Alexithymia and the Recognition of Facial Emotion in Schizophrenic Patients

OBJECTIVES: Schizophrenic patients have been shown to be impaired in both emotional self-awareness and recognition of others' facial emotions. Alexithymia refers to the deficits in emotional self-awareness. The relationship between alexithymia and recognition of others' facial emotions needs to be explored to better understand the characteristics of emotional deficits in schizophrenic patients. METHODS: Thirty control subjects and 31 schizophrenic patients completed the Toronto Alexithymia Scale-20-Korean version (TAS-20K) and facial emotion recognition task. The stimuli in facial emotion recognition task consist of 6 emotions (happiness, sadness, anger, fear, disgust, and neutral). Recognition accuracy was calculated within each emotion category. Correlations between TAS-20K and recognition accuracy were analyzed. RESULTS: The schizophrenic patients showed higher TAS-20K scores and lower recognition accuracy compared with the control subjects. The schizophrenic patients did not demonstrate any significant correlations between TAS-20K and recognition accuracy, unlike the control subjects. CONCLUSIONS: The data suggest that, although schizophrenia may impair both emotional self-awareness and recognition of others' facial emotions, the degrees of deficit can be different between emotional self-awareness and recognition of others' facial emotions. This indicates that the emotional deficits in schizophrenia may assume more complex features.

GABA(A)-NMDA Hypothesis and Pharmacotherapy of Catatonia / 대한정신약물학회지

Catatonia is a pathological condition in which the patient shows inappropriate motor, behavioral and affective responses to external stimuli. Catatonia can be observed in major depressive disorder, bipolar disorder, schizophrenia, and other conditions. Although the overall prevalence of catatonia has decreased dramatically, nearly 10% of schizophrenic inpatients still exhibit catatonic symptoms that are divided into immobility, abnormal repetitive behaviors and extreme emotional responses. Although numerous pharmacotherapies have been investigated for catatonia, benzodiazepine remains the treatment of choice. NMDA receptor antagonists such as amantadine and memantine have emerged as promising alternatives. As an effort to explain catatonia, 'GABA-NMDA collaboration model' has been proposed. According to this model, functional impairment of GABA-ergic orbitofrontal cortex can lead to disinhibition of subcortical motor system which utilize NMDA as neurotransmitter. This model was able to explain many aspects of catatonia.

Psychotherapeutic Significance of the Buddhist Thought of 'Not-self'(Anatta) / 신경정신의학

This article was conducted to understand the Buddhist doctrine of 'not-self' (anatta) in respect of psychotherapy. The author reviewed the earliest Buddhist canons (Nikayas) and extracted the thoughts of 'not-self'. The Buddhist self (or ego) is not equal to the recent psycological self (or ego). It is rather the systemic being than the single one, which is composed of 5 aggregates. 'Anatta' does not mean 'no self' but 'not-self'. Buddha regards that self or ego is not real but conceptual. The Buddhist doctrine of 'anatta' is based upon the theory of the dependent origination (paticcasamuppada). Buddhism and psychotherapy consent that one could be emancipated from sufferings not by belief, but by introspection. Just as the emotional insight may lead to the change of behavior and personality in psychotherapy, so the true insight to Enlightenment in Buddhism. The psychotherapeutic significance of 'not-self' implies both the recognition and extinction of the conscious and the unconscious adherence. Therefore psychotherapeutic analysis can be introduced into Buddhism and the meditative contemplation of 'paticcasamuppada' can be adopted by psychotherapy.

Therapeutic Factors Recognized by The Patient and The Therapist in Community Meeting / 신경정신의학

This research was conducted to investigate the responses of the patients and the therapists who attend the community meeting, to evaluate the therapeutic effects of community meeting as a group psychotherapy by applying short form scale of Yalom's Q-sort, to diagnose and complement the problems of the community meeting and to aim at activating the therapeutic function as the group psychotherapy The community meeting was held by 10 times during the stage of oscillation of the community and 26.7 patients group(+/-2.95) and 8.5 therapists group(+/-1.43) attended the every meeting. Consequently, both patients group and therapists group evaluate the community meeting as positive, and on the item which is helpful to them, while patient group responds it is 'mutual understanding and love' and 'self-understanding', therapist group does it is 'frank self-expression' and 'conversation'. On all items of group psychotherapy factors in the community meeting, the patients group evaluates it is more therapeutic in comparison with the therapists group, especially there is a significant difference in nine items such as 'altruism', 'group cohesiveness', 'interpersonal input', 'interpersonal output', 'identification', 'instillation of hope', 'family reenactment', 'self-understanding' and 'existential awareness'. In addition, on the therapeutic factor which is activated group psychotherapy factor in the community meeting, both patients and therapists respond that it is 'existential awareness' and 'universality', and they evaluate 'interpersonal output' as an non-activated therapeutic factor.

Medication Compliance in Psychiatric Outpatients of a University Hospital / 신경정신의학

OBJECTIVE: In view of the facts that education about diseases and realization of the need for drugs can improve compliance of the patients, we assessed the knowledge about drugs and medication compliance in psychiatric outpatients. In addition, we investigated factors that influence patients' compliance to develop a model of medication compliance. METHODS: One-hundred twelve male and eighty female psychiatric outpatient were asked about drug information using questionnaires. We developed a model that predicts medication compliance using chi square tests and multiple regression analysis. RESULTS: More than a hart of the patients knew at least one of the names and the effects of the drugs they had taken, but many of them didn't know the side effects of drugs. About eighty percent of the patients showed good compliance. Knowledge of side effects, belief in the benefits of drugs, and level of education could predict medication compliance reliably. CONCLUSIONS: Because education level could not be managed by physician, we could enhance compliance through education about drug side effects and benefits of medications.