A Comparison of Drinking, Emotional Characteristics and Their Correlations between Patients with Alcohol Use Disorder with and without Criminal Record / 생물치료정신의학

Objectives@#：In this study, socio-demographic, drinking and emotional characteristics, and their correlations were compared among patients with alcohol use disorder (AUD) according to the presence or absence of any type of criminal record. @*Methods@#：Among patients admitted to the hospital with AUD, 27 with and 31 without criminal records were included. Socio-demographic data and drinking characteristics such as first drinking age, average daily alcohol consumption were collected. In addition, the severity of alcohol problems, the degree of change readiness for drinking alcohol, depressive symptoms, anxiety symptoms, and impulsivity were evaluated using scales and statistically analyzed. Pearson’s correlation test was applied to reveal the differences in correlation of the characteristics according to the presence or absence of criminal records. @*Results@#：The first drinking age was significantly earlier in the AUD group with criminal records. Interestingly, the degree of change readiness regarding alcohol problem as shown in SOCRATES-K was significantly higher in the AUD group with criminal records. Anxiety symptoms were statistically significantly higher in the AUD group with criminal records. In AUD with criminal records, first drinking age negatively correlated with the degree of change readiness. In AUD without criminal records, first drinking age correlated negatively with the severity of alcohol problem, and the degree of change readiness, and the degree of change readiness negatively with age, and the degree of change readiness positively with the severity of alcohol problem. In Both groups, anxiety symptoms positively correlated with depressive symptoms. @*Conclusions@#：This study showed that AUD patients with criminal record had a faster first drinking age and the higher degree of change readiness regarding alcohol problem. Significantly higher symptoms of anxiety were also presented in AUD patients with criminal record than AUD patients who have no criminal records. Some differences were identified in correlations among characteristics between the two groups.

Elderly Patient Trends in a Chronic Mental Hospital and Accompanying Medical Diseases

OBJECTIVE: It investigated the tendency of the increase of elderly patients in a psychiatric hospital. In this regard, it examined whether the number of patients with outpatient consultant, discharge, medical diseases, and neurocognitive disorder increased or not. METHODS: It retrospectively reviewed inpatient medical records for the years 2008, 2011, 2014, 2017. To investigate the changes of elderly patients admitted to psychiatry, it examined the changes of patients who are older than 50 or 60 years in addition to the people who are older than 65 years. It analyzed diagnosis, discharge, medical diseases, and outpatient consultant of the three groups respectively. RESULTS: It confirmed that the number of elderly patients who are older than 50, 60, and 65 years has increased in mental hospital for 10 years. There was a significant increase in the number of neurocognitive disorder patients, the ratio of consultant outpatient, and the mean number of outpatient consultant. Diabetes increased in all three groups. Especially it has significantly increased for patients who are older than 50 and 60 years. In the case of patients discharged due to transfer, the number of patients increased in all three groups but it was statistically significant for the patients who are older than 50 years. CONCLUSION: The study shows that the number of elderly patients increased with the trend of aging society. In relation to this, the rate of outpatient consultant and discharge, including diabetic and dementia patients, also increased. Therefore, if the mental health department provides a system to manage the elderly ward or nursing ward to respond to the increase of elderly patients, or to manage the accompanying chronic diseases such as diabetes and its complications, it could solve the inconvenience of patients due to the consultation outside a hospital or discharge.

Relationship between Metabolic Syndrome and Cognitive Functions in Patients with Chronic Schizophrenia / 정신신체의학

OBJECTIVES: The aim of this study was to investigate the relationship between metabolic syndrome and cognitive functions among chronic schizophrenia patients. METHODS: The survey participants were 105(40 metabolic syndrome and 65 non-metabolic syndrome) chronic schizophrenia patients at Yang-san Hospital. Each score of cognitive test(A Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet, stroop test), Positive and Negative Syndrome Scale, Hamilton rating scale for Depression were assessed. Statistical analysis of the relationship between various tests of A Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet and metabolic syndrome were performed using ANCOVA and logistic regression. RESULTS: Schizophrenia patients with lower score on construction praxia were likely to be included in Metabolic syndrome group. However, there were no significant relationships in other tests between the two groups. CONCLUSION: This study found metabolic syndrome caused cognitive decline in chronic schizophrenia patients, especially Construction praxia. This study could be a basis to show metabolic syndrome has to be treated appropriately in schizophrenia patients and suggests the necessity of following longitudinal designed study.

The Study on Reliability and Validity of Korean Alcohol Urge Questionnaire(AUQ-K) for Alcohol Dependence

OBJECTIVES: The Alcohol Urge Questionnaire(AUQ) has been used in alcohol dependence treatment and research. The goal of this study is to develop of the Korean Alcohol Urge Questionnaire(AUQ-K). METHODS: To examine the AUQ-K's psychometric properties, responses from 104 patients admitted in alcohol dependence treatment facility were investigated. RESULTS: The internal consistency of the 8-item AUQ-K, measured by coefficient alpha, was high(Cronbach's alpha =0.78). AUQ-K scores showed significant correlation when the retest interval was 1 day(p<0.01). The AUQ-K's validity was investigated using correlational analyses with two other craving scales[the Obsessive Compulsive Drinking Scale(OCDS) and the Visual Analogue Scale(VAS)]. The high correlations were obtained between total AUQ-K scores and total OCDS scores, and between total AUQ-K scores and the VAS scores(p<0.01, respectively). CONCLUSION: The AUQ-K is a reliable and valid short scale for measurement of self-reported alcohol craving. This scale may offer significant advantages over existing single-item measures of alcohol craving in the fields of alcohol dependence treatment and research.

A Study of the Reliability and Validity of the Korean Version of the Penn Alcohol Craving Scale for Alcohol-Dependent Patients

OBJECTIVE: The Penn Alcohol Craving Scale (PACS) is a stronger predictor of subsequent drinking and relapse of alcohol dependence that can be administered more quickly and easily than other craving scales. The goal of this study was to develop the Korean version of the Penn Alcohol Craving Scale (PACS-K). METHODS: To examine the psychometric properties of the PACS-K, responses were chosen from 80 patients admitted to a treatment facility for alcohol dependence. RESULTS: The PACS-K possesses good psychometric properties, as assessed by Cronbach's alpha estimates (Cronbach's alpha=0.91). The test-retest reliability of the PACS-K showed high correlation (p<0.01) when the retest interval was 1 day. When the validity of the PACS-K was investigated using correlation analysis with two other craving scales (the Obsessive Compulsive Drinking Scale (OCDS) and the Visual Analogue Scale (VAS), high correlations were obtained between total PACS scores and total OCDS scores, and between total PACS scores and VAS scores (p<0.01, respectively). CONCLUSION: The PACS-K is a reliable and valid measure of alcohol cravings, and it could be useful for predicting which individuals are at risk for subsequent relapse.

Reliability and Validity of the Korean Version of the Psychotic Symptom Rating Scale / 신경정신의학

OBJECTIVES: Psychotic Symptom Rating Scale (PSYRATS) is an assessment tool to measure the severity of different dimensions of auditory hallucinations and delusions. The reliability and validity of the Korean version of PSYRATS (K-PSYRATS) were examined in Korean patients with major psychosis. METHODS: The inter-rater reliability of the K-PSYRATS was determined from the videotaped interviews of the five schizophrenic patients. To measure validity and internal consistency reliability, the 109 patients with auditory hallucinations or delusions were assessed using the K-PSYRATS, Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression-Severity (CGI-S) scale. RESULTS: K-PSYRATS was found to have excellent inter-rater reliability (intra-class correlation coefficient of auditory hallucination= 0.81, p<.001, intra-class correlation coefficient of delusion=0.97, p<.001) and internal consistency reliability (Cronbach's alpha of auditory hallucination=0.77, Cronbach's alpha of delusion=0.76). Significant correlation was found between K-PSYRATS and positive syndrome subscale of PANSS and CGI. CONCLUSION: K-PSYRATS is a useful assessment instrument for psychotic symptoms in Korea.

Differences of Glucose and Lipid Metabolism among the Type of Antipsychotic Drugs in Schizophrenia Patients with Long-Term Use of Antipsychotic Drugs / 대한정신약물학회지

OBJECTIVE: The development of metabolic disorders including diabetes mellitus and hyperlipidemia has been reported among schizophrenia patients treated with atypical antipsychotic drugs. The role of antipsychotic drugs in the development of this condition has not been proven yet. This study was conducted to investigate whether antipsychotic drugs that often induce weight gain influence glucose and lipid metabolism including insulin resistance and serum leptin level. METHODS: The study population consisted of 63 patients (all meeting DSM-IV criteria for schizophrenia), who were divided into 3 treatment groups: haloperidol (N=21), risperidone (N=21), and olanzapine (N=21) monotherapy, and 31 healthy control subjects. Fasting blood samples for glucose, insulin, leptin and lipids were analysed. In addition, insulin resistance (IR) was calculated through the homeostatic model assessment (HOMA) and body mass index (BMI) was also calculated. RESULTS: In patients receiving olanzapine, significant increases in BMI (p<0.01) and lipid profiles including LDL-cholesterol (p<0.05), triglyceride (p<0.01) and leptin levels (p<0.001) were found in comparison with the normal control group. A significantly higher degree of IR, as measured with the HOMA index, was found in patients receiving olanzapine than in patients receiving haloperidol (p<0.01) and risperidone (p<0.05), and in the normal control group (p<0.01). After removal of the impacts of BMI on the degree of HOMA-IR and serum leptin levels, the degree of HOMA-IR (p<0.05) and serum leptin levels (p<0.001) was also higher in patients receiving olanzapine than in the normal control group. CONCLUSION: The results of this study suggest that olanzapine has more significant influence on metabolic complications than haloperidol and risperidone and the characteristics of antipsychotic drug per se may be involved in the development of metabolic complication as well as weight change.

Association Study of Functional micro Opioid Receptor Genotypes with Korean Female Alcoholics / 대한정신약물학회지

OBJECTIVES: Previous studies have shown that the endogenous opioid system, which plays an important role in drinking behavior, might be related to the genetic etiology of alcohol dependence. And a recent study reported that the affinity of micro opioid receptor, which is closely related to the endogenous opioid system activity, is affected by the genotype of micro opioid receptor gene (OPRM1) A118G. To investigate the gender difference in genetic etiology of alcohol dependence, this study examined the association of the genotype of OPRM1 A118G with female alcohol dependence in Koreans. METHODS: The author studied the genotype of OPRM1 A118G in 106 male and 35 female Korean with alcohol dependence and 80 male and 60 female healthy Koreans as control. RESULTS: 1) A statistically significant increase in A/G or G/G (G+) genotype of OPRM1 A118G was observed in women with alcohol dependence compared to the controls. 2) Among men with alcohol dependence, no significant difference in OPRM1 A118G polymorphism was observed relative to the age at which drinking started, age of onset of alcohol-related problems, age of first admission to psychiatric hospital for alcohol-related problems, drinking days per month, drinks per drinking day, family history of alcohol dependence in the first-degree relatives or history of severe alcohol withdrawal symptoms. But the drinking days per month is significantly less in those who have A/G or G/G genotypes of OPRM1 A118G. CONCLUSION: These results suggest that G+ genotypes of micro opioid receptor gene A118G are important genetic factors in the etiology of female alcohol dependence.

The Effects of Olanzapine Medication on Cognition in Patients with Schizophrenia / 신경정신의학

OBJECTIVES: The purpose of this study is to examine differences of treatment responses and cognitive functions between typical antipsychotics and Olanzapine in schizophreniac inpatients. METHODS: Ninety-nine patients with schizophrenia treated by Olanzapine (n=56) or typical antipsychotics (n=43) by their attending were included in this study. Prior to entering the study, all subjects did not take any antipsychotics for at least 4 weeks. Cognitive and psychopathological evaluations were carried out on three times: prior to drug assignment immediately after admission (baseline), 3 months and 6 months after starting medications. Cognitive assessments were blinded to medication and psychopathological status. Cognitive functions were examined for sustained attention, sensory register, executive function, concentration and attention, and verbal memory and learning using Degraded Stimulus Continuous Performance Test, Span Apprehension Task, Wisconsin Card Sorting Test, Digit Span, and Rey Auditory Verbal Learning Test. RESULTS: The Olanzapine group presented a significantly greater improvement in the perseverative response, perseverative errors, number of completed categories of Wisconsin Card Sorting Test, forward Digit Span, immediate recall of Rey Auditory Verbal Learning Test, and positive and negative symptomatology than the typical antipsychotic group in the repeated-measures of ANCOVA among baseline, 3 month and 6 month assessments. These cognitive differences remained statistically significant after covarying out changes in symptomatology except forward Digit Span, which was affected by positive symptom in 3 month assessments. CONCLUSION: These data suggest that Olanzapine is associated with significantly greater symptomatic improvement and less cognitive than typical antipsychotics, and its benefits continued after 3 and 6 months of treatment in patients with schizophrenia.

Association of Functional microOpioid Receptor Genotypes with Alcohol Dependence in Koreans / 신경정신의학

OBJECTIVES: Previous studies have shown that the endogenous opioid system, which plays an important role in drinking behavior, might be related to the genetic etiology of alcohol dependence. And a recent study reported that the affinity of micro opioid receptor, which is closely related to the endogenous opioid system activity, is affected by the genotype of micro opioid receptor gene (OPRM1) A118G. The present study examined the association of the genotype of OPRM1 A118G with alcohol dependence in Koreans. METHODS: The author studied the genotype of OPRM1 A118G in 112 Korean patients with alcohol dependence and 140 healthy Korean control subjects. RESULTS: 1) A statistically significant increase in A/G or G/G genotype of OPRM1 A118G was observed in patients with alcohol dependence (67.0%) compared to the controls (51.4%). 2) Among patients with alcohol dependence, no significant difference in OPRM1 A118G polymorphism was observed relative to the age at which drinking started, the age of onset of alcohol-related problems, the age of first admission to psychiatric hospital for alcohol-related problems, the family history of alcohol dependence in the first-degree relatives or of severe alcohol withdrawal symptoms. But the frequency of A/G or G/G genotypes of OPRM1 A118G was significantly higher in those who drank 17 days or more per month in the previous year (80.8%) than in those with fewer days of drinking (56.5%). CONCLUSION: These results suggest that A/G or G/G genotypes of micro opioid receptor gene A118G are important genetic factors in the etiology of alcohol dependence.

Relations among Social Functioning, Psychopathology and Attentional Deficits in Schizophrenic Outpatients / 신경정신의학

In order to study the relations between attentional deficits and social functioning of the schizophrenia, 83 stable outpatients with DSM-IV schizophrenia and matched 60 normal controls were examined for their sustained attention, sensory register, and social functioning by means of Continuous performance test(CPT), Span apprehension task(SPAN), and Korean version of Social Adjustment Scale II-Revised Version(KSAS II-RV) respectively. Psychopathology was assessed using the Positive and Negative Syndrome Scale(PANSS). The results were as follows. 1) Schizophrenic patients showed a significant deficit in the sustained attention and sensory register as manifested in the data of CPT and SPAN, compared with the matched normal controls. Schizohrenic patients also showed a significantly poor social functioning in measure of KSAS II-RV compared with the matched normal controls. 2) There was no correlation between three type of symptoms(positive/negative/general) and total scores of social functioning. But negative symptoms was correlated with the social leisure subarea of KSAS II-RV. 3) CPT was correlated with total scores of social functioning including the instrumental role and friend relation subareas of KSAS II-RV, whereas SPAN was only correlated with the instrumental role subarea of social functioning. 4) In the relations between attention and symptoms, CPT was correlated with negative symptoms. These results suggest that the deficit of the sustained attention may be a predictive factor of social functioning in the schizophrenic outpatients.

Family Burden of Schizophrenics in the Primary Caregivers and Siblings / 신경정신의학

In order to investigate the factors associated with family burdens of schizophrenics, 92 primary caregivers and 68 siblings of 92 persons with schizophrenia were examined by means of self-report scales about the effect of positive and negative symptom behaviors, clinical and sociodemographic variables, and guilty feelings toward patient on the objective and subjective burden. The results were as follows. 1) There was no difference in the objective and subjective burden scores between the primary caregivers and siblings, even though the former showed a higher scores compared to the latter. 2) Burden scores were significantly affected by the factors such as age of patients, duration of illness, total duration of hospitalizations, monthly family income, and the experience of family education in the primary caregivers or siblings of schizophrenics. 3) Objective and subjective burden were related to both the severity of positive, negative, and the other symptom behaviors in the primary caregivers and siblings. The positive and negative symptom behaviors were more related to subjective burdens compared to objective burdens in the primary caregivers and siblings. The positive symptom behaviors were more related to perceived objective and subjective burdens compared to negative symptom behaviors in the siblings. 4) The correlations between guilty feelings toward patient and burden scores was significant only in the primary caregivers. These results could be used as useful datas to develop the more effective family intervention for reducing family burden.

Development of the Korean Version of the Social Adjustment Scale in the Schizophrenics: A Study on the Reliability and Validity / 신경정신의학

OBJECTIVES: The purpose of this study was to develop the Korean version of the Social Adjustment Scale II-Revised Version (KSAS II-RV) in the schizophrenics. METHODS: KSAS II-RV was administered to 67 schizophrenic patients and 78 matched normal controls for examining the reliability and validity. RESULTS: Data analysis showed statistically significant reliabilities and validities of KSAS II-RV. The test-retest reliability, inter-rater reliability, and internal consistency for total scores of KSAS II-RV were 0.85, 0.89. and 0.87, respectively. Evidence for discriminant validity of KSAS II-RV comes from the results that the mean scores of schizophrenic patients were significantly high than those of normal controls. Construct validity was assessed by calculating the 10 inter-subareas correlations of the KSAS II-RV, and all except the sexual adjustment area were statistically significant. Significant correlations between the global area scores of KSAS II-RV and those of Global Assessment of Functioning Scale lend support for the concurrent validity of this instrument indirectly. CONCLUSION: KSAS II-RV was found to be a valid and reliable instrument which can be used to evaluate the degree of social adjustment in the schizophrenic patients.

Performance of Wisconsin Card Sorting Test in the Offspring of Schizophrenic Patients / 신경정신의학

In order to evaluate whether Wisconsin Card Sorting Test(WCST) could be used to detect the vulnerability markers of schizophrenia, three groups such as offsprings of schizophrenic patients(n=28), offsprings of alcoholic patients(n=18), and offsprings of psychiatrically normal persons(n=41) were examined for their concept formation and abstract thinking by means of WCST.The results were as follows; 1) No significant differences were noted in all variables of the WCST such as number of totol administered trials, total correct response %,total error response $,perseverative response %,perseverative error response %,nonperseverative error response %,conceptual level response %,number of completed category,number of trials to complete 1st category,number of failure to maintain a set,and learning to learn among three groups. 2) There was no difference in the number of cases with extreme low WCST total correct % of lower 10% of the normal controls among three groups. These results suggest that Wcst could be an ineffective instrument for using to detect the vulnerability markers of schizophrenia.

Effects of Psychiatric Rehabilitation on the Number of Relapse, Number of Admission, Days of Hospitalization, and Direct Treatment Costs of Schizophrenic Patients: Two-Year Follow-up Study / 신경정신의학

OBJECTIVE: We evaluated the clinical efficacy of a comprehensive psychiatric rebabiliation of schizophrenia, including family psychoeducation,patient education,socail skills tranining,group psychotherapy,art therapy,and ocupational therapy. METHOD: From September 1993 to february 1995,173 chronic schizophrenics who met DSM-lV criteria and were discharged from a locked ward were assigned into the psychiatric rehabilitation service group(psychiatric rehabilitation group,n=46) or the customary out patient service group(out-patient group,n=127)prospectively,but not randomly. Assignment was based on preferences of patients and their relatives. Each subject included in the psychiatric rehabilitation group received twice weekly patient education,social skills training, family psychoeducation, group psychotherapy, art therapy, occupational therapy and maintenance chemotherapy during a 6-month period. Those in the out-patient group received individual supportive psychotherapy and maintenance chemotherapy according to their clinical needs for 10-20 minutes once per week. After entry into the study,all subjects were assessed for the number of readmission,days of hospitalization,and the direct treatment costs through the first and second year of follow-ups. These outcome variables were also compared pre-and post-2 years at the time point of entry into the study. Aftercare chemotherapy on a weekly to monthly basis continued for the remailder of the two year follow-up period. RESULTS: With regard to the mean number of hospital admissions per vear,the mean days of hospitalization per year, and the direct treatment costs per year, psychiatric rehabilitation broup had significantly decreased all clinical outcomes 2 years after compared with before receiving psychiatric rehabilitation. But there were no significant differences in the all clinical outcomes between between before and after study intake in the out-patient group. For the number of relapse regardless of drug compliance, 4 patients(9%) during first year and 14 patients(30%) during second year were relapsed in the 46 subjects of the psychiatric rehabiliation group. In contrast, 75 patients(59%) during first year and 90 patients(71%) during second year relapsed in the out-patient group. When considering the effect of drug noncompliance to relapse,4(9%) and 14 patients(30%) were relapsed while on medication respectively during the first and second year in the 46 of the psychiatric rehabilitation group, vs. 27(34%) of 79 patients on medication during the first year and 31(46%) of 68 patients on medication during the second year were relapsed in the out-patient group. CONCLUSIONS: These results indicate that the comprehensive psychiatric rehabiliation can be useful therapeutic intervention both to improve the clinical outcomes of schizophrenic patients and to reduce the economical burden of their relatives.

Disturbances of Attention in the Offspring of Schizophrenic Parents / 신경정신의학

In order to study the possible vulnerability in the markers of schizophrenia, offsprings of the schizophrenic parents(n=28), offsprings of the alcohol dependent parents(n=18), and offsprings of the psychiatrically normal persons(n=41) were examined for their sustained attention and sensory register by means of Continuous performance test(CPT) and Span apprehension task(SPAN) respectively. The results were as follows: 1) The offsprings of the schizophrenic parents showed a significant deficit in the sustained attention as manifested in the data of CPT by significantly lower hit rate and sensitivity, compared with the offspring of the alcohol dependent parents and those of the psychiatrically normal persons. No difference was evident in the false alarm rate and response bias among three groups. There was no difference in all variables of the CPT between the offsprings of the alcohol dependent parents and those of the psychiatrically normal persons. 2) The deficit in the sustained attention as revealed by lower hit rate and sensitivity was not apparent in the first part of the CPT. However it emerged and aggravated itself as the test continued in the offsprings of the schizophrenic parents only. 3) Proportion of subjects falling in the extreme low sensitivity of lower 10% of the normal controls was significantly higher in the offsprings of the schizophrenic parent group as compared with the offsprings of the alcohol dependent parents and those of the psychiatrically normal persons with a rate of 29%, 17%, and 10% respectively. 4) No significant difference was noted in all variables of MMPI among normal controls, index group, and the extreme low CPT sensitivity subgroup of index group. 5) The offsprings of the schizophrenic parents showed a significantly delayed response in the time to correct and incorrect response in SPAN compared to offsprings of the alcohol dependent parents and those of the psychiatrically normal persons. No difference was evident in the number of correct response, number of incorrect response, and number of no response among three groups. There was no difference in all variables of the SPAN between the offsprings of the alcohol dependent parents and those of the psychiatrically normal persons. These results suggest that a subgroup of the offsprings of schizophrenic parents may suffer from the deficit in the sustained attention which may be a vulnerability marker of schizophrenia.

The Validity and Reliability of Addiction Severity Index in Alcoholic Patients / 신경정신의학

OBJECTIVE: The purpose of this study was to evaluate the validity and reliability of Korean version of Addiction Severity Index for the systematic diagnosis and evaluation of alcoholism. METHODS: The authors selected 65 alcoholic patients with the criteria of DSM-VI. RESULTS: The results were as follows: 1) The exception of the significant correlation between psychiatric and the family/social problem area, the 6 sections of ASI were mutually independent. 2) There was significant inter-rater reliability in all sections of ASI. 3) In medical, alcohol use, family/social and psychiatry section, the calculation of composite score showed reasonable level of item consistency. In all sections, there was significant correlation between composite scores and severity ratings of corresponding section. 4) The important items of each section were most highly correlated with their corresponding severity ratings except two sections. 5) In the multiple regression analysis, the amount of variance accounted far by the most important 4 items were 83% in medical section, 45% in employment/support,43% in alcohol use section, 55% in legal section,53% in family/social section and 84% in psychiatric section. 6) Severity rating of psychiatric section was significantly correlated with the scores of MMFI, MAST and SCL-90-R. CONCLUSION: The result suggests that Korean version of the ASI showed relatively reasonable reliability and validity and it can be used in treatment and study of alcoholic patients.

Effect of 5-HT2c Receptor Modulation on the m-Chlorophenlpiperazine-Induced Hypoactivity / 대한정신약물학회지

It was aimed to investigate the effect of 5-HT2C receptor modulation on the rat behavioral responses induced by 1-(m-chlorophenyl) piperazine(mCPP), a major metabolite of trazodone. The animal activities(ambulation, stereotypy and total activity) were measured for 3 hours following mCPP administration, using an animal activity meter which accumulates the frequency of light beam interruption. mCPP(1-10 mg / kg, i.p.) induced dose-dependent decreases in ambulation and stereotypy, consequently leading to hypoactivity. The hypoactivity induced by mCPP(1mg / kg, i.p.) was significantly inhibited by pretreatment with mianserin(1mg / kg, i.p.), an antagonist with high affinity for 5-HT2C receptor, whereas pretreatment with 5-HT2 antagonists, ketanserin and ritanserin(1mg / kg, i.p., respectively) was without effect. Furthermore, long-term pretreatment with imipramine(10mg / kg, i.p., b.i.d. for 2 weeks) markedly attenuated the mCPP-induced hypoactivity. Mianserin and imipramine in the absence of mCPP did not increase the animal activity. Taken together, these results indicate that the mCPP-induced hypoactivity is mediated by 5-HT2C receptor, and that selective 5-HT2C antagonists and down regulation of 5-HT2C receptor might be useful for inhibiting the mCPP-induced hypoactivity.

One Case Report of Creutzfeldt-Jakob Disease

The original article was reported by Creutzfeld in 1920, and Jakob in 1921 respectively. CJD is an encephalopathy with worldwide distribution caused by an unidentified unconventional virus. The principal clinical features of CJD are dementia, upper and in some instances, lower motor neuron disorders; basal ganglionic and cerebellar dysfunction; and myoclonus including a heightened startle reaction. The disease is rapidly progressive, leading in several months to stupor, coma, and death. Pathologic changes are widespread, involving the cerebral cortex, basal ganglia, cerebellum, pyramidal tracts, and lower motor neruons of the brain stem and/or spinal cord. This case was 51 years old Korean male, who presented progressive dementia, myoclonus, heightened startle reaction, pyramidal, extrapyramidal symptoms, decerebrated rigidity, and died about 4 months after onset. We diagnosed this case as CJD with typical serial EEG pattern and clinical feature.