• Title/Summary/Keyword: 기질성 정신장애

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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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The Rate of Diagnostic Agreement and Concordance Ratings on Psychiatric Recommendation in Consulted Delirious Cases (자문의뢰된 섬망환자에 대한 진단 일치율과 정신과 의견의 반영도)

  • Oh, Eung-Seok;Nam, Jung-Hyun;Kim, Seok-Hyeon;Park, Yong-Chon;Kim, Sung-Mok
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.2
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    • pp.174-181
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    • 2001
  • Objectives : The author investigated the rate of diagnostic agreement between consultants and consultees and concordance ratings on the consultees' recommendation to examine the interactive collaborativeness and find the factors that influence the reflectiveness on treatment. Methods : The subjects were 54 patients with delirium selected from 583 cases referred from other departments who were admitted to Hanyang University Kuri Hospital from July 1, 1995 to Dec. 31, 1997. The information on demographic data, diagnostic impression, symptoms, management before consultation, psychiatric recommendation, management after consultation, diagnoses at the referring departments and the psychiatric department on delirium was obtained by medical records and consultation papers retrospectively. The reflectiveness of the psychiatric recommendation was divided into complete concordance, partial concordance, and nonconcordance and among them the complete and partial concordance were considered for concordance. The reflectiveness was compared among all the departments and between medical unit and surgery unit. Results: The rate of diagnostic agreement on the cause of delirium was highest(85.7%) in organic brain syndrome and lowest in general medical condition(0%). There was no statistically significant differences between medical unit and surgery unit. Neither differences were there among all the departments. In comparing symptoms affecting the reflectiveness, it was 73.5% in impulsive and aggressive behavioral changes, whereas 40.0% in behavioral changes. Reflectiveness of psychiatric recommendation showed higher scores in the case of behavioral changes. The cases of sleep problem showed higher scores of reflectiveness. When these two symptoms of behavioral change and sleep problem were compared as one factor, the results suggested that there were significant differences. The cases with both two symptoms showed 80% in reflectiveness, and the cases with only one symptom or no symptoms showed 44.8% in reflectiveness. There were no statistical significances between concordance ratings and symptoms such as disturbance of consciousness, disorientation, and hallucination that cannot be easily evaluated at the referring departments. Conclusions : The rate of diagnostic agreement on the cause of delirium was highest in the case of organic brain syndrome in which lesions can be easily recognized. The factors that influence the reflectiveness of psychiatric recommendation were behavior changes and sleep disorders in the symptoms of evaluated cases.

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THE DIFFERENCE OF TEMPERAMENT, GOODNESS OF FIT AND BEHAVIORAL PROBLEMS IN ADHD SUBTYPES OF ADOLESCENT HIGH RISK GROUP (청소년 ADHD 고위험군의 하위유형별 기질, 기질 적합성 및 문제행동의 차이 비교)

  • Park, Hae-Song;Choi, Eun-Ju
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.106-116
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    • 2005
  • Summary : This study was designed to identify the difference in temperament, parent-adolescent's goodness of fit and behavioral problems between early-adolescent high risk group which can be divided into subgroups (ADHD-I and ADHD-HI/C) and normal group. Method : Subjects of this study were students of a Boy's Middle School and their parents. ADHD high risk group was determined by using three rating scales of ADHD behavioral symptoms : 1. Korean-ADHD Rating Scale, 2. Abbreviated Conners Parents Rating Scale, 3. Conners-Wells' Adolescent Self-Report Scale. Final research was based on the subjects including 25 people in ADHD-I high risk group, 70 ADHD-HI/C high risk group, 70 in normal group. Revised Dimensions of Temperament (DOTS-R) was used for students to assess their temperament, while DOTS-R : Ethnology for parents to access environmental demands. Goodness of fit between parent and adolescent was figured out by results of the two scales. Korean Youth Self Report (K-YSR) was used to examine behavioral problems. Results : When it comes to temperament of adolescents, ADHD-HI/C high risk group was found to be associated with higher scores on general activity level. In contextual parent demand to adolescent, ADHD-HI/C parents showed higher level of demands in general activity than other groups, and lower expectation of positive mood than ADHD-I parents. In parent-adolescent's goodness/poorness of fit, the research found out that ADHD-I and ADHD-HI/C had lower level of fit on pesitive/negative mood than normal group and indicated that ADHD behavioral symptoms connected with poorness of fit in emotional relationship between adolescents and their parents. In behavioral problems, ADHD-HI/C high risk group had severe externalizing and internalizing problems distinctly. It had more severe in externalizing problems than ADHD-I, while there were no differences in internalizing problems between the two subgroups. Conclusion The two ADHD subgroups in high risk adolescents had differences on temperamental activity level and on goodness of fit about positive mood. In addition, they had different patterns in externalizing/internalizing problems.

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THE SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY FINDINGS IN DEVELOPMENTAL LANGUAGE DISORDERS (발달성언어장애아(發達性言語障碍兒)의 단일광자방출전산화단층촬영(單一光子防出電算化斷層撮影) 소견(所見)에 관한 연구)

  • Park, Jin-Seng;Cho, Soo-Churl;Lee, Myung-Chul
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.3 no.1
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    • pp.46-55
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    • 1992
  • The pathophysiology of developmental language disorder is a highly controversial matter. In order to investigate the neural mechanisms involved in developmental language disorders, the authors studied three dimensional regional cerebral blood flow(rCBF) using Tc-99mH-MPAO in 42 children with developmental language disorders. The results are summarized as follows : 1) 61.9% (26/42) of this series revealed decreased perfusion in SPECT. 2) Regions of hypoperfusion were seen in cerebral cortex(47.6%, 20/42), thalamus(33.3%, 14/42), basal ganglia(11.9%, 5/42) and cerebellum(7.1%, 3/42). This study suggests that developmental language disorder could be due to specific functional impairment of the local brain regions which could not detected by conventional investigations such as brain CT or EEG.

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Characteristics Involved in Internet Addiction Tendency of Adult Males with Attention Deficit/Hyperactivity Disorder (성인 남자 주의력결핍 과잉행동장애 환자에서 인터넷 중독 성향에 관여하는 특성)

  • Noh, Dong Hyun;Kim, Jun Won;Min, Kyung Joon;Lee, Young Sik;Kim, Bung Nyun;Cheong, Jae Hoon;Ahn, Jee Young;Han, Doug Hyun
    • Journal of Korean Neuropsychiatric Association
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    • v.53 no.3
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    • pp.154-161
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    • 2014
  • Objectives This study was conducted in order to investigate characteristics of temperament, depression, anxiety, attention, and impulsivity in adult males with Attention Deficit/Hyperactivity Disorder (ADHD) and internet addiction tendency. Methods The survey participants were 181 (121 patients and 60 healthy control subjects) adult males older than 19 years of age in Chung-Ang University Hospital and Gongju National Hospital. Subjects were divided according to ADHD with internet addiction tendency (AI), pure adults with ADHD (AD), and healthy control subjects (HC). All groups completed the Adult ADHD Scale (AADHD), Wender-Utah ADHD Rating Scale (WUADHD), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), the Korean Version of Young Internet Addiction Scale (YIAS-K), Barratt Impulsiveness Scale (BIS) and Temperament Character Inventory-Revised Short version for identification of relationship between ADHD and internet addiction tendency. Results AI groups were found to have higher AADHD, WUADHD, BDI, YIAS-K, and Novelty Seeking scores, compared to the AD and HC groups. The Cooperativeness score of the AI group was significantly lower than that of the AD group and HC group. The BAI and BIS scores of the AI group and AD group were significantly higher than those of the HC group. The Self-Directedness scores of the AI group and AD group were decreased, compared to the HC group. YIAS-K scores were partially related to BDI scores in the AI group. Conclusion The results of this study indicate an association of higher score of BDI with internet addiction tendency in adult patients with ADHD. Management of temperament characteristics, depression, anxiety, attention, and impulsivity may be important for adults with ADHD and internet addiction tendency.

The Temperament and Character Pattern of Korean Narcolepsy Patients (한국인 기면병 환자의 기질 및 성격 유형)

  • Choi, Jong-Bae;Lee, Yu-Jin;Kim, Seog-Ju;Lyoo, In-Kyoon;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.45-49
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    • 2005
  • Objectives: To compare the biogenetic temperament and character patterns of subjects with narcolepsy and those of healthy control subjects. Methods: Twenty-two subjects with narcolepsy, diagnosed with the International Classification of Sleep Disorder (ICSD) criteria, and 22 healthy control subjects were recruited. The Korean version of the Temperament and Character Inventory was administered to all subjects. Results: Compared to healthy control subjects, subjects with narcolepsy showed significantly higher Novelty-Seeking (ANCOVA, F=5.42, p=0.025), lower Persistence (F=8.41, p=0.006) and lower Self-Directedness scores (F=4.70, p=0.036). Conclusion: Narcoleptic patients have a distinct pattern of biogenetic temperament and character. Our findings suggest that narcoleptic patients are exploratory in response to novelty but give up easily. In addition, our findings show that narcoleptic patients consider themselves ineffective, purposeless, and fragile.

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A COMPARISON OF THE CHARACTERISTICS OF CHILDREN WITH TOURETTE AND CHRONIC TIC DISORDER ACCORDING TO THEIR BIRTH ORDERS (뚜렛 및 만성 틱 아동의 출생순위에 따른 특성 비교)

  • Kim, Ja-Sung;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.4 no.1
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    • pp.124-132
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    • 1993
  • We studied the clinical characteristics of 45 children with tic symptoms, and a comparison was made according to their birth order patterns. The results were as follows. Sex ration was 14:1 higher for boys. The eldest children were 46.7%, single children, 15.6%, the youngest children, 33.3%, and twins 4.4% of all Organicity was suggested in 37.8%, early developmental problems in 71.1%, and family problems were in 89.9%. Among the co-existing problems, ADHD 46.7%, OCD 17.7%, Separation anxiety disorder 24.4%, GAD or anxiety dreams 17.8%, somatization disorder and enuresis 13.3% each, stuttering 8.9%, and other conditions. Overall, 84.4% of the patients have one or more co-existing conditions other than tic symptoms. When compared according to birth order patterns, the most significant difference was the time of onset The youngests have more incidences around the entrance period for elementary school(p<0.01). Among the twins, the lower birth-weight child was the patient. Summing up these findings, we concluded there were significant environmental factors working on the manifestation of tic and tourette disorders.

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Association of the Symptoms of Parental Attention-Deficit Hyperactivity Disorder and the Parental Personality Patterns with the Symptoms of Boys with Attention-Deficit Hyperactivity Disorder (주의력결핍 과잉행동장애 남아의 증상과 부모의 주의력결핍 과잉행동 증상 및 인격 양상과의 관련성)

  • Shin, Woo-Seung;Choi, Hye-Ra;Kim, Kun-Woo;Lee, Joong-Sun;Park, Su-Bin;Hong, Jin-Pyo;Yoo, Han-Ik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.20 no.1
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    • pp.23-28
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    • 2009
  • Objectives : This study was conducted to investigate the association between the symptoms of boys with attention-deficit hyperactivity disorder (ADHD) and the attention-deficit hyperactivity symptoms, temperament and character patterns of their parents. Methods : Forty-five boys with ADHD and who met the DSM-IV criteria were evaluated by using the ADHD rating scale (ADHD-RS), and their parents completed the Korean Adult ADHD scale (K-AADHDS) and the Temperament and Character Inventory (TCI). Results : The parental K-AADHDS scores were not associated with the ADHD-RS total score and the subscale scores of their siblings. The most potent variable related to the ADHD-RS total score was the maternal self-directedness, and the second was the maternal persistence. The maternal self-directedness was the variable that was most correlated with the hyperactivity/impulsivity subscale scores of the ADHD-RS. Conclusion : The results suggest that the paternal ADHD symptoms may not be related to the ADHD symptoms of boys with ADHD. Higher maternal self-directedness and persistence may decrease overall the ADHD symptoms of these boys, and higher maternal self-directedness itself may predict lower hyperactivity/impulsivity symptoms of the boys with ADHD.

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MUSIC THERAPY FOR ADOLESCENTS WITH CONDUCT DISORDER (품행장애 청소년의 음악치료 사례연구)

  • Jhin, Hea-Kyung;Kwon, Hea-Kyung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.110-123
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    • 2000
  • The short-term music therapy was performed for adolescents with conduct disorder admitted to Seoul National Mental Hospital for 3 months from Jun to September, 1998. This case study focused mainly on two female patients who participated regularly in the group music therapy. The music therapy process was divided into three phases;beginning, opening up, and closing. This music therapy session consisted of three parts;hello song as beginning, various musical activities, and sound & movement activity as closing. Free musical improvisation, song discussion, musical monodrama, and sound & movement were the mainly applied techniques. Free improvisation was used to enhance, motivate, identify and contain the adolescents' feelings and ideas. Song discussion was used to convey their thoughts and to support each other. Musical monodrama was used to make them have insights into interpersonal relationships. Sound & movement was used to enhance spontaneity. It made them explore their body and voice as an expressive medium. Throughout three months period of music therapy, patient A's communication skill, socialization, and behavior areas were assessed with improvement. She could use music as a symbolic form and was able to share her feelings about herself and her family. Patient B's self-expression and cognitive areas were assessed with improvement. She became more spontaneous and could verbalize her emotions during the group session. Music as a non-verbal and therefore often a non-threatening medium wherein so much can be expressed provided two female patients an atmosphere where a sense of trust may be regained.

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SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY FINDINGS IN TOURETTE'S AND CHRONIC MOTOR TIC DISORDER (뚜렛씨병과 만성틱장애의 단일광자방출전산화단층촬영 소견에 관한 연구)

  • Cho, Soo-Churl;Lee, Myung-Chul;Kim, Ja-Sung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.4 no.1
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    • pp.68-78
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    • 1993
  • The pathophysiology and neural mechanism involved in Tourette's and chronic motor tic disorder are highly controversial. In order to investigate the functional abnormalities of brain. In Tourette's and chronic motor tic disorder, 42 children with Tourette's and chronic motor disorder underwent single photon emission computed tomography(SPECT) using Tc-99m-HM-PAO. The results are summarized as follows : 1) 31.0% (13/42) of this series revealed perfusion defect in cerebral cortex. 2) 4.8% (2/42) revealed perfusion defect in basal ganglia. 3) 4.8(2/42) revealed perfusion defect in thalamus. 4) 16.7%(7/42) showed perfusion defect in cerebellum. 5) The frequency of abnormal perfusion showed no significant difference between tic with and without attention deficit hyperactivity disorder. 6) The frequency of abnormal perfusion showed no significant difference between Tourette's and chronic motor tic disorder. These findings support the hypothesis of a possible involvement of brain dysfunction in the production of Tourette's and chronic motor tic disorder, and quantification of blood flow and co-registration with magnetic resonance imaging will increase the validity of this study.

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