Clinical efficacy and safety analysis of olanzapine in the treatment of mental disorders associated with brain organic diseases / 中国综合临床

Objective To observe the clinical efficacy and safety of olanzapine in the treatment of mental disorders caused by brain organic diseases.Methods Eighty-one patients with mental disorder caused by brain organic disease were enrolled in the study and randomly divided into the control group(39 cases)and the experimental group(42 cases).The control group was treated with risperidone tablets and the experimental group was treated with olanzapine tablets,the patients in the two groups were treated for 4 weeks.After 4 weeks, the clinical efficacy,the scores of BPRS and the adverse reactions in the treatment were observed.Results The total efficiency of the control group 66.7%(26/39),the total efficiency of experimental group was 92.8%(39/42),there was significant difference in total efficiency between the two groups(χ2=7.889,P<0.05).Before the treatment,BRPS scores in the two groups were(51.42±6.38)points and(50.32±7.15)points,respectively, After 4 weeks of treatment,BRPS scores were(39.21 ± 7.43)points and(30.10 ± 3.88)points in the two groups,the differences in BPRS score in the two groups before treatment and at 4 weeks after treatment were statistically significant(control group: t=7.845,P=0.003,experimental group: t=8.321,P=0.002),there was significant difference between the control group and the experimental group in BPRS score(t=6.773,P=0.003).The incidence rate of body mass increase in the experimental group was 40.5%(17/42),significantly higher than that of the control group(15.4%)(6/39),the difference was statistically significant(χ2=6.576,P<0.05),while the incidence rates of myotonia and tremor adverse reaction were 16.7%(7/42)and 19.0%(8/42),significantly lower than those in the control group 35.9%(14/39)and 38.5%(15/39),the differences were statistically significant(myotonia:χ2=5.187,P<0.05;tremor; χ2=4.433,P<0.05).Adverse drug reactions can be effectively alleviated after symptomatic treatment.Conclusion Olanzapine has good clinical efficacy and safety and low adverse reactions in the treatment of mental disorders caused by organic brain disease.

Development of the Korean version of Postconcussional Syndrome Questionnaire / 정신신체의학

OBJECTIVES: The purpose of this study was to evaluate reliability and validity of the Korean version of the Postconcussional Syndrome Questionnaire(KPCSQ) which was originally developed in 1992 by Lees-Haley. METHODS: Patients with traumatic brain injury were recruited from April 2009 to December 2011 from the Korean University Ansan Hospital. We selected patients that met the ICD-10 diagnostic criteria of postconcussional syndrome and organic mental disorder including organic mood disorder, organic emotionally labile disorder, organic anxiety disorder and organic personality disorder. The KPCSQ, Trait and State Anxiety Inventory(STAI-I, II), and Center for Epidemiologic Studies Depression Scale(CESD) were administered to all subjects. Factor analysis of the items were performed and test-retest correlation were evaluated. Internal consistency of the KPCSQ and its subscales was assessed with Cronbach's alpha. External validity of the KPCSQ were examined by correlation coefficient with the STAI-I, II, and CESD. RESULTS: The Cronbach's alpha coefficient of the total PCSQ was 0.956. The test-retest reliability coefficient was 0.845. The PCSQ showed significant correlation with STAI-I, II and CESD. The factor analysis of the PCSQ yielded 4 factors model. Factor 1 represented 'affective and cognitive symptoms', factor 2 represented 'somatic symptoms', factor 3 represented 'infrequent symptoms' and factor 4 represented 'exaggeration or inattentive response'. There was no significant difference between the PCS group and the organic mental disorder group in the score on each measure. The scores on KPCSQ and its subscales in the subjects that had scored 5 or more in 'exaggeration or inattentive response' are significantly higher than those in the subjects had scored 4 in 'exaggeration or inattentive response'. CONCLUSIONS: This study suggests that the Korean version of PCSQ is a valid and reliable tool for assessing psychiatric symptomatology of patients with traumatic brain injury. Further investigations with greater numbers of subjects are necessary to assess the clinical usefulness of the KPCSQ.

Clinical Characteristics of Neurocognitive Function in Patients with Traumatic Brain Injury Referred for Mental Disability Evaluation / 신경정신의학

OBJECTIVES: The purpose of this study is to investigate the clinical characteristics of neurocognitive functions in patients with traumatic brain injury referred for mental disability evaluation. METHODS: The neurocognitive functions of 293 patients, who were referred for mental disability evaluation, were assessed using a computerized neurocognitive test. The patients were divided into three groups according to head trauma history and brain imaging studies. We also measured their intelligence and memory, using the K-WAIS and the Rey-Kim Memory Test. RESULTS: The group with organic mental disorder showed more impaired concentration, language, memory, intelligence, executive function and visuospatial function than those with nonorganic mental disorder without traumatic brain injury. The group with organic mental disorder also showed greater impairments in selective attention, some part of language, long-term memory, and hypothesis formation than those with postconcussional disorder. The group with organic mental disorder obtained lower intelligence and memory test scores than those with postconcussional disorder and nonorganic mental disorder without traumatic brain injury. There was no difference in intelligence or memory between postconcussional disorder and nonorganic mental disorder without traumatic brain injury. CONCLUSION: Patients with postconcussional disorder share the characteristics of neurocognitive function with organic mental disorder and nonorganic mental disorder without traumatic brain injury. We suggest the computerized neurocognitive test that evaluated details of neurocognitive functions for patients with traumatic brain injury referred for mental disability evaluation.

Risperdal Sachet and Oral Lorazepam versus Intramuscular Haloperidol and Lorazepam Injection for Acute Psychotic Symptom in the Elderly Patients with Organic Mental Disorder

OBJECTIVES: The purpose of present study was to investigate the effect, safety and tolerability of risperdal sachet(oral solution) with lorazepam tablet versus intramuscular haloperidol and lorazepam injection for management of acute psychotic symptom in the elderly with organic mental disorder. METHODS: Total 37 patients who have dementia, medical or physical diseases, associated with acute psychotic symptom were randomly assigned to oral treatment with 1mg of risperdal sachet(oral solution) plus 1mg of lorazepam(N=17) or to intramuscular treatment with 2.5mg of haloperidol plus 2mg of lorazepam(N=20). The change of CGI scores was used for the evaluation of efficacy. RESULTS: Mean score improvements at 15, 30, 60, and 120 minutes after treatment were statistically significant at each time point in both groups(p<0.001) and were similar in both groups(p=0.189). CONCLUSION: A single oral dose of risperdal sachet(oral solution) plus lorazepam was as effective and tolerable as parenterally administered haloperidol plus lorazepam for the rapid control of acute psychotic symptom in the elderly with organic mental disorder.

Factor Analysis of K-WAIS in a Sample of Patients with Organic Mental Disorder due to Head Trauma / 신경정신의학

OBJECTIVES: The purpose of this study was to investigate the factor structure of the K-WAIS. METHODS: The sample was consisted of 138 patients with organic mental disorder due to head trauma. A principal component analysis was used worth varimax rotation. RESULTS: Two factors in a sample patients with organic mental disorder due to head trauma were abstracted from the K-WAIS by factor analysis. Variance of the two factors was 73.3%. And variance of factor 1 (verbal comprehension) factor 2 (perceptual organization) were 62.0% and 11.7%, respectively. CONCLUSION: Two factors in a sample patients with organic mental disorder due to head trauma were abstracted from the K-WAIS using the principal component analysis by varimax rotation.