• Title/Summary/Keyword: 공존장애

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COMPARISON OF MEMORY FUNCTION BETWEEN ATTENTION DEFICIT/HYPERACTIVITY DISORDER AND LEARNING DISORDER CHILDREN (주의력 결핍/과잉운동 장애와 학습 장애 아동의 기억 기능 비교)

  • Kim, Yong-Hee;Cho, Soo-Churl;Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.85-92
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    • 2002
  • Objectives:This study was conducted to compare the memory function among the attention deficit/hyperactivity disorder(ADHD), the learning disorder(LD) and the comorbidity disorder(ADHD+LD) groups. Methods:Thirty-four children(11 ADHD, 5 LD, 9 ADHD+LD, and 8 Psychiatric control) were individually assessed using the KEDI-WISC and Memoty Assessment Scale(MAS), and then the results of those test were analyzed. Results:In memory test, all of three group showed lower performances than control group. The comorbidity, the LD and the ADHD group showed lower scores in almost subtests of MAS respectively. The good performance in memory test was significantly correlated with the types of memory strategy and error response children used during testing. Discussion:The clinical utility of the memory test like MAS was discussed in terms of differential diagnosis for ADHD, LD and ADHD+LD children.

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Influence of Comorbid Mental Disorder on Time to Seeking Treatment in Anxiety Disorder : Comparison of Social Anxiety Disorder and Panic Disorder (불안장애의 치료추구시간에 대한 공존 정신질환의 영향 : 사회불안장애와 공황장애 간 비교)

  • Kim, Hye-Min;Ha, Juwon;Lim, Se-Won;Oh, Kang-Seob
    • Anxiety and mood
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    • v.8 no.2
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    • pp.146-152
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    • 2012
  • Objective : Individuals with anxiety disorders experience a wide range of time to seeking treatment (TST) as well as various comorbid mental disorders. The present study examined the TST in social anxiety disorder (SAD) and panic disorder. This study aimed to find out the influence of comorbid mental disorder on TST of anxiety disorder through the comparison of SAD and panic disorder. Methods : This study included 311 SAD and 378 panic disorder patients at the initial visit of psychiatric clinic. Contribution of clinical (number of comorbidity, comorbid type and onset age) and demographic (current age) factors to TST were investigated by multivariate analysis. Results : The median length of TST was 14.03 years in SAD and 2.26 years in panic disorder. In social anxiety disorder, fewer comorbidity, younger onset age, and older age were factors associated with delayed TST. In panic disorder, only younger onset age was associated with delayed TST. In both disorders, comorbid depressive disorder was associated with shorter TST. Conclusion : Our data provided the differences in illness behavior needing help based on comorbid mental disorders between SAD and panic disorder. In addition to comorbid disorder, factors affecting TST of anxiety disorder requires future investigation.

THE CHARACTERISTICS OF CHILD AND ADOLESCENT INPATIENTS WITH SEVERE OBSESSIVE-COMPULSIVE DISORDER (심각한 소아 ${\cdot}$ 청소년 강박장애로 입원한 환아들의 특징)

  • Hwang, Jun-Won;You, So-Young;Chang, Jun-Hwan;Shin, Min-Sup;Cho, Soo-Churl;Hong, Kang-E;Kim, Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.2
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    • pp.143-151
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    • 2004
  • Objectives : Child and adolescent onset obsessive compulsive disorder(C-OCD) is known to be associated with poor drug response, high comorbid rate and strong genetic tendencies. Till now studies for C-OCD have been very rare in Korea. We conducted this study to investigate the informations about clinical features, familial psychiatric loading, treatment profiles and course of server C-OCD from the retrospective analysis of inpatient data of Seoul National University Children's Hospital. Method : Retrospective chart review and data analysis was performed. Twenty(male 16 : female 4) patients with final C-OCD diagnosis by DSM-IV at discharge from 1994 to 2002 were found and their medical chart, psychological data, family interview data and nursing reports were collected and analyzed. Results : 1) The sex ratio of C-OCD was male dominant(4:1). 2) Phenomenological, most common obsession was pathologic doubt, contamination fear, followed by aggressive obsession, need for symmetry, sexual obsession, most common compulsion was checking and washing, followed by breathing, movement, symmetry, repetitive asking, hoarding, mental compulsion. 3) Most common comorbid diagnosis was depression. Other axis-I diagnosis associated OCD were anxiety disorder, tic disorder, conduct and oppositional defiant disorder and psychosis. 4) Regarding psychiatric familial loadings, 17 patients(85%) had relatives with psychiatric disorders, OC-spectrum disorders(OCD or OCPD) were found in 9 patients(45%). 5) The majority of patients(75%) have received SSRI and antipsychotics treatment. The response rate above 'moderate improved" by CGI was 75%. 6) During follow-up period in outpatient clinic, five patients(25%) showed continuous complete remission, 10 patients (50%) did residual symptoms with chronic course. Conclusion : This seems to be the first systemic investigation of severe pediatric OCD patients in Korea. The children & adolescents with severe OCD in inpatient-setting showed the high comorbid rate, familial psychiatric loading, and combined pharmacotherapy with antipsychotics, As for symptoms, high rate of aggressive-sexual obsession and atypical compulsions like breathing and moving was reported in this study. Severe pediatric OCD patients, however, responded well to the combined SSRI and antipsychotics regimen.

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STANDARDIZATION OF WORD/NONWORD READING TEST AND LETTER-SYMBOL DISCRIMINATION TASK FOR THE DIAGNOSIS OF DEVELOPMENTAL READING DISABILITY (발달성 읽기 장애 진단을 위한 단어/비단어 읽기 검사와 글자기호감별검사의 표준화 연구)

  • Cho, Soo-Churl;Lee, Jung-Bun;Chungh, Dong-Seon;Shin, Sung-Woong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.81-94
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    • 2003
  • Objectives:Developmental reading disorder is a condition which manifests significant developmenttal delay in reading ability or persistent errors. About 3-7% of school-age children have this condition. The purpose of the present study was to validate the diagnostic values of Word/Nonword Reading Test and Letter-Symbol Discrimination Task for the purpose of overcoming the caveats of Basic Learning Skills Test. Methods:Sixty-three reading-disordered patients(mean age 10.48 years old) and sex, age-matched 77 normal children(mean age 10.33 years old) were selected by clinical evaluation and DSM-IV criteria. Reading I and II of Basic Learning Skills Test, Word/Nonword Reading Test, and Letter-Symbol Discrimination Task were carried out to them. Word/Nonword Reading Test:One hundred usual highfrequency words and one hundred meaningless nonwords were presented to the subjects within 1.2 and 2.4 seconds, respectively. Through these results, automatized phonological processing ability and conscious letter-sound matching ability were estimated. Letter-Symbol Discrimination Task:mirror image letters which reading-disordered patients are apt to confuse were used. Reliability, concurrent validity, construct validity, and discriminant validity tests were conducted. Results:Word/Nonword Reading Test:the reliability(alpha) was 0.96, and concurrent validity with Basic Learning Skills test was 0.94. The patients with developmental reading disorders differed significantly from normal children in Word/Nonword Reading Test performances. Through discriminant analysis, 83.0% of original cases were correctly classified by this test. Letter-Symbol Discrimination Task:the reliability(alpha) was 0.86, and concurrent validity with Basic Learning Skills test was 0.86. There were significant differences in scores between the patients and normal children. Factor analysis revealed that this test were composed of saccadic mirror image processing, global accuracy, mirror image processing deficit, static image processing, global vigilance deficit, and inattention-impulsivity factors. By discriminant analysis, 87.3% of the patients and normal children were correctly classified. Conclusion:The patients with developmental reading disorders had deficits in automatized visuallexical route, morpheme-phoneme conversion mechanism, and visual information processing. These deficits were reliably and validly evaluated by Word/Nonword Reading Test and Letter-Symbol Discrimination Task.

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CLINICAL STUDY OF THE ABUSE IN PSYCHIATRICALLY HOSPITALIZED CHILDREN AND ADOLESCENTS (소아청소년 정신과병동 입원아동의 학대에 대한 임상 연구)

  • Lee, Soo-Kyung;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.145-157
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    • 1999
  • This study was performed by the children and adolescents who were abused or neglected physically, emotionally that were selected in child & adolescents psychiatric ward. We investigated the number of these case in admitted children & adolescents, and also observed characteristics of symptoms, developmental history, characteristics of abuse style, characteristics of abusers, family dynamics and psychopathology. We hypothesized that all kinds of abuse will influnced to emotional, behavioral problems, developmental courses on victims, interactive effects on family dynamics and psychopathology. That subjects were 22 persons of victims who be determined by clinical observation and clinical note. The results of the study were as follows:1) Demographic characteristics of victims:ratio of sex was 1:6.3(male:female), mean age was $11.1{\pm}2.5$. According to birth order, lst was 12(54.5%), 2nd was 5(23%), 3rd was 2(9%) and only child was 3(13.5%). 2) Characteristics of family:According to socioeconomic status, middle to high class was 3(13.5%), middle one was 9(41.% ), middle to low one was 9(41%), low one was 1(0.5%). according to number of family, under the 3 person was 3(13.5%), 4-5 was 17(77.5%), 6-7 was 2(9%). according to marital status of parents, divorce or seperation were 5(23%), remarriage 2(9%), severe marital discord was 19(86.5%). In father, antisocial behavior was 7(32%), alcohol dependence was 10(45.5%). In mother, alcohol abuse was 5(23%), depression was 17(77.3%), history of psychiatric management was 6(27%). 3) Characteristics of abuse:Physical abuse was 18(81.8%), physical and emotional abuse and neglect were 4(18.2%). according to onset of abuse, before 3 years was 15(54.5%), 3-6 years was 5(27.5%), schooler was 1(15%). Only father offender was 2(19%), only mother offender was 8(35.4%), both offender was 8(35.4%), accompaning with spouse abuse was 7(27%), and accompaning with other sibling abuse was 4(18.2%). 4) General characteristics and developmental history of victims:Unwanted baby was 12(54.5%), developmental delay before abuse was9(41%), comorbid developmental disorder was 15(68%). there were 6(27.5%) who didn‘t show definite sign of developmental delay before abuse. 5) Main diagnosis and comorbid diagnosis:According to main diagnosis, conduct disorder 6(27.3%), borderline child 5(23%), depression4(18%), attention deficit hyperactivity disorder(ADHD) 4(18%), pervasive developmental disorder not otherwise specified 2(9%), selective mutism 1(5%). According to comorbid diagnosis, ADHD, borderline intelligence, mental retardation, learning disorder, developmental language disorder, oppositional defiant disorder, chronic tic disorder, functional enuresis and encoporesis, anxiety disorder, dissociative disorder, personality disorder due to medical condition. 5) Course of treatment:A mean duration of admission was $2.4{\pm}1.5$ months. 11(15%) showed improvement of symtoms, however 11(50%) was not changed of symtoms.

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ANTIDEPRESSANT INDUCED-MANIC EPISODE IN ADOLESCENTS WITH PRECEDING ANXIETY SYMPTOMS (불안증상을 보이는 환아에서 항우울제 투여로 유발된 조증삽화)

  • Chungh Dong-Seon;Kim Jeong-Hyun;Ha Kyoo-Seob
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.124-131
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    • 2005
  • Childhood and adolescent onset-bipolar disorders have higher rate of comorbidity with anxiety disorders as well as attention deficit hyperactivity disorder and conduct disorder. Obsessive compulsive disorder, social phobia, panic disorder, and separational anxiety disorder are common comorbid anxiety disorders with bipolar disorders in child and adolescent. Prospective and reliable data on temporal and causal relationship between the onset of bipolar disorders and the onset of comorbid anxiety disorders are still in debate. The authors report 2 adolescent cases with antidepressant induced-manic episodes with preceding anxiety symptoms. The authors suggest careful prescription of antidepressants for anxiety disorders, even for those who do not have definite past history or family history of bipolar disorders. Further comprehensive and prospective studies are requested for the temporal relationship and pharmacological guideline for comorbid bipolar disorders and anxiety disorder in child and adolescent.

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A STUDY OF PSYCHOSOCIAL VARIABLES WITHIN ADHD WITH OR WITHOUT EXTERNALIZING SYMPTOM (ADHD 아동과 외면화 증후를 공존질환으로 갖는 ADHD 아동간의 심리사회적 변인에 관한 비교연구)

  • Lee, Kyung-Sook;Ryu, Yoon-Jung;Ahn, Dong-Hyun;Shin, Yee-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.2
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    • pp.203-212
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    • 1996
  • In this thesis, we investigate the psychosocial variables within the family environments of Attention Deficit Hyperactivity Disorder with (ADHD+CD/ODD) or without (ADHD) externalizing symptoms. The subjects in this research were 86 boys and girls(aged range 6 to 14 years) consisted of 20 ADHD, 22 comorbid ADHD(ADHD+CD/ODD) and 44 normal control group(NC). We have collected data on children and their mothers. The psychosocial variables included in the analysis are socioeconomic status, parent's educational level, life stress event, and the rate of psychiatric disorders in relatives. The self-reported questionnaires marital discord(MAS), parenting stress(PSI), and parenting attitute(MBRI) completed by mothers. The results indicated that ADHD+CD/ODD is supposed to have higher level of family adversity suggested by the lower SES, lower parental educational level, higher life stress events, and more psychic disorders in relatives compared with ADHD or normal control group. In MAS, ADHD+CD/ODD group has significantly the lowest scores on each factor of the measure of marital adjustment. Parents of ADHD+CD/ODD are much more likely to have positive parenting stress when compared with the parents of ADHD. Especially, mothers of ADHD+CD/ODD have the lowest tendency in the mean score on affective, accepted attitudd. In an inapropriate parenting attitude perceived by children, father of ADHD+CD/ODD have the most negative, contradictory attitude and mothers of ADHD+CD/ODD have the most restrictive, negative and contradictory attitude.

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Survey of Knowledge on Insomnia for Sleep Clinic Clients (수면클리닉을 방문한 환자들의 불면증에 대한 인식조사)

  • Soh, Minah
    • Sleep Medicine and Psychophysiology
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    • v.26 no.1
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    • pp.23-32
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    • 2019
  • Objectives: Insomnia is not only the most common sleep-related disorder, but also is one of the most important. Knowledge of the comorbidities of insomnia is essential for proper treatment including pharmacological and non-pharmacological methods to prevent disease chronification. This study aimed to determine sleep clinic patients' knowledge of insomnia. Methods: This study recruited 44 patients (24 males and 20 females; mean age $54.11{\pm}16.30years$) from the sleep clinic at National Center for Mental Health. All subjects were asked to complete a self-report questionnaire about their reasons for visiting a sleep clinic and about their knowledge of treatment and comorbidities of insomnia. Results: The reasons for visiting the sleep clinic were insomnia symptoms of daytime sleepiness, irregular sleeping time, nightmares, snoring, and sleep apnea, in that order. Of the responders, 72.7% had a comorbidity of insomnia, and 22.7% showed high-risk alcohol use. In addition, 70.5% of responders chose pharmacological treatment of insomnia as the first option and reported collection of information about treatment of insomnia mainly from the internet and medical staff. More than half (52.3%) of the respondents reported that they had never heard about non-pharmacological treatments of insomnia such as cognitive behavioral treatment (CBT-I) or light therapy. The response rate about comorbidities of varied, with 75% of responders reporting knowledge of the relation between insomnia and depression, but only 38.6% stating awareness of the relation between insomnia and alcohol use disorder. Of the total responders, 68.2% were worried about hypnotics for insomnia treatment, and 70% were concerned about drug dependence. Conclusion: This study showed that patients at a sleep clinic had limited knowledge about insomnia. It is necessary to develop standardized insomnia treatment guidelines and educational handbooks for those suffering from insomnia. In addition, evaluation of alcohol use disorders is essential in the initial assessment of sleep disorders.

TIC DISORDER AND OBSESSIVE COMPULSIVE DISORDER IN CHILDHOOD (틱 장애 및 소아기 발병 강박 장애)

  • Hong, Hyun-Ju;Song, Dong-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.2
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    • pp.183-191
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    • 2005
  • Tic disorder including Tourette's disorder is a neurodevelopmental disorder that appears in childhood and characterized by the presence of motor and vocal tics. Childhood-onset obsessive-compulsive disorder (OCD) is suggested to be a phenomenologically and etiologically distinct subtype of OCD, bearing a close genetic relationship to tic-disorders. Tourette's disorder and OCD are comorbid in $40-75\%$ of patients initially diagnosed with either disorder. Basal ganglia and cortico-striato-thalamic circuits are implicated in the pathophysiology of both disorders and these disorders have similar clinical features. Over the past decades, the progress in research on Tourette's disorder and OCD has been extraordinary. This review describes some of important insights from these work, involving these areas : 1) clinical implication 2) genetics and epidemiology 3) brain imaging study 4) neuroche-mistry 5) pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS).

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A COMPARATIVE STUDY ON AUDITORY ATTENTION AND PHONEME DIFFERENTIAL ABILITY AMONG CHILDREN WITH READING DISABILITY AND WITH ATTENTION DEFICIT/HYPERACTIVITY (읽기 장애와 주의력 결핍/과잉 운동 장애아동의 주의력 과제와 음소 변별 과제 수행 비교 - 청각 과제를 중심으로 -)

  • Lee, Kyung-Hee;Shin, Min-Sup;Kim, Boong-Nyun;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.2
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    • pp.197-208
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    • 2003
  • Objective:In this study, we hypothesized that deficit in processing rapid linguistic stimuli is at the heart of Reading Disability(RD) and deficit in response inhibition is at the heart of Attention Deficit/Hyperactivity(ADHD). We conducted experiments to identify the core cognitive characteristics of children either with RD or with ADHD or with both, using attentional tasks and phoneme differential tests. Method:In the study 1, 28 children with ADHD, 16 children with RD+ADHD were individually administered visual/auditory performance tests. Then, the differences of performance on attentional tasks between two groups were compared while IQs of two groups were controlled. In the study 2, 13 children with RD+ADHD/RD, 13 children with ADHD, and 13 normal children were administered computerized phoneme differential tests. Result:Visual attentional tasks did not distinguish an ADHD group from a RD+ADHD group. With auditory attentional tasks, however, the comorbid group showed significantly more difficulties, causing a large variance in reaction time. RD, RD+ADHD, and ADHD groups showed more errors in phoneme differential tests than a normal control group, and each group showed distinctive performance patterns. Discussion:An ADHD group had difficulty in response inhibition and sustained attention, and children who also had RD along with ADHD magnified the auditory attentional difficulties. Even though children with RD had more trouble with responding correctly to target stimuli, their responses were not significantly different from those of children with ADHD.

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