• 제목/요약/키워드: Neuropsychiatric disorder

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The Relationship of Clinical Symptoms with Social Cognition in Children Diagnosed with Attention Deficit Hyperactivity Disorder, Specific Learning Disorder or Autism Spectrum Disorder

  • Sahin, Berkan;Karabekiroglu, Koray;Bozkurt, Abdullah;Usta, Mirac Bans;Aydin, Muazzez;Cobanoglu, Cansu
    • Psychiatry investigation
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    • 제15권12호
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    • pp.1144-1153
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    • 2018
  • Objective One of the areas of social cognition is Theory of Mind (ToM) is defined as the capacity to interpret, infer and explain mental states underlying the behavior of others. When social cognition studies on neurodevelopmental disorders are examined, it can be seen that this skill has not been studied sufficiently in children with Specific Learning Disorder (SLD). Methods In this study, social cognition skills in children diagnosed with attention deficit hyperactivity disorder (ADHD), SLD or Autism Spectrum Disorder (ASD) evaluated before puberty and compared with controls. To evaluate the ToM skills, the first and second-order false belief tasks, the Hinting Task, the Faux Pas Test and the Reading the Mind in the Eyes Task were used. Results We found that children with neurodevelopmental disorders as ADHD, ASD, and SLD had ToM deficits independent of intelligence and language development. There was a significant correlation between social cognition deficits and problems experienced in many areas such as social communication and interaction, attention, behavior, and learning. Conclusion Social cognition is an important area of impairment in SLD and there is a strong relationship between clinical symptoms and impaired functionality.

소아기 붕괴성 장애의 양상을 보이는 PANDAS 1례 (A CASE OF PANDAS WITH CHILDHOOD DISINTEGRATIVE DISORDER)

  • 조수철;성덕규
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제12권1호
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    • pp.149-156
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    • 2001
  • 베타 용혈성 A군 연구균(group A beta-hemolytic streptococcus)에 의한 류마치스성 열 이후에 Sydenham 무도병이 발현되는 환자 군에서 강박 증상 또는 틱 증상이 나타난다는 보고가 있은 후, A군 연구균 감염과 강박 장애 또는 틱 장애 사이의 관계가 주목받게 되었다. A군 연구균 감염 후에 강박 증상 또는 틱 증상이 유발되는 환자들은 갑작스런 발병과 극적인 증상 악화를 보이고 사춘기 이전에 발병하며 무도병 모양의 운동 및 독특한 양상의 운동 과잉 등의 신경학적 이상을 보이고 또 그 경과가 악화 및 완화를 반복하는 양상을 보인다. 이런 임상적 특징을 보이는 소아 환자 군을 PANDAS(pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections)라고 부르게 되었다. 이후 현재까지 강박 장애와 틱 장애뿐 아니라 주의력 결핍/과잉운동 장애, 신경성 식욕부전증, 신체이형장애 환자들이 PANDAS 범주에 속한다는 보고들이 있어 왔다. 본 증례는 7세까지 정상적인 발달을 보이다가 A군 연구균 감염 수개월 후부터, 인지 기능, 사회성, 언어 및 의사소통에 장애를 보이고 틱 증상과 함께 얼굴과 손발에 이상 운동을 보이는 환자를 기술하였다. 이에 저자들은 본 증례가 소아기 붕괴성 장애의 양상을 보이는 PANDAS 증례라고 생각되어 이를 문헌 고찰과 함께 보고함으로써, PANDAS가 틱 장애, 강박 장애, 주의력 결핍/과잉운동 장애, 신경성 식욕부전증, 그리고 신체이형장애 등의 양상을 보일 뿐 아니라 소아기 붕괴성 장애의 양상을 보일 수 있다는 사실을 보고하고자 한다.

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공황장애 호흡기 아형과 비호흡기 아형의 임상 특성 비교 (Comparison of Clinical Characteristics Between Respiratory and Non-Respiratory Subtypes of Panic Disorder)

  • 하주원;임세원;오강섭
    • 생물정신의학
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    • 제16권1호
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    • pp.46-52
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    • 2009
  • Objectives : The goal of this study was to compare the clinical characteristics of panic disorder respiratory subtype(PD-R) and non-respiratory subtype(PD-NR). Methods : 84 patients with panic disorder were enrolled and divided into 2 groups, 29 PD-R and 55 PD-NR. Diagnosis of panic disorder was evaluated using Diagnostic and Statistical Manual of Mental Disorders $4^{th}$ edition and Mini International Neuropsychiatric Interview. They were also measured with Hamilton Rating Scale for Anxiety(HAM-A), Hamilton Rating Scale for Depression(HAM-D), and Panic Disorder Severity Scale (PDSS). Results : PD-R group showed significantly higher scores in PDSS than those of PD-NR group(p=.027). After controlling for the severity of panic disorder and gender, PD-R group showed higher HAM-D and somatic anxiety subscale of HAM-A than those of PD-NR group. Furthermore, results of logistic regression analysis suggested that the somatic anxiety was a possible risk factor of PD-R(OR=1.404,p=0.009). Conclusion : These results suggest that somatic anxiety and depressive symptom would be important clinical characteristics of PD-R.

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임상 신경심리학적 평가 (Clinical Neuropsychological Evaluation)

  • 오병훈
    • 생물정신의학
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    • 제2권1호
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    • pp.28-37
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    • 1995
  • Clinical neuropsychology which belongs to the necuroscience field is concerned with relationship between human behaviors and the brain structure. Clinical neuropsychology has grown to be a specialized separate field within psychology over the last twenty years. Clinical neuropsychology offers an objective methodology to consider the mind-body interaction and evaluate the behavioral consequences and functional deficits associated with brain lesions. Clinical neuropsychological assessment is composed of cognitive, perceptual, motor and emotional function through various neuropsychological examinations such as Halsted-Reitan and Luria-Nebraska batteries, and computerized neuropsychological test such as PCIS Vienna Test System and Stim. The goals of neuropsychological evaluation are to identify of neuropsychological dysfuncitions, to develop execute and monitor treatment plans, and to make rehabilitation programs. Recently, the neuropsychiatric patients are increasing in number and 15-20% of acute psychiatric patients suffer from organic mental problems. Moreover, clinical neuropsychology has an increasingly important role in both neurobehavioral foundation and clinical application. So, psychiatrists must play a major role in the development of clinical neuropsychology in psychiatry.

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급성기 양극성우울증 약물치료 전략 (Pharmacological Treatment Strategies for Acute Bipolar Depression)

  • 김세주
    • 신경정신의학
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    • 제57권4호
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    • pp.287-300
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    • 2018
  • Of the different phases of bipolar disorder, bipolar depression is more prevailing and is more difficult to treat. However, there is a deficit in systemic research on the pharmacological treatment of acute bipolar depression. Therefore, consensuses on the pharmacological treatment strategies of acute bipolar depression has yet to be made. Currently, there are only three drugs approved by the Food and Drug Administration for acute bipolar depression : quetiapine, olanzapine-fluoxetine complex, and lurasidone. In clinical practice, other drugs such as mood stabilizers (lamotrigine, lithium, valproate) and/or the other atypical antipsychotics (aripiprazole, risperidone, ziprasidone) are frequently prescribed. There remains controversy on the use of antidepressants in bipolar depression. Here, we summarized the evidence of current pharmacological treatment options and reviewed treatment guidelines of acute bipolar depression from recently published studies.

아동기 주의력결핍 과잉행동장애의 유해환경인자 (Harmful Environmental Factors Leading to Attention-Deficit Hyperactivity Disorder)

  • 권호장;하미나;김붕년;임명호
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제27권4호
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    • pp.267-277
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    • 2016
  • Attention-deficit hyperactivity disorder (ADHD) is a common, childhood-onset, neuropsychiatric disorder with an estimated prevalence of 2-7.6% in Korean children. Although the etiology of ADHD is not well understood, evidence from genetic factor and environmental factor studies suggests that ADHD results from a gene environmental interaction. In the current study, we reviewed the evidence for and clinical implications of the hypothetical roles of organophosphate pesticides, organochlorine pesticides, polychlorinated biphenyls, phthalate, bisphenol, polyfluoroalkyl chemicals, polycyclic aromatic hydrocarbons, mercury, lead, arsenic, cadmium, manganese, tobacco, alcohol as harmful risk factors in the development of ADHD.

공황장애 환자에서 공존 주요 우울증과 연관된 임상요인들 (Clinical Factors Associated with Comorbid Major Depressive Disorder in Patients with Panic Disorder)

  • 장현채;임세원;신영철;신동원;오강섭
    • 대한불안의학회지
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    • 제10권1호
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    • pp.17-23
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    • 2014
  • Objective : Panic disorders are frequently accompanied by major depressive disorder (MDD). There is insufficient information about which clinical factors in panic disorder are associated with comorbid MDD. The aim of this study is to identify clinical factors related with comorbid MDD in patients with panic disorder. Methods : Two experienced psychiatrists diagnosed panic disorder based on DSM-IV criteria. This diagnosis in the 275 subjects was confirmed again by Mini-International Neuropsychiatric Interview (MINI). Lifetime comorbid psychiatric diagnoses were examined by MINI. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and Panic Disorder Severity Scale (PDSS) were used to assess the severity of depressive, anxiety and panic symptoms. Results : The result of MINI showed that 95 patients (34%) with panic disorder satisfied the diagnosis of MDD. Multivariate logistic regression model showed that comorbid generalized anxiety disorder (GAD) and the symptom of "fear of losing control or going crazy" were associated with MDD in patients with panic disorder. In female patients, the "chills or hot flushes" symptom was also associated with comorbid MDD. Conclusion : These results showed that coexisting GAD and certain symptoms of panic are associated with comorbid MDD.

공황장애의 발병연령에 따른 정신과적 공존질환의 차이 (Difference in Psychiatric Comorbidity of Panic Disorder According to Age of Onset)

  • 김은지;임세원;오강섭
    • 생물정신의학
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    • 제16권1호
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    • pp.37-45
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    • 2009
  • Objectives : It is reported that panic disorder is frequently comorbid with other psychiatric illnesses. The aim of this study was to investigate differences of psychiatric comorbidity according to age of onset of panic disorder. Methods : Three hundred-two patients participated in the study. All the patients were evaluated by clinical instruments for the assessment the presence of other comorbid psychiatric disorders and various clinical features; Korean version of Mini International Neuropsychiatric Interview, Self-report questionnaires(Beck Anxiety Inventory, Beck Depression Inventory, Anxiety Sensitivity Index and State-Trait Anxiety Inventory) and clinical rating scale (Hamilton Anxiety Scale, Hamilton Depression Scale and Global Assessment of Functional score). Chi-square test was used to determine the difference between early onset and late onset panic disorder. Results : Forty percent of panic patients were found to have at least one comorbid psychiatric diagnosis. There were no differences among the groups divided by number of comorbidity in sex, agoraphobia comorbidity, duration of panic disorder, except onset age of panic disorder. Early onset group had more comorbidy with social phobia, agoraphobia, PTSD. We also found that Early onset panic disorder patients were more likely to experience derealization, nausea, parethesia than late onset panic disorder patients. Conclusion : The results of our study are in keeping with previous data from other parts of the world. Our finding suggest that earier onset of panic disorder related to more psychiatric comorbidity.

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Neurodegeneration with Brain Iron Accumulation

  • Lee, Jae-Hyeok
    • Journal of Interdisciplinary Genomics
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    • 제2권1호
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    • pp.1-4
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    • 2020
  • Recent advances in magnetic resonance imaging and identification of causative genes led to the recognition of a new group of disorders named neurodegeneration with brain iron accumulation (NBIA). NBIA is a group of inherited disorders characterized by abnormal iron deposition in the brain, usually in the basal ganglia. The disorder shares the clinical features of movement disorders and is accompanied by varying degrees of neuropsychiatric abnormalities. In this review, the causative genes, clinical presentations, neuroimaging features, and pathological findings are summarized.

경두개 직류 자극-정신과적 활용과 현황 (Transcranial Direct Current Stimulation-Psychiatric Application and Its Current Status)

  • 김평규;김도형
    • 생물정신의학
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    • 제24권4호
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    • pp.175-187
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    • 2017
  • Transcranial direct current stimulation (TDCS) is a clinically safe and effective method of delivering weak electric current to modulate cortical activities. And based on the cumulating scientific evidences, the method is recommended to treat major depressive disorder (MDD) and other psychiatric disorders. In this paper, we review the development of TDCS in the rising field of neuromodulation. Then with suggested biochemical and physical mechanism of TDCS, we summarize the reported cases of using TDCS to alleviate major neuropsychiatric disorders. And, in particular, the treatment of MDD is highlighted as an illustrative example of using TDCS. We discuss here the therapeutic potentials of this method in psychiatry. And in closing remarks, we evaluate the current technical limitations and suggest the future directions of this method in both the clinical and research aspects.