• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.15 no.2
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• pp.160-167
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• 2004

Objectives : There have been very few studies on the compliance of methylphenidate-immediate releasing form(MPH-IR), which is the most frequently used drug in Korea, in Attention Deficit Hyperactivity Disorder(ADHD). This study was conducted to investigate the compliance rate and the related factors in the one year pharmacotherapy process via OPD for children with ADHD. Method : Total 100 ADHD patients were selected randomly among patients who have been treated with MPH-IR from September in 2002 to December in 2002. All the selected patients were diagnosed with DSM-IV-ADHD criteria and fulfilled the inclusion criteria. In March, 2003(at the time of 6 month treatment), all the patients and parents received the questionnaire for the compliance and satisfaction for MPH-IR treatment. In October 2003(at time of 1 year treatment), we, investigators evaluated the socio-demographic variables, developmental data, medical data, family data, comorbid disorders, treatment variables, and compliance rate. Through these very comprehensive data, The compliance rate at the time of mean 1 year treatment and the related factors were investigated. Result : 1) In the questionnaire for compliance and satisfaction for MPND treatment, the 60% of respondents(parents) reported more than moderate degree of satisfaction in the effectiveness of MPND. Their compliance rate for the morning prescription was 81%, but the rate of afternoon prescription was 43%. 2) In the evaluation at the time of 1 year treatment(October 2003), the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1 year treatment was 62%. the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1year treatment was 62%. 3) Compared with the noncompliant group(drop-out group), compliant group showed higher total, verbal and performance IQ scores. In the treatment variables, higher reposponder rate(clinician rating), higher medication dosage and more compliance rate in afternoon prescription were found in the compliant group compared with the noncompliant group. There were no statistical differences in the demographic variables(age, sex, SES, parental education level), medical data, developmental profiles and academic function. Conclusion : To our knowledge, this is the first report about the compliance rate of the MPH-IR treatment for the children with ADHD. The compliance rate at the time of mean 1year treatment was 62%, which was comparable with other studies performed in foreign countries, especially States. In this study, the compliance related factors were IQ score, clinical treatment response, dosage of MPH-IR, and early compliance for the afternoon prescription. These results suggest that clinician plan the strategies for the promotion of the early compliance for the after prescription and enhancement of overall treatment response.

• Journal of Ginseng Research
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• v.34 no.1
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• pp.8-16
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• 2010

Attention deficit hyperactivity disorder (ADHD) affects 4-12% of chool-age children worldwide and is characterized by three core symptoms: hyperactivity, inattention, and impulsivity. Although standard pharmacological treatments, such as methylphenidate and atomoxetine, are available, concerns about drug-induced psychological and cardiovascular problems, as well as growth retardation and sleep disturbances, highlight the continuing need for new therapeutic interventions. Using a neonatal hypoxia-induced hyperactivity model in rats, the potential positive role that oral administration of red ginseng extract may have in relation to the hyperactive phenotype was investigated. Hypoxia was induced in 2-day-old male Sprague-Dawley (SD) rat pups by placing them in a nitrogen chamber for 15 min. The neonatal hypoxia-induced rats showed a significant increase in hyperactivity phenotype, such as increased movement duration, movement distance, and rearing frequency, which was determined by monitoring their spontaneous locomotor activity using the Ethovision video tracking system. One week of oral treatment with red ginseng extract decreased the hyperactivity phenotype of the neonatal hypoxia-induced rats and increased the locomotor activity of the control rats. In the neonatal hypoxia-induced rats, expression of the norepinephrine transporter in the forebrain was increased, and red ginseng treatment partially prevented its up-regulation, while increasing its level in the control rats. Taken together, these results suggest that red ginseng extract decreased the neonatal hypoxia-induced hyperactivity phenotype, although it increased locomotor activity in normal animals.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.23 no.2
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• pp.82-89
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• 2012

Objectives : Demands for comprehensive and intensive treatment programs for treatment of children with attention-deficit hyperactivity disorder (ADHD) who suffer from serious impairment in various psychosocial areas are increasing. The aim of this study was to evaluate the possibility of developing new types of camp programs focused on improving social adjustment of children and helping parents effectively manage their children's problem behaviors. Methods : Fifteen children diagnosed as ADHD according to Diagnostic and Statistical Manual of Mental Disorders-IV (mean age 9.5 years) and their parents participated in this program. Eight consecutive camps were held at two-week intervals, from Jun 2007 to Oct 2007 in an adolescent training center located at Chungtaesan, in Korea. Each camp program included social skills training in the classroom and outdoor activities in the forest for children, as well as parent training for mothers. In addition, after the sixth camp, we conducted one parental session for fathers and a three-day booster family camp three months later. Finally, eleven families adhered to the program. Results : All children, parents, and therapists rated questionnaires or checklists at baseline, intra-, and post-treatment. Parenting burden rated using the Parenting Stress Index showed a significant decrease, from 57.89 to 46.22 (p=.019). And, overprotection rated using the Parenting Bonding Instrument showed a significant decrease, from 16.56 to 12.44 (p=.046). However, no significant improvement in children's behavioral and emotional problems was observed. Conclusion : In this study, the consecutive ADHD family camp program was effective for empowerment of parental competency, but not for general improvement of children's behavioral and emotional symptoms.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.33 no.3
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• pp.67-72
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• 2022

Objectives: This study investigated the reliability and validity of the Korean version of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Level 2 Cross-Cutting Symptom Measure-Patient-Reported Outcomes Measurement Information System (PROMIS)-Depression and the Irritability for parents of children aged 6-17 years. Methods: Participants were 190 children diagnosed with depressive disorder (n=14), anxiety disorder (n=21), attention-deficit/hyperactivity disorder (ADHD; n=111), ADHD with anxious depression (n=13), and tic disorder with somatic symptoms (n=31). Patients were 8-15 years of age. The participants' mothers completed the Korean versions of the DSM-5 Level 2 Cross-Cutting Symptom Measure-PROMIS Depression and Irritability (Affective Reactivity Index, ARI), and the Korean Child Behavior Checklist (K-CBCL). Using these data, we calculated the reliability coefficient and examined the concurrent and discriminant validity of the PROMIS Depression and the Irritability (ARI) scales for assessing depression and irritability in children. Results: The reliability coefficient of the PROMIS Depression scale (Cronbach's α) was 0.93. The correlation coefficient with the K-CBCL DSM emotional problem score was 0.71. The PROMIS Depression scale significantly discriminated children with depressive disorders from those with other conditions. The reliability coefficient of the Irritability (ARI) scale was 0.91, suggesting its high reliability. Conclusion: Our results suggest that the Korean version of the DSM-5 Level 2 Cross-Cutting Symptom Measure for Depression and Irritability Scales for parents of children aged 6-17 years is reliable and valid and may be an efficient alternative to the K-CBCL.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.23 no.2
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• pp.49-56
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• 2012

Methylphenidate is a widely used stimulant for treatment of attention-deficit hyperactivity disorder (ADHD). In addition to core symptoms of attention and behavioral symptoms, methylphenidate is even effective for executive functions. However, abuse and misuse of stimulants, including methylphenidate, for the purpose of cognitive enhancement is an issue of concern worldwide. Some prejudices and misunderstandings against methylphenidate are popular ; however, little attention has been given to the neuropsychiatric evidence of methylphenidate for enhancement of cognitive function among healthy populations. In this article, our aim was to conduct a review of previous studies investigating the effect of methylphenidate in healthy populations. Findings from several recent studies have demonstrated the effectiveness of methylphenidate for enhancement of cognitive function in healthy populations. The mechanisms of cognitive enhancement are thought to be associated with motivation and the reward circuit in the brain. However, when considering the risk to benefit, an official discussion of the use of methylphenidate among healthy members of the population would be premature. Instead, investigation of epidemiological studies of the prevalence of misuse of stimulants among healthy members of the population, particularly adolescents and college students, is needed. In addition, based on achievements reported in previous studies, investigation of the effect of an approach using non-pharmacological enhancing motivation, which will in turn result in increased cognitive function would be helpful.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.15 no.1
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• pp.82-90
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• 2004

Objectives：The study was performed to compare the executive function(EF；Inhibition, Planning and Working memory) between ADHD and normal group, and to controll the effect of age and intelligence. And the function of inhibition was assessed in two dimensions(cognitive inhibition and motor inhibition). Methods：K-WISC III and EF test(Go-No-Go, Stroop test, Tower of Hanoi, Digit) was administered to both 25 children with ADHD and 25 normal control participants, all aged between 7 and 12. The results were analyzed after statistically controlled for age and intelligence. Results：Children in the ADHD group had significantly lower IQ score than those in the control group and consistent relations were found between the child's age and the study's major variables. Once IQ and age were controlled, results indicated that children with ADHD had deficit only cognitive inhibition and motor inhibition. There was no significant difference in planning and working memory. Conclusion：These results suggested that specific deficits in inhibition control rather than general EF deficits are associated with ADHD. So inhibition is the core problem of children with ADHD. Thus, the therapeutic approach focused on cognitive inhibition and motor inhibition is required.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.1
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• pp.149-156
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• 2001

After the fact that obsessive-compulsive symptoms or tic symptoms are common in Sydenham's chorea which is a sequale of rheumatic fever produced by group A beta-hemolytic streptococcus was reported, the association between group A beta-hemolytic streptococcus and a subgroup of obsessivecompulsive disorder(OCD) or tic disorder has been attentioned. This subgroup shared a unique clinical course, characterized by an abrupt onset of symptoms and/or dramatic exacerbations. And this subgroup was distinguished by pre-pubertal onset of symptoms, neurological abnormalities(choreiform movements and a unique pattern of motoric hyperactivity), as well as by relapsing and remitting symptom course. Acronym PANDAS(pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection) was used to denote a subgroup of OCD or tic disorder patients with these clinical characteristics. Then, there was a report suggesting that PANDAS category include some of attention-deficit/hyperactivity disorder(ADHD) and were two case reports of anorexia nervosa and body dysmorphic disorder with characteristics of PANDAS. This case is a patient who developed normally until age of 7, but after pharyngeal inflammation with high fever, he showed disturbance of cognition, social relationship, and language and communication, as well as tic symtoms and abnormal movement on face, hand, and foot. We report this case with review of literatures, because we think that this case belongs to the PANDAS category. Based on this observation, we suggest that PANDAS category include some of childhood disintegrative disorder as well as OCD, tic disorder, and ADHD.

• Biomolecules & Therapeutics
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• v.20 no.2
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• pp.226-233
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• 2012

Ethanol exposure during gestational period is related to growth retardation, morphological abnormality, and even in neurological abnormalities including attention deficit/hyperactivity disorder (ADHD)-like behaviors on offspring. However, relatively little is known about the effects of maternal ethanol consumption prior to conception on their offspring. In this study, we investigated whether maternal ethanol administration during preconceptional phase produces ADHD-like behaviors in the rat offspring. Sprague-Dawley (SD) female rats were administrated ethanol via intragastric intubation with dosing regimen of 6 g/kg daily for 10 consecutive days and treated female rats then mated with non-treated male SD rats after 8 weeks. Another group subjected to the same procedure as those conducted on ethanol treated group except the saline administration instead of ethanol. Offspring was tested for their ADHD-like behaviors using open field test, Y maze test and impulsivity test that is performed in the aversive electronic foot shock paradigm. Offspring of preconceptional ethanol treated (EtOH) group showed hyperlocomotive activity, attention deficit and impulsivity. And reduction of striatal dopamine transporter (DAT) level was observed by Western blot in the EtOH group, compared to control (Con) group, while the immunohistochemical analysis exhibited increased expression of norepinephrine transporter (NET) in the frontal cortex. These results suggest that maternal ethanol consumption in the preconceptional phase induces ADHD-like behaviors in offspring that might be related to the abnormal expression of DAT and NET in rat.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.11 no.2
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• pp.13-26
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• 2007

Background: Neurofeedback is an electroencephalographic biofeedback technique for training individuals to alter their brain activity via operant conditioning. Also neurofeedback is a form of behavioural training aimed at developing skills for brain activity. Within the past decade, several neurofeedback studies have been published that tend to overcome the methodological shortcomings of earlier studies. This research describes the methodical basis of neurofeedback and reviews the evidence base for its clinical efficacy and effectiveness in attention-deficit hyperactivity disorder (ADHD). Methods: In neurofeedback training, self-regulation of specific aspects of electrical brain activity is acquired by means of immediate feedback and positive reinforcement. In frequency training, activity in different EEG frequency bands has to be decreased or increased. Slow cortical potentials (SCPs) training is focused on the regulation of cortical excitability. Results: Neurofeedback studies revealed training-specific effects on, for example, attention and memory processes and performance improvements in real-life conditions, in healthy subjects as well as in patients. In several studies it was shown that ADHD symptomatology was reduced after frequency training or SCP(Slow cortical potentials) training. Moreover a decrease of impulsivity errors and an increase of the contingent negative variation. Conclusions: This research provides evidence for both positive behavioural and specific neurophysiological effects of neurofeedback training. Also there is growing evidence for neurofeedback as a valuable module in neuropsychiatric disorders. Further, controlled studies are warranted.

• The Journal of Korean Academy of Sensory Integration
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• v.13 no.1
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• pp.13-22
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• 2015

Objective : The aim of this study is to verify validity of Long Form Assessment, which is an Interactive Metronome $measure^{(R)}$(LFA-IM), as a measurement of praxis of children. Methods : The study was implemented from March 2015 to July 2015. Twenty-five children with Attention Deficit Hyperactivity Disorder (ADHD) and those without ADHD (age of 6~11) were selected from a local university hospital and community in Gyeoung-Nam province and Busan for this study. In order to examine discriminative validity of LFA-IM, Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2) was used to compare the difference of results with LFA-IM for both children with- and without ADHD. For concurrent validity, correlation between LFA-IM and BOT-2 was investigated using spearman correlation coefficients. Results : For the comparison between children with ADHD and children without ADHD, there were significant differences in the total scores of LFA-IM (p<.05). Regarding the concurrent validity, there was a strong negative correlation between the total scores of LFA-IM and BOT-2 (p<.05). In addition, there was high correlation between LFA-IM and BOT-2 for the area of hand control (rs=-.532), and high negative correlation for the area of fine-motor accuracy (rs=-.447), hand dexterity (rs=-.532), and balance control (rs=-.623) (p<.05). Conclusion : This study identified validities of LFA-IM as an assessment of praxis of children. The results showed that it is appropriate to evaluate praxis of children with the total score of LFA-IM and, thus, it is believed that LFA-IM has a potential clinical utility. However, there should be more researches with large number of subjects.