• Anxiety and mood
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• v.9 no.1
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• pp.19-24
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• 2013

Objectives: The objective of this study is to examine the association between the children's psychopathology and age, intellectual quotient, and parental psychopathology in children with post-traumatic stress disorder (PTSD). Methods: The emotional and behavioral problems of 35 children with PTSD (23 boys, 12 girls, mean age, $10.26{\pm}2.47$ years) were investigated by retrospective chart review. Their parents' anxiety and depression symptoms were also investigated. We examined the correlations between children's psychopathology and their parents' anxiety and depression symptoms, as well as their age and IQ. Results: There were positive correlations between maternal trait anxiety and depression, and children's emotional problems. State and trait anxiety of children with PTSD were positively correlated with age, and attention-deficit hyperactivity disorder symptoms were negatively correlated with age. Conclusion: Our results suggest that psychiatric manifestation of children who experienced trauma could differ according to the development stage, and the treatment of children with PTSD should involve parental education about the effect of maternal emotional states on children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.29 no.2
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• pp.47-53
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• 2018

Objectives: This study aimed to develop the attention-deficit hyperactivity disorder (ADHD)-After School Checklist (ASK) to evaluate the severity of ADHD symptoms and self-management ability in children and adolescents in South Korea. Additionally, we evaluated the reliability and validity of the scale. Methods: We developed the ASK to evaluate the effect of ADHD psychopathologies on self-management and interpersonal impulsivity. We investigated the reliability and validity of the scale with 1349 parents (male 56.9%; 1202 parents of non-ADHD children, 147 parents of children with ADHD) in Seoul and Gyeonggi Province, Korea. Results: According to the construct validity test using principal constant analysis with the varimax rotation method, two factors explained 60.7% of the cumulative variance in ASK scores. Cronbach's alpha for the whole scale was 0.71. There was no statistical difference between mean ASK scores at test and retest. Mean total ASK scores of the ADHD group were significantly higher than those of the non-ADHD group (p<0.001). Conclusion: The ASK can be used as a reliable and valid tool to evaluate not only self-management capability of children and adolescents with ADHD in their academic and everyday life, but also their impulsiveness in interpersonal relationships.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.4
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• pp.251-257
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• 2015

Objectives : We compared the clinical presentations of manic and depressive episodes and the treatment response among children and adolescents with bipolar disorder (BD) types I and II and BD not otherwise specified (NOS). Methods : The sample consisted of 66 patients, aged between 6 and 18 years, who were admitted for BD to a 20-bed child and adolescent psychiatric ward in a university hospital located in Seoul, Korea. Results : Patients with BD type I were more likely to have lower intelligence quotients and exhibit violent behaviors during manic episodes than patients with BD type II or BD NOS and to show better treatment responses during manic episodes than patients with BD NOS. Patients with BD NOS were more likely to have an irritable mood rather than a euphoric mood during the manic phase than patients with BD type I or II and to exhibit violent behaviors during the depressive phase and chronic course than patients with BD type II. Conclusion : Pediatric BD patients are heterogeneous with respect to their clinical characteristics. Implications for the usefulness of the current diagnostic subtype categories should be investigated in future studies.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.20 no.2
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• pp.61-67
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• 2009

Objectives: The purpose of this study was to examine the performance and electrophysiological characteristics of drug-naive children with attention-deficit/hyperactivity disorder(ADHD) during the Go/NoGo task. Methods: Twenty-three boys with ADHD and 18 age-matched normal boys were recruited at a child psychiatric outpatient clinic in Seoul. All subjects were assessed by the Kiddie Schedules for Affective Disorders and Schizophrenia Present and Lifetime version. The investigator also assessed all subjects using the ADHD Rating Scale-IV(ADHDRS). Event-related potentials were recorded from 8 scalp electrodes during the visual Go/NoGo task. Results: Children with ADHD showed a larger mean of standard deviation of response time during the Go/NoGo task than normal children. The temporal N200 and P300 amplitudes were larger in children with ADHD relative to controls. The parietal N200 and P300 latencies were more prolonged in children with ADHD compared to normal controls. Conclusion: These results suggest that psychotropic-naive children with ADHD may have more variable performance ability, more difficulty in discriminating visual stimuli, and slower information processing speed than their normal age-matched counterparts.

• Anxiety and mood
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• v.4 no.2
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• pp.121-126
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• 2008

Objective : The present study investigated gender differences in the symptoms of posttraumatic stress disorder (PTSD) among Korean PTSD patients from a multicenter sample. Methods : Data were collected from 18 psychiatric units of training hospitals nationwide. All the patients were interviewed by attending psychiatrists using a structured format for PTSD by DSM-IV diagnoses. Additionally the Davidson Trauma Scale was used to evaluate all self-reported symptomatology. Results : Forty-three patients with PTSD, 23 female and 20 male patients, were enrolled in this study. There were significant differences in the frequency and severity of avoidance symptoms, and severity of re-experience symptoms. The female patients reported a higher level of re-experience and avoidance symptoms than the male patients. Conclusion : The results of the present study were found to be consistent with previous studies on gender differences. Women were more susceptible to PTSD symptoms than men, especially exaggerated re-experience and chronic avoidance. Since all patients groups were enrolled from the hospital, this findings needs to be reexamined using community samples.

• Biomolecules & Therapeutics
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• v.20 no.1
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• pp.125-131
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• 2012

Impulsiveness is an important component of many psychiatric disorders including Attention-deficit/hyperactivity disorder (ADHD). Although the neurobiological basis of ADHD is unresolved, behavioral tests in animal models have become indispensable tools for improving our understanding of this disorder. In the punishment/extinction paradigm, impulsivity is shown by subjects that persevere with responding despite punishment or unrewarded responses. Exploiting this principle, we developed a new behavioral test that would evaluate impulsivity in the most validated animal model of ADHD of the Spontaneously Hypertensive rat (SHR) as compared with the normotensive "control" strain, the Wistar Kyoto rat (WKY). In this paradigm we call the Electro-Foot Shock aversive water Drinking test (EFSDT), water-deprived rats should pass over an electrified quadrant of the EFSDT apparatus to drink water. We reasoned that impulsive animals show increased frequency to drink water even with the presentation of an aversive consequence (electro-shock). Through this assay, we showed that the SHR was more impulsive than the WKY as it demonstrated more "drinking attempts" and drinking frequency. Methylphenidate, the most widely used ADHD medication, significantly reduced drinking frequency of both SHR and WKY in the EFSDT. Thus, the present assay may be considered as another behavioral tool to measure impulsivity in animal disease models, especially in the context of ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.29 no.3
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• pp.129-136
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• 2018

Objectives: This study aimed to evaluate the efficacy of the attention-deficit/hyperactivity disorder (ADHD)-After School Checklist (ASK) by comparing the results of the Comprehensive Attention Test (CAT) and Clinical Global Impression-Severity (CGI-S) Scale and then by calculating the area under the receiver operating characteristic (ROC) curve. Methods: We performed correlation analyses on the ASK and CAT results and then the ASK and CGI-S results. We created a ROC curve and evaluated performance on the ASK as a diagnostic tool. We then analyzed the test results of 1348 subjects (male 56.8%), including 1201 subjects in the general population and 147 ADHD subjects, aged 6-15 years, from kindergarten to middle school in Seoul and Gyeonggi province, South Korea. Results: According to the correlation analyses, ASK scores and the Attention Quotient (AQ) of CAT scores showed a significant correlation of -0.20--0.29 (p<0.05). The t-test between ADHD scores and CGI-S also showed a significant correlation (t=-2.55, p<0.05). The area under the ROC curve was calculated as 0.81, indicating good efficacy of the ASK, and the cut-off score was calculated as 15.5. Conclusion: The ASK can be used as a valid tool not only to evaluate functional impairment of ADHD children and adolescents but also to screen ADHD.

• Journal of Ginseng Research
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• v.35 no.2
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• pp.226-234
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• 2011

We investigated the clinical effects of Korean red ginseng on attention deficit hyperactivity disorder (ADHD) in children. Eighteen subjects aged between 6 and 14 diagnosed with ADHD based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition diagnosis criteria were enrolled. Korean red ginseng (Panax ginseng) at 1,000 mg b.i.d. was administered to the subjects for 8 weeks. Eighteen children completed the questionnaire and clinical assessment by visiting the hospital at baseline, then in the first, fourth and eighth weeks. Clinical assessments were performed by using the ADHD Diagnostic System (ADS, a computerized attention assessment program), the abbreviated Conners' rating scale in addition to psychiatric interviews. After 8 weeks, significant differences were found in the omisssion errors of ADS ($78.56{\pm}43.33$ at baseline, $55.17{\pm}21.44$ at 8 weeks, p<0.023), Conners ADHD Rating Scale ($13.78{\pm}6.32$ at baseline, $9.50{\pm}4.80$ at 8 weeks, p<0.042) and Spielberger State Anxiety Scale ($30.94{\pm}6.25$ at baseline, $28.83{\pm}6.23$ at 8 weeks, p<0.024). In the Korean Personality Inventory for Children, a significant reduction of score was found in the physical development scale ($56.44{\pm}9.63$ at baseline, $50.94{\pm}8.91$ at 8 weeks, p<0.017) and social dysfunction scale ($56.33{\pm}6.82$ at baseline, $51.94{\pm}7.13$ at 8 weeks, p<0.025). These results suggest that Korean red ginseng may be effective in improving inattentiveness in ADHD children, but it remains uncertain if it improves the general severity of ADHD, depression, anxiety personality and behavioral changes.

• YAKHAK HOEJI
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• v.57 no.2
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• pp.101-109
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• 2013

Depressive disorders are the most common psychiatric problem in the elderly. Most depression treatment guidelines emphasize treatment with antidepressant medication and recommend that benzodiazepine use be minimized for limited period, particularly to elderly patients. In order to evaluate appropriate use of antidepressants and benzodiazepine, retrospective review of prescriptions was performed. The study population are older than 65 years who had been newly diagnosed with major depressive disorder in specialty mental health at a community general hospital from January $1^{st}$, 2007 to October $31^{th}$, 2012 (N=373). Initial antidepressant accounted for 89.5% with SSRI, and escitalopram accounted for 60.9% of SSRI group. 79% or more of the patients were prescribed the recommended dosage. The maintenance rate for 4 weeks of initial antidepressant was 48% and 6 weeks was 39%. Treatment-discontinuation rate was 68% at 3 month. Alprazolam (short acting benzodiazepine) was prescribed the most, followed by clonazepam (long acting benzodiazepine) and then diazepam. 55% of patients received a duplicated prescription for short acting plus long acting benzodiazepine. 61% of patients used long acting benzodiazepines. Prescribed dosages of benzodiazepines were commonly within a recommended range, while no one was prescribed a appropriate period (up to 2 weeks) except for the early discontinued patients. Appropriate use of zolpidem was only 16.2%. The depressed elderly treated in specialty mental health mostly received long-term treatment with benzodiazepines in combination with antidepressants, guideline recommendations was not followed. Multidisciplinary interventions like audit and feedback of benzodiazepine use are needed and education for the elderly is needed to properly maintain antidepressant treatment.

• Anxiety and mood
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• v.7 no.1
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• pp.40-47
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• 2011

Objective : This study aimed to investigate the prevalence of obsessive-compulsive disorder (OCD) in schizophrenia, and the relationship among OCD, severity of psychopathology, and social function in stable patients with chronic schizophrenia. Methods : We interviewed 138 symptom-stable inpatients who had been on a constant dose of antipsychotics for at least 1 month prior and diagnosed as chronic schizophrenia. Subsequently, patients were classified according to the existence of OCD as investigated using the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Further, all clinical and demographic data was investigated. To investigate potential interrelationships, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Korea-Positive and Negative Symptom Scale (K-PANSS), and the Korean Personal and Social Performance (K-PSP) were used. An independent ttest and Chi-square test were used to compare groups and a Pearson's correlation coefficient was used to assess the relationship between the Y-BOCS and other clinical rating scales. Results : The prevalence of OCD in schizophrenia patients was 18.1%. Patients with schizophrenia and OCD exhibited significantly earlier onset of schizophrenia, more severe psychiatric symptoms, and lower personal and social performance ability as compared to those without OCD. There was no significant relationship among Y-BOCS, K-PANSS, and K-PSP. Conclusion : We found that comorbid OCD was relatively more frequent in patients with schizophrenia. An investigation involving larger samples of schizophrenia patients with OCD with respect to social function and thus, the effect on quality of life is required.