• Title/Summary/Keyword: young adolescent patient

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CHILDHOOD ONSET SCHIZOPHRENIA IN DEVELOPMENTAL ASPECT (소아 정신분열병의 발달학적 측면)

  • Lee, Young-Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.2
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    • pp.173-182
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    • 2005
  • This review is a clinical and research update of recent literature related to childhood onset schizophrenia (with an onset of psychosis by age 12). Childhood onset schizophrenia(COS) is a rare disorder, but that may represent a more homogeneous patient population in which to search for risk or etiologic factors of schizophrenia. These overview data show that COS shares the same clinical and neurobiological features as later onset forms of the disorder. Compared with later onset schizophrenia, however, this subgroup of patients appear to have more severe premorbid neurodevelopmental abnormalities, more cytogenic abnormalies, poor outcome, and potentially greater family histories of schizophrenia and associated spectrum disorders. Future studies of this subgroup may provide important clues as to the genetic basis for schizophrenia and how gene products influence certain feature of the disease, such as age of onset and mode of inheritance.

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A CASE OF PRADER-WILLI SYNDROME TREATED WITH FLUOXETINE (Prader-Willi 증후군의 Fluoxetine 치험 1례)

  • Shin, Dong-Won;Song, Dong-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.1
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    • pp.133-138
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    • 1997
  • Prader Willi Syndrome(PWS) was first recognized and reported by Prader-Willi. The etiology of the syndrome is not fully understood, but 50-70% of the patients show small deletion in chromosome 15. Manifested symtoms vary according to developmental age. In early life, hypotonia, areflexia, feeding difficulties, hypothermia, microgenitalia, hypoplastic scrotum, cryptochordism were observed. But in several years, hypotonia disappears, and polyphagia, decreased satiety, psychomotor retardation, obesity, hypogonadism and short stature become main problems. Behavioural problems including temper and aggressive outbursts, stealing food, hoarding food, and self excoriating skin picking, trichotillomania are more prominent during adolescence and young adulthood. Also, irritable, depressed mood are described. Lots of psychological and behavioural problems explain the reason why psychiatrists have managed and reported this syndrome. However, there has been no official report of PWS in our country. So authors report the clinical characteristics and issues in management of a patient with PWS.

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Recurrent macrophage activation syndrome since toddler age in an adolescent boy with HLA B27 positive juvenile ankylosing spondylitis

  • Park, Joon Hyeong;Seo, Yu Mi;Han, Seung Beom;Kim, Ki Hwan;Rhim, Jung Woo;Chung, Nack Gyun;Kim, Myung Shin;Kang, Jin Han;Jeong, Dae Chul
    • Clinical and Experimental Pediatrics
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    • v.59 no.10
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    • pp.421-424
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    • 2016
  • Recurrent macrophage activation syndrome (MAS) is very rare. We present the case of an adolescent boy with human leukocyte antigen (HLA) B27-positive ankylosing spondylitis (AS), who experienced episodes of recurrent MAS since he was a toddler. A 16-year-old boy was admitted because of remittent fever with pancytopenia and splenomegaly after surgical intervention for an intractable perianal abscess. He had been diagnosed with hemophagocytic lymphohistiocytosis (HLH) 4 different times, which was well controlled with intravenous immunoglobulin and steroids since the age of 3. We were unable to identify the cause for the HLH. He remained symptom-free until the development of back pain and right ankle joint pain with swelling at 15 years of age. He was diagnosed with HLA B27-positive AS with bilateral active sacroiliitis. He showed symptom aggravation despite taking naproxen and methotrexate, and the symptoms improved with etanercept. On admission, his laboratory data showed leukopenia with high ferritin and triglyceride levels. Bone marrow biopsy examination showed histiocytic hyperplasia with hemophagocytosis. There was no evidence of infection. He received naproxen alone, and his symptoms and laboratory data improved without any other immunomodulatory medications. Genetic study revealed no primary HLH or inflammasome abnormalities. In this case, underlying autoimmune disease should have been considered as the cause of recurrent MAS in the young patient once primary HLH was excluded.

Effect of Sling Lmubar Stabilization Exercise Program on the Balance of Adolescent Idiopathic Scoliosis Patients (슬링 요부안정화 운동프로그램이 청소년기 특발성 척추측만증 환자의 균형에 미치는 영향)

  • Bae, Young-Hyeon;Park, Sun-Hee;Lee, Hye-Lim;Lee, Suk-Min
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.7
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    • pp.3074-3084
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    • 2012
  • The purpose of this study lies in examining how sling lumbar stabilization exercise affects static standing balance of adolescent idiopathic scoliosis patients. The subjects were forty patients who were diagnosed with idiopathic scoliosis. They were randomly assigned either to a experimental group (n=20) that received sling lmubar stabilization exercise program or to a control group (n=20) that received only education. Data were obtained for each patient from total sway path and sway velocity in standing on both feet with eyes closed and standing on both feet with eyes open were measured, using balance performance monitor. All variables were measured at pre- and post-exercise. There were significantly differences between the both groups for all variables at post-exercise (p<.05). The experimental group showed a significantly decreases in all variables at pre- and post-exercise (p<.05). But the control group showed a no significantly differences. These results revealed that sling lumbar stabilization exercise improved static standing balance, by reducing COP(center of pressure) sway path and sway velocity of idiopathic scoliosis patients, and it is expected that sling lumbar stabilization exercise will be used as balance enhancement exercise intervention for the treatment of adolescent idiopathic scoliosis patients.

Factors Affecting Adherence to Pharmacotherapy in Children with Attention-Deficit Hyperactivity Disorder: A Retrospective Study (주의력결핍 과잉행동장애 아동의 약물치료 순응도에 영향을 미치는 요인 : 후향적 연구)

  • Kim, Yoon-Jung;Oh, So-Young;Lee, Ji-Ah;Moon, Su-Jin;Lee, Won-Hae;Bahn, Geon-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.21 no.3
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    • pp.174-181
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    • 2010
  • Objectives: To identify the factors affecting long-term adherence to methylphenidate treatment in children with attention-deficit hyperactivity disorder (ADHD). Methods: A retrospective medical record review of 239 ADHD patients (mean age $9.3{\pm}2.6$ years, range 6.0-17.4 years) who had visited the child and adolescent psychiatry clinic at a university hospital, in Seoul, Korea from March 2005 to February 2008. Subjects were diagnosed as ADHD based on the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision version (DSM-IV-TR) and underwent neuropsychological tests including the continuous performance test (CPT). Treatment discontinuation was defined as the last prescription date when the medication possession rate (MPR) became less than 0.80. Subjects were divided into three groups and labeled as Group I, non-adherence without pharmacotherapy, Group II, non-adherence with short-term pharmacotherapy, and Group III, adherence with long-term pharmacotherapy. Results: Ninety (37.7%) patients were grouped as non-adherent (Groups I+II) and 149 (62.3%) as adherent (Group III). The adherence group exhibited lower intelligence, higher symptom severity, and a higher number of comorbid psychiatric disorders than controls. The use of stimulants was significantly associated with long-term adherence to treatment. Additionally, the duration of interval between the date of the first visit and the date of the first prescription was positively associated with long-term adherence. Conclusion: About two-thirds of patients diagnosed as ADHD adhered to the treatment six months after the first visit. With respect to patient evaluation and the development of treatment strategies, factors affecting early drop-out and longer follow-up must be considered.

Comparison of Soft Tissue Changes between Adolescents and Adults in Class II Malocclusion Treatment (청소년 및 성인 환자에서 II급 부정교합 치료시 연조직 변화에 관한 비교)

  • Chang, Na-Young;Cho, Jin-Hyoung;Lee, You-Mee;Kang, Kyung-Hwa
    • Journal of Oral Medicine and Pain
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    • v.34 no.3
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    • pp.277-294
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    • 2009
  • The purpose of this study was to evaluate the soft tissue changes of class II adolescents and adults in respect to extraction or nonextraction. The study included 68 patients from Wonkwang Dental Hospital were categorized to adolescent extraction group, adolescent nonextraction group, adult extraction group, adult nonextraction group. Cephalometric tracing of each patient was done to compare pretreatment and posttreatment of each group, to compare the changes between groups. And among the variables that showed significancy, correlation analysis and simple linear regression were done. The results were as follows. 1. In both adolescents and adults after extraction treatment, nasolabial angle significantly increased and in both subjects after non extraction treatment, nasolabial angle significantly decreased. 2. In extraction subjects, there were positive correlation between the amount of treatment changes of vertical-U1 and E line-upper lip, the changes of vertical-L1 and E line-lower lip, the changes of vertical-L1 and vertical-Li. 3. In extraction subjects, simple regression equations of E line-upper lip, E line-lower lip, Li were calculated by regression analysis. According to the results above, it could be considered that the effect of the extraction or nonextraction treatment was greater than the effect of growth.

Elevation of Procalcitonin in an Adolescent Acetaminophen Intoxication (아세트아미노펜 중독 청소년에서의 프로칼시토닌 상승)

  • Kim, So Eun;Lee, Jae Baek;Jin, Young Ho;Yoon, Jae Chol;Jo, Si On;Jeong, Tae Oh
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.1
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    • pp.38-41
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    • 2019
  • Procalcitonin (PCT) is commonly employed in medical practice as a diagnostic biomarker of bacterial infection and also as a monitoring biomarker for antimicrobial therapy. There have been a few published reports concerning elevated PCT levels in people with acute liver injury caused by an overdose of acetaminophen. We report here on a case of PCT elevation in an adolescent with acute acetaminophen poisoning without any bacterial infection or liver injury. A 15-year-old girl had deliberately ingested 20 tablets of 650 mg acetaminophen (13 g) and she presented to our emergency department. The PCT level on admission was elevated to 65.64 ng/mL (reference range: 0-0.5 ng/mL). Her PCT level on the second day peaked up to 100 ng/mL and then it gradually decreased. There was no evidence of liver injury or infection on the computed tomography examination and other lab tests. The patient regained her good health and was discharged on the sixth day of hospitalization.

The Influence of Depression and School Life on the Quality of Life of Korean Child and Adolescent Patients with Attention-Deficit/Hyperactivity Disorder: A Comparison of the Perspectives of the Patients and Their Caregivers

  • Park, Byeong-Eon;Lee, Jeong-Seop;Kim, Hee-Yun;Bae, Jae-Nam;Kim, Won-Hyoung;Kim, Hye-Young;Rim, Mi-Roo;Kang, Sang-Gu;Choi, Seo-Hyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.30 no.1
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    • pp.2-8
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    • 2019
  • Objectives: This study aimed to compare the quality of life reported by patients with attention-deficit/hyperactivity disorder (ADHD) to the patients' quality of life as reported by their caregivers. In addition, it aimed to examine how emotional problems, including depression and anxiety, and the severity of the symptoms affect the quality of life reported by the patients and their caregivers. Methods: The patients' quality of life and their degree of depression and anxiety were measured using the Pediatric Quality of Life Inventory (PedsQL) 4.0 Child Self-Report, the Children's Depression Inventory (CDI), and the Revised Children's Manifest Anxiety Scale, respectively. The caregivers' perception of the patients' quality of life and severity of the ADHD symptoms were measured using the PedsQL 4.0 Parent Proxy Report and the Conners' Parent Rating Scale (CPRS), respectively. A total of 66 participants completed the survey. The independent-samples t-test, Pearson's correlation analysis, and multiple regression analysis were conducted. Results: The mean score of the PedsQL 4.0 Child Self-Report was significantly higher than the mean score of the PedsQL 4.0 Parent Proxy Report. However, for school function, the PedsQL 4.0 Child Self-Report score was significantly lower than that of Parent Proxy Report. The correlation between the PedsQL 4.0 Child Self-Report and PedsQL 4.0 Parent Proxy Report scores was significant only for emotional function and social function. The multiple regression analysis showed that the PedsQL 4.0 Child Self-Report and PedsQL 4.0 Parent Proxy Report scores were significantly predicted by the CDI and CPRS scores, respectively. Conclusion: Our results demonstrate that there are clear differences between the quality of life reported by the patient themselves and that reported by their caregivers. In addition, the findings suggest that it is critical to treat the patients' accompanying depressive symptoms.

A COMPARATIVE STUDY ON THE ANTICARIOGENICITY OF ENAMEL SURFACE ADJACENT TO RESIN RESTORATION POLYMERIZED BY VISIBLE LIGHT OR ARGON LASER. (가시광선과 아르곤 레이저에 의해 중합된 레진 수복물 주변 법랑질의 항우식효과에 관한 비교연구)

  • Park, Young-Soo;Kim, Jong-Soo;Kim, Yong-Kee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.23 no.4
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    • pp.840-858
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    • 1996
  • The main purpose of this study was to evaluate the anticariogenic effect of argon laser. Histological observations on lesion initiation and progression were performed under the polarized microscope. The results from the present study can be summarized as follows; 1. The specimens of laser cured group were shown to have more irregular and discontinuous lesion body in general than visible light cured group with rather continuous positive birefringence. 2. With lesion initiation and progression, almost all the specimens showed deeper body of lesion with shallower intact surface zone in the visible light cured group than the laser cured group(p<0.05). When the comparision was made between the two argon laser cured groups, the single-cure group showed deeper lesion body and the shallower surface layer than double-cure group. 3. Based upon the above mentioned results of this study, it can be assumed that the use of argon laser in the procedure of resin polymerization may provide the child and adolescent patient population with anticariogenic effect as well as efficient polymerization. Further studies using various materials and experimental conditions are being encouraged.

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Borderline Personality Disorder with Infanticide and Denial of Pregnancy : A Case Report (영아살해와 임신거부증을 주소로 내원한 경계선 인격장애의 치료사례)

  • Jung, Semina;Paik, Ki Chung;Lee, Jun Hyung;Kim, Kyung Min;Doh, Jin Ah;Lim, Myung Ho
    • Anxiety and mood
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    • v.8 no.2
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    • pp.161-166
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    • 2012
  • Though infanticide, killing the baby after birth of the neonate and denial of pregnancy, are very rare psychiatric disorder, they have been receiving a lot of social concerns. We report and review infanticide and denial of pregnancy administration in a 19 year-old adolescent with bipolar disorder and borderline personality disorder. Patients with a young age, cognitive immaturity, an unwanted child, hid the pregnancy facts were consistent with the results of previous studies. In addition, the patient's impulsivity and emotional instability is affecting infanticide. After inpatient care with pharmacotherapy (escitalopram 20mg, alprazolam 1.5 mg, clonazepam 0.5 mg, valproate sodium 1,100-1,300 mg, and quetiapine 100-400 mg) and supportive psychotherapy, and there were significant improvement of clinical symptoms.