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한국어판 DISC-IV(Diagnostic interview schedule for children version IV)의 신뢰도 및 타당도
조수철(Soo-Churl Cho),김붕년(Boong-Nyun Kim),김재원(Jae-Won Kim),김효원(Hyo-Won Kim),최현정(Hyun-Jeong Choi),정선우(Sun-Woo Jung),양영희(Young-Hui Yang),정동선(Dong-Seon Chungh),고복자(Bock-Ja Go),김봉석(Bong-Seog Kim),신민섭(Min-Sup 대한소아청소년정신의학회 2007 소아청소년정신의학 Vol.18 No.2
주의력결핍/과잉행동장애와 양극성장애 공존 환아군과 주의력결핍/과잉행동장애 환아군의 비교연구
정동선,하규섭,정희연,구훈정,황준원,김붕년,신민섭,조수철,홍강의 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.6
Objective : Attention deficit hyperactivity disorder (ADHD) is frequently comorbid with a variety of psychiatric disorders. Among them, bipolar disorder (BPD) has especially attracted growing interest. This is partly due to the fact that early onset BPD has been frequently misdiagnosed as ADHD because of symptomatic overlap. The aim of the present study is to find the differences in demographic data and clinical features of ADHD+BPD and ADHD in children and adolescents. Method : Children and adolescents patients participating in the present study have been enrolled at the child psychiatric clinic since 2004. 14 patients meeting the DSM-IV chteria for ADHD+BPD and 19 patients meeting the criteria for ADHD and 15 healthy comparison subjects were recruited. All groups were evaluated through the Schedule for Affective disorders and Schizophrenia for School-Age Children-Present and Life Time version-Korean version (K-SADS-PL-K). Demographic data and clinical charactehstics of the subjects were also collected. Parents were asked to complete the Child Behavior Check List(CBCL) and the Toddler Temperamental Scale (TTS) clinical ratings were obtained using the Young Mania Rating Scale(YMRS), the Children's Depression Iventory (CDI) and the Dupaul ADHD scale. Clinical variables between ADHD+BPD and ADHD were analyzed using the Mann-Whitney U test. YMRS, CDI, Dupaul ADHD scale (inattention and hyperactivity), CBCL, and TTS among the three groups were analyzed using the Kruskal-Wallis test with post-hoc Mann-Whitney U test. Results : 1) ADHD+BPD group had an earlier onset age of ADHD than ADHD group 2) ADHD+BPD group had more co-morbid psychiathc disorders than ADHD group. 3) Compared to ADHD group, ADHD+BPD had more psychiathc family history, especially mood disorders. 4) ADHD+BPD group had prodromal symptoms such as irritability, anger dyscontrol and academic dysfunction, compared to ADHD group who rarely showed prodromal symptoms. 5) ADHD+BPD group had higher ADHD scores than the ADHD group in the Dupaul ADHD inattentive scale. 6) In global functions of CBCL, ADHD+BPD group showed more impaired functions at home and school than ADHD group. 7) In Attention diagnostic system (ADS), ADHD+BPD group had more omission and commission errors than ADHD group, especially in the visual system. 8) In the subtests of the IQ profile, ADHD+BPD group had lower arithmetic and block design scores than ADHD group. Conclusion : Clinicians have to rule out underlying bipolarity in children and adolescents with ADHD who show earlier age of onset and severe clinical features. Bipolarity should be explored intensively in ADHD children and adolescents who have early onset of symptoms and severe functional impairment.
정신병에서 Risperidone 사용으로 인해 유발된 조증
정동선,한상우,한선호 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.2
Risperidone은 강력한 도파민(D₂)과 세로토닌(5-HT₂) 수용체 길항작용을 지니는 새로운 계열의 비전형 항정신병 약물중 하나이다. 최근 몇 년간에 걸쳐 분열정동형 장애나 정신분열병을 치료하는 과정에서 risperidone으로 인해 유발된 조종중상에 관한 여러 보고가 있어왔다. 우리는 2명의 정신분열 병 환자와 1명의 amphetamine 정신병 환자에서 risperidone으로 인해 유발된 조증 3례를 보고하고자 한다. 이런 현상은 risperidone이 다른 항정신병 약물과는 구별되는 강력한 후 시냅스 5-HT₂ 수용체 길항작용 때문인 것으로 추측된다. 그리하여 risperidone에 의한 세로토닌 수용체 차단작용을 정동장애에서 보여 지는 것과 유사한 세로토닌 결핍을 초래하고 조증을 유발시킨다. 그러므로 우리는 정신병을 치료하는데 risperidone의 사용에 주의를 기울여야 할 것 같다. Risperidone is one of a new class of atypical antipsychotic drugs that combines potent dopamine(D₂) and serotonin(5-HT₂) receptor antagonist properties. In the last few years there have been several report of risperidone-induced manic symptoms during treatment of schizoaffective disorder or schizophrenia. We report three cases of mania developed in two schizophrenia patients and one amphetamine-induced psychotic disorder which appear to have been precipitated by risperidone. This inducing effect might be attributed to its ability to block postsynaptic 5-HT₂ receptors, a property that distinguishes it self from other antipsychotic agents. The blocking of serotonin receptors by risperidone may create a perceived depletion of serotonin similar to that seen in affective disorder and lead to mania. Therefore, we should be cautious in the treatment of psychotic disorder with risperidone.