Gender Differences in Empathic Ability and Facial Emotion Recognition of Schizophrenic Patients

OBJECTIVES: The aim of the present study was to investigate gender difference in empathic ability and recognition of facial emotion expression in schizophrenic patients. METHODS: Twenty-two schizophrenic outpatients (11 men and 11 women) and controls (10 men and 12 women) performed both the scale of Empathic Quotient (EQ) and facial emotion recognition test. We compared the scores of EQ and the facial emotion recognition test among each group according to diagnosis and gender. RESULTS: We found a significant sex difference in the scores of EQ and the facial emotion recognition test in the schizophrenic patients. And there were significantly negative correlation between the score of the facial emotion recognition test and the scores of Positive and Negative Symptom Scale (PANSS) in female schizophrenic patients. However, in male schizophrenic patients, there were no significant correlations between the score of each test and the scores of PANSS. CONCLUSIONS: This study suggests that the sex difference in empathic ability and facial emotion recognition would be very important in chronic schizophrenic patients. Investigation of sex effects in empathic ability and facial emotion recognition in chronic schizophrenic patients would present an important solution for constructing optimal rehabilitation program.

Survey of Influencing Factors on Depression and Anxiety in Vietnamese Marriage Immigrant Women

OBJECTIVES: The number of marriage immigrant women has been increasing in the past several years in Korea and their adaptations to the new environment have been an important social issue. The aims of this study were to evaluate the psychosocial and mental health statuses of Vietnamese marriage immigrant women (VMIW). We intended to compare the mental health of VMIW with married Vietnamese women living in Vietnam and reveal the demographic or psychosocial factors affecting their mental health. METHOD: Subjects comprised one-hundred-forty-three VMIW who enrolled in multiculture family support centers in Chungbuk Province and forty-eight women from Vinh Phuc province in Vietnam. Marital satisfaction, domestic violence and social support were evaluated as psychosocial factors, and the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and General Health Questionnaire (GHQ) were used to evaluate mental health. RESULTS: VMIW had a larger age gap with their husbands but better psychosocial statuses. BDI (p = 0.20), BAI (p = 0.08), GHQ (p = 0.13) scores of VMIW were not significantly different compared to Vietnamese residents. Marriage duration of VMIW affects significantly their marital satisfaction, social support and depressive levels (p < 0.01). The level of domestic violence showed a significant difference according to the educational levels of their husbands, composition of family members and marriage process (p < 0.05). VMIW with older husbands and jobless VMIW had low levels of anxiety (p < 0.01). CONCLUSION: The results suggest that VMIW have no difference in mental health compared to Vietnamese women living in Vietnam which is contrary to general expectations. However, various environmental factors, such as marriage duration, have an effect on the mental health of VMIW. As marriage duration is proven to be important factor on mental health of VMIW, more extended duration of care and interventions are needed to maintain good mental health. Networking system connecting mental health screenings by the multiculture family support center to the local mental healthcare center is needed to care those with poor screening outcomes.

An fMRI Study Investigating Adolescent Brain Activation by Rewards and Feedback

OBJECTIVE: This study aimed to investigate the adolescent brain activation patterns in response to performance feedback (PF), social reward (SR) and monetary reward (MR) and their association with psychological factors. METHODS: Functional magnetic resonance imaging (fMRI) was performed while middle school boys (n=15) performed tests pertained to PF, SR and MR. The brain activation pattern in each condition was investigated, and the extent of brain activation in each of the three conditions was compared at once. RESULTS: The caudate and the dorsal prefrontal area were activated in all three conditions. Furthermore, the cuneus showed significantly greater activation in the PF condition than the SR or MR condition. And the self - related areas, such as the right precentral gyrus and paracenral lobule, were more activated in the SR condition than the PF or MR condition. The left middle frontal gyrus was more activated in the MR condition than the PF or SR condition. CONCLUSION: Not only various reward stimuli but also feedback stimulus might commonly activate dorsal prefrontal and subcortical area in adolescents. Moreover, several different brain activation patterns were also observed in each condition. The results of this study could be applied to planning of learning and teaching strategy for adolescents in various ways.

The Role of Job Stress and Brain-Derived Neurotrophic Factor Gene Polymorphism on the Severity of Alcohol Drinking in Korean Office Workers in Their Twenties

OBJECTIVES: The aim of this study was to examine the effects of brain-derived neurotrophic factor (BDNF) genetic polymorphism and job stress on the severity of alcohol drinking. It was hypothesized that individuals with the Met/Met BDNF genotype would be more vulnerable than those carrying the Val allele. METHODS: Participants were 133 healthy Korean adults (mean age 28.2 +/- 1.1). Job stress and the severity index of drinking were investigated through self-reported questionnaires. BDNF (rs6265) gene was genotyped. RESULTS: There was no significant association between job stress and the severity of alcohol drinking. Although the severity of alcohol drinking was not associated with BDNF genetic polymorphism, there was a significant difference in men according to genotype and job stress. Men with homozygous BDNF Met allele were more severe in alcohol drinking when job stress was high, less severe in alcohol drinking when job stress was low than those carrying the Val allele (F = 4.47, p = 0.038). Also higher level of job stress was correlated with higher severity of alcohol drinking in men homozygous for BDNF Met allele (rs = 0.620, p = 0.005). CONCLUSIONS: These findings suggest the possibility that Met allele could have differential susceptibility, with men homozygous for BDNF Met allele being more susceptible to both more adverse and less adverse environmental influences.

The Effects of Triallelic Serotonin Transporter Gene Polymorphism and Stressful Life Event on Depression in Patients with Alcohol Dependence

OBJECTIVES: The purpose of this study is to investigate the relationship between the triallelic serotonin transporter gene and stressful life events to determine their effect on depression with alcohol dependence. METHODS: Ninety-five hospitalized patients with alcohol dependence (73 male, 22 female) were enrolled in this study. Thirty-two (33.7%) of the total patients were diagnosed with major depressive disorder and dysthymic disorder by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV. The characteristics of stress were evaluated using the stressful life events scale, and depressive symptoms were assessed using the depression scale (Beck Depression Inventory, BDI). Alcoholism with depression (n = 32) and alcoholism without depression (n = 63) were genotyped for the triallelic serotonin transporter gene (LA : higher expressing allele, LG/S : lower expressing allele). RESULTS: There was no significant difference in the allele frequency between the depression group and the non-depression group (chi2 = 0.345, p = 0.619). LG/S alleles had more comorbid depression in the higher score of stressful life events scale [Mental-Haenszel (MH)-chi2 = 4.477, p = 0.034]. But there was no significant difference in the comorbidity according to the scores from the stressful life event scale in the LA alleles (MH-chi2 = 0.741, p = 0.399). In the results, alcohol-dependent individuals with LG/S alleles had more comorbid depression than those with LA alleles when they had experienced severe stressful life events (MH-odds ratio = 2.699, p = 0.028). CONCLUSIONS: These results suggest that there is no direct relationship between triallelic serotonin transporter gene and depression in the alcohol dependent patients. But alcohol dependent individuals with the lower expressing alleles of the serotonin transporter gene were more susceptible to depression than those with the higher expressing alleles in response to stressful life events.

The Association among the Genetic Polymorphism of Dopamine D4 Receptor, Temperament and Alcohol Drinking Behavior in Young Korean Adults

OBJECTIVES: The aim of this study is to explore the association among DRD4 polymorphism, temperament and alcohol drinking behavior of Koreans in their early adulthood. METHOD: Participants were 172 healthy Korean adults (mean age 28.1 +/- 0.8). Their temperament was assessed with the Temperament and Character Inventory (TCI) and their alcohol drinking behavior were evaluated with a self-reported questionnaire including the CAGE and the Korean version of Alcohol Use Disorder Identification Test (AUDIT-K). DRD4 exon III 48 base pair variable number of tandem repeats (VNTR) was genotyped by PCR. RESULTS: No significant association was found between DRD4 polymorphism and TCI temperament dimension (novelty seeking, harm avoidance, reward dependence, and persistence) as well as alcohol drinking behavior scales. However, novelty seeking was significantly associated with alcohol drinking behavior. The higher level of novelty seeking was associated with the higher severity index of drinking (B = -0.225, p < 0.001) and problematic alcohol use on the CAGE and AUDIT-K [Odds Ratio (OR) = 1.111, 95% Confidence Interval (CI) 1.021-1.209, p = 0.015, OR = 1.087, 95% CI 1.009-1.170, p = 0.028]. CONCLUSION: In our study, while there is no significant association of DRD4 polymorphism with temperament and alcohol drinking behavior, novelty seeking affects problematic alcohol use. Results suggest that novelty seeking may play an important role in problematic alcohol use in young Korean adults.

A Study of Covert Narcissism in Adolescent Internet Addiction : Relationshipto Anonymity, Presence, Interactivity, and Achievement Motivation

OBJECTIVES: This study compared covert narcissistic propensity in adolescents with internet addiction tendency to normal adolescents. Further, we investigated the correlation between such propensities and anonymity in cyberspace, presence feeling and interactivity in internet gaming, and achievement motivation in adolescents with internet addiction tendencies. METHODS: Male middle school students with internet addiction tendencies (Addiction Tendency Group, N=27) and normal students (Control Group, N=29) were recruited. The scale of internet use, Covert Narcissism Scale, scale of achievement motivation, scale of anonymity in cyberspace, scale of presence feeling in internet games, and the scale of interactivity in internet games were administered. A comparison of the average scores and correlation analyses were performed. RESULTS: 1) Compared with Control Group, the Addiction Tendency Group showed significantly higher scores on all subscales of the Covert Narcissism Scale, and both the scale of presence feeling and that of interactivity in internet games. Further, the score on the scale of achievement motivation for the Addiction Tendency Group was significantly lower than that of the Control Group. 2) In the Addiction Tendency Group, the scores on several subscales of the Covert Narcissism Scale were significantly positively correlated with the scores on the scale of presence feeling in internet games, anonymity in cyberspace, and interactivity in internet games. However, in the Control Group, the scores of several subscales on the Covert Narcissism Scale were significantly negatively correlated with the score on the scale of achievement motivation, and was significantly positively correlated with the score on the scale of interactivity in internet games. There were no other significant correlations between the scores on the subscales of the Covert Narcissism Scale and the scores of either presence feeling in internet games or anonymity in cyberspace. CONCLUSION: These results suggested that adolescents with a tendency to be addicted to the internet exhibited higher covert narcissistic propensities than normal adolescents and that the covert narcissistic tendencies were related with presence feeling in cyber games as well as with anonymity in cyberspace.

The Influence of ADH1B, ALDH2 Activities and Their Combination on Drinking Behaviors of Korean Young Adults

OBJECTIVES: It is well-known that Korean people show distinctive drinking behaviors depending on the gene polymorphisms of alcohol metabolizing enzymes. This study examined the gene polymorphisms of ALDH2 and ADH1B and their combination on the drinking behaviors of Korean young adults. METHODS: Through a follow-up survey performed for a cohort consisting of 551 university freshmen for six years, the authors attempted to identify genetic factors affecting drinking behaviors. In 2000, drinking behaviors and scores of CAGE questionnaires were assessed and ALDH2 gene polymorphism was determined with PCR-RFLP. In 2006(n= 150), AUDIT-K was assessed in addition to the above and gene polymorphism of ADH1B was determined through SNaPshottrade mark method. RESULTS: While ALDH2*2 allele was associated with increased degree of drinking in 2000 and 2006. When both enzymes were active, the possibility to be classified into the risk group for alcohol dependence such as AUDIT-K(>12), and CAGE(>2) was high. CONCLUSION: The ALDH2 genotype had a significant effect on drinking behavior and degree of drinking during early adulthood. However, the combination of the active form of ADH1B and the active form of ALDH2 can be risk factor for problem drinking.

The Genetic Factors Affecting Drinking Behaviors of Korean Young Adults with Variant Aldehyde Dehydrogenase 2 Genotype

OBJECTIVE: We determined whether aldehyde dehydrogenase 2 (ALDH2) activity alters the way in which drinking behaviors are affected by gene polymorphisms of other alcohol-metabolizing enzymes and serotonin-related proteins. METHODS: Through a follow-up survey with a cohort comprising 551 university freshmen over a period of 6 years, we examined the genetic factors affecting drinking behaviors. In 2000, drinking behaviors were assessed and tryptophan hydroxylase (TPH) and ALDH2 gene polymorphisms were determined. Drinking behaviors were repeated in 2006 (n=150), and the gene polymorphisms of ADH1B, ADH1C, CYP2E1, 5-HTR2A 1438A/G, and 5-HTR2A IVS2 were also determined. RESULTS: In 2000, the variant and wild-type ALDH2 groups exhibited little difference in terms of drinking frequency and problem drinking. Furthermore, some genotypes influenced only the variant group: ADH1B*2/*2 was associated with a lower drinking frequency, and CYP2E1 c2 allele was associated with an increased risk of problem drinking. In 2006, drinking frequency and risk of problem drinking were significantly lower in the variant group than in the wild-type group. However, the TPH AA genotype disturbed that difference, meaning that the subjects in the variant group had developed a similar level of risk of problem drinking to that in the wild-type group. CONCLUSION: Korean university freshmen who were identified as a variant group drank as frequently as those in the wild-type group. For the subsequent 6 years they drank less frequently, thus decreasing the risk of problem drinking. However, that frequency drop was interrupted in those with gene polymorphisms such as ADH1B*1, CYP2E1 c2, and TPH A.

An fMRI Study Regarding the 'Theory of Mind' in Korean Schizophrenic Patients Using a First Order False Belief Task / 신경정신의학

OBJECTIVES: The aim of this study was to investigate brain activation during a Korean language-based 'theory of mind (TOM)' task and fMRI in Korean schizophrenic patients. METHODS: Fourteen Korean schizophrenic patients and 15 normal controls participated in this study. For all participants, several clinical states and psychosocial functions were evaluated. The subjects were then scanned while performing Korean language-based fMRI tasks. The tasks were comprised of conditions-first order false belief (TOM task), physical causality, and unrelated situations. Imaging data were analyzed using SPM2 software (uncorrected p<0.005, extent threshold kappa=10). RESULTS: 1) Compared with the control group, the patient group showed significantly poorer performance on the TOM task, and no significant correlation between TOM and empathic abilitiesy. 2) In the patient group, there were no significantly activated brain regions associated with the TOM task as compared to the physical causality task. With respect to between-group differences, the patient group showed significantly less activation of the left medial frontal region (primarily BA 8) and signifcantly different activation of the left precuneus (BA 7) associated with the TOM task. CONCLUSION: These results suggest that Korean schizophreniac patients show different brain activity associated with TOM functions, especially with respect to the Korean language-based first order false belief tasks.

Effects of Genetic and Environmental Factors on the Depression in Early Adulthood

OBJECTIVES: The authors purposed to present data for explaining gene-environmental interaction causing depressive disorder by examining the effects of genetic factors related to the serotonin system and environmental factors such as stressful life events in early adulthood. METHODS: The subjects were 150 young adults(mean age 25.0+/-0.54), a part of 534 freshmen who had completed the previous study of genotyping of TPH1 gene. We assessed characteristics of life events, depression and anxiety scale and checked if they had a depressive disorder with DSM-IV SCID interview. Along with TPH1 A218C genotype confirmed in previous study, TPH2 -1463G/A and 5HTR2A -1438A/G genes were genotyped using the SNaPshotTM method. RESULTS: In comparison with the group without C allele of TPH1 gene, the number of life events had a significant effect on the probability of depressive disorder in the group with C allele. Other alleles or genotypes did not have a significant effect on the causality of life events and depressive disorder. CONCLUSION: The results of this study suggest that TPH1 C allele is a significant predictor of onset of depressive disorder following environmental stress. It means that the TPH1 gene may affect the gene-environmental interaction of depressive disorder.

The Genetic and Psychosocial Factors Affecting the Change of Drinking Behavior of Male College Students / 신경정신의학

OBJECTIVES: This study aimed to determine the general predictive factors of change in drinking behavior and to provide materials for preventing drinking problems during early adulthood through examining genetic and psychosocial factors affecting the change of drinking behavior in college students. METHODS: The subjects were 101 male college students, a part of 534 students who had completed the previous study in 2000. In the present study as a 6-years follow up, we reassessed the drinking pattern and psychosocial variables and compared the results with previous data of the same subjects. To identify factors affecting the current drinking pattern, we used stepwise multiple regression and logistic regression analysis. RESULTS: D allele (ALDH2) was found to reduce the degree of drinking and suppress problematic drinking, and C allele (TPH) had a suppression effect on problematic drinking. Drinking motive had a direct effect on the degree of drinking and problematic drinking. Negative cognitive expectancy had a direct effect on problematic drinking. CONCLUSION: Authors found some factors affecting the change of alcohol drinking behavior in college students and confirmed that there were hierarchies of significance among these factors. These may be applicable as variables for predicting drinking behavior in early adulthood.

A case of lithium poisoning with a maintenance dose treated by hemodialysis / 대한내과학회지

Lithium is a commonly prescribed drug for bipolar disorder. Because of the narrow therapeutic range, lithium intoxication continues to be prevalent. Drugs that alter renal function such as ACEI, ARB, NSAIDS, and thiazide can increase the risk of chronic lithium toxicity even to stable patients. A 65-year old woman was admitted for hand tremor, cognitive impairment, and lethargy. A medical history included major depressive disorder, mitral stenosis, atrial fibrillation, and hypertension. Her prescription included lithium, quetiapine, digoxin, furosemide, and warfarin. She recently received Atacand Plus (candesartan plus thiazide) for hypertension. At the time of admission, the patient was drowsy and confused. The serum lithium level was 4.25 mEq/L. The patient received hydration. Due to neurologic complications and the degree of lithium toxicity, a total of three sessions of hemodialysis were performed, and the post-dialysis serum lithium level was 0.54 mEq/L. The neurologic symptoms recovered completely after a third dialysis session.

The Properties of Temperament, Character and Stress Response in Patients with Irritable Bowel Syndrome / 신경정신의학

OBJECTIVES: The purpose of this study was to assess the specific properties of temperament, character and stress response in patients with irritable bowel syndrome compared to those with peptic ulcer disease and healthy controls. METHODS: We studied nineteen subjects with irritable bowel syndrome, twenty-six subjects with peptic ulcer disease and thirty-three healthy control subjects. All subjects completed Temperament and Character Inventory (TCI), Stress Response Inventory (SRI) and questionnaire of demographic characteristics and several variables. RESULTS: From the results of the TCI's, the scores of harm avoidance (HA1, HA2, HA3, HA4, HA total) were significantly higher in the irritable bowel syndrome group than those of the peptic ulcer disease group or the healthy control group. In contrast, the scores of self directedness (SD3) were lower in the irritable bowel syndrome group than the healthy control group. From the results of the SRI's, somatization, anger, fatigue and frustration were significantly higher in the irritable bowel syndrome group. No significant difference was found in TCI and SRI results between the peptic ulcer disease group and the healthy control group. CONCLUSION: The results of this study suggest that patients with irritable bowel syndrome show specific properties of temperament, character and stress response compared with either peptic ulcer disease patients or healthy controls.

The Tryptophan Hydroxylase A218C Polymorphism in Patients with Bipolar Disorder / 대한정신약물학회지

OBJECTIVE: This study has been carried out to explore the genetic causes of bipolar disorder by comparing the frequency of Tryptophan Hydroxylase (TPH) A218C polymorphism between bipolar disorder patients and normal controls, and to explore the relation between clinical characteristics of bipolar disorder patients and TPH polymorphism. METHODS: The genotype and allele frequencies of TPH in the genome of 113 hospitalized patients with bipolar disorder was compared with those of 124 normal control subjects using polymerase chain reaction and restriction fragment length polymorphism. The association between TPH A218C polymorphism and clinical characteristics in bipolar disorder patients were explored. RESULTS: The distributions of TPH A218C polymorphism between the patients with bipolar disorder and normal control subjects show no difference statistically. There was a significant difference in the distribution of TPH genotype by clinical characteristics. The frequency of C allele is significantly higher in patients with a history of suicidal attempts. The frequency of A allele is significantly higher in patients with family history of bipolar disorder. CONCLUSION: This study suggests that suicidal attempts and family history in the patients with bipolar disorder are clearly associated with TPH A218C polymorphism and may explain, in part, the biological basis for these typologies.

Effects of Polygalae Radix on Apomorphine-Induced Stereotyped Behaviors in Mice / 신경정신의학

OBJECTIVES: This study was to investigate in vivo activities of Polygalae Radix, a natural plant including active components having affinities to central nervous system receptors, using an animal model for psychotic disorders in terms of behavioral psychopharmacology. METHODS: The extracts of Polygalae Radix in two concentrations of 5.0mg/g and 0..5mg/g were administered to mice in order to explore the suppression of apomorphine-induced stereotyped behaviors visually and to compare with the effects of haloperidol and control. 10 mice were tested in each groups. RESULTS: The capacities of suppressing the apomorphine-induced stereotyped behaviors were observed in decreasing order of haloperidol, Polygalae Radix 5.0mg/g, Polygalae Radix 0..5mg/g and control. The extracts of Polygalae Radix in both concentrations suppressed apomorphine- induced stereotyped behaviors significantly, and Polygalae Radix 5.0mg/g was as potent as haloperidol. CONCLUSION: This suggests that Polygalae Radix contain some effective ingredients to influence the central dopamine pathway in vivo. The identification of the chemical structures and the exploration of the biochemical and pharmacological characteristics of active components are to be required through further studies.