The Effects of Narrative Therapy for Children with Attention Deficit Hyperactivity Disorder / 신경정신의학

OBJECTIVES: Clinical symptoms and related psychological problems in children with attention deficit hyperactivity disorder (ADHD) are associated with low self-control and problematic interpersonal relationship between family members. A therapeutic narrative treatment based on "Treating Huckleberry Finn" by David Nylund was reported to be effective in reduction of individual or family conflicts. We hypothesized that therapeutic narrative treatment would improve self-control and parent-child relational problems. METHODS: Sixteen children who were diagnosed as ADHD participated in the current study. They were classified according to two groups, narrative treatment group and medication treatment group. The narrative treatment group (NTG) was asked to participate in 6 weeks combined therapy of medication and 11 sessions of narrative therapeutic treatment. The medication group (MG) was asked to participate in 6 weeks combined therapy of medication and education for behavior controls in ADHD children. RESULTS: During the 6-week treatment period, the clinical symptoms in NTG improved at a trend level, compared to MG [F(1,16)=4.32, p=0.054]. During the 6-week treatment period, the sub-scale of respecting for children in parent-child interaction scores [F(1,16)=8.65, p=0.010] and self-control scores [F(1.16)=3.78, p<0.01] in NTG improved significantly, compared to MG. CONCLUSION: Based on the current results, therapeutic narrative treatment can be a complementary trial for improving self-control and parent-child interaction in children with ADHD.

Internet Gaming Disorder Treatment Options in the Hospital Setting

Internet gaming disorder (IGD), one of the common subtypes of internet addiction, is now classified in Section 3 of DSM-5 and is increasingly regarded as a growing health concern in many parts of the world. Consequently, many psychotherapeutic and psychopharmacological approaches have been considered and some research regarding therapeutic strategies has been conducted. However, treatment of IGD is in its early stages and therefore is not yet well established. This article reviews multiple therapeutic modalities including our own treatment model for IGD according to clinical and biological effects, thus providing suggestions for standard treatment strategies. The two main streams are psychopharmacological treatment and cognitive-behavior treatment, and the cognitive-behavior approach includes cognitive reconstruction, psychoeducation, and parenting coach. Many other non-pharmacological treatments are also recommended for personalized treatment of IGD.

The Effect of Living with Spouse on Cognitive Decline and Depressive Symptom in Elderly People

OBJECTIVE: The aim of this study was to determine whether living with spouse contributes to cognitive decline and depressive symptom among elderly people. METHODS: 939 participants were recruited through Keum-Cheon center for dementia in Seoul. All subjects were assessed using the Korean version of Mini-Mental Status Examination (MMSE-K), Korean version of Consortium to Establish a Registry for Alzheimer's disease (CERAD-K) and Geriatric Depression Scale (GDS). Furthermore, epidemiological factors (age, sex, education year, and characteristics of family) assessed to find correlation with cognitive decline. RESULTS: Controlling for gender, age, and education year, living with spouse was significantly associated with cognitive decline (B=-0.486, S.E=0.203, Wald=0.331, Exp (B)=1.107, p=0.01). Living with spouse group has lower depressive symptom, compared to living without spouse group (F=14.6, p<0.01). CONCLUSION: Correctly, our results suggest that spouse absent state may accelerate cognitive decline and depression. Further, elderly people living alone should be closely monitored for both depression and cognitive impairment.

A Case of Very-late-onset Schizophrenia-like Psychosis

This paper presents the case of a 67-year-old woman who visited the Psychiatry Department complaining of persecutory ideas and auditory hallucinations after a buccal cancer operation. On neuropsychological testing, she demonstrated paranoid psychosis and bizarre thoughts. Hospital admission was recommended for supportive care and treatment with antipsychotics. She was initially treated with olanzapine, but this medication had little effect and was replaced with amisulpride, which reduced the residual symptoms. The aim of this report was to discuss the diagnostic process and treatment of very late-onset schizophrenia-like psychosis.