• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.34 no.3
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• pp.169-174
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• 2023

Objectives: Oppositional defiant disorder (ODD) is often comorbid with other psychiatric disorders in childhood. This study aimed to investigate comorbid psychiatric symptoms and associated factors in elementary school children with symptoms of ODD. Methods: The participants consisted of 205 mother-offspring pairs. Psychiatric symptoms were measured using the Diagnostic Predictive Scales and Korean Child Behavior Checklist. Psychiatric comorbid symptoms were compared between children with ODD symptom and those without ODD symptom. Multivariate logistic regression analysis was used to estimate the odds ratio of psychiatric symptom on ODD. Results: ODD group had a significant association with internalizing and externalizing problem (p=0.001, p<0.001, respectively). ODD group were more comorbid with anxiety disorder, depressive disorder, attention-deficit/hyperactivity disorder, and conduct disorder. Among psychiatric disorder, generalized anxiety disorder (GAD) (adjusted odds ratio [AOR]=18.620, p<0.001) and conduct disorder (AOR=9.529, p=0.014) were associated with ODD symptom. Conclusion: These findings suggest that children with ODD symptom had significantly higher rates of comorbid psychiatric symptoms. And GAD and conduct disorder are related to ODD symptom.

• 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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.22 no.2
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• pp.95-102
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• 2011

Objectives : This present study examined the power of the Korean Child Behavior Checklist (K-CBCL) subscales to predict a DSM-IV diagnosis of oppositional defiant disorder (ODD). Methods : The sample included 37 children and adolescents with ODD and 46 normal controls. The participants and their parents were interviewed for clinical diagnosis using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) and the parents completed the K-CBCL. Logistic regression analysis was used to predict the diagnosis of ODD. Results : Among the CBCL subscales, Delinquent and Aggressive Behavior scales significantly predicted ODD diagnosis. The means of these CBCL subscales were significantly higher in the ODD group when compared to the controls. Conclusion:Two CBCL subscales (Deliquent and Aggressive Behavior) displayed good diagnostic efficiency for assessing ODD in children and adolescents. Through combining information from the CBCL, an empirical-quantitative approach to psychopathology in children and the DSM-IV diagnostic criteria, the results demonstrated that a clinical diagnostic approach is an effective diagnostic paradigm for children with ODD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.1
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• pp.30-37
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• 2015

Objectives: The purpose of this study was to verify the validity and clinical cutoff score of the Child Behavior Checklist for ages 1.5-5 (CBCL 1.5-5) for diagnosis of autism spectrum disorder (ASD). Methods: 44 ASD infants and 100 normal infants participated. T-test, discriminant analysis, receiver operating characteristic (ROC) curve analysis, and odds ratio analysis were performed on the data. Results: Discriminant validity was confirmed by mean differences and discriminant analysis on the subscales of Withdrawn, Attention problems, Internalizing problems, Externalizing problems, Total problems, and all Diagnostic and Statistical Manual of Mental Disorders (DSM)-oriented scales between the two groups. ROC curve analysis showed that Withdrawn, Attention problems, Internalizing problems, Externalizing problems, Total problems, DSM pervasive developmental problems, DSM attention deficit/hyperactivity problems, and DSM oppositional defiant problems significantly predicted ASD infants compared to normal infants. In addition, the clinical cutoff score criteria adopted in the Korean CBCL 1.5-5 for subscales of Withdrawn, Attention problems, Internalizing problems, Externalizing problems, Total problems, DSM pervasive developmental problems, DSM attention deficit/hyperactivity problems, and DSM oppositional defiant problems were shown to be valid. Conclusion: The subscales of Withdrawn, Attention problems, Internalizing problems, Externalizing problems, Total problems, DSM pervasive developmental problems, DSM attention deficit/hyperactivity problems, and DSM oppositional defiant problems significantly discriminated for the diagnosis of ASD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.16 no.1
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• pp.79-89
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• 2005

Objectives : To acquire an improved understanding of oppositional defiant disorder, we evaluated the characteristics of children who have the symptoms of ODD in community sample. Methods : 1200 children from an elementary school in Bucheon (an urban community near Seoul) were recruited by randomized sampling method. By Disruptive Behavior Disorder Scale according to DSM-III-R & DSM-IV, we evaluated the symptoms of ODD and selected subjects with ODD. Psychiatric comorbidity, character trait were compared in subjects with ODD and comparison group. Also we examined the association between prenatal/perinatal risk factors, family functions and the symptoms of ODD. Data were analyzed by appropriate statistical method using SPSS 11.5 window version. Result : Children with oppositional defiant disorder were revealed to have significantly higher rates of psychiatric comorbidity and significantly greater family dysfunction compared to comparison group. Among the prenatal/perinatal risk factors, severe emotional stress during pregnancy, postpartum depression, medication during pregnancy were revealed as risk factors of ODD. In character inventory, ODD group were evaluated to have high score in novelty seeking, harm avoidance, but low in reward dependency. Conclusion : These results support that 1) prenatal/perinatal and psycho-social risk factors could be a important role in the progression of ODD, and 2) children with ODD have diverse comorbid psychiatric symptoms.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.7 no.2
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• pp.190-202
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• 1996

This study assessed psychiatrically referred 5-to 13-year-old children who presented inattention or hyperactivity as chief complaints. Demographic characteristics, primary diagnosis, and comorbid psychiatric conditions of them were identified, and they were assessed using questionnaires and neuropsychological tests. Primary diagnoses included ADHD, anxiety disorder, mental retardation, depression, oppositional defiant disorder, developmental language disorder and others. functional enuresis, conduct disorder, and developmental language disorder were among the secondarily diagnosed disorders. In patients diagnosed as ADHD, overall comorbidity rate was 55.3%. The disorders that frequently co-occured with ADHD were specific developmental disorder, conduct disorder, oppositional defiant disorder, anxiety disorder and other. ADHD groups with or without comorbidity differed in performance IQ and CPT scores. ADHD group differed from externalizing disorders group in the information subscore of IQ, MFFT, and CPT scores, and differed in teachers rating scales, the uncommunication factor of CBCL, and CPT card error compared with internalizing disorders group. The authors concluded that inattentive or hyperactive children should be assessed using various instruments to differentiate other disorders and to identify possible presence of comorbid conditions.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.93-103
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• 2002

The aim of this study is to examine the diagnostic profiles and related clinical variables of children with attention and hyperactivity in psychiatric outpatient clinic. Seventy one children with age range of 5 to 14 were diagnosed by DSM-IV, and assessment battery including KEDI-WISC, KPI-C, ADS(ADHD Diagnostic System) were completed. The subjects were divided into 3 diagnostic groups：ADHD only(n=17), ADHD comorbid(n=27), Other diagnosis(n=27). The results were as follows：In ADHD comorbid group, tic disorder, developmental language disorder, borderline intellectual function, oppositional defiant/conduct disorder, and learning disorder were combined in descending order. Other diagnosis group consisted of tic disorder, borderline intellectual function, depression/anxiety, oppositional defiant/conduct disorder, and others. There were significant differences in IQ, PIQ, and VIQ among the three groups, and ADHD only group showed higher scores of IQ and VIQ than ADHD comorbid group. On the KPI-C, there were no significant differences in all subscales among the three groups. On the visual ADS, omission error and sensitivity showed significant differences among the three groups, and ADHD comorbid group represented higher omission error and lower sensitivity than other diagnostic group. The findings indicated that the inattention and hyperactivity symptoms could be diagnosed into diverse psychiatric disorders in child psychiatry, and ADHD children with comorbidity will show more problems in academic performance and school adjustment.

• The Journal of Pediatrics of Korean Medicine
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• v.15 no.2
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• pp.141-165
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• 2001

Attention-deficit/hyperactivity disorder(ADHD) is one of the most common childhood-onset psychlatric disorders. It is distinguished by symptoms of inattention, hyperactivity, and impulsivity. ADHD may be accompanied by learning disabilities, depression, anxiety, conduct disorder, and oppositional defiant disorder. The etiology of ADHD is unknown, and the disorder may have several different causes. Individual with ADHD present in childhood and may continue to show symptoms as they enter adolescence and adult life. Public interest in ADHD has increased along with debate in the media concerning the diagnostic process and treatment strategies. The purpose of this study is oriental medical approach to ADHD. This study was progressed for oriental diagnosis and treatment for ADHD. In oriental medicine, the reason of ADHD was deficiency of the kidney, hyperactivity of the liver(腎虛肝亢), deficiency of the heart and the spleen(心脾不足), heart disturbed by phlegm and heat(痰熱擾心). The method of medical treatment was nourishing the kidney and checking exuberance of yang(滋腎潛陽), relieving mental stress and promoting wisdom(寧神益智), nourishing the heart and strengthening the spleen(養心健脾), tranquilzation(安神定志). removing heat-phlegm(淸熱化痰), inducing resuscitation and tranquilzation(開窮安神). The prescription was commonly used as Liuwei Dihuang Wan jiajian(六味地黃丸加減), Guipi Tang he Ganmai Dazao Tang jiajian(歸脾湯合甘麥大棗湯加減), Huanglian Wendan Tang jiawei(溫黃連溫膽湯加味). It should help primary care providers in their assessment of a common child health problem.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.1
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• pp.112-122
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• 2003

Objectives：Considerable data indicate that diminished serotonergic activity is related to aggressive behavior. In order to understand the biological etiology in conduct disorder, we studied the relationships of plasma serotonin and 5-HIAA levels in conduct disorders to measures of aggression, violation of rules and oppositional defiant behavior. Methods：Subjects were selected from inpatients and outpatients department of the Division of Child and Adolescent Psychiatry of Seoul National University Hospital. 41 conduct disorders(18 childhoodonset type, 23 adolescent-onset type) and 23 normal controls were included in this study. For the assessment of aggression, rule violation and oppositional behavior, parents completed the rating scale for conduct disorder and oppositional behavior based on the DSM-IV diagnostic criteria. Plasma serotonin and 5-HIAA levels were determined by HPLC with electrochemical detection. Results：1) Plasma 5-HT and 5-HIAA levels were not significantly different among childhood-onset conduct disorder, adolescent-onset conduct disorder and normal control subjects. 2) No significant correlations were found between plasma 5-HT levels and aggression or rule violation. 3) Plasma 5-HT levels showed significant positive correlations with oppositional behavior both in childhood-onset conduct disorder and adolescent-onset conduct disorder. 4) Age-related changes were not found in plasma 5-HT and 5-HIAA levles. Conclusion：Our findings do not support the hypothesis that dysregulation of serotonergic function may be associated with aggresson. Instead, our data suggest that serotonergic function is more closely related with oppositional behavior than aggression.

• Korean Journal of Child Studies
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• v.29 no.3
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• pp.1-21
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• 2008

This research explored links between mother/child personality characteristics based on their diagnostic and clinical pathology. The 232 participants, selected from mother-child pairs receiving psychological care in a hospital setting, were tested and interviewed by clinical practitioners. Correlations were found between mothers' Psychopathic Deviate, Paranoia, Psychasthenia, and Schizophrenia and sons' Psychasthenia, aggression, alienation, depression, and anger. Mothers classified with Hysteria were likely to have aggressive children. Mothers with low self-esteem, repression, frustration, and strong levels of extroversion had daughters with anger/rage issues. Sons of mothers diagnosed with Hypochondriasis, Depression, Hysteria, Psychopathic Deviate, Paranoia, and Psychasthenia had high rates of Oppositional Defiant Disorder and ADHD. Children of mothers diagnosed with depression had high rates of ADHD. Specifically, mothers with Hypochondriasis, Hysteria, and Psychopathic Deviate had daughters with high rates of ADHD.