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Psychiatric Treatment of Ruminative Vomiting and the Associated Weight Loss in an Adolescent Boy with Autism: A Case Report.

Yun O SHIN ; Moon Sung RHEE

Journal of the Korean Academy of Child and Adolescent Psychiatry.2009;20(1):39-43.

We treated the persistent ruminative vomiting of a 13-year-old autistic boy by using a behavioral and psychopharmacological approach in a closed ward. Before the interventions, the patient had lost about 10kg of body weight due to very high-frequency ruminative vomiting. Together with psychopharmacological trials, the psychiatric treatment included a combination of a behavioral approach and food regulation that emphasized food restrictions, and we provided regular light meals. There was a considerable reduction of the ruminative vomiting and 2kg weight gain was achieved during the admission. These therapeutic gains were maintained at the 4-month follow-up assessment and the vomiting symptom reached a near-zero level and the weight loss were recovered by about 8kg. The issues related to the treatment approaches for ruminative vomiting with autism are discussed.
Adolescent ; Autistic Disorder ; Body Weight ; Follow-Up Studies ; Humans ; Light ; Meals ; Vomiting ; Weight Gain ; Weight Loss

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The Efficacy of a Short-Term Group Program for Treating Depressive Disorder in Female Adolescents: A Comparison of the Cognitive-Behavioral and Psychoeducation Programs: A Preliminary Study.

Eun Jung PARK ; Min Sup SHIN ; Kwang Mo JUNG ; Young Heu YANG ; Boong Nyun KIM

Journal of the Korean Academy of Child and Adolescent Psychiatry.2009;20(1):29-38.

OBJECTIVES: This preliminary study evaluated the efficacy of two short-term programs for reducing depressive symptoms in female adolescents with depressive disorder. METHODS: The participants were 23 middle school students who were randomly assigned to three groups: the cognitivebehavioral program group, the psychoeducation-program group and the no-intervention control group. RESULTS: At postintervention, the students in cognitive-behavioral program group reported significantly lower levels of depressive symptoms, negative self-statement, automatic thought and psychiatric symptoms than did those in the nointervention group and those in the psychoeducation-program group. CONCLUSIONS: The results suggest that the cognitive-behavioral program for female adolescent with depressive disorder was more effective in reducing depressive symptoms than the psychoeducation-program.
Adolescent ; Depression ; Depressive Disorder ; Female ; Humans

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Association of the Symptoms of Parental Attention-Deficit Hyperactivity Disorder and the Parental Personality Patterns with the Symptoms of Boys with Attention-Deficit Hyperactivity Disorder.

Woo Seung SHIN ; Hye Ra CHOI ; Kunwoo KIM ; Joong Sun LEE ; Subin PARK ; Jin Pyo HONG ; Hanik K YOO

Journal of the Korean Academy of Child and Adolescent Psychiatry.2009;20(1):23-28.

OBJECTIVES: This study was conducted to investigate the association between the symptoms of boys with attentiondeficit hyperactivity disorder (ADHD) and the attention-deficit hyperactivity symptoms, temperament and character patterns of their parents. METHODS: Forty-five boys with ADHD and who met the DSM-IV criteria were evaluated by using the ADHD rating scale (ADHD-RS), and their parents completed the Korean Adult ADHD scale (K-AADHDS) and the Temperament and Character Inventory (TCI). RESULTS: The parental K-AADHDS scores were not associated with the ADHD-RS total score and the subscale scores of their siblings. The most potent variable related to the ADHD-RS total score was the maternal self-directedness, and the second was the maternal persistence. The maternal self-directedness was the variable that was most correlated with the hyperactivity/impulsivity subscale scores of the ADHD-RS. CONCLUSIONS: The results suggest that the paternal ADHD symptoms may not be related to the ADHD symptoms of boys with ADHD. Higher maternal self-directedness and persistence may decrease overall the ADHD symptoms of these boys, and higher maternal self-directedness itself may predict lower hyperactivity/impulsivity symptoms of the boys with ADHD.
Adult ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Parents ; Siblings ; Temperament

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The Effect of Impulsivity and the Ability to Recognize Facial Emotion on the Aggressiveness of Children with Attention-Deficit Hyperactivity Disorder.

Seung Min BAE ; Dong Won SHIN ; Soo Jung LEE

Journal of the Korean Academy of Child and Adolescent Psychiatry.2009;20(1):17-22.

OBJECTIVES: A higher level of aggression has been reported for children with attention-deficit/hyperactivity disorder (ADHD) than for non-ADHD children. Aggression was shown to have a negative effect on the social functioning of children with ADHD. The ability to recognize facial emotion expression has also been related to aggression. In this study, we examined whether impulsivity and dysfunctional recognition of facial emotion expression could explain the aggressiveness of children with ADHD. METHODS: 67 children with ADHD participated in this study. We measured the ability to recognize facial emotion expression by using the Emotion Recognition Test (ERT) and we measured aggression by the T score of the aggression subscale of the Child Behavior Checklist (CBCL). Impulsivity was measured by the ADHD diagnostic system (ADS). RESULTS: The teacher rated level of aggression was related to the score of recognizing negative affect. After controlling for the effect of impulsivity, this relationship is not significant. Only the score of the visual commission errors explained the level of aggression of children with ADHD. CONCLUSIONS: Impulsivity seems to have a major role in explaining the aggression of children with ADHD. The clinical implication of this study is that effective intervention for controlling impulsivity may be expected to reduce the aggression of children with ADHD.
Aggression ; Checklist ; Child ; Child Behavior ; Humans

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A Study on the Attention, Intellectual Functioning and Behavior Characteristics of Girls with Attention-Deficit Hyperactivity Disorder.

Il Seon KANG ; Ara CHO ; Bongseog KIM

Journal of the Korean Academy of Child and Adolescent Psychiatry.2009;20(1):10-16.

OBJECTIVES: The purpose of this study was to investigate the characteristics of attention, intellectual functioning and adaptation of girls with attention-deficit hyperactivity disorder (ADHD). METHODS: The scores of the ADHD Diagnostic System (ADS), the Korean Wechsler Intelligence Scale for Children-III (K-WISC-III) and the Korean Personality Inventory for Children (KPI-C) were compared between 26 girls with ADHD and 26 boys with ADHD. RESULTS: 1)There was no significant gender difference in the intellectual functioning, except for the picture completion subscale. 2) Compared to the boys, the girls responded more slowly on the ADS visual task. 3) The girls were rated higher by their parents for the depression and social relationship problems of the KPI-C. CONCLUSIONS: The results suggest that there are noticeable gender differences for the attention problems and social functioning of children with ADHD.
Child ; Depression ; Humans ; Intelligence ; Parents ; Personality Inventory

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The Association of COMT Gene Polymorphism and Tourette Syndrome: A Family Based and Case Control Study.

Won Seok LIM ; Myung Ho LIM ; Eun Young SONG ; Mi Young PARK ; Jong Wan KIM ; Tae Hyun KIM ; Se Hoon SHIM ; Tae Won PARK ; Hyun Woo KIM

Journal of the Korean Academy of Child and Adolescent Psychiatry.2009;20(1):3-9.

OBJECTIVES: Tourette disorder is known to be a disease with a strong genetic trait. There has been some recent research on the relationship between the allelic frequency distribution and Tourette disorder. In Korea, the relationship between the genetic type and the alleles for the COMT gene has been studied in Tourette patients. METHODS: Seventy two patients who were diagnosed with Tourette disorder according to the DSM-IV diagnostic criteria were selected for this study. The diagnosis and clinical features were confirmed by the Yale Global Tic Severity Scale. For the control group, the parents of the patients were chosen. Blood samples were taken from the 289 subjects. DNA was extracted from the blood lymphocytes and PCR was performed for assessing COMT gene. RESULTS: On comparing the Tourette disorder transmitted group and the not-transmitted group, no significant difference was seen between the COMT genetic type and the allelic distribution. CONCLUSION: Even though this result is viewed that there is no relationship between Tourette disorder and the COMT gene, it is difficult to firmly accept this negative result. Follow up studies with a larger patient population or pure subgroups are expected in the future.
Alleles ; Case-Control Studies ; Diagnostic and Statistical Manual of Mental Disorders ; DNA ; Humans ; Korea ; Lymphocytes ; Parents ; Polymerase Chain Reaction ; Tics ; Tourette Syndrome

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A Case Report of Noonan Syndrome with Mental Retardation and Attention-Deficit Hyperactivity Disorder.

Won Woo KIM ; Se Hoon SHIM

Journal of the Korean Academy of Child and Adolescent Psychiatry.2012;23(1):31-35.

Noonan syndrome is characterized by short stature, typical facial dysmorphology, and congenital heart defects. The main facial features of Noonan syndrome are hypertelorism with down-slanting palpebral fissures, ptosis, and low-set posteriorly-rotated ears with a thickened helix. The cardiovascular defects most commonly associated with this condition are pulmonary stenosis and hypertrophic cardiomyopathy. Other associated features are webbed neck, chest deformity, mild intellectual deficit, cryptorchidism, poor feeding in infancy, bleeding tendency, and lymphatic dysplasias. The patient is a 10-year-old boy. He had experienced repeated febrile convulsions. He had typical facial features, a short stature, chest deformity, cryptorchidism, vesicoureteral reflux, and mental retardation. His language and motor development were delayed. When he went to school, it was difficult for him to pay attention, follow directions, and organize tasks. He also displayed behavior such as squirming, leaving his seat in class, and running around inappropriately. Clinical observation is important for the diagnosis, so we report a patient who was diagnosed with Noonan syndrome, mental retardation, and attention-deficit hyperactivity disorder.
Cardiomyopathy, Hypertrophic ; Child ; Congenital Abnormalities ; Cryptorchidism ; Ear ; Heart Defects, Congenital ; Hemorrhage ; Humans ; Hypertelorism ; Intellectual Disability ; Male ; Neck ; Noonan Syndrome ; Pulmonary Valve Stenosis ; Running ; Seizures, Febrile ; Thorax ; Vesico-Ureteral Reflux

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Victims of Bullying among Korean Adolescents: Prevalence and Association with Psychopathology Evaluated Using the Adolescent Mental Health and Problem Behavior Screening Questionnaire-II Standardization Study Data.

Soo young BHANG ; Hanik K YOO ; Ji Hoon KIM ; Bongseog KIM ; Young Sik LEE ; Donghyun AHN ; Dong Su SUH ; Soo Churl CHO ; Jun Won HWANG ; Geon Ho BAHN

Journal of the Korean Academy of Child and Adolescent Psychiatry.2012;23(1):23-30.

OBJECTIVES: This study was conducted to investigate the prevalence of victims of bullying and the demographic characteristics of victims, and their related psychopathology, in a Korean nationwide sample of youths in middle and high school over a one month period. METHODS: During the autumn of 2009, students in the 7th to 12th grades at 23 secondary schools participated in a nationwide, cross-sectional study. The study subjects completed the Adolescent Mental Health and Problem Behavior Screening Questionnaire- II (AMPQ-II) and Symptom Checklist-90-Revision (SCL-90-R). Based on the data acquired, descriptive statistics, correlation coefficients and multiple logistic regression analysis were performed. RESULTS: Among the 3364 participants, 2272 (67.54%) completed the questionnaire. The prevalence of victimization was 28.9%. Male gender was positively associated with victimization, and grade level was negatively related to victimization. The AMPQ-II bullying score (Factor 4) was significantly (p<.001) and positively correlated to the AMPQ-II student total score (r= 0.50), Worry and thought (Factor 1 ; r=0.38), Mood and suicide (Factor 2 ; r=0.31), Academic and Internet-related problems (Factor 3 ; r=0.24), Rule violations (Factor 5 ; r=0.23), and AMPQ-II teacher total score (r=0.11). Somatization (r=0.23), Obsessive-compulsive behavior (r=0.24), Interpersonal sensitivity (r=0.30), Depression (r=0.33), Anxiety (r=0.26), Hostility (r=0.30), Phobic anxiety (r=0.22), Paranoid ideation (r=0.36), and Psychoticism (r=0.31) results from the SCL-90-R were also found to be positively related to the AMPQ-II bullying score, and remained significant after adjusting for age and gender. A total of 26% of the victims reported suicidal ideations as compared to 9% of non-victims over the month prior to the evaluation (chi2=119.595, df=1, p<.001). The multiple logistic regression analysis indicated that the AMPQ-II bullying score significantly increased the risk of suicidal ideation [Exp(b)=1.55, df=1, p<.001] after adjusting for age and gender. CONCLUSION: School bullying was highly prevalent among Korean middle and high school students. This study provided strong evidence that suicidal ideation and psychopathology were serious problems among the victims of bullying.
Adolescent ; Anxiety ; Bullying ; Crime Victims ; Cross-Sectional Studies ; Depression ; Hostility ; Humans ; Logistic Models ; Male ; Mass Screening ; Mental Health ; Prevalence ; Psychopathology ; Suicidal Ideation ; Suicide ; Surveys and Questionnaires

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Temperament and Character Traits of Adolescents by Ego Resilience and Ego Control Level.

Young Soon JUN ; Tae Ho KIM ; Soon Taeg HWANG ; Eun Jeong KWON ; Mok ok LIM

Journal of the Korean Academy of Child and Adolescent Psychiatry.2012;23(1):14-22.

OBJECTIVES: The purpose of present study is to identify the differences between temperament and character traits among adolescents classified by ego resilience and ego control level. METHODS: A Junior Temperament and Character Inventory (TCI) was performed on participants, and a California Child Q-Test (CCQ) was tested for by the parents of the adolescent participants. RESULTS: The result of the factor analysis and discriminant analysis show that the participants are classified into three different groups based on CCQ score and item response patterns. The three groups are named the ego resilience group, the undercontrolled group, and the overcontrolled group. The ego resilience group indicates that they have a high level of interest and curiosity but yet they are not easily tempered. Moreover, they behave proactively with a reasonable level of responsibility in order to improve themselves. In contrast, among the undercontrolled group, it is observed that, although the group shows even higher level of interest, curiosity and honesty, they are careless, more impulsive, and have a lack of delayed gratification and shame. CONCLUSION: The overcontrolled group shows that they are the most cautious and reflective group among the three but also show emotional instability such as strong criticism and passive-aggressiveness. In this study, implications and limitations are discussed.
Adolescent ; California ; Child ; Ego ; Exploratory Behavior ; Humans ; Parents ; Temperament

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No Association between Single Nucleotide Polymorphisms in Urocanase Domain Containing 1 (UROC1) and Autism Spectrum Disorders (ASDs) in the Korean Population.

JungWon PARK ; MyungJa RO ; Min NAM ; Hee Jung BANG ; Jae Won YANG ; Kyung Sik CHOI ; Su Kang KIM ; Joo Ho CHUNG ; KyuBum KWACK

Journal of the Korean Academy of Child and Adolescent Psychiatry.2012;23(1):8-13.

OBJECTIVES: Urocanase domain containing 1 (UROC1) has never been studied in prior studies on autism spectrum disorders (ASDs). UROC1 causes urocanic aciduria, one of the symptoms of which is mental retardation. The aim of this study was to investigate the association between the UROC1 gene and ASDs in a Korean population. METHODS: A total of 258 control and 214 patients with ASD were used as subjects of this study. SNPs selected from UROC1 were genotyped using Illumina Golden-Gate Genotyping assay with VeraCode(R) technology. Statistical analysis was performed using SAS and Plink software. RESULTS: We found no association of the 12 SNPs in the UROC1 gene with ASDs in a Korean population. CONCLUSION: Our study suggests that the 12 SNPs (11 SNPs and 1 SNP in the intron and 3'UTR region, respectively) in the UROC1 were not associated with ASDs in a Korean population. Further study on the exon region of UROC1 is needed.
3' Untranslated Regions ; Autistic Disorder ; Child ; Autism Spectrum Disorder ; Exons ; Humans ; Intellectual Disability ; Introns ; Phenothiazines ; Polymorphism, Single Nucleotide ; Urocanate Hydratase

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