Psychiatry and Neurology / 신경정신의학

OBJECTIVES: The objective of this article is to clarify the similarities and differences between psychiatry and neurology. METHODS: The author reviewed articles regarding the reciprocal relationship of psychiatry and neurology in Korea and western countries. RESULTS: The divided domains of psychiatry and neurology according to mind/body dualism is arbitrary and wrong. Mind is the function or activity of brain. Psychiatry is a branch of medicine which treats the mind disorders (dysfunction of the brain) caused by various biopsychosocial factors. Neurology is also a branch of medicine which treats the anatomical or structural abnormalities of the brain. Progress in the neuroscience and other disciplines heralds a new understanding of the brain leading to new approaches to neuropsychiatric disorders. CONCLUSION: Integration of the two disciplines is desired for mutual benefits and their patients' benefits near future in Korea.

Hippocampal Volume in Elderly Patients with Major Depressive Disorder

OBJECTIVES: Many recent studies of relationship between geriatric depression and changes in brain have examined the structural abnormalities in hippocampus. Using MRI, the hippocampal volumes of patients with major depression were measured and compared with control subjects for research of above relationship. METHOD: Fourteen patients (early-onset five, late-onset nine) with major depressive disorder based on DSM-IV and fourteen age-matched normal controls are included. Applying semiautomated computer program to MRI, we measured and compared the hippocampal volumes in two groups. Moreover we identified the laterality and the correlation of the volumes with age of onset, duration of education, numbers of psychiatric admission, duration of illness, MMSE scores at admission, and severity of depression. RESULT: No significant difference was observed between the hippocampal volumes of patients with major depressive disorder and those of control subjects. A significant correlation in patients was observed between duration of illness and left hippocampal volume to cerebral volume ratio. In early-onset depressed patients, left hippocampal volume was larger than in late-onset depressed patients and the positive correlation was observed between MMSE scores at admission and left hippocampal volume to cerebral volume ratio. In late-onset depressed patients, there was the negative correlation between numbers of psychiatric admission and MMSE scores at admission as well as and between cerebral volume and age of onset. CONCLUSION: Our study indicated no change in the volume of hippocampus among geriatric major depressive patients. So we suggest that more extensive and systematic studies for structural abnormality of hippocampus will be required.

Effect of Psychological Treatment: Through Brain Change? / 신경정신의학

OBJECTIVES: The aim of this review article is to consider conceptual models of psy-chotherapy aff-ecting the brain. METHODS: Discuss the article by Eric R. Kandel describing the influence of psycho-therapy on the brain. CONCLUSIONS: Psychotherapy effects on memory system(conscious or unconscious) and other areas of the brain bringing structural and/or functional changes. It means that the brain and mind is not two but one, that is "mind is the function of the brain". The future task of 21st century psychiatrists is the integration of the brain biology and psycho-ther-apy: to explore the "biology of psychotherapy" or "psychotherapeutic effects of biological therapies".

A Multicenter Study on Effects of Nefazodone(Serzone TM) on Depression, Anxiety, Sleep, Sexual Functions, and Quality of Life in Patients with Depression / 대한정신약물학회지

OBJECTIVE: The aim of this study is to determine effects of nefazodone on depression, anxiety, sleep and sexual function in depressive patients. SUBJECTS AND METHODS: This is an open, non-comparative, multi-center study. Antidepressant and other clinical effects of nefazodone were evaluated in 230 patients of 26 centers, aged 14 years or more, who met DSM-IV criteria to major depressive disorder or dysthymic disorder and didn't have other psychiatric disorders and were physically healthy. The clinical efficacy was assessed at week 1, 2, 4 and 8 using Clinical Global Improvement (CGI), Hamilton Depression Scale (HAM-D), Beck Depression Inventory (BDI), State and Trait Anxiety Inventory-State Anxiety (STAI-SA). Other clinical effects were assessed with Weekly Sleep Questionnaire, Sexual Functioning Questionnaire and GHQ-QOL-12, a scale for quality of life. Adverse drug reactions were checked with a questionnaire. Post-treatment effects of drug were compared with pre-treatment baseline condition. RESULTS: The response rates by Clincal Grobal Improvement and HAM-D after 8 weeks treatment were 62.4% and 75.2% respectively. Comparing to baseline, nefazodone was proved to have significantly higher antidepressant and antianxiety effects in depressive patients and it improved also sleep, sexual functions and quality of life. Both patients and physicians satisfied with the effects of drug. Adverse drug reactions were a few and not serious, and most of them disappeared as treatment continued. CONCLUSION: These results suggest that not only nefazodone has antidepressant effects and antianxiety effects, but also it improves sleep disturbance, sexual dysfunction and the quality of life in depressive patients. Adverse drug reactions were a few and not serious.

Efficacy and Safety Profile of Risperidone in Schizophrenia: Long-term Follow-up Study / 신경정신의학

OBJECTIVES: The purpose of this study was to evaluate the long-term efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. METHOD: This multicenter open label study included 116 schizophrenic patients drawn from 19 university hospitals. After a wash-out period of 1 week, the patients were treated with risperidone for 56 weeks and evaluated at 8 points:at baseline, and the 8th, 16th, 24th, 32nd, 40th, 48th, 56th weeks of treatment. The dose was started at 2mg of risperidone on day 1, and increased to 4mg on day 2, and 6mg on day 3,7 and adjusted to a maximum of 16mg/day according to the individual's clinical response. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. RESULTS: Eighty-seven(75%) of 116 patients completed the 56-week trial of risperidone. Clinical improvement(as defined by a 20% of reduction in total PANSS score at end point) was shown by 92.0% of the patients. The mean dose of risperidone was 5.0mg/day in the 56 week follow-up. PANSS total scores showed significant improvements between consecutive two points at baseline, 8th, 16th, 24th, 32nd, and 48th week of treatment. CGI scores showed significant reductions between consecutive two points at baseline, 8th, 16th, 24th, and 48th week of treatment. Three PANSS factors(positive, negative, general) showed a significant improvement from the 8th week of treatment, and, after then, remained improved in the rest of the study period. ESRS showed no significant change during the 56 week trial. Laboratory parameters showed no significant changes during the course of treatment. CONCLUSIONS: This multicenter long-term open study suggests that risperidone is a antipsychotic drug with long term efficacy and safety in the treatment of schizophrenic patients.

Possibility in Unification of Oriental and Western Medicine Education by Combination of Educational Curricula / 의사학

The authors attempted a pdssibility of unifcation in the educational curricula of both Oriental and Western medical schools for the unification of two medicines . Historically the two medicines were originated from the most primitive state like intinctive method and we can say two medicines were entirely same. However after abrupt and current development of science in 19 century by discovery of microscope and bacteria as well as cells changed medicine into recent unbelievable current medicine from old ancient style medicine like Chinese Medicine which was just the remnant old medicine. The unification of educational curricular is thought to be possible to combine each other by technical adjustment from mutual understanding and cooperations for the most high quality of people's lives. There were good equality to partial corrrespondances between two educational curricular around 90 % at two pre- and schools from the study to analyse. The combined medicine is thought to be more efficient to the diagnosis and treatment of patients because of the effectiveness of Oriental medicine in a certain disease conditions like chronic illness by acupuncture as a alternative medicine or herbs.

Efficacy and Safety Profile of Risperidone in Schizophrenia: Open Multicenter Clinical Trial / 신경정신의학

OBJECTIVE: The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. METHOD: This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points: at baseline, and 1,2,4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. RESULTS: 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action: a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. CONCLUSIONS: This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

Unification of Oriental and Western medicine with study on Oriental and Western medicine / 의사학

In Korea the system of medical management has been bifurcated into two parts since the restoration of nation from Japanese after World War II. One is 'Western Medicine' and the other is 'Oriental Medicine' like Chinese but not like Japanese. The authors attempted to study on the unification of both medicines to prevent the confusion of medicare for people. The major part of medical care is accomplished by Western medicine among people in Korea and China. However, Oriental medicine is still present as well as college of Oriental medicine in small number. There have been long struggles between two parts of medicine because of each assertions for the theories. The ancient medicine has been likely to have its characteristics either in Western or Oriental medicine although in many countries were succeeded by Western medicine except a few Asian countries such as Korea and China. In Japan since the license of Oriental(herb) medicine was ceased about one hundred years ago, the Western medicine has been authorized by law until today and the herb is the secondary medicine as a kind of folk treatment as well as continuous and enormous study for scientification. In only China and Korea this herb medicine has been kept to use as a part of medicine by law though China has developed combined medicine to use both Western and Oriental medicine by one physician since previous prime minister Chou En-Lai around the year 1950 who made a recommendation to the two medical societies, Western and Oriental. This fact has a big sense to establish the unification of two medicines in near future in Korea as well as China. For this accomplishment of medical unification both parts of medicine require sincere and enormous efforts to study the theory and practice of herb medicine even from now on. This unification of two medicines will provide the best medicare in most convenient way to the people in the world creating new world medicine like the third medicine including alternative medicine. The acupuncture is changing to a new method in Western medicine especially applying into anesthesia and pain clinic in even USA and Western countries at this time. In conclusion the unification of the Western and Oriental medicine will provide the most reasonable and practical medicare including alternative medicine to people in the world. Because the Oriental medicine will be used at least separately to supplement the Western medicine by one physician

The effects of haloperidol on human immune function / 신경정신의학

No abstract available.

Therapeutic effects of resperidone in the treatment of chronic schizophrenia / 신경정신의학

No abstract available.