• Title/Summary/Keyword: 아동의 병리적 특성

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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 COGNITIVE-BEHAVIORAL DIFFERENCES BETWEEN CHRONIC MOTOR TIC DISORDER AND TOURETTE'S DISORDER (만성 운동성 틱 장애와 뚜레뜨 장애의 인지-행동적 차이)

  • Shin, Min-Sup;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.133-141
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    • 1993
  • Present study investigated the differences in psychological tests responses between chronic motor tic disorder and tourette's disorder to clarify whether chronic motor tic and tourette's disorder constitute a single disorder on a continuum or not. Based on the diagnosis by child psychiatrists 29 chronic motor tic disorder and 10 tourette's disorder children between the age of 6 to 13 were selected, and the psychological tests responses of two diagnostic groups were compared. The results showed that tourette's disorder is more related to neulological problems than chronic motor tic disorder. Also it was found that children with tourette's disorder have more difficulties in social-emotional adjustment than children with chronic motor tic disorder. These results suggested that interactions among neurological factor, emotional factor and temperamental characristics might be more involved in tourette's disorder than in chronic motor tic disorder. The limitations of present study and the need for futher research on the comorbidity of tourette's disorder and ADHD were discussed.

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Regional differences in Korean children's development of speech production (우리나라 아동의 지역별 말소리 발달 차이)

  • Shin, Moonja;Ha, Ji-Wan;Kim, Young Tae;Kim, Soo-Jin
    • Phonetics and Speech Sciences
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    • v.11 no.3
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    • pp.57-67
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    • 2019
  • This study aimed to investigate regional differences in the development of speech production in Korean children. A total of 619 children aged 2 to 7 years from the Jeolla, Seoul/Gyeonggi, Chungcheong, and Gyeongsang areas were included in this study. The subjects were assessed with the UTAP2 word-level test. In PWC, PMLU, and PWP, the performance was significantly lower in Gyeongsang at 2 years 11 months and in Jeolla and Chungcheong at 3 years 5 months than in Seoul/Gyeonggi. The total PCC of Gyeongsang and Chungcheong and UTAP PCC of Chungcheong were significantly lower at 2 years 11 months compared with those of Seoul/Gyeonggi, while Jeolla and Chungcheong showed significantly lower total PCC and UTAP PCC than Seoul/Gyeonggi at 3 years 5 months. However, no regional difference was observed in any indicators after the age of 3 years 6 months. These results suggest that there are regional differences in the ability to produce speech sounds at a very young age, and that the differences can be explained by the differences between Seoul/Gyeonggi and the other provinces rather than by the individual characteristics of specific regions.

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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DIFFERENCES IN THE PATTERNS OF PARENTAL REARING BETWEEN DEPRESSION AND DEPRESSIVE CONDUCT DISORDER IN ADOLESCENCE (청소년의 우울증과 우울 행동 장애에서의 부모 양육 태도에 관한 연구)

  • Jeon, Seong-Il;Lee, Jung-Ho;Lee, Gi-Chul;Choi, Young-Min
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.1
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    • pp.34-43
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    • 1996
  • In adolescence, the symptoms of depression are more various and different from those of adult. Conduct behaviours are frequently represented in adolescent's depression. The patients who have the depression and conduct disorder are defined as depressive condor disorder in ICD-10. We hypothesized that there might be different parental rearing patterns between the patients with depression alone and the depressive conduct disorder. We applied children's depression inventory (CDI), parental rating form for conduct disorder based on DSM-III-R, and parental bonding instrument (PBI) to patients and normal control adolescent group. The results were as follows : 1) There were no significant differences in severity of depressive symptoms, maternal care, maternal overprotection, and paternal care. 2) Paternal overprotection showed significant higher scores in depressive conduct disorder group than depression group and normal control group. 3) There were positive correlations in the severity of depressive symptoms and behavior problems in all subjects. 4) There were no correlations in maternal care and overprotecion with conduct problems, but with depressive symptoms in all subject. 4) There were no correlations in paternal care with conduct problems and depressive symptoms in all subjects. 5) There were significant correlations in patienral overprotective, intrusive attitudes with conduct problems, not with depressive symptoms in all subjects.

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Depression, Anxiety, Alexithymia, Stress Response in Caregivers of Attention Deficit Hyperactivity Disorder Patient (주의력결핍 과잉행동장애 환아 보호자의 우울, 불안, 감정표현불능, 스트레스반응)

  • Jeong, Jong-Hyun;Hong, Seung-Chul;Han, Jin-Hee;Lee, Sung-Pil
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.2
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    • pp.95-101
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    • 2005
  • Objectives : This study was designed to investigate depression, anxiety, alexithymia, stress res ponses in caregivers of patients with attention deficit hyperactivity disorder. Methods : The subjects were 38 attention deficit hyperactivity disorder patients caregivers(38 women, mean age $37.5{\pm}6.5$). Patients were diagnosed with DSM-IV ADHD criteria. Korean version of Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI), Toronto Alexithymia Scale(TAS) and Stress Response Inventory(SRI) were used for assessment. Results 1) The BDI scores of ADHD patients caregiver group were significantly higher than control group$(16.4{\pm}7.1\;vs.\;10.9{\pm}5.5)(p=0.011)$. 7 of the 38 caregivers(18.4%) and none of control group(0%) had BDI scores over 20 points(p=0.021). Calculated relative risk for ADHD in the presence of caregivers' depression was 1.516 overall(95% confidence interval, 1.234-1.862). 2) In ADHD patient's caregiver group, the scores of Stress Response Inventory were significantly higher than control group$(44.2{\pm}20.2\;vs.\;26.5{\pm}16.8)(p=0.006)$. 3) No significant differences were found in the score of STAI, SIAIS, SIAI-T, TAS between caregiver and control group. Conclusion : This study suggest that ADHD patients' caregivers are likely to have more depressive symptoms and higher stress response level than control group. We propose that physicians should consider integrated approaches for caregiver's psychopathology in the management of ADHD.

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COMPLIANCE STUDY OF METHYLPHENIDATE IR IN THE TREATMENT OF ADHD (주의력결핍과잉행동장애 치료 약물 Methylphenidate IR의 순응도 연구)

  • Hwang, Jun-Wan;Cho, Soo-Churl;Kim, Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.2
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    • pp.160-167
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    • 2004
  • Objectives : There have been very few studies on the compliance of methylphenidate-immediate releasing form(MPH-IR), which is the most frequently used drug in Korea, in Attention Deficit Hyperactivity Disorder(ADHD). This study was conducted to investigate the compliance rate and the related factors in the one year pharmacotherapy process via OPD for children with ADHD. Method : Total 100 ADHD patients were selected randomly among patients who have been treated with MPH-IR from September in 2002 to December in 2002. All the selected patients were diagnosed with DSM-IV-ADHD criteria and fulfilled the inclusion criteria. In March, 2003(at the time of 6 month treatment), all the patients and parents received the questionnaire for the compliance and satisfaction for MPH-IR treatment. In October 2003(at time of 1 year treatment), we, investigators evaluated the socio-demographic variables, developmental data, medical data, family data, comorbid disorders, treatment variables, and compliance rate. Through these very comprehensive data, The compliance rate at the time of mean 1 year treatment and the related factors were investigated. Result : 1) In the questionnaire for compliance and satisfaction for MPND treatment, the 60% of respondents(parents) reported more than moderate degree of satisfaction in the effectiveness of MPND. Their compliance rate for the morning prescription was 81%, but the rate of afternoon prescription was 43%. 2) In the evaluation at the time of 1 year treatment(October 2003), the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1 year treatment was 62%. the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1year treatment was 62%. 3) Compared with the noncompliant group(drop-out group), compliant group showed higher total, verbal and performance IQ scores. In the treatment variables, higher reposponder rate(clinician rating), higher medication dosage and more compliance rate in afternoon prescription were found in the compliant group compared with the noncompliant group. There were no statistical differences in the demographic variables(age, sex, SES, parental education level), medical data, developmental profiles and academic function. Conclusion : To our knowledge, this is the first report about the compliance rate of the MPH-IR treatment for the children with ADHD. The compliance rate at the time of mean 1year treatment was 62%, which was comparable with other studies performed in foreign countries, especially States. In this study, the compliance related factors were IQ score, clinical treatment response, dosage of MPH-IR, and early compliance for the afternoon prescription. These results suggest that clinician plan the strategies for the promotion of the early compliance for the after prescription and enhancement of overall treatment response.

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CLINICAL CHARACTERISTICS OF CHILD AND ADOLESCENT PSYCHIATRIC INPATIENTS WITH MOOD DISORDER (입원한 기분장애 소아청소년의 임상특성 - 주요 우울증과 양극성장애의 우울삽화 비교를 중심으로 -)

  • Cho, Su-Chul;Paik, Ki-Chung;Lee, Kyung-Kyu;Kim, Hyun-Woo;Hong, Kang-E;Lim, Myung-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.2
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    • pp.209-220
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    • 2000
  • The purpose of this study is to find out the characteristics of depressive episode about major depression and bipolar disorder in child and adolescent. The subjects of this study were 34 major depression patients and 17 bipolar disorder patients hospitalized at child and adolescent psychiatry in OO university children's hospital from 1st March 1993 to 31st October 1999. The method of this study is to review socio-demographic characteristics, diagnostic classification, chief problems and symptoms at admission, frequency of symptoms, maternal pregnancy problem history, childhood developmental history, coexisting psychiatric disorders, family psychopathology and family history and therapeutic response through their chart. 1) The ratio of male was higher than that of female in major depressive disorder while they are similar in manic episode, bipolar disorder. 2) Average onset age of bipolar disorder was 14 years 1 month and it was 12 years 8 months in the case of major depression As a result, average onset age of major depression is lower than that of bipolar disorder. 3) The patients complained of vegetative symptoms than somatic symptoms in both bipolar disorder and depressive disorder. Also, the cases of major depression developed more suicide idea symptom while the case of bipolar disorder developed more aggressive symptoms. In the respect of psychotic symptoms, delusion was more frequently shown in major depression, but halucination was more often shown in bipolar disorder. 4) Anxiety disorder coexisted most frequently in two groups. And there coexisted symptoms such as somartoform disorder, mental retardation and personality disorder in both cases. 5) The influence of family loading was remarkable in both cases. Above all, the development of major depression had to do with child abuse history and inappropriate care of family. It is apparent that there are distinctive differences between major depression and bipolar disorder in child and adolescent through the study, just as in adult cases. Therefore the differences of clinical characteristics between two disorders is founded in coexisting disorders and clinical symptoms including onset age, somatic symptoms and vegetative symptoms.

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