• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.17 no.2
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• pp.106-113
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• 2006

Objectives : The purpose of this study was to investigate the adult attachment style characteristics of mothers with selective mutism children and their relations to selective mutism. Methods :The subjects of this study were 15 mothers with selective mutism children who were diagnosed by DSM-IV criteria at psychiatry outpatient department of Kyungpook National University Hospital from March 1998 to February 2005. The controls of this study were 30 mothers with normal children who are in the second grade of elementary school in Daegu. We assessed the adult attachment style characteristics of these mothers by Revised Adult Attachment Scale, and Reciprocal Attachment Questionnaire-Korean version, self-report attachment style questionnaire. Results : 1) On the self-report attachment style questionnaire, it revealed that mothers with selective mutism children had both of the secure and the dismissing-avoidant types predominantly and the tendency that mothers with selective mutism children more commonly had dismissing-avoidant type than controls did. 2) On the comparison of attachment quality of mothers, although only the anxiety subscale difference was significant, it revealed that mothers with selective mutism children had generally lower score pattern in all of closeness, dependence and anxiety subscale than controls did. It was consistent with the consequence of self-report attachment style questionnaire in this study. Conclusion : This study showed that the distribution of adult attachment style of mothers with selective mutism children was different from those of controls. The dismissing-avoidant attachment style was predominant in mothers with selective mutism children. we suppose the possibility that the dismissing-avoidant attachment style of mothers with selective mutism children has relation with selective mutism.

• The Journal of Internal Korean Medicine
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• v.37 no.2
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• pp.330-336
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• 2016

Objectives: This clinical study was conducted to evaluate the effectiveness of traditional Korean medicine (TKM) on a patient with akinetic mutism.Method: A patient with akinetic mutism diagnosed with left-anterior cerebral artery infarction was treated with acupuncture and herbal medication; the patient was then evaluated for any improvements in clinical symptoms.Results: Improvements in akinetic mutism symptoms were observed following the TKM treatment.Conclusion: This study shows that TKM treatment for akinetic mutism due to left-anterior cerebral artery infarction may be an effective treatment option.

• Journal of Oriental Neuropsychiatry
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• v.12 no.1
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• pp.193-200
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• 2001

This is a case report that dysautonomia and catatonia are accompanied by Akinetic Mutism in a 28 year old patient whose symptoms, seemed to catatonic schizophrenia. This study is aimed to assist about comprehension, diagnosis and treatment of dysautonomia and catatonia are accompanied by Akinetic Mutism, because this case is not common. This patient's chief complains that hyperhidrosis, muscular rigidity, akinesia etc are seemed to Neuroleptic Malignant Syndrome. Neuroleptic Malignant Syndrome is a side effect during taking antipsychotic that unknowned high, fever, stupor, muscular rigidity, akinesia, tachycardia, hyperhidrosis, salivation. We cannot rule out Neuroleptic Milignant Syndrome, but this case is seemed to catatonic schizophrenia. The symptoms of catatonic schizophrenia is that prodrome(relaxed concern, ataraxy, lacked concentration) is progressed and akinesia, mutism, ankylosis, stupor etc, are appeared. Oriental medicine, environment with more objective study and treatment are needed.

• Korean Journal of Child Studies
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• v.33 no.1
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• pp.41-62
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• 2012

This study explored the case of sandplay therapy for a 4th grade girl suffering from selective mutism. Her selective mutism apparently began following an extremely embarrassing experience in kindergarten. Her symptoms were a combination of symbiotic, reactive and passive- aggressive type behaviors. The goal of the therapy undertaken with this child was to enable her to express her repression and suppression, within a free and protective space during sandplay therapy. There were a total of 60 sessions of sandplay therapy. The client described the situations she had experienced in the first sandtray, by placing babies absent caring adults and food on the sandbox. She also placed baby fish away from their mother. In the mid-point of the sessions, she repeated her regressive behaviors by babbling like a baby and fought with snakes and monsters. In the final sessions, she showed integration and adaptation by engaging in snow play, expressing the union of opposites, placing blue and red mig and making a cross on the sand. This study showed the effectiveness of sandplay therapy since her selective mutism was lessened.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.6 no.1
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• pp.74-89
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• 1995

Selective mutism is a childhood condition defined by persisten failure to speak in specific social situation when speaking is expected, dispite preserved ability to comprehend spoken language and speak. Present study is to investigate clinical characteristics, treatment method and outcome of 23 children who were diagnosed as selective mutism by DSM-IV criteria at the child psychiatry ouptatient department of SNUH. The results were as follows : 1) The Sex ratio was 1: 4.8, female dominant Mear age of onset was 33 years old and mean age of first referral was 7.7 years old. 2) 22% of subjects had perinatal problem such as low birth weight, preterm birth, 26% of the subjects have history of delayed language development. There are subjects who had been separated with mam caretaker before 3 years old(26%) and who experienced physical or psychological trauma before 3 years old(26%). A few subjects had enurests(30%) and encoprests(4%). 3) Many subjects(65%) had symbiotic relationship with their mother. These families consist of dominant, verbally aggressive mother and passive father. Parents of 39% of all subjects were judged to have definite psychopathology(social phobic, depression, hysterical trait or alcohol problem) 26% of all subject, were reported physically abused. 4) The personality trait of the subjects were frequently described as follows(in order of frequency) ; Shy(100%), anxious(83%), stubborn(83%)m rigid and tense posture(78%), immature(65%) overdependent(65%), irritable(52%), manipulative(39%), depressive(39%). 5) The mean performance IQ of 16 subjects by KEDI-WISC was 88.3 Among them, the subjects with IQ below 69 were seven and those with IQ above 70 were nine. When comparing these two group(Mental retardation group vs Normal IQ group), we could find some difference in language development, personality trait, family dynamics and treatment outcome. 6) Among several treatment methods for selective mutism, play therapy was the most frequently used method(65%). Other commonly used treatment methods were pharmacotherapy(21%), behavioral therapy(8%), combined therapy(play therapy+pharmacotherapy+family therapy+behavioral therapy)(12%), 7) Regarding the outcome of treatment 8.6% was evaluated as Excellent, 30.4% as Good, 52% as Fair, 8.7% as Poor at the tinic of treatment. At follow up interview 21.7% was evaluated Excellent, 13% as Good, 21.7% as Fair, 34.8% as Poor. 8) We classified all subjects by Havden's 4 subtype. Symbiotic mutism was most common(65%) and other subtypes are Speech phobic mutism(8.6), Reactive mutism(13%) and Passive-aggressive mutism(30%).

• Journal of Oriental Neuropsychiatry
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• v.24 no.4
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• pp.385-392
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• 2013

This case report presents a 34-year-old female patient. Her chief complaints are akinetic mutism and cognitive dysfunctions. We have diagnosed her with leukoencephalopathy. She was treated with Korean traditional herbal medicines (Joojackwhan) for 33 days continuously. The effects of treatment were measured by the Korean Mini - Mental State Examination and Modified Bathel Index. After treatment, her chief complaints have been improved. Furthermore, the K-MMSE, MBI scores increased. From this case, we deduced that the Korean traditional herbal medicines (Joojackwhan) could be effective for cognitive dysfunctions and akinetic mutism caused by leukoencephalopathy.

• Journal of Korean Neurosurgical Society
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• v.60 no.3
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• pp.367-370
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• 2017

Dural injury during spinal surgery can subsequently give rise to a remote cerebellar hemorrhage (RCH). Although the incidence of such injury is low, the resulting hemorrhage can be life threatening. The mechanism underlying the formation of the hemorrhage is not known, but it is mostly thought to develop after venous infarction. Cerebellar mutism (CM) is a frequent complication of posterior fossa operations in children, but it is rarely seen in adults. The development of CM after an RCH has not been described. We describe the case of a 65-year old female who lost cerebrospinal fluid after inadvertent opening of the dura during surgery. Computerized tomography performed when the patient became unable to speak revealed a bilateral cerebellar hemorrhage.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.2
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• pp.266-272
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• 1997

We examine the clinical efficacies of fluoxetine in treating the children with selective mutism. In an 8-week open-label clinical study, 17 children with selective mutism are received 20-60mg/day of fluoxetine. Our results reveal that 13 subjects(76%) of 17 subjects improve statistically in within subjects comparison of pre- and post-treatment changes in the scores of Clinical Global Impression scale for mutism, Children’s Depression Inventory scale, and Revised Children’s Manifest Anxiety Scale. These data suggest that selective serotonergic antidepressants may be effective in treating selective mutism in children and adolescents.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.3 no.1
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• pp.138-146
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• 1992

The study presented the experience of playtherapy of a 6-yr old girl with elective mutism and attempted to understand her psychopathology and formulated her psychodynamic which was expressed though the therapeutic process of playtherapy in the viewpoint of developmental model. Therapist's attitude was nondirective and supportive. Main theme of her play, fantasy and art was separation anxiety and abandonment fear as the result of continued psychic traumas such as separation from her grandmother and physical abuse by her father and mother etc. So she couldn't achieve developmental tasks such as autonomy and separation individuation and became generally inhibited and selectively mute. The process of play therapy was summarized and coceptualized as her successful progress through sequential developmental phases within the therapeutic relation ship. By reexperiencing this developmental process, she could accomplish her autonomy and separation individuation and developed to oedipal stage and successfully resolve oedipal conflict.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.7 no.1
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• pp.34-43
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• 1996

In adolescence, the symptoms of depression are more various and different from those of adult. Conduct behaviours are frequently represented in adolescent's depression. The patients who have the depression and conduct disorder are defined as depressive condor disorder in ICD-10. We hypothesized that there might be different parental rearing patterns between the patients with depression alone and the depressive conduct disorder. We applied children's depression inventory (CDI), parental rating form for conduct disorder based on DSM-III-R, and parental bonding instrument (PBI) to patients and normal control adolescent group. The results were as follows : 1) There were no significant differences in severity of depressive symptoms, maternal care, maternal overprotection, and paternal care. 2) Paternal overprotection showed significant higher scores in depressive conduct disorder group than depression group and normal control group. 3) There were positive correlations in the severity of depressive symptoms and behavior problems in all subjects. 4) There were no correlations in maternal care and overprotecion with conduct problems, but with depressive symptoms in all subject. 4) There were no correlations in paternal care with conduct problems and depressive symptoms in all subjects. 5) There were significant correlations in patienral overprotective, intrusive attitudes with conduct problems, not with depressive symptoms in all subjects.