Correlations between Anxious, Depressive Mood and Positive, Negative Symptoms in Chronic Schizophrenics: a Differential Relationship with the Presence of Akathisia / 신경정신의학

OBJECTIVES: In previous studies, the significant correlations between depression-anxiety symptoms and positive symptoms had been reported in schizophrenia. However, it is suggested that these correlations reflect the common influence of third variable, and akathisia-associated dysphoria may be the strong mediator of these relationships. The aim of this study is to investigate the correlations between depression-anxiety symptoms and the schizophrenic symptoms including direct measures of drug-induced akathisia. METHODS: The subjects were 57 patients with chronic schizophrenia. All patients were functioning cognitively at a level to understand and complete the several self-report inventories. Akathisia was rated using Barnes akathisia rating scale (BARS), and depression-anxiety symptoms were assessed by two self-report measures, Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). The symptoms of schizophrenia were assessed using Manchester Scale. RESULTS: In the whole group of subjects, the scores on BDI and dysphoria composite index were significantly correlated with total positive symptom scores and all subscale scores of positive symptoms. In akathisia group, the scores on BDI and dysphoria composite index were still significantly correlated with total positive symptom scores and the subscale scores of delusion. In non-akathisia group, however, there were no significant correlations between self-report depression, anxiety symptoms and total positive symptom scores. CONCLUSION: These results suggest that the akathisia is the important factor in correlations between dysphoric symptoms and positive symptoms. Therefore, the caution is necessary in the interpretation of previous studies which report the direct correlations between depression and positive symptoms. Future research is needed to investigate the associations in akathisia, depression, and the schizophrenic symptom complexes.

Obsessive-compulsive Disorder in a Patient with 47,XXX, Triple X Syndrome / 신경정신의학

Triple X syndrome is a relatively rare sex chromosomal anomaly, and its association with psychopathology is not well understood. The authors report one case of obsessive-compulsive disorder(OCD)with karyotype-confirmed triple X syndrome, 47,XXX. She had incomplete sexual development, seconddary amenorrhea and multiple obsessive-compulsive symptoms. Magnetic resonance imaging of the brain revealed left occipital white matter hyperintensity lesion. The patient's multiple obsessive-compulsive symptoms were responded partially with fluoxetine and adjunctive buspirone treatment, however, her overall psychological functions were much improved. With the literature reviews, the authors suggest the possibility that a certain type of sex chromosome aneuploidy might be susceptible to obsessive-compulsive spectrum disorders(OCSDs)or OCD.

A Survey on the Long-term Hospitalized, Chronically Mentally-ill Patients in Mental Health Facilities / 신경정신의학

OBJECTIVES: In an attempt to identify the demographic characteristics and the factors influencing long-term hospitalization of chronically mentally-ill patients, a survey on the chronically mentally-ill patients who had been staying longer than 1 year in mental health facilities was conducted. METHODS: Checklist including some demographic data that were regarded as independent variables was applied to 3,477 subjects through administration system of Pusan Metropolitan City. Statistical analyse were done using distribution-free, non-parametric tests. RESULTS: 1)Subjects who had been staying longer than 1 year were 70.7% of the total inpatients of mental health facilities, and median duration of their hospitalization was 5.5 years. 2)In mental hospitals and asylums, the ratio of chronically mentally-ill subjects to the total inpatients in each facilitiy was 46.3% and 95.1%, respectively. 3)All of the 10 independent variables had an influence on the hospitalization duration. CONCLUSIONS: These results indicated that many indirect, extramedical factors had an influence the long-term hospitalization of chronically mentally-ill patients, and it is likely to reflect the underdevelopment of mental health services in Korea.

A Comparative Study on the Characteristics of Demographic Data, Clinical Features, and Personality in Hospitalized Male and Female Alcoholics / 신경정신의학

OBJECTIVE: This study was designed to compare the characteristics of demographic data, clinical features, and personality in male and female alcoholics and to identify the clinically meaningful differences in the etiologies and the clinical features between the two groups. METHODS: The study group was composed of 30 males and 21 females who were recruited into the inpatient treatment. The researchers used self-reporting questionnaire composed of demographic data and drinking patterns, Michigan alcoholism screening test(MAST), self-rating anxiety scale(SAS) and self-rating depression scale(SDS) of Zung, Minnesota Multiphasic Personality Inventory(MMPI), symptom Checklist-90-revision(SCL-90-R), and Eysenck personality questionnaire(EPQ) . The differences between the two groups were tested by chi-square test and independent-samples t-test. RESULTS: 1) Education level of female alcoholics was significantly less than that of male alcoholics(p<0.05) and the birth order of female alcoholics was significantly higher than that of male alcoholics(p<0.05). 2) The level of socioeconomic status of female alcoholics was significantly lower than that of male alcoholics(p<0.01). 3) The initial motivations of female alcoholics were mainly due to social, psychological, and intrafamilial problems while those of male alcoholics were due to social problems. There were significant differences between the two groups(p<0.05). 4) The onset of initial drinking in female alcoholics was significantly earlier than that of male alcoholics(p<0.001). 5) The average amount of daily drinking in female alcoholics was significantly less than that of male alcoholics(p<0.01). 6) Withdrawal symptoms, physical disorders, and social or legal problems induced by alcohol drinking in female alcoholics were significantly less than those of male alcoholics(p<0.05) 7) The mean scores of PY scale of SCL90R and of L scale of EPQ in female alcoholics were significantly higher than those of male alcoholics(p<0.05). CONCLUSION: Demographic and psychosocial factors differed to a significant degree between male and female alcoholism. We suggest that these factors are more important in female alcoholism than in male one in the etiologies and the clinical features. These differences are due to more complex factors rather than simple ones, thus the further evaluations are needed to elucidate the differences in the etiologies between male and female alcoholism.