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

{"title":"Tic-Like Repetitive Ear-Popping Behavior With Objective Eustachian Tube Opening in an Adult With Tourette Syndrome.","authors":"Kyoko Hoshino, Mayuko Okada, Ayako Nishio, Yuri Nagao, Maki Nozaki, Michiko Kawai, Yuko Yatomi, Michio Fukumizu, Kazue Kimura, Masaharu Hayashi","doi":"10.5765/jkacap.260009","DOIUrl":"10.5765/jkacap.260009","url":null,"abstract":"<p><p>Tourette syndrome presents with diverse motor and vocal tics, yet involvement of Eustachian tube dynamics has not been previously described. We report the case of a 31-year-old woman who developed an unusual symptom she described as an \"ear-popping tic,\" characterized by a strong premonitory urge to release air from the ears and clicking sounds. Her long clinical history included childhood-onset tics, emotional instability, psychiatric hospitalizations, and fluctuating tic severity. At age 31, she reported repetitive ear-popping sensations accompanied by voluntary suppression to some extent. Ear, nose, and throat examination revealed normal tympanic membranes and hearing thresholds. Acoustic Eustachian tube function testing objectively demonstrated repetitive Eustachian tube opening independent of swallowing, a finding not previously documented in tic disorders. The patient described a strong urge to engage in ear-popping and partial suppressibility, although the temporal relationship between the auditory sensation and the urge was unclear. Differential diagnoses included voluntary ear-popping behavior, palatal myoclonus, middle ear myoclonus, and tensor tympani syndrome. The repetitive non-swallow-related tube opening was considered most consistent with tic-like contractions of the tensor veli palatini and levator veli palatini muscles, although voluntary components could not be fully excluded. One month later, she adopted lifestyle practices inspired by traditional East Asian medicine, leading to gradual psychological stabilization. The ear-popping tic became less intrusive, and all medications were eventually discontinued. This case highlights the importance of objective assessment in distinguishing tic-like phenomena from other causes of Eustachian tube opening.</p>","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":"37 3","pages":"146-150"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370324","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":"Effects of Tic Suppression and Urge Monitoring on Premonitory Urges and Tic Frequency in Tourette Syndrome.","authors":"Natsumi Matsuda, Yukiko Kano","doi":"10.5765/jkacap.260010","DOIUrl":"10.5765/jkacap.260010","url":null,"abstract":"<p><strong>Objectives: </strong>Behavioral interventions for Tourette syndrome (TS) involve tic suppression and attention to premonitory urges. However, some patients believe that focusing on tic symptoms or urges may worsen symptoms, and that suppressing tics may exacerbate urges. Using a single experimental dataset with real-time urge monitoring, this study addressed two analytical aims. Aim 1 examined whether tic suppression worsens the intensity, frequency, and persistence of premonitory urges. Aim 2 examined whether sustained attention to urges increases tic frequency or worsens subjective urges.</p><p><strong>Methods: </strong>Ten adult men with TS and frequent tic symptoms (mean age=28.3 years, standard deviation=9.1 years) completed four 5-min conditions twice: rest, suppression, urge-reporting, and suppression+urge-reporting. In the urge-reporting conditions, participants used a handheld monitor to continuously report urges. The sessions were video-recorded, and tic frequency was coded. For Aim 1, the mean urge intensity, frequency of threshold-crossing urge episodes, and post-threshold persistence patterns were compared between the urge-reporting and suppression+urge-reporting conditions. For Aim 2, tic frequency and subjective states were compared between the conditions with and without urge-reporting.</p><p><strong>Results: </strong>At the group level, tic suppression was not associated with consistent worsening of mean urge intensity, frequency of threshold-crossing urge episodes, or post-threshold persistence patterns. This overall pattern did not clearly differ by obsessive-compulsive symptoms, although participants with these symptoms showed larger and more persistent urge responses in the descriptive plots. Sustained urge-reporting was not associated with a consistent group-level increase in tic frequency; instead, marked individual variability was observed. Subjective urge intensity and fatigue were higher after suppression+urge-reporting condition than after suppression condition.</p><p><strong>Conclusion: </strong>Under short-term laboratory conditions, tic suppression was not associated with a consistent group-level worsening pattern in premonitory urge indices, and real-time urge reporting was not associated with a consistent group-level increase in tic frequency. However, individual variability was substantial; this variability may be partly related to obsessive-compulsive symptoms.</p>","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":"37 3","pages":"135-145"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370347","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":"Relationship of Serum Tricellulin, MarvelD3, and Tumor Necrosis Factor-Alpha Levels With Obsessive-Compulsive Disorder Severity in Children and Adolescents.","authors":"Kübranur Ünal, Yasemin Taş Torun, Mehmet Emre Erol, Zeynep Kübra Kurt, Cansu Özbaş","doi":"10.5765/jkacap.250045","DOIUrl":"10.5765/jkacap.250045","url":null,"abstract":"<p><strong>Objectives: </strong>Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder characterized by obsessions and compulsions, with a prevalence of 1%-3%. Tight junction (TJ) proteins contribute to maintaining the epithelial barrier. This study investigated the association of serum TJ-associated MARVEL protein family and inflammatory markers with OCD severity in children and adolescents.</p><p><strong>Methods: </strong>A total of 43 drug-naive children with \"pure\" OCD and 37 age-matched healthy controls were included in the study. Serum levels of occludin, tricellulin, MarvelD3, which belong to the TJ-associated MARVEL protein family, along with inflammatory markers (C-reactive protein, tumor necrosis factor-alpha [TNF-α], interleukin-6) were assessed. The severity of OCD was ascertained using the Maudsley Obsessive-Compulsive Inventory (MOCI). Biochemical data of patients and control groups were compared against clinical features such as OCD severity and time since symptom onset.</p><p><strong>Results: </strong>Both groups showed similar sociodemographic factors, except that psychiatric disorders and family histories of OCD were significantly higher in the OCD group. Although serum TJ levels were not significantly different between groups, serum tricellulin (r= 0.427, p=0.004), MarvelD3 (r=0.489, p<0.001), and TNF-α (r=0.495, p<0.001) levels had a positive correlation with the severity of OCD based on MOCI.</p><p><strong>Conclusion: </strong>The findings suggest that tricellulin, MarvelD3, and TNF-α may be associated with OCD severity. Further comprehensive research is required to determine the role of TJ proteins belonging to the MARVEL protein family in the pathophysiology of OCD.</p>","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":"37 2","pages":"105-114"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677440","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":"Psychological Characteristics Associated With Cyberbullying: Focusing on the Victim-Perpetrators and Gender Differences.","authors":"Geon-Taek Bae, Sang-Ick Lee, Chul-Jin Shin, Jung-Woo Son, Siekyeong Kim, Gawon Ju, Jeonghwan Lee, Joon Hyung Jung, Seungwon Chung","doi":"10.5765/jkacap.250058","DOIUrl":"10.5765/jkacap.250058","url":null,"abstract":"","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":"37 2","pages":"95-104"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677364","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":"Exploring Both In-Depth Theories of Disorders and the Current State of Child and Adolescent Mental Health at the Same Time.","authors":"Jung-Woo Son","doi":"10.5765/jkacap.260006","DOIUrl":"10.5765/jkacap.260006","url":null,"abstract":"","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":"37 2","pages":"81"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677457","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 Concept of Autism in Autism Spectrum Disorder and Schizophrenia Spectrum Disorder: Historical Divergence and Phenomenological Rapprochement.","authors":"Seong Hoon Jeong, Jung-Woo Son","doi":"10.5765/jkacap.260003","DOIUrl":"10.5765/jkacap.260003","url":null,"abstract":"<p><p>This study aims to trace the historical origins and conceptual divergence of \"autism\" as employed in autism spectrum disorder (ASD) and schizophrenia spectrum disorder (SSD), and to examine their recent rapprochement through the lens of phenomenological psychopathology. A narrative review was conducted to analyze primary historical sources, including works by Bleuler, Kanner, and their predecessors, along with contemporary literature on neurodevelopmental perspectives, social cognition, and phenomenological psychopathology. The analysis focused on comparing the structures of self-experience between patients with ASD and those with SSD using frameworks such as ipseity disturbance and anomalous self-experience. Bleuler's \"Autismus\" (1911) denoted active withdrawal from reality and construction of an inner fantasy world in schizophrenia, whereas Kanner's \"infantile autism\" (1943) described innate deficits in forming affective bonds. Despite strict diagnostic separation since DSM-III, recent research reveals shared genetic pathways, social cognitive impairments, and clinical presentations. Phenomenological analysis revealed that while both conditions share common predicaments in being-in-the-world, they manifest qualitatively distinct patterns of self-disorder. Patients with SSD exhibit ipseity disturbance characterized by instability of the minimal self, diminished self-affection, and hyperreflexivity, whereas patients with ASD generally show preserved minimal self but deficient intersubjective attunement. Social withdrawal in SSD represents a defensive retreat against ontological anxiety and self-dissolution, whereas in ASD it reflects involuntary isolation arising from impaired intuitive connections with others. ASD and SSD share common predicaments in being-in-the-world, yet manifest qualitatively distinct forms of self-disorder. This phenomenological framework offers a promising transdiagnostic approach for clarifying the relationship between these two conditions and understanding the essence of \"autism.\"</p>","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":"37 2","pages":"82-94"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677452","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":"Longitudinal Associations Between Child and Family Factors With Korean Children's Subjective Happiness Before and During COVID-19 in Late Childhood.","authors":"Jungtae Choi","doi":"10.5765/jkacap.250046","DOIUrl":"10.5765/jkacap.250046","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated the trajectories of subjective happiness among children aged 8-13, assessed the impact of the COVID-19 pandemic, and identified child- and family-level predictors of variations in happiness.</p><p><strong>Methods: </strong>Drawing on 5855 person-years of data from the nationally representative Panel Study on Korean Children, we employed longitudinal multilevel modeling to examine trends, including those during the pandemic period, and to estimate the influence of child- and family-level predictors. Sex differences were analyzed using interaction terms and stratified analyses.</p><p><strong>Results: </strong>The study revealed a significant negative temporal trend in children's subjective happiness from ages 8 to 13 years, with a sharp decline associated with the onset of the pandemic in 2020 (b=-1.524, p<0.001). Regarding child-level predictors, male sex, sleep duration, subjective health, and number of friends were positive predictors. Maternal education was a positive family-level predictor, whereas maternal stress was a negative predictor. In terms of sex differences, the happiness levels of both males and females remained significantly below the pre-pandemic levels. Overweight/obesity, sleep duration, maternal education level, and paternal subjective health were significant predictors among females but not among males.</p><p><strong>Conclusion: </strong>Although we found a decline in happiness with age, we confirmed that COVID-19 had a significant impact on children's subjective happiness. Our findings underscore the need to identify the key predictors of happiness and to consider proactive strategies to prepare for future infectious disease outbreaks.</p>","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":"37 2","pages":"115-123"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677434","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":"An Exploratory Pilot Study of Brain Functional Connectivity and Heart Rate Variability in Male Children With Autism Spectrum Disorder.","authors":"Huiyeong Jeon, Ahjeong Hur, Hoyeon Lee, Seungwon Chung, Jung-Woo Son","doi":"10.5765/jkacap.250056","DOIUrl":"10.5765/jkacap.250056","url":null,"abstract":"<p><strong>Objectives: </strong>The brain and autonomic nervous system are tightly interconnected and may be involved in various psychiatric conditions. We explored whether electroencephalographic (EEG) coherence and vagally mediated heart rate variability (vmHRV) differ between male children with autism spectrum disorder (ASD) and typically developing (TD) children, and how these measures are associated with the clinical characteristics of ASD.</p><p><strong>Methods: </strong>We recorded resting-state EEG and vmHRV in 14 male children with ASD and 14 TD children. The Social Responsiveness Scale (SRS) was used to assess the clinical characteristics of the ASD group.</p><p><strong>Results: </strong>vmHRV measures (root mean square of successive RR intervals [RMSSD], percentage of successive RR intervals that differ by more than 50 ms [pNN50], and high-frequnecy power) did not differ between the ASD and TD groups. By contrast, the beta1 coherence between the T5 and T6 electrodes (beta1 coherence [T5-T6]) was lower in the ASD group than in the TD group, even after correction for multiple comparisons. This coherence measure demonstrated a positive correlation with RMSSD and a negative correlation with the SRS social motivation subscale score (SRS-Motivation). Moreover, pNN50 acted as a moderator of the association between beta1 coherence (T5-T6) and SRS-Motivation.</p><p><strong>Conclusion: </strong>Resting-state EEG coherence may be associated with the clinical characteristics of ASD, and vmHRV may exert a moderating effect on this relationship. These preliminary findings suggest that the concurrent evaluation of brain and autonomic functions can be useful for elucidating the pathophysiology of ASD.</p>","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":"37 1","pages":"70-80"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12782996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953142","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":"Grief in Children and Adolescents: A Developmentally Informed Clinical Review With Illustrative Cases.","authors":"Vanessa Budiawan Soetioso, Izzatul Fithriyah","doi":"10.5765/jkacap.250036","DOIUrl":"10.5765/jkacap.250036","url":null,"abstract":"<p><p>Grief in children and adolescents is a complex and often misunderstood process, distinct from adult mourning in both its expression and developmental impact. Young people may struggle to articulate their emotions, leading to behavioral changes that are frequently misinterpreted or overlooked in clinical practice. This review explores how grief manifests across developmental stages, highlighting age-specific responses, common clinical presentations, and factors that influence resilience or vulnerability. Drawing on current evidence and clinical insight, we examine assessment strategies and therapeutic approaches tailored to the needs of grieving children and adolescents. Case illustrations are used to provide context and deepen understanding. By emphasizing a developmentally sensitive, emotionally attuned, and culturally aware perspective, this article aims to equip clinicians with practical tools to better support children and adolescents coping with loss.</p>","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":"37 1","pages":"44-50"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12782988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953122","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":"Regulation-Focused Psychotherapy for Children With Emotion Dysregulation.","authors":"Seri Maeng, Yang Suk Kim, Duk-Soo Moon","doi":"10.5765/jkacap.250059","DOIUrl":"10.5765/jkacap.250059","url":null,"abstract":"<p><p>Emotion dysregulation is a transdiagnostic risk factor in childhood psychopathology that contributes to externalizing behaviors. To address this, regulation-focused psychotherapy for children (RFP-C) has been developed as a manualized, short-term psychodynamic intervention for 5- to 12-year-olds with externalizing behaviors rooted in underlying emotion dysregulation and affective conflict. The therapy follows a structured protocol comprising 16 child play therapy sessions and 4 parent sessions. Therapists use symbolic play, identify defense-based play disruptions, and adopt affect labeling to enhance implicit emotion regulation. In parent sessions, the \"triangle of conflict\" was deployed to reframe behavior as defensive, strengthen reflective functioning, and scaffold regulatory growth. Pilot data (n=3) and a randomized controlled trial (n=43) demonstrated feasibility, high adherence, and statistically significant reductions in oppositional defiant symptoms, with maintenance at the three- and six-month follow-ups. The limitations included a small sample size, reliance on waitlist controls, and scarce long-term durability data. Future research is needed to conduct multisite trials with active comparators, assess applicability across diverse conditions, and examine changes in defense mechanisms. To implement RFP-C across broader clinical settings, it is crucial to train specialized clinicians, identify children who are well suited for RFP-C, and integrate appropriate interventions tailored to each child's unique challenges.</p>","PeriodicalId":42806,"journal":{"name":"Journal of the Korean Academy of Child and Adolescent Psychiatry","volume":"37 1","pages":"4-13"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12782995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953158","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}