• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.10 no.1
• /
• pp.64-75
• /
• 1999

Objective：The purpose of this study was to investigate the prevalence and characteristics of comorbid disorders and associated symptoms in pervasive developmental disorder(PDD) and to examine the correlation between associated symptoms and developmental characteristics in PDD children. Method：The sample consisted of 209 cases of PDD and 143 cases of developmental language disorder(DLD)(control group) who were treated at the Seoul National Mental Hospital from Jan. 1996 to Mar. 1999. The diagnostic work based on DSM-IV criteria was performed by one or two child psychiatrists, while the clinical feature was evaluated by doctors’s notes, occupational/speech therapy reports, and results of social maturity scale(SMS), childhood autism rating scale(CARS), and psycho-educational profile(PEP). Two groups were compared on a wide range of measures including comorbid disorders, associated symptoms, treatment drugs, and PEP. The relation between associated symptom & PEP was investigated in total(106 cases) and in each dignostic group. Sixty-four cases of PDD were divided into three groups by CARS and then compared on associated symptoms. Result：The prevalence of comorbid disorder was 19.6% in PDD, 41.2% in DLD. The rate of manifestation of 13 associated symptoms was 31.47% in PDD, 22.13% in DLD on the average. Associated symptoms significantly high in PDD were preoccupation, obsession, self-mutilation, stereotypy, sleep problems, and odd response. In total patient group, associated symptoms that significantly influenced PEP were preoccupation, self-stimulation, stereotypy, inappropriate affect, sleep problems, and odd response. But, in each diagnostic group, no associated symptom influenced PEP. Associated symptoms significantly different between the 3 groups of CARS were stereotypy, anxiety, and sleep problems. Conclusion：These preliminary results suggest that developmental characteristics may influence associated symptoms in PDD children and a realistic approach considering minute diagnosis by associated symptoms and comorbid disorders is required.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.22 no.1
• /
• pp.25-37
• /
• 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
• /
• v.13 no.1
• /
• pp.93-103
• /
• 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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.28 no.2
• /
• pp.58-69
• /
• 2017

Attention-deficit hyperactivity disorder (ADHD) is a highly prevalent, impairing, and comorbid disorder that persists into adulthood. ADHD should be diagnosed in the same manner as other common adult mental health disorders. The three most important components in the comprehensive evaluation of patients with ADHD are the clinical interview, medical examination, and completion and scoring of behavior rating scales. The diagnostic evaluation of ADHD should include questions about the symptoms, family history, prior evaluation and treatment of ADHD, as well as other problems including alcohol and drug use. Screening interviews or rating scales, as well as interviews, should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with the objective assessments of the ADHD symptoms, such as through psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. As comorbidity is the rule rather than the exception, clinicians should carefully screen for comorbid disorders as part of a comprehensive assessment of ADHD. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in his or her daily functioning, and must not meet the criteria for other mental disorders which might better account for the observed symptoms, such as mental retardation, autism or other pervasive developmental disorders, mood disorders and anxiety disorders. This report aims to suggest practice guidelines for the assessment and diagnosis of children, adolescents and adults with ADHD in Korea.

• Journal of Preventive Medicine and Public Health
• /
• v.36 no.4
• /
• pp.390-398
• /
• 2003

Objectives : To evaluate the degree of adolescent internet addiction, and investigate its relationship to the general characteristics, internet environments, and contents, especially the stress measured by the psychosocial wellbeing index-short form(PWI-SF). Methods : The data was obtained from self-administered questionnaires from 886 11th grade urban area students. The questionnaires consisted of general characteristics, internet user's environments, frequencies by internet contents, internet addiction test and PWI-SF. Results : The possible rate of internet use at home was 95.1%, and the area of most internet use was the home. The frequencies of internet game and porno site use were higher in males, with web searching and community uses higher in females. The total mean of internet addiction score was 56.8, and was higher for male than for female students. From multiple regression, as analyzed by the internet addiction score as a dependent variable, on-line friends, internet use times, years of internet use, frequencies of internet game, & porno site use, and PWI-SF scores were significant in male. Internet use times, the frequencies of internet game, chatting, community use, and PWI-SF score were significant in female. Four PWI-SF subscales(social role & self reliability, depression, general health & vitality, and sleep disturbance & anxiety) and internet addiction were significantly correlated in both male and female students, with depression having the most correlation. Conclusion : The results of this study suggest that intervention should be provided to prevent internal addiction, especially for coping with stress in Korean teenage students.

• Korean Journal of Social Welfare
• /
• v.55
• /
• pp.341-364
• /
• 2003

The purpose of this study was to investigate the relationship between adolesccents' cybersexual addiction and psychosocial traits. In addition, the relationship between cybersexual addiction and mental health were examined. For the study, 1,742 students attending middle schools and high schools were surveyed. According to the results of study, first, 1.3% of the adolescents reported the severe degree of cybersexual addiction, 2.3% of them had the moderate degree of addiction, 4.2% of them showed the minor degree. The result indicated that 7.8% of entire adolescents had cybersexual addiction. Second, middle school students showed the highest rate of cybersexual addiction and the students attending general high schools reported the lowest rate. Third, the following groups were likely to have the higher levels of cybersexual addiction; students who were males, had low self-control and less emotional support from the family and friends, and whose parents had marital problems. Fourth, the cybersexually addicted adolescents had experienced more psychological symptoms than general internet users had. Fifth, there was the positive relationship between cybersexual addition and psychological symptoms among adolescents. In particular, cybersexual addiction had the most serious effect on phobic anxiety. Finally, T-score measuring the degree of psychopathological symptoms had the positive relationship with the level of cybersexual addiction among adolescents. Moreover, adolescents who had clinical psychopathology and T-score over 70 showed the various rates from 10.9% to 45.2% in the 9 domains of symptoms.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.6 no.1
• /
• pp.3-17
• /
• 1995

The so-called borderline children are characterised by disturbances in the sense of reality and interpersonal relationships, lack of control, fluctuation of functioning, uneven development and excessive anxiety. But the concept of borderline disorder of childhood is very difficult to define and diagnose in current classification system. The present study adapted the consensus symptoms in borderline children by Bemporad and Vera eight cases aged 7-11 were examined in 37 variables. Results are as follows 1) All subjects are boys and girl hardly be diagnosis n current diagnostic system and have many concurrent diagnoses. Common chief complaints in the sense of reality. 2) In KEDI-WISC test, the borderline children showed average intelligence, but performance IQ tends to be higher than verbal IQ. In Rorscharch test, they showed high thought disorder index, emotional instabilities and aggressive impulses. The results of TOVA suggested attentional deficit in half of the subjects. The organicity is not prominent. 3) Many of the borderline children were unwanted baby. Although primary care takers of all the subjects were their mothers there were moderate problems in caring attitude of their children and marital relationship with their husband. Sccioeconomic status was generally below middle class. Most of all subjects have delayed language development, but have overcome subsequently. Many subjects were rejected by peers because of their aggression. 4) The first visit of the subjects was about 6 years of age. Average duration of treatment was 2 years. All of them were treated in the outpatient basis except one. The effect of pharmacotherapy was doubtful and the necessity of long term play therapy was suggested. Although there were many limitations of method in present study, it was suggested that further research is needed for diagnostic criteria, epidemiology and treatment.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.11 no.1
• /
• pp.51-59
• /
• 2000

This study aims to reveal whether attachment relationship with parents can differ from children being accepted and rejected in peer relations, and whether children's rejection sensitivity can differ from children having secure and insecure attachment relationship with parents. Subjects were 218 students in fifth and sixth grade of primary school. Inventory of Parent and Peer Attachment(IPPA), Children's Rejection Sensitivity Questionnaire(CRSQ), and peer relation sociometrics were used as measurements. The results showed that children in secure attachment with parents had lower scores on the subscales of CRSQ, such as anxiety, anger, belief, and psychological reaction, than children in insure attachment relationship with parents. And IPPA scores were higher in children being accepted in peer relation than children being rejected. These results can be considered that early attachment relationship with parents may influence children's rejection sensitivity and peer relation.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.14 no.2
• /
• pp.218-228
• /
• 2003

Objectives：This study investigated the relationship among child's behavior problems, maternal depression, and parenting stress in children with psychiatric diagnoses and their mothers, and the effect of these variables to the mothers' parenting stress. Methods：Seventy-three children(31 externalizing, 24 internalizing, 18 mixed) and their mothers were involved in this study. The mothers of three groups completed MMPI, KPI-C(Korean Personality Inventory for Children), and PSI(Parenting Stress Index). To investigate the relationships among each variables, ANOVA, Pearson correlation, stepwise regression analysis were performed. Results：There was no significant difference in maternal depression among three groups of children. In 2-Way ANOVA, main effect of maternal depression was statistically significant on depression, parent health, and relationship with spouse subfactor in parent domain, parent domain total, and overall parenting stress. But the main effect of child group was statistically significant on distractability/hyperactivity subfactor in child domain only. In regression analysis, maternal depression explained the parent domain of parenting stress most effectively, and child's hyperactivity and anxiety explained the child domain of parenting stress significantly. Conclusion：These findings suggest that it is important to intervene maternal depression to reduce the parenting stress, along with the treatment of the child's behavior problems.

• Child Health Nursing Research
• /
• v.19 no.1
• /
• pp.21-28
• /
• 2013

Purpose: This study was done to provide basic data for developing nursing interventions to enhance quality of life of pediatric patients with cancer (children and adolescents) by examining the quality of life and related factors. Methods: Participants were 134; 67 pediatric patients and 67 parents. The PedsQL$^{TM}$ 3.0 Cancer Module was employed to measure quality of life in the participants. The related factors included general and clinical characteristics of the participants. Results: Mean score for quality of life in the patients was 75.07, and mean score for patient quality of life as perceived by their parents was 64.40. Among the quality of life subscales, treatment anxiety had the highest score whereas nausea had the lowest score. Mean score in adolescent patients (13-18 years of age) was 71.62, lower than the 78.04 for child patients (8-12 years of age). Regarding general and clinical characteristics of the participants, there were no significant differences in the scores. Conclusion: The results indicate that there is difference in perception of quality of life between patients and their parents, and between children and adolescents and these differences should be taken into account when planning and providing nursing care.