Epidemiology of Erectile Dysfunction in one Korean Rural Community / 신경정신의학

OBJECTIVES: The purpose of this study was to investigate the prevalence of erectile dysfunction (ED) in a rural area of Korea and to examine the relationship between the prevalence and correlates of subjects. METHOD: This study was done as a part of the chronic disease survey of rural area by the Asan Foundation. Among 30 years or older population from Jung Eup, a rural area of Korea, 711 male subjects were sampled using a cluster probability sampling method. Trained interviewers visited and interviewed subjects aged 30 years or older with a structured interview. ED was categorized as 'none', 'mild', 'moderate', or 'severe' according to the ability to 'attain and/or maintain an erection satisfactory for sexual intercourse'. Response rate was 54.3% (N=386). RESULTS: The age weighted prevalence of ED was 27.2% (minimal 14.1%, moderate 7.6%, severe 5.5%). Prevalence and severity increased with age. Liver disease and underweight were significantly (p<0.05) associated with ED. Smoking seemed to be correlated with ED, but did not reach statistically significant level. CONCLUSION: ED was highly prevalent in the rural community of Korea. Medical, sociodemographic, and lifestyle variables associated with ED may alert physicians to patients at risk for ED and offer insight to its etiology.

A Case of Progressive Supranuclear Palsy with Schizophrenic Symptoms / 신경정신의학

We have experienced a rare case of progressive supranuclear palsy with hallucination and delusion. The common manifestations of progressive supranuclear palsy are gait disturbance, mental change and sign of vertical ophthamoplegia but no efficacious therapy has been known. Neuropsychiatric symptom clusters include cognitive impairment, affective and behavioral changes, sleep disturbance, and psychotic symptoms. Though schizophrenia-like psychosis has been reported but this is certainly rare. Addressing a case of progressive supranuclear palsy, in whom parkisonian symptoms appeared with concurrent psychotic symptoms, we emphasize accurate diagnosis.

Development of Korean Version of Structured Clinical Interview Schedule for DSM-IV Axis I Disorder: Interrater Reliability / 신경정신의학

OBJECTIVE: Accurate diagnosis and assessment for psychiatric disorders is crucial for research, as well as for clinical practice. Structured Clinical Interview for DSM-IV(SCID-RV) is a less time-consumimg and more accurate structured diagnostic interview form. It can be used by clinical professions and is known for a reliable diagnostic tool. Present study was conducted to develop Korean version of SCID-RV and to test the inter-rater reliability. METHOD: The authors have translated original SCID-RV into Korean, and revised in parallel with sociocultural background of Korea. Ninety patients from two psychiatric hospitals, both outpatient and inpatient, were interviewed and rated independently by three raters. RESULT: The kappa coefficients for most of illnesses, such as major depressive disorder, dysthymia, schizophrenia, alcohol abuse and dependency, anxiety disorder and eating disorder were excellent (>0.70) in the evaluation of current disorders. And the kappa coefficients for bipolar disorder, delusional disorder, agoraphobia, undifferentiated somatoform disorder, and hypochondriasis were acceptable (>0.40) in the evaluation of current disorders. In the evaluation of lifetime disorders, the concordant rates of all the diagnoses except bipolar disorder and undifferentiated somatoform disorder were excellent. Lack of hierarchy in DSM-IV allows for multiple Axis I diagnoses. Mean numbers of Axis I diagnoses per subject assigned by the three raters were 1.5-1.7. CONCLUSION: Our findings confirm that SCID-RV yields highly reliable diagnoses. SCID-RV is recommended for accurate diagnosis in clinical practice and research on psychiatric disorders.