• Title/Summary/Keyword: 소아와 장애인

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SURVEY OF SELF-CONCEPT AND DEPRESSION-ANXIETY OF THE ELEMENTARY SCHOOL BOYS WITH LEARNING DISABILITIES (학습장애를 가진 초등학교 남학생의 자아상 개념과 우울-불안 특성 조사)

  • Kim, Bong-Soo;Seong, Deock-Kyu;Jung, Yeong;Yoo, Hee-Jung;Cho, Soo-Churl;Shin, Sung-Woong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.1
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    • pp.125-137
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    • 2001
  • We investigated the self-concept, subjective depression, and state-trait anxiety of the school boys with learning disabilities(abbr. LD, n=86) and compared them with normal boys(n=52) using Piers-Harris Self-Concept Inventory, Child Depression Inventory(abbr. CDI), and State-Trait Anxiety Inventory(abbr. STAI). With regard to Piers-Harris Self-Concept Inventory total scores, there was no significant difference between two groups, but normal boys showed higher scores in intellectual and school status, physical appearance, and happiness-satisfaction subscales than patients with LD. The male patients with LD showed significantly higher ratings in CDI total scores, and CDI subscales - ineffectiveness, anhedonia, negative self-esteem than normal children. The patients with LD reported significantly higher state anxiety, but not trait anxiety. Correlation analyses revealed that self-concept decreased over time, and depression-anxiety increased across grades in the patients with LD, but not in normal children. Especially, negative mood, anhedonia, negative self-esteem subscales of CDI, and state-trait anxiety showed significant positive correlation with grades. In both groups, CDI scores were inversely correlated with Piers-Harris Self-Concept and positively with State-Trait anxiety. In conclusion, self-concept problems which were related with school achievement and self-esteem were more abundant in the patients with LD than normal children, self-image problem, depression and anxiety increased across grades. According to regression analysis, age, behavior subscale, intellectual-school status, anxiety, popularity, happiness-satisfaction, CDI-ineffectiveness, interpersonal problem, negative self-esteem, and state anxiety could explain the self-concept in the patients with LD, not in normal children. So, the self-concept of the patients with LD were found to be related to the school achievement and stress when comparing with peers. In conclusion, elementary school boys with LD showed lower self-concept, higher depression and anxiety, and these differences increased across grades. Since the patients with LD have concomitant depression and anxiety disorders, it is important that comorbidity with emotional problems should be explored and managed properly.

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Somatoform Disorders of Children and Adolescents (소아 및 청소년의 신체형장애)

  • Kim, Seung-Tai P.
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.2
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    • pp.277-285
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    • 1996
  • Somatoform disorders do occur among children and adolescents. Among the seven disorders under the grouping of somatoform disorders of DSM-IV, three disorders, namely somatization disorder, pain disorder and conversion disorder are seen relatively more often than one can expect in childhood and adolescence. Pain disorders are more prevalent among children before adolescence, whereas conversion disorder and somatoform disorder are seen more often during adolescence and early adulthood. Diagnoses of somatofram disorders should not be made by the process of exclusion, but based on positive findings that positive evidence that normal functioning is possible and that a positive history of psychosocial stress and or intrapsychic conflict exists. Treatment strategy should be mindful of including collaboration with primary care health professionals and family therapy staff in addition to all the basic treatment modalities essential for the treatment of children and adolescents.

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DENTAL CARE AND THE STATE OF EDUCATION AND TRAINING OF DENTISTS FOR THE HANDICAPPED (장애인의 치과진료 현황과 치과의사의 교육 및 훈련 정도에 대한 조사연구)

  • Kim, Seon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.1
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    • pp.87-94
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    • 2001
  • A survey was undertaken among a group of dentists working at private dental clinics to investigate the state of dental care and the level of education and training in the dental care to people with handicaps. Forty four percents of dental clinics take care of one more patients per month. The types of handicaps were physical, mental, sensory handicap and autism. The common problems are difficulty in communication and delay of treatment. Forty nine percents of dentists got education and nineteen percents had clinical experience for dental care of handicapped patients. Most of dentists felt necessity of training program and establishment of specialized dental hospital supported by government for the handicapped. This study indicated the necessity of undergraduate and postgraduate education and clinical training for dental care of handicapped patients.

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Obesity Prevalence in Pediatric Headaches (소아청소년 두통 환자에서 비만 유병률)

  • Han, A-Luem;Shin, Chan Ok;Cho, Kyoung Soon;Bin, Joong Hyun;Jung, Min Ho;Suh, Byung-Kyu
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.263-268
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    • 2018
  • Purpose: Obesity and headache are two highly prevalent diseases both in childhood and adolescent. In this study, we assessed the prevalence of obesity in pediatric headaches patients in a single institution in Korea, and differences according to age, sex, headache type, frequency, intensity, and disability. Methods: We retrospectively reviewed the medical records of 340 subjects (6-18 years of age) who visited the Pediatric Headache Clinic of Bucheon St. Mary's Hospital during the period from January 2015 through March 2018. Data on age, sex, height and weight, as well as headache type, frequency, intensity and disability, were collected. Body Mass Index (BMI) percentile was calculated based on the 2017 Korean Children Adolescence Growth Chart. Results: 17.6% of the pediatric headache patients were obese. The prevalence of obesity in male patients was higher than females (Male 23.8% VS Female 11.6%, P=0.002). There were no significant differences in obesity rate according to age, headache type, frequency, intensity, and disability. Conclusion: The prevalence of obesity in the pediatric headache population was 17.6% which is higher than 10.1% in general population (Korea National Health and Nutrition Examination Survey, KNHANES, 2013).

Sleep Disordered Breathing in Children (어린이의 수면호흡장애)

  • Yeonmi, Yang
    • Journal of the korean academy of Pediatric Dentistry
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    • v.49 no.4
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    • pp.357-367
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    • 2022
  • Sleep disordered breathing (SDB) is a disease characterized by repeated hypopnea and apnea during sleep due to complete or partial obstruction of upper airway. The prevalence of pediatric SDB is approximately 12 - 15%, and the most common age group is preschool children aged 3 - 5 years. Children show more varied presentations, from snoring and frequent arousals to enuresis and hyperactivity. The main cause of pediatric SDB is obstruction of the upper airway related to enlarged tonsils and adenoids. If SDB is left untreated, it can cause complications such as learning difficulties, cognitive impairment, behavioral problems, cardiovascular disease, metabolic syndrome, and poor growth. Pediatric dentists are in a special position to identify children at risk for SDB. Pediatric dentists recognize clinical features related to SDB, and they should screen for SDB by using the pediatric sleep questionnaire (PSQ), lateral cephalometry radiograph, and portable sleep monitoring test and refer to sleep specialists. As a therapeutic approach, maxillary arch expansion treatment, mandible advancement device, and lingual frenectomy can be performed. Pediatric dentists should recognize that prolonged mouth breathing, lower tongue posture, and ankyloglossia can cause abnormal facial skeletal growth patterns and sleep problems. Pediatric dentists should be able to prevent these problems through early intervention.

Childhood Brain Tumors (소아 뇌종양 - 항암화학요법을 중심으로 -)

  • Ghim, Thad T.
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1055-1058
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    • 2002
  • 뇌종양 치료성적은 점차 향상되고 있지만 백혈병 등 다른 소아암에 비해 향상 속도가 느리다. 하지만, 근래 MRI, PET scan 등 neuro-imaging 기술의 발달, 뇌종양의 분자유전학적 연구, 외과 수술 방법의 진전, 치료방사선요법의 다양화 등 많은 분야에서 꾸준한 발전을 보이고 있다. 그리고 여러 가지 신약개발에 의한 제 1, 제 2상의 약제시험, antiangiogenesis 약제의 임상시험, gene therapy 등의 연구가 활발하게 진행되고 있으므로, 이에 따른 환자의 치료 성적도 향상될 것으로 기대하고 있다. 외국에서는 여러 대학이 함께 참여하여 작성한 공동의 치료 protocol에 의한 치료가 활발하게 진행되어 생존율을 높이는데 반해, 우리나라에서는 아직까지 각 기관의 협조체제가 구축되지 못한 형편이다. 하지만 금년에 처음으로 여러 대학에서 임상각과가 참석하는 한국소아 뇌종양연구회가 탄생되어 우리나라 뇌종양 환아들의 치료 protocol 개발에 기여할 것을 기대하고 있다. 뇌종양 치료 후 생존하는 아이들을 위한 정밀한 추적관찰이 필수사항인데 여기에 소아과 의사들의 역할은 클 것으로 사료된다. 지능장애, 부적절한 대인관계, 사회적응의 어려움, 치료 후 발생한 내분비계통의 후유증 그리고 2차 암의 발생 등의 정확한 진단 및 치료가 소아과 의사들의 몫으로 남는다. 또한, 이러한 장애가 있는 환아들이 사회에 잘 적응하도록 하기 위해서는 재활교육에 대한 사회적인 관심과 그에 적절한 지원제도의 확립이 절실히 요구된다. 이 점에 있어서도 소아과 의사들의 관심과 지원이 필요하다.

Prevalence of Lactose Malabsorption in Children by Breath Hydrogen Test (소아에서 호기내 수소검사를 이용한 유당 흡수장애 유병률)

  • Chung, Ju-Young;Bae, Sun-Hwan;Choi, Kwang-Hae;Ko, Jae-Sung;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.1
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    • pp.62-67
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    • 2002
  • Purpose: The aim of this study was to investigate the age of onset and the prevalence of lactose malabsorption in early childhood in Korea. Methods: We conducted a study of lactose malabsorption by breath hydrogen test in healthy children aged between 25~96 months old. Standard lactose loading (2 g lactose/kg, maximum 40g) test was done in 129 children and cow's milk (10 mL/kg) loading in 126 children followed by breath sampling of 60 and 120 minutes after the loading. An increase above baseline of 20 ppm or more was used as a criteria for positive responses. Results: The prevalence of lactose malabsorption was 7% in 25~36 months old, 19% in 37~48 months old, 35% in 49~60 months old, 55% in 61~72 months old, 82% in 72~84 months old, 80% in 85~96 months old children. Only 1% of the children showed positive result in breath hydrogen test after the cow's milk challenge. Conclusion: The prevalence of lactose malabsorption was increased between 37 months and 60 months of age, reached to adult level of prevalence after 72 months of age. When physiological dose of lactose was used as the challenge, the number of lactose malabsorbers become clinically insignificant.

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MMPI PROFILE TYPES OF MOTHERS WITH PSYCHIATRIC DISORDERED CHILDREN (정신 장애 아동들의 어머니의 MMPI 유형 분석)

  • Shin, Min-Sup;Oh, Kyung-Ja;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.3 no.1
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    • pp.97-105
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    • 1992
  • Present study investigated the relationship between children's psychiatric disorders and their mothers' psychological problems. Ninety-one psychiatric outpatients from a children's hospital were classified into three diagnostic groups - internalizing symptom group(n=35), externalizing symptom group(n=35), and developmental disorder group(n=21) - based on their psychiatric problems. A normal control group was formed by matching on the age and education of mothers. Mothers' MMPI profiles which were classified into five types - normal, depression, anxiety disorder, somatization disorder, and personality disorder - were examined in relation with children's diagnoses. The profiles of the mothers in the normal control group were mostly normal, while depressive profiles were dominant among those of the clinical groups regardless of the children's diagnoses. Therefore, the data implied association between children's psychiatric problems and their mothers' psychological problems. A possibility of negative reciprocal interactions between children and their mothers was discussed. It was also suggested that further research need to examine the specific effects of children's psychiatric problems on the psychological adjustment of their mothers, as well as the effects of parental psychiatric problems on the adjustment of their offsprings.

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THE COMORBIDITY AND EMOTIONAL STATE OF THE ENURETIC CHILDREN (유뇨증 소아의 공존질병 및 정서상태)

  • Lee, Kyu-Kwang;Shin, Yun-O;Lee, Tae-Yong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.1
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    • pp.34-42
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    • 1997
  • Enuresis is repeated involuntary or intentional voiding of urine into bed or clothes over age 5. Though it would be a self-remitting disorder, it could be serious problem in emotional and socio-adaptational aspects. The author reviewed the enuretic patients of Child & Adolescence psychiatric section in Chungnam National University Hospital during past 3 years. 46(4.9%) of 936 patients were diagnosed as enuresis in DSM-Ⅳ. The author evaluated their comorbidity by the data of diagnostic review made in two psychiatrists, and emotional aspects(self-concept, anxiety, depression) through the self-rating scales (Piers-Harris children’ self concept scales, RCMAS, state-trait anxiety inventory for children, child’s depresson inventory). Thirty(65.2%) of the 46 enuretic patients had additional diagnoses such as attention deficit hyperactive disorder, mental retardation, encopresis, oppositional defiant disorder, depression, anxiety disorder, autism, somatoform disorder, tic disorder, obsessive-compulsive disorder, sleep disorder, etc. Sixteen enuretic patients had at least one comorbid disorder. Eleven patients had two, and three patients had more than three. Fourteen of 46 enuretic patients were evaluated through self-rating scales of self-concept, anxiety and depression. But we couldn’t obtain meaningful results. Maybe it was due to the small sample size(N=14) and the influence of the comorbid disorders. Finally, it was an impressive evidence that there exist many comorbid disorders in enuresis(esp. attention deifict/hyperactive disorder). In emotional aspects, the author thought that further evaluation should be needed for more meaningful results.

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The Pharmacotherapy of Pediatric Bipolar I Disorder : Case Report (소아기 발병 제1형 양극성 정동장애의 약물치료 : 증례 보고)

  • Hong, Hyun-Ju;Choi, Tae-Kyou;Yook, Ki-Hwan
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.18 no.1
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    • pp.66-71
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    • 2007
  • There has been increasing recognition of pediatric bipolar disorder in the psychiatric field during the past 10 years. The clinical presentation of this disorder in preadolescent is greatly debated and few studies have been conducted in Korea. The authors report 3 cases of children with bipolar I disorder whose clinical symptoms were improved after pharmacotherapy. The authors also review current concepts, debates and treatment of pediatric bipolar disorder.

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