Childhood Anxiety Disorders

Jeewook Choi(최지욱) 대한소아청소년정신의학회 2011 대한소아청소년정신의학회 학술대회논문집 Vol.2011 No.6

약물 복용력이 없는 주의력결핍 과잉행동장애 아동에서의 뒤쪽 내정상태회로 이상

최지욱(Jeewook Choi),고효진(Hyo Jin Go),우영섭(Young Sup Woo),송승훈(Seung Hoon Song),양보성(Po Song Yang),정범석(Bumseok Jeong) 대한소아청소년정신의학회 2012 소아청소년정신의학 Vol.23 No.2

Objectives:Characteristic symptoms, including hyperactivity and easy distractibility, in children with attention-deficit hyperactivity disorder (ADHD) suggest that their brain status, even at rest, might differ from that of healthy children. This study was conducted in order to determine whether resting state brain activity is compromised in medication-naive children with ADHD. Methods:Twenty medication-naive children with ADHD (mean age 10.3±2.5) and 28 age- and gender-matched healthy volunteers (mean age 10.3±2.0) underwent measurements for resting state brain activity using functional magnetic resonance imaging (fMRI). Among resting state related-independent components (RSICs) extracted from fMRI data using independent component analysis, a significant difference in RSICs was observed between groups, using a mixed Gaussian/gamma model. Results:Except for IQ, which was higher in the healthy control group, no demographic difference was observed between the two groups (p<.001). Significantly less activation of one RSIC, which includes the bilateral precuneus/posterior cingulate cortex, occipito-temporal junction, and anterior cingulate cortex, was observed in the ADHD group, compared with the control group (p<.05). Conclusion:An abnormal RSIC, posterior default mode network (DMN), was observed in the medication-naive ADHD group. Results of our study suggest that abnormality of posterior DMN is one of the main pathophysiologies of ADHD.

코로나19가 성인 및 소아청소년에 미치는 영향과 지원 방안

최지욱(Jeewook Choi) 대한신경정신의학회 2021 신경정신의학 Vol.60 No.1

The coronavirus disease 2019 (COVID-19) pandemic is profoundly affecting human life around the world. While the mental health of patients and quarantined is of increasing concern, the general public’s mental health also requires significant attention. COVID-19 also has the potential to threaten the mental health of children and adolescents significantly. This paper reviews the effects of the pandemic on the mental health of the general public, including children and adolescents. The risk factors for mental health problems are also reviewed. South Korea has implemented preemptive and aggressive quarantine measures against COVID-19. Mental health professionals have performed various psychological services to support the general public immediately and actively. This paper presents those supporting measures and discusses their limitations. Recognizing the importance of the impact of the pandemic on the mental health of the general public, observing its direct and indirect consequences, and organizing a multi-disciplinary system based on empathy and collaboration are important for developing effective support measures. In particular, national policies and support are needed to implement them.

성인 주의력결핍 과잉행동장애의 약물치료

양재원(Jaewon Yang),김지훈(Ji-Hoon Kim),김재원(Jae-Won Kim),최지욱(Jeewook Choi),홍현주(Hyun Ju Hong),정유숙(Yoo-Sook Joung) 대한소아청소년정신의학회 2012 소아청소년정신의학 Vol.23 No.S

This review examined the treatment of attention-deficit/hyperactivity disorder (ADHD) in adults. It briefly addresses the issues about the cause of hospital visit, diagnosis, and impact of disease, specific to adults. The article focused on the evidence regarding the efficacy and tolerability of short- and long-acting stimulant medications, as well as the non-stimulant medications such as atomoxetine and bupropion in the treatment of the adult ADHD. Generally speaking, variability in diagnostic criteria, dosing parameters and response rates between the various studies were considerable. The aggregated literature shows that both the stimulants and non-stimulants had clinically significant beneficial effect on treating ADHD in adults. Special attention is given to the pharmacological treatment for patients with adult ADHD and various comorbidities. In summary, medications are effective and combined medication and psychosocial treatment is the most beneficial treatment option for most adult patients with ADHD.

주의력결핍 과잉행동장애 아동에서 틱 장애 동반 여부에 따른 확산 텐서 영상 비교 연구

최지욱,임명호,이창화,박진균,손정우,심세훈,유인규,강현수,정범석 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.5

Objectives : Diffuse tensor imaging (DTI) was applied to explore the difference in regional distribution and extent of white matter (WM) abnormalities in boys with Attention-deficit/hyperactivity disorder (ADHD) versus boys with comorbid ADHD and tic disorders. Methods : Fifteen boys with ADHD (mean age 9.3 +1.8), 24 ADHD boys with chronic tic disorder or Tourette's disorder(9.9 =b 1.2) and 9 age-, gender-matched controls (9.2 d= 1.8) received DTI assessments. Fractional Anisotropy (FA) maps of WM were compared between groups with a voxel-wise analysis after intersubject registration to MNI space. Results : Bo groups, ADHD group and ADHD with tic disorder group, commonly showed decreased FA than healthy control group in left cerebellar middle peduncle and right frontal lobe, increased FA in right middle occipital WM. In the common areas of left cerebellar middle peduncle and right middle occipital WM, comorbid group showed broader areas of significant FA. The comorbid group also showed increased FA in right cerebellar peduncle, additionally. Conclusion : The findings in ADHD group support previous ADHD hypothesis of the functional abnormalities in corticocerebellar circuit, and suggest that ADHD might have more complicated pathology of neuronal circuit including occipital visual system. The comorbid group showed common areas of overlapping but more extensive abnormalities and also had additional WM abnormalities. ADHD with chronic tic disorders may represent a severe form of ADHD with additional regions of abnormal connectivity.

정신분열병의 비이환 형제 자매 집단에서 얼굴 정보처리 관련 뇌회로의 이상 : 기능적 뇌자기공명영상 예비 연구

최경숙,정범석,김지웅,최지욱 大韓神經精神醫學會 2009 신경정신의학 Vol.48 No.2

Objectives A neural circuit including amygdala, the hippocampal complex and prefrontal cortex was associated with deficits in facial processing in schizophrenia. These deficits have a significant impact on social functioning in schizophrenia. Both neuropsychological deficits and brain structural abnormalities in first-degree relatives of schizophrenia patients suggest that they may also have the deficit in facial information processing as genetic factors. The purpose of this study was to explore the dysfunction of facial information processing in first-degree relatives of schizophrenia patients using functional magnetic neuroimaging (fMRI). Methods Ten non-affected siblings of schizophrenic patients and 10 normal comparison subjects having no schizophrenic siblings underwent fMRI during the dynamic facial change procedure consisting of presentations of facial emotion and gender discrimination stimuli. The emotion discrimination condition consisted of the presentation of 12 happy faces and 12 disgust/fear faces. The gender discrimnation condition consisted of the presentation of 12 male faces and 12 female faces. Condition-specific brain activations were compared between non-affected siblings and normal comparison subjects Results The facial information processing related brain regions including fusiform gyrus, several areas of frontal, temporal, occipital, and cerebellar regions exhibited more activation during gender discrimination than emotion discrimination tasks in each group. During gender discrimination task, siblings of schizophrenic patients showed less activation in right fusiform gyrus, both middle and superior frontal gyrus, left cuneus, and left inferior frontal gyrus, compared with normal comparison subjects. Conclusion Dysfunctional facial information processing, such as a deficit in gender discrimination, might be an endophenotype of schizophrenia.