-
[show abstract]
[hide abstract]
ABSTRACT: PURPOSE: Compared with the general population, adolescent psychiatric patients are subject to premature death from all causes, but suicide-specific mortality rates in this population have not been carefully investigated. Therefore, we examined the high mortality due to unnatural causes, particularly suicide, using standardized mortality ratios (SMRs) relative to sex, diagnosis, and type of psychiatric service. METHODS: A total of 3,029 patients aged 10-19 years presented to the outpatient clinic of a general hospital in Seoul, Korea, or were admitted to that hospital for psychiatric disorders from January 1995 to December 2006. Unnatural causes mortality risk and suicide mortality risk in these patients were compared with those in sex- and age-matched subjects from the general Korean population. RESULTS: The SMR for unnatural causes was 4.6, and for suicide it was 7.8. Female subjects, the young, and inpatients had the highest risks for unnatural causes of death or suicide. Among the different diagnostic groups, patients with psychotic disorders, affective disorders, and personality disorders had significantly increased SMRs for unnatural causes, and those with psychotic disorders, affective disorders, and disruptive behavioral disorders had significantly increased SMRs for suicide. CONCLUSIONS: The risks of unnatural death and suicide are high in adolescent psychiatric inpatients in Korea, but not as high in adolescent outpatients. Effective preventative measures are required to reduce suicide mortality in adolescent psychiatric patients, particularly female patients admitted for general psychiatric care.
Journal of Adolescent Health 02/2013; 52(2):207-211. · 3.33 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Neurobehavioral tests are among the most efficient methods of identifying the adverse health effects of neurotoxicants. The reliability of neurobehavioral tests may be affected by racial or cultural backgrounds, but the widely used computerized neurobehavioral tests have been developed and standardized for Western children. It is thus necessary to assess the reliability of the existing computerized neurobehavioral tests for Korean children. For this reason, 254 healthy 7- to 8-year-old Korean children completed a neurobehavioral test-retest, with the test and retest held two months apart. Six neurobehavioral test items adapted from Korean Computerized Neurobehavioral Tests (KCNT) and modified to match the children's ability levels: Simple Reaction Time, Choice Reaction Time, Color Word Vigilance, Addition, Symbol Digit, and Finger Tapping Speed. The test reliability was assessed using the Pearson product-moment correlation coefficient (r) and the intraclass correlation coefficient (ICC). The ICCs ranged from 0.46 to 0.84 and were very similar to the Pearson coefficients. High reliability was detected in Symbol Digit (r=0.84, ICC=0.83), followed by the Finger Tapping Speed of the dominant hand (r=0.67, ICC=0.67) and of the non-dominant hand (r=0.65, ICC=0.65). The study findings suggest that the reliability of most computerized neurobehavioral tests is appropriate for epidemiological researches on Korean children, and that Symbol Digit and Finger Tapping Speed are more satisfactory bases for the periodic examination of neurobehavioral performance. These findings can also be useful in the future assembly of a neurobehavioral test battery, by providing more stable neurobehavioral test items for Korean children.
NeuroToxicology 09/2012; 33(5):1362-7. · 3.10 Impact Factor
-
[show abstract]
[hide abstract]
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. · 2.48 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Genetic variation in the serotonin-2C receptor encoded by the HTR2C gene is one of the genetic determinants of antipsychotic-induced weight gain. Peroxisome proliferator-activated receptors are nuclear receptors regulating the expression of genes involved in lipid and glucose metabolism. In this cross-sectional study, we investigated whether HTR2C-759C/T, HTR2C-697G/C, PPARα V227A, and PPARγ 161C/T genotypes were associated with metabolic syndrome (MetS) in patients with schizophrenia taking clozapine.
One hundred forty-six Korean patients using clozapine for more than one year were genotyped for the HTR2C-759C/T, HTR2C-697G/C, PPARα V227A, and PPARγ 161C/T polymorphisms, and their weight, waist circumference, blood pressure, triglycerides, high-density lipoprotein-cholesterol, total cholesterol, and glucose were measured. We used the criteria for MetS proposed by the National Cholesterol Education Program-adapted Adult Treatment Panel III.
The prevalence of MetS was 47.3% and was similar among men (49%) and women (42.9%). We found no significant differences between patients with and without MetS in terms of genotypes or allele frequencies. Logistic regression analyses also revealed no association between MetS and each genotype.
We did not find significant associations between four polymorphisms (HTR2C-759C/T, HTR2C-697G/C, PPARα V227A, and PPARγ 161C/T) and MetS in patients with schizophrenia taking clozapine.
Psychiatry investigation 09/2011; 8(3):262-8. · 0.99 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The objectives of this 12-week multicenter, open-label, noncomparative study were to evaluate the overall effectiveness of paliperidone extended release (ER), the feasibility of maintaining patients on the initial dose of 6 mg, and the relationship between dose pattern and treatment response in schizophrenic patients with inadequate responses to initial treatment in a natural setting.
All patients received 6 mg of paliperidone ER during the first 2 weeks, and subsequently, the dose was adjusted at each visit based on the patient response. We examined the response rate and the effectiveness of different dose patterns of paliperidone ER such as "early increase (dose increased to 9 mg at week 2)," "late increase (dose increased to 9 mg at week 4)," and "maintenance group."
The response rate based on the Clinical Global Impression of Improvement or Severity response criteria was 33.6% or 61.7%, respectively. The proportion of patients who stayed with the initial dose of 6 mg was 44.5% and the response rate of these patients was 79.8%. When the treatment response to the initial dose of 6 mg is inadequate (Clinical Global Impression of Improvement ≥ 4 at week 2), an early increase in the dose seems to be more effective than maintenance or late increase of the initial dose.
This study suggests that paliperidone ER may be an effective and well-tolerated antipsychotics in the treatment of patients with schizophrenia.
Clinical neuropharmacology 06/2011; 34(5):186-90. · 2.35 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The gene encoding D-amino acid oxidase (DAO), which acts as a receptor for the schizophrenia-associated neurotransmitter, N-methyl-D-aspartate (NMDA), is regarded as a potential candidate gene for schizophrenia. However, the potential association of the DAO gene with schizophrenia has been the subject of some debate. Here, we tested three single nucleotide polymorphisms (SNPs) of DAO in a group of Korean schizophrenia patients, and found no significant association in the overall study subjects. Interestingly, however, we found gender-specific differences in allele distributions, with SNP rs2070586 appearing to act as a risk allele in female schizophrenia patients, but as a protective allele in males. Our data support the hypothesis that DAO plays a role in schizophrenia, possibly in a gender-dependent manner.
Psychiatry Research 09/2010; 179(2):121-5. · 2.52 Impact Factor
-
Jung-Sun Lee,
Seockhoon Chung,
Joon-Noh Lee,
Jun Soo Kwon,
Do Hoon Kim,
Chul Eung Kim,
Kang Seob Oh,
Yang-Whan Jeon,
Min-Soo Lee,
Myung Ho Lim,
Hye-Ryein Chang, Chang Yoon Kim
[show abstract]
[hide abstract]
ABSTRACT: To determine if the maintenance effectiveness and tolerability of aripiprazole demonstrated in a 12-week study were maintained in an extension phase (up to 26 weeks).
This study was the extension of our switching study from other antipsychotics to aripiprazole in symptomatically stable patients with schizophrenia or schizoaffective disorder. All the patients were randomly assigned to the aripiprazole group or the non-aripiprazole group. The effectiveness analysis consisted of the comparison of the upper bound of the 95% confidence interval (CI) of the mean Clinical Global Impression-Improvement (CGI-I) score to 4 (no change) at the end of the study.
At the baseline, the aripiprazole group (n=135) and the non-aripiprazole group (n=31) were comparable with respect to their mean ages, gender distribution, baseline Positive and Negative Syndrome Scale scores, and Clinical Global Impression-Severity (CGI-S) scores. The study showed that the mean CGI-I score was 2.92 (95% CI: 2.72-3.12) in the aripiprazole group and 2.81 (95% CI: 2.35-3.26) in the non-aripiprazole group at 26 weeks. In the aripiprazole group, the remission rates at 12 and 26 weeks were 74.8% and 72.6%, respectively, and 80.2% of the patients with remission at 12 weeks maintained their remission state until the end of the study. About one-fourth of the patients in the aripiprazole group reported one or more spontaneous treatment-emergent adverse events, such as insomnia, headache, and nausea.
This study suggested that most clinically stable outpatients with schizophrenia maintain their remission states after being switched to aripiprazole, without serious symptom aggravation and adverse events over a course of 26 weeks.
Psychiatry investigation 09/2010; 7(3):189-95. · 0.99 Impact Factor
-
Jung-Sun Lee,
Joon Ho Ahn,
Do-Hoon Kim,
Jong-Jin Kim,
Tae-Young Kim,
So-Young Yoo,
Dong-Geun Lee,
Sang-Hyuk Lee,
Se-Won Lim,
Weon-Jeong Lim,
Il-Kyung Jung,
Hae-Kyung Jung,
Dong-Hwan Cho,
In-Hee Cho, Chang-Yoon Kim
[show abstract]
[hide abstract]
ABSTRACT: This study aimed to examine the effectiveness of quetiapine and the effects of dosage relates to its effectiveness on schizophrenia and schizoaffective disorder in a naturalistic setting in Korean people.
This study was a 24-week, open-label, non-comparative, naturalistic study of quetiapine in patients diagnosed with schizophrenia and schizoaffective disorder according to DSM-IV. We stratified the patients into mild [(clinical global impression severity (CGI-S) <4 at baseline)] and severe groups (CGI-S >/=4 at baseline). We investigated the response rate, defined as clinical global impression improvement (CGI-I) </=2, in the severe group and the aggravation rate in the mild group using the last-observation-carried-forward (LOCF) and the Kaplan-Meier method (K-M).
During the 24 weeks, 151 (18.4%) of the participants dropped out of the study. There was a significant decrease in the mean CGI-S score, from 4.5+/-1.1 at baseline to 2.8+/-1.1 at 24 weeks. The response rate of severe group was 54.5% (estimated by LOCF) and 73.3% (K-M estimated) at 24 weeks. All patients who completed the study had taken a mean quetiapine dosage of 507.9+/-245.9 mg daily. The decrease of CGI-S score in high-dose group (the maximum dose was 750 mg/d or above) was statistically significant than that in recommended-dose group (the maximum dose was less than 750 mg/d).
This study demonstrated the long-term effectiveness of quetiapine in the treatment of schizophrenia and schizoaffective disorder in a naturalistic setting in Korean people. This study suggests that higher than recommended quetiapine dosages could be more effective in some patients.
Psychiatry investigation 06/2010; 7(2):128-34. · 0.99 Impact Factor
-
Chang Yoon Kim,
Seockhoon Chung,
Bong-Jin Hahm,
Kyung Sue Hong,
Jin-Sang Yoon,
Young-Hoon Kim,
Won-Myong Bahk,
Sang-Yeol Lee,
Yanghyun Lee,
In-Won Chung,
Chan-Hyung Kim
[show abstract]
[hide abstract]
ABSTRACT: Objectives. The aim of this non-randomized, single-arm, multi-center, 9-month extension study was to evaluate the maintained efficacy and tolerability of long-acting risperidone injection when we switched to it from previous oral antipsychotics in symptomatically stable patients with schizophrenia or other psychotic disorders. Methods. A total of 98 patients who had completed a previous 12-week acute phase study were included. Efficacy and tolerability were assessed with the Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression (CGI), Global Assessment of Functioning (GAF), and Extrapyramidal Symptom Rating Scale (ESRS). Results. The remission rate of 77.6% (76/98) at baseline and 57.1% (56/98) at the end of the study. Of patients who were in remission at baseline, 65.8% (50/76) maintained their remission state until the end. The symptom worsening rate was relatively low (11.1%), and there was no aggravation in mean PANSS total and subscale scores. Spontaneous treatment-emergent adverse events (TEAE) were reported by 21 (21.4%) patients, and most commonly reported adverse events were extrapyramidal symptoms (N=6, 6.1%) and insomnia (N=4, 4.1%). Extrapyramidal symptoms were significantly improved. Conclusions. Switching to long-acting risperidone injection from oral antipsychotics was a safe and well-tolerated strategy for maintaining clinical stability in symptomatically stable patients with schizophrenia.
09/2009; 13(3):192-198.
-
[show abstract]
[hide abstract]
ABSTRACT: Objective. To compare the effectiveness of olanzapine, risperidone, quetiapine, or haloperidol monotherapy in patients with schizophrenia who were treated in routine clinical practice settings for a period of 2 years. The incidence and persistence of adverse events encountered during long-term therapy are also reported. Method. Outpatients with schizophrenia who entered this 3-year, prospective, observational study were classified according to their initially prescribed antipsychotic monotherapy: olanzapine (n=3222), risperidone (n=1116), quetiapine (n=189), or haloperidol (n=256). Patients were included in the analysis for as long as this treatment was maintained. Results. Over 2 years, olanzapine recipients had significantly (P≤0.001) greater reduction in overall CGI-S score (and the negative, depressive, and cognitive symptoms domains), lower incidence of sexual and motor dysfunction, and greater odds of response compared to risperidone or haloperidol-treated patients. However, olanzapine patients gained more weight than patients in other treatment groups. The incidence of motor dysfunction was significantly (P≤0.001) greater in haloperidol-treated patients, relative to the atypical treatment groups. Conclusion. The results of this observational study indicate that, in these patients with schizophrenia, long-term monotherapy with olanzapine may offer benefits over risperidone and haloperidol, but the potential for weight gain should be considered in the clinical management of these patients.
07/2009; 12(3):215-227.
-
[show abstract]
[hide abstract]
ABSTRACT: Objective. The aim of this study was to investigate the treatment response and optimal maintenance period of antidepressants to minimize the risk of switching in bipolar depression in clinical practice. Methods. In a retrospective chart review, 78 bipolar patients, treated for a depressive episode by adding antidepressant to ongoing mood-stabilizing medications and had been followed for at least 6 months were identified. We determined recovery to euthymia and/or switching into mania during the 6-month follow-up period and estimated the time from antidepressant initiation to mood change. Results. Antidepressants treatment responses were classified into four groups. In one group, depression was sustained for 6 months despite continuous antidepressant treatment (poor-response group, 10.3%). In the second, abrupt switch into mania occurred during antidepressant treatment (acute-switch group, 19.2%). In the third, the depression improved to euthymia without manic switching (good-response group, 50%). In the fourth, the depression improved to euthymia but manic switching occurred during maintenance with antidepressants (delayed-switch group, 20.5%), and the mean duration of antidepressants maintenance was 54.6±38.9 days. Conclusions. Bipolar depression has heterogeneous treatment responses to adjunctive antidepressant. Antidepressants should be discontinued within 8 weeks after improvement to euthymia to minimize the risk of manic switching.
07/2009; 13(2):130-137.
-
[show abstract]
[hide abstract]
ABSTRACT: The 116C/G polymorphism in the promoter region of XBP1 is known to be associated with bipolar disorders. The G allele of the XBP1-116C/G polymorphism has reduced XBP1-dependent transcription activity compared with the C allele. Valproate treatment has been known to rescue the impaired response of cells with the G allele. We investigated the hypothesis that the G allele of XBP1-116C/G has better prophylactic treatment response to valproate compared to the C allele. This study involved 51 patients with bipolar disorder who were treated with valproate for prophylactic treatment. Prophylactic treatment response to valproate was retrospectively assessed using a scale described by Grof et al. [Grof, P., Duffy, A., Cavazzoni, P., Grof, E., Garnham, J., MacDougall, M., O'Donovan, C., Alda, M., 2002. Is response to prophylactic lithium a familial trait? Journal of Clinical Psychiatry 63, 942-947.]. We found that the patients with the G allele of XBP1-116C/G showed a better prophylactic treatment response to valproate compared to the C allele. This result is in agreement with in-vitro data showing that valproate ameliorates the endoplasmic reticulum (ER)-stress response compromised by the G allele.
Psychiatry Research 07/2009; 168(3):209-12. · 2.52 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The substitution of valine by methionine in the brain-derived neurotrophic factor (BDNF Val/Met) gene alters the intracellular trafficking and regulated secretion of BDNF. This study tested whether the BDNF Val/Met polymorphism is associated with bipolar disorder in Korean subjects, and whether clinical features vary according to genotype.
The allelic and genotypic distributions of BDNF Val/Met were determined in a population of 169 bipolar patients and 251 normal controls. Between-genotype comparisons of clinical features were performed without a priori knowledge of the genotype of individual patients.
Allelic distributions did not differ significantly between bipolar patients and controls (chi(2) = 0.400, p = 0.821). However, the rate of suicide attempts among the Val/Val (11.3%), Val/Met (28.8%) and Met/Met (38.9%) genotype groups were significantly different (chi(2) = 9.879, p = 0.007). Relative to patients with the Val/Val genotype, those with the Met/Met genotype had a 4.9-fold higher risk of suicide attempts (95% CI, 1.7-14.7).
These findings suggest that BDNF Val/Met is related to the suicidal behavior of bipolar patients, and may have clinical relevance as a biological indicator of bipolar patients at risk of suicide.
Neuropsychobiology 11/2008; 58(2):97-103. · 2.67 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Thrombophilia and hypofibrinolysis have been implicated in the pathogenesis of osteonecrosis of the femoral head (ONFH). Tissue factor pathway inhibitor (TFPI), a multivalent protease inhibitor, is an important regulator of the tissue factor-mediated blood coagulation pathway. Mutations of the TFPI gene can increase the risk of thrombin generation and venous thrombosis. The aim of this study was to evaluate the association of TFPI gene polymorphisms with ONFH. All exons and their boundaries of the TFPI gene, including the -1500 bp promoter region, were directly sequenced in 24 Korean individuals and four sequence variants were identified. These four polymorphisms [-51096 G > A (C-399T), -50984A > G (T-287C), + 24999A > G (Int7 -33T > C), + 37339T > A] were genotyped in 474 ONFH patients and 349 control subjects. The association of genotyped SNPs with ONFH was not found in the present study. The haplotype AAAT of TFPI was significantly associated with total, alcohol-induced, and idiopathic ONFH (p = 0.003, 0.021, and 0.007, respectively), and the haplotype GAAT was significantly associated with total and alcohol ONFH (p = 0.022 and 0.009, respectively). In addition, a new SNP + 37339 T > A in the 3'-UTR of the TFPI gene, was found in the Korean population. To date, this study is the first to show that haplotypes of the TFPI gene are associated with an increased susceptibility for ONFH. The results suggest that genetic variations in TFPI may play an important role in the pathogenesis and risk factors of ONFH.
Molecules and Cells 08/2008; 26(5):490-5. · 2.18 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A new functional single nucleotide polymorphism (SNP) Ala72Ser in the COMT gene was discovered recently. The purpose of our study is to examine the association between Ala72Ser and Val158Met functional polymorphisms in COMT gene and homicidal behavior in schizophrenia. DNA was genotyped for the Ala72Ser and Val158Met SNPs of the COMT gene in a sample of 93 schizophrenic patients who committed homicide (H-SCZ) and 100 schizophrenic patients who had never committed homicide (NH-SCZ). A statistically significant difference was found in genotype distribution and allele frequencies in SNP Ala72Ser of COMT gene between H-SCZ and NH-SCZ group. In haplotype analysis, the frequency of the combination of high-high activity allele (Ala-Val) was lower in H-SCZ group than in NH-SCZ group (P = 0.000069). Our study showed a highly significant association between a COMT haplotype of two functional SNPs and aggressive behavior in schizophrenia.
American Journal of Medical Genetics Part B Neuropsychiatric Genetics 08/2008; 147B(5):658-60. · 3.70 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: This study was conducted to determine the reference interval of serum thyroid hormones (TSH, FT3, FT4) in healthy Korean adults.
Health examination data from 1,591 healthy Korean adults who visited an university hospital were analyzed. Patients with specific health conditions capable of altering laboratory results were excluded from the study. Serum thyroid hormones were measured using IMMULITE 2000 (DPC, USA, 2002). Subjects were 18-65 years old; 911 were male, and 690 were female.
The arithmetic means of TSH, FT3, and FT4 values for male subjects were 1.28+/-1.84 microIU/ml, 3.23+/-0.57 pg/ml, and 1.42+/-0.22 ng/dl, respectively. In female subjects, the arithmetic means of TSH, FT3, and FT4 values were 1.49+/-2.08 microIU/ml, 3.08+/-0.54 pg/ml, and 1.29 +/-0.24 ng/dl, respectively. The arithmetic mean FT4 value for males decreased with age (p<0.01). The arithmetic mean FT3 value for females increased with age (p<0.01). The arithmetic mean thyroid hormone values of all study subjects differed significantly based on season. The arithmetic mean of male FT4 decreased with increasing BMI (p<0.01). The arithmetic mean of female FT3 increased with increasing BMI (p<0.01). The reference intervals recommended by the IMMULITE 2000 manufacturer are 0.40-4.00 microIU/ml for TSH, 1.80-4.20 pg/ml for FT3, and 0.80-1.90 ng/dl for FT4 (same values for both genders).
There was a significant difference in the interval of thyroid hormones between males and females, but the reference interval of IMMULITE 2000 was not established by gender. There is a need to reestablish the reference interval for thyroid hormones in Korean healthy adults.
Journal of Preventive Medicine and Public Health 04/2008; 41(2):128-34.
-
[show abstract]
[hide abstract]
ABSTRACT: This study seeks to replicate previous results indicating that T102C in the serotonin 2A receptor (HTR2A) and Ser9Gly in the dopamine D3 receptor (DRD3) were associated with a risperidone response to acutely exacerbated schizophrenia, and to determine whether possession of these alleles predicts clinical improvement in a naturalistic setting.
We consecutively recruited 100 schizophrenia patients and assessed clinical improvement after 4 weeks of risperidone treatment.
The patients with T/T in the HTR2A gene showed less clinical improvement than did those with T/C or C/C (p = 0.044). In the case of the DRD3 gene, we did not find statically significant association with clinical improvement (p = 0.061). When patients were categorized into responders and nonresponders, the C allele was more frequent in responders (OR = 2.28, 95%CI = 1.06-4.91, p = 0.039). When combinations of the two polymorphisms were considered, patients who had T/T in the HTR2A gene and encoded Ser/Ser or Ser/Gly from DRD3 gene had a higher propensity to non-responsiveness compared to other subjects (OR = 3.57, 95%CI = 1.10-11.62, p = 0.039).
Our findings suggest that the HTR2A T102C could be a potential indicator of clinical improvement after risperidone treatment.
Human Psychopharmacology Clinical and Experimental 02/2008; 23(1):61-7. · 2.48 Impact Factor
-
Psychiatric Genetics 11/2007; 17(5):313. · 2.58 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: This study aimed to investigate the efficacy and tolerability of aripiprazole, an atypical antipsychotic with dual agonist and antagonist actions toward dopaminergic imbalance and partial serotonin-2A receptor antagonism, for treating children and adolescents with tic disorders.
Twenty-four outpatients aged 7 to 18 years with DSM-IV-diagnosed tic disorders were treated with aripiprazole using an open-label, flexible dosing schedule for 8 weeks from January 2005 to August 2006. The Korean versions of the Yale Global Tic Severity Scale (YGTSS), the Clinical Global Impressions-Improvement scale (CGI-I), and the CGI-Severity of Illness scale (CGI-S) scores were used to measure the drug efficacy. Side effects were assessed using an adverse effect checklist, the Extrapyramidal Symptom Rating Scale, height and weight measurements, laboratory tests, and electrocardiograms.
Aripiprazole was prematurely discontinued in 6 (25%) of the 24 subjects due to intolerable adverse effects. After a mean of 9.8 +/- 4.8 mg/day of aripiprazole for 8 weeks, there was a 52.8% reduction in the mean YGTSS Total Tic scores (from 26.7 +/- 5.5 to 12.6 +/- 7.6, p < .001). Nineteen patients (79.2%) showed either much improved or very much improved status according to the CGI-I. The CGI-S score was also reduced (from 5.5 +/- 0.5 to 3.0 +/- 1.4, p < .001). The initial dose of 5 mg/day aripiprazole for 2 weeks was also found to reduce tic symptoms significantly (Total Tic scores decreased from 26.7 +/- 5.5 to 17.9 +/- 8.7, p < .001). Fourteen subjects (58.3%) experienced unwanted side effects, the most common being hypersomnia (37.5%), nausea (20.8%), and headache (16.6%).
This open-label study suggests that aripiprazole is an efficacious and safe treatment for children and adolescents with tic disorders.
The Journal of Clinical Psychiatry 07/2007; 68(7):1088-93. · 5.80 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Most Korean blue-collar workers are taking government-mandated medical screening periodically. The periodic neurobehavioral test provides a great chance to evaluate the functional change of the central nervous system. To utilize periodic neurobehavioral tests effectively, the reliability of currently used neurobehavioral tests needs to be evaluated. Test-retest of neurobehavioral tests were conducted to evaluate the reliability of neurobehavioral tests that are commonly used for Korean workers. The test-retest of five computerized tests, simple reaction time, additions, symbol digit, digit span, and finger tapping speed, and five traditional tests, Benton visual retention, digit symbol, digit span, pursuit aiming, and pegboard, were administered to 85 college students and 35 hospital workers over a 1 month interval. Computerized additions was found to have the highest test-retest reliability coefficient (r=0.90), followed by finger tapping speed (nondominant hand, r=0.89; dominant hand, r=0.85), symbol digit (r=0.82), and digit span (r=0.74). However, only two traditional tests, digit symbol (r=0.86) and pursuit aiming (r=0.72), showed a reliability coefficient greater than 0.70. These results suggest that the computerized additions, symbol digit, finger tapping speed, and traditional digit symbol are more satisfactory for periodical evaluation of the central nervous system of workers exposed to neurotoxic substances in Korea.
NeuroToxicology 04/2007; 28(2):235-9. · 3.10 Impact Factor
