Korean Journal of Biological Psychiatry

Individuals with developmental disorders exhibit a broad spectrum of aggressive behaviors, including self-directed actions and those directed toward others. These behaviors can lead to physical harm, disruptions in daily life, caregiver stress, and an increased risk for abuse and institutionalization. An integrated and multidisciplinary approach, including psychosocial approaches and pharmacotherapy, has been attempted to treat self-injurious and aggressive behaviors, but has shown limited effectiveness in reducing those behaviors. Recently, the use of electroconvulsive therapy has increased as an alternative treatment for pediatric and adolescent patients with treatment-resistant behavior problems in developmental disorders. This review elucidates the indications and clinical effectiveness of electroconvulsive therapy in the management of self-injurious behavior and catatonia in patients with developmental disorders such as autism spectrum disorders and intellectual disabilities.

Neurodevelopmental disorder; Self-injurious behavior; Intellectual disabilities; Autism spectrum disorder; Catatonia; Electroconvulsive therapy.

A conceptual summary of recent trends in the use of electroconvulsive therapy (ECT) for treatment-resistant behavioral problems associated with developmental disorders was provided in the previous review, and this review offers information needed for clinical practice. As it is essentially impossible to obtain evidence-based data in this regard, we have attempted to present a review of practical issues related to the implementation of ECT, such as the public perception by the media, and ethical issues where the target population may include children and adolescents. In addition, we described the assessment tools required for the symptom identification to be treated and the evaluation of symptom changes in response to treatment, which are necessary for determining whether ECT is valid even in treatment-resistant conditions. In order to complement the direct clinical experience of ECT practitioners needed to assess the appropriateness of the currently administered treatment, case reports from other countries were introduced to illustrate the ECT course in each case. To this end, the issues related to the practical process of safe and effective ECT have been summarized in relatively specific detail.

Developmental disorder; Self-injurious behavior; Catatonia; Intellectual disabilities; Autism spectrum disorder; Electroconvulsive therapy.

Cannabis, presently being one of the most commonly employed psychoactive agents globally, ranks after alcohol and nicotine. Despite the permissibility of employing cannabis for medicinal objectives in Korea, the discussion regarding the authorization and control of cannabis for both recreational and medicinal intentions persists, giving rise to apprehensions about the plausible hazards and repercussions of cannabis on public well-being and health. Cannabis has the potential to induce positive experiences that mitigate certain psychiatric symptoms depending on the individual. However, a multitude of studies have demonstrated a close association between cannabis usage and detrimental effects on the brain, including the onset of schizophrenia and the deterioration of cognitive function. The endocannabinoid (eCB) system, which serves as the primary target for the active components of cannabis, was only recently discovered, and the precise mechanisms through which the intricate substances within cannabis interact with the body remain inadequately comprehended. The use of medical cannabis for mental illness has shown promise in treating anxiety, post-traumatic stress disorder, sleep disorders, and substance use disorders. Recent research has focused on the discovery of the eCB system, which plays a role in the therapeutic effects of cannabinoids. These studies are advancing the development of new treatments for mental disorders through research and clinical trials. In conclusion, while cannabis-related substances carry a risk for mental health, the eCB system also holds potential as a new therapeutic mechanism. Further research is needed to better understand the mechanisms of cannabinoids and determine appropriate medical uses.

Cannabis; Medical cannabis; Cannabis legalization; Drug safety; Cannabinoids; Cannabidiol.

Objectives  This study explores knowledge of and attitudes toward electroconvulsive therapy (ECT) among psychiatrists in Korea.
Methods  We emailed questionnaires to psychiatrists to assess their knowledge of and attitudes toward ECT. The present analysis focuses on responses to Lutchman’s questionnaire.
Results  A total of 293 psychiatrists (260 specialists and 33 residents) responded to the questionnaire. The responses showed positive attitudes towards ECT, with an average approval rating of 77.68%. There were no differences between genders, or between specialists and residents, in knowledge of and attitudes toward ECT. However, psychiatrists generally reported insufficient knowledge and/or negative attitudes toward techniques, methods, side effects, and other factors related to clinical implementation of ECT, as well as a lack of clinical experience. In addition, responses were influenced by personal views.
Conclusions  We assume that insufficient knowledge, lack of experience with the advanced technologies and methods of modern ECT, and negative perceptions of side effects limit the use of ECT for treating mental disorders. Further research aimed at improving knowledge of and attitudes toward ECT among psychiatrists is needed to enhance therapeutic efficacy in the treatment of mental disorders.

Electroconvulsive therapy; Psychiatric specialists; Survey of knowledge and attitudes.

Objectives  ZCognitive intervention treatment is known to be effective among dementia patients. To establish an effective nonpharmacological treatment for dementia patients, it is necessary to study how it affects not only cognitive function but also emotional function as well as daily life abilities. This study examined the effects of a cognitive intervention program using the robot PIO.
Methods  The robot-mediated cognitive intervention using “laughter-PIO” was applied to 36 participants rated Clinical Dementia Rating 0.5 or 1. The cognitive function, emotional state, and daily life abilities were evaluated before and after the program.
Results  After the cognitive intervention, the Geriatric Depression Scale-Korean score improved from 11.6 ± 6.3 to 9.0 ± 6.0 (p = 0.03). The subtests of the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet, J2 Boston Name test, J3 Mini-Mental State Exam, and J7 Word Recognition test, showed significant improvements (p < 0.05). The Digit Span Test result increased from 13.1 ± 5.4 to 15.2 ± 6.1 after the program (p < 0.05).
Conclusions  The cognitive intervention program using the robot “PIO” improved cognitive function and the emotional state of dementia patients, and daily life abilities.

Robot; Cognitive intervention program; Cognition; Emotion; Dementia.

Wernicke’s encephalopathy is a life-threatening central nervous system disease caused by thiamine deficiency. Emergent diagnosis is crucial but is frequently underdiagnosed. If Wernicke’s encephalopathy is concomitant with underlying psychiatric disorders, the progression of symptoms becomes less discernible. This can present challenges for clinicians in establishing definitive diagnoses. Frequent problematic drinking and chronic thiamine deficiency have been reported in the homeless population. Clinicians should consider the possibility of developing Wernicke’s encephalopathy in this population. This case report describes a 43-years-old homeless patient with Wernicke’s encephalopathy presented with psychiatric symptoms.

Wernicke encephalopathy; Ill-housed persons; Psychotic disorders.