Gender Differences in the Formal Thought Disorder in Patients with Schizophrenia / 신경정신의학

OBJECTIVES: Formal thought disorder has been regarded as an essential symptom in the diagnostic criteria for schizophrenia. The aim of our study was to present gender differences in the formal thought disorder among patients with schizophrenia. METHODS: We tested for potential gender differences in the formal thought disorder among 167 inpatients with schizophrenia (86 men and 81 women). The Scale for the Assessment of Thought, Language and Communication (TLC scale), Clinical Language Disorder Rating Scale (CLANG), Brief Psychiatric Rating Scale, Young Mania Rating Scale, and Calgary Depression Scale for Schizophrenia were used for evaluation of thought disorder, language disorder, overall symptoms, manic symptoms, and depressive symptoms, respectively. Using the analysis of covariance for continuous variables and logistic regression analysis for discrete variables, gender differences in the formal thought disorder were evaluated. RESULTS: After adjusting for the effects of marital status and religious affiliation, men showed a significantly higher score on the perseveration (TLC scale ; F=7.538, p=0.007), blocking (TLC scale ; F=8.956, p=0.003), stilted speech (TLC scale ; F=6.921, p=0.009), lack of details (CLANG ; F=7.375, p=0.007), dysfluency (CLANG ; F=21.250, p<0.0001), and dysarthria (CLANG ; F=31.198, p<0.0001) items than women. CONCLUSION: Our study has a virtue of exploring gender differences in the formal thought disorder in patients with schizophrenia. Based on our findings, further study might enlighten regarding neural correlates (namely, cerebral asymmetry/lateralization) for gender-differed patterns of the formal thought disorder in patients with schizophrenia.

A Comparison Study between Visual Interpretation and Statistical Parametric Mapping Analysis of Single Photon Emission Computed Tomography Images in Traumatic Brain Injury Patients / 신경정신의학

OBJECTIVES: The first objective of this study was to examine the extent to which the results of the visual interpretation of brain single photon emission computed tomography (SPECT) images correspond with those of SPM analysis in patients with traumatic brain injury (TBI). The second objective was to explore the possibility of the clinical application of SPM analysis for finding the brain lesions related to the neuropsychiatric symptoms, of which the patients complained. METHODS: SPECT images from 10 TBI patients (all male, mean age: 46.8+/-12.32) and 10 age- and sex-matched control subjects were interpreted by an experienced radiologist. Their SPECT images were also analyzed by SPM2 software for comparing the individual images with the controls. RESULTS: The results of visual interpretation of SPECT images generally corresponded with those of SPM analysis in five of the 10 TBI cases. In the remaining cases, brain lesions not identified from visual interpretation were found through SPM analysis. The location of these lesions included the anterior cingulate gyrus, caudate nucleus, thalamus, and subcallosal gyrus. SPM analysis also made it easy to find brain hypoperfusion areas associated with the TBI patients' neuropsychiatric symptoms. CONCLUSION: This study suggested possible clinical applications of SPM analysis of SPECT data from patients with TBI. Its advantages and limitations were discussed.