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

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.1
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• pp.83-91
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• 1997

Objects：This study investigated whether depression, anxiety and perceived parental rearing patterns of the conduct disorder patients are different from those of the normal control group. The correlations were also assessed between perceived parenting style and depression, anxiety, severity of conduct problems and age at onset of conduct disorder in adolescents with conduct disorder. Methods：Thirty hospitalzed patients who met the DSM-Ⅳ criteria of conduct disorder, and 30 normal control subjects completed self-report questionnaires containing the Children’s Depression Inventory(CDI), the State-Trait Anxiety Inventory for Children(STAIC) and the Parental Bonding Instrument(PBI). Results：In the conduct disorder group, the results were as follows：1) The mean scores of CDI and STAIC-T(Trait) were not significantly different from those of the control group, but STAIC-S (State) showed significantly higher scores. 2) Parenting style was perceved to be less caring and more overprotective than in the control subjects. 3) There were negative correlations between maternal care and CDI and between maternal care and severity of conduct problems. 4) There were positive correlations between maternal overprotection and STAIC-T(Trait). 5) There were no correlations between paternal rearing patterns and depression, anxiety, severity of conduct problems, or age at onset of conduct disorder. Conclusion：We failed to identify depression and anxiety as common comorbid disorders in conduct disorder. Parental rearing patterns are thought to be significantly negativistic in conduct disorder group. It is guessed that less caring and more overprotective rearing style of parents, especially of mothers, could have much influence on depression and anxiety, more severe conduct problems and earlier age at onset of conduct disorder in the adolescents with conduct disorder.

• Anxiety and mood
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• v.13 no.2
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• pp.141-147
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• 2017

Objective : This study aimed to evaluate the relationship between comorbid obsessive compulsive disorder (OCD) and quality of life in stable patients with schizophrenia. Methods : We interviewed 162 symptom-stable inpatients who have been on a constant dose of antipsychotics for at least 3 months prior and diagnosed as chronic schizophrenia. Subsequently, patients were classified according to the existence of OCD as evaluated using the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). Further, all clinical and demographic data were collected and evaluated. To investigate potential interrelationships, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Korea-Positive and Negative Symptom Scale (K-PANSS), Korean Modification of the Scale to Measure Subjective Well-Being under Neuroleptic Treatment (KmSWN) and Korean Version Quality of Life Scale (K-QOLS) were performed. Independent t-test and Chi-square test were used to compare groups and regression analysis was done to assess the relationship between the Y-BOCS and quality of life. Results : Schizophrenia patients with OCD showed significantly earlier onset of schizophrenia, more severe psychiatric symptoms and lower quality of life, compared to those without comorbid OCD. OCD might be associated with lower quality of life in schizophrenia. Conclusion : Schizophrenia patients with OCD showed lower quality of life than those without OCD. In the treatment for schizophrenia, evaluation of OCD might be needed to improve their quality of life and social function.

• Anxiety and mood
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• v.2 no.2
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• pp.108-114
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• 2006

Objectives : Only a few prospective studies of panic disorder are available. This study investigated naturalistic outcome of panic disorder patients at twelve months after the initial diagnosis. Methods : A total of 84 subjects were diagnosed with panic disorder by diagnostic interview, Structured Clinical Interview for DSM-IV (SCID-IV) and Anxiety Disorder Interview Schedule for DSM-IV (ADISIV). Among them, 80 subjects could be evaluated by means of Panic Disorder Severity Scale (PDSS) at follow-up interview after twelve months. Treatment continuation was also examined at follow-up interview. Results : At initial intake, 80 patients were classified into 22% with mild, 33% with moderate-to-marked, and 45% with severe symptoms on the basis of their PDSS total score. At twelve months, 20% of patients reached remission, 65% had mild and 15% had moderate-to-marked symptoms. Initial panic symptom severity, presence of agoraphobia, panic symptom duration before diagnosis, number of comorbid Axis I disorders were associated with significantly higher PDSS total score at twelve months. Forty six percent of total patients continued medication and 23% have stopped treatment by clinician's recommendation and 31% have selfdiscontinued their medication. At twelve months, all three groups were improved but self-discontinuation group had significantly higher PDSS total score. Conclusion : In the one-year naturalistic outcome study of panic disorder patients, high percentage of patients achieved remission or had mild symptoms.

• Korean Journal of Biological Psychiatry
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• v.14 no.1
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• pp.42-47
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• 2007

Objectives : Studies have reported differences between depressed adults and controls in quantitative measures of EEG alpha asymmetry, but, there are few using Korean subjects. So, the present study compared EEG regional alpha asymmetries of patients having major depressive disorder(MDD) and normal controls. Methods : The subjects in this study were 11 unmedicated unipolar depressed patients and 11 non-depressed, age matched controls. Resting EEG(eyes closed and eyes open) was recorded from each participant using 8 scalp electrodes. Beck Depression Inventory(BDI), 17-item Hamilton Depression Rating Scale(HDRS), Zung's Self-Rating Depression Scale(SDS) and Spielberger's State-Trait Anxiety Inventory(STAI) were used to evaluate depression and anxiety symptoms. Results : The severities of depression measured by self-report questionnaires were positively associated with those of anxiety(state and trait) ; The subjects were both anxious and depressed. Anxious-depressed patients differed from controls in alpha asymmetry at T4 channels. They showed evidence of greater activation over right than left temporal site. Conclusion : These findings are consistent with the previousely reported alpha asymmetry of depressed patients with an anxiety disorder. The failure to find the evidence of reduced right parietal activity in depression is presumed to be due to opposing effects of comorbid anxiety on parietotemporal activity.

• Anxiety and mood
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• v.7 no.1
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• pp.40-47
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• 2011

Objective : This study aimed to investigate the prevalence of obsessive-compulsive disorder (OCD) in schizophrenia, and the relationship among OCD, severity of psychopathology, and social function in stable patients with chronic schizophrenia. Methods : We interviewed 138 symptom-stable inpatients who had been on a constant dose of antipsychotics for at least 1 month prior and diagnosed as chronic schizophrenia. Subsequently, patients were classified according to the existence of OCD as investigated using the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Further, all clinical and demographic data was investigated. To investigate potential interrelationships, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Korea-Positive and Negative Symptom Scale (K-PANSS), and the Korean Personal and Social Performance (K-PSP) were used. An independent ttest and Chi-square test were used to compare groups and a Pearson's correlation coefficient was used to assess the relationship between the Y-BOCS and other clinical rating scales. Results : The prevalence of OCD in schizophrenia patients was 18.1%. Patients with schizophrenia and OCD exhibited significantly earlier onset of schizophrenia, more severe psychiatric symptoms, and lower personal and social performance ability as compared to those without OCD. There was no significant relationship among Y-BOCS, K-PANSS, and K-PSP. Conclusion : We found that comorbid OCD was relatively more frequent in patients with schizophrenia. An investigation involving larger samples of schizophrenia patients with OCD with respect to social function and thus, the effect on quality of life is required.

• 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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.7 no.2
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• pp.190-202
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• 1996

This study assessed psychiatrically referred 5-to 13-year-old children who presented inattention or hyperactivity as chief complaints. Demographic characteristics, primary diagnosis, and comorbid psychiatric conditions of them were identified, and they were assessed using questionnaires and neuropsychological tests. Primary diagnoses included ADHD, anxiety disorder, mental retardation, depression, oppositional defiant disorder, developmental language disorder and others. functional enuresis, conduct disorder, and developmental language disorder were among the secondarily diagnosed disorders. In patients diagnosed as ADHD, overall comorbidity rate was 55.3%. The disorders that frequently co-occured with ADHD were specific developmental disorder, conduct disorder, oppositional defiant disorder, anxiety disorder and other. ADHD groups with or without comorbidity differed in performance IQ and CPT scores. ADHD group differed from externalizing disorders group in the information subscore of IQ, MFFT, and CPT scores, and differed in teachers rating scales, the uncommunication factor of CBCL, and CPT card error compared with internalizing disorders group. The authors concluded that inattentive or hyperactive children should be assessed using various instruments to differentiate other disorders and to identify possible presence of comorbid conditions.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.25 no.4
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• pp.209-216
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• 2014

Objectives : Alcohol use disorder (AUD) is often comorbid with adult attention-deficit hyperactivity disorder (ADHD) and other psychiatric illnesses. When associated with other mental problems, the prognosis of the AUD can be more serious. This study shows research on the clinical and neuropsychological characteristics according to whether or not ADHD symptoms and AUD were comorbid. Methods : A total of 64 adult inpatients who completed AUD scales about adult ADHD, alcohol dependence, depression, anxiety, and impulsiveness. They also completed neuropsychological tests about attention and executive function. According to the Adult ADHD Self-Report Scale score, patients were categorized into two groups (ADHD symptom positive/negative group). Results : Fourteen among the 64 subjects were part of the ADHD symptom positive group (21.9%). They had statistically significant shorter abstinence periods and a higher rate of history of 'rule violation during school' and 'physical damage in childhood' compared to the ADHD symptom negative group. Conclusion : The comorbidity rate with ADHD symptom in adult AUD is higher than the general population. The ADHD symptom positive group suffered from more severe and refractory AUD. Considering the more frequent history of rule violation during school in the ADHD symptom positive group, the association between ADHD and AUD may be mediated by conduct disorder. Therefore we suggest the necessity of careful evaluation and intervention in children and adolescents with ADHD and conduct disorder.

• Anxiety and mood
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• v.6 no.1
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• pp.3-9
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• 2010

Even experienced clinicians have difficulties in diagnosing posttraumatic stress disorder (PTSD) exactly, due to its diverse clinical features, which vary according to individuals, traumas, and various comorbid psychopathologies, and its related compensation issues. It is usually mandatory for clinicians and researchers to use screening and assessment tools when diagnosing and evaluating PTSD. To date, research has developed numerous PTSD screening and assessment tools ; therefore one of the cardinal issues is to select the best of the various tools, the one most suitable for the clinician's or researcher's purposes. This article reviews several currently-available subjective and objective instruments for the diagnosis and evaluation of PTSD and groups them according to whether they are Diagnostic and Statistical Manual for Mental Disorders-Correspondent Measures ; PTSD-Focused, Non-DSM-Correspondent Measures ; or Empirically Derived Measures. We present the instruments' psychometric properties and scoring methods and describe their merits and weak points, focusing on their practical usage.