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.

Development of Parental Screening Questionnaire for Hidden Youth

OBJECTIVES: The definition of a hidden youth is a young person who has completely withdrawn from society and shut himself or herself away for more than 3 months. Those pathologically-withdrawn youths have become a burden not only to society but also to the family. However, screening of these hidden youths cannot be done easily. This study focused on developing a primary effective screening tool for these hidden youths. METHODS: The 42 participants of this study were parents of hidden youths that are between 8 to 25 years old. They were selected from from mental health centers and psychiatric clinics around Seoul and Gyeonggi Province. We also recruited 239 parents of middle and high school students in the Seoul metropolitan area for a control group. In order to decide the concurrent validity of this questionnaire, we used the Symptom Checklist-90-Revision, Children's Depression Inventory, Beck Depression Inven-tory, Social Anxiety Scale for Children-Revised, Social Anxiety and Distress Scale, Avoidant Personality Disorder Scale, and State-Trait Anxiety Inventory for Children. SPSS version 12.0 was used for statistical analysis. RESULTS: Cronbach's alpha values, the reliability coefficient to represent internal consistency, were between 0.396 and 0.935, which showed relatively high internal consistency for this questionnaire. The test-retest coefficient was between 0.68 and 0.78, which was a statistically significant result. In a factor analysis, 4 factors such as avoidance, withdrawal, isolation, and apathy were extracted. In a concurrent validity test with SCL-90-R, the isolation factor showed a statistically-significant relationship with a phobic-anxiety sub-scale, and avoidance and withdrawal sub-scales were remarkably correlated with the interpersonal sensitivity sub-scale. CONCLUSION: Since the questionnaire for socially withdrawn youths has achieved statistically-satisfactory reliability and validity, it will be a useful method to screen for hidden youths in educational, community, and clinical settings.

Development of Parental Screening Questionnaire for Hidden Youth

OBJECTIVES: The definition of a hidden youth is a young person who has completely withdrawn from society and shut himself or herself away for more than 3 months. Those pathologically-withdrawn youths have become a burden not only to society but also to the family. However, screening of these hidden youths cannot be done easily. This study focused on developing a primary effective screening tool for these hidden youths. METHODS: The 42 participants of this study were parents of hidden youths that are between 8 to 25 years old. They were selected from from mental health centers and psychiatric clinics around Seoul and Gyeonggi Province. We also recruited 239 parents of middle and high school students in the Seoul metropolitan area for a control group. In order to decide the concurrent validity of this questionnaire, we used the Symptom Checklist-90-Revision, Children's Depression Inventory, Beck Depression Inven-tory, Social Anxiety Scale for Children-Revised, Social Anxiety and Distress Scale, Avoidant Personality Disorder Scale, and State-Trait Anxiety Inventory for Children. SPSS version 12.0 was used for statistical analysis. RESULTS: Cronbach's alpha values, the reliability coefficient to represent internal consistency, were between 0.396 and 0.935, which showed relatively high internal consistency for this questionnaire. The test-retest coefficient was between 0.68 and 0.78, which was a statistically significant result. In a factor analysis, 4 factors such as avoidance, withdrawal, isolation, and apathy were extracted. In a concurrent validity test with SCL-90-R, the isolation factor showed a statistically-significant relationship with a phobic-anxiety sub-scale, and avoidance and withdrawal sub-scales were remarkably correlated with the interpersonal sensitivity sub-scale. CONCLUSION: Since the questionnaire for socially withdrawn youths has achieved statistically-satisfactory reliability and validity, it will be a useful method to screen for hidden youths in educational, community, and clinical settings.

Insecure Attachment and Impulsivity-Inattention Problem in Adolescent with a High Risk of Substance or Internet Addiction / 신경정신의학

OBJECTIVES: This study was done in adolescents with a high risk of substance or internet addiction in order to confirm the assumption that insecure attachment formation and impulsivity-inattention problems are major risk factors in adolescent addictive behavior. METHODS: 2,188 middle and high school students including a nicotine dependent treatment group were assessed using self-reporting scales : Adolescent Drinking Index (ADI), Fagerstrom Tolerance Questionnaire, Young Internet Addiction Scale, Revised Adult Attachment Scale (RAAS), and the Conner and Well's Self-reporting Scale for ADHD (CASS) were used. Subjects were classified into risk groups including substance addiction, internet addiction, as well as a combined group. RESULTS: Significant correlations were found between attachment formation and internet addiction tendencies, with respect to dependence, anxiety, and closeness (r=-0.185, r=0.248, r=-0.147, p<0.01, respectively). Impulsivity-inattention problems had positive correlations with internet addiction, alcohol addiction and nicotine addiction groups (r=0.345, r=0.211, r=0.187, p<0.01). With regard to attachment formation, the four groups showed significant differences regarding dependence (F=19.427, p<0.01), anxiety (F=28.926, p<0.01), and closeness (F=12.853, p<0.01). In addition, the four groups showed significant difference with respect to impulsivity-inattention problems (F=83.857, p<0.01), of which the combined risk group showed the highest scores, and the non-addicted group had the lowest scores. CONCLUSION: Insecure attachment formation and impulsivity-inattention problems were major risk factors for adolescent addictive behavior including internet addiction.

Serum S100B Protein in Medication-Free Schizophrenic Patients

OBJECTIVES: Previous studies have suggested that S100B protein play an important role in the pathogenesis and progress of schizophrenia. In the present study, we evaluate the serum levels of S100B in the patients with schizophrenia, and compare them with those of healthy controls. METHOD: The serum S100B levels were measured by lectrochemiluminescence immunoassay in 21 schizophrenic patients(8 males, 13 females) and 27 normal controls(11 males, 16 females). The Positive and Negative Syndrome Scale(PANSS) was used to evaluate the symptoms of the patients with schizophrenia, and the correlation between PANSS subscale scores and serum S100B levels was examined. RESULTS: No significant difference was found between the serum S100B levels of the schizophrenic patients(0.074+/-0.039ng/ml) and those of the normal controls(0.072+/-0.030ng/ml)(p=0.925). Correlationships between the high serum S100B level with high negative symptom scores(p=0.065) or with the low positive symptom scores(p=0.080) did not exist. CONCLUSION: The relation between serum S100B level and schizophrenia was not found in the present study. However, to confirm this result, further studies, such as measurement of S100 protein level in CSF, postmortem study, long-term follow-up study, and studies with other neurotrophic proteins are needed.