• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.5 no.1
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• pp.36-40
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• 1994

Child and adolescent depressive disorders are complex clinical problems. Although our knowledge of the epidemiology, clinical manifestation and etiology of child and adolescent depressive disorder has grown enormously, less has been established concerning effective managements for this disorder Some articles suggest that children and adolescents may require significant modification of adult treatment. This article reviews the range of available therapies for the condition add provides a systematic approach for the clinician. And guidelines f3r management of depression have been described. In conclusion, approaches to the treatment of this disorder must be comprehensive and broad-based to be successful. And practitioners should be encouraged to become skilled iii as many treatment as possible, because the needs of individual children and adolescents with depressive disorder and their families can vary greatly.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.2
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• pp.148-153
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• 1998

Objectives：This study investigated the severity and frequency of depression in mothers with autistic children and the correlation between K-BDI score of mothers with autism and severity of autistic symptoms of their children. Methods：The subjects for this study consisted of 45 autistic children and their mothers. The severity of autistic symptoms of children were evaluated by K-CARS and severity of depressive symptoms of mothers with autistic children evaluated by the K-BDI. Results：1) Total K-BDI scores of mothers with autistic children were $17.3{\pm}10.9$ and this score was belonged to subclinical depression on the K-BDI STEN score. There were significant differences of total KBDI score between in mothers with autistic children and in those of normal control. The 26.7% of 45 mothers with autistic children were depression. 2) There was no correlation between total K-BDI score and each factor of mothers with autistic children and K-CARS score of the their children. Conclusion：There were many depression in mothers with autistic children than in those of normal control. This result suggested that the education and the supportive psychotherapy for mothers with autistic children is as important as the treatment for autism.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.1
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• pp.12-25
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• 2003

Objectives：As increasing number of new antidepressants have been being introduced in clinical practice, pharmacological understanding has been broadened. These changes mandate new information and theories to be incorporated into the treatment process of children with depressive disorders. In light of newly coming knowledge, this review intended to recapitulate the characteristics of new antidepressants and to consider the pivotal issues to develope guidelines for the treatment of depression in childhood and adolescence. Methods：Searching the Pub-Med online database for the articles with the key words of 'new', 'antidepressants' and 'children' ninety-seven headings of review articles were obtained. The author selected the articles of pertinent subjects in terms of either treatment guideline or psychopharmacology of new antidepressants. When required, articles about the clinical effectiveness of individual antidepressants were separatedly searched. In addition, the safety information of new antidepressants was acquired by browsing the official sites of the United States Food and Drugs Administration and Department of Health and Human Services. Results：1) For the clinical course, treatment phase, and treatment outcome, the reviews or treatment guidelines adopted the information from adult treatment guidelines. 2) Systematic and critical reviews unambiguously concluded that selective serotonin reuptake inhibitors(SSRIs) excelled tricyclic antidepressants( TCAs) for both efficacy and side effect profiles, and were recommend for the first-line choice for the treatment of children with depressive disorders. 3) New antidepressants generally lacked treatment experiences and randomized controlled clinical trials. 4) SSRIs and other new antidepressants, when used together, might result in pharmacokinetic and/or pharmacodynamic drug-to-drug interaction. 5) The difference of the clinical effectiveness of antidepressants between children and adults should be addressed from developmental aspects, which required further evidence. Conclusion：Treatment guidelines for the pharmacological treatment of childhood and adolescence depression could be constructed on the basis of clinical trial findings and practical experiences. Treatment guidelines are to best serve as the frame of reference for a clinician to make reasonable decisions for a particular therapeutic situation. In order to fulfill this role, guidelines should be updated as soon as new research data become available.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.5 no.1
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• pp.28-35
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• 1994

Research on biological aspects on adult depression has been subjected to more than 25 years of systematic research, while biologic investigations regarding childhood and adolescent depression are only now being initiated. Although no unifying, explanatory theory of the biologic etiology of childhood depression emerges from the results of studies reviewed above, the findings do support that biological factors may be involved in the genesis of childhood depression. The research reviewed in this paper suggests that age and pubertal factors have major effects in most biological markers of depression. Some of these markers, like sleep EEG and neuroendocrine markers should be broken down by decades during adult life span. Thus, although adult data are very valuable points of departure for biological research on child and adolescent depression, it is very hard to transfer the adult data to prepubertal children and adolescents, ignoring the biological changes that take place in growth and development, pubety and aging. A great deal of work in basic developmental neuroscience remains to be done. It will be crucial for further advances in this field to determine the normal patterns of neurotransmitter interaction in this age group and to study children at high risk for depression. It will be also crucial to use primate models of depressive illness in order to be able to answer the many queations that cannot be investigated in humans for ethical issues. Conclusively, much closer collaboration between developmental and neurobiological and behavioral studies in primates and in humans will be essential for further development.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.5 no.1
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• pp.12-27
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• 1994

Until recently there were arguments on the existence and the definition of childhood depression. In DSM-III(1980) childhood depression was accepted as the formal psychiatric disorder in childhood. As the diagnostic criteria for childhood depression is less clearly defined than those for other psychiatric disorders as well as prominent age-related variations in depression symptomatology, informations from various sources are very important in accurate diagnosis of childhood depression. Present study reviewed various assessment methods such as self-report questionnaires, interviews, behavior rating scales, structured tests and projective techniques with discussion on the merits and limitations of each method. Also several issues on the reliability and the validity of assessment techniques for childhood depression were discussed.

• 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.6 no.1
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• pp.34-42
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• 1995

Borderline personality disorder in adolescents present with suicide attempts or gestures, and they are characterized by the same patterns of splitting, devaluation, manipulation, need-gratifying object relations, impulsivity, and ego deficits that are finds in borderline adults, Symptomatolgy are depression, anxiety, identity crisis, and occasionally antisocial behavior in borderline personality disorder in adolescents. These findings should be differentiated to normal stormy adolescents. Theses borderline personality disorder in adolescents are known about the instability of object relations, labile affect, splitting, and psychotic episode in severe stress. According to thses finding, schizophrenia, mood disorder, schizoptypal personality disorder, paranoid personality disorder could be differentiated. Etiology is complex including psychodynamic, genetic, familial factor. Treatments are individual psychotherapy, group therapy, and pharmacotherapy. The continuity or discontinuity of borderline states from childhoon to adult life is controversy.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.1
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• pp.116-123
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• 1999

Objectives : The authors attempted to assess how much the mechanism of dissociation affects somatization disorder patients psychopathologically, and explore the relationship between sexual or physical abuse and somatic symptoms in somatization disorder patients. Methods : The authors administered the Dissociative Experiences Scales-Korean version(DESK) and Dissociative Disorders Interview Schedule to 25 patients with somatization disorder and 51 normal subjects. Results : There were no significant demographic differences between patient and control groups. The mean score of DES-K for patient group was 18.2, and 10.0 for the control group. The percentage of the individuals with high scores(20 and over) was 36.0 in the patient group and 7.8 in the control group, respectively. The percentage of the individuals with sexual and/or physical abuse was 16.0 in the patient group and zero in the control group. Our results showed that DES-K scores were not influenced by the factor of age or religion in either group, but the scores of the patients with somatization disorder were significantly higher than those in the normal subjects. Conclusion : There was an implication that the mechanism of dissociation affects issues of psychopathogenesis and psychopathology in Korean patients with somatization disorder, even though they have different sociocultural backgrounds in comparison to Western patients. The authors suggest it is useful to focus attention on childhood abuse and dissociation in the evaluation and dynamic psychotherapy of patients with somatization disorder.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.10 no.2
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• pp.178-185
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• 1999

Objective：This study was designed to examine the validity of the Ego Impairment Index(EII) in adolescent psychiatric patients(depression, depressive-conduct disorder, schizophrenia), and to explore the validity of the depressive-conduct disorder as a diagnostic entity. Method：19 depressives, 13 depressive-conduct disordered, and 10 schizophrenics with the age from 12 to 18 were selected based on DSM-IV and ICD-10 criteria, and their responses of the Rorschach and MMPI were analyzed. The EII was empirically developed by Perry and Viglione(1991) in order to assess the degree of ego impairment, and was derived from the Rorschach test. Results：It was founded that a single factor, ego impairment, was derived from the principal component analysis and explained 57.18% of total variances. The degree of ego impairment was grater in schizophrenics than in the other two groups, but there were no difference between depressives and depressive-conducts. Conclusions：These results offered support for the use EII as an empirical means of assessing the degree of ego impairment in adolescent patients. And these results suggest that depressive-conduct disorder group is more similar to the depressive group, implying that depressive-conduct disorder might correspond to so called masked depression. The clinical implication and limitation of present study were discussed.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.3
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• pp.269-279
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• 2021

The purpose of this study is to evaluate the effect of the spread of a new type of coronavirus infection (COVID-19) on the mental state in school-age children and parents focusing on the aspects of sleep disorders and depression. A questionnaire survey was conducted for 123 parents and 108 school-age children who visited Department of Pediatric Dentistry, Kyung Hee University Dental Hospital at Gangdong from April 2, 2020 through April 25, 2020, via the direct writing method. Participants were assessed with Pittsburgh Sleep Quality Index, Generalized Anxiety Disorder (GAD)-7, Center for Epidemiology Scale for Depression. Logistic regressions were used with a level of significance of 5%. The prevalence of GAD, depression, and poor sleep in parents were 34.1%, 17.1% and 44.7%, respectively. The prevalence of GAD in children was 20.4%. Logistic regression showed that stress from Emergency Alert Messages about COVID-19 was associated with GAD and depression in parents. In children, the degree of emotional change after COVID-19 was associated with GAD. This study confirmed that there was a change in the psychological status of children and guardians due to the epidemic of coronavirus disease-2019, and it would be necessary to consider their psychological status during dental treatment.