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Date Presented 03/22/24 Memory and executive function predict social participation in Parkinson's disease (PD). It is important to tailor cognitive rehabilitation strategies based on cognitive function to promote social participation in PD. Primary Author and Speaker: Moon Young Kim Contributing Authors: Erin R. Foster [ABSTRACT FROM AUTHOR]

Background With the increasing interests in obesity, obesity treatment is in vogue among men as well as women. For easy and quick weight reduction, the use of diet aids have been increased. As increased consumption of psychotropic food restrainers, its various side effects became a big issue of current society. The purpose of reports is to highlight the clinical features of a 27-year-old female and a 34-year-old male who were diagnosed as psychotic disorder following the use of diet aids. These cases report demonstrate the potential dangers of unreasonable use of diet aids. Methods Two cases will be presented. Results Case 1: A 27-year old female, a graduate student was admitted to department of neuropsychiatry via emergency room with acute onset auditory hallucination, idea of reference, and persecutory delusion. The patient has used a diet aid branded "slim-30" which contained didesmethylsibutramine for 1 month over 2–3 folds higher doses. Didesmethylsibutramine is a sibutramine metabolyte and have a similar structure of sibutramine. Didesmethylsibutramine is not an approved medicine and is illegally blended with herbal medicines. Sibutramine is a serotonin and norepinephrine reuptake inhibitor. FDA approval was granted in 1997, and it is marketed in US. But, Sibutramine was withdrawn from the market in January 2010 due to an increased risk of cardiovascular incidents. Her symptoms disappeared in 3 days with risperidone 2mg/day after admission. Three months later after discharge, risperidone was discontinued. Another 3 months later, she has still no psychotic symptoms. She was confirmed to have causal relation with prescription of diet pills. Case 2: 34-year old male was accompanied by his family to department of neuropsychiatry for evaluation of mood swing, auditory hallucination, tactile hallucination and behavioral change. He has prescribed diet medicines at the local diet clinic with Phentermine, fluoxetine, topiramate and caffeine for about 3 years. About 1 year ago, he has overused 3~4 folds than prescribed dosages during stressful times. He experienced acute onset severe psychomotor agitation, paranoid feature and hallucination intermittently correlated with overdose of diet medications. After admission, he took paliperidone 6mg/day. There were no symptoms in 3 days after admission. One month later after discharge, he still takes paliperidone 3mg/day and no symptoms exist. Discussion Two cases showed the importance of attention for diet aids medication. Both patients had personality problems and psychiatric family history. Psychotic symptoms disappeared within 2 or 3 days after cessation of diet aids and antipsychotics medication. Accordingly, psychiatrists have to obtain a careful medical history for evaluation of psychotic patients. And before prescribing diet aids, psychiatrist must get the information of customer's personality and family history of psychiatric disease, especially when prescribing diet aids with psychostimulant medications. To secure the safety of patients, the managements for using the diet medicine have to be thoroughly performed through the cooperation among government, consumer organization, and other professional groups. Detailed information and cautions regarding the side effects of diet medicines must be established for customers to know about safety, efficacy and effects of diet therapy. [ABSTRACT FROM AUTHOR]

Background The objective of the present study was to investigate the efficacy of combined therapy with olanzapine and amisulpride compared with olanzapine continuation therapy in the treatment of acute schizophrenia in patients who did not show initial response to olanzapine treatment. Methods Fourteen patients treated with olanzapine for more than 1 week but less than 3 weeks, but those with an inadequate response [Clinical Global Impression (CGI)-improvement score ≥4 and Positive and Negative Syndrome Scale (PANSS) total score ≥60 at baseline], were randomly assigned to olanzapine maintenance therapy (N=7) or olanzapine-amisulpride combination therapy (N=7). Four-week effect sizes were calculated. Psychotic symptoms, side effect, and extrapyramidal symptoms were also assessed. Results At 4weeks, Brief Psychiatric Rating Scale (BPRS) total scores significantly decreased by 19.7±15.7 points for combination therapy, but 4.4±4.9 points for olanzapine continuation therapy (p=0.046). Discussion In current study, amisulpride add-on appears to be more effective for treating psychotic symptoms in patients with nonresponse to previous olanzapine therapy than olanzapine continuation. [ABSTRACT FROM AUTHOR]

Background Poor sleep quality has been frequently noted in normal populations with metabolic syndrome (MetS). There were little evidences on the relations between sleep problem and metabolic syndrome in schizophrenia. The authors examined the association of sleep quality and metabolic syndrome in schizophrenic patients using actigraphy. Methods A total of 101 schizophrenic patients were included in this study. Fifty-four (53.4%) patients met the criteria of MetS. Self-assessment of subjective sleep quality, daytime sleepiness, physical activities were measured using Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and International Physical Activity Questionnaire (IPAQ), respectively. Psychopathology was assessed by Positive and Negative Syndrome Scale (PANSS). Objective sleep quality and physical activity were measured by Actigraph (ActiGraph wGT3X-BT). Actigraph was applied to each patient's dominant wrist for 1 week. Results There were no significant differences on gender, age, marital status, educational level, duration of illness between patients with MetS and non-MetS. Scores of PSQI, ESS, IPAQ and PANSS also did not differ between two groups. Total time in bed, sleep latency, wake after sleep onset (WASO) and average awakening were significantly longer in patients with MetS than those of non-MetS. Sleep efficiency of patient with MetS was lower than those of non-MetS. Total sleep time and number of awakening showed no differences between two groups. Activity parameters of actigraphy were not differed between groups. Results of multiple logistic regression showed that longer sleep latency, lower sleep efficiency were high risk factors for metabolic syndrome. Dose of antipsychotics and severity of psychopathology did not associate with the risk of metabolic syndrome. Discussion This may be the first study to find out the correlations of sleep quality and metabolic syndrome in schizophrenic patients by objective sleep measurements. Although some sleep parameters were correlated with metabolic syndrome in schizophrenic patients, more extensive and complicated designed studies may be needed to confirm the association of metabolic syndrome and sleep problems in schizophrenic patients. [ABSTRACT FROM AUTHOR]

Background Poor emotional expression and depression of patients with schizophrenia are difficult problems in clinical situation. The objective of this study was to investigate the effects of group arts therapy based on emotion management training on emotional expression, positive emotion and negative emotion, alexithymia, depression and quality of life in patients with schizophrenia Methods 24 of 160 in-patients with schizophrenia, according to DSM-IV from H Mental Health Hospital, were randomly assigned to either an experimental or control group. Each group consisted of 12 patients. Group arts therapy was conducted on the experimental group twice a week, 60 minutes per session, for a total of 16 sessions, while the control group was left untreated. The following scales were used for assessment: Berkeley Expressivity Questionnaire (BEQ), Positive Affective and Negative Affect Schedule (PANAS), Toronto Alexithymia Scale-Korean version (TAS-20K), Depression Scale for Schizophrenia (K-CDSS), Positive and Negative Syndrome Scale (PANSS), and Schizophrenia Quality of Life Scale (SQLS-R4K). Independent t-test was conducted to confirm the homogeneity, and to find the effects of group arts therapy, repeated measures ANOVA was conducted to confirm the differences for scores of each scale regarding groups, measuring timing, and also the interaction between groups and measuring timing by pre, post and follow-up test. Results First, total score, expressivity factors and impulse strength factors of emotional expressivity were significantly increased after group arts therapy compared to the control group. Second, positive emotion was significantly increased and negative emotion was significantly decreased after group integrative therapy compared to the control group. Third, total score, difficulty identifying feelings of Alexithymia were significantly decreased after group arts therapy compared to the control group. Fourth, depression was significantly decreased after group integrative arts therapy compared to the control group. Fifth, negative syndromes and general psychopathology were significantly decreased after group arts therapy compared to the control group. Sixth, quality of life was significantly increased after group arts therapy compared to the control group. Discussion The group arts therapy has significantly improved the emotional expression, positive emotion, negative emotion and Alexithymia in patients with schizophrenia and also improved negative syndromes, general psychopathology, depression and quality of life. These results suggest that group arts therapy based on emotion management training could be a useful intervention for emotional disturbance treatment for in patients with schizophrenia. [ABSTRACT FROM AUTHOR]