Volume 21(3); March

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Journal of the Korean Pediatric Society 1978;21(3):198-206.
Published online March 15, 1978.
Clinical Evaluation of Children with Psychiatric Problems among Pediatric Patients.
Kyung Tai Whang, Byung Churl Lee, Sung Hoon Cho, Haeng Sook Kim
Department of Pediatrics, Catholic Medical College, Seoul, Korea.
Abstract
Patients who visited to the pediatric department sometimes present psychiatric problems, but this interesting field seems to have been neglected frequently by clinicians. The authors were analyzed 130 cases of pediatric patients who referred to psychiatric department for the evaluation of psychiatric problems from July, 1974 to June, 1977 at the St. Mary's hospital, Catholic medical college. The results were as follows: 1. Of the 130 children, 63.1% were male and 36.9% were female and the ratio was 1.7:1. The majority of the patients (68.4%) fall into the age group of primary school children. 2. In sibling order, the first and second child were occupied of 60.8% of total patients. The frequency of only son and daughter among the observed children were 28.5%. 3. Ten major reasons for referral in the order of frequency were somatic compainlts (23.9%), anxiety (6.7%), conversion symptom (5,7%), sleep disturbance (5.4%), convulsive disorder (5.0%), tic (4.7%), depression (4.4%), hyperactivity (4.0%), over sensitivity (2.7%) and aggressive behavior (2.7%). There were diffierent reasons for referral by sex. Somatic complaints were the most common reason in both sex, but convulsive disorder and tic were more common in male and anxiety and depression in female respectively. 4. Neurosis (40.0%) was the most common psychiatric diagnosis found on consultation and the other frequent diagnosis were organic brain syndrome (15.4%), transient situational disorder (14.6%), special symptom (10.8%) and psychophysiologic disorder (9.2%). 5. The primary physician's reason for referral correlated with the psychiatric diagnosis. When a child was referred for a somatic complains on the pediatric clinic he was more likely to be a neurosis, transient situational disorder and psychophysiologic disorder than to have any other diagnosis. Referral for convulsive disorder and hyperactivity were associated with the diagnosis of organic brain syndrome and conversion symptoms with neurosis respectively. Also the reason for referral correlated with the school age group. Hyperactivity and sleep disturbance were more common in preschool age group and somatic complaints in middle school age group respectively.




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