• 제목/요약/키워드: 공존질환

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Clinical Characteristics in Attention-Deficit Hyperactivity Disorder with/or without Developmental Coordination Disorder Patients (발달협응장애 동반 유무에 따른 주의력결핍 과잉행동장애 아동들의 임상적 특성)

  • Song, Yoon-Jae;Joung, Yoo-Sook
    • 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.

Network Analysis of Depressive and Anxiety Symptom in Young Adult of an Urban City (일 도시 청년 인구의 불안 우울 공존 증상 네트워크 분석)

  • Jong wan Park;Hyochul Lee;Jae Eun Hong;Seok Bum Lee;Jung Jae Lee;Kyoung Min Kim;Hyu Seok Jeong;Dohyun Kim
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.118-124
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    • 2023
  • Objectives : Depressive disorder and anxiety disorder frequently co-occur, even at sub-threshold level. This study aims to identify network structure of co-morbid depression and anxiety at symptom level in nonclinical population and to reveal the central symptoms and bridge symptoms of the co-morbidity. Methods : This study was based on 2022 Asan Youth Mental Health Screening. Patient health questionnaire (PHQ-9) and Generalized anxiety disorder scale (GAD-7) were used to assess depressive and anxiety symptoms of 810 young adult participants from community sample. Network structure of co-morbid depressive and anxiety symptoms was estimated by Isingfit model. Results : Depressed mood, Restlessness and Nervousness were the most central symptoms in the network. Bridge symptoms between anxiety and depression were Restlessness and Irritability. Conclusions : This study revealed key central symptoms and bridge symptoms of co-morbid depression and anxiety in nonclinical population and provided potential insight for treatment targets to reduce co-morbidity.

Relationships Between Premonitory Urge, Tics and Comorbidities in Children and Adolescents With Chronic Tics (만성 틱장애 소아청소년의 전조충동, 틱증상 심각도, 동반질환 간의 관련성)

  • Joo-Han Kwon;Sang-Keun Chung;Jong-Chul Yang;Jong-Il Park;Ha-Min Kim;Tae Won Park
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.142-148
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    • 2023
  • Objectives : The purpose of this study is to investigate the relationships between premonitory urge, tic severity, and comorbidities in children and adolescents with chronic tic disorders. Methods : In this study, scales for tic symptoms, premonitory urge, obsessive-compulsive symptoms, and ADHD symptoms were repeatedly measured twice in 26 children and adolescents aged 10 to 18 years with chronic tic disorders. Correlations between scales were confirmed through repeated measures correlation analysis, and causal relationships between scales were confirmed through regression analysis using a linear mixed model. Results : The degree of premonitory urges showed a significant positive correlation with the severity of tic symptoms, the severity of obsessive-compulsive symptoms, and the severity of ADHD symptoms. The ADHD symptoms showed a significant positive correlation with the severity of tic symptoms. These results were the same even in children and adolescents with tic disorders who were not diagnosed with obsessive-compulsive disorder. Additionally, premonitory urges were found to have a significant positive effect on the severity of tic symptoms. Conclusions : These results may be helpful in treating tic disorders and can be used in future tic disorder research considering developmental trajectory.

Comparative Analysis of arterial Gases and Acid-base status in Patients with Congenital and Acquired Heart Disease at Preoperative Period, During Extracorporeal Circulation. and Postoperative Period (선천성 및 후천성 심질환 환자에서 체외순환 전, 중, 후의 동맥혈 가스의 비교 분석)

  • 이동석;이봉근;김송명
    • Journal of Chest Surgery
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    • v.34 no.11
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    • pp.831-842
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    • 2001
  • Background: Patients with cardiac diseases who have structural defects in their heart bring about metabolic insult such as preoperative acid-base imbalance. Cardiac operation requires many nonphysiologic procedures such as extracorporeal circulation, hypothermia, and hemodilution. We studied the acid-base status of surgical heart diseases pre-operatively, during extracorporeal circulation, and post-operatively and researched the treatment indications of acid-base disturbances. Material and Method: From January 1997 to May 1999, fifty two cases of open heart surgery were carried out under extracorporeal circulation, which divided into a set of pediatric and adult groups, congenital and acquired groups, non-cyanotic and cyanotic groups, The $\alpha$ -stat arterial blood gas analysis was done in each group during the preoperative period, during the operation with extracorporeal circulation, and during the postoperative period. Result: Before surgery, all patients present metabolic acidosis, PaO2 was low in adult group and acquired group and compensatory respiratory alkalosis was noted in cyanotic group. During extracorporeal circulation, adult group revealed alkalosis and normal in acquired group. Pediatric group presents low Pa$CO_2$, metabolic acidosis and respiratory alkalosis. Congenital group and non-cyanotic group showed non-compensatory alkalosis trend and non-compensatory respiratory acidosis were observed in cyanotic group during extracorporeal circulation. Postoperative acid-base status of adult group was recovered to normal and the standard bicarbonate was increased in the acquired group. All of the pediatric, congenital non-cyanotic, and cyanotic groups revealed the lack of buffer base.

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Respiratory Microbiome in Children (소아의 호흡기 미생물군 유전체)

  • Kim, Dong Hyun
    • Pediatric Infection and Vaccine
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    • v.26 no.3
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    • pp.129-139
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    • 2019
  • The human respiratory tract hosts both pathogenic and commensal bacteria. The development of well-conserved 16S rRNA sequencing and culture-independent techniques has enabled many achievements in the study of the human microbiome. Microbial composition of the respiratory tract in early childhood has been shown to correlate to respiratory health in later stages of life. This review highlights current understandings of respiratory microbiota development in healthy children, examples of microbial interactions, impacts on the host immune system, and the relationship between respiratory tract microbiome and respiratory health.

A Pilot Study of the Usefulness of Intelligence Test in Assessment of Attention-Deficit Hyperactivity Disorder (주의력결핍 과잉행동장애 환아 평가시 지능검사의 유용성에 관한 예비연구)

  • Min, Jung-Won;Lee, Won-Hye;Hong, Min-Ha;Bahn, Geon Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.23 no.4
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    • pp.196-203
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    • 2012
  • Objectives:We analyzed the usefulness of intelligence test in assessing attention-deficit hyperactivity disorder (ADHD). Methods:The medical records of 312 patients with ADHD who visited the child psychiatry department in one university hospital in Seoul, Korea, were reviewed. Demographic data and scores on the Korean Wechsler Intelligence Scale for Children-III (K-WISC-III) and Korean-Conners' Parent Rating Scale (K-CPRS) were analyzed. To assess the relationship with comorbidities, AD-HD subjects were classified as; externalizing disorders, internalizing disorders, tic disorders, and no comorbidities. Results:Verbal intelligence quotient (VIQ) was significantly higher than performance IQ (PIQ)($102.6{\pm}14.44$, $99.2{\pm}14.48$, p<.001). Using mean scatter method, subtest scores such as 'information, similarities, digit span and coding' were significantly lower than mean scores of sum of subtests of VIQ or PIQ (p<.05). Regarding comorbidities, children with externalizing disorders exhibited. Lower scores on 'information and vocabulary' than other groups (p=.008). Children with no comorbidities exhibited higher scores on 'similarities and object assembly' than children with externalizing/internalizing disorders (p=.001) and also on 'comprehension' than children with externalizing disorders (p=.006). For subtypes of ADHD, children with hyperactive-impulsive type had higher scores on 'comprehension' than children with inattentive and combined type (p=.004). Conclusion:These results suggested that intelligence test might provide useful information for assessing ADHD.

Clinical Application of the Korean Personality Rating Scale for Children in Attention-Deficit Hyperactivity Disorder (주의력결핍 과잉행동장애에서 한국아동 인성평정척도의 임상적 적용)

  • Yoon, Woon;Park, Kee-Jeong;Kweon, Kukju;Kim, Hyo-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.26 no.3
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    • pp.217-225
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    • 2015
  • Objectives : The objective of this study was to compare the Korean Personality Rating Scale for Children (K-PRC) profile between children with attention-deficit hyperactivity disorder (ADHD) and typically developing children. We also aimed to investigate the association of K-PRC and ADHD symptoms. Methods : Ninety-nine youth (age $8.3{\pm}2.4$ years, 72 boys) with ADHD and 84 controls (age $9.2{\pm}2.5$ years, 43 boys) were recruited from the Department of Pediatric Psychiatry of the Asan Medical Center Children's Hospital. Diagnoses of ADHD and comorbid psychiatric disorders were confirmed with the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). The parents of the subjects completed the ADHD rating scale, and K-PRC. Independent t-tests, analysis of covariance, partial correlation analyses, and Mc Nemar test were used for analysis. Results : Children and adolescents with ADHD showed higher K-PRC scores in verbal development, physical development, depression, delinquency, hyperactivity, family dysfunction and psychoticism. Delinquency and hyperactivity were significantly correlated with parent-rated ADHD rating scales and ADHD scores on K-SADS-PL. The hyperactive/impulsive and combined subtypes showed higher scores on hyperactivity and delinquency than the inattentive subtype, and the inattentive subtype showed higher scores on depression and social dysfunction of the K-PRC. Conclusion : Our results suggest that K-PRC could be used to comprehensively evaluate symptoms, combined psychopathologies, developmental delay and family dysfunction of children with ADHD.

Clinical Characteristics in Panic Disorder Patients in Emergency Department (공황발작으로 응급실에 내원한 공황장애 환자들의 임상 특징)

  • Lee, Chang-Ju;Nam, Beom-Woo;Sohn, In-Ki
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.1
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    • pp.26-33
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    • 2021
  • Objectives : This study was designed to investigate datas related to panic attack and treatment in emergency room of panic disorder patients who visited emergency room for panic attack. Methods : A retrospective analysis of medical records was conducted on 92 patients with panic disorder who visited Chungju Konkuk university hospital emergency department due to panic attack and had bodily symptoms from 1st January 2010 to 31th December 2019. In addition to demographic characteristics and comorbid disorders, triggering stressors and alcohol consumption were corrected as pre-panic attack datas, bodily symptoms at the time of panic attack were corrected as datas during attack, electrocardiogram trial, consultation with psychiatrist, admission and information of used psychotropic drugs were corrected as post-attack data. Depending on size of data, Chi-square test or Fisher's exact test was used. Collected data was analyzed using R 4.03. Results : Cardiovascular disease was accompanied by 5.4% and depressive disorder was the most common coexisting mental disorder. Among triggering stressors, economic problem/work-related stress was significantly higher in men than women (𝛘2=4.322, p<0.005). The most common physical symptom during attack was circulatory (65.2%), followed by respiratory (57.6%), numbness-paralysis (33.7%), dizziness (19.6%), gastro-intestinal (14.1%) and autonomic symptom (12.0%). Electrocardiogram was taken at higher rate when patients complained circulatory symptom (𝛘2=8.46, p<0.005). The psychotropic drug most commonly used in emergency room was lorazepam, used in 92.1%. Conclusions : The most common bodily symptom during panic attack was circulatory symptom and the most common triggering stressor in men was economic problem/work-related stress. The most commonly used psychotropic for panic attack was lorazepam.

Subtypes of Hepatitis B Surface Antigen Among Chronic Liver Disease (B형 간염 바이러스 양성인 만성 간질환에서 Hepatitis B 표면항원의 아형)

  • Cho, Hee-Soon;Lim, So-Yeo;Lee, Chae-Hoon;Kim, Kyung-Dong;Kim, Chung-Sook
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.272-278
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    • 1996
  • Four subtypes of hepatitis B surface antigen are useful in the epidemiologic studies of the route of virus transmission and clinical significance of simultaneous occurance of hepatitis B surface antigen and antibody to hepatitis B surface antigen in the same serum as well as useful marker for population migration. The sera were obtained from 214 HBs Ag positive patients who are diagnosed as chronic liver disease and following up in the Yeungnam university hospital. The subtypes were determined by solid-phase sandwich EIA using monoclonal antibodies. Among 214 specimens, the subtype adr was 93.9%, adw was 2.8%, ayr was 0.9%, ar was 0.9%, adwr was 1.4% and ayw was not detected. There were no correlation between subtype pattern and disease. In summary, the subtype adr was prominent in our study and the difference of subtype pattern by severity of disease was not significant. However, to determine the prognostic value of HBs Ag subtype and relationship between subtype and disease progression, long-term follow up will be needed.

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A PRELIMINARY STUDY FOR THE DEVELOPMENT OF THE ASSESSMENT SCALE FOR ADHD IN ADOLESCENTS:RELIABILITY AND VALIDITY FOR CASS(S) (청소년 ADHD 평가 도구 개발을 위한 예비연구-CASS(S)의 신뢰도 및 타당도 연구)

  • Shin, Min-Sup;Cho, Soo-Churl;Hong, Kang-E;Bahn, Geon-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.2
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    • pp.218-224
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    • 2001
  • Although Attention Deficit Hyperactivity Disorder(ADHD) has been considered as the disorder occurring during childhood, the prevalence is increasing among adolescents and adults. The prevalence rate varies from 2.0 to 14.3% due to the difference of diagnostic criteria, different assessment methods, or subjects' age difference. Therefore, it needs to make age specific(i.e., for children, for adolescents, and for adults) assessment tools. Authors translated Conners-Wells Adolescents Self-Report Scales(short form)[CASS(S)] in to Korean to get validity and reliability as a way of development of assessment tool for adolescent with ADHD in Korea. CASS(S) was translated and corrtected by three psychiatrists and one clinical psychologist. To examine the concurrent validity and test-retest validity, CASS(S) was applied with K-YSR on one class of each grade in a middle school in Seoul with two week interval(total 115:male 58, female 57). To test validity, authors analysed and got Cronbach's as internal consistency. Construct validity was done by principal axis factor analysis on 4,354 students. As a result, Cronbach's alpha for internal consistency was .88, Pearson coefficient for test-retest reliability .83, and coefficient for concurrent validity .65. And in the factor analysis to examine construct validity, three factors were revealed as cognition, hyperactivity, and conduct. These results shows that CASS(S) may be useful tool for adolescents with ADHD, although there was a limit not to be done the comparison with clinical groups.

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