• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.27 no.1
• /
• pp.64-71
• /
• 2016

Objectives: The objective of this study was to examine the effects of osmotic-controlled release oral delivery system methylphenidate on changes in regional cerebral blood flow (rCBF) in children with attention-deficit hyperactivity disorder (ADHD) using single photon emission computed tomography (SPECT). Methods: A total of 26 children with ADHD (21 boys, mean age: $9.2{\pm}2.05$ years old) were recruited. Each ADHD participant was examined for changes in rCBF using technetium-99m-hexamethylpropylene amine oxime brain SPECT before and after 8 weeks methylphenidate medication. Brain SPECT images of pediatric normal controls were selected retrospectively. SPECT images of ADHD children taken before medication were compared with those of pediatric normal controls and those taken after medication using statistical parametric mapping analysis on a voxel-wise basis. Results: Before methylphenidate medication, significantly decreased rCBF in the cerebellum and increased rCBF in the right precuneus, left anterior cingulate, right postcentral gyrus, right inferior parietal lobule and right precentral gyrus were observed in ADHD children compared to pediatric normal controls (p-value<.0005, uncorrected). After medication, we observed significant hypoperfusion in the left thalamus and left cerebellum compared to pediatric normal controls (p-value<.0005, uncorrected). In the comparison between before medication and after medication, there was significant hyperperfusion in the superior frontal gyrus and middle frontal gyrus and significant hypoperfusion in the right insula, right caudate, right middle frontal gyrus, left subcallosal gyrus, left claustrum, and left superior temporal gyrus after methylphenidate medication (p-value<.0005, uncorrected). Conclusion: This study supports dysfunctions of fronto-striatal structures and cerebellum in ADHD. We suggest that methylphenidate may have some effects on the frontal lobe, parietal lobe, and cerebellum in children with ADHD.

• Journal of East-West Nursing Research
• /
• v.29 no.2
• /
• pp.150-160
• /
• 2023

This study aimed to identify the actor and partner effects of parenting efficacy, spousal support on parenting stress and depression in couples with children with attention deficit hyperactivity disorder (ADHD). Methods: A cross-sectional survey design was used. Participants were 103 couples (103 husbands, 103 wives) with children with ADHD visiting child adolescent psychiatry clinic or community mental health center in Seoul, Gyeonggi-do, South Korea. Data were analyzed by SPSS 20.0 and AMOS 20.0 program. Results: The parenting efficacy of husbands and wives had direct actor effect (β=-.69, p=.004; β=-.60, p=.004) and partner effect (β=-.22, p=.007; β=-.18, p=.026) on their parenting stress. In addition, husbands and wives's parenting efficacy had a direct actor effect (β=-.25, p=.031; β=-.21, p=.025) on their depression and indirect actor effect (β=-.25, p=.004; β=-.34, p=.004) through parenting stress on their depression. However, parenting stress did not show a partner effect on depression. Husband and wife's parenting efficacy had a direct effect (β=.46, p=.004; β=.25, p=.009) on perceived spousal support. The effects of husbands and wives were the same in actor effect size (χ² differences=0.74, p=.390) and partner effect size (χ² differences=0.20, p=.652) of parenting efficacy on parenting stress. In addition, the effect sizes of husbands and wives were the same in actor effect size (χ² differences=0.93, p=.334) and partner effect size (χ² differences=0.15, p=.704) for parenting stress and depression. Conclusion: The results of this study may provide the foundation for developing a nursing intervention program that can maximize interaction between couples with ADHD children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.27 no.4
• /
• pp.313-318
• /
• 2016

Objective: The purpose of this study was to investigate the clinical utility of the Korean Wechsler Intelligence Scale for Children-Fourth Edition (K-WISC-IV) and General Ability Index (GAI) in children with attention-deficit hyperactivity disorder (ADHD). Methods: The GAI and Full Scale IQ (FSIQ) in K-WISC-IV were compared for a group of 79 children with ADHD and 234 normal children. The mean differences within each group were testified by the t-test and Cohen's d. The Wechsler's descriptive classifications for each GAI and FSIQ score were analyzed in the children with ADHD. Additionally, the critical value for the difference between the means of the FSIQ and GAI was calculated in the normal children. Results: The score on the GAI was higher than that on the FSIQ in the children with ADHD, with a mean difference of 2.19 points. The implications of these findings are discussed regarding the cognitive characteristics of the children with ADHD. According to Wechsler's descriptive classification, the application of the GAI showed a lower (7.59%), equal (61.65%) or higher (60.76%) prevalence of ADHD compared to the application of FSIQ. Conclusion: The implications of these findings are discussed regarding the cognitive characteristics of the children with ADHD. The GAI reflecting the attention and behavioral problems in children with ADHD could be utilized as an alternative global intelligence estimate that considers their potential for development.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.14 no.2
• /
• pp.238-246
• /
• 2003

Objectives：Mental health problems have been found to be more common among juvenile delinquents. This report assessed the reliability, and validity of the MAYSI-2K(Massachusettes Youth Screening Instrument-2 Korean) in Korean delinquents to examine the utility as a screening measure. Methods：The study consisted of 119 male juvenile youths(mean age 16) who admitted in the probation & detention office. They completed an assessment battery including MAYSI-2K and K-YSR(Korean-Youth Self Report) upon entry. Factor analysis, reliability test, and validity test were conducted. Results：The results of factor analysis represented 14 factors which showed more factor structures in comparison with published factor loadings of 7 in the MAYSI. In factor analysis according to the each subscale of the MAYSI, the internal coefficients of 7 subscales ranged from .142 to .756. Test-retest reliability revealed significant correlations(r= .84). There were significant correlations among subscales of MAYSI-2K and K-YSR. Conclusion：Our findings suggested that MAYSI-2K might be a useful screening measure. But further studies with extended number of subjects and culturally appropriate items are required for clinical utility of the MAYSI-2K in Korean delinquents.

• Clinical and Experimental Pediatrics
• /
• v.53 no.3
• /
• pp.300-306
• /
• 2010

Purpose : Recent changes in the population structure of Korea, such as rapid decline in birth rate and exponential increase in old-aged people, prompted us to prepare a new health improvement program in children and adolescents. Methods : We reviewed current health screenings applied for children and adolescents in Korea and other developed countries. We collected and reviewed population-based data focused on mortality and morbidity, and other health-related statistical data. We generated problem lists in current systems and developed new principles. Results : Current health screening programs for children and adolescents were usually based on laboratory tests, such as blood tests, urinalysis, and radiologic tests. Almost all of these programs lacked evidence based on population data or controlled studies. In most developed countries, laboratory tests are used only very selectively, and they usually focus on primary prevention of diseases and health improvement using anticipatory guidance. In Korea, statistics on mortality and morbidity reveal that diseases related to lifestyle, such as obesity and metabolic syndrome, are increasing in all generations. Conclusion : We recommend a periodic health screening program with anticipatory guidance, which is focused on growth and developmental surveillance in infants and children. We no longer recommend old programs that are based on laboratory and radiologic examinations. School health screening programs should also be changed to meet current health issues, such as developing a healthier lifestyle to minimize risk behaviors—or example, good mental health, balanced nutrition, and more exercise.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.16 no.2
• /
• pp.231-238
• /
• 2005

Objectives : This study was done to figure out the incidence of Korean adolescents with gender identity problem and homosexual tendency. Self esteem and sexual liberality were also checked to evaluate the relation with these problems. Method : Subjects were 1,748 adolescents (359 middle school boys, 452 middle school girls, 483 high school boys, and 454 high school girls). DSM-IV-TR gender identity disorder criteria, Kinsey's sexual orientation scale, Hudson's short form sexual liberality scale, and Halter's Self-perception profile for children were applied to them. Result : 1) $15\%$ of the middle school boys, $16.7\%$ of the high school boys, $39.4\%$ of the middle school girls, and $40.5\%$ high school girls showed gender identity problem. Incidence of mild problem was more frequent in girls, however severe problem that suggested gender identity disorder was more frequent in boys, especially in high school boys. 2) Gender identity problem group showed lower self esteem than no problem group, especially in the middle school boys (p=0.033) and high school girls (p=0.020). 3) $17\%$ of the middle school boys, $5.4\%$ of the high school boys, $17.7\%$ of the middle school girls, and $12\%$ of the high school girls showed homosexual tendency. The order of more vivid homosexual orientation incidence was as follows ; $3.3\%$ in the middle school girls, $3.1\%$ in the middle school boys, $2.1\%$ in the high school girls, and $1.7\%$ in the high school boys. 4) There was no difference in the score of sexual liberality according to homosexual tendency. In high school girl, self esteem score was lower in homosexual tendency group than that of heterosexual group (p=0.039). 5) Gender identity problem group showed higher incidence of homosexual tendency than that of gender identity formation group (p=0.001). 6) The incidence of sexual identity problem was not changed by age, but homosexual tendency was decreased with age, especially in boys. Conclusion : Adolescents with gender identity problem or homosexual tendency showed low self esteem. Therefore, more attention on systemic evaluation for early detection in school based mental health and psychiatric management for them are needed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.8 no.1
• /
• pp.34-42
• /
• 1997

Enuresis is repeated involuntary or intentional voiding of urine into bed or clothes over age 5. Though it would be a self-remitting disorder, it could be serious problem in emotional and socio-adaptational aspects. The author reviewed the enuretic patients of Child & Adolescence psychiatric section in Chungnam National University Hospital during past 3 years. 46(4.9%) of 936 patients were diagnosed as enuresis in DSM-Ⅳ. The author evaluated their comorbidity by the data of diagnostic review made in two psychiatrists, and emotional aspects(self-concept, anxiety, depression) through the self-rating scales (Piers-Harris children’ self concept scales, RCMAS, state-trait anxiety inventory for children, child’s depresson inventory). Thirty(65.2%) of the 46 enuretic patients had additional diagnoses such as attention deficit hyperactive disorder, mental retardation, encopresis, oppositional defiant disorder, depression, anxiety disorder, autism, somatoform disorder, tic disorder, obsessive-compulsive disorder, sleep disorder, etc. Sixteen enuretic patients had at least one comorbid disorder. Eleven patients had two, and three patients had more than three. Fourteen of 46 enuretic patients were evaluated through self-rating scales of self-concept, anxiety and depression. But we couldn’t obtain meaningful results. Maybe it was due to the small sample size(N＝14) and the influence of the comorbid disorders. Finally, it was an impressive evidence that there exist many comorbid disorders in enuresis(esp. attention deifict/hyperactive disorder). In emotional aspects, the author thought that further evaluation should be needed for more meaningful results.

• Anxiety and mood
• /
• v.2 no.1
• /
• pp.50-55
• /
• 2006

Objectives : In the psychiatry, structured interview is very important tool to be used in epidemiological or psychopharmacological studies. However, investigators often find that the administration of comprehensive diagnostic interviews is time-consuming and expensive to be used in clinical or research settings. Considering these points, Sheehan and his colleagues developed MINI (Mini International Neuropsychiatric Interview) to meet the need for a brief, reliable, and valid structured diagnostic interview for psychiatric disorders. The MINI has been translated into many languages and used in many countries. Therefore, we translated the MINI into Korean and determined its validity in this study. Methods : Twohundred seventy patients and normal subjects participated in the validation of the MINI versus an expert's professional opinion. Schizophrenia and other psychotic disorders, mood disorders including major depressive disorder and bipolar disorder, anxiety disorders including panic and other phobic disorders, and alcohol dependence were included in this study. The validity was obtained by examination whether MINI based diagnoses were compatible with diagnoses by expert psychiatrists. Results : The range of Kappa values was 0.22 (somatoform disorder) to 0.93 (bipolar disorder - past). Overall agreement between MINI and expert's diagnoses were good. The Kappa values for anxiety disorders seemed to be higher than those for other disorders. Conclusion : The MINI Korean version has the good validity. It also has potential applications as a diagnostic tool for psychiatric disorders.

• Korean Journal of Psychosomatic Medicine
• /
• v.28 no.2
• /
• pp.99-107
• /
• 2020

Fibromyalgia is a disorder characterized by the core symptom of chronic widespread pain, along with fatigue, sleep disturbances, mood changes, and cognitive difficulties. The etiology of fibromyalgia involves a combination of biological factors, such as genetic vulnerability, alterations in pain processing and stress response system ; psychological factors, such as anxiety, depression, anger, and perceived stress ; environmental factors, such as infections, febrile diseases, and trauma. Central sensitization, which is amplified in the process of sensory stimulation, has been emphasized as a key etiological factor, as supported by enhanced wind-up, delayed aftersensation, decreased nociceptive flexion reflex threshold and functional imaging studies. Several guidelines recommend that a multimodal approach be used to treat fibromyalgia, including both pharmacological and non-pharmacological treatments, tailored to each individual, and that clinicians should provide an intellectual framework through sufficient education and emphasis on the importance of self-management. The prevalence of mood disorders, anxiety disorders, and other psychiatric problems is 7-9 times higher in patients with fibromyalgia than in the general population ; moreover, the association between fibromyalgia and certain psychopathologies or sleep problems has also been suggested. Since psychiatric problems, with shared vulnerabilities and risk factors, interact with fibromyalgia bidirectionally and also affect the disease course, an integrated management approach is needed to determine the risk of comorbidities.

• Korean Journal of Psychosomatic Medicine
• /
• v.23 no.2
• /
• pp.86-92
• /
• 2015

Objectives : The aim of this study was to investigate the gender differences of direct aggression and relational aggression in Korean elementary and middle school students. Methods : Parents of 946 elementary school students(age $9.54{\pm}1.72$ years, 485 boys, 461 girls) completed the Child Behavior Checklist(CBCL). Six-hundred-and-three middle school students(age $13.98{\pm}0.93$ years, 301 boys, 302 girls) completed the Youth Self-Report(YSR). Independent t-test, chi-square test, and Fisher's exact test were used. Results : Boys had significantly higher direct aggression scores than girls in elementary school students(p<0.001). There was no significance gender difference of relational aggression in elementary school students(p=0.235). In middle school students, boys had significantly higher direct aggression than girls(p=0.017), and girls had significantly higher relational aggression compared to the boys(p<0.001). Conclusions : Our results suggest the presence of gender differences in manifestation of aggression subtypes in Korean elementary and middle school students. These gender differences should be taken into account in prevention and intervention approaches of aggression in children and adolescents.