Relationship between clinical features and cognitive function of patients with schizophrenia / 西安交通大学学报(医学版)

Objective: To investigate the relationship between the 5 Positive and Negative Syndrome Scale (PANSS) factors of a recent consensus model and cognitive performance in patients with schizophrenia. Methods: Totally 130 inpatients and 85 healthy controls matched for age, gender and education were recruited. The MATRICS Consensus Cognitive Battery (MCCB) was used to evaluate cognitive function. PANSS was used to evaluate symptoms. Results: Compared with those of the controls, scores of TMT, BACS, Fluency, WMS, HVLT-R, BVMT-R, NBA and MSCEIT tests in MCCB were lower in the patients (all P<0.001). The PANSS cognitive factor showed a small to moderate significant association with MCCB speed of processing, verbal learning, reasoning and problem solving and social cognition (all P<0.050). Notably, however, no relationship was found between the other PANSS factors and any of the MCCB scores. Conclusion: There are a wide range of cognitive function impairments in patients with schizophrenia. These results support the relative independence of cognition from other domains of psychopathology, including negative symptoms, in patients with schizophrenia. Therefore, we need to make different kinds of plans when treating patients.

Combination of Electroconvulsive Therapy and Clozapine in Treatment-Resistant Schizophrenia

OBJECTIVE: This study aimed to investigate the effectiveness and tolerability of the combination of electroconvulsive therapy (ECT) in patients with clozapine-treated schizophrenia. METHODS: Patients with clozapine-treated schizophrenia during five years of pre-determined period were recruited from Electronic Medical Record. Clinical effects of acute ECT on psychotic symptoms were investigated. We also tried to identify predictive variables requiring maintenance treatment of ECT. RESULTS: Fourteen patients received ECT and clozapine and sixteen were treated with clozapine alone. In the ECT group, which could be refined as clozapine-resistance, PANSS total score was significantly reduced by 19.0±9.9 points, corresponding to a reduction rate of 18.5±8.3%. The clinical remission defined as 20% PANSS reduction criteria was achieved at 42.9%. The subscale factors were significantly reduced, among which the negative symptom was the least. There was no difference in demographic and clinical information between patients receiving and not receiving maintenance ECT, and not all patients seemed to need maintenance ECT if clozapine is continued. CONCLUSION: Combination of ECT and clozapine in patients with clozapine-resistant schizophrenia resulted in a rapid and substantial reduction of psychotic symptoms. Further studies are needed to improve the effectiveness and tolerability of ECT.

Study Of Suicidality And Suicide Behavior Among Individuals With Long-Standing Duration Of Schizophrenia In India: An Explorative Study

Suicide is a common occurrence in schizophrenia and is seen in all phases of the illness. Early identification of patients who are more likely to attempt suicide may help in suicide prevention among patients with schizophrenia. The present study was aimed at determining the clinical differences and differences in demographic and risk factors in patients with schizophrenia that attempt suicide and those that do not. Methods: A total of 200 consecutive follow-up patients having schizophrenia were assessed clinically for variables related to suicide and suicidal behaviour in the outpatient department of a tertiary psychiatry centre. All patients were administered the Positive and Negative Symptom Scale (PANSS) for schizophrenia to assess clinical symptoms and severity while the Clinical Global Impression – Severity (CGI-S) scale was also used. Results: Out of the 200 patients studied, 38% (n = 76) patients had made one severe suicide attempt by excluding parasuicide or deliberate self-harm at least once, and 9.5% (n = 19) had attempted suicide more than three times. More patients with a suicide attempt showed good clinical outcome (CGI ≥ 3) (42.1% versus 33.0%, χ 2 = 1.040, p = 0.301). The patients who attempted suicide were predominantly male, with a mean age of 34.2 years. Lesser number of them was single (32.89% vs. 43.5%, χ 2 = 1.814, p = 0.178). Their duration of illness was shorter (9.6 years versus 11.4 years, t = 2.8841, p = 0.0043) and more patients with attempted suicide had higher scores on negative symptoms scales of PANSS (t=2.1122, p = 0.035) at the time of assessment. Conclusions: The findings in our research warrant the need studying suicide in schizophrenia in larger samples and to replicate our findings and also determine methods to reduce the incidence of suicide in schizophrenia via interventional programmes. ASEAN Journal of Psychiatry, Vol. 17 (2): July – December 2016: XX XX.

Study of Serum Selenium Levels in Schizophrenic Patients.

Deficiency and excess amount of trace elements play an important role in several well recognized diseases, studies are going on to establish their role in schizophrenia. Selenium and other trace elements are indispensable components for certain enzymes responsible for various metabolic processes in different tissues including the brain as they play important functional roles in peripheral and central nervous systems. Objectives: In this study, we examined the levels of selenium in serum of patients of schizophrenia and compare them with normal healthy controls. Selenium was also measured in acute and chronic stage of schizophrenia categorized on the basis of PANSS score and correlated by Spearman’s Correlation Coefficient (ρ) in total cases, acute cases and chronic cases. Method: The study population comprised 150 patients and 150 age matched controls. We measured levels of Selenium by AAS (Atomic Absorption Spectrophotometer). Results: We found that selenium levels were significantly lower in patients with schizophrenia than in the control group. The levels of micronutrients studied were also correlated with disease severity and duration but found non-significant relation. Conclusion: Evaluation of selenium levels in patients with schizophrenia could prove useful. There may be role of Selenium in the pathogenesis and course of Schizophrenia and new therapeutic approaches warrants further study.

Evaluation of the efficacy of the continuation electroconvulsive therapy in treatment-resistant schizophrenia / Avaliação da eficácia da eletroconvulsoterapia contínua para esquizofrenia resistente ao tratamento

Background: Electroconvulsive therapy (ECT) has been reported being a safe and effective treatment in schizophrenia. However, there are a limited number of studies assessing continuation ECT utilization in patients with schizophrenia giving partial response to pharmacological treatment. Objective: The aim of this study is to evaluate the effectiveness of continuation ECT in preventing relapse in patients with treatment-resistant schizophrenia. Methods: In this retrospective analysis, schizophrenia patients (n = 73) were defined in three groups such as patients who received only AP treatment (only AP), patients who received acute ECT only during hospitalization (aECT+AP), patients who received acute ECT and continuation ECT (a-cECT+AP). Three groups were compared according to positive and negative syndrome scale (PANSS) and Brief Psychiatric Rating Scale (BPRS) scores. Results : As per comparison of only AP group, aECT+AP group and a+cECT+AP groups in terms of after discharge PANSS and after discharge BPRS scores for 1st month, 3rd month and 6th month; 3rd and 6th month’s PANSS scores of a+cECT+AP group were statistically significantly lower than other two groups. Discussion: Although this study suffers the limitations of retrospective medical chart analysis, results suggest that, in patients with a diagnosis of schizophrenia who have responded to an acute course of ECT, continuation ECT in combination with antipsychotics is more effective than antipsychotics alone in preventing relapse...

Contexto: A eletroconvulsoterapia (ECT) tem mostrado ser um tratamento seguro e eficaz para esquizofrenia. No entanto, o número de estudos que avaliam a utilização contínua de ECT em pacientes com esquizofrenia e a resposta parcial ao tratamento farmacológico é limitado. Objetivo: O objetivo deste estudo é avaliar a eficácia da ECT de continuação na prevenção de recaída em pacientes com esquizofrenia resistente ao tratamento. Métodos: Nesta análise retrospectiva, pacientes com esquizofrenia (n = 73) foram alocados em três grupos: pacientes que receberam apenas o tratamento AP (somente AP), pacientes que receberam um curso agudo de ECT durante a hospitalização (aECT+AP) e pacientes que receberam um curso agudo de ECT durante a hospitalização e ECT de continuação (a-cECT+AP). Esses três grupos foram comparados de acordo com a pontuação atribuída na Positive and Negative Syndrome Scale (PANSS) e na Brief Psychiatric Rating Scale (BPRS). Resultados: De acordo com a comparação dos grupos, somente em AP, aECT+AP e a+cECT+AP, em termos de PANSS e BPRS, após descarga no primeiro, terceiro e sexto mês, as pontuações na PANSS no terceiro e sexto mês no grupo a+cECT+AP foram estatística e significativamente menores do que nos outros dois grupos. Conclusões: Embora este estudo mostre limitações causadas pela análise retrospectiva de prontuários, os resultados sugerem que a continuação da ECT em combinação com antipsicóticos é mais eficaz do que somente os antipsicóticos, na prevenção da recaída em pacientes com diagnóstico de esquizofrenia que responderam ao curso agudo de ECT...

The effect of cognitive behavior therapy on PANSS of schizophrenia: a Meta-analysis / 中国实用护理杂志

Objective To assess systematically the effect of (cognitive behavior therapy,CBT) on PANSS of schizophrenia.Methods Relative literature was searched by computer at home according to the inclusion and the exclusion criteria,which were analyzed by RevMan5.2 software,and literature selection and repetition were used according to the Note Express software.Results A total of 11 studies were brought into the study.According to the different time of intervention,the results showed that,the cognitive behavior therapy intervention continued for 2 months,I2 was 80％,the statistical result of random effects model analysis was [SMD=-0.64,95％CI (-1.14～-1.13),P＜0.05]; the cognitive behavior therapy intervention continued for 6 months,I2 was 64％,the statistical result of random effects model analysis was [SMD=-0.40,95％CI (-0.71,-0.08),P＜0.05]; the cognitive behavior therapy intervention continued for 12 months,the statistical result of fixed effects model analysis was[MD=-5.65,95％CI(-6.20,-5.09),P＜0.01].The replacement of statistical models for the sensitive analysis showed that the result was stabile and reliable.Conclusions The cognitive behavior therapy may reduce PANSS of patients with schizophrenia,But because the influence of some factors,the time of intervention is limited,so the result of this research is that the best intervention time for clinical symptoms improvement is from 6 months to 1 year.

Changes in the Metabolic Parameters and Positive and Negative Syndrome Scale (PANSS) Scores of Patients with Schizophrenia 8 Weeks after Switching to Paliperidone

OBJECTIVES: The purpose of this study was to examine the changes in metabolic parameters and Positive and Negative Syndrome Scale (PANSS) scores of patients previously treated with atypical antipsychotic drugs other than paliperidone, after 8 weeks of treatment with paliperidone. METHODS: Changes in body weight, body mass index, leptin, lipid levels, fasting glucose, and PANSS scores of patients who switched from other atypical antipsychotic drugs to paliperidone were measured after 8 weeks of treatment with paliperidone. We compared these results with those of patients who had not been treated with antipsychotic drugs for at least 2 weeks prior to treatment with paliperidone (antipsychotic drug-free patients). RESULTS: The antipsychotic drug-free group (n = 9) did not show significant changes in metabolic parameters, but showed a significant improvement in total and subscale scores of PANSS. In the group that switched from other atypical antipsychotic drugs to paliperidone (n = 13), body weight, body mass index and fasting glucose level significantly increased, while total and subscale scores of PANSS significantly improved. CONCLUSIONS: Paliperidone treatment will benefit patients with schizophrenia who have been antipsychotic drug-free or who have had difficulty with other atypical antipsychotic drugs, with regard to their psychopathological state. However, if patients have been treated with other atypical antipsychotic drugs before switching to paliperidone, they could gain body weight or their fasting glucose level could increase over a short period because of a change in receptor number and sensitivity caused by the previously prescribed antipsychotic drugs, and hence, paliperidone should be prescribed with caution for these patients.

Observation on the Therapeutic Effect of Electroacupuncture Combined with Small Dose of Clozapine in Clinical Treatment of Refractory Schizophrenia / 针刺研究

Objective To observe the effect of electroacupuncture(EA) in combination with small dose of clozapine on clinical symptoms of refractory schizophrenia patients so as to evaluate its validity and security.Methods Eighty schizophrenia patients were randomized into medication group and EA+medication group(n=40/group).Patients of medication group were treated with conventional oral administration of clozapine(50-100 mg/d to 200-500 mg/d,for 8 weeks) and those of EA+ medication group treated by EA of Baihui(GV 20) and bilateral Taiyang(EX-HN 5) and oral administration of clozapine(50 mg/d to 100-150 mg/d).EA was given to the patients,3 times a week for 8 weeks.Scores of the Positive and Negative Symptom Scale(PANSS) and the Untoward Effect Symptom Scale(TESS) were used to assess the therapeutic effect.Results Following treatment,PANSS scores for positive symptoms and the common psychiatric symptoms of the medication and EA+medication groups all decreased evidently from the 2rd week on(P0.05).But TESS score of EA+medication group was evidently lower than that of medication group(P

Alteration in Plasma BDNF Level after Repetitive Transcranial Magnetic Stimulation(rTMS) in Treatment-Resistant Schizophrenia: A Pilot Study

OBJECTIVES: To assess clinical improvement and change in plasma brain-derived neurotrophic factor(BDNF) level after repetitive transcranial magnetic stimulation(rTMS) in patients with treatment-resistant schizophrenia. METHODS: Seven patients with DSM-IV schizophrenia, who were proven to be treatment-resistant, were treated with 15 sessions of rTMS for three weeks as an adjuvant therapy to antipsychotic treatment. Clinical improvement and change in plasma BDNF level were measured after the treatment period. The symptom severity was assessed with the Positive and Negative Syndrome Scale(PANSS) and the Korean Version of Calgary Depression Scale for Schizophrenia(K-CDSS) at baseline and 7 days after the treatment. Plasma BDNF level was measured by enzyme-linked immunosorbent assay(ELISA) at baseline and 7 days after the treatment. RESULTS: After the rTMS treatment, there was no significant improvement in PANSS total score(Z=-1.693, p=0.090) and no significant change in plasma BDNF was found(Z=-1.183, p=0.237). Negative correlations were found between percentage change in PANSS positive subscale score and duration of illness(rho=-0.991, N=7, p<0.0005, two-tailed), and PANSS negative subscale score at baseline and percentage change in plasma BDNF level(rho=-0.821, N=7, p=0.023, two-tailed). CONCLUSION: This preliminary study suggests that rTMS didn't make a significant change in clinical symptoms nor in plasma BDNF level in treatment-resistant schizophrenia. Percentage change in plasma BDNF, however, might be correlated with treatment resistance in schizophrenic patients. This is a pilot study with a small sample size, therefore, a further study with a larger sample size is needed.

Correlations of Cerebellar Function with Psychotic Symptoms and Cognitive Function in Schizophrenic Patients

OBJECTIVES: There is increasing evidence that the cerebellum plays an important role in cognition and psychiatric symptoms as well as motor coordination. The concept of cognitive dysmetria has been making cerebellar function in schizophrenia the focus of current studies. In other words, disruption in the cortico-cerebellum-thalamic -cortical circuit could lead to disordered cognition and clinical symptoms of schizophrenia. The purposes of this study were to determine cerebellar dysfunction in male schizophrenic patients semiquantitatively with ICARS and to investigate the clinical and cognitive correlates of ICARS in patients. METHODS: We compared the scores of cerebellar neurologic sign using ICARS in 47 male patients with a DSM-IV-TR diagnosis of schizophrenia with 30 gender and age-matched healthy control subjects. The semiquantitative 100-point ICARS consists of 19 items divided into 4 unequally weighted subscores: posture and gait disturbances, kinetic functions, speech disorders and oculomotor disorders. All subjects were also assessed with cognitive function test. Cognitive functions were evaluated by Korean-Mini Mental Status Examination(K-MMSE), Verbal fluency test, and Clock drawing test. The patients were administered Korea version of Positive and Negative Symptom Scale(K-PANSS) to assess the symptom severity. RESULTS: Schizophrenic patients had significantly higher scores on the ICARS than control subjects with posture and gait disturbances, kinetic functions, and oculomotor disorders. They also showed more significant impairments in cognitive function tests than control subjects. There was a significant correlation between ICARS and negative symptoms of patients. In cognitive function test, Clock drawing test was significantly associated with negative symptoms. In addition, Clock drawing test was negatively correlated with the total score of ICARS. CONCLUSION: In this study, we confirmed that schizophrenic patients have significant impairments in cognitive and cerebellar function, and that those were related with negative symptoms of schizophrenic patients. These results support a role of the cerebellum in schizophrenia. It is meaningful that we used a structured, and reliable procedure for rating neurological soft signs, ICARS. We hope that future prospective studies using a similar design help that rate of neurological sign should have been visible with the progression of illness.

The Korean Version of 4th Revision of Schizophrenia Quality of Life Scale: Validation Study and Relationship with PANSS / 신경정신의학

OBJECTIVES: The present study was performed to verify the validity and value of 4th revision of Schizophrenia Quality of Life Scale (SQLS-R4) as an assessment tool in a Korean-language version (SQLS-R4K). METHODS: The subjects for present study were 174 patients with a diagnosis of schizophrenia as defined by DSM-IV. The SQLS-R4K was administered together with self-report Korean version of World Health Organization Quality of Life-Brief Scale (WHOQOL-BREF) to assess validity. A subset of respondents also completed the SQLS-R4K for a second time to assess test-retest reliability. To evaluate the relationship SQLS-R4K and clinical characteristics, psychotic symptoms and general functioning were evaluated using the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning Scale (GAF) score respectively. RESULTS: All the scales of SQLS-R4K showed good internal consistency reliability. The correlations of items with their scale total revealed that all items were significantly correlated with their own scale score. In test-retest reliability, paired t-tests indicated that responses did not alter significantly between the two assessment. There was moderate correlation between WHOQOL-BREF sub-scores and SQLS-R4K score total. Also relevant correlations between PANSS, current GAF and SQLS-R4K were proved. CONCLUSION: From the results of the testing the reliability and validity of the SQLS-R4K, it is concluded that the SQLS-R4K is a simple and reliable scale for measuring quality of life in schizophrenic patients.

Basic Symptoms in Schizophrenic Patients / 신경정신의학

OBJECTIVES: This study is to explore the frequency of basic symptoms and their relationship with current clinical variables in patients with schizophrenia. METHODS: Eighty-eight schizophrenic patients diagnosed with SCID were interviewed with the Bonn Scale for the Assessment of Basic Symptom (BSABS) and Positive and Negative Syndrome Scale (PANSS). RESULTS: Most frequent basic symptoms were related to abnormalities in perception, cognition and stress reactivity. After controlling age effect, number of admission was correlated negatively with cluster 3 (impaired tolerance to normal stress). Onset age was correlated positively with cluster 3 and cluster 4 (disorders of emotion and affect) and total score. Scores of cluster 1 (thought, language, perception, motor disturbances), and cluster 2 (impaired bodily sensations), and total score of BSABS were significantly lower in paranoid type than residual type of schizophrenia. Scores of cluster 1, cluster 2, and total score of BSABS were correlated positively with subscales for positive and negative symptoms and general psychopathology and total score of PANSS. Cluster 3 was correlated positively only with general psychopathology score and cluster 4 with both positive symptoms and general psychopathology score. CONCLUSION: These findings suggest that certain basic symptoms aggregate significantly in schizophrenia, especially in paranoid type schizophrenia and that systemic evaluation of basic symptoms can be used for the prediction of onset and progress of schizophrenia.

Basic Symptoms in Schizophrenic Patients / 신경정신의학

OBJECTIVES: This study is to explore the frequency of basic symptoms and their relationship with current clinical variables in patients with schizophrenia. METHODS: Eighty-eight schizophrenic patients diagnosed with SCID were interviewed with the Bonn Scale for the Assessment of Basic Symptom (BSABS) and Positive and Negative Syndrome Scale (PANSS). RESULTS: Most frequent basic symptoms were related to abnormalities in perception, cognition and stress reactivity. After controlling age effect, number of admission was correlated negatively with cluster 3 (impaired tolerance to normal stress). Onset age was correlated positively with cluster 3 and cluster 4 (disorders of emotion and affect) and total score. Scores of cluster 1 (thought, language, perception, motor disturbances), and cluster 2 (impaired bodily sensations), and total score of BSABS were significantly lower in paranoid type than residual type of schizophrenia. Scores of cluster 1, cluster 2, and total score of BSABS were correlated positively with subscales for positive and negative symptoms and general psychopathology and total score of PANSS. Cluster 3 was correlated positively only with general psychopathology score and cluster 4 with both positive symptoms and general psychopathology score. CONCLUSION: These findings suggest that certain basic symptoms aggregate significantly in schizophrenia, especially in paranoid type schizophrenia and that systemic evaluation of basic symptoms can be used for the prediction of onset and progress of schizophrenia.

Depression in Schizophrenia / 신경정신의학

OBJECTIVE: The heterogeneity of symptomatology within the group of schizophrenias is still a major obstacle for defining clinically useful subgroups of these disorders. One of these symptoms is depression. Recently there is a growing evidence suggesting that depressive symptoms and related mood disturbances are important in treating schizophrenia. This is so because of the improvement of such side effects as extrapyramidal symptoms with increasing use of atypical antipsychotics. Although depression is known to be a serious problem of many schizophrenic patients, the nature and course of depression in schizophrenia remain unknown. METHODS: The author examined the depressive features in 31 patients with schizophrenia. Ratings on the PANSS, BDI and HDRS were obtained. Eighteen percent of the total patients had BDI score above 21, considered depressed. RESULTS: There were no differences in BDI, HDRS and PANSS-D between positive symptom group and negative symptom group. There was also no correlation between subject scale(BDI) and objective scales(HDRS, PANSS-D). CONCLUSIONS: Depression in schizophrenia needs intensive studies. It is also considered as another heterogeneous domain beside negative or positive symptom domains. Out of respect for the high prevalence and serious outcome of depression in schizophrenia, a more differentiated assessment, analysis, and treatment of depressive symptom is recommended.

Interaction between Estrogen Receptor 1 and the Epsilon 4 Allele of Apolipoprotein E in Korean Schizophrenic Patients / 신경정신의학

OBJECTIVES: Recent studies indicated that estrogen receptor 1 subtype(ESR1) genetic polymorphisms may affect the expression of ESR1, and are associated with Alzheimer's disease. This study was designed to investigate the interaction between ESR1 polymorphism and the epsilon4 allele of apolipoprotein E(ApoE) in Korean schizophrenic patients. METHODS: We studied 46 schizophrenic patients and 40 healthy controls. The ESR1 & ApoE polymorphisms were assessed by PCR-restriction fragment length polymorphism(RFLP) or reverse hybridization. RESULTS: The distribution of the genotype in schizophrenic patients with XX, Xx, xx, PP, Pp, pp were 7(15.2%), 20(43.5%), 19(41.3%), 10(21.7%), 19(41.3%), 17(37%), and the controls were 1(2.5%), 12(30%), 27(67.5%), 7(17.5%), 21(52.5%), and 12(30%). No significant differences for genotype distribution were revealed between controls and schizophrenic patients except Xba I genotype. The genotype frequency of schizophrenia with xx of ESR1 and epsilon4 of ApoE were 58.7%, 6.5% and that of the controls were 58.7%, and 15%, respectively. The ESR1 genotypes and ApoE were not associated with onset age, psychiatric symptoms, familial history, subtype(positive vs negative) of schizophrenic cases. In kappa-square, there is no significant difference between the two groups, and we are with an assum the interaction between the homogenous ESR1 xx genotype and the ApoE epsilon4 allele was not ob-served in schizophrenic patients. CONCLUSION: The ESR1 gene may not appears to interact with the ApoE epsilon4 genotype in determining schizophrenia susceptibility. There was no significant association between schizophrenia and ESR1 & ApoE gene polymorphism. But, Xba I genotype may be closer to schizophrenia than Pvu II genotype.

Relationships between Subjective Symptoms and Objective Psychopathology in Patients with Schizophrenia / 신경정신의학

OBJECTIVES: Kyung Hee-Frankfurter Beschwerde-Fragebogen(K-FBF) is a representative subjective symptom measuring tool of schizophrenic patients. We performed psychopathology measurements using K-FBF, Positive and Negative Syndrome Scale(PANSS) and Symptom Checklist-90-Revised(SCL-90-R) in patients with schizophrenia and then compared the results of these three examinations one another, in order to examine which psychopathologic aspects K-FBF might reflect and to measure the possibility whether this instrument reflect the negative symptoms or cognitive impairments, which are difficult to measure by conventional objective instruments measuring psychopathology. METHODS: All 66 patients satisfying DSM-IV criteria for schizophrenia, were approached. Their education level was more than high school and they were not in the acute stage of schizophrenia. They performed K-FBF and SCL-90-R, and at the same day, they were interviewed by one of both psychiatirsts using PANSS. We examined the patterns of K-FBF response and performed facor analysis about 10 subscales. We examined the correlation between K-FBF and age, sex and insight. Also, we performed correlation analysis among the K-FBF, PANSS and SCL-90-R. RESULTS: As for K-FBF, with increasing age, the number of positive response items and the symptom severity were decreased. Even when controlling prevalence period as control variable, the correlation remained unchanged. Performing factor analysis to the K-FBF subscales, we created 2 factors, ie summation subscales. We named those recognized distress(RD) and perceptual alteration(PA) each. Using K-FBF standardized total scores as controlling variable, we performed partial correlation between PA and PANSS negative symptom scale. The result was PA and PANSS have statistically significant correlation. This correspons with the view that Huber's basic symptoms are reflecting subjective approach of negative symptoms of schizophrenia. While K-FBF standardized total scores and PANSS total scores had statistically strong correlations, SCL-90-R total scores and PANSS total scores had statistically significant, but very mild correlations. So, we had the judgement that the correlations among the psychopathology measurement tools are more influenced by the rater than the contents of tools. CONCLUSION: We concluded that Huber's basic symptoms, measured by K-FBF, reflect more negative symptoms of schizophrenia than other symptoms. And K-FBF has more correlation with the PANSS, objective psychopathology measuring tool, than the SCL-90-R, self-report quetionnaire. But, more studies using patients with another disease stages and another demographic variables are needed in order to generalize the results of this study.

Relationship between Clinical Symptoms and P300 in Schizophrenia / 신경정신의학

OBJECTIVE: This research was performed to evaluate the relation clinical symptoms and P300 in patients with schizophrenia. METHODS: 25 patients with schizophenia by DSM-IV in Soonchunhyang Chunan University hospital were participated. Clinical symptoms were checked by BPRS (Brief Psychiatric Rating Scale) and PANSS (Positive and Negative Syndrome Scale). Auditory event related potentials P300 components were obtained with "Oddball paradigm". RESULTS: P300 in T 3 was smaller and more delayed than T 4 in patients with schizophrenia. Especially, P300 on T 3 were correlated with BPRS scores and negative symptoms scores of PANSS, which were also correlated with P300 on Fz. CONCLUSION: The results of this study suggest that P300 on frontal and left temporal lobe reflect clinical symptoms in patients with schizophrenia.

Reliability and Validity of the Korean Version of the Positive and Negative Syndrome Scale / 신경정신의학

OBJECTIVES: We tested the reliability and validity of the Korean version of the PANSS (PANSS-KV). METHODS: The PANSS ratings were obtained from 101 subjects with DSM-IV diagnoses of schizophrenia or schizophreniform disorder. To study the concurrent validity, the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS) were also administrated in 38 patients. Using these data, inter-rater reliability, test-retest reliability, internal consistency, criterion validity and concurrent validity were evaluated. Factor structure was analyzed by the principal axis factoring. RESULTS: The inter-rater reliability of the Korean version of the PANSS was satisfactory in positive (r=0.92) and negative syndrome subscales(r=0.86), but somewhat low in general psychopathology subscale (r=0.78). The test-retest correlations for the 3 PANSS subscales ranged between 0.89 and 0.95, so it showed excellent test-retest reliability. The Cronbach's alpha for the positive, negative and general psychopathology subscales were 0.73, 0.84 and 0.74, respectively and thus the 3 subscales of the PANSS had good internal consistencies. All separate items revealed significant corrected item-total correlations in the positive and negative syndrome subscales, but some items of the general psychopathology subscale showed no or low corrected item-total correlations. The positive and negative syndrome subscales held a high concurrent validity in relation to the SAPS and the SANS. It was confirmed that positive and negative syndromes were independent constructs. The factor analysis by the principal axis factoring produced 5 components: cognitive, excitement, depression, positive and negative. CONCLUSION: These findings prove that the reliability and validity of the PANSS-KV are comparable to those of the original PANSS. So, the PANSS-KV can be widely and extensively used in researches for schizophrenia.

Clinical Availability of Topographic Auditory Event Related Potential P300 as a Biological Marker in Patients with Schizophrenia / 신경정신의학

This study was designed to investigate the clinical availability of topographic auditory event related potential P300 as a biological marker in patients with schizophrenia. The subjects were composed of normal controls(N=30) and patients(N=30) with schizophrenia by DSM-IV. Topographic auditory event related potential P300 and N100 were measured by "oddball paradigm", which was known as a standard method. Schizophrenics were evaluated twice, initial and follow-up, by 4 week interval. P300 latency and N100 latency were deter-mined by Global Field Power. At this time point the maximum amplitude and its location, according to X-Y coordinates, were determined in brain topography. Clinical symptoms were evaluated by Positive and Negative Syndrome Scale(PANSS). P300 latencies of normal controls, initial group of schizophrenics, and follow-up group of schizophrenics were 315.8+/-24.2msec, 403.8+/-42.3msec, and 364.7+/-43.2msec, respectively. P300 amplitudes of normal controls, initial group of schizophrenics, and follow-up group of schizophrenics were 8.8+/-2.7microV, 4.4+/-1.9microV, and 4.4+/-2.5microV, respectively. They had significantly different P300 latencies one another by measuring ANCOVA, of which covariables were N100 latency, age, and CCP(correct counted percent)(p<0.01). X-Y coordinates was not significant. In P300, there were some different characters between normal controls and schizophrenics even though excluding N100, which was supposed to be exogeneous component by external stimuli. When clinical symptoms were improved, P300 latency was decreased. However, P300 amplitude was not changed. These results suggest that P300 woald be available clinically as a biological marker, P300 latency be a state marker, and P300 amplitude be a trait marker in schizophrenia.

Effects of Mianserin on Negative Symptoms of Chronic Schizophrenia / 신경정신의학

This study was designed to examine the mianserin effects on the negative symptoms of chronic schizophrenia. The chronic schizophrenics(N= 14) diagnosed by DSM-III-R, who were treated at the Catholic University St. Mary Hospital from March 1, 1993 to August 31, 1995, were divided into two groups. One group was composed of 7 patients who were treated with a single classical antipsychotic agent(monotherapy group, MG), and another was composed of 7 Patients treated with combined medications(combined therapy group, CG), including classical antipsychotics plus fixed dose of mianserin 30 mg/day at bed time. Symptoms were evaluated by BPRS(Brief psychiatric Rating Scale) and PANSS(Positive and Negative Syndrome Scale) biweekly for 6 weeks, i.e., total 4 times(at baseline, at 2 weeks, at 4 weeks, and at 6 weeks). The results were as follows: 1) Assessed by PANSS, the negative symptoms of CG were statistically significantly improved more than those of MG at 2 weeks, at 4 weeks, and at 6 weeks. 2) Assessed by PANSS, the positive symptoms of CG were not statistically different from those of MG. In both of CG and MG, there was no difference of the positive symptoms across time intervals. 3) Assessed by PANSS, the total symptoms of CG were statistically significantly improved more than those of MG at 2 weeks, at 4 weeks, and at 6 weeks. But, assessed by BPRS, the total symptoms of CG were not statistically different from those of MG. 4) Assessed by PANSS, the general psychopathology symptoms of CG were not statistically different from those of MG. In CG, the general psychopathology symptoms at 6 weeks were statistically significantly improved more than those of baseline. In summary, mianserin, when combined with classical antipsychotic agent, appears to be effective in diminishing negative symptoms of chronic schizophrenic patients. However, it did not influence positive symptoms.