• Korean Journal of Psychosomatic Medicine
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• v.12 no.1
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• pp.15-22
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• 2004

Objectives: Delirium after head trauma results in various cognitive and behavioral dysfunction. This study aimed at developing and validating a predicitive model for clinical improvement after delirium based on precipitating factors during hospitalization Method: Data were collected on 45 patients who developed delirium after head trauma using 5 year retrospective design, based on reviews of medical charts including psychiatric consultation reports. The differences of the group who sustained residual symptoms of delirium(The RS group) and the group of full recovery(The FR group) at 4 week follow-up visits were compared by motoric type of delirium, socio-demographic variables, neuroimaging variables and clinical variables of interest. Result: There was significant difference in reason for initial consultation between two groups, in terms of hyperactivity(p<.01). The presence of compensation claim, subcortical gray matter lesion was significantly associated with the RS group(p<.05). Total length of intensive care unit(ICU) admission and of hospital stay were significantly longer in RS group than FR group(p<.01). Conclusion: This study shows that hyperactivity on initial consultation, compensation claims, specific brain lesion were altogether significant factors in explaining prolonged duration of delirium after head trauma. A simple predictive model based on the presence of precipitating factors might be used to identify delirious patients at high risk for prolonged cognitive dysfunction. Early psychiatric intervention would be required for evaluating efficacious management and shortening admission period.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.4 no.1
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• pp.106-113
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• 1993

Using a reliable assessment procedure and according to the severity of hyperactivity, thirty-six clinic-referred outpatients, 6-12 years of age, were given a diagnosis of Attention Deficit Disorder with Hyperactivity(ADD+H) or without Hyperactivity(ADD-H). Comparisons of behavioral measurement by Conners Rating Scale(CRS) and Home/School Situations Questionnaire(HSQ/SSQ) revealed that the children with ADD+H displayed more pervasive behavior problems at home and school than the children with ADD-H. Also the children with ADD+H were more likely to be delinquent and aggressive compared to the children with ADD-H when using the Child Behavior Check-list(CBCL) for parents Hyperactivity symptom in ADHD is highly correlated with aggression scale on CBCL These finding suggest that ADD+H and ADD-H may differ in clinical disease entity.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.3 no.1
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• pp.84-96
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• 1992

The present study was designed to investigate variables associated with mother-child interaction patterns of Attention Deficit Hyperactivity Disorder(ADHD), and also to evaluate short-term effects of stimulant medication on the behaviors of ADHD children and their mothers during interaction. 15 ADHD boys(ages 5${\sim}$10 years) were treated with metylphenidate(0.5mg/kg per day) for 1 month, and their behaviors as well as their mothers for the 10 minute free play and 20 minute task performance period were videotaped through one-way mirror. The childrens attention was also evaluated using the Continuous Performance Task(CPT) and ratings of their hyperactive behaviors were obtained from their mother prior to the treatment. The videotaped interaction were rated according to the Response Class Matrix developed by Mash, Terdal & Anderson(1973). Results indicated that percentage of behavior of the mother and child during interaction was highly correlated with each other, which, in turn, was highly correlated with the symptom severity of the ADHD child. That is the more severe the cognitive and behavioral symptoms of ADHD, the more negative the interaction behavior pattern was. After 4 weeks of stimulant medication the mothers as well as the ADHD children showed a significant decrease in the percentage of negative-aggressive behavior during the task performance period. The results indicated that negative interaction behavior of the mothers was in large part a response to the negative behavior of their ADHD children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.16 no.1
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• pp.47-53
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• 2005

Objectives : Few studies have examined the relation between the attachment styles of the primary caregivers and the behavioral problems of their children. This study was performed to identify the impact of the insecure parental attachment patterns on the development of their higher grades elementary school children's psychiatric manifestations and disorders. Methods : 504 higher elementary pupils and their primary caretakers were included in our study. Relationship Questionnaire, Kovacs Children's Depression Inventory, Spielberger's State-Trait Anxiety Inventory for children, and Korean Child Behavior Checklist were applied to them. Results : The grade-school children of the parents who belonged to preoccupied attachment type revealed higher Withdrawn, Anxious/depressed, Social Problems, Attention Problems, Delinquent Problems, Aggressive Problems, Internalizing Problems, Externalizing Problems, Total Behavioral Problems scores than ones of securely attached parents (p<0.01). Internalizing Problems score of preoccupied parents' children was highest, and one of avoidant and secure typed parents' kids followed in order (p=0.004) . More youngsters revealed Total Behavior Problem score high enough to clinically meaningful level in insecure parental attachment style than in secure one (p=0.038). Higher CDI score in insecure parental group was reported than in secure one (p=0.040). Conclusion : Parental insecure attachment can be associated with the development of the behavioral problems and psychiatric illness of their children.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.2
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• pp.119-126
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• 2018

Objectives : The aim of this study is to investigate correlation between degree of white matter hyperintensities (WMH) and neurocognitive function along with behavioral and psychological symptoms of dementia (BPSD) in Korean patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Methods : Participants were 115 elderly subjects diagnosed with Alzheimer's disease or mild cognitive impairment in this retrospective study. WMH in brain MRI were rated with standardized visual rating scales (Fazekas scales) and the subjects were divided into two groups according to Fazekas scale. Cognitive function was evaluated with Korean version of the consortium to establish a registry for Alzheimer's Disease (CERAD-K), and BPSD was evaluated with Korean neuropsychiatric inventory (K-NPI). Independent t-test was performed to analyze the relationship between the degree of WMH and neurocognitive functions & BPSD. Results : Especially, the group with high severity of WMH showed significantly lower language fluency (p<0.05). In addition, the group with high severity of WMH showed significantly higher score in K-NPI. Conclusions : There was a significant association between WMH and neurocognitive test related with executive function. Moreover, WMH seems to affect BPSD severity. Evaluation of WMH would provide useful information in clinical settings.

• Korean Journal of Psychosomatic Medicine
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• v.12 no.2
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• pp.103-121
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• 2004

Conversion disorder and factitious disorder should be ruled out before making diagnosis of malingering. For this work, inspection of patient's behavior along with complete neurological examinations, psychological tests, and meticulous psychiatric interview are necessary. Facial expression test, thermography, dynamometry were failed differentiating conversion disorders to the malingered pain and motor symptoms, however, controlled diagnostic block showed positive result partly in patients with regional or cervical pain syndrome. Chronic pain patients who are related to the process of litigation encounter stressful life situations which lead them into various neurobehavioral and psychosocial complications. Most of suspected malingered patients would not revealed pure form rather mixed with factitious and/or conversion features. At the time of increasing number of chronic patients associated with traffic accidents or industrial injuries who are involved in litigation, psychiatrist are needed sharp eyes and tenacity for evaluating malingering or medically unexplained symptoms.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.10 no.2
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• pp.195-200
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• 1999

Objective：This study was to investigate the effects of familial risk factors on the behavior problems of ADHD group and normal group. Method：The familial risk factors and behavioral problems of the children were administered to 160 mothers, comprised of 29 ADHD children and 131 normal children. Results：The results showed that the ADHD group and normal group were significantly different in the degree of marital satisfaction, state-trait anxiety, and depression. Familial risk factors and the behavior problems of children were significantly correlated. Conclusion：Marital unsatisfaction and parental affective problems were closely related to behavior problems of ADHD patients.

• Journal of Korean Academy of Nursing
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• v.35 no.5
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• pp.896-903
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• 2005

Purpose: This study was designed to exam me the effects of an assertive training program on interpersonal relations, and psychiatric symptoms in patients with a mental disorder. Method: The study employed a quasi experimental design. The subjects included 44 patients with a mental disorder, 20 in the experimental group, and 24 in the control group. Data was collected using structured questionnaires over a 3 month period. Results: There were greater significant increases in scores of interpersonal relations and content of communication in the experimental group than the control group. Also, there was a greater significant decrease in the score of psychiatric symptoms in the experimental group than the control group. Conclusion: Assertive training has an effect on increasing content of communication and decreasing psychiatric symptoms.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.1
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• pp.3-11
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• 2003

Attention-deficit/Hyperactivity disorder(ADHD) is the most common psychiatric disorder of childhood and among the most prevalent chronic health conditions affecting school-aged children. Children with ADHD experience significant functional problems, such as school difficulties, academic underachievement, troublesome interpersonal relationships with family members and peers, and low self-esteem. The most widely used pharmacological treatments for ADHD are psychostimulants, such as methylphenidate and amphetamine salts. These medications provide clinical efficacy by increasing the availability of catecholamines, primarily dopamine, in the frontal lobe of the brain. immediate-release(IR) formulations of sychostimulants were among the most effective psychotrophic medications in the psychopharmacological treatment. However, there are some limitations of IR formulations：the short half-life and duration of efficacy, which result in the need for multiple daily dosing and the poor compliance. These limitations have led to the development of once-daily, extended-release(ER) formulations of methylphenidate and amphetamine salts. However, these ER formulations may not be as immediately helpful to ADHD children due to delayed onset of action and the acute tolerance which is the failure to sustain the efficacy with the same concentration of drug as the initial stage of medication. OROS-methylphenidate(Concerta$^{\circledR}$) given once a day produces an ascending-pattern plasma drug level generated by the osmotically released, timed drug-delivery system. These new formulations of the psychostimulants have been shown to be a useful alternative to old stimulant medications through the evidence by the clinical trials.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.1
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• pp.43-53
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• 2016

Objectives : Somatic symptoms after the exposure of psychological trauma frequently developed. However, the somatic symptoms are not covered under the diagnostic criteria of posttraumatic stress disorder(PTSD) in detail, although they are often associated with social and occupational functioning and patient-doctor relationships. The aim of this article is to highlight the potential mechanisms, the common manifestations, and the treatment of the somatic symptoms. Methods : This article studied the somatic symptoms searched using academic search engines like PubMed, Scopus, Google Scholar, KoreaMed and KISS from the earliest available date of indexing to March 31, 2016. Results : The mechanism of somatic symptoms after the exposure was described as psychological and physiological aspects. Psychological mechanism consisted of psychodynamic theory, cognitive behavioral theory, and others. Physiological mechanism involved changes in neuroendocrine and immune system, autonomic nervous system and central nervous system. Somatization associated with psychological trauma manifested various health conditions on head and neck, chest, abdominal, musculoskeletal, and dermatological and immune system. Few studies described the standardization of treatment for the somatic symptoms. Conclusions : Clinicians and disaster behavioral health providers should think of the accompanying somatic symptoms during intervention of psychological trauma and PTSD. Further studies are needed on the somatic symptoms seen in psychological trauma and PTSD.