• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권4호
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• pp.192-196
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• 2017

Social (pragmatic) communication disorder (SCD) is a new diagnosis included under communication disorders in the neurodevelopmental disorders section of Diagnostic and Statistical Manual of Mental Disorders-5. SCD is defined as a primary deficit in the social use of nonverbal and verbal communication. SCD has very much in common with pragmatic language impairment, which is characterized by difficulties in understanding and using language in context and following the social rules of language, despite relative strengths in word knowledge and grammar. SCD and Autism Spectrum Disorder (ASD) are similar in that they both involve deficits in social communication skills, however individuals with SCD do not demonstrate restricted interests, repetitive behaviors, insistence on sameness, or sensory abnormalities. It is essential to rule out a diagnosis of ASD by verifying the lack of these additional symptoms, current or past. The criteria for SCD are qualitatively different from those of ASD and are not equivalent to those of mild ASD. It is clinically important that SCD should be differentiated from high-functioning ASD (such as Asperger syndrome) and nonverbal learning disabilities. The ultimate goals are the refinement of the conceptualization, development and validation of assessment tools and interventions, and obtaining a comprehensive understanding of the shared and unique etiologic factors for SCD in relation to those of other neurodevelopmental disorders.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제20권3호
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• pp.122-128
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• 2009

Objectives : Autism is a well-known psychiatric disorder that is presumed to have a neural basis. To investigate the underlying neurofunctional abnormalities of autism, the authors performed single photon emission computed tomography (SPECT) on children with autism. Methods : Fifty-five children with untreated autism (47 boys and 8 girls, mean age=$50.6{\pm}20.28$ months) were selected from among the patients visiting the child and adolescent psychiatric clinic of Seoul National University Hospital. Psychiatrists had diagnosed the participants according to the DSM-IV criteria for autistic disorder and the Childhood Autism Rating Scale (CARS) criteria for a diagnosis of autism. All participants were examined using 99mTC-HMPAO Brain SPECT. Using statistical parametric mapping (SPM) analysis, we compared the participants' SPECT images to standardized SPECT images of normal children, which had been retrospectively selected by the authors, on a voxel by voxel basis. Voxels with a p-value less than .001 were considered to be significantly different. Results : The autistic group showed significant hypoperfusion in the right medial frontal gyrus, right precentral gyrus, and left precuneus gyrus. In addition, they showed no significant hyperperfusion areas when compared to the control group. Conclusion : The findings of hypoperfusion in the medial-frontal lobe and precuneus are accord with hemodynamic abnormalities that have been already reported. Therefore, these findings are compatible with the recently suggested "theory of mind" hypothesis and the disturbances in attention shifting that have been observed in autistic children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제13권1호
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• pp.93-103
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• 2002

저자는 소아정신과 영역에서 흔하게 관찰되는 주의산만과 과잉운동을 주소로 하는 아동들의 진단특성과 이와 관련된 임상변인들을 알아보기 위하여 본 연구를 시행하였다. 대학병원 소아정신과에 내원한 아동들에서 주의력과 과잉운동 문제를 보이는 5세에서 14세 사이 총 71명(남자 63 명, 여자 8명)을 대상으로 하여, KEDI-WISC, KPI-C, ADS를 시행하였고 진단 분류에 따라 1) ADHD만 있는 군 2) 공존 질환이 있는 ADHD군 3) ADHD 이외의 진단군으로 나누어 비교한 결과 아래와 같은 결과를 얻었다. 1) ADHD 단독 진단군이 17명(23.9%), 공존질환이 ADHD는 26명(38.0%)이었으며 공존질환은 틱장애가 가장 많고 발달성 언어장애, 경계성 지능, 적대적 반항/품행장애, 경계성 지적능력, 학습장애의 순서를 보였으며, ADHD 이외의 진단군 27명(38.0%)은 틱장애, 경계성 지능, 우울/불안장애, 적대적 반항/품행장애의 진단 분포를 나타냈다. 2) 지능검사에서 전체지능, 언어성 지능, 동작성 지능 모두 군별 차이를 보였고 ADHD만 있는 군에서 공존질환 ADHD군보다 전체지능과 언어지능이 유의하게 높은 수치를 나타냈다. KPI-C 임상 척도는 군별 차이를 보이지 않았다. ADS 시각자극 검사에서 누락오류(omission)와 민감도(d')가 세 군 사이에 의미있는 차이를 보였고, 공존질환이 있는 ADHD 군이 ADHD이외의 진단군에 비해 유의하게 누락오류가 많고 민감도는 낮았다. 본 연구 결과를 볼때 아동의 주의산만과 과잉운동 증상은 주 진단인 ADHD 이외에도 다양한 정신과 질환으로 진단될 수 있으므로 이에 대한 감별이 필요하며, 또한 공존질환이 있는 ADHD군이 ADHD만 있는 군이나 기타 질환군보다 주의력에 문제가 많고 지능 수치가 상대적으로 낮아 학습 및 학교 생활 적응에 어려움이 더 많을 것이므로 적극적인 치료개입이 필요할 것으로 생각되었다.

• 한국간호교육학회지
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• 제1권1호
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• pp.32-45
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• 1995

This thesis is a study to develop the tentative objectives and present the professional and courses for the nursing college. The conclusions conducted by the purpose of this study are as follows. First, on the basis of the concepts of the nursing and the view-points of nursing education, the tentative goals for the nursing education are set up as follows. 1. To understand human being's life, dignity and their physical, mental, and social aspects. 2. To understand the basic concepts and the principles of human sciences, social sciences, natural sciences, and medical sciences. To apply their knowledges to nursing practices. 3. To diagnose and assess the problems of individual, family and community in terms of nursing practice. To develop the ability of planning, negotiation, management, and evaluation for the nursing education. 4. To develop appropriate knowlege, attitudes, and skills to promote the clients' health and treat their illness. 5. To accomplish all tasks effectively as a trained and qualified professional nurse through the endless studies. Second, the nursing areas and courses for the nursing college in terms of validity, Importance, continuity, relationship, utility and appropriateness are listed as follows. 1. Fundamental courses of the nursing. (1) General courses communication human development, behavior science, biochemistry, microbiology, pharmacology (2) Medical courses physiology, anatomy, pathology 2. Basic courses in nursing (1) General nursing fundamental nursing, introduction of nursing, nursing history, nursing process, health education, health assessment, philosophy of nursing, nursing psychology (2) Maternal-Child nursing child-health nursing, child-disease nursing, adolescent nursing, obstetric nursing, post-partum nursing, gyneco-pathy nursing (3) Adult nursing adult health nursing, adult disease nursing I(fluid & electrotonic, shock, anoxia disorder), adult disease nursing II(nutrition-excretion disorder, sexual dysfunction), adult disease nursing III(sense-, control-, activity-, sleep disorder), adult disease nursing IV(operation, rehabilitation, emergency), gerontological nursing (4) Psychiatric nursing child-adolescent psychiatric nursing, adult psychiatric nursing, gerontological psychiatric nursing, spiritual nursing (5) Community health nursing community nursing, school nursing, industrial nursing, family nursing, nursing epidemiology 3. Nursing management and research skills (1) Nursing management nursing administration, nursing ethics, laws related to nursing (2) Research skills nursing statistics, nursing research methodology Finally, the principles of the statement of the specific objectives are the followings : 1. To state the specific objectives on the basis of the syllabus of each courses. 2. To match a content with a verb or gerund as the basic form of objectives. 3. To control the level of the objectives according to the rule 'the higher the level of a content, the lower the level of a verb or a gerund'. This rule applies in the reverse, as well. 4. To decide the number of the objectives in each course on the basis of the numbers of the syllabus and the level of its comprehensiveness, 5. To correct, supplement or eliminate the stated objectives by a professional or professional groups in that area.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제16권1호
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• pp.15-25
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• 2005

과거 10년간 신경생화학계의 정상발달에 대한 자료가 많이 축적되고 있으며, 새로운 이론 및 가설이 제창되고 있다. 이러한 발전의 배경에는 과거의 연구 방법론 보다 좀더 신뢰도와 타당도, 예민도와 특이도가 높아진 생화학적 방법론의 발달이 있다. 최근에는 분자생물학적인 방법론에 기반을 둔 연구가 획기적으로 늘고 있는 양상이어서, 좀 더 정교한 자료의 획득이 가능해 지고 있다. 소아정신장애, 특히 생물학적인 기반을 가진 장애들은 아마도 이들 신경생화학계의 개체발생상의 문제가 그 장애의 병태생리의 기저에 깔려 있을 것으로 생각되므로, 개체발달에 대한 연구를 통해 얻어지는 결과들이 앞으로 그 질환의 본체에 접근에 가는데 있어서 없어서는 안 될 귀중한 자료가 될 것이라는 데에는 이견의 여지가 없는 것 같다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제22권3호
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• pp.156-161
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• 2011

Objectives: Externalized behavioral problems are prevalent in adolescents, due to the difficulties associated with this developmental stage. Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD), as well as other psychiatric disorders, such as major depressive disorder, result in the manifestation of many behavioral problems during adolescence. Methods: For this report, we analyzed a sample of 31 adolescents, each of whom had presented with CD or ODD at Chosun University Hospital between 2002 and 2010. We separated subjects into depressed and non-depressed groups according to their Beck Depression Inventory scores (BDI<10, non-depressed ; BDI${\geq}$10, depressed). Then we analyzed for neuropsychological differences between the depressed and non-depressed groups. Results: In our sample, adolescents in the depressed group showed less of a stealing (deceitfulness and/or theft) behavioral pattern and presented with more anxiety symptoms, lower self-esteem, and greater sensitivity in interpersonal relationships, as compared to the non-depressed group. Conclusion: When adolescents exhibit disruptive behavior, clinicians should consider the underlying causes of the behavior.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제17권2호
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• pp.114-123
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• 2006

Objectives : The special class has been made, bringing rapid increase quantitatively. The authors carried out the child psychiatric interview and evaluation for 9 special-classed children in Asan city to find out clinical diagnosis and emotional/behavioral characteristics. Methods : The child psychiatrists evaluated special class children by DSM-IV and K-SADS-PL. Tools for the evaluation were Child Behavior Checklist- Korean version, Korean Personality Inventory for Children, Children's Depression Inventory, Abbreviated Conners Parent-Teacher Rating Scale-Revised, State-Trait Anxiety Inventory for Children, Vineland Social Maturity Scale, Wechsler Intelligence Scale for Children-III, and Childhood Autism Rating Scale. Results : Ultimately 53 children, consisting of 35 boys(67.9%) and 18 girls(32.1%), participated, and the average age was $10.5{\pm}1.3$ years old. Their measure of Vineland Social Maturity Scale was $78.7{\pm}20.0$, Childhood Autism Rating Scales was $25.4{\pm}9.0$, Child Depression Inventory was $22.2{\pm}5.2$, State-Trait Anxiety Inventory for Children was $35.2{\pm}8.2/36.5{\pm}6.2$, and Abbreviated Conners Parent-Teacher Rating Scale was $11.0{\pm}4.6$. In the clinical diagnosis evaluation, the prevalence rate of learning disorder was decreased compared to early research, ADHD had been newly appeared and depression disorder and anxiety disorder had been increased. Conclusion : This result suggests that a lot of children in a special class have complex emotional and behavioral problems in addition to educational problems.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제16권1호
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• pp.79-89
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• 2005

연구목적 : 본 연구에서는 지역사회에서 확인된 반항성 도전장애 (Oppositional defiant disorder 이하 ODD) 아동들을 대상으로 이들의 역학적 특징, 공존 정신병리 및 환경적 위험 요인을 파악하고자 하였다. 방법 : 본 연구는 서울 근교의 지방도시(부천시)에서 무작위로 선정된 1학년부터 6학년까지의 초등학생 986명을 대상으로 시행되었으며, 모든 정보는 부모로부터 얻었다. 우선 DSM-III-R과 DSM-IV에 의한 파탄적 행동 평가척도를 통해 대상군을 선정하였고, 나머지 군을 대조군으로 선정하였다. 소아행동조사표, 아동성격척도를 통해 아동 문제 및 기질을 조사하였다. 또한 가족적응/결속척도, 가족기능/만족도척도를 통해 가족 기능을 평가하였고, 동시에 임신-분만-주산기 문제들을 조사하였다. 두 군간의 차이는 t-검정과 $\chi^2$-검정을 통해 비교하였다. 결과 : ODD군 아동은 대조군에 비해 아동행동조사표(child behavior checklist : CBCL)의 모든 소항목과 파탄적행동장애평가표(disruptive behavior disorder scale : DBDS)의 주의력결핍/과잉행동 장애 항목에서 유의하게 높은 점수를 보여 전반적인 공존 정신병리가 심한 것으로 평가되었고, 가족 결속력, 가족 기능/만족도가 낮은 것으로 평가되었다. 임신-분만-주산기 문제 중에서는 임신기의 심한 정서적 스트레스, 임신 중 약물 복용, 산후 우울증 빈도에서 대조군에 비해 유의하게 높은 빈도를 나타냈다. 성격척도에서는 ODD군이 보다 높은 위험회피성, 새것추구성을 보이는 것에 반해 보상의존성은 낮은 것으로 평가되었다. 결론 : 본 연구는 ODD를 독립된 대상군으로 선정하여 시행된 첫번째 지역사회 연구라는 점에 의의를 가진다. 본 연구의 결과는 반항성 도전장애 아동들에게 임신-분만-주산기의 생물학적인 환경적 위험 요인과 가족 기능으로 대표되는 심리-사회학적인 환경적 위험 요인이 동시에 증상 발현에 관여할 가능성이 있음을 시사하는 것이다. 또한 대조군에 비해 높은 수준에서 주의력결핍과잉행동장애(attention deficit hyperactivity disorder ; ADHD), 우울, 불안 등의 다양한 공존 병리를 보여 ODD에 동반된 증상에 대한 정확한 진단과 치료가 요구된다고 할 수 있다. 향후 ODD의 질병 경과를 파악하고 위험 요인간의 상호관계를 밝히며 공존 병리 존재 시 치료 모델을 확립하기 위한 보다 자세한 연구가 요구된다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제5권1호
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• pp.12-27
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• 1994

성인의 우울증과는 달리 아동기 우울증의 존재와 정의에 대해서는 많은 논란이 있어왔다. DSM-III(1980)에 이르러서야 공식적인 병명으로 인정되었으나, 아직도 아동기 우울증은 다른 정신적인 장애에 비해 진단 준거 자체가 명확하게 정의되어 있지 못할 뿐만 아니라 발달 단계에 따라 우울증상은 다른 양상으로 표현되므로, 아동기 우울증의 정확한 진단을 위해서는 다양한 평가 방법을 사용하여 여러 사람들로부터 정보를 얻는 것이 매우 중요하다. 따라서 본 연구에서는 자기보고형 질문지, 면접, 행동 평정 척도, 구조화된 검사, 투사법 검사 등 주요 평가 방법들을 고찰해보았고, 앞으로 아동기 우울증 평가 방법에서 해결되어야 할 신뢰도 및 타당도에 관한 몇가지 문제점들에 대해 논의하였다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제26권3호
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• pp.165-175
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• 2015

Objectives : The purpose of this study was to investigate changes in child and adolescent outpatients at a university hospital in Daegu from 2004 to 2013. Methods : The subjects were first-visit patients under 18 years old, who visited Dongsan Medical Center, Keimyung University, from January 1, 2004 to December 31, 2013. Computerized medical records of 2,738 patients (male 1,906, female 832) were reviewed. Results : The ratio of male to female was 2.3 : 1 in the period of study. The most prevalent age category was 7-9 years. The mean age was $10.12{\pm}4.68$ years ($9.84{\pm}4.59$ years in males, $10.76{\pm}4.81$ years in females). The ratio of child and adolescent patients to total outpatients was 27.0%. The most common diagnostic category was the attention-deficit hyperactivity disorder (ADHD) group, followed by the mental retardation (MR) group. In males, the ADHD, MR, communication disorder groups were more prevalent, but in females, the MR, ADHD, depressive disorder groups were more prevalent. Conclusion : The female to male ratio and total mean age were on the rise. The ADHD group was the most prevalent and the depressive disorder group was also on the rise in this period.