Incidence and Course of Depression in Patients with Alzheimer's Disease

OBJECTIVE: Depressive symptoms are common in Alzheimer's disease (AD) and they might influence the course and prognosis of AD. Depression could appear anytime in the course of the disease, and could either last considerably long or disappear easily. This study is intended to investigate the occurrence of depression in the course of AD and the risk factors of incidence. METHODS: This study targeted 1,272 AD patients without depressive symptoms at the start of this study in Korea. A total of 775 subjects completed the study, and the occurrence of depression was assessed after 12 months. Demographic information of subjects was collected and cognitive functions, overall functions, and depression severity were assessed at the start of this study and after 12 months. RESULTS: Among the 775 subjects, 103 subjects (13.29%) developed depression 12 months later. The MMSE-KC scores showed significant changes in both groups that developed depression and did not. In the univariate analysis, significant differences in the incidence of depression were found in terms of gender, the administration of the antidepressant at the baseline, the SGDS-K score, and the GDS score. The multiple logistic regression analysis showed that the increase in the incidence of depression was associated with a female, in the increase in SGDS-K score and the GDS score. CONCLUSION: The incidence of depression in the subjects who completed the 12-month follow-up observation was 13.29%. Moreover, in the multivariate analysis, a female gender and the severity of dementia, including the overall functions, seemed associated with the occurrence of depression.

Comparison of QEEG Findings between Adolescents with Attention Deficit Hyperactivity Disorder (ADHD) without Comorbidity and ADHD Comorbid with Internet Gaming Disorder

Internet gaming disorder (IGD) is often comorbid with attention deficit hyperactivity disorder (ADHD). In this study, we compared the neurobiological differences between ADHD comorbid with IGD (ADHD+IGD group) and ADHD without comorbidity (ADHD-only group) by analyzing quantitative electroencephalogram (QEEG) findings. We recruited 16 male ADHD+IGD, 15 male ADHD-only adolescent patients, and 15 male healthy controls (HC group). Participants were assessed using Young's Internet Addiction Scale and ADHD Rating Scale. Relative power and inter- and intra-hemispheric coherences of brain waves were measured using a digital electroencephalography (EEG) system. Compared to the ADHD-only group, the ADHD+IGD group showed lower relative delta power and greater relative beta power in temporal regions. The relative theta power in frontal regions were higher in ADHD-only group compared to HC group. Inter-hemispheric coherence values for the theta band between F3–F4 and C3–C4 electrodes were higher in ADHD-only group compared to HC group. Intra-hemispheric coherence values for the delta, theta, alpha, and beta bands between P4–O2 electrodes and intra-hemispheric coherence values for the theta band between Fz–Cz and T4–T6 electrodes were higher in ADHD+IGD group compared to ADHD-only group. Adolescents who show greater vulnerability to ADHD seem to continuously play Internet games to unconsciously enhance attentional ability. In turn, relative beta power in attention deficit in ADHD+IGD group may become similar to that in HC group. Repetitive activation of brain reward and working memory systems during continuous gaming may result in an increase in neuronal connectivity within the parieto-occipital and temporal regions for the ADHD+IGD group.

Balance Deficit and Brain Connectivity in Children with Attention-Deficit/Hyperactivity Disorder

OBJECTIVE: We aimed to assess disturbances in postural and gait balance and functional connectivity within the brain regions controlling balance in children with attention-deficit/hyperactivity disorder (ADHD). METHODS: Thirteen children with ADHD and 13 age- and sex-matched controls were recruited. Gait balance was assessed by the difference in the center of pressure (COP) between the left and right foot, as well as the difference in plantar pressure between the left and right foot during gait. Neuroimaging data were acquired using a 3.0 Tesla MRI scanner. Functional connectivity between the vermis of the cerebellum and all other brain regionswas assessed. RESULTS: The difference in plantar pressure between the left foot and right foot in the ADHD group was greater than that observed in the control group. The average COP jerk score of the right foot in the ADHD group was higher than that observed in the control group. A higher functional connectivity between the cerebellum and the right middle frontal gyrus (premotor cortex) and medial frontal gyrus (cingulate gyrus) was observed in the control group relative to the ADHD group. In the ADHD group, the difference in plantar pressure between the left and right foot was also negatively correlated with the beta-value within the middle frontal gyrus. CONCLUSION: Children with ADHD had disturbance of balance as assessed by plantar pressure. Decreased brain connectivity from the cerebellum to the premotor cortex and anterior cingulate was associated with disturbances of posture and balance in children with ADHD.

Opioid Analgesics and Depressive Symptoms in Burn Patients: What Is the Real Relationship?

OBJECTIVE: Major burn injuries are strongly associated with both psychological trauma and severe pain, and opioids are the mainstay analgesics for the treatment of severe burn pain. The objectives of this study are to find the complex relationship between opioid dose, depression, and post-traumatic stress disorder (PTSD) symptoms during the acute management of pain in burn patients. METHODS: The symptoms of depression and PTSD were assessed in 43 burn patients immediately following wound stabilization and 2 weeks after the initial evaluation. RESULTS: Total opioid doses and Hamilton Depression Scale (HAMD) scores obtained during the second evaluation were positively but weakly correlated after controlling for age and total burn surface area (R=0.33, p=0.03). Moreover, pain management with opioids was significantly more common in burn patients with low Clinician Administered PTSD Scale scores (evaluation 1) and high HAMD scores (evaluation 2) (F=6.66, p=0.001). CONCLUSION: High opioid dose following acute burn trauma might have correlation with depressive symptoms. Monitoring of depressive symptoms may be important following acute burn trauma and consequent opioids pain management, particularly when PTSD symptoms appear minimal during the early stabilization of patients.

The Correlation between Maternal Adult Attachment Style and Postpartum Depression and Parenting Stress / 신경정신의학

OBJECTIVES: We aimed to determine whether the adult attachment styles of pregnant women could predict development of postpartum depression. METHODS: Korean version of Revised Adult Attachment Scale, State Trait Anxiety Inventory-State/Trait (STAI-S/T), and Center for Epidemiologic Studies-Depression Scale (CES-D) were administered at baseline. Edinburgh Postnatal Depression Scale (EPDS), Parenthood Stress Questionnaire (PSQ), STAI-S, and CES-D were assessed at week 2 and 6 postpartum. Participants were categorized into the secure-mom (SM ; n=48) or insecure-mom (IM ; n=9) group. RESULTS: While STAI-S scores in SM showed a continuous decrease during the entire observation period, STAI-S scores in IM decreased during the first two weeks but increased during the next four weeks. While SM showed decreased CES-D scores from week 2 to 6, IM showed increased CES-D scores from week 2 to 6. Although SM showed decreased EPDS scores from week 2 to 6, IM showed increased EPDS scores from week 2 to 6. In SM, the change in EDPS score from week 2 to week 6 showed positive correlation with PSQ-ability and PSQ-social subscale scores. CONCLUSION: Assessing the maternal adult attachment style before giving birth appears to be helpful for screening the high-risk group who are vulnerable to development of postpartum depression.

The Effect of Living with Spouse on Cognitive Decline and Depressive Symptom in Elderly People

OBJECTIVE: The aim of this study was to determine whether living with spouse contributes to cognitive decline and depressive symptom among elderly people. METHODS: 939 participants were recruited through Keum-Cheon center for dementia in Seoul. All subjects were assessed using the Korean version of Mini-Mental Status Examination (MMSE-K), Korean version of Consortium to Establish a Registry for Alzheimer's disease (CERAD-K) and Geriatric Depression Scale (GDS). Furthermore, epidemiological factors (age, sex, education year, and characteristics of family) assessed to find correlation with cognitive decline. RESULTS: Controlling for gender, age, and education year, living with spouse was significantly associated with cognitive decline (B=-0.486, S.E=0.203, Wald=0.331, Exp (B)=1.107, p=0.01). Living with spouse group has lower depressive symptom, compared to living without spouse group (F=14.6, p<0.01). CONCLUSION: Correctly, our results suggest that spouse absent state may accelerate cognitive decline and depression. Further, elderly people living alone should be closely monitored for both depression and cognitive impairment.

Performance Enhancement with Low Stress and Anxiety Modulated by Cognitive Flexibility

OBJECTIVE: The purpose of this study was to compare cognitive flexibility abilities, stress, and anxiety between starters and non-starter athletes. METHODS: A total of 30 male professional-soccer and 40 professional-baseball athletes were recruited. Wisconsin Card Sorting Test (WCST) and Trail Making Test A & B (TMT A & B) were administered to assess cognitive flexibility during competition. The Korean version of the STAI form Y (STAI-KY) and Visual analogue scale for anxiety and stress were used to assess the anxiety and stress. RESULTS: The starter group had better cognitive function (fewer perseverative errors and rapid TMTB times) (Z=3.32, p<0.01; Z=2.20, p=0.03, respectively) and lower stress and anxiety (F=4.34, p=0.01; F=6.61, p<0.01, respectively) during competition than the non-starter group. CONCLUSION: The better cognitive performances were negatively correlated with stress and anxiety. Current results suggested that cognitive flexibility would enhance human performance by modulation of the anxiety and stress during competition.

A Case of Very-late-onset Schizophrenia-like Psychosis

This paper presents the case of a 67-year-old woman who visited the Psychiatry Department complaining of persecutory ideas and auditory hallucinations after a buccal cancer operation. On neuropsychological testing, she demonstrated paranoid psychosis and bizarre thoughts. Hospital admission was recommended for supportive care and treatment with antipsychotics. She was initially treated with olanzapine, but this medication had little effect and was replaced with amisulpride, which reduced the residual symptoms. The aim of this report was to discuss the diagnostic process and treatment of very late-onset schizophrenia-like psychosis.

Insecure Attachment and Impulsivity-Inattention Problem in Adolescent with a High Risk of Substance or Internet Addiction / 신경정신의학

OBJECTIVES: This study was done in adolescents with a high risk of substance or internet addiction in order to confirm the assumption that insecure attachment formation and impulsivity-inattention problems are major risk factors in adolescent addictive behavior. METHODS: 2,188 middle and high school students including a nicotine dependent treatment group were assessed using self-reporting scales : Adolescent Drinking Index (ADI), Fagerstrom Tolerance Questionnaire, Young Internet Addiction Scale, Revised Adult Attachment Scale (RAAS), and the Conner and Well's Self-reporting Scale for ADHD (CASS) were used. Subjects were classified into risk groups including substance addiction, internet addiction, as well as a combined group. RESULTS: Significant correlations were found between attachment formation and internet addiction tendencies, with respect to dependence, anxiety, and closeness (r=-0.185, r=0.248, r=-0.147, p<0.01, respectively). Impulsivity-inattention problems had positive correlations with internet addiction, alcohol addiction and nicotine addiction groups (r=0.345, r=0.211, r=0.187, p<0.01). With regard to attachment formation, the four groups showed significant differences regarding dependence (F=19.427, p<0.01), anxiety (F=28.926, p<0.01), and closeness (F=12.853, p<0.01). In addition, the four groups showed significant difference with respect to impulsivity-inattention problems (F=83.857, p<0.01), of which the combined risk group showed the highest scores, and the non-addicted group had the lowest scores. CONCLUSION: Insecure attachment formation and impulsivity-inattention problems were major risk factors for adolescent addictive behavior including internet addiction.

The Effects of Antidepressants on the Leptin, Adiponectin, and Adiponectin Receptor mRNA Expression in Model Diabetogenic Rats / 신경정신의학

OBJECTIVES: Weight gain and glucose intolerance are the most common symptoms of metabolic syndrome. Certain patients complain of weight-change and hyperglycemia after receiving antidepressants. Our study evaluated the effects of antidepressants on serum glucose and energy metabolism. METHODS: Subjects were 32 Otsuka Long-Evans Tokushima Fatty (OLETF) and 35 wild-type Long-Evans Tokushima Otsuka (LETO) rats. From age 11 weeks, the rats were divided into 4 subgroups within each strain. We administered the designated antidepressant-amitriptyline, fluoxetine, or mirtazapine-to these subgroups, allocating the fourth as the control. After exactly 4 weeks' medication, we sacrificed the animals and checked their weight, glucose, insulin, leptin, adiponectin, and expression of adiponectin receptor mRNA. RESULTS: Fluoxetine subgroups in both strains gained the least weight. The glucose, triglyceride, and cholesterol levels of all OLETF antidepressant subgroups did not differ from the controls. Adiponectins in amitriptyline- and mirtazapine-subgroups were higher than control. All antidepressant subgroups showed elevated expressions of adiponectin receptor mRNA in fat, muscle, and the pancreas. CONCLUSION: Amitriptyline and mirtazapine seem to regulate adiponectin and expression of adiponectin receptor mRNA. Even though the underlying mechanisms were different, we conclude none of the antidepressants would have negative influences on energy metabolism in diabetogenic animals.

The Association of Cognitive Dysfunction with White Matter Hyperintensity in Alzheimer's Disease and Mild Cognitive Impairment / 신경정신의학

OBJECTIVES : We investigated the relationship between periventricular and deep white matter hyperintensity and cognitive function in Alzheimer's disease (AD) and mild cognitive impairment (MCI). METHODS : T2-weighted MRI scans were performed in 41 subjects with AD 38 subjects with mild cognitive impairment and 38 control subjects. Periventricular and deep white matter hyperintensities were rated on a Fazekas 0-3 scale by a medical specialist of the department of radiology blind to clinical diagnosis. Cognitive function was assessed by using Cognitive Assessment and Reference Diagnoses System. RESULTS : No significant differences between demographic characteristics and vascular risk factors were revealed comparing AD, MCI and controls. The frequencies of AD were significantly higher than those of MCI and normal control in Grade 2 and 3 of periventricular hyperintensity and Grade 3 of deep white matter hyperintensity. The scores of amnesia, executive function and attention were significantly lower in Grade 2 and 3 of periventricular hyperintensity than in Grade 0 and 1. The scores of attention were significantly lower in Grade 3 of deep white matter hyperintensity than in Grade 0, 1 and 2. CONCLUSION : Periventricualr hyperintensities are associated with cognitive decline in amnesia, executive function and attention, while deep white matter hyperintensities are associated with cognitive decline in attention.

The Association of Cognitive Dysfunction with White Matter Hyperintensity in Alzheimer's Disease and Mild Cognitive Impairment / 신경정신의학

OBJECTIVES : We investigated the relationship between periventricular and deep white matter hyperintensity and cognitive function in Alzheimer's disease (AD) and mild cognitive impairment (MCI). METHODS : T2-weighted MRI scans were performed in 41 subjects with AD 38 subjects with mild cognitive impairment and 38 control subjects. Periventricular and deep white matter hyperintensities were rated on a Fazekas 0-3 scale by a medical specialist of the department of radiology blind to clinical diagnosis. Cognitive function was assessed by using Cognitive Assessment and Reference Diagnoses System. RESULTS : No significant differences between demographic characteristics and vascular risk factors were revealed comparing AD, MCI and controls. The frequencies of AD were significantly higher than those of MCI and normal control in Grade 2 and 3 of periventricular hyperintensity and Grade 3 of deep white matter hyperintensity. The scores of amnesia, executive function and attention were significantly lower in Grade 2 and 3 of periventricular hyperintensity than in Grade 0 and 1. The scores of attention were significantly lower in Grade 3 of deep white matter hyperintensity than in Grade 0, 1 and 2. CONCLUSION : Periventricualr hyperintensities are associated with cognitive decline in amnesia, executive function and attention, while deep white matter hyperintensities are associated with cognitive decline in attention.

The Effects of Antidepressants on the Energy Metabolism in LETO Rat / 대한정신약물학회지

Objectives : A diverse range of adverse effects has been linked to the application of antidepressants for the treatment of depressive disorder. Recently, evidence has been emerging of the adverse metabolic effects of antidepressants. This study investigated the effects of antidepressants on plasma glucose and other factors in the fat and muscle tissue relating to metabolism. METHODS : Long-Evans-Tokushima-Ostuka (LETO) rats were used to evaluate the effects of different antidepressants. Amitriptyline, fluoxetine, and mirtazapine were administered to each of three subgroups for 4 weeks, between 11 and 15 weeks old, while a fourth subgroup was administered no antidepressant during the same period. Changes of weight and daily intake were monitored. Tissues and blood were collected at 15 weeks. RESULTS : The fluoxetine subgroup showed lower weight gain and lower food efficacy ratio than did the other subgroups. Blood glucose and other circulating factors showed no significant differences among groups, except for the leptin levels of the fluoxetine subgroup. However, the amitriptyline and mirtazapine subgroups showed similar patterns in the response of mRNA expression of peroxisome proliferator-activated receptors gamma cofactor-1 and uncoupling protein-1, 2, 3. CONCLUSION : These results could indicate possible differences in metabolic response based on the kind of antidepressant used.

Effect of Galantamine on Caregiver Time and Activities of Daily Living in Mild to Moderate Alzheimer's Disease: A 1-Year Prospective Study

OBJECTIVE: This study aims to investigate the effect of galantamine on caregiver time and activities of daily living(ADLs) in patients with mild to moderate Alzheimer's disease(AD) in a Korean population. DESIGN: Quasi-experimental study: A rndomized, double-blind, parallel-group clinical trial and a naturalistic longitudinal community study METHOD: For this 1-year prospective study, 138 patients residing in the community were recruited(baseline MMSE score of. 10-22). The two groups were composed of 72 patients treated with galantamine and 66 patients selected as the control group from an untreated community cohort of AD patients. The primary efficacy outcome was the caregiver time and the secondary efficacy measure was the Korean version of the Disability Assessment for Dementia(DAD-K) scale. RESULTS: The results of a mixed model analyses demonstrated reduced caregiver time and improved ADLs in galantamine group relative to baseline and compared with the community control group in this 1-year prospective study. Significant improvement in galantamine group observed in the DAD scores demonstrated beneficial effects of galantamine on delaying functional deterioration in patients with mild to moderate AD. Difference in caregiver time between two groups was equivalent to additional 9.5 working days per month or 113 working days per year. CONCLUSION: Treatment with Galantamine is associated with a significantly slower decline in basic and instrumental ADLs in patients with mild to moderated AD. These benefits on functional capacity in patients with AD treated with galantamine were associated with less caregiver time, lower caregiver burden and higher economic benefits.

MRI Structure and Histological Change of Rat after Memantine Intake in Olfactory Bulbectomised Depression Model / 대한정신약물학회지

OBJECTIVE: The validity of olfactory bulbectomized rat as an animal depression model and the possibilities of the NMDA antagonist as an antidepressant would be evaluated by demonstrating structural alterations in their brain MRIs and histological findings of hippocampus. METHODS: Those 8-week old male Sprague-Dawley rats received either an olfactory bulbectomy or sham operation and volume changes at ventricles and caudate nucleus in their brain MRI were acquired at preoperation and postoperation. Those olfactory bulbectomized rats received either memantine, an uncompetitive NMDA antagonist, or normal saline, a placebo, and their brain structural changes in MRI were acquired. At preoperation, postoperation, and postmedication each one of the rats with sham-operation, with memantine, and with placebo was sacrificed to acquire histological impressions. RESULTS: 1) Comparison of the volume changes between preoperation and postoperation showed statistical significance; the volumes of the left and right lateral ventricles (p=0.007, p=0.008) and the third ventricle (p=0.003) increased significantly but the volumes of left and right caudate nucleus decreased (p=0.014, p=0.032), compared to that of the controls. 2) After 6-weeks of memantine administrations, the OB rats revealed more definite recovery in brain MRIs statistically than the controls: the volumes of left and right ventricles and left and right caudate nucleus (p=0.004, p=0.03 ; p=0.04, p=0.05). 3) The hippocampus histological findings of the olfactory bulbectomy showed frequently eosinophilic cytoplasm and hyperchromatic nucleus with shrinkage in CA3. After memantine intake, the hippocampus histological findings returned to nearly normal and showed mixtures of normal cell and abnormal neuron cell. CONCLUSION: The OB models would be valid as an animal model of depression and alterations in their brain MRI images after administrations of NMDA antagonist could be an indicator of antidepressant effects.

The Feasibility Test of Korean Medication Algorithm for the Treatment with Schizophrenic Patients(III): The Influence of Therapeutic Environment on Application of Korean Medication Algorithm Project for Schizophrenia / 대한정신약물학회지

OBJECTIVE: Korean Medication Algorithm Project(KMAP) for schizophrenia was started in 2001. Phase II of this algorithm project for schizophrenia was a feasibility trial and was done to investigate suitability of the algorithm. The purpose of this paper was to evaluate the influence of the therapeutic environment in application of Korean medication algorithm project for schizophrenia. METHOD: A total 108 schizophrenic patients were enrolled at 16 general hospitals and at 3 mental hospitals. All subjects were treated and evaluated according to the algorithm. After the application of the algorithm, clinical effects, switching tendency of antipsychotics and degree of satisfaction for algorithm were compared between general hospitals and mental hospitals. RESULT: There were no significant demographic differences in the two hospital groups. But, cognitive and obsessive symptoms were significantly more severe in mental hospital patients. In general hospital, transitions between each treatment stages were more frequent than in mental hospital. After 4 months of antipsychotic medications trial, most patients were still in the stage 1 (83.3%) in mental hospital group compared to 51.85% of patients in general hospital group. After 4 months of algorithm trial, changes in PANSS (32.85+/-18.87) and CGI (3.47+/-1.81) in general hospital group were significantly greater than those in mental hospital group. Necessities of treatment algorithm were more emphasized by clinician working at the mental hospitals. Overall, degrees of satisfaction for treatment algorithm were not significantly different between two hospital groups. CONCLUSION: These results could be due to the different characteristics of patients or therapeutic environment between the two groups. Also, the resources needed to implement the algorithm may be different between the two groups. To use the Korean Medication Algorithm for schizophrenia with treatment as usual, the difference between therapeutic environments should be considered.

The Feasibility Test of Korean Medication Algorithm for the Treatment with Schizophrenic Patients(I): Analysis Focusing on the Effectiveness of Treatment / 대한정신약물학회지

OBJECTIVES: The Korean College of Neuropsychopharmacology and the Korean Academy of Schizophrenia developed the Korean algorithm project for schizophrenia to aid clinical decisions. The purpose of this study was to assess the feasibility of Korean Medication Algorithm for Schizophrenia patients in clinical settings in Korea. METHODS: A total of 108 schizophrenia and schizophreniform disorder patients were enrolled at 19 centers and treated according to the algorithm. PANSS (Positive and Negative Symptom Scale) and CGI (Clinical Global Impression) were used to evaluate symptom severity. Also UKU (UKU side effect rating scale) and LUNSERS (Liverpool University Neuroleptic Side Effect Rating Scale), DAI-10 (Drug Attitude Inventory-10), PPS (Patient Preference Scale), SWN (Subjective Well-Being under Neuroleptic treatment) and WHOQOL (World Health Organization Quality of Life) were used to evaluate tolerability and satisfaction of patient respectively. RESULTS: Overall ratings including symptom severity, compliance of medication, side effect of medication, quality of life were favorable. The treatment response (PANSS improvement > or = 20%) rate was 63%, 75% at the first Clinical decision point (CDP) and 4 month respectively. CONCLUSION: Symptom improvement, tolerability and quality of life were all favorable. These results suggest that this algorithm can be useful in clinical practices.

Temperament and Genetic Polymorphism in Korean Male Adolescents with Internet Addiction Tendency / 신경정신의학

OBJECTIVES: Among chemical and non-chemical dependence, internet addiction is one of the most frequent addictive behavior in adolescent. This study was performed to detect certain temperamental and genetic characteristics in adolescent with internet addiction tendency. METHODS: 87 adolescents with internet addiction tendency (AIT) and 78 adolescents without internet addiction tendency (NAIT) were classified by Young's Internet Addiction Test. Cloninger's Temperament Character Inventory and 6 candidate genes of drug addiction (DRD2 TaqI A, DRD4, DAT1, 5-HTTLPR, NET-8, and COMT) polymorphisms were tested between two groups. RESULTS: Novelty Seeking scores (p=0.001) and Harm Avoidance scores (p=0.042) were significantly higher in AIT. The frequency of DRD2-A1/A1 genotype and G allele of NET-8 in AIT was higher than that in NAIT. In AIT, Novelty Seeking scores were significantly different (p=0.011) according to NET-8 genotypes (G/G>G/A>A/A). CONCLUSION: These data suggest that male adolescents with internet addiction tendency have the specific temperament and genetic polymorphisms like chemical dependence.

Comparison of Serum Homocysteine, Folate and Vitamin B12 Level in Korean Schizophrenics

OBJECTIVE: There have been a kind of transmethylation theory that high homocysteine serum concentration affects schizophrenia by neurotoxic mechanism and clinical reports that some schizophrenic patients with high homocysteine were improved by high folate ingestion. This study was done to confirm previous research results and find the clinical characteristics of schizophrenia showing high serum homocysteine and low folate. METHOD: We compared the serum levels of homocysteine, folate and vitamin B12 level between 234 schizophrenic patients(male 99, female 135) group and 234 normal controls(male 99, female 135) group. The subjects of two groups were age and sex matched. The evaluated clinical characteristics items were sex, age, onset of disease, hereditary loading, disease course, hallucination and subtype of schizophrenia. RESULTS: 1) Homocysteine level of the schizophrenia group was significantly higher than the normal control group and folate level of the schizophrenia group was significantly lower than the normal control group. Homocysteine level was more negatively correlated with folate level in the schizophrenia group than the normal control group. 2) The percentage of high homocysteine(above 12.46umol/L;90 percentile of normal control) was 33.8% of schizophrenia patients and 51.5% of male schizophrenia. The percentage of low folate(below 3.8nM/L;bottom tertile of normal control) was 66.2% of schizophrenia. 3) In low folate group and not-low folate group, schizophrenia showed significantly higher homocysteine level than normal control. Especially, low folate schizophrenia group showed significantly higher homocysteine level than low folate normal control group. CONCLUSIONS: Some schizophrenia patients with high serum homocysteine may be genetic defector and having low folate serum level. In that case, folate ingestion could be a good management for clinical improvement.

Serum Brain-Derived Neurotrophic Factor in Schizophrenia

OBJECTIVES: Abnormalities in neurotrophic factors that regulate neuronal development and synaptic plasticity are often implicated as some causes of schizophrenia. In previous studies, researchers reported that brain and serum BDNF levels underwent similar changes during maturation and aging processes in rats. They also found a positive correlation between serum and cortical BDNF levels. In this study, we investigated whether the serum levels of BDNF in Korean schizophrenic patients would be different from those of healthy controls. METHODS: Using an ELISA kit, serum BDNF levels were assessed in schizophrenic group(N=49) and control group(N=50). RESULTS: Serum BDNF levels in the schizophrenic group(36.29+/-19.78ng/ml) were significantly higher than those in control group(22.4+/-14.4ng/ml). The BDNF levels did not correlate with duration of treatment, age or daily dose of antipsychotics in patients with schizophrenia. CONCLUSIONS: This result suggests that schizophrenia is characterized by high serum BDNF levels and supports the hypothesis of neurotrophic factor involvement in psychotic disorder. Serum BDNF level is likely to be one of the possible biological markers for schizophrenia.