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한국판-Gilliam 자폐증 평정척도-2(K-GARS-2) 표준화 연구
진혜경,윤혜주,박진박 대한생물치료정신의학회 2011 생물치료정신의학 Vol.17 No.2
Objectives:Autism is one of the most important developmental disorder of childhood, which has been studied in many fields of research. The importance of early detection, diagnosis and early treatment of autism has been emphasized in Korea. However, appropriate diagnostic tools to meet these needs, were insufficient. With increasing number of autistic adults, a need for diagnostic tool which can cover wide range of age has emerged. The Gilliam Autism Rating Scale-2(GARS-2) is based on Autism Society of America and DSM-IV-TR(Diagnostic and Statistical Manual of Mental Disorders-fourth Edition-Text Revision) diagnostic criteria for autism. It is the only available test so far. The target age of this test is from 3 years to 22 years old with autism, therefore this test is thought to be valuable. In this study, Korean-Gilliam Autism Rating Scale-2(K-GARS-2) was standardized, and verified the reliability, validity. Methods:K-GARS-2 was standardized and the reliability, validity was evaluated for 109 patients with autism aged 3 to 22 years. Results:Cronbach’s alpha coefficient of K-GARS-2 is 0.94 in the total 42 items and reliability was verified. KGARS-2 standard scores were highly correlated with scores of CARS and also Items-discrimination coefficients also showed a high correlation. Autism subscale standard score and the Autism quotient also showed a strong correlation. When compared with the other mental disorder groups, autism group show significantly higher scores. Conclusion:With the increasing prevalence of autism, the importance of accurate diagnosis and therapeutic approach is increasing in Korea. In this perspective, K-GARS-2 standardization process is very meaningful.
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소아청소년 자폐 스펙트럼장애에서 메칠페니데이트 사용의 임상적 특징에 대한 후향적 분석
박진박(Jin-Park Park),이종일(Jong-Il Lee),진혜경(Hea-Kyung Jhin),민혜지(Hae-Ji Min),황준원(Jun-Won Hwang),김예니(Yeni Kim) 대한소아청소년정신의학회 2012 소아청소년정신의학 Vol.23 No.3
Objectives:The purpose of this study was to investigate clinical characteristics of children and adolescents with autism spectrum disorders (ASDs) using methylphenidate (MPH). Methods:Retrospective review of the charts of 79 children and adolescents with ASDs, who visited the Department of Child and Adolescent Psychiatry of Seoul National Hospital, from July 2010 to July 2011, was conducted. Changes in illness severity and improvement were measured using the Clinical Global Impression-Severity of illness (CGI-S) and Clinical Global Impression-Improvement (CGI-I) Scales. Results:We found that MPH was prescribed in 23 (29.1%) children and adolescents. Of the 23 patients on MPH, 4 patients (17.4%) were on MPH monotherapy and 18 patients (78.3%) were using risperidone concomitantly. MPH was prescribed primarily for symptoms of hyperactivity and impulsivity in ASDs patients. The mean dosage of MPH was 26.2±11.1㎎g/day and mean duration of treatment was 31.9±28.7 months. Mean CGI-S score improved significantly from baseline to endpoint (from 5.4±0.6 to 4.1±0.9 ; p<.01). MPH was reported to be effective in 17 patients (17/23, 73.9%), and 10 patients (10/23, 43.5%) reported side effects. Side effects included decreased appetite (4/23, 17.4%), tic (2/23, 8.6%), sleep disturbances (2/23, 8.6%), headache (1/23, 4.3%) and irritability (1/23, 4.3%). Conclusion:The results of this study demonstrate that MPH may be used effectively and safely in children and adolescents with ASDs with hyperactivity and impulsivity. Future controlled trials are needed to confirm these findings.
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소아청소년 자폐성 스펙트럼 장애에서 SSRI 장기 사용에 대한 후향적 분석
구애진,박진박,이종일,진혜경,김예니,Goo, Ae-Jin,Park, Jin-Park,Lee, Jong-Il,Jhin, Hye-Kyung,Kim, Yeni 대한생물정신의학회 2012 생물정신의학 Vol.19 No.4
Objectives The purpose of this study was to investigate clinical profile, efficacy, and safety of long-term treatment with selective serotonin reuptake inhibitors (SSRIs) in Korean autism spectrum disorders (ASDs) patients. Methods Effectiveness was assessed through a retrospective review of self-reported target symptom improvement at the last follow-up visit. Changes in illness severity and improvement were measured using the Clinical Global Impression-Severity (CGI-S) of illness and Clinical Global Impression-Improvement (CGI-I) Scales. Tolerability was assessed through a review of the reason for discontinuation of SSRI and documented adverse events. Results A total of 21 ASDs patients (aged 9 to 19 years) treated with SSRI during July 2010 to July 2011 in department of child and adolescent psychiatry of Seoul National Hospital were identified. The mean duration of SSRI treatment was 47.9 (standard deviation = 36.9) months (range 0.7-114.5), and the mean fluoxetine equivalent dosage of SSRIs was $27.1{\pm}10.8$ mg. Nineteen (90.5%) patients were using concomitant medication. We found that SSRIs were prescribed for symptoms of agitation, stereotyped behavior, aggression, depression, impulsivity and self-injury in ASDs. Ten patients (47.6%) reported improvement in their target symptom after SSRI treatment based on CGI-I scores (CGI-I ${\leq}$ 2). The side effects were reported in 5 patients (23.8%) ; vomiting (n = 2, 9.5%), excessive mood elevation (n = 1, 4.8%), insomnia (n = 1, 4.8%), somnolence (n = 1, 4.8%) and decreased appetite (n = 1, 4.8%). Self-injurious behavior was reported in one patient (4.8%). Conclusions The results of this study suggest that SSRIs may be used effectively in children and adolescents diagnosed with ASDs. However, safety issues need to be considered carefully when choosing SSRIs for treatment. Future controlled trials are needed to confirm these findings.
KCI
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