• 제목/요약/키워드: Behavioral symptoms

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주의력결핍 과잉행동장애 한국형 치료 권고안(IV) - 비약물적 치료 - (The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (IV) - Non-Pharmacologic Treatment -)

  • 신윤미;김의정;김윤신;방수영;이은하;이철순;장형윤;홍민하;신동원
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제28권2호
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    • pp.84-95
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    • 2017
  • Attention-deficit hyperactivity disorder (ADHD) is a neuropsychiatric disorder that begins in early childhood and can persist throughout adulthood. ADHD causes difficulties in various area of life, such as academic achievement, peer relationships, family functioning, employment and marriage. Although ADHD is known to respond well to medication, such treatment is more effective when combined with psychosocial (non-pharmacologic) therapy in terms of alleviating the core symptoms and improving appropriate functions. Psychosocial treatment interventions are divided into psychoeducation, behavioral parent training, school intervention, cognitive behavior therapy, social skill training, parent-child interaction therapy, play therapy, other treatments (coaching, complementary and alternative medicine), neurofeedback and Cogmed. Adult ADHD cognitive behavioral therapy is described separately. These practice parameters summarize the evidence for psychosocial treatment. Based on this evidence, specific recommendations are provided for psychosocial interventions.

암생존자를 위한 심리교육중재의 효과에 대한 체계적 고찰 및 메타분석 (Effects of Psychoeducational Intervention for Cancer Survivors: A Systematic Review and Meta-Analysis)

  • 박진희;배선형
    • 대한간호학회지
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    • 제47권2호
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    • pp.143-163
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    • 2017
  • Purpose: This study was a systematic review and meta-analysis designed to investigate effects of psychoeducational intervention for cancer survivors. Methods: Ten databases were searched. Two reviewers independently performed the selection of the studies, data extraction and assessment. The risk of bias was assessed using Cochrane Collaboration's tool. To estimate the effect size, meta-analysis of the studies was performed using Comprehensive Meta-Analysis and RevMan programs. Results: Of 18,781 publications identified, 35 met inclusion criteria, and 25 studies were used to estimate effect size of psychoeducational intervention. Effect sizes (standardized mean difference [SMD]) were heterogeneous and random effects models were used in the analyses. Psychoeducational intervention was effective for quality of life (n=2,410, ES=0.23; 95% CI: 0.09~0.37), coping and self-efficacy (n=179, ES=0.68; 95% CI: 0.26~1.11), anxiety (n=1,786, ES=-0.26; 95% CI: -0.37~-0.15), depression (n=1,910, ES=-0.28; 95% CI: -0.37~-0.18), and psychological distress (n=2,242, ES=-0.31; 95% CI: -0.46~-0.17). Subgroup analysis showed that counseling was the most effective intervention for quality of life, and behavioral therapy was an effective intervention for all positive and negative outcomes. Publication bias was not detected except for psychological distress. Conclusion: Psychoeducational intervention appears to be effective in improving quality of life and coping and self-efficacy, and it is effective in reducing psychological symptoms in cancer survivors. Behavioral therapy, especially, is commonly effective in improving psychosocial outcomes. However, low-quality evidence, variability in the designs of existing studies, and publication bias suggest that additional high-quality trials should be conducted in the future.

Differential Effects of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine on Motor Behavior and Dopamine Levels at Brain Regions in Three Different Mouse Strains

  • Lee, Keun-Sung;Lee, Jin-Koo;Kim, Hyung-Gun;Kim, Hak Rim
    • The Korean Journal of Physiology and Pharmacology
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    • 제17권1호
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    • pp.89-97
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    • 2013
  • Developing an animal model for a specific disease is very important in the understanding of the underlying mechanism of the disease and allows testing of newly developed new drugs before human application. However, which of the plethora of experimental animal species to use in model development can be perplexing. Administration of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is a very well known method to induce the symptoms of Parkinson's disease in mice. But, there is very limited information about the different sensitivities to MPTP among mouse strains. Here, we tested three different mouse strains (C57BL/6, Balb-C, and ICR) as a Parkinsonian model by repeated MPTP injections. In addition to behavioral analysis, endogenous levels of dopamine and tetrahydrobiopterin in mice brain regions, such as striatum, substantia nigra, and hippocampus were directly quantified by liquid chromatography-tandem mass spectrometry. Repeated administrations of MPTP significantly affected the moving distances and rearing frequencies in all three mouse strains. The endogenous dopamine concentrations and expression levels of tyrosine hydroxylase were significantly decreased after the repeated injections, but tetrahydrobiopterin did not change in analyzed brain regions. However, susceptibilities of the mice to MPTP were differed based on the degree of behavioral change, dopamine concentration in brain regions, and expression levels of tyrosine hydroxylase, with C57BL/6 and Balb-C mice being more sensitive to the dopaminergic neuronal toxicity of MPTP than ICR mice.

임상가용 아동 및 청소년을 위한 외상 후 스트레스장애 척도를 통한 학교폭력 피해아동의 인지행동집단치료 효과 : 예비연구 (The Effects of Cognitive-Behavioral Group Therapy on Victims of School Violence as Assessed by the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA) : A Preliminary Study)

  • 김형욱;김태형;은헌정;최말례;권태완;구정일;조수진;송옥선
    • 대한불안의학회지
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    • 제3권2호
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    • pp.97-103
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    • 2007
  • Objective : The present study was carried out in order to assess the effects of Cognitive-Behavioral Group Therapy (CBGT) on victims of school violence, as assessed by the CAPS-CA. Methods : The subjects were 14 children who had experienced school violence and were subsequently diagnosed with PTSD and partial PTSD using the Clinician-Administered PTSD scale for Children and Adolescents (CAPS-CA). Seven children agreed to participate in CBGT, and they received 10 sessions of therapy. After CBGT, both the CBGT and non-CBGT groups were assessed using the CAPS-CA and School Adaptation Test. Results : The study results showed significant decreases in avoidance (p=0.010) and hyperarousal in the CBGT group (p=0.009) following the completion of CBGT. The analysis of school adaptation showed that there was a significant improvement in peer relationships after CBGT in the CBGT group (p=0.045). Conclusion : CBGT is effective in improving PTSD symptoms in children who experience school violence and subsequently suffer from PTSD.

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소아수면과다증과 수면무호흡 (Childhood Hypersomnia and Sleep Apnea Syndrome)

  • 손창호;정도언
    • 수면정신생리
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    • 제3권2호
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    • pp.65-76
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    • 1996
  • Natural sleep pattern and its physiology in childhood are much different from those in adulthood. Several aspects of clinical evaluation for sleepiness in childhood are more difficult than in adulthood. These difficulties are due to several factors. First, excessive sleepiness in childhood do not always develop functional impairments. Second, objective test such as MSLT may not be reliable since it is hard to be certain that the child understand instructions. Third, sleepiness in children is often obscured by irritability. paradoxical hyperactivity, or behavioral disturbances. Anseguently, careful clinical evaluation is needed for the sleepy children. Usual causes of sleepiness in children are the disorders that induce insufficient sleep such as sleep apnea syndrome, schedule disorder, underlying medical and psychiatric disorder, and so forth. After excluding such factors, we can diagnose the hypersomnic disorders such as narcolepsy, Kleine-Levin syndrome, and idiopathic central nervous system hypersomnia. Among the variety of those causes of sleepiness, I reviewed the clinical difference of narcolepsy and obstructive sleep apnea syndrome in childhood compared with in adulthood. Recognition of the childhood narcolepsy is difficult because even severely sleepy children often do not develop pathognomic cataplexy and associated REM phenomena until much later. Since childhood narcolepsy give srise to many psychological, academical problem. Practicers should be concerned about these aspects. Childhood obstructive sleep apnea syndrome is different from adult obstructive sleep apnea syndrome too. Several aspects such as pathophysiology. clinical feature, diagnostic criteria, complication, management, and prognosis differ from those in the adult syndrome. An important feature of childhood obstructive sleep apnea syndrome is the variety of severe complications such as behavioral disorders, cognitive impairment, cardiovascular symptoms, developmental delay, and ever death. Fortunately, surgical interventions like adenotosillectomy or UPPP are more effective for Childhood OSA than adult form. CPAP is a "safe, effective, and well-tolerated" treatment modality too. So if early detection and proper management of childhood OSA were done, the severe complication would be prevented or ever cured.

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간호학생들의 에이즈 환자 간호의도에 영향을 미치는 요인 (A Study for Investigating Predictors of AIDS and Patients Care Intention Among Nursing Students)

  • 이종경
    • 대한간호학회지
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    • 제31권2호
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    • pp.292-303
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    • 2001
  • The purpose of the study was to find out the level of knowledge, attitude, subjective norm, social interaction, and behavioral intention of nursing students regarding AIDS. It also identified factors that predict behavioral intentions and to provide care for patients with AIDS using Theory of Reasoned Action. The subjects consisted of 117 nursing students at three universities. Data was collected with self reporting in a questionnaire of with 67 items. Data was analyzed by an SPSS pc+ program. The results were as follows; 1. The mean age of the subjects was 20.98 years. The mean score for HIV/AIDS knowledge was 24.444 out of 32. Mostly Korean students were quite knowledgeable about the basic facts and symptoms of AIDS but confused about the made of transmission such as public toilets, prevention methods, and especially infection control. 2. This study found that social interaction, attitudes and subjective norms of Korean nursing students explained the intention to care for AIDS patients. The students who had a more positive attitude toward caring for AIDS patients and those who perceived more support from their significant others for caring the AIDS patients reported a more positive intention to care for AIDS patients. 3. In stepwise multiple regression analysis, 47.58% of the variance in AIDS patient care intention was accounted for by social interaction (33.41%), attitude (9.1%), and subjective norm (5.0 %). According to the finding of this study, and social interaction are the most significant predictors of intentions. Therefore it can be suggested that a HIV/AIDS prevention program should focus on transmission modes and prevention methods, especially in infection control. AIDS education efforts aimed at nursing students should place greater emphasis on correcting these kinds of misconceptions. Nursing intenvention for reducing fear of contagion, improving perception of social interaction, fostering positive attitudes and increasing intention to care for AIDS patients should be provided for nursing students. They also recommended that nursing students be adequately prepared to care for AIDS patients because of the increasing probability that they will encounter AIDS patients. Therefore it is important that education about HIV/AIDS should be incorporated within current undergraduate curriculum.

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사회공포증 환자에서 자기 및 타인 얼굴 인식의 행동 특성 (Behavioral Characteristics of Face Recognition for Self and Others in Patients with Social Phobia)

  • 손인정;윤형준;신유빈;김재진
    • 대한불안의학회지
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    • 제10권1호
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    • pp.37-43
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    • 2014
  • Objective : Social Phobia is associated with extensive disability and reduced quality of life. The concept of 'social self' is a representation of the self-reflected in the eyes of others, and is recruited during self-face recognition, which is closely related to self-esteem. The aim of this study was to identify the relationship of face recognition for self and others using measures of social anxiety and self-esteem in patients with social phobia. Methods : Twenty-seven patients with social phobia and twenty-three normal controls were evaluated with scales of self-esteem, depression, anxiety and other psychiatric symptoms. All participants completed the self-face recognition task. Nine self-faces, nine other faces and eighty-one morphed faces were presented randomly for each trial. The participants were instructed to make a decision as to whether the stimuli were self-face or not. The responses and reaction times were recorded during the task. Results : There were no group differences of the morphing composition at the recognition start point as self-face. In patients with social phobia, the mean reaction time at the start point of recognizing as a self-face was 1,037.6 ms, which was significantly longer than that of normal controls (911.3 ms, p<0.05). Patients with social phobia showed a significant negative correlation between the mean reaction time and the severity of depression when the stimuli were recognized as a self-face (r=-0.421, p<0.05). Conclusion : A difficulty in attention rather than avoidance may be an important factor of face recognition in patients with social phobia. When considering self-face recognition in such patients, many factors, such as anxiety, depression, working memory and theory of mind, need to be considered.

Protective Effects of Ginsenoside Rg3 against Cholesterol Oxide-Induced Neurotoxicity in the Rat

  • Kim, Jong-Hoon
    • Journal of Ginseng Research
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    • 제33권4호
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    • pp.294-304
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    • 2009
  • Ginsenosides are among the most well-known traditional herbal medicines frequently used for the treatment of various symptoms in South Korea. The neuroprotective effects of ginsenoside $Rg_3$ (G-$Rg_3$) on cholesterol-oxide-(CO)-induced neurotoxicity were investigated through the analyses of rat brains. The recently accumulated reports show that ginseng saponins (GTS), the major active ingredients of Panax ginseng, have protective effects against neurotoxin insults. In the present study, the neuroprotective effects of G-$Rg_3$ on CO-induced hippocampal excitotoxicity were examined in vivo. The in-vitro studies using rat cultured hippocampal neurons revealed that G-$Rg_3$ treatment significantly inhibited CO-induced hippocampal cell death. G-$Rg_3$ treatment not only significantly reduced CO-induced DNA damage but also attenuated CO-induced apoptosis. The in-vivo studies that were conducted revealed that the intracerebroventricular (i.c.v.) pre-administration of G-$Rg_3$ significantly reduced i.c.v. CO-induced hippocampal damage in rats. To examine the mechanisms underlying the in-vitro and in-vivo neuroprotective effects of G-$Rg_3$ against CO-induced hippocampal excitotoxicity, the effect of G-$Rg_3$ on the CO-induced elevations of the apoptotic cells in cultured hippocampal cells was examined, and it was found that G-$Rg_3$ treatment inhibited CO-induced apoptosis. The histopathological evaluation demonstrated that G-$Rg_3$ significantly diminished the apoptosis in the hippocampus and also spared the hippocampal CA1, CA3, and dentate gyrus neurons. G-$Rg_3$ also significantly improved the CO-caused behavioral impairment. G-$Rg_3$ itself had no effect, however, on the CO-induced inhibition of succinate dehydrogenase activity (data not shown). These results collectively indicate the G-$Rg_3$-induced neuroprotection against CO in rat hippocampus. With regard to the wide use of G-$Rg_3$, this agent is potentially beneficial in treating CO-induced brain injury.

ADHD 치료에서 가족치료캠프의 적용 (Application of Family Treatment Camp in Treatment of ADHD)

  • 황병주;안동현;이재영
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제23권2호
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    • pp.82-89
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    • 2012
  • Objectives : Demands for comprehensive and intensive treatment programs for treatment of children with attention-deficit hyperactivity disorder (ADHD) who suffer from serious impairment in various psychosocial areas are increasing. The aim of this study was to evaluate the possibility of developing new types of camp programs focused on improving social adjustment of children and helping parents effectively manage their children's problem behaviors. Methods : Fifteen children diagnosed as ADHD according to Diagnostic and Statistical Manual of Mental Disorders-IV (mean age 9.5 years) and their parents participated in this program. Eight consecutive camps were held at two-week intervals, from Jun 2007 to Oct 2007 in an adolescent training center located at Chungtaesan, in Korea. Each camp program included social skills training in the classroom and outdoor activities in the forest for children, as well as parent training for mothers. In addition, after the sixth camp, we conducted one parental session for fathers and a three-day booster family camp three months later. Finally, eleven families adhered to the program. Results : All children, parents, and therapists rated questionnaires or checklists at baseline, intra-, and post-treatment. Parenting burden rated using the Parenting Stress Index showed a significant decrease, from 57.89 to 46.22 (p=.019). And, overprotection rated using the Parenting Bonding Instrument showed a significant decrease, from 16.56 to 12.44 (p=.046). However, no significant improvement in children's behavioral and emotional problems was observed. Conclusion : In this study, the consecutive ADHD family camp program was effective for empowerment of parental competency, but not for general improvement of children's behavioral and emotional symptoms.

현저한 정신증상으로 발현된 결핵성 뇌수막뇌염 1예 (A Case of Tuberculous Meningoencephalitis Presenting as Prominent Psychotic Features)

  • 유현정;오지영;김지현;김정은;박기덕
    • Tuberculosis and Respiratory Diseases
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    • 제51권6호
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    • pp.603-608
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    • 2001
  • 저자들은 속립성 폐결핵과 연관되어 급성 경과를 보인 결핵성 뇌수막뇌염 환자에서 뇌혈관 자기공명영상으로 혈관염 소견을 확인하고, 스테로이드의 투여와 중단, 재투여에 따라 뇌증의 증세가 뚜렷히 변하는 임상경과, 증상이 호전된 후 추적한 뇌혈관 자기공명영상에서 혈관 영상이 정상화된 것을 확인할 수 있었던 사례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

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