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조기정신증에서 정신병적 증상 발현 후에 약물반응도가 증가되어 관해된 사례

Symptom Remission Related to Increased Drug Response after Conversion Into Schizophrenia in Early Psychosis : A Case Report

박종익|김정훈
대한조현병학회 (Korean Academy of Schizophrenia)|2016.10|대한조현병학회지 (Korean Journal of Schizophrenia Research)|제19권 제2호|pp. 89-93

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참고문헌

키워드

조현병SchizophreniaTreatment timing항정신병약물AntipsychoticsEarly psychosis조기정신증치료시기
주제분류정신과학

초록

In recent years, early intervention is the paradigm in psychosis treatment. The logic of early intervention paradigm is based on the view that the earliest possible detection and intervention for psychosis will deliver the best outcome for patients. Therefore, in recent decades, most of studies focused on indentifying people with psychosis as early as possible, reducing the duration of untreated psychosis. However, while there are well documented and sometimes serious side effects associated with antipsychotic medication in the short-term, the iatrogenic risks of atypical antipsychotic medication are underscored. Furthermore, against this paradigm, the recent of longitudinal studies of schizophrenia suggest a new paradigm shift in treatment timing of psychosis. In this respect, this case which showed symptom remission after conversion into schizophrenia in early psychosis suggests wondering about the time of treatment. Similar cases have not been reported. And review of the effects of timing, in fact, has yet to be done. If similar cases would be reported in the future more, treatment timing may be the next paradigm shift in the therapeutics of early psychosis.

Abstract

In recent years, early intervention is the paradigm in psychosis treatment. The logic of early intervention paradigm is based on the view that the earliest possible detection and intervention for psychosis will deliver the best outcome for patients. Therefore, in recent decades, most of studies focused on indentifying people with psychosis as early as possible, reducing the duration of untreated psychosis. However, while there are well documented and sometimes serious side effects associated with antipsychotic medication in the short-term, the iatrogenic risks of atypical antipsychotic medication are underscored. Furthermore, against this paradigm, the recent of longitudinal studies of schizophrenia suggest a new paradigm shift in treatment timing of psychosis. In this respect, this case which showed symptom remission after conversion into schizophrenia in early psychosis suggests wondering about the time of treatment. Similar cases have not been reported. And review of the effects of timing, in fact, has yet to be done. If similar cases would be reported in the future more, treatment timing may be the next paradigm shift in the therapeutics of early psychosis.

참고문헌 (30)

  1. Almond S, "Relapse in schizophrenia: costs, clinical outcomes and quality of life", Br J Psychiatry, 184, pp.346~351 (2004)
  2. 장성만, "Economic Burden of Schizophrenia in South Korea", Journal of Korean Medical Science, 23(2), pp.167~175 (2008), 대한의학회
  3. Thomas H, "McGlashan and Jan Olav Johannessen, Early Detection and Intervention With Schizophrenia: Rationale", Schizophr Bull, 22, pp.201~222 (1996)
  4. Perkins DO, "Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia:a critical review and meta-analysis", Am J Psychiatry, 162, pp.1785~1804 (2005)
  5. Malla AK, "First-episode psychosis, early intervention, and outcome: What have we learned?", Can J Psychiatry, 50, pp.881~891 (2005)
  6. Clarke M, "Untreated illness and outcome of psychosis", Br J Psychiatry, 189, pp.235~240 (2006)
  7. Johannessen JO, "Early detection strategies for untreated first-episode psychosis", Schizophr Res, 51, pp.39~46 (2001)
  8. Klosterkötter J, "Diagnosing schizophrenia in the initial prodromal phase", Arch Gen Psychiatry, 58, pp.158~164 (2001)
  9. McGlashan, Thomas H, "Treatment Timing vs Treatment Type in First-episode psychosis: a paradigm Shift in Strategy and effectiveness", Schizophrenia Bulletin, 38(5), pp.902~903 (2012)
  10. Bertelsen M, "Five-year follow-up of a randomized multicenter trial of intensive early intervention vs standard treatment for patients with a first episode of psychotic illness: the OPUS trial", Arch Gen Psychiatry, 65, pp.762~771 (2008)
  11. Llorca PM, "Tardive dyskinesias and antipsychotics: a review", Eur Psychiatry, 17, pp.129~138 (2002)
  12. Tschoner A, "Metabolic side effects of antipsychotic medication", Int J Clin Pract, 61, pp.1356~1370 (2007)
  13. Francey SM, "Who needs antipsychotic medication in the earliest stages of psychosis? A reconsideration of benefits, risks, neurobiology and ethics in the era of early intervention", Schizophr Res, 119, pp.1~10 (2010)
  14. Shin YM, "A descriptive study of pathways to care of high risk for psychosis adolescents in Korea", Early Interv Psychiatry, 4, pp.119~123 (2010)
  15. McGlashan TH, "Early detection and intervention of schizophrenia:rationale and research", Br J Psychiatry, 172, pp.3~6 (1998)
  16. McGorry PD, "Early intervention in psychosis: an overdue reform", Aust NZ J Psychiatry, 37, pp.393~398 (2003)
  17. McGorry PD, "Issues for DSM-V: clinical staging: a heuristic pathway to valid nosology and safer, more effective treatment in psychiatry", Am J Psychiatry, 164, pp.859~860 (2007)
  18. Edwards J, "Implementing Early Intervention in Psychosis:A Guide to Establishing Early Psychosis Services" (2002), Dunitz
  19. Marshall M, "Association between duration of untreated psychosis and in cohorts of first-episode outcome patients-a systematic review", Arch Gen Psychiatry, 62, pp.975~983 (2005)
  20. Harrigan SM, "Does treatment delay in firstepisode psychosis really matter?", Psychol Med, 33, pp.97~110 (2003)
  21. Perkins DO, "Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia:a critical review and meta-analysis", Am J Psychiatry, 162, pp.1785~1804 (2005)
  22. Marshall M, "Association between duration of untreated psychosis and in cohorts of first-episode outcome patients-a systematic review", Arch Gen Psychiatry, 62, pp.975~983 (2005)
  23. Keshavan MS, "Early intervention in schizophrenia:current and future perspectives", Curr Psychiatry Rep, 9, pp.325~328 (2007)
  24. Allison DB, "Antipsychotic-induced weight gain: a review of the literature", J Clin Psychiatry, 62, pp.22~31 (2001)
  25. Alvarez-Jimenez M, "Antipsychoticinduced weight gain in chronic and first-episode psychotic disorders:a systematic critical reappraisal", CNS Drugs, 22, pp.547~562 (2008)
  26. Muench J, "Diabetes mellitus associated with atypical antipsychotic medications: new case report and review of the literature", J Am Board Fam Pract, 14, pp.278~282 (2001)
  27. Tschoner A, "Metabolic side effects of antipsychotic medication", Int J Clin Pract, 61, pp.1356~1370 (2007)
  28. Stahl SM, "Which comes first: atypical antipsychotic treatment or cardiometabolic risk?", Acta Psychiatr Scand, 119, pp.171~179 (2009)
  29. Bertelsen M, "Five-year follow-up of a randomized multicenter trial of intensive early intervention vs standard treatment for patients with a first episode of psychotic illness: the OPUS trial", Arch Gen Psychiatry, 65, pp.762~771 (2008)
  30. Keller MB, "Differential outcome of pure manic, mixed", cycling, and pure depressive episodes in patients with bipolar illness, 1986, pp.13(255), 3138~3142

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