• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.11 no.2
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• pp.290-296
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• 2000

Objective：This study aims to investigate the cognitive characteristics of clinically referred children with symptoms of inattention, cach as having ADHD, tic disorder, and emotional disorder. Methods：65 boys(38 with ADHD, 17 with Tic disorder, and 10 with Emotional disorder) were individually assessed using the KEDI-WISC(FIQ, VIQ, PIQ) and T.O.V.A.(errors of omission, errors of commission, reaction time, variability, anticipatory response, multiple response), and the results of those tests were analyzed. Results：There was significant difference among three diagnostic groups of the VIQ of KEDIWISC and the reaction time of T.O.V.A. after the correction of the effect of age difference. Conclusion：The findings suggest that the reaction time of T.O.V.A. might be the useful variable to differentiate the ADHD from other psychiatric disorders and the effect of age and IQ difference should be considered carefully to diagnose in clinical setting.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.1 no.1
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• pp.117-129
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• 1990

35 children(17 boys, 18 girls) with Recurrent Abdominal pain(RAP) without apparent organic causes, referrd from pediatric department of Seoul National University Children's Hospital were studied during 1988. 7. 1 ${\sim}$ 1989. 2. 28. The aims of this study are to examine clinical characteristics of the patients with RAP, to find possible factors influencing the onset and the course of the disorder, to evaluate the psychological status and the relationship with psychiatric diagnoses. The study subjects were compared with the age and sex matched control subjects on measures of social and school functioning, family-environment, behavior traits by CBCL and parent-environment rating scale. All patients and their mothers were interviewed by a child psychiatrist. The results were as follows ; 1) Abdominal pain was found to be more frequent when with a care taker, and related with traumatic life stresses such as separation from parents, death of family members. 2) Family members of the patients with RAP also had a high rate of a history of gastrointestinal dysfunctions with could not be attributed to organic etiologies. 3) Among 35 patients with RAP, 16 were diagnosed as psychiatric disorders. They were adjustment disorders (4), overanxious disorders (4), depression (2), tic disorders (2), attention deficit disorders (2), separation anxiety disorders (1), enuresis (1). 4) On CBCL, the patients with RAP were more internalized, socially less competent and less active compared with the control subjects. 5) According to the parent-environment rating scale, the patients with RAP had more conflicts with their parents about control issues. Family members of the patients with RAP were socially less competent and less abjustable. The parents of the patients with RAP were more affectionate and spent more time with their children but they were unfair and vague on instruction and discipline.

• Journal of the East Asian Society of Dietary Life
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• v.14 no.5
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• pp.425-437
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• 2004

Medicinal plants are of great importance in providing healthcare to a large portion of the population in Korea. A number of plants are described in Dong-Ui-Bo-Gam for use in the treatment of allergic disorders, namely psoriasis, eczema, bronchial asthma, etc. In this study, we evaluated the effect of AllerQ, which is multi-complexes of various plants extracts such like Mori folium, Scutellaria baicallensis, Glycyrrhiza uralnsis, Mentha sacharinensis and Poncirus trifoliata on compound 48/80 induced anaphylactic shock, ovalbumin induced asthma in vivo and anti-IgE antibody induced hypersensitivity in vitro. We found antianaphylactic or antiallergic properties of AllerQ when given orally. AllerQ for prophylactic treatment for anaphylactic shocks have produced good results. AllerQ may modulate various aspects of immune function and allergic inflammation. In the present study, we analyse the effects of AllerQ on mast cell degranulation, mortality, cAMP/cGMP, O₂, H₂O₂ level, cyokine production and on the elicitation of IgE-mediated mast cell-dependent allergic inflammation in vivo and in vitro. We have established that AllerQ inhibited histamine release, cAMP/cGMP, O₂, H₂O₂ level, IL-4, tumor necrosis factor-alpha(TNF-α) and IL-6 production without having any significant physical change. These effects have been observed in mast cell(in vitro) and serum(in vivo) derived from three different origins that were activated by either immunological or non-immunological stimuli. These results suggest that the antianaphylactic and antiasthma tic action of AllerQ may be associated with an increase in the intracellular inhibition of the cAMP phosphodiesterase. Furthermore, AllerQ identified as potent inhibitors on O₂, H₂O₂ and cytokine activity. these data suggest that AllerQ may have an inhibitory role in mast cell-mediated allergic inflammation, and thus might be considered as an useful functional food.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.22 no.1
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• pp.25-37
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• 2011

Objectives：This study was conducted to develop a Korean algorithm of pharmacological and non-pharmacological treatment strategies in attention-deficit hyperactivity disorder (ADHD) and its specific comorbid disorders (e.g. tic disorder, depressive disorder, anxiety disorder, bipolar disorder, and oppositional defiant disorder/conduct disorder). Methods：Based on a literature review and expert consensus, both paper- and web-based survey tools were developed with respect to a comprehensive range of questions. Most options were scored using a 9-point scale for rating the appropriateness of medical decisions. For the other options, the surveyed experts were asked to provide answers (e.g., duration of treatment, aver-age dosage) or check boxes to indicate their preferred answers. The survey was performed on-line in a self-administered manner. Ultimately, 49 Korean child & adolescent psychiatrists, who had been considered experts in the treatment of ADHD, vol untarily completed the questionnaire. In analyzing the responses to items rated using the 9-point scale, consensus on each option was defined as a non-random distribution of scores as determined by a chi-square test. We assigned a categorical rank (first line/preferred choice, second line/alternate choice, third line/usually inappropriate) to each option based on the 95% confidence interval around the mean rating score. Results：Specific medication strategies for key clinical situations in ADHD and its comorbid disorders were indicated and described. We organized the suggested algorithms of ADHD treatment mainly on the basis of the opinions of the Korean experts. The suggested algorithm was constructed according to the templates of the Texas Child & Adolescent medication algorithm Project (CMAP). Conclusion：We have proposed a Korean treatment algorithm for ADHD, both with and without comorbid disorders through expert consensus and a broad literature review. As the tools available for ADHD treatment evolve, this algorithm could be reorganized and modified as required to suit updated scientific and clinical research findings.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.129-138
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• 2002

Objectives：In order to treatment guideline of ADHD, present clinical practise of child psychiatrists and their opinion of optimal intervention were evaluated. Methods：Structured questionnaire items about diagnostic workup, drug choice of 5 different situations according to different co-morbid disorders, and non - pharmacological treatment were applied to 32 child psychiatrists working at university and general hospital. we compared the data with Texas Algorithm Project guideline. Results：(1) Intelligence Test, Sentence Completion Test, sustained attention test, and Conner's questionnaire were the basic routine test that must be performed. (2) Main trend of medication in this study was not different from TAP guideline. (3) In case of co-morbid tic disorder, first recommending drug is still psychostimulant in the TAP guideline. But in this study initial psychostimulant prescription was not main trend. (4) In case of MPH non-response co-morbid disruptive behavior disorder, MPH medication combined with other drug were more common than switching to other drug as suggested the TAP guidelines. (5) In non-pharmacological treatment, most child psychiatrists reported the importance of parent management. Conclusion：There were some difference in medication trend in this study compared with TAP guideline. Further study and conference are needed for experts consensus in Korea.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.23 no.3
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• pp.154-160
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• 2012

Objectives : The purpose of this study was to investigate clinical characteristics of children and adolescents with autism spectrum disorders (ASDs) using methylphenidate (MPH). Methods : Retrospective review of the charts of 79 children and adolescents with ASDs, who visited the Department of Child and Adolescent Psychiatry of Seoul National Hospital, from July 2010 to July 2011, was conducted. Changes in illness severity and improvement were measured using the Clinical Global Impression-Severity of illness (CGI-S) and Clinical Global Impression-Improvement (CGI-I) Scales. Results : We found that MPH was prescribed in 23 (29.1%) children and adolescents. Of the 23 patients on MPH, 4 patients (17.4%) were on MPH monotherapy and 18 patients (78.3%) were using risperidone concomitantly. MPH was prescribed primarily for symptoms of hyperactivity and impulsivity in ASDs patients. The mean dosage of MPH was $26.2{\pm}11.1$mg/day and mean duration of treatment was $31.9{\pm}28.7$ months. Mean CGI-S score improved significantly from baseline to endpoint (from $5.4{\pm}0.6$ to $4.1{\pm}0.9$ ; p<.01). MPH was reported to be effective in 17 patients (17/23, 73.9%), and 10 patients (10/23, 43.5%) reported side effects. Side effects included decreased appetite (4/23, 17.4%), tic (2/23, 8.6%), sleep disturbances (2/23, 8.6%), headache (1/23, 4.3%) and irritability (1/23, 4.3%). Conclusion : The results of this study demonstrate that MPH may be used effectively and safely in children and adolescents with ASDs with hyperactivity and impulsivity. Future controlled trials are needed to confirm these findings.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.3
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• pp.327-333
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• 2016

Tourette's syndrome is a chronic neuropsychiatric disorder characterized by the presence of vocal and multiple motor tics. Tics are defined as brief, intermittent, repetitive, unpredictable, purposeless, and stereotyped movements or sounds. Some patients experience physical pain from intense and complex tics. In addition, motor tics can result in self-injury which is a common feature of Tourette's syndrome. A 9-year-old boy was referred by the department of neuropsychiatry because of a severe tongue laceration. His parents reported that he had been biting his tongue irregularly for 2 months before referral and suffered from an intense burning sensation. The repeated biting resulted in ulcers on the tongue, which quickly worsened and led to progressive difficulty chewing and swallowing food. We offered to give him a two-piece removable appliance to limit tongue biting; it was made of soft silicone and fitted to both the maxillary and mandibular arches. As we emphasized that the device could help alleviate his pain, he agreed to accept it and adapted well. Just 3 weeks later, his tongue lesions had healed significantly.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.1
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• pp.34-42
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• 1997

Enuresis is repeated involuntary or intentional voiding of urine into bed or clothes over age 5. Though it would be a self-remitting disorder, it could be serious problem in emotional and socio-adaptational aspects. The author reviewed the enuretic patients of Child & Adolescence psychiatric section in Chungnam National University Hospital during past 3 years. 46(4.9%) of 936 patients were diagnosed as enuresis in DSM-Ⅳ. The author evaluated their comorbidity by the data of diagnostic review made in two psychiatrists, and emotional aspects(self-concept, anxiety, depression) through the self-rating scales (Piers-Harris children’ self concept scales, RCMAS, state-trait anxiety inventory for children, child’s depresson inventory). Thirty(65.2%) of the 46 enuretic patients had additional diagnoses such as attention deficit hyperactive disorder, mental retardation, encopresis, oppositional defiant disorder, depression, anxiety disorder, autism, somatoform disorder, tic disorder, obsessive-compulsive disorder, sleep disorder, etc. Sixteen enuretic patients had at least one comorbid disorder. Eleven patients had two, and three patients had more than three. Fourteen of 46 enuretic patients were evaluated through self-rating scales of self-concept, anxiety and depression. But we couldn’t obtain meaningful results. Maybe it was due to the small sample size(N＝14) and the influence of the comorbid disorders. Finally, it was an impressive evidence that there exist many comorbid disorders in enuresis(esp. attention deifict/hyperactive disorder). In emotional aspects, the author thought that further evaluation should be needed for more meaningful results.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.15 no.2
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• pp.143-151
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• 2004

Objectives : Child and adolescent onset obsessive compulsive disorder(C-OCD) is known to be associated with poor drug response, high comorbid rate and strong genetic tendencies. Till now studies for C-OCD have been very rare in Korea. We conducted this study to investigate the informations about clinical features, familial psychiatric loading, treatment profiles and course of server C-OCD from the retrospective analysis of inpatient data of Seoul National University Children's Hospital. Method : Retrospective chart review and data analysis was performed. Twenty(male 16 : female 4) patients with final C-OCD diagnosis by DSM-IV at discharge from 1994 to 2002 were found and their medical chart, psychological data, family interview data and nursing reports were collected and analyzed. Results : 1) The sex ratio of C-OCD was male dominant(4:1). 2) Phenomenological, most common obsession was pathologic doubt, contamination fear, followed by aggressive obsession, need for symmetry, sexual obsession, most common compulsion was checking and washing, followed by breathing, movement, symmetry, repetitive asking, hoarding, mental compulsion. 3) Most common comorbid diagnosis was depression. Other axis-I diagnosis associated OCD were anxiety disorder, tic disorder, conduct and oppositional defiant disorder and psychosis. 4) Regarding psychiatric familial loadings, 17 patients(85%) had relatives with psychiatric disorders, OC-spectrum disorders(OCD or OCPD) were found in 9 patients(45%). 5) The majority of patients(75%) have received SSRI and antipsychotics treatment. The response rate above 'moderate improved" by CGI was 75%. 6) During follow-up period in outpatient clinic, five patients(25%) showed continuous complete remission, 10 patients (50%) did residual symptoms with chronic course. Conclusion : This seems to be the first systemic investigation of severe pediatric OCD patients in Korea. The children & adolescents with severe OCD in inpatient-setting showed the high comorbid rate, familial psychiatric loading, and combined pharmacotherapy with antipsychotics, As for symptoms, high rate of aggressive-sexual obsession and atypical compulsions like breathing and moving was reported in this study. Severe pediatric OCD patients, however, responded well to the combined SSRI and antipsychotics regimen.