The Bodily Panic Symptoms and Predisposing Stressors in Korean Patients with Panic Disorder / 신경정신의학

OBJECTIVES@#The purpose of this study was to investigate the distinctive features of bodily panic symptoms and the predisposing conditions in Korean patients with panic disorder.@*METHODS@#This was a retrospective chart review study and the data were collected from twelve university-affiliated hospitals in Korea. The patients selected met the diagnostic criteria for panic disorder, were older than 20 years of age, and had initially visited a psychiatry department. The assessments included the chief complaints related to bodily panic symptoms, recent stressors, recent history of alcohol and sleep problems, and time to visit an outpatient clinic.@*RESULTS@#A total of 814 participants were included in the study. The most commonly experienced symptoms were cardiovascular and respiratory symptoms, which were observed in 63.9% and 55.4% of participants, respectively. Just before the onset of a panic attack, 25.6% of participants experienced sleep-related problems. Episodic binge drinking was also frequently observed (13.2%) and was more prevalent in men than in women (22.6% vs. 4.9%, p<0.001). About 75% of participants experienced stressful life events just before panic onset. Work-related issues were more prevalent in men than in women (22.0% vs. 13.4%, p=0.001). Family-related issues (4.8% vs. 14.1%, p<0.001) and conflict with a spouse or partner (4.0% vs.11.7%, p<0.001) were more prominent in women than in men.@*CONCLUSION@#Our results suggest that cardiovascular symptoms are the most common bodily panic symptoms in Korean patients. Our results suggest that a substantial portion of the Korean patients experienced stressful life events, sleep problems, and/or episodic binge drinking just before the onset of panic disorder.

Korean guidelines for the treatment of panic disorder

The Korean Association of Anxiety Disorders developed a Korean guideline for the treatment of panic disorders in 2018 to help clinicians make treatment decisions. This study investigated the consensus about treatment strategies for initial and maintenance treatment, non-responsive cases, comorbid conditions, and psychotherapy in patients with panic disorder. The executive committee developed questionnaires about treatment strategies for patients with panic disorder based on guidelines, algorithms, and clinical trials previously published in foreign countries and Korea. Seventy-two 61% of 112 experts on a committee reviewing panic disorders responded to the questionnaires. We classified the consensus of expert opinions into 3 categories (first-line, second-line, and third-line treatment strategies) and identified the treatment of choice according using the chi-square test and 95% confidence intervals. This study presents useful information about the consensus among Korean experts regarding pharmacotherapy and cognitive behavior therapy for patients with panic disorder.

Korean guidelines for the treatment of panic disorder

The Korean Association of Anxiety Disorders developed a Korean guideline for the treatment of panic disorders in 2018 to help clinicians make treatment decisions. This study investigated the consensus about treatment strategies for initial and maintenance treatment, non-responsive cases, comorbid conditions, and psychotherapy in patients with panic disorder. The executive committee developed questionnaires about treatment strategies for patients with panic disorder based on guidelines, algorithms, and clinical trials previously published in foreign countries and Korea. Seventy-two 61% of 112 experts on a committee reviewing panic disorders responded to the questionnaires. We classified the consensus of expert opinions into 3 categories (first-line, second-line, and third-line treatment strategies) and identified the treatment of choice according using the chi-square test and 95% confidence intervals. This study presents useful information about the consensus among Korean experts regarding pharmacotherapy and cognitive behavior therapy for patients with panic disorder.

Changes in the Metabolic Parameters and Positive and Negative Syndrome Scale (PANSS) Scores of Patients with Schizophrenia 8 Weeks after Switching to Paliperidone

OBJECTIVES: The purpose of this study was to examine the changes in metabolic parameters and Positive and Negative Syndrome Scale (PANSS) scores of patients previously treated with atypical antipsychotic drugs other than paliperidone, after 8 weeks of treatment with paliperidone. METHODS: Changes in body weight, body mass index, leptin, lipid levels, fasting glucose, and PANSS scores of patients who switched from other atypical antipsychotic drugs to paliperidone were measured after 8 weeks of treatment with paliperidone. We compared these results with those of patients who had not been treated with antipsychotic drugs for at least 2 weeks prior to treatment with paliperidone (antipsychotic drug-free patients). RESULTS: The antipsychotic drug-free group (n = 9) did not show significant changes in metabolic parameters, but showed a significant improvement in total and subscale scores of PANSS. In the group that switched from other atypical antipsychotic drugs to paliperidone (n = 13), body weight, body mass index and fasting glucose level significantly increased, while total and subscale scores of PANSS significantly improved. CONCLUSIONS: Paliperidone treatment will benefit patients with schizophrenia who have been antipsychotic drug-free or who have had difficulty with other atypical antipsychotic drugs, with regard to their psychopathological state. However, if patients have been treated with other atypical antipsychotic drugs before switching to paliperidone, they could gain body weight or their fasting glucose level could increase over a short period because of a change in receptor number and sensitivity caused by the previously prescribed antipsychotic drugs, and hence, paliperidone should be prescribed with caution for these patients.

Use of the Terms "Schizophrenia" and "Schizophrenic" in the South Korean News Media: A Content Analysis of Newspapers and News Programs in the Last 10 Years

OBJECTIVE: In this study, we explored the meaning attributed to the words "jungshinbunyeolbyung" (schizophrenia) and "jungshinbunyeol" (schizophrenic) in South Korean newspapers and news programs in the last 10 years. METHODS: We screened the websites of three national newspapers and the broadcasts of three nationwide television news programs from January 1, 2001, to December 31, 2010. We classified a total of 490 articles and 257 news segments by category and quantitatively and qualitatively analyzed them. The articles and news segments were assigned to one of the following categories based on their use of the term "schizophrenia": 1) negative, 2) neutral or positive, 3) incidental, and 4) metaphorical. RESULTS: The negative viewpoint accounted for 349 incidences (46.7%), while the neutral and positive viewpoints included 225 incidences (30.1%). Incidental uses accounted for 95 incidences (12.7%), and metaphorical uses accounted for 78 incidences (10.4%). The majority of the negative uses focused on violence or dangers posed by patients (137 mentions, 37.8%), while the metaphorical uses mainly focused on the idea of splitting (51 mentions, or 65%). CONCLUSION: This study showed that the South Korean news media do not provide balanced information about schizophrenia to the public. This study also showed that no significant move has been made toward a more positive use of the term since a previous study was conducted on the subject. Although the term schizophrenia has given way to "attunement disorder," it will be difficult to establish the new term as the standard if the South Korean media continue to use the term "schizophrenic symptom." Even though the term has been changed, guidelines are necessary to encourage the mass media to provide balanced articles and reduce prejudice.