Predictors of Change in Behavioral Psychological Symptoms of Dementia in Patients With Alzheimer’s Disease in Korea

Objective@#The purpose of our study was to identify the correlation between clinical characteristics and behavioral psychological symptoms of dementia (BPSD) and to identify factors that predict BPSD changes. @*Methods@#Demographic characteristics were collected and BPSD was assessed using the Korean version of Neuropsychiatric Inventory (K-NPI) for 213 patients with Alzheimer’s disease. BPSD was reassessed to identify changes in the K-NPI score for 65 of the 213 patients. Seoul Neuropsychological Screening Battery was conducted to evaluate specific cognitive functions. Correlation and stepwise regression analyses were conducted to identify the association between several factors and the baseline K-NPI total score. Logistic regression analysis was conducted to identify predictors of improvement of BPSD. @*Results@#Stepwise analysis showed that the baseline K-NPI total score was significantly affected by higher Seoul-Instrumental Activities of Daily Living and having family history of dementia. Multivariate logistic regression analysis showed that improvement of BPSD was significantly associated with a higher baseline K-NPI total score. However, changes in BPSD were not predicted by any specific cognitive functions. @*Conclusion@#Severe BPSD at baseline is a significant predictor of improvement of BPSD. The findings support that severe BPSD at baseline had more chance to benefit from the intervention. Therefore, clinicians need more intensive observation and early inter-vention for patients in the early stages of dementia.

Factors Affecting the Quality of Life of Schizophrenia: Focused on Resilience / 신경정신의학

OBJECTIVES: The purpose of this study was to identify factors, including resilience, that influence the quality of life of schizophrenia patients. METHODS: Subjects included thirty-eight patients with schizophrenia. Each subject was administered questionnaires regarding their socio-demographic characteristics, resilience, quality of life, and social supports. Depressed mood severity and psychopathology of each patient were determined. The Korean version of the 4th revision of Schizophrenia Quality of Life assessment and the Korean modification of the Scale to Measure Subjective Well-being under Neuroleptic treatment were used to assess quality of life. RESULTS: Resilience, occupation, income, social supports, psychopathology, and depressed mood were correlated with quality of life. Multiple regression analysis results indicated that depressed mood and income have an effect on quality of life (R²=0.526, p=0.000). Moreover, resilience, social supports, and depressed mood also contributed to quality of life (R²=0.635, p=0.000). CONCLUSION: The result of this study indicate that psychosocial factors including resilience should be considered when caring for schizophrenia patients.

The Characteristic Analysis of Researches Network for Journal of Korean Neuropsychiatric Association / 신경정신의학

OBJECTIVES: This study evaluated the structural characteristics of a scientific network of psychiatry and the effect of social networks on the performance of scholars. METHODS: The data were extracted from 261 articles published from 1996 to 2013 in the Journal of the Korean Neuropsychiatric Association, and were transformed into a co-author and their affiliation matrix. We used measures from network analysis (i.e., degree centrality, weighted degree centrality, eigenvector centrality, betweenness centrality) for evaluating the effect of co-authorship network on the performance of scholars (h-index). Netminer 4.1 was used for the network analysis. RESULTS: Both co-authorship and affiliation network demonstrated power law distribution. Coauthor's centralities were correlated with research achievements. Results from poisson regression analysis showed that the eigenvector centrality has a significant positive influence on the h-index and the weighted degree centrality has a significant negative influence on the h-index. CONCLUSION: This study shows that the small world phenomenon exists in the psychiatric coauthorship network, and finds collaboration patterns and effects on scientific performance. The results suggest that in order to achieve better research performance it would be helpful for scholars to work with other well-performing scholars and avoid other scholars who previously worked together.

Relationship between Premorbid Personality and Behavioral and Psychological Symptoms in Dementia in Korean Patients with Alzheimer's Disease

OBJECTIVE: We performed a cross-sectional study to examine the relationship between premorbid personality and behavioral and psychological symptoms in dementia (BPSD) in Korean patients with Alzheimer's disease (AD). METHODS: We assessed 103 patients diagnosed with AD for the presence of BPSD over the disease course by using the caregiver-rated Korean version of the Neuropsychiatric Inventory (K-NPI) and for the premorbid personality by using a retrospective version of the NEO-Five Factor Inventory questionnaire completed by informants. RESULTS: Premorbid neuroticism was significantly correlated with delusion, agitation, anxiety, disinhibition, total K-NPI score (p<0.05), and sleep disturbances (p<0.01). Lower premorbid conscientiousness was significantly correlated with symptoms of hallucinations and sleep disturbances in AD patients (p<0.05). However, premorbid neuroticism and low premorbid conscientiousness did not act as independent predictors for "psychosis, hyperactivity," or "moods, apathy, frontal" factors of BPSD. CONCLUSION: Premorbid personality was associated with the K-NPI score, but was not observed to be potential predictors of BPSD.

An Open Label Multi-Center Prospective Observational Study of Paliperidone Extended Release to Assess the Medication Satisfaction and Treatment Response in Patients with Schizophrenia / 대한정신약물학회지

OBJECTIVE: The aim of this study was to demonstrate changes of subjective medication satisfaction and clinical benefit after once-daily paliperidone extended release (ER) in treatment of schizophrenia. METHODS: In an open-label, observational, and multicenter study, 374 patients with schizophrenia who switched to paliperidone ER due to any reason were recruited. Medication Satisfaction Questionnaire (MSQ), Clinical Global Impression-Severity (CGI-S), Clinical Global Impression-Improvement and visual analogue scale for sleep (VAS) were assessed at baseline, 4 weeks and 8 weeks after treatment. We also examined the type, frequency, and severity of adverse events newly formed. RESULTS: Among 374 patients, 320 patients (76.5%) were included in the intent-to-treat analysis set. The mean dose of paliperidone ER was 5.33+/-2.31 mg/day at the initiation. At the endpoint, the mean dose of paliperidone ER was 6.68+/-3.13 mg/day. The percentages of patients satisfied with medication were changed from 40.9% at baseline to 67.8% at endpoint (p<0.001). Both CGI-S scores and VAS for daytime drowsiness were significantly decreased after 8 weeks (both p<0.0001) and mean scores of MSQ and VAS for sleep quality were improved after 8 weeks (both p<0.0001). CONCLUSION: After switching to paliperidone ER, 67.8% of patients with schizophrenia who had any reason to switch medication showed subjective satisfaction for medication and clinical improvement without significant adverse events. Regarding that medication satisfaction was associated with changes of clinical states, medication satisfaction can be used for measures for clinical scales in the treatment of schizophrenia.