소아정신과 외래환자에 대한 임상적 연구

Abstract

요 약 저자들은 1984년 1월부터 1990년 12월까지 계명대학교 동산의료원 정신과 외래에서 초진받은 만 15세이하 소아정신과 환자 1,147명을 대상으로 조사하여 다음과 같은 결과를 얻었다. 조사대상 환자의 남녀 비율은 2.1 : 1로서 남자가 많았으며, 이들의 평균나이는 8.49±4.36세(남자 8.08±4.28세, 여자 9.39±4.39세)이었다. 연도별 남자가 차지하는 비율은 1984년 55.8%에서 매년 증가하여 1990년에는 75.4%였다. 연도별 연령분포는 1987년까지는 연령이 증가할수록 대상 수가 증가하였으나, 1989년이후에는 어린 연령의 대상수가 더 많은 경향을 나타내었다. 평균 연령은 1984년에는 11.81±2.93세에서 매년 낮아져서 1990년에는 6.88±4.20세였다. 전체 환자에 대한 소아 환자의 비율은 14.7%이었고, 매년 소아환자가 차지하는 비율 및 절대수는 증가하는 경향이었다. 진단적 분포는 정서장애 22.1%, 주의력결핍장애 20.9%, 정신지체 17.8%, 간질 13.8%, 전반적발달장애 13.0%, 특수발달장애 10.4%, 그 외에 적응장애, 수면장애, 배설장애, 기타장애, 상동성운동장애, 기질성뇌증후군, 정신분열병, 정동장애, V code, 기타정신병, 행동장애 등의 순으로 나타났다. 연령과 진단과의 관계는 전반적발달장애와 특수발달장애는 6세이하, 주의력결핍장애는 9세이하, 기질성뇌증후군과 기타장애는 7세이후, 행동장애, 정서장애와 적응장애는 10세이후, 정신병은 13세이후, 상동성운동장애는 7~12세, 수면장애와 배설장애는 4~12세에 편중되어 있었다. 성별에 따른 진단 분포는 남자에서는 주의력결핍장애, 정신지체, 정서장애, 전반적발달장애, 특수발달장애 및 간질 등의 순이며, 여자에서는 정서장애, 간질, 정신지체, 주의력결핍장애, 적응장애 등의 순으로 나타났다. 남자가 여자에 비해 높은 빈도를 보이는 장애는 주의력결핍장애, 상동성운동장애, 전반적발달장애, 특수발달장애이며, 여자에서 더 높은 비율을 보인 경우는 정서장애와 정동장애로 나타났다. 연도에 따른 진단분포는 1984년부터 1988년까지는 정서장애가, 1989년에는 정신지체, 1990년에는 주의력결핍장애가 가장 많이 진단되었다.

The authors studied retrospectively the clinical characteristics of 1147 child psychiatric outpatients who made their first visit to Department of Psychiatry. Dongsan Medical Center, Keimyung University, from January 1984 to December 1990. The results were as follows; There were significant differences of sex distribution among probands and the ratio between male and female was 2.1:1. There were significant differences of the percentage of male patients according to year from 55.8% in 1984 to 75.4% in 1990. There were some differences of age distrubution according to year. Old age group was more frequent from 1984 to 1987, while younger age group was more frequent in 1989 and 1990. The percentage of child outpatients to the total psychiatric outpatients was 14.7% and was increased by year, such as 4.0% in 1984 and 27.1% in 1990, and the number of child patients had also increasing tendency. The distributions of psychiatric disorders of probands were in the following order; Emotional disorder, Attention deficit disorder, Mental retardation, Epilepsy, Pervasive developmental disorder, Specific developmental disorder, Adjustment disorder, Sleep disorder, Elimination disorder, Other disorder, Stereotyped movement disorder, Organic brain syndrome, Schizophrenia, Affective disorder, V code, Other psychosis, Conduct disorder, No mental disorder. There were some differences in the distribution of psychiatric disorders accrding to age. Pervasive devemopmental disorder and Specific developmental disorder were more frequent before age of 6, Attention deficit disorder was more frequent before age of 9, Organic brain syndrome and Other disorder were more frequent after age of 7, Conduct disorder, Emotional disorder and Adjustment disorder were more frequent after age of 10, Psychosis was more frequent after age of 13, Stereotyped movement disorder was more frequent in the age of 7-12, Sleep disorder and Elimination disorder were more frequent in the age of 4-12. There were some differences in the distribution of psychiatric disorders according to sex. Attention deficit disorder, Stereotyped movement disorder, Pervasive developmental disorder and Specific developmental disorder were more frequent in male, while Emotional disorder and Affective disorder were more frequent in female. There were some differences in the distribution of psychiatric disorders according to year. Emotional disorder was the most frequent diagnosis from 1984 to 1988, Mental retardation in 1989 and Attention deficit disorder in 1990.