• Title/Summary/Keyword: 아동기 우울

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A CLINICAL STUDY OF CHILD AND ADOLESCENT PSYCHIATRIC CONSULTATION IN A GENERAL HOSPITAL (종합병원 소아정신과에 자문의뢰된 환아에 대한 임상적 고찰)

  • Kim Yeoung-Rang;Hong Sungdo D.;Lee Sang-Sin;Lim Seong Hu;Park Jeoung Hwan
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.72-78
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    • 2005
  • Objectives : This study is to investigate the clinical characteristics of psychiatric consultation for children and adolescents in a general hospital. Methods : Hospital records of 302 children and adolescents who were referred for psychiatric consultation in a general hospital over 4 years were reviewed and analyzed. Results : The mean referral rate for psychiatric consultation for school age children and adolescents was $2.15\%$. While more girls were referred in middle and high school age group, more boys were referred in pre-school age group. Fifty percent of the consultation was requested from department of internal medicine and pediatrics. Main reason for requesting psychiatric consultation was fur the assessment of the patients from psychiatric point of view $(31.1\%)$, followed by the management of depression $(11.6\%)$ and anxiety $(11.3\%)$. Most frequently rendered psychiatric services for the treatment was psychosocial education and supportive therapy $(21.2\%)$. Conclusion : There are differences in clinical nature of psychiatric consultation and referral patterns between adult patients and child and adolescent patients. Future research is needed to strengthen the services for child and adolescent psychiatric consultation.

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A PSYCHIATRIC STUDY ON THE CHILDREN WITH RECURRENT ABDOMINAL PAIN (반복적 복통 환아의 정신과적 연구(反復的 腹痛 患兒의 精神科的 硏究))

  • Choi, Jin-Sook;Hong, Kang-E;Seo, Jeong-Kee
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.117-129
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    • 1990
  • 35 children(17 boys, 18 girls) with Recurrent Abdominal pain(RAP) without apparent organic causes, referrd from pediatric department of Seoul National University Children's Hospital were studied during 1988. 7. 1 ${\sim}$ 1989. 2. 28. The aims of this study are to examine clinical characteristics of the patients with RAP, to find possible factors influencing the onset and the course of the disorder, to evaluate the psychological status and the relationship with psychiatric diagnoses. The study subjects were compared with the age and sex matched control subjects on measures of social and school functioning, family-environment, behavior traits by CBCL and parent-environment rating scale. All patients and their mothers were interviewed by a child psychiatrist. The results were as follows ; 1) Abdominal pain was found to be more frequent when with a care taker, and related with traumatic life stresses such as separation from parents, death of family members. 2) Family members of the patients with RAP also had a high rate of a history of gastrointestinal dysfunctions with could not be attributed to organic etiologies. 3) Among 35 patients with RAP, 16 were diagnosed as psychiatric disorders. They were adjustment disorders (4), overanxious disorders (4), depression (2), tic disorders (2), attention deficit disorders (2), separation anxiety disorders (1), enuresis (1). 4) On CBCL, the patients with RAP were more internalized, socially less competent and less active compared with the control subjects. 5) According to the parent-environment rating scale, the patients with RAP had more conflicts with their parents about control issues. Family members of the patients with RAP were socially less competent and less abjustable. The parents of the patients with RAP were more affectionate and spent more time with their children but they were unfair and vague on instruction and discipline.

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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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CLINICAL AND NEUROPSYCHOLOGICAL CHARACTERISTICS OF DSM-IV SUBTYPES OF ATTENTION DEFICIT HYPERACTIVITY DISORDER (주의력결핍 과잉행동장애의 아형별 신경심리학적 특성 비교)

  • Cheung, Seung-Deuk;Lee, Jong-Bum;Kim, Jin-Sung;Seo, Wan-Seok;Bai, Dai-Seg;Chun, Eun-Jin;Suh, Hae-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.139-152
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    • 2002
  • Objectives:This study was conducted to compare the clinical and neuropsychological characteristics by DSM-IV subtypes of attention deficit hyperactivity disorder(ADHD) patients who did not have comorbid psychiatric disorders. Methods:5-15 year old children with ADHD were recruited at psychiatric outpatient clinic of Yeungnam University hospital and the patients with comorbidity or neurological abnormalities were excluded. Finally, total 404 children with ADHD were selected for this study. There were 234 subjects of ADHD-C(57.9%), 156 subjects of ADHD-I(38.6%) and 14 subjects of ADHD-HI(3.5%), who fulfilled the DSM-IV diagnostic criteria. The mean age of the total subjects was 9.63±2.49 years old. The psychopathology, IQ, behavioral problems, neuropsychological executive function were evaluated before pharmacological treatment. The measures were Korean Personality Inventory of Child(K-PIC) for psychopathology, 4 behavioral check lists(ADDES-HV, ACTeRS, CAP, SNAP) for behavioral symptoms of ADHD, K-ABC and KEDI-WISC for IQ and Conner's CPT, WCST, SST for neuropsychological executive functions. Results:1) The prevalence of subtypes was ADHD-C, ADHD-I, ADHD-HI in decreasing order. There was no sex difference of prevalence among three subtypes. The mean age of ADHD-I was older than other subtypes. 2) There was significant differences of psychopathology among subtypes, the ADHD-C and ADHD-HI had higher than the ADHD-I in the scores of delinquent, hyperactivity and psychosis;the ADHD-C had higher than the ADHD-I in the scores of family relation and autism, the scores of ego resilience were lower than the ADHD-I. However, there was no difference in anxiety, depression and somatization scores among them. 3) The results of behavioral symptom check lists, the ADHD-C had higher the score of inattention, hyperactivity and impulsivity than the ADHD-I. Meanwhile the results of ACTeRs, which rated by the teachers, were different. 4) There were significant differences of sequential processing scale and arithmetics among subtypes in IQ using K-ABC, but there was no significant difference between the ADHD-C and the ADHD-I after excluding the ADHD-HI due to small numbers. 5) There was numerical difference among subtypes but did not reach statistical significance in three neuropsychological executive function tests. Conclusion:In conclusion, our results revealed that there was significant difference in clinical features among three subtypes but, no significant difference in executive functions.

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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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Socio-Economic Factors Affecting the Health and Nutritional Status of the Aged (노인의 건강과 영양상태에 영향을 미치는 사회경제적 요인분석)

  • 김숙희;강혜경;김주현
    • Journal of Nutrition and Health
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    • v.33 no.1
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    • pp.86-101
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    • 2000
  • Various kinds of living circumstances are making population structure of Korean changed. That is, number of the children is decreased and that of the aged is increased. It is predicted that population of the children and the aged will be almost same until 2020. With above, as the expectation of the aged on healthy living might be increased, some special programs for the aged will be needed strongly. At this point, Korean aged population might be economically poor, comparing with other generation. In general, economic factor affects the subjective living-satisfaction and health status of them. Moreover, educational status, household shape and family tieing also affect their health status. According to the foreign articles, health status of the aged might be related to income, educational status, job, employed or/not, marital status, family structure, sex, and childhood condition. decrease of the income or unemployment could make the death rate of the aged higher. During childhood, discordance among the family might affect their health status after. IGUR is also important factor to affect the adulthood health. Positive life style of the aged would lessen their unequality of the health among them. Nutritional status of the Korean aged population might be indicated under the nutritional recommendation. It is affected by their income, education level, social class, and residing place. (Korean J Nutrition 33(1) : 86-101, 2000)

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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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THE CLASSIFICATION OF ADOLESCENTS IN RUNAWAY SHELTERS BY THE EVALUATION OF THEIR PSYCHOPATHOLOGY (보호시설 가출청소년의 정신병리에 대한 평가와 분류)

  • Lee, Jong-Sung;Kwack, Young-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.2
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    • pp.192-217
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    • 2001
  • Object:This study was carried out to classify adolescents in runaway shelters by evaluating their psychopathology. And the ultimate purpose is to offer basic data for preventing adolescents‘ runaway and for diversifying runaway shelters suitable for the problem of individual adolescent. Method:128 adolescents who stay in the runaway shelters were asked to complete self-report qeustionnaires including basic sociodemographic data, Child Behavior Check List(CBCL), Minnesota Multiphasic Personality Inventory(MMPI), and Symptom Check List-90-Revised(SCL-90-R). Korean Wechsler Adult Intelligence Scale(K-WAIS)[or Korean Educational Developmental Institute-Wechsler Intelligence Scale for Children(KEDI-WISC)] and Bender-Gestalt test(BGT) were also done by clinical psychologists. Results:The most common age of the subjects were 15-year-old, and they dropped out their schools in the middle school most commonly. Mostly they were from middle class family and their parents' educational level were high school graduates. The first runaway episode was most common in the middleschool period, and their runaways were repeated. The most common frequency of runaways were more than 10 times. About 10% of them abused drugs and about 80% of them abused alcohol. One third of them had experiences of illegal problems and 10% of them engaged in sexual activity for money. 95 adolescents(83%) in CBCL, 42 adolescents(36%) in SCL-90-R, and 70 adolescents(69.3%) in MMPI showed clinical significance. In intelligence test, 22 adolescents(22%) were mentally retarded. In BGT, 35 adolescents(39.4%) manifested brain dysfunction signs. Conclusion:Runaway adolescents in the shelters have variable and severe psychopathology. Their psychopathology is classified as follows;The behavior disorder group, the mood disorder group with anxiety/depression, the somatic disorder group with somatic symptoms, and the psychosis group with possibility of severe psychopathology. Therefore it is very important to evaluate psychiatric problems of runaway adolescents, and specific therapeutic interventions according to their problems are required.

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