• Title/Summary/Keyword: 주의력결핍-과잉행동장애

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PSYCHOPHARMACOLOGY OF ADHD WITH COMORBID DISORDERS (주의력결핍 과잉행동장애와 공존질환의 약물치료)

  • Cho, In-Hee
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.36-52
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    • 2003
  • Attention deficit/hyperactivity disorder is one of the most comminly treated conditions in the child psychiatric units and results in substantial impairment in peer, family and academoc functioning. For 70% to 80% of children with a diagnosis of ADHD, stimulant tratment results in successful improvement of the core ADHD symptoms. However, children with ADHD have high level of comorbidity and may respond differently from children with ADHD without comorbidity. Therefore they may need specific treatment plan. We reviewed efficacy and safety of prescribed medication for treating children with ADHD, the relationship between ADHD and the comorbid conditions and treatment algorithm projects of ADHD with/without comorbid conditions performed Korean and American child psychiatrists. Our main objective is to increase the uniformity of treatment and improve the clinical outcomes of children with comorbid ADHD.

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The Effect of a Chorus Program for Children in a Local Child Center on Character, Social Skills, Problematic Behavior, and Attention Deficit ADHD (지역아동센터 아동대상 합창프로그램이 인성, 사회적 기술, 문제행동, 주의력결핍에 미치는 효과)

  • Kim, Eun-Im;Song, Sun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.12
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    • pp.310-320
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    • 2017
  • The purpose of this study is to examine the effects of a chorus program in a local child center regarding character, social skills, problematic behaviors, and ADHD. Subjects of this study included 24 children in elementary schools participating in the daytime programs at a local child center located in Suwon, South Korea. The chorus program was comprised of 12 sessions of 60 minutes each, conducted from April 5-July 5, 2017. Results of this study were as follows: First, during the interviews on the character of the children before and after participation in the chorus program, it was noted that the children became more active in terms of the relationships with others and leadership. However, it was also noted that children were more active at the center than they were at their schools. Second, the differences in social skills before and after the chorus program among children were significant in overall social skills and their sub-variables, indicating that there were effective in adjusting social skills. Third, the differences in problematic behaviors before and after participation in the chorus program were significant only in overall problematic behaviors and excessive behavior. This indicates that the program was effective in improving problematic behaviors, particularly for excessive behavior. Fourth, the differences before and after participation in the chorus program in terms of ADHD were statistically significant for ADHD and its sub-variables of carelessness and hyperactivity impulsiveness. This indicates that there was an overall improvement in attention deficit/hyperactivity disorder. Therefore, the findings in this study showed that the chorus program was effective on enhancing character, social skills, problematic behaviors, and ADHD behaviors.

Off-label use of Psychotropic Medications in Preschool Children with Attention-deficit Hyperactivity Disorder (주의력결핍 과잉행동장애에서 허가 초과 약물 처방 : 학령전기 아동 중심으로)

  • Kim, Eui-Jung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.22 no.2
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    • pp.74-80
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    • 2011
  • Attention-deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder with an onset of symptoms before 7 years of age, often starting as early as the preschool years. The off-label use of methylphenidate (MPH) for 3- to 6-year-old preschool children with ADHD is being more common, although MPH is not licensed for use in children younger than age 6 years, in most countries. Despite the limited data, the review of the literature suggests that MPH meets evidence based criteria as beneficial and safe for carefully diagnosed ADHD preschool children. Carefully monitored administration of evidence-based psychotropic medication in preschool children with ADHD may be indicated if psychosocial treatments are ineffective.

Stimulants Medication of Attention-Deficit Hyperactivity Disorder (주의력결핍 과잉행동장애에서 정신자극제를 이용한 약물치료)

  • Yang, Young-Hui;Yoo, Hee-Jeong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.19 no.2
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    • pp.61-71
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    • 2008
  • Attention-deficit hyperactivity disorder (ADHD) is characterized by inattention, hyperactivity, impulsiveness and problems in other higher cognitive processes such as executive function deficits. Currently, there are many treatment modalities, of which pharmacotherapy is the most strongly supported by scientific and clinical evidence. Stimulants, which are first choice in the pharmacological treatment of ADHD, block dopamine reuptake by binding the dopamine transporter and so increasing the concentration of dopamine in synaptic clefts. Stimulants are effective in improving core ADHD symptoms, as well as the nonspecific symptoms, such as aggressiveness and oppositional behavior. Frequently reported short-term adverse effects are decreased appetite, sleep disturbance, headache, dizziness and irritability. Although questions have been raised about the long-term side effects of stimulants, including growth suppression, cardiovascular events, and abuse potential, there is no clear evidence to support these concerns.

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Non-Stimulant Medications in the Treatment of Attention-Deficit Hyperactivity Disorder (주의력결핍 과잉행동장애에서 비정신자극제 약물치료)

  • Hwang, Jun-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.19 no.2
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    • pp.72-82
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    • 2008
  • The aim of this paper is to evaluate the use of non-stimulants, including atomoxetine, bupropion and modafinil, as alternative approaches to the treatment of children with attention-deficit hyperactivity disorder. A comprehensive review of the empirically based literature regarding the efficacy and the safety of the non-stimulants was performed. There is a large and increasing body of data supporting the efficacy and the safety of non-stimulants. Although the treatment effect sizes for non-stimulants may be smaller than those for stimulants, non-stimulants alone have been shown to be effective in the treatment of attention-deficit hyperactivity disorder as well as several comorbidities. These results suggest that non-stimulants are effective in the treatment of attention-deficit hyperactivity disorder. Further studies are needed to improve our understanding of alternative pharmacological medications in the treatment of attention-deficit hyperactivity disorder.

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Attention Deficit Hyperactivity Disorder and Sleep Problems (주의력결핍 과잉행동장애와 수면 문제)

  • Park, Eun-Jin
    • Sleep Medicine and Psychophysiology
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    • v.18 no.1
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    • pp.10-16
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    • 2011
  • There has been a growing interest in sleep problems associated with attention deficit hyperactivity disorder (ADHD). In this paper, we reviewed the current literature on the underlying sleep problems associated with ADHD. Sleep problems are very common in children with ADHD. Patients with ADHD may have sleep difficulties including difficulty falling asleep, frequent night awakening, increased tiredness upon waking. Children with ADHD are associated to restless legs syndrome, periodic limb movement and sleep-disordered breathing. Screening for other psychiatric comorbidities and the side effects of medications, such as psychostimulants, is also necessary when considering sleep problems in ADHD. Sleep problems can cause a negative impact on the quality of life and emotional well-being both of children with ADHD and their parents. Many evidences suggest that assessment of sleep difficulties should be included in evaluating the patient of ADHD.

BIO-PSYCHOSOCIAL STUDY OF EMOTIONAL BEHAVIORAL PROBLEMS IN KOREAN ELEMENTARY SCHOOL CHILDREN(II) -Quantitated Various EEG Elements of Basic Activity in ADHD and Emotional Behavioral Problem Children by Computerized Wave Form Recognition Method - (국민학교 아동의 정서행동문제에 대한 생물 ${\cdot}$ 정신사회학적 연구(II) -뇌파자동해석장치에 의한 주의력 결핍과잉운동장애 아동과 정서행동문제아동의 뇌파조사-)

  • Lee, Chung-Kyoon;Jang, Kyung-June;Park, Seong-Ho;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.40-54
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    • 1990
  • The author studied EEG differences among normal, children, children with emotional behavioral problems determined by Rutter's questionnaire and children with attention-deficit hyperactivity disorder according to DSM-III-R. The results are as follows ; There were no differences in incidence and pattern of abnormal EEG between normal control children and children with emotional behavioral problems. But children with attention-deficit hyperactivity disorder tend to show lower average amplitude, and less wave percentage time of alpha wave in occipital area than normal did, furdermore wave percentage time of alpha wave appeared more in left occipital area than in right occipital area, These results demonstrated that emotional behavioral problems in elementary school children may not be related to EEG abnormality, Where as children with attention deficit hyperactivity disorder showed underdeveloped alpha waves as compared with normal control children.

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EFFECT OF THE SOCIAL SKILL TRAINING IN ADHD CHILDREN (주의력 결핍 과잉운동장애 아동에서 사회기술훈련의 효과)

  • Park, Soon-Young;Kwack, Young-Sook;Kim, Mi-Koung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.2
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    • pp.154-164
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    • 1998
  • Medication is widely accepted as an effective method to reduce the problem of attention deficit, hyperactivity, impulsivity, resistance and violence of ADHD children. However, it does not provide us with the solution on the conflicting routinized behavioral patterns to gain a high level of self-control and acceptable behavior. As a way of replacing medication, this study applies the social skills training program for ADHD children and measures the level of improvement of social skills and the change of the behavioral patterns. The experiment is carried out on 16 children ranged from 6 to 13 years of age for 10 weeks. The patients are divided into three groups:a pure ADHD group, an ADHD group with conduct disorder, an ADHD group with mental retardation and other symptoms. The change of symptoms and the change of social skills are measured by the Child Behavior Checklist(CBCL), the ADD-H Comprehensive Teacher’s Rating Scale(ACTeRS) and the Social Skills Rating Scale(SSRS), and finally Mastson Evaluation of Social Skills for Youth(MESSY). Wilcoxon signed ranks test is used to evaluate the effect of the treatment, and Kruskal-Wallis test is also used to measure the change after the treatment in each of the three groups. In the ADHD group with conduct disorder, the examination of the effect of the treatment shows a significant reduction of violence in the area of behavior(p<.05), and a significant difference of activity and social skills in the area of social competent(p<.001). In the ADHD group with mental retardation and other symptoms, a significant rise of social skills is found in the area of social skills evaluation (p<.05). However, there is no significant difference of effect by the treatment among the three groups. In addition, the current examination shows that the social skills training program does not make a statistically significant contribution to the social skills of the ADHD children. On the other hand, the training helps some children, when it is suitable for the characteristics and accompanying symptoms of the children:it reduces the level of violence in the ADHD group with conduct disorder, and it raises the social skills in the ADHD group with mental retardation. In other words, the social skills training program will reduce the conduct disorder and helps peer relation for ADHD children.

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COMPARISON BETWEEN ATTENTION DEFICIT HYPERACTIVITY DISORDER AND MANIA IN CHILDREN AND ADOLESCENTS (주의력결핍과잉행동장애와 소아, 청소년기 조증의 비교 연구)

  • Sung, Yang-Sook;Hong, Kang-E;Cho, Soo-Churl;Nam, Min
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.91-99
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    • 1999
  • Objects:It is difficult to differentiate between attention deficit hyperactivity disorder(ADHD) and mania because of similar symptoms and atypical symptoms of mania in children and adolescents. The purpose of this study is to identify the characteristics and to clarify the relationship by comparing the clinical features and comorbidities of ADHD and manic patients. Methods:The subjects consisted of 35 patients with ADHD and 19 manic patients. To Compare the characteristic symptoms between the two disorders, we selected 29 patients with ADHD and 14 patients with manic disorders. 6 ADHD patients who had manic disorders as comorbid disorder, and 5 manic patients who had ADHD as comorbid disorders were manic disorders were excluded. Results:1) There were significant differences in ages of onset and state anxiety scale scores, birth weights, numbers of perinatal problem, gestational ages, school behavioral problems between ADHD patients and manic patients(p<0.01). 2) There were significant differences in loses things(p<0.05) of ADHD-symptoms and grandiosity(p<0.01), decrease in sleep(p<0.05), delusions(p<0.01), hallucinations(p<0.05) of mania-symptoms between ADHD patients and manic patients. 3) The comorbid disorders of ADHD patients are significantly high(p<.05) than that of manic patients in major depression. 4) The familial loading of manic patients are significantly high(p<.05) than that of ADHD patients in mood disorder. Conclusions:The above results suggest that ADHD and mania are different disorders, considering the significant differences of clinical features and characteristics, familial loadings of the two disorders.

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Correlation of Executive Function and Quantitative Electroencephalography in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder (주의력결핍 과잉행동장애 소아청소년의 실행기능과 정량화 뇌파의 상관성 연구)

  • Jeong, Yu-jin;Park, Jin Young;Kim, Hyunjung;Choi, Jungwon;Jhung, Kyungun
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.1
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    • pp.63-72
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    • 2017
  • Objectives : Attention-deficit hyperactivity disorder(ADHD) is characterized by significant impairments in executive functions, with a prevalence of approximately 3-5% of all children worldwide. The goal of this study was to examine the relationship between executive functions and electrophysiological activities in children and adolescents with ADHD. Methods : In 31 patients with ADHD, resting-state EEG was recorded, and Comprehensive Attention Test(CAT), Stroop Color-Word Inference Test(Stroop CWIT), Trail Making Test(TMT), and Wisconsin Card Sorting Test(CST) were administered. Korean version of the ADHD Rating Scale(K-ARS) was assessed. Results : Alpha and beta power positively correlated with the Attention Quotient(AQ), while delta power negatively correlated with AQ from CAT. In the Stroop CWIT, decreased delta power and increased beta power were related to higher performance. Power of the alpha band increased with higher TMT performance. Moreover, delta power negatively correlated with good performance on the CST, while alpha and high gamma band showed a positive correlation. Correlation with the parent-rating of ADHD symptoms showed a negative correlation between alpha power and higher scores on the K-ARS. Conclusions : These findings indicate that relative power in higher frequency bands of EEG is related to the higher executive function in children and adolescents with ADHD, while the association with the relative power in lower frequency bands of EEG seem to be vice versa. Furthermore, the findings suggest that QEEG may be a useful adjunctive tool in assessing patients with ADHD.