Journal of the Korean Academy of Child and Adolescent Psychiatry最新文献

{"title":"Dissociative Identity Disorder in an Adolescent With Nine Alternate Personality Traits: A Case Study.","authors":"Sang-Hun Lee,&nbsp;Na Ri Kang,&nbsp;Duk-Soo Moon","doi":"10.5765/jkacap.220005","DOIUrl":"https://doi.org/10.5765/jkacap.220005","url":null,"abstract":"<p><p>Since dissociative identity disorder (DID) has symptoms similar to schizophrenia, such as auditory hallucinations and delusional thoughts of being controlled, there are difficulties in its differential diagnosis. A 16-year-old adolescent male patient who was previously diagnosed with schizophrenia from a different hospital was admitted to our inpatient psychiatric unit for the evaluation of auditory hallucinations and suicide attempts. Through psychiatric evaluations, it was determined that the patient suffered from identity alternation, dissociation, and amnesia. As for the diagnostic evaluations, the following measures were implemented: a psychiatric interview regarding the diagnostic criteria, mental status examination, laboratory tests, brain imaging studies, electroencephalography, and full psychological test for adolescents, and the self-reported measure of the Adolescent Dissociative Experiences Scale. The patient was diagnosed with DID, and the following treatments were administered: pharmacotherapy, ego state therapy, psychoeducation regarding emotions, trauma-focused psychotherapy including stabilization, and family therapy. Following treatment, in the internal dimensions, the patient was able to recognize the nine alternate identities in charge of his emotions, which established a basis for the potential integration of identities. In the external dimensions, he showed improvements in the aspects of family conflicts and issue of school refusal. This is the first reported case of DID in an adolescent in Korea; it emphasizes the consideration of DID in the differential diagnosis of other mental illnesses such as schizophrenia, bipolar disorder, and posttraumatic stress disorder and expands the treatment opportunities for DID by sharing the procedures of ego state therapy.</p>","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ec/36/jkacap-33-3-73.PMC9242847.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40589751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescents in Society.","authors":"","doi":"10.5765/jkacap.220017","DOIUrl":"https://doi.org/10.5765/jkacap.220017","url":null,"abstract":"Adolescents form an ever-changing culture as they actively interact with their surrounding environment, and each phenomenon has received clinical attention during the previous eras. For example, the use of inhalants by adolescents in underserved areas, problematic internet use, school violence, and non-suicidal self-injury (NSSI) have reflected or appeared to parallel social changes. Problematic internet use, “game addiction” in a narrower sense, gained worldwide recognition when high-speed internet became widely accessible, and the game industry showed unprecedented growth in the market. As a novel phenomenon at the time, many mental health professionals had to develop hypotheses to understand its nature. Initially, it was viewed as the equivalent of substance dependence in terms of the brain’s reward pathway to interpersonal psychology, seeing the internet as an extension of a parent-child relationship and as a remedy for social anxiety arising from frustration in relationships [1]. Nevertheless, one of the most straightforward explanations is the relationship with other mental health conditions, such as attention deficit hyperactivity disorder, depressive disorder, obsessive-compulsive disorder, and anxiety disorder, reflecting common underlying psychopathology or vulnerability to behavioral addiction [2]. Through this process, our society has been molded by various perspectives, from blaming the gaming industry to forming policies to limit the amount of time adolescents spend on internet games. Today, in the perspective of mental health conditions, excessive internet use has secured a temporary position in the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition [3] research criteria, patiently awaiting further investigation of its essence as an independent disorder. School violence, especially social rejection and victimization at school, passed similar pathways. While school violence has always existed, it was not until the recent tragic stories of the victims that it began to receive clinical and social attention. Similar to the internet gaming disorder, diverse aspects of school bullying have caused concerns, including influences of changes in the social hierarchy, educational system, and moral issues, as well as comorbid internalizing and externalizing behaviors in both the bullies and the victims. Based on the accumulated research findings, school violence is like a zig-saw puzzle that cannot be defined as a single phenomenon but involves a little bit of everything. The solutions suggested have been multi-dimensional, ranging from universal, holistic intervention in the school environment to educating bystanders and establishing a legal system for perpetrators to receive active interventions targeting comorbid psychiatric conditions in both parties. While these approaches alone will not eradicate the violent behaviors inside school settings, efforts from multiple parties have made our society more vigilant about it. Recen","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0f/af/jkacap-33-3-57.PMC9242848.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40589750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics of Adolescents Hospitalized Through Emergency Room for Intentional Self-Harm or Suicide Attempts.","authors":"Tae Yeon Yoon,&nbsp;Hyun Sook Lee,&nbsp;Jung-Woo Son,&nbsp;Sang Mi Kim,&nbsp;Je Jung Lee","doi":"10.5765/jkacap.220002","DOIUrl":"https://doi.org/10.5765/jkacap.220002","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the clinical characteristics of adolescents hospitalized through the emergency room for intentional self-harm or suicide attempts.</p><p><strong>Methods: </strong>This retrospective study used data from the Korean National Hospital Discharge In-depth Injury Survey conducted between 2006 and 2018 for individuals aged 10-24 years. The clinical characteristics of the patients were analyzed and compared across sex and age groups using the Rao-Scott chi-square tests and multiple logistic regression analysis for complex survey data.</p><p><strong>Results: </strong>The most common psychiatric diagnosis was mood disorder (22.0%), and more female patients were diagnosed with it than male patients (p=0.010). The 19-24 years age group was diagnosed with mood disorder the most compared to other younger groups (p=0.012). Male patients used lethal methods more than female patients (p=0.008), and the 19-24 years age group used more drug poisoning and cutting or piercing (p<0.001) for intentional self-harm or suicide attempts than younger groups.</p><p><strong>Conclusion: </strong>Adolescents hospitalized for intentional self-harm or suicide attempts showed significant differences in clinical characteristics across sex and age groups. These findings suggest that measures for preventing self-harm or suicide attempts need to be differentiated according to the sex and age of adolescents.</p>","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/08/86/jkacap-33-3-59.PMC9242849.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40589752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary Validation Study of the Korean Version of the DSM-5 Level 2 Cross-Cutting Symptom Measure: Depression and Irritability for Parents of Children Aged 6-17 Years.","authors":"Min-Sup Shin,&nbsp;Bung-Nyun Kim,&nbsp;Mirae Jang,&nbsp;Hanbyul Shin,&nbsp;Gyujin Seo","doi":"10.5765/jkacap.220009","DOIUrl":"https://doi.org/10.5765/jkacap.220009","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated the reliability and validity of the Korean version of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Level 2 Cross-Cutting Symptom Measure-Patient-Reported Outcomes Measurement Information System (PROMIS)-Depression and the Irritability for parents of children aged 6-17 years.</p><p><strong>Methods: </strong>Participants were 190 children diagnosed with depressive disorder (n=14), anxiety disorder (n=21), attention-deficit/hyperactivity disorder (ADHD; n=111), ADHD with anxious depression (n=13), and tic disorder with somatic symptoms (n=31). Patients were 8-15 years of age. The participants' mothers completed the Korean versions of the DSM-5 Level 2 Cross-Cutting Symptom Measure- PROMIS Depression and Irritability (Affective Reactivity Index, ARI), and the Korean Child Behavior Checklist (K-CBCL). Using these data, we calculated the reliability coefficient and examined the concurrent and discriminant validity of the PROMIS Depression and the Irritability (ARI) scales for assessing depression and irritability in children.</p><p><strong>Results: </strong>The reliability coefficient of the PROMIS Depression scale (Cronbach's α) was 0.93. The correlation coefficient with the KCBCL DSM emotional problem score was 0.71. The PROMIS Depression scale significantly discriminated children with depressive disorders from those with other conditions. The reliability coefficient of the Irritability (ARI) scale was 0.91, suggesting its high reliability.</p><p><strong>Conclusion: </strong>Our results suggest that the Korean version of the DSM-5 Level 2 Cross-Cutting Symptom Measure for Depression and Irritability Scales for parents of children aged 6-17 years is reliable and valid and may be an efficient alternative to the K-CBCL.</p>","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4b/1e/jkacap-33-3-67.PMC9242850.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10520108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stimulant Induced Movement Disorders in Attention Deficit Hyperactivity Disorder","authors":"S. Nam, M. Lim, T. Park","doi":"10.5765/jkacap.210034","DOIUrl":"https://doi.org/10.5765/jkacap.210034","url":null,"abstract":"Stimulants, such as amphetamine and methylphenidate, are one of the most effective treatment modalities for attention deficit hyperactivity disorder (ADHD) and may cause various movement disorders. This review discusses various movement disorders related to stimulant use in the treatment of ADHD. We reviewed the current knowledge on various movement disorders that may be related to the therapeutic use of stimulants in patients with ADHD. Recent findings suggest that the use of stimulants and the onset/aggravation of tics are more likely to be coincidental. In rare cases, stimulants may cause stereotypies, chorea, and dyskinesia, in addition to tics. Some epidemiological studies have suggested that stimulants used for the treatment of ADHD may cause Parkinson’s disease (PD) after adulthood. However, there is still a lack of evidence that the use of stimulants in patients with ADHD may cause PD, and related studies are only in the early stages. As stimulants are one of the most commonly used medications in children and adolescents, close observations and studies are necessary to assess the effects of stimulants on various movement disorders, including tic disorders and Parkinson’s disease.","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85533935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of Restricted and Repetitive Behaviors in Toddlers and Young Children with Autism Spectrum Disorder","authors":"Da-Yea Song, Dabin Kim, Hannah J. Lee, Guiyoung Bong, Jae Hyun Han, H. Yoo","doi":"10.5765/jkacap.220001","DOIUrl":"https://doi.org/10.5765/jkacap.220001","url":null,"abstract":"Objectives Restricted and repetitive behaviors (RRBs) are a core symptom in the diagnosis of autism spectrum disorder (ASD). The complexity of behavioral patterns has called for the creation of phenotypically homogeneous subgroups among individuals with ASD. The purpose of this study was 1) to investigate the different types of RRBs and 2) to explore whether subgroups created by RRBs would show unique levels of functioning in toddlers and young children with ASD. Methods A total of 313 children with ASD, aged 12–42 months were included in the analysis. The Autism Diagnostic Interview-Revised was used to obtain information on the different types of RRBs by grouping 15 items into six categories. The Vineland Adaptive Behaviors Scale, a parent-reported questionnaire, was used to measure adaptive functioning. A portion of the children were analyzed separately for verbal-related RRBs based on their expressive language level. Two-step cluster analysis using RRB groups as features was used to create subgroups. Analysis of covariance while covarying for age and language was performed to explore the clinical characteristics of each cluster group. Results Sensory-related RRBs were the most prevalent, followed by circumscribed interests, interest in objects, resistance to change, and repetitive body movements. A subset of the children was analyzed separately to explore verbal-related RRBs. Four cluster groups were created based on reported RRBs, with multiple RRBs demonstrating significant delays in adaptive functioning. Conclusion Heterogeneity of RRBs emerges at a young age. The different patterns of RRBs can be used as valuable information to determine developmental trajectories with better implications for treatment approaches.","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83134514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Must We Prepare in the Next Decades When Caring for Those With Developmental Disabilities: “Grown Up” (2018)","authors":"Jun-Won Hwang","doi":"10.5765/jkacap.220007","DOIUrl":"https://doi.org/10.5765/jkacap.220007","url":null,"abstract":"The Guarantee of Rights and Support for Persons with Developmental Disabilities Act was enacted and revised in 2014. However, national measures for persons with developmental disabilities remain insufficient. In the film, “Grown Up,” director Hyeyoung Jang filmed the daily life of her sister, who has developmental disabilities. She raised not only the issue of institutionalization in people with developmental disabilities in Korea but also the issue of a lack of policies that would be essential to them and their family members. In the future, I hope that as experts, child and adolescent psychiatrists in Korea will pay more attention to the lives of people with developmental disabilities outside the clinic and propose policies to help them and their family members.","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87223964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concept of Synchronized Individuation Based on the Characters in a Movie and a Fairy Tale","authors":"D. Moon, G. Bahn","doi":"10.5765/jkacap.220004","DOIUrl":"https://doi.org/10.5765/jkacap.220004","url":null,"abstract":"Objectives Among adolescent development tasks, being independent of parents is an essential process for emotional and physical separation. There are many conflicts of separation and individuation between parents and adolescents; however, most clinicians explore the process of separation and individuation only from adolescents’ perspective. Whether simultaneously or sequentially, separation-individuation occurs between adolescents and parents, respectively. The authors have already introduced the theory of synchronized individuation in a clinical case to explain the concept of this intersubjective phenomena. This study also attempts to prove the synchronized individuation theory through the interaction of characters in a movie and a fairy tale. Methods The authors present the basis for the theory of synchronized individuation of adolescence through the growing process of Mason Junior, the main character of the movie “Boyhood,” and from the process of the separation of a hen, Sprout, and an orphaned duckling in “The hen who dreamed she could fly.” Results Synchronized individuation was developed and observed from Mason, the son’s perspective in “Boyhood,” and Sprout, the mother’s subjective perspective in the story of the hen. Conclusion Increasing conflict and mutual impact in the relationship between adolescents and parents, ambivalent feelings for separation, selective identification of each other, mutual respect through mutual recognition, and role changes in relationship position were confirmed. Sons and mothers were individualized with synchronization.","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90520575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finding Common Interests.","authors":"Hee Jeong Yoo","doi":"10.5765/jkacap.210035","DOIUrl":"https://doi.org/10.5765/jkacap.210035","url":null,"abstract":"","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d7/d7/jkacap-33-1-1.PMC8733414.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39825130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary Report of Validity for the Infant Comprehensive Evaluation for Neurodevelopmental Delay, a Newly Developed Inventory for Children Aged 12 to 71 Months.","authors":"Minha Hong,&nbsp;Kyung-Sook Lee,&nbsp;Jin-Ah Park,&nbsp;Ji-Yeon Kang,&nbsp;Yong Woo Shin,&nbsp;Young Il Cho,&nbsp;Duk-Soo Moon,&nbsp;Seongwoo Cho,&nbsp;Ram Hwangbo,&nbsp;Seung Yup Lee,&nbsp;Geon Ho Bahn","doi":"10.5765/jkacap.210033","DOIUrl":"https://doi.org/10.5765/jkacap.210033","url":null,"abstract":"<p><strong>Objectives: </strong>Early detection of developmental issues in infants and necessary intervention are important. To identify the comorbid conditions, a comprehensive evaluation is required. The study's objectives were to 1) generate scale items by identifying and eliciting concepts relevant to young children (12-71 months) with developmental delays, 2) develop a comprehensive screening tool for developmental delay and comorbid conditions, and 3) assess the tool's validity and cut-off.</p><p><strong>Methods: </strong>Multidisciplinary experts devised the \"Infant Comprehensive Evaluation for Neurodevelopmental Delay (ICEND),\" an assessment method that comes in two versions depending on the age of the child: 12-36 months and 37-71 months, through monthly seminars and focused group interviews. The ICEND is composed of three parts: risk factors, resilience factors, and clinical scales. In parts 1 and 2, there were 41 caretakers responded to the questionnaires. Part 3 involved clinicians evaluating ten subscales using 98 and 114 questionnaires for younger and older versions, respectively. The Child Behavior Checklist, Strengths and Difficulties Questionnaire, Infant- Toddler Social Emotional Assessment, and Korean Developmental Screening Test for Infants and Children were employed to analyze concurrent validity with the ICEND. The analyses were performed on both typical and high-risk infants to identify concurrent validity, reliability, and cut-off scores.</p><p><strong>Results: </strong>A total of 296 people participated in the study, with 57 of them being high-risk (19.2%). The Cronbach's alpha was positive (0.533-0.928). In the majority of domains, the ICEND demonstrated a fair discriminatory ability, with a sensitivity of 0.5-0.7 and specificity 0.7-0.9.</p><p><strong>Conclusion: </strong>The ICEND is reliable and valid, indicating its potential as an auxiliary tool for assessing neurodevelopmental delay and comorbid conditions in children aged 12-36 months and 37-71 months.</p>","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/62/0c/jkacap-33-1-16.PMC8733413.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39825132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}