• Title/Summary/Keyword: 정신과외래

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IMPACT OF PARENTAL PSYCHIATRIC DISORDER ON OFFSPRING'S DEPRESSION, ANXIETY, SELF CONCEPT AND PERCEPTION OF FAMILIAL RELATIONSHIP (정신과 환자 자녀의 우울, 불안, 자기 개념 그리고 가정환경의 특성에 대한 연구)

  • Lee, Jung-Bum;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.1
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    • pp.54-66
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    • 1998
  • Objectives:This study was to investigate the impact of parental psychiatric disorder on offspring's depression, anxiety, self concept, perception of familial relationship compared with offspring of normal control. In offsprings of parents with psychiatric disorder, this study explored whether their psychopathology, self concept, and perception of familial relationship were influenced by parent’s sex, onset time of parent’s psychiatric disorder and parent’s psychiatric diagnosis. Methods:52 offsprings aged 10-18 years of 39 psychiatric outpatient were surveyed from June, 1997 to April, 1998 and completed several questionnaaire, including Korean from of the Family Environment Scale, Korean form of the State-Trait Anxiety Inventory for Children, Korean form of Kovac’s Children’s Depression Inventory, and Korean form of Piers-Harris Children’s Self-Concept Scale. Their score was compared with offsprings’ of normals. In offsprings of parents with psychiatric disorder, they were compared according to parent’s sex, onset time of parent's psychiatric disorder and parent’s psychiatric diagnosis. Results:The results were as follows:1) Offsprings of parents with psychiatric disorder reported higher level of state anxiety and lower level of the FES expressive subscale than offsprings of normals(p<0.05). But they reported higher level of PHCSCS intellectual & school status subscale and popularity subscale than normals(p<0.05). 2) There were no differences in anxiety, depression, self concept, and perception of familial relationship between patient’s sex. 3) Offsprings less than 3 years old when parent’s psychiatric disorder had developed showed higher level of trait anxiety and lower level of FES control subscale than offsprings more than 3 years old (p<0.05). 4) There were no diferences in anxiety, depression, self concept, and perception of familial relationship between patient’ diagnostic groups(schizophrenia spectrum disorder-mood disoderneurosis). Conclusion:The finding indicated that self reported scale of anxiety and depression showed no significant difference between offsprings of psychiatric patients and offsprings of normals. In offsprings of parents with psychiatric disorder, parent’s sex and psychiatiric diagnosis had no influence on offspring’s psychopathology. But the offspring’s age(before 3 years old) when the parent’s psychiatriric disorder developed had influence on higher level of offspring’s trait anxiety. For further high risk group study, direct interview and evaluation of parent-child agreement or teacher-child agreement will be needed in longitudinal study.

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THE CHARACTERISTICS OF CHILD AND ADOLESCENT INPATIENTS WITH SEVERE OBSESSIVE-COMPULSIVE DISORDER (심각한 소아 ${\cdot}$ 청소년 강박장애로 입원한 환아들의 특징)

  • Hwang, Jun-Won;You, So-Young;Chang, Jun-Hwan;Shin, Min-Sup;Cho, Soo-Churl;Hong, Kang-E;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.143-151
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    • 2004
  • Objectives : Child and adolescent onset obsessive compulsive disorder(C-OCD) is known to be associated with poor drug response, high comorbid rate and strong genetic tendencies. Till now studies for C-OCD have been very rare in Korea. We conducted this study to investigate the informations about clinical features, familial psychiatric loading, treatment profiles and course of server C-OCD from the retrospective analysis of inpatient data of Seoul National University Children's Hospital. Method : Retrospective chart review and data analysis was performed. Twenty(male 16 : female 4) patients with final C-OCD diagnosis by DSM-IV at discharge from 1994 to 2002 were found and their medical chart, psychological data, family interview data and nursing reports were collected and analyzed. Results : 1) The sex ratio of C-OCD was male dominant(4:1). 2) Phenomenological, most common obsession was pathologic doubt, contamination fear, followed by aggressive obsession, need for symmetry, sexual obsession, most common compulsion was checking and washing, followed by breathing, movement, symmetry, repetitive asking, hoarding, mental compulsion. 3) Most common comorbid diagnosis was depression. Other axis-I diagnosis associated OCD were anxiety disorder, tic disorder, conduct and oppositional defiant disorder and psychosis. 4) Regarding psychiatric familial loadings, 17 patients(85%) had relatives with psychiatric disorders, OC-spectrum disorders(OCD or OCPD) were found in 9 patients(45%). 5) The majority of patients(75%) have received SSRI and antipsychotics treatment. The response rate above 'moderate improved" by CGI was 75%. 6) During follow-up period in outpatient clinic, five patients(25%) showed continuous complete remission, 10 patients (50%) did residual symptoms with chronic course. Conclusion : This seems to be the first systemic investigation of severe pediatric OCD patients in Korea. The children & adolescents with severe OCD in inpatient-setting showed the high comorbid rate, familial psychiatric loading, and combined pharmacotherapy with antipsychotics, As for symptoms, high rate of aggressive-sexual obsession and atypical compulsions like breathing and moving was reported in this study. Severe pediatric OCD patients, however, responded well to the combined SSRI and antipsychotics regimen.

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A STUDY OF RELIABILITY & VALIDITY FOR THE KOREAN VERSION OF ASPERGER SYNDROME DIAGNOSTIC SCALE (한국판 아스퍼거 증후군 진단척도(The Korean version of Asperger Syndrome Diagnostic Scale : K-ASDS) 의 신뢰도 및 타당도 연구)

  • Kim, Joo-Hyun;Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.98-105
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    • 2005
  • Objectives : The purpose of this study was to examine the reliability and validity of the Korean version of Asperger Syndrome Diagnostic Scale as a tool to diagnose Asperger disorder. Methods : Subjects consisted of 15 Asperger disorder, 20 PDD & PDD NOS, 20 Communication disorder children who visited the department of child psychiatric outpatient clinic. The age range of the children was between 5 years 1 month and 15 years 6 month. The K-ASDS, the Korean version of Asperger disorder inventory (K-ADI), and K-CARS were administered to mothers of all children by clinical psychologists. Results The internal consistency of the ASDS was high (Chronbach's $\alpha=0.88$) and the range internal consistencies of each subscales of K-ASDS were from .83 to 66. Correlation coefficients between K-ASDS and KADI was significant. Discriminant analysis showed that the Korean version of ASDS significantly discriminate Asperger disorder from PDD and Communication disorder, and the percentage of correct classification were $71\%$. Conclusion : The results of this study proved that the Korean version of ASDS was a reliable and valid measure for Asperger disorder.

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Comparison of Alexithymia among Patients with Psychosomatic Disorders, Anxiety Disorders and Depressive Disorders (정신신체장애, 불안장애 및 우울장애 환자들 간의 Alexithymia의 비교)

  • Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.2 no.1
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    • pp.59-68
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    • 1994
  • A comparison was made regarding the degree of alexithymia among patients with psychosomatic disorders, anxiety disorders and depressive disorders. The author examined the degree of alexithymia in three groups : 100 psychosomatic patients(including 47 patients with tension headache), 52 outpatients with anxiety disorden, and 50 outpatients with depressive disorders. Alexithymia was assessed by Alexithymia provoked Response Questionnaires(APRQ) developed as a semi-structured interview form. No significant difference was found in the degree of alexithymia among Patients with Psychosomatic disorders, anxiety disorders, and depressive disorders. On the other hand, patients with tension headache were significantly more alexithymic than patients with anxiety disorders and depressive disorders, respectively. However, there was no significant difference in degree of alexithymia between patients with anxiety disorders and those with depressive disorders. Multiple regression analysis revealed that demographic variables such as set age, education level, and marital status did not make a significant influence on alexithymia scores. These results suggest a greater degree of alexithymia in patients with a specific group of psychosomiatic disorders such as tension headache than in patients with emotional disorders, unlike the previous report that in general, psychosomatic patients are alexithymic. Thus, it is necessary to develop special forms of interview which can induce and encourage expression of emotion as a therapeutic strategy for patients with tension headache.

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A Study of Depression in Positive and Negative Schizophrenics (양성 및 음성 정신분열증 환자의 우울에 관한 연구)

  • Lee, Jung-Hoon
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.338-351
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    • 1994
  • This study was to find out whether there were differences in the levels of depressions between positive and negative schizophrenics. This research was derived from the fact that negative schizophrenics show higher levels of depression than positive schizophrenics. This study also examined the levels of psychomotor dysfunction in positive and negative schizophrenics. For this study, there were 453 subjects. They consisted of 119 positive schizophrenics, 122 negative schizophrenics and 212 normal people. They were asked to complete Zung's Self-Rating Depression Scale(SDS) and to perform one subtest, Digit Symbol of KWIS(Korean Wechsler Intelligence Scale). Subjects' levels of depression were measured by the SDS. the level of psychomotor dysfunction was measured by Digit Symbol subtest of Korean Wechsler Intelligence Scale. ANOV A and Duncan's multiple comparison analysis were used to examine whether there were differences of depression and psychomotor dysfunction among the normal people, positive and negative schizophrenics. The results were as follows: It was found that the depression level was higher in the negative schizophrenic patients than positive schizophrenic patients. Levels of depression were significantly higher in negative schizophrenics than positive schizophrenics. Psychomotor retardation symptom was the most effective variable that discriminates between the normals and the schizophrenics. And it would be concluded that the psychomotor dysfunction was more severe in negative schizophrenics than positive schizophrenics.

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A STUDY OF THE DEVELOPMENT AND STANDARDIZATION OF ADHD DIAGNOSTIC SYSTEM (전산화된 주의력장애 진단시스템의 개발 및 표준화 연구)

  • Cho, Sung-Zoon;Chun, Sun-Young;Hong, Kang-E;Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.91-99
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    • 2000
  • Objectives:Present study developed the computerized ADHD Diagnostic System(ADS) in order to diagnose ADHD and evaluate treatment effect of it, and conducted a standardization study for ADS. Methods:The normative group was composed of 847 children and adolescents between the age of 5 and 15(boy 429, girl 418) living in the areas of Seoul, Kyunggi-do, and Kangwon-do. 30 ADHD children with age ranged 7 to 9 years were participated present study to evaluate the validity of ADS. To establish the norms for diagnosing ADHD, the means and standard deviations of normative group were used to calculate T-scores for each age group. Results:The reliability coefficient of ADS(Cronbach's ${\alpha}$) was .85. There were significant differences in the measures of ADS except commission error between the normal and the ADHD groups. Three factors were extracted through factor analysis of ADS, which were labelled 'inattention', 'slow information processing' and 'impulsivity'. Discriminant analysis showed that ADS significantly discriminate the normal and the ADHD groups. Percentage of correct classification by ADS variables was 96.7%. Conclusion:These results put together strongly support the reliability and validity of ADS as a diagnostic instrument for ADHD.

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A Study of Psychiatric Problems of North Korean Refugees Who Visited a Psychiatric Clinic (한 정신건강의학과에 내원한 북한이탈주민의 정신의학적 문제 고찰)

  • Kang, Hee-Young;Byeon, Seong-Hye;Shin, Sang-Ho;Kim, Hyun-Chung;Lee, So-Hee;Yoo, So-Young
    • Sleep Medicine and Psychophysiology
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    • v.19 no.1
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    • pp.35-41
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    • 2012
  • Purpose: According to the statistics announced by the Ministry of Unification, the number of North Korean refugees living in South Korea has increased by 200 on average monthly in 2010. The number of refugees increased only by 300 annually until 2000. The total number of refugees as of February 2012 was 20,956. This study aims to investigate the psychobiology of the North Korean refugees who consulted psychiatric clinics among those living daily life in South Korea. Methods: The subjects of this study were 85 North Korean refugees that consulted psychiatric clinics from January 1, 2005 to July 2011. This study obtained demographic and psychiatric information in a retrospective approach. Results: Among the 85 North Korean refugees, 75 (88.2%) were females and their average age was 48 years of age. A total of 16 (18.8%) were admitted to a clinic and among the inpatients, 4 were admitted twice and two were admitted three times. As for the claimed symptoms of outpatients, insomnia was shown in 47 (55.3%) patients, headaches in 37 (43.5%), anxiety in 20 (23.5%), depression in 19 (22.4%), etc. The major symptoms represented by inpatients were insomnia in 14 (87.5%) patients, depression in 12 (75%), and headaches in 8 (50%), etc. Conclusion: The most frequent psychiatric symptoms of North Korean refugees living in South Korea were insomnia and headaches. It suggests that when performing psychiatric diagnosis and treatment of North Korean refugees, we have to take into consideration the fact that they claimed the physical symptoms more than the emotional ones. Also, from the aspect that most symptoms of North Korean refugees were insomnia, more profound research on sleep is required in the future.

A study of Extraversion-introversion as a Dimension of Personality in Schizophrenics (정신분열증 환자에서 성격차원으로서의 외-내향성에 관한 연구)

  • Lee, Jung-Hoon
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.338-344
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    • 1993
  • The purpose of this study was to investigate the trait cortical arousal level, measured by extraversion-introversion, in schizophrenics. Subjects in this study were 231 (chronic schizophrenics=78, acute schizophrenics=62, and normal persons=91). All subjects were asked to respond to extraversion-introversion subtest scale in the korean EPQ(Korean Version Eysenck Personality Questionnaire). Collected data were analyzed by using the t-test and one-way analysis of variance. Results were as follows : 1) Trait cortical arousal level of chronic schizophrenics, which was measured by extraversion-introversion subtest scale in the Korean EPQ, was statistically higher than that of acute schizophrenics and normals. 2) Acute schizophrenics and normals were not significantly different in the trait cortical arousal level. However, the trait cortical arousal level of chronic schizophrenics was higher than that of acute schizophrenics. Therefore, it may state that the trait cortical arousal level of schizophrenics is getting higher when schizophrenic symptoms become more chronic.

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Brain wave results in children with attention deficit hyperactivity disorder and treatment result with central nervous system stimulants (주의력결핍 과잉행동장애 환아에서 시행한 뇌파 결과 및 중추신경자극제 치료에 따른 결과)

  • Lim, Young Su;Sim, Ji Yun;Son, Jung-Woo;Kim, Won Seop
    • Clinical and Experimental Pediatrics
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    • v.51 no.12
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    • pp.1324-1328
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    • 2008
  • Purpose : Attention deficit hyperactivity disorder (ADHD) is a syndrome characterized by inattention, impulsive disruptive behavior, impaired concentration, and motor restlessness. This study examined the relationships among electroencephalographic (EEG) findings, stimulant use, and seizure occurrence in children with ADHD. Methods : We retrospectively studied 308 children with ADHD who visited the neuropsychiatric clinic of our hospital from January 2001 to December 2005. We retrospectively analyzed age distribution, etiology, abnormal EEG findings, and use of CNS stimulants. Among these children, brain waves was recorded in 84 patients. Results : Eighty-four children (72 males, 85.7%, 9.3 years mean age; 12 females, 14.3%, 8.0 years mean age) with ADHD had electroencephalograms (EEGs) performed at our institute. Nineteen patients (22.6%) demonstrated epileptiform abnormalities, and 65 (77.4%) demonstrated normal EEGs. Stimulant therapy was applied to 59 of 84 patients (70.2%). Seizures occurred in 1 of 65 patients with a normal EEG (incidence, 1.5%) and 3 of 19 treated patients with epileptiform EEGs (incidence, 15.7%). Conclusion : These data suggest that patients with normal EEGs have minor risk for seizure. In contrast, patients with epileptiform EEGs have higher risk for seizure than patients with normal EEGs.

THE EFFICACY AND SAFETY OF RISPERIDONE IN CHILD & ADOLESCENT PSYCHIATRIC INPATIENT (소아 청소년 정신과 입원 환자에서 Risperidone의 효과 및 안정성에 관한 연구)

  • Park Jeong-Hyun;Kim Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.2
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    • pp.239-250
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    • 2005
  • Objective : The purpose of this study was obtaining data on the efficacy and safety of risperidone in child and adolescent psychiatric patients. Method : Thirty one children and adolescents (males n=18, females n=13, age ranged from 5.4 to 17.3 years) treated with risperidone were selected among child and adolescent psychiatric inpatients of Seoul National University Hospital from January, 2001 to June, 2002, and charts for them were reviewed retrospectively. Results : The primary psychiatric disorders treated with risperidone were schizophrenia and other psychosis, bipolar I disorder with psychotic features, Tourette's disorder, autism spectrum disorders, mixed receptive and expressive language disorder, attention deficit-hyperactivity disorder, conduct disorder and obsessive-compulsive disorder. twelve of these had comorbid mental retardation. Primary target symptoms of risperidone were psychotic symptoms (n=13 or $41.9\%$), behavioral symptoms (n=10 or $32.3\%$) including aggression, impulsivity, hyperactivity, stereotypy nonresponsive to other psychiatric treatments, and chronic and severe tics (n=8, $25.8\%$). The efficacy of risperidone was measured by clinical global improvement (CGI) for target symptoms, $67.7\%$ of subjects showed moderate or marked improvements and its therapeutic effect appeared to be maintained during at least 7.5 months. Mean daily dosage of risperidone was $0.05{\pm}0.01mg/kg$, the group with psychotic symptoms had significantly higher mean daily dosage (0.07mg/kg) compared with other two groups (0.04mg/kg) with behavioral symptoms or tics. A variety of adverse events were reported in this study : weight gain (n=23) most commonly reported, extrapyramidal symptoms (n=15), autonomic symptoms (n=6), sedation (n=5) and symptoms related to hyperprolactinemia (n=2) etc. Although there was no drug change related to the adverse events of risperidone, and $90\%$ of subjects at their last visits were maintained on it, thus its tolerability appeared good. Conclusions Results suggest that risperidone may be relatively safe and effective drug in managing a wide variety of child and adolescent psychopathologies such as psychotic symptoms, behavioral symptoms including aggression, impulsivity, hyperactivity and stereotypy nonresponsive to other psychiatric treatments, and chronic and severe tics. Controlled and long-term studies of efficacy and safety of risperidone treatment for children and adolescents are recommended in the future.

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