• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제31권3호
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• pp.131-145
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• 2020

The microbiota-gut-brain axis, which refers to the bidirectional communication pathway between gut bacteria and the central nervous system, has a profound effect on important brain processes, from the synthesis of neurotransmitters to the modulation of complex behaviors such as sociability and anxiety. Previous studies have revealed that the gut microbiota is potentially related to not only gastrointestinal disturbances, but also social impairment and repetitive behavior-core symptoms of autism spectrum disorder (ASD). Although studies have been conducted to characterize the microbial composition in patients with ASD, the results are heterogeneous. Nevertheless, it is clear that there is a difference in the composition of the gut microbiota between ASD and typically developed individuals, and animal studies have repeatedly suggested that the gut microbiota plays an important role in ASD pathophysiology. This possibility is supported by abnormalities in metabolites produced by the gut microbiota and the association between altered immune responses and the gut microbiota observed in ASD patients. Based on these findings, various attempts have been made to use the microbiota in ASD treatment. The results reported to date suggest that microbiota-based therapies may be effective for ASD, but largescale, well-designed studies are needed to confirm this.

• 생물정신의학
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• 제26권2호
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• pp.47-58
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• 2019

Objectives The purpose of this study was to investigate the differences between adolescents and adults, in the perspective-taking ability, as well as the brain activation patterns during the perspective-taking situation. Methods We recruited healthy adolescents aged 13 years to 15 years (n = 20) and adults aged 19 years to 29 years (n = 20). All the subjects were scanned while performing the perspective-taking task, in which an emotional situation was presented in the form of statements comprising first person, as well as third person perspectives. Differences in brain activation between groups were assessed by contrasting neural activity during the tasks. Results In the between-group analysis, while performing the third-person perspective-taking task, the adolescent group showed greater neural activities in the middle frontal gyrus and precentral gyrus as compared to the adult group. Positive correlation was observed between the activity in the frontal areas (Brodmann area 6/9) and the score of scales related to perspective-taking and social cognition in the adolescent group. Conclusions This study suggests that several frontal brain areas of adolescents needs to be overactivated in order to compensate for low perspective-taking ability when they ought to take another person's point of view.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제35권2호
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• pp.143-149
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• 2024

Objectives: This study aimed to identify the effectiveness of treatment programs for children with reading (RD) or mathematics disorders (MD). Structured treatment programs were developed to improve phonological awareness and number sense among children and adolescents with RD or MD, respectively, and the effectiveness of the learning disorder treatment programs were evaluated. Methods: We used standardized, objective diagnostic, and evaluation tools not only to recruit participants with RD, MD, or comorbid attention deficit and hyperactivity disorder, but also to assess the effectiveness of the treatments regarding both improved core neurocognitive deficits of RD or MD and academic achievement. Forty children with RD or MD received one-on-one treatments from therapists. Results: In the RD group, treatment effects were observed in all subtests. In the word and paragraph reading tests, the accuracy rates and fluency improved. The results of the phonological working memory test, word-sound correspondence test, and rapid automatic naming tests also improved. In the MD group, the accuracy rate and fluency on the arithmetic test improved. An increase in the accuracy rate in the size and distance comparison tests and a decrease in the error rate in the estimation test were also observed. However, there were no improvements in reaction time in these subtests. Conclusion: Learning disorder treatment programs that focus on improving phonological awareness or number sense in children with RD or MD improved achievement, phonological awareness, and number sense.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제18권1호
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• pp.31-37
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• 2007

Objectives : A voxel based investigation of cerebral blood flow was conducted to identify functional differences during resting state between children with early-onset schizophrenia and normal controls. Methods : 19 children and adolescents with early-onset schizophrenia(8 boys and 11 girls, mean age $14.0{\pm}1.7$ years old) and 17 comparison children(13 boys and 4 girls, mean age $11.0{\pm}1.9$ years old) were examined by HMPAO-SPECT. The SPECT images were compared using statistical parametric mapping analyses, controlling for age and sex. Results : Increased cerebral blood flow in left medial and inferior frontal gyrus, right superior and middle frontal gyrus, both inferior temporal gyrus, and right cerebellar tonsil was found in children and adolescents with early-onset schizophrenia compared to control subjects. In addition, decreased cerebral blood flow in right thalamus, left posterior cingulate gyrus, right anterior cingulate gyrus and relatively wide areas from left medical frontal gyrus to superior parietal lobule were found in children and adolescents with early-onset schizophrenia compared to control subjects. Conclusion : The results of the current study provide additional evidences for brain areas involving the onset of schizophrenia in early age.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제29권3호
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• pp.101-113
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• 2018

Objectives: The purpose of this study was to investigate whether the neural activity of autism spectrum disorder (ASD) patients is different from that of normal individuals when performing aesthetic judgments. Methods: We recruited typical ASD patients without savant skills (ASD group, n=17) and healthy controls (HC group, n=19) for an functional magnetic resonance imaging study. All subjects were scanned while performing aesthetic judgment tasks on two kinds of artwork (magnificent landscape images and fractal images). Differences in brain activation between the two groups were assessed by contrasting neural activity during the tasks. Results: The aesthetic judgment score for all images was significantly lower in the ASD group than in the HC group. During the aesthetic judgment tasks, the ASD group showed less activation than the HC group in the anterior region of the superior frontal gyrus, and more activation in the temporoparietal area and insula, regardless of the type of images being judged. In addition, during the aesthetic judgment task for the fractal images, the ASD group exhibited greater neural activity in the amygdala and the posterior region of the middle/inferior temporal gyrus (Brodmann area 37) than the HC group. Conclusion: The results of this study suggest that the brain activation patterns associated with aesthetic experiences in ASD patients may differ from those of normal individuals.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제29권2호
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• pp.47-53
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• 2018

Objectives: This study aimed to develop the attention-deficit hyperactivity disorder (ADHD)-After School Checklist (ASK) to evaluate the severity of ADHD symptoms and self-management ability in children and adolescents in South Korea. Additionally, we evaluated the reliability and validity of the scale. Methods: We developed the ASK to evaluate the effect of ADHD psychopathologies on self-management and interpersonal impulsivity. We investigated the reliability and validity of the scale with 1349 parents (male 56.9%; 1202 parents of non-ADHD children, 147 parents of children with ADHD) in Seoul and Gyeonggi Province, Korea. Results: According to the construct validity test using principal constant analysis with the varimax rotation method, two factors explained 60.7% of the cumulative variance in ASK scores. Cronbach's alpha for the whole scale was 0.71. There was no statistical difference between mean ASK scores at test and retest. Mean total ASK scores of the ADHD group were significantly higher than those of the non-ADHD group (p<0.001). Conclusion: The ASK can be used as a reliable and valid tool to evaluate not only self-management capability of children and adolescents with ADHD in their academic and everyday life, but also their impulsiveness in interpersonal relationships.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제29권3호
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• pp.129-136
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• 2018

Objectives: This study aimed to evaluate the efficacy of the attention-deficit/hyperactivity disorder (ADHD)-After School Checklist (ASK) by comparing the results of the Comprehensive Attention Test (CAT) and Clinical Global Impression-Severity (CGI-S) Scale and then by calculating the area under the receiver operating characteristic (ROC) curve. Methods: We performed correlation analyses on the ASK and CAT results and then the ASK and CGI-S results. We created a ROC curve and evaluated performance on the ASK as a diagnostic tool. We then analyzed the test results of 1348 subjects (male 56.8%), including 1201 subjects in the general population and 147 ADHD subjects, aged 6-15 years, from kindergarten to middle school in Seoul and Gyeonggi province, South Korea. Results: According to the correlation analyses, ASK scores and the Attention Quotient (AQ) of CAT scores showed a significant correlation of -0.20--0.29 (p<0.05). The t-test between ADHD scores and CGI-S also showed a significant correlation (t=-2.55, p<0.05). The area under the ROC curve was calculated as 0.81, indicating good efficacy of the ASK, and the cut-off score was calculated as 15.5. Conclusion: The ASK can be used as a valid tool not only to evaluate functional impairment of ADHD children and adolescents but also to screen ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제24권3호
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• pp.124-131
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• 2013

South Korea is changing into a multi-cultural society, due to an increase in international marriage, foreign workers and transcultural immigration. In addition, the number of North Korean defectors entering South Korea has increased and now, there are approximately 25000. Therefore, this review have focused on a research that pertains to adaptation and mental health concerns of their children. Children who have immigrated themselves or whose parents have immigrated, might experience language barriers, difficulties in school adjustment, identity confusion and mental health problems. However, their academic performance and developmental status are known to be variable and be affected by socioeconomic status and their parents' educational level. Studies that evaluated the psychological problems of North Korean adolescent refugees' indicated the need for interests in both emotional and behavioral problems. The risk factors of North Korean adolescent refugees' mental health are suggested to be past traumatic experiences, long duration of defection and short period of adaptation. When mental health professionals provide assessment and treatment, they should consider the pre- and post-migration experiences & cultural background that affect the illness behaviors and attitudes toward mental illnesses. Lastly, the majority of children with multi-cultural background are still under an adolescent period and we should follow up with long-term perspectives.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제35권3호
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• pp.163-168
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• 2024

Stress is a natural state that emerges due to the dynamics of an individual's life. Children must learn how to effectively manage stress as part of their growth and development. Resolution is possible when children are exposed to stress and receive adequate support from their families. However, when stress is intense, frequent, protracted, or traumatic, as in cases of childhood abuse, it can become toxic and interfere with the development of the child's brain and body. This results in vulnerability, which can have detrimental effects on the child's overall physical, mental, and emotional health. This perspective discusses the impact of childhood maltreatment and toxic stress, drawing on insights gained during the COVID-19 pandemic. We aimed to shed light on the lessons learned from this unique and challenging period and how they inform our understanding of the effects of stress on children's well-being.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제20권3호
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• pp.115-121
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• 2009

Trichotillomania (TTM) is a disorder characterized by repetitive hair pulling, frequently from the scalp and/or eyebrows, leading to noticeable hair loss and functional impairment. TTM remains a poorly understood and inadequately treated disorder despite increased recognition of its prevalence. We review available neuroimaging studies conducted in patients with TTM, covering structural and functional neuroimaging in turn. Data from patients' structural and functional neuroimaging results enabled us to identify the neural circuitry involved in the manifestation of hair pulling. Finally, we highlighted the future importance of neuroimaging studies in children and adolescents with TTM.