• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.93-103
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• 2002

The aim of this study is to examine the diagnostic profiles and related clinical variables of children with attention and hyperactivity in psychiatric outpatient clinic. Seventy one children with age range of 5 to 14 were diagnosed by DSM-IV, and assessment battery including KEDI-WISC, KPI-C, ADS(ADHD Diagnostic System) were completed. The subjects were divided into 3 diagnostic groups：ADHD only(n=17), ADHD comorbid(n=27), Other diagnosis(n=27). The results were as follows：In ADHD comorbid group, tic disorder, developmental language disorder, borderline intellectual function, oppositional defiant/conduct disorder, and learning disorder were combined in descending order. Other diagnosis group consisted of tic disorder, borderline intellectual function, depression/anxiety, oppositional defiant/conduct disorder, and others. There were significant differences in IQ, PIQ, and VIQ among the three groups, and ADHD only group showed higher scores of IQ and VIQ than ADHD comorbid group. On the KPI-C, there were no significant differences in all subscales among the three groups. On the visual ADS, omission error and sensitivity showed significant differences among the three groups, and ADHD comorbid group represented higher omission error and lower sensitivity than other diagnostic group. The findings indicated that the inattention and hyperactivity symptoms could be diagnosed into diverse psychiatric disorders in child psychiatry, and ADHD children with comorbidity will show more problems in academic performance and school adjustment.

• Anxiety and mood
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• v.4 no.1
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• pp.42-48
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• 2008

Objective : Due to a better understanding of the pathophysiology of posttraumatic stress disorder (PTSD) and the relative limitations in the treatment of patients with PTSD, a variety of medications and treatment algorithms for PTSD have been investigated. This study was conducted to investigate the trends in the pharmacotherapy used in the treatment of inpatients with PTSD at a single university hospital in Korea. Methods : Data from 75 patients diagnosed with PTSD according to the DSM-IV criteria from January 1998 to December 2007 were collected. Demographic data and clinical data, including medications prescribed, were investigated. Results : Thirty-three of the 75 subjects included in this study were male, and 42 were female. Considering psychiatric comorbidity, depressive disorder, cognitive disorder, psychotic disorder and anxiety disorder were reported in order. Approximately 97% of the subjects were treated with antidepressants, including paroxetine in 54.7%, and 24% of the subjects were treated with two different kinds of antidepressants. In addition, atypical antipsychotics were prescribed in 33.3% of patients, mood stabilizers in 17.3%, and anxiolytics in 94.7% of the subjects. Conclusion : In our study, various kinds of antidepressants were prescribed for most patients with PTSD. Antipsychotics and mood stabilizers were added to the treatment regimens of some subjects, and anxiolytics were added to the treatment regimens of most subjects. Despite its many limitations, this study shows the prescription pattern and trends in PTSD treatment in Korea. We hope that these preliminary data would be helpful for the development and integration of a practical guideline for the treatment of PTSD in Korea.

• Sleep Medicine and Psychophysiology
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• v.12 no.1
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• pp.50-57
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• 2005

Objectives: This study was designed to evaluate the differences in clinical characteristics and severity of symptoms between panic patients with and without comorbid major depressive disorder, and to ascertain the differences in the function of the autonomic nerve system measured by heart rate variability (HRV). Methods: The subjects were 60 patients who have panic disorder without major depressive disorder and 19 patients who met DSMIV criteria for both panic disorder and major depressive disorder. First, they drew up symptom checklists and self-rating scales, and were measured by Anxiety Disorder Inventory Schedule-Panic Attack & Agoraphobia (ADIS-P&A), Clinical Global Impression (CGI), Hamilton Rating Scale for Depression (HAM-D), Panic Disorder Severity Scale (PDSS) and Heart Rate Variability (HRV). For statistical analysis, we performed t-test to compare the scores of self reported scales and clinician’s rating scales in panic patients with comorbid major depressive disorder and those without major depressive disorder. ANCOVA was used to compare the variables of HRV, considering age as a covariate. Results: The subjective severities of depression and anxiety that comorbid patients complained of were higher than those of patients with only panic disorder. Futhermore, comorbid patients were more sensitive to anxiety and physical sensations, and they tend to be more negative in their thinking. The scores of clinician-rating scales such as CGI and PDSS were also higher in the comorbid patients. However, there were no significant differences in HRV variables between both groups, despite a tendency to low heart rate variability in the comorbid group. Conclusion: This study suggests that patients with panic disorder and comorbid major depressive disorder tend to complain of more symptoms and to be more sensitive to various symptoms than those with panic disorder without comorbid depression. However, in this study comorbid major depressive disorder did not have a significant impact on the HRV variables of patients with panic disorder.

• Anxiety and mood
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• v.13 no.1
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• pp.10-16
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• 2017

Objective : This study aimed to investigate differences in demographic, clinical characteristics, and quality of life between panic-disorder patients with generalized anxiety disorder (PD+GAD) and without generalized anxiety disorder (PD-GAD). Methods : We examined data from 218 patients diagnosed with PD+GAD (150 patients) and PD-GAD (68patients). The following instruments were applied: Stress coping strategies, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Panic Disorder Severity Scale (PDSS), Anxiety Sensitivity Index-Revised (ASI-R), Albany Panic and Phobia Questionnaire (APPQ), NEO-neuroticism(NEO-N), Short Form health survey-36 (SF-36). Results : Compared to the PD-GAD group, the PD+GAD group had higher scores in emotion-focused coping strategies and clinical severity, such as BDI, BAI, PDSS, ASI, APPQ, and neuroticism. The PD+ GAD group showed lower scores in most scales in SF-36 status than PD-GAD group. Conclusions : This study shows that PD+GAD patients are different from PD-GAD patients in coping strategies, clinical severity and quality of life. It emphasizes the need of personalized therapy in clinical approach among patients with PD+GAD.

• Korean Journal of Psychosomatic Medicine
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• v.12 no.1
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• pp.76-85
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• 2004

Objectives: The purpose of the present study was to investigate the emotional state and personality characteristics of patient with panic disorder. Methods: Twenty patients with panic disorder, 21 patients with somatoform disorder, and 20 normal healthy controls were studied. Korean version of Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI) and Korean standardized edition of Cattell's 16 Personality Factors Questionnaire(16-PF) were used for assessment. Statistically, One-way ANOVA with Scheffe test were used by SPSS/PC for windows. Results: 1) Total score of BDI was higher in the panic group than the somatoform group and normal control group(p<0.001). 2) Total score of state anxiety and trait anxiety in the panic group was higher than the somatoform group and normal control group(p<0.001). 3) In 16 PF, there were no definitely abnormal range of scores. But in first-stratum source traits of 16PF, the panic group was higher than the somatoform group and normal healthy group in O-factor (p<0.01) and Q4-factor(p<0.001). In second-stratum source traits of 16PF, the panic group was higher than the somatoform group in ANX-factor(p<0.05), but lower than normal control group in TOUfactor(p<0.05). 4) There were no differences in the panic subgroup according to sex and cutoff points of BDI score 16 and STAI-T score 54. 5) According to cutoff point of STAI-S score 52, the panic subgroup above 52 was higher than the panic subgroup under 52 in G-factor(p<0.001), Q3-factor(p<0.05) and SUP-factor(p<0.001), but lower in L-factor(p<0.05). Conclusion: These results suggest that emotional state of patients with panic disorder are depressive and anxious as compared with patients with somatoform disorder and normal controls. Patients with panic disorder did not show any abnormal personality characteristics but were more guilt-prone, anxious, emotionally sensitive. We propose that the understanding of panic patients' emotional state and personality characteristics will helpful to treat and manage in patient with panic disorder.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.10 no.1
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• pp.64-75
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• 1999

Objective：The purpose of this study was to investigate the prevalence and characteristics of comorbid disorders and associated symptoms in pervasive developmental disorder(PDD) and to examine the correlation between associated symptoms and developmental characteristics in PDD children. Method：The sample consisted of 209 cases of PDD and 143 cases of developmental language disorder(DLD)(control group) who were treated at the Seoul National Mental Hospital from Jan. 1996 to Mar. 1999. The diagnostic work based on DSM-IV criteria was performed by one or two child psychiatrists, while the clinical feature was evaluated by doctors’s notes, occupational/speech therapy reports, and results of social maturity scale(SMS), childhood autism rating scale(CARS), and psycho-educational profile(PEP). Two groups were compared on a wide range of measures including comorbid disorders, associated symptoms, treatment drugs, and PEP. The relation between associated symptom & PEP was investigated in total(106 cases) and in each dignostic group. Sixty-four cases of PDD were divided into three groups by CARS and then compared on associated symptoms. Result：The prevalence of comorbid disorder was 19.6% in PDD, 41.2% in DLD. The rate of manifestation of 13 associated symptoms was 31.47% in PDD, 22.13% in DLD on the average. Associated symptoms significantly high in PDD were preoccupation, obsession, self-mutilation, stereotypy, sleep problems, and odd response. In total patient group, associated symptoms that significantly influenced PEP were preoccupation, self-stimulation, stereotypy, inappropriate affect, sleep problems, and odd response. But, in each diagnostic group, no associated symptom influenced PEP. Associated symptoms significantly different between the 3 groups of CARS were stereotypy, anxiety, and sleep problems. Conclusion：These preliminary results suggest that developmental characteristics may influence associated symptoms in PDD children and a realistic approach considering minute diagnosis by associated symptoms and comorbid disorders is required.

• Anxiety and mood
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• v.10 no.1
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• pp.17-23
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• 2014

Objective : Panic disorders are frequently accompanied by major depressive disorder (MDD). There is insufficient information about which clinical factors in panic disorder are associated with comorbid MDD. The aim of this study is to identify clinical factors related with comorbid MDD in patients with panic disorder. Methods : Two experienced psychiatrists diagnosed panic disorder based on DSM-IV criteria. This diagnosis in the 275 subjects was confirmed again by Mini-International Neuropsychiatric Interview (MINI). Lifetime comorbid psychiatric diagnoses were examined by MINI. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and Panic Disorder Severity Scale (PDSS) were used to assess the severity of depressive, anxiety and panic symptoms. Results : The result of MINI showed that 95 patients (34%) with panic disorder satisfied the diagnosis of MDD. Multivariate logistic regression model showed that comorbid generalized anxiety disorder (GAD) and the symptom of "fear of losing control or going crazy" were associated with MDD in patients with panic disorder. In female patients, the "chills or hot flushes" symptom was also associated with comorbid MDD. Conclusion : These results showed that coexisting GAD and certain symptoms of panic are associated with comorbid MDD.

• Anxiety and mood
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• v.15 no.1
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• pp.20-28
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• 2019

Objective : The purpose of this study was to compare and analyze effectiveness of various psychotherapies of depressive symptoms in patients with anxiety disorders by means of a systemic review. Methods : A systematic search using key words was conducted using EMBASE, MEDLINE and CENTRAL. Results : Five studies were included in this systematic review. The Scottish Intercollegiate Guidelines Network (SIGN) was used for quality assessment. Diagnostic-specific cognitive behavioral therapies for various anxiety disorders (ds CBT) were also effective in reducing comorbid depression. Transdiagnostic cognitive behavioral therapies targeting anxiety and depression (tCBT-AD) were not superior than ds CBT for anxiety disorders. Mindfulness-based stress reduction (MBSR) was more effective than traditional cognitive behavioral therapy. Conclusion : ds CBT relieves anxiety symptoms as well as depressive symptoms comorbid with anxiety disorders effectively. In addition, MBSR is more successful for anxiety disorders with co-occurring depression by focusing broadly on the shifting relationship to internal experience rather than focusing narrowly on specific symptoms.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.11 no.2
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• pp.209-220
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• 2000

The purpose of this study is to find out the characteristics of depressive episode about major depression and bipolar disorder in child and adolescent. The subjects of this study were 34 major depression patients and 17 bipolar disorder patients hospitalized at child and adolescent psychiatry in OO university children's hospital from 1st March 1993 to 31st October 1999. The method of this study is to review socio-demographic characteristics, diagnostic classification, chief problems and symptoms at admission, frequency of symptoms, maternal pregnancy problem history, childhood developmental history, coexisting psychiatric disorders, family psychopathology and family history and therapeutic response through their chart. 1) The ratio of male was higher than that of female in major depressive disorder while they are similar in manic episode, bipolar disorder. 2) Average onset age of bipolar disorder was 14 years 1 month and it was 12 years 8 months in the case of major depression As a result, average onset age of major depression is lower than that of bipolar disorder. 3) The patients complained of vegetative symptoms than somatic symptoms in both bipolar disorder and depressive disorder. Also, the cases of major depression developed more suicide idea symptom while the case of bipolar disorder developed more aggressive symptoms. In the respect of psychotic symptoms, delusion was more frequently shown in major depression, but halucination was more often shown in bipolar disorder. 4) Anxiety disorder coexisted most frequently in two groups. And there coexisted symptoms such as somartoform disorder, mental retardation and personality disorder in both cases. 5) The influence of family loading was remarkable in both cases. Above all, the development of major depression had to do with child abuse history and inappropriate care of family. It is apparent that there are distinctive differences between major depression and bipolar disorder in child and adolescent through the study, just as in adult cases. Therefore the differences of clinical characteristics between two disorders is founded in coexisting disorders and clinical symptoms including onset age, somatic symptoms and vegetative symptoms.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.22 no.4
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• pp.307-313
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• 2011

Objectives : This study explored the clinical differences in attention-deficit hyperactivity disorder (ADHD) patients with and without developmental coordination disorder (DCD). Methods : Participants were 49 children and adolescents with ages between 6 and 18 years. These subjects were placed into 2 groups: ADHD without DCD (24) and ADHD with DCD (25). We used several evaluation tools on both groups: the Affective Disorders and Schizophrenia-Present and Lifetime Version- Korean Version (K-SADS-PL), Wechsler Intelligence Scale for Children-III (WISC-IIII), Child Behavior Check List (CBCL), Korean Personality Rating Scale for Children (K-PRC), and Bruininks-Osretsky Test of Motor (BOT-2). Results : Patients with both ADHD and DCD had a lower performance intelligence quotient and more internal and external behavioral symptoms than patients with ADHD but not DCD. It is possible that patients with ADHD and motor coordination problems should be noticed earlier and given intensive treatment.