Attention Deficit Hyperactivity Disorder Like Behavioral Problems and Parenting Stress in Pediatric Allergic Rhinitis

OBJECTIVE: Previous studies have reported comorbidity of attention deficit and hyperactivity disorder (ADHD) and allergic diseases. The current study investigated ADHD like behavioral symptoms and parenting stress in pediatric allergic rhinitis. METHODS: Eighty-seven children (6-13 years old) with allergic rhinitis and 73 age- and sex-matched children of control group were recruited. Diagnosis and severity assessments of allergic rhinitis were determined by a pediatric allergist. The Parenting Stress Index-Short Form (PSI-SF), ADHD Rating Scale (ARS), and Child Behavior Checklist (CBCL) were completed by their mothers. RESULTS: In the allergic rhinitis group, the total PSI-SF score (p<0.01), ARS score (p<0.01), the subscale scores of the CBCL including somatization, attentional problems and emotional instability (p=0.01; p<0.01; p<0.01) and prevalence of ADHD (p=0.03) were significantly higher than those of the control group. Among mothers of children with allergic rhinitis, those of children with comorbid ADHD demonstrated significantly higher parenting stress than those without comorbid ADHD (p<0.01). Parenting stress was correlated with severity of child's allergic symptoms and the ARS total score (beta=0.50, p<0.01; beta=0.39, p<0.01). There was a significant correlation between allergic symptom severity and the ARS total score (B=8.4, SD=2.5, t=3.3, p<0.01). CONCLUSION: This study demonstrated that ADHD symptoms were common in children with allergic rhinitis, and this factor increased parenting stress and disrupted the parent-child relationship. Routine evaluation and early management of ADHD symptoms in pediatric allergic rhinitis may benefit families of children with allergic rhinitis.

Comparison of Atypical Antipsychotics Discontinuation Rate in Acute Phase Hospitalized Patients-Retrospective Chart Review Study / 대한정신약물학회지

OBJECTIVE: The purpose of this study was to compare the discontinuation rate of widely prescribed atypical antipsychotics when administered to newly admitted, acutely ill patients with schizophrenia or bipolar mania. METHODS: Medical records of patients admitted to psychiatric ward of two university hospitals between January 2007 and December 2008 were retrospectively reviewed. Subjects were eligible for inclusion if they prescribed olanzapine, risperidone or aripiprazole for their psychotic or manic symptom control. Patient groups (olanzapine/risperidone/aripiprazole) were compared for rate of antipsychotics discontinuation and duration of treatment continuation. RESULTS: There was no statistically significant difference in the rates of discontinuation during hospitalized period between olanzapine, risperidone and aripiprazole. Rates of discontinuation were 14.5% for olanzapine, 18.6% for aripiprazole and 24.0% for risperidone. Predictor of treatment discontinuation was short titration period and long illness duration. CONCLUSION: This study demonstrated that risperidone, olanzapine and aripiprazole were comparable with no difference found on the discontinuation rate in treating acutely ill psychiatric patients. However, the small number of patients who participated in this study made it difficult to establish significance.

Predicting Factors Associated with Drug Compliance in Psychiatric Outpatients of a University Hospital / 대한정신약물학회지

OBJECTIVE: Drug compliance is closely related to progress and prognosis of psychiatric disease. We investigated drug compliance in psychiatric outpatients and factors that influence their compliance. METHODS: Patients who visited a university hospital were asked about drug information and drug compliance using questionnaires. Medical records of the patients were reviewed. Demographic variables, clinical characteristics and drug compliance related variables were compared between non-compliance group and compliance group. Logistic regression analysis was performed to clarify predictors of poor compliance. RESULTS: One hundred eighty one patients participate in this study. 150 patients (82.9%) were compliance group, 31 patients (17.1%) were included in non-compliance group. Patient-related, illness-related and treatment-related factors, DAI total score and knowledge of side effect did not show any difference in both groups. However, illness severity was relatively higher in non-compliance group (p = 0.070) and patient's satisfaction about explanation of side effect was lower in noncompliance group (p = 0.061). Moreover, patients who negatively answered for question about negative recognition to psychiatric medication in DAI questionnaire were more common in non-compliance group (p = 0.075). In logistic regression, answering negatively to question about negative recognition to psychiatric medication in DAI questionnaire was related to non-compliance, but did not reached statistical significance (p = 0.086). CONCLUSION: This study suggests that improving negative recognition about psychiatric medication through drug education and good doctor patient relationship could enhance drug compliance.