Factors Related to Weight Gain in Patients with Schizophrenia Treated with Serotonin-Dopamine Antagonists / 신경정신의학

OBJECTIVES: The purpose of this study was to investigate demographic, clinical, behavioral and metabolic-endocrine factors related to weight gain in patients with schizophrenia treated with serotonin-dopamine antagonists(SDA). METHODS: Forty-two in-patients with DSM-IV schizophrenia were recruited from Samsung Seoul Hospital and St. Andrew Neuropsychiatric Hospital. The subjects were first-episode patients or patients who did not take any antipsychotics for the previous two months. All the patients were administered with one of the SDAs for 8 weeks. Body weights and body mass index (BMI) were measured weekly during the treatment period. The mean levels of daytime activities were evaluated at baseline and 4 weeks and 8 weeks after the treatment. To assess the clinical response to the medication, the Krawiecka Rating Scale (KRS) and Clinical Global Impression (CGI) were applied before and after the treatment. Fasting blood levels of glucose, cholesterol, triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL), and serum level of prolactin were measured before and after the treatment. RESULTS: The body weight and BMI were significantly increased through the treatment periods. There were significant increases in the blood levels of cholesterol, TG and prolactin after 8 weeks. KRS total score showed significant decrease and the mean level of daytime activities showed significant increase by the treatment. Significant negative correlations were observed between the weight gain indices and the baseline BMI. The level of clinical improvement was significantly correlated with the degree of weight gain. Gender, age, smoking, daily dosages of antipsychotics, level of daytime activity and changes in appetite did not show any association with the weight gain indices. Neither the baseline biochemical variables nor their changes after the treatment were significantly correlated with the indices of weight gain. CONCLUSION: This result implies that low baseline BMI could be a risk factor of weight gain in short-term treatment of schizophrenia with SDAs. And it is also suggested that the effects of SDAs on weight gain and the clinical improvement might be developed through the same pharmacodynamic pathway.

Genetic and Clinical Characteristics of Multiplex Schizophrenia Families / 신경정신의학

OBJECTIVES: This study aims at exploring genetic and clinical characteristics of multiplex Korean families with schizophrenia. METHODS: Thirty-three families having two or more schizophrenics by DSM-IV criteria within the second degree relatives were obtained from the clinics of general hospitals and mental hospitals. Sixty-nine affected and forty-five unaffected subjects from these families were interviewed using Korean version of Diagnostic Interview for Genetic Studies. Krawieka Rating Scale and The Schedule for the Deficit Syndrome were also applied for further evaluation of psychopathologies of the patients. Patterns of inheritances of the disease were analyzed by the inspection of the pedigrees. Parent-of-origin effect was evaluated by the comparison of the occurrence rate and the clinical characteristics between the subgroups of maternal and paternal origins. RESULTS: There were similar rates of maternal and paternal transmission in the families for which unilineal transmission of the disease was estimated. Only one family showed bilineal transmission. Observed patterns of transmission were not compatible with the recessive single locus model or sex-linked model. The most frequently observed non-schizophrenic disorders in these families were personality disorders/traits of schizophrenia spectrum. We could not find any clinical characteristics which might be unique to the patients from multiplex families. Parent-of-origin effect was not suggested. CONCLUSION: This study provides preliminary clinical and genetic data on the multiplex schizophrenia families which could be used for the determination of the genetic parameters and the boundaries of the phenotype in the linkage analyses.

Psychological Characteristics and Changes after the Tattoo Removal

Tattooing has been practised since pre-Christian times, as an object of both fascination and revulsion. In the Present day, body tattoo has been a flourishing and contemporary teen issue. Adolescents have discovered tattoos as a means of self-expression. Due to the external characteristics of the tattoo however, a lot of researchers have shown their interest and done various researches. The examination of the psychological characteristics of the tattooed people revealed that a lot of people have psychological problems, the tattoos revealing the person's deviated image. As a result, several attempts have been made to try and correlate tattoos with the psychiatric diagnoses such as schizophrenia or personality disorder, or with adverse social circumstances such as poverty. The subject of tattoo removal is as old as the history of tattooing itself. Plastic surgeons have witnessed numerous tragic instances where a tattoo has caused hardship, including diminished employment prospects, even loss of love and affection from family and friends and, very commonly, loss of self-esteem. For this reason, the bearers of tattoo often consider the inevitable scarring left by tattoo removal as a preferable alternative. Past techniques of removing tattoos, using corrosive agents or skin graft, have been universally unsuccessful, or certainly less than satisfactory. But, currently laser therapy has been introduced into the market to remove tattoos. As a result, a lot of people have visited hospitals to get tattoos removed. In addition, many of those who had tried to hide the fact that they had tattoos, have been given the opportunity to express their feelings, and rate their psychological statements. This research enables to find the best approach to the person's psychiatric point of view, by objectively observing the person's psychological characteristics and psychological changes after the tattoo removal.

A Standardization Study (I)of the Korean Version of Occupational Stress Inventory(K-OSI) Reliability and Validity Study / 신경정신의학

OBJECTIVES: The present study explored the reliability and the validity of our newly constructed job stress scale, the Korean version of the Occupational Stress Inventory (K-OSI) METHODS: Through preliminary item-analysis, we constructed 140 items of the Korean version of Occupational Stress Inventory (K-OSI) K-OSI consists of three subscales measuring three sections, 'ORQ'(Occupational Role Questionnaire) 'PSQ'(Personal Strain Questionnaire) and 'PRQ'(Personal Resource Questionnaire) respectively. The normative group consisted of 805 adult workers who represented six major job classes in Korea. RESULTS: The internal consistency coefficients of 'ORQ', 'PSQ', and 'PRQ' ranged from .89 to .92, and of those 14 subscales ranged from .70 to .88. The test-retest reliability coefficients of 8 week duration ranged from .62 to . 79, and bilingual's consistency coefficient ranged from .82 to . 96. The validity of the K-OSI was investigated by factor-analysis, yielding 3 factors of overall job stress and its responses, personal stress coping, psychological, physical, and behavioral responses of job stress. CONCLUSION: The present results indicate that the K-OSI is a reliable and valid measure of job stress.

A Standardization Study II on Korean Version of Occupational Stress Inventory (K-OSI): Demographic Variables and Norm / 신경정신의학

OBJECTIVES: This study examined the effects of demographic variables on the job stress experience and established the norms of the Korean version of Occupational Stress Inventory. METHODS: The normative group consisted of 805 adult workers who represent seven major job class in Korea. K-OSI were administered to normative group and data were analyzed by subjects' demographic variables. RESULTS: To explore the effects of demographic variables on K-OSI, we considered several factors such as age, sex, duration of employment, job class, job position and so on. The results were as follows: 1) We found significant sex difference in K-OSI. Compared with men, women showed higher scores in Role Insufficiency, Role Ambiguity, Social Support, Vocational Strain Scales and men showed higher scores in Role Overload, Responsibility Scales. 2) Generally, a person who was older, earned higher salary, more duration of employment experienced job stress and had more coping resources. 3) In general, white-collar workers, job classes and job position had little effects on job stress. But other workers such as security guards, military officers were different from general white-collar workers in K-OSI. CONCLUSION: Because men and women showed significant difference in K-OSI, we constructed norms according to sex. K-OSI would be an useful instrument to identify one's job stress experience and to develop intervention plan.