Korean Journal of Schizophrenia Research最新文献

{"title":"Association of the First Antipsychotic Treatment Duration With the Re-Initiation of Treatment in Schizophrenia: A National Health Insurance Data-Based Study","authors":"Mi-Yoen Song, Jungsun Lee, Harin Kim, S. Ahn, Y. Choi, Y. T. Jo, S. W. Joo","doi":"10.16946/kjsr.2021.24.2.60","DOIUrl":"https://doi.org/10.16946/kjsr.2021.24.2.60","url":null,"abstract":"Schizophrenia is a psychiatric disorder with an estimated lifetime prevalence of approximately 1% and leads to cognitive devastation and social maladjustment. Antipsychotic drug plays a crucial role in the treatment of schizophrenia. Previous studies have reported that after the stabilization of symptoms for 1–2 years, 57%–98% of the patients with firstepisode schizophrenia experience relapse after discontinuation or reduction in dose of antipsychotics. Relapse is associated with an increased risk of self-harm or violence and poses a detrimental effect on interpersonal relationships and occupational function. Recurrent relapses, usually defined as aggravation of psychotic symptoms, may indicate progression of the disease and hinder patients from recovering to their previous level of functioning. Therefore, several studies have been conducted to prevent relapse and identify risk factors associated with relapse, including caregiver criticism, substance use disorder, low treatment compliance, and poor premorbid adjustment. Many studies have reported that the continuation of antipsychotic treatment is essential to prevent relapse and improve long-term outcomes in first-episode schizophrenia, along with inadequate effectiveness of intermittent treatment. Although it has been well acknowledged that the discontinuation of antipsychotic treatment is highly predictive of relapse in first-episode schizophrenia, the optimal maintenance period in terms of a balance between the prevention of relapse and adverse effects owing to a long-term use of antipsychotics, such as obesity and metabolic syndrome remains unclear. A recent systematic review including six randomized control trials (RCTs) showed no correlation of the duration of maintenance treatment with relapse rate in firstepisode schizophrenia. However, the findings need to be replicative and verified because of the limitations which were different treatment durations and short observation periods Received: August 22, 2021 / Revised: September 23, 2021 Accepted: September 29, 2021 Address for correspondence: Sung Woo Joo, Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympicro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: 02-3010-3410, Fax: 02-485-8381 E-mail: jootak01@gmail.com Association of the First Antipsychotic Treatment Duration With the Re-Initiation of Treatment in Schizophrenia: A National Health Insurance Data-Based Study","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"41 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":"116307609","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":"Effect of Delayed Clozapine Initiation on Acute Treatment Response in Treatment-Resistant Schizophrenia","authors":"Soyung Yang, Jung-Kyu Choi, Sunyoung Park, Jaesub Park","doi":"10.16946/kjsr.2021.24.2.52","DOIUrl":"https://doi.org/10.16946/kjsr.2021.24.2.52","url":null,"abstract":"클로자핀(clozapine)은 TRS 환자에게서 유의한 효과를 보 인 유일한 약물이며, 치료 반응률은 연구마다 다양하나 대 체로 30%-60% 정도로 보고되고 있다. 클로자핀은 다른 Received: May 20, 2021 / Revised: June 4, 2021 Accepted: July 6, 2021 Address for correspondence: So Yung Yang, Department of Psychiatry, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang 10444, Korea Tel: 031-900-3562, Fax: 031-900-0343 E-mail: soryul@naver.com 본 연구는 국민건강보험 일산병원의 연구비 지원으로 이루어졌음(NHIMC20 20CR078). 클로자핀의 지연된 사용이 치료저항성 조현병 환자의 급성기 약물 반응에","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"667 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":"131856074","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":"Pseudo-Resistant Schizophrenia: Non-Adherence to Treatment","authors":"Hye-Yeon Kim, Seung Jae Lee","doi":"10.16946/kjsr.2020.23.2.51","DOIUrl":"https://doi.org/10.16946/kjsr.2020.23.2.51","url":null,"abstract":"Treatment-resistant schizophrenia (TRS) has been defined as the persistence of positive symptoms despite two or more trials of antipsychotic medication of adequate dose and duration. TRS is a serious clinical problem and occurs in approximately 30% of patients with schizophrenia. It is important that patients who do not adequately respond to antipsychotics be reevaluated to ex-clude or address causes other than non-responsiveness to medication, that is, the possibility of pseudo-resistance. In particular, non-adherence to oral antipsychotic treatment should be monitored to rule out pseudo-resistant cases of TRS. Moreover, patients with TRS who take their medication as required may have subtherapeutic antipsychotic plasma levels, secondary to pharmacoki-netic factors. In this paper, we review the concept and exclusion of pseudo-resistance, especially owing to non-adherence or phar-macokinetic factors, and present methods to enhance drug adherence. (Korean J Schizophr Res 2020;23:51-57)","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123171416","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":"Korean Treatment Guideline on Pharmacotherapy of Co-existing Symptoms and Antipsychotics-related Side Effects in Patients with Schizophrenia","authors":"J. Yun, Jung Suk Lee, S. Kang, Beomwoo Nam, Seung Jae Lee, Seung Hwan Lee, Joonho Choi, Chan-Hyung Kim, Young-Chul Chung","doi":"10.16946/kjsr.2019.22.2.21","DOIUrl":"https://doi.org/10.16946/kjsr.2019.22.2.21","url":null,"abstract":"Je-Yeon Yun, MD, PhD, Jung Suk Lee, MD, PhD, Shi Hyun Kang, MD, PhD, Beomwoo Nam, MD, PhD, Seung Jae Lee, MD, PhD, Seung-Hwan Lee, MD, PhD, Joonho Choi, MD, PhD, Chan-Hyung Kim, MD, PhD, and Young-Chul Chung, MD, PhD Seoul National University Hospital, Seoul, Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, Adult Psychiatry, Division of Medical Services, National Center for Mental Health, Seoul, Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Department of Psychiatry, School of Medicine, Kyoungpook National University, Daegu, Department of Psychiatry, Inje University, Ilsan-Paik Hospital, Goyang, Department of Psychiatry, Hanyang University Guri Hospital, Guri, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Korea","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130296800","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 Characteristics, Drug Adherence to Antipsychotics and Medical Use Trends in Patients First Diagnosed with Psychotic Disorder: A Preliminary Study","authors":"Jungeun Heo, Dongwook Kim, Seung-Taek Oh, W. Choi, Jaesub Park","doi":"10.16946/kjsr.2019.22.2.42","DOIUrl":"https://doi.org/10.16946/kjsr.2019.22.2.42","url":null,"abstract":"탕으로 최근까지 대부분의 연구와 정책들은 전구기에 있는 Received: June 4, 2019 / Revised: June 18, 2019 Accepted: August 29, 2019 Address for correspondence: Jaesub Park, Department of Psychiatry, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang 10444, Korea Tel: 031-900-0432, Fax: 031-900-0343 E-mail: psy.ilsan@nhimc.or.kr 본 연구는 국민건강보험 일산병원의 연구비 지원으로 이루어졌으며, 본 연구 에 사용된 자료의 관리번호는 NHIS-2017-1-159임. 정신병적 장애로 첫 내원한 환자들의 임상 특징과 투약 순응도 및","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124856521","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":"The Effectiveness on Prevention of Rehospitalization with Long-Term Psychosocial Interventions for Patients with Major Psychiatric Disorders","authors":"J. Jeong, M. Kang, M. Kwon, Sang Min Lee, Kyu-Young Lee","doi":"10.16946/kjsr.2019.22.2.66","DOIUrl":"https://doi.org/10.16946/kjsr.2019.22.2.66","url":null,"abstract":"Objectives: This study aimed to elucidate the effectiveness of long-term psychosocial intervention in reducing the disabling period of patients with major psychiatric disorders by their rehospitalization rate. Methods: Of the 210 patients with major psychiatric disorders received psychosocial interventions in a Mental Health and Welfare Center, 192 patients (147 with schizophrenia spectrum disorders, 45 with mood disorders) who received interventions more than 6 months were selected. Review of case management records was conducted to obtain information. Results: The number and length of hospitalization and the hospital days per year significantly decreased after psychosocial intervention. Additional analysis of 102 patients followed up for more than 5 years suggested that the effectiveness of the intervention persisted for a sufficient period. However, no significant difference was observed in the number of rehospitalization in 45 patients with mood disorders, though the length of hospitalization significantly decreased. In addition, the hospital days per year of 21 patients with mood disorder followed up for more than 5 years also showed no significant decrease. Conclusion: Long-term psychosocial intervention had a significant effect on reducing the number and length of hospitalization for patients with major psychiatric disorder and the effectiveness maintained for more than 5 years. (Korean J Schizophr Res 2019;22:66-73)","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"177 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121623166","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":"The Insight Paradox among Outpatients with Schizophrenia","authors":"T. Kim, Jun Gee Kim, C. Kim","doi":"10.16946/kjsr.2019.22.2.56","DOIUrl":"https://doi.org/10.16946/kjsr.2019.22.2.56","url":null,"abstract":"조현병과 같은 심한 정신질환을 앓고 있는 환자들은 자신 이 병을 앓고 있다는 사실을 알아차리지 못한다. 대부분의 조현병 환자들은 급성기에 자신이 병을 앓고 있다는 사실을 인식하지 못하며, 정신병적 증상이 회복한 후에도 반 이상이 부분적인 병식결여를 보인다. 이러한 병식 결여는 조현병 환 자에서 흔히 발견되기 때문에 특징적인 증상 중의 하나로 간 주된다. 병식이란 단순히 자신이 앓고 있는 병명을 아는 것 이 아니다. 그보다는 앓고 있는 병의 성질, 증상, 경과, 치료, 예후 등에 대해 포괄적으로 이해하는 것을 의미한다. 병식 이 있다는 것은 병으로부터 회복하기 위해 자신이 무엇을 어 떻게 해야 하는지를 안다는 것과 같은 의미이다. 따라서 조현 병 치료에서 병식회득은 치료를 하는 주요 목적이었고 좋은 예후를 예측하는 요인으로 여겨졌다. 실제로 병식이 빈약한 조현병 환자는 여러 면에서 나쁜 치 료결과를 보이며 회복에 커다란 장애물로 작용한다. 병식이 없는 조현병 환자는 치료를 받는 것에 부정적이기 때문에 지 속적으로 치료를 받지 않고 약물치료에 대해 부정적이며 치료자와도 좋은 관계를 유지하지 못한다. 또 재입원 비율 이 더 높고 사회기술이 더 떨어지고 취업과 일의 수행능 력이 떨어지고 전반적인 사회기능이 떨어진다. 반면 병 식이 있는 조현병 환자는 약물치료에 긍정적이고 사회기능 을 잘 하고 자기 효능감도 높다. 그런데 조현병 환자에서 병식을 획득하는 것이 긍정적인 치 료결과만을 보이는 것이 아니라는 결과들도 보고된다. 조현병 Received: July 7, 2019 / Revised: August 11, 2019 Accepted: August 18, 2019 Address for correspondence: Chul Kwon Kim, Department of Psychiatry, College of Medicine, Dong-A University, 26 Daesingongwon-ro, Seo-gu, Busan 49201, Korea Tel: 051-240-5467, Fax: 051-253-3542 E-mail: kimck@dau.ac.kr 조현병 외래 환자에서 병식 모순","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115442532","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":"Comparative Study of Clinical Features between Early- and Late-Onset Schizophrenia in South Korea","authors":"M. Ko, Seon-Koo Lee, Jung Suk Lee","doi":"10.16946/kjsr.2019.22.2.51","DOIUrl":"https://doi.org/10.16946/kjsr.2019.22.2.51","url":null,"abstract":"late-onset schizophrenia-like psychosis (VLOSP)라 하였 다. 후기 발병 조현병은 LOS와 VLOSP를 모두 합쳐서 부 Received: January 15, 2019 / Revised: August 20, 2019 Accepted: September 10, 2019 Address for correspondence: Jung Suk Lee, Department of Psychiatry, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang 10444, Korea Tel: 031-900-0269, Fax: 031-900-0343 E-mail: thanato9@nhimc.or.kr 본 연구는 국민건강보험 일산병원의 연구비 지원으로 이루어졌음(NHIMC2017CR022). 조기 발병 조현병과 후기 발병 조현병의 임상 양상에 대한 비교 연구","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121208233","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":"Public Attention to Crime of Schizophrenia and Its Correlation with Use of Mental Health Services in Patients with Schizophrenia","authors":"Hyunwoo Park, Yu Sang Lee, Sang Yup Lee, Seungyeoun Lee, K. Hong, S. Koike, J. Kwon","doi":"10.16946/kjsr.2019.22.2.34","DOIUrl":"https://doi.org/10.16946/kjsr.2019.22.2.34","url":null,"abstract":"","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120935159","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":"A Study of Total Medical Cost and Hospitalization Risk of Patients with Schizophrenia and Type 1 Diabetes Mellitus","authors":"Sang Uk Lee, You Seok Kim","doi":"10.16946/KJSR.2019.22.1.8","DOIUrl":"https://doi.org/10.16946/KJSR.2019.22.1.8","url":null,"abstract":"정신질환은 특정 집단에 국한되어 나타나는 것이 아닌 모든 지역, 국가, 사회에서 나타난다. 세계경제포럼에서는 2010년 기준 정신질환의 질병부담이 8.5조 달러로, 심혈관질환, 암, 만성호흡기질환의 질병부담 보다 높으며, 증가하는 속도 역시 매우 빨라 2030년에는 약 2배에 달할 것으로 보고하였다. 한국의 경우에도 정신질환으로 인한 의료비용과 사회적 비용 이 매우 높게 보고되고 있으며, 2011년 기준 정신질환 관련 총 진료비는 2조 480억 원으로 제시되었다. 또한 국민의 4 명 중 1명이 일생 동안 한번 이상 정신질환을 경험하였으며, 조현병 스펙트럼 장애의 평생 유병률은 0.5%로 조사되었다. 세계적으로 조현병의 유병률은 약 0.5~1%이며 환자의 삶에 부정적인 영향을 주는 질환으로도 알려져 있다. 이런 조현병 환자의 기대 수명은 일반인보다 20년 정도 짧으며 이는 신체 질환 등의 문제와 관련성이 있다. 조현병 환자의 사망위험은 정신과적 문제 보다는 신체적인 문제로 기인하는 요인이 더 크고 특히 심혈관 및 내분비계 질환이 큰 역할을 하며, 이 중 당뇨병은 주요한 요인 중 하나로 고려할 수 있다. 조현병 환자의 제2형 당뇨병 위험은 여러 논문에서 제시되 어 왔는데, 유병률은 약 10%정도이며, 치료를 위한 약물 사 용, 신체 활동량의 감소 등이 발생요인으로 알려져 왔다. 또한, 당뇨병의 치료율은 매우 낮으며, 저혈당 및 고혈당 등 으로 인해 입원 위험이 일반인 대비 1.7배 이상 높은 것으로 보고되었다. 이렇게 여러 선행연구를 통해 조현병 환자의 제2형 당뇨병 위험 및 입원 위험 등은 명확히 알려져 있는 반 Received: January 3, 2019 / Revised: April 2, 2019 Accepted: April 3, 2019 Address for correspondence: You-Seok Kim, National Center for Mental Health, 127 Yongmasan-ro, Gwangjin-gu, Seoul 04933, Korea Tel: 02-2204-0104, Fax: 02-2204-0389 E-mail: kysmd@hanmail.net 본 논문은 국립정신건강센터의 2018년도 임상연구사업(연구과제: 2018-05) 의 지원에 의한 것임. 제1형 당뇨병을 동반한 조현병 환자의 총 의료비용 및 입원 위험","PeriodicalId":314956,"journal":{"name":"Korean Journal of Schizophrenia Research","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125894495","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}