• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.sup2
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• pp.19-28
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• 2008

Chronic abdominal pain, defined as long-lasting intermittent or constant abdominal pain, is a common pediatric problem encountered by primary care physicians and medical subspecialists. Chronic abdominal pain in children is usually functional, i.e., without objective evidence of an underlying organic disorder. Functional abdominal pain is categorized as functional dyspepsia, irritable bowel syndrome, functional abdominal pain, abdominal migraine, and aerophagia according to the Rome II criteria for pediatric functional gastrointestinal disorders. There is insufficient evidence to state that the nature of abdominal pain or the presence of associated symptoms can discriminate between functional and organic disorders. The presence of alarming symptoms or signs, such as weight loss, gastrointestinal bleeding, persistent fever, and chronic severe diarrhea, is associated with a higher prevalence of organic disease. Most children with chronic abdominal pain are unlikely to require diagnostic testing; such children often need pharmacologic and behavioral therapy.

• Journal of Oriental Neuropsychiatry
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• v.16 no.2
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• pp.171-179
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• 2005

School violence is known to cause various emotional, behavioral and social problems. Low self-esteem, lack of self consciousness, sense of alienation, guilty consciousness, somatoform symptoms and low concentration happened to adolescent victims. This patient was suffering for school violence during about a year, then Pain disorder occurred to him. Neurofeedback has been used as a complementary therapeutic relaxation and a increasing self-esteem technique. This patient, is a 13-year- boy, who had been exposed school violence for a year and caused severe and constant pain, was successfully treated by Neurofeedback therapy with oriental medication. This case report is focused on treatment through these methods.

• The Journal of Korean Academy of Sensory Integration
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• v.21 no.3
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• pp.79-102
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• 2023

Objective : Autistic Spectrum Disorders(ASD) is a developmental disorder characterized by atypical sensory adaptation, communication problem, stereotyped behavior, and feeding disorders. The reasons for ASD feeding disorders are oral sensory motor, cognitive, behavioral, and social problems. Major symptoms include picky eating, selective eating, food refusal, food neophobia, limited food variety, and food aversion. ASD feeding disorders could be accompanied by various problems such as health and nutrition intake problems, feeding development, eating-related sociability, and family and caregiver stress. Feeding problems and disorders in ASD can present from birth. However, ASD is diagnosed by the age of 3, and there might be an appropriate treatment gap. Usually, symptoms of feeding disorders tend to decrease with age. However, the symptoms often remain, so early evaluation, intervention, and periodic checking are necessary. In this study, the general information about the feeding disorder characteristics of ASD, influencing factors, and intervention were described through a literature review. Conclusion : Sensory-based therapy and behavior-based therapies are generally used for feeding disorders in ASD. Sensory-based therapy is effective for food sensitivity and behavior-based therapy for food selection. As the symptoms of feeding disorders in ASD are diverse, a comprehensive approach includes play and participation, oral motor exercise, diet, and daily life. However, appropriate evaluation, intervention protocol, and guidelines for the treatment of feeding disorders in ASD are limited. Therefore, a complex approach based on a more systematic understanding is needed. Feeding rehabilitation specialists, such as occupational therapists, should provide appropriate evaluation and intervention.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.25 no.4
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• pp.187-195
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• 2014

Objectives : The objective of this study was to investigate the relationship between restricted, repetitive behaviors and interests (RRBI) and autistic symptoms in Korean high functioning autism spectrum disorder (ASD) children and to examine the structure of RRBI. Methods : Participants included 147 high functioning ASD subjects and 181 unaffected siblings. ASD subjects were divided into two groups based on the presence of RRBI. The domain scores of the Korean version of Autism Diagnostic Interview-Revised (K-ADI-R), Korean version of Asperger Syndrome Diagnostic Scale and total scores of Korean translated version of Social Responsiveness Scale, Korean version of Social Communication Scale were used for comparison of ASD symptoms between the groups. Eleven items from the RRBI domain of the K-ADI-R were used in principal axis factor analysis (PAF). Results : A statistically lower nonverbal IQ score was observed for ASD with RRBI than for ASD without RRBIs, and more social deficit, communication deficit, and behavioral and emotional problems were observed for ASD with RRBI compared to ASD without RRBI. Using PAF, two distinct factors were identified. 'Resistance to trivial changes in environment', 'Difficulty with minor changes in personal routine & environment', and 'Compulsion/ritual' were included as one factor. Conclusion : Analysis of the data suggests that the presence of RRBI in high functioning ASD is associated with a more severe presentation of autistic disorder. In addition, there appears to be heterogeneity within RRBI in autism except insistence on sameness.

• Korean Journal of Biological Psychiatry
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• v.27 no.2
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• pp.42-57
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• 2020

Electroconvulsive therapy (ECT) is indicated for various mental disorders (e.g., major depressive disorder, schizophrenia, and bipolar disorder) and the behavioral and psychological symptoms of dementia in elderly patients. Furthermore, ECT is a useful first-line treatment in emergency and crisis situations such as suicide risk, violent behavior, catatonia, and food refusal, which are more frequent in elderly patients. ECT is also effective in the treatment of the motor symptoms of neurological disorders, such as Parkinson's disease and Huntington's disease. Due to the high risk of various physical diseases, the comorbid physical conditions of elderly patients should be individually controlled to optimize ECT treatment. Compared to young adults, in elderly patients the seizure threshold is higher, the seizure duration is shorter, and the anesthetic dose is lower. On the contrary, the response rate in the elderly is both faster and higher. Considering potential cognitive decline and the prevention of further deterioration of cognitive function in elderly patients, in the absence of significant comorbidities, twice weekly sessions and right unilateral electrode placement with a lower seizure threshold and less cognitive effect are preferred to bilateral electrode placement, which has a high risk of adverse cognitive effects. After an acute course of ECT, continuation and maintenance of ECT, combined with prescription of therapeutic drugs, may prevent possible relapse or recurrence of mental disorders. In conclusion, ECT can be used to treat mental disorders in elderly adults, with safety and effectiveness comparable to that in young adults.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.1
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• pp.63-72
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• 2017

Objectives : Attention-deficit hyperactivity disorder(ADHD) is characterized by significant impairments in executive functions, with a prevalence of approximately 3-5% of all children worldwide. The goal of this study was to examine the relationship between executive functions and electrophysiological activities in children and adolescents with ADHD. Methods : In 31 patients with ADHD, resting-state EEG was recorded, and Comprehensive Attention Test(CAT), Stroop Color-Word Inference Test(Stroop CWIT), Trail Making Test(TMT), and Wisconsin Card Sorting Test(CST) were administered. Korean version of the ADHD Rating Scale(K-ARS) was assessed. Results : Alpha and beta power positively correlated with the Attention Quotient(AQ), while delta power negatively correlated with AQ from CAT. In the Stroop CWIT, decreased delta power and increased beta power were related to higher performance. Power of the alpha band increased with higher TMT performance. Moreover, delta power negatively correlated with good performance on the CST, while alpha and high gamma band showed a positive correlation. Correlation with the parent-rating of ADHD symptoms showed a negative correlation between alpha power and higher scores on the K-ARS. Conclusions : These findings indicate that relative power in higher frequency bands of EEG is related to the higher executive function in children and adolescents with ADHD, while the association with the relative power in lower frequency bands of EEG seem to be vice versa. Furthermore, the findings suggest that QEEG may be a useful adjunctive tool in assessing patients with ADHD.

• Korean Journal of Psychosomatic Medicine
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• v.11 no.2
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• pp.205-213
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• 2003

Objectives: The authors intended to evaluate long-term outcome of group cognitive behavioral therapy(GCBT) for panic disorder and examined the variables to predict high end-state functioning in 12 months follow-up. Methods: 236 patients meeting DSM-IV criteria for panic disorder were assessed by STAI, ASI, BDI, BSQ, PBQ, ACQ at pre & post treatment, and were asked about the frequency of panic attacks during recent one month. We executed stepwise discriminant analysis on the clinical variables at pre treatment assessment to find the variables for discriminating between high end-state function(HES) and low end-state function(LES). Results: After GCBT, 82.6% of panic patients maintained high end-state functioning at 12 months follow-up. The results of discriminant analysis showed that BDI and BSQ at pre treatment assessment were significant variables to predict end-state functioning at 12 months follow-up. The hit ratio of discriminant analysis was 69.2%. Conclusion: These results suggest that the therapeutic effect of GCBT can be maintained through 12 months. Especially, it is likely that patients who were less depressed and who had less experienced the fear of physical symptoms at pre-treatment can maintain HES.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.2
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• pp.154-164
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• 1998

Medication is widely accepted as an effective method to reduce the problem of attention deficit, hyperactivity, impulsivity, resistance and violence of ADHD children. However, it does not provide us with the solution on the conflicting routinized behavioral patterns to gain a high level of self-control and acceptable behavior. As a way of replacing medication, this study applies the social skills training program for ADHD children and measures the level of improvement of social skills and the change of the behavioral patterns. The experiment is carried out on 16 children ranged from 6 to 13 years of age for 10 weeks. The patients are divided into three groups：a pure ADHD group, an ADHD group with conduct disorder, an ADHD group with mental retardation and other symptoms. The change of symptoms and the change of social skills are measured by the Child Behavior Checklist(CBCL), the ADD-H Comprehensive Teacher’s Rating Scale(ACTeRS) and the Social Skills Rating Scale(SSRS), and finally Mastson Evaluation of Social Skills for Youth(MESSY). Wilcoxon signed ranks test is used to evaluate the effect of the treatment, and Kruskal-Wallis test is also used to measure the change after the treatment in each of the three groups. In the ADHD group with conduct disorder, the examination of the effect of the treatment shows a significant reduction of violence in the area of behavior(p<.05), and a significant difference of activity and social skills in the area of social competent(p<.001). In the ADHD group with mental retardation and other symptoms, a significant rise of social skills is found in the area of social skills evaluation (p<.05). However, there is no significant difference of effect by the treatment among the three groups. In addition, the current examination shows that the social skills training program does not make a statistically significant contribution to the social skills of the ADHD children. On the other hand, the training helps some children, when it is suitable for the characteristics and accompanying symptoms of the children：it reduces the level of violence in the ADHD group with conduct disorder, and it raises the social skills in the ADHD group with mental retardation. In other words, the social skills training program will reduce the conduct disorder and helps peer relation for ADHD children.

• Journal of Oriental Neuropsychiatry
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• v.33 no.4
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• pp.377-388
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• 2022

Objectives: For diagnosis and evaluation, evaluation tools are needed. Various tools can be used to diagnose and evaluate mental disorders. Among them, psychological tests are widely used. For Korean Standard Classification of Diseases (KCD) diagnosis, psychological tests are also required. Currently developed critical pathway (CP) presented tools for diagnosis and evaluation of mental disorders. The CP suggests the use of tools based on the Clinical Practice Guideline (CPG). Therefore, CPG-based tools should be able to be used in the clinical scene of Korean Medicine for diagnosing and evaluating mental disorders according to CP. Methods: Tools suggested by CPs are summarized. The degree of utilization of tools in CPGs is also summarized. A review was conducted by Korean Medicine neuropsychiatrist experts on tools and user's usage plan. Results: As a result, developed CPs suggested using 19 tools for anxiety disorder, 13 tools for insomnia), 12 tools for Hwabyeong, and 9 tools for dementia. In CPG, 48, 34, 44, and 44 tools were used for anxiety disorder, insomnia, Hwabyeong, and dementia, respectively. Among tools presented in CP, HAM-A, HAM-D, CGI, SAS, and TESS for anxiety disorder, CPG, ISI, and PSQI for insomnia disorder, CPG, STAI, and STAXI for Hwabyeong were frequently used in CPG. For dementia CPG, MoCA, MMSE, HDS, ADL, and ADAS-cog were frequently used. Among them, MoCA, ADL, and ADAS-cog were suggested tools in CP. Conclusions: As a result of analyzing tools suggested and used in the developed CPs and CPGs, it was verified that various tools were used in each study. Most of them were symptom and behavioral evaluation scales. Therefore, symptoms and behavior evaluation scales used more frequently should be able to be used in the clinical scene of Korean Medicine.

• Korean Journal of Psychosomatic Medicine
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• v.23 no.1
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• pp.3-11
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• 2015

Objectives:To determine the influence of parental behaviors on the onset and severity of eating disorders, this study compared aspects of perceived parental styles, according to eating disorder subtypes and age at onset in Korean women with eating disorders. Methods:One hundred and sixty-seven patients with eating disorders[Anorexia Nervosa (AN), N=49; Bulimia Nervosa(BN), N=118] were recruited for this study. Perceived parent behaviors were assessed with Parental Behavior Inventory(PBI) self-rating scale. The study subjects also completed the Eating Disorder Inventory -2 (EDI-2) to assess the severity of eating disorder symptoms. Results:In anorexia nervosa, early onset group(<16 years) reported low paternal affection and high paternal rational expression, low maternal interference than group with age at onset over 16 years. The severity of eating disorder symptoms was negatively associated with mother affection and rational expression in two subtypes of eating disorder(AN and BN). On stepwise regression analysis, paternal affection and maternal over-protection were associated with age of onset only in AN group and maternal affection was associated with the severity of symptoms in both groups of eating disorder. Conclusions:Considering the role of family function and perceived parental styles could help improve the management of eating disorders. These results emphasize the importance of fathers' role in the eating disorder on the age of onset, a relatively unexplored area of eating disorder research. Also, we investigated the importance of mothers' affection on the severity of symptoms.