OBJECTIVES: This study was conducted in order to evaluate the effectiveness of a day-center treatment program to promote development of children with pervasive development disorder (PDD) and pervasive development disorder/mental retardation (PDD/MR). METHODS: Twenty five children (14 in the PDD group and 11 in the PDD/MR group) participated in a day-center treatment program. They had been enrolled in the whole program for 2-3 years. Their performance was evaluated according to the Preschool Language Scale (PRES), Social Maturity Scale (SMS), and Korean version of the Childhood Autism Rating Scale (CARS). They were grouped by diagnosis at the beginning of the program and the treatment effect was compared. RESULTS: Children who participated in the day-center treatment program showed a significant increase in their PRES and SMS scores and a decrease in their CARS scores. CONCLUSIONS: A day-center treatment program is effective for development of children with PDD and PDD/MR.
Autistic Disorder ; Child ; Child Development Disorders, Pervasive ; Humans

OBJECTIVES: The objective of this study was to examine the perinatal and developmental risk factors of attention-deficit hyperactivity disorder (ADHD) diagnosed with a structured interview among Korean children. METHODS: The current study included 924 children (6-15 years) recruited from schools in five Korean cities or a child psychiatry outpatient clinic of Seoul National University Children's Hospital. The parents of the children completed the structured diagnostic interview for attention-deficit hyperactivity disorder, as well as questionnaires on perinatal and developmental risk factors. RESULTS: Preterm delivery, severe maternal stress during pregnancy, change in primary care taker during the first three years, postpartum depression, and delayed first sentence showed a significant association with ADHD diagnosis. CONCLUSION: These findings suggest that perinatal and developmental factors contribute to development of ADHD in Korean children. Conduct of future research using a prospective design is needed in order to identify the causal relationship between observed risk factors and development of ADHD.
Ambulatory Care Facilities ; Child ; Child Psychiatry ; Depression, Postpartum ; Female ; Humans ; Parents ; Pregnancy ; Primary Health Care ; Risk Factors ; Surveys and Questionnaires

Early detection and intervention is critical in improving prognosis of developmental disorders. Developmental delay can have many different causes and the clinical features of developmental delay are diverse according to its etiologic causes and severity. The vast and rapid growth of the child's neurobehavioral repertoire from birth through adolescence requires the physician's abundant experience, knowledge, and understanding of development. Here, we summarize instruments for use in neurodevelopmental assessment of infants and toddlers, focusing on motor development, which is the most frequent complaint listed in the developmental clinic.
Adolescent ; Humans ; Infant ; Parturition ; Prognosis

Trichotillomania is a neuropsychiatric disorder characterized by repetitive pulling out of one's hair. We present a trichotillomania case study illustrating the effectiveness of habit reversal training, which has recently been found, in western countries, to be a very effective cognitive behavioral treatment. The refractory patient in our study had previously received 1 year of drug treatment and psychiatric consultation for the disorder. We administered 10 habit reversal training sessions, which was followed by an obvious improvement in the patient's trichotillomania symptoms. Our observations indicate that habit reversal training might be effective in the treatment of trichotillomania.
Cognitive Therapy ; Hair ; Humans ; Trichotillomania

OBJECTIVES: We investigated the parenting stress and depressive mood of mothers with developmentally-delayed children and the effects of participation in a mother-child development promotion program on same. METHODS: Subjects were the mothers of 20 developmentally-delayed children. The severity of the mothers' parenting stress was evaluated via the Korean version of the Parenting Stress Index, Short Form (K-PSI-SF) and the severity of their depressive symptoms were evalueted by the Korean version of the Beck Depression Inventory (K-BDI). RESULTS: The mean K-PSI-SF score and mean K-BDI score for these mothers were 93.35 (SD=10.47) and 23.25 (SD=10.42), respectively. These scores correspond to high parenting stress and moderate depression. The mothers who participated in a mother-child attachment- promotion program showed significant decreases in their K-PSI-SF and KBDI scores. CONCLUSION: Our data suggest that a mother-child attachment promotion program with emphasis on child development is effective in reducing parenting stress and depressive mood in mothers of developmentally-delayed children.
Child ; Child Development ; Depression ; Humans ; Mothers ; Parenting ; Parents

OBJECTIVES: We conducted this study to investigate the relationship between sleep duration and body mass index (BMI), in Korean children. METHODS: We performed a cross-sectional analysis of data collected on 3,639 boys and girls (aged 7-12) in Daegu, Korea. The data included each child's age, sex, weight, height, extracurricular activities, bedtime, wake-up time, sleep latency, total sleep duration, parents' occupations, and parents' educational levels. The relationship between sleep duration and each variable was examined via analysis of variance (ANOVA). RESULTS: The analysis showed an association between short sleep duration and high BMI. Boys showed a graded inverse relationship between sleep duration and BMI. However, there was no significant corresponding result for girls. In the total sample, hours of computer use, time when the computer was turned off, time when the television was turned off, mother's bedtime, and hours of extracurricular activity were associated with longer sleep duration. No association was found between sleep duration and hours of watching television, child's wake-up time, or educational level of the parents. CONCLUSION: The results of this study show an inverse relationship between a child's sleep duration and BMI;thus, children with shorter sleep duration tend to have higher BMIs.
Body Mass Index ; Child ; Cross-Sectional Studies ; Humans ; Korea ; Occupations ; Television

OBJECTIVES: This study explored the differences in their ego defense mechanisms between adolescents with conduct disorder and normal adolescents. METHODS: Subjects were 35 adolescents with conduct disorder and 44 normal adolescents. The Ewha Defense Mechanism Test (EDMT), consisting of 200 items and 20 scales, was administered, to examine the defense mechanisms of both groups of adolescents. RESULTS: Normal adolescents presented statistically significantly higher scores on the reaction formation, controlling, suppression, anticipation, dissociation, and distortion scales than did adolescents with conduct disorder. Zn addition, adolescents with conduct disorder used neurotic defense mechanisms of both neurotic and mature levels less frequently than normal adolescents did. Factor analysis revealed that, normal adolescents had higher scores on ego-expansive factor scales and behavior control factor scales thanadolescents with conduct disorder did. CONCLUSION: The results suggest adolescents with conduct disorder use mature and ego-expansive defense mechanisms less frequently than do normal adolescents.
Adolescent ; Behavior Control ; Conduct Disorder ; Defense Mechanisms ; Dissociative Disorders ; Ego ; Humans ; Weights and Measures

OBJECTIVES: This study evaluated the effectiveness of school-based mental health screening and treatment linkage programs, focusing on attention-deficit hyperactivity disorder (ADHD) and adolescent depression. METHODS: All 11,158 children and adolescents aged 8-14 years in Seoul received a school-based mental health screening, consisting of the Korean versions of the ADHD rating scale and the Child Behavior Checklist (CBCL), for ADHD, and the Center for Epidemiological Studies Depression Scale (CES-DS) and the Suicidal Ideation Questionnaire-Junior (SIQ-JR), for depression. The high-risk children's and adolescents' diagnoses were confirmed using the Diagnostic Interview Schedule for Children-IV (DISC-IV). Treatment linkage programs were managed by the Seoul Metropolitan Community Mental Health Center (Program 1), the Seoul Metropolitan Office of Education (Program 2), or the Dongjak District Office of Education (Program 3). We estimated and compared the referral rates of the three programs. RESULTS: Program 1 screened and referred 22.9% of ADHD youths to mental health services, Program 2, 68.8%, and Program 3, 40.0%. Program 1 screened and referred 22.8% of depressed youths to mental health services, Program 2, 53.8%, and Program 3, 88.9%. Key elements for successful screening and referral programs were an effective school/community mental health center/Office of Education network, the parents' financial support and perception of their child's mental health status as being problematic, and the teachers' active engagement. CONCLUSION: This is the first study investigating the effectiveness of school-based mental health screenings' linkage to treatment for primary and middle school students in Korea. An effective network for community mental health and improvements in parents' and teachers' perceptions regarding mental health are needed for more successful treatment linkage.
Adolescent ; Aged ; Appointments and Schedules ; Checklist ; Child ; Child Behavior ; Depression ; Epidemiologic Studies ; Financial Support ; Humans ; Korea ; Mass Screening ; Mental Health ; Mental Health Services ; Referral and Consultation ; Suicidal Ideation

OBJECTIVES: Autism is a well-known psychiatric disorder that is presumed to have a neural basis. To investigate the underlying neurofunctional abnormalities of autism, the authors performed single photon emission computed tomography (SPECT) on children with autism. METHODS: Fifty-five children with untreated autism (47 boys and 8 girls, mean age=50.6+/-20.28 months) were selected from among the patients visiting the child and adolescent psychiatric clinic of Seoul National University Hospital. Psychiatrists had diagnosed the participants according to the DSM-IV criteria for autistic disorder and the Childhood Autism Rating Scale (CARS) criteria for a diagnosis of autism. All participants were examined using 99mTC-HMPAO Brain SPECT. Using statistical parametric mapping (SPM) analysis, we compared the participants' SPECT images to standardized SPECT images of normal children, which had been retrospectively selected by the authors, on a voxel by voxel basis. Voxels with a p-value less than .001 were considered to be significantly different. RESULTS: The autistic group showed significant hypoperfusion in the right medial frontal gyrus, right precentral gyrus, and left precuneus gyrus. In addition, they showed no significant hyperperfusion areas when compared to the control group. CONCLUSION: The findings of hypoperfusion in the medial-frontal lobe and precuneus are accord with hemodynamic abnormalities that have been already reported. Therefore, these findings are compatible with the recently suggested "theory of mind" hypothesis and the disturbances in attention shifting that have been observed in autistic children.
Adolescent ; Autistic Disorder ; Brain ; Child ; Diagnostic and Statistical Manual of Mental Disorders ; Hemodynamics ; Humans ; Perfusion ; Psychiatry ; Retrospective Studies ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon

Trichotillomania (TTM) is a disorder characterized by repetitive hair pulling, frequently from the scalp and/or eyebrows, leading to noticeable hair loss and functional impairment. TTM remains a poorly understood and inadequately treated disorder despite increased recognition of its prevalence. We review available neuroimaging studies conducted in patients with TTM, covering structural and functional neuroimaging in turn. Data from patients' structural and functional neuroimaging results enabled us to identify the neural circuitry involved in the manifestation of hair pulling. Finally, we highlighted the future importance of neuroimaging studies in children and adolescents with TTM.
Adolescent ; Brain ; Child ; Eyebrows ; Functional Neuroimaging ; Hair ; Humans ; Neuroimaging ; Prevalence ; Scalp ; Trichotillomania