• Title/Summary/Keyword: 주의력결핍/과잉행동장애

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NEW DRUG THERAPY IN CHILD AND ADOLESCENT PSYCHIATRY-NEW LONG-ACTING PSYCHOSTIMULANTS (소아청소년 정신과 영역에서의 새로운 약물치료:새로운 장기작용형 중추신경자극제)

  • Choi, Sung-Ku
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.3-11
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    • 2003
  • Attention-deficit/Hyperactivity disorder(ADHD) is the most common psychiatric disorder of childhood and among the most prevalent chronic health conditions affecting school-aged children. Children with ADHD experience significant functional problems, such as school difficulties, academic underachievement, troublesome interpersonal relationships with family members and peers, and low self-esteem. The most widely used pharmacological treatments for ADHD are psychostimulants, such as methylphenidate and amphetamine salts. These medications provide clinical efficacy by increasing the availability of catecholamines, primarily dopamine, in the frontal lobe of the brain. immediate-release(IR) formulations of sychostimulants were among the most effective psychotrophic medications in the psychopharmacological treatment. However, there are some limitations of IR formulations:the short half-life and duration of efficacy, which result in the need for multiple daily dosing and the poor compliance. These limitations have led to the development of once-daily, extended-release(ER) formulations of methylphenidate and amphetamine salts. However, these ER formulations may not be as immediately helpful to ADHD children due to delayed onset of action and the acute tolerance which is the failure to sustain the efficacy with the same concentration of drug as the initial stage of medication. OROS-methylphenidate(Concerta$^{\circledR}$) given once a day produces an ascending-pattern plasma drug level generated by the osmotically released, timed drug-delivery system. These new formulations of the psychostimulants have been shown to be a useful alternative to old stimulant medications through the evidence by the clinical trials.

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A FAMILY-BASED AND CASE-CONTROL ASSOCIATION STUDY OF THE DOPAMINE BETA HYDROXYLASE GENE POLYMORPHISM IN ATTENTION DEFICIT HYPERACTIVITY DISORDER (한국인 주의력결핍 과잉행동장애와 Dopamine Beta Hydroxylase 유전자의 관련성 : 가족기반 연구 및 환자-대조군 연구)

  • Park Tae Won;Kim Boong Nyun;Im Myung-Ho;Yoo Hee Jeone;Kang Daehee;Cho Soo Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.54-62
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    • 2005
  • Objective : Attention deficit hyperactivity disorder (ADHD) is the most common childhood psychiatric disorder, affecting $3-5\%$ of school age children. Although the biological basis of ADHD is unknown, family studies provide strong evidence that ADHD has a genetic basis. Recent genetic studies have suggested associations between ADHD and Taq I polymorphism of dopamine beta hydroxylase gene(DBH) . The aim of this study is to test the association between ADHD and Taq I polymorphism of DBH in Korean population. Method : We processed DNA extraction and genotyping for 106 korean children with ADHD and their parents. Genotyping was additionally performed for 212 age and gender matched normal controls. Case-control association study was applied. And we tested the association using the transmission disequilibrium test (TDT) and haplotype-based haplotype relative risk test (HHRR). Results : There were no statistical differences of genotype distributions between cases and controls. However, we did observe preferential transmission of allele Al of DBH Taq T polymorphism in ADHD. Conclusion : On the whole, our results lend credence to the notion that the relationship between ADHD and DBH is complex. The number of cases and informative transmissions were small, therefore it would be premature to make any conclusions from our study concerning the role of DBH in ADHD. Further work is needed to support these findings.

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Association of the Symptoms of Parental Attention-Deficit Hyperactivity Disorder and the Parental Personality Patterns with the Symptoms of Boys with Attention-Deficit Hyperactivity Disorder (주의력결핍 과잉행동장애 남아의 증상과 부모의 주의력결핍 과잉행동 증상 및 인격 양상과의 관련성)

  • Shin, Woo-Seung;Choi, Hye-Ra;Kim, Kun-Woo;Lee, Joong-Sun;Park, Su-Bin;Hong, Jin-Pyo;Yoo, Han-Ik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.20 no.1
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    • pp.23-28
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    • 2009
  • Objectives : This study was conducted to investigate the association between the symptoms of boys with attention-deficit hyperactivity disorder (ADHD) and the attention-deficit hyperactivity symptoms, temperament and character patterns of their parents. Methods : Forty-five boys with ADHD and who met the DSM-IV criteria were evaluated by using the ADHD rating scale (ADHD-RS), and their parents completed the Korean Adult ADHD scale (K-AADHDS) and the Temperament and Character Inventory (TCI). Results : The parental K-AADHDS scores were not associated with the ADHD-RS total score and the subscale scores of their siblings. The most potent variable related to the ADHD-RS total score was the maternal self-directedness, and the second was the maternal persistence. The maternal self-directedness was the variable that was most correlated with the hyperactivity/impulsivity subscale scores of the ADHD-RS. Conclusion : The results suggest that the paternal ADHD symptoms may not be related to the ADHD symptoms of boys with ADHD. Higher maternal self-directedness and persistence may decrease overall the ADHD symptoms of these boys, and higher maternal self-directedness itself may predict lower hyperactivity/impulsivity symptoms of the boys with ADHD.

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RELATIONSHIP BETWEEN CHANGES IN EVENT-RELATED POTENTIALS AND CHANGES IN CONTINUOUS PERFORMANCE TEST UNDER THE INFLUENCE OF METHYLPHENIDATE IN ATTENTION-DEFICIT/HYPERACTIVITY DISORDER (주의력 결핍 ${\cdot}$ 과잉행동장애 아동에서 Methylphenidate에 의한 사건관련전위와 연속과제수행 변화사이의 상관성)

  • Choi, Young;Lee, Mu-Suk;Lee, Mi-Suk
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.2
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    • pp.273-286
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    • 1997
  • Objective:This study was designed to evaluate effects of methylphenidate(MPH) on event-related potentials(ERP) and continuous performance test(CPT) in attention-deficit hyperactivity disorder (ADHD) and to see the correlation between changes in ERP and changes in performance. Method:ERP and CPT were used to examine the acute effects of MPH(0.5mg/kg) in eleven ADHD boys(89-103 months old). Results:1) After MPH administration, P3 latency to nontarget stimuli at Fz was significantly decreased (p<0.01) and P2 amplitudes to target stimuli at Pz and at Oz and P3 amplitude to target stimuli at Cz were significantly increased(p<0.05). 2) Commission error and omission error in the CPT-X and commission error in the CPT-AX were decreased(p<0.01), and hits and perceptual sensitivity(d') in the CPT-X and d′ in the CPT-AX were increased(p<0.01). 3) The change of P3 latency to nontarget stimuli at Fz and the change of d′ in the CPT-X were negatively correlated(p<0.05), and the change of P2 amplitude to target stimuli at Pz and d′ in the CPT-AX were positively correlated(p<0.05). Conclusion:MPH improves change orienting reaction, the delivery of task relevant information, accuracy and perceptual sensitivity in ADHD. And the increase of ability to discriminate targets from non-targets reflects reduced evaluation time in large memory component task and enhanced change orienting reaction in simple task.

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Convergence Study of Psychosocial Characteristics and Factors Relating on Internet Addiction in Patients with Internet Addiction (인터넷 중독 임상군의 심리사회적 특성과 인터넷 중독 영향요인에 대한 융합 연구)

  • Song, Yul-Mai;Kim, Sunah
    • Journal of the Korea Convergence Society
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    • v.9 no.7
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    • pp.337-346
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    • 2018
  • The purpose of this study was to identify the characteristics and the attributes related to Internet use in patients with Internet addiction. This study is a descriptive secondary analysis study, at Internet addiction clinics used the data of 63 patients diagnosed with Internet addiction. Data were obtained from Internet addiction clinic Electronic Medical Records(EMR), there was included the Korean Internet addiction scale(K-scale), Beck Anxiety Inventory(BAI), Beck Depression Inventory(BDI), Barratt Impulsivity scale(BIS), Conners ADHD Rating Scale(CAARS), Lubben Social Network Scale(LSNS). K-scale had significantly correlations with Internet use time per day, anxiety, impulsivity, Attention deficit Hyperactivity Disorder(ADHD) symptom. In stepwise multiple regression, factors significantly affecting ADHD symptom (${\beta}=.37$), Internet use time per day(${\beta}=.29$), Impulsivity(${\beta}=.25$), which accounted for 44% of the variance. Results indicate that patients with Internet addiction had psychological difficulties and suggest that children with ADHD needed to intervention for appropriate internet use.

Depression, Anxiety, Alexithymia, Stress Response in Caregivers of Attention Deficit Hyperactivity Disorder Patient (주의력결핍 과잉행동장애 환아 보호자의 우울, 불안, 감정표현불능, 스트레스반응)

  • Jeong, Jong-Hyun;Hong, Seung-Chul;Han, Jin-Hee;Lee, Sung-Pil
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.2
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    • pp.95-101
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    • 2005
  • Objectives : This study was designed to investigate depression, anxiety, alexithymia, stress res ponses in caregivers of patients with attention deficit hyperactivity disorder. Methods : The subjects were 38 attention deficit hyperactivity disorder patients caregivers(38 women, mean age $37.5{\pm}6.5$). Patients were diagnosed with DSM-IV ADHD criteria. Korean version of Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI), Toronto Alexithymia Scale(TAS) and Stress Response Inventory(SRI) were used for assessment. Results 1) The BDI scores of ADHD patients caregiver group were significantly higher than control group$(16.4{\pm}7.1\;vs.\;10.9{\pm}5.5)(p=0.011)$. 7 of the 38 caregivers(18.4%) and none of control group(0%) had BDI scores over 20 points(p=0.021). Calculated relative risk for ADHD in the presence of caregivers' depression was 1.516 overall(95% confidence interval, 1.234-1.862). 2) In ADHD patient's caregiver group, the scores of Stress Response Inventory were significantly higher than control group$(44.2{\pm}20.2\;vs.\;26.5{\pm}16.8)(p=0.006)$. 3) No significant differences were found in the score of STAI, SIAIS, SIAI-T, TAS between caregiver and control group. Conclusion : This study suggest that ADHD patients' caregivers are likely to have more depressive symptoms and higher stress response level than control group. We propose that physicians should consider integrated approaches for caregiver's psychopathology in the management of ADHD.

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ATTENTION DEFICIT-HYPERACTIVITY DISORDER: A CASE REPORT (주의력결핍-과잉행동장애 환아의 증례)

  • So, Jeong-Won;Ra, Ji-Young;Lee, Kwang-Hee;An, So-Youn;Kim, Yun-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.4
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    • pp.482-487
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    • 2010
  • Attention Deficit-Hyperactivity Disorder(ADHD) is the most common psychiatric disorder in school-age children which is increasing gradually. It is hard for ADHD children to focus on particular stimulus for a long time. ADHD children are characterized by hyperactivity which shows in behaviors like, talking too much, getting up from their seats without permission, running around, keep on moving their arms and legs. ADHD children have problems with impulse controlling that they tend to fall and get into an accident very often. Thus dentist's attention and care must increase when dental treatment is performed with ADHD children since behavior control, oral hygiene problems, and trauma might be expected. By using sedative drugs and psychological behavior control, chief complaint was resolved in a 8-years-old female diagnosed for ADHD.

Major Lessons from the MTA in Treatment of Attention-Deficit Hyperactivity Disorder (주의력결핍 과잉행동장애 치료에서 MTA의 주요 교훈)

  • Hwang, Jun-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.21 no.1
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    • pp.3-10
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    • 2010
  • Objectives : The current review aimed to describe the major findings of the NIMH Collaborative Multisite Multimodal Treatment Study of Children with Attention-Deficit Hyperactivity Disorder (MTA) with regard to the treatment of children with attention-deficit hyperactivity disorder (ADHD). Methods : We performed a general review of the literature regarding the efficacy of the MTA's proposed treatments. Results : There is a large and still increasing body of evidence regarding the MTA's treatment outcomes. We present and discuss details of the findings at each follow-up point. Conclusion : Currently, findings regarding the MTA's treatments suggest children with combined-type ADHD exhibit significant impairment in adolescence, despite their initial symptom improvement. Further studies, using innovative treatment approaches and targeting specific areas of adolescent impairment, are needed in order to enhance ADHD treatment outcomes.

The Relationship Between Mother-Child Interaction Play Assessment of Children with Attention Deficit Hyperactivity Disorder and Delinquency-Oriented Behavior : Observational Study (주의력결핍 및 과잉행동장애 아동의 모-자녀 상호작용 놀이평가와 비행성향행동과의 관계 : 관찰연구)

  • Oh, Mi Kyoung
    • Korean Journal of Child Studies
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    • v.25 no.3
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    • pp.59-74
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    • 2004
  • The purpose of the this study was to examine the relationship between mother-child interaction play assessment of children with Attention Deficit Hyperactivity Disorder(ADHD) and delinquency through observational method. The subjects were 30children(normal: 15, ADHD: 15) between 4-6 elementary school grade. Instruments used Parent-Child Interaction Assessment(P-CIPA), Inventory of Delinquency-Oriented Behavior and Korea Children Behavior Check List(K-CBCL). Results showed that following : 1) ADHD affect the delinquency-oriented behavior; 2) there were significant differences in mother-child interaction play assessment between normal children group and ADHD children group; and 3) there was a significant relationship between parent-child interaction play assessment and delinquency.

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COMPARATIVE STUDY OF BEHAVIOR AND COGNITIVE FUNCTION BY ADMINISTRATION OF METHYLPHENIDATE AND IMIPRAMINE IN ATTENTION DEFICIT-HYPERACTIVITY DISORDER (Methylphenidate와 Imipramine투여에 따른 주의력 결핍${\cdot}$과잉운동장애 환아의 행동 및 인지기능 변화에 대한 연구)

  • Ahn, D.H;Hong, K.E;Oh, K.J;Shin, M.S;Yoo, B.C;Chung, K.M
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.3 no.1
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    • pp.26-45
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    • 1992
  • This study presents the behavioral and cognitive changes by administration of methylphenidate(MPH) and imipramine(IMI) for the treatment of attention-deficit hyperactivity disorder(ADHD) in $5_{1/2}{\sim}12$ years old children referred to child psychiatric clinics. Behavioral changes are assessed with parent's and teacher's ratings. Drug effects on attention. short-term memory, and impulsivity are evaluated with psychological tests in laboratory. The changes were assessed twice in a 8-week periods. The data were analyzed seperately for 15 subjects each drug using repeated measured analysis of variance(ANOVA). The findings indicates that behavioral and cognitive impairments are improved by both drugs, but impulsivity is not. And MPH is superior to IMI on the improvement of attentional problem ; especially the findings indicates important differences between simple task and complex. perceptual-search task. These data confirm the effectiveness of MPH for treatment of ADHD, also raise questions regarding assessment method of attention and impulsivity as fell as importance of impulsivity in ADHD.

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