• Title/Summary/Keyword: Child psychiatric disorder

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Clinical Implications of Social Communication Disorder (사회적 의사소통장애의 임상적 이해)

  • Shin, Suk-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.4
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    • pp.192-196
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    • 2017
  • Social (pragmatic) communication disorder (SCD) is a new diagnosis included under communication disorders in the neurodevelopmental disorders section of Diagnostic and Statistical Manual of Mental Disorders-5. SCD is defined as a primary deficit in the social use of nonverbal and verbal communication. SCD has very much in common with pragmatic language impairment, which is characterized by difficulties in understanding and using language in context and following the social rules of language, despite relative strengths in word knowledge and grammar. SCD and Autism Spectrum Disorder (ASD) are similar in that they both involve deficits in social communication skills, however individuals with SCD do not demonstrate restricted interests, repetitive behaviors, insistence on sameness, or sensory abnormalities. It is essential to rule out a diagnosis of ASD by verifying the lack of these additional symptoms, current or past. The criteria for SCD are qualitatively different from those of ASD and are not equivalent to those of mild ASD. It is clinically important that SCD should be differentiated from high-functioning ASD (such as Asperger syndrome) and nonverbal learning disabilities. The ultimate goals are the refinement of the conceptualization, development and validation of assessment tools and interventions, and obtaining a comprehensive understanding of the shared and unique etiologic factors for SCD in relation to those of other neurodevelopmental disorders.

Regional Cerebral Perfusion Abnormalities in Autistic Disorder : Statistical Parametric Mapping Analysis (자폐 장애에서의 국소 대뇌관류 이상)

  • Kim, Su-Jin;Kim, Boong-Nyun;Cho, Soo-Churl;Kang, Je-Wook;Kim, Jae-Won;Shin, Min-Sup;Cheong, Kwang-Mo;Kim, Hyo-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.20 no.3
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    • pp.122-128
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    • 2009
  • Objectives : Autism is a well-known psychiatric disorder that is presumed to have a neural basis. To investigate the underlying neurofunctional abnormalities of autism, the authors performed single photon emission computed tomography (SPECT) on children with autism. Methods : Fifty-five children with untreated autism (47 boys and 8 girls, mean age=$50.6{\pm}20.28$ months) were selected from among the patients visiting the child and adolescent psychiatric clinic of Seoul National University Hospital. Psychiatrists had diagnosed the participants according to the DSM-IV criteria for autistic disorder and the Childhood Autism Rating Scale (CARS) criteria for a diagnosis of autism. All participants were examined using 99mTC-HMPAO Brain SPECT. Using statistical parametric mapping (SPM) analysis, we compared the participants' SPECT images to standardized SPECT images of normal children, which had been retrospectively selected by the authors, on a voxel by voxel basis. Voxels with a p-value less than .001 were considered to be significantly different. Results : The autistic group showed significant hypoperfusion in the right medial frontal gyrus, right precentral gyrus, and left precuneus gyrus. In addition, they showed no significant hyperperfusion areas when compared to the control group. Conclusion : The findings of hypoperfusion in the medial-frontal lobe and precuneus are accord with hemodynamic abnormalities that have been already reported. Therefore, these findings are compatible with the recently suggested "theory of mind" hypothesis and the disturbances in attention shifting that have been observed in autistic children.

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CLINICAL EVALUATION OF CHILDREN WITH INATTENTION AND HYPERACTIVITY IN A PSYCHIATRIC CLINIC (주의산만과 과잉운동을 주소로 하는 정신과 내원 아동들의 임상 평가)

  • Kweon, Yong-Sil
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.93-103
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    • 2002
  • The aim of this study is to examine the diagnostic profiles and related clinical variables of children with attention and hyperactivity in psychiatric outpatient clinic. Seventy one children with age range of 5 to 14 were diagnosed by DSM-IV, and assessment battery including KEDI-WISC, KPI-C, ADS(ADHD Diagnostic System) were completed. The subjects were divided into 3 diagnostic groups:ADHD only(n=17), ADHD comorbid(n=27), Other diagnosis(n=27). The results were as follows:In ADHD comorbid group, tic disorder, developmental language disorder, borderline intellectual function, oppositional defiant/conduct disorder, and learning disorder were combined in descending order. Other diagnosis group consisted of tic disorder, borderline intellectual function, depression/anxiety, oppositional defiant/conduct disorder, and others. There were significant differences in IQ, PIQ, and VIQ among the three groups, and ADHD only group showed higher scores of IQ and VIQ than ADHD comorbid group. On the KPI-C, there were no significant differences in all subscales among the three groups. On the visual ADS, omission error and sensitivity showed significant differences among the three groups, and ADHD comorbid group represented higher omission error and lower sensitivity than other diagnostic group. The findings indicated that the inattention and hyperactivity symptoms could be diagnosed into diverse psychiatric disorders in child psychiatry, and ADHD children with comorbidity will show more problems in academic performance and school adjustment.

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Development of the Tentative Educational Objectives for the Nursing College (대학간호교육목표의 시안개발)

  • Lee Haw-Ja
    • The Journal of Korean Academic Society of Nursing Education
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    • v.1 no.1
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    • pp.32-45
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    • 1995
  • This thesis is a study to develop the tentative objectives and present the professional and courses for the nursing college. The conclusions conducted by the purpose of this study are as follows. First, on the basis of the concepts of the nursing and the view-points of nursing education, the tentative goals for the nursing education are set up as follows. 1. To understand human being's life, dignity and their physical, mental, and social aspects. 2. To understand the basic concepts and the principles of human sciences, social sciences, natural sciences, and medical sciences. To apply their knowledges to nursing practices. 3. To diagnose and assess the problems of individual, family and community in terms of nursing practice. To develop the ability of planning, negotiation, management, and evaluation for the nursing education. 4. To develop appropriate knowlege, attitudes, and skills to promote the clients' health and treat their illness. 5. To accomplish all tasks effectively as a trained and qualified professional nurse through the endless studies. Second, the nursing areas and courses for the nursing college in terms of validity, Importance, continuity, relationship, utility and appropriateness are listed as follows. 1. Fundamental courses of the nursing. (1) General courses communication human development, behavior science, biochemistry, microbiology, pharmacology (2) Medical courses physiology, anatomy, pathology 2. Basic courses in nursing (1) General nursing fundamental nursing, introduction of nursing, nursing history, nursing process, health education, health assessment, philosophy of nursing, nursing psychology (2) Maternal-Child nursing child-health nursing, child-disease nursing, adolescent nursing, obstetric nursing, post-partum nursing, gyneco-pathy nursing (3) Adult nursing adult health nursing, adult disease nursing I(fluid & electrotonic, shock, anoxia disorder), adult disease nursing II(nutrition-excretion disorder, sexual dysfunction), adult disease nursing III(sense-, control-, activity-, sleep disorder), adult disease nursing IV(operation, rehabilitation, emergency), gerontological nursing (4) Psychiatric nursing child-adolescent psychiatric nursing, adult psychiatric nursing, gerontological psychiatric nursing, spiritual nursing (5) Community health nursing community nursing, school nursing, industrial nursing, family nursing, nursing epidemiology 3. Nursing management and research skills (1) Nursing management nursing administration, nursing ethics, laws related to nursing (2) Research skills nursing statistics, nursing research methodology Finally, the principles of the statement of the specific objectives are the followings : 1. To state the specific objectives on the basis of the syllabus of each courses. 2. To match a content with a verb or gerund as the basic form of objectives. 3. To control the level of the objectives according to the rule 'the higher the level of a content, the lower the level of a verb or a gerund'. This rule applies in the reverse, as well. 4. To decide the number of the objectives in each course on the basis of the numbers of the syllabus and the level of its comprehensiveness, 5. To correct, supplement or eliminate the stated objectives by a professional or professional groups in that area.

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NEUROCHEMICAL BASIS OF CEREBRAL DEVELOPMENT (뇌신경발달의 신경생화학적 기초)

  • Kim Boong-Nyun;Cho Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.15-25
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    • 2005
  • During the recent decade, the new data about normal neurochemical system development have been accumulated very much. Based on these new data, the up-to-date theory and hypothesis have been developed. These development of this field results from the technological/methodological development which increase the sensitivity, specificity and validity of neurochemical research. Especially, molecular technological development support the recent neurochemical development. In this review article, the authors described the recent research findings in the field of normal neurochemical development of neurotransmitter system in animal and human. Most of child psychiatric disorder, especially neuropsychiatric developmental disorders (ADHD, Autism, Tourette's disorder, MR etc) seem to have underlying neurochemical developmental problems in the pathophysiological basis. So, the data on the normal ontogeny of neurotransmitter system can be the most valuable resources for the research on the etiology of the diverse child psychiatric disorders.

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Characteristics Related to Depression in Adolescent Conduct Disorder and Oppositional Defiant Disorder (청소년의 품행장애와 반항성 장애에서 보이는 우울증상과 연관된 특성)

  • Lee, Moon-In;Kim, Sang-Hoon;Kim, Hak-Ryeol;Park, Sang-Hak
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.22 no.3
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    • pp.156-161
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    • 2011
  • Objectives: Externalized behavioral problems are prevalent in adolescents, due to the difficulties associated with this developmental stage. Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD), as well as other psychiatric disorders, such as major depressive disorder, result in the manifestation of many behavioral problems during adolescence. Methods: For this report, we analyzed a sample of 31 adolescents, each of whom had presented with CD or ODD at Chosun University Hospital between 2002 and 2010. We separated subjects into depressed and non-depressed groups according to their Beck Depression Inventory scores (BDI<10, non-depressed ; BDI${\geq}$10, depressed). Then we analyzed for neuropsychological differences between the depressed and non-depressed groups. Results: In our sample, adolescents in the depressed group showed less of a stealing (deceitfulness and/or theft) behavioral pattern and presented with more anxiety symptoms, lower self-esteem, and greater sensitivity in interpersonal relationships, as compared to the non-depressed group. Conclusion: When adolescents exhibit disruptive behavior, clinicians should consider the underlying causes of the behavior.

Clinical Diagnosis and Emotional Behavioral Characteristics Study of Children in a Special Education Class in Korean Elementary School (초등학교 특수학급아동의 임상적 진단 및 감정 행동특성 연구)

  • Lim Myung-Ho;Kang Jin-Kyung;Lee Joo-Hyun;Kim Hyun-Woo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.17 no.2
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    • pp.114-123
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    • 2006
  • Objectives : The special class has been made, bringing rapid increase quantitatively. The authors carried out the child psychiatric interview and evaluation for 9 special-classed children in Asan city to find out clinical diagnosis and emotional/behavioral characteristics. Methods : The child psychiatrists evaluated special class children by DSM-IV and K-SADS-PL. Tools for the evaluation were Child Behavior Checklist- Korean version, Korean Personality Inventory for Children, Children's Depression Inventory, Abbreviated Conners Parent-Teacher Rating Scale-Revised, State-Trait Anxiety Inventory for Children, Vineland Social Maturity Scale, Wechsler Intelligence Scale for Children-III, and Childhood Autism Rating Scale. Results : Ultimately 53 children, consisting of 35 boys(67.9%) and 18 girls(32.1%), participated, and the average age was $10.5{\pm}1.3$ years old. Their measure of Vineland Social Maturity Scale was $78.7{\pm}20.0$, Childhood Autism Rating Scales was $25.4{\pm}9.0$, Child Depression Inventory was $22.2{\pm}5.2$, State-Trait Anxiety Inventory for Children was $35.2{\pm}8.2/36.5{\pm}6.2$, and Abbreviated Conners Parent-Teacher Rating Scale was $11.0{\pm}4.6$. In the clinical diagnosis evaluation, the prevalence rate of learning disorder was decreased compared to early research, ADHD had been newly appeared and depression disorder and anxiety disorder had been increased. Conclusion : This result suggests that a lot of children in a special class have complex emotional and behavioral problems in addition to educational problems.

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COMORBIDITY AND RISK FACTORS ASSOCIATED WITH CHILDREN WHO HAVE THE SYMPTOMS OF OPPOSITIONAL DEFIANT DISORDER - COMMUNITY BASED STUDY - (반항성 도전 장애 아동과 연관된 공존 증상 및 위험 요인에 관한 연구 - 지역사회 연구 -)

  • Kim Boong-Nyun;Jung Kwang-Mo;Cho Soo Churl;Hong Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.79-89
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    • 2005
  • Objectives : To acquire an improved understanding of oppositional defiant disorder, we evaluated the characteristics of children who have the symptoms of ODD in community sample. Methods : 1200 children from an elementary school in Bucheon (an urban community near Seoul) were recruited by randomized sampling method. By Disruptive Behavior Disorder Scale according to DSM-III-R & DSM-IV, we evaluated the symptoms of ODD and selected subjects with ODD. Psychiatric comorbidity, character trait were compared in subjects with ODD and comparison group. Also we examined the association between prenatal/perinatal risk factors, family functions and the symptoms of ODD. Data were analyzed by appropriate statistical method using SPSS 11.5 window version. Result : Children with oppositional defiant disorder were revealed to have significantly higher rates of psychiatric comorbidity and significantly greater family dysfunction compared to comparison group. Among the prenatal/perinatal risk factors, severe emotional stress during pregnancy, postpartum depression, medication during pregnancy were revealed as risk factors of ODD. In character inventory, ODD group were evaluated to have high score in novelty seeking, harm avoidance, but low in reward dependency. Conclusion : These results support that 1) prenatal/perinatal and psycho-social risk factors could be a important role in the progression of ODD, and 2) children with ODD have diverse comorbid psychiatric symptoms.

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ASSESSMENT OF CHILDHOOD DEPRESSION (아동기 우울증의 평가)

  • Shin, Min-Sup;Kim, Min-Kyung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.5 no.1
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    • pp.12-27
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    • 1994
  • Until recently there were arguments on the existence and the definition of childhood depression. In DSM-III(1980) childhood depression was accepted as the formal psychiatric disorder in childhood. As the diagnostic criteria for childhood depression is less clearly defined than those for other psychiatric disorders as well as prominent age-related variations in depression symptomatology, informations from various sources are very important in accurate diagnosis of childhood depression. Present study reviewed various assessment methods such as self-report questionnaires, interviews, behavior rating scales, structured tests and projective techniques with discussion on the merits and limitations of each method. Also several issues on the reliability and the validity of assessment techniques for childhood depression were discussed.

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The Distributional Changes in the First-Visit Psychiatric Child and Adolescent Outpatients at a University Hospital over a Ten-Year Period (지난 10년간 일 대학병원 정신건강의학과 소아청소년 초진환자 분포의 변화)

  • Kim, Hyo-Jin;Jung, Sung-Won;Jung, Chul-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.26 no.3
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    • pp.165-175
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    • 2015
  • Objectives : The purpose of this study was to investigate changes in child and adolescent outpatients at a university hospital in Daegu from 2004 to 2013. Methods : The subjects were first-visit patients under 18 years old, who visited Dongsan Medical Center, Keimyung University, from January 1, 2004 to December 31, 2013. Computerized medical records of 2,738 patients (male 1,906, female 832) were reviewed. Results : The ratio of male to female was 2.3 : 1 in the period of study. The most prevalent age category was 7-9 years. The mean age was $10.12{\pm}4.68$ years ($9.84{\pm}4.59$ years in males, $10.76{\pm}4.81$ years in females). The ratio of child and adolescent patients to total outpatients was 27.0%. The most common diagnostic category was the attention-deficit hyperactivity disorder (ADHD) group, followed by the mental retardation (MR) group. In males, the ADHD, MR, communication disorder groups were more prevalent, but in females, the MR, ADHD, depressive disorder groups were more prevalent. Conclusion : The female to male ratio and total mean age were on the rise. The ADHD group was the most prevalent and the depressive disorder group was also on the rise in this period.