Chronic tic disorder or Tourette syndrome is known to be a chronic neuro-behavioral disease for which cognitive behavioral therapy (CBT) strategies have recently been introduced. Here, we report the effectiveness of CBT in a case of childhood chronic tic disorder, which is very common in clinical settings. The DSM-IV clinical diagnosis was applied by a child psychiatrist. The Yale Global Tic Severity Scale, Kovac's children's depression inventory, Spielberger State-Trait Anxiety Inventory, Abbreviated Conners' Rating Scales, and the Dupaul ADHD Rating Scales were used. This case involved a pharmacological treatment-refractory patient over the previous year. Thus, psychiatric consultation was undertaken. Subsequently, we administered five sessions of CBT for four weeks, consisting of symptom evaluation and planning, habit reversal training, and ventilation training. Following four weeks of CBT administration, there were improvements in the scores of the Yale Global Tic Severity Scale and the Clinical Global Improvement scale. Our observations indicate that CBT may be effective in the treatment of childhood tic disorder.
Anxiety ; Child ; Cognitive Therapy ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Psychiatry ; Symptom Assessment ; Tic Disorders ; Tics ; Tourette Syndrome ; Ventilation ; Weights and Measures

OBJECTIVES: This study was conducted to develop a Korean algorithm of pharmacological and non-pharmacological treatment strategies in attention-deficit hyperactivity disorder (ADHD) and its specific comorbid disorders (e.g. tic disorder, depressive disorder, anxiety disorder, bipolar disorder, and oppositional defiant disorder/conduct disorder). METHODS: Based on a literature review and expert consensus, both paper- and web-based survey tools were developed with respect to a comprehensive range of questions. Most options were scored using a 9-point scale for rating the appropriateness of medical decisions. For the other options, the surveyed experts were asked to provide answers (e.g., duration of treatment, average dosage) or check boxes to indicate their preferred answers. The survey was performed on-line in a self-administered manner. Ultimately, 49 Korean child & adolescent psychiatrists, who had been considered experts in the treatment of ADHD, voluntarily completed the questionnaire. In analyzing the responses to items rated using the 9-point scale, consensus on each option was defined as a non-random distribution of scores as determined by a chi-square test. We assigned a categorical rank (first line/preferred choice, second line/alternate choice, third line/usually inappropriate) to each option based on the 95% confidence interval around the mean rating score. RESULTS: Specific medication strategies for key clinical situations in ADHD and its comorbid disorders were indicated and described. We organized the suggested algorithms of ADHD treatment mainly on the basis of the opinions of the Korean experts. The suggested algorithm was constructed according to the templates of the Texas Child & Adolescent medication algorithm Project (CMAP). CONCLUSION: We have proposed a Korean treatment algorithm for ADHD, both with and without comorbid disorders through expert consensus and a broad literature review. As the tools available for ADHD treatment evolve, this algorithm could be reorganized and modified as required to suit updated scientific and clinical research findings.
Adolescent ; Anxiety Disorders ; Bipolar Disorder ; Child ; Comorbidity ; Consensus ; Depressive Disorder ; Humans ; Psychiatry ; Texas ; Tic Disorders ; Surveys and Questionnaires

OBJECTIVES: This study examined the prevalence of psychiatric problems in children with scholastic difficulties who had been referred for mental health services from the Office of Education in Ulsan Metropolitan City. METHODS: Child psychiatrists evaluated the referred children using the DSM-IV. Evaluation tools included the Wechsler Intelligence Scale for Children-III, the Children's Depression Inventory, the Korean form of the State-trait anxiety Inventory for children, the ADHD rating. RESULTS: Seventy-six children consisting of 64 boys (84.2%) and 12 girls (15.8%) participated in the study. The average age was 10.3 (SD=0.93) years old. Approximately 74% of the children referred for scholastic difficulties were diagnosed with mental retardation. The Axis I diagnosis among these children were ADHD (86.8%), depression (21.1%), learning disorder (9.2%), communication disorder (4.8%), pervasive developmental disorder (3.6%), internet addiction (1.3%), and mood disorder (1.3%). Their overall measure according to the Child Depression Inventory was 22.7 (SD=16.8), that for the State-Trait Anxiety Inventory for Children was 33.3 (SD=7.9)/32.4 (SD=9.5), and that for the ADHD rating scale was 18.9 (SD=10.9). CONCLUSION: These results suggest that many children with scholastic difficulties have both complex psychiatric and educational problems.
Anxiety ; Axis, Cervical Vertebra ; Child ; Communication Disorders ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Intellectual Disability ; Intelligence ; Internet ; Learning Disorders ; Mental Health Services ; Mood Disorders ; Parents ; Prevalence ; Psychiatry ; Psychopathology

In this review, we have provided an overview of the environmental risk factors for attention deficit hyperactivity disorder (ADHD), focusing on the major environmental toxicants related to the disorder. Researchers have indicated that since the characteristics of ADHD are complex, the disorder's etiology involves multiple genes of moderate effect interacting with environmental factors. The possible roles of prenatal and perinatal exposure have been the main focus of research on environmental risk factors for ADHD. Among environmental toxicants, we reviewed the potential effects on the development of ADHD of exposure to lead, nicotine, alcohol, polychlorinated biphenyls (PCBs), and dioxin. Further, for the each neurotoxicant, clinical prevention or intervention strategies aimed at reducing a child's risk from environmental toxic insults have been presented.
Attention Deficit Disorder with Hyperactivity ; Nicotine ; Polychlorinated Biphenyls ; Risk Factors

Autism and autistic spectrum disorder are chronic neuro-developmental disorders characterized by social and language impairments and stereotyped, repetitive patterns of behavior. The etiology of autism remains unknown; however, a strong genetic component has been detected and environmental factors may also be involved in their etiologies. In the current study, we reviewed evidence for the presence of prenatal and perinatal factors, gastrointestinal factors, food allergies, metabolic and heavy metal factors, and other nutritional factors that may represent risk factors for the development of autism and autistic spectrum disorder.
Autistic Disorder ; Food Hypersensitivity ; Risk Factors

OBJECTIVES: The aim of the current study is to test for the association of DRD4 exon III VNTR polymorphism with attention-deficit hyperactivity disorder(ADHD) in Korean children population. METHODS: 113 Korean children with ADHD, 102 parents, and 133 control subjects participated with the current study. The distribution of genotypes and alleles of DRD4 exon III VNTR in children with ADHD was compared with that in control subjects. In addition, 69 children with ADHD and their parents were analyzed using the transmission disequilibrium test(TDT). RESULTS: We could not find any significant differences in the distribution of genotypes and alleles at DRD4 exon III VNTR polymorphism between children with ADHD and control subjects. In addition, there was no preferential transmission of long allele of DRD4 exon III VNTR polymorphism. CONCLUSION: These results suggest that DRD4 is not associated with ADHD in Korean children population.
Alleles ; Child* ; Exons* ; Genetic Association Studies ; Genotype ; Humans ; Parents

OBJECTIVES: This study was focused on the influence of chronic aircraft noise exposure on children's continuous performance, intelligence and reading skill. METHODS: We enrolled 586 children in 4-6th grade of 7 primary schools near air base in Korea. Continuous performance was measured using the computerized ADS program. We analyzed 477-512 children on the visual continuous performance test, auditory continuous performance test, intelligence test, and reading and the vocabulary test. Intelligence was measured using vocabulary, digit span, block design, and digit symbol tests of K-WISC-III. RESULTS: The commission error and variability deviation of auditory continuous performance test and reading test were significantly higher among children in schools with the helicopter noise and the fighting plane noise compared to children in the low noised schools. CONCLUSION: There was a possibility that chronic aircraft noise exposure was associated with impairment of the school performance. The result of our study also shows chronic aircraft noise was associated with reading ability.
Aircraft* ; Child* ; Cognition* ; Humans ; Intelligence ; Intelligence Tests ; Korea ; Language Tests ; Noise* ; Reading ; Vocabulary

OBJECTIVES: The aim of this study was to evaluate the reliability and validity of the Korean Version of the Diagnostic Interview Schedule for Children Version IV(DISC-IV), a highly structured diagnostic interview used to assess more than 30 psychiatric disorders in children and adolescents. METHODS: A total of 91 study subjects, including 67 subjects who visited the child and adolescent psychiatry outpatient clinic at our institution and 24 community-based subjects, were assessed using the Korean Version of the DISCIV. Clinical diagnosis was used as a gold standard for the examination of the validity of the DISC-IV. Forty-four of the study subjects were randomly selected for test-retest reliability measurement. RESULTS: The validity of the Korean Version of the DISC-IV showed kappa values ranging from 0.25 to 0.40 in the clinical sample and 0.65 to 1.00 in the community sample. The sensitivities varied according to the diagnostic categories, but the specificities were excellent for all diagnostic entities. CONCLUSION: The Korean Version of the DISC-IV showed good reliability and validity in Korean children and adolescents. The Korean Version of the DISC-IV might be a useful tool for assessing psychiatric disorders in children and adolescents.
Adolescent ; Adolescent Psychiatry ; Ambulatory Care Facilities ; Appointments and Schedules* ; Child* ; Diagnosis ; Humans ; Reproducibility of Results*

OBJECTIVES: Studies investigating problematic internet use have increased rapidly and have been focused on its causes, psychopathology, prevalence, characteristics and so on. However, there are few studies concerning the correlation between problematic internet use and youth health risk behavior. Therefore, the purpose of this study was to examine the relationship between problematic internet use and youth health risk behavior. METHODS: A community sample of 632 high school students in grades 10 and 11 was collected for the survey. The sample was assessed using the Youth Risk Behavior Surveillance System(YRBSS) and Young's Diagnostic Questionnaire of Internet Addiction(YDQ). The subjects were classified into two groups: normal and problematic internet use, and the problematic internet use group was further divided into at-risk use and addiction groups. RESULTS: There were 56 subjects(8.9%) in the internet addiction group and 56 subjects(8.9%) in the at-risk internet use group. The other 507 subjects were classified as normal. The subjects in the internet addiction group kissed more frequently and ate less fruit than those in the normal group. They also showed a relatively higher tendency to watch TV, ride in a car driven by a drunk driver and to carry a weapon than those in the normal group. There were no differences in health risk behaviors between the subjects in the internet addiction group and those in the at-risk internet use group, except for the possibility of riding in a car driven by a drunk driver. CONCLUSION: Unlike the normal group, there was very little difference in health risk behavior between the internet addiction group and the at-risk internet use group, which indicates that the addiction group and the at-risk internet use groups are homogenous. It is important to focus on the behavior of individuals in the at-risk group, and preventive measures should be taken in order to reduce the possibility of at-risk adolescents becoming addicted.
Adolescent ; Fruit ; Humans ; Internet* ; Prevalence ; Psychopathology ; Risk-Taking* ; Weapons ; Surveys and Questionnaires

OBJECTIVES: Autism is a complex neurodevelopmental spectrum disorder with a strong genetic component. Previous neurochemical and genetic studies have suggested the possible involvement of the serotonin system in autism. Tryptophan 2,3-dioxygenase(TDO2) is the rate-limiting enzyme in the catabolism of tryptophan, which is the precursor of serotonin synthesis. The aim of this study was to investigate the association between the TDO2 gene and autism spectrum disorders(ASD) in a Korean population. METHODS: The patients were diagnosed with ASD on the basis of the DSM-IV diagnostic classification outlined in the Korean version of the Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule. The present study included the detection of four single nucleotide polymorphisms(SNPs) in the TDO2 gene(rs2292536, rs6856558, rs6830072, rs6830800) and the family-based association analysis of the single nucleotide polymorphisms in Korean ASD trios using a transmission disequilibrium test(TDT) and haplotype analysis. The family trios of 136 probands were included in analysis. 87.5% were male and 86.0% were diagnosed with autism. The mean age of the probands was 78.5+/-35.8 months(range: 26-264 months). RESULTS: Two SNPs showed no polymorphism, and there was no significant difference in transmission in the other two SNPs. We also could not find any significant transmission in the haplotype analysis(p>.05). CONCLUSION: We could not find any significant statistical association between the transmission of SNPs in the TDO2 gene and ASD in a Korean population. This result may not support the possible involvement of the TDO2 gene in the development of ASD, and further exploration might be needed to investigate other plausible SNP sites.
Appointments and Schedules ; Autistic Disorder* ; Child ; Autism Spectrum Disorder* ; Classification ; Diagnostic and Statistical Manual of Mental Disorders ; Haplotypes ; Humans ; Male ; Metabolism ; Polymorphism, Single Nucleotide ; Serotonin ; Tryptophan