The Biological Research and The Pharmacological Treatment in Alcoholism

In the paper, studies in genetis, reward system, role of neurotransmitters, especially dopamine and opiate system, other biological causes and drug treatments were reviewed. Based on biological hypothesis, various forms of drug treatment have been developed. Treatment for detoxification, for prevention and treatment of withdrawal symptoms, for alcholism-related mental disorders, for craving and for avoiding drinking behavior were reviewed, too. As biological mechanisms in alcoholism will be clarified in the future, it is expected that new treatment method with specific drugs will be available.ope

The Influence of Aesthetic Surgery on Patients’ Mental Health

Objectives：This study was to investigate the effects of aesthetic surgery on mental health. Method：Sixty-four patients were assessed for their mental health and the degree of satisfaction with their body image before and after operations. The subjects’ mental health was evaluated by the Korean version of Symptom Check List-90(SCL-90), a satisfaction scale with body image, and a questionnaire for demographic data and operation. Results： 1) The average score of SCL-90 significantly improved from 68.17(S.D.±48.26) to 58.03(S.D.± 46.93) after operation(p<0.01). The scores of all subscales for somatization symptoms, interpersonal sensitivity, depression, hostility and psychoticism improved significantly. Significant improvement was also found in patients who were in their 20’s and 40’s, had family support and had positive attitudes toward their operations. Family support had a more positive influence in the group who had a poorer state of mental health before the operation. 2) The average score of satisfaction with their body image improved significantly from 58.54(S.D. ±23.14) to 78.14(S.D.±18.30)(p<0.01). The more they were satisfied with their body image, the more their mental health state improved. The degree of improvement in satisfaction was significant (p<0.01) in patients who had shown a poorer mental health state before operation. Conclusion：These results suggest that aesthetic surgery has positive influence on patients’ mental health and improved satisfaction with their body image and also that, in selection of patients for aesthetic surgey, their age and possible family support should be considered.ope

A CLINICAL STUDY ON TOURETTE’S DISORDER

Objective：The objective of this study is to examine the clinical characteristics and behavioral comorbidity of patients with Tourette’s disorder. Method：Subjects consisted of 157 patients with Tourette’s disorder diagnosed by DSM-IIIR, who were examined and diagnosed from Jan. 1988 to May 1994 at the Tourette’s Clinic of Yonsei University Medical Center. Characteristics and behavioral comorbidity of Patients were assessed by a semi-structured interview schedule. Behavioral problems like hyperactivity, obsession-compulsion, self destructiveness, enuresis, sleep problem were assessed by global clinical impression. Results：The mean age of patients was 14.49(±7.99) years. Patients consisted of 138 males(87.9%) and 19 females(12.1%). The sex ratio was 7：1, showing a male preponderance. The number of right-handers was 133(84.7%), and the number of non-right handers was 24(15.3%). Mean age of onset was 8.85(±4.56) years, ranging from 2-to-16 years. More than half of the patients had their age of onset at 6-10 years. Bimodal peak in age of onset was observed；the first peak was around 6 and the second peak was around 10 years. There was no sex difference in bimodal age of onset. The most common initial symptom was eye blinking. More than 55% of patients reported eye blinking as their first symptom. The second common initial symptom was head turning and the third was vocal tic. The most common symptoms that patients reported on their first visit since onset were eye blinking(82.2%), head turning or nodding(57.9%), shoulder shrugging(52.7%) and forearm movement(32.6%). Of 157 cases, 101(64.3%) patients showed downward progression of symptoms, and 25(15.9%) showed upward progression of symptoms. Nineteen fathers(12%) of patients had a past history of obsessive-compulsive disorder(OCD). Seventeen fathers(10.6%) had a history of tic disorder. SSevenmothers(4.5%) had OCD, 4 mothers(2.5%) had tic disorder. One hundred and eighteen patients(75.1%) had comorbid hyperactivity, 95 patients(60.5%) had obsession, 55 patiens(35.0%) had self destructiveness, 46 patients(29.3%) had impulsivity, and 35 patients(22.3%) had enuresis. Age of onset had a significant positive correlation with age, duration, and the global severity of obsession；and a negative correlation with the severity of hyperactivity. Hyperactivity had a significant positive correlation with impulsivity, obsession-compulsion, enuresis, and self destructiveness. Obsession-compulsion had a significant positive correlation with hyperactivity, sleep problems, and self destructiveness. Conclusion：These data suggest that clinical characteristcs and behavioral comorbidity of patients with Tourette’s disorder in this study are similar to previous research findings in Korea and other contries. The younger the age of onset was, the more severe hyperactivity was, and the less severe obsession-compulsion was. And severity of hyperactivity had a positive correlation with the severity of obsession-compulsion, impulsivity, enuresis, and self destructiveness.ope

Past, Present and Future of Psychopharmacology in Korea

History of psychopharmacology in Korea since 1885 was reviewed, when western medicine was firstly introduced to Korea. Barbiturates and fever therapy had been main therapies for mental patients until 1940s. The true era of psychopharmacology started around 1960 with introduction to Korea of chlorpromazine followed by other phenothiazines and meprobamate. Since then, Korean psychopharmacology has developed following international development in psychopharmacology and neuroscience. Around 1990s, second generations of antidepressants and antipsychotic agents had been introduced to Korea. These days, most major psychotherapeutic drugs have become available in Korea soon after they appeared in world market. Meanwhile most researches were clinical ones until 1990s. However basic researches have been limited due to not only lack of financial support but poor conditions for research. Recently general condition for research are improving with general economical development of Korea. Many young researchers have returned to Korea after years of training abroad and are leading researches and international activities. Future directions for researches in psychopharmacology and for activities of Korean College of Neuropsychopharmacology (KCNP) are discussed related to future social changes and especially focused on integration of drug treatment with psychosocial treatment.ope

EFFECT OF METHYLPHENIDATE ON FUNCTIONAL CEREBRAL LOCALIZATION DURING ATTENTIONAL TASKS IN BOYS WITH ATTENTION-DEFICIT/HYPERACTIVITY DISORDER

This study aims at investigating the effects of psychotimulant on functional cerebral localization during the attentional tasks in ADHD. Inclusional subjects were 13 boy between 6-12 years old who met the DSM-IV criteria for ADHD. In each patient, there was a drug-free period(without methyphenidate) and a drug-loaded period(with oral methylphenidate administration), and within each period there was a resting state and a stimulated state with TOVA. Comparisons were made by measuring the amplitudes of four bands(α,β,δ,θ) of quantitative EEG to see if there were any differences between the drug-free period(resting and stimulated) and the drug-loaded period(resting and stimulated). In the resting state, there was no difference between the drug-free and drug-loaded periods. In the stimulated state with TOVA, the presence of methylphenidate induced significant changes in the theta to beta ratio(θ/β) in the right frontal, right parieto-occipital, and left temporal-parietal areas in contrast to the drug-free period. These data suggest that methylphenidate shows electrophysiological influences on cerebral topographical activities during the attentional tasks in ADHD.ope

A study on quality of life of Cancer Patients

Objectives: This study was purposed to evaluate the quality of life of cancer patients and compare it with those of general medical patients group & healthy group. Methods: Quality of life was evaluated in 58 patients with cancers in pulmonary or gastrointestinal system, 202 patients with general medical diseases in pulmonary or GI system and 228 healthy persons. Data of 3 groups were compared with analysis of cavarience. Results: The WHOQOL score was lowest in the cancer patient group and was followed by the patients of other general medical diseases and the healthy persons. Especially QOL score of cancer patients were subjectly lower in the physical domain, the phycholosical domain, the independence domain, the environmental domain, the spiritual domain, while scores of the social domain showed no difference. Among these domains, the scores of the physical domain and the independence domain were lowest in cancer patients. The domains of which scores were not different between general internal patients and cancer patients were the phychological domain and the environmental domain. QOL of spiritual domain was lower in cancer patients than general patients. The path analysis suggests that the phychological quality of life is the most important in quality of life. Conclusion: Theses results show that the quality of life of cancer patients was lower than not only healthy persons but also general medical patients and suggest that cancer patients need more specialized helps in physical pain, independency, spiritual problems, and finally psychological problems.ope

Clinical Correlates of Hwa-Byung and a Proposal for a New Anger Disorder

This paper reviewed the studies on hwa-byung (HB), which literally means anger disorder and this is known as the culture-related chronic anger syndrome of Koreans. Based on these studies and a review of the literature on the anger syndromes of other cultures, I have proposed a new anger disorder. The rationale for this proposition is first that the clinical correlates of HB, including the epidemiological data, the etiological factors, the symptoms and the clinical course, are unique and different from those of the depressive disorders, which have been postulated to be similar to HB. Second, the symptoms of HB are characterized by pent-up anger and somatic and behavioral symptoms related to the release and suppression of anger. Third, a group of patients with only HB and who visit psychiatrists for treatment have been identified. Fourth, anger is thought to be the basic target of treatment for HB patients. Last, anger syndromes like HB have been identified, with various names, in other cultures. By reducing the cultural variation of HB and integrating the common clinical correlates of the syndromes related to anger, a new anger disorder for the mood of anger can be conceptualized, like that for other mood disorders for the corresponding pathological moods. The research diagnostic criteria for HB and the new anger disorder are also suggested. I propose that the new anger disorder to be included in the new international classification system as a member of the larger family of mood disorders. International collaborative studies are needed not only to identify such anger disorder in various cultures, but also to explore giving better treatment to these patients based on the bio-psycho-social model of anger disorderope

Quality of Life of North Korean Defectors in South Korea

Objectives：The objective of this study is to evaluate the subjective quality of life(QOL) of North Korean defectors in South Korean society and to compare it with QOL when they were in North Korea and QOL of South Korean. Method：The subjects were 43 North Korean defectors who had lived for 1 to 3 years in South Korea, who rated their subjective quality of life(QOL). A group of 113 North Korean defectors under a socializing education program of governmental organization before releasing to South Korean society rated retrospectively the subjective QOL which they had felt while they were in North Korea. Instrument was the Korean Version of bief form of World Health Organization Quality of Life Scale(WHOQOL-BREF). These results were compared with data from the standardization study of the Korean Version of WHOQOL as a control group which consist of 324 South Koreans. Result：The total score of WHOQOL-Bref of North Korean defectors in South Korean society was not significantly different with that of South Koreans, but scores in psysical domain, negative feeling and economic resource were significantly lower in defectors. Especially QOL in facets of negative feeling and economic resource become lower after defection to South Korea. But QOL in psychological domain and environmental domain become higher. In retrospective rating, The total score of QOL in North Korea was significantly lower than that of South Koreans and especially lower in physical domain, psychologocal domain and environmental domain. However in general, QOL of North Korean defectors in negative feeling, self-esteem, body image and appearance and personal relationship seem not to be worse than that of South Koreans. Conclusion：The result of this study suggest that, as QOL of North Korean defectors in South Korean society generally is low, they need help, especially help for resolving conflict due to negative feeling, economic support, medical service, educational service and spiritual support.ope

Family's Expressed Emotion Perceived by Schizophrenic Patients, Social Adjustment of Patients and Family Burden

Objectives : This study was to study correlation between schizophrenic patients' subjectively perceived expressed emotion by family and their social adjustment and perceived burden of family. Methods : Subjects were 81 schizophrenic patients and their family. Patients rated Korean version of Level of Expressed Emotion(K-LEE) and Social Adjustment Scale. Their family rated a Scale for Family Burden. Collected data were analysed with Pearson correlation test. Results: Mean total score of K-LEE, Scale for Family Burden and Social Adjustment were 11.57±2.20, 1.20±.67 and 2.50±0.63 respectively. There was no significant correlation among them. However among subscales, there were some significant correlations. The less family support was and the more severe intervention of family was, the poorer were patients' social relationship, leisure activities, functions in extended family and functions occupational life. And the severer patients perceived family's blaming was, the greater family's subjective and objective burden were. Conclusion : These results suggest that, for patients, better social adjustment, family have to provide more support, reduce intervention and restrain blaming.ope

ADOLESCENT VIOLENCE TOWARD PARENTS

Object：The purpose of this study was to investigate frequency and risk factor of violence toward parents seen in adolescents. We also want to apply this data toward developing a prevention program for adolescent violence. Method：A total of 1,345 students from 5 middle schools in Seoul, participated in this study：675 males, 670 females. We administered self-reporting questionnaire including violence toward parents, exposure to violence, family history of alcoholism, substance abuse of adolescetnt and dermographic data etc. Result：The frequency of boys’ violence toward parent was 2.8%, which was significantly higher than girls’(p<0.001). The frequency of violence toward the father was higher than the mother. The risk factors for violence toward parents were sex, parental alcohol problem, adolescent alcoholsmoking-drug problem, exposure to violence at home in the last year and exposure to violence in the life(p<0.0001). The grade, punishment, socioeconomic status, educational level of parent were not significantly related to violence toward parents. Conclusion：These suggest that adolescent violence toward parents is not rare problem any more and preventive intervention is needed for high-risk groups, that is related with experience domestic violence, substance abuse, alcoholic parent.ope