• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.23 no.2
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• pp.57-62
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• 2012

Objectives : Characteristic symptoms, including hyperactivity and easy distractibility, in children with attention-deficit hyperactivity disorder (ADHD) suggest that their brain status, even at rest, might differ from that of healthy children. This study was conducted in order to determine whether resting state brain activity is compromised in medication-naive children with ADHD. Methods : Twenty medication-naive children with ADHD (mean age $10.3{\pm}2.5$) and 28 age- and gender-matched healthy volunteers (mean age $10.3{\pm}2.0$) underwent measurements for resting state brain activity using functional magnetic resonance imaging (fMRI). Among resting state related-independent components (RSICs) extracted from fMRI data using independent component analysis, a significant difference in RSICs was observed between groups, using a mixed Gaussian/gamma model. Results : Except for IQ, which was higher in the healthy control group, no demographic difference was observed between the two groups (p<.001). Significantly less activation of one RSIC, which includes the bilateral precuneus/posterior cingulate cortex, occipito-temporal junction, and anterior cingulate cortex, was observed in the ADHD group, compared with the control group (p<.05). Conclusion : An abnormal RSIC, posterior default mode network (DMN), was observed in the medication-naive ADHD group. Results of our study suggest that abnormality of posterior DMN is one of the main pathophysiologies of ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.27 no.4
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• pp.313-318
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• 2016

Objective: The purpose of this study was to investigate the clinical utility of the Korean Wechsler Intelligence Scale for Children-Fourth Edition (K-WISC-IV) and General Ability Index (GAI) in children with attention-deficit hyperactivity disorder (ADHD). Methods: The GAI and Full Scale IQ (FSIQ) in K-WISC-IV were compared for a group of 79 children with ADHD and 234 normal children. The mean differences within each group were testified by the t-test and Cohen's d. The Wechsler's descriptive classifications for each GAI and FSIQ score were analyzed in the children with ADHD. Additionally, the critical value for the difference between the means of the FSIQ and GAI was calculated in the normal children. Results: The score on the GAI was higher than that on the FSIQ in the children with ADHD, with a mean difference of 2.19 points. The implications of these findings are discussed regarding the cognitive characteristics of the children with ADHD. According to Wechsler's descriptive classification, the application of the GAI showed a lower (7.59%), equal (61.65%) or higher (60.76%) prevalence of ADHD compared to the application of FSIQ. Conclusion: The implications of these findings are discussed regarding the cognitive characteristics of the children with ADHD. The GAI reflecting the attention and behavioral problems in children with ADHD could be utilized as an alternative global intelligence estimate that considers their potential for development.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.27 no.1
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• pp.64-71
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• 2016

Objectives: The objective of this study was to examine the effects of osmotic-controlled release oral delivery system methylphenidate on changes in regional cerebral blood flow (rCBF) in children with attention-deficit hyperactivity disorder (ADHD) using single photon emission computed tomography (SPECT). Methods: A total of 26 children with ADHD (21 boys, mean age: $9.2{\pm}2.05$ years old) were recruited. Each ADHD participant was examined for changes in rCBF using technetium-99m-hexamethylpropylene amine oxime brain SPECT before and after 8 weeks methylphenidate medication. Brain SPECT images of pediatric normal controls were selected retrospectively. SPECT images of ADHD children taken before medication were compared with those of pediatric normal controls and those taken after medication using statistical parametric mapping analysis on a voxel-wise basis. Results: Before methylphenidate medication, significantly decreased rCBF in the cerebellum and increased rCBF in the right precuneus, left anterior cingulate, right postcentral gyrus, right inferior parietal lobule and right precentral gyrus were observed in ADHD children compared to pediatric normal controls (p-value<.0005, uncorrected). After medication, we observed significant hypoperfusion in the left thalamus and left cerebellum compared to pediatric normal controls (p-value<.0005, uncorrected). In the comparison between before medication and after medication, there was significant hyperperfusion in the superior frontal gyrus and middle frontal gyrus and significant hypoperfusion in the right insula, right caudate, right middle frontal gyrus, left subcallosal gyrus, left claustrum, and left superior temporal gyrus after methylphenidate medication (p-value<.0005, uncorrected). Conclusion: This study supports dysfunctions of fronto-striatal structures and cerebellum in ADHD. We suggest that methylphenidate may have some effects on the frontal lobe, parietal lobe, and cerebellum in children with ADHD.

• Clinical and Experimental Pediatrics
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• v.51 no.12
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• pp.1324-1328
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• 2008

Purpose : Attention deficit hyperactivity disorder (ADHD) is a syndrome characterized by inattention, impulsive disruptive behavior, impaired concentration, and motor restlessness. This study examined the relationships among electroencephalographic (EEG) findings, stimulant use, and seizure occurrence in children with ADHD. Methods : We retrospectively studied 308 children with ADHD who visited the neuropsychiatric clinic of our hospital from January 2001 to December 2005. We retrospectively analyzed age distribution, etiology, abnormal EEG findings, and use of CNS stimulants. Among these children, brain waves was recorded in 84 patients. Results : Eighty-four children (72 males, 85.7%, 9.3 years mean age; 12 females, 14.3%, 8.0 years mean age) with ADHD had electroencephalograms (EEGs) performed at our institute. Nineteen patients (22.6%) demonstrated epileptiform abnormalities, and 65 (77.4%) demonstrated normal EEGs. Stimulant therapy was applied to 59 of 84 patients (70.2%). Seizures occurred in 1 of 65 patients with a normal EEG (incidence, 1.5%) and 3 of 19 treated patients with epileptiform EEGs (incidence, 15.7%). Conclusion : These data suggest that patients with normal EEGs have minor risk for seizure. In contrast, patients with epileptiform EEGs have higher risk for seizure than patients with normal EEGs.

• The Journal of the Korea institute of electronic communication sciences
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• v.17 no.5
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• pp.809-814
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• 2022

ADHD is a disorder showing inattentiveness and hyperactivity. Since symptoms diagnosed in childhood continue to the adulthood, it is important to diagnose ADHD and start treatments in early stages. However, it has the problems to acquire enough and accurate data for the diagnosis because the mental state of children is immature using the self-diagnosis method or the computerized test. In this paper, we present the classification method based on the CNN model and execute experiment using the EEG data to improve the objectiveness and the accuracy of ADHD diagnosis. For the experiment, we build the 3D convolutional networks model and exploit the 5-folds cross validation method. The result shows the 97% accuracy on average.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.16 no.1
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• pp.90-97
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• 2005

Objectives : The present study was conducted to investigate a correlation of ADS and KEDI-WISC measures. Methods : The data of 91 children were used. On KEDI-WISC, PIQ, VIQ, and 11 subtest measures, and on ADS, 4 variables (ommission error rate, commission error rate, response time mean, and response time deviation) were analyzed. Results : The correlations of Ommission Error Rate and Coding, Digit Span, and Arithmetic, the correlations of Commission Error Rate and Object assembly, Picture Completion, Arithmetic, Digit Span, and Coding, the correations of Response Time Mean and Coding, and the correlations of Response Time Deviation and PIQ, and Coding were significant. Conclusion : ADS variables and several IQ scores are significantly related.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.2
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• pp.174-179
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• 1998

Objective：Present study investigated the relationship between mothers' self-perception and perception of children's problems. Method：Subjects were 63 children, mothers, who visited child & adolescent psychiatric clinic. Their mothers completed Minnesota Mulpiphasic Personality Inventory(MMPI) & Korean Personality Inventory for Children(KPI-C). Correlation between validity scales of mothers' MMPI and validity scales of KPI-C was analysed, and then we divided subjects into two group(High & Low Group) according to the MMPI validity scales, and compared KPI-C's validity scales by student t-test. Result：There were significant positive correlation(r=.30) between K scale of MMPI and L scale of KPI-C, significant negative correlation(r=-.32) F scale of MMPI and L scale of KPI-C. The Means of T scores did show significant difference according to MMPI F, K scales in KPI-C L scale, to MMPI L scale in KPI-C F scale. Conclusion：These results indicated that defensive mothers tend to perceive her child's problems more defensively. However mothers who exaggerate their problem more severely, do not exaggerate their children's problem. Therefore, these result suggested that we should be careful not to underestimate children's problem whose mother elevated in K scale of MMPI.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.7 no.1
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• pp.92-109
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• 1996

The objectives of the present study were to provide comprehensive assessment of the impact of epilepsy on the psychological well-being of children with epilepsy and to identify the neurological factors associated with the psychopathology. The participant patients were recruited from the population of children and adolescent aged 7 to 16 attending the OPD of department of pediatric neurology in Seoul National University Hospital in Korea. We exclude mental retardation, pervasive developmental disorder and brain organic pathology. As control group, formal students were chosen and their sex, age, achievement, socioeconomic status were matched to patients. The first author interviewed the children and their family members and obtained the developmental history and family information. We used the following 10 scales for assessing psychological and behavioral problems in patients and their family member. The scales were standardized and their validity and reliability were confirmed before. Parent rating scales : Yale children's inventory, Disruptive behavior disorder scale, Parent's attitude to epilepsy questionnaire, Family environment scale, Symptom check-list-90 revision, Children behavior check-list. Children's self rating scales : Children's depression inventory, Spielberger's state-trait anxiety anxiety, Piers-Harris self-concept inventory and Self-administered Dependency questionnaire for Mother. The result showed the risk factors associated depression were early onset, complex partial seizure, lateralized temporal focal abnormality on EEG, Drug polypharmacy, high seizure frequency and sick factors associated anxiety were old age of patient, lateralized temporal focal abnormality EEG, Drug polypharmacy, high seizure frequency. Also the result of this present study indicated that risk factors associated oppositional defiant disorder, conduct disorder and attention deficit hyperactivity disorder were young age, male, early onset, lateral temporal EEG abnormality and high seizure frequency. According to these results, common risk factors associated psychological and behavioral problems were lateralized EEG temporal abnormality, high seizure frequency in neurological factors.

• Therapeutic Science for Rehabilitation
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• v.10 no.2
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• pp.129-140
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• 2021

Objective : The purpose of this study was to examine differences in social maturity and behavioral problems according to the level of sleep problems in children with ASD. Methods : The participants were 102 mothers of infants with ASD aged 1-5 years. The Social Maturity Scales (SMS) and Child Behavior Checklist 1.5-5 were used as the measuring tools. Results : The level of sleep problems in infants with ASD was 56.58T on the sleep problems scale. The participants were grouped based on scores on the sleep problems scale: those with scores <65 (good sleepers) or scores ≥65 (poor sleepers). Sleep problems significantly correlated with all the scales on the CBCL. However, no association was found between sleep problems and social quotients. Poor sleepers achieved significantly lower scores on the social quotient scale of the SMS than good sleepers. Poor sleepers achieved significantly higher scores in internalizing problems, externalizing problems, and DSM-oriented scales on the CBCL compared to those in the good sleepers. Conclusion : The significance of this study is that it has verified the severity of sleep problems in infants with ASD and has examined the differences in social maturity and behavioral problems between poor sleepers and good sleepers.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.1
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• pp.12-25
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• 2003

Objectives：As increasing number of new antidepressants have been being introduced in clinical practice, pharmacological understanding has been broadened. These changes mandate new information and theories to be incorporated into the treatment process of children with depressive disorders. In light of newly coming knowledge, this review intended to recapitulate the characteristics of new antidepressants and to consider the pivotal issues to develope guidelines for the treatment of depression in childhood and adolescence. Methods：Searching the Pub-Med online database for the articles with the key words of 'new', 'antidepressants' and 'children' ninety-seven headings of review articles were obtained. The author selected the articles of pertinent subjects in terms of either treatment guideline or psychopharmacology of new antidepressants. When required, articles about the clinical effectiveness of individual antidepressants were separatedly searched. In addition, the safety information of new antidepressants was acquired by browsing the official sites of the United States Food and Drugs Administration and Department of Health and Human Services. Results：1) For the clinical course, treatment phase, and treatment outcome, the reviews or treatment guidelines adopted the information from adult treatment guidelines. 2) Systematic and critical reviews unambiguously concluded that selective serotonin reuptake inhibitors(SSRIs) excelled tricyclic antidepressants( TCAs) for both efficacy and side effect profiles, and were recommend for the first-line choice for the treatment of children with depressive disorders. 3) New antidepressants generally lacked treatment experiences and randomized controlled clinical trials. 4) SSRIs and other new antidepressants, when used together, might result in pharmacokinetic and/or pharmacodynamic drug-to-drug interaction. 5) The difference of the clinical effectiveness of antidepressants between children and adults should be addressed from developmental aspects, which required further evidence. Conclusion：Treatment guidelines for the pharmacological treatment of childhood and adolescence depression could be constructed on the basis of clinical trial findings and practical experiences. Treatment guidelines are to best serve as the frame of reference for a clinician to make reasonable decisions for a particular therapeutic situation. In order to fulfill this role, guidelines should be updated as soon as new research data become available.