• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.1
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• pp.368-378
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• 2018

This study examined the relationship between hostility and obsessive-compulsive symptoms to clarify the differential role of overt hostility and covert hostility on obsessive-compulsive symptoms. In addition, this study examined whether impulsivity has a moderating effect on the relationship between hostility measures and obsessive-compulsive symptoms. The Buss Durkee Hostility Inventory (BDHI), Revised Obsessive Compulsive Inventory (OCI-R), and Barratt Impulsivity Scale (BIS) were used to measure hostility, obsessive-compulsive symptoms, and impulsivity, respectively. Data were collected from 150 online university students and analyzed using the correlation and moderated multiple regression model. The result showed that overt hostility was positively correlated with obsessive thoughts; covert hostility was positively correlated with obsessive thoughts and compulsive behavior. In addition, the regression results, which set the hostility variables as the predicting variable, revealed covert hostility to increase obsessive thinking and compulsive behavior, whereas overt hostility had no significant effect on both variables. Impulsivity was found to function as a moderator in the prediction of covert hostility on obsessive thought. With the result, the implications and limitations of this study are discussed.

• Korean Journal of Biological Psychiatry
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• v.8 no.2
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• pp.271-275
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• 2001

Hyposexuality after stroke has been frequently observed, but hypersexuality as a sequela of stroke has not been commonly documented. We report a patient who exhibited hypersexuality and obsessive-compulsive behaviors after stroke in the region of the left mesial frontal cortex and both basal ganglia. At 2 months after stroke, he visited psychiatric unit due to these symptoms. His motor function was almost full recovered. He was treated with fluvoxamine and perphenazine. With two-month medication, his hypersexuality and obsessive-compulsive behavior disappeared. This case may indicate that basal ganglia-thalamocortical circuit plays an important role in the mediation of sexual behavior and obsessive-compulsive behavior. Since changes in sexual activity may not be spontaneously reported, a systemic inquiry into patient's sexual functioning after infarction in frontal lobe or basal ganglia is warranted.

• Korean Journal of Psychosomatic Medicine
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• v.31 no.2
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• pp.142-148
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• 2023

Objectives : The purpose of this study is to investigate the relationships between premonitory urge, tic severity, and comorbidities in children and adolescents with chronic tic disorders. Methods : In this study, scales for tic symptoms, premonitory urge, obsessive-compulsive symptoms, and ADHD symptoms were repeatedly measured twice in 26 children and adolescents aged 10 to 18 years with chronic tic disorders. Correlations between scales were confirmed through repeated measures correlation analysis, and causal relationships between scales were confirmed through regression analysis using a linear mixed model. Results : The degree of premonitory urges showed a significant positive correlation with the severity of tic symptoms, the severity of obsessive-compulsive symptoms, and the severity of ADHD symptoms. The ADHD symptoms showed a significant positive correlation with the severity of tic symptoms. These results were the same even in children and adolescents with tic disorders who were not diagnosed with obsessive-compulsive disorder. Additionally, premonitory urges were found to have a significant positive effect on the severity of tic symptoms. Conclusions : These results may be helpful in treating tic disorders and can be used in future tic disorder research considering developmental trajectory.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.2
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• pp.209-217
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• 1998

Object：The purpose of this study was to investigate that infection with group $A[{\beta}]$ hemolytic streptococcus may associate the mechanisms that cause or exacerbate the tic symptoms in some cases of Tourette's disorder Method：Fourteen cases with abrupt worsening of tics participated in this study：10 males,4 females. The subjects were divided into two groups composing of the group with increasing level of ASO titer and the group with normal level of ASO titer. The subjects were administered Yale Global Tic Severity Scale(YGTSS). Result：The global severity scores and overall TS impairment rating scores of YGTSS in the group with increasing level of ASO titer were more higher than in the group with normal level of ASO titer Conclusion：These results suggest that increasing level of ASO titer, resulting from group $A[{\beta}]$ hemolytic streptococcal infection has affected worsening the tic symptoms in Touette's disorder.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.11 no.1
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• pp.124-143
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• 2000

Objectives：The primary purpose of this study is to understand the psychopathology of the victims of school violence in terms of early psychosis. By doing this, the early detection of psychosis among the victims is possible, and early detection may lead to early intervention. Methods：Two-thousand and nine-hundred seventy two students from 16 middle schools in Seoul were asked to fill out questionnaire comprised of popularity and intellectual and school status of Piers-Harris Children's Self Concept Inventory, Symptom Check List-90-Revised, and Ostracism Scale. The subjects whose scores upon Ostracism Scale were higher than average by two standard deviation were labeled as ‘Repelled and Isolated group', and subjects whose scores on popularity were significantly lower than average and whose scores on psychoticism of SCL-90-R were higher than average were defined as 'tentative early psychosis group'. Odds ratios were calculated from the numbers of subjects with and without high psychoticism scores and high ostracism scores. On the subjects of 'tentative early psychotic group', we examined every clinical characteristic and conducted correlation analysis and regression analysis in order to find out the risk factors and to construct theoretical model that explains the psychoticism scores. Results：The results were as follows：1) Total 157(5.3%) subjects were rated significantly higher on ostracism scale, and among them, 47 subjects(29.9%) were rated significantly higher than average on psychoticism scale, while only 50 subjects among 2,135 students who were rated within normal range showed significantly higher score on psychoticism scale. Odds ratio for psychotic group of isolated group were 17.82 and it was statistically significant. 2) Forty-seven subjects(31 boys, 16 girls) who were rated as they were unpopular and rejected from peers had significantly higher psychoticism scores. They were not significantly different from simply high psychoticism subjects in anxiety, social anhedonia scale, magical thinking, obsessivecompulsive symptoms, phobic anxiety, psychoticism, somatization, but showed higher ostracism scores and paranoid tendencies. Among school violence victims, who rated themselves unpopular and showed higher psychoticism scores, the psychoticism scores were mainly explained by anxiety, depression, hostility, interpersonal sensitivity, obsessive-compulsive symptoms, paranoid tendency, somatization scales($r^2=0.93$). Conclusion：Thus, it can be concluded that the subjects with higher ostracism score have the substantially high risk for psychosis development. By these results, we propose that school violence victims with anxiety, depression, hostility, interpersonal sensitivity, obsessive-compulsive symptoms, paranoid tendency, somatization should be tested individually considering school adjustment, attentional deficit, concept formation problems.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.1
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• pp.92-100
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• 1997

Objective：The objective of this study is to examine the clinical characteristics and behavioral comorbidity of patients with Tourette’s disorder. Method：Subjects consisted of 157 patients with Tourette’ disorder diagnosed by DSM-IIIR, who were examined and diagnosed from Jan. 1988 to May 1994 at the Tourette’s Clinic of Yonsei University Medical Center. Characteristics and behavioral comorbidity of Patients were assessed by a semi-structured interview schedule. Behavioral problems like hyperactivity, obsession-compulsion, self destructiveness, enuresis, sleep problem were assessed by global clinical impression. Results：The mean age of patients was 14.49(${\pm}7.99$) years. Patients consisted of 138 males (87.9%) and 19 females(12.1%). The sex ratio was 7：1, showing a male preponderance. The number of right-handers was 133(84.7%), and the number of non-right handers was 24(15.3%). Mean age of onset was 8.85(${\pm}4.56$) years, ranging from 2-to-16 years. More than half of the patients had their age of onset at 6-10 years. Bimodal peak in age of onset was observed；the first peak was around 6 and the second peak was around 10 years. There was no sex difference in bimodal age of onset. The most common initial symptom was eye blinking. More than 55% of patients reported eye blinking as their first symptom. The second common initial symptom was head turning and the third was vocal tic. The most common symptoms that patients reported on their first visit since onset were eye blinking(82.2%), head turning or nodding(57.9%), shoulder shrugging(52.7%) and forearm movement(32.6%). Of 157 cases, 101(64.3%) patients showed downward progression of symptoms, and 25(15.9%) showed upward progression of symptoms. Nineteen fathers(12%) of patients had a past history of obsessive-compulsive disorder(OCD). Seventeen fathers(10.6%) had a history of tic disorder. SSevenmothers(4.5%) had OCD, 4 mothers (2.5%) had tic disorder. One hundred and eighteen patients(75.1%) had comorbid hyperactivity, 95 patients(60.5%) had obsession, 55 patiens(35.0%) had self destructiveness, 46 patients(29.3%) had impulsivity, and 35 patients(22.3%) had enuresis. Age of onset had a significant positive correlation with age, duration, and the global severity of obsession；and a negative correlation with the severity of hyperactivity. Hyperactivity had a significant positive correlation with impulsivity, obsession-compulsion, enuresis, and self destructiveness. Obsession-compulsion had a significant positive correlation with hyperactivity, sleep problems, and self destructiveness. Conclusion：These data suggest that clinical characteristcs and behavioral comorbidity of patients with Tourette’ disorder in this study are similar to previous research findings in Korea and other contries. The younger the age of onset was, the more severe hyperactivity was, and the less severe obsession-compulsion was. And severity of hyperactivity had a positive correlation with the severity of obsession-compulsion, impulsivity, enuresis, and self destructiveness.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.15 no.2
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• pp.143-151
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• 2004

Objectives : Child and adolescent onset obsessive compulsive disorder(C-OCD) is known to be associated with poor drug response, high comorbid rate and strong genetic tendencies. Till now studies for C-OCD have been very rare in Korea. We conducted this study to investigate the informations about clinical features, familial psychiatric loading, treatment profiles and course of server C-OCD from the retrospective analysis of inpatient data of Seoul National University Children's Hospital. Method : Retrospective chart review and data analysis was performed. Twenty(male 16 : female 4) patients with final C-OCD diagnosis by DSM-IV at discharge from 1994 to 2002 were found and their medical chart, psychological data, family interview data and nursing reports were collected and analyzed. Results : 1) The sex ratio of C-OCD was male dominant(4:1). 2) Phenomenological, most common obsession was pathologic doubt, contamination fear, followed by aggressive obsession, need for symmetry, sexual obsession, most common compulsion was checking and washing, followed by breathing, movement, symmetry, repetitive asking, hoarding, mental compulsion. 3) Most common comorbid diagnosis was depression. Other axis-I diagnosis associated OCD were anxiety disorder, tic disorder, conduct and oppositional defiant disorder and psychosis. 4) Regarding psychiatric familial loadings, 17 patients(85%) had relatives with psychiatric disorders, OC-spectrum disorders(OCD or OCPD) were found in 9 patients(45%). 5) The majority of patients(75%) have received SSRI and antipsychotics treatment. The response rate above 'moderate improved" by CGI was 75%. 6) During follow-up period in outpatient clinic, five patients(25%) showed continuous complete remission, 10 patients (50%) did residual symptoms with chronic course. Conclusion : This seems to be the first systemic investigation of severe pediatric OCD patients in Korea. The children & adolescents with severe OCD in inpatient-setting showed the high comorbid rate, familial psychiatric loading, and combined pharmacotherapy with antipsychotics, As for symptoms, high rate of aggressive-sexual obsession and atypical compulsions like breathing and moving was reported in this study. Severe pediatric OCD patients, however, responded well to the combined SSRI and antipsychotics regimen.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.1
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• pp.98-104
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• 1998

A 12-year-old girl with a 6 year history of childhood-onset schizophrenia required 2 hospitalizations and long-term clozapine trial due to inadequate responses to combinations of typical neuroleptics and traditional treatments of schizophrenic disorder. On admission, she had continuous auditory and visual hallucinations, persecutory delusion, emotional instability, regression of behaviors including temper tantrums as well as specific developmental delays in learning, language, and motor coordination. The clozapine trial significantly reduced most of the positive symptoms, and facilitated in successful discharge from the hospital. During the 4 year clozapine treatment, no significant adverse reactions were noted, and she returned to a structured school setting with minimal degrees of schizophrenic symptoms. From this clinical experience, we suggest that clozapine might be safe and effective in treating treatment-refractory schizophrenic children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.1
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• pp.149-156
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• 2001

After the fact that obsessive-compulsive symptoms or tic symptoms are common in Sydenham's chorea which is a sequale of rheumatic fever produced by group A beta-hemolytic streptococcus was reported, the association between group A beta-hemolytic streptococcus and a subgroup of obsessivecompulsive disorder(OCD) or tic disorder has been attentioned. This subgroup shared a unique clinical course, characterized by an abrupt onset of symptoms and/or dramatic exacerbations. And this subgroup was distinguished by pre-pubertal onset of symptoms, neurological abnormalities(choreiform movements and a unique pattern of motoric hyperactivity), as well as by relapsing and remitting symptom course. Acronym PANDAS(pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection) was used to denote a subgroup of OCD or tic disorder patients with these clinical characteristics. Then, there was a report suggesting that PANDAS category include some of attention-deficit/hyperactivity disorder(ADHD) and were two case reports of anorexia nervosa and body dysmorphic disorder with characteristics of PANDAS. This case is a patient who developed normally until age of 7, but after pharyngeal inflammation with high fever, he showed disturbance of cognition, social relationship, and language and communication, as well as tic symtoms and abnormal movement on face, hand, and foot. We report this case with review of literatures, because we think that this case belongs to the PANDAS category. Based on this observation, we suggest that PANDAS category include some of childhood disintegrative disorder as well as OCD, tic disorder, and ADHD.

• Trans-
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• v.16
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• pp.69-105
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• 2024

The House that Jack Built (2018), a film about how the protagonist Jack is reborn as a "mad artist" with psychotic symptoms during a 12-year killing spree, provides an interesting opportunity to analyze the film in terms of psychoanalysis and religion. Jack, an engineer who suffers from OCD, finds pleasure in the accidental murder of a character and considers killing people as an art form, overcoming his OCD in the process. The question we are interested in is whether the symptoms of OCD are truly overcome by the act of repeated killing. The idea is that Jack's OCD is not overcome by killing, but rather that the symptoms disappear as he moves from neurosis to a stabilized psychotic state. According to the theory of the famous French psychoanalyst Lacan, the hallucinations or delusions that human subjects experience when they lose their realistic stability are a phenomenon that occurs when they are confronted with The Real, which penetrates through the cracks of the symbolic system. Phenomena such as Jack's illusory reality and delusions in the movie are pathological symptoms of the absence of a paternal figure in his life, causing the Name-of-the-Father to fail to take hold. This paper deciphers the psychotic structure of Jack, the protagonist of Lars von Trier's House of Jack, through Lacanian psychoanalysis.