Influence of Nurse Manager and Peer Group Caring Behaviors as Perceived by Nurses on Organizational Socialization and Nursing Performance / 간호행정학회지

Purpose@#The study was examined to investigate the influence of nurse manager and peer group caring behaviors on organizational socialization and nursing performance @*Methods@#The subjects were 286 clinical nurses from a general hospital in S city. The collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation and hierarchical regression analysis with the SPSS 25.0 program. Nurse manager and peer group caring behaviors, organizational socialization, and nursing performance were measured using organizational climate for caring scale, peer group caring interaction scale, organizational socialization and performance measurement scale for hospital nurses. @*Results@#There was no significant difference in organizational socialization between nurse manager and peer group caring behaviors. The significant predictors of nursing performance were position (β=-.26), nurse manager caring behaviors (β=.23), and peer group caring behaviors (β=.17). These variables explained 23% of the variance in nursing performance. Conclusion: The results suggest that it is necessary to increase both manager and peer group caring behaviors in order to improve nursing performance.

Clinical Features in Adult Schizophrenics with Minor Physical Anomalies / 대한정신약물학회지

OBJECTIVE: There have been several evidences that the central nervous system deflect is one of the etiologic factor in schizophrenia and minor physical anomalies can reflect these deflects indirectly. These central nervous deflects are particularly related to the negative symptoms of schizophrenia. In this study, we examined the relationship between minor physical anomalies and psychopathology in schizophrenia. METHODS: Forty-four patients(22 males, 22 females) satisfying the DSM-IV criteria for schizophrenia were measured for minor physical anomalies by using Waldrop Anomaly Scale(WS) and we used Positive and Negative Syndrome Scale(PANSS), Ulmann-Giovannoni Process-Reactive Questionnaire(PRQ), and Phillips Premorbid Adjustment Scale(PAS) for evaluating psychopathology and clinical variables. RESULTS: Schizophrenic patients had a higher group mean WS score than that found in the control group. Score of WS was correlated with PANSS and PAS score positively, and with PRQ score negatively. CONCLUSION: This study shows minor physical anomalies are associated with clinical variables with regard to symptom severity, poor premorbid adjustment and process of illness in at least some schizophrenics.

Change of Dopamine Receptor mRNA Expression in Lymphocyte from Schizophrenic Patients / 신경정신의학

OBJECTIVES: Schizophrenia, commonly developed in adolescence and young adulthood, is one of the most common mental diseases in psychiatry. The etiology or pathogenesis of this disease is uncertain yet, but the dysfunction of dopaminergic system in the brain has been proposed. However, there is no direct evidence of dysfunction of brain dopaminergic systems in schizophrenic patients because the direct assessment of brain dopaminergic systems is almost impossible at present. To overcome this problem, recently founded dopamine receptors and their mRNAs in peripheral lymphocytes was used. The purpose of this study was to define whether the dopamine receptors of peripheral lymphocytes can be the peripheral markers of schizophrenia or not. METHODS: The total numbers of subjects are 87 schizophrenic patients. Among them 44 patients were schizophrenics who had been taking antipsychotic drugs for more than 3 years(medicated patients) 43 schizophrenics who recently are not taken antipsychotic drugs for more than 3 months(drugfree patients) For controls age and sex matched 31 healthy persons were enrolled. Sequential reverse transcription and quantitative polymerase chain reaction of the mRNA were used to investigate the expression of dopamine receptors in peripheral lymphocytes. The gene expression of dopamine receptors were compared in each groups and after starting antipsychotic medicines in drug-free patients, the clinical scales and the dopamine receptors of peripheral lymphocytes were sequentially studied before, 2 weeks after and 8 weeks after medication. RESULTS: 1)In drug-free schizophrenics, D3 dopamine receptor mRNA expression of peripheral lymphocytes was significantly increased comparing with that of controls and drug-medicated schizophrenics and D5 dopamine receptor mRNA expression was increased comparing with only that of drug-medicated schizophrenics. There was no difference between controls and drug-medicated schizophrenics. 2)After antipsychotic medication, dopamine receptors of lymphocytes were increased tendency. 3)Drug-free patients were divided into two groups according to dopamine receptor expression in controls to evaluate the significance of increased dopamine receptor expression. The group of patients with increased dopamine receptor expression had following clinical characteristics. (1)More severe psychiatric symptoms (2)Poor pharmacological response of pBPRS on medicines (3)Severe extrapyramidal side effects after pharmacological treatment CONCLUSION: These results revealed that the molecular biologically determined dopamine receptors of peripheral lymphocytes were reactive, and increased expression of dopamine receptor in peripheral lymphocyte had clinical significance for subgrouping and prognostication. These findings suggested that dopamine receptors of peripheral lymphocyte may represent dopamine receptors of the brain, even the location cannot be determined.

Two Cases of Serotonin Syndrome

We report 2 cases of serotonin syndrome with variable symptoms after being treated with antidepressants. A 57-year-old woman developed agitation, diaphoresis, and tremor after combination therapy with fluoxetine and trazodone. The second patient, a 76-year-old female woman, became partially disoriented and developed brief, jerky myoclonus of all extremities after discontinuation of sertraline and consecutive imipramine treatment. These two patients rapidly improved with supportive care. The serotonin syndrome is not always easy to diagnose and sometimes causes a serious and fatal event. For this reason, if possible, the practice of multiple serotonergic drugs should be avoided because of the risk for potential serious pharmacodynamic drug interactions. Clinicians should not view the serotonin syndrome as an idiosyncratic reaction, but rather, as a predictable one with a variability in occurrence and severity among patients. Heightened awareness by clinicians will help to minimize pharmacodynamically mediated interactions that may occur between prescribed drugs and, ideally avoid this syndrome.