• Title/Summary/Keyword: 공존병리

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COMORBIDITY AND RISK FACTORS ASSOCIATED WITH CHILDREN WHO HAVE THE SYMPTOMS OF OPPOSITIONAL DEFIANT DISORDER - COMMUNITY BASED STUDY - (반항성 도전 장애 아동과 연관된 공존 증상 및 위험 요인에 관한 연구 - 지역사회 연구 -)

  • Kim Boong-Nyun;Jung Kwang-Mo;Cho Soo Churl;Hong Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.79-89
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    • 2005
  • Objectives : To acquire an improved understanding of oppositional defiant disorder, we evaluated the characteristics of children who have the symptoms of ODD in community sample. Methods : 1200 children from an elementary school in Bucheon (an urban community near Seoul) were recruited by randomized sampling method. By Disruptive Behavior Disorder Scale according to DSM-III-R & DSM-IV, we evaluated the symptoms of ODD and selected subjects with ODD. Psychiatric comorbidity, character trait were compared in subjects with ODD and comparison group. Also we examined the association between prenatal/perinatal risk factors, family functions and the symptoms of ODD. Data were analyzed by appropriate statistical method using SPSS 11.5 window version. Result : Children with oppositional defiant disorder were revealed to have significantly higher rates of psychiatric comorbidity and significantly greater family dysfunction compared to comparison group. Among the prenatal/perinatal risk factors, severe emotional stress during pregnancy, postpartum depression, medication during pregnancy were revealed as risk factors of ODD. In character inventory, ODD group were evaluated to have high score in novelty seeking, harm avoidance, but low in reward dependency. Conclusion : These results support that 1) prenatal/perinatal and psycho-social risk factors could be a important role in the progression of ODD, and 2) children with ODD have diverse comorbid psychiatric symptoms.

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Attention in Child Psychiatry (소아정신과 장애에서 주의력의 문제)

  • Shin, Min-Sup
    • Sleep Medicine and Psychophysiology
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    • v.5 no.2
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    • pp.134-154
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    • 1998
  • This paper first reviewed the definition, criteria, and neurological theories concerning the etiology of AD/HD, and the empirical studies dealing with the comorbidity of AD/HD with other psychiatric disorders. Secondly, results of studies using various neuropsychological tests for assessing the cognitive and behavioral problems in AD/HD children were examined, which suggest the possibility that dysfunction may exist in neural pathways involving many areas of the brain in AD/HD. However, because most of neuropsychological test used in Korea for ADHD children had been developed abroad, further study involving AD/HD, normal control, and other psychiatric control groups is needed to obtain developmental norms for interpreting the results, and to make more accurate diagnosis, and to clarify comorbidity of AD/HD with other disorders.

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A Trend in Pharmacotherapy for Inpatients with Posttraumatic Stress Disorder at a Single University Hospital (일 대학병원에서 외상 후 스트레스장애 입원환자의 약물 치료 경향)

  • Min, Jung-Ah;Jung, Young-Eun;Seo, Ho-Jun;Bahk, Won-Myong;Jun, Tae-Youn;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.4 no.1
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    • pp.42-48
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    • 2008
  • Objective : Due to a better understanding of the pathophysiology of posttraumatic stress disorder (PTSD) and the relative limitations in the treatment of patients with PTSD, a variety of medications and treatment algorithms for PTSD have been investigated. This study was conducted to investigate the trends in the pharmacotherapy used in the treatment of inpatients with PTSD at a single university hospital in Korea. Methods : Data from 75 patients diagnosed with PTSD according to the DSM-IV criteria from January 1998 to December 2007 were collected. Demographic data and clinical data, including medications prescribed, were investigated. Results : Thirty-three of the 75 subjects included in this study were male, and 42 were female. Considering psychiatric comorbidity, depressive disorder, cognitive disorder, psychotic disorder and anxiety disorder were reported in order. Approximately 97% of the subjects were treated with antidepressants, including paroxetine in 54.7%, and 24% of the subjects were treated with two different kinds of antidepressants. In addition, atypical antipsychotics were prescribed in 33.3% of patients, mood stabilizers in 17.3%, and anxiolytics in 94.7% of the subjects. Conclusion : In our study, various kinds of antidepressants were prescribed for most patients with PTSD. Antipsychotics and mood stabilizers were added to the treatment regimens of some subjects, and anxiolytics were added to the treatment regimens of most subjects. Despite its many limitations, this study shows the prescription pattern and trends in PTSD treatment in Korea. We hope that these preliminary data would be helpful for the development and integration of a practical guideline for the treatment of PTSD in Korea.

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THE COMORBIDITY AND EMOTIONAL STATE OF THE ENURETIC CHILDREN (유뇨증 소아의 공존질병 및 정서상태)

  • Lee, Kyu-Kwang;Shin, Yun-O;Lee, Tae-Yong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.1
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    • pp.34-42
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    • 1997
  • Enuresis is repeated involuntary or intentional voiding of urine into bed or clothes over age 5. Though it would be a self-remitting disorder, it could be serious problem in emotional and socio-adaptational aspects. The author reviewed the enuretic patients of Child & Adolescence psychiatric section in Chungnam National University Hospital during past 3 years. 46(4.9%) of 936 patients were diagnosed as enuresis in DSM-Ⅳ. The author evaluated their comorbidity by the data of diagnostic review made in two psychiatrists, and emotional aspects(self-concept, anxiety, depression) through the self-rating scales (Piers-Harris children’ self concept scales, RCMAS, state-trait anxiety inventory for children, child’s depresson inventory). Thirty(65.2%) of the 46 enuretic patients had additional diagnoses such as attention deficit hyperactive disorder, mental retardation, encopresis, oppositional defiant disorder, depression, anxiety disorder, autism, somatoform disorder, tic disorder, obsessive-compulsive disorder, sleep disorder, etc. Sixteen enuretic patients had at least one comorbid disorder. Eleven patients had two, and three patients had more than three. Fourteen of 46 enuretic patients were evaluated through self-rating scales of self-concept, anxiety and depression. But we couldn’t obtain meaningful results. Maybe it was due to the small sample size(N=14) and the influence of the comorbid disorders. Finally, it was an impressive evidence that there exist many comorbid disorders in enuresis(esp. attention deifict/hyperactive disorder). In emotional aspects, the author thought that further evaluation should be needed for more meaningful results.

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AUTISTIC DISORDER AND OTHER PERVASIVE DEVELOPMENTAL DISORDER : NEURODEVELOPMENTAL PATHOLOGY (자폐 장애 및 기타 전반적 발달장애 : 신경발달학적 병리 소견)

  • Cheon Keun-Ah;Jung Chul-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.2
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    • pp.153-159
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    • 2005
  • Autistic disorder and other PDD are currently viewed as a largely genetically determined neurodevelopmental disorder, although its underlying biological causes remain to be established. In this review, we examine the available neurodevelopmental literature on autistic disorder and discuss the findings that have emerged. Typical neuropathological observations are rather consistent with respect to the limbic system (increased cell packing density and smaller neuronal size), the cerebellum (decreased number of Purkinje cells) and the cerebral cortex ($>50\%$ of the cases showed features of cortical dysgenesis). However, most of the reported studies had to contend with the problem of small sample sizes, the use of quantification techniques, not free of bias and assumptions, and high percentages of autistic subjects with comorbid mental retardation or epilepsy. Furthermore, data from the limbic system and on age-related changes lack replication by independent groups. It is anticipated that future neuropathological studies held great promise, especially as new techniques such as design-based stereology and gene expression are increasingly implemented and combined, larger samples are analysed, and younger subjects free of comorbidities are investigated.

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CLINICAL CHARACTERISTICS OF CHILD AND ADOLESCENT PSYCHIATRIC INPATIENTS WITH PERVASIVE DEVELOPMENTAL DISORDER (입원한 전반적발달장애 소아청소년의 임상특성)

  • Pyo, Kyung-Sik;Bahn, Geon-Ho;Hong, Kang-E;Park, Tae-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.2
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    • pp.237-246
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    • 1998
  • Objectives and Methods:This study investigated clinical characteristics, treatment modality, outcome of 57 children and adolescent inpatients(male 53, female 4) who were diagnosed as pervasive developmental disorder(PDD) by DSM-Ⅳ criteria recent five years. Results:1) The mean age at admission was $96{\pm}28.2$ months, and the mean age at which they first visited treatment facility was $52{\pm}26.6$ months. The mean hospitalization period was $43.7{\pm}31.3$ days. 2) Diagnosis:Twenty-seven(47.4%) of subjects met DSM-Ⅳ criteria for PDD NOS. Fifteen (26.3%) met for autistic disorder, nine(15.8%) met for Asperger's syndrome, and two(3.5%) met for childhood disintegrative disorder. 3) Comorbid diagnosis:The most common comorbid dignosis was attention deficit hyperactivity disorder(23.8%). 4) IQ test:IQ test for twenty-eight subjects was possible. The Average of the subjects was $70{\pm}27.5$. Fifteen(53.6%) of the subjects were approximate or under 70. 5) Neurology Abnormality:EEG findings of eleven(21.2%) subjects were abnormal, brain CT or MRI findings of eight subjects(21.6%) were abnormal. 6) Family Hx:Depressive disorder were found in Eight mothers(14%). Familial loading was found in twenty families(35.1%), and familial loading of PDD was found in three(5.3%). Conclusion:The most important thing for the management of PDD is early detection and early treatment. To do so, multidisciplinary team approach should be emphasized.

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A PRELIMINARY STUDY OF CHILDREN WITH LEARNING DISORDER IN KOREA (한국에서의 학습장애 아동에 대한 예비적 연구 - 종합병원 학습장애 특수 클리닉 내원 아동을 중심으로 -)

  • Kim, Seung-Tai;Kim, Ji-Hae;Hong, Sung-Do;Joung, Yoo-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.2
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    • pp.247-257
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    • 1996
  • This is a preliminary report on the first segment of a continuing and prospective teaming disorder study project in Korea. Study subjects were 197 children, aged between 6 and 15 referred for psychiatric evaluation of scholastic problems. Demographic data, psychiatric diagnoses and intelligence and achievement test results were reviewed and analyzed. Analyses of data lead to the following conclusions : (1) About 20.8% of children referred for scholastic problems were diagnosed of teaming disorder(LD). The most prevalent diagnosis among these children with scholastic problem was emotional disorder, especially depressive disorder(33%), (2) The comorbid rate of attention deficit/hyperactivity disorder(ADHD) of 41 children with LD was 44%, (3) Male/female ratio was 5.8:1 among all of the LD children, 17:1 among children with LD and ADHD and 3.6:l among children with LD but without ADHD, (4) 83% of children with LD scored above middle level on socioeconomic status(SES), (5) Age, SES, IQ, family psychiatric history, past history of medical and psychiatric illness, onset of age, pattern of peer relationship, number of friends, presence of adaptation problem and academic achievements of children with LD and ADHD compared to those of children with LD but without ADHD. No significant differences between two groups were found on age, SES, IQ, family psychiatric history, past history of medical and psychiatric illness, pattern of peer relationship, number of friends and presence of adaptation problem. However, there were significant differences in academic achievements of Korean language total, speaking and listening score, arithmetic score, social science score and music score of children with LD and ADHD compared to those of children with LD but without ADHD. Also there was an ealier onset of age in LD and ADHD group when compared to LD but without ADHD group.

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Clinical Characteristics of Korean Male Patients with Eating Disorders (남성 섭식장애 환자의 섭식장애 병리의 특징)

  • Kim, Sung-Soo;Im, Su Geun;Hwang, Boin;Kim, Youl-Ri
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.185-192
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    • 2017
  • Objectives : The aims of present study was to investigate clinical characteristics of male patients with eating disorders. Methods : The present study included 32 male patients with eating disorders and 75 female patients with eating disorders, recruited from an eating disorders specialized clinic in a university hospital, Seoul, Korea. We compared clinical characteristics of eating disorders and comorbid conditions of depression and anxiety between men and women with eating disorders. Correlations between eating disorders psychopathology in men with eating disorders and their weight suppression(WS) were investigated. Results : There was no difference in age at presentation, age of onset, illness duration, and body mass index at presentation between genders. Male patients with eating disorders had higher rates of premorbid overweight or obesity than female patients with eating disorders had. WS in the male patients was associated with the severity of their eating disorders. Conclusions : The present study provides grounds for improved understanding for clinical features of eating disorders in males.

CLINICAL CHARACTERISTICS OF CHILDREN AND ADOLESCENTS WITH CONDUCT PROBLEMS ADMITTED INTO A PSYCHIATRIC UNIT (소아정신과 병동에 입원한 품행장애 소아 청소년의 임상 특성)

  • Pyo, Kyung-Sik;Kang, Yun-Hyong;Bahn, Geon-Ho;Cho, Soo-Churl;Lee, Eun-Jung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.2
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    • pp.227-236
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    • 1998
  • Objectives:Conduct disorder is one of the most frequent diagnosis in outpatient and inpatient mental health facilities for children and adolescents. This study investigated the clinical characteristics of children and adolescents with conduct disorder. Methods:The study employed a retrospective review of 45 inpatients diagnosed with conduct disorder by DSM-IV criteria at SNUH Child Psychiatric Unit from 1993, March to 1998, September. Results:The results were as follows:1) The sex ratio was 2:1, male dominant. Mean age on admission was $12.8{\pm}2.4$ years old(male:$12.2{\pm}2.3$, female:$14.1{\pm}2.1$). The mean age of male subjects was significantly lower than that of female subjects(p<.05). 2) We classified all subjects according to child- or adolescent-onset type by DSM-Ⅳ. Childhoodonset type was 42.2%, and adolescent-onset, 57.8%. The onset of male subjects were significantly earlier than that of female subjects(p<.05). 3) The most common complaint was 'serious violation of rules'(77.8%) by DSM-Ⅳ dimensions, while the most common single symtom was 'run away from home overnight at least twice while living in parental or parental surrogate home'(48.9%). 4) The comorbid psychopathology of the subjects were frequently described as follows, in order of frequency:substance use(42.2%), ADHD(35.6%), depression(20.0%), tic disorder(11.1%), bipolar disorder(4.4%). 5) On MMPI, both Pd and Ma subscales got the highest scores. The mean of total IQ by KEDIWISC was $100.0{\pm}15.1$. Female subjects' IQ was higher than that of male subjects. 6) Regarding the number of visits to the OPD after discharge, many subjects(33.3%) had visited OPD fewer than four times. Conclusions:In this study, the male to female ratio of adolescent type showed a decreasing trend. An interesting finding was the fact that socio-economic circumstances, as well as the level of education among patients, were higher than those of previous studies. The subjects' problem were also principally self contered and posed no threat to others.

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Endobronchial Leiomyoma Combined with Pulmonary Sequestration -A case report - (폐격리증을 동반한 기관지 내 평활근종 -1예 보고-)

  • Lee Seock-Yeol;Oh Jae-Yoon;Lee Seung-Jin;Lee Cheol-Sae;Lee Kihl-Rho;Cho Hyun-Deuk
    • Journal of Chest Surgery
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    • v.39 no.7 s.264
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    • pp.556-560
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    • 2006
  • A 42-year-old female was admitted to our hospital complaining of a dyspnea. Chest X-ray showed left atelectasis. A mass was detected in left main bronchus by computed tomography and bronchoscopy. The mass was diagnosed as a endobronchial leiomyoma by biopsy exam. After open thoracotomy and bronchotomy, mass removal was done and middle lobe was ventilated normally. Aberrant arterial supply from descending aorta to left lower lobe of the lung was detected and left lower lobectomy was done. The lower lobe of the left lung was pathologically diagnosed as intralobar pulmonary sequestration. Herein we report a rare coexistent case of endobronchial leiomyoma and intralobar pulmonary sequestration.