• Journal of Preventive Medicine and Public Health
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• 제55권2호
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• pp.164-172
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• 2022

Objectives: We aimed to estimate the space-time distribution of the risk of suicide mortality in Iran from 2006 to 2016. Methods: In this repeated cross-sectional study, the age-standardized risk of suicide mortality from 2006 to 2016 was determined. To estimate the cumulative and temporal risk, the Besag, York, and Mollié and Bernardinelli models were used. Results: The relative risk of suicide mortality was greater than 1 in 43.0% of Iran's provinces (posterior probability >0.8; range, 0.46 to 3.93). The spatio-temporal model indicated a high risk of suicide in 36.7% of Iran's provinces. In addition, significant upward temporal trends in suicide risk were observed in the provinces of Tehran, Fars, Kermanshah, and Gilan. A significantly decreasing pattern of risk was observed for men (β, -0.013; 95% credible interval [CrI], -0.010 to -0.007), and a stable pattern of risk was observed for women (β, -0.001; 95% CrI, -0.010 to 0.007). A decreasing pattern of suicide risk was observed for those aged 15-29 years (β, -0.006; 95% CrI, -0.010 to -0.0001) and 30-49 years (β, -0.001; 95% CrI, -0.018 to -0.002). The risk was stable for those aged >50 years. Conclusions: The highest risk of suicide mortality was observed in Iran's northwestern provinces and among Kurdish women. Although a low risk of suicide mortality was observed in the provinces of Tehran, Fars, and Gilan, the risk in these provinces is increasing rapidly compared to other regions.

• 대한소아치과학회지
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• 제43권3호
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• pp.327-333
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• 2016

틱이란 불수의적이고 갑작스러운 소리냄과 리듬이 없는 근육의 움직임을 말한다. 다수의 운동틱과 한 가지 이상의 음성틱이 모두 존재하는 경우 뚜렛 증후군으로 분류되며, 운동틱에 의한 자해 행위는 뚜렛 증후군 환자에서 흔히 나타나는 증상 중 하나이다. 본 증례에서 9세 소년이 혀의 심각한 궤양을 주소로 신경정신과로부터 의뢰되었다. 두 달 전부터 시작된 반복적인 혀 씹기에 의해 궤양은 빠르게 진행되었으며, 환아는 그로 인한 식이 및 연하의 어려움을 호소하였다. 우리는 부드러운 실리콘 재질을 이용하여 상, 하악이 분리된 가철성 장치를 제작하기로 결정하였다. 장치의 지속적 사용이 고통을 줄일 수 있는 방법임을 강조하였기 때문에, 환아는 장치 장착에 동의하였으며 잘 적응하였다. 3주 후 혀의 병소가 상당히 개선된 것을 확인할 수 있었다. 현재 구강 내 자해 행위를 치료하기 위한 표준화된 지침은 없다. 따라서 임상가는 약물 치료를 비롯하여 구강 내 장치 적용이나 관련 치아의 연마 등 다양한 접근 방법을 고려하여야 한다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제26권4호
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• pp.273-278
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• 2015

Objectives : We retrospectively investigated the efficacy and tolerability of risperidone monotherapy in subjects with autism spectrum disorder (ASD). In addition, we did mixed effect model analysis of the effects of risperidone in patients with ASDs naturalistically treated in a routine clinical setting to determine whether the clinical effects were maintained and the side effects were tolerable. Methods : This retrospective study assessed children and adolescents with ASD, who were on risperidone monotherapy from July 2010 to July 2011 at the Child and Adolescent ASD Clinic at Seoul National Hospital. Outcome measures included the Clinical Global Impression-Severity of Illness (CGI-S) and the CGI-Improvement (CGI-I) scales along with other clinical indices: dosage, target symptoms, and side effects. Results : The mean dose of risperidone in 47 children and adolescents with ASD (40 males, 7 females; age range 5-19 years) who were on risperidone monotherapy was $1.6{\pm}0.8mg/day$, and the mean duration of the treatment period was $20.2{\pm}17.3months$. Aggressive behavior, stereotypic behavior, irritability, and self-injurious behavior were the most frequent target symptoms of risperidone. The most common side effects were weight gain followed by somnolence and extrapyramidal symptoms. In a mixed effects model analysis of CGI-I scores, the mean CGI-I score at the 1 month follow-up was significantly different from the mean CGI-I score of the 3-month follow-up (p=.046), and the CGI-I scores were equally maintained over 3 to 48 months [F(6, 28.9)=4.393, p=.003]. Of the 47 patients, 33 patients (70.2%) were identified as the response group, showing an end point CGI-I rating of 3 or under and having continued risperidone treatment for at least 6 months. The baseline CGI-S score showed significant association with clinical response to risperidone (p=.005), the mean baseline CGI-S was higher in the response group compared to the non-response group. Conclusion : In this study, clinical improvement of risperidone stabilized around 3 months and was equally maintained up to 48 months with tolerable side effects, supporting maintenance of risperidone treatment in children and adolescents with ASDs.