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

다국어 초록 (Multilingual 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 (Reference)

1 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" 119 : 1-10, 2010

2 Stahl SM, "Which comes first: atypical antipsychotic treatment or cardiometabolic risk?" 119 : 171-179, 2009

3 Clarke M, "Untreated illness and outcome of psychosis" 189 : 235-240, 2006

4 McGlashan, Thomas H, "Treatment Timing vs Treatment Type in First-episode psychosis: a paradigm Shift in Strategy and effectiveness" 38 (38): 902-903, 2012

5 Llorca PM, "Tardive dyskinesias and antipsychotics: a review" 17 : 129-138, 2002

6 Perkins DO, "Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia:a critical review and meta-analysis" 162 : 1785-1804, 2005

7 Perkins DO, "Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia:a critical review and meta-analysis" 162 : 1785-1804, 2005

8 Almond S, "Relapse in schizophrenia: costs, clinical outcomes and quality of life" 184 : 346-351, 2004

9 Tschoner A, "Metabolic side effects of antipsychotic medication" 61 : 1356-1370, 2007

10 Tschoner A, "Metabolic side effects of antipsychotic medication" 61 : 1356-1370, 2007

11 Thomas H, "McGlashan and Jan Olav Johannessen, Early Detection and Intervention With Schizophrenia: Rationale" 22 : 201-222, 1996

12 McGorry PD, "Issues for DSM-V: clinical staging: a heuristic pathway to valid nosology and safer, more effective treatment in psychiatry" 164 : 859-860, 2007

13 Edwards J, "Implementing Early Intervention in Psychosis:A Guide to Establishing Early Psychosis Services" Dunitz 2002

14 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" 65 : 762-771, 2008

15 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" 65 : 762-771, 2008

16 Malla AK, "First-episode psychosis, early intervention, and outcome: What have we learned?" 50 : 881-891, 2005

17 장성만, "Economic Burden of Schizophrenia in South Korea" 대한의학회 23 (23): 167-175, 2008

18 Keshavan MS, "Early intervention in schizophrenia:current and future perspectives" 9 : 325-328, 2007

19 McGorry PD, "Early intervention in psychosis: an overdue reform" 37 : 393-398, 2003

20 Johannessen JO, "Early detection strategies for untreated first-episode psychosis" 51 : 39-46, 2001

21 McGlashan TH, "Early detection and intervention of schizophrenia:rationale and research" 172 : 3-6, 1998

22 Harrigan SM, "Does treatment delay in firstepisode psychosis really matter?" 33 : 97-110, 2003

23 Keller MB, "Differential outcome of pure manic, mixed/cycling, and pure depressive episodes in patients with bipolar illness" 13 (13): 3138-3142, 1986

24 Klosterkötter J, "Diagnosing schizophrenia in the initial prodromal phase" 58 : 158-164, 2001

25 Muench J, "Diabetes mellitus associated with atypical antipsychotic medications: new case report and review of the literature" 14 : 278-282, 2001

26 Marshall M, "Association between duration of untreated psychosis and in cohorts of first-episode outcome patients-a systematic review" 62 : 975-983, 2005

27 Marshall M, "Association between duration of untreated psychosis and in cohorts of first-episode outcome patients-a systematic review" 62 : 975-983, 2005

28 Alvarez-Jimenez M, "Antipsychoticinduced weight gain in chronic and first-episode psychotic disorders:a systematic critical reappraisal" 22 : 547-562, 2008

29 Allison DB, "Antipsychotic-induced weight gain: a review of the literature" 62 : 22-31, 2001

30 Shin YM, "A descriptive study of pathways to care of high risk for psychosis adolescents in Korea" 4 : 119-123, 2010