No abstract available.
Comorbidity ; Conduct Disorder ; Humans

OBJECTIVE: Externalizing disorders such as attention-deficit/hyperactivity disorder (ADHD), conduct disorder and antisocial personality disorder, as well as depression are common comorbidities in alcohol use disorder (AUD). The current study focused on the temporal relationship between the onsets of these disorders and AUD, and investigated the serial multiple mediator model of externalizing disorders (e.g., ADHD) and depression on AUD. METHODS: We analyzed the mediated effects of the Adult ADHD Self-Report Scale (ASRS), the Barratt Impulsiveness Scale motor (BIS_M) and the Beck Depression Inventory (BDI) on Korean version of the Alcohol Dependence Scale (ADS_K) using the multiple-step multiple mediation procedure regression analysis. In addition, we comparatively analyzed different clinical characteristics in relation to conduct problems. RESULTS: The multiple-step multiple mediation procedure found the serial multiple mediated effects of the BIS_M and the BDI on the relationship between the ASRS and the ADS_K. Also, the group with conduct problem was significantly high in ADHD symptoms, depression, anxiety, impulsivity, legal problems and alcohol-related problems, compared to the group without conduct problems. CONCLUSION: To sum up, the results of this study show that ADHD symptoms in childhood could exert significant effects on the severity of AUD in adulthood, and both disorders might be mediated by the externalizing disorders characterized by the core feature of motor impulsivity, and depression serially. Thus, the treatment of preceding disorders in accordance with developmental stages is an overarching clinical component for preventing the subsequent development of AUD and for its treatment.
Adult ; Alcoholism ; Antisocial Personality Disorder ; Anxiety ; Attention Deficit Disorder with Hyperactivity ; Comorbidity ; Conduct Disorder ; Depression* ; Humans ; Impulsive Behavior ; Negotiating

Raynaud's phenomenon is a recurrent vasospastic condition with reducing in peripheral blood flow due to cold, or emotional stress. White, blue and red discolorations occur during the attacks. Serotonin reuptake inhibitors, psychostimulants, and aripiprazole are reported to be related with Raynaud's phenomenon. Risperidone is an atypical antipsychotic drug with dopaminergic and serotonergic effects. In children and adolescents, risperidone is used for bipolar disorder, tic disorders, conduct disorder, schizophrenia, symptoms of irritability and self-mutilation. Here we report a case of Raynaud's phenomenon associated with risperidone in a 12-year-old boy. Raynaud's phenomenon occurred two weeks after starting risperidone and disappeared after stopping risperidone.
Adolescent ; Aripiprazole ; Bipolar Disorder ; Child ; Conduct Disorder ; Humans ; Male ; Risperidone ; Schizophrenia ; Serotonin Uptake Inhibitors ; Stress, Psychological ; Tic Disorders

OBJECTIVE: As one of the most popular designs used in genetic research, family-based design has been well recognized for its advantages, such as robustness against population stratification and admixture. With vast amounts of genetic data collected from family-based studies, there is a great interest in studying the role of genetic markers from the aspect of risk prediction. This study aims to develop a new statistical approach for family-based risk prediction analysis with an improved prediction accuracy compared with existing methods based on family history. METHODS: In this study, we propose an ensemble-based likelihood ratio (ELR) approach, Fam-ELR, for family-based genomic risk prediction. Fam-ELR incorporates a clustered receiver operating characteristic (ROC) curve method to consider correlations among family samples, and uses a computationally efficient tree-assembling procedure for variable selection and model building. RESULTS: Through simulations, Fam-ELR shows its robustness in various underlying disease models and pedigree structures, and attains better performance than two existing family-based risk prediction methods. In a real-data application to a family-based genome-wide dataset of conduct disorder, Fam-ELR demonstrates its ability to integrate potential risk predictors and interactions into the model for improved accuracy, especially on a genome-wide level. CONCLUSIONS By comparing existing approaches, such as genetic risk-score approach, Fam-ELR has the capacity of incorporating genetic variants with small or moderate marginal effects and their interactions into an improved risk prediction model. Therefore, it is a robust and useful approach for high-dimensional family-based risk prediction, especially on complex disease with unknown or less known disease etiology.
Area Under Curve ; Computer Simulation ; Conduct Disorder/physiopathology* ; Family Health ; Female ; Genetic Markers ; Genetic Predisposition to Disease ; Genetic Variation ; Genome, Human ; Genome-Wide Association Study ; Genomics ; Humans ; Likelihood Functions ; Male ; Models, Genetic ; Odds Ratio ; Pedigree ; ROC Curve ; Reproducibility of Results ; Risk Factors

PURPOSE: The aim of this study was to identify the parenting experience of mothers who have teenage girls with conduct disorders and to identify the meaning and structure of their experiences. METHODS: This study was a qualitative research based on Parse's research method. Participants were 9 mothers who had a daughter diagnosed with conduct disorder at a community hospital in the central region of South Korea. RESULTS: The core concept on the parenting experiences of mothers of teenage girls with conduct disorder were survival against a violent environment, a sense of guilt related to the conduct disorder, confusion and frustration concerning mother's role, and hope for the future. The experiences of these mothers can be defined as the process of human becoming with powering and transforming while connecting-separating and enabling-limiting with valuing. CONCLUSION: This research is expected to contribute to understanding of mothers' suffering and struggling and be useful in developing nursing care for clients with conduct disorder and their mothers.
Adolescent ; Conduct Disorder* ; Female* ; Frustration ; Guilt ; Hope ; Hospitals, Community ; Humans ; Korea ; Methods* ; Mothers* ; Nuclear Family ; Nursing Care ; Parenting* ; Parents* ; Qualitative Research

OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is associated with a high rate of comorbid disorders. We aimed to investigate the medical and psychiatric comorbidities of Korean children and adolescents with ADHD. METHODS: Data were obtained from Korean National Health Insurance Review and Assessment Service-National Patient Sample (HI-RA-NPS) for 2011. We included 2,140 (mean age, 10.9±3.1 years; boys, 1,710) and 219,410 (non-ADHD; mean age, 12.4±3.7 years; boys, 113,704) children and adolescents with and without ADHD, respectively. We compared medical and psychiatric comorbidities between the groups, and performed weighted logistic regression analyses to obtain odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Most medical comorbidities were more likely in patients with ADHD and included nervous system disease (OR, 2.59; 95% CI, 2.52–2.66); endocrine, nutritional, and metabolic disease (OR, 2.09; 95% CI, 2.04–2.15); and congenital malformations, deformations, and chromosomal abnormalities (OR, 2.00; 95% CI, 1.90–2.11). Oppositional defiant disorder and conduct disorder were more prevalent in patients with ADHD (OR, 81.88; 95% CI, 79.00–84.86), followed by learning (OR, 75.61; 95% CI, 69.69–82.04), and depressive disorders (OR, 55.76; 95% CI, 54.44–57.11). CONCLUSION: Our results suggest that Korean children and adolescents with ADHD are more likely to suffer medical and psychiatric comorbidities than those without ADHD.
Adolescent* ; Attention Deficit and Disruptive Behavior Disorders ; Child* ; Chromosome Aberrations ; Comorbidity* ; Conduct Disorder ; Depressive Disorder ; Humans ; Learning ; Logistic Models ; Metabolic Diseases ; National Health Programs ; Nervous System Diseases ; Odds Ratio

PURPOSE: To investigate the neuro-ophthalmic diagnosis and clinical manifestations of intracranial aneurysm. METHODS: A retrospective survey of 33 patients who were diagnosed with intracranial aneurysm and underwent neuro-ophthalmic examination from April 2008 to December 2016. Frequency of the first diagnosis of intracranial aneurysm in ophthalmology, neuro-ophthalmic diagnosis, location of intracranial aneurysm, examination of intracranial aneurysm rupture, and neurologic prognosis of Terson's syndrome patients were analyzed by image examination, neurosurgery, and ophthalmology chart review. RESULTS: Of the 33 patients, most patients (n = 31, 94%) were diagnosed with intracranial aneurysm at the neurosurgical department and only 2 patients were diagnosed initially at the ophthalmology department. Causes and association were: Terson's syndrome (n = 10, 30%), third cranial nerve palsy (n = 10, 30%), internclear ophthalmoplegia (n = 4, 12%), visual field defect (n = 3, 9%), optic atrophy (n = 3, 9%), sixth cranial nerve palsy (n = 2, 6%), and nystagmus (n = 1, 3%). The location of intracranial aneurysms were: anterior communicating artery (n = 13, 39%), medial communicating artery (n = 12, 36%), and posterior communicating artery (n = 5, 15%). Ten of 33 patients had Terson's syndrome, and 6 patients (60%) with Terson's syndrome had apermanent neurological disorder such as agnosia, gait disorder and conduct disorder. CONCLUSIONS: Third cranial nerve palsy was the most common neuro-ophthalmic disease in patients presenting with intracranial aneurysm. The neuro-ophthalmic prognoses for those diseases were relatively good, but, if Terson's syndrome was present, neurological disorders (agnosia, gait disorder, conduct disorder) were more likely to remain after treatment.
Abducens Nerve Diseases ; Agnosia ; Arteries ; Conduct Disorder ; Diagnosis ; Gait ; Humans ; Intracranial Aneurysm* ; Nervous System Diseases ; Neurosurgery ; Oculomotor Nerve ; Ophthalmology ; Ophthalmoplegia ; Optic Atrophy ; Paralysis ; Prognosis ; Retrospective Studies ; Rupture ; Visual Fields

Our case had hiccups arising in an adolescent with the attention deficit and hyperactivity disorder (ADHD) and conduct disorder (CD) after adding aripiprazole treatment to extended-release methylphenidate. Actually, antipsychotics are also used in the treatment of hiccups, but studies suggest that they can cause hiccups as well. Within 12 hours of taking 2.5 mg aripiprazole added to extended-release methylphenidate at a dose of 54 mg/day, 16-year-old boy began having hiccups in the morning, which lasted after 3–4 hours. As a result, aripiprazole was discontinued and methylphenidate was continued alone because we could not convince the patient to use another additional drug due to this side effect. Subsequently, when his behavior got worsened day by day, his mother administered aripiprazole alone again at the dose of 2.5 mg/day at the weekend and continued treatment because hiccup did not occur again. But when it was administered with methylphenidate on Monday, hiccup started again next morning and lasted one hour at this time. In conclusion, we concluded that concurrent use of methylphenidate and aripiprazole in this adolescent led to hiccups.
Adolescent* ; Antipsychotic Agents ; Aripiprazole* ; Conduct Disorder* ; Cytochrome P-450 CYP2D6 ; Hiccup* ; Humans ; Male ; Methylphenidate* ; Mothers

OBJECTIVE: Risperidone has been widely used to control aggression and conduct disorder (CD) in youth; however, treatment compliance is a major problem in CD. Our aim is to evaluate the effectiveness and tolerability of long-acting risperidone (LAR) in treating nonadherent cases. METHODS: The medical records of children and adolescents who had CD and were nonadherent to conventional drugs and psychosocial interventions (and therefore taking LAR) were reviewed. Informed consent on offlabel use of LAR was obtained from the parents. Clinical Global Impression (CGI) Severity (CGI-S) and CGI-Improvement scales were used and baseline and end points were compared. RESULTS: The study comprised 14 children and adolescents (5 girls, 9 boys). All had comorbid disorders: substance use disorder (n=8), attention deficit hyperactivity disorder (n=6), and major depression (n=2). Mean duration of LAR use was 3.1 months (1.5–8 months). We observed significant improvements in the baseline and endpoint CGI-S scores for CD in all but one patient (Z=−3.198; p < 0.001). Only mild adverse effects were observed: weight gain (n=2), sedation (n=1), leg cramps (n=1), and increased appetite with no weight gain (n=1). CONCLUSION: LAR is effective and tolerable for patients with CD who can’t be medicated with oral preparations due to non-adherence to treatment. Even short-term LAR use is effective to get compliance. As CD predicts numerous problems in adulthood, appropriate treatment is crucial. To our knowledge, this is the first study on LAR use in youth with CD. The use of LAR deserves careful consideration and further controlled studies are needed to confirm our findings.
Adolescent* ; Aggression ; Antipsychotic Agents ; Appetite ; Attention Deficit Disorder with Hyperactivity ; Child ; Compliance ; Conduct Disorder* ; Depression ; Female ; Humans ; Informed Consent ; Leg ; Medical Records ; Muscle Cramp ; Parents ; Retrospective Studies* ; Risperidone* ; Substance-Related Disorders ; Weight Gain ; Weights and Measures

Attention-deficit hyperactivity disorder (ADHD) occurs with a high prevalence of comorbid disorders, and these comorbid disorders can affect assessment, clinical symptoms, prognosis, and treatment strategies for children with ADHD. The goal of this study was to develop a clinical practice guideline for ADHD and its specific comorbid disorders. Due to limited numbers of previous clinical studies, current recommendations are based on literature review and expert consensus among Korean child and adolescent psychiatrists. We suggest the use of multidisciplinary evaluations, interview techniques, and assessment tools in order to differentiate major comorbid disorders from ADHD. Specific ADHD comorbid disorders (e.g., medical comorbidity, oppositional defiant disorder, conduct disorder, bipolar disorder, major depressive disorder, anxiety disorder, specific learning disorder, tic disorder, and substance use disorder) have suggested treatment protocols that include pharmacological and behavioral treatments. Children and adolescents with ADHD may have comorbid disorders. The use of current clinical practice guidelines will be helpful when treating ADHD children with comorbid disorders.
Adolescent ; Anxiety Disorders ; Attention Deficit and Disruptive Behavior Disorders ; Bipolar Disorder ; Child ; Clinical Protocols ; Comorbidity ; Conduct Disorder ; Consensus ; Depressive Disorder, Major ; Humans ; Prevalence ; Prognosis ; Psychiatry ; Specific Learning Disorder ; Tic Disorders