정신병동에 입원한 중학생환자의 임상적 고찰

Clinical Characteristics of Early Adolescents Admitted to Psychiatric Ward

This is a retrospective study on clinical features and socioenvironmental factors of 34 early adolescents, who were admitted to a psychiatric ward for the first time from July 1979 to December 1981. Inpatient charts of the subjects were reviewed in detail. A follow-up study was carried out and it was possible to locate 20 subjects who were visited, or telephone interviewed regarding their post-discharge adjustment. The results were as follows. 1. The diagnostic distributions were the schizophrenics (29.4%), somatoform disorders (23.5%),schizophreniform disorder (17.6%), affective disorder (8. 8% ), Tourette disorder (2. 9%). 2. The most frequent presenting symptom was behavioral symptoms and the nexts were emotional symptoms, interpersonal relationship problems, somatic complaints, sleep problems in order of frequency. 3. 61.896 of the subjects was the first or only child. Nearly a half of the subjects did not have good relationship with their parents. Their attitudes toward their fathers were indifferent or avoidant, in contrast, they were indifferent or resistant and rebellious to their mother. Almost 8096 of the subjects parent had some form of marital problems. A family history of psychosis was found in 20% of the subjects. 4. 70% of the subjects reported that they experienced major life change within 1 year prior to admission. They were separation from parents (26.5%) , illness in family member (20.696), economic bankruptcy (11. 8% ), change of school (11.8%). 5. 20 subjects were able to be located for the follow-up study and 14 subjects couldn t be interviewed because of unknown address (10), imigration (3) and one subject died from brain tumor who were misdiagnosed as hysterical conversion. 6. The follow-up assessment revealed that schizophrenics, Tourette disorder, borderline personality disorder did not do well at all after discharge while schizophreniform disorder, affective disorder, somatoform disorder showed satisfactory adjustment. 7 subjects (3 schizophrenics. 1 schizophreniform disorder, 1 affectjve disorder, 1 borderline personality disorder, 1 adjustment disorder) were not attending to school at the time of follow-up study. Relationship with family memlpers improved in the half of the Gases. One subject originally diagnosed as schizophreniform disorder and the other as adjustment disorder during admission appeared to be schizophrenics at the time of follow-up study. 7. In conclusion, junior high school period, corresponding to puberty and early adolescence, is the period in which major psychiatric disorders can occur frequently in association with sudden biological, psychological, and sociological changes