OBJECTIVES: Contemporary empirical studies have suggested high rates of comorbid attention-deficit hyperactivity disorder(ADHD) or obsessive compulsive disorder(OCD) in children with tic disorders. Not infrequently, ADHD or OCD is as source of greater impairment than are the tic symptoms. The studies in the pathophysiology of tic disorder have implicated abnormalities of dopamine, serotonin and norepinephrine. The studies in pathophysiology of ADHD or OCD also have implicated abnormalities of dopamine, serotonin and norepinephrine. This study was purposed to examine the differences in tic severities and in the levels of plasma homovanillic acid(HVA) and 5-hydroxyin-doleacetic acid(5-HIAA) according to the presence of comorbid ADHD or OCD in patients with chronic tic disorders. METHODS: In fifty chronic tic patients, OCD or ADHD was also diagnosed. And then tic symptoms, obsessive-compulsive symptoms, and attention-deficit hyperactive symptoms were assessed using Yale global tic severity scale(YGTSS), Leyton obsessional inventory-child version(LOI-CV), and Conners parent rating scale. The plasma HVA and 5-HIAA levels were measured using high performance liquid chromatography with electrochemical detection method. RESULTS: Fifty-eight percent of the patients with chronic tic disorders had comorbid ADHD or OCD. But severities of tic did not differ regardless of the presence of comorbid ADHD or OCD. There was a significant positive correlation between tic severities and plasma HVA levels but none between tic severities and plasma 5-HIAA levels. There was a significant inverse correlation between resistance and interference scores and plasma 5-HIAA levels. Plasma HVA levels showed significant positive correlations with plasma 5-HIAA levels. CONCLUSION: These results showed that tic severities didn't vary according to the presence of comorbidities, and that tic severities were correlated with plasma HVA levels, not with plasma 5-HIAA levels. These results suggested that the pathophysiology of chronic tic disorder was strongly correlated with abnormalities of dopaminergic system.
Child ; Chromatography, Liquid ; Comorbidity* ; Dopamine ; Homovanillic Acid* ; Humans ; Hydroxyindoleacetic Acid ; Norepinephrine ; Obsessive Behavior ; Obsessive-Compulsive Disorder ; Parents ; Plasma* ; Serotonin ; Tic Disorders* ; Tics*

There has been increasing recognition of pediatric bipolar disorder in the psychiatric field during the past 10 years. The clinical presentation of this disorder in preadolescent is greatly debated and few studies have been conducted in Korea. The authors report 3 cases of children with bipolar I disorder whose clinical symptoms were improved after pharmacotherapy. The authors also review current concepts, debates and treatment of pediatric bipolar disorder.
Bipolar Disorder ; Child ; Drug Therapy* ; Humans ; Korea

OBJECTIVES: This study aimed to examine the association between norepinephrine transporter gene (SLC6A2) polymorphisms and attention-deficit hyperactivity disorder (ADHD) and to examine the relationship between the genotypes and allele variants of SLC6A2 and results of the Korean version of the parent ADHD rating scale (K-ARS). METHODS: We examined the association between ADHD and norepinephrine transporter gene polymorphism using DNA from 137 Korean children with ADHD and 120 normal controls. We compared the genotype distributions and allele frequencies of SLC6A2 polymorphism between the control group and the ADHD group. Then, we correlated the children's K-ARS mean totals, inattention scores, and hyperactivity/impulsivity scores with the genotypes and alleles for each SLC6A2 polymorphism. RESULTS: There were no significant differences in genotype and allele distribution for each SLC6A2 polymorphism, as shown by the Chi-square test (p>.01). There was a trend toward a difference in allele frequency in rs 5568, but it was not statistically significant after adjusting for multiple comparisons (p=.048). Also, there were no significant differences in K-ARS scores according to the genotypes and alleles for the SLC6A2 polymorphisms. CONCLUSION: Our study found no significant evidence of an association between SLC6A2 polymorphisms and ADHD.
Alleles ; Case-Control Studies ; Child ; DNA ; Gene Frequency ; Genotype ; Humans ; Norepinephrine ; Norepinephrine Plasma Membrane Transport Proteins ; Parents

OBJECTIVES: The objective of this study was to identify the risky behavior subtypes in adolescents with depression, and the relationship between those subtypes and suicide attempt. METHODS: Ninety adolescents who met the Diagnostic and Statistical Manual of Mental Disorders-4th edition criteria for major depressive disorder, dysthymia, or depressive disorder not otherwise specified participated in the study. Participants were interviewed about suicidal attempts, non-suicidal self-injuries. Smoking, drinking behaviors, and searching for the word "suicide" on the internet, negative life events including bulling-bullied experiences, and history of abuse were also included with questionnaires. RESULTS: The results of cluster analysis showed that four risky behaviors were divided into three clusters : non-risky type, characterized by few risky behaviors ; delinquency type, which was characterized by smoking and drinking ; non-suicidal self-injury type. In non-suicidal self-injury type, percentage of girls was higher and clinical symptoms were more severe than delinquency type. In addition, delinquency type members could be a bully, while non-suicidal self-injury type members could be abused by a family member. Logistic regression analysis showed that both risky behavior subtypes were significant predictors of suicide attempt. CONCLUSION: These results suggest that two types of risky behaviors of depressed adolescents have an effect on the suicide attempts independently. Then, the implications and limitations of the study were discussed and directions for future studies were suggested.
Adolescent* ; Depression* ; Depressive Disorder ; Depressive Disorder, Major ; Drinking ; Drinking Behavior ; Female ; Humans ; Internet ; Logistic Models ; Smoke ; Smoking ; Suicide*

OBJECTIVES: The aim of our study was to investigate association of norepinephrine transporter gene (SLC6A2) polymorphism and side effects of osmotic-release oral system methylphenidate (OROS MPH) in children with attention-deficit hyperactivity disorder (ADHD). METHODS: We recruited drug naive children with ADHD (N=97). We administered OROS MPH by tolerable dosage. At week 8 of treatment, parents completed the Barkley's side effect rating scale. We analyzed two SLC6A2 single nucleotide polymorphisms (SNPs), rs192303 and rs3785143, with blood of subjects. We compared the frequency and severity of each side effect among SLC6A2 genotypes of 2 SNPs. RESULTS: In the analysis of frequency of each side effect, irritability differed according to rs192303 and rs3785143 genotype. In comparisons of severity, talking less and disinterest differed according to rs192303 genotype. In the case of rs3785143, severities of disinterest and irritability were involved with genotype. CONCLUSION: Side effects of OROS MPH showed an association with SLC6A2 genotype.
Child ; Genotype ; Humans ; Methylphenidate* ; Norepinephrine Plasma Membrane Transport Proteins* ; Parents ; Polymorphism, Single Nucleotide

OBJECTIVES: The purpose of this study was to examine the effect of cognitive-behavioral group therapy on improving adolescents' behavioral problems, especially violent behavior. METHOD: The subjects were 27 middle school students referred by their teachers for behavioral problems. We devided them into 4 teams and treated them for 15 sessions of cognitive-behavioral group therapy. The control group were 20 middle school students who had no cognitive-behavioral therapy. We assessed their behaviors pre- and post intervention by two series of scale, ie. self ratings and teacher ratings. Self ratings included 'misbehavior scales' and 'violent behavior subscale'; teacher ratings included 'teacher-children rating scale' and 'detection of misbehavior scale'. RESULT: 1)In self-rating scales, the misbehavior of the subject group decreased more than the coltrol group, but not the violent scale. There were statistically significant group differences of improving effect in misbehavior scales. 2)In teacher rating scales, there was no significant decrease in the behavioral problems of the subject group. 3)By teams there were significant different intervention effects among 4 teams in self rating misbehavior scale. Team 2 improved on all scales except teacher-rating detection of misbehavior scale. 4)Determinant factors of intervention effect on behavioral problems were the degree of baseline behavioral problems, sex of subjects and therapist. CONCLUSION: The results from this study suggest that cognitive-behavioral group therapy was effective in decreasing the behavioral problems of adolescents. But the effect of therapy depends on sex, the degree of behavioral problems of subjects and the therapist.
Adolescent ; Humans ; Psychotherapy, Group* ; Violence ; Weights and Measures

OBJECTIVES: This study aims to investigate possible associations between proneness toward smartphone addiction and certain psychopathological variables to evaluate the psychopathological meaning of smartphone addiction. METHODS: Questionnaires were assigned to 755 adults between September and November 2012. We used the Korean Smartphone Addiction Proneness Scale (SAPS), the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), the Obsessive-Compulsive Inventory-Revised (OCI-R), and the Barratt Impulsivity Scale-11 (BIS-11). Subjects were classified into two groups according to the scores of the SAPS ; the addiction proneness group and the normal-user group. RESULTS: The addiction proneness group had significantly higher scores than the normal-user group in the BDI, BAI, OCI-R, and BIS-11. The scores of the SAPS were positively correlated with the scores of the BDI, BAI, OCI-R, and BIS-11. Using logistic regression analysis, smartphone addiction proneness showed a significant association with BIS-11. CONCLUSIONS: The results of this study suggest that smartphone addiction proneness may be associated with depression, anxiety, obsessive-compulsive symptoms, and impulsivity. Furthermore, impulsivity could be a vulnerability marker for smartphone addiction proneness.
Adult ; Anxiety ; Depression ; Humans ; Impulsive Behavior ; Logistic Models ; Psychopathology* ; Smartphone ; Surveys and Questionnaires

Objective: Early trauma significantly affects the severity of panic disorder (PD) symptoms and suicidal ideation. However, few studies have explored the specific effects of different early trauma subtypes on PD. This study analyzed how childhood trauma subtypes, including general, physical, emotional, and sexual, influence panic and phobia levels and suicidal ideation in adults with PD and healthy controls (HCs). Methods: In total, 455 adults with PD and 149 HCs participated in this study. The independent variables were sociodemographic and clinical variables such as coping strategies and early trauma subtypes from the Early Trauma Inventory Self Report-Short Form. The dependent variables were the Albany Panic and Phobia Questionnaire (APPQ), the Panic Disorder Severity Scale, and the Scale for Suicide Ideation (SSI). Results: Early emotional trauma significantly influenced the APPQ scores, whereas early physical trauma significantly influenced the SSI scores in patients with PD. However, in HCs, only early emotional trauma was significantly associated with the APPQ and SSI scores. Conclusion These findings highlight the influence of early trauma subtypes on the phobic symptom severity of PD and suicidal ideation among patients with PD. Early emotional trauma is associated with the severity of phobic symptoms, whereas early physical trauma is associated with suicidal ideation, suggesting distinct clinical outcomes based on the type of trauma in patients with PD.

OBJECTIVE: Suicide is the leading cause of death for adolescents. The internet is widespread in Korea and has influence on mental health of adolescents. This study aims to investigate the relationship between the internet use and suicidal behavior resulting from adolescent depression. METHODS: The subjects consisted of 61 adolescents between the ages of 13 and 18 who were diagnosed as depression by Kiddie-Schedule for Affective Disorder and Schizophrenia Present and Lifetime Korean Version and Diagnostic and Statistical Manual of Mental Disorder 4th edition. Suicidal behavior was assessed by Columbia Suicide Severity Rating Scale. Patients were inquired about their internet use using questionnaires and other clinical variables using Beck Depression Inventory, Beck Suicidal Ideation Scale, Revised Children's Manifest Anxiety Scale, Internet Game Addiction Scale and Physical Abuse Scale. RESULTS: The patients within the high-risk group were more prone to searching for the word 'suicide' on the internet and having suicidal idea compare to the patients within the low-risk group. Among the high-risk group, the patients who searched for the word 'suicide' tended to be more anxious compared to the patients who did not search the word. CONCLUSION: The results of the present study suggest that searching the word 'suicide' on the internet is associated with suicidal idea. It is suggested that intervention on the patients within the searching group may reduce the suicidal idea resulting from adolescent depression.
Adolescent ; Cause of Death ; Depression ; Humans ; Internet ; Korea ; Manifest Anxiety Scale ; Mental Disorders ; Mental Health ; Mood Disorders ; Surveys and Questionnaires ; Schizophrenia ; Suicidal Ideation ; Suicide

Vitamin E is the most important lipid-soluble antioxidant in humans. Although alpha-tocopherol is suggested that it has protective effect from many diseases, little is known about the prevention of occludin alteration in tight junction of blood-brain barrier (BBB) under pathologic insults producing reactive oxygen species (ROSs). In this study, the effects of alpha-tocopherol on H2O2-induced tight junction occludin were studied. Primary culture of rat brain microvessel endothelial cells was investigated with confocal microscopy, Western blot, and cell viability assay. Alpha-tocopherol had no apparent cytotoxicity up to 2.8 mM. The preincubation with alpha-tocopherol suppressed the H2O2-induced cytotoxicity in Alamar Blue assay and phase contrast microscopy. In confocal laser microscopy and Western blot, H2O2-induced loss of occludin was suppressed by preincubation with alpha-tocopherol. The present findings provide evidence that alpha-tocopherol may be beneficial for cellular protection from pathologic insults. Since alpha-tocopherol was demonstrated to have far fewer adverse effects, it would become a noteworthy nutrient or drug for the treatment of neurodegenerative diseases.
alpha-Tocopherol* ; Animals ; Blood-Brain Barrier* ; Blotting, Western ; Brain ; Cell Survival ; Endothelial Cells ; Humans ; Microscopy, Confocal ; Microscopy, Phase-Contrast ; Microvessels ; Neurodegenerative Diseases ; Occludin* ; Rats ; Reactive Oxygen Species ; Tight Junctions* ; Vitamin E ; Vitamins