Journal of the Korean Academy of Child and Adolescent Psychiatry

Korean Academy of Child and Adolescent Psychiatry (대한소아청소년정신의학회)
권호 표지
DOI QR코드

DOI QR Code

Comparison of Attention-Deficit/Hyperactivity Disorder Practice in Adults According to a Training Background in Child Psychiatry

  • Hong, Minha (Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine) ;
  • Lee, Seung-Yup (Department of Psychiatry, Kyung Hee University School of Medicine) ;
  • Lee, Young Sik (Department of Psychiatry, Chung-Ang University College of Medicine) ;
  • Kim, Bongseog (Department of Psychiatry, Inje University College of Medicine) ;
  • Joung, Yoo Sook (Department of Psychiatry, Sungkyunkwan University College of Medicine) ;
  • Yoo, Hanik K (Seoul Brain Research Institute) ;
  • Kim, Eui-Jung (Department of Psychiatry, College of Medicine, Ewha Womans University) ;
  • Lee, Soyoung Irene (Department of Psychiatry, Soonchunhyang University College of Medicine) ;
  • Park, Su-Bin (National Center for Mental Health) ;
  • Bhang, Soo-Young (Department of Psychiatry, Eulji University Hospital, Eulji University School of Medicine) ;
  • Han, Doughyun (Department of Psychiatry, Chung-Ang University College of Medicine) ;
  • Bahn, Geon Ho (Department of Psychiatry, Kyung Hee University School of Medicine)
  • Received : 2019.06.12
  • Accepted : 2019.06.21
  • Published : 2019.07.01
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: Awareness of attention-deficit/hyperactivity disorder (ADHD) in adults has significantly increased; however, clinical data specific to the Korean population are insufficient. Clinical experience of ADHD may differ based on whether psychiatrists have received pediatric psychiatry-specific training. In order to prepare a practice parameter for adult ADHD patients in Korea, we examined questionnaire data to observe how pediatric psychiatry training could affect clinical practice for adults with ADHD. Methods: A questionnaire about the diagnosis and treatment process was distributed to both general psychiatrists (GPsy) and child and adolescent psychiatrists (CAP) at the summer and winter workshop meetings of Korean Academy of Child and Adolescent Psychiatry. Results: In total, 142 psychiatrists participated in the survey (86 GPsy, 56 CAP). GPsy and CAP preferred pharmacotherapy (GPsy 82.40%, CAP 64.30%) as the primary treatment option and answered that the clinical psychiatric interview is the most necessary step in diagnostic assessment (GPsy 22.16%, CAP 19.00%). The GPsy responded with an optimal and average treatment duration that was shorter than that reported by CAP. Conclusion: Identification of the initial presenting symptom as the correct diagnosis and the optimal duration of pharmacotherapy differed between GPsy and CAP in practice, whereas concepts in diagnosis and treatment of ADHD in adults were similar for both groups. These results suggest the urgent need for the Continuing Medical Education program for psychiatrists treating adults with ADHD.

Keywords

References

  1. American Psychiatric Association. DSM-5 Task Force. Diagnostic and statistical manual of mental disorders: DSM-5TM. 5th ed. Washington DC: American Psychiatric Association;2013. p.947.
  2. Sibley MH, Mitchell JT, Becker SP. Method of adult diagnosis influences estimated persistence of childhood ADHD: a systematic review of longitudinal studies. Lancet Psychiatry 2016;3:1157-1165. https://doi.org/10.1016/S2215-0366(16)30190-0
  3. Sibley MH, Swanson JM, Arnold LE, Hechtman LT, Owens EB, Stehli A, et al. Defining ADHD symptom persistence in adulthood: optimizing sensitivity and specificity. J Child Psychol Psychiatry 2017;58:655-662. https://doi.org/10.1111/jcpp.12620
  4. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington DC: American Psychiatric Association Publishing;2013.
  5. Agnew-Blais JC, Polanczyk GV, Danese A, Wertz J, Moffitt TE, Arseneault L. Evaluation of the persistence, remission, and emergence of attention-deficit/hyperactivity disorder in young adulthood. JAMA Psychiatry 2016;73:713-720. https://doi.org/10.1001/jamapsychiatry.2016.0465
  6. Caye A, Rocha TB, Anselmi L, Murray J, Menezes AM, Barros FC, et al. Attention-deficit/hyperactivity disorder trajectories from childhood to young adulthood: evidence from a birth cohort supporting a late-onset syndrome. JAMA Psychiatry 2016;73:705-712. https://doi.org/10.1001/jamapsychiatry.2016.0383
  7. Noh GM, Lee SM, Bahn GH. Social function of adult men with attention-deficit/hyperactivity disorder in the context of military service. Neuropsychiatr Dis Treat 2018;14:3349-3354. https://doi.org/10.2147/NDT.S180806
  8. Kooij SJ, Bejerot S, Blackwell A, Caci H, Casas-BruguE M, Carpentier PJ, et al. European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD. BMC Psychiatry 2010;10:67. https://doi.org/10.1186/1471-244X-10-67
  9. Young S, Adamou M, Asherson P, Coghill D, Colley B, Gudjonsson G, et al. Recommendations for the transition of patients with ADHD from child to adult healthcare services: a consensus statement from the UK adult ADHD network. BMC Psychiatry 2016;16:301. https://doi.org/10.1186/s12888-016-1013-4
  10. Faltinsen E, Zwi M, Castells X, Gluud C, Simonsen E, Storebo OJ. Updated 2018 NICE guideline on pharmacological treatments for people with ADHD: a critical look. BMJ Evid Based Med 2019;24:99-102. https://doi.org/10.1136/bmjebm-2018-111110
  11. Seixas M, Weiss M, Muller U. Systematic review of national and international guidelines on attention-deficit hyperactivity disorder. J Psychopharmacol 2012;26:753-765. https://doi.org/10.1177/0269881111412095
  12. Sibley MH, Pelham WE, Molina BSG, Gnagy EM, Waxmonsky JG, Waschbusch DA, et al. When diagnosing ADHD in young adults emphasize informant reports, DSM items, and impairment. J Consult Clin Psychol 2012;80:1052-1061. https://doi.org/10.1037/a0029098
  13. Kim JH, Lee EH, Joung YS. The WHO adult ADHD self-report scale: reliability and validity of the Korean version. Psychiatry Investig 2013;10:41-46. https://doi.org/10.4306/pi.2013.10.1.41
  14. Kooij JJS. Adult ADHD. Diagnostic assessment and treatment. 3rd ed. London: Springer-Verlag;2013. p.292.

Cited by

  1. Development of the Korean Practice Parameter for Adult Attention-Deficit/Hyperactivity Disorder vol.31, pp.1, 2019, https://doi.org/10.5765/jkacap.190030
  2. The Past Four Years Research Work of the Adult Attention-Deficit/Hyperactivity Disorder Special Interest Group in the Korean Academy of Child and Adolescent Psychiatry vol.31, pp.1, 2019, https://doi.org/10.5765/jkacap.190031
  3. Being a Chameleon vol.31, pp.1, 2020, https://doi.org/10.5765/jkacap.190042