Association between Thyroid Dysfunction and Severity, Treatment Response in Schizophrenic Inpatients

OBJECTIVES: Thyroid hormone deficiency during the neurodevelopmental period can impair brain development and induce psychiatric symptoms. This study examined the association between thyroid dysfunction and the severity of symptoms in schizophrenia patients, and the treatment response of patients with schizophrenia. METHODS: Three hundred thirty-eight schizophrenia patients, with no prior history of thyroid disease or taking medication associated with it, were studied. We assessed the blood thyroid hormone level, the Brief Psychiatric Rating Scale (BPRS) scores on the day of admission and discharge, admission period, dose of administered antipsychotics, and the number of antipsychotic combinations. The collected data were subsequently analyzed using the Kruskal-Wallis test and Pearson's chi-square test. RESULTS: The percentage of schizophrenia patients who presented with abnormal thyroid hormone level was 24.6%. High total triiodothyronine (TT3) (p = 0.003), low TT3 (p = 0.001), and high free thyroxine (fT4) (p < 0.001) groups showed a higher BPRS score on admission than did the normal thyroid hormone group, while thyroid stimulating hormone (TSH) levels were not significantly correlated with the severity of symptoms. Furthermore, thyroid hormone was not associated with the treatment response assessed by the rate of BPRS score reduction, admission days, use of clozapine, and dose of antipsychotics. CONCLUSIONS: The TT3 and fT4 hormone levels were significantly associated with the severity of symptoms in schizophrenia patients. These relations suggested that thyroid dysfunction may be associated with the severity of schizophrenia. And hence, further analysis of the results of the thyroid function test, which is commonly used in cases of psychiatric admission, is required.

A Validation Study for the Scale of the Media Reports Regarding Suicide

OBJECTIVE: This study was conducted to develop the evaluating scale of adherence to guideline 2.0 for suicide reporting declared by Ministry of Health and Welfare and the Korea Suicide Prevention Center. METHODS: Four hundred and fifty one subjects who work in suicide prevention center or mental health center across the country participated in survey. They responded to 20 items after reading media report regarding suicide episode. Two hundred and twenty six cases of recruited data were analyzed. Reliability and validity were assessed by Chronbach-α and exploratory factor analysis. Then, confirmatory factor analysis based on another 225 data was conducted. RESULTS: The Results of exploratory factor analysis shows three factor structures. The validity of previous three factor structure based on confirmatory factor analysis was appropriate and the three factor structure consisted of 10 questionnaires with three subconcepts such as ‘glorification’, ‘lasciviousness’, and ‘providing information’. CONCLUSION: Three factor structures in the scale on media reports regarding as suicide is appropriate and this scale will contribute to evaluating suicide report on media.

Relationship of Sleep Parameters with Neurocognitive Function in the Elderly with Excessive Daytime Sleepiness (EDS) / 신경정신의학

OBJECTIVES: Excessive daytime sleepiness (EDS) in the elderly is related to cognitive dysfunction. We aimed to analyze the difference in the neurocognitive function between the elderly groups with and without EDS and examine the correlation between sleep parameters and the neurocognitive function in the elderly with EDS. METHODS: Thirty seven subjects who visited Kangwon National University Hospital were recruited. We excluded those who had abnormalities in laboratory examination or chronic systemic diseases. For each subject, a neuropsychological battery in the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) Assessment Packet was applied. Nocturnal polysomnographies were conducted in 16 subjects with EDS. RESULTS: There were no significant differences in the neurocognitive function between EDS positive and EDS negative groups. In the EDS positive group, the amount of stage 1 sleep negatively correlated with scores on Boston naming test, word list memory and Stroop interference, respectively (r=-0.611, -0.583, -0.611). Also, REM sleep amount positively cor-related with scores of word list recognition (r=0.568), and limb movement index negatively correlated with scores of word list memory (r=-0.523). CONCLUSION: The poor sleep quality was associated with impaired language, memory and executive functions. Also, increased limb movements were associated with the memory decline.