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Psychiatry Investig > Volume 15(2); 2018 > Article
Psychiatry Investigation 2018;15(2):118-123.
DOI:    Published online November 24, 2017.
Incidence and Comorbidity of Reactive Attachment Disorder: Based on National Health Insurance Claims Data, 2010–2012 in Korea
Minha Hong1, Duk Soo Moon2, Hyejung Chang3, Seung Yup Lee4, Seong Woo Cho4, Kyung-Sook Lee5, Jin-Ah Park6, Sang Min Lee7, Geon Ho Bahn8
1Department of Psychiatry, Seonam University College of Medicine, Myongji Hospital, Goyang, Republic of Korea
2Department of Psychiatry, Seoul Children’s Hospital, Seoul, Republic of Korea
3School of Business, Kyung Hee University, Seoul, Republic of Korea
4Department of Psychiatry, Graduate School, Kyung Hee University, Seoul, Republic of Korea
5Department of Rehabilitation, Hanshin University, Osan, Republic of Korea
6Sewon Infant and Child Development Center, Seoul, Republic of Korea
7Department of Psychiatry, Konyang University College of Medicine, Konyang University Hospital, Daejeon, Republic of Korea
8Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, Republic of Korea
Correspondence  Geon Ho Bahn ,Tel: +82-2-958-8542, Fax: +82-2-957-1997, Email:
Received: August 29, 2017   Revised: October 2, 2017   Accepted: November 1, 2017   Published online: November 24, 2017
We aimed to investigate the current diagnostic incidence, and medical and psychiatric comorbidities of reactive attachment disorder (RAD) using the National Health Insurance Review and Assessment (HIRA) claims data.
To examine the diagnostic incidence, we selected patients who were under 10-year-old and who had at least one medical claim containing a 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) code for RAD (F94.1 and F94.2) and who had not been diagnosed in the previous 360 days, from 2010 to 2012. In this study, we used the term ‘reactive attachment disorder’ representing for both RAD per se and Disinhibited social engagement disorder. Comorbid disorders were categorized according to ICD-10.
Among 14,029,571, the total population under 10-year-old during 2010–2012, incident cases of RAD were 736. The mean diagnostic incidence of RAD was 5.25 per 100,000 annually. Language disorders (F80-84) were the most common psychiatric comorbidities in both boys and girls in age groups 0–3 years and 4–6 years, and attention deficit hyperactivity disorder was the most common in both sex aged 7–9 years. In non-psychiatric comorbidities, diseases of the respiratory system (J00–99) were the commonest in both sex in all age groups, and diseases of the digestive system (K00–99) were the next.
RAD was very rare in practice and would be disguised as other psychiatric disorders. Children with RAD might have more medical comorbidities than typically developed children.
Keywords: Reactive attachment disorder, Incidence, Comorbidity
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