Opinions on the Recovery of Outpatients with Schizophrenia and Their Wills to Recover / 대한정신분열병학회지

Objectives@#To examine the opinions regarding recovery and assess their will to recover in outpatients with schizophrenia. @*Methods@#Total 98 stable outpatients with schizophrenia were enrolled. To investigate the outpatients’ opinions regarding recovery, we asked the subjects to write down the ways they could think they had recovered from their current disease. We classified their answers and chose final 39 statements. Using this questionnaire, they were asked to what extent they agreed with each statement. Moreover, the Recovery Assessment Scale (RAS) was used to measure the subjects’ will to recover. @*Results@#Many of the 39 subjects who were surveyed about their opinions on recovery agreed on 11 statements about taking medicine, social life, daily life, social functioning, positivity about life (happiness, hope, confidence, and tranquility), symptoms, occupation, and self-control. The RAS score showed a significant correlation with age (r=-0.26, p<0.01), age at onset (r=0.26, p<0.01), duration of illness (r=-0.52, p<0.01), and number of hospitalization (r=-0.46, p<0.01). @*Conclusion@#This study shows that positivity about life is an important part of the patients’ subjective recovery criteria in schizophrenia. Therefore, if clinicians pay more attention to this part of subjective recovery, it would strengthen the patients’ will for recovery.

Opinions on the Recovery of Outpatients with Schizophrenia and Their Wills to Recover / 대한정신분열병학회지

Objectives@#To examine the opinions regarding recovery and assess their will to recover in outpatients with schizophrenia. @*Methods@#Total 98 stable outpatients with schizophrenia were enrolled. To investigate the outpatients’ opinions regarding recovery, we asked the subjects to write down the ways they could think they had recovered from their current disease. We classified their answers and chose final 39 statements. Using this questionnaire, they were asked to what extent they agreed with each statement. Moreover, the Recovery Assessment Scale (RAS) was used to measure the subjects’ will to recover. @*Results@#Many of the 39 subjects who were surveyed about their opinions on recovery agreed on 11 statements about taking medicine, social life, daily life, social functioning, positivity about life (happiness, hope, confidence, and tranquility), symptoms, occupation, and self-control. The RAS score showed a significant correlation with age (r=-0.26, p<0.01), age at onset (r=0.26, p<0.01), duration of illness (r=-0.52, p<0.01), and number of hospitalization (r=-0.46, p<0.01). @*Conclusion@#This study shows that positivity about life is an important part of the patients’ subjective recovery criteria in schizophrenia. Therefore, if clinicians pay more attention to this part of subjective recovery, it would strengthen the patients’ will for recovery.

The Comparison of Clinical Variables Among Competitive Employment, Partial Employment, and Unemployment Group in Schizophrenic Outpatients / 신경정신의학

Objectives@#The purpose of this research was to examine differences between clinical variables among outpatients with schizophrenia in competitive and partial employed and unemployed groups. @*Methods@#The study subjects were 168 outpatients with schizophrenia, and these were divided into three groups, that is, competitive (n=20), partial (n=28), and unemployed (n=120) groups, based on employment status. Job and psychopathology data were collected by interview and using self-report questionnaires (self-stigma, will to recover, family attitude, perceived social support, insight into disease, self-esteem, hopelessness, and attitude to drugs). @*Results@#The proportion of male patients in the competitive employment group was greater than in the partial or unemployed groups. Education level was significantly higher, and the number of hospitalizations was significantly lower in the competitive group than in the unemployed group.Levels of self-stigma, will to recover, and perceived social support were significantly higher, and levels of self-esteem and hopelessness were significantly lower in the competitive and partial employment groups than in the unemployed group. Patients in these two groups also reported a more positive family attitude, more insight into the disease, and a more positive attitude toward drugs than patients in the unemployed group. @*Conclusion@#Most clinical variables were similar in the competitive and partial employment groups.The findings of this study suggest environmental and systematic factors are more important for the employment of outpatients with schizophrenia than disease-associated factors.

The Insight Paradox among Outpatients with Schizophrenia / 대한정신분열병학회지

OBJECTIVES: The primary objective was to test the phenomenon known as the insight paradox, which refers to the association between higher levels of insight and lower self-esteem, higher hopelessness, and a higher perception of social prejudice among patients with schizophrenia. METHODS: A total of 216 outpatients with schizophrenia according to the DSM-IV diagnostic criteria were recruited. All participants were receiving ongoing outpatient treatment and were in a stable phase of the disorder. The participants were divided into a good-insight (N=109) and a poor-insight (N=107) group by the direct interview and the mean score of questionnaire. The parameters used for analysis and comparison were demographic variables (age, gender, education), clinical variables (age at onset, number of hospitalizations), self-esteem, hopelessness, self-stigma, and quality of life. RESULTS: Compared with the poor-insight group, the good-insight group was found to have a lower number of hospitalizations, lower self-esteem, higher hopelessness, lower quality of life, and a higher level of internalized stigma. CONCLUSION: The insight can cause the negative consequences in patients with schizophrenia. Therefore, clinicians should pay attention to the negative aspects of insight for improving the quality of life in the treatment of patients with schizophrenia.

Factors Affecting the Empowerment Experienced by Outpatients with Schizophrenia / 대한정신분열병학회지

OBJECTIVES: To identify various factors that might affect the empowerment of outpatients with schizophrenia. METHODS: Of patients who had been receiving outpatient treatments at the department of psychiatry in Dong-A university hospital, 116 patients with a DSM-IV-TR diagnosis of stable schizophrenia were enrolled in this study. The empowerment, psychiatric symptoms, social functions, insight, family attitude, social support and self-esteem were assessed through an interview or self-report measures. Overall, multiple regression analyses were performed in consideration of 11 factors (age, sex, level of education, age of onset, frequency of hospitalization, symptoms, social functions, insight, family attitude, social support, self-esteem) as explanatory variables for the empowerment. RESULTS: Multiple regression analyses using a backward elimination revealed that the following four factors were found to be significant explanatory variables for the empowerment: age of onset, social functions, family attitude and self-esteem. A coefficient of determination for these four explanatory variables was 0.65. CONCLUSION: In conclusion, the results showed that four factors, such as age of onset, social functions, family attitude and self-esteem, were found to be significant explanatory variables for the empowerment of outpatients with schizophrenia. Since these four variables accounted for 65% of total empowerment, however, further studies in a larger group of patients are warranted to identify other potential factors for the empowerment.

Comparisons of the Clinical Variables between High and Low Self-Stigma Group in the Outpatients with Schizophrenia / 대한정신분열병학회지

OBJECTIVES: The purpose of this research was to investigate the differences of clinical variables between high and low self-stigma group in the outpatients with schizophrenia. METHODS: 209 schizophrenic outpatients were assigned to high self stigma group (n=76) and low self stigma group (n=133) based on the scores of perceived stigma, and compared age, sex, education, age of onset, duration of illness, number of hospitalization, symptom, social functioning, insight, self-esteem, empowerment between two groups. RESULTS: 1) The high self-stigma group had significantly lower age of onset, higher duration of illness and number of hospitalizations compared to the low self-stigma group. 2) In the PANSS, the high self-stigma group showed significantly higher score in the total score and general symptoms compared to the low self-stigma group. No significant difference was found in the positive symptoms and negative symptoms between two groups. 3) The high self-stigma group had significantly lower empowerment and self-esteem compared to the low self-stigma group. 4) The high self-stigma group had significantly higher insight compared to the low self-stigma group. CONCLUSION: Self-stigma in patients with schizophrenia directly reduces self-esteem and empowerment, and may cause depression and a lower quality of life. Therefore, identifying self-stigma and its degree is one of the important factors for good outcome.

Factors Influencing Burden on the Primary Caregivers of Remitted Schizophrenic Outpatients / 대한정신분열병학회지

OBJECTIVES: The purpose of this study is to investigate the variables besides symptom that influence the family burden in the primary caregivers of remitted schizophrenic outpatients, and to evaluate the impact of changeable or unchangeable variables by clinical practice on the family burden. METHODS: A total 105 remitted schizophrenic outpatients and 105 their primary caregivers were participated in the psychiatric outpatient clinic of the university hospital. Socio-demographic characteristics (age, sex, education, income, marital status, religion), clinical variables (duration of illness, age of onset), patients' symptom (korean version of the positive and negative syndrome scale), patients' social function (korean version of the social functioning scale), patients' insight (self-appraisal of illness questionnaire), patients' attitude toward medication (drug attitude inventory), family perceived social support (multidimensional scale of perceived social support), family attitude toward patient (family attitude scale) were gathered from subjects. RESULTS: Total score of family burden scale (0–144) of the primary caregivers of remitted schizophrenic outpatients was 71.3 (SD 20.7) and mean score per item was 1.9. Unchangeable six variables by clinical practice (relation with patient, patients' education, age of onset, duration of illness, parent age, parent income) explain 17%, and changeable four variables (family attitude toward patient, family perceived social support, patients' social function, patients' insight) explain 72% of family burden. Four areas such as interpersonal communication, independence-performance, independence-competence, occupation/ employment explain family burden significantly in the seven areas of the social functioning scale. CONCLUSION: Primary caregivers of remitted schizophrenic outpatients feel burden considerably even though their ill relatives show few psychiatric symptoms. Changeable variables by clinical practice were more explanation than unchangeable variables on the family burden.

Factors Influencing Burden on the Primary Caregivers of Remitted Schizophrenic Outpatients / 대한정신분열병학회지

OBJECTIVES: The purpose of this study is to investigate the variables besides symptom that influence the family burden in the primary caregivers of remitted schizophrenic outpatients, and to evaluate the impact of changeable or unchangeable variables by clinical practice on the family burden. METHODS: A total 105 remitted schizophrenic outpatients and 105 their primary caregivers were participated in the psychiatric outpatient clinic of the university hospital. Socio-demographic characteristics (age, sex, education, income, marital status, religion), clinical variables (duration of illness, age of onset), patients' symptom (korean version of the positive and negative syndrome scale), patients' social function (korean version of the social functioning scale), patients' insight (self-appraisal of illness questionnaire), patients' attitude toward medication (drug attitude inventory), family perceived social support (multidimensional scale of perceived social support), family attitude toward patient (family attitude scale) were gathered from subjects. RESULTS: Total score of family burden scale (0–144) of the primary caregivers of remitted schizophrenic outpatients was 71.3 (SD 20.7) and mean score per item was 1.9. Unchangeable six variables by clinical practice (relation with patient, patients' education, age of onset, duration of illness, parent age, parent income) explain 17%, and changeable four variables (family attitude toward patient, family perceived social support, patients' social function, patients' insight) explain 72% of family burden. Four areas such as interpersonal communication, independence-performance, independence-competence, occupation/ employment explain family burden significantly in the seven areas of the social functioning scale. CONCLUSION: Primary caregivers of remitted schizophrenic outpatients feel burden considerably even though their ill relatives show few psychiatric symptoms. Changeable variables by clinical practice were more explanation than unchangeable variables on the family burden.

Sex and Age Differences in Psychiatric Disorders among Children and Adolescents: High-Risk Students Study

OBJECTIVE: The aims of the present study are to investigate the rate of the psychiatric disorders in psychiatrically high-risk children and adolescents and to examine sex and age differences in the diagnosis of psychiatric disorders. METHODS: The participants included students aged 6-16 from the 27 elementary and the 45 middle schools in Busan, Korea. We screened psychopathology using the Korean version of Child Behavior Checklist (K-CBCL) or the Youth Self Report (K-YSR). A total of 2,912 students were selected as high-risk students on the basis of cut-off scores (T-score > or =60) for a total behavior problem score of K-CBCL/K-YSR. Of these high-risk students, 1,985 students participated in and completed individual diagnostic interviews. Psychiatric diagnosis was assessed using a Korean version of the Kiddie-Schedule for Affective Disorders and Schizophrenia. Multivariate logistic regression analysis was conducted to examine sex and age differences of psychiatric diagnosis. RESULTS: Based on sex, boys were more likely to have ADHD and girls were more likely to have depression. Based on age, children were more likely to have ADHD and adolescents were more likely to have affective disorder, conduct disorder, psychotic disorder, and anxiety disorders except separation anxiety disorder. CONCLUSION: This is the largest study to conduct face-to-face interviews with subjects and parent(s) among Korean studies in this field. The present study revealed significant differences across sex and age among specific psychiatric disorders in children and adolescents. Future population-based studies will be required to ascertain the sex- and age-related differences of psychiat prevalence.

Factors Affecting a Stigma That is Experienced by Outpatients with Schizophrenia / 신경정신의학

OBJECTIVES: To identify various factors that might affect stigmas affecting outpatients with schizophrenia, and to further clarify the effects of both factors affected by the treatment and other factors on stigmas in a clinical setting. METHODS: Of patients who had been receiving outpatient treatments at the Donga University Hospital Department of Psychiatry and those who had been attending the community mental health center and community psychiatric rehabilitation center, 178 patients with a DSM-IV diagnosis of schizophrenia with stable symptoms were enrolled in this study. In these patients, through an interview or self-reporting, we assessed stigmas (the Korean version of Mental Health Consumers' Experience of Stigmas), psychiatric symptoms (the Korean version of the Positive and Negative Syndrome Scale), social functions (the Korean version of the Social Functioning Scale), insight (the Self-Appraisal of Illness Questionnaire), empowerment (a Consumer-Constructed Empowerment Scale), and self-esteem (Rosenberg Self-Esteem Scale). In more detail, we performed an ANOVA in consideration of 11 factors (age, gender, the level of education, economic status, the duration of disease, the frequency of hospitalization, symptoms, insight, self-esteem, empowerment, and social functions) as explanatory variables for stigmas. RESULTS: On a multiple regression analysis using backward elimination, the following five factors were found to be significant explanatory variables for stigmas that are experienced by outpatients with schizophrenia : the disease of duration, self-esteem, insight, age, and gender. The coefficient of determination for these five explanatory variables was 0.44. CONCLUSION: In conclusion, our results showed that five factors were found to be significant explanatory variables for stigmas that are experienced by outpatients with schizophrenia. These five factors were the duration of the disease, self-esteem, insight, age, and gender. Because these five variables accounted for only 44% of total stigmas, however, further studies in a larger group of patients are warranted to identify other factors that might affect stigmas.

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

Objectives : The purpose of this study was to develop the Korean version of the Social Functioning Scale (KSFS) in the patients with schizophrenia. METHODS : KSFS was administered to 90 schizophrenic patients and 80 their parents and 90 normal controls for examining the reliability and validity. RESULTS : Data analysis showed statistically significant reliabilities and validities of KSFS. The test-retest reliability, rater vs. self-report reliability, and internal consistency for total scores of KSFS were 0.93, 0.44 and 0.94 respectively. Evidence for discriminant validity of KSFS comes from the results that the mean scores of schizophrenic patients were significantly higher than those of normal controls. Construct validity was assessed by calculating the 7 inter-areas correlations of the KSFS, and all areas were statistically significant. Significant correlations between the total scores of KSFS and those of SOFAS lend support for the concurrent validity of this instrument. Factor analyses were performed and two factors were extracted accounting for 63.7% of the variance. Sensitivity was assessed indirectly via the distribution and range of scores on the SFS. The normal control group showed a distribution around a higher mean with a moderate positive skew. CONCLUSION : KSFS was found to be a valid, reliable, and sensitive instrument which can be used to evaluate the degree of social functioning in the patients with schizophrenia.

Past, Present, and Future of Brain Imaging Studies in Trichotillomania

Trichotillomania (TTM) is a disorder characterized by repetitive hair pulling, frequently from the scalp and/or eyebrows, leading to noticeable hair loss and functional impairment. TTM remains a poorly understood and inadequately treated disorder despite increased recognition of its prevalence. We review available neuroimaging studies conducted in patients with TTM, covering structural and functional neuroimaging in turn. Data from patients' structural and functional neuroimaging results enabled us to identify the neural circuitry involved in the manifestation of hair pulling. Finally, we highlighted the future importance of neuroimaging studies in children and adolescents with TTM.

Comparison of the Effects of Video-Based Contact and Educational Lectures on the Stigma of Mental Illness in College Students / 신경정신의학

OBJECTIVES: The purpose of this study was to compare the effects of video-based contact with educational lectures on the stigma of mental illness and to follow-up to determine any changes in their effects on college students. METHODS: A total of 107 college students were randomly assigned to either an education group (n=50) or a video-based contact group (n=57). All were completed pre-tested, post-tested, and subjected to three month follow-up measures using the Community Attitudes to the Mentally Ill Inventory (CAMI). RESULTS: The video-based contact group showed significant positive improvement in the subtypes authoritarianism, social restrictiveness, and community mental health ideology of the CAMI at posttest and three month follow-up. The education group also showed significant positive improvement in subtypes social restrictiveness and community mental health ideology of the CAMI; however, its effects were limited only after education. There were no significant changes in the benevolence subtype of the CAMI in either group at post-test and three month follow-up. CONCLUSION: In comparison with education that utilizes lectures, the video-based contact showed more effectiveness in decreasing the stigma of mental illness and its effects were evident at posttest and three month follow-up.

Development of the Service Satisfaction Scale for Psychiatric Inpatients / 신경정신의학

OBJECTIVES: To develop and test the validity and reliability of a brief self-completed questionnaire (Service Satisfaction Scale: SSS) for routinely assessing the quality of service in psychiatric ward inpatients. METHODS: A 30-item multidimensional questionnaire was developed by several steps of face validity and content validity. The questionnaire was administered to inpatients (n=348) discharged from psychiatric hospitals, general hospitals, and university hospitals. Construct validity was supported by performing principal component analysis. Reliability was estimated by calculating internal consistency of Cronbach's alpha. RESULTS: Factor analysis yielded five factors comprising staff attitude, treatment quality, ward environment, access/cost, and ward rule, which account for 63.04% of the common variance. The internal consistency of the scale was high (Cronbach's alpha=0.95). The concurrent validity was supported by the significant correlation of each of five factors with item that measured overall satisfaction of SSS. Patients with neurosis (anxiety disorder, somatoform disorder, obsessive compulsive disorder) and mood disorders were significantly satisfied than those with psychosis and alcoholic disorders. Patients who admitted voluntarily were more significantly satisfied than those who admitted involuntarily. Sociodemographic variables such as age, gender, marital status, monthly income, education level, employment status and religion were not significantly different at the total scores of SSS. Similarly, clinical characteristics such as age of onset, duration of illness, lengths of hospital stay and number of previous hospitalization did not associate significantly with the total scores of SSS. Patients discharged from university hospitals were significantly more satisfied than those of the general and psychiatric hospitals. CONCLUSION: SSS performed well in the validity and reliability, indicating that it can be a useful tool for measuring satisfaction of psychiatric inpatients in Korea.

Comparison of the Effects between Olanzapine and Typical Antipsychotics on Social Functioning in Patients with Schizophrenia / 신경정신의학

OBJECTIVES: The purpose of this study was to compare the social functioning between schizophrenic patients treated with olanzapine and those with typical antipsychotics. METHODS: Fifty-seven schizophrenic patients with acute exacerbation entered consecutively to olanzapine treatment (N=33) or typical antipsychotic treatment (N=24). The assessment of social functioning and symptoms were made at 3 time points:at the time of admission (baseline), 6 months and 12 months after starting medications. Social functioning and symptoms were examined using the Korean version of Social Adjustment Scale II-Revised Version (KSAS II-RV) and the Positive and Negative Syndrome Scale (PANSS). RESULTS: After 6-months and 12-months treatments, olanzapine treatment group showed significantly improved PANSS total scores (p=.02), positive scores (p=.04), negative scores (p=.01), and KSAS II-RV total score (p=.004), instrumental role (p=.002), social leisure (p=.03), personal well-being subarea scores (p=.02), compared with the scores of typical antipsychotic treatment group. CONCLUSION: Olanzapine was more effective than typical antipsychotics in reducing the severity of psychopathology and in improving some subareas of social functionings in patients with schizophrenia. The benefits of olanzapine on social functioning, although modest, may be important factor considering their accumulative effects for long-term treatment.

Comparison of the Effects between Olanzapine and Typical Antipsychotics on Social Functioning in Patients with Schizophrenia / 신경정신의학

OBJECTIVES: The purpose of this study was to compare the social functioning between schizophrenic patients treated with olanzapine and those with typical antipsychotics. METHODS: Fifty-seven schizophrenic patients with acute exacerbation entered consecutively to olanzapine treatment (N=33) or typical antipsychotic treatment (N=24). The assessment of social functioning and symptoms were made at 3 time points:at the time of admission (baseline), 6 months and 12 months after starting medications. Social functioning and symptoms were examined using the Korean version of Social Adjustment Scale II-Revised Version (KSAS II-RV) and the Positive and Negative Syndrome Scale (PANSS). RESULTS: After 6-months and 12-months treatments, olanzapine treatment group showed significantly improved PANSS total scores (p=.02), positive scores (p=.04), negative scores (p=.01), and KSAS II-RV total score (p=.004), instrumental role (p=.002), social leisure (p=.03), personal well-being subarea scores (p=.02), compared with the scores of typical antipsychotic treatment group. CONCLUSION: Olanzapine was more effective than typical antipsychotics in reducing the severity of psychopathology and in improving some subareas of social functionings in patients with schizophrenia. The benefits of olanzapine on social functioning, although modest, may be important factor considering their accumulative effects for long-term treatment.

Symptoms and Cognitive Function in Chronic Schizophrenia: 6 Months Follow-up Study / 수면정신생리

OBJECTIVES: The purpose of this study was to investigate whether longitudinal changes in positive and negative symptoms affect cognitive functioning in chronic schizophrenia. METHODS: Sixty-eight patients diagnosed with DSM-IV schizophrenia were examined on two occasions over 6 months for symptoms and cognitive changes. Symptoms were measured by PANSS. Cognitive functions were examined for sustained attention, executive function, concentration and attention, and verbal memory and learning using Degraded Stimulus Continuous Performance Test, Wisconsin Card Sorting Test, Digit Span, and Rey Auditory Verbal Learning Test, respectively. Twenty control subjects were assessed to compare the cognitive scores of remitted schizophrenic patients. RESULTS: Patients showed significant improvement in symptoms and all cognitive tests after 6 months treatments. Significant improvements in positive and negative symptoms did not predict improvements in any aspect of cognitive functioning measured. Normal controls performed significantly better than remitted schizophrenic patients on all cognitive tests. The results show no relationship between change in symptoms and change in cognition in chronic schizophrenia. CONCLUSION: We suggest that symptomatic and cognitive impairment may be a distinct construct. These findings highlight the importance of treating cognitive impairment in addition to the clinical symptoms of schizophrenia.

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.

Differences of the Neurocognitive Function in the Specific Symptom Subgroups of Schizophrenia / 신경정신의학

OBJECTIVES: This study investigated the validity of positive-negative dichotomy model by comparing the differences of neurocognitive function in the specific symptom subgroups of schizophrenia. METHODS: Factor analysis was performed on 14 items of the Positive and Negative Syndrome Scale (PANSS) among 71 inpatients with schizophrenia. All patients were assigned to one of specific symptom subgroups based on a ratio score and compared the neurocognitive distinction of each subgroups with normal control group, which was composed of 60 healthy persons without psychiatric illness. Neurocognitive functions include sustained attention, sensory register, executive function, attention and concentration, and verbal memory and learning obtained using Degraded Stimulus Continuous Performance Test, Span Apprehension Task, Wisconsin Card Sorting Test, Digit Span, and Rey Auditory Verbal Learning Test respectively. RESULTS: Three factors, positive, negative and disorganized, were yielded from factor analysis on 14 items of the PANSS. Three symptom subgroups showed the differential neurocognitive profiles. Disorganized symptom subgroup showed significant deficits in the sustained attention, sensory register, executive function, attention and concentration, and verbal memory and learning compared with the normal controls. Negative symptom subgroup showed significant deficits in the sustained attention, sensory register, executive function, and verbal memory and learning. Positive symptom subgroup showed significant deficits only in the sustained attention and sensory register compared with the normal controls. No significant differences were noted in the sustained attention, sensory register, attention and concentration, and verbal memory and learning among three symptom subgroups. But the disorganized symptom subgroup showed a significant deficit in the executive function compared to the positive symptom subgroup. CONCLUSIONS: These results support that three symptom dimensions including disorganization may be more valid than the positive-negative symptom dichotomy in the dimensions of schizophrenic symptoms.

Comparisons of Symptoms and Neurocognitive Functions in Schizophrenic Patients Divided by Social Functioning / 신경정신의학

OBJECTIVE: The purpose of this research was to investigate the differences of symptoms and neurocognitive functions with good and poor social functioning schizophrenic outpatients. METHOD: 152 schizophrenic outpatients were divided to good social functioning group(n=26) and poor social functioning group(n=126) based on the instrumental role of workers or students. Neurocognitive functions of these patient groups were compared with normal control group, which was composed of 30 healthy persons without a history of psychiatric illness. Schizophrenic symptoms were assessed by the Positive and Negative Syndrome Scale(PANSS). Neurocognitive function tests include the sustained attention, sensory register, executive function, concentration and attention, and verbal memory and learning assessed with Degraded Stimulus Continuous Performance Test(DS-CPT), Span Apprehension Task(SAT), Wisconsin Card Sorting Test(WCST), Digit Span(DS), and Rey Auditory Verbal Learning Test(RAVLT). RESULTS: 1) No significant differences were noted in the symptom subtypes of PANSS between good and poor social functioning patient groups. 2) The poor social functioning patient group showed significant deficits in the sustained attention, sensory register, concentration and attention, and verbal memory and learning as manifested in the data of DS-CPT, SAT, DS, and RAVLT compared with normal control and good social functioning patient groups. But there were no differences in these neurocognitive functions between good social functioning patient group and normal control group. CONCLUSIONS: These results suggested that some neurocognitive deficits such as sustained attention, sensory register, concentration and attention, and verbal memory and learning may be more important factors than symptoms for social functioning in the stable schizophrenic outpatients.