Childhood- and adolescent-onset schizophrenia are rare. Along with positive, negative, affective and cognitive symptoms, eye-tracking dysfunction characterized by a disturbance in the smooth pursuit system has been the only associated visual impairment found in schizophrenia. This case report highlights a case of a child with persistent hyperplastic primary vitreous who had gradual onset of psychosis over two years duration. A final diagnosis of schizophrenia was considered and she was started on antipsychotics, to which she showed gradual response with mild extrapyramidal side effects
Child psychiatry

OBJECTIVE: This study aimed to identify temperament and character profiles associated with internalizing and externalizing problems in children with attention deficit hyperactivity disorder (ADHD). METHODS: Children with ADHD (n=114, 8.51±1.87 years) were selected from the Department of Child and Adolescent Psychiatry at Jeju National University Hospital. They were diagnosed by Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version and evaluated using the Advanced Test of Attention and Korean Wechsler Intelligence Scale for Children-Fourth Edition. Their parents completed the ADHD Rating Scale, Korean-Child Behavioral Checklist, and Junior Temperament and Character Inventory. RESULTS: The participants with both internalizing and externalizing problem had more severe ADHD symptoms and significantly higher novelty seeking, harm avoidance, and self-transcendence, as well as lower self-directedness and cooperativeness than those who had not comorbid problems. Harm avoidance was correlated with their level of internalizing problems regardless of severity of ADHD symptoms. In addition, novelty seeking and sex (male) were being associated with the level of externalizing problems. CONCLUSION: Differences were observed in the temperament and character profiles of children with ADHD according to their comorbid psychopathology. Results suggested that temperament and character profiles may affect the comorbid psychopathology in children with ADHD regardless of ADHD symptom severity.
Adolescent ; Adolescent Psychiatry ; Attention Deficit Disorder with Hyperactivity ; Checklist ; Child ; Humans ; Intelligence ; Mood Disorders ; Parents ; Psychopathology ; Temperament

OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in elementary school children. The present study investigated the characteristics of ADHD in Korean elementary school children using the Korean version of the ADHD Rating Scale (K-ARS). The data was compared with those obtained from a comparable American population. METHODS: Participants included 29,914 elementary school children, aged 6–12 years, from a medium-sized city. The parents completed the home version of the K-ARS. The total and subscale-specific normative data and sex- and age-related mean score differences were analyzed. These data were compared with those obtained from the American population using independent t-tests. RESULTS: Mean total and subscale K-ARS scores were significantly higher among boys (vs. girls) and younger children aged equal to or less than 8 years old (vs. older children). Mean scores on the hyperactivity-impulsivity subscale were lower than those of American children, but similar to another Korean sample. CONCLUSION: Our data characterized ADHD symptoms in Korean children. However, further studies are needed to identify the cultural differences underlying ratings of ADHD symptom severity.
Child Psychiatry ; Child ; Cross-Cultural Comparison ; Humans ; Impulsive Behavior ; Neurodevelopmental Disorders ; Parents

Little is known about the treatment of gender dysphoria among children and adolescents in Japan. This preliminary survey aims to improve understanding of current clinical practice for treatment of children with gender dysphoria. Subjects were 315 certified child and adolescent psychiatrists in Japan. The questionnaire asked about clinical experiences concerning gender dysphoria and gender identity-related concerns. A total of 128 psychiatrists responded to the questionnaire. Mean length of clinical experience was 24.2±10.0 years in total and 16.9±11.5 years as child and adolescent psychiatry specialists. Among the respondents, 74 (57.8%) had seen children and adolescents with DSM-5 gender dysphoria, and 87 (67.7%) had examined cases with gender identity-related concerns. The mean number of experienced cases with gender dysphoria was 1.80±2.3 per respondent. We found that even among certified child and adolescent psychiatrists in Japan, experience with treatment of children with gender dysphoria was limited.
Adolescent Psychiatry ; Adolescent ; Child ; Gender Dysphoria ; Humans ; Japan ; Psychiatry ; Specialization ; Surveys and Questionnaires ; Transgender Persons

Along with the field of adult psychiatry, antipsychotic agents are increasingly used in the field of child and adolescent psychiatry. Although neuroleptic malignant syndrome (NMS) and rhabdomyolysis are rare complication associated with antipsychotic agent, clinicians should need to pay attention to all potential adverse drug reaction (ADR). Also, ADRs in child and adolescent could show different signs and symptoms compared with those in adult. In this case report, we present a case of NMS in a child which occurred shortly after the resolution of rhabdomyolysis which was induced by low-dose risperidone.
Adolescent Psychiatry ; Adolescent ; Adult ; Antipsychotic Agents ; Child ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Neuroleptic Malignant Syndrome ; Rhabdomyolysis ; Risperidone

OBJECTIVES: Awareness of attention-deficit/hyperactivity disorder (ADHD) in adults has significantly increased; however, clinical data specific to the Korean population are insufficient. Clinical experience of ADHD may differ based on whether psychiatrists have received pediatric psychiatry-specific training. In order to prepare a practice parameter for adult ADHD patients in Korea, we examined questionnaire data to observe how pediatric psychiatry training could affect clinical practice for adults with ADHD. METHODS: A questionnaire about the diagnosis and treatment process was distributed to both general psychiatrists (GPsy) and child and adolescent psychiatrists (CAP) at the summer and winter workshop meetings of Korean Academy of Child and Adolescent Psychiatry. RESULTS: In total, 142 psychiatrists participated in the survey (86 GPsy, 56 CAP). GPsy and CAP preferred pharmacotherapy (GPsy 82.40%, CAP 64.30%) as the primary treatment option and answered that the clinical psychiatric interview is the most necessary step in diagnostic assessment (GPsy 22.16%, CAP 19.00%). The GPsy responded with an optimal and average treatment duration that was shorter than that reported by CAP. CONCLUSION: Identification of the initial presenting symptom as the correct diagnosis and the optimal duration of pharmacotherapy differed between GPsy and CAP in practice, whereas concepts in diagnosis and treatment of ADHD in adults were similar for both groups. These results suggest the urgent need for the Continuing Medical Education program for psychiatrists treating adults with ADHD.
Adolescent ; Adolescent Psychiatry ; Adult ; Attention Deficit Disorder with Hyperactivity ; Child ; Child Psychiatry ; Child ; Diagnosis ; Drug Therapy ; Education ; Education, Medical, Continuing ; Humans ; Korea ; Psychiatry

No abstract available.
Adolescent ; Adolescent Psychiatry ; Adolescent ; Child ; Humans

No abstract available.
Asia ; Child ; Child Psychiatry ; Child ; Humans

OBJECTIVE: The Center for Epidemiological Studies Depression Scale (CES-D) is designed to measure the current level of depressive symptomatology in the general population. However, no review has examined whether the scale is reliable and valid among children and adolescents in Korea. The purpose of this study was to test whether the Korean form of the CES-D is valid in adolescents. METHODS: Data were obtained from 1,884 adolescents attending grades 1–3 in Korean middle schools. Reliability was evaluated by internal consistency (Cronbach’s alpha). Concurrent validity was evaluated by a correlation analysis between the CES-D and other scales. Construct validity was evaluated by exploratory factor and confirmatory factor analyses. RESULTS: The internal consistency coefficient for the entire group was 0.88. The CES-D was positively correlated with scales that measure negative psychological constructs, such as the State Anxiety Inventory for Children, the Korean Social Anxiety Scale for Children and Adolescents, and the Reynold Suicidal Ideation Questionnaire, but it was negatively correlated with scales that measure positive psychological constructs, such as the Korean version of the Rosenberg Self-Esteem Scale and the Connor-Davidson Resilience Scale-2. The CES-D was examined by three-dimensional exploratory factor analysis, and the three-factor structure of the scale explained 53.165% of the total variance. The variance explained by factor I was 24.836%, that explained by factor II was 15.988%, and that explained by factor III was 12.341%. The construct validity of the CES-D was tested by confirmatory factor analysis, and we applied the entire group’s data using a three-factor hierarchical model. The fit index showed a level similar to those of other countries’ adolescent samples. CONCLUSION: The CES-D has high internal consistency and addresses psychological constructs similar to those addressed by other scales. The CES-D showed a three-factor structure in an exploratory factor analysis. The present findings suggest that the CES-D is a useful and reliable tool for measuring depression in Korean adolescents.
Adolescent Psychiatry ; Adolescent ; Anxiety ; Child ; Depression ; Epidemiologic Studies ; Fibrinogen ; Humans ; Korea ; Prothrombin ; Psychometrics ; Suicidal Ideation ; Thromboplastin ; Weights and Measures

OBJECTIVES: To initiate and develop a treatment guideline in multidisciplinary approaches for related professions who are either working and/or living with children and adolescents with neurodevelopmental disorders who show behavioral problems. METHODS: To collect and reflect opinions from multiple professions who assumedly have different interventions or mediations on behavioral problems, a self-report survey and Focus Group Interview (FGI) were conducted for a group of child and adolescent psychiatrists, behavioral therapists, special education teachers, social welfare workers, and caregivers. RESULTS: According to a self-report survey and FGI results from multiple professional groups, aggressive behavior is the mostly common behavioral problem necessitating urgent interventions. However, both mainly used intervention strategies and effective treatment methods were different depending on professional backgrounds, such as pharmacological treatment, parent training, and behavior therapy, even though they shared an importance of improving communication skills. In addition, there was a common understanding of necessity to include parent training in a guideline. Lastly the data suggested lack of proper treatment facilities, qualified behavior therapists, and lack of standardized treatment guideline in the field needed to be improved for a quality of current therapeutic services. CONCLUSION: It is supported that several subjects should be included in the guidelines, such as how to deal with aggressive behavior, parent training, and biological aspects of neurodevelopmental disorders. Also, it is expected that publishing the guideline would be helpful to above multiple professions as it is investigated that there are lack of treatment facility and qualified behavioral therapists compared to need at the moment.
Adolescent* ; Autistic Disorder ; Behavior Therapy ; Caregivers ; Child* ; Developmental Disabilities ; Education, Special ; Focus Groups ; Humans ; Negotiating* ; Neurodevelopmental Disorders* ; Parents ; Problem Behavior* ; Psychiatry ; Social Welfare