• Title/Summary/Keyword: Obsessive Compulsive Adolescent

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ANTIDEPRESSANT INDUCED-MANIC EPISODE IN ADOLESCENTS WITH PRECEDING ANXIETY SYMPTOMS (불안증상을 보이는 환아에서 항우울제 투여로 유발된 조증삽화)

  • Chungh Dong-Seon;Kim Jeong-Hyun;Ha Kyoo-Seob
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.124-131
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    • 2005
  • Childhood and adolescent onset-bipolar disorders have higher rate of comorbidity with anxiety disorders as well as attention deficit hyperactivity disorder and conduct disorder. Obsessive compulsive disorder, social phobia, panic disorder, and separational anxiety disorder are common comorbid anxiety disorders with bipolar disorders in child and adolescent. Prospective and reliable data on temporal and causal relationship between the onset of bipolar disorders and the onset of comorbid anxiety disorders are still in debate. The authors report 2 adolescent cases with antidepressant induced-manic episodes with preceding anxiety symptoms. The authors suggest careful prescription of antidepressants for anxiety disorders, even for those who do not have definite past history or family history of bipolar disorders. Further comprehensive and prospective studies are requested for the temporal relationship and pharmacological guideline for comorbid bipolar disorders and anxiety disorder in child and adolescent.

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Effect of Cognitive-Behavioral Treatment in Children with Anxiety Disorder: A Preliminary Study (소아기 불안장애의 인지행동치료 효과 : 예비 연구)

  • Song, Dong-Ho;Ha, Eun-Hye;Oh, Wook-Jin;Ko, Kwang-Bum;Lew, Young-Min
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.19 no.3
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    • pp.182-189
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    • 2008
  • Objectives: This study aimed to evaluate preliminarily the clinical effects of cognitive-behavioral treatment in children with anxiety disorders. Methods: Subjects were 11 children between 2nd and 6th grade with anxiety disorder. All subjects were diagnosed through Kiddie-Schedule for Affective Disorder and Schizophrenia Present and Lifetime Version (K-SADS-PL) interview. The CBT program consisted of sessions once a week (60min/session) for 14 weeks with parent education. Results: Children and parents reported significantly improved social skills, social competence and decreased anxiety. However, there were no significant changes in children's negative thoughts and subjective depressive symptoms. Conclusion: Cognitive-behavioral treatment is expected to be effective in children with anxiety disorders such as generalized anxiety disorder, phobia, separation anxiety disorder, and obsessive-compulsive disorder.

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Effects of Group Comprehensive Behavioral Intervention for Tics in Children With Tourette's Disorder and Chronic Tic Disorder

  • Kang, Na Ri;Kim, Hui-Jeong;Moon, Duk Soo;Kwack, Young Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.33 no.4
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    • pp.91-98
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    • 2022
  • Objectives: Comprehensive behavioral intervention for tics (CBIT) is effective in children with chronic tic disorders. This study aimed to assess the effect of group-based CBIT (group-CBIT) on tic severity and comorbid symptoms. We compared the efficacy of group CBIT with that of a control. Methods: Thirty children with chronic tic disorder or Tourette's disorder were enrolled in this study. Eighteen were assigned to the group-CBIT for eight sessions, and 12 were assigned to the control group. Tics and comorbid symptoms were assessed pre- and post-intervention using the Yale Global Tic Severity Scale (YGTSS), Premonitory Urge for Tics Scale, attention-deficit hyperactivity disorder Rating Scale-IV, Children's Yale-Brown Obsessive-Compulsive Scale, and the Korean-Children Behavioral Checklist. We compared the pre- and post-intervention results of each group and determined the difference in the pre- and post-intervention results between intervention and the control group. Results: The YGTSS motor and vocal tic interference, global impairment, and global severity scores decreased in the intervention group only. Group CBIT was superior in reducing the motor tic interference, impairment score, and global severity score to the control group. Conclusion: The group-CBIT showed an improvement in tic symptoms, especially in reducing the level of interference and impairment of tics.

THE CHARACTERISTICS OF CHILD AND ADOLESCENT INPATIENTS WITH SEVERE OBSESSIVE-COMPULSIVE DISORDER (심각한 소아 ${\cdot}$ 청소년 강박장애로 입원한 환아들의 특징)

  • Hwang, Jun-Won;You, So-Young;Chang, Jun-Hwan;Shin, Min-Sup;Cho, Soo-Churl;Hong, Kang-E;Kim, Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.2
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    • pp.143-151
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    • 2004
  • Objectives : Child and adolescent onset obsessive compulsive disorder(C-OCD) is known to be associated with poor drug response, high comorbid rate and strong genetic tendencies. Till now studies for C-OCD have been very rare in Korea. We conducted this study to investigate the informations about clinical features, familial psychiatric loading, treatment profiles and course of server C-OCD from the retrospective analysis of inpatient data of Seoul National University Children's Hospital. Method : Retrospective chart review and data analysis was performed. Twenty(male 16 : female 4) patients with final C-OCD diagnosis by DSM-IV at discharge from 1994 to 2002 were found and their medical chart, psychological data, family interview data and nursing reports were collected and analyzed. Results : 1) The sex ratio of C-OCD was male dominant(4:1). 2) Phenomenological, most common obsession was pathologic doubt, contamination fear, followed by aggressive obsession, need for symmetry, sexual obsession, most common compulsion was checking and washing, followed by breathing, movement, symmetry, repetitive asking, hoarding, mental compulsion. 3) Most common comorbid diagnosis was depression. Other axis-I diagnosis associated OCD were anxiety disorder, tic disorder, conduct and oppositional defiant disorder and psychosis. 4) Regarding psychiatric familial loadings, 17 patients(85%) had relatives with psychiatric disorders, OC-spectrum disorders(OCD or OCPD) were found in 9 patients(45%). 5) The majority of patients(75%) have received SSRI and antipsychotics treatment. The response rate above 'moderate improved" by CGI was 75%. 6) During follow-up period in outpatient clinic, five patients(25%) showed continuous complete remission, 10 patients (50%) did residual symptoms with chronic course. Conclusion : This seems to be the first systemic investigation of severe pediatric OCD patients in Korea. The children & adolescents with severe OCD in inpatient-setting showed the high comorbid rate, familial psychiatric loading, and combined pharmacotherapy with antipsychotics, As for symptoms, high rate of aggressive-sexual obsession and atypical compulsions like breathing and moving was reported in this study. Severe pediatric OCD patients, however, responded well to the combined SSRI and antipsychotics regimen.

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A SURVEY OF THE PSYCHOSIS AMONG SCHOOL VIOLENCE VICTIMS (학교폭력 피해자의 정신병 실태 조사)

  • Kwon, Seok-Woo;Shin, Min-Sup;Cho, Soo-Churl;Shin, Sung-Woong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.124-143
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    • 2000
  • Objectives:The primary purpose of this study is to understand the psychopathology of the victims of school violence in terms of early psychosis. By doing this, the early detection of psychosis among the victims is possible, and early detection may lead to early intervention. Methods:Two-thousand and nine-hundred seventy two students from 16 middle schools in Seoul were asked to fill out questionnaire comprised of popularity and intellectual and school status of Piers-Harris Children's Self Concept Inventory, Symptom Check List-90-Revised, and Ostracism Scale. The subjects whose scores upon Ostracism Scale were higher than average by two standard deviation were labeled as ‘Repelled and Isolated group', and subjects whose scores on popularity were significantly lower than average and whose scores on psychoticism of SCL-90-R were higher than average were defined as 'tentative early psychosis group'. Odds ratios were calculated from the numbers of subjects with and without high psychoticism scores and high ostracism scores. On the subjects of 'tentative early psychotic group', we examined every clinical characteristic and conducted correlation analysis and regression analysis in order to find out the risk factors and to construct theoretical model that explains the psychoticism scores. Results:The results were as follows:1) Total 157(5.3%) subjects were rated significantly higher on ostracism scale, and among them, 47 subjects(29.9%) were rated significantly higher than average on psychoticism scale, while only 50 subjects among 2,135 students who were rated within normal range showed significantly higher score on psychoticism scale. Odds ratio for psychotic group of isolated group were 17.82 and it was statistically significant. 2) Forty-seven subjects(31 boys, 16 girls) who were rated as they were unpopular and rejected from peers had significantly higher psychoticism scores. They were not significantly different from simply high psychoticism subjects in anxiety, social anhedonia scale, magical thinking, obsessivecompulsive symptoms, phobic anxiety, psychoticism, somatization, but showed higher ostracism scores and paranoid tendencies. Among school violence victims, who rated themselves unpopular and showed higher psychoticism scores, the psychoticism scores were mainly explained by anxiety, depression, hostility, interpersonal sensitivity, obsessive-compulsive symptoms, paranoid tendency, somatization scales($r^2=0.93$). Conclusion:Thus, it can be concluded that the subjects with higher ostracism score have the substantially high risk for psychosis development. By these results, we propose that school violence victims with anxiety, depression, hostility, interpersonal sensitivity, obsessive-compulsive symptoms, paranoid tendency, somatization should be tested individually considering school adjustment, attentional deficit, concept formation problems.

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D8/17 Expression on B Lymphocytes of Children and Adolescents with Tic Disorder (소아청소년 틱장애 환자의 B림프구에서 D8/17의 발현)

  • Oh, Young-Gun;Park, Tae-Won;Jung, Yong Woo;Chung, Sang-Keun;Chung, Young-Chul;Yang, Jong-Chul
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.24 no.3
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    • pp.151-156
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    • 2013
  • Objectives : It has been reported that higher percentage of B cells react with monoclonal D8/17 antibody in patients with rheumatic fever, childhood onset obsessive-compulsive disorder, Tourette's disorder, or prepubertal anorexia nervosa. The purpose of this study is to replicate the previous studies in a Korean young population with tic disorder and to identify any relationship between D8/17 and clinical symptoms. Methods : The binding of D8/17 to B cells was determined in patients with tic disorder (N=21) and healthy controls (N=9) by Fluorescence-Activated Cell Sorter analysis. Results : In the sample examined by this study, the average percentage of B cells expressing D8/17 in tic disorder was 2.05%; healthy controls was 3.15%. No statistically significant differences were found in the mean percentages of D8/17 between the two groups. Conclusion : The expression of D8/17 in B cells was very low in this study. No subjects with tic disorder or healthy controls was above 12% in D8/17 positive proportion. Further studies, including higher number of patients and control group members, should be performed.

Development of the Korean Form of the Premonitory Urge for Tics Scale: A Reliability and Validity Study

  • Kim, Mira;Chung, Sang-Keun;Yang, Jong-Chul;Park, Jong-Il;Nam, Seok Hyun;Park, Tae Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.31 no.3
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    • pp.146-153
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    • 2020
  • Objectives: This study aimed to evaluate the reliability and validity of the Korean Form of the Premonitory Urge for Tics Scale (K-PUTS). Methods: Thirty-eight patients with Tourette's disorder who visited Jeonbuk National University Hospital were assessed with the K-PUTS. Together with the PUTS, the Yale Global Tic Severity Scale (YGTSS), the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), the attention-deficit/hyperactivity disorder (ADHD) rating scale (ARS), and the Adult ADHD Self-Report Scale (ASRS) were implemented to evaluate concurrent and discriminant validity. Results: The internal consistency of items on the PUTS was high, with a Cronbach's α of 0.79. The test-retest reliability of the PUTS, which was administered at 2 weeks to 2 months intervals, showed high reliability with a Pearson correlation coefficient of 0.60. There was a significant positive correlation between the overall PUTS score and the YGTSS score, showing concurrent validity. There was no correlation between the PUTS, CY-BOCS, and ASRS scores, demonstrating the discriminant validity of the PUTS. Factor analysis for construct validity revealed three factors: "presumed functional relationship between the tic and the urge to tic," "the quality of the premonitory urge," and "just right phenomena." Conclusion: The results of this study indicate that the K-PUTS is a reliable and valid scale for rating premonitory urge of tics.

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

  • Cho, Soo-Churl;Seong, Deock-Kyu
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.1
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    • pp.149-156
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    • 2001
  • After the fact that obsessive-compulsive symptoms or tic symptoms are common in Sydenham's chorea which is a sequale of rheumatic fever produced by group A beta-hemolytic streptococcus was reported, the association between group A beta-hemolytic streptococcus and a subgroup of obsessivecompulsive disorder(OCD) or tic disorder has been attentioned. This subgroup shared a unique clinical course, characterized by an abrupt onset of symptoms and/or dramatic exacerbations. And this subgroup was distinguished by pre-pubertal onset of symptoms, neurological abnormalities(choreiform movements and a unique pattern of motoric hyperactivity), as well as by relapsing and remitting symptom course. Acronym PANDAS(pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection) was used to denote a subgroup of OCD or tic disorder patients with these clinical characteristics. Then, there was a report suggesting that PANDAS category include some of attention-deficit/hyperactivity disorder(ADHD) and were two case reports of anorexia nervosa and body dysmorphic disorder with characteristics of PANDAS. This case is a patient who developed normally until age of 7, but after pharyngeal inflammation with high fever, he showed disturbance of cognition, social relationship, and language and communication, as well as tic symtoms and abnormal movement on face, hand, and foot. We report this case with review of literatures, because we think that this case belongs to the PANDAS category. Based on this observation, we suggest that PANDAS category include some of childhood disintegrative disorder as well as OCD, tic disorder, and ADHD.

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A Study on the Relation Between Self Esteem and Mental Health in Middle School Students (청소년의 자아존중감과 정신건강에 관한 연구)

  • Choi, Eun-Young;Choi, In-Ryoung
    • Journal of the Korean Society of School Health
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    • v.15 no.1
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    • pp.63-72
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    • 2002
  • The purpose of this study was to find out the relationship between self-esteem and mental health in Middle school students, and provided basic data to develop a nursing program for the prevention of mental disease and the promotion of mental health in adolescence. Subjects were 153 students in the third year of three middle schools located in K city. Instruments used in this study were the self-esteem questionnaire developed by Choi, B. K. & Jun, G. Y.(1993) and the simplified SCL-90 developed by Lee, H. K.(1986) for measuring mental health. Data were analyzed by Cronbach's alpha, descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient by using SPSS/PC+ program. It was found that the mean score of the self-esteem was 3.20. The score of self-esteem in family was high and the score of self-esteem in school was low. The mean score of mental health was 1.94. The scores of depression, obsessive-compulsive and interpersonal sensitivity were high, the scores of phobic anxiety and somatization were low. There were significant differences among religions (F=2.709, p= .032), and between personalities (t=-2.285, p= .024) with respect to self esteem. There were no significant differences between general characteristics variables and mental health. However there was significant negative correlation between the mean self-esteem score and the mean mental health score (r=-.431, p= .000). In conclusion, mental health is strongly related to self-esteem. If and adolescent who suffers from mental health is not received proper treatment, his or her mental health prohibits him from managing sound social life even after grown-up. Thus, nursing intervention in adolescence should be developed to enhance the self-esteem of adolescence and to help him raise sound mind.

Perceived Family Support and Mental Health of Middle school students (중학생이 지각한 가족지지와 정신건강)

  • Suh, Soon-Rim;Kim, Jeong-Bok
    • Journal of the Korean Society of School Health
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    • v.15 no.2
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    • pp.219-232
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    • 2002
  • This study was conducted to identify the relationship between the perceived family support and mental health of middle school students and provide basic data to develop a nursing program for prevention of mental disease and mental health promotion in adolescent. The subjects for this study were 427 students in their first, second and third year of two middle school in K city. The data were collected from December 12th to 19th, 2001. The instruments used for this study were the family support scale by Kang and the mental health assessment scale was the Symptom Check List-90-R. The data were analyzed by frequency, percentage, mean, standard deviation, Pearson Correlation Coefficient, ANOVA, and Duncan test with SPSS program. The results were as follows: The mean score of the perceived family support was 42.26 and the mean score of mental health was 52.24. As a subarea of mental health was analyses, the scores of obsessive-compulsive reaction and hostility were respectively higher but the scores of phobia were lower than others. Family support was significantly different according to student's grade, religion and economic status, and educational level, the relationship between them, and living in parents. the characteristic influence on the level of mental health were sex, grade, and economic status of students and the relationship between them of parents. There was a significant correlation between the perceived family support and the level of mental health was revealed a significant correlation(r=-.35(P=0.001)). In conclusion, this study was found that family support was an important factor for promoting mental health of middle school students. In order to increase mental health of middle school students effectively, family support must be increased. Efforts to promote mental health of students are required in home and school. School authorities have to search a plans like "family support-class program" as one countermeasure to increase family support. teachers have to make educational programs to promote mental health constantly with participating parents.