ranged between 0.89 and 0.95, so it showed excellent test-retest reliability. The Cronbach's alpha for the positive, negative and general psychopathology subscales were 0.73, 0.84 and 0.74, respectively and thus the 3 subscales of the PANSS had good internal consistencies. All separate items revealed significant corrected item-total correlations in the positive and negative syndrome subscales, but some items of the general psychopathology subscale showed no or low corrected item-total correlations. The positive and negative syndrome subscales held a high concurrent validity in relation to the SAPS and the SANS. It was confirmed that positive and negative syndromes were independent constructs. The factor analysis by the principal axis factoring produced 5 components: cognitive, excitement, depression, positive and negative. CONCLUSION: These findings prove that the reliability and validity of the PANSS-KV are comparable to those of the original PANSS. So, the PANSS-KV can be widely and extensively used in researches for schizophrenia.