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기분 장애 소아 청소년 환자에서 자살 행동, 공격 행동과 인지기능과의 관계
윤희준(Hee Joon Yoon),오윤혜(Yunhye Oh),정유숙(Yoo Sook Joung) 대한소아청소년정신의학회 2016 소아청소년정신의학 Vol.27 No.1
Objectives: The aim of this study was to examine the association between current suicidal or violent behavior and deficits of specific neurocognitive variables in child and adolescent inpatient samples diagnosed with mood disorder. Methods: A retrospective review of the charts of mood disorder patients hospitalized at Samsung Medical Center between April 2004 and April 2015 was conducted. Child and adolescent patients aged between 10 and 18 years old and those who finished neurocognitive function testing during their hospitalization were included. Among them patients whose full scale IQ was between 85 and 115 were selected (N=111). Participants were first divided into two age-groups–group Y (10≤age≤15, N=54) and group O (16≤age≤18, N=57)–because neurocognitive function test tools were different according to age [Wechsler Intelligence Scale for Children (WISC) for 10 to 15-year-old patients, Wechsler Adult Intelligence Scale (WAIS) for 16 to 18-year-old patients]. They were then divided according to their suicidal or violent behavior–non suicidal/violent group (NG), suicidal group (SG), violent group (VG), and both suicidal/violent group (BG). The Child Behavior Checklist (CBCL) was checked for measurement of participants’ behavior and the Gordon Diagnostic System was checked for measurement of their attention efficiency. Kruskal-Wallis Test and Tukey test was used to determine the differences in neurocognitive function between groups. Results: O-SG patients showed lower scores on the comprehension subscale of WAIS-III than O-NG patients (χ<SUP>2</SUP>=8.454, p=.015). O-VG patients showed lower scores on the block design subscales of WAIS than O-SG patients (χ<SUP>2</SUP>=7.496, p=.024). Y-VG patients showed higher scores in aggressive behavior, externalizing problems, and total problems scores of CBCL. Conclusion: This study showed relationship between specific neurocognitive deficits and suicidal or violent behavior. These relationships were significant in relatively older adolescents.
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발달장애 문제행동 치료 가이드라인 제작을 위한 다학제적 접근
홍경기(Kyungki Hong),송호광(Hokwang Song),오매화(Maehwa Oh),오윤혜(Yunhye Oh),박수빈(Subin Park),김예니(Yeni Kim),최성구(SungKu Choi) 대한신경정신의학회 2018 신경정신의학 Vol.57 No.2
Objectives : To initiate and develop a treatment guideline in multidisciplinary approaches for related professions who are either working and/or living with children and adolescents with neurodevelopmental disorders who show behavioral problems. Methods : To collect and reflect opinions from multiple professions who assumedly have different interventions or mediations on behavioral problems, a self-report survey and Focus Group Interview(FGI) were conducted for a group of child and adolescent psychiatrists, behavioral therapists, special education teachers, social welfare workers, and caregivers. Results : According to a self-report survey and FGI results from multiple professional groups, aggressive behavior is the mostly common behavioral problem necessitating urgent interventions. However, both mainly used intervention strategies and effective treatment methods were different depending on professional backgrounds, such as pharmacological treatment, parent training, and behavior therapy, even though they shared an importance of improving communication skills. In addition, there was a common understanding of necessity to include parent training in a guideline. Lastly the data suggested lack of proper treatment facilities, qualified behavior therapists, and lack of standardized treatment guideline in the field needed to be improved for a quality of current therapeutic services. Conclusion : It is supported that several subjects should be included in the guidelines, such as how to deal with aggressive behavior, parent training, and biological aspects of neurodevelopmental disorders. Also, it is expected that publishing the guideline would be helpful to above multiple professions as it is investigated that there are lack of treatment facility and qualified behavioral therapists compared to need at the moment.
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