Prescription Status and Efficacy of OROS-MPH and Parent Perception in Children with Attention Deficit Hyperactivity Disorder : Multi-Center, Observational Study during 4 Weeks / 대한정신약물학회지

OBJECTIVE: This study was performed to evaluate the current prescription status by clinicians, the efficacy of once-daily OROS-methylphenidate (MPH) in the treatment of children with attention deficit hyperactivity disorder (ADHD) and parent anticipation, concern and satisfaction about treatment. METHODS: The subjects with ADHD between 6 and 18 years were prescribed 18, 36, 54 mg OROS-MPH, depending on clinician's judgment. ADHD symptoms and improvement were assessed by clinicians using the Clinical Global Impression-Severity (CGI-S) and the Clinical Global Impression-Improvement (CGI-I). Parents were also measured the Conners Abbreviated Parent Rating Scale (CAPRS) and by the questionnaires inquiring about parental anticipation, concern, satisfaction about treatment at baseline and the 4th week after OROS-MPH trial. RESULTS: A total of 704 subjects were enrolled in the observational study and 645 completed the trial. There was an 18% increase in mean daily dose and 14% increase in mean daily dose per kg during 4 weeks. About 56% of subjects were scored 2 or less by the CGI-I. CAPRS scores were significantly decreased from 14.8 to 8.81. Before treatment, parents anticipated the symptom improvement firstly, followed by education material, parental education and non-pharmacological treatment. Parent concerned about side effect, growth, dependency and abuse. In general, 95% of parent were satisfied with OROS-MPH . CONCLUSION: According to this study, there was an increase in mean daily dose over the study period. OROS-MPH appears to be efficacious for decreasing the symptoms of ADHD and was satisfactory to parents of children with ADHD.

Validation Study of Tripartite Model of Anxiety and Depression in Children and Adolescents: Clinical Sample in Korea

Although the currently available literature has provided some empirical support for a tripartite model of child and adolescent anxiety and depression, one of the limitations of these studies was that they have been conducted in America, primarily with Caucasians. In order to make this model more applicable to diverse ethnic and cultural groups, this study used a tripartite model for child and adolescent anxiety and depression in Korea, using confirmatory factor analysis with logically selected items from the Revised Children's Manifest Anxiety Scale (RCMAS), as well as the Children's Depression Inventory (CDI). The results indicated that the model fit of a threefactor model was superior to one- and two-factor models. In addition, the findings of discriminant analysis demonstrated that the correct classification rate with three factors of the tripartite model was superior to the classification rate achievable using CDI and RCMAS. In a departure from Clark and Watson's hypothesis, however, the correlations of three factors were significantly higher than had been expected. The results are discussed on the basis of cultural background.

The Self-Esteem Attributed by Self Perception of Body Image in Community Adolescents / 신경정신의학

OBJECTIVES: Obesity is associated with a range of adverse health impacts on physical and psychosocial aspects. Psychosocial effects may include body image disturbance, negative self-perception and peer problem. We investigated the association between self perception of body image, real body mass index (BMI), and self-esteem in middle school students and explored factors that most attribute to self-esteem. METHODS: We randomly selected 477 middle school students ot 13 to15 years old. Informations on weight, height and BMI were colleted. Subjective perception of body image, wished body image, depression scales and self-esteem scales were checked by the participants. Subjects were divided into three groups according to their BMI values. Underweight, normal-weight and overweight groups were identified and compared with demographic data and several scales. RESULTS: Mean BMI of participants was within the normal range. Male students perceived their body images to be underweight, but female students perceived their body image to be overweight (x2=15.140, p=0.010). Wished body images were in counter directions. Male students wanted to gain weight, but female students wanted to lose weight (x2=39.432, p<0.001). In male students, overweight group had lower scores in total self-esteem, athletic competence and physical appearance than normal weight and underweight groups. In female students, overweight group had lower scores in physical appearance than normal weight and underweight groups. Self perception of body image was the most important factor in their total, athletic competence and physical appearance self-esteem. CONCLUSION: The self-esteem of early adolescents attributed to the self perception of body image and not by BMI or parent's perception of their child's body image.

Comparisons of Temperamental and Sociodemographic Characteristics in Three Groups of Preschool Children with Delayed Language Development / 신경정신의학

OBJECTIVES: Temperamental and sociodemographic characteristics of developmentally delayed preschool children have not been adequately studied. This research compares temperamental and sociodemographic characteristics in 3 groups of preschool children: those with communication disorder (CD), those with mental retardation (MR), and those with pervasive developmental disorder (PDD). METHODS: One hundred ninety eight preschool children (160 males, 38 females, average age 37.8 months) with delayed language development were included in this study. Developmental status of children was assessed by Bayley scales of infant development II, and temperamental characteristics were assessed by PTQ (Parental Temperamental Questionnaire). Sociodemographic characteristics of children were assessed with a questionnaire developed by us. Subjects were divided into three groups according to Bayley scale and Childhood autism rating scale (CARS). RESULTS: CD groups showed higher scores on rhythmicity and persistence than MR and PDD groups. CD group showed lower scores on threshold of reaction than MR group. On intensity of reaction and quality of mood, CD group showed higher scores than the PDD group. Sociodemographic characteristics were not different among the 3 groups. CONCLUSION: There are differences in temperamental characteristics but not in sociodemographic characteristics among CD, MR, and PDD.

The Effect of Donepezil on Language Functions in Children with Autism Spectrum Disorders / 신경정신의학

OBJECTIVES: Recent studies in autistic brain samples have shown diminished acetylcholine and nicotinic receptor activity. We hypothesized that acetylcholinergic enhancement may pharmacologically improve some autistic characteristics. Donepezil hydrochloride, a cholinesterase inhibitor, was studied in few studies which showed improvement in the expressive and receptive speech of autistic children. We therefore undertook an open label trial to evaluate this effect on speech function in Korean autistic children. METHODS: Twenty-one patients (18 males, 3 females, average age 77.9+/-23.7 months), with a diagnosis of autism spectrum disorder enrolled in a 12-week open label trial of donepezil hydrochloride. Changes were evaluated by PLS (Preschool language scale). Testing was administered at baseline and at 12-week follow-up. RESULTS: Test administered at baseline and at 12-week follow-up showed gains in both expressive and receptive speech functions. CONCLUSION: Donepezil hydrochloride, a cholinesterase inhibitor, appears to improve expressive and receptive speech functions of autistic children.

Temperament and Character Patterns of Patients with Attention Deficit Hyperactivity Disorder / 신경정신의학

OBJECTIVES: The purpose of this study is to compare temperament/character patterns of patients with attention deficit hyperactivity disorders with normal controls. METHODS: The Junior Temperament and Character Inventory was given to a clinical sample of one hundred-four patients with ADHD (all male, mean age 10.46+/-1.45) and their parents. The diagnoses were done using DSM-IV criteria. Fifty ones of the patients with ADHD were confirmed by K-SADS-PL-K. One hundred forty four normal controls (all male, mean age 13.26+/-0.26) and their parents were enrolled to compare temperament and character patterns with ADHD patients. RESULTS: Novelty seeking was significantly higher in parental JTCI of patients with ADHD. Reward dependence, persistence, self directedness, cooperativeness and self transcendence (ST23) were significantly lower in both self and parental JTCI of patients with ADHD. Using K-SADS-PL-K, ADHD patients were divided into three groups with their ADHD subtype (combined type: 32, inattentive type: 11, NOS type: 7). Self transcendence (ST23) in self JTCI was significantly lower in ADHD patients of the inattentive type than those of the combined type. CONCLUSION: The temperament and character patterns of ADHD patients were different from those of normal controls. Novelty seeking was significantly higher in the ADHD patients. Reward dependence, persistence, self directedness, cooperativeness, self transcendence (ST23) were significantly lower in the ADHD patients.

Childhood Psychopathology: Autistic Disorder and Developmental Language Disorder

No abstract available.