• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.28 no.1
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• pp.4-13
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• 2017

The seeds of addiction are typically sown years prior to the onset of addictive substance use or engagement in addictive behaviors, due to the priming of the reward pathway (RewP) by alterations in the mechanism of stress-signaling from the hypothalamic-pituitary-adrenal axis (HPA) and related pathways. Excessive stress from a single-event and/or cumulative life experiences during childhood, such as those documented in the Adverse Childhood Experiences Study, is translated into neurobiological toxicity that alters the set-point of the HPA axis and limbic system homeostasis [suggested new term: regulation pathway (RegP)]. The resultant alteration of the RegP not only increases the risk for psychiatric and physical illness, but also that for early onset and chronic addictions by dysregulating the RewP. This paper reviews the interface of these symbiotic pathways that result in the phenotypic pathology of emotional dysregulation, cognitive impairment, and compulsive behaviors, as well as morbidity and shorter life expectancy when dysregulated by chronic stress.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.25 no.1
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• pp.6-13
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• 2014

Objectives : The aim of this study is to assess the career paths and practice patterns of child and adolescent psychiatrists in South Korea. Methods : A survey on demographic data, work environment, opinion on fellowship training program, and current practice patterns was conducted in 76/223 (34.0%) of all child and adolescent psychiatrists (N=223) were from 1980 to 2008. The survey data from the responders were analyzed. Results : More than half of those surveyed were women. The mean age of survey participants was 40.8 years; most were married, and lived in the Seoul National Capital Area. In general, the responders were very satisfied with their work. They worked in private practice, public sector, group practice, and as consultants. Up to 87% of the patients treated were children and adolescents. The most common treatment modalities were medication and parent psychoeducation. Social skills training and play therapy were applied mainly for children aged 4 to 12 years old. Cognitive behavioral therapy and counseling were preferred in adolescents. Conclusion : The current study used a database approach in order to define current practice patterns. These data may be helpful in consideration of future training programs, workforce issues in child and adolescent psychiatry in South Korea, and also in collaboration with other mental health providers.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.32 no.3
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• pp.112-117
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• 2021

Objectives: This study identified changes in social communication and interaction among children with autism spectrum disorder (ASD) through Theraplay. Methods: This study included 20 children who were diagnosed with ASD by a child and adolescent psychiatrist and were recommended to undergo Theraplay in 2012-2017. The Marschak interaction method was used to identify and analyze the interactions between parents and their children. The Korean version of the Social Communication Questionnaire (K-SCQ) was used to evaluate symptoms of ASD. The Wilcoxon signed-rank test was used to compare the differences before and after Theraplay. Results: Upon comparing the differences in total K-SCQ scores, there were statistically significant changes (z=-3.269, p=0.001) in children with ASD. Changes were also confirmed in each category, namely social interaction, communication, and limited and repetitive behavior patterns (p=0.011, p=0.025, p=0.039, respectively). Conclusion: This study found that Theraplay may cause significant changes in social communication in children with ASD. Further studies are needed to establish the effectiveness of Theraplay in children with ASD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.24-29
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• 2002

The social attention about disaster psychiatry was increased after 911 terror in New York. The role of child psychiatrist and specific consideration for the treatment of child victim in disaster were reviewed. The following were main points. 1) The most single determining factor of prognosis is supporting system and parental attitude to their child victim. So family therapy and parental eucation are needed. 2) Cognitive Behavior Therapy is known to the most effective treatment in many literature. 3) Brief group therapy with fellow victim is cost effective preventive methods and screening tool for more serious victim, 4) Eye Movement Desensitization and Reprocessing(EMDR) could be a very amazing method in reducing repetative horrible traumatic image. 5) Many kinds of drug using in adult are considered with caution.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.22 no.1
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• pp.38-43
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• 2011

Chronic tic disorder or Tourette syndrome is known to be a chronic neuro-behavioral disease for which cognitive behavioral therapy (CBT) strategies have recently been introduced. Here, we report the effectiveness of CBT in a case of childhood chronic tic disorder, which is very common in clinical settings. The DSM-IV clinical diagnosis was applied by a child psychiatrist. The Yale Global Tic Severity Scale, Kovac's children's depression inventory, Spielberger State-Trait Anxiety Inventory, Abbreviated Conners' Rating Scales, and the Dupaul ADHD Rating Scales were used. This case involved a pharmacological treatment-refractory patient over the previous year. Thus, psychiatric consultation was undertaken. Subsequently, we administered five sessions of CBT for four weeks, consisting of symptom evaluation and planning, habit reversal training, and ventilation training. Following four weeks of CBT administration, there were improvements in the scores of the Yale Global Tic Severity Scale and the Clinical Global Improvement scale. Our observations indicate that CBT may be effective in the treatment of childhood tic disorder.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.17 no.1
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• pp.3-9
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• 2006

Objectives: Obesity is one of risk factors for psychological and social adjustment problems (depression, low self esteem, low school function etc). Quality of life(QOL) is comprehensive and multidimensional construct including physical, emotional, social and school functioning. Some authors reported that child and adolescent obesity is associated with impaired QOL. This study was to examine the association between QOL and body mass index (BMI) in middle school students. Methods : Cross sectional analysis of 471 adolescents between the ages of 13 and 14 years ($mean{\pm}SD,\;13.4{\pm}0.6$), who attended one of middle schools in Seoul, Korea. Participants' QOL were scored by using Korean version of pediatric QOL inventory generic score scale ($PedsQL^{TM}$ 4.0). Participants had a $mean{\pm}SD\;BMI\;of\;21.3{\pm}4.0$. Self reports and parent proxy reports using $PedsQL^{TM}$ 4.0 were administered to measure participant's QOL. Participants were divided into four groups by BMI (Male: obesity group >26.5, at risk group 23.2-26.5, normal weight group 15.8-23.1, underweight group <15.8, Female : obesity group >25.2, at risk group 22.9-25.2, normal weight group 16.0-22.8, underweight group <16.0). Results : Compared with other groups, obese adolescents reported significantly(p<0.01) love. QOL in all domains. Obese adolescents were more likely to have impaired QOL than normal weight adolescents (Odds Ratio, 8.3, 95% confidence interval, 4.0-16.7). Conclusion : Obese adolescents have lower QOL than normal weight adolescents. Psychiatrist, parents, and teachers need to be informed of the risk fur impaired QOL in obese adolescents to target interventions that could enhance health outcomes.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.23 no.3
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• pp.127-133
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• 2012

Objectives : The aims of this study were to examine agreement between parent and teacher ratings of the Korean version Strengths and Difficulties Questionnaire (SDQ-Kr) for the children's psychopathology and to determine whether it is effective in diagnostics as the Korean version of Childhood Behavior Checklist (K-CBCL). Methods : SDQ-Kr and K-CBCL were completed by parents and teachers of 165 children aged 6-12 years. The clinical diagnosis was made by a child and adolescent psychiatrist who did not have knowledge of the outcome. Spearman's correlations were computed for associations between parents' and teachers' ratings on a subscale level. The Mann-Whitney U test was performed for the influence of child's age and sex on the results. Finally, AUC values were calculated for the diagnostic capacity and the difference between informants was tested using the z test. Results : High correlations were observed between parents' and teachers' SDQ-Kr on every scale. Parents were more sensitive to emotional symptoms of girls, while teachers appeared to be more responsive to externalized symptoms of boys, inattention-hyperactivity of young children, and emotional symptoms of seniors. Parents' SDQ-Kr demonstrated the highest prediction of attention-deficit hyperactivity disorder. Conclusion : Teachers' SDQ-Kr can be used in identification of child psychopathology when parents are absent or when their reliability is considered low.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.21 no.3
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• pp.161-167
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• 2010

Objectives: In assessing behavioral/emotional problems in school-aged children, the importance of multi-informant reporting has been well documented. However, in clinical settings obtaining multiple informants' opinions has proven difficult. For that reason, we researched the agreement and predictive validity of the Child Problem-Behavior Screening Questionnaire (CPSQ) in order to reveal how accurate parents' assessments reflected teachers'opinions. Methods: We conducted the first screening for second- and third-grade children from 3 elementary schools in Seoul from 2003 to 2007 using the CPSQ. There were 1178 children included in the analysis. We then administered the Korean version of the Child Behavior Checklist (K-CBCL) as a second screening tool and subsequently, the ADHD Diagnostic System (ADS) and the Korean Educational Development Institute version of the Wechsler Intelligence Scale for Children (KEDI-WISC) was administered by a psychiatrist. We examined each item on the CPSQ and the subscale's agreement between parent and teacher as well as the predictive validity of the CPSQ in children diagnosed with emotional/behavioral problems. Results: The agreement rates between parents and teachers appeared high for questions 18 (0.433), 1 (0.385), and 2 (0.325). Among the subscales, a relatively high correlation was found for externalizing problems, attention deficit hyperactivity disorder, and cognitive problems. For all diagnosed children, their parents revealed a higher sensitivity and lower specificity than teachers. Conclusion: From these results, we confirmed that the CPSQ can be useful for sorting out externalizing and cognitive problems. There is a need for further study, however, with a larger sample size.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.1
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• pp.1-11
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• 2015

Phenomenology has been developed by philosophers like Kant and Husserl since the late 18th century. Jaspers, a German psychiatrist, adopted it into psychopathology studies and accumulated data by closely observing and recording the patients' symptoms and signs. Among descriptions done even before the psychopathology or diagnostic criteria of disorders in the field of child psychiatry was established, we can find exact and valuable descriptions matching the autism spectrum disorder or attention deficit/hyperactivity disorder. The diagnostic criteria of modern childhood psychiatric disorders were established based on these grounds. Phenomenological/descriptive methods in various psychiatric fields lead to medical study methods for social phenomenon such as oiettolie, hikikomori, and internet game addiction. Since Romanian orphans were adopted to the western world, descriptive studies along with neurobiological studies on the influence of stimulus deprivation on emotional and physical development are being conducted. While phenomenology, which was adopted by Jaspers to verify psychopathology, was developed mainly by observation and description, recent studies are explaining such descriptive phenomena even at the synapse level due to advances in neurobiology. Although phenomenological/descriptive psychiatry, describing precise and detailed experiences of patients, is less applied nowadays among modern study methods, we must remember that such descriptions may lead to biological studies and provide evidence to improve the accuracy of choosing and applying treatment methods.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.5 no.1
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• pp.102-107
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• 1994

Recently several studies showed a strong and specific association of Attention-Deficit Hyperactivity Disorder(ADHD) and generalized resistance to thyroid hormone(GRTH). The recommandation that all children with ADHD be screened for GRTH is an newer controversial issue in child psychiatric field. Author examined thyroid indices(T3, T4, TSH) and clinical characteristics in the 51 clinical populations with ADHD, developmental delay, and language disorders. The results are that 11 cases were out of the normal range of both T2 and T4 inspite of normal TSH. This finding is suggestive of the finding of GRTH cases. Therefore I suggest that child psychiatrist should pay attention to ADHD symptoms secondary to GRTH and that all children with familial ADHD and developmental delay(including launguage disorder) be screened for thyroid abnormalities.