Korean Journal of Schizophrenia Research最新文献

{"title":"One-Year Clinical Outcomes After Diagnosis According to Early Medication Adherence in First-Episode Schizophrenia: A Nationwide, Health Insurance Data-Based Retrospective Cohort Study","authors":"W. Choi, S. W. Joo, S. Ahn, Y. Choi, Sun Min Kim, Jungsun Lee","doi":"10.16946/kjsr.2023.26.1.24","DOIUrl":"https://doi.org/10.16946/kjsr.2023.26.1.24","url":null,"abstract":"Objectives: Early pharmacologic intervention is considered necessary for improving the prognosis in patients with first-episode schizophrenia (FES). However, few nationwide population-based studies have focused on early medication adherence. We investigated the status of early adherence to antipsychotics and the effect of early adherence on later clinical outcomes in FES.Methods: We used data from the South Korean Health Insurance Review Agency database (2009-2021). We selected 28,931 patients with FES who had a prescription record of at least one antipsychotic medication within 180 days after their diagnosis. We measured early medication adherence using the medication possession ratio (MPR) and compared demographic characteristics and results of psychiatric hospitalization between the adherence group (0.6≤MPR<1.1) and the non-adherence group (MPR<0.6).Results: The average early medication adherence was 0.82 by MPR, and the non-adherence group accounted for 15.6% of all subjects. From 1 to 2 years after diagnosis, the adherence group showed a higher number of psychiatric hospitalizations per hospitalized patient but a shorter duration than the non-adherence group. Additionally, the proportion of patients who experienced psychiatric hospitalizations was smaller in the adherence group.Conclusion: In patients with FES, early medication adherence is associated with lower rates of psychiatric hospitalization and shorter hospitalization durations.","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128327915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Token Economy Intervention on Hospitalized Patients With Schizophrenia","authors":"Sung-Jin Kim, Y. Seo, Kyoung-Duck Park, J. Moon, J. Jeong, D. Jung","doi":"10.16946/kjsr.2023.26.1.18","DOIUrl":"https://doi.org/10.16946/kjsr.2023.26.1.18","url":null,"abstract":"Objectives: The purpose of this study was to investigate the effect of token economy intervention on the clinical characteristics and global function of patients with schizophrenia.Methods: From June 1, 2022 to September 1, 2022, token economy intervention was conducted for hospitalized patients with schizophrenia in a mental hospital. Assessments were conducted before and after the intervention. Clinical Global Impression-Schizophrenia scale (CGI-SCH), Schizophrenia Quality of Life Scale (SQLS), Insight Scale for Psychosis (ISP), and Apathy Evaluation Scale (AES) were used to evaluate clinical characteristics. World Health Organization Disability Assessment Schedule (WHODAS) was used for global functional assessment.Results: A total of 51 patients were included in the study. Through token economy intervention, depressive (p=0.001), cognitive symptom domain scores (p<0.001) in CGI-SCH, and SQLS score were significantly decreased (p=0.044). In the WHODAS evaluated by the clinician, the scores of self-care (p=0.012), life activities (p=0.006), and participation in society (p=0.040) decreased significantly.Conclusion: It was confirmed that token economy intervention had a positive effect on depressive symptoms, cognitive symptoms, quality of life, self-care function, daily living function, and social participation function in hospitalized patients with schizophrenia.","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122440365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk for Self-Harm or Harm to Others: Definition and Assessment of Dangerousness","authors":"Kounseok Lee","doi":"10.16946/kjsr.2023.26.1.12","DOIUrl":"https://doi.org/10.16946/kjsr.2023.26.1.12","url":null,"abstract":"The Mental Health Act of 1995 was fully revised on May 29, 2016, and implemented on May 30, 2017, under the name of the Mental Health Promotion and Mental Health Service Support Act (Mental Health Welfare Act). The act newly defined mentally ill people as those with significant limitations in independent daily life and reduced their classification based on severity. Before the revision, patients could be admitted to the hospital if satisfied with the risk of self-injury or harm to others or the need for treatment. The self-injury and harm to others risk criteria for involuntary admission is based on the idea of respecting patients’ right to self-determination. However, predicting future risks can be challenging, and the situation at the time of judgment should be considered. This study aims to examine the administrative and legal interpretation of the self-injury or harm to others risk for involuntary admission, review definitions and evaluations of the risk of self-harm in various areas, and suggest improvements for mental health policies or guidelines.","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133795425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breakthrough Psychosis and Long-Acting Injectable Antipsychotics","authors":"E. Joo, K. Lee, S. Jeong, Y. S. Kim","doi":"10.16946/kjsr.2023.26.1.1","DOIUrl":"https://doi.org/10.16946/kjsr.2023.26.1.1","url":null,"abstract":"“Breakthrough” of psychosis despite good compliance of antipsychotics medication for a long time is a major obstacle to the treatment of schizophrenia, whether the mechanism is caused by dopamine hypersensitivity or insufficient dose of antipsychotics. Researchers advocating “Dopamine Supersensitivity Psychosis” (DSP) emphasize to avoid excessive inhibition of dopamine 2 receptors from the beginning of treatment. On the other hand, researchers advocating “Breakthrough psychosis on Antipsychotic Maintenance Medication” (BAMM) in which psychosis recurs due to insufficient medication despite continuous administration of antipsychotics without non-adherence argue that dose of antipsychotics should be increased to enhance therapeutic effect. In patients using long-acting antipsychotics injection (LAI), non-compliance can be ruled out. We believe that in treating non-affective psychosis, it is necessary to continuously maintain the lowest dose possible using the optimal dose considering the side effects of second-generation antipsychotics and the cycle and stage of psychosis, and the optimal formulation such as LAI.","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125295838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Factors Affecting Constipation in Patients with Schizophrenia Taking Clozapine","authors":"Min-Joo Lee, Sung-Jin Kim, J. Moon, D. Jeon, D. Jung","doi":"10.16946/kjsr.2022.25.2.54","DOIUrl":"https://doi.org/10.16946/kjsr.2022.25.2.54","url":null,"abstract":"Objectives: To investigate clinical factors affecting constipation in patients with schizophrenia taking clozapine.Methods: The participants were patients with schizophrenia taking clozapine and tested for the Therapeutic Drug Monitoring from September 1, 2020 to July 1, 2022 at a university hospital. To evaluate the effect of clozapine on constipation, clozapine dosage, clozapine concentration, and norclozapine concentration were investigated. To evaluate effects of drugs other than clozapine on constipation, dosage and type of other drug were investigated. Anticholinergic Drug Scale was used to evaluate anticholinergic action.Results: A total of 56 patients were enrolled in the study. Clozapine daily dose, clozapine concentration, and norclozapine concentration were higher in the constipated patient group. Through logistic regression analysis, it was discovered that the risk of constipation increased as the norclozapine concentration increased, and the results remained similarly even after adjustments of related variables was performed.Conclusion: It was discoverd that among patients taking clozapine, the higher the norclozapine concentration, the higher the probability of constipation. Among patients taking clozapine, patients with high norclozapine concentration may need additional evaluation and management of constipation.","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133594191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Attachment Behavior in Psychosis","authors":"Y. Kim","doi":"10.16946/kjsr.2022.25.2.23","DOIUrl":"https://doi.org/10.16946/kjsr.2022.25.2.23","url":null,"abstract":"Psychosis is a symptom of functional decline due to hallucinations, delusions, and the resulting behavior, and it appears in several psychiatric conditions including schizophrenia and severe mood episodes of bipolar affective disorder. Psychosis is influenced by environmental factors, including childhood stress, as well as genetic predisposition. People with psychosis are known to have more insecure attachments than the general population, and are particularly more likely to display dismissive attachment styles. Attachment behavior is related to stress-induced CRH secretion, CRH suppression by oxytocin, and dopamine release in the brain. Imbalances of CRH, oxytocin, and dopamine are expected in psychotic patients with unstable attachments, requiring tailored treatment for this condition. Therefore, this review intends to investigate the effects of insecure attachment in individuals with psychosis.","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124041306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Probability of Transition to Psychosis and Bipolar Disorder in Individuals With Neurodevelopmental Disorders","authors":"S. An, Bum-Sung Choi, Eun-ra Yu, J. Jeong, S. Huh","doi":"10.16946/kjsr.2022.25.2.62","DOIUrl":"https://doi.org/10.16946/kjsr.2022.25.2.62","url":null,"abstract":"Objectives: The clinical trajectories of adolescent-onset psychosis and bipolar disorder are worse than that of adult-onset cases. Although psychosis and bipolar disorder are more prevalent among those with neurodevelopmental disorders such as ADHD and autism spectrum disorder compared with the general population, the incidence during adolescence has not yet been explored.Methods: Out of 3,730 patients who visited the Department of Pediatric Psychiatry at Pusan National University Yangsan Hospital between November 2008 and May 2021, patients with neurodevelopmental disorders who did not meet the criteria for psychosis or bipolar disorder and had at least one year of the follow-up period were selected. A Kaplan-Meier analysis was performed to examine the cumulative incidence of psychosis and bipolar disorder in patients with neurodevelopmental disorders.Results: The sample included 591 patients with neurodevelopmental disorders (mean age 12.6 years, range 10-18 years). The 9-years cumulative incidences of psychosis and bipolar disorder are 1.3% (95% CI=0.2%-2.4%), 11.6% (95% CI=7.4%-15.6%), respectively.Conclusion: Patients with neurodevelopmental disorders showed a high incidence of psychosis and bipolar disorder during adolescence. This suggests that patients diagnosed with neurodevelopmental disorders should be continuously evaluated and monitored of the occurrence of comorbidities during adolescence.","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"127 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122350145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Affecting the Family Attitude Toward the Outpatients With Schizophrenia","authors":"S. Choi, Hyun Soo Kim, C. Kim","doi":"10.16946/kjsr.2022.25.2.43","DOIUrl":"https://doi.org/10.16946/kjsr.2022.25.2.43","url":null,"abstract":"Objectives: To identify various factors that might affect a high expressed emotion recognized by primary caregivers of the schizophrenic outpatients.Methods: Of patients who had been receiving outpatient treatments at department of psychiatry of Dong-A university hospital, 154 patients with a DSM-V diagnosis of schizophrenia with stable symptoms and their primary caregivers were enrolled in this study. Family attitude (family attitude scale) was assessed through an interview with primary caregivers. In these patients, symptoms (brief psychiatric rating scale), problem behavior (behavior and symptom identification scale), general health status (shortform 36 health survey), recovery (recovery assessment scale), drug attitude (drug attitude inventory), insight (self-appraisal of illness questionnaire) were assessed through a self reporting questionnaire. Multiple regression analysis were performed in consideration of 15 factors (age, sex, the level of education, marital status, job status, age of onset, duration of illness, number of hospitalization, chlorpromazine equivalent dose, symptoms, problem behavior, general health status, recovery, drug attitude, insight) as explanatory variables for a family attitude.Results: On a multiple regression analysis, the following five factors were found to be significant explanatory variables for a family attitude that is experienced by primary caregivers of the schizophrenic outpatients: job status, duration of illness, number of hospitalization, problem behavior, and drug attitude. A coefficient of determination for these five explanatory variables was 0.58. The high expressed emotion group had significantly higher number of hospitalizations and problem behavior, but lower employment, poorer genral health status, negative drug attitude, and lack of insight compared to the low expressed emotion group.Conclusion: Our results showed that five factors such as job status, duration of illness, number of hospitalization, problem behavior, and drug attitude were found to be significant explanatory variables for family attitude that is experience by primary caregivers of the schizophrenic outpatients. Because these five variables account for 58% of total family attitude, however, further studies are needed to identify other factors that might affect a family attitude.","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126113331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Structured Group Acceptance and Commitment Therapy for Psychological Acceptance and Recovery Among Inpatients With Psychotic Disorder: A Pilot Study","authors":"Narae Jeong, Hyesu Jeon, Do-Jae You, Yu Sang Lee","doi":"10.16946/kjsr.2022.25.2.32","DOIUrl":"https://doi.org/10.16946/kjsr.2022.25.2.32","url":null,"abstract":"Objectives: Psychosocial intervention method is very important for clinical recovery and personal recovery for psychosis. Acceptance and Commitment Therapy (ACT) is a trans-diagnostic approach that has been proven effective in the recovery for psychosis but there are few studies in South Korea testing its effects. In this paper, the structured protocol, ‘Group Acceptance and Commitment Therapy for Psychosis Recovery (G-ACTp)’ was adopted and a systematized manual was developed to investigate the effects on psychological acceptance and recovery.Methods: 17 patients receiving treatment for psychotic symptoms were randomly assigned to the treatment group and control group, respectively. The treatment group (n=9) received G-ACTp for 5 weeks in addition to the treatment as usual, and the control group (n=8) waited with only the treatment as usual, and the scores of pre assesment, post assesment, and follow-up assessment for acceptance, recovery, mindfulness, psychotic symptoms, depression, anxiety, and quality of life were all compared.Results: As a result, there was a significant interaction effect of time and group in acceptance and recovery variables. Also, in the mindfulness variable, there was a significant trend in the time and group interaction. There were no significant effects on psychotic symptoms, depression and anxiety symptoms, and quality of life variables.Conclusion: As a result of this study, it was mentioned that the ACT for psychosis can be widely used as an effective method in the personal recovery of psychosis, and that results can be linked to the application of mental health services in South Korea. Finally, the significance and limitations of the studies were discussed.","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126893133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting Patients With Schizophrenia in the Era of COVID-19","authors":"Sung-Wan Kim","doi":"10.16946/kjsr.2021.24.2.45","DOIUrl":"https://doi.org/10.16946/kjsr.2021.24.2.45","url":null,"abstract":"2020년 초에 시작된 코로나19 (coronavirus disease 2019, COVID-19)의 세계적 확산은 우리 사회의 구조와 생활 방식 에 큰 변화를 주었다. 바이러스로 인한 감염성 질환이지만 의학적 측면은 물론이고 사회문화적 측면에도 큰 영향을 미치 고 있다. 코로나19 확산을 막기 위한 사회적 거리두기의 장기 화는 사람들의 일상 활동 형태를 변화시키고 사회경제적 어려 움을 야기하여 심리적 스트레스를 가중시키고 있다. 의학적 측면에서 코로나19는 전염력이 높을 뿐만 아니라 노인과 기저 신체질환이 있는 사람들에게 치명률이 높은 감염성 질병이다. 의료체계가 코로나19 감염 확산 방지와 감염자 대응에 초점 을 두고 운영이 되면서 일반 질병 치료는 과거에 비해 소극적 으로 대처하게 되는 경향이 있다. 특히 꾸준한 의료적 치료와 지역사회 재활이 필요한 조현병 환자들은 코로나19 유행 시기 에 심각한 영향을 받고 있다. 이에 본 논문에서는 그간의 연구 결과와 경험을 기반으로 코로나19 유행 시기에 조현병 환자들 이 받는 영향에 대해 살펴보고 질병을 관리하고 지원하는데 고려해야 하는 사항들을 제시하고자 한다.","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127409306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}