• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.32 no.3
• /
• pp.118-125
• /
• 2021

Objectives: Childhood adversity is a risk factor for anxiety symptoms, but it affects anxiety symptoms in attention-deficit/hyperactivity disorder (ADHD). The current study aimed to examine the association between childhood adversity and anxiety symptoms in participants with and without ADHD. Methods: Data were obtained from a school-based epidemiological study of 1017 randomly selected children and adolescents. The ADHD and non-ADHD groups were divided using the Diagnostic Interview Schedule for Children Predictive Scale (DPS). The DPS was also used to assess comorbidities such as anxiety and mood disorders. The childhood adversities were assessed using the Early Trauma Inventory Self Report-Short Form, and the anxiety symptoms were assessed using the Screen for Child Anxiety Related Disorders. Linear and logistic regression models were used to investigate the association between childhood adversity and anxiety in the ADHD and non-ADHD groups with adjustments for age and sex. Results: This study found that the ADHD group did not show any significant association between anxiety symptoms and childhood adversities, whereas the non-ADHD group always showed a significant association. In a subgroup analysis of the non-ADHD group, the normal group without any psychiatric disorders assessed with DPS demonstrated a statistically significant association between childhood adversities and anxiety symptoms. These results were consistent with the association between childhood adversities and anxiety disorders assessed using DPS, as shown by logistic regression. Conclusion: The association between anxiety symptoms and childhood adversities statistically disappears in ADHD; ADHD may mask or block the association. Further longitudinal research is necessary to investigate this relationship.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.13 no.1
• /
• pp.85-92
• /
• 2002

Objectives：This study was conducted to compare the memory function among the attention deficit/hyperactivity disorder(ADHD), the learning disorder(LD) and the comorbidity disorder(ADHD+LD) groups. Methods：Thirty-four children(11 ADHD, 5 LD, 9 ADHD+LD, and 8 Psychiatric control) were individually assessed using the KEDI-WISC and Memoty Assessment Scale(MAS), and then the results of those test were analyzed. Results：In memory test, all of three group showed lower performances than control group. The comorbidity, the LD and the ADHD group showed lower scores in almost subtests of MAS respectively. The good performance in memory test was significantly correlated with the types of memory strategy and error response children used during testing. Discussion：The clinical utility of the memory test like MAS was discussed in terms of differential diagnosis for ADHD, LD and ADHD+LD children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.28 no.4
• /
• pp.213-219
• /
• 2017

Objectives: Early intensive interventions are very important for children with autism spectrum disorder. We examined the actual conditions of hospital-based early intensive interventions for autism spectrum disorder in Seoul, in order to help develop and implement an evidence-based early intensive intervention model for use in Korea. Methods: Nine hospital-based institutes running an early intensive intervention program for children with autism spectrum disorder responded to a questionnaire in September 2014. They provided a brief introduction to their program, explained its theoretical bases, and reported the number of children, their age, intervention time, duration and so on. Results: In the majority of the institutions, the intervention was provided for over 20 hours every week, and the theoretical bases included various applied behavioral analysis (ABA) methods and other therapies (language and occupational therapy). The therapist-child ratio ranged from 1:1 to 5:3. Various types of therapists were involved, including behavioral analysts, special education teachers and (or) language pathologists. There was only one clinic where the behavioral analyst was the main therapist. Usually, the intervention was terminated just before the child entered elementary school. The main merit of the hospital-based intervention in our survey was the effectiveness of the multi-disciplinary intervention plan and its other merits were the accuracy of the diagnosis, its ability to be combined with medicine, and so on. Conclusion: The current hospital-based early intensive intervention programs provide interventions for over 20 hours per week and employ multidisciplinary approaches. However, there are very few institutes for children with autism and very few intervention specialists and specialist education courses in the country. We need more educational programs for intervention therapists and have to try to develop policies which encourage the implementation of an evidence-based early intensive intervention program nationwide.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.5 no.1
• /
• pp.150-161
• /
• 1994

Clinical Characteristics of 83 tic patients referred to child psychiatric clinics were studied including the patients' sexes, birth orders and onset ages. We compared the differences between patients and normal control regarding the co-morbidity, and mothering attitude using CBCL(Child Behavioral Check List) and MBRI(Mothering Behavior Rating Instrument). And we also evaluated the influence of types of tic disorder and the presence of behavioral characteristics of the tic patients. The following results were obtained. 1) The sex ration was 5.9:1, male dominant. 2) The eldest children were being twice as many as the youngest children(eldest : youngest : single=4.7 : 1.7 : 1). 3) The eldest children tended to have earlier onset than others. 4) The tic children as a whole had more accompanying behavioral problems than the normal children according to the CBCL scales' scores. 5) The mothers of tic children had more negative view of their children, more rejecting and more hostile attitude toward their children. 6) The types of tic disorder(the Tourette disorder vs chronic moter tic disorder) did not make a difference in the incidence of behavior problems. 7) Those who had attentional problems regardless the types of tic had more behavioral problems than those who had not. 8) Those who had familial loadings of tic disorder tended to have more likely Tourette disorders than chronic tic disorders.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.27 no.3
• /
• pp.196-206
• /
• 2016

Objectives: Individuals with autism spectrum disorder (ASD) are considered to have problems with empathy. It has recently been suggested that there are two systems for empathy; cognitive and emotional. We aimed to investigate the neural response to cognitive and emotional empathy and elucidate the neurobiological aspects of empathy in patients with ASD. Methods: We recruited patients with ASD (N=17, ASD group) and healthy controls (HC) (N=22, HC group) for an functional magnetic resonance imaging study. All of the subjects were scanned while performing cognitive and emotional empathy tasks. The differences in brain activation between the groups were assessed by contrasting their neural activity during the tasks. Results: During both tasks, the ASD group showed greater neural activities in the bilateral occipital area compared to the HC group. The ASD group showed more activation in the bilateral precunei only during the emotional empathy task. No brain regions were more activated in the HC group than in the ASD group during the cognitive empathy task. While performing the emotional empathy task, the HC group exhibited greater neural activities in the left middle frontal gyrus and right anterior cingulate gyrus than the ASD group. Conclusion: This study showed that the brain regions associated with cognitive and emotional empathy in ASD patients differed from those in healthy individuals. The results of this study suggest that individuals with ASD might have defects both in cognitive empathy and in emotional empathy.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.28 no.3
• /
• pp.183-189
• /
• 2017

Objectives: The study aimed to identify the characteristics of attention-deficit hyperactivity disorder (ADHD) that was not diagnosed in childhood or adolescence, but only in adulthood. Methods: The characteristics of patients diagnosed with ADHD in adulthood were compared with those of patients diagnosed in childhood were assessed via a retrospective review of the medical records at one university hospital from 2005 to 2013. If the age at which they were confirmed as having ADHD was less than 19 years old, they were grouped as childhood-diagnosed group (CD); if they were 19 years old or more, they were grouped as adulthood-diagnosed group (AD). Results: The CD and AD included 50 (46.3%) and 58 (53.7%) patients, respectively. Inattention was the most common symptom in both groups. Behavioral and emotional problems were the second most frequent symptoms in the CD and AD, respectively. The intelligent quotient was significantly higher in the AD than in the CD. The most common comorbidity was depression in the CD and personality disorder in the AD. The most common reason for visiting the hospital was referral by acquaintances in the CD and media coverage in the AD. Conclusion: Clinicians should put ADHD on the index of suspicion when they examine adults with various psychiatric symptoms, because the diagnosis of ADHD might have been missed in childhood and the symptoms of ADHD might have changed as they grew up.

• Anxiety and mood
• /
• v.7 no.1
• /
• pp.34-39
• /
• 2011

Objectives : An early age at onset of obsessive compulsive symptoms in family studies has been strongly associated with a more familial form of obsessive compulsive disorder (OCD). Further, many reports have suggested that early- and late- onset OCD represent separate subtypes of the disorder. The aim of this study was to investigate the associations between the glutamate receptor, the ionotropic, n-methyl-d-aspartate (NMDA) subunit 2B gene (GRIN2B) polymorphisms, and onset of OCD in the Korean population. Methods : We recruited 109 OCD patients and classified them into early- (age of onset <18 years) and late-onset groups (age of onset${\geq}$18). Genomic DNA was extracted from their blood after which the genotypes and allelic frequencies of the two GRIN2B polymorphisms (5072T/G and 5988T/C) were compared in the two groups. We also compared genetic data between child- (age of onset${\leq}$15) and adult-onset groups (age of onset${\geq}$19) using the same protocol. Results : There were no significant differences between the early- and late-onset groups with respect to genotype. Moreover, we could not find any differences in genotype frequencies between child and adult-onset groups. Conclusions : Our study suggested that GRIN2B polymorphisms (5072T/G and 5988T/C) do not affect the onset of OCD in Koreans. However, this finding has resulted from a preliminary study and thus, further study is required.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.18 no.1
• /
• pp.58-65
• /
• 2007

Objectives : Motivational factor is a unique contributor to the typically poor academic performance of children with ADHD. However, few study has directly intervened learning motivation in children with ADHD. We conducted this study to explore the direct effects of the learning motivation improvement program applied to children with ADHD. Method The program was designed in order to increase an interest-inducing educational intervention, an academic skills integration, a basic learning activity (reading, writing, and math), and children's self-esteem. We conducted the program twice a week (total 10 sessions) and assessed learning motivation, teaming attitude, self-esteem, academic performance, and problem behaviors of participating children. Results : After the program, teachers reported improvement in teaming motivation. In addition, parents notified sisnificant reduction of problem behaviors. Children reported improvement in a few domains of teaming motivation and learning attitude. Conclusion : While loaming motivation is regarded as an important factor in education, there have been few studies considering this issue in both educational and psychiatric fields. The teaming motivation improvement would be needed in both field in order to reduce the deficits in academic performance in children with ADHD.

• 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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.9 no.2
• /
• pp.227-236
• /
• 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.