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Journal of the Korean Academy of Child and Adolescent Psychiatry
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Korean Academy of Child and Adolescent Psychiatry
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Volume 4, Issue 1 - Dec 1993
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AUTISTIC DISORDER - AN OVERVIEW OF THE NATURE AND THE CHANGING CONCEPTS IN COMMEMORATION OF KANNER'S ORIGINAL PUBLICATION -
Hong, Kang-E.M. ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 4, issue 1, 1993, Pages 3~26
PHARMACOLOGICAL TREATMENT IN PERVASIVE DEVELOPMENTAL DISORDERS
Choi, Jin-Sook ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 4, issue 1, 1993, Pages 27~38
Pervasive developmental disorder is one of the most severe clinical disorder in child psychiatry and is associated with deviancies in multiple areas of development. Medication does not cure pervasive developmental disorder and its effectiveness is generally nonspecific. But psychopharmacological treatment can be important for some children with pervasive developmental disorder and can make many young autistics more amenable to behavior modification and education. Haloperidol, the most widely studied antipsychotics, was statistically and clinically superior to placebo, and furthermore, was known to facilitate the positive functioning such as, discrimination learning and imitative communication, without side effects. However, administration of haloperidol is associated with drug related dyskinesia, and it warrants the introduction and use of the other novel drugs. Several biochemical studies suggest that subgroups of children with pervasive developmental disorder show hyperserotonemia and increased endogenous opioid level as compared with controls. Psychopharmacological trials were conducted according to these findings(ex : fenfluramine, naltrexone), with mixed results till now. These and another drugs that have been used in children with pervasive developmental disorder and their effectiveness are reviewed.
BEHAVIORAL THERAPY OF AUTISTIC DISORDERED PATIENTS
Bristol, Marie M. ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 4, issue 1, 1993, Pages 39~41
FOLLOW-UP STUDY AND PROGNOSIS ON AUTISM IN JAPAN
Kobayashi, Ryuji ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 4, issue 1, 1993, Pages 42~43
SEASON OF BIRTH, BIRTH ORDER AND MATERNAL AGE IN INFANTILE AUTISM
Lee, Young-Sik ; Min, Kyung-Joon ; Choi, Jin-Sook ; Kim, Dong-Hyun ; Cho, Soo-Churl ; Lee, Kil-Hong ; Hong, Kang-E ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 4, issue 1, 1993, Pages 46~53
To find some involvement of environmental factors in autism, season of birth, birth order, and maternal age at birth of autistic children were investigated Total number of clinical outpatient autistic children was 357, which consisted of 319 male and 38 female, then male-to-female sex ratio was 8.4 to 1, and all subjects were born during
These data were compared with those of controlled general populations. The results were as follows : 1) In monthly and seasonal distributions of birth, autistic children were not different from normal control 2) Comparing with control group by Slater's and Greenwood-Yule's birth order calculation methods, there was no significant difference in birth order of autistic children 3) The maternal ages at birth in autistic group were significantly higher than those of control group(P<01) 4) High-risk pregnancies were significantly frequent in autistic group compared with control group(p<01)Our study supported the idea that at least some environmental factors, especially at-risk pregnancy, are involved in autism causation.
A STUDY ON THE STRESS IN MOTHER OF AUTISTIC CHILDREN
Yoon, Soo-Young ; Han, Kyung-Ja ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 4, issue 1, 1993, Pages 54~67
This study is to investigate the stress and stress degree in mothers of autistic children. In order to obtain data for planning nursing strategies for mothers of autistic children The assessment tool for the stress was constructed through reviewing literatures on the stress and gathering the stress items by nonstructed face to face interviewing 14 mothers of autistic children The stress tool consists of 74 items each with five point rating scale A data collection was made front 160 mothers of autistic children from 11 institutions for autistic children in Seoul and Kyung-Ki province. The reliability coefficients by Cronbach's a test was 0.94 for the stress scale. The results are as follows : 1) The mean of stress is 3.19, in the area of the etiology, prognosis and the treatment-education, with cause of the treatment the edeucatlon and the prognosis of child's handicap. The mean of stress is 2.85 In the area of the negative of mother's self image, 2.45 in the area of the mother's ordinary life. The mean of stress was 2.05, lowest in the family and social relationship 2) The mean score for the total was 2.62 points. The items with highest stress score were 'All autistic child has not been understood by the society', 'If we die, 1'm afraid that this child will not be cared by someone', 'There is no institution that the child get the schoolibg', etc The stress item with the lowest mean score were 'Keep away the child from husband', 'Being divorced by husband', etc. 3) An analysis of relationship of stress degree to general characteristic shows a statisically significants difference in the number of children in the family and the cognition of the seventy of the child problem
SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY FINDINGS IN TOURETTE'S AND CHRONIC MOTOR TIC DISORDER
Cho, Soo-Churl ; Lee, Myung-Chul ; Kim, Ja-Sung ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 4, issue 1, 1993, Pages 68~78
The pathophysiology and neural mechanism involved in Tourette's and chronic motor tic disorder are highly controversial. In order to investigate the functional abnormalities of brain. In Tourette's and chronic motor tic disorder, 42 children with Tourette's and chronic motor disorder underwent single photon emission computed tomography(SPECT) using Tc-99m-HM-PAO. The results are summarized as follows : 1) 31.0% (13/42) of this series revealed perfusion defect in cerebral cortex. 2) 4.8% (2/42) revealed perfusion defect in basal ganglia. 3) 4.8(2/42) revealed perfusion defect in thalamus. 4) 16.7%(7/42) showed perfusion defect in cerebellum. 5) The frequency of abnormal perfusion showed no significant difference between tic with and without attention deficit hyperactivity disorder. 6) The frequency of abnormal perfusion showed no significant difference between Tourette's and chronic motor tic disorder. These findings support the hypothesis of a possible involvement of brain dysfunction in the production of Tourette's and chronic motor tic disorder, and quantification of blood flow and co-registration with magnetic resonance imaging will increase the validity of this study.
IMMUNOHISTOCHEMICAL STUDY ON THE POSTNATAL DEVELOPMENT OF SOMATOSTATIN IMMUNOREACTIVE NEURONS IN THE RAT CEREBRAL CORTEX
Kim, Seon-Mi ; Cha, Choong-Ik ; Hong, Kang-E ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 4, issue 1, 1993, Pages 79~90
With immunohistochemical method, We have examined the distribution, the size, the number, and the morphology of somatostatin-immunoreactive neurons in the cerebral cortex of rats at the 1st. 2nd, 3rd, 4th postnatal week and the 2nd and 3rd months of age. The results are summarized as follows : 1) Strongly immunoreactive somatostatin neurons were found in the layer V and VI at the first postnatal week and then they were observed to be densely populated in the layer II and III from the 3rd postnatal week on as in the adult rat. 2) The size of the neuron was largest at the 2nd postnatal week while the number of the neurons was greatest in the 1st or 2nd postnatal week, depending on the different areas of the cortex. Overall the postnatal development of somatostatin neurons are well corresponds with the general principle of neuronal development of CNS.
COMORBIDITY OF CHILD AND ADOLESCENT INPATIENTS
Shin, Yun-O ; Cho, Soo-Churl ; Hong, Kang-E ; Kim, Ja-Sung ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 4, issue 1, 1993, Pages 91~97
The objective of this paper was to determine the degree of diagnostic overlap. In a pilot study of 56 inpatients(mean age 12) with DSM-III-R axis I and/or II disorders, the degree of psychiatric comorbidity was examined. 64.3% had two or more diagnoses. The samples were divided into the following 9 groups 1) attention deficit hyperactivity disorder 2) conduct disorder 3) oppositional defiant disorder 4) schizophrenia 5) mood disorders 6) tie disorders 7) elimination disorders 8) mental retardation 9) personality disorders Substantial overlap(especially tic disorders, elimination disorders, disruptive behavior disorders) occured among inpatients Patients had about 2 DSM-III-R axis I & II diagnoses. Additional research with increased sample size is necessary to clarify its relationship with other psychiatric diagnoses.
HYPERACTIVE BEHAVIORAL CHARACTERISTICS BY PARENTAL REPORTS IN ALLERGIC CHILDREN
Choi, Bo-Moon ; Lee, Joon-Sung ; Park, Nan-Sook ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 4, issue 1, 1993, Pages 98~105
Objective ' The purpose of this study was to investigate the behavioral characteristics of children with allergic disease Method : In a population of 80 children who were registered at a pediatric allergic clinic in Kangnam St Mary's hospital, parents completed a standardized child behavior checklist (CBCL) to evaluate their children Clinical factors associated with allergy were examined in relation to the rated scores of CBCL Results : Allergic children were rated significantly more aggressive and delinquent, and less withdrawned on the CBCL rating when compared to the age- and sex-matched normal control children. Within the allergic population, children who had family history of allergic disease had higher scores of CBCL in hyperactivity and aggressive behavior than the children without family history. Conclusion : The results were discussed with the respect to familial traits of allergy and temperament as risk factors for the emergence of behavior problems in childhood allergy
BEHAVIORAL CHARACTERISTICS IN ATTENTION DEFICIT HYPERACTIVITY DISORDER - COMPARISONS OF ATTENTION DEFICIT DISORDER WITH AND WITHOUT HYPERACTIVITY -
Song, Dong-Ho ; Joung, Yoo-Sook ; Lee, Hong-Shick ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 4, issue 1, 1993, Pages 106~113
Using a reliable assessment procedure and according to the severity of hyperactivity, thirty-six clinic-referred outpatients, 6-12 years of age, were given a diagnosis of Attention Deficit Disorder with Hyperactivity(ADD+H) or without Hyperactivity(ADD-H). Comparisons of behavioral measurement by Conners Rating Scale(CRS) and Home/School Situations Questionnaire(HSQ/SSQ) revealed that the children with ADD+H displayed more pervasive behavior problems at home and school than the children with ADD-H. Also the children with ADD+H were more likely to be delinquent and aggressive compared to the children with ADD-H when using the Child Behavior Check-list(CBCL) for parents Hyperactivity symptom in ADHD is highly correlated with aggression scale on CBCL These finding suggest that ADD+H and ADD-H may differ in clinical disease entity.
TEMPERAMENTAL CHARACTERISTICS OF ATTENTION DEFICIT HYPERACTIVITY DISORDER
Cho, Soo-Churl ; Kim, Dong-Hyun ; Kim, Ja-Sung ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 4, issue 1, 1993, Pages 114~123
The authors applied Toddler Temperament Scale(TTS) to ADHD patient group, other disease group and normal control group to elucidate temperamental characteristics of ADHD patients in their toddler stage. 1) ADHD group showed significant difference from the control group in 'activity', 'rhythmicity', 'approach', 'adaptability', 'intensity', 'persistence' and 'threshold' categories. 2) ADHD group and other disease showed significant difference from the control group in 'adaptability' and 'persistence' categories. 3) ADHD group was significantly different from other disease group or control group in 'activity' and 'approach' categories. 4) In total scores of TTS, ADHD group and other diease group showed significant difference from control group. 5) Classification ratio of TTS for ADHD by discriminant analysis was 84.3%. Above results suggest that the ADHD patients may reveal characteristic traits in their toddler stage Further research should be focused on the development and refinement of assessment tools for the early detection and prevention for ADHD.
A COMPARISON OF THE CHARACTERISTICS OF CHILDREN WITH TOURETTE AND CHRONIC TIC DISORDER ACCORDING TO THEIR BIRTH ORDERS
Kim, Ja-Sung ; Hong, Kang-E ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 4, issue 1, 1993, Pages 124~132
We studied the clinical characteristics of 45 children with tic symptoms, and a comparison was made according to their birth order patterns. The results were as follows. Sex ration was 14:1 higher for boys. The eldest children were 46.7%, single children, 15.6%, the youngest children, 33.3%, and twins 4.4% of all Organicity was suggested in 37.8%, early developmental problems in 71.1%, and family problems were in 89.9%. Among the co-existing problems, ADHD 46.7%, OCD 17.7%, Separation anxiety disorder 24.4%, GAD or anxiety dreams 17.8%, somatization disorder and enuresis 13.3% each, stuttering 8.9%, and other conditions. Overall, 84.4% of the patients have one or more co-existing conditions other than tic symptoms. When compared according to birth order patterns, the most significant difference was the time of onset The youngests have more incidences around the entrance period for elementary school(p<0.01). Among the twins, the lower birth-weight child was the patient. Summing up these findings, we concluded there were significant environmental factors working on the manifestation of tic and tourette disorders.
THE COGNITIVE-BEHAVIORAL DIFFERENCES BETWEEN CHRONIC MOTOR TIC DISORDER AND TOURETTE'S DISORDER
Shin, Min-Sup ; Kim, Ja-Sung ; Hong, Kang-E ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 4, issue 1, 1993, Pages 133~141
Present study investigated the differences in psychological tests responses between chronic motor tic disorder and tourette's disorder to clarify whether chronic motor tic and tourette's disorder constitute a single disorder on a continuum or not. Based on the diagnosis by child psychiatrists 29 chronic motor tic disorder and 10 tourette's disorder children between the age of 6 to 13 were selected, and the psychological tests responses of two diagnostic groups were compared. The results showed that tourette's disorder is more related to neulological problems than chronic motor tic disorder. Also it was found that children with tourette's disorder have more difficulties in social-emotional adjustment than children with chronic motor tic disorder. These results suggested that interactions among neurological factor, emotional factor and temperamental characristics might be more involved in tourette's disorder than in chronic motor tic disorder. The limitations of present study and the need for futher research on the comorbidity of tourette's disorder and ADHD were discussed.
TASKS AND TECHNIQUES IN THE INITIAL PHASE OF PLAYPSYCHOTHERAPY ILLUSTRATED BY GROUP SUPERVISION PROCESSES
Hong, Kang-E ; Park, Min-Sook ; Nam, Min ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 4, issue 1, 1993, Pages 142~163
A 8 year old boy with problems of hyperactivity, impulsivity received playpsychotherapy. Through the detailed examination of their contents and group supervision of play therapy session, common mistakes novice therapist make frequently and tasks in the initial phase of play psychotherapy are illustrated. Therapist's personality and anxiety frequently interferes therapeutic processes. Common mistakes therapist makes during initial phase of play therapy are ; therapist's over-enthusiasm, overinvolvement or non-responsiveness, premature or inappropriate interpretation and direct connection of play theme to reality. It is utmost important for the therapist to make positive and trusting relationship with the patient in the initial phase of the therapy. In order to do so therapist must accept the patient as he is, permit the patient takes his leads. And as a result, the Patient can go through corrected developmental experience. In conclusion, it is a therapist's main task to establish relationship.
A STUDY ON THE PSYCHOTHERAPEUTIC PROCESS OBSERVED IN AN OBSESSIVE COMPULSIVE ADOLESCENT
Kim, Hak-Riong ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 4, issue 1, 1993, Pages 164~172
By observing the psychotherapy process expressed by an adolescent with obssessive compulsive disorder, the author suggests that the main problem of OCD is not merely a product of an unconscious process as traditionally thought, but a learned problem solving process as a method surviving the more realistic conflicts, and therefore the treatment should be directed to more or less conscious and realistic issues and conflicts, family therapy should be offered too.
A CASE OF NARCOLEPSY IN A 11 YEAR-OLD BOY
Choi, Bo-Moon ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 4, issue 1, 1993, Pages 173~178
Narcolepsy's age at onset is reported to be relatively homogeneous, occuring usually after the onset of puberty, although most cases are diagnosed when the patients are in their late teens to late 20s. It is very unusual for a patient to develop narcolepsy before 15 years of age or after 30 years of age. A 11-year old boy who has developed excessive daytime sleepiness since age of 7 and has all the four major features of narcolepsy by the time of evaluation is presented. On polysomnographic examination, the patient showed two sleep onset REM periods in the three latency test of the multiple sleep latency test and the nocturnal polysomnogram. In addition, the findings of typing HLA class I and II of the patient's family are presented. Reports of pediatric narcolepsy previously reported are reviewed.