• Title/Summary/Keyword: 소아정신장애

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A CASE-ANALYSIS OF THE PSYCHIATRIC SEQUELAE IN ADOLESCENTS VICTIMIZED BY SCHOOL VIOLENCE (학교폭력 피해 청소년의 정신의학적 후유증에 관한 사례 연구)

  • Yook, Ki-Hwan;Lee, Ho-Bun;Noh, Kyung S.;Song, Dong-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.2
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    • pp.232-241
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    • 1997
  • The psychological problems following the experiences of school-violence could be more important than the physical problems. Victims could suffer from fear, depression, anger, lowered self-esteem, suicidal thought, and personality changes. To study the risk factors for school violence and the psychiatric problems after the experiences to school-violence provide us important informations to prevent and solve the problems of school violence. We examined clinical characteristics and psychosocial backgrounds of 13 adolescents who visited the psychiatric clinic after exposures to school violence from September, 1996 to May, 1997. The clinical data included intensity, motivations, durations, and methods of violence, psychiatric symptoms following exposure, findings of psychological test, and treatment course. The socioeconomic data included developmental characteristics of subjects, family characteristics, school life, and peer relationships. Of the 13 adolescents who experienced exposure to violence, 8 have experienced chronic psychiatric disturbances, 5 experienced transient psychiatric symptoms such as anxiety, depression, suicidal attempt who eventually returned to home and school life. Of the 8 adolescents who experienced chronic psychiatric disturbances, 4 experienced PTSD and depression lasting 3-6 months more, otherwise 4 showed converted features, such as aggressive behavioral disorder or perpetrator by strong compensatory effects after psychological shock. The subjects who have experienced chronic psychiatric disturbance have clinical characteristics such as physical or emotional abuse, physical illness or handicap, defects of ego functionings, and lack of family support. In summary, victims by school-violence manifested serious psychiatric disturbances, and they had clinically significant risk factors and some of them became perpetrators of school-violence.

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NEUROPSYCHOLOGICAL ASSESSMENT OF CHILDREN WITH ATTENTION DEFICIT/HYPERACTIVITY DISORDER (주의력결핍/과잉운동장애 아동의 신경심리학적 평가)

  • Shin, Min-Sup;Park, Suzanne
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.2
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    • pp.217-231
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    • 1997
  • This paper first reviewed the current neurological theories concerning the etiology of ADHD and secondly, examined results of studies that applied neuropsychological assessment methods in the examination of ADHD children both here in Korea and abroad. ADHD children were found to exhibit characteristic responses indicating deficits in vigilance, sustained attention, distractibility, allocation and regulation of attention in many assessments of attention, in addition to deficits in executive functioning, working and associative memory. Such neuropsychological assessment results suggest that in addition to dysfunction in the frontal lobe and the reticular activation system, dysfunction may exist in other neural pathways involving many areas of the brain. However, because a substantial number of neuropsychological assessment tools being employed in Korea for ADHD children had been developed abroad, a Korean standardization project involving ADHD and normal control children, in addition to other child psychiatric population pools must be conducted in order to obtain appropriate age norms and test validity, and in order to make possible a more accurate and precise comparison and interpretation in the assessment of ADHD children.

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THE TREATMENT RESULTS OF A DAY TREATMENT PROGRAM FOR CHILDREN WITH DEVELOPMENTAL DISORDERS (발달 장애 아동에게 시행된 주간 치료실 프로그램의 치료 결과에 대한 고찰)

  • Kwak, Young-Sook;Kang, Gyung-Mi;Lee, Hae-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.100-109
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    • 2000
  • Objective:This was conduced to evaluate the effect of early intervention to promote the development of children with developmental disorders. Methods:49 children(31 in PDD group and 18 in DLD group) participated in a one year day treatment program conduced from 1996 to 1999. They were performed PEP, CARS, and SMS. They were grouped by diagnosis, comorbidity, chronological age and CARS score at the beginning of the program and the treatment effect was compared. Results:The children who participated in the day treatment program showed significant increase in their PEP, SMS score, and decrease trend in their CARS score. When children were grouped by diagnosis, comorbidity, chronological age, and severity in CARS score we did not find out significant difference between groups. Conclusion:Our data suggest that the day treatment program which emphasis on development is effective in treating children with developmental disorders.

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DENTAL CARIES STATUS AND RELATED FACTORS AMONG DISABLED CHILDREN AND ADOLESCENT IN KOREA (우리나라 소아.청소년 장애인의 치아우식증 실태와 관련요인)

  • Jeong, Seong-Hwa;Kim, Ji-Young;Park, Ji-Hye;Choi, Youn-Hee;Song, Keun-Bae;Kim, Young-Jin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.1
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    • pp.102-109
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    • 2008
  • The aims of this study were to evaluate dental caries status and to analyze the dental caries related factors which could explain the relationship between dental caries and disabled type, severity of handicap, and oral health behaviors among disabled children and adolescent in Korea. A total of 677 subjects aged from 6 to 18 were finally selected by stratified cluster sampling. They were examined by 13 trained dentists and interviewed with questionnaire. For the crude and adjusted associations, bivariate and multivariate analysis were performed using SPSS program(SPSS Inc, Chicago, USA). DMFT index were 0.90(ages 6-8), 2.32(ages 9-11), 3.63(ages 12-14) and 4.93(ages 15-17), respectively. The DMFT index was significantly related to age, frequency and dependency of toothbrushing, and mastication and functional disorder. Specialized preventive care program which accounted the age and toothbrushing instruction be developed and adapted to promote oral health status and behaviors of disabled children and adolescent in Korea.

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FACTORS OF MENTALLY HANDICAPPED CHILDREN AND THEIR FAMILY ASSOCIATED WITH THE QUALITY OF LIFE AND THE EMOTIONAL WELLBEING OF THEIR MOTHERS (장애 아동의 행동 특성과 가족환경이 어머니의 정서적 안녕감과 삶의 질에 미치는 영향)

  • Lee, Yong-Ho;Chung, Yong-Kyoon;Cho, Soo-Churl;Koo, Young-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.100-112
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    • 1999
  • Objective:In life-long disabilities like autism and mental retardation, the authors thought that it is important for clinician to consider the quality of life of a primary caregiver for long-term management and prognosis. This study was to investigate the factors of children and family environment affecting the quality of life and depression in mothers with autistic and/or mentally retarded children. Methods:41 autistic and/or mentally retarded children aged 5-12 years with their mothers were surveyed from September, 1998 to January, 1999, with K-CBCL, K-BDI, K-FES, and K-SBQOL scale and compared with data from 35 normal control subjects. Results:1) Total K-BDI and K-SBQOL scores of mothers with mentally handicapped children were significantly poorer than the scores of normal control group. Independence, intellectual/cultural orientation and active recreation subscales of K-FES in mentally handicapped children were significantly decreased than those in normal control group. 2) Total K-BDI score of mothers with mentally handicapped children was correlated with their children’s behavioral problems, especially internalizing and thought symptoms, and with family cohesion, expressiveness, conflict and independence. 3) Totol K-SB quality of life score of mothers with mentally handicapped children was correlated with their children’s behavioral problems, especially attention problem, and with family cohesion, conflict, independence, intellectual/cultural orientation, and moral-religional emphasis. 4) The quality of life of mothers with mentally handicapped children was predicted by attention problem($R^2$=.36, p=.000) and social competence($R^2$=.07, p=.038) in children and family cohesion ($R^2$=.16, p=.001). 5) Depression of mothers with mentally handicapped children was predicted by internalizing symptom ($R^2$=.21, p=.003) and thought disorder($R^2$=.06, p=.048) in children and family cohesion($R^2$=.14, p=.008). Conclusion:Reducing behavioral problems and family therapeutic intervention in autistic and mentally retarded children can improve the quality of life of primary caregivers and long-term prognosis of the children, although those are not curative.

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CASE STUDY : FLUOXETINE INDUCED MANIA IN A SCHIZOPHRENIC PATIENCT AND REVIEW OF LITERATURES (정신분열증 여아환자에서 Fluoxetine 투여후 발생한 조증 증례보고 및 문헌고찰)

  • Kim, Bung-Nyun;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.6 no.1
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    • pp.116-122
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    • 1995
  • 목적 : 다음과 같은 fluoxetine으로 유발된 조증 증례를 보고한다. 이와 함께 fluoxetine사용이후 보고된 조증 증례보고를 모아서 정리하고 함께 문헌고찰을 하였다. 증례요약 : 가족력상 기분장애의 병력이 없었으며, 다른 주요 정신과적 질환의 병력은 없었다. 환아는 개인력상 5세경에 주의력 결핍, 과잉행동의 양상을 보였던 병력이 있었고, 13세때에 피해 망상, 환청이 지속되어 haloperidol로 치료받기 시작하였다. 이후 피해 망상의 내용을 언급하거나 환청에 영향받는 행동은 없어졌고 간혹 우울감을 호소하였다. 이후 정신분열증의 진단 하에 haloperidol만으로 3년간 유지하였다. 1994년 환아는 18세때 고3이 되면서 대입에 대한 걱정과 신체적인 허약감을 자주 호소하며, 우울증상이 두드려져 fluoxetine 20mg를 3일간 투여하던 중 갑자기 조증의 임상적 양상을 보이기 시작하여 본원의 입원치료를 받게 되었는데, 입원당시 보인 임상양상은 앙양된 기분, 이자극성(irritability), 사고의 비약, 연상의 이완과 지리멸렬, 과대망상, 피해망상, 관계망상, 환청 등이었고 사람, 장소, 시간에 대한 지남력까지 일시적으로 상실되는 심헌 정신병적 조증상태였다. 토의 : fluoxetine 사용이후 현재까지 세계적으로 문헌상 보고된 14개의 증례보고를 모아서 정리하였다. fluoxetine-induced mania의 병태생리학적인 기전은 명확하지 않지만 가능한 기전에 대해 토론하였다. 이 약물의 중대한 부작용중의 하나인 조증을 예방하기 위해, 이 약물을 다루는 의사는 가능한 조증 발병의 위험인자들에 대하여 인식하고, 약물의 용량조절시에도 주의를 하여야 한다. 가능한 발병 위험인자들에 관해서도 검토하였다.

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A CASE OF CONDUCT DISORDER CONFINED TO FAMILY CONTEXT (가정에 국한된 품행장애 1례)

  • Chung, Sun-Ju;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.2
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    • pp.287-297
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    • 1997
  • Conduct disorder has been subclassified by the symptom characteristics of socialization, aggression, or age of onset. In ICD-10, ‘Conduct disorder confined to family context’ has been developed as a distinct subtype. Which delineates the conduct problems which take place only in the family and related situation. These authors experienced a case which presents a child who shows aggressive and violent behavior to his parent and brother, severe tamper tantrum and destructiveness only in family. By through history taking, observation and treatment after admission, we could find that insecure and ambivalent attachment between parent and child due to chronic neglect and abuse, and inconsistent parental behavior contribute to many behavioral and emotional problems of this child. We reviewed the relationship between conduct disorder and family pathology and treatment strategy for conduct disorder with family problems.

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Functional Impairment and Executive Dysfunction of Children with Tourette Disorder : Comparison with Attention-Deficit Hyperactivity Disorder and Non-Affected Controls (뚜렛 장애 아동 청소년의 기능장애 및 실행기능 결함 : 주의력결핍 과잉행동장애 아동 청소년과 정상 대조군과의 비교)

  • Kang, Hanna;Lee, Soyoung Irene;Lee, A Reum;Kim, Shin-Gyeom;Jung, Han-Young
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.26 no.3
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    • pp.190-196
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    • 2015
  • Objectives : The aim of this study was to determine whether children with Tourette disorder (TD) have functional impairment and executive dysfunction in comparison to children with attention-deficit hyperactivity disorder (ADHD) and non-affected controls. Methods : From January 2006 to December 2013, 45 children and adolescents with TD and 50 children and adolescents with ADHD diagnosed at the Soonchunhyang University Bucheon Hospital and 50 non-affected controls were enrolled in this study. Functional impairment of the subjects was assessed using the Child and Adolescents Functioning Impairment Scale (CAFIS), parent and teacher versions. In addition, neuropsychological tests including Stroop color-word Test, Finger windows Test (FWT), and Digit span were administered. Outcomes were compared across the TD, ADHD, and non-affected controls. Results : No difference in CAFIS-parent and CAFIS-teacher results was observed between children with TD and non-affected controls, whereas, children with ADHD showed more impairments relative to non-affected controls in the CAFIS-parent. According to the Stroop color-word Test, FWT, and Digit span, executive function in children with TD did not differ from non-affected controls. Children with ADHD had poorer performance in measures of the Stroop color-word Test compared to children with TD. Conclusion : Children and adolescents with TD but not ADHD were not significantly different from non-affected controls on most measures of functional impairment and executive function. These findings suggest that an education program and intervention for children with TD would be important to reducing the stigma of TD.

A CASE OF CORENELIA DE LANGE SYNDROME WITH MENTAL RETARDATION AND AUTISTIC DISORDER (정신지체와 자폐장애를 보이는 Cornelia De Lange 증후군 1예)

  • Kim, Se-Joo;Choi, Nak-Kyoung;Song, Jung-Eun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.123-127
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    • 2003
  • Cornelia de Lange syndrome is a dysmorphogenic disorder characterized by multiple congenital abnormalities, mental retardation, growth retardation and neurodevelopmental abnormalities. Diagnosis for the Cornelia de Lange syndrome is dependent on the clinical observation because neither definite biological marker nor definite chromosomal abnormality have been investigated. Clinical observation is important for the diagnosis, so we report a case of Corenelia de Lange syndrome with mental retardation and autistic disorder. The patient is a 6-year old girl. Her motor development and language development have been delayed. She could say no meaningful word and understood simple command partially. She showed poor eye contact and poor emotional interaction. Social interaction was impaired and she Showed stereotypic behaviors. Thus we diagnosed her as mental retardation with autistic disorder. She had vesicoureteral reflux, frequent upper respiratory infection and pneumonia. She had experienced febrile convulsions 4 times. She had short stature, confluent eyebrows, long eyelashes, and upturned nose with anteverted nostrils. She also showed low hairline and hypertrichosis in body and extremities. Her finger was short. In this case, we diagnosed Cornelia de Lange syndrome by her characteristic face, hypertrichosis and medical and behavioral problems that were frequently showed in this syndrome.

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FAMILY ENVIRONMENT OF ATTENTION DEFICIT HYPERACTIVITY DISORDER (주의력결핍 ${\cdot}$ 과잉운동장애의 가정환경에 대한 연구)

  • So, Jun-Hyun;Shin, Yon-O;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.1
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    • pp.44-51
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    • 1996
  • Objective : The authors investigated family environemtn of ADHD referred to child psychiatric clinics. Method : Seventy two patients were grouped into pure ADHD and comorbid ADHD. Patient's lither and mother conducted the Korean Form of the Family Environment Scale(K-FES). And then, scores were compared with that of 77 normal controls. Results : Among subscales of K-FES, expressiveness, achievement orientation and organization were scored significantly lower in ADHD mothers' reporting than ADHD fathers' And only organization subscale was scored significantly lower in ADHD fathers' reporting than controls' In post hoc comparison, subscales of expressiveness, moral-religious emphasis and organization were significantly lower in mothers' reporting of pure ADHD and comorbid ADHD than of controls, and only organization subscale was significantly lower in fathers' reporting of comorbid ADHD than of controls. Conclusion : Parents of ADHD patients agreed that their families were not well organized, and each perceived somewhat differently on the family environment. Further study is needed to eludicate whether specific family environment causes ADHD or is caused by behavior of ADITD patients.

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