Neutropenia in Psychiatric Out-Patients / 대한정신약물학회지

OBJECT: The study was performed to examine the psychotrophic drugs used in psychiatric out-patients in which neutropenia developed and current state of consultation and to confirm the importance of complete blood count and differential count (CBC/DC). SUBJECTS AND METHODS: The subjects were 60 patients of our university hospital in which neutropenia developed in out-patient department (OPD) of psychiatry during recent three years. The absolute neutrophil counts of patient were below 2,000/mm3. RESULTS: The reasons why exam was performed were mainly to follow-up exam during medications. Mood stabilizers such as carbamazepine, phenytoin, sodium valproate were identified to cause neutropenia in the group using multiple drugs, and clozapine was highly related in the group using single drug. But many kinds of drugs were related with neutropenia. We have not checked well enough the CBC/DC and have not consulted well to hematologist in OPD of neuropsychiatry. CONCLUSIONS: It is important to find neutropenia in the psychiatric out-patients using psychotropic drugs. We had better check CBC/DC routinely and consult to hematologist.

Frequency and Clinical Characteristics of Pain of the Patients in Psychiatric Out-patient Clinics / 신경정신의학

OBJECTIVES: The purposes of this study were to investigate the frequency and clinical characteristics of pain among the psychiatric out-patients in three clinics. METHODS: A Total of 843 psychiatric adult out-patients (298 subjects from a private clinic, 99 subjects from a general hospital, 446 subjects from a university hospital) were assessed for the presence of pain during OPD follow-up and at the time assessed. And, the presence of organic causes, duration and site of pain, aggravating factors, compensation problems, and prescribed drugs were also investigated. RESULTS: 1) The frequency of pain among psychiatric out-patients was overall 41.3% (44.9% in private clinic, 44.5% in general hospital, and 38.1% in university hospital, respectively). 2) The frequency of pain at the time assessed was 24.1%. In severity of pain, the average of VAS was 46.7+/-18.0mm. Patients of private clinic showed more severe pain than that of general hospital. Moreover, patients who experienced over 'marked' occupied 34.0% and pain as over 'distressed' occupied 26.2%. 3) Only a few subjects had the definite organic causes (1.5-5.9%). The most common site of pain was on head. The patients having a pain over 6 months (i.e. chronic pain) occupied 68.7%. 4) The most common drugs prescribed were anxiolytics; 41.4% of patients were prescribed. The analgesics were prescribed only in 3.2% of patients. CONCLUSION: This result revealed that more than 40% of patients experienced pain in psychiatric OPD and two third of patients were suffered from chronic pain. Therefore, the evaluation and management of pain should be more emphasized.