• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제5권1호
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• pp.150-161
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• 1994

본 연구에서는 83명의 틱 장애 환자를 대상으로 그들의 임상적인 특성(성별빈도 차이, 형제순위별 특성, 동반 행동문제, 스트레스 정도 등)을 살펴보았고, 아동 행동조사표(CBCL)과 어머니 양육태도 검사(MBRI)를 이용하여 동반된 행동문제의 정도와 어머니 양육태도를 대조군과 비교하였다. 또한 DSM-III-R별 진단에 따른 차이, 주의집중문제의 동반효과 등에 관하여 검토하여 다음과 같은 결과를 얻었다. 1) 남자가 5.9 : 1로 많았다. 2) 형제순위별로는 첫째가 막내보다 두배 이상 많았다. (맏이 : 막내 : 외동=4.7 : 1.7 : 1) 3) 형제순위별로 발병시기에서는 맏이가 빠른 경향을 보였다. 4) 틱 장애에서 대조군보다 동반된 행동문제가 유의하게 많았다. 5) 틱 장애 아동의 어머니들이 대조군의 어머니들보다 더욱 증오적, 거절적이었고, 아동을 부정적으로 평가하고 있었다. 6) 뚜렛 장애 아동이 만성 틱 장애 아동에 비해 동반된 행동문제가 더 심하지는 않았다. 7) 주의집중 문제가 동반된 경우가 그렇지 않은 경우보다 다른 행동문제가 더 심했다. 8) 가족력이 있는 경우일수록 뚜렛장애 진단이 더 많았다.

• 대한한의학회지
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• 제42권3호
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• pp.139-152
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• 2021

Objectives: The purpose of this review is to investigate the latest traditional Chinese medicine clinical studies on pediatric tic disorder with Tuina treatment and propose the directions of future studies and clinical applications. Methods: To obtain data from CNKI, set the field by '中醫學', '中藥', '中西醫結合' and used keywords '抽动障碍', '抽動穢語綜合', '小兒抽动', '兒童抽动' and '推拿', '導引', '按摩', 'Tuina', 'massage' in cross combination way. Results: 12 clinical studies were selected. These studies were analyzed by author & year, subjects, diagnostic criterion, evaluation criterion, syndrome differentiation, treatment period, methods& results, frequent acupoints and assessment of the quality of studies. All of reports achieved effective therapeutic results on the pediatric tic disorder with Tuina treatment. Conclusion: Tuina treatment has a positive effect and are easily accepted by children who have fear and rejection to traditional Korean Medicine such as acupuncture and Herbal remedy. It is also safe and simple to operate. So the Tuina treatment is worthy to disseminate potential for further development in the treatment of pediatric tic disorders.

• Journal of Acupuncture Research
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• 제25권2호
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• pp.179-187
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• 2008

Objectives : The purpose of this study is to review the acupuncture treatment studies of tic disorder in traditional chinese medicine. Methods : We reviewed the 16 studies about acupuncture treatment of tic disorder which were published from 2005 through 2007. We selected those studies from CNKI(中國知識基礎設施工程 http://www.cnki.net). Results : Selected 16 studies were divided into 8 case reports and 8 control studies. CCMD(6 studies) and DSM(4 studies) were frequently used in the diagnosis of tic disorder. Acupuncture points frequently used were 百會(Baekhoe, $GV_{20}$), 太衝(Taechung, $LR_3$), 風池(Pungji, $GB_{20}$), 合谷(Hapgok, $LI_4$), 神門(Sinmun, $HT_7$), 三陰交(Sameumgyo, $SP_6$), 內關(Naegwan, $PC_6$) and so on. According to specific parts of symptom, some acupuncture points were added. Most of studies reported that acupuncture treatments of tic disorder were very effective. Conclusions : There have been reported many acupuncture treatment studies of tic disorder in traditional chinese medicine. We believe that these studies could be applied to the clinical practices in Korea.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제25권2호
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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.

• 동의신경정신과학회지
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• 제20권1호
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• pp.119-146
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• 2009

Objectives : In this study, patients with tic disorders who visited an Oriental medicine clinic were examined for their demographic characteristics, characteristics of symptoms, relation to Attention-deficit Hyperactivity Disorder(ADHD) and peculiarity according to various variables such as motor and vocal tics. Methods : After surveying 292 patients who visited an Oriental medicine clinic with tic symptoms as main complaints for 17 months, SAS 9.1, a statistical program was used for statistical analysis. Results : 1. The BMI of male tic patients was significantly higher than female ones and it was similar to or higher than the normal group. 2. Patients who are eldest children were 1.7 times higher than those who are not eldest ones. 3. The most usual case of motor tics was the eye blink and the most one of vocal tics was a dry cough. 4. There was no significant difference between male and female patients for all symptoms of motor and vocal tics, but male patients had significantly more obsessions related to tics than female ones. 5. There was no significant difference in the age of initial occurrence of Transient tic disorder(TTD), Chronic tic disoder(CTD) and Tourette's disorder(TD). 6. For the general disorder of a tic and Conners' ADHD rating scale, there was no significance in TTD, CTD and TD. 7. 66% out of the total subjects of 197 cases were found to score more than 65 points in more than 1 items among 8 items such as the time, hearing, wrong alarm, mean response time and standard deviation in the response time, etc. of the ADHD diagnosis system(ADS). 8. The eye blink among motor tics was shown mainly by patients under 10 years old and the frown, movement of the head, shrug and movement of the arms were shown mainly by 11-19 years old patients. Conclusions : For the number, frequency, seriousness and inconvenience in life of tics, TD showed a significantly higher result than TTD and CTD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제34권1호
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• pp.37-44
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• 2023

Objectives: Tic disorders are highly heritable; however, growing evidence suggests that environmental factors play a significant role in their pathogenesis. Studies on these factors have been inconsistent, with conflicting results. Therefore, this study aimed to examine the associations of pre- and perinatal exposure to Tourette syndrome (TS) or chronic tic disorders (CTD) in Korean school-aged children. Methods: This case-control study used data from a large prospective cohort study. The primary outcome was TS/CTD diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria and Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version. Demographic, pre-, and perinatal information was obtained from the maternal questionnaires. Data between the TS/CTD and control groups were compared using the chi-squared or Student's t-test, as appropriate. Two-step logistic regression analyses were used to test the association between TS/CTD and pre- and perinatal risk factors. Results: We included of 223 children (78 with TS/CTD and 145 controls). Significant differences in the demographic data between the two groups were observed. The male sex ratio, mean parental age, parental final education level, and family history of tics were included as confounders. In the final adjusted multivariable model, TS/CTD was significantly associated with antiemetic exposure during pregnancy (odds ratio [OR]=16.61, 95% confidence interval [CI] 1.49-185.22, p=0.02) and medically assisted reproduction (OR=7.89, 95% CI 2.28-27.28, p=0.01). Conclusion: Antiemetic exposure and medically assisted reproduction are significantly associated with the risk of TS/CTD. These results should be replicated in future prospective and gene-by-environment studies.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제19권3호
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• pp.147-155
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• 2008

Objectives: The purpose of this study was to evaluate the efficacy and tolerability of osmotic release oral system-methylphenidate (OROS-MPH) in children with attention-deficit hyperactivity disorder (ADHD) and comorbid psychiatric disorders. Methods: This was an 8-week open label study of OROS-MPH monotherapy. The subjects were 113 children with ADHD aged 6-12 years. Outcome measures were the Korean version of the parent ADHD Rating Scale (K-ARS), Korean version of the Conners Parent Rating Scale (K-CPRS), Clinical Global Impression-Severity and Clinical Global Impression-Improvement. Side effects were monitored using Barkley's Side Effect Rating Scale. We compared the change-over-time in the mean scores of the outcome measure according to the comorbidity of disruptive behavior disorder, depressive disorder, anxiety disorder, and tic disorder. Results: The mean K-ARS and K-CPRS scores were significantly decreased, regardless of the comorbidity. The mean doses of OROS-MPH and dropout rate did not differ significantly according to comorbidity. The OROS-MPH was well tolerated, regardless of the comorbidity. However, children with tic disorder reported a higher frequency of tics or nervous movements between the $2^{nd}\;and\;8^{th}$ week than those without tic disorder. Conclusion: The OROS-MPH is effective for decreasing the symptoms of ADHD, and it is well tolerated, even by patients with comorbid psychiatric disorders.

• 생물정신의학
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• 제13권4호
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• pp.299-304
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• 2006

Objectives : The purpose of the present study was to investigate whether the TaqI A polymorphism of dopamine receptor D2 gene(DRD2) is associated with Tourette syndrome(TS) and chronic motor tic disorder(CMT) in Korean population. Methods : DRD2 TaqI A RFLP genotyping was carried out with DNA extracted from blood samples of 75 patients with tic disorders(47 with TS and 28 with CMT) and 90 healthy subjects. Genotype and allelic frequencies for the DRD2 gene polymorphisms of the tic disorder group as a whole were compared to those of the control group. Separating the TS group, thereafter, the frequency of genotypes and alleles were compared to those of the controls. Results : The results demonstrated that genotype and allele distributions for the DRD2 gene polymorphism in the tic disorder as a whole, TS, and control groups were not significantly different. Conclusion : No association was found for DRD2 gene, TS and CMT. The data suggest that DRD2 gene may not be a useful marker for the prediction of the susceptibility of tic disorder.

• 대한불안의학회지
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• 제6권1호
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• pp.24-30
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• 2010

Objectives : Tic disorder is known to be a chronic neuro-behavioral disease, cognitive behavioral treatment (CBT) strategies, like habit reversal training (HRT), are introducing recently. We report the effectiveness of HRT in Tourette disorder, which are very common in clinical settings. Methods : The DSM-IV clinical diagnosis applied by child psychiatrist. YGTSS, Kovac's children's depression inventory, Spielberger State-Trait Anxiety Inventory, Abbreviated Conners' Rating Scales, Dupaul ADHD Rating Scales are used. Ultimately, totally 10 children were evaluated. Subject group are consist of 6 boys and 4 girls, and the mean age was $10.90{\pm}1.73$ years old. This study is treatment-refractory 10 patients (from 9-14 years old) though 1 years drug treatment and psychiatric consultation were taken. We administered 5 times of HRT for 4 weeks. Results and Conclusion : There were improvement of scores in Yale Global Tic Severity Scale, Clinical Global Improvement. Our observations indicate that HRT might be effective in the treatment of Tourette disorder.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제12권1호
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• pp.115-124
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• 2001

연구목적：본 연구는 일과성 틱 장애(Transient tic disorder：TTD), 만성 틱 장애(chronic tic disoder：CTD), 뚜렛 장애(Tourette's disorder：TD) 아동의 임상 양상을 비교하고, 틱 장애의 질환 심각도와 연관된 변인을 알아보기 위해 시행되었다. 방 법：DSM-Ⅳ 진단분류에 따라 틱 장애로 진단된 69명의 아동과 대조군 43명을 대상으로 인구학적 변인 및 틱과 관련된 임상적 변인을 조사하였다. 틱 증상의 심각도를 알아보기 위해 예일 틱 증상 평가 척도(Yale Global Tic Severity Scale)을 시행하였으며 연구 대상 모두에게 동반된 정서/행동 문제를 평가하기 위해 아동 행동조사표(Child Behavior Checklist)를 시행하였다. 결 과：TTD군은 CTD 및 TD군과 비교할 때 틱 증상의 지속 기간이 짧을 뿐 아니라 틱 증상의 심각도와 장해 정도도 미약하였다. TTD군의 동반된 정서/행동 문제 역시 CTD, TD군에 비해 유의하게 적었으며 공격성 소척도 점수를 제외하고는 정상대조군과 차이가 없었다. CTD군과 TD군간에는 틱 증상의 종류, 개수와 CBCL의 사회성 문제 소척도 점수외에는 통계적으로 유의한 차이를 나타내는 변인이 없었다. 틱 증상으로 인한 장해 정도를 가장 잘 예측해 주는 변인은 운동틱의 강도와 방해도, 틱 증상의 지속기간이었으며, CBCL 총 문제행동 점수와 가장 높은 연관성이 있는 변인은 주의력결핍/과잉운동장애(Attention deficit hyperactivity disorder：ADHD)의 존재여부였다. 결 론：본 연구의 결과는 틱 증상의 심각도 외에 증상의 지속 기간이 틱 장애 아동들의 틱으로 인한 장해도에 큰 영향을 미치며, 동반된 ADHD의 존재가 이들의 임상상을 결정하는 데 있어 중요한 역할을 한다는 점을 시사한다. 또한 위와 같은 임상 변인들이 틱 장애의 진단적 분류보다도 틱 장애 아동의 질환 심각도를 판단하고 치료방침을 결정하는데 있어 더욱 중요함을 시사한다.