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In order to establish clinical experience and objective indicators for managing them, this paper investigated the rating scales of Alzheimer's disease, Parkinson's disease, and Wilson's disease cases, and reviewed the quality standards necessary for the development of the rating scale. In order to manage this in the gut microbiome analysis platform, we intend to implement a consensus algorithm by providing a consensus algorithm proposal based on clinical experience and a rating scale setting function in the analysis platform.

Purpose: The aim of this study was to develop an Ethical Nursing Competence Self-rating Scale for Clinical Nurses. Methods: A scale-development study was applied that comprised eight stages of DeVellis. The scale verificationinvolved a convenience sample of 423 nurses from September to October 2019 at three general hospitals locatedin Korea. The content validity, factorial structure validity, item-convergent/discriminant validity, known-group validity,convergent validity, internal consistency reliability, and test-retest reliability of the Ethical Nursing CompetenceSelf-rating Scale for Clinical Nurses were evaluated. Data were analyzed using exploratory and confirmatory factoranalyses, Pearson’s correlation coefficient, Heterotrait-monotrait (HTMT), Cronbach’s ?, and intraclass correlationcoefficient. Results: Exploratory and confirmatory factor analyses yielded five-factors. Known-group validity wasdemonstrated by clinical experience and nursing ethics education experience. Convergent validity was demonstratedusing measures of defining issue. Internal consistency reliability and test-retest reliability were found to be acceptable,as indicated by a Cronbach’s ? of .70~.85 and an intraclass correlation coefficient of .72~.89. Conclusion: The EthicalNursing Competence Self-rating Scale for Clinical Nurses is a new instrument that comprehensively measures theaspects of ethical behavior, ethical decision-making and action, ethical sensitivity, ethical reflection, and ethicalknowledge. It consists of 20 items scored on a 4-point Likert scale. The validity and reliability of the scale were verified. These findings indicate that the instrument can be applied in clinical practice, nursing education, and research.

This study was carried out to identify the influence of continuous physical therapy on long-stay elderly patients. This study classified 92 patients who had been hospitalized for one year into experimental group who continued to perform physical therapy and control group who did not conduct physical therapy and these two groups were classified into 0.5 point-questionable group, 1 point-mild dementia group, and 2 point-moderate dementia group based on the Clinical Dementia Rating Scale(CDR) when they were hospitalized in order to analyze the changes at the early stage of hospitalization and after one year has passed. As a result, it was appeared that both in CDR 0.5-point subgroup of questionable group and in CDR 1-point subgroup of mild dementia group, CDR was statistically significantly reduced in the experimental group whose physical therapy was continuously performed than in the control group whose physical therapy was not performed(p<.05) and that there was no significant difference in changes in the CDR between experimental group and control group in CDR 2-point group, which is a moderate dementia group.

본 논문은 아동분리반응척도 개발에 관한 것으로 그 신뢰도와 타당성, 그리고 정신과 입원 아동들에 대한 임상 연구 이용도를 검증하였다. 아동분리반응척도는 신뢰성과 타당성있는 연구 기구임이 나타났고 아동의 분리반응을 들의 정신병리와 구별지어주는데 유용한 것으로 나타났다. 이것은 또한 감별진단하는데 임상가들에게 도움이 될것으로 보이며 아동의 정신과 입원시 일어날수 있는 분리반응과 그 부작용에 대한 이해의 필요성을 시사하였다. 이 기초연구는 입원치료 프로그램은 입원 아동들의 발달적 요구와 능력 그리고 정신병리시 나타나는 특정한 결함에 대해 반드시 관심을 보여야 한다는 개념을 지지하였다.

This paper reports on the development of the Children's Separtion Rating Scale(CSRS), its initial reliability and validity, and clinical/research utility with psychiatrically hospitalized children. The CSRS appears to be a reliable and valid instrument, and useful in distinguishing children's separation reaction from their general psychopathology. It may be also useful in aiding clinicians in differential diagnosis. This study points to the need for further understanding of children's psychiatric hospitalization in relation to their separation reaction and its possible untoward effects. Findings of this pilot study support the notion that inpatient treatment programs should address the developmental needs and abilities of the various age groups and the particular deficits reflected in their psychopathology.

Objective: The aim of this study was to validate the psychotic depression assessment scale (PDAS), which includes the six-item melancholia subscale from the Hamilton depression rating scale (HAMD-6) and the five-item psychosis subscale from the brief psychiatric rating scale (BPRS-5). Data from the Clinical Research Center for Depression (CRESCEND) study, which is a 52-week naturalistic trial, were analyzed. Methods: Fifty-two patients with psychotic depression from the CRESCEND study met our inclusion criteria. The patients underwent the following psychometric assessments: the PDAS, including HAMD-6 and BPRS-5, the clinical global impression scales, the HAMD, the positive symptom subscale, and the negative symptom subscale. Assessments were performed at the baseline and then at weeks 1, 2, 4, 8, 12, 24, and 52. Spearman correlation analyses were used to assess the clinical validity and responsiveness of the PDAS. Results: The clinical validity and responsiveness of the PDAS, including HAMD-6 and BPRS-5, were acceptable, with the exception of the clinical responsiveness of the PDAS for positive symptoms and the clinical responsiveness of BPRS-5 for negative symptoms. Conclusion: The clinical relevance of the PDAS has been confirmed and this clinical validation will enhance its clinical utility and availability.

Objectives: This study was conducted to re-validate the clinical efficacy of the Korean Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Rating Scale (K-AARS), which is a self-report scale for ADHD in adults, and to determine the clinical utility and cut-off scores of K-AARS. Methods: The participants were 135 drug naïve adults with ADHD and 144 healthy controls. To diagnose ADHD based on the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, two board-certified pediatric psychiatrists interviewed the participants and completed the Mini International Neuropsychiatric Interview. K-AARS was applied to all participants. K-AARS comprises six clinical subscales, one impairment subscale, and one driving behavior subscale. The receiver operating characteristic analysis was conducted to calculate the cut-off scores of K-AARS. Results: All subscale scores, including six clinical subscale, impairment subscale, and driving behavior subscale scores, were found to be significant in distinguishing adults with ADHD from healthy controls. The sensitivity and specificity of the six clinical subscales were 63.0-77.0% and 66.7-79.9%, respectively. The combined total score of the six clinical subscales, had a sensitivity of 80.0% and specificity of 79.9%. Conclusion: The discriminative power of K-AARS for the diagnosis of ADHD in adults was excellent, and K-AARS and the empirical diagnosis of adults can be useful in diagnosing ADHD in adulthood.

Background and Purpose Visual assessment of medial temporal-lobe atrophy (MTA) has been quick, reliable, and easy to apply in routine clinical practice. However, one of the limitations in visual assessments of MTA is the lack of widely accepted age-adjusted norms and cutoff scores for MTA for a diagnosis of Alzheimer’s disease (AD). This study aimed to determine the optimal cutoff score on a T1-weighted axial MTA Visual Rating Scale (VRS) for differentiating patients with AD from cognitively normal elderly people. Methods The 3,430 recruited subjects comprising 1,427 with no cognitive impairment (NC) and 2003 AD patients were divided into age ranges of 50?59, 60?69, 70?79, and 80?89 years. Of these, 446 participants (218 in the NC group and 228 in the AD group) were chosen by random sampling for inclusion in this study. Each decade age group included 57 individuals, with the exception of 47 subjects being included in the 80- to 89-year NC group. The scores on the T1-weighted axial MTA VRS were graded by two neurologists. The cutoff values were evaluated from the area under the receiver operating characteristic curve. Results The optimal axial MTA VRS cutoff score from discriminating AD from NC increased with age: it was ≥as ≥1, ≥2, and ≥3 in subjects aged 50?59, 60?69, 70?79, and 80?89 years, respectively (all p<0.001). Conclusions These results show that the optimal cutoff score on the axial MTA VRS for diagnosing of AD differed according to the decade age group. This information could be of practical usefulness in the clinical setting.

Objective The Altman Self-Rating Mania Scale (ASRM) has been recommended as a brief and psychometrically promising tool for the self-reporting of (hypo)manic symptoms. However, there is a shortage of validation in clinical samples, and none for the newly developed 11-item version. Thus, this study aimed to test the reliability and validity of the ASRM-11 in comparison with the ASRM-5.Methods Through a retrospective chart review, self-reported data on the Korean ASRM (K-ASRM) were collected from 122 patients diagnosed with either bipolar or depressive disorder via a (semi)structured diagnostic interview. They were interviewed individually using the Korean Young Mania Rating Scale (K-YMRS). The reliability, construct, convergent, and diagnostic validity were also examined.Results The reliability of both versions of the K-ASRM ranged from good to excellent. Factor analyses revealed a unifactorial solution for K-ASRM-5, while a dual-factor structure emerged for K-ASRM-11, corresponding to the bright and dark sides of (hypo)mania. Moreover, both versions demonstrated a significant positive correlation with the total K-YMRS score. In the receiver operating curve analysis, the discriminating ability of both versions was fair when distinguishing manic from non-manic patients.Conclusion Both the K-ASRM-5 and K-ASRM-11 demonstrated comparable levels of sound psychometric properties, which supports their continued usage in research and clinical practice. It is necessary to test potential utility of the K-ASRM-11 for symptom monitoring and treatment response because of its additional coverage of dark-side (hypo)manic symptoms, including irritability and impulsivity, which are considered important for the quality of life of patients with bipolar disorder.

Objective: We aimed to examine the reliability and validity of the Korean Altman Self-Rating Mania Scale (K-ASRM) in a large sample of Korean non-clinical undergraduates. Methods: Participants (n=1,091) filled out the K-ASRM with other self-report questionnaires assessing bipolarity, mood symptoms and affect. Reliability test, exploratory factor analysis and correlation analyses were conducted to examine its psychometric properties. Results: The reliability of the K-ASRM was adequate (Cronbach’s α=0.73, item-to-total correlation 0.53?0.78) and the exploratory factor analysis yielded one factor of mania. The K-ASRM demonstrated significant associations with measures of hypomanic personality (r=0.33), lifetime history of hypomanic symptoms (r=0.23). Also, the K-ASRM was significantly correlated with positive affect (r=0.53), negative affect (r=-0.17) and depressive symptoms (r=-0.35). Conclusion: These results suggest preliminary possibility that the K-ASRM can be utilized as self-rating tool for mania in Korea as well as future directions for further validation.

본 연구는 가족의 상호작용을 관찰한 평정자가 가족기능을 평가할 수 있는 관찰평정척도를 개발하는 데 목적이 있다. 예비 연구를 통해 척도의 구성요인을 정의하고 문항과 평정매뉴얼 및 구조화된 가족상호작용과제를 개발해 1차 척도를 완성하였고 이를 이용해 5가족의 녹화된 비디오자료를 2인의 전문가가 평정하고 척도를 재분석해 수정보완한 후 내용 타당도 검증을 통해 2차 척도를 완성하였다. 본 연구는 부부와 초등학생인 두 자녀로 구성된 핵가족 53가족을 대상으로 하였다. 녹화한 비디오자료를 이용해 80%의 일치도를 보일 때까지 20시간 이상 훈련을 받은 평정자 3명이 비디오를 시청한 후 2차 척도를 이용해 가족기능을 평정하였다. 구조화된 가족상호작용과제는 자유놀이, 행동과제, 토론과제의 순서대로 30분간 진행되었다. 자료분석은 SPSS 18.0과 AMOS 17.0 프로그램을 사용해 탐색적 요인분석과 확인적 요인분석, 상관분석으로 타당도를 검증하였고, 평정자간 일치도와 내적일치도로 신뢰도를 검증하였다. 최종적으로 선택된 척도의 구성요인은 ‘가족구조’, ‘긍정적 정서반응’, ‘부정적 정서반응’, ‘문제해결적 의사소통’이며, ‘가족구조’는 ‘부부’, ‘부모’, ‘자녀’의 하위요인으로 나뉘었다. 공인 타당도 검증 결과 본 척도가 주관적 척도와는 성격이 다른 객관적 척도로서의 고유성이 입증되었고, 자기보고식 척도들과의 유의한 상관이 있어서 가족기능평가와 연구에 있어 상호보완적인 활용도가 높음이 시사되었다. 각 요인에 대한 신뢰도(Cronbach's α)는 .83∼.90이었고, 평정자의 일치도는 최소 88.03%였다. 본 연구의 의의는 첫째, 가족의 상호작용을 관찰해 평정자가 객관적으로 평가하는 척도를 개발함으로써 다양한 방법으로 가족평가를 할 수 있는 방법론의 발달에 기여하였다. 둘째, 가족을 관찰해서 가족기능을 평가할 때 객관적인 평가준거를 제시함으로써 가족치료와 평가 분야의 교육 및 훈련 자료로 사용될 수 있을 것이다. 셋째, 가족치료장면에서 가족의 상호작용을 촬영한 비디오자료를 통해 내담자 가족의 통찰을 도울 수 있는 새로운 상담과 평가의 도구를 마련하였다.

Objectives: The purpose of this study was to develop a Clinical Rating Scale for Family Functioning. The scale includes a rating manual that describes how to evaluate family functioning, based on raters’ observations of interactions among family members. Methods: This pilot study was conducted to construct the rating scale, rating questions, rating manual, and structured family tasks for observing families’ interactions. Eleven experts reviewed the researcher’s materials to confirm content validity. The structured family tasks were then implemented with 53 families. Using the data collected through the implementation of the tasks, the researchers used correlation and factor analyses to investigate construct validity. Concurrent validity was also reviewed by analyzing the relationships with other scales containing similar content. Finally, the researchers examined the scale’s inter-rater reliability and analyzed the internal consistency coefficient. All analyses were conducted using SPSS 18.0. Results: The results showed that the final scale included the following content areas: family structure, positive emotional response, negative emotional response, and communication for problem solving. These findings are similar to those of previous studies. The family structure content area was divided into three sub-factors: couples, parents, and children. Reliability verification of the scale revealed a Cronbach's alpha range of .83-.90, and consistency among the three raters was higher than 88% in all categories. Conclusions: Understanding family functioning is essential for family therapists. The rating scale developed in this study can help family therapists observe and evaluate family functioning in a quantitative way, which can provide objective information during the early stages of family therapy. The scale can be also used for educational and training purposes in the fields of family treatment and evaluation. Families may benefit from insight made available from the rating scale and from video recordings of their interactions during family therapy.

Objectives : The objective of this study was to compare the Korean Personality Rating Scale for Children (K-PRC) profile between children with attention-deficit hyperactivity disorder (ADHD) and typically developing children. We also aimed to investigate the association of K-PRC and ADHD symptoms. Methods : Ninety-nine youth (age $8.3{\pm}2.4$ years, 72 boys) with ADHD and 84 controls (age $9.2{\pm}2.5$ years, 43 boys) were recruited from the Department of Pediatric Psychiatry of the Asan Medical Center Children's Hospital. Diagnoses of ADHD and comorbid psychiatric disorders were confirmed with the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). The parents of the subjects completed the ADHD rating scale, and K-PRC. Independent t-tests, analysis of covariance, partial correlation analyses, and Mc Nemar test were used for analysis. Results : Children and adolescents with ADHD showed higher K-PRC scores in verbal development, physical development, depression, delinquency, hyperactivity, family dysfunction and psychoticism. Delinquency and hyperactivity were significantly correlated with parent-rated ADHD rating scales and ADHD scores on K-SADS-PL. The hyperactive/impulsive and combined subtypes showed higher scores on hyperactivity and delinquency than the inattentive subtype, and the inattentive subtype showed higher scores on depression and social dysfunction of the K-PRC. Conclusion : Our results suggest that K-PRC could be used to comprehensively evaluate symptoms, combined psychopathologies, developmental delay and family dysfunction of children with ADHD.

Objectives: The purpose of this study was to review the status of numeric rating scale (NRS) usage and suggest the potential for use in multicenter retrospective studies of various diseases. Methods: Articles published from 2011 to 2021 that used the keywords "NRS", "Multi-center", and "RCT" were identified in foreign databases, including EMBASE, PubMed, CENTRAL. The articles were analyzed according to their use of "NRS" by symptoms and by disease group using the major classifications of the Korean Standard Classification of Diseases (KCD-7). Results: Classification by symptom in a total of 288 articles illustrates that the NRS was not only commonly used in pain evaluation but also for non-pain symptoms. In usage with non-pain symptoms, chief complaint of patients was the most common at 79%, and other factors included treatment satisfaction, evaluation of daily life, and sleep quality. In disease classification according to the KCD-7, the NRS was commonly used in connection with musculoskeletal and connective tissue diseases but was also utilized in various other disease groups. Conclusions: This study confirms usage of the NRS in multi-center RCTs, as the NRS was widely used in all types of diseases and symptoms. Considering the result and the advantages of the NRS, it is recommended for use as a daily evaluation tool for the collection of common data in multicenter retrospective studies.

Objectives This study aimed to investigate the association between depressive symptoms and the clinical features of adult attention-deficit/hyperactivity disorder (ADHD). Methods This study included 40 adult ADHD patients, aged ≥18, who visited the outpatient clinic of the Department of Psychiatry at Ewha Womans University’s Mokdong Hospital. Patients undergoing pharmacological treatment were excluded from the sample of 243 patients. To assess the clinical features of ADHD, the Adult ADHD Self-Report Scale and the Korean Adult Attention- Deficit/Hyperactivity Disorder Rating Scale (K-AARS) were administered to the patients. Depressive symptoms were evaluated using Beck’s Depression Inventory (BDI) questionnaire. Pearson and Spearman correlation analyses were employed to explore the relationship between ADHD and depressive symptoms, and linear regression analyses were used to further investigate their associations. Results Participants were aged 19?54 years (27.47±7.05) and included a higher proportion of males (77.5%). Higher BDI scores were related to unmarried status, coexisting disorders, and lower education of the subjects. Inattention, emotional dysregulation, disorganization, impulsivity, and functional impairment measured by the K-AARS were correlated with higher BDI scores. Multiple linear regression analysis revealed significant associations between disorganization (β=0.858, p=0.008), impulsivity (β=0.759, p=0.001), emotional dysregulation (β=0.464, p<0.001), inattention (β=0.266, p=0.019), and subtotal score (β=0.069, p=0.031) in the K-AARS, and BDI. Conclusion The current study showed that elevated levels of inattention, impulsivity, disorganization, emotional dysregulation, and severity of ADHD symptoms were associated with higher levels of depressive symptoms in patients with adult ADHD. We suggest that it is important to understand the relationship between ADHD and depressive symptoms when managing adult ADHD patients with depressive symptoms.