Differences in temperament and character dimensions of personality between patients with Hwa-byung, an anger syndrome, and patients with major depressive disorder.

OBJECTIVE: This study examined differences in temperament and character dimensions of personality between patients with Hwa-byung (HB) and those with major depressive disorder (MDD). METHOD: Of 144 participants, 96 completed the Korean version of the Temperament and Character Inventory-Revised Short (TCI-RS) and the Hwa-byung Scale. We diagnosed participants according to the DSM-IV and the Research Diagnostic Criteria for Hwa-byung. We compared TCI scores between the HB group (with or without MDD; N=55) and the MDD-only group (N=41) and correlated them with the total scores on six HB-specific symptoms (global HB severity) on the Hwa-byung Scale. RESULTS: Compared to patients with only MDD, patients with HB with or without MDD exhibited significantly higher scores on Impulsiveness; Harm Avoidance (HA) and its subscales of Anticipatory Worry; and Self-Transcendence (ST), with its subscale of Self-Forgetfulness. However, HB patients had lower scores on Self-Directedness, with its subscales of Responsibility, and Self-Acceptance; and Acceptance. Moreover, Global HB Severity had significant, positive correlations with ST, its subscale Self-Forgetfulness, and Anticipatory Worry but negative correlations with Attachment and Compassion. LIMITATIONS: Our data are cross-sectional and self-reported, so they are subject to personal perceptual bias. The number of participants may be too low for us to generalize the results. CONCLUSION: These results suggest that HB is a different clinical entity from MDD in relation to personality traits, and that symptoms unique to HB are closely correlated with ST.

The Tolerability of Mirtazapine Augmentation in Schizophrenic Patients Treated with Risperidone: A Preliminary Randomized Placebo-controlled Trial.

OBJECTIVE: Some patients with schizophrenia may need mirtazapine augmentation to improve negative and cognitive symptoms. However there have been a few studies about the tolerability of mirtazapine augmentation to antipsychotics such as akathisia, extrapyramydal symptoms, weight gain, and body mass index (BMI). METHODS: This study was an eight-week double-blind, randomized controlled trial (RCT) of mirtazapine augmentation to risperidone. Twenty-one stabilized participants diagnosed with schizophrenia and undergoing treatment with risperidone were randomized to adjunctive treatment with mirtazapine (15 mg/day for the first two weeks, 30 mg/day for the next six weeks) or placebo. Eleven patients were assigned to the mirtazapine group, and nine patients were given placebo. RESULTS: There was no significant difference between the mirtazapine and placebo groups with respect to Barnes Akathisia rating Scale (BAS) and Sympsom-Angus Scale (SAS). However, the mirtazapine group exhibited a statistically significant increase in weight and BMI (p<0.05). CONCLUSION: These results suggest that mirtazapine augmentation can be tolerable in schizophrenic patients treated with risperidone; however, we should pay attention to the weight gain with mirtazapine. Our results should be replicated in a large-scale lengthy trial.