Erratum: Posttraumatic Stress Disorder Symptoms and Posttraumatic Growth Following Indirect Trauma from the Sewol Ferry Disaster, 2014

In the original publication, reference number 20 was incorrect.

Posttraumatic Stress Disorder Symptoms and Posttraumatic Growth Following Indirect Trauma from the Sewol Ferry Disaster, 2014

OBJECTIVE: The definition of psychological trauma, which was traditionally restricted to immediate and direct experience, is now expanding to include mediated or vicarious experience. So the present study aims to examine the relationship between the negative effects and the positive outcomes to a national disaster by assessing the posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth of the general public. METHODS: A nationwide survey of the Korean population (n=811) who were exposed to the Sewol ferry disaster through the media participated in this research, completing a self-report questionnaire consisting of demographic characteristics, Impact of Event Scale-Revised- Korean, and Korean-Stress-related Growth Scale-Revised. The participants were divided into three groups according to the severity of PTSD symptoms, then one-way ANOVA were conducted. RESULTS: The results revealed 30.4% of the sampled participants reported stress symptoms equivalent to partial or full PTSD. Posttraumatic growth was significantly higher in the full and the partial PTSD symptom groups when compared to the normal group [F (2, 759)=20.534, p < 0.001]. At a subscale level, mature thinking showed a more significant result [F (2,759)=23.146, p < 0.001] than religious growth [F (2, 180.984)=4.811, p < 0.01]. CONCLUSION: The results indicated a general linear trend between the severity of PTSD symptoms and posttraumatic growth level, suggesting that indirect trauma also induces both PTSD symptoms and posttraumatic growth like direct trauma does. The theoretical implications based on these findings were discussed.

Analysis of Epidemiological Factors and Clinical Variations to Determine Whether Violent Behavior Appears in Trauma- and Stressor-Related Disorder Patients / 신경정신의학

OBJECTIVES: The purpose of this study was to identify variables and determine their correlation with violent behavior in trauma- and stressor-related disorder diagnostic patients. METHODS: A one-year retrospective study (2012 to 2013) was performed on 91 trauma- and stressor-related disorder diagnosed patients at Hallym University Kangnam Sacred Heart Hospital. Study data were obtained from previous medical records. The subjects were divided into two groups based on the presence of violent behavior. RESULTS: Of the 91 trauma- and stressor-related disorder diagnosed patients, 33 patients exhibited violent behavior during their clinical course. Sociodemographic factors of age and marital status and their socioeconomic-environmental status were variables significantly related with the presence of violent behavior. Clinical data from Structured Clinical Interview for DSM, Post Traumatic Growth Inventory, and Social Support Scale scores were significantly associated with violence in trauma- and stressor-related disorder patients. CONCLUSION: In the clinical course of subjects with trauma- and stressor-related disorder, appearance of violent behavior should be monitored and approached in multiple ways to address socio-demographic, clinical, and psychological problems. Monitoring of significantly related variables and treatment compliance should be considered part of an appropriate therapeutic strategy for trauma- and stressor-related disorder patients.

Social Function in Patients with Personality Disorder Diagnosed by Single Dimensional Severity Using Korean Version of Social Functioning Questionnaire / 신경정신의학

OBJECTIVES: The aims of this study were to examine validity and reliability of the Korean version of the Social Function Questionnaire (SFQ) and evaluated social function with SFQ in patients with personality disorder. METHODS: The SFQ was administered to 186 psychiatric patients (155 patients with personality disorder and 31 patients without personality disorder), and 22 healthy men were recruited to examine the test-retest reliability of SFQ. The severity of personality disorders was determined using the proposed the International Classification of Diseases (ICD)-11th revision (ICD-11) personality disorders. All participants completed the NEO-Five Factor Inventory, Beck Depression Inventory, and Spielberger State and Trait Anxiety Inventory to examine the convergent validity of SFQ. RESULTS: The Korean version of the SFQ showed good internal consistency (Cronbach's alpha=0.811) and test-retest reliability (r=0.746). Patients with personality disorder had more social dysfunction than those without personality disorder. A graded increase in social dysfunction was observed with increasing severity of personality disorder. Social dysfunction showed a strong linear relationship with the 5 factor model. CONCLUSION: The Korean version of the SFQ has good psychometric properties. The results of our study support the severity classification of personality disorder integrated to upcoming ICD-11.

The Relationship between Social Exclusion and Paranoid Ideation: Analysis of Moderating and Mediating Effects of Depression and Self-Esteem / 신경정신의학

OBJECTIVES: The aim of this study was to investigate the relationship between social exclusion and paranoid ideation, and to explore moderating and mediating effects of depression and self-esteem in that relationship. METHODS: Ninety seven neurosis patients receiving treatment in a psychiatric outpatient setting were selected. Social Exclusion Scale, Beck Depression Inventory, paranoia scale of Symptom Checklist-90-Revised, and Rosenberg Self-Esteem Scale were used for evaluation. RESULTS: Social exclusion showed highly positive correlation with paranoid ideation, and had significant influence. Among three types of social exclusion, contempt, bullying, and isolation, only isolation showed significant influence on paranoid ideation. Depression showed a partial mediating effect on that relationship indicating that social exclusion affects paranoid ideation not only directly, but also indirectly. On the other hand, self-esteem showed no moderating or mediating effects on that relationship. CONCLUSION: Depression mediates the influence of social exclusion on paranoid ideation. This finding provides an opportunity to decrease paranoid ideation of neurosis patients by not only prescription of antipsychotic agents but also therapeutic approach to social exclusion and depression. An experimental study to verify these findings seems to be needed.

Anti-Intrusion Effect of Lorazepam: An Experimental Study

OBJECTIVE: Easy triggering of trauma-related episodic memory fragments caused by perceptual cues is tied to strong perceptual priming in the implicit memory system. And among benzodiazepines, only lorazepam has been consistently reported to have an atypical suppression effect on perceptual priming processes. The aim of this study was to investigate the effects of single doses of lorazepam, diazepam, and a placebo on intrusive memories after exposure to a distressing videotape and to explore whether the anti-intrusive effect of lorazepam is acquired as a result of the suppression of perceptual but not conceptual priming processes. METHODS: Under prospective, randomized, and double-blind conditions, we compared the anti-intrusion effect of a single dose of lorazepam (n=22) with that of diazepam (n=22) and a placebo (n=21) in young healthy Korean college students following exposure to a traumatic videotape. RESULTS: We present the first finding for an anti-intrusion effect of lorazepam. One day after the medication, lorazepam, rather than diazepam or the placebo, significantly reduced the extent of intrusion and data-driven processing of the traumatic information. There were no differences among the three conditions in state anxiety, depression, and an arousal scale throughout the experiment. CONCLUSION: Results from this study suggest the possibility of lorazepam as a candidate anti-intrusion drug, as well as the cautious use of diazepam in the treatment of PTSD patients. The anti-intrusive effect of lorazepam is directly related to its atypical inhibitory effect on implicit perceptual priming processes. The present study provides support for the enhanced perceptual priming hypothesis of PTSD.

Plasma Levels of IL-23 and IL-17 before and after Antidepressant Treatment in Patients with Major Depressive Disorder

OBJECTIVE: Cytokines are believed to have a role in the pathophysiology of major depression. The alteration in levels of pro-inflammatory cytokines [interleukin 1beta (IL-1beta), IL-2, IL-6, IL-12, interferon gamma, and tumor necrosis factor alpha] in major depression supports the cytokine hypothesis of this illness. IL-23 and IL-17 are also pro-inflammatory cytokines, but few studies have focused on their role in major depression. This study investigated the potential role of the IL-23 and IL-17 axis in major depression. METHODS: Plasma IL-23 and IL-17 levels were measured in 26 major depressive disorder (MDD) patients before and after 6-week treatment with antidepressants; these levels were measured in 28 age- and sex-matched normal controls. Depression severity was assessed using the Hamilton Depression Rating Scale (HDRS). IL-23 and IL-17 plasma levels were estimated using quantitative enzyme-linked immunosorbent assay. RESULTS: Pre-treatment plasma levels of IL-23 and IL-17 in MDD patients were not significantly different from those of normal controls. In MDD patients, IL-23 and IL-17 levels after 6 weeks of antidepressant treatment were not different from the baseline levels. There was no significant correlation between changes in the cytokine levels and changes in the HDRS scores representing the severity of depression. CONCLUSION: The present study does not support a potential involvement of IL-23 and IL-17 axis in major depression. Replication and extension using a larger sample are required.

State Effect of Traumatic Experience on Personality Structure

OBJECTIVE: Personality is defined as the trait-like qualities of a person. However, it has been recently suggested that the state effect of a situation leads to changes in scores on personality assessments. We predicted that traumatic experiences would induce changes not only in personality scores but also in the factor structures of personality assessments. METHODS: MethodsaaWe conducted a cross-sectional, case-controlled study using two data sets: a traumatized adolescent sample (n=71) and a non-traumatized adolescent sample (n=296). Personality factor structures were compared between the two samples using exploratory factor analyses for 25 lower-ordered subscales of the Temperament and Character Inventory (TCI). In the non-traumatized sample, evaluation of the scree plot suggested a five-factor solution supporting TCI's original seven-factor model. RESULTS: The traumatized sample showed a three-factor structure representing a biological factor, a social factor and an existential factor. This decrease in number of personality factors was caused by strengthened correlations among personality subscales related to coping with traumatic situations. Cloninger's psychobiological model of personality (i.e., temperament-character) was adequate in capturing personality traits of non-traumatized adolescents, but the tripartite view of existential psychology (i.e., body-mind-spirit) clearly corresponded to the factor structure of the traumatized adolescents. CONCLUSION: The three-factor solution of the present traumatized group is consistent with the tripartite model of personality (i.e., body-mind-spirit), while the five-factor solution of the non-traumatized group corresponds to Cloninger's seven-factor model. This is the first study to describe the state effects of traumatic experiences on personality structure.

Diabetes, Depression and Doctor-Patient Relationship / 당뇨병

Although diabetes mellitus (DM) is treatable, it is still not curable. Its chronicity is associated with a high prevalence of psychiatric disorders, especially depression in type 2 DM and learned helplessness in type 1 DM. In turn, this depression and helplessness may affect a patient's adherence to medical appointments, compliance to treatment, and effective doctor-patient relationships, which are vital to promising outcomes. This study reviews the existing literature regarding the interactional relationships between depression, DM and the doctor/patient relationship, and also suggests certain aspects of the doctor/patient relationship which can contribute to more successful treatment outcomes.

Illness Representation for Pathological Gambling / 신경정신의학

OBJECTIVES: In our studies, we have made efforts to compare illness representation among the pathological gamblers, social gamblers, the family members of gambler, the gambling industry employees, and general adults and to investigate what kinds of illness representation make an estimate of therapy intention. METHODS: 222 gambling users, 125 family members of gambler, 95 employees in gambling industry, and 1383 general adults were included in this study. Symptom representation, negative characteristic representation, negative consequence representation, internal and external attribution representation, spontaneous recovery representation, recovery representation through therapeutic help of speciality, time lapse representation were constructed and included for illness representation of pathological gambling. RESULTS: 1) Pathological gamblers had lower symptoms, negative characteristics, negative consequences and therapeutic help seeking representation than other groups, on the other hand higher external attribution representation and spontaneous recovery representation. 2) Families of problem gambler have inconsistent characteristics higher external attribution and negative consequences and lower therapeutic help seeking representation. 3) It was founded that negative consequences representation and external representation were low in gambling industry employees. 4) The more symptom representation increased and external attribution decreased, the more therapeutic intention increased in case of problem gamblers and their families. CONCLUSION: Pathological gamblers have the lowest awareness and acceptance on mental problem caused by excessive gambling. However, suggested that family members of gambler and gambling industry employees also have partially self defensive and contradicted representations. It was suggested that awareness on severity of symptom and internal attribution representation needs to be increased in order to participate therapeutic place.

Changes of HRV after Antidepressant Treatment in Psychiatric Outpatients / 신경정신의학

OBJECTIVES: The purpose of this study was to investigate the change of heart rate variability after antidepressant treatment in depressed or anxious patients. We tried to find the usefulness of heart rate variability as a predictive marker of response to pharmacological treatments in the psychiatric field. METHODS: Forty-seven patients with major depression, anxiety disorder, and somatoform disorder were treated over 4 weeks with antidepressants and were then classified as responders or nonresponders according to Hamilton depression scales or CGI scores. The HRV variables were measured and compared among the responders/nonresponders and the matched normal control. RESULTS: The responders group exhibited low heart rate, low PSI, high SDNN, RMSSD, HRV index, NN50, pNN50, LNTP, LNLF, and LNHF compared with the nonresponders after 4 weeks antidepressant treatment. However, no significant difference in HRV variables was observed between the responders group after treatment and the normal control group and the response group after treatment. CONCLUSION: These results indicate that HRV variables would are normalized after successful antidepressant treatment and it that HRV has some possible uses as a predicting marker of antidepressant response.

The Efficacy and Safety of Quetiapine Monotherapy in Patients with Acute Mania: A Multi-Center, Open-Label Trial / 대한정신약물학회지

OBJECTIVE: Recently, the atypical antipsychotics such as quetiapine, olanzapine, risperidone, aripiprazole and ziprasidone are increasingly used in the management of acute manic patients as the monotherapy. But there are only a few reports on the use of these drugs in the treatment of bipolar disorder in Korea. The aim of this study was to evaluate the efficacy and tolerability of quetiapine monotherapy in patients with acute mania. METHOD: This study is multi-center, open-label, 6-week evaluation of the efficacy of quetiapine in bipolar mania. In this study, patients with a DSM-IV diagnosis of bipolar I disorder (manic or mixed episodes) were included to treatment with quetiapine (flexibly dosed up to 800 mg/day). Clinical improvements were rated by Young Mania Rating Scale (YMRS), Clinical Global Impression-Bipolar Version (CGI-BP), Brief Psychiatric Rating Scale (BPRS) and Montgomery-Asberg Depression Rating Scale (MADRS). Adverse events were measured using Simpson-Angus Rating Scale (SARS) and Barnes Akathisia Rating Scale (BARS), and subjective reports of patients were evaluated. Global Assessment Scale (GAS) was used to evaluate the general functioning of patients. All assessments were done at baseline and at days 7, 14, 21, and 42 except GAS (at days 21 and 42). Analyses were focused on change from baseline to day 42. RESULTS: Total 78 (male=30, female=48) patients were included and 59 patients (75.6%) completed the study. The mean initial dose of quetiapine was 268.0+/-223.2 mg/day and mean daily dose at day 42 was 585.3+/-244.5 mg/day. YMRS and CGI-BP were significantly improved at day 7, 14, 21, and 42 as compared to baseline. Mean scores of BPRS and MADRS were also significantly decreased at the each assessment points. Fifty-two patients (66.7%) showed response (more than 50% of decrease in YMRS score from baseline) and 35 patients (44.6%) reached remission (YMRS score < or =12) at day 21. GAS showed the improvements of patient's global functioning at days 21 and 42 of quetiapine monotherapy compared to baseline. There was no significant difference between baseline and any assessment points on SARS and BARS scores. CONCLUSIONS: The data showed that quetiapine monotherapy has favorable effects across a broad range of mood symptoms with minimal adverse events in addition to functional improvement in acute manic patients. This result suggests that quetiapine may be preferred for patients with acute mania as one of the first-line agents.

The Effects of Antidepressant Treatment on Serum Cytokines and Nutritional Status in Hemodialysis Patients

The aim of this study was to investigate the effects of antidepressant treatment on serum cytokines and nutritional status in hemodialysis patients. Twenty-eight hemodialysis patients with a depressed mood were given 20 mg of fluoxetine for 8 weeks. The degree of depressive symptoms, the serum levels of interleukin-1beta, interleukin- 2, interleukin-6, tumor necrosis factor-alpha, c-reactive protein, and markers of nutritional status were assessed at baseline and after treatment. The outcome was assessed in terms of response to treatment (>50% reduction in the score of the Hamilton depression rating scale). Antidepressant treatment decreased the serum level of interleukin- 1 in both response and nonresponse groups, and increased the serum level of interleukin-6 only in the response group. At baseline, the level of interleukin-6 in the response group was lower than in the nonresponse group. Antidepressant treatment also increased fat distribution significantly in the response group which might have slightly improved the nutritional status. This study suggests that antidepressant treatment improve depressive symptoms and may affect immunological functions and nutritional status in chronic hemodialysis patients with depression.

Dopamine D2 Receptor Gene Polymorphism in Cigarette Smoking / 신경정신의학

OBJECTIVE: This study was to examine the effects of DRD2 TaqI A polymorphism on the smoking in Koreans. Also this study examined molecular heterosis and gender difference in the genetic effect of cigarette smoking. METHODS: DRD2 TaqI A RFLP genotyping was carried out with DNA extracted from blood samples of 187 healthy individuals including 94 smokers and 93 non-smokers, RESULTS: Among the total subjects, the smokers were not significantly different from the non-smokers in respect to the frequency and prevalence of A1 allele, the genotype distribution, or the frequency of heterozygotes. Separating the subjects by gender, however, in male subjects smokers showed a significantly higher frequency (p=0.049) and prevalence of A1 allele (p=0.016) than non-smokers. Also, genotype distribution (p=0.055) and frequency of heterozygotes (p=0.058) of smokers showed some different distributions, but there were no significant statistical difference. In contrast, female subjects showed significant difference between smokers and non-smokers in the comparison of frequency of heterozygotes (p=0.018), but not in the comparison of the frequency (p=0.582) and prevalence (p=0.082) of A1 allele and genotype distribution (p=0.060). CONCLUSION: No significant difference between smokers and non-smokers in the genotype distributions of the total sample could be explained by the reciprocal effects of gender difference in the genetic effect of DRD2 A1 allele of the smoking. Our findings support gender difference and molecular heterosis at the DRD2 gene effects of smoking.

Exploring Sources of Life Meaning among Koreans / 신경정신의학

OBJECTIVES: The purpose was to explore sources of Koreans' life meaning and determine its structure that is reflective of Koreans' unique culture and values. METHODS: The study consisted of both qualitative and quantitative research methods. To this end, two sample data sets were collected. Study One was an exploratory study in which the qualitative component was conducted in order to gather all possible attributes of sources of life meaning among Koreans. All possible sources of life meaning were extracted through content analysis. Study Two was a quantitative study using a closed questionnaire and conducted in order to determine the structure of Koreans' life meaning by measuring Koreans' current level of life meaning. For the study, factor analysis was carried out. RESULTS: From Study One, 106 attributes of all possible sources of Koreans' life meaning were extracted. In Study Two, factor analysis with the responses from 638 subjects reduced 106 attributes to 53 attributes and ten factors were extracted as Koreans' sources of life meaning: Achievement, Security, Religion, Acceptance & Affirmation, Relationship, Self-Transcendence, Good Character, Self-Discipline, Physical Health and Intimate Friend. CONCLUSION AND IMPLICIATIONS: Among the ten factors extracted from this study, the factors of Security, Acceptance and Affirmation, Good Character, Self-Discipline, and Physical Health are Koreans' unique factors of Life Meaning, while Achievement, Religion, Relationship, Self-Transcendence and Intimate Friend are comparable to Wong's1) Personal Meaning Profile for Canadians. It implies that it is necessary to develop Koreans' own measurement tool in order to assess their life meaning properly. However, because this study was an exploratory in developing Koreans' life meaning mea-surement and had several limitations, in order to determine structure of Koreans' life meaning, further study must be necessary.

Association between Dopamine Receptor D4 Polymorphisms and Novelty Seeking Personality Trait in a Korean Population / 신경정신의학

OBJECTIVES: We investigated the relationship of personality traits with dopamine D4 receptor(DRD4) exon III polymorphism in a Korean population. METHODS: We analysed DRD4 exon III 48-bp repeats polymorphism in 173 Korean healthy female adolescents(age=13.88+/-0.29 years) who also completed Temperament and Character Inventory(TCI). RESULTS: Novelty seeking score of the TCI was significantly higher in the subjects with DRD4 long alleles(>or=5 repeats) compared with the subjects without these(t=2.11, p=0.037). CONCLUSION: The present study supports the previous reports that long repeats of the DRD4-exon III polymorphism are related with Novelty Seeking personality.

Effect of Dopamine D2 Receptor Gene Polymorphism for Smoking in Patients with Schizophrenia / 신경정신의학

OBJECTIVE: The authors examined the genetic effect of DRD2 Taq I polymorphism to the smoking in the Korean schizophrenics. Also this study examined molecular heterosis and gender difference in the genetic effect to smoking in schizophrenics. METHODS: The study subjects were composed of 167 schizophrenic patients, 96 smokers and 71 non-smokers. DRD2 Taq I RFLP genotyping was carried out with DNA extracted from subjects' blood samples. RESULTS: Among the total schizophrenics, the smokers were not significantly different from the non-smokers in respect to the frequency and prevalence of A1 allele, the genotype distribution, or frequency of heterozygotes. In male schizophrenics, genotype distribution of smoking patients differed significantly from non-smoking patients(p=0.010), with a higher prevalence of A1 allele (p=0.020) and frequency of heterozygotes(p=0.005). In male schizophrenics, A1A2 heterozygotes showed significantly higher smoking rate than A1A1 or A2A2 homozygotes and non-smokers were deficient in heterozygotes. The deviation from Hardy-Weinberg expectations was observed in male and female non-smokers with opposite directions. Moreover, highly significant differences were seen between male and female non-smokers in A1 prevalence(p=0.001), genotype distribution(p<0.00011), and frequency of heterozygotes(p<0.00003). CONCLUSION: No significant difference between smokers and non-smokers in the genotype distributions of the total sample could be explained by the gender difference in the genetic effect of DRD2 A1 allele to the smoking with opposite directions. Our findings support molecular heterosis at the DRD2 gene.

Association of Dopamine D4 Receptor(DRD4) Gene Polymorphism with Korean Schizophrenic Patients

BACKGROUND: No association between schizophrenia and dopamine D4 receptor polymorphisms have been reported. Despite these results, it is premature to exclude the association. It has been suggested that the susceptibility to develop schizophrenia could result from variation at a number loci which may interact or co-act with each other. Therefore, we investigated a possible assoication of combinations of exon III 48bp polymorphism [D4E3] and exon I 12bp polymorphism of the DRD4 gene [D4E1] with schizophrenia. METHOD: 207 unrelated Korean schizophrenic patients and 191 healthy controls wee recruited. DRD4 genotype was established using the polymerase chain reaction. Statistical analysis consisted of chi2 tests for Hardy-Weinberg proportions and genotypic and allelic frequencies in the patients and control groups. RESULT: There were no statistically significant differences in the each polymorphisms between schizophrenics and controls. And all genotype frequencies were within Hardy-Weinberg expectations. When the combinations of the polymorphism in schizophrenia and controls were compared, however, there were significant differences at A1A2*2/4 in the distributions of the combinations of D4E1 and D4E3(p<0.01). CONCLUSION: These findings suggest that the certain combination of D4E1 and D4E3 (A1A2*2/4) has the protective role to a susceptibility for schizophrenia.

Comparison of Therapeutic Effects actor Side Effects between Nemonapride and Haloperidol Treated Schizophrenic Patients / 대한정신약물학회지

OBJECTIVE: This open prospective study was performed to investigate the therapeutic efforts and side effects profiles of nemonapride in the schizophrenic patients, and was compared with one of typical anti-psychotics, haloperidol. METHOD: Sixty male or female schizophrenic patients were treated for 12 weeks with nemonapride(n=32) and haloperidol(n=28). The overall clinical therapeutic effects were assessed at baseline, 1st week, 2nd week, 4th week, 8th week and 12th week using the PANSS, the BPRS and the CGI scale. Also, the overall clinical side effects were assessed in the same time period using ESRS, UKU side effect rating scale and global assessment for side effect scale. RESULTS: There were not a significant differences in PANSS score(total, positive, negative and general psychopathology subscale), BPRS(total score), CGI scale score between nemonapride and haloperidol trial groups. And also, there were not a significant differences in the ESRS, the UKU side effect rating scale, the Global assessment far side effect stale score between nemonapride and haloperidol trial groups. 59% of the nemonapride-treated patients(n=32) were categorized as treatment responders, who showed at least a 20% decrease in total PANSS score at baseline state, was compared with 64% of haloperidol-treated patients(n=28). 72% of the nemonapride-treated patients were categorized as treatment responders, who showed at least a 20% decrease in total BPRS score at baseline state, compared with 68% of haloperidol-treated patients. There were not significant differences in these both treatment responder groups. CONCLUSION: There were no significant differences in the therapeutic effects and side effects profiles of nemonapride and haloperidol groups.

The Dopamine D2 Receptor Locus as a Modifying Gene in Korean Schizophrenia, Alcoholism and Drug Addiction

The authors attempted to examine the allelic association between the A1 allele of Dopamine D2 receptor and schizophrenia, alcoholism, drug addiction in Koreans. Schizophrenic patients(n=31), alcoholism(n=65), drug addiction(n=18) and controls(n=52) were examined by case-control study for distribution of the Taql polymorphism of the dopamine D2 receptor gene in Korean population to minimize the effect of racial differencies in gene frequencies. In schizophrenics, the numbers of schizophrenics with A1A1, A1A2, A2A2 were 9(29%), 15(48%) and 7(22%) respectively and in alcoholics with A1A1, A1A2, A2A2 were 14(21.5%), 36(55.4%) and 15(23.1%) respectively and in drug addiction with A1A1, A1A2, A2A2 were 4(7.6%), 24(46.2%) and 24(46.2%) respectively. The prevalence of the A1 allele in schizophrenics, alcoholics, drug addiction and controls were 77%, 76.9%, 67% and 53.8% respectively. And the frequency of the A1 allele in schizophrenics, alcoholics, drug addiction, and controls were 0.53 0.49, 0.39 and 0.31 respectively. There was significant difference in the frequency of the A1 allele between schizophrenics, alcoholics and controls. We also classified our alcoholic population. For classification by severity, we used the median MAST score 30 in our samples. There was also significant difference in the frequency of the A1 allele between less severe group(0.42) and more severe group(0.57). This data suggest that the A1 allele is associated with schizophrenia and alcoholism in Korean. Furthermore the prevalence of the A1 allele increased in more severely affected alcoholics. The authors conclude that our data support an allelic association between the A1 allele at dopamine D2 receptor and schizophrenia, alcoholism. These results suggest the A1 allele of the DRD2 gene is associated with a number of behavior disorders in which it may act as a modifying gene rather than as the primary etiological agent.