Journal of the Korean Academy of Child and Adolescent Psychiatry

Korean Academy of Child and Adolescent Psychiatry (대한소아청소년정신의학회)
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A Preliminary Study on the Development of Korean Medication Algorithm for Attention-Deficit Hyperactivity Disorder

한국형 주의력결핍 과잉행동장애 약물치료 알고리듬 개발을 위한 예비연구

  • Park, Jae-Hong (Department of Psychiatry, Seoul National University College of Medicine) ;
  • Kim, Bung-Nyun (Department of Psychiatry, Seoul National University College of Medicine) ;
  • Kim, Jae-Won (Department of Psychiatry, Seoul National University College of Medicine) ;
  • Kim, Ji-Hoon (Department of Psychiatry, School of Medicine, Pusan National University) ;
  • Son, Jung-Woo (Department of Neuropsychiatry, Chungbuk National University College of Medicine) ;
  • Shin, Dong-Won (Department of Psychiatry, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital) ;
  • Shin, Yun-Mi (Department of Psychiatry and Behavioral Sciences, School of Medicine, Ajou University) ;
  • Yang, Su-Jin (Department of Psychiatry, Chonnam National University Hospital) ;
  • Yoo, Hanik-K. (Department of Psychiatry, College of Medicine University of Ulsan, Asan Medical Center) ;
  • Yoo, Hee-Jeong (Department of Psychiatry, Seoul National University College of Medicine, Bundang Hospital) ;
  • Lee, Soyoung Irene (Department of Psychiatry, Soonchunhyang University Medical School, Bucheon Hospital) ;
  • Cheon, Keun-Ah (Department of Psychiatry and Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine) ;
  • Hong, Hyun-Ju (Department of Psychiatry, Hallym University College of Medicine) ;
  • Hwang, Jun-Won (Department of Neuropsychiatry, Eulji University College of Medicine)
  • 박재홍 (서울대학교 의과대학 정신과학교실) ;
  • 김붕년 (서울대학교 의과대학 정신과학교실) ;
  • 김재원 (서울대학교 의과대학 정신과학교실) ;
  • 김지훈 (부산대학교 의학전문대학원 정신과학교실) ;
  • 손정우 (충북대학교 의과대학 정신과학교실) ;
  • 신동원 (성균관대학교 의과대학 정신과학교실) ;
  • 신윤미 (아주대학교 의과대학 정신과학교실) ;
  • 양수진 (전남대학교 의과대학 정신과학교실) ;
  • 유한익 (울산대학교 의과대학 서울아산병원 정신과학교실) ;
  • 유희정 (서울대학교 의과대학 분당서울대학교병원 정신과학교실) ;
  • 이소영 (순천향대학교 의과대학 정신과학교실) ;
  • 천근아 (연세대학교 의과대학 정신과학교실) ;
  • 홍현주 (한림대학교 의과대학 정신과학교실) ;
  • 황준원 (을지대학교 의과대학 정신과학교실)
  • Received : 2010.02.01
  • Accepted : 2010.03.28
  • Published : 2011.03.31
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Abstract

Objectives：This study was conducted to develop a Korean algorithm of pharmacological and non-pharmacological treatment strategies in attention-deficit hyperactivity disorder (ADHD) and its specific comorbid disorders (e.g. tic disorder, depressive disorder, anxiety disorder, bipolar disorder, and oppositional defiant disorder/conduct disorder). Methods：Based on a literature review and expert consensus, both paper- and web-based survey tools were developed with respect to a comprehensive range of questions. Most options were scored using a 9-point scale for rating the appropriateness of medical decisions. For the other options, the surveyed experts were asked to provide answers (e.g., duration of treatment, aver-age dosage) or check boxes to indicate their preferred answers. The survey was performed on-line in a self-administered manner. Ultimately, 49 Korean child & adolescent psychiatrists, who had been considered experts in the treatment of ADHD, vol untarily completed the questionnaire. In analyzing the responses to items rated using the 9-point scale, consensus on each option was defined as a non-random distribution of scores as determined by a chi-square test. We assigned a categorical rank (first line/preferred choice, second line/alternate choice, third line/usually inappropriate) to each option based on the 95% confidence interval around the mean rating score. Results：Specific medication strategies for key clinical situations in ADHD and its comorbid disorders were indicated and described. We organized the suggested algorithms of ADHD treatment mainly on the basis of the opinions of the Korean experts. The suggested algorithm was constructed according to the templates of the Texas Child & Adolescent medication algorithm Project (CMAP). Conclusion：We have proposed a Korean treatment algorithm for ADHD, both with and without comorbid disorders through expert consensus and a broad literature review. As the tools available for ADHD treatment evolve, this algorithm could be reorganized and modified as required to suit updated scientific and clinical research findings.

Keywords

References

  1. Brown RT, Freeman WS, Perrin JM, Stein MT, Amler RW, Feldman HM, et al. Prevalence and assessment of attention-deficit/hyperactivity disorder in primary care settings. Pediatrics 2001; 107:E43. https://doi.org/10.1542/peds.107.3.e43
  2. Rowland AS, Lesesne CA, Abramowitz AJ. The epidemiology of attention-deficit/hyperactivity disorder (ADHD): a public health view. Ment Retard Dev Disabil Res Rev 2002;8:162-170. https://doi.org/10.1002/mrdd.10036
  3. Kim JY, Ahn DH, Shin YJ. Screening for Attention Deficit/Hyperactivity Disorder in Community Mental Health Services for Children. Kor J Neuropsychiatr Assoc 1999;38:784-793.
  4. Cho SC, Kim BN, Kim JW, Rohde LA, Hwang JW, Chungh DS, et al. Full syndrome and subthreshold attention-deficit/hyperactivity disorder in a Korean community sample: comorbidity and tempera-ment findings. Eur Child Adolesc Psychiatry 2009;18:447-457. https://doi.org/10.1007/s00787-009-0755-7
  5. Kessler RC, Adler L, Barkley R, Biederman J, Conners CK, Demler O, et al. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry 2006;163:716-723. https://doi.org/10.1176/appi.ajp.163.4.716
  6. Jensen PS, Martin D, Cantwell DP. Comorbidity in ADHD: implications for research, practice, and DSM-V. J Am Acad Child Adolesc Psychiatry 1997;36:1065-1079. https://doi.org/10.1097/00004583-199708000-00014
  7. Bradley C. The behavior of children receiving benzedrine. Am J Psychiatry 1937;94:577-585. https://doi.org/10.1176/ajp.94.3.577
  8. The MTA Cooperative Group. A 14-month randomized clinical trial of treatment strateges for attention-deficit/hyperactivity disorder. Arch Gen Psychiatry 1999;56:1073-1086. https://doi.org/10.1001/archpsyc.56.12.1073
  9. Pliszka SR, Crismon ML, Hughes CW, Corners CK, Emslie GJ, Jensen PS, et al. The Texas Children's Medication Algorithm Project: revision of the algorithm for pharmacotherapy of attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2006;45:642-657. https://doi.org/10.1097/01.chi.0000215326.51175.eb
  10. Gillberg C, Gillberg IC, Rasmussen P, Kadesjo B, Soderstrom H, Rastam M, et al. Co-existing disorders in ADHD -- implications for diagnosis and intervention. Eur Child Adolesc Psychiatry 2004;13 Suppl 1:I80-92.
  11. Pliszka S. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2007;46:894-921. https://doi.org/10.1097/chi.0b013e318054e724
  12. Taylor E, Sergeant J, Doepfner M, Gunning B, Overmeyer S, Mobius HJ, et al. Clinical guidelines for hyperkinetic disorder. European Society for Child and Adolescent Psychiatry. Eur Child Adolesc Psychiatry 1998;7:184-200. https://doi.org/10.1007/s007870050067
  13. National Institute for Health and Clinical Excellence. Attention Deficit Hyperactivity Disorder: The NICE Guideline on Diagnosis and Management of ADHD in Children, Young People and Adu-lts. The British Psychological Society and The Royal College of Psychiatrists; 2009; Available from: http://www.nice.org.uk/nicemedia/pdf/ADHDFullGuideline.pdf.
  14. The Royal Australasian College of Physicians. Australian guidelines on attention deficit hyperactivity disorder. National Health and Medical Research Council; 2009; Available from: http://www.nhmrc.gov.au/_files_nhmrc/file/publications/synopses/adhd/NHMRC-draft-ADHD-guidelines.pdf.
  15. Saito M. Diagnosis and therapeutic guideline for attention deficit hyperkinetic syndrome (ADHD). Seishin Shinkeigaku Zasshi 2005;107:167-179.
  16. Yoo HJ, Yang SJ, Shin D, Kang H, Kim BN, Kim JH, et al. The Korean practice parameter for the treatment of attention-deficit hyperactivity disorder (III): pharmacologic treatment. J Kor Acad Child Adolesc Psychiatry 2007;18:16-25.
  17. Kim BN, Yoo HK, Kang H, Kim JH, Shin D, Ahn D, et al. The Korean practice parameter for the treatment of attention-deficit hyperactivity disorder (IV): non-pharmacologic treatment. J Kor Acad Child Adolesc Psychiatry 2007;18:16-25.
  18. Sachs GS, Printz DJ, Kahn DA, Carpenter D, Docherty JP. The expert consensus guideline series: medication treatment of bipolar disorder 2000. Postgrad Med 2000;Spec No:1-104.
  19. Kim YC. Modern statistics,revised. Seoul: Jeonyoungsa;1996. p. 229-243.
  20. Biederman J, Mick E, Faraone SV. Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type. Am J Psychiatry 2000;157:816-818. https://doi.org/10.1176/appi.ajp.157.5.816
  21. Lee YS, Kim EY, Ra C. Preliminary study for ADHD treatment guideline. J Kor And Child Adolesc Psychiatry 2002;13:129-138.
  22. Spencer T, Biederman J, Wilens T, Harding M, O'Donnell D, Griffin S. Pharmacotherapy of attention-deficit hyperactivity disorder across the life cycle. J Am Acad Child Adolesc Psychiatry 1996; 35:409-432. https://doi.org/10.1097/00004583-199604000-00008
  23. Bloch MH, Panza KE, Landeros-Weisenberger A, Leckman JF. Meta-analysis: treatment of attention-deficit/hyperactivity disorder in children with comorbid tic disorders. J Am Acad Child Adolesc Psychiatry 2009;48:884-893. https://doi.org/10.1097/CHI.0b013e3181b26e9f
  24. The MTA Cooperative Group. National Institute of Mental Health Multimodal Treatment Study of ADHD follow-up: 24-month outcomes of treatment strategies for attention-deficit/hyperactivity disorder. Pediatrics 2004;113:754-761. https://doi.org/10.1542/peds.113.4.754
  25. Jensen PS, Arnold LE, Swanson JM, Vitiello B, Abikoff HB, Greenhill LL, et al. 3-year follow-up of the NIMH MTA study. J Am Acad Child Adolesc Psychiatry 2007;46:989-1002. https://doi.org/10.1097/CHI.0b013e3180686d48
  26. Michelson D, Faries D, Wernicke J, Kelsey D, Kendrick K, Sallee FR, et al. Atomoxetine in the treatment of children and adolescents with attention-deficit/hyperactivity disorder: a randomized, placebo-controlled, dose-response study. Pediatrics 2001;108:E83. https://doi.org/10.1542/peds.108.5.e83
  27. Wang Y, Zheng Y, Du Y, Song DH, Shin YJ, Cho SC, et al. Atomoxetine versus methylphenidate in paediatric outpatients with attention deficit hyperactivity disorder: a randomized, double-blind comparison trial. Aust N Z J Psychiatry 2007;41:222-230. https://doi.org/10.1080/00048670601057767
  28. Faraone SV, Sergeant J, Gillberg C, Biederman J. The worldwide prevalence of ADHD: is it an American condition? World Psychiatry 2003;2:104-113.
  29. Barrickman LL, Perry PJ, Allen AJ, Kuperman S, Arndt SV, Herrmann KJ, et al. Bupropion versus methylphenidate in the treatment of attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 1995;34:649-657. https://doi.org/10.1097/00004583-199505000-00017
  30. Conners CK, Casat CD, Gualtieri CT, Weller E, Reader M, Reiss A, et al. Bupropion hydrochloride in attention deficit disorder with hyperactivity. J Am Acad Child Adolesc Psychiatry 1996;35:1314-1321. https://doi.org/10.1097/00004583-199610000-00018
  31. Pliszka SR. Non-stimulant treatment of attention-deficit/hyperactivity disorder. CNS Spectr 2003;8:253-258. https://doi.org/10.1017/S1092852900018460
  32. Spencer T, Biederman J, Wilens T. Pharmacotherapy of attention deficit hyperactivity disorder. Child Adolesc Psychiatr Clin N Am 2000;9:77-97.
  33. Biederman J, Thisted RA, Greenhill LL, Ryan ND. Estimation of the association between desipramine and the risk for sudden death in 5- to 14-year-old children. J Clin Psychiatry 1995;56:87-93.
  34. Allen AJ, Kurlan RM, Gilbert DL, Coffey BJ, Linder SL, Lewis DW, et al. Atomoxetine treatment in children and adolescents with ADHD and comorbid tic disorders. Neurology 2005;65:1941-1949. https://doi.org/10.1212/01.wnl.0000188869.58300.a7
  35. Gadow KD, Sverd J, Sprafkin J, Nolan EE, Grossman S. Longterm methylphenidate therapy in children with comorbid attentiondeficit hyperactivity disorder and chronic multiple tic disorder. Arch Gen Psychiatry 1999;56:330-336. https://doi.org/10.1001/archpsyc.56.4.330
  36. Garnock-Jones KP, Keating GM. Atomoxetine: a review of its use in attention-deficit hyperactivity disorder in children and adolescents. Paediatr Drugs 2009;11:203-226. https://doi.org/10.2165/00148581-200911030-00005
  37. Gammon GD, Brown TE. Fluoxetine and methylphenidate in combination for treatment of attention deficit disorder and comorbid depressive disorder. J Child Adolesc Psychopharmacol 1993;3:1-10. https://doi.org/10.1089/cap.1993.3.1
  38. Daviss WB, Bentivoglio P, Racusin R, Brown KM, Bostic JQ, Wiley L. Bupropion sustained release in adolescents with comorbid attention-deficit/hyperactivity disorder and depression. J Am Acad Child Adolesc Psychiatry 2001;40:307-314. https://doi.org/10.1097/00004583-200103000-00010
  39. Wilens TE, Prince JB, Spencer T, Van Patten SL, Doyle R, Girard K, et al. An open trial of bupropion for the treatment of adults with attention-deficit/hyperactivity disorder and bipolar disorder. Biol Psychiatry 2003;54:9-16. https://doi.org/10.1016/S0006-3223(02)01664-5
  40. Geller D, Donnelly C, Lopez F, Rubin R, Newcorn J, Sutton V, et al. Atomoxetine treatment for pediatric patients with attentiondeficit/hyperactivity disorder with comorbid anxiety disorder. J Am Acad Child Adolesc Psychiatry 2007;46:1119-1127. https://doi.org/10.1097/chi.0b013e3180ca8385
  41. Kowatch RA, Youngstrom EA, Danielyan A, Findling RL. Review and meta-analysis of the phenomenology and clinical characteristics of mania in children and adolescents. Bipolar Disord 2005;7:483-496. https://doi.org/10.1111/j.1399-5618.2005.00261.x
  42. Klein RG, Abikoff H, Klass E, Ganeles D, Seese LM, Pollack S. Clinical efficacy of methylphenidate in conduct disorder with and without attention deficit hyperactivity disorder. Arch Gen Psychiatry 1997;54:1073-1080. https://doi.org/10.1001/archpsyc.1997.01830240023003
  43. Pappadopulos E, Woolston S, Chait A, Perkins M, Connor DF, Jensen PS. Pharmacotherapy of aggression in children and adolescents: efficacy and effect size. J Can Acad Child Adolesc Psychiatry 2006;15:27-39.
  44. Schur SB, Sikich L, Findling RL, Malone RP, Crismon ML, Derivan A, et al. Treatment recommendations for the use of antipsychotics for aggressive youth (TRAAY). Part I: a review. J Am Acad Child Adolesc Psychiatry 2003;42:132-144. https://doi.org/10.1097/00004583-200302000-00007
  45. Campbell M, Adams PB, Small AM, Kafantaris V, Silva RR, Shell J, et al. Lithium in hospitalized aggressive children with conduct disorder: a double-blind and placebo-controlled study. J Am Acad Child Adolesc Psychiatry 1995;34:445-453. https://doi.org/10.1097/00004583-199504000-00011
  46. Donovan SJ, Stewart JW, Nunes EV, Quitkin FM, Parides M, Daniel W, et al. Divalproex treatment for youth with explosive temper and mood lability: a double-blind, placebo-controlled crossover design. Am J Psychiatry 2000;157:818-820. https://doi.org/10.1176/appi.ajp.157.5.818
  47. Cueva JE, Overall JE, Small AM, Armenteros JL, Perry R, Campbell M. Carbamazepine in aggressive children with conduct disorder: a double-blind and placebo-controlled study. J Am Acad Child Adolesc Psychiatry 1996;35:480-490. https://doi.org/10.1097/00004583-199604000-00014

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