Predicting Variables of Violent Behavior in Schizophrenic Patients / 신경정신의학

OBJECTIVES: This study aims to investigate the variables predicting violent behavior in schizophrenic patients. METHODS: Subjects were 65 schizophrenic patients diagnosed according to DSM-IV. Schizophrenic symptom and the insight of patients were evaluated with the Postive and Negative Syndrome Scale (PANSS) and the Scale of Unawareness of Mental Disorder (SUMD). Violent behaviors were evaluated with the Modified Overt Aggression Scale (MOAS). The State Trait Anger Expression Inventory (STAXI) and the Symptom Checklist-90-Reversion (SCL-90-R) self-reported measures were used for the evaluation of anger state & trait, and general psychopathology. Statistic method used in analized variables were stepwise multiple regression and discriminant analysis as well as t-test. RESULTS: Anger out style, hostility and trait anger variables were extracted as the significant predictors in stepwise multiple regression (37%). Emotion and attitude factors related to anger were more powerful predictor than symptom factors. These three variables could discriminate between violent group and nonviolent group in 72.4%. CONCLUSION: Violent behavior of schizophrenic patients could be predicted more accurately by stable factors such as attitude and emotion related to anger than by symptom factors.

Fate of Bypass Grafts for Renal Artery Reconstruction: Angiographic Findings

Renal atery reconstuction (RAR) for renal artery stenosis has been preferred selective method to correct hypertension and to preserve renal function. But evaluation of renal artery reconstruction with use of angiography has demonstrated not only postoperative graft occlusion due to technical problem but also long term graft failure in 7~20%. This is thought to be due to intimal hyperplasia of anastomotic, midgraft or primary disease progression or extensive fibrosis on the surface of the graft compresssing the lumen. From August 1983 to Februrary 1997, we reviewed 7 patients with 12 grafts who were undertaken aortorenal bypass and performed angiographic study following at least 2 years after operation among 32 patients during these periods. The follow-up period ranged from 24 months to 124 months (average : 76 month)with studies of CT angiography in 6, conventional angiography in 1. There were 4 male and 3 female patients, and their age ranged from 17 to 50 (median age : 31). The causes of the renal artery stenosis in renovascular hypertension were athersclerosis in 2, Takayasu's arteritis in 4, fibromuscular dysplasia in 1. Postoperative blood pressure response showed cure in 2, improvement in 5 according to previously published criteria. The long term angiographic finding showed occlusion in 2, stenosis in 1, dilatation in 1 among vein grafts and stenosis in 1, occlusion in 1 among PTFE grafts. There was no change of renal function during perioperative period. Despite short term good results of renovascular reconstructions, many graft abnormalities were observed. We conclude that regular morphologic follow-up study is required as a postoperative surveillance after renovascular reconstruction.