Study on Mental Disorders in Abused Children / 신경정신의학

OBJECTIVES: Child abuse can affect mental and physical health of abused children. Accurate assessment of mental health of abused children is integral to providing proper treatment and preventing any further impact of childhood abuse on their future life. In this study, we investigated psychiatric illnesses among abused children. METHODS: Semi-structured interviews using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version were conducted for 61 abused children after obtaining consent from their guardians. We also assessed the relationship between the demographic data of these abused children and their diagnoses. RESULTS: Among the abused children, more than half had more than one psychiatric disorder. The most frequently diagnosed disorders were attention-deficit/hyperactivity disorder, posttraumatic stress disorder, depressive disorder, and oppositional defiant disorder. The incidence of posttraumatic stress disorder was higher in abused girls compared with abused boys. Abused children had a higher suicide risk than the general population. Among the parents of abused children, 50.8% had alcohol use disorders. CONCLUSION: Among the abused children, 50.8% had psychiatric disorders. Administration of intensive psychiatric treatment to abused children, and prevention of child abuse by education, treatment, and monitoring high-risk parents is imperative.

Lamotrigine Augmentation in Patients with Treatment-Resistant Major Depressive Disorder: A Naturalistic Study / 대한정신약물학회지

OBJECTIVE: Lamotrigine's possible efficacy in the treatment of depressive disorders has been suggested. This naturalistic study investigated clinical response to lamotrigine augmentation in patients with treatment-resistant depression. Characteristics of the lamotrigine-responders were also explored. METHODS: Clinical data from 40 lamotrigine- treated patients with treatment-resistant unipolar depression were analyzed. The subjects were diagnosed with DSM-IV major depressive disorder and resistant to at least 2 antidepressants. Efficacy of lamotrigine treatment was measured by the changes in mean scores of the Clinical Global Impression Severity subscale (CGI-S), which were extracted from the prospective mood chart and structured interviews. Response was defined as a decrease of at least 2 or more from baseline on the CGI-S. Untoward effects associated with lamotrigine treatment were also assessed through medical records. RESULTS: Significant reduction in the CGI-S mean score was observed from baseline through 8 week lamotrigine augmentation in 40 patients with treatment-resistant unipolar depression (t=5.7, df=39, p<.01), and the magnitude of treatment effect was large (r(effect size)=0.68). Drop-outs were mainly attributable to lamotrigine-associated rash (N=5). Greater rate of improvement was associated with responder group (N=14) compared to non-responder group (N=17) from week 3 onward. CONCLUSION: The results of current study lend support to the potential benefit of lamotrigine augmentation in a subpopulation of patients with treatmentresistant unipolar depression. Continuation of lamotrigine add-on for more than 3 weeks may be needed to assess clinical outcome. Lamotrigine augmentation was generally well-tolerated. Large scale, double-blind studies are necessary to confirm its use as an augmentation agent.

Low Dose Olanzapine Induced Tardive Dyskinesia: A Case Report / 대한정신약물학회지

Olanzapine is known to induce extrapyramydal symptom and tardive dysknesia less than typical antipsychotics. However, there are accumulating reports of tardive dyskinesia induced by olanzapine. We experienced a patient with schizophrenia who demonstrated tardive dyskinesia following treatment with low dose olanzapine. This case suggests that even patients with low dose olanzapine are exposed to the risk of tardive dyskinesia.