• 생물정신의학
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• 제25권2호
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• pp.21-30
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• 2018

Attention deficit hyperactivity disorder (ADHD) is a common childhood psychiatric disorder. Recently, it has been suggested that brain-derived neurotropic factor (BDNF) may play a role in the pathogenesis of ADHD. Our aim of this review is to understand the physiological functions of BDNF and its potential relationship with ADHD and therapeutic approaches of ADHD. Searches were conducted in Pubmed and Research Information Service System (RISS). In this review, we summarized important literatures for the physiological functions of BDNF in neurodevelopment, change of serum BDNF level in ADHD, association of BDNF polymorphism and ADHD and potential association of treatment of ADHD with serum BDNF level. Further studies are required to more clearly understand the source and the role of BDNF in ADHD and to develop BDNF based-ADHD treatement.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제7권2호
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• pp.190-202
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• 1996

본 논문은 주의산만이나 과잉운동을 주소로 대학병원 정신과에 내원한 5세에서 13세 사이의 환아들을 대상으로 인구학적 특성과 주진단 및 공존질병에 대해서 조사하였고, 그 중에서 주의력결핍 과잉운동장애(ADHD)로 진단 받은 환아들의 인구학적 및 임상적 특성을 조사하였으며, 공존질병이 있는 집단과 ADHD만 있는 집단을 비교 분석하였다. 또한 ADHD군과 외향적장애군 및 내향적장애군 등 세집단간의 임상특성과 심리검사상의 차이를 알아보았다. 주진단은 ADHD가 가장 많았고. 불안장애, 정신지체, 우울증, 반항장애, 발달성언어장애 등의 순이었다. 두 가지 이상의 진단이 내려진 경우가 48.9% 이었고, 부진단으로는 유뇨증, 품행장애, 발달성언어장애 등이 있었다. 주진단을 ADHD로 받은 환아들에서 공존질병이 있는 경우가 55.3%에 달했고. 공존질병은 특수발달장애, 품행장애, 반항장애, 불안장애 등의 순이었다. 순수 ADHD군에 비해서 공존질병 수반군에서는 동작성 지능검사와 연속과제수행검사에서 저조한 수행을 보였다. 외향적장애군은 ADHD군에 비해 지능검사의 상식 소검사 및 같은 그림찾기 검사와 연속과제수행검사에서 수행의 저하를 보였다. 내향적장애군은 ADHD군에 비해 교사 평정척도 점수가 낮았고, 아동행동조사표의 소통불능요인이 높았으며 연속과제수행검사에서는 카드 오류수가 낮았다. 본 연구의 결과를 볼 때 주의산만이나 과잉운동이 주증상으로 나타날 경우 각종 평가 및 신경심리검사도구를 광범위하게 사용하여 ADHD 외에도 외향적 및 내향적장애군 등 다양한 질환을 감별하여야 하며, ADHD 진단을 내리는 경우에도 수반된 공존질병의 유무를 확인하여 이를 치료계획에 반영하여야 할 것으로 생각된다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권2호
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• pp.123-131
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• 2017

Objectives: Executive dysfunction including working memory deficit has been suggested to be one of the major neuropsychological etiologies of attention-deficit hyperactivity disorder (ADHD). The purpose of this study was to investigate the augmentative effects of Cogmed working memory training on the symptoms and neurocognitive functions in medicated children and adolescents with ADHD. Methods: Twenty-five children with ADHD, aged 7 to 19 years, taking ADHD medication participated in this study. The participants were trained for 5 weeks with a commercially available and computerized working memory program ($Cogmed^{(R)}$) without any changes to their medication. The Korean version of the ADHD Rating Scale, Clinical Global Impression Scale, and Comprehensive Attention Test were administered before training and 4 weeks and 7 months after training, respectively. Results: After completing the training, the clinical symptoms and function, rated by the parents and clinician, were improved. In addition, the level of commission errors was significantly reduced in the selective attention (visual/auditory) task, sustained attention to response task, and flanker task. The untrained visuospatial short-term memory and working memory were also improved. These effects were still observed 7 months after the training. Conclusion: Cogmed working memory training can be a promising training option for the additional improvement of the symptoms and deficits in working memory and response inhibition in medicated children with ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권2호
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• pp.70-83
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• 2017

The objective of this review is the revision of the Korean practice parameters for the pharmacological treatment of attention-deficit hyperactivity disorder (ADHD) based on the change in the diagnostic system from DSM-IV-TR to DSM-5 and psychopharmacological developments. For the evidence-based approach, the authors conducted a review of the literature, including controlled clinical trials, studies of the side effects of drugs, toxicology and meta-analyses from the United States and Europe, as well as recent research conducted in Korea. The review committee composed of Korean experts on ADHD reviewed the revised parameters. This revised version reveals how to use central nervous system psychostimulants, non-stimulants such as atomoxetine and alpha2 agonists, and other medication for ADHD, and how to manage the adverse effects of such medication. At the end of this revised version, the authors propose recommendations for the pharmacotherapy of ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권2호
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• pp.84-95
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• 2017

Attention-deficit hyperactivity disorder (ADHD) is a neuropsychiatric disorder that begins in early childhood and can persist throughout adulthood. ADHD causes difficulties in various area of life, such as academic achievement, peer relationships, family functioning, employment and marriage. Although ADHD is known to respond well to medication, such treatment is more effective when combined with psychosocial (non-pharmacologic) therapy in terms of alleviating the core symptoms and improving appropriate functions. Psychosocial treatment interventions are divided into psychoeducation, behavioral parent training, school intervention, cognitive behavior therapy, social skill training, parent-child interaction therapy, play therapy, other treatments (coaching, complementary and alternative medicine), neurofeedback and Cogmed. Adult ADHD cognitive behavioral therapy is described separately. These practice parameters summarize the evidence for psychosocial treatment. Based on this evidence, specific recommendations are provided for psychosocial interventions.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제26권2호
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• pp.112-119
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• 2015

Objectives : The purpose of this study was to examine the prenatal, perinatal and developmental risk factors of attention-deficit hyperactivity disorder (ADHD), compared to unaffected siblings (SIB), and typically developing children (TC). Methods : Subjects with ADHD, their SIB, and TC were recruited from the child psychiatry outpatient clinic of the Asan Medical Center Children's Hospital. The parents of the children completed questionnaires on perinatal and developmental risk factors. Results : Fifty-eight subjects with ADHD (41 boys, $7.7{\pm}1.3years$), 21 SIB (8 boys, $8.2{\pm}1.8years$), and 22 TC (8 boys, $8.5{\pm}2.1years$) were included. The ADHD group showed higher rates of maternal stress during pregnancy than the SIB group (p=.002), and the ADHD group showed higher rates of familial psychiatric history than the TC (odds ratio, 8.76 ; 95% confidence interval, 1.69 to 45.45). Conclusion : These findings suggest that among perinatal and developmental factors, maternal stress during pregnancy contribute to the development of ADHD. Future prospective studies will be needed in order to determine the causal relationship between perinatal risk factors and development of ADHD.

• 한국간호교육학회지
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• 제20권3호
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• pp.382-391
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• 2014

Purpose: The purpose of this study was to identify the predictors influencing on educational intervention for Attention Deficit Hyperactivity Disorder (ADHD) after analyzing the relationship among teachers' internal-external locus of control, leadership type and educational intervention for ADHD. Methods: A cross sectional study design was conducted with 255 teachers in three schools located in D, K and Y city. The data were analyzed by t-test, one-way ANOVA, Pearson correlation coefficients and multiple regression using SPSS 20.0. Results: Internal locus of control showed significantly positive correlations with educational intervention for ADHD. Efficient leadership type, harmony-oriented leadership type showed significant differences in inefficient leadership type on educational intervention for ADHD. Significant factors of the educational intervention were efficient leadership type, harmony-oriented leadership type, task-oriented leadership type and internal locus of control that were explained by 20.0% (F=12.5, p<.001) of educational intervention for ADHD. Conclusion: Based on the findings of this study, it is necessary to have teacher's efficient leadership type focused on ADHD symptoms. Teachers need to enhance their positive domain of internal-external locus of control towards students with ADHD to increase the effectiveness of their educational interventions for ADHD.

• 생물정신의학
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• 제14권4호
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• pp.256-261
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• 2007

Objectives : The aim of the present study was to examine whether anxiety and depression of children and mothers were associated with the children's medically unexplained somatic symptoms in attention-deficit/hyperactivity disorder(ADHD). Methods : 83 clinic-referred boys with ADHD and 52 boys without ADHD were included in this study. The frequency of the medically unexplained somatic symptoms, such as general-ache, headache, nausea, eye problems, skin problems, abdominal pain, vomiting was evaluated using the somatic symptom domain of the Child Behavior Checklist(CBCL). Children's anxiety and depression were evaluated using Kovacs Children's Depression Inventory(CDI) and Spielberger's State-Trait Anxiety Inventory(STAI) for children. Maternal anxiety and depression were measured by Spielberger's State-Trait Anxiety Inventory(STAI) and Beck's Depression Inventory(BDI). Stepwise linear regression analysis was used to examine the hypothesis. Results : Score of maternal state anxiety affects the T score of the somatic symptom domain in CBCL significantly(adjusted $R^2$=0.057 ; p=0.026). Conclusion : The frequency of medically unexplained somatic symptom of children perceived by mothers was associated with the high level of maternal state anxiety in ADHD. Frequent maternal report of the children's somatic symptom may be a warrant for the evaluation and management of the maternal state anxiety in ADHD.

• 대한불안의학회지
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• 제7권2호
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• pp.101-106
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• 2011

Objectives : The aim of this study was to investigate whether and how the symptoms of adult attention deficit hyperactivity disorder (ADHD) affect the stress and depressive symptoms in Korean soldiers. Methods : Data were collected on 131 subjects through self-report using the Korean Adult Attention-Deficit/Hyperactivity Disorder Scale (K-AADHDS), Center for Epidemiological Studies Depression Scale (CES-D), Korean Wender Utah Rating Scale (K-WURS), and the Brief Encounter Psychosocial Instrument (BEPSI-K). Student t-tests, Pearson Correlation, Logistic regression, and Path analysis were performed. Results : The scores related to adult ADHD symptoms on the K-AADHDS and K-WURS were correlated with stress scores on the BEPSI-K (r=0.529, p<0.001 and r=0.484, p<0.001) and with depressive symptoms on the CES-D (r=0.686, p<0.001 and r=0.628, p<0.001). Scores related to adult ADHD on the K-AADHDS were the most significant risk factors for stress (O.R=1.198, 95% CI=1.104-1.299), and depressive symptoms (O.R=1.306, p95% CI=1.112-1.534). Path analysis on depressive symptoms showed that adult ADHD symptoms affected stress and depressive symptoms. Conclusion : The results suggest that it may be important to consider the evaluation and treatment of adult ADHD in soldiers. Prospective studies with larger numbers of subjects are warranted to further explore the relevance of the present results.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제22권2호
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• pp.57-66
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• 2011

Introduction : Attention-deficit hyperactivity disorder (ADHD) was a newly coined term for a disease that existed prior to its naming in the mid 20th century. The issue about whether ADHD is a new disorder or merely a new name for an existing disorder is still controversial. The authors tried to find the clues to the answer for this question through reviewing historical documents for traces of ADHD. Contents : We could find literatures and medical records that contain possible ADHD symptoms. In particular, in 1845, Heinrich Hoffmann's 'fidgety Philip' or 'Johnny Look-in-the-air' nearly satisfies today's criteria for ADHD. Methylphenidate was approved as a promising chemical for inattention in 1957 before the establishment of the concept of ADHD. In 1968, ADHD was first officially introduced as "Hyperactivity Reaction of Childhood" by DSM-II. In 1980, DSM-III, 'Attention Deficit Disorder (ADD)' was adopted as an official diagnostic term and changed to 'ADHD' since the creation of DSM-III-R in 1987. Conclusion : As stated above, ADHD has existed since long ago and became familiar via an advanced diagnostic system and therapeutic options.