• The Korean Journal of Applied Statistics
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• v.31 no.1
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• pp.13-28
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• 2018

The ministry of Environment of Korea initiated two follow-up surveys in 2005 and 2006 to investigate environmental effect on children's health. These two cohorts, referred to as the 2005 Cohort and 2006 Cohort, were followed up three times every two years. This data set was referred to as the Children's Health and Environmental Research (CHEER) data set. This paper reproduces the existing research results of Kim et al. (Journal of the Korean Data and Information Science Society, 25, 987-998, 2014) and Lee et al. (The Korean Journal of Applied Statistics, 29, 1295-1310, 2016) and derive a benchmark dose lower limit (BMDL) for blood lead level for attention deficit hyperactivity disorder (ADHD) after pooling two cohort data sets. The different ADHD rating scales were unified by applying the conversion formula proposed by Lee et al. (2016). The random effect model and AR(1) model were built to reflect the longitudinal characteristics and regression to the mean phenomenon. Based on these models the BMDLs for blood lead levels were derived using the BMDL formula and the simulation. We obtained a hight level of BMDLs when we pooled two independent cohort data sets.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.21 no.3
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• pp.174-181
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• 2010

Objectives: To identify the factors affecting long-term adherence to methylphenidate treatment in children with attention-deficit hyperactivity disorder (ADHD). Methods: A retrospective medical record review of 239 ADHD patients (mean age $9.3{\pm}2.6$ years, range 6.0-17.4 years) who had visited the child and adolescent psychiatry clinic at a university hospital, in Seoul, Korea from March 2005 to February 2008. Subjects were diagnosed as ADHD based on the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision version (DSM-IV-TR) and underwent neuropsychological tests including the continuous performance test (CPT). Treatment discontinuation was defined as the last prescription date when the medication possession rate (MPR) became less than 0.80. Subjects were divided into three groups and labeled as Group I, non-adherence without pharmacotherapy, Group II, non-adherence with short-term pharmacotherapy, and Group III, adherence with long-term pharmacotherapy. Results: Ninety (37.7%) patients were grouped as non-adherent (Groups I+II) and 149 (62.3%) as adherent (Group III). The adherence group exhibited lower intelligence, higher symptom severity, and a higher number of comorbid psychiatric disorders than controls. The use of stimulants was significantly associated with long-term adherence to treatment. Additionally, the duration of interval between the date of the first visit and the date of the first prescription was positively associated with long-term adherence. Conclusion: About two-thirds of patients diagnosed as ADHD adhered to the treatment six months after the first visit. With respect to patient evaluation and the development of treatment strategies, factors affecting early drop-out and longer follow-up must be considered.

• Journal of the East Asian Society of Dietary Life
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• v.19 no.4
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• pp.493-502
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• 2009

This study aimed to examine the relationship between nutrient intake and attention deficit hyperactivity (ADH) of children suffering atopic dermatitis. We examined clinical symptoms as well as the status of ADH and the dietary intake of 47 children with atopic dermatitis aged between 4 and 6 against 84 children in the control group. Family history of the atopic dermatitis group was significantly higher than the control group. There was no significant difference between the diet habit of the two groups. The daily energy intake of the atopic dermatitis group and the control group were 1,189.7 kcal and 1245.0 kcal, respectively. There was no significant difference between the nutrient intake of the two groups. In regards to the clinical symptom items, the point for 'anxieties' was 0.5 in the atopic dermatitis group, which was significantly higher than 0.3 of the control group (p<0.05). In terms of the detailed items in ADH assessed by kindergarten teachers, the point for 'changeable feeling' was 0.8 in the atopic dermatitis group, which was significantly higher than 0.5 of the control group (p<0.05). As for the correlation among nutrient intake, the ADH score and clinical symptoms, total fat intake (p<0.05) and animal fat intake (p<0.05) showed a significantly negative correlation with the point of ADH assessed by the teachers, while the intake of fiber (p<0.05) displayed a significantly negative correlation with the point of ADH assessed by the parents. Since atopic dermatitis and ADH may be caused by the same dietary factors, it will be necessary to conduct more studies in this field in the future. In addition, appropriate nutrition management will be necessary for children in the growing period who suffer from atopic dermatitis.

• Molecules and Cells
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• v.38 no.6
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• pp.540-547
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• 2015

Attention deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders, affecting approximately 5% of children. However, the neural mechanisms underlying its development and treatment are yet to be elucidated. In this study, we report that an ADHD mouse model, which harbors a deletion in the Git1 locus, exhibits severe astrocytosis in the globus pallidus (GP) and thalamic reticular nucleus (TRN), which send modulatory GABAergic inputs to the thalamus. A moderate level of astrocytosis was displayed in other regions of the basal ganglia pathway, including the ventrobasal thalamus and cortex, but not in other brain regions, such as the caudate putamen, basolateral amygdala, and hippocampal CA1. This basal ganglia circuit-selective astrocytosis was detected in both in adult (2-3 months old) and juvenile (4 weeks old) $Git1^{\check{s}/\check{s}}$ mice, suggesting a developmental origin. Astrocytes play an active role in the developing synaptic circuit; therefore, we performed an immunohistochemical analysis of synaptic markers. We detected increased and decreased levels of GABA and parvalbumin (PV), respectively, in the GP. This suggests that astrocytosis may alter synaptic transmission in the basal ganglia. Intriguingly, increased GABA expression colocalized with the astrocyte marker, GFAP, indicative of an astrocytic origin. Collectively, these results suggest that defects in basal ganglia circuitry, leading to impaired inhibitory modulation of the thalamus, are neural correlates for the ADHD-associated behavioral manifestations in $Git1^{\check{s}/\check{s}}$ mice.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.3
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• pp.165-175
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• 2015

Objectives : The purpose of this study was to investigate changes in child and adolescent outpatients at a university hospital in Daegu from 2004 to 2013. Methods : The subjects were first-visit patients under 18 years old, who visited Dongsan Medical Center, Keimyung University, from January 1, 2004 to December 31, 2013. Computerized medical records of 2,738 patients (male 1,906, female 832) were reviewed. Results : The ratio of male to female was 2.3 : 1 in the period of study. The most prevalent age category was 7-9 years. The mean age was $10.12{\pm}4.68$ years ($9.84{\pm}4.59$ years in males, $10.76{\pm}4.81$ years in females). The ratio of child and adolescent patients to total outpatients was 27.0%. The most common diagnostic category was the attention-deficit hyperactivity disorder (ADHD) group, followed by the mental retardation (MR) group. In males, the ADHD, MR, communication disorder groups were more prevalent, but in females, the MR, ADHD, depressive disorder groups were more prevalent. Conclusion : The female to male ratio and total mean age were on the rise. The ADHD group was the most prevalent and the depressive disorder group was also on the rise in this period.

• Journal of Digital Convergence
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• v.15 no.5
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• pp.363-372
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• 2017

Attention deficit hyperactivity disorder (ADHD) is a relatively common condition of childhood onset and is of significant educational and social concern in elementary school. Investigating the determinants of teachers' attitudes and behavior and their relative importance is crucial for improving teaching practices and initial teacher education for effective inclusion of ADHD children. Based on two hundred and twenty seven survey responses from elementary school teachers, having experienced in dealing with ADHD students, this paper examines the age, gender, career and training-hours effects on the knowledge, attitude, stress and inclusive education involving ADHD children. The regression analysis shows that the gender influences the level of stress and that the training hours has some impact on the knowledge about ADHD at 5% significance level. However, the number of ADHD children experienced, age, gender, career and training-hours were identified as the non-significant predictors of teaching behavior in relation to ADHD children. As a conclusion, a brief discussion concerning the critical needs of elementary school teachers is also presented.

• Korean Journal of Biological Psychiatry
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• v.17 no.2
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• pp.70-78
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• 2010

Objectives : This study investigated the differences of working memory among the subtypes of ADHD. Methods : Eighty-one children and adolescents with ADHD and thirty normal controls were recruited. Children with any cognitive disorders and low intelligence were excluded. In order to evaluate the verbal and visuospatial working memory, Digit span and Finger windows tasks were measured, respectively. Performances on these measures between children with ADHD and controls were compared. Further, performances among the groups of ADHD predominantly inattentive(ADHD-IA)(n=40), predominantly hyperactive-impulsive(ADHD-HI)(n= 10), and combined type(ADHD-C)(n=31), were compared. Results : Scores of Finger windows forward task were lower in the ADHD group as compared to the control group, whereas, the Digit span forward showed no difference. Both scores of Digit span backward and Finger windows backward task were lower in the ADHD group than the controls. Children with ADHD-IA performed poorer than children with ADHD-C on the Finger windows backward task. Conclusion : The results of this study showed that children with ADHD have deficits in spatial short-term memory and verbal and visuospatial working memory when compared to normal children. The deficits were evident in children with ADHD-IA subtype and in particular, performance on the visuospatial working memory task in this group was poorer than the ADHD-C group.

• 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.

• 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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.139-152
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• 2002

Objectives：This study was conducted to compare the clinical and neuropsychological characteristics by DSM-IV subtypes of attention deficit hyperactivity disorder(ADHD) patients who did not have comorbid psychiatric disorders. Methods：5-15 year old children with ADHD were recruited at psychiatric outpatient clinic of Yeungnam University hospital and the patients with comorbidity or neurological abnormalities were excluded. Finally, total 404 children with ADHD were selected for this study. There were 234 subjects of ADHD-C(57.9%), 156 subjects of ADHD-I(38.6%) and 14 subjects of ADHD-HI(3.5%), who fulfilled the DSM-IV diagnostic criteria. The mean age of the total subjects was 9.63±2.49 years old. The psychopathology, IQ, behavioral problems, neuropsychological executive function were evaluated before pharmacological treatment. The measures were Korean Personality Inventory of Child(K-PIC) for psychopathology, 4 behavioral check lists(ADDES-HV, ACTeRS, CAP, SNAP) for behavioral symptoms of ADHD, K-ABC and KEDI-WISC for IQ and Conner's CPT, WCST, SST for neuropsychological executive functions. Results：1) The prevalence of subtypes was ADHD-C, ADHD-I, ADHD-HI in decreasing order. There was no sex difference of prevalence among three subtypes. The mean age of ADHD-I was older than other subtypes. 2) There was significant differences of psychopathology among subtypes, the ADHD-C and ADHD-HI had higher than the ADHD-I in the scores of delinquent, hyperactivity and psychosis；the ADHD-C had higher than the ADHD-I in the scores of family relation and autism, the scores of ego resilience were lower than the ADHD-I. However, there was no difference in anxiety, depression and somatization scores among them. 3) The results of behavioral symptom check lists, the ADHD-C had higher the score of inattention, hyperactivity and impulsivity than the ADHD-I. Meanwhile the results of ACTeRs, which rated by the teachers, were different. 4) There were significant differences of sequential processing scale and arithmetics among subtypes in IQ using K-ABC, but there was no significant difference between the ADHD-C and the ADHD-I after excluding the ADHD-HI due to small numbers. 5) There was numerical difference among subtypes but did not reach statistical significance in three neuropsychological executive function tests. Conclusion：In conclusion, our results revealed that there was significant difference in clinical features among three subtypes but, no significant difference in executive functions.