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

{"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":"33 1","pages":"16-23"},"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}

{"title":"The Efficacy of Visual Activity Schedule Intervention in Reducing Problem Behaviors in Children With Attention-Deficit/Hyperactivity Disorder Between the Age of 5 and 12 Years: A Systematic Review.","authors":"Naveena Thomas,&nbsp;Sudhin Karuppali","doi":"10.5765/jkacap.210021","DOIUrl":"https://doi.org/10.5765/jkacap.210021","url":null,"abstract":"<p><strong>Objectives: </strong>Children with attention-deficit/hyperactivity disorder (ADHD) tend to be noisy and violate rules with their disruptive behaviors, resulting in greater difficulties with off-task behaviors and being at risk for social refusal. The visual activity schedule (VAS) intervention program is a frequently used method to teach multiple skills involving on-task, use of schedules, transition behaviors, social initiation, independent play skills, classroom skills, and academic skills. The current systematic review aimed to examine the efficacy of using VAS intervention in reducing problem behaviors in children with ADHD between 5 and 12 years of age.</p><p><strong>Methods: </strong>Systematic searches were conducted using two electronic databases (PubMed and Scopus) to identify relevant studies published in English between 2010 and 2020. Four studies met the inclusion criteria: two studies examined the effect of schedule-based tasks and the use of an iPad on classroom skills, while the other two examined randomized clinical trials (RCTs) of psychosocial treatment for ADHD inattentive type and a cross-sectional study examined the impact of the group size on task behavior and work productivity in children with ADHD.</p><p><strong>Results: </strong>The findings indicate that the interventions used in all four studies could lead to increased satisfaction among participants and parents, as well as a reduction in problem behavior. In terms of the research indicators, the RCT had low quality, while the others were of high quality.</p><p><strong>Conclusion: </strong>A larger number of studies and the ADHD clinical population would help to increase the generalizability of future reviews of treatments in this context.</p>","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":"33 1","pages":"2-15"},"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/e7/08/jkacap-33-1-2.PMC8733412.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39825131","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":"Beyond Statistics","authors":"H. Yoo","doi":"10.5765/jkacap.220010","DOIUrl":"https://doi.org/10.5765/jkacap.220010","url":null,"abstract":"Statistics based on measurable data protect us from the temptation of saying our intuition is true. However, they cannot sometimes reveal the truths hidden behind a phenomenon. Sometimes, data cannot be collected in the middle of an ongoing phenomenon. Many factors make the process hard, including practical difficulties in data collection, available measures, age of participants, various biases of data collection, and representativeness of the sample. For example, how can we measure the active changes in the brain of very young infants when they are developing basic social emotions, learning a language at the single word level, and consolidating secured attachment with their primary caregivers? How can we quantify ever-changing emotional reciprocity during the rapprochement period of 2-year-old toddlers and their parents? Even if we can capture a certain aspect of brain activities during the early developmental stage, a more robust story and context are attenuated within the data, and its implication in development might lose its depth. As another example, it has been more than 2 years since the COVID-19 pandemic started, and while some children are experiencing both physical and mental issues, others are not; statistics have not been able to capture or integrate what we experience and feel in everyday life. There has been a tremendous increase in cases of neurodevelopmental disorders, including autism spectrum disorder, in the last four decades. Nonetheless, the statistics per se are insufficient to understand the situation without knowing the why behind the rapid increase, which is extremely hard to answer clearly. We know that children in Ukraine are facing tremendous crises in the face of war, and the data are unavailable and even powerless in such a rigorous existential reality. An in-depth understanding of typical developmental trajectories is an essential research area for atypical development and decoding psychopathology in child psychiatry. Studies have tried to prove the developmental process both in behavior and at the brain level. Many outstanding longitudinal studies examining developmental brain structure or connectivity changes have been published, with some examining brain changes associated with specific traits, such as reading, arithmetic ability, and preterm birth [1-3]. Prospective follow-up databases for brain development have been launched to set up more comprehensive insight into human brain development in an unbiased setting [4]. Various experimental models were developed and utilized to reproduce developmental processes in laboratory settings, from classic examples such as Ainsworth’s strange situation procedure to examine mother-child attachment patterns and false belief tasks to test the theory of mind to more complicated cognitive tasks. These might be researchers’ trials to make more abstract issues more concrete and transform further intersubjective phenomena into more visible, ubiquitous ones. With these attempts, w","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":"101 1","pages":"25 - 26"},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77892858","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":"Disrupted Association Between Empathy and Brain Structure in Attention-Deficit/Hyperactivity Disorder.","authors":"Jeonghwan Lee,&nbsp;Jung-Woo Son,&nbsp;Siekyeong Kim,&nbsp;Ji-Eun Kim,&nbsp;Seungwon Chung,&nbsp;Hei-Rhee Ghim,&nbsp;Sang-Ick Lee,&nbsp;Chul-Jin Shin,&nbsp;Gawon Ju","doi":"10.5765/jkacap.210009","DOIUrl":"https://doi.org/10.5765/jkacap.210009","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the relationship between brain structure and empathy in early adolescents with attention-deficit/hyperactivity disorder (ADHD).</p><p><strong>Methods: </strong>Nineteen early adolescents with ADHD and 20 healthy controls underwent 3T MRI. All the participants were assessed for different aspects of empathy using measures including the Interpersonal Reactivity Index and Empathy Quotient. Cortical thickness and subcortical structural volume based on T1-weighted scans were analyzed using FreeSurfer.</p><p><strong>Results: </strong>Cognitive empathy (t=-2.52, p=0.016) and perspective taking (t=-2.10, p=0.043) were impaired in the ADHD group compared with the control group. The cluster encompassing the left posterior insular, supramarginal, and transverse temporal cortices [cluster-wise p-value (CWP)=0.001], which are associated with emotional empathy, was significantly smaller in the ADHD group, and the volume of the left nucleus accumbens was greater than that of the control group (F=10.12, p=0.003, effect size=0.22). In the control group, the left superior temporal (CWP=0.002) and lingual cortical (CWP=0.035) thicknesses were positively associated with cognitive empathy, while the right amygdala volume was positively associated with empathic concern (Coef=14.26, t=3.92, p=0.001). However, there was no significant correlation between empathy and brain structure in the ADHD group.</p><p><strong>Conclusion: </strong>The ADHD group had a smaller volume of the cortical area associated with emotional empathy than the control group, and there was no brain region showing significant correlation with empathy, unlike in the control group.</p>","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":"32 4","pages":"129-136"},"PeriodicalIF":2.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/88/d3/jkacap-32-4-129.PMC8499037.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39537812","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":"Reduced Volume of a Brainstem Substructure in Adolescents with Problematic Smartphone Use.","authors":"In Hee Cho,&nbsp;Jae Hyun Yoo,&nbsp;Ji-Won Chun,&nbsp;Hyun Cho,&nbsp;Jin-Young Kim,&nbsp;Jihye Choi,&nbsp;Dai-Jin Kim","doi":"10.5765/jkacap.210007","DOIUrl":"https://doi.org/10.5765/jkacap.210007","url":null,"abstract":"<p><strong>Objectives: </strong>Despite the growing concern regarding the adverse effects related to problematic smartphone use (PSU), little is known about underlying morphologic changes in the brain. The brainstem is a deep brain structure that consists of several important nuclei associated with emotions, sensations, and motor functions. In this study, we sought to examine the difference in the volume of brainstem substructures among adolescents with and without PSU.</p><p><strong>Methods: </strong>A total of 87 Korean adolescents participated in this study. The PSU group (n=20, age=16.2±1.1, female:male=12:8) was designated if participants reported a total Smartphone Addiction Proneness Scale (SAPS) score of ≥42, whereas the remaining participants were assigned to the control group (n=67, age=15.3±1.7, female:male=19:48). High-resolution T1 magnetic resonance imaging was performed, and the volume of each of the four brainstem substructures [midbrain, pons, medulla, and superior cerebellar peduncle (SCP)] was measured. Analysis of covariance was conducted to reveal group differences after adjusting for effects of age, gender, whole brain-stem volume, depressive symptoms, and impulsivity.</p><p><strong>Results: </strong>The PSU group showed a significantly smaller volume of the SCP than the control group (F=8.273, p=0.005). The volume of the SCP and the SAPS score were negatively correlated (Pearson's r=-0.218, p=0.047).</p><p><strong>Conclusion: </strong>The present study is the first to reveal an altered volume of the brainstem substructure among adolescents with PSU. This finding suggests that the altered white matter structure in the brainstem could be one of the neurobiological mechanisms underlying behavioral changes in PSU.</p>","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":"32 4","pages":"137-143"},"PeriodicalIF":2.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/01/jkacap-32-4-137.PMC8499038.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39537813","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":"Evolution of Digital Natives and the New Role of Research.","authors":"Hee Jeong Yoo","doi":"10.5765/jkacap.210029","DOIUrl":"https://doi.org/10.5765/jkacap.210029","url":null,"abstract":"Digital media, including the internet, computer games, and smartphones, has been subject to intense debate in relation to its impact on child and adolescent mental health. Although the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) did not include internet gaming disorder in the main disease criteria, it should be investigated whether it has similar characteristics to other substance-related conditions and whether they share the same biological mechanisms. Recently, there has been an increasing interest in screen media such as smartphones and smart pads. While internet gaming is a matter of choice in which an individual can decide whether to use it or not, a smartphone is an essential part of life. It is a lifeline to save you in an emergency, a certificate to confirm your identity, and a virtual network to help you keep living a quasi-normal life in the so-called new normal era of the pandemic. Today, the young generation is referred to as digital natives or born with the ubiquitous influence of the internet and digital media. Even very young children can operate smartphone applications, including YouTube and Instagram, in an intuitive manner. Digital media has become a necessity of daily living, corresponding with the fact that we cannot go back to the era when there were no automobiles. Here, the more serious issue arises: how can the potential hazard of exposure to media and the inevitable evolution of human species be compromised? It is not easy to determine the amount of smart media use among children, how early they are exposed to it, whether it has a negative impact on them, and what the related variables are, if any. Observing temporal relationships and trajectories may be the best way to understand their complex interplay. In 2015, the Kids Cohort for Understanding of Internet Addiction Risk Factors in Early Childhood (K-CURE) initiated a prospective, longitudinal follow-up study to explore the cause and effect of media-related conditions. Thus far, owing to the efforts of investigators who followed up with a group of young children for more than five years, K-CURE has presented evidence of smart media use among children. Accordingly, 12.0% of toddlers use smartphones during weekdays while 23.4% use it only on weekends, maternal depression is linked to children’s over-exposure to television, children with smartphone overuse showed shorter sleep time and poor sleep quality, and mother’s smartphone addiction is related to early smartphone exposure in children [1-4]. In the current issue, K-CURE reported observations from the most recent follow-up, stating that elementary school children with screen overuse showed higher externalization behavior, social problems, and rule violation behavior than those in the control group. Another article in the current issue reported significant brainstem structure changes in adolescents with problematic smartphone use. These studies imply that media overuse might be a universal issue throu","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":"32 4","pages":"127-128"},"PeriodicalIF":2.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/81/d6/jkacap-32-4-127.PMC8499039.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39537811","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":"The Association of Anxiety Severity With Health Risk Behaviors in a Large Representative Sample of Korean Adolescents.","authors":"Kyung Soo Woo,&nbsp;Yoonmi Ji,&nbsp;Hye Jeong Lee,&nbsp;Tae Young Choi","doi":"10.5765/jkacap.210017","DOIUrl":"https://doi.org/10.5765/jkacap.210017","url":null,"abstract":"<p><strong>Objectives: </strong>Anxiety disorders are the most common psychiatric disorders in adolescents and seem to occur the earliest among all forms of psychopathology. The aim of this study was to investigate the association of anxiety severity with health risk behaviors and mental health in adolescents.</p><p><strong>Methods: </strong>Data from the 2020 Korean Youth Risk Behavior Web-Based Survey were analyzed. A total of 54948 adolescents responded to the 7-item Generalized Anxiety Disorder Scale (GAD-7) for the assessment of their anxiety severity as well as to the mental health and health risk behavior survey. Logistic regression analysis, t tests, and variance analysis of a complex sample general linear model were used to examine the association of anxiety severity with health behaviors and mental health.</p><p><strong>Results: </strong>After statistical adjustment for sociodemographic characteristics, the subjects in the severe anxiety group were significantly more likely to be current smokers (odds ratio [OR]: 2.08, 95% confidence interval [CI]: 1.72-2.50), current drinkers (OR: 1.91, 95% CI: 1.67-2.19), experience habitual substance use (OR: 10.89, 95% CI: 8.22-14.42), have sexual intercourse (OR: 2.10, 95% CI: 1.76-2.51), and have unprotected intercourse (OR: 2.21, 95% CI: 1.67-2.92) than those in the normal group. Anxiety severity negatively correlated with sleep satisfaction and happiness, but positively correlated with stress perception, loneliness, depressive symptoms, and suicidality.</p><p><strong>Conclusion: </strong>Adolescent anxiety is associated with health risk behaviors and poor mental health. Thus, early screening and intervention for anxiety in adolescents could contribute to the management and coping of youth health risk behaviors in the community.</p>","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":"32 4","pages":"144-153"},"PeriodicalIF":2.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/6e/jkacap-32-4-144.PMC8499041.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39536699","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":"The Facts That We Have Been Mistaken About Our Minds, Language, and Octopuses; “Other Minds: The Octopus, The Sea, and The Deep Origins of Consciousness”","authors":"Jung-Woo Son","doi":"10.5765/jkacap.210025","DOIUrl":"https://doi.org/10.5765/jkacap.210025","url":null,"abstract":"To date, we have made inferences on the behavior and mind of humans and animals from the perspective of humans, or for the sake of familiarity, vertebrates. The book, “Other Minds; The Octopus, The Sea, and The Deep Origins of Consciousness” by Peter Godfrey-Smith makes us realize how erroneous preconceived notions could be, and presents a novel perspective on the results of evolution. Through-out this book, readers will learn about the characteristics of the nervous system, behavior, and habits of cephalopods, which include oc-topuses. Through this book, readers will gain a new perspective on the embodiment, minds, nervous systems, consciousness, and soci-ality of humans and animals. Furthermore, the book will provide the imaginary experience of swimming in “Octopolis” inside the ocean with the author.","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":"1 1","pages":"170 - 172"},"PeriodicalIF":2.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89598792","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":"Association Between Suicide and Drinking Habits in Adolescents.","authors":"Ji Won Lee,&nbsp;Bong-Jo Kim,&nbsp;Cheol-Soon Lee,&nbsp;Boseok Cha,&nbsp;So-Jin Lee,&nbsp;Dongyun Lee,&nbsp;Jiyeong Seo,&nbsp;Young-Ji Lee,&nbsp;Youn-Jung Lee,&nbsp;Eunji Lim,&nbsp;Jae-Won Choi","doi":"10.5765/jkacap.210024","DOIUrl":"https://doi.org/10.5765/jkacap.210024","url":null,"abstract":"<p><strong>Objectives: </strong>Adolescent suicide is a serious social problem. Adolescent alcohol use is one of the most important risk factors for adolescent suicide. This study aimed to identify the relationship between drinking habits and suicide among Korean adolescents.</p><p><strong>Methods: </strong>Data from the 14th and 15th Korean Youth Risk Behavior Web-based Survey, conducted in 2018 and 2019, were used for analysis. Multiple logistic regression analysis was used to identify the relationship between drinking habits-including the age of drinking initiation, frequency of drinking, average drinking amount, frequency of drunkenness-and suicidal ideation, plans, and attempts.</p><p><strong>Results: </strong>Even after adjusting for age, sex, school grade, academic achievement, socioeconomic status, depression, stress, and drinking habits, the frequencies of drinking and drunkenness increased the risk of suicide attempts. Suicide attempts were associated with the frequency of drinking in girls and middle school students, and with the frequency of drunkenness in boys and high school students.</p><p><strong>Conclusion: </strong>This study identified associations between drinking habits (the age of drinking initiation, frequency of drinking, average amount of drinking, frequency of drunkenness) and suicidal behavior in adolescents. Our findings suggest that to prevent adolescent suicide, it might be necessary to investigate drinking habits, including the frequencies of drinking and drunkenness. Moreover, considering the differences in sex and school grade, it is important to include the individual group characteristics when evaluating drinking habits.</p>","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":"32 4","pages":"161-169"},"PeriodicalIF":2.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e9/80/jkacap-32-4-161.PMC8499040.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39536701","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":"Inside Out.","authors":"Hee Jeong Yoo","doi":"10.5765/jkacap.210016","DOIUrl":"https://doi.org/10.5765/jkacap.210016","url":null,"abstract":"In the past, when diagnoses in child psychiatry were unfamiliar and relatively rare, the word from an authoritative figure was a “marker” for a disease. Once an expert confirmed a diagnosis through careful examination and suggested ways of treatment, they were accepted as the truth, even as the gold standard. If the clinical opinion was backed up by psychological measurements, not many people would have raised concerns regarding the diagnosis, even regarding the possible prognosis. However, this is not as simple and clear today. Parents already have a vast amount of information, both correct and incorrect, and try to reconcile their pre-existing knowledge with the novel information given by the clinician. They need a second opinion from other clinicians regarding treatment options, as well as diagnostic accuracy. It is sometimes awkward for clinicians to feel like competing with random information from the community; however, facing such changes might be inevitable. It is even more evident in disorders with complex manifestations, such as autism spectrum disorder (ASD). Doctor-patient relationships in child psychiatry have tended to be paternalistic models, in which clinicians care for children and their families in a warm, holding, and sometimes firm manner; however, this is now transforming into a more informative/interpretative model. There are several sophisticated mechanisms underlying such changes, including the diversity of symptoms of neurodevelopmental disorders, the plethora of information and people’s ability to interpret them, availability of multiple doctors within the healthcare transfer system, and general skepticism about healthcare experts. Whatever the reason behind it might be, it seems clear that there is currently a significant paradigm shift towards pursuing more objective measures of underlying pathogenic mechanisms of diseases, replacing expert opinion and close behavioral observation, that is, biomarkers. Biomarkers are objectively measured, quantifiable indicators of both normal and pathologic biological processes or biological responses to therapeutic interventions [1]. They include 1) risk biomarkers, used to identify individuals at high risk for a certain condition, such as having a family history; 2) diagnostic biomarkers used to confirm the diagnosis, identify the subtype of the disease, and stratify its severity; 3) treatment biomarkers, representing treatment responses to biological agents, including drugs; and 4) prognostic biomarkers, indicating the progression, long-term prognosis, or recurrence of the disease [1,2]. Prediction biomarkers, surrogate endpoint biomarkers, and safety biomarkers can be defined based on the classification system of biomarkers. The essential value of biomarkers in terms of precision medicine lies in diagnosis, tailoring treatment options to individual profiles, and determining prognoses. However, reliable biomarkers are not yet widely used, except for diagnostic markers for Alzheimer","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":"32 3","pages":"83-84"},"PeriodicalIF":2.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/72/4f/jkacap-32-3-83.PMC8262975.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39203620","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}