• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제23권1호
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• pp.31-35
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• 2012

Noonan syndrome is characterized by short stature, typical facial dysmorphology, and congenital heart defects. The main facial features of Noonan syndrome are hypertelorism with down-slanting palpebral fissures, ptosis, and low-set posteriorly-rotated ears with a thickened helix. The cardiovascular defects most commonly associated with this condition are pulmonary stenosis and hypertrophic cardiomyopathy. Other associated features are webbed neck, chest deformity, mild intellectual deficit, cryptorchidism, poor feeding in infancy, bleeding tendency, and lymphatic dysplasias. The patient is a 10-year-old boy. He had experienced repeated febrile convulsions. He had typical facial features, a short stature, chest deformity, cryptorchidism, vesicoureteral reflux, and mental retardation. His language and motor development were delayed. When he went to school, it was difficult for him to pay attention, follow directions, and organize tasks. He also displayed behavior such as squirming, leaving his seat in class, and running around inappropriately. Clinical observation is important for the diagnosis, so we report a patient who was diagnosed with Noonan syndrome, mental retardation, and attention-deficit hyperactivity disorder.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제5권1호
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• pp.41-53
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• 1994

1944년 Hans Asperger는 아동기에 사회적인 고립과 특이한 행동 양식을 보이는 400명의 증례를 보고하고 자폐적 병질(autistic psychopathy)이라 명명하였는데 이 아동들은 1943년 Kanner에 의하여 기술된 자폐 아동들과 여러 가지면에서 유사하였으나 임상적인 관찰에서 몇몇 현저한 차이를 나타냈다. 가장 주목할 만한 것은 정상 언어 발달과 지능 수준의 차이를 들 수 있다. 이후에 이들은 Asperger's syndrome([CD-10) 혹은 Asperger's disorder(DSM-IV)로 명명되었는데 이들은 자폐증과 연속선상에 있는 높은 기능 수행을 보이는 경한 형태의 발달장애로 보는 시각, 아동기 인격 장애의 특수한 형태로 보는 시각, 혹은 성인 정신분열증의 초기 아동기 행태로 보는 시각등이 있는데, 모두 그들 나름대로 연구 방법의 타당성과 결과 해석의 문제점을 안고 있다. ICD-10(1992)과 DSM-IV(1994)에서 전반적 발달 장애의 영역내에 새로이 독립된 진단 체계로써 확고히 자리한 지금에 와서도 이들 질환과 완전히 분리된 개념으로 간주하기에는 미흡한 실정이다. 저자는 이 질환의 현재 개념에 이르기까지의 역사적 고찰과 더불어 독립된 질환이냐의 논의점과 최근 연구 경향에 대해 문헌 고찰을 하였으며 이 증후군이 큰 맥락에서 사회적 본능(social instinct)에 결함이 있는 장애라는 견지에서 연계 질환들과의 관계를 도식적으로 요약해 보았다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제23권1호
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• pp.3-7
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• 2012

Objectives : The early onset of mood symptoms in bipolar disorder has been associated with poor outcomes in many studies. However, aspects of the clinical course of bipolar disorder in children and adolescents are controversial. The goal of this article is to review the clinical characteristics and longitudinal course of children and adolescents with bipolar disorders. Methods : Searches were conducted in MedLine, PsycINFO, KISS, and RISS using the terms phenomenology, clinical course, outcome, BPD, pediatric, children and adolescents. Twenty-one reports were selected : either original articles reporting symptoms and clinical characteristics of subjects (ages 5-18 years), or published articles in reviewed journals about bipolar disorder in children and adolescents. Results : Approximately 70% of subjects with bipolar disorder recovered from their index episode, and 50% had at least 1 syndromal recurrence, particularly depressive episodes. For 60% of the follow-up time, subjects had syndromal or subsyndromal symptoms with numerous changes in symptoms and shifts of polarity. Approximately 20% of BP-II subjects converted BP-I. Conclusion : Bipolar disorders in children and adolescents are characterized by episodic illness with subsyndromal and syndromal episodes with mainly depressive and mixed symptoms and rapid mood changes. Extensive follow-up time is needed to evaluate the continuity of bipolar disorder symptoms from childhood to adulthood.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제16권1호
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• pp.26-32
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• 2005

신경발달학적 신경영상학은 급속하게 발전하는 분야이고 사용되는 새로운 영상학적인 기술의 수도 해마다 급속하게 증가하고 있다. 신경발달학적인 관점에서 소아청소년 정신과적 장애들에서 아직 명확한 신경병리학적인 원인은 밝혀지지 않았으나, 점차로 많은 수의 논문에서 일관적인 뇌영상학적인 이상 소견들이 발표되고 있다. 이 논문에서는 신경발달학적인 관점에서 신경영상학적인 연구에서 과거와 현재 상황을 기술하고 제한점과 함께 미래에 대한 조망을 하고자 한다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제8권1호
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• pp.83-91
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• 1997

본 연구의 목적은 품행장애를 보이는 청소년에서 우울및 불안의 정도를 알아보고 또한 자신의 부모가 보이는 자녀 양육 방식에 대해 그들이 어떠한 지각을 하고 있는가를 살펴봄으로써, 품행장애 환아들에서 흔히 동반되는 우울, 불안 증상과 부모양육방식 사이에는 어떤 상호관련이 있으며 이는 또한 품행장애의 임상경과와 어떤 관련이 있는지를 알아보는데 있다. 이러한 목적하에 저자들은 DSM-Ⅳ의 진단기준에 부합되는 품행장애 입원환아 30명과 정상대조군으로 30명의 중학생을 선정하였으며, 이들에게 소아우울척도(CDI), 소아 상태-특성 불안척도(STAI), 부모-자녀 결합형태 검사(PBI)를 시행한 바 다음과 같은 결과를 얻었다. 1) 품행장애 환아들은 정상대조군에 비해 증상면에서 상태불안(state anxiety)이 높았으나 우울과 특성불안(trait anxiety)은 의미있는 차이를 보여주지 않았다. 2) 품행장애 환아들은 부모의 양육태도에 있어서 아버지와 어머니 모두에 대해 돌봄이 적고 과보호가 많다는 부정적인 인식을 가지고 있는 것으로 나타났다. 3) 어머니의 돌봄은 우울 및 품행문제의 심각도와 부적 상관관계를 보였다. 4) 어머니의 과보호는 특성불안과 정적 상관관계를 보였다. 품행장애 환아에 있어 아버지 양육태도의 특성은 그다지 의미있는 결과를 보여주지 않아 아버지보다는 어머니의 부정적인 양육 방식이 품행장애 소아청소년의 우울, 불안 및 품행문제의 심각도등의 임상경과와 보다 밀접한 관련성을 갖는 것으로 보인다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제25권2호
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• pp.53-64
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• 2014

Tic disorder is a childhood neuropsychological disorder characterized by abrupt, involuntary, and repetitive stereotyped muscle movement or vocal sound. Tourette's disorder shows a chronic prognosis, and can last for life if no treatment is applied. Although tic disorder has been known for ages, the underlying cause is still not well known. Non-pharmacological treatments have long been used for the tic disorder, but few clinical studies were conducted. However, the European Society for the Study of Tourette's Syndrome recently issued non-pharmacologic guidelines for treatment of tic disorders based on the research findings obtained so far. In addition, guidelines for non-pharmacologic evidence-based treatment were reported in Canada, North America. By synthesizing the newly reported foreign guidelines for treatment and review articles, the aim of this study is to investigate the non-pharmacologic therapies used for treatment of tic disorder or Tourette's disorder.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제22권3호
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• pp.156-161
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• 2011

Objectives: Externalized behavioral problems are prevalent in adolescents, due to the difficulties associated with this developmental stage. Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD), as well as other psychiatric disorders, such as major depressive disorder, result in the manifestation of many behavioral problems during adolescence. Methods: For this report, we analyzed a sample of 31 adolescents, each of whom had presented with CD or ODD at Chosun University Hospital between 2002 and 2010. We separated subjects into depressed and non-depressed groups according to their Beck Depression Inventory scores (BDI<10, non-depressed ; BDI${\geq}$10, depressed). Then we analyzed for neuropsychological differences between the depressed and non-depressed groups. Results: In our sample, adolescents in the depressed group showed less of a stealing (deceitfulness and/or theft) behavioral pattern and presented with more anxiety symptoms, lower self-esteem, and greater sensitivity in interpersonal relationships, as compared to the non-depressed group. Conclusion: When adolescents exhibit disruptive behavior, clinicians should consider the underlying causes of the behavior.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제23권4호
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• pp.188-195
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• 2012

Objectives:This study was conducted in order to evaluate the effectiveness of a day-center treatment program to promote development of children with pervasive development disorder (PDD) and pervasive development disorder/mental retardation (PDD/MR). Methods:Twenty five children (14 in the PDD group and 11 in the PDD/MR group) participated in a day-center treatment program. They had been enrolled in the whole program for 2-3 years. Their performance was evaluated according to the Preschool Language Scale (PRES), Social Maturity Scale (SMS), and Korean version of the Childhood Autism Rating Scale (CARS). They were grouped by diagnosis at the beginning of the program and the treatment effect was compared. Results:Children who participated in the day-center treatment program showed a significant increase in their PRES and SMS scores and a decrease in their CARS scores. Conclusions:A day-center treatment program is effective for development of children with PDD and PDD/MR.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권4호
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• pp.192-196
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• 2017

Social (pragmatic) communication disorder (SCD) is a new diagnosis included under communication disorders in the neurodevelopmental disorders section of Diagnostic and Statistical Manual of Mental Disorders-5. SCD is defined as a primary deficit in the social use of nonverbal and verbal communication. SCD has very much in common with pragmatic language impairment, which is characterized by difficulties in understanding and using language in context and following the social rules of language, despite relative strengths in word knowledge and grammar. SCD and Autism Spectrum Disorder (ASD) are similar in that they both involve deficits in social communication skills, however individuals with SCD do not demonstrate restricted interests, repetitive behaviors, insistence on sameness, or sensory abnormalities. It is essential to rule out a diagnosis of ASD by verifying the lack of these additional symptoms, current or past. The criteria for SCD are qualitatively different from those of ASD and are not equivalent to those of mild ASD. It is clinically important that SCD should be differentiated from high-functioning ASD (such as Asperger syndrome) and nonverbal learning disabilities. The ultimate goals are the refinement of the conceptualization, development and validation of assessment tools and interventions, and obtaining a comprehensive understanding of the shared and unique etiologic factors for SCD in relation to those of other neurodevelopmental disorders.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제22권4호
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• pp.307-313
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• 2011

Objectives : This study explored the clinical differences in attention-deficit hyperactivity disorder (ADHD) patients with and without developmental coordination disorder (DCD). Methods : Participants were 49 children and adolescents with ages between 6 and 18 years. These subjects were placed into 2 groups: ADHD without DCD (24) and ADHD with DCD (25). We used several evaluation tools on both groups: the Affective Disorders and Schizophrenia-Present and Lifetime Version- Korean Version (K-SADS-PL), Wechsler Intelligence Scale for Children-III (WISC-IIII), Child Behavior Check List (CBCL), Korean Personality Rating Scale for Children (K-PRC), and Bruininks-Osretsky Test of Motor (BOT-2). Results : Patients with both ADHD and DCD had a lower performance intelligence quotient and more internal and external behavioral symptoms than patients with ADHD but not DCD. It is possible that patients with ADHD and motor coordination problems should be noticed earlier and given intensive treatment.