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Exploring the Clinical Characteristics and Comorbid Disorders of Borderline Intellectual Functioning

  • Minae Kim;Keun-Ah Cheon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.35 no.3
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    • pp.181-187
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    • 2024
  • Borderline intellectual functioning (BIF) is characterized by cognitive impairment and deficits in adaptive functioning. Despite affecting a significant proportion of the population, BIF still remains underdiagnosed and poorly understood. In addition to cognitive impairments across a range of domains, individuals with BIF face a greater risk of academic failure and often require special educational support. They suffer from emotional problems, such as difficulties with emotional awareness, anxiety, depressed mood, and unhappiness. Individuals with BIF are more likely to have an impairment of social and adaptive functioning. Furthermore, individuals with BIF are at higher risk of physical and mental health problems, often receive inadequate treatment, and have a poorer prognosis. This review aims to enhance the understanding of clinicians, educators, and policymakers by providing an overview of the characteristics of BIF and its associated challenges, ultimately contributing to the improvement of support systems for individuals with BIF.

Non-Psychopharmacologic Therapy of Tic or Tourette's Disorder (틱장애 혹은 뚜렛장애의 비약물치료)

  • Lim, Myung Ho;Lee, Young Lim;Kim, Bung-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.25 no.2
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    • pp.53-64
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    • 2014
  • Tic disorder is a childhood neuropsychological disorder characterized by abrupt, involuntary, and repetitive stereotyped muscle movement or vocal sound. Tourette's disorder shows a chronic prognosis, and can last for life if no treatment is applied. Although tic disorder has been known for ages, the underlying cause is still not well known. Non-pharmacological treatments have long been used for the tic disorder, but few clinical studies were conducted. However, the European Society for the Study of Tourette's Syndrome recently issued non-pharmacologic guidelines for treatment of tic disorders based on the research findings obtained so far. In addition, guidelines for non-pharmacologic evidence-based treatment were reported in Canada, North America. By synthesizing the newly reported foreign guidelines for treatment and review articles, the aim of this study is to investigate the non-pharmacologic therapies used for treatment of tic disorder or Tourette's disorder.

Patterns of the Diagnosis Prevalence of Psychiatric Disorders in the Population Aged 0-18 Years Based on the Nationwide Insurance Sample Data

  • Lee, Seung Yup;Bahn, Geon Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.31 no.4
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    • pp.214-224
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    • 2020
  • Objectives: This study aimed to examine the trend in diagnostic prevalence of psychiatric disorders in children and adolescents. Methods: Individuals aged 0-18 years were included in the study based on the National Health Insurance Claims Data. To investigate the trends in diagnosis and diagnostic prevalence of psychiatric disorders reflecting the decrease in the birth rate, data were analyzed from 2010 as a reference year to 2015. Results: The number of patients diagnosed with psychiatric disorder decreased annually, from 23,412 on 2010 to 18,821 on 2015. The most common disorder was hyperkinetic disorder in male and depressive episode in female. Although there was no significant change in overall diagnostic prevalence rate of psychiatric disorders, age groups <10 years and some disorders had significant changes in prevalence rate. This study classified the diagnostic prevalence by age into two unique patterns: group in which the diagnosis rate increases with age and group in which the diagnosis rate peaks at a certain age and then decreases. Conclusion: Diagnostic prevalence of psychiatric disorders was different according to age and sex. These patterns should be reflected in the formulation of policies related to mental health and in medical practice for pediatric patients. It is urgent to identify how these patterns change in young adults.

The Impact of Referral to Mental Health Services on Suicide Death Risk in Adolescent Suicide Survivors

  • Kim, Joonbeom;Hong, Sung Hee;Hong, Hyun Ju
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.31 no.4
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    • pp.177-184
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    • 2020
  • Objectives: This study aims to examine the effect of adolescent suicide survivors' experience on suicide death risk, and the effect of referral to mental health services (hereafter referral) in this regard. Methods: This study used the data of 878 suicide-deceased and suicide-attempted adolescents aged 8-19 years, managed by the Suicide and School Mental Health Institute from 2016 to 2018. Results: Regression analysis for main effects showed that although suicide experience had no direct effect on suicide death, non-referral status was associated with a greater risk of death by suicide. While the "non-suicide survivor with non-referral" and "suicide survivor with non-referral" groups showed 1.87 [adjusted odds ratio=1.87, 95% confidence interval (CI)=1.21-2.89] and 4.59 (adjusted odds ratio=4.59, 95% CI=2.02-10.42) times higher odds of suicide death, respectively, the "suicide survivor with referral" group showed no difference compared to the "non-suicide survivor with referral" group. Conclusion: From these findings, there is a need to strengthen referral to mental health services and apply complicated grief treatment to improve the mental health of adolescent suicide survivors.

Classification of Adolescent Suicide Based on Student Suicide Reports

  • Kwon, Hoin;Hong, Hyun Ju;Kweon, Yong-Sil
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.31 no.4
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    • pp.169-176
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    • 2020
  • Exploring the risk factors of adolescent suicide is important for effective suicide prevention. This study explored the clustering of adolescent suicides based on six risk factors: mental disorder, broken family, depression, anxiety, previous suicide attempts, and deviant behaviors. Using 173 student suicide reports obtained from the Ministry of Education, we evaluated the associations between suicide and variables related to mental disorders; dysfunctional family life; depression and anxiety; previous suicide attempts; deviant behaviors such as drinking and smoking; and school life characteristics, including attendance and discipline, problems within the past year, and incidents prior to suicide. In addition, reports of warning signs just before suicide were included in the analysis. The two-stage cluster analysis classified the students into three clusters: the silent type (cluster 1; 48.55%), in which no risk factors were observed; environmental-risk type (cluster 2: 24.28%), which featured a high frequency of broken households, deviant behaviors such as smoking/drinking and running away from home; and depressive type (cluster 3: 27.17%), which featured a high frequency of mental health problems such as depression, anxiety, and suicide attempts. Identifying the sub-types of adolescent suicide may help to inform tailored suicide prevention and intervention strategies in school.

Characteristics Related to Depression in Adolescent Conduct Disorder and Oppositional Defiant Disorder (청소년의 품행장애와 반항성 장애에서 보이는 우울증상과 연관된 특성)

  • Lee, Moon-In;Kim, Sang-Hoon;Kim, Hak-Ryeol;Park, Sang-Hak
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.22 no.3
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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.

The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (I) - Clinical Presentation and Comorbidity - (주의력결핍 과잉행동장애 한국형 치료 권고안 개정안(I) - 서론, 임상양상 및 공존질환 -)

  • Kim, Eun Jin;Kim, Yunsin;Seo, Wan Seok;Lee, So Hee;Park, Eun Jin;Bae, Seung-Min;Shin, Dongwon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.2
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    • pp.46-57
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    • 2017
  • Attention-deficit hyperactivity disorder (ADHD) is a common psychiatric disorder that can affect individuals across their lifespan. It is characterized by the core symptoms of inattention, impulsivity and hyperactivity. ADHD develops as a result of the complex interplay between genetic and environmental factors. Children and adults with ADHD usually suffer concomitantly from other psychiatric comorbidities, including both externalizing and internalizing disorders. It is associated with functional impairment and poor long-term outcomes. This review aims to summarize the key findings from recent research into ADHD and its prevalence, core symptoms, cause and comorbidities from childhood to adulthood.

Body Mass Index, Body Weight Perception, and Depressed Mood in Korean Adolescents

  • Lim, Yooli;Kim, Bongseog
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.1
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    • pp.31-37
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    • 2017
  • Objectives: We examined the relationships between the body mass index, body weight perception, and depressed mood in a nationally representative sample of Korean adolescents. Methods: We analyzed the data from the 2013 Korean Youth Risk Behavior Web-based Survey and evaluated the relationships between the body mass index, body weight perception, and depressed mood by gender (36655 boys and 35780 girls). Results: For boys, a low body mass index and perceiving oneself as underweight were related to depressed mood. For girls, both low and high body mass indices were negatively related to depressed mood. In addition, self-perceptions of being underweight or overweight were positively related to depressed mood. Body weight perception was not a significant mediator in the relationship between body mass index and depressed mood. Conclusion: These results suggest that both body mass index and body weight perception significantly contribute to Korean adolescents' depressed mood. Thus, research and clinical attention needs to be given to underweight as well as overweight adolescents, because those who perceive their weight as not normal are at risk for depression.

The Use of Virtual Reality in Psychiatry: A Review

  • Kim, Suji;Kim, Eunjoo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.31 no.1
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    • pp.26-32
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    • 2020
  • With the advancement in modern information technology, virtual reality (VR) is being increasingly used for the diagnosis, assessment, and treatment of mental disorders. Recently, a VR-based cognitive behavioral therapy for social phobia has been recognized as a new medical technology in South Korea. This might lead to an increase in the use of VR in the field of psychiatry. The present review provides an overview of the status of VR therapies in various psychiatric conditions such as anxiety disorder, post-traumatic stress disorder, psychosis, addiction, and eating disorder. Besides, it summarizes the role of VR therapy in the management of disorders associated with child and adolescence psychiatry as well as various other clinical applications. Additionally, we discuss the merits and limitations of VR therapy, which might serve as a useful reference for researchers. In the current environment wherein novel medical models consisting of a combination of digital devices and medicine are being developed; understanding new technologies such as VR could open new doors to mental health treatments.

Internet Gaming Disorder Treatment Options in the Hospital Setting (임상환자를 대상으로 한 인터넷 게임장애의 치료방법 고찰)

  • Park, Jeong Ha;Hyun, Gi Jung;Son, Ji Hyun;Lee, Young Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.26 no.2
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    • pp.75-85
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    • 2015
  • Internet gaming disorder (IGD), one of the common subtypes of internet addiction, is now classified in Section 3 of DSM-5 and is increasingly regarded as a growing health concern in many parts of the world. Consequently, many psychotherapeutic and psychopharmacological approaches have been considered and some research regarding therapeutic strategies has been conducted. However, treatment of IGD is in its early stages and therefore is not yet well established. This article reviews multiple therapeutic modalities including our own treatment model for IGD according to clinical and biological effects, thus providing suggestions for standard treatment strategies. The two main streams are psychopharmacological treatment and cognitive-behavior treatment, and the cognitive-behavior approach includes cognitive reconstruction, psychoeducation, and parenting coach. Many other non-pharmacological treatments are also recommended for personalized treatment of IGD.