Reliability and Validity of the Korean Version of the Psychotic Symptom Rating Scale / 신경정신의학

OBJECTIVES: Psychotic Symptom Rating Scale (PSYRATS) is an assessment tool to measure the severity of different dimensions of auditory hallucinations and delusions. The reliability and validity of the Korean version of PSYRATS (K-PSYRATS) were examined in Korean patients with major psychosis. METHODS: The inter-rater reliability of the K-PSYRATS was determined from the videotaped interviews of the five schizophrenic patients. To measure validity and internal consistency reliability, the 109 patients with auditory hallucinations or delusions were assessed using the K-PSYRATS, Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression-Severity (CGI-S) scale. RESULTS: K-PSYRATS was found to have excellent inter-rater reliability (intra-class correlation coefficient of auditory hallucination= 0.81, p<.001, intra-class correlation coefficient of delusion=0.97, p<.001) and internal consistency reliability (Cronbach's alpha of auditory hallucination=0.77, Cronbach's alpha of delusion=0.76). Significant correlation was found between K-PSYRATS and positive syndrome subscale of PANSS and CGI. CONCLUSION: K-PSYRATS is a useful assessment instrument for psychotic symptoms in Korea.

Intravenous Anti-obsessive Agents : A Review / 대한정신약물학회지

Oral (p.o.) administration has a delayed onset time of several weeks and moderate efficacy in obsessive-compulsive disorder (OCD), therefore a more rapidly effective treatment is required. The aim of this paper was to review available data detailing the clinical outcome of intravenously (i.v.) administered antiobsessional drug in OCD patients. Review of the research indicates that i.v. administration exhibits a faster onset and greater improvement than p.o. administration. I.v. pulse administration showed clinically significantly faster onset than i.v. gradual administration. I.v. administration was safe and rapidly effective in treatment resistant OCD patients and might be a valuable new treatment.

Relations among Social Functioning, Psychopathology and Attentional Deficits in Schizophrenic Outpatients / 신경정신의학

In order to study the relations between attentional deficits and social functioning of the schizophrenia, 83 stable outpatients with DSM-IV schizophrenia and matched 60 normal controls were examined for their sustained attention, sensory register, and social functioning by means of Continuous performance test(CPT), Span apprehension task(SPAN), and Korean version of Social Adjustment Scale II-Revised Version(KSAS II-RV) respectively. Psychopathology was assessed using the Positive and Negative Syndrome Scale(PANSS). The results were as follows. 1) Schizophrenic patients showed a significant deficit in the sustained attention and sensory register as manifested in the data of CPT and SPAN, compared with the matched normal controls. Schizohrenic patients also showed a significantly poor social functioning in measure of KSAS II-RV compared with the matched normal controls. 2) There was no correlation between three type of symptoms(positive/negative/general) and total scores of social functioning. But negative symptoms was correlated with the social leisure subarea of KSAS II-RV. 3) CPT was correlated with total scores of social functioning including the instrumental role and friend relation subareas of KSAS II-RV, whereas SPAN was only correlated with the instrumental role subarea of social functioning. 4) In the relations between attention and symptoms, CPT was correlated with negative symptoms. These results suggest that the deficit of the sustained attention may be a predictive factor of social functioning in the schizophrenic outpatients.

The Effects of Fentanyl and Lidocaine on the Hemodynamic Changes to Tracheal Intubation / 대한마취과학회지

Tracheal intubation is accompanied by varying degrees of sympathetic stimulation as reflected by increases in heart rate and blood pressure. Several clinical trials to reduce the effects on blood pressure and heart rate by pharmacologic agents such as alpha and beta blockers, calcium channel blockers, narcotics and lidocaine, have been reported. To evaluate the effect of fentanyl and lidocaine on the hemodynamic changes induced by intubation, we administered thiopental 5 mg/kg only (group 1), fentanyl 3 ug/kg with thiopental 4 mg/kg (group 2) or fentanyl 3 ug/kg-lidocaine 1.5 mg/kg with thiopental 4 mg/kg (group 3) for induction of anesthesia, and measured heart rate, systolic pressure, diastolic pressure, mean pressure and rate- pressure products before induction, after induction and at 1, 3, 5, 7 and 10 minutes after intubation. 1) In group 1, intubation caused a significant increase in heart rate (27%), blood pressure (31%) and RPP (64%) at 1 min after intubation, but each paramenter returned to the normal level within 7 min. 2) In group 2, increases in heart rate, blood pressure and RPP with intubation were attenuated by fentanyl. 3) In group 3, the increase in heart rate induced by intubation was abolished by fentanyl-lidocaine, and the pressor effect was more attenuated compared to group 2. These results suggested that a low dose of fentanyl-lidocaine significantly blunts postintubation hypertension and tachycardia when used as an adjunt to thiopental.