Test–Retest Reliability of Attention Network Test Scores in Schizophrenia / 정신신체의학

OBJECTIVES: Although the Attention Network Test(ANT) has been widely used to assess selective attention including alerting, orienting, and conflict processing, data on its test-retest reliability are lacking for clinical population. The objective of the current study was to investigate test-retest reliability of the ANT in healthy controls and patients with schizophrenia. METHODS: Fourteen patients with schizophrenia and 23 healthy controls participated in the study. They are tested with ANT twice with 1 week interval. Test–retest reliability was analyzed with Pearson and Intra-class correlations. RESULTS: Patients with schizophrenia showed high test–retest correlations for mean reaction time, orienting effect, and conflict effect. Also, they showed moderate to high test-retest correlations for mean accuracy and moderate test-retest correlations for alerting effect and conflict error rate. On the other hand, healthy controls revealed high test–retest correlations for mean reaction time and moderate to high test-retest correlations for conflict error rate. In addition, they revealed moderate test-retest correlations for alert effect, orienting effect, and conflict effect. CONCLUSIONS: The mean reaction time, alerting effect, orienting effect, conflict effect, and conflict error rate of ANT showed acceptable test–retest reliabilities in healthy controls as well as patient with schizophrenia. Therefore, the analyses of these reliable measures of ANT are recommended for case-control studies in patients with schizophrenia.

Current State of Vocational Rehabilitation Program for Individuals with Disabling Mental Illness in Korea / 정신신체의학

OBJECTIVES: There has been long lasting trend of deinstitutionalization and public health centered care in management of individuals with disabling mental illness. We aimed to investigate current vocational rehabilitation state and effectiveness of system in korea. METHODS: We carried basic survey via telephone and e-mail beforehand to figure out how many and which institutions are operating vocational rehabilitation programs to psychiatric patients. A questionnaire packages were sent to total of 108 institutions in Korea which were operating occupation rehabilitation program. RESULTS: Of 108 institutions, 40.74% were returned with answers. The person in charge of vocational rehabilitation at each institution was mainly mental health social worker(48.8%), and the budget under \1,000,000 was the majority(61.5%) among surveyed institutions. The most commonly used vocational rehabilitation programs was case management(23.1%), followed by psychosocial rehabilitation program(21.2%), and on-the-job training(17.9%). The most effective program was case management(27.4%), followed by psychosocial rehabilitation program(19.8%), on-the-job training(17.9%). The main barrier of occupation rehabilitation to be conducted widely was ‘worries about being excluded from beneficiary of National Basic livelihood Protection Act’. CONCLUSIONS: Our results suggest that, in spite of high demand in vocational rehabilitation programs, government financial support is still lacking.

Clinical Features of Distal Anterior Cerebral Artery Aneurysms Based on 26 Consecutive Cases / 대한뇌혈관외과학회지

OBJECTIVE: Distal anterior cerebral artery (DACA) aneurysms are relatively uncommon, and operative management is usually difficult because of narrow operative fields, deep exposure, interhemispheric adhesions, and problems in achieving proximal vessel control. We present our experience with 26 DACA aneurysm cases and analyze the clinical features and surgical outcomes retrospectively. METHODS: From 1998 to 2008, surgical clipping of DACA aneurysms was carried out in 26 patients among a total of 504 patients with intracranial aneurysms. In each case, the clinical and radiological features were carefully reviewed through angiograms, medical records, and intraoperative findings. RESULTS: The most common location of DACA aneurysms was the junction of the pericallosal and callosomarginal arteries: 23 occurred at pericallosal-callosomarginal (PC-CM) junctions while three occurred in the pericallosal-frontopolar (PC-FP) region. Multiple aneurysms were found in 15 cases (58%), and associated vascular anomalies were noted in three cases (12%). Eleven (64.7%) of the 17 ruptured aneurysms and seven (77.8%) of the nine unruptured aneurysms were smaller than 7 mm; only two aneurysms (7.7%) were larger than 10 mm. Seven cases (26.9%) underwent minor premature rupture with proximal artery control. CONCLUSION: Despite the small patient group, our data suggest that in general, DACA aneurysms tend to rupture at a smaller size than do intracranial aneurysms. Thus, unruptured DACA aneurysms require aggressive treatment, even when they are small.