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ABSTRACT: BACKGROUND: The purpose of the present study was to compare anomalous subjective experiences in patients with schizophrenia, bipolar disorder, and unipolar depression, in order to elucidate differences in subjective experiences and examine their potential clinical correlates in schizophrenia and mood disorders. METHODS: The subjective experiences of 78 outpatients with schizophrenia (n=32), bipolar disorder (n=24) and unipolar depression (n=22), and 32 healthy controls were comprehensively assessed using the Frankfurt Complaint Questionnaire (FCQ). RESULTS: The FCQ total score was significantly higher in the schizophrenia and depression groups than in the healthy control group. There were no significant differences in the FCQ total or subscale scores among the schizophrenia, unipolar depression, and bipolar disorder groups. In the schizophrenia group, the Positive and Negative Syndrome Scale negative factor score was a significant negative predictor of the severity of subjective experiences assessed by the FCQ total score. Disruption of subjective experiences in patients with unipolar depression was associated with greater severity of depressive symptoms and younger age. In the bipolar disorder group, women reported more disruptions in subjective experience. CONCLUSIONS: Anomalous subjective experiences measured by the FCQ are not specific to schizophrenia, and the severity of these experiences in unipolar depression is substantially high. The finding of a dissimilar pattern of predictors of subjective experiences across different diagnostic groups suggests the complexity and variety of factors contributing to anomalous subjective experiences in schizophrenia and mood disorders.
Comprehensive psychiatry 01/2013; · 2.08 Impact Factor
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ABSTRACT: Previous studies have suggested the utility of nonlinear complexity measures of heart rate variability (HRV) in evaluating the regulatory capacity of the neuroautonomic system. The purpose of the present study was to investigate the effects of clozapine on the nonlinear complexity measures of HRV in patients with treatment-resistant schizophrenia to find novel electrophysiological markers that indicate response to clozapine treatment. Forty patients with treatment-resistant schizophrenia were evaluated during 8 weeks of clozapine monotherapy. For nonlinear complexity measures of HRV, the approximate entropy (ApEn) and sample entropy (SampEn) values were obtained. The response rate to clozapine was 37.5%. The results of multivariate analysis of covariance revealed that the ApEn and the SampEn values of HRV at week 8 were significantly higher in the responders than in the nonresponders. Repeated-measures analysis of covariance showed a significant group by time interaction effect in the ApEn and SampEn indices. The responder group showed an increasing pattern of change in these complexity measures after administration of clozapine, whereas the nonresponder group showed a decreasing pattern of change. These results suggest that the nonlinear dynamic complexity measures of HRV, which indicate the irregularity and complexity of the biosystem, may be useful in evaluating the therapeutic changes of neuroautonomic function in schizophrenia. The response to clozapine treatment is expected to be more favorable when the plasticity of the neuroautonomic system reflected in the nonlinear complexity measures is high.
Journal of clinical psychopharmacology 12/2012; · 5.09 Impact Factor
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ABSTRACT: Considering the widespread use of the Positive and Negative Syndrome Scale (PANSS) and its factors around the world in clinical trials, it is clearly necessary to perform a transcultural validation of the factor structure of the PANSS. The purpose of the present study was to examine the PANSS factor structure in a Korean sample of subjects with schizophrenia. A total of 150 outpatients were assessed using the PANSS and other clinical rating scales. Principal component analyses revealed five factors, i.e., negative, cognitive/disorganization, positive, excitement, and depression/anxiety dimensions, which accounted for 64.1% of the total variance. All five factors showed good internal consistency, suggesting that the reliability of the factors extracted was adequate. Significant correlations were found between the five components of the PANSS and the corresponding clinical rating scales. The results of the present study indicate that the five-factor model best fit the data from our patients and that it was validated transculturally. The factor structures should be further validated using various neurobiological methods to ultimately help in clarifying the heterogeneity and pathogenesis of symptomatology in schizophrenia.
Psychiatry Research 02/2012; 197(3):285-9. · 2.52 Impact Factor
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ABSTRACT: Kim J-H, Ann J-H, Lee J. Relationship between heart rate variability and the severity of psychotic symptoms in schizophrenia.Objective: The relationship between autonomic neurocardiac function and schizophrenia remains elusive. This study investigated the relationship between the heart rate variability (HRV) parameters and the severity of psychotic symptoms in schizophrenic patients.Methods: Twenty-one patients receiving risperidone monotherapy and 21 matched normal control subjects were evaluated for HRV analysis. The severity of schizophrenic symptoms was assessed using the Positive and Negative Syndrome Scale (PANSS) and a five-factor model of the PANSS was used.Results: The value of the ratio of low-to-high frequency spectral power was significantly higher in the patient group. The patient group also showed a significantly lower value of approximate entropy. After controlling the dosage of risperidone, the PANSS total score had significant negative correlations with the standard deviation of all RR intervals (SDNN) and the square root of the mean squared differences of successive normal sinus intervals (RMSSD). With respect to the PANSS factors, the score of the PANSS cognitive/disorganisation factor had significant negative correlations with SDNN and RMSSD.Conclusion: These results provide some evidence that the severity of psychotic symptoms, especially cognitive/disorganisation symptom dimensions, may be associated with reduced HRV, suggesting a potential involvement of neuroautonomic dysfunction in the pathophysiology of specific symptoms of schizophrenia.
Acta Neuropsychiatrica 07/2011; 23(4):161 - 166. · 0.58 Impact Factor
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ABSTRACT: We examined the relationship between antipsychotic-associated mental side effects and dopamine D2 receptor occupancy in striatal subdivisions using high-resolution positron emission tomography with [11C]raclopride to better characterize the neurochemical mechanism underlying these adverse effects. Twenty-one patients with schizophrenia receiving stable doses of antipsychotics and 24 age- and sex-matched healthy controls completed 3-Tesla magnetic resonance imaging and high-resolution positron emission tomography scans with [11C]raclopride to measure D2 receptor binding potential (BP ND) in the striatum. The D2 receptor BP ND was obtained using a Logan plot, and receptor occupancy was calculated as the percentage reduction of receptor BP ND with drug treatment relative to baseline. The data obtained from age- and sex-matched healthy controls were used as an estimate of the patients' baseline, as previously proposed. Antipsychotic-associated mental side effects were measured with the Liverpool University Neuroleptic Side Effect Rating Scale. The whole striatal D2 receptor occupancy ranged from 54% to 95%. The analysis revealed that the Liverpool University Neuroleptic Side Effect Rating Scale score had significant positive associations with D2 occupancy in the precommissural dorsal caudate, postcommissural caudate, and ventral striatum. The results suggest that mental side effects of antipsychotics are associated with D2 receptor blockade in the associative and limbic subdivisions of the striatum, which are considered to play a crucial role in cognition and reward motivation.
Journal of clinical psychopharmacology 06/2011; 31(4):507-11. · 5.09 Impact Factor
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ABSTRACT: The purpose of the present study was to examine the relationship between age and dopamine D(2) receptor availability in striatal subdivisions of young and middle-aged healthy subjects using high-resolution positron emission tomography (PET) with [(11)C]raclopride to better characterize the nature of age-related decrements in striatal D(2) receptor availability. Twenty-four healthy volunteers completed 3-Tesla magnetic resonance imaging and high-resolution [(11)C]raclopride PET scans. The analyses using linear and exponential models revealed that age had a significant negative correlation with D(2) receptor availability in the post-commissural putamen (postPU) and that D(2) receptor binding in the postPU decreased significantly more with age than in the ventral striatum, suggesting subregional differences in age-related changes in D(2) receptor binding. The postPU, which belongs to the sensorimotor striatum, may be particularly vulnerable to the effects of age in young and middle-aged subjects.
European neuropsychopharmacology: the journal of the European College of Neuropsychopharmacology 04/2011; 21(12):885-91. · 3.68 Impact Factor
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Australian and New Zealand Journal of Psychiatry 03/2011; 45(3):262. · 2.93 Impact Factor
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ABSTRACT: We examined the relationship between the personality trait of harm avoidance (HA) and the dopamine D(2/3) receptor availability in striatal subdivisions using high resolution positron emission tomography (PET) with [(11)C]raclopride. Twenty-one healthy subjects completed 3T magnetic resonance imaging and high resolution PET scans with [(11)C]raclopride in order to measure D(2/3) receptor availability in subregions of the striatum. The D(2/3) receptor availability was obtained on the basis of the Logan graphical method. The Temperament and Character Inventory was used to measure the biogenetic temperament of HA. The analysis revealed that the HA score had significant negative correlations with D(2/3) receptor availability in the pre-commissural dorsal caudate and post-commissural putamen, suggesting that HA is associated with D(2/3) receptor availability in the associative and sensorimotor subdivisions of the striatum, which are mainly involved in cognition and locomotion. Further research is required to determine if pathological states have similar dopaminergic mechanisms in specific striatal subdivisions.
Biological psychology 02/2011; 87(1):164-7. · 4.36 Impact Factor
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ABSTRACT: Poor insight is prevalent among patients with schizophrenia and improved insight is one of the major goals of treatment. The purpose of the present study was to examine the relationship between insight and subjective well-being during acute treatment of schizophrenia with atypical antipsychotics in a naturalistic clinical setting.
Forty inpatients with schizophrenia were examined before and 8 weeks after the initiation of new treatment with atypical antipsychotics.
There were significant correlations between changes in insight and those in psychopathology and global functioning. The change in insight score was significantly correlated with that in subjective well-being score, indicating that the improvement in insight was positively related to improved subjective well-being. This correlation remained significant even after controlling for the influence of psychopathology. The insight score at baseline was also significantly correlated with the subsequent change in subjective well-being score.
The improvement of insight was positively correlated not only with that of psychopathology and global functioning, but also with that of subjective well-being, suggesting the potential value of interventions that improve patients' awareness of the nature of their illness and the need for pharmacological treatment.
Journal of Clinical Pharmacy and Therapeutics 11/2010; 36(6):687-94. · 1.57 Impact Factor
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ABSTRACT: Subjective experiences are subtle, self-experienced disturbances, a thorough description of which is provided within the framework of the concept of basic symptoms. Recent studies have shown that subjective experiences have important diagnostic implications for schizophrenia and related disorders. The purpose of the present study was to examine the relationship between subjective experiences and psychopathological dimensions in schizophrenia.
Sixty-seven outpatients with schizophrenia were evaluated. Subjective experiences were comprehensively assessed using the Frankfurt Complaint Questionnaire (FCQ). Symptoms of schizophrenia were evaluated using the Manchester Scale (MS). Pearson's partial correlation analysis was performed between the FCQ and the MS scores, controlling for the influence of extrapyramidal adverse effects.
The analysis revealed that the MS positive symptom score had significant positive correlations with the FCQ total score and subscales scores. The MS negative symptom score did not have significant correlations with the FCQ scores.
The results of our study suggest that subjective experiences are significantly associated with positive symptomatology in schizophrenia, suggesting that they may share a common underlying neural basis. Future prospective studies are necessary to confirm the stability of these relationships and to explore the diagnostic and therapeutic implications of subjective experiences in a diverse group of patients at different stages of illness.
Australian and New Zealand Journal of Psychiatry 10/2010; 44(10):952-7. · 2.93 Impact Factor
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ABSTRACT: Akathisia remains a significant issue even in the era of atypical antipsychotics. The purpose of the present study was to examine the association of akathisia with various domains of subjective tolerability in order to contribute to the renewed interest in akathisia and the subjective experience of antipsychotic treatment. Fifty schizophrenic outpatients receiving stable doses of risperidone were evaluated for akathisia, schizophrenic symptoms, and subjective tolerability. Subjective tolerability was comprehensively assessed using the Liverpool University Neuroleptic Side Effect Rating Scale. Analysis of covariance revealed that the akathisia group had a significantly higher total score as well as higher subscale scores of extrapyramidal side effect, psychic side effect, and autonomic side effect on the Liverpool University Neuroleptic Side Effect Rating Scale. Further analysis using binary logistic regression analysis revealed that these variables were significantly associated with akathisia. The results of our study suggest that akathisia is significantly associated with a wide range of subjective tolerability profiles, implying the necessity to effectively manage akathisia even its mild forms considering its strong association with subjective tolerability in general.
The International journal of neuroscience 07/2010; 120(7):507-11. · 0.86 Impact Factor
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ABSTRACT: The percentage of successive normal cardiac interbeat intervals greater than 50 msec (pNN50) is a widely used heart rate variability measure, which is useful in identifying the neuroautonomic dysfunction of psychiatric disorders. However, pNN50 is only one member of a larger family of pNNx statistics, where x is greater than 0 msec. The potential application of the general pNNx statistics has not yet been explored in the psychiatric field. The authors examined the pNNx statistics in clozapine-treated subjects and normal controls to evaluate the usefulness of the general pNNx statistics.
Sixty-one schizophrenic patients treated with clozapine and fifty-nine normal controls were evaluated. Probability values for the differences between the groups at each pNN value (range: pNN1-pNN100) were calculated using data obtained from a 30-minute electrocardiogram.
The conventional pNN50 and pNNx values with x<50 msec were all significantly lower in the patient group (p<0.05). The distinction between the two groups was more prominent at pNN values less than 50 msec than that observed at pNN50. The maximum separation between groups occurred at pNN5 (68.2+/-19.1 vs. 22.5+/-20.5, p<10(-22)).
The pNNx with x<50 msec provided more robust discrimination between the groups than the conventional pNN50, suggesting the importance of analyzing very small variations of interbeat interval in discriminating normal and pathological heart rate patterns. The results also suggest that the general pNNx statistics may be applied and useful in evaluating the neuroautonomic dysfunction in patients treated with clozapine, complementing the traditionally computed pNN50 value.
Psychiatry investigation 12/2009; 6(4):294-8. · 0.99 Impact Factor
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ABSTRACT: The purpose of the present study was to examine the association of adverse drug effects with subjective well-being in patients with schizophrenia receiving stable doses of risperidone.
Thirty outpatients with schizophrenia receiving stable doses of risperidone were comprehensively evaluated for psychopathology, subjective well-being, and adverse drug effects. Subjective well-being was assessed using the Subjective Well-being Under Neuroleptics Scale (SWN). Adverse drug effects were evaluated using the Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS) and the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS).
In correlation analysis controlling for relevant variables, the SWN score had significant negative correlations with the following subscale scores of the LUNSERS: extrapyramidal side effect (EPS) (r = -0.54, P < 0.01), akathisia (r = -0.46, P < 0.05), and autonomic adverse effect (r = -0.44, P < 0.05). The SWN score also had a significant negative correlation with the global severity of EPS as measured by the DIEPSS (r = -0.44, P < 0.05).
The results of our study suggest that adverse effects, particularly EPS and akathisia, are significantly associated with subjective well-being, implying the necessity to develop rational strategies to control these variables effectively. The results also suggest that EPS and akathisia continue to be major adverse effects associated with a low level of subjective well-being in patients receiving risperidone. Further studies are required to investigate the multidimensional factors associated with subjective well-being in patients receiving atypical antipsychotics and to determine their relative contributions.
Clinical neuropharmacology 07/2009; 32(5):250-3. · 2.35 Impact Factor
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ABSTRACT: Numerous studies have been conducted to investigate the phenomenological characteristics of auditory verbal hallucinations in schizophrenia. Difficulties in understanding the clinical significance of auditory verbal hallucinations may be attributed to the changes in symptom structure over the long-term course of the illness. The purpose of the present study was therefore to investigate the longitudinal changes in the phenomenological dimensions of auditory verbal hallucinations in patients with schizophrenia.
Using the Psychotic Symptom Rating Scales-Auditory Hallucination Subscale, 40 patients meeting DSM-IV criteria for schizophrenia (drug-naive first-episode schizophrenia, n=21; and drug-free chronic schizophrenia, n=19) who reported persistent auditory verbal hallucinations were assessed before the initiation of antipsychotic treatment and after 6 months of treatment. To detect the changes in underlying clusters of phenomenological variables, hierarchical clustering and multidimensional analysis were performed.
The phenomenological variables of auditory verbal hallucinations formed two main clusters with 6 month treatment: emotional and cognitive. Physical characteristics failed to indicate a stable cluster. Psychosocial disruption, which initially formed a cluster with cognitive variables, congregated with emotional variables at 6 months. Subgroup analysis indicated that the cluster structure of the first-episode group showed more dynamic changes than did that of the chronic schizophrenia group.
Phenomenological variables characterizing persistent auditory verbal hallucinations can be differentiated into emotional and cognitive clusters with achievement of symptom stabilization, and the changes in physical characteristics may not be the sole sign of clinical improvement.
Australian and New Zealand Journal of Psychiatry 04/2009; 43(3):244-51. · 2.93 Impact Factor
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ABSTRACT: The purpose of the present study was to examine the relationship between drug-induced parkinsonism (DIP) and subjective non-motor cognitive impairments in schizophrenia by performing comprehensive assessments of extrapyramidal side effects (EPS) and the subjective cognitive-perceptual functioning.
Ninety-one outpatients with schizophrenia were evaluated for DIP and other EPS. Subjective cognitive-perceptual dysfunction was comprehensively assessed using the Frankfurt Complaint Questionnaire (FCQ). To examine the association between DIP and non-motor cognitive-perceptual dysfunction, Pearson's partial correlation analysis was performed between the FCQ scores and the severity of DIP, controlling for relevant variables.
The analysis revealed that the severity of DIP had a significant correlation with the total FCQ score (p < 0.05). In phenomenological subscales, the severity of DIP showed significant correlations with "deterioration of discrimination," "psychomotor disorder," "perceptual disorder," "cognitive floating," and "automatic behavior disorder" (p < 0.05).
The results of our study suggest that DIP is significantly associated with a wide range of subjective non-motor cognitive impairments. Clinicians should be careful of the appearance of DIP and the associated non-motor cognitive-perceptual symptoms, which may cause considerable distress and reduce the quality of life in an already vulnerable group of patients.
Human Psychopharmacology Clinical and Experimental 03/2009; 24(2):129-33. · 2.48 Impact Factor
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ABSTRACT: Urinary incontinence and enuresis are well-known side effects of clozapine. However, clinical experience has shown that patients also suffer from diverse lower urinary tract symptoms (LUTS). The natural course of clozapine-related LUTS is unclear. Thus, a longitudinal follow-up study is needed. A total of 101 subjects who were taking clozapine initially participated. Their LUTS were evaluated using the International Prostate Symptom Score (IPSS), other questionnaires, and a medical records review. After 2 years, 87 of the original subjects could be contacted, and the status of their LUTS was re-evaluated. The average IPSS total was 7.4 +/- 5.9 at the initial evaluation. Although only 11 subjects (10.9%) reported actual incontinence, 42 subjects (41.6%) were found to have clinically significant LUTS (IPSS total score > or =8). No influencing factors could be found among the demographic and clinical variables. At the follow-up, the average IPSS total (7.9 +/- 6.0) and the percentage of subjects with clinically significant LUTS (43.7%) had both increased, although the change was not statistically significant. The prevalence of LUTS in clozapine-medicated patients was higher than in the general population of the same age. However, the prevalence of incontinence was only a quarter of that of LUTS. If clinicians focus only on incontinence, distress from LUTS will not receive appropriate attention. Furthermore, contrary to literature observations, clozapine-related LUTS did not remit easily but rather persisted even into the long-term maintenance phase. More concern should be directed at these troublesome and often neglected side effects.
Journal of clinical psychopharmacology 12/2008; 28(6):618-24. · 5.09 Impact Factor
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ABSTRACT: The authors investigated the subjective cognitive dysfunction associated with drug-induced parkinsonism (DIP) among 58 stabilized schizophrenic outpatients. Subjective cognitive dysfunction was comprehensively assessed using the Frankfurt Complaint Questionnaire (FCQ). Multivariate analysis revealed that the DIP group scored significantly higher on the total FCQ score than the non-DIP group. In phenomenological subscale scores, the DIP group had significantly higher scores on "deterioration of discrimination", "psychomotor disorder", and "perceptual disorder" than the non-DIP group. These results suggest that DIP is significantly associated with subjective cognitive-perceptual dysfunction, reflecting the complex nature of DIP that includes motor and cognitive aspects.
Parkinsonism & Related Disorders 02/2008; 14(3):239-42. · 3.80 Impact Factor
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ABSTRACT: Antipsychotic-induced akathisia leads to poor compliance with medication and is still a source of concern in the treatment with antipsychotic drugs. Regarding clinical characteristics, the distinguishing features of akathisia in comparison with other extrapyramidal syndromes are prominent subjective symptoms. The purpose of the present study was to examine the subjective cognitive dysfunction associated with antipsychotic-induced akathisia.
Sixty-seven outpatients with schizophrenia receiving stable doses of risperidone or haloperidol were evaluated for akathisia and other extrapyramidal side effects. Subjective cognitive dysfunction was comprehensively assessed using the Frankfurt Complaint Questionnaire (FCQ). The severity of subjective cognitive deficits was compared between the groups with and without akathisia using analysis of covariance with relevant variables as covariates.
The akathisia group (n = 25) scored significantly higher on the total FCQ score than the non-akathisia group (n = 42) (P < 0.05). In phenomenological subscale scores, the akathisia group had significantly higher scores on various subscales, i.e. 'anxiety', 'disorder of selective attention', 'deterioration of discrimination', 'perceptual disorder' and 'disorder of coping responses' than the non-akathisia group (P < 0.05).
These results suggest that akathisia is significantly associated with a variety of subjective cognitive-perceptual deficits. Early therapeutic interventions for akathisia should be performed considering its significant association with the subjective cognitive dysfunction and the impairment of coping responses.
Journal of Clinical Pharmacy and Therapeutics 10/2007; 32(5):461-7. · 1.57 Impact Factor
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ABSTRACT: The relationship between antipsychotic-induced extrapyramidal syndrome (EPS) and the autonomic neurocardiac function was examined in 57 schizophrenic patients treated with atypical antipsychotics. Comprehensive assessments of EPS and heart rate dynamics were performed. There was a significant negative correlation of non-hypokinetic parkinsonism, akathisia, and dyskinesia with several linear and novel non-linear heart rate dynamics measures, suggesting reduced neurocardiac dynamics associated with some forms of EPS. Assessment of heart rate dynamics may be useful for the detection of these adverse effects and may serve as a useful non-invasive method providing a dynamic window into the alterations of complex neuronal activity.
European Neuropsychopharmacology 09/2006; 16(6):459-63. · 4.05 Impact Factor
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ABSTRACT: Ginseng has been reported to increase mental and physical abilities, improve mood and promote general health and well-being. The purpose of this study was to examine the effects of sun ginseng (SG) on quality of life in cancer patients.
A randomized, double-blind, placebo-controlled pilot trial was performed for 12 weeks. Fifty-three patients were randomly assigned to SG 3000 mg a day (n = 32) or placebo (n = 21) in a 3 : 2 ratio. Patients' diagnoses were gynecologic cancer (n = 28), hepatobiliary cancer (n = 13) and other cancers (n = 12). Quality of life was assessed using the World Health Organization Quality of Life Assessment-Bref (WHOQOL-BREF) and the General Health Questionnaire-12 (GHQ-12).
After 12 weeks of therapy, the 'psychological domain' score of the WHOQOL-BREF was significantly improved in patients randomized to SG, compared with those randomized to placebo (P = 0.02). There was a tendency for SG to improve the 'physical health' (P = 0.06) and 'environment' (P = 0.07) domain scores of the WHOQOL-BREF, compared with placebo. The GHQ-12 total score was significantly improved in patients treated with SG than in those with placebo (P < 0.01). No significant adverse events were observed in both groups of patients.
Sun ginseng was found to be beneficial in improving some aspects of mental and physical functioning after 12 weeks of therapy in cancer patients, who were mainly diagnosed with gynaecologic cancer or hepatobiliary cancer. Further studies are required to evaluate the long-term effects of SG on multiple facets of quality of life in various cancer patients.
Journal of Clinical Pharmacy and Therapeutics 08/2006; 31(4):331-4. · 1.57 Impact Factor
