Help Seeking Behavior about Children's Problem and Satisfaction with Psychiatric Service: Multicenter Point Epidemiologic Study / 신경정신의학

OBJECTIVES: This study was done to evaluate present status of child and adolescent psychiatric practice in the view of medical consumers. Help seeking behaviour process after recognizing their children's problem, satisfaction with psychiatric service, and difficult problems during practice were evaluated, and variable factors affecting them were analysed. METHODS: Through 10 multi-center point epidemiologic survey, 540 parents and their psychiatrists were involved in this study by structured questionnaire. RESULTS: Above 70% of subjects reported positive response to psychiatric service. The barrier to psychiatric service were different by subjects' age. In children, parents' inability to identify severity of children's problem and proper management place were major reason. However in adolescent, children's lack of desire to receive help and parents' worry about stigma related to receiving help were major barrier to psychiatric service. CONCLUSION: These findings suggest the importance of interagency collaboration and education services. Researchers and policymakers should consider strategies to reduce barrier related to perceptions of mental health problems and services, especially in adolescents.

Temperamental Characteristics of Korean Children from the Viewpoint of Family Environment and Development / 신경정신의학

OBJECTIVES: The purpose of this study was to find the differences of temperamental characteristics of Korean children according to family environment and developmental history. METHODS: 1) The mothers whose children had been educated at twenty-five Samsung Child Care Centers nationwide participated in the survey using Parent Temperament Questionnaire for Children (PTQ) and the Child Development Questionnaire (CDQ). 2) The temperament of 1,175 children whose mothers completed PTQ were classified into 5 diagnostic clusters (Easy, Intermediate Low, Intermediate High, Difficult, Slow-To-Warm-Up) according to the method proposed by Fullard et al. 3) The results of classification were compared and analysed statistically according to each CDQ parameters. RESULTS: Statistically meaningful difference in the distribution of temperamental clusters were found in the CDQ parameters such as birth order of children, number of intimate friends, children's relationship with their peers, children's relationship with their siblings, children's relationship with their parents, type of milk feeding, motor development of children during 2 years after birth, motor development during from age 2 to 5, stranger anxiety, present health state of children, and relationship between parents. After all, the proportion of Easy type was greater in the children who were first-born, or who had good relationship with their peers or family, fast motor development, mild stranger anxiety, good health condition, or good relationship between each parent. CONCLUSION: This study shows that the distribution of temperamental cluster was significantly different in several parameters of family environment and developmental history of Korean children. The children with fast development, good interpersonal relationship or favorable family environment are more likely to be the Easy type.

Temperamental Characteristics of Asthmatic Children in Korea / 신경정신의학

The objective of this study was to determine temperamental characteristics of children with bronchial asthma. An earlier preliminary study(Kim SP, Ferrara A, Chess S, 1980) results show that the asthmatic children, as a group, are significantly different from two other control groups (I. children with eczema, allergic rhinitis, or both without asthma: II. normal healthy children in their temperamental profile). The parents of 85 Korean children with bronchial asthma, ages 3 to 7 years, completed the Korean version of Parental Temperamental Questionnaire developed by Thomas and Chess. The data collected were of ordinal type, ranked from 1 to 7 and the non-parametric Mann-whitney U Test was utilized. Any child with a suspected history or diagnosis of premature birth, organic brain syndrome, mental retardation, childhood psychosis, congenital physical anomaly, hereditary disease or any other medical or surgical conditions, other than asthma, requiring continuous physicians care was excluded from the study population. The results showed that asthmatic female children were characterized by lower adaptability and lower threshold of responsiveness. And 22% of asthmatic children were of the difficult type, compared to 11% of normal children. Both groups were statistically different In terms of temperamental constellation. The findings strongly suggest the existence of a distinct temperamental profile of asthmatic children. Early detection of the profile may be of great value for parents and child health care providers in understanding the asthmatic children's correct developmental needs and in determining appropriate parenting approaches for the chronically ill children at the risk of behavioral disorders.

Subtypes and Characteristics of Alcohol Use Disorder / 신경정신의학

OBJECTIVE: Multiple typologies of alcoholics have been studied, such as Jellineck's disease concept classification, Cloninger's neurobiological learning model, Bucker's developmental model, DSM III-B and DSM IV classification, and Babor's multidimensional typology. To study if Babor's typology modification could be used to classify Korean alcoholics, we grouped 95 male inpatient alcoholics into Babor's typology modification. METHODS: This study employed cluster analysis of measures representing several dimensions premorbid risk and vulnerability dependence severity and alcohol-related problems, chronicity and alcohol-related consequences, and comorbid psychopathology. We compared demographic and clinical characteristics among Babor's type A and type B alcoholics and normal control group. RESULTS: Type B alcoholics showed more characteristic symptoms in family history, more childhood behavior problems, earlier onset, more drinking amount, and more dependence severity, more medical, social, physical problems, more life time severity, more depressive, anxiety, hostility, compared with type A alcoholics. The statistically significant variables differentiating three groups(type A, type B, normal control group) were drinking days, dependence severity, lifetime severity, medical, social consequence. Alcohol Use Inventory to Babor s typology of alcoholism was very useful scale differentiating three groups. CONCLUSION: Babor's typology of alcoholism was useful for classification of inpatient alcoholics of Korea. It can be helpful and applicable to clinical diagnosis and research in Korean alcoholic patients.