Chul-Eung Kim

Inha University Hospital, Sinhyeon, South Gyeongsang, South Korea

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Publications (22)30.98 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of the present study was to refine the 20-item Subjective Well-Being under Neuroleptic Treatment Scale (SWN-20) using the Rasch rating model to validate measurements of subjective well-being in patients with schizophrenia undergoing antipsychotic treatment. In total, 854 (403 males, 451 females) inpatients (n=213) and outpatients (n=641) with schizophrenia participated in this study, which was designed as an open-label investigation of paliperidone extended release. The participants completed the Korean version of the SWN-20 themselves. Refinement of the Korean version of the SWN-20 was accomplished using the Rasch rating model. Infit and outfit statistics for all 20 items satisfied the criterion for construct validity. Second, all items except items 2 and 20 had suitable point-measure correlations, reflecting content validity. Third, item characteristic curves indicated that roughly 18 items were evenly distributed along the person ability continuum. Finally, option analysis of the category characteristics showed that categories 3 and 4 in the SWN-20 response format were unnecessary. We offer several recommendations for improving the SWN-20: (a) items 2 and 20 should be omitted to ensure construct validity; (b) easier items would be added related to the person ability estimates in the process of validating a short form of the SWN scale based on item response theory; and (c) the number of response categories should be reduced for schizophrenic patients. Copyright © 2014 Elsevier Inc. All rights reserved.
    Comprehensive Psychiatry 12/2014; DOI:10.1016/j.comppsych.2014.12.003 · 2.26 Impact Factor
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    ABSTRACT: Electroconvulsive therapy (ECT) is an effective and safe treatment method for a variety of psychiatric disorders, including major depressive disorder. Although there is no absolute contraindication to ECT, clinicians often hesitate to apply this method to patients with a skull defect. We report a case of ECT performed on a major depressive disorder patient with an open wound after craniectomy. We summarize successful ECT cases of patients with a permanent skull defect and discuss various factors that may influence ECT outcomes in patients with a skull defect, including electrode placement, benzodiazepines, and anticonvulsants. © 2014 Wiley Publishing Asia Pty Ltd.
    Asia-Pacific Psychiatry 12/2014; 6(4):454-7. DOI:10.1111/appy.12130 · 0.42 Impact Factor
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    ABSTRACT: Objective Switching antipsychotics is one useful therapeutic option when the treatment of schizophrenia encounters suboptimal efficacy and intolerability issues. This study aimed to investigate the efficacy and tolerability of cross-tapering switching to ziprasidone from other antipsychotics. Methods A total of 67 patients with schizophrenia or schizoaffective disorder were recruited in this 12-week, multicenter, non-comparative, open-label trial. Prior antipsychotics were allowed to be maintained for up to 4 weeks during the titration of ziprasidone. Efficacy was primarily measured using the 18-item Brief Psychotic Rating Scale (BPRS) at baseline, 4 weeks, 8 weeks, and 12 weeks. Efficacy was secondarily measured by the Clinical Global Impression-Severity (CGI-S) scale and the Global Assessment of Functioning (GAF) scale at each visit. Regarding the metabolic effects of switching to ziprasidone, weight, body mass index (BMI), waist-to-hip ratio (WHR), and lipid profile-including triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol levels-were measured at each follow-up visit. Results The BPRS scores were significantly improved at 12 weeks after switching to ziprasidone (F=5.96, df=2.11, p=0.003), whereas the CGI-S and GAF scores were not significantly changed. BMIs, WHRs, and TG levels were significantly decreased, with no significant changes in other lipid profiles. Conclusion Cross-tapering switching to ziprasidone is effective for patients with schizophrenia spectrum disorders. Beyond the efficacy of the procedure, favorable metabolic profiles show that switching to ziprasidone may be helpful for maintenance therapy over an extended period.
    Psychiatry investigation 10/2014; 11(4):459-66. DOI:10.4306/pi.2014.11.4.459 · 1.15 Impact Factor
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    ABSTRACT: Objective This study investigated the prescription patterns for Korean patients with schizophrenia with a particular focus on antipsychotic polypharmacy. All data were gathered from patients presenting at 41 tertiary university hospitals and 8 secondary hospitals. Methods Data from three multicenter studies conducted in Korea were retrospectively reviewed and integrated to identify patients with schizophrenia who had their antipsychotic medication switched to paliperidone extended-release between 2008 and 2009. The rates for antipsychotic polypharmacy, combined use of different antipsychotic classes with a special focus on atypical antipsychotics, and psychotropic polypharmacy using benzodiazepines, mood stabilizers, and other relevant drugs were identified. Results Of the 851 Korean patients analyzed in this study, 20.4% (n=173) had been prescribed antipsychotic polypharmacy. Of the 678 patients receiving antipsychotic monotherapy, 6.9% (n=47) were prescribed a typical antipsychotic and 93.1% (n=631) were prescribed an atypical antipsychotic. Of the 173 patients receiving a combination of antipsychotic drugs, only 6.4% (n=11) had been prescribed polypharmacy with typical antipsychotics, while 46.82% (n=81) were prescribed atypical+atypical antipsychotics or typical+atypical antipsychotics. The highest co-prescription rates for other psychotropic drugs in conjunction with antipsychotics included benzodiazepines (30.3%), anticholinergic drugs (28.8%), antidepressants (13.3%), β-blockers (10.1%), and mood stabilizers (8.7%). Conclusion The present findings demonstrate that the rate of antipsychotic polypharmacy is relatively low in Korea and that Korean clinicians prefer to prescribe atypical, rather than typical, antipsychotic drugs. This suggests that there is a distinct prescription pattern in Korea that is focused on antipsychotic polypharmacy.
    Clinical Psychopharmacology and Neuroscience 08/2014; 12(2):128-36. DOI:10.9758/cpn.2014.12.2.128
  • Hee-Yun Kim, Byoung Wook Bang, Chul-Eung Kim
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    ABSTRACT: Belching is the audible escape of air from the esophagus into the pharynx. It is considered a disorder when the symptom is very frequent and causes significant distress to the patients. Excessive belching can be divided according to excessive supragastric and gastric belching. Gastric belching is usually physiological. In contrast, supragastric belching can be considered learned behavior. In addition, many psychiatric conditions, including anxiety, have been described in patients with supragastric belching and some patients have reported that their symptoms increased during stressful events. We report on a case of supragastric belching in a depressive patient and discuss its management through psychiatric approaches.
    01/2014; 53(5):327. DOI:10.4306/jknpa.2014.53.5.327
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    ABSTRACT: Paliperidone extended-release tablet (paliperidone ER) is a new oral psychotropic agent developed for schizophrenia treatment. There have been some studies about paliperidone's good efficacy and tolerability. Clinicians appear to change the antipsychotic medication to paliperidone ER. However, it is not known what patients are favorable responsive to paliperidone ER. The aim of this study was to evaluate the characteristics of early responders and investigate predictors of acute response when the medications changed to paliperidone ER. Data were analyzed from schizophrenic patients who participated in a multi-center, open-label, non-comparative clinical trial. Total 320 patients were examined in this study. Sociodemographic, psychopathology, social function and metabolic data were evaluated. Unpaired t-test for continuous and χ(2) for categorical data, respectively, were used to compare early responder and non-responders. Logistic regression analysis was used to establish a prediction model. 38.7% of study subjects (124 of 320) responded to paliperidone ER treatment. Logistic regression analysis showed that a good paliperidone ER response was more likely when patients were social drinkers, when patients had started medication at inpatient, when negative symptoms were less severe, and when patients' social relationship and self-care were better. Early response to paliperidone ER treatment is associated with less negative symptoms and good social relationships and self-care. Strategies to reduce these symptoms may contribute to early response to paliperidone ER.
    Psychiatry investigation 12/2013; 10(4):407-16. DOI:10.4306/pi.2013.10.4.407 · 1.15 Impact Factor
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    ABSTRACT: Although antipsychotic polypharmacy is widely used in the pharmacotherapy of schizophrenia, its effectiveness is controversial. In particular, clinicians tend to avoid switching to monotherapy in patients who have been prescribed polypharmacy. In the present study, the authors investigate whether there is difference in time to discontinuation of antipsychotics between patients on previous monotherapy or polypharmacy. Pooled analysis was conducted on two 24-week, multicenter, open-label, non-comparative studies that were originally designed to investigate the effectiveness of switching to paliperidone extended-release (ER) in patients with schizophrenia. Patients were divided into two groups according to previously prescribed antipsychotics, that is, to a polypharmacy group or a monotherapy group. The primary outcome measure was time to discontinuation of paliperidone ER. In addition, the authors sought to identify clinical variables that influence time to discontinuation. Before switching to paliperidone ER, 535 of 673 (79.5%) patients were prescribed antipsychotic monotherapy, and the remaining 138 (20.5%) patients were prescribed antipsychotic polypharmacy. No significant differences in time to discontinuation of paliperidone ER were observed between the polypharmacy and monotherapy groups. Personal and social performance scale score was the only factor found to influence time to discontinuation of paliperidone ER. No differences in psychopathology or adverse effects were found between the monotherapy and polypharmacy groups. Our results suggest that number of antipsychotics prescribed before switching to monotherapy does not influence clinical prognosis in patients with schizophrenia.
    Clinical Psychopharmacology and Neuroscience 12/2013; 11(3):152-7. DOI:10.9758/cpn.2013.11.3.152
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    ABSTRACT: Objectives : The aim of this study was to examine attitudes of middle-school students toward happiness, suicide, and factors associated with suicide. Methods : A self-administered questionnaire was used in a cluster sample of 1,319 middle-school students (male 793, female 526). Data were obtained on a wide range of constructs regarding their attitude towards happiness, suicidal ideation and attempts, and factors associated with suicide. Results : Middle-school students choose 'love within family' as most important factor for their happiness. Subjective mental health status was mostly associated with happiness. Subjects in lower socioeconomic status tended to respond their mental health status was not good and have more suicidal idea. 48.7% of subjects had permissive attitudes toward suicide, especially, girls. However, 65.0% responded that suicide was preventable problem. Compared to older people, middle-school students perceived that environmental factors were more important than innate and personal factors for suicide. Conclusion : Results of the study indicate that middle-school students have permissive attitudes toward suicide, but positive attitudes for the prevention of suicide. This suggest that education in these age group could be effective for the prevention of suicide. Also, approaches to suicide prevention programs should be developed based on the family intervention. Especially, we should care about girls and adolescents in lower socioeconomic status.
    03/2013; 24(1). DOI:10.5765/jkacap.2013.24.1.28
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    ABSTRACT: OBJECTIVE: This study assessed whether the subjective experience of patients with schizophrenia improved after switching from an oral antipsychotic to flexibly-dosed paliperidone extended-release. METHODS: We conducted a 24-week, multicenter, non-comparative, open-label trial. A total of 387 patients with schizophrenia participated the study. The primary study outcome was the change in subjective symptoms measured by the Symptom Checklist-90-Revised version (SCL-90-R) from baseline. Visual analogue scales were used for sleep and daytime somnolence as secondary subjective assessments. The clinical global impression-schizophrenia-severity scale was used to assess overall symptom severity. Social functioning was evaluated by the personal and social performance scale. Adverse events were also evaluated. RESULTS: All subjective symptoms measured by the SCL-90-R improved significantly. The early responders, who achieved >20% reduction in the SCL-90-R within 1 week, maintained significantly lower severity through the 24 weeks. The clinical global impression-schizophrenia-severity scale and personal and social performance scores also improved significantly. The visual analogue scales revealed that daytime somnolence improved significantly, whereas nocturnal sleep quality was unaltered. CONCLUSION: Our results suggest that switching to paliperidone extended-release was associated with improvements in various subjective symptoms, decreased overall symptom severity, and increased social functioning. The results also suggest that early detection and reduction of subjective symptoms are important for treatment outcome. Copyright © 2013 John Wiley & Sons, Ltd.
    Human Psychopharmacology Clinical and Experimental 03/2013; 28(2). DOI:10.1002/hup.2284 · 1.85 Impact Factor
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    ABSTRACT: Metabolic syndrome and antipsychotic medications are associated with inflammation. This study investigated the relationship between inflammation and metabolic syndrome in patients with schizophrenia. It also examined the effects of paliperidone extended release (ER) treatment on metabolic parameters. Data were analyzed from schizophrenic patients who participated in a multi-center, open-label, non-comparative clinical trial. Anthropomorphic measurements (i.e., weight, waist circumference, and blood pressure) were assessed along with fasting laboratory values, including white blood cell (WBC) count, glucose, high-density lipoprotein, and triglycerides. Among the 225 patients at baseline, the group with the highest WBC count displayed a 5.9-fold risk for metabolic syndrome compared with that of the lowest group. An increase of 10(3)WBCs/μL was associated with a 1.4-fold increased risk for metabolic syndrome. After 24weeks of treatment with paliperidone ER, significant increases were observed in waist circumference and body weight. Changes in WBC count were positively correlated with changes in waist circumference. Schizophrenic patients with high levels of inflammation should be carefully monitored for metabolic syndrome. Moreover, strategies to reduce inflammation and obesity may prevent metabolic syndrome in patients with schizophrenia who take atypical antipsychotic medication.
    Progress in Neuro-Psychopharmacology and Biological Psychiatry 07/2012; 39(2):295-300. DOI:10.1016/j.pnpbp.2012.06.024 · 4.03 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate the efficacy and safety of quetiapine fumarate extended release (XR) in the treatment of Korean subjects with acute schizophrenia. This was an 8-week, multi-center, open-label, non-comparative study to evaluate the efficacy and safety of quetiapine fumarate XR at a daily dose of 400-800 mg. Changes in total scores on the Positive and Negative Syndrome Scale (PANSS) from baseline to week 8 were analyzed to evaluate the efficacy of quetiapine XR. Additionally, the Clinical Global Impression scale and the Montgomery-Åsberg Depression Rating Scale were administered. The mean change in PANSS total scores was -26.8, and the mean PANSS total score at the endpoint was significantly lower than that at baseline. The mean PANSS positive score, negative score, and general score showed statistically significant reductions at the end of the study. Statistically significant changes were also observed in Clinical Global Impression-Severity and Montgomery-Åsberg Depression Rating Scale scores. The most common treatment-related adverse events in the group receiving quetiapine XR were sedation (10.6%) and constipation (9.6%). In this study of Korean patients with acute schizophrenia, quetiapine XR showed clinical efficacy and relatively good tolerability.
    Human Psychopharmacology Clinical and Experimental 07/2012; 27(4):403-10. DOI:10.1002/hup.2241 · 1.85 Impact Factor
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    ABSTRACT: Objectives : The purpose of this study was to examine the association of exposures to heavy metals with positive diagnosis for attention-deficit hyperactivity disorder (ADHD) and Tourette's syndrome (TS). Methods : Study participants included 27 children diagnosed with ADHD ( years of age), 21 diagnosed with Tourette's disorder ( years of age), and 45 normal control children ( years of age). A Perkin-Elmer mass spectrometer was used to measure the concentrations of 5 heavy metals (Pb, Cd, U, Be, Hg) in hair samples obtained from each participant. Each heavy metal concentration was compared among the groups by use of a Kruskal-Wallis test. Results : The levels of lead (p=.006) and cadmium (p=.037) observed in the hair of children diagnosed with ADHD were significantly higher than those found in the control subjects. There were no significant differences observed for heavy metal levels when comparing TS and control subjects. Conclusion : We confirmed that lead exposure is a risk factor for ADHD. We also identified that cadmium may be a new candidate risk factor for manifestation of ADHD. We did not find an association between heavy metals and manifestation of TS.
    06/2012; 23(2). DOI:10.5765/jkacap.2012.23.2.63
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    ABSTRACT: This study aimed to evaluate the subjective well-being and attitudes toward antipsychotic medication of patients with schizophrenia who had switched to paliperidone extended release (ER). A total of 291 patients with schizophrenia treated with antipsychotics participated in this open-label, 24-week switching study. The primary outcome measures were the Subjective Well-Being under Neuroleptic Treatment Scale-short version (SWN-K) and the Drug Attitude Inventory (DAI). The Krawiecka scale, Clinical Global Impression-Schizophrenia (CGI-SCH), Personal and Social Performance scale (PSP) were used to evaluate psychopathology and psychosocial functioning, respectively. Data from a total of 243 subjects who received the study medication and had at least one follow-up assessment without a major protocol violation were analyzed. Scores on the DAI and SWN-K showed significant improvement between baseline and end-point measurements beginning during the second week. Scores on the Krawiecka scale, all five subscales of the CGI-SCH scale, and the PSP scale were also significantly improved at the end point compared with the baseline. Significant predictors of improvements in the SWN-K and DAI after a switch to paliperidone ER were baseline scores, reductions in scores on the Krawiecka scale, and previous risperidone use. A clinically relevant increase in body weight (≥7% weight gain) occurred in one-fourth of the participants who completed the 24-week study. Switching to paliperidone ER improved the subjective well-being and attitudes towards antipsychotic medication in patients with schizophrenia. Exploratory analyses revealed that these improvements were particularly pronounced in patients who had been treated with risperidone before treatment with paliperidone ER.
    Progress in Neuro-Psychopharmacology and Biological Psychiatry 04/2012; 38(2):228-35. DOI:10.1016/j.pnpbp.2012.04.004 · 4.03 Impact Factor
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    ABSTRACT: In patients with schizophrenia, the prevalence of smoking is significantly higher than that of the general population. This study aimed to evaluate the relationships between cigarette smoking and socio-demographic and clinical characteristics in patients with schizophrenia in South Korea.
    01/2012; 51(5):255. DOI:10.4306/jknpa.2012.51.5.255
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    ABSTRACT: To compare the effectiveness of amisulpride in acute (up to 8 weeks) and maintenance (week 8 to 12 months) phases of a 12-month course of treatment in a heterogeneous group of patients with schizophrenia. We conducted a 12-month, open-label clinical trial with flexible doses of amisulpride among 129 Korean patients with schizophrenia. The Positive and Negative Symptom Scale (PANSS) and several other scales measuring efficacy and tolerability were analyzed during the acute and maintenance phases. The completion rates were 78.3% by week 8 and 55.8% by month 12. Total PANSS scores and scores on the negative-symptom and general-symptom subscales improved significantly during both acute and maintenance periods, but scores on the positive-symptom subscale improved only during the acute phase. Improvement during both treatment phases was significant in all other scales except for the Drug Attitude Inventory. The negative-symptom and mixed-symptom groups showed significant improvement in the PANSS negative subscale, the Clinical Global Impression scale, and the Global Assessment of Functioning during the maintenance period. Hyperprolactinemia and related events were commonly reported. This study demonstrated the significant effectiveness and a good safety profile of amisulpride for treating acute and 12-month phases of schizophrenia under natural conditions.
    Human Psychopharmacology Clinical and Experimental 12/2011; 26(8):568-77. DOI:10.1002/hup.1246 · 1.85 Impact Factor
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    ABSTRACT: There have been few long-term studies that have assessed factors influencing treatment discontinuation and long-term outcome of schizophrenia in Korea. The present study aimed to evaluate factors affecting treatment discontinuation and treatment outcome, after 10 years, in patients with schizophrenia. Among hospitalized patients between 1997 and 1999, 191 patients were given continuous follow-up service. We examined the clinical characteristics and outcome of patients who remained in treatment. Regression analyses were used to find any clinical factors affecting treatment discontinuation. One hundred thirty-three patients (71.12%) discontinued the treatment. The treatment retention group contained more female patients, paranoid-type patients, patients who had shown self-harming behavior, patients receiving clozapine, and patients with good medication compliance. The recovery rate was 25%. However, 42.3% did not have gainful employment. Further, most patients couldn't live independently. The results show the importance of gender, patient behavior, medication, and medication compliance in predicting treatment discontinuation in patients with schizophrenia.
    Psychiatry investigation 03/2011; 8(1):22-9. DOI:10.4306/pi.2011.8.1.22 · 1.15 Impact Factor
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    Myung-Ji Lee, Chul-Eung Kim
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    ABSTRACT: This report describes the efficacy of combined use of aripiprazole in the treatment of a patient with clozapine induced enuresis. Aripiprazole acts as a potential dopamine partial agonist and the dopamine blockade in the basal ganglia might be one of the causes of urinary incontinence and enuresis. We speculate that aripiprazole functioned as a D2 agonist in hypodopaminergic state of basal ganglia caused by clozapine and maintained dopamine level that would improve enuresis ultimately.
    Journal of Korean medical science 02/2010; 25(2):333-5. DOI:10.3346/jkms.2010.25.2.333 · 1.25 Impact Factor
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    ABSTRACT: We investigated the neurocognitive deficits in schizophrenic patients with and without obsessive-compulsive disorder (OCD). We grouped 27 patients as either obsessive-compulsive or non-obsessive-compulsive based on the presence of OCD. The two groups completed the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Positive and Negative Symptom Scale (PANSS), and Hamilton Depression Scale. The intelligence quotient (IQ) was tested using the Korean Wechsler Adult Intelligence Scale. The memory quotient (MQ) was tested using the Korean-Auditory Verbal Learning and Korean-Complex Figure Test. The executive intelligence quotient (EIQ) was determined using the Kims executive intelligence test (EXIT). Ten of the 27 patients had OCD. The compulsion score of Y-BOCS was positively correlated with positive symptoms, negative symptoms, and the total scores of PANSS. The OCD-schizophrenia patients had higher IQs. No difference was found in MQ. Although the EIQ did not differ between the two groups, the OCD-schizophrenia patients performed better at the Stroop-interference and verbal fluency tests, which was highly dependent on executive function. Our findings suggest that OCD may have a protective effect on some cognitive function, at least in relatively early stage of illness. Moreover, based on clinical, neurocognitive features, schizophrenia with OCD could be considered as a distinct subtype of schizophrenia.
    Psychiatry investigation 12/2009; 6(4):286-93. DOI:10.4306/pi.2009.6.4.286 · 1.15 Impact Factor
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    ABSTRACT: Progressive supranuclear palsy (PSP) is a neurodegenerative disease characterized by vertical supranuclear palsy and parkinsonian symptoms. The neuropsychiatric symptoms of PSP include anhedonia, depressed mood and cognitive impairment. Patients with PSP have an increased risk for developing depressive disorders within the next year. However, it is rare to find that major depressive disorder was the antecedent diagnosis of a patient who was later diagnosed with PSP. We present here a patient who suffered from PSP with repetitive falls, a masked face and dysarthria after developing a major depressive disorder.
    Psychiatry investigation 06/2009; 6(2):112-4. DOI:10.4306/pi.2009.6.2.112 · 1.15 Impact Factor
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    ABSTRACT: We examined short- and long-term changes in neurocognitive functions in patients with schizophrenia who were either started or switched to amisulpride in comparison with the normal controls. Fifty-seven patients treated with amisulpride and 60 normal controls completed a comprehensive neurocognitive function test battery at the baseline, the 8-week, and the 1-year follow-up. We conducted and compared the results of both intention-to-treat (ITT) and per-protocol (PP) analyses to account for the follow-up loss. Three general results obtained were as follows: (1) the degree of the improvements in neurocognitive function was comparable to those of other second-generation antipsychotics in both ITT and PP analysis; (2) in light of the relative effect size, the composite effect size and the effect size in most measures in both ITT and PP analyses were smaller for the patient group than those of the control group, signifying that improvement in performance may be largely attributable to practice effects; and (3) nonetheless, there were evidences of both short- and long-term improvements in some cognitive tasks, such as in the Korean-Wechsler Adult Intelligence Scale vocabulary subtest and the Trail Making Test, that may not be accounted by practice effect. These results suggest the need to include a healthy control group to validate the medication effect of cognitive improvements in patients with schizophrenia and to consider practice effect in interpreting the results of repeated administration of neurocognitive function tests.
    Journal of clinical psychopharmacology 05/2009; 29(2):117-23. DOI:10.1097/JCP.0b013e31819a6995 · 3.76 Impact Factor