• 제목/요약/키워드: ADHD problems

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ADHD 치료에서 가족치료캠프의 적용 (Application of Family Treatment Camp in Treatment of ADHD)

  • 황병주;안동현;이재영
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제23권2호
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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.

Association between polycystic ovary syndrome and risk of attention-deficit/hyperactivity disorder in offspring: a meta-analysis

  • Maleki, Azam;Bashirian, Saeid;Soltanian, Ali Reza;Jenabi, Ensiyeh;Farhadinasab, Abdollah
    • Clinical and Experimental Pediatrics
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    • 제65권2호
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    • pp.85-89
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    • 2022
  • Background: There is evidence of a relationship between prenatal excess androgen exposure and central nervous developmental problems and attention-deficit/hyperactivity disorder (ADHD) in the offspring of mothers with polycystic ovary syndrome (PCOS). Purpose: Here we aimed to use a meta-analysis to investigate whether the offspring of mothers with PCOS are at an increased chance of developing ADHD. Methods: Three main English databases were searched for articles published through December 2020. The Newcastle-Ottawa Scale was used to assess study quality. Study heterogeneity was determined using I2 statistics and publication bias was assessed using Begg and Egger tests. The results are presented as odds ratio (OR) and relative ratio (RR) estimates with 95% confidence intervals (CIs) using a random-effects model. Results: Six articles (3 cohort and 3 case-control studies; 401,413 total ADHD cases) met the study criteria. Maternal PCOS was associated with an increased risk of ADHD in the offspring based on OR and RR (OR, 1.42; 95% CI, 1.27-1.57) and (RR, 1.43; 95% CI, 1.35-1.51), respectively. There was no heterogeneity among the included articles based on OR (I2=0.0%, P=0.588) and RR (I2=0.0%, P=0.878). Conclusion: Our study showed that maternal PCOS is a risk factor for ADHD. Therefore, screening their offspring for ADHD should be considered part of the comprehensive clinical care of women with PCOS.

국민학교 아동의 설탕섭취량이 주의결핍 과잉활동장애와 미친 영향 (The Effect of Sugar Intake on Attention Deficit Hyperactivity Disorder of School Children)

  • 정혜경
    • Journal of Nutrition and Health
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    • 제28권7호
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    • pp.644-652
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    • 1995
  • The purpose of this study was to examine the relationship between sugar intake and behavioral problems in Korean school children. The subjects were 280 school children lived in Soung Nam city. Nutrient and sugar intakes were measured by 24-hour recall method and food frequency method through personal interview. Hyperactivity scores of children were measured by teacher and mother using conners Rating Scale-Revised. The average daily total sugar intake for the total sample was 63.0$\pm$37.4g(Range : 10g-220g). The result of stepwise multiple regression analysis using the sugar intake as dependent variable showed that energy, participation of school lunch program, Vit B2, protein, education of fathers, niacin, calcium are significant explanatory variables, explaining 44.8% of variation. As a result of the Conners scale test by teacher, 4% of children were Attention Deficit Hyperactivity Disorder(ADHD) children. A result of the Conners scale test by mother, 8% of children were ADHD children. The result of simple regression analysis had not shown significant relationship between sugar intake and ADHD scores. But the result of the Conners test by teacher, sugar intake(69.9$\pm$37.1g) of ADHD children were significantly higher than sugar intake(62.9$\pm$37.7g) of normal children(p<0.01).

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한국 웩슬러 아동 지능검사-4판(K-WISC-IV)에서 일반능력 지표(GAI)의 임상적 유용성: 주의력결핍 과잉행동장애 아동을 대상으로 (Cognitive Characteristics of Attention-Deficit Hyperactivity Disorder in Korean Wechsler Intelligence Scale for Children-Fourth Edition: Focused on General Ability Index and Cognitive Proficiency Index)

  • 구민제;오상우;이상열;백영석;이지혜;황규식
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제27권4호
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    • pp.313-318
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    • 2016
  • Objective: The purpose of this study was to investigate the clinical utility of the Korean Wechsler Intelligence Scale for Children-Fourth Edition (K-WISC-IV) and General Ability Index (GAI) in children with attention-deficit hyperactivity disorder (ADHD). Methods: The GAI and Full Scale IQ (FSIQ) in K-WISC-IV were compared for a group of 79 children with ADHD and 234 normal children. The mean differences within each group were testified by the t-test and Cohen's d. The Wechsler's descriptive classifications for each GAI and FSIQ score were analyzed in the children with ADHD. Additionally, the critical value for the difference between the means of the FSIQ and GAI was calculated in the normal children. Results: The score on the GAI was higher than that on the FSIQ in the children with ADHD, with a mean difference of 2.19 points. The implications of these findings are discussed regarding the cognitive characteristics of the children with ADHD. According to Wechsler's descriptive classification, the application of the GAI showed a lower (7.59%), equal (61.65%) or higher (60.76%) prevalence of ADHD compared to the application of FSIQ. Conclusion: The implications of these findings are discussed regarding the cognitive characteristics of the children with ADHD. The GAI reflecting the attention and behavioral problems in children with ADHD could be utilized as an alternative global intelligence estimate that considers their potential for development.

ADHD아동의 감각자극에 대한 생리학적 반응 특성과 행동학적 특성: 체계적 고찰 (The Physiological Responses and Behavior Characteristics of Sensory Stimulation of ADHD Children: A Systematic Review)

  • 이나핼;김경미
    • 대한감각통합치료학회지
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    • 제9권2호
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    • pp.51-60
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    • 2011
  • 목적 : ADHD아동의 감각자극에 대한 생리학적 반응특성은 감각자극의 종류, 측정도구, 그리고 반응으로 알아보고, 행동학적 특성은 측정도구, 빈도, 측정도구별로 공통된 문제 항목을 분석하여 ADHD아동의 감각자극에 대한 특성을 알아보고자 하였다. 연구방법 : 체계적 고찰방법을 사용하였다. 1990년 1월부터 2011년 12월 31일까지 학회지에 게재된 논문을 Riss4U, MEDLINE/PubMed, CINAH을 통해 검색하였다. 주요 검색어는 "ADHD, Children, Sensory processing, sensory integration, SP, SSP, SOR, TIE, CSP, SEP, EDR"으로 하였으며, 최종적으로 15개의 논문을 분석하였다. 결과 : 1. ADHD아동을 대상으로 감각자극에 대한 생리학적 반응에 관한 연구는 5개(33.33%)이고, 행동학적 반응에 관한 연구는 10개(66.67%)이며, 두 가지를 병행한 연구는 2개(13.33%)로 전체 15개(100%)논문을 분석하였다. 2. 생리학적 반응에 관한 연구 5개 중, 촉각과 고유 감각 자극을 사용한 연구는 3개, 후각, 청각, 시각, 촉각, 전정감각을 모두 사용한 연구는 2개였다. 3. 행동학적 특성에 관한 연구 10 중, SP는 5개, SSP는 3개, SOR은 2개, TIE는 1개, CSP는 1개이다. 4. ADHD아동의 감각자극에 대한 생리학적 반응특성은 일차감각피질의 손 영역에 있는 신경원세포의 활동전위에서 큰 반응을 보였다. 반응 시 초기에 큰 반응을 보였고 뒤로 갈수록 빠른 습관화를 보이는 것으로 나타났고, 회복 시에 많은 비 특이적 반응을 보였다. 5. 행동학적 반응특성은 부주의/산만, 전정감각처리, 지구력/근 긴장도 조절, 감정반응에 대한 감각입력 조절, 활력이 부족하고 허약함을 보이는 특성이 있었다. 결론 : ADHD아동의 감각자극에 대한 생리학적 반응 특성과 행동학적 특성을 아는 것은 ADHD아동의 감각조절 문제를 이해하는데 중요한 근거가 된다.

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Behavioral and intelligence outcome in 8- to 16-year-old born small for gestational age

  • Yi, Kyung Hee;Yi, Yoon Young;Hwang, Il Tae
    • Clinical and Experimental Pediatrics
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    • 제59권10호
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    • pp.414-420
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    • 2016
  • Purpose: We investigated behavioral problems, attention problems, and cognitive function in children and adolescents born small for gestational age (SGA). Methods: Forty-six SGA children born at term and 46 appropriate for gestational age (AGA) children born at term were compared. Psychiatric symptoms were examined with reference to the Korean-Child Behavior Checklist, Korean-Youth Self Report, and Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS). Cognitive function was estimated using the Wechsler Intelligence Scale. Sociodemographic data were recorded from interviews. Results: SGA children had high scores on delinquent behavior, aggressive behavior, and the externalizing scale, and they also showed a propensity for anxiety and depression. The SGA group had a higher mean ADHD-RS score than the AGA group ($10.52{\pm}8.10$ vs.$9.93{\pm}7.23$), but the difference was not significant. The SGA group had a significantly lower verbal intelligence quotient (IQ) than the AGA group, but the mean scores of both groups were within normal limits. Conclusion: This study indicates marked behavioral problems, such as delinquency, aggressiveness, and anxiety and depression, as well as low verbal IQ in the SGA group than in the AGA group. Even in cases in which these symptoms are not severe, early detection and proper treatment can help these children adapt to society.

주의력 결핍 과잉활동장애의 행동 특성 - 과잉활동성 유무에 따른 임상적 특성의 비교 - (BEHAVIORAL CHARACTERISTICS IN ATTENTION DEFICIT HYPERACTIVITY DISORDER - COMPARISONS OF ATTENTION DEFICIT DISORDER WITH AND WITHOUT HYPERACTIVITY -)

  • 송동호;정유숙;이홍식
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제4권1호
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    • pp.106-113
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    • 1993
  • 저자들은 Attention Deficit Hyperactivity Disorder(ADHD) 환자에서 과잉활동증을 동반한 집단과 과잉활동증을 동반하지 않은 집단간에 행동 및 정서적 특성을 비교하고, 각 증상척도들 간의 임상적 관계를 알아보기 위하여 본 연구를 시행하였다. ADHD 환자 36명을 Werry-Weiss-Peters Activity Rating Scale(WWPARS) 평가기준(20점)에 따라 Attention Deficit Disorder with Hyperactivity(ADD+H) 집단 19명과 Attention Deficit Disorder without Hyperactivity(ADD-H) 집단 17명으로 분류하여 Conners Rating Scale(CRS), Home Situations Questionnaire(HSQ), School Situations Questionnair(SSQ), Child Behavior Check-list(CBCL) 등을 시행한 결과 다음과 같은 결과를 얻었다. 1) 두 집단간에 인구학적 특성은 차이가 없었다. 2) ADD+H 집단의 CRS 행동증상척도는 점수는 ADD-H 집단에 비하여 유의하게 높았으며, HSQ와 SSQ를 통하여 가정과 학교에서의 행동문제 상황을 비교한 결과, ADD+H 집단의 행동문제 상황의 유형이나 개수 및 증상의 심도가 ADD-H 집단에 비하여 유의하게 높았다. 3) 각 집단의 CBCL 8개 소척도 점수를 비교하였을 때, ADD+H 집단의 비행척도와 공격성 척도가 유의하게 높았다. 4) ADHD의 행동증상과 CBCL의 행동정서척도 간의 상관관계를 조사한 결과, CRS, WWWPARS의 행동증상척도와 CBCL의 공격성척도, 비행척도, 정서불안정척도 간에는 유의한 양성 상관관계가 있었으며, 특히 공격성척도와 과잉활동증 간에는 매우 유의한 상관성이 있음을 알 수 있었다. 본 연구결과로 미루어 ADHD는 과잉활동증의 유무에 따라 그 임상적 특징이 차이가 있음을 시사하며, 향후 ADHD의 여러 임상적 유형과 약물치료효과 간의 관련성에 대한 연구 및 ADHD 환자에서 행동 특성과 인지기능이 통합된 연구의 필요성이 요구된다.

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학습장애의 조기 발견을 위한 소아과적 접근 (Pediatric approach to early detection of learning disabilities)

  • 성인경
    • Clinical and Experimental Pediatrics
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    • 제51권9호
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    • pp.911-921
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    • 2008
  • Learning disabilities (LD) are heterogeneous group of disorders with evidences of genetic or familial trait, intrinsic to the individual and presume to be due to central nervous dysfunction. Learning disabilities and attention deficit hyperactivity disorder (ADHD) are the two of the most common disorders in the population of school-age children. Typically academic achievements in children with learning disabilities are significantly lower than expected by their normal or above normal range of IQ. Although academic and cognitive deficits are hallmarks of children with LD, those children are also at risk for a broad range of behavioral and emotional problems. Almost all cases meet criteria for at least one additional diagnosis such as ADHD, developmental coordination disorder, depression, anxiety, obsessive compulsive disorder, tic disorder, among which ADHD is particularly predominant. Because of the response to the therapeutic intervention program is promising and positive when applied early, it is critical to recognize patients as early as possible. Pediatricians often are the first to hear from parents worried about a childs academic progress. It is not the responsibility of pediatrician to make a diagnosis, referring children for a diagnostic evaluation of LD is a reasonable first step. Pediatricians can make early referral of suspicious children by asking some serial short questions about basic and processing skills. With a basic knowledge about the clinical characteristics, diagnostic and therapeutic procedures of LD, pediatricians also can provide primary counseling and education for parents at their outpatient clinical settings.

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

  • 성양숙;홍강의;조수철;남민
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제10권1호
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    • pp.91-99
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    • 1999
  • 목 적:초기아동기에서부터 시작된 주의력결핍과잉행동장애와 아동기및 청소년시기에 발병한 기분장애, 조증은 서로 다른 질환군에 속해있다. 그러나 이들 질환의 증상이 서로 유사한 부분이 많고, 어른과 달리 소아, 청소년기 조증에서는 특징적으로 나타나는 비전형적인 증상들로 인해 두 질환을 감별하고 진단하는 데 많은 어려움이 있다. 본 연구에서는 이들 두 질환을 가지고 있는 아동과 청소년들의 일반적 특성과 임상양상 및 공존질환 등을 비교함으로써 각 질환의 특성을 파악하고 이들 질환사이의 관계를 규명하고자 하였다. 방 법:대상군은 고려대학교 구로병원 신경정신과와 서울대학병원 소아정신과로 내원하여 진단받은 35명의 주의력결핍과잉행동장애아와 19명의 조증환아로 선정하였다. 각각의 질환에서 특징적으로 보이는 증상들을 규명하고자 할 경우에는 서로의 질환을 동반하고 있지 않은 환아들로만 선정하여 각각 29명과 14명을 대상으로 하였다. 결 과:주의력결핍과잉행동장애와 소아, 청소년기에 발병한 기분장애의 조증 환자군을 비교한 결과, 발병연령(p<.01), 상태불안척도(p<.01), 출생시 체중(p<.01), 임신기간동안 입원 또는 사고경력(p<.05), 임신기간(p<.01), 주산기문제(p<.01), 학교에서의 문제행동(p<.01) 등에서 두 군사이에 의미있는 차이가 있었다. 두 질환의 증상들을 서로가 어느정도 공통적으로 가지고 있는 지를 비교해본 결과에서는 주의력결핍과잉행동장애 아동들이 물건을 잘 잃어버린다 항목에서 의미있게(p<.05)높았으며, 조증 증상항목의 과대사고(p<.01), 수면욕구의 감소(p<.05), 망상(p<.01), 환각(p<.05)항목에서 조증 환자들이 의미있게 높았다. 또한 이들 환자들의 공존질환들은 주의력결핍과잉행동장애 환아들에서 특히 주요우울증이 조증 환아들에서 보다 의미있게(p<.05)높게 나타났다. 가족력에서는 조증 환아들의 가족들에서 주의력결핍과잉행동장애 환자들의 가족들에서보다 기분장애가 의미있게(p<.05)높게 나타났다. 결 론:이들 두 질환들의 대상군들이 일반적 특성, 임상양상, 공존질환, 가족력 등에서 유의한 차이를 보이는 점에서 서로 독립적인 질환으로 생각되었으며, 향후 두 질환이 공존하는 환자군과 연령에 따라 보다 세분된 환자군 간의 다각적인 비교연구가 필요할 것으로 보인다.

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기초학습부진으로 의뢰된 일 광역시의 일반학급 초등학생의 심리, 정신과적 평가 및 부모의 특성 (Clinical Diagnoses, Psychopathology, and Neurocognitive Tests in Children Referred for Scholastic Difficulties and Their Parents)

  • 방수영;박정환;임재인
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제22권1호
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    • pp.16-24
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    • 2011
  • Objectives:This study examined the prevalence of psychiatric problems in children with scholastic difficulties who had been referred for mental health services from the Office of Education in Ulsan Metropolitan City. Methods:Child psychiatrists evaluated the referred children using the DSM-IV. Evaluation tools included the Wechsler Intelligence Scale for Children-III, the Children's Depression Inventory, the Korean form of the State-trait anxiety Inventory for children, the ADHD rating. Results:Seventy-six children consisting of 64 boys (84.2%) and 12 girls (15.8%) participated in the study. The average age was 10.3 (SD=0.93) years old. Approximately 74% of the children referred for scholastic difficulties were diagnosed with mental retardation. The Axis I diagnosis among these children were ADHD (86.8%), depression (21.1%), learning disorder (9.2%), communication disorder (4.8%), pervasive developmental disorder (3.6%), internet addiction (1.3%), and mood disorder (1.3%). Their overall measure according to the Child Depression Inventory was 22.7 (SD=16.8), that for the State-Trait Anxiety Inventory for Children was 33.3 (SD=7.9)/32.4 (SD=9.5), and that for the ADHD rating scale was 18.9 (SD=10.9). Conclusion:These results suggest that many children with scholastic difficulties have both complex psychiatric and educational problems.