OBJECTIVES: This study was conducted to examine the characteristics of spirituality in Korean traditional culture and to apply these to the basic concepts of psychiatry. METHODS: The author interpreted books concerning traditional culture, including God-concept, death-concept, world-view of afterlife, Shamanistic thinking, traditional religion, as well as traditional culture in general, such as play, music, art, dance, literature, pottery, architecture, naming method, authentic recordings (Shillock), and Hangul. RESULTS: The common characteristic of spirituality reflected in the reviewed materials was ‘Gegensatzvereinigung’ which means the unification of opposing concepts. The unity of the Western and Eastern cultures, the old and the new, death and life, the rich and the poor, and the concrete and the abstract are examples of ‘Gegensatzvereinigung.’ CONCLUSION: The ultimate goal of psychiatric treatment is to maintain the harmonious interaction among thinking, affect and behavior. Furthermore, the most harmonious interaction is to unify into one. Thus, the spirituality of traditional culture can be applied to psychiatric treatment.
Dancing ; Methods ; Music ; Spirituality ; Thinking

OBJECTIVES: Dysregulation of the central noradrenergic system may be involved in the pathophysiology of attention-deficit hyperactivity disorder (ADHD). The aim of this study was to examine the differences in pre- and post-treatment cerebral perfusion according to the MspI polymorphisms of the alpha-2A-adrenergic receptor gene (ADRA2A) in children with ADHD. METHODS: Thirty seven drug-naive ADHD children (8.9+1.8 years old, M=32, F=5) were genotyped. Baseline single-photon emission computed tomography (SPECT) and clinical assessments were performed for ADHD children. After treatment with methylphenidate for eight weeks, SPECT and clinical assessment were repeated. RESULTS: No differences in baseline clinical assessments or cerebral perfusion were observed according to the MspI genotype. However, after treatment, ADHD children with the G/G genotype at the MspI polymorphism showed hyperperfusion in the right cerebellar declive (p=.001, uncorrected) and hypoperfusion in the left lentiform nucleus and left cingulate gyrus (p<.001 and p=.001, uncorrected), compared to children without the G/G genotype. CONCLUSION: Although the results of this study should be interpreted cautiously, they suggest a possible role of the MspI polymorphisms of the ADRA2A gene in methylphenidate-induced changes in cerebral perfusion.
Brain ; Child ; Corpus Striatum ; Genotype ; Gyrus Cinguli ; Humans ; Methylphenidate ; Perfusion ; Pharmacogenetics ; Receptors, Adrenergic, alpha-2 ; Tomography, Emission-Computed ; Tomography, Emission-Computed, Single-Photon

OBJECTIVES: The objective of this paper is to suggest a new model in psychiatry for understanding the psychopathology and to provide a new treatment modality. METHODS: In this paper, the author attempted to apply the concept of 'Consilience' to the field of psychiatry. Recently, the term 'Consilience' has been very popular and has been used frequently across the various academic fields. The original meaning of 'Consilience' is 'to jump (consilience) together (con). 'Consilience' was first used by William Whewell and Edward Wilson borrowed it to describe the unity of knowledge. In one word, 'Consilience' can be defined as 'to unify every field of knowledge and science to understand the human being and to improve the life of human being'. RESULTS: First, the human being by itself is the integrative being and consilient. Second, the developmental processes of psychiatry show that there are three definite developmental phases, including 'period of Consilience', 'period of diverse development', and 'reappearance of period of Consilience'. Third, in terms of historical perspective, the basic attitudes of religion have been closely associated with the basic concept of psychiatry. Finally, the treatment modalities in psychiatry show that integrative methods, including biological, psychological, social, and spiritual treatment have been applied. CONCLUSION: Based on these findings, the 'Bio-Psycho-Socio-Spiritual Model' is suggested to apply the concept of 'Consilience' to the field of psychiatry.
Humans ; Psychopathology

OBJECTIVE: This multicenter, randomized, open-label, parallel trial aimed to provide a detailed dose-response profile for atomoxetine in Korean pediatric outpatients with attention-deficit/hyperactivity disorder (ADHD). METHODS: Male and female outpatients aged 6-18 years with ADHD meeting symptom severity criteria of 1.5 standard deviations above age and gender norms on the ADHD Rating Scale-IV-Parent: Investigator-Administered and Scored (ADHDRS-IV-Parent: Inv), and a Clinical Global Impression-ADHD-Severity score > or =4 were randomized to atomoxetine (mg/kg/day) 0.2 fixed, 0.5 fixed or 0.5 (7 days), 0.8 (7 days) then 1.2 for 28 days. The primary efficacy measure was change in ADHDRS-IV-Parent: Inv total score after 6 weeks of atomoxetine treatment. RESULTS: Of 153 randomized patients, 83.7% were male and mean age was 9.8 (SD+/-2.4) years. The completion rate was 86.9%. A graded dose response was apparent with mean change in ADHDRS-IV-Parent: Inv total scores of -9.6, -12.3 and -14.5 with atomoxetine 0.2, 0.5 and 1.2 mg/kg/day, respectively (p=0.024 - F-test). Moreover, a greater reduction in ADHD symptoms, as assessed by mean change from baseline to endpoint CGI-S and mean CGI-ADHD-Improvement at endpoint, was also observed with increasing atomoxetine dose. More patients receiving atomoxetine 1.2 mg/kg/day reported > or =1 treatment-emergent adverse event/s (58.3%) compared with 0.5 (40.7%; p=0.11) or 0.2 mg/kg/day (29.4%; p=0.005). These were generally mild to moderate. CONCLUSION: Atomoxetine was found to be safe and well tolerated at all doses administered in Korean pediatric ADHD patients, and 1.2 mg/kg/day was an efficacious dose in this population.
Aged ; Female ; Humans ; Korea ; Male ; Outpatients ; Propylamines ; Atomoxetine Hydrochloride

OBJECTIVE: A significant proportion of children with autism spectrum disorders (ASD) have regression characterized by loss of previously acquired skills. The purpose of this study was to compare demographic, clinical characteristics and autism-related symptomatology of the children who have regression with children who don't have regression. METHODS: The subjects with ASD and their unaffected siblings (SIB) were recruited from the Korean Autism Genetic Study Consortium. Typically developing children (TC) were volunteered from community. The subjects were administered the Korean version of Autism Diagnostic Interview-Revised (K-ADI-R) and the Korean version of Autism Diagnostic Observation Schedule (K-ADOS) to diagnose or exclude ASD. Regression was defined on the basis of K-ADI-R data. The Korean version of Vineland Adaptive Behavior Scale (K-VABS), Aberrant Behavior Checklist (K-ABC) and Social Responsiveness Scale (K-SRS) were obtained from their parents. RESULTS: Regression occurred in 8.33% (n=14) of children with ASD (n=168). Any SIB (n=166) and TC (n=53) did not experience regression. Regression was associated with lower IQ and lower score of K-VABS. There was no difference in autism symptom severity and K-ABC, K-SRS scores, between children with ASD who experienced regression and who did not. CONCLUSION: Regression seems to be a distinctive feature of ASD. Regression is associated with cognitive and more general functions, rather than symptoms specific to autism.
Adaptation, Psychological ; Appointments and Schedules ; Autistic Disorder ; Checklist ; Child ; Autism Spectrum Disorder ; Humans ; Siblings

OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of methylphenidate HCL OROS extended-release (OROS-MPH) among children with attention deficit hyperactivity disorder (ADHD) who had been previously treated with methylphenidate HCL immediate-release (MPH-IR). METHODS: The sample included 102 children aged 6-12 (9.4+/-2.6) years who had been diagnosed with ADHD according the criteria of the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV; American Psychiatric Association, 1994) and who were attending seven centers in Korea. All participants had been medicated with a stable dose of MPH (10-60 mg/day) for at least 3 weeks before entry into the study. Doses of OROS-MPH were comparable to daily doses of MPH. Efficacy was assessed at baseline (day 0) and at day 28 with the Inattentive-Overactive with Aggression (IOWA) Conners Rating Scale, which was completed by parents/caregivers and teachers, the Peer Interaction Rating Items, which were completed by teachers, and the Clinical Global Impression (CGI) scale, which was completed by child psychiatrists. Paired t-tests were used, and P-values were set at the 0.05 level. RESULTS: Of the subjects, 92.2% were boys and 79.4% were students in the first to fourth grades of elementary school. 72% were diagnosed with the combined type of ADHD, 23% were diagnosed with the inattentive type, and 5% were diagnosed with the hyperactive-impulsive type. The results of the parents' responses to the Inattention/Hyperactivity (I/H) and Oppositional/Defiant (O/D) subscales of the IOWA Conners scale indicated statistically significant improvement in childrens behavior after 4 weeks of treatment with OROS-MPH (t=6.28, p<.001, t=4.12, p<.001). However, the teachers' responses to the Conners I/H and O/D subscales indicated no significant improvement at 4 weeks. The teachers also reported no significant improvements under the OROS-MPH compared with the MPH-IR condition with respect to peer interactions. Scores on the CGI scale showed that 46.1% of children with ADHD were rated by psychiatrists as "minimally improved", 27.5% as "much improved," 1.0% as "very much improved," 3.9% as "minimally worse," and 16.7% as showing "no change". Children exhibited significantly fewer tics with OROS-MPH treatment than with MPH-IR treatment (19.6% vs. 27.7%). We found no differences between in sleep and appetite problems according to medication. CONCLUSION: The results of this study indicated that an MPH-IR regimen can be successfully changed to a once-daily OROS-MPH regimen without any serious adverse effects. The changes in parent/caregiver IOWA Conners ratings suggested that OROS-MPH improved the control of symptoms after school, a finding that is consistent with the 12-h duration of action of this medication. Because the therapeutic effect of OROS-MPH is sufficiently longer than that of a b.i.d. dose of MPH-IR, OROS-MPH had significant positive effects on oppositional/defiant behavior in addition to its effects on the core symptoms of ADHD.
Aged ; Aggression ; Appetite ; Attention Deficit Disorder with Hyperactivity ; Child ; Humans ; Iowa ; Korea ; Methylphenidate ; Phenazines ; Psychiatry ; Tics

OBJECTIVES: The purpose of this study was to evaluate the prenatal, perinatal, and infancy history of children with autism spectrum disorder (ASD) as compared to unaffected siblings (SIB) and typically developing children (TC). METHODS: Subjects with ASD, their SIB, and TC were recruited. All subjects were assessed using both the Korean version of Autism Diagnostic Interview-Revised (K-ADI-R) and the Korean version of Autism Diagnostic Observation Schedule (K-ADOS) and were subsequently identified as affected or unaffected. Prenatal, perinatal, and infancy history was obtained from the primary caregivers and each facet was compared in those with ASD, the SIB, and the TC groups using SPSS ver. 17.0 (p<.05). RESULTS: 70 individuals with ASD (63 males, 87.94+/-37.8months), 53 SIB (27 males, 85.40+/-48.06 months), and 32 TC (19 males, 104.19+/-23.409 months) were analyzed. The ASD group showed significantly higher rates of insufficient vaccination as they aged age (chi2=15.54, p=.000). Among the scheduled vaccinations, the DPT vaccination (chi2=10.08, p=.006) was insufficient in ASD groups. The ASD group also showed higher rates of sleep disturbances from infancy. Differences in maternal/paternal age at conception, gestational age, and growth parameters at birth were not significantly difference among the three groups. CONCLUSION: These results do not support the previous controversies regarding the relationship between prenatal/perinatal complications and ASD. However, these results indicate that perinatal and prenatal factors may contribute to the development of ASD.
Aged ; Appointments and Schedules ; Autistic Disorder ; Caregivers ; Child ; Autism Spectrum Disorder ; Fertilization ; Gestational Age ; Humans ; Male ; Parturition ; Siblings ; Vaccination

This article provides an overview of the major psychiatric disorders in the adolescence. Attention and disruptive behavior disorders, mood disorders, anxiety disorders, alcohol and substance use disorders, and schizophrenia are the main diagnostic categories of adolescent psychiatric disorders. Attention and disruptive behavior disorders include attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder. Mood disorders include depressive disorder and bipolar disorder, and anxiety disorders include obsessive compulsive disorder, social phobia, and posttraumatic stress disorder. Eating disorders and tic disorders are described in the category of other disorders. This article discusses the demographic and clinical characteristics of the aforementioned disorders, focusing on the adolescent-specific clinical characteristics and the possible co-morbid conditions of each disorder. Diagnostic and evaluative points of each disorder for clinicians are also highlighted.
Adolescent ; Anxiety Disorders ; Attention Deficit and Disruptive Behavior Disorders ; Attention Deficit Disorder with Hyperactivity ; Bipolar Disorder ; Conduct Disorder ; Depressive Disorder ; Feeding and Eating Disorders ; Humans ; Mental Disorders ; Mood Disorders ; Obsessive-Compulsive Disorder ; Phobic Disorders ; Schizophrenia ; Stress Disorders, Post-Traumatic ; Substance-Related Disorders ; Tic Disorders

In this paper, we give an overview of the child psychiatry perspectives on developmental disorders and introduce the diagnostic categories of developmental disorders, based on the DSM-IV and ICD-10 classification systems. Pervasive developmental disorders, mental retardation and specific developmental disorders are the three main diagnostic categories of developmental disorders in this article. Pervasive developmental disorders include autistic disorder, Asperger's disorder, Rett disorder, childhood disintegrative disorder and pervasive developmental disorder not otherwise specified. Specific developmental disorders include communication disorder, learning disorder and motor skills disorder. This article discusses the developmental and clinical characteristics of the above mentioned disorders, focusing on the developmental disabilities of each disorder and the differential diagnosis with other disorders. Future directions for diagnosis are also highlighted.
Asperger Syndrome ; Autistic Disorder ; Child ; Child Psychiatry* ; Child* ; Classification ; Communication Disorders ; Developmental Disabilities ; Diagnosis ; Diagnosis, Differential ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; International Classification of Diseases ; Learning Disorders ; Mental Disorders ; Motor Skills Disorders ; Rett Syndrome

OBJECTIVES: This study was designed to evaluate the relationship between the degree of obesity and psychopathology in children. METHODS: 504 children from the Kimpo City and their parents participated in this study. According to BMI percentile for their gender and age, we divided them into three groups; the normoweight group, the overweight group, and the obese group. The Child Depression Inventory (CDI), the Stait-Trait Anxiety Inventory for Children (STAI-C), and the subscale 3 of the Piers-Harris Self-Concept Scale were used for children. The Korean-Child Behavioral Checklist (K-CBCL) was completed by their parents. RESULTS: In subscale 3 of the Piers-Harris Self-Concept Scale, 'the physical appearance and attitude', the score of the overweight group was significantly lower than that of the normoweight group. In CDI and STAI-C, there were no differences among three groups. We found significant differences among three groups in the mean scores of social problems, delinquent behavior, aggressive behavior, externalizing symptoms, and total problem in the CBCL scale. CONCLUSION: The findings in this study showed evidences for a psychosocial at-risk population in a community samples of children with overweight and obesity. The nation-wide study including adolescents is needed.
Adolescent ; Anxiety ; Body Image ; Checklist ; Child* ; Depression ; Gyeonggi-do ; Humans ; Obesity* ; Overweight* ; Parents ; Pediatric Obesity ; Psychopathology* ; Social Problems