• Title/Summary/Keyword: somatization

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Validity and Reliability of the Korean Version of the Global Assessment of Recent Stress Scale (전반적인 스트레스평가 척도 한국판의 타당도 및 신뢰도)

  • Koh, Kyung-Bong;Park, Joong-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.2
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    • pp.201-211
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    • 2000
  • Objectives : The purpose of this study was to determine the validity and reliablity of the Korean version of the Global Assessment of Recent Stress(GARS) Scale developed for assessing the severity of current perceived stressors, and then to use the scale in clinical practice. Methods : The questionnaire was completed by 215 healthy subjects. A comparison was made regarding the perception of stressors among 242 patients(71 with anxiety disorder, 73 with depressive disorder, 47 with somatoform disorder, and 51 with psychosomatic disorder) and 215 healthy subjects. Factor analysis was done using oblique rotation after maximum-likelihood factor analysis. Results : Factor analysis yielded 1 subscale. Reliability was computed by administering the GARS Scale to 69 healthy subjects during a 2-week interval. Test-retest reliability for 8 items and the total score was significantly high, ranging between 0.85-.95. Internal consistency was significant(Cronbach's a for 7 items : .86). Convergent validity was computed by correlating the 8 items and the total score with the total score of the stress response inventory(SRI), the perceived stress questionnaire(PSQ), and the somatization, anxiety, depression, hostility subscales and general indices of the symptom checklist-90-revised(SCL-90-R). The correlations were all at significant levels. Discriminant validity was computed by comparing the 8 item scores of the patient and control groups. Significant differences were found in area relevant to sickness or illness and the overill global area. The patients with anxiety disorder were significantly higher in area relevant to sickness or illness than the healthy group, whereas the patients with depressive disorder was significantly higher in the overall global score than healthy group. The depressive disorder group was the highest in overall global score of the GARS scale among 4 patient groups, and showed a significant higher scores in interpersonal relationship and overall global area than the psychosomatic disorder group. Conclusions : These results indicate that the Korean version of the GARS scale is highly reliable and valid, and that it can be utilized as an effective measure of perceived stressors for research in stress-related fields. It is suggested that depressive disorder patients are more likely to perceive recent stressors than psychosomatic disorder patients.

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Stress Perception, Stress Response and Coping Strategy of Patients with Chronic Prostatitis (만성전립선염 환자들의 스트레스 지각, 스트레스 반응 및 대처방식)

  • Kim, Sun-Kyung;Lee, Jin;Jeong, Seong-Yun;Kim, Hack-Ryul;Park, Sang-Hag;Lee, Moon-In;Kim, Sang-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.17 no.1
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    • pp.8-14
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    • 2009
  • Objectives : The purpose of this study was to investigate the various aspects of stress in patients with chronic prostatitis. Methods : Thirty two chronic prostatitis patients meeting the criteria of NIH-category III were compared with sixty four controls. Data pertaining to the source of, response to, and coping with stress, as well as chronic prostatitis symptom index were collected using a self-report questionnaire. The questionnaire consisted of a Global Assessment of Recent Stress(GARS), Stress Response Inventory(SRI), Ways of Coping Checklist(WCC), in addition to the NIH-CPSI. Results : From the results of GARS subscales, the scores of changes in relationship, sickness or injury and financial were significantly higher in patients with chronic prostatitis than normal controls. Chronic prostatitis patients had greater amplification of somatization, depression and anger in SRI and significantly lower score in ways of coping checklist compared with controls. In the NIH-CPSI of chronic prostatitis patients, the degree of symptom played a role in depression as stress response item and significant negative correlationship between the symptom point and problem focused, seeking social support coping strategy was observed. Conclusion : These results show that patients with chronic prostatitis have greater stress, higher stress response and insufficient coping strategy. Therefore, these efforts should be considered that enhancing healthier coping strategy and evaluation and management of stress experienced by chronic protatitis patients

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A STUDY OF THE EFFECTIVENESS OF THE BEREAVEMENT PROGRAM OF SEVERANCE HOSPICE (세브란스 호스피스 추후관리 프로그램의 효과에 관한 연구)

  • Wang, Mae-Ryeon
    • The Korean Nurse
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    • v.31 no.2
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    • pp.51-69
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    • 1992
  • Grief that is not acknowledged and worked through may manifest itself in some emotional, mental or physical problem. In recent years much has been learned about coping with grief which the hospice program can utilize to help family members cope with their grief. This study was carried out to determine the helpfulness of the bereavement care of Severance Hospice and to learm more about the grief response of the bereaved. The tools used to collect data were an assessment form used in the bereavement program and the Grief Experience Inventory developed by Sanders and revised and translated 'by the researcher. Data was obtained from bereaved family members(54 for the final grief assessment and 39 for the grief response assessment) receiving bereavement follow-up, from July 1989 to March 1991. Results of the study were as follows: 1. Final Grief Assessment Regarding the resolution of their grief the majority of the bereaved accepted the reality of the death of their family member, while slightly more than three-quarters were able to express their feelings toward their loss. A large majority had returned to activities of daily living well or fairly well and had reinvested their energy in a person other than the deceased. In addition, the physical condition of the majority was good or fairly good. A majority of the bereaved considered the bereavement care to be helpful and almost three-quarters were not considered to be in need of more follow-up. 2. Grief Response Assessment Age was found to have a modoerately positive correlation to appetite disturbance(r=.41, P<.Ol) and loss of vigor(r=.37, P<.Ol) A moderately positive correlation was found between the number of contacts and sleep disturbance(r=2.38, P<.01) Significant differences were found between men and women in regard to guilt(t=2.38, P<.05), social isolation(t=2.44, P<.05) and depersonalization(t=2.07, P<.05) with men having the more intense grief. Significant differences were found in the grief responses of somatization(F=5.82, P<.001), physical symptoms(F=5.87, P<.OOl), appetite disturbance(F=4.40, P<.Ol), despair(3.79, P<,Ol), anger(Fp2.83, P<.05), social isolation(F=3.61, P<.05), guilt(F=3.62, P<.05) and depersonalization (F = 2.58, P <.05). In the first six of these grief responses mothers scored highest, followed by husbands and then wives, In the grief response of guilt, daughters scored highest and on the grief response of depersonalization sons scored highest. Only one grief response, that of sleep disturbance(t= -2.19, P<.05) was found to be statistically significant, with those family members who died at home having the higher scores. Based on the results of this study several suggestions are presented as follows: 1. Since unresolived grief can have a detrimental effect on the bereaved person's mental and phys. ical health it would be good for the nurse, to include questions related to death of family members and the bereaved person's response to the grief, in her nursing assessment. And in the case of unresolved grief the nurse should encourage the person to talk with a trusted friend or counselor and express their fellings of grief. 2. A study to determine the degree of resolution of the grief of those in the bereavement program could be carried out by use of the Grief Experience Inventory early in their bereavement and again 13 months after the death of their family member. 3. A comparison of the grief response of the bereaved in the bereavement program and bereaved not in the program could be carried out using the Grief Experience Inventory. 4. After bereavement programs have been started in other hospice programs it would be good to carry out a joint study of bereavement outcomes of those in the bereavement programs.

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Alexithymia in Somatoform Disorder and Diabetes Mellitus (신체형장애 환자와 당뇨병 환자에서의 Alexithymia)

  • Lee, Kyung-Kyu;Lee, Jeong-Yeob;Kim, Hyun-Woo;Choi, Sang-Jun
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.203-212
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    • 1999
  • Objectives : "Alexithymia" mean literally "no word for mood(or emotion)". It is not only a marked constriction in emotional functioning but a deficit in their cognitive processing. We designed this study to investigate the level of alexithymia, psychopathology and personality factors of patients with somatoform disorder and with diabetes mellitus. Methods : The subjects were consisted of patients with somatoform disorder(N=20), patients with diabetes mellitus(N=20), and normal control(N=20). The level of alexithymia, psychopathology and personality factors were assessed by the Toronto Alexithymia Scale(TAS), the Symptom Checklist 90-Revision(SCL 90-R), and the Sixteen Personality Factor Questionnaire(16-PF). And we compared demographic characteristics, psychopathology and personality factors among three groups, and assessed the relationship between alexithymia and psychopathology, and between alexithymia and personality factors. Results : The results were as follows. 1) Patients with somatoform disorder showed significantly higher TAS scores compared to patients with diabetes mellitus and the normal control group. 2) Patients With somatoform disorder showed significantly higher scores of somatization, anxiety scales than patients with diabetes mellitus and the normal control group, and showed significantly higher scores of obsessive-compulsive, depression, phobic anxiety, psychoticism scales than the normal control group by the SCL-90-R. 3) The normal control group showed high intelligence scores only as compared to patients with somatoform disorder by the 16-PF. 4) A significant relationship was found between TAS scores and psychopathology in patients with somatoform disorder. 5) All three groups did not shown any correlation between TAS and 16-PF. Conclusion : Patients with somatoform disorder showed higher TAS scores and more multiple psychopathology than patients with diabetes mellitus and the normal controls. A significant relationship was found between TAS scores and psychopathology in patients with somatoform disorder. We suggest that the therapeutic approach to patients with somatoform disorder to express emotions and manage psychopathology, and that the treatment methods of patients with diabetes mellitus aims to improve firstly physical conditions are more helpful.

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Victims of Bullying among Korean Adolescents: Prevalence and Association with Psychopathology Evaluated Using the Adolescent Mental Health and Problem Behavior Screening Questionnaire-II Standardization Study Data (청소년정서행동발달검사 표준화연구 자료를 활용한 학교폭력 피해 전국유병률 및 관련요인 조사)

  • Bhang, Soo-Young;Yoo, Han-Ik K.;Kim, Ji-Hoon;Kim, Bong-Seog;Lee, Young-Sik;Ahn, Dong-Hyun;Suh, Dong-Su;Cho, Soo-Churl;Hwang, Jun-Won;Bahn, Geon-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.23 no.1
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    • pp.23-30
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    • 2012
  • Objectives : This study was conducted to investigate the prevalence of victims of bullying and the demographic characteristics of victims, and their related psychopathology, in a Korean nationwide sample of youths in middle and high school over a one month period. Methods : During the autumn of 2009, students in the 7th to 12th grades at 23 secondary schools participated in a nationwide, cross-sectional study. The study subjects completed the Adolescent Mental Health and Problem Behavior Screening Questionnaire-II (AMPQ-II) and Symptom Checklist-90-Revision (SCL-90-R). Based on the data acquired, descriptive statistics, correlation coefficients and multiple logistic regression analysis were performed. Results : Among the 3364 participants, 2272 (67.54%) completed the questionnaire. The prevalence of victimization was 28.9%. Male gender was positively associated with victimization, and grade level was negatively related to victimization. The AMPQ-II bullying score (Factor 4) was significantly (p<.001) and positively correlated to the AMPQ-II student total score (r= 0.50), Worry and thought (Factor 1 ; r=0.38), Mood and suicide (Factor 2 ; r=0.31), Academic and Internet-related problems (Factor 3 ; r=0.24), Rule violations (Factor 5 ; r=0.23), and AMPQ-II teacher total score (r=0.11). Somatization (r=0.23), Obsessive-compulsive behavior (r=0.24), Interpersonal sensitivity (r=0.30), Depression (r=0.33), Anxiety (r=0.26), Hostility (r=0.30), Phobic anxiety (r=0.22), Paranoid ideation (r=0.36), and Psychoticism (r=0.31) results from the SCL-90-R were also found to be positively related to the AMPQ-II bullying score, and remained significant after adjusting for age and gender. A total of 26% of the victims reported suicidal ideations as compared to 9% of non-victims over the month prior to the evaluation ($x^2$=119.595, df=1, p<.001). The multiple logistic regression analysis indicated that the AMPQ-II bullying score significantly increased the risk of suicidal ideation [Exp(b)=1.55, df=1, p<.001] after adjusting for age and gender. Conclusion : School bullying was highly prevalent among Korean middle and high school students. This study provided strong evidence that suicidal ideation and psychopathology were serious problems among the victims of bullying.

Antinociceptive Effect of Testosterone in Androgenized Female Mice (남성화된 암컷 생쥐에서 Testosterone이 통각예민도에 미치는 영향)

  • Chon, Myong-Ho;Kim, Myung-Jung;Park, Je-Min;Yang, Gu-Beum;Lee, Kook-Hee;Jang, Sae-Heon;Kang, Cheol-Joong
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.1
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    • pp.65-71
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    • 2000
  • Objects : Aimed to test the hypothesis that neonatal testosterone exposure in female mice influences the development of testosterone-related pain inhibitory system and that testosterone administered in adulthood decreases the pain sensitivity. Methods : Thirty androgenized(testosterone propionate $100{\mu}g$ ip within 24 hrs after birth) adult female and twenty five control(normal saline $100{\mu}g$ ip within 24 hrs after birth) adult female mice were injected with testosterone propionate 1mg/kg/day for 3 consecutive days from 84th experimental days. Nociceptive sensitivity was measured before and after treatment of testosterone by tail flick latency on 84th and 86th experimental days. Results : 1) On the 84th experimental day, basal nociceptive sensitivity was significantly higher in the androgenized group($2.7{\pm}0.4$ sec) as compared to the control group($3.3{\pm}1.1$ sec). 2) Testosterone treatment on the 84th experimental day significantly lowered nociceptive sensitivity in both androgenized($5.2{\pm}0.9$ sec) and control groups($4.6{\pm}1.8$ sec). However the effect was significantly greater in the androgenized group. 3) Nociceptive sensitivity on 86th experimental day before administration of testosterone was significantly lower in the androgenized group($4.8{\pm}1.9$ sec) as compared to the control group($3.9{\pm}1.2$ sec). 4) Testosterone treatment on the 86th experimental day significantly lowered the nociceptive sensitivity in both groups, but the androgenized group($5.9{\pm}0.9$ sec) showed significantly lower post-treatment nociceptive sensitivity as compared to the control group($4.9{\pm}1.5$ sec). 5) Nociceptive sensitivity was decreased significantly after injection of testosterone once a day for two consecutive days in the androgenized group(${\Delta}2.1{\pm}1.0$ sec), but not in the control group(${\Delta}0.5{\pm}1.3$ sec). Conclusions : There may be a testosterone-related pain inhibitory system, the development of which is enhanced by exposure to testosterone in the neonatal period, and the activity of which is also mediated by testosterone in the later life.

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Disappearance of Hysteria(Conversion Disorder) and the Evolutionary Brain Discord Reaction Theory (히스테리아(전환장애)의 소실과 진화적 뇌신경 부조화 반응 가설)

  • Song, Ji Young
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.28-42
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    • 2016
  • Objectives : The author tried to find out reasons why and how hysteria(and conversion disorder) patient numbers, which were so prevalent even a few decades ago, have decreased and the phenotype of symptoms have changed. Methods : The number of visiting patients diagnosed with conversion disorder and their phenotype of symptoms were investigated through chart reviews in a psychiatric department of a University hospital for the last 12 years. Additionally, the characteristics of conversion disorder patients visiting the emergency room for last 2 years were also reviewed. Those results were compared with previous research results even if it seemed to be an indirect comparisons. The research relied on Briquet P. and Charcot JM's established factors of the vicissitudes of hysteria(and conversion disorder) which has been the framework for more than one hundred and fifty years since hysteria has been investigated. Results : The author found decreased numbers and changes of the phenotype of the hysteria patients(and conversion disorder) over the last several decades. The decreased numbers and changes of the symptoms of those seemed to be partly due to several issues. These issues include the development of the diagnostic techniques to identify organic causes of hysteria, repeated changes to the symptom descriptions and diagnostic classification, changes of the brain nervous functions in response to negative emotions, and the influence of human evolution. Conclusions : The author proposed that the evolutionary brain discord reaction theory explains the causes of disappearance of and changes to symptoms of hysteria(conversion disorder). Most patients with hysteria(conversion disorder) have been diagnosed in the neurological department. For providing more appropriate treatment and minimizing physical disabilities to those patients, psychiatrists should have a major role in cooperating not only with primary care physicians but with neurologists. The term 'hysteria' which had been used long ago should be revived and used as a term to describe diseases such as somatic symptom disorder, functional neurological symptoms, somatization, and somatoform disorders, all of which represent almost the same vague concept as hysteria.

Personality Characteristics Predicting Depression, Anxiety and Resilience in the Graduate Medical Students (의학전문대학원 학생들의 우울, 불안, 회복력과 연관된 성격 특징)

  • Wee, Sung-Hoon;Lee, So-Jin;Park, Chul-Soo;Kim, Bong-Jo;Lee, Cheol-Soon;Cha, Boseok;Lee, Dongyun;Seo, Ji-Yeoung;Choi, Jae-Won;Ahn, In-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.102-111
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    • 2018
  • Objectives : This study aimed to investigate the relationship between personality characteristics of medical students at their admission and the level of depression, anxiety, and resilience at their third year. Methods : Self-reported questionnaires were conducted to the students at the beginning of the first year and the third year. When the students in their first year, they performed the personality assessment inventory, the Beck depression inventory, and the Beck anxiety inventory. When they were in the third year, the students answered the composite Scale of morningness and Conner-Davidson resilience scale-10 in addition to the BDI and BAI. Multiple linear regression analyses were performed to identify predictors of the level of depression, anxiety, and resilience. Results : Of the subscales of depression in the PAI, the physiological depression (${\beta}=-0.285$, p=0.049) associated with increase in the depression from the first to the third year. Among the anxiety-related disorder subscale in the PAI phobia (${\beta}=0.119$, p=0.022) and traumatic stress (${\beta}=0.375$, p=0.007) associated with the level of depression at third grade. Somatization (${\beta}=0.631$, p<0.001) in the PAI associated with the level of anxiety at third year. The anxiety (${\beta}=-0.531$, p<0.001) in the PAI was positive associated with the resilience at third grade. Conclusions : This study showed that certain personality characteristics at admission had significant relationships with the level of depression, anxiety, and resilience at the third grade medical students.

Evaluation of sleep quality and stress response in patients requiring dental prosthetic treatment (치과보철치료를 요하는 환자에서의 수면질과 스트레스 반응 평가)

  • Jeon, Hye-Mi;Jung, Kyoung-Hwa;Choi, Na-Rae;Song, Jae-Min;Lee, So-Hyoun;Kim, So-Yeun
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.2
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    • pp.181-189
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    • 2021
  • Purpose: The purpose of this study is to investigate the stress response and sleep state of the new patients who visit the hospital for prosthodontic treatment due to tooth loss to make reference to further treatment direction. Materials and methods: Examinations, consultations, and surveys were conducted on 236 patients (94 males, 142 females, and 24-86 years old), who newly registered at the department of prosthodontics at Pusan national university hospital, for 2 years from 2018. The number of remaining teeth, edentulous arch, possibility of mastication, and future prosthetic treatment directions were recorded. The visual analogue scale (VAS), stress response inventory (SRI) and Insomnia severity index (ISI) were used as tools to measure patient's subjective discomfort, stress response, and sleep status. Results: Among the entire prosthodontic patient group, the average value of 'fatigue' was significantly higher among the 7 items of SRI, and the value of 'aggression' was significantly lower (P<.001). There are a significant difference between the edentulous and full dentition in the oral discomfort value measured by VAS (P=.004). In cases where less than 20 teeth remain, mastication is impossible, and patients who are planning treatment with removable prostheses, VAS value and 'depression' and 'fatigue' values in SRI were higher than those in the reverse case (P<.05). The patients showed severe level in VAS value have high value of 'tension', 'somatization', 'depression', 'fatigue'and 'frustration'in SRI than non-serious patients (P<.05). Clinical insomnia occurred in 11.4% of all patients, and women had significantly lower sleep quality than men (P=.044). Patients with insomnia showed significantly higher scores on the VAS value and all 7 SRI items than those of normal sleepers (P<.05). Conclusion: The new prosthetics had high 'fatigue' value among the 7 items of SRI. The oral condition, number of residual teeth and mastication function and clinical insomnia affected oral discomfort and the stress response.

CLINICAL AND NEUROPSYCHOLOGICAL CHARACTERISTICS OF DSM-IV SUBTYPES OF ATTENTION DEFICIT HYPERACTIVITY DISORDER (주의력결핍 과잉행동장애의 아형별 신경심리학적 특성 비교)

  • Cheung, Seung-Deuk;Lee, Jong-Bum;Kim, Jin-Sung;Seo, Wan-Seok;Bai, Dai-Seg;Chun, Eun-Jin;Suh, Hae-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.139-152
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    • 2002
  • Objectives:This study was conducted to compare the clinical and neuropsychological characteristics by DSM-IV subtypes of attention deficit hyperactivity disorder(ADHD) patients who did not have comorbid psychiatric disorders. Methods:5-15 year old children with ADHD were recruited at psychiatric outpatient clinic of Yeungnam University hospital and the patients with comorbidity or neurological abnormalities were excluded. Finally, total 404 children with ADHD were selected for this study. There were 234 subjects of ADHD-C(57.9%), 156 subjects of ADHD-I(38.6%) and 14 subjects of ADHD-HI(3.5%), who fulfilled the DSM-IV diagnostic criteria. The mean age of the total subjects was 9.63±2.49 years old. The psychopathology, IQ, behavioral problems, neuropsychological executive function were evaluated before pharmacological treatment. The measures were Korean Personality Inventory of Child(K-PIC) for psychopathology, 4 behavioral check lists(ADDES-HV, ACTeRS, CAP, SNAP) for behavioral symptoms of ADHD, K-ABC and KEDI-WISC for IQ and Conner's CPT, WCST, SST for neuropsychological executive functions. Results:1) The prevalence of subtypes was ADHD-C, ADHD-I, ADHD-HI in decreasing order. There was no sex difference of prevalence among three subtypes. The mean age of ADHD-I was older than other subtypes. 2) There was significant differences of psychopathology among subtypes, the ADHD-C and ADHD-HI had higher than the ADHD-I in the scores of delinquent, hyperactivity and psychosis;the ADHD-C had higher than the ADHD-I in the scores of family relation and autism, the scores of ego resilience were lower than the ADHD-I. However, there was no difference in anxiety, depression and somatization scores among them. 3) The results of behavioral symptom check lists, the ADHD-C had higher the score of inattention, hyperactivity and impulsivity than the ADHD-I. Meanwhile the results of ACTeRs, which rated by the teachers, were different. 4) There were significant differences of sequential processing scale and arithmetics among subtypes in IQ using K-ABC, but there was no significant difference between the ADHD-C and the ADHD-I after excluding the ADHD-HI due to small numbers. 5) There was numerical difference among subtypes but did not reach statistical significance in three neuropsychological executive function tests. Conclusion:In conclusion, our results revealed that there was significant difference in clinical features among three subtypes but, no significant difference in executive functions.

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