Multidisciplinary Approaches in Developing Guideline for Mediating Behavioral Problems in Children and Adolescents with Neurodevelopmental Disorders / 신경정신의학

OBJECTIVES: To initiate and develop a treatment guideline in multidisciplinary approaches for related professions who are either working and/or living with children and adolescents with neurodevelopmental disorders who show behavioral problems. METHODS: To collect and reflect opinions from multiple professions who assumedly have different interventions or mediations on behavioral problems, a self-report survey and Focus Group Interview (FGI) were conducted for a group of child and adolescent psychiatrists, behavioral therapists, special education teachers, social welfare workers, and caregivers. RESULTS: According to a self-report survey and FGI results from multiple professional groups, aggressive behavior is the mostly common behavioral problem necessitating urgent interventions. However, both mainly used intervention strategies and effective treatment methods were different depending on professional backgrounds, such as pharmacological treatment, parent training, and behavior therapy, even though they shared an importance of improving communication skills. In addition, there was a common understanding of necessity to include parent training in a guideline. Lastly the data suggested lack of proper treatment facilities, qualified behavior therapists, and lack of standardized treatment guideline in the field needed to be improved for a quality of current therapeutic services. CONCLUSION: It is supported that several subjects should be included in the guidelines, such as how to deal with aggressive behavior, parent training, and biological aspects of neurodevelopmental disorders. Also, it is expected that publishing the guideline would be helpful to above multiple professions as it is investigated that there are lack of treatment facility and qualified behavioral therapists compared to need at the moment.

Erratum: Multidisciplinary Approaches in Developing Guideline for Mediating Behavioral Problems in Children and Adolescents with Neurodevelopmental Disorders / 신경정신의학

This correction is being published to correct the degree of the author Maehwa Oh, in the article.

Cognitive Impairments in Clinically Stable Late-Life Depression : Relationship to Cardiovascular Risk : A Pilot Study

OBJECTIVE: The purpose of this study was to test the hypothesis that cardiovascular risk is associated with cognitive impairments in clinically stable late-life depression. METHODS: A total of 59 clinically stable late-life depression patients over age 60 were enrolled in a cross-sectional study. Evaluation tools used in this study include Hamilton Rating Scale for Depression, Geriatric Depression Scale, State-Trait Anxiety Inventory, the Framingham general cardiovascular disease risk profile and the cognitive function battery designed for this study. Correlation analysis, analysis of variance and analysis of covariance were performed. RESULTS: Patients with higher cardiovascular risk performed significantly poorer in the domains of executive function and short-term or long-term memory. In models adjusted for age, sex, education, 10% higher cardiovascular risk was associated with poorer executive function. CONCLUSION: Our findings suggested that cardiovascular risk could be a significant factor associated with poor executive function in clinically stable late-life depression and the management which is necessary as a component of treatment planning. This pilot study provided good prospects for future studies to document this relationship on larger samples.

The Relationship among Psychopathology, Cognitive Function, Insight and Quality of Life in Elderly Patients with Chronic Schizophrenia

OBJECTIVE: The aim of this study was to investigate the association with psychopathology, cognitive function, insight and quality of life (QOL) in elderly patients with chronic schizophrenia over age 55. METHODS: 103 schizophrenic patients over age 55 with illness duration over 10 years, are enrolled in a cross-sectional study. The subjects were assessed by the Korean version of 4th Revision of Schizophrenia Quality of Life Scale, Korean Version of Scales to Assessment Unawareness of Mental Disorder, Positive and Negative Syndrome Scale (PANSS) and the cognitive function battery designed for this study. Multiple regression stepwise selection models were executed to identify the relations among variables, and the contributing factors to QOL. RESULTS: Among schizophrenic patients with lower illness-severity with PANSS total score below 75, higher PANSS positive subscale score and lower number of hospitalization were related to lower QOL. Among patients with higher illness-severity with PANSS total score of 75 and over, higher PANSS general psychopathology subscale score, better intelligence, better delayed recall function, worse attention, better awareness of medication effect and later onset were related to lower QOL. CONCLUSION: Results of our study suggest that improvement in positive symptom and general psychopathology could increase the QOL in elderly patients with chronic schizophrenia over age 55. And the management which could improve attention, awareness of need for medication would attribute the QOL.