Increased Bone Mineral Density after Abstinence in Male Patients with Alcohol Dependence

OBJECTIVE: This study aimed to compare the bone mineral density of male patients with alcohol dependence with that in healthy controls and to assess changes in bone density after abstinence. METHODS: Forty-four inpatients with confirmed the Diagnostic and Statistical Manual of Mental Disorders, fourth edition diagnosis of alcohol abuse and 42 controls were recruited. Bone density was determined with dual-energy X-ray absorptiometry in the lumbar spine as well as in the femoral neck, trochanter, and Ward’s triangle regions of the proximal right femur. RESULTS: There were no significant differences in age and body mass index between patients with alcohol dependence and healthy controls. In the alcohol dependence group, osteopenia and osteoporosis were found in 54.5% and 34.1% of the patients, respectively, whereas in the control group, the corresponding values were 45.2% and 11.9% (p=0.001). Although the actual bone density in the femur and the corresponding T-scores were significantly lower in the alcohol dependence group, no significant differences were found in the lumbar spine. In both groups, body mass index showed a significant correlation with bone mineral density in all areas. After 3 to 4 years of abstinence, bone density significantly increased in the lumbar and femur. CONCLUSION: We conclude that bone mineral density in patients with alcohol dependence was significantly lower than that in healthy controls, and the rates of osteopenia and osteoporosis are higher. Importantly, abstinence from alcohol increases bone density.

Electroconvulsive Therapy for Patients with Treatment-Resistant Schizophrenia Patients : A Retrospective Study / 신경정신의학

OBJECTIVES: This study analyzes the effect of electroconvulsive therapy (ECT) by predicting the factors contributing to the effectiveness of ECT and evaluating the persistency of ECT effect in patients with treatment-resistant schizophrenia. METHODS: Using retrospective review of the charts of 24 schizophrenic inpatients who were admitted to Busan Paik Hospital between March 1, 2005 and December 31, 2009. We compared the pre-ECT Clinical Global Impression (CGI) scores and post-ECT CGI scores among these patients. We evaluated the differences in the ECT responses by sex, age, duration of illness and dose of antipsychotic agents, and investigated the rate of continuation of out-patient treatment and readmission, and the change of the CGI score for 12 months after the ECT. RESULTS: ECT resulted in an overall clinical improvement as measured on the CGI scale. 15 (62.50%) patients were good responders, while 9 (37.50%) were poor responders. There was no significant difference between sex, age, duration of the illness, and dose of antipsychotics taken by the patient before the ECT. 21 (87.50%) patients continuously visited the outpatient department for 12 month, and 14 (66.67%) of them maintained the ECT effect with medical treatment only and without readmission. CONCLUSION: This study showed that the ECT could be a useful treatment option for schizophrenic patients who are resistant to antipsychotics.

Effects of Antipsychotics-Induced Amenorrhea on Attitudes Toward Treatment and Quality of Life in Women with Schizophrenia / 대한정신약물학회지

OBJECTIVE: This study was aimed to identify the correlation between antipsychotics-induced amenorrhea, and attitudes toward treatment and quality of life in women with schizophrenia. METHODS: Twenty female schizophrenic patients with antipsychotics-induced amenorrhea and thirty female schizophrenic patients without antipsychotics-induced amenorrhea were evaluated. Attitudes toward treatment were assessed by the Korean version of Drug Attitude Inventory (KDAI-10) and quality of life was assessed by the Korean version of World Health Organization Quality of Life Assessment Instrument-BREF (WHOQOL-BREF). The psychopathology of each patient was assessed by the Positive and Negative Syndrome Scales and the Clinical Global Impression-Severity. Adverse effects were evaluated using the Drug-Induced Extrapyramidal Symptoms Scale. Correlation analysis and multiple linear regression were conducted. RESULTS: The KDAI-10 score was not significantly correlated antipsychotics-induced amenorrhea. In WHOQOL-BREF score, social relation domain only showed significant correlation with antipsychotics-induced amenorrhea. Multiple linear regression analysis revealed that the number of family members contributed significantly to the Positive Subjective Feelings Scores of KDAI-10 and marital status contributed significantly to the social relation domain of WHOQOL-BREF in amenorrhea group. CONCLUSION: The results of present study suggest that antipsychotics-induced amenorrhea lower part of the quality of life domain in women with schizophrenia. Clinicians must pay attention to treatment of amenorrhea and various factors that correlated with attitudes toward treatment and quality of life in women with schizophrenia.

A Correlation of Cognitive Function, Depression, Suicidal Idea and Serum Lipid Levels in the Elderly Over Sixty Years of Age

OBJECTIVES: We investigated a correlation of cognitive function, depression, suicidal idea and serum lipid levels in Korean elderly over 60 years old to find risk factors of deprssion and cognitive decline. METHODS: 834 persons participated in this study. Clinical evaluation was done at a point by using Mini-Mental State Examination in the Korean version of CERAD assessment packet(MMSE-KC). We also evaluated 165 persons that agreed to our exact examination for Geriatric Depression Scale(GDS), Scale for Suicidal Ideation(SSI), Hachinski Ischemic Score and serum lipid profile. Correlation analysis was used to evaluate correlation among serum lipid levels, MMSE-KC and SSI. One-way ANOVA was used for comparison of serum lipid levels and cognitive function, depression and SSI. We did a post-hoc analysis. RESULTS: Depression and suicidal ideation were related with cognitive impairment in Korean elderly over 60 years old. Those who have more severe cognitive impairment and depressive symptom, have higher Hachinski ischemic score. We can see high HDL cholesterol levels only in the normal control group. Low total, HDL, LDL cholesterol were related with depression. CONCLUSION: There was high prevalence of depression in the Korean elderly over 60 years old and low serum lipid level was related with severity of depression and high suicidal ideation. In the normal control group, we can see high HDL cholesterol levels. To confirm this result, we need well-designed and wide range study.

Effects of Psychoeducation Program on Insight and Treatment Attitudes in Patients with Schizophrenia, Schizophreniform Disorder, and Schizoaffective Disorder / 대한정신약물학회지

OBJECTIVE: This study aimed to confirm effectiveness of psychoeducation program on insight and treatment attitudes in patients with schizophrenia, schizophreniform disorder and schizoaffective disorder. METHODS: Seventy eight psychotic patients who were diagnosed as schizophrenia, schizophreniform disorder, and schizoaffective disorder by Diagnostic and Statistical Manual of Mental Disorders 4th edition Text Revision (DSM-IV TR) were included. Subjects who decline more than 30% compared with baseline in Positive and Negative Syndrome Scale (PANSS) scores participated in psychoeducation program. Insight and Treatment Attitudes Questionnaire (ITAQ) and Drug Attitude Inventory (DAI) were assessed at pre-psychoeducation, post-psychoeducation and 2 months after discharge to estimate insight and treatment attitudes. RESULTS:There were significant improvement in ITAQ and DAI scores at post-psychoeducation and 2 months after discharge. Increase in DAI scores related with high ITAQ scores at post-psychoeducation. Small changes in PANSS scores and ITAQ scores at post-psychoeducation had positive relationship. Subjects of late onset of illness and female took better ITAQ and DAI scores after psychoeducation. CONCLUSION: This study showed that psychoeducation program would be effective for insight and treatment attitudes in patients with schizophrenia, schizophreniform disorder, and schizoaffective disorder.