The influence of functional oral health literacy on perceived oral health status in Korean adults / 대한구강보건학회지

OBJECTIVES: This study was conducted to analyze the effect that oral health literacy of adults has on perceived oral health state and to identify the factors that affect perceived oral health status. METHODS: A self-administered questionnaire survey was distributed to 554 adults who lived in the Daegu or Gyeongbuk areas and visited dental institutions located in the Daegu area. For adults who were 60 years old or older, direct interviews were conducted. Statistical analysis was performed with t-tests, analysis of variance, and multiple regression using SPSS RESULTS: Between oral health literacy and perceived oral health status, a significant positive correlation was revealed (r=0.142, P<0.01). A significant positive correlation was revealed between oral health literacy and knowledge (r=0.397, P<0.01). A significant but weakly positive correlation was revealed between oral health knowledge and perceived oral health status (r=0.086, P<0.05). To identify factors affecting perceived oral health status, multiple regression analysis was conducted, and the result showed that oral health literacy was a statistically significant factor (β=0.105, p<0.05). Among general characteristics, age was a statistically significant negatively affecting factor, as it showed a negative relationship with perceived oral health status (β=−0.140, P=0.001, adjusted R2=0.049). CONCLUSIONS: When these study results are taken into consideration, oral health literacy is a factor affecting perceived oral health status, and as such, oral health literacy of the research targets should be taken into consideration when implementing oral health education to promote oral health.

Critique of Mental Health Welfare Law in Korea : Focusing on Involuntary Hospitalization Criteria / 신경정신의학

Under new mental health and welfare law, involuntary admission is allowed only for persons with mental illness based on the narrowed criteria of mental illness when they meet both need for treatment and danger to themselves and others. These stringent danger criteria along with narrowed definition of mental illness may prevent timely intervention for people with acute psychosis. It is claimed that the danger criteria is essential to keep up with international (UN, WHO) principles for legislation of mental health acts and laws of advanced countries. The international principles, however, do not necessarily call for stringent danger criteria for involuntary hospitalization. Danger criteria are not also prerequisites for involuntary hospitalization in many advanced countries. In countries with strict danger criteria, complementary measures seem to be taken for the drawback of danger criteria. As for the involuntary hospitalization by legal guardians, the complicated qualification for legal guardians may hinder prompt admission. The required number of legal guardians also needs to be changed from two to one person. Even in the situation where involuntary hospitalization is deemed urgent, there is no way to transport the patients to the hospital for assessment or temporary admission unless the police judges the patients to be dangerous to themselves or others. Outpatient treatment order can be an alternative to involuntary admission. However, it is rarely used since the order cannot be applied to those who do not have history of admission due to danger. For voluntary admission, status conversion to involuntary admission needs to be allowed in case of aggravation of symptoms to meet involuntary admission criteria. In addition, informal admission needs to be introduced to avoid unnecessary formal procedures for patients admitting voluntarily to open ward. In view of all these issues with new mental health and welfare law, entire revision of new mental health law is urgent to balance the rights to proper treatments and protection of human rights of persons with mental disorder.

The New Mental Health and Welfare Law in Korea: Issues with Additional Diagnosis by External Psychiatrist and the Role of Admission Review Committee / 신경정신의학

The new Mental Health and Welfare Law in Korea was revised to require additional diagnosis by a psychiatrist from another public or designated hospital for involuntary admission beyond 2 weeks. In addition, it features the newly established Admission Review Committee for better protection of human rights. The provision of the additional diagnosis by an external psychiatrist resulted from misinformation about the distinction between the second opinion for medical assessment and the review of admission by independent authorities. An additional diagnosis is not required by an external doctor since it is not for review of adequacy of admission but just for second opinion for better medical assessment. Given the limited number of qualified public hospital psychiatrists, additional diagnosis by external psychiatrists does not seem practical unless private hospital doctors are required to visit neighboring hospitals. The current method of cross checking between neighboring doctors is not in accordance with the principles that review should be done by independent authorities. The Admission Review Committee also does not seem to serve the purpose since the role of the Committee is limited to document review, while the proper role of the Committee is left to individual doctors. Admission review should be performed through a thorough interview with the patient by a judicial (or quasi-judicial) authority. Law revision is urgently needed to ensure proper judicial (or quasi-judicial) review of admission, and to streamline unnecessary procedures such as the additional diagnosis by external doctors.

The United Nations Convention on the Rights of Persons with Disabilities and Compulsory Admission of Persons with Mental Illness: A Critique of Prohibition of Compulsory Admission / 신경정신의학

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) has often been cited as the basis for the abolition of involuntary hospitalization for persons with mental illness. Although the UNCRPD itself does not refer explicitly to the abolition of involuntary hospitalization, the General Comment prohibited all compulsory admission without adequate explanation. While the disability status alone may not justify the denial of legal capacity, the existence of impaired decision-making ability can raise issues regarding whether involuntary admission can be justified in the best interest of persons with mental illness. The General Comment, however, argues that involuntary admission does not comply with the CRPD which prohibits discrimination on the basis of disabilities. This statement defies logic since the issue is whether the existence of impaired decision-making ability may be an exceptional case. It is also against the principles of beneficence to withhold treatment for persons with mental illness just for self-determination when poor outcomes are anticipated if left untreated. The concept of supported decision making suggested by the General Comment is also ambiguous, and not clearly distinguishable from substitute decision making. Another reason for the prohibition of involuntary admission relates to doubt concerning the accuracy of assessment of mental capacity, which implies adequate assessment may justify involuntary admission. In practice, it is not always complicated to assess mental capacity in order to make treatment-related decisions. The third reason concerns the argument that psychiatric treatments lack empirical evidence concerning effectiveness. Scientific evidence supporting the effectiveness of psychiatric treatment is abundant. The rights of persons with mental illness are important ethical issues. However, it is doubtful whether the blanket prohibition of compulsory admission is appropriate and ethical. Critical review of the UNCRPD and the General Comment is urgent for timely treatment and for the well-being of persons with mental illness.

A Case of Catatonia Later Diagnosed with NMDA Receptor Encephalitis / 대한정신분열병학회지

We report a case of a young female patient with catatonic features who later turned out to be suffering from an anti-NMDA (N-methyl-D-aspartate)-receptor-antibody encephalitis. A previously healthy 21-year-old woman was admitted to psychiatric inpatient care presenting with acute psychotic behavior with catatonic features. Laboratory tests of serum and CSF (Cerebrospinal fluid), EEG (Electroencephalogram), brain MRI (Magnetic Resonance Imaging) were unremarkable except vague slow wave on EEG. However, subtle cognitive impairment at the bedside examination suggested further imaging studies to rule out possible organic etiology like autoimmune encephalitis. Brain PET (Positron Emission Tomography) and SPECT (Single Photon Emission Computed Tomography) suggested probable inflammation in the brain. In case of autoimmune encephalitis, given the severity of symptoms and worsening course, steroid pulse therapy was initiated promptly even though the diagnosis was not confirmed but presumed at that time. She recovered completely with steroid therapy. Later her disease turned out to be anti-NMDA-receptor-antibody encephalitis by the antibody test which was not available at the time of admission. Psychiatrists need to be aware of autoimmune encephalitis like anti-NMDA-receptor-antibody encephalitis in the differential diagnosis of acute psychosis with catatonic features. Subtle cognitive impairment which tends to be overlooked due to catatonic features might be a clue to suspect the organic etiology.

Effectiveness and Safety of Electroconvulsive Therapy in Clinical Practice / 신경정신의학

OBJECTIVES: There is little research on the practice and effectiveness of electroconvulsive therapy (ECT) in Korea. This study investigated the practice pattern, effectiveness, and safety of ECT. METHODS: This chart review study included electronic medical records of 180 patients treated with ECT between January 2007 and December 2013 at the Asan Medical Center. Symptomatic improvement was assessed using Clinical Global Impression (CGI) scale. Treatment response was defined as CGI improvement scale score of 2 or less. Re-hospitalization was used as an indicator of recurrence. Safety was assessed by spontaneous reports from patients. RESULTS: One hundred and eighty patients underwent 1539 sessions of modified ECT. Their most frequent diagnosis was major depressive disorder (n=74, 41.1%). The most common indication for ECT was poor response to medication (n=177, 75.3%). Treatment response rate was 66.9% in acute phase group and 63.8% in the patients with poor response to medication. The recurrence rate at six months after the end of the course was 29.6%. Memory impairment or amnesia was the most common adverse effect. CONCLUSION: There was a remarkable improvement following ECT in patients who responded poorly to medications, and most adverse effects were tolerable and temporary. The present study suggests that ECT could be a useful treatment option.

Current Human Rights Education for Psychiatrists Leaves Much to Be Desired / 신경정신의학

OBJECTIVES: Human rights education programs have been implemented annually since Korea enacted human rights legislation in 2009. The purpose of this study was to investigate attitudes of Korean psychiatrists toward human rights education and assess the relevance of the provided education materials. METHODS: Questionnaires comprised of 8 items were provided to 274 psychiatrists attending the April 2015 Korean Neuropsychiatric Association seminar. In addition, 12 cases related to education material developed by the Korean National Human Rights Commission were examined to determine whether the material's content was relevant and appropriate for human rights education. RESULTS: Data from 267 psychiatrists that answered all requested questions were included in the analysis. Although respondents in general accepted the beneficial intent of human rights education, the majority of respondents (71.5%) disagreed with the mandatory 4 h of annual human rights education. Approximately half of respondents (49.4%) believed that frequency of such education should be decreased. A substantial percentage of respondents (38.7%) expressed overall dissatisfaction with the education program, and more than half of respondents (55.6%) were skeptical that the current education program could produce a real difference in attitudes toward human rights. The case reviews highlighted several problems. First, all education materials were heavily weighted toward psychiatric hospitalization legal proceedings rather than human rights. Among the 12 cases examined, four were considered inappropriate for human rights education because they were presented as if human rights abuse was synonymous with violation of a law, even if the law was ambiguous. CONCLUSION: The current human rights education program does not meet psychiatrists' expectations. The results of this study suggest there is a need to reconsider the purpose and means of providing human rights education to psychiatrists.

Admission Status Conversion from Voluntary into Involuntary, Is It Illegal / 신경정신의학

OBJECTIVES: The current Korean Mental Health Act (KMHA) indicates that a patient, who voluntarily gave their permission for admission into a mental health facility, has the right to be discharged upon personal request. However, there is no clause in the KMHA that allows a change in a patient's voluntary status under special circumstances. The purpose of this study was to investigate problems that may arise from the lack of such a clause ; problems that can result in misinterpretation and lead to the prohibition of voluntary admission status conversion. METHODS: Previous cases presented to the National Human Rights Commission of Korea were investigated in order to determine the current state in Korean psychiatric practice regarding the conversion from voluntary to involuntary admission status. In addition, examples of similar mental health legislation in use by the United Nations (UN), World Health Organization (WHO), and several advanced countries pertaining to such conversions were investigated. These examples were used as models for making recommendations for possible changes to the KMHA. RESULTS: From 2010 to 2014, more than 220 petitions were filed with the National Human Right Commission of Korea. The petitions involved voluntarily institutionalized patients who had their requests for discharge rejected. Based on mental health regulations of the UN, WHO, and such countries as the United States, England, Canada, Australia, and Japan, the KMHA should include a provision that, upon receiving a discharge request, allows for discharge refusal if the voluntarily admitted patient is considered not mentally fit. CONCLUSION: The results suggest that the absence of a regulation allowing admission status conversion in the current KMHA is inappropriate. Rectification of this absence is urgently needed.

Validation of a Video Based Scale for Measuring Social Cognition in Schizophrenia / 신경정신의학

OBJECTIVES: Social cognition plays an important role in psychiatric symptoms and prognosis in patients with schizophrenia. Diagnostic scales are predominantly text-based or intended for the evaluation of theoretical concepts, with limited usefulness in clinical settings. We therefore developed a video based social cognition scale. METHODS: Our scale consists of 20 video clips portraying frequently experienced social interactions in real life. Patients were asked which interactions were socially unnatural and the reasons for lies told by actors. Our scale was validated and social cognition and its relationship with symptoms was evaluated using item response theory. RESULTS: A total of 209 participants (schizophrenia, 101 ; bipolar disorder, 49 ; healthy controls 59) were enrolled. Our scale showed high reliability and concurrent validity compared with the order subtest of the short form of the Weschler Adult Intelligence scale. Internal validity also was high (Cronbach's alpha=0.904). Most items were easy to answer and highly discriminative. The test information curve showed our scale to be more informative in patients with low social cognition ability. CONCLUSION: Our scale may aid in the study of pathology and social cognition deficits in patients with schizophrenia.

A Psychiatric Approach to Prince Sado: A Bipolar Disorder Sufferer or a Victim of Party Strife / 신경정신의학

OBJECTIVES: Prince Sado was the tragic royal heir who was sealed in a rice chest and starved to death by his father, King Yeongjo. The question of whether he was a victim of party strife or his death was the result of his psychiatric disorder is still controversial. In this paper, we investigated the question of whether he had suffered from bipolar disorder by reviewing his psychiatric symptoms and family history. METHODS: We examined the available literature on Prince Sado and his family, particularly focusing on Hanjungnok (Memoirs of Lady Hyegyeong), written by Prince Sado's wife. RESULTS: Review of the literature showed that Prince Sado suffered from psychiatric symptoms, including depressed mood, anxiety, suicidal behavior, aggressive behavior, and persecutory delusion from the age of 13 to 27. Many of his symptoms match the Diagnostic and Statistical Manual of Mental Disorders' criteria for depressive and manic episodes and it is highly suspected that he had bipolar disorder. He also showed clothing phobia, which can be regarded as an obsessive compulsive symptom. Some of his relatives, King Gyeongjong and Sanggyegun, might have suffered from depressive disorder. CONCLUSION: The characteristics of his symptoms suggest that Prince Sado might have had bipolar disorder. His mental disorder might explain in part the cause of his death.

A Psychiatric Approach to Prince Sado: A Bipolar Disorder Sufferer or a Victim of Party Strife / 신경정신의학

OBJECTIVES: Prince Sado was the tragic royal heir who was sealed in a rice chest and starved to death by his father, King Yeongjo. The question of whether he was a victim of party strife or his death was the result of his psychiatric disorder is still controversial. In this paper, we investigated the question of whether he had suffered from bipolar disorder by reviewing his psychiatric symptoms and family history. METHODS: We examined the available literature on Prince Sado and his family, particularly focusing on Hanjungnok (Memoirs of Lady Hyegyeong), written by Prince Sado's wife. RESULTS: Review of the literature showed that Prince Sado suffered from psychiatric symptoms, including depressed mood, anxiety, suicidal behavior, aggressive behavior, and persecutory delusion from the age of 13 to 27. Many of his symptoms match the Diagnostic and Statistical Manual of Mental Disorders' criteria for depressive and manic episodes and it is highly suspected that he had bipolar disorder. He also showed clothing phobia, which can be regarded as an obsessive compulsive symptom. Some of his relatives, King Gyeongjong and Sanggyegun, might have suffered from depressive disorder. CONCLUSION: The characteristics of his symptoms suggest that Prince Sado might have had bipolar disorder. His mental disorder might explain in part the cause of his death.

The Development of Questionnaire for Relapse Assessment in Psychotic Disorder / 신경정신의학

OBJECTIVES: The aims of this study were to develop an instrument for detection of relapse in psychotic disorder and to validate the instrument. METHODS: A total of 55 outpatients with psychotic disorder (schizophrenia, schizoaffective disorder, bipolar disorder) and 46 of their caregivers were enrolled. We developed the Questionnaire for Relapse Assessment in Psychotic disorder (QRAP), a self/report inventory. The patients and caregivers drew up the QRAP at two different time points, 'current' and 'the best state during the past three months'. In addition, we rated other established scales in order to evaluate psychotic and mood symptoms of patients. We divided patients into two groups, stable (n=30) and impending relapse (n=35) and evaluated the effectiveness of QRAP by calculating sensitivity and specificity. RESULTS: For all patients and caregivers, QRAP total score at 'current' was higher than 'the best state during the past three months' and showed significant positive correlation with other established scales. As expected, QRAP total score at 'current' in the impending relapse group was higher than that of the stable group. With cut off criteria 1, the QRAP demonstrated 80.0% sensitivity and 56.3% specificity in caregivers and effectively detected impending relapse. CONCLUSION: The results of our study suggest the effectiveness of QRAP as an instrument for detection of relapse in patients with psychotic disorder.

Dosing Pattern and Effectiveness of Quetiapine for Schizophrenic Patients Treated with Flexible Doses for 6 Weeks / 대한정신약물학회지

OBJECTIVE: Recommended dosage of quetiapine for patients with schizophrenia is from 150 mg to 750 mg, which is based on randomized controlled study. But there are trends of increasing quetiapine dosage in clinical practice. Therefore, we evaluated the clinical aspect of schizophrenic patients who took quetiapine by naturalistic non-intervention study. METHODS: Schizophrenia outpatients in 88 mental hospitals were selected and 170 psychiatrists evaluated Clinical Global Impressions Scale for Severity (CGI-S) before starting quetiapine medication and CGI-S, Clinical Global Impressions Scale for Improvement (CGI-I), quetiapine dosage and medication compliance at 6 weeks after starting quetiapine medication. Overall efficacy and difference of efficacy between drug-naive patients and medication-switch patients were evaluated. We clustered the patients into 4 groups by using cluster analysis with three variables such as quetiapine dose at week 6, baseline CGI-S, and end-point CGI-S. We compared clinical aspect of each cluster with analysis of variance. RESULTS: 841 patients were enrolled. Efficacy of quetiapine was replicated, and improvement rate defined as CGI-I < or =2 was 55.9%. Drug-naive patients show more improvement in CGI-I than medication-switch patients, and efficacy for patients with insufficient treatment was also reported. Dosage for each clustered group was 25-350 mg, 400-500 mg, 600-700 mg and 750-1,500 mg. 750-1,500 mg group shows more decrease in CGI-S than 400-500 mg group and 600-700 mg group. CONCLUSION: This study suggests that there is a cluster of patients who take more benefits in reducing symptoms and show more compliance in high-dose quetiapine.

The Effect of Listening to Music on Auditory Hallucination in Patients with Schizophrenia / 신경정신의학

OBJECTIVES: Auditory hallucinations are a common complaint in patients with schizophrenia. They are also refractory to treatment in a substantial number of patients. The aim of this study was to investigate the effects of listening to music on auditory hallucinations, positive and negative symptoms, depression, and quality of life in subjects with schizophrenia. METHODS: Our study employed a single-blind (assessor blinded) randomized design with a crossover trial. Ten patients with schizophrenia were randomly assigned to two groups. The first group (AB group) experienced an initial 'music listening period', followed by a resting period. This sequence was reversed in the second group (BA group). Each period was two weeks in duration. Measurements of outcome were performed by a blind assessor at baseline and at two and four weeks after randomization. RESULTS: The effect of listening to music on auditory hallucinations, positive and negative symptoms, depression, and quality of life was not statistically significant. On self-report questionnaires, 40% of the subjects reported that 'listening to music was helpful' and 90% responded that they would positively consider listening to music when experiencing an auditory hallucination in the future. CONCLUSION: Listening to music did not result in a statistically significant treatment effect according to objective symptom scales. However, several subjects replied that it was 'helpful', implying that it may be useful as an adjunctive treatment for patients suffering from refractory auditory hallucinations.

Eveningness, Sleep Patterns, Daytime Sleepiness and Fatigue in Korean Male Adolescents / 수면정신생리

OBJECTIVES: Individuals differ in their biological rhythms. This study investigated the association between the morningness-eveningness and sleep patterns, daytime sleepiness and fatigue in Korean male adolescents. METHODS: Participants were 501 eleventh grade male students (16.9+/-0.2 years of age) in one male high school in Seoul. Each student completed the Korean translation of composite scale (KtCS), Epworth sleepiness scale (ESS), Fatigue Severity Scale (FSS) and a questionnaire about their sleep schedule. RESULTS: The evening group had shorter weekday sleep time than the intermediate (p<0.001) or morning group (p=0.029). The evening group had more daytime napping (16.8%, p<0.001), high rate of caffeine use (58.8%, p<0.001) and snoring (18.5%, p=0.037). The evening group showed more daytime sleepiness (8.7, SD=3.2, p<0.001) and severe fatigue (4.4, SD=1.2, p<0.001) than the intermediate or morning group. CONCLUSION: Adolescents with eveningness have higher problems in weekday sleep, daytime sleepiness and fatigue. An intervention program for sleep problem in these adolescents should be considered.

Eveningness, Sleep Patterns, Daytime Sleepiness and Fatigue in Korean Male Adolescents / 수면정신생리

OBJECTIVES: Individuals differ in their biological rhythms. This study investigated the association between the morningness-eveningness and sleep patterns, daytime sleepiness and fatigue in Korean male adolescents. METHODS: Participants were 501 eleventh grade male students (16.9+/-0.2 years of age) in one male high school in Seoul. Each student completed the Korean translation of composite scale (KtCS), Epworth sleepiness scale (ESS), Fatigue Severity Scale (FSS) and a questionnaire about their sleep schedule. RESULTS: The evening group had shorter weekday sleep time than the intermediate (p<0.001) or morning group (p=0.029). The evening group had more daytime napping (16.8%, p<0.001), high rate of caffeine use (58.8%, p<0.001) and snoring (18.5%, p=0.037). The evening group showed more daytime sleepiness (8.7, SD=3.2, p<0.001) and severe fatigue (4.4, SD=1.2, p<0.001) than the intermediate or morning group. CONCLUSION: Adolescents with eveningness have higher problems in weekday sleep, daytime sleepiness and fatigue. An intervention program for sleep problem in these adolescents should be considered.

Recognition of Musical Nuance in Patients with Schizophrenia / 신경정신의학

OBJECTIVES: Emotion perception deficit has long been suggested to be one of the core features of schizophrenia. Although there have been several studies examining responses to facial expressions, few studies addressed music emotion recognition. The aim of this study was to examine the difference in emotion recognition in music between normal subjects and patients with schizophrenia. METHODS: Twenty pieces of music were presented to 43 patients with chronic schizophrenia and 82 healthy controls. The set of music consisted of ten pieces of sad music and ten pieces of cheerful music. The subjects were asked to answer whether each piece of music was sad or cheerful. RESULTS: The correct response rate of music emotion recognition was lower in patients with schizophrenia compared with that in healthy controls (76.67+/-19.03% vs. 93.54+/-8.18%, p<0.001). When subgroup analyses was done by type of music ('sad' or 'cheerful'), patients showed a significantly lower correct response rate in recognizing both sad and cheerful emotion in music than healthy controls (sad emotion : 65.12+/-31.15% vs. 91.95+/-15.27%, cheerful emotion : 88.0+/-16.83% vs. 95.12+/-8.64%). The significant correlations between the clinical symptom severity of schizophrenia and music emotion recognition were not found to be. CONCLUSION: The results suggest that patients with schizophrenia might have difficulties in recognizing musical nuances.

The Actual State of Industrial Accidents in Small-medium Manufacturing Industries / 산업간호학회지

PURPOSE: This study was conducted to assess reported industrial accidents and non-reported industrial accidents that took place in 63 small and medium sized manufacturing industries located in Daegu and Gyeongsangbuk-do in the year of 2009. METHODS: During the period from January to December 2009, the number of industrial accidents that happened each month was examined according to the characteristics of industry, industrial accidents, workers with industrial accidents, treatment, as well as causes and treatment of the non-reported. RESULTS: The total incidence rate of industrial accidents was 3.48%, of which only 0.31% reported. The incidence rate in packing and distribution among manufacturing workplace, and in the industry with 50~99 employees, was higher than the other groups. Of the non-reported, over 80% in required under 10 days of medical treatment, and 56% in required cost of less than 100,000 won. Kappa values were 0.771 concurrence in opinions for causes of non-reported, and 0.571 concurrence in opinions for management termination of non-reported between the employees and employer. CONCLUSION: It is suggested that more supportive policy and precise, nationwide survey on the actual state of industrial accidents, including non-reported cases, be implemented to efficiently manage industrial accidents.

Genetic Polymorphisms in the HTR2C and Peroxisome Proliferator-Activated Receptors Are Not Associated with Metabolic Syndrome in Patients with Schizophrenia Taking Clozapine

OBJECTIVE: Genetic variation in the serotonin-2C receptor encoded by the HTR2C gene is one of the genetic determinants of antipsychotic-induced weight gain. Peroxisome proliferator-activated receptors are nuclear receptors regulating the expression of genes involved in lipid and glucose metabolism. In this cross-sectional study, we investigated whether HTR2C-759C/T, HTR2C-697G/C, PPARalpha V227A, and PPARgamma 161C/T genotypes were associated with metabolic syndrome (MetS) in patients with schizophrenia taking clozapine. METHODS: One hundred forty-six Korean patients using clozapine for more than one year were genotyped for the HTR2C-759C/T, HTR2C-697G/C, PPARalpha V227A, and PPARgamma 161C/T polymorphisms, and their weight, waist circumference, blood pressure, triglycerides, high-density lipoprotein-cholesterol, total cholesterol, and glucose were measured. We used the criteria for MetS proposed by the National Cholesterol Education Program-adapted Adult Treatment Panel III. RESULTS: The prevalence of MetS was 47.3% and was similar among men (49%) and women (42.9%). We found no significant differences between patients with and without MetS in terms of genotypes or allele frequencies. Logistic regression analyses also revealed no association between MetS and each genotype. CONCLUSION: We did not find significant associations between four polymorphisms (HTR2C-759C/T, HTR2C-697G/C, PPARalpha V227A, and PPARgamma 161C/T) and MetS in patients with schizophrenia taking clozapine.

Attitudes about Imported U.S. Beef in Relation to Human Mad Cow Disease in Participants of a Candlelight Rally / 신경정신의학

OBJECTIVES: This study was aimed to examine whether participants of a Korean candlelight rally had correct medical information about human mad cow disease and rational attitudes about imported U.S. beef in relation to human mad cow disease. METHODS: A total of 393 face-to-face interviews were conducted, and subjects completed questions about prevalence of senile dementia and human mad cow disease in U.S. and whether they will eat U.S. beef even if no cases of human mad cow disease occurred in the U.S. or if the chance of being affected with human mad cow disease was lower than dying in a plane crash. RESULTS: Correct answer rates to the questions about prevalence of senile dementia and human mad cow disease were 28.2% and 36.1%, respectively. A majority of respondents answered that they would not eat U.S. beef even if there were no reported cases of human mad cow disease in the U.S. or if their chance of being affected with human mad cow disease was lower than dying in a plane crash (75.6% and 86.0%, respectively). CONCLUSION: At least 64.4% of participants had incorrect medical information about human mad cow disease, and their attitudes about imported U.S. beef may be rooted in emotion rather than fact.