• 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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.24 no.4
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• pp.191-198
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• 2013

Objectives : The objective of this study is to find out the differences in psychopathology, temperament, and character factors between young adults with and without childhood attention-deficit hyperactivity disorder (ADHD) symptoms. Methods : The subjects consisted of 314 university students (male=72, female=242) in Gongju. They were divided into childhood ADHD group (N=54) and normal group (N=260) to the Wender-Utah Rating Scale. Participants were assessed using Korean Adult ADHD Scale, Beck Depression Inventory-II, Beck Anxiety Inventory, Kimberly Young's Internet Addiction Test, Barratt Impulsiveness Scale, Paranoia Scale, Korean-Schizotypal Ambivalence Scale, Lubben Social Network Scale, and Temperament and Character Inventory-Revised. Descriptive statistics, t-test, chi-square, spearman correlation, and stepwise multiple regression were applied to analyze the data. Results : Participants with childhood ADHD symptoms had high level of adult ADHD symptoms (p<.001), impulsiveness (p=.001), depression (p<.001), anxiety (p<.001), internet addiction (p<.001), paranoia tendency (p<.001) and low level of selfesteem (p<.001) compared to normal group. Self-directedness (p<.001) was lower, Harm avoidance (p=.001) and Self-transcendence (p=.029) were higher in the childhood ADHD group. In correlation and stepwise multiple regression, childhood ADHD symptoms were significantly associated with cooperativeness (r=-0.515 and ${\beta}$=-0.547, p<.001 respectively). Conclusion : This result showed that young adults with childhood ADHD symptoms had various forms of psychopathology and childhood ADHD symptoms were influenced by character such as cooperativeness. Therefore, more thorough evaluation regarding childhood ADHD symptoms is needed.

• 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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.28 no.3
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• pp.183-189
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• 2017

Objectives: The study aimed to identify the characteristics of attention-deficit hyperactivity disorder (ADHD) that was not diagnosed in childhood or adolescence, but only in adulthood. Methods: The characteristics of patients diagnosed with ADHD in adulthood were compared with those of patients diagnosed in childhood were assessed via a retrospective review of the medical records at one university hospital from 2005 to 2013. If the age at which they were confirmed as having ADHD was less than 19 years old, they were grouped as childhood-diagnosed group (CD); if they were 19 years old or more, they were grouped as adulthood-diagnosed group (AD). Results: The CD and AD included 50 (46.3%) and 58 (53.7%) patients, respectively. Inattention was the most common symptom in both groups. Behavioral and emotional problems were the second most frequent symptoms in the CD and AD, respectively. The intelligent quotient was significantly higher in the AD than in the CD. The most common comorbidity was depression in the CD and personality disorder in the AD. The most common reason for visiting the hospital was referral by acquaintances in the CD and media coverage in the AD. Conclusion: Clinicians should put ADHD on the index of suspicion when they examine adults with various psychiatric symptoms, because the diagnosis of ADHD might have been missed in childhood and the symptoms of ADHD might have changed as they grew up.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.29 no.2
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• pp.62-72
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• 2018

Objectives: The molecular mechanisms underlying attention-deficit hyperactivity disorder (ADHD) remain unclear. Therefore, this study aimed to identify the genetic susceptibility loci for ADHD in Korean children with ADHD. We performed a case-control and a family-based genome-wide association study (GWAS), as well as genome-wide quantitative trait locus (QTL) analyses, for two symptom traits. Methods: A total of 135 subjects (71 cases and 64 controls), for the case-control analysis, and 54 subjects (27 probands and 27 unaffected siblings), for the family-based analysis, were included. Results: The genome-wide QTL analysis identified four single nucleotide polymorphisms (SNPs) (rs7684645 near APELA, rs12538843 near YAE1D1 and POU6F2, rs11074258 near MCTP2, and rs34396552 near CIDEA) that were significantly associated with the number of inattention symptoms in ADHD. These SNPs showed possible association with ADHD in the family-based GWAS, and with hyperactivity-impulsivity in genome-wide QTL analyses. Moreover, association signals in the family-based QTL analysis for the number of inattention symptoms were clustered near genes IL10, IL19, SCL5A9, and SKINTL. Conclusion: We have identified four QTLs with genome-wide significance and several promising candidates that could potentially be associated with ADHD (CXCR4, UPF1, SETD5, NALCN-AS1, ERC1, SOX2-OT, FGFR2, ANO4, and TBL1XR1). Further replication studies with larger sample sizes are needed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.30 no.3
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• pp.121-126
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• 2019

Objectives: Awareness of attention-deficit/hyperactivity disorder (ADHD) in adults has significantly increased; however, clinical data specific to the Korean population are insufficient. Clinical experience of ADHD may differ based on whether psychiatrists have received pediatric psychiatry-specific training. In order to prepare a practice parameter for adult ADHD patients in Korea, we examined questionnaire data to observe how pediatric psychiatry training could affect clinical practice for adults with ADHD. Methods: A questionnaire about the diagnosis and treatment process was distributed to both general psychiatrists (GPsy) and child and adolescent psychiatrists (CAP) at the summer and winter workshop meetings of Korean Academy of Child and Adolescent Psychiatry. Results: In total, 142 psychiatrists participated in the survey (86 GPsy, 56 CAP). GPsy and CAP preferred pharmacotherapy (GPsy 82.40%, CAP 64.30%) as the primary treatment option and answered that the clinical psychiatric interview is the most necessary step in diagnostic assessment (GPsy 22.16%, CAP 19.00%). The GPsy responded with an optimal and average treatment duration that was shorter than that reported by CAP. Conclusion: Identification of the initial presenting symptom as the correct diagnosis and the optimal duration of pharmacotherapy differed between GPsy and CAP in practice, whereas concepts in diagnosis and treatment of ADHD in adults were similar for both groups. These results suggest the urgent need for the Continuing Medical Education program for psychiatrists treating adults with ADHD.

• The Journal of Korean Academy of Sensory Integration
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• v.15 no.2
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• pp.35-45
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• 2017

Objective : The purpose of this study is to investigate the effect of modified Interactive Metronome (IM) program which is applicable to clinical practice based on the IM protocol on the behavioral symptoms, timing and motor function of children with Attention Deficit Hyperactivity Disorder (ADHD). Method : This study used one-group pretest-posttest research design. 13 ADHD children aged 7-12 years in Busan were participated in this study. The participants were underwent 24 sessions of 30 minutes intervention, 3 times a week. Evaluations were performed before- and after the intervention. Measurements used in this study were Korean-ADHD Rating Scale for behavior symptom, Long Form Assessment (LFA) for the timing, and second version of Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) for the motor function. Results : There was a significant improvement in hyperactivity / impulsivity among the behavioral symptoms, and there was a statistically significant improvement in timing, hand coordination, and body coordination. Conclusion : Modified IM program for clinical application has significant effect on improving behavioral symptoms, timing and motor function of children with ADHD.

• 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.3 no.1
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• pp.84-96
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• 1992

The present study was designed to investigate variables associated with mother-child interaction patterns of Attention Deficit Hyperactivity Disorder(ADHD), and also to evaluate short-term effects of stimulant medication on the behaviors of ADHD children and their mothers during interaction. 15 ADHD boys(ages 5${\sim}$10 years) were treated with metylphenidate(0.5mg/kg per day) for 1 month, and their behaviors as well as their mothers for the 10 minute free play and 20 minute task performance period were videotaped through one-way mirror. The childrens attention was also evaluated using the Continuous Performance Task(CPT) and ratings of their hyperactive behaviors were obtained from their mother prior to the treatment. The videotaped interaction were rated according to the Response Class Matrix developed by Mash, Terdal & Anderson(1973). Results indicated that percentage of behavior of the mother and child during interaction was highly correlated with each other, which, in turn, was highly correlated with the symptom severity of the ADHD child. That is the more severe the cognitive and behavioral symptoms of ADHD, the more negative the interaction behavior pattern was. After 4 weeks of stimulant medication the mothers as well as the ADHD children showed a significant decrease in the percentage of negative-aggressive behavior during the task performance period. The results indicated that negative interaction behavior of the mothers was in large part a response to the negative behavior of their ADHD children.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.147-154
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• 2019

Objectives : Cognitive dysfunction, including inattention, is often observed in patients with depression. Inattentive symptoms in patients with depression is similar to those among attention deficit/hyperactivity disorder (ADHD) patients. It is important to diagnose the two diseases accurately, because the treatment varies depending on the cause of inattention. This study aimed to investigate the coexistence rate of ADHD and the correlation between ADHD symptoms and depression in patients with depression. Methods : Participants in this study were 158 outpatients presenting with depression, who visited the psychiatric department from March 2015 to July 2018. Participants divided into a depression and a non-depression group according to the Korean version of the Center for Epidemiological Studies-Depression Scale (CES-D) score and were administered the following : a sociodemographic variables form (age, sex, academic background, occupation), the self-reporting test for adult ADHD (Adult Attention Deficit/Hyperactivity Disorder self-report scale-V 1.1; ASRS V1.1), and the Korean version of the Connors adult ADHD rating scale (K-CAARS). Descriptive statistical analysis, crossover analysis, t-tests, and Pearson's correlation coefficient were conducted on the data. Results : The coexistence rate of adult ADHD symptom was as high as 36.7% in patients with depression (p<0.001). In K-CAARS, the depression group (Inattention=1.80, Hyperactivity=1.92, Impulsivity=1.56, Self-concept=2.06) showed higher average scores on ADHD symptoms than the non-depressive group (Inattention=1.28, Hyperactivity=1.25, Impulsivity=1.09, Self-concept=1.42, p<0.001). Conclusions : This study confirmed that ADHD symptoms coexist in the depression group. When evaluating the symptoms of patients who complain of depression, it is suggested that they should be accurately diagnosed and appropriately treated with interest to the coexistence of ADHD symptoms and the possibility for ADHD diagnosis.