Neuropsychological Outcomes of Preterm Birth in Children With No Major Neurodevelopmental Impairments in Early Life

OBJECTIVES: To investigate cognition, social adaptive functioning, behavior, and emotional development in the preschool period and to determine the effects of the age of onset of walking on those developmental areas in children who were born preterm without major neurodevelopmental impairments (NDI) early in life. METHODS: Fifty-eight children who were born preterm without major NDI early in life participated in this study. The Korean versions of the Wechsler Preschool and Primary Scale of Intelligence or the Bayley Scales of Infant Development, the social maturity scale, the Korean version of the Child Behavior Checklist (CBCL), Conners' abbreviated parent/teacher rating scale, the Childhood Autism Rating Scale, and a speech developmental test were administered. The participants were divided into two groups: early walkers (group A) and late walkers (group B). RESULTS: The full-scale intelligence quotient (IQ) and performance IQ were significantly lower in group B than in group A, while the verbal IQ did not differ significantly between the groups. The children in group B had greater risks of cognitive deficits than did the children in group A, especially in performance skills. The social quotient (SQ) was significantly lower in group B than in group A (p<0.05). The rates of mild or significant deficits based on SQ and the CBCL did not differ significantly between the groups. Four children in group A and one child in group B had attention/hyperactivity problems. One child in group A had autistic behavior. Only one child in group B showed a significant speech developmental delay. CONCLUSIONS: Problems in cognition, social adaptive functioning, and emotional and behavioral development can occur in children without major NDI early in life. Late walkers had significantly lower scores in cognition and social adaptive functioning than did early walkers.

Discriminant Validity of the CBCL 1.5-5 in Diagnosis of Developmental Delayed Infants

OBJECTIVES: The purpose of this study was to verify discriminant validity and the clinical cutoff score of Child Behavior Checklist 1.5-5 in the diagnosis of developmental delayed infants. METHODS: The participants were screened by Denver II which includes 156 developmental delayed infants and 288 normal infants. Chi-squared test, t-test, ROC curve analysis, odds ratio analysis were performed on the data. RESULTS: Only 47 items out of 99 items among the CBCL 1.5-5 of total groups, 36 items of boys and 48 items of girls, discriminated developmental delayed infants well. Discriminant validity was confirmed by mean differences on the subscales of Withdrawn, Sleep Problems, Attention Problems, Internalizing Problems, Externalizing Problems, Total Problems, DSM Pervasive Developmental Problems and DSM Attention Deficit/Hyperactivity Problems between the two groups. Additionally, ROC analyses demonstrated that Withdrawn, Attention Problems, Internalizing Problems, Total Behavior Problems and DSM Pervasive Developmental Problems significantly predicted developmental delayed infants compared to normal infants. Also, the clinical cutoff score criteria adopted in the Korean CBCL 1.5-5 for subscales of Withdrawn, Attention Problems, Internalizing Problems, Total Behavior Problems and DSM Pervasive Developmental Problems were shown to be valid. CONCLUSION: The subscales of Withdrawn, Attention Problems, Internalising Problems, Total Behavior Problems and DSM Pervasive Developmental Problems significantly discriminated in the diagnosis of developmental delayed infants well.

Relationship of Language, Intelligent and Social Quotients in Children with Speech and Language Disorder

OBJECTIVE: To investigate the relationship of language, intelligent and social quotients in children with speech and language disorder and to evaluate the clinical usefulness of language quotient for predicting the extents of cognitive and social functions. METHOD: Total 139 children who visited the department of rehabilitation medicine for the evaluation of suspected speech-language delay. All children were evaluated for receptive and expressive language quotients, articulation accuracy, verbal, performance and full-scale intelligent quotients and social maturation assessment. RESULTS: Approximately 70% of the children who had chief complaints of speech or language disorder were diagnosed as 'receptive and expressive language developmental delay'. Intelligent and social quotients of the children with receptive and expressive language developmental delay were significantly lower than those of the other groups (p<0.05). Both receptive and expressive language quotients, but not dysarticulation, were significantly correlated with intelligent and social quotients (p<0.05). Multiple regression analysis demonstrated that the language quotients could predict intelligent and social quotients as simple equations (p<0.01). CONCLUSION: Primary result of receptive and expressive language quotients from screening test of language evaluation might be able to predict cognitive function and social maturity, which also showed high-degree positive correlation with intelligent and social quotients. This result could provide a useful guideline for further developmental studies in children with speech and language disorder who received primary speech evaluation.

The Comparison of Post-stroke Related Depression Scales

OBJECTIVE: To compare the characteristics between geriatric depression scale (GDS), Hamilton depression rating scale (HDRS) and post-stroke depression scale (PSDS) in the aspect of diagnosis and severity assessment for post-stroke depression. METHOD: 45 post-stroke patients were included for this study. Subjects were classified through DSM-IV criteria into three different groups; depression-free, minor depression and major depression. GDS, HDRS, PSDS were also assessed in all subjects simultaneously. Three depression assessment scales were compared between groups based on DSM-IV criteria, and the sensitivity and specificity using cut-off value were analyzed. RESULTS: All scales showed the significant differences between depression group and depression-free group. GDS showed higher sensitivity and specificity than HDRS and PSDS and GDS showed the significant difference between minor depression and no depression group, but other scales did not. HDRS and PSDS in major depression group showed the significant differences compared with minor depression group (p<0.05), but GDS did not. CONCLUSION: GDS may be more useful to identify the presence of depression compared to GDRS and PSDS. However, to measure the severity of depression, HDRS and PSDS may be more useful than GDS.

Macronutrient, Mineral and Vitamin Intakes in Elderly People in Rural Area of North Kyungpook Province in South Korea

Poor dietary habits and inadequate nutrient intakes are of concern in the elderly, even it is worse in rural areas. In the present study, we conducted the anthropometric measurement and the dietary intakes including macronutrients, minerals and vitamins to assess the nutrient intakes and nutritional risk in elderly people in rural kyungpook province in South Korea. Subjects (n = 168, mean age, 67.3 yrs) were interviewed using d general questionnaire and 3 days of 24-hours recall for dietary intake. Nutrient intakes were analyzed using CAN-pro soft program and compared to Korean RDA and nutrition reference values (NRV). The anthropometric measurement showed that the weight and the height of the subjects in the rural area were below the average of the same age of Korean elderly people. The energy and protein intakes were 85% and 90% of Korean RDA, respectively. The intakes of lipid, cholesterol and dietary fiber were 62%, 40% and 22% of NRV for Korean adults. Main sources for protein and lipid intakes came from the vegetable sources and this pattern was more prominent in female elderly people. Ca intake was half of Korean RDA (56%), while P intake was 132% of Korean RDA. For the antioxidant trace mineral (Fe, Cu, Mn, Zn, and Se) intakes, Fe and Zn intakes were 78% and > 103% of Korean RDA. Cu, Mn and Se intakes were > 113%, > 275%, and > 185% of Korean NRV. Thiamin, niacin and vitamin C intakes were above Korean RDA, but the intakes of vitamin A and riboflavin were 88% and 63% of Korean RDA, respectively. On summarizing the results of the present study, the elderly people in rural area consume less lipid, cholesterol, Ca, and dietary fiber. Ca intake is lower, while P intake is higher, and this would be the potential risk for bone health. Also, Na intake was high, which can be the potential risk for the cardiovascular disease prevailance. Vitamin intakes were fairly good status, excepting riboflavin. Antioxidant mineral intakes were much higher than Korean NRV, unexpectedly. The results suggest that the elderly people in rural area have inadequate intakes of protein, lipid, dietary fiber and Ca, which mainly should be supplied from animal products. Recommendations to increase diet variety would be emphasized for this nutritionally poor-conditioned subjects, specially including animal food products and high dietary fiber food.

Relation Dietary and Urinary Na, K, and Ca Level to Blood Pressure in Elderly People in Rural Area

It has been considered that high Na intake, and low Ca/K intake are related to the incidence of hypertension. In this preliminary study, dietary Na, K, and Ca intake and their urinary excretion in rural area in Kyungpook province were measured to recognize the relationship between those blood pressure-related minerals and blood pressure regulation in elderly people in rural area of South Korea. Sixty eight subjects (male 39, female 29) aged over 60 were randomly selected in rural area in South Korea. Blood pressure and soup saltness were measured, and dietary intake using 24 hours recall and urinary excretion of Na, K and Ca were measured. Depending on the blood pressure level, the data were analyzed using non-parametric ANOVA of Kruskal Wallis analysis on the basis of categorizing of one of four blood pressure groups, such as normal, high normal, hypertension I and hypertension II. Mean systolic (124.2+/-15.1 mmHg) and diastolic (79.0+/-10.2 mmHg) blood pressures were within the normal range. Soup saltiness and systolic pressure was positively correlated (p<0.05). Even without statistical significance, dietary Na intake was higher in the upper systolic blood pressure groups then in the lower ones, which suggested higher Na intake caused the increase of blood pressure. No consistency was shown between the urinary concentration of Na, K, Ca level and blood pressure level, respectively. From the results of this study, it is assumed that high Na intake might be related to the incidence of hypertension. Further study with large sample size is needed to supplement the limitation of this preliminary study.

Evaluation of Sexual Function in Adults with Cerebral Palsy

OBJECTIVE: To investigate current status of psychosexual function in adults with cerebral palsy (CP) by Derogatis Sexual Functioning Inventory (DSFI), which is a widely used multidimensional measure of sexual functioning. METHOD: Forty-two adults with CP and 150 healthy controls participated in this study. All participants were interviewed with DSFI, which consisted of 10 domains such as sexual information, experience, drive, attitude, psychological symptoms, affect, gender role, fantasy, body image and satisfaction. RESULTS: Adults with CP showed significantly lower scores in sexual information, experience and satisfaction, and higher scores in psychological distress symptoms and conservative attitude, compared with controls (p<0.05). Especially, unmarried men with CP had a significant sexual dysfunction in most substantive domains of DSFI (p<0.05). However, there was no statistical difference in married men, unmarried women and married women, compared with normal controls. Sexual experience, drive, body image and satisfaction were significantly distressed in non-ambulatory CP, compared with functional ambulators (p<0.05). The score of sexual satisfaction had a significant relationship with those of sexual experience, attitude, psychological symptoms and body image in adults with CP (p<0.05). CONCLUSION: Adults with CP showed a distress in psychosexual functioning, especially in unmarried men and non- ambulators. Therefore, active interventions of sexual counseling and education will be helpful for enhancing their sexual function.

Evaluation of Sexual Function with Derogatis Sexual Functioning Inventory (DSFI) in Spinal Cord Injured Men

OBJECTIVE: To investigate the current state of the psychological aspects for the sexual function in spinal cord injured (SCI) men and to provide a basis of sexual rehabilitation program. METHOD: Seventy-seven spinal cord injured men and 87 healthy adults participated and completed Derogatis Sexual Functioning Inventory (DSFI). This questionnaire consisted of 10 subtests such as sexual information, experience, drive, attitude, psychological symptoms, affect, gender role, sexual fantasy, body image, and sexual satisfaction. RESULTS: Compared with healthy adults, SCI men had lower sexual experience, drive and satisfaction with a statistical significance (p<0.05). They also had more psychological distress symptoms, negative affect, and negative body image (p<0.05). There was no significant differences between tetraplegia and paraplegia, complete and incomplete injury, nor inpatient and outpatient. However, the SCI men with independent mobility had significantly greater sexual satisfaction, compared with the SCI men with dependent mobility (p<0.05). CONCLUSION: Most SCI men had psychologic sexual dysfuctions as well as organic problems, especially among the married men with dependent mobility. We suggest that more aggressive intervention of sexual rehabilitation need to be provided for this group.

Effects of Sports Activity in Spinal Cord Injured Persons

OBJECTIVE: The purpose of this study is to evaluate the effects of regular sports activity on psychosocial adaptation, natural killer cell activity (NKCA) as an immunologic measure and HDL-cholesterol level as an indirect index of heart disease in chronic spinal cord injured persons. METHOD: We compared two groups. One is sports group (n=13) who has been doing regular sports activity more than three hours a week for at least one year. Another group who leads sedentary life matched age and body mass index served as a control group (n=13). For the evaluation of psychosocial adaptation, we assessed Rosenberg Self Esteem Scale as subjective measure, Craig Handicap Assessment and Reporting Technique (CHART) as objective measure and Symptom Checklist 90 Revision (SCL-90-R) as a psychologic evaluation. NKCA and serum HDL-cholesterol level were assessed. RESULTS: There was no significant difference in subjective measure and psychologic evaluation between two groups. CHART score and NKCA are significantly higher in the sports group than in the control group (p<0.05). HDL cholesterol level was increased in the sports group compared with the control group. CONCLUSION: Participating in regular sports activity improved the psychosocial adaptation and immune system in chronic spinal cord injured persons.