Clinical Utility of the MMPI-A-RF’s Internalization and Externalization Higher-Order Scales: Comparison With the K-CBCL’s Internalization and Externalization Scales / 정신신체의학

Objectives@#：The purpose of this study was to examine the clinical utility of the internalization and externalization higher-order scales of the Minnesota Multiphasic Personality Inventory-Adolescent Restructured Form (MMPI-A-RF), compared with those scales of the Korean Child Behavior Checklist (K-CBCL). @*Methods@#：43 adolescents with internalizing disorders and 44 adolescents with externalizing disorders and their parents were administered the MMPI-A-RF and K-CBCL each. To verify the difference between the internalization and externalization scales of the MMPI-A-RF and K-CBCL for each group, independent-sample t test was performed. To compare the agreement between the MMPI-A-RF and K-CBCL, correlation analysis was also conducted. Lastly, to identify which scales significantly best predict each of the internalizing and externalizing disorder, logistic regression analysis was conducted. @*Results@#：Internalization scales of the MMPI-A-RF and K-CBCL were significantly higher in the internalizing disorder group, and the externalization scales were significantly higher in the externalizing disorder group. The positive correlation was significant only for internalization problems between the two evaluation measures in both groups (each r=0.360, p<0.05, r=0.572, p<0.05). In addition, the scales significantly predicted internalizing and externalizing disorders were the internalization and externalization scales of the MMPI-A-RF, followed by the externalization scale of the K-CBCL (R2 =0.407, p<0.05). @*Conclusions@#：The internalization and externalization higher-order scales of the MMPI-A-RF were found to reliably reflect the characteristics of each disorder in adolescents and be useful evaluative scales to differentiate dis-orders. Moreover, if adolescents show externalization problems, additional information from the K-CBCL can be more useful to differentiate disorders.

Relationship between Insight and Manic Symptoms in Stable Patients with Chronic Schizophrenia / 우울ㆍ조울병

OBJECTIVES: Patient insight is a very important factor in the management of schizophrenia. Manic symptoms can occasionally be identified by the patient, even in cases of schizophrenia. The aim of this study is to examine the relationship among patient insight, the psychotic and manic symptoms, and the demographic clinical variables.METHODS: Seventy-four participants (male 44, female 30) with chronic schizophrenia in community mental health facilities were evaluated according to the Korean version of the Scale to assess Unawareness of Mental Disorder (SUMD-K), the Korean version of Mood Disorder Questionnaire (K-MDQ), and the Brief Psychiatric Rating Scale (BPRS).RESULTS: The mean number of previous admissions was 3.85. The mean CGI-S score was 3.8 and a significant negative correlation (r=0.26) was shown with “awareness of mental disorder”. Thirty-five percent of subjects were K-MDQ positive (cutoff point=7 or more). Among the SUMD-K, “awareness of effect of medication” showed a significant negative correlation (r=−0.33) with the total K-MDQ score, but not with the total BPRS score. The negative correlation was more obvious in participants with negative K-MDQ (total K-MDQ score 6 or less, r=−0.31).CONCLUSION: A possible relationship was observed between these manic symptoms and patient insight. Identification of manic symptoms in schizophrenia would be considerable in a clinical setting.

Dimensional Analyses of the Yale-Brown Obsessive-Compulsive Scale and Yale-Brown Obsessive-Compulsive Scale Checklist / 대한정신약물학회지

OBJECTIVE: Although obsessive-compulsive disorder (OCD) has long been a unitary diagnosis, there is much recent interest in its potential heterogeneity, as manifested by symptom subgroups. Although the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) is a widely used instrument to assess obsessive-compulsive symptomatology, the variables reflecting the pathogenesis of OCD and Y-BOCS subscores usually were not significantly associated. The aims of this study are to clarify identification of dimensional structure of the symptoms from YBOCS checklist and to explore the factor structure of the Y-BOCS. METHODS: Ninety five OCD patients participated in this study and performed the Y-BOCS and Y-BOCS checklist. The 13 main symptom categories from Y-BOCS checklist and 10 items from Y-BOCS were factor analyzed by using principal components analysis, respectively. RESULTS: Using principal component analysis, we derived 4 factors from 13 main contents of YBOCS checklist. Four factors-hoarding/repeating, contamination/cleaning, aggressive/sexual, and religious/somatic- accounted for more than 60% of the variance. And we derived 3 factors from 10 items of Y-BOCS and these 3 factors-severity of obsession, severity of compulsion, and resistance to symptoms-accounted for more than 70% of variance. CONCLUSIONS: The four symptom dimensions from Y-BOCS checklist and three symptom dimensions from Y-BOCS were identified as significant factors accounting for the variance. These factors may be of value in future genetic, neurobiological, and treatment response studies.