• Clinical and Experimental Pediatrics
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• 제64권9호
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• pp.489-493
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• 2021

Background: There is evidence of destructive effects of oxytocin use during labor on neurodevelopment. Purpose: This meta-analysis pooled all observational studies to determine the association between labor induction and the risk of attention-deficit/hyperactivity disorder (ADHD) among children. Methods: All observational studies (case-control and cohort) were reviewed until September 2020 after searches of the PubMed, Scopus, and Web of Science databases, the gray literature, and conference proceedings. The pooled odds ratios (ORs), relative ratios (RRs), and 95% confidence intervals (CI (swere calculated as random effect estimates of association among studies. Results: All observational studies were reviewed, including 4 cohort studies including 2,885,743 participants and 3 case-control studies including 51,135 participants (10,961 with ADHD and 40,174 in control groups) with a sample size of 2,936,878 participants. The pooled estimates of OR and RR did not indicate a significant association between labor induction and ADHD among children (OR, 1.13; 95% CI, 0.90-1.35) and (RR, 1.10; 95% CI, 0.96-1.24). Conclusions: The findings showed that labor induction is not associated with an increased risk of ADHD among children. However, more studies are needed to investigate the relationship between labor induction and ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제30권4호
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• pp.153-160
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• 2019

Objectives: This study aimed to evaluate the addiction to highly caffeinated drinks among university students, and we investigated the relationships between smartphone addiction, depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), burnout, self-esteem, impulsiveness in high caffeine drink addiction risk group (high caffeine group). We also compared these mental health factors differences between the high caffeine group and the control group; and, investigated the relative risk between the independent variables of the high caffeine group. Methods: This study was conducted in Korea, from June 2015 to July 2016. A set of questionnaires was administered on 511 college students. Results: The participants who belonged to the high caffeine group were more likely to demonstrate the symptoms of ADHD and higher levels of burnout and impulsiveness. Further, the results of logistic regression analysis confirmed the association between the high caffeine group and burnout. Conclusion: These behaviors among university students addicted to highly caffeinated drinks suggests the need for timely and effective interventions for those at risk of addiction.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제32권3호
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• pp.85-92
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• 2021

Attention-deficit/hyperactivity disorder (ADHD) leads to functional decline in academic performance, interpersonal relationships, and development in school-aged children. Early diagnosis and appropriate intervention can significantly reduce the functional decline caused by ADHD. Currently, there is no established biological marker for ADHD. Some studies have suggested that various indicators from the quantitative electroencephalogram (QEEG) may be useful biological markers for the diagnosis of ADHD. Until the 2010s, theta/beta ratio (TBR) was a biomarker candidate for ADHD that consistently showed high diagnostic value. However, limitations of TBR have recently been reported. Studies have demonstrated that phase-amplitude coupling, especially theta phase-gamma amplitude coupling, are related to cognitive dysfunction and may assist in the diagnosis of ADHD. As yet, the underlying mechanism is not clearly established, and the clinical efficacy of these biomarkers needs to be proven through well-controlled studies. Based on the heterogeneous characteristics of ADHD, subgrouping through QEEG plays a key role in diagnosis and treatment planning. Sophisticated, well-designed studies and meta-analyses are necessary to confirm these findings.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제33권2호
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• pp.27-34
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• 2022

Stimulants, such as amphetamine and methylphenidate, are one of the most effective treatment modalities for attention deficit hyperactivity disorder (ADHD) and may cause various movement disorders. This review discusses various movement disorders related to stimulant use in the treatment of ADHD. We reviewed the current knowledge on various movement disorders that may be related to the therapeutic use of stimulants in patients with ADHD. Recent findings suggest that the use of stimulants and the onset/aggravation of tics are more likely to be coincidental. In rare cases, stimulants may cause stereotypies, chorea, and dyskinesia, in addition to tics. Some epidemiological studies have suggested that stimulants used for the treatment of ADHD may cause Parkinson's disease (PD) after adulthood. However, there is still a lack of evidence that the use of stimulants in patients with ADHD may cause PD, and related studies are only in the early stages. As stimulants are one of the most commonly used medications in children and adolescents, close observations and studies are necessary to assess the effects of stimulants on various movement disorders, including tic disorders and Parkinson's disease.

• 대한한방소아과학회지
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• 제36권3호
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• pp.63-74
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• 2022

Objective This study aimed to analyze the efficacy and safety of Tuina therapy for attention-deficit hyperactivity disorder (ADHD) through a randomized controlled clinical study in China. Methods We used the China National Knowledge Infrastructure (CNKI) as a resource and conducted a search using key words: 'ADHD', '推拿'. Six randomized control studies were identified and analyzed in this study. Results 1. The Tuina treatment group showed significant changes compared to the control group. 2. The most commonly used meridians were Spleen meridian (脾經穴), Liver meridian (肝經穴), Errenshangma (二人上馬穴), Xiaotianxin (小天心), Qinghetianshu (清河天水), Kidney meridian (腎經穴). Conclusions The results of this study showed that Tuina therapy is effective for ADHD patients with ADHD. It can be used for future research on Tuina therapy for ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제34권2호
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• pp.125-132
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• 2023

Objectives: This study investigated the relationship between suicidal behavior and the use of methylphenidate (MPH) or atomoxetine (ATX) in patients with attention deficit hyperactivity disorder (ADHD). Methods: The Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were used to conduct a meta-analysis. The Physiotherapy Evidence Database scale was used to score the quality of the studies. Results: Nine studies were included in this quantitative analysis. The analysis included 602864 patients with ADHD (521125 and 81739 patients were taking methylphenidate [MPH group] and atomoxetine [ATX group], respectively) and 19230 healthy controls. The overall estimates were in the order of the control, MPH, and ATX groups; however, no statistically significant between-group difference was observed in the incidence of events (p=0.553 for control vs. MPH; p=1.000 for control vs. ATX; p=1.000 for MPH vs. ATX). Conclusion: The rate of suicidal behavior was higher in the ADHD groups treated with MPH and ATX than in the control group. However, no statistically significant difference was observed between the ADHD groups treated with MPH and ATX, and the control group. Therefore, MPH and ATX did not increase suicidal behavior.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제35권1호
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• pp.82-89
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• 2024

Objectives: This study aimed to investigate the effectiveness and safety of combining psychostimulants and nonstimulants for patients under treatment for attention deficit hyperactivity disorder (ADHD). Methods: The study included 96 patients aged 6-12 years who were diagnosed with ADHD, among whom 34 received combination pharmacotherapy, 32 received methylphenidate monotherapy, and 30 received atomoxetine monotherapy. Statistical analysis was conducted to compare treatment and adverse effects among groups and to analyze changes before and after combination pharmacotherapy. The difference between combination pharmacotherapy and monotherapy was investigated. Logistic regression analysis was used to identify the predictors of combination pharmacotherapy. Results: No significant differences were observed between the groups in terms of age or pretreatment scores. The most common adverse effect experienced by 32% of patients in the combination pharmacotherapy group was decreased appetite. Clinical global impression-severity score decreased significantly after combination pharmacotherapy. All three groups showed significant clinical global impression-severity score improvements over time, with no significant differences among them. The predictive factors for combination pharmacotherapy included the Child Behavior Checklist total score internalizing subscale. Conclusion: Combination pharmacotherapy with methylphenidate and atomoxetine is a relatively effective and safe option for patients with ADHD who do not respond to monotherapy.

• 대한한방소아과학회지
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• 제15권2호
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• pp.141-165
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• 2001

Attention-deficit/hyperactivity disorder(ADHD) is one of the most common childhood-onset psychlatric disorders. It is distinguished by symptoms of inattention, hyperactivity, and impulsivity. ADHD may be accompanied by learning disabilities, depression, anxiety, conduct disorder, and oppositional defiant disorder. The etiology of ADHD is unknown, and the disorder may have several different causes. Individual with ADHD present in childhood and may continue to show symptoms as they enter adolescence and adult life. Public interest in ADHD has increased along with debate in the media concerning the diagnostic process and treatment strategies. The purpose of this study is oriental medical approach to ADHD. This study was progressed for oriental diagnosis and treatment for ADHD. In oriental medicine, the reason of ADHD was deficiency of the kidney, hyperactivity of the liver(腎虛肝亢), deficiency of the heart and the spleen(心脾不足), heart disturbed by phlegm and heat(痰熱擾心). The method of medical treatment was nourishing the kidney and checking exuberance of yang(滋腎潛陽), relieving mental stress and promoting wisdom(寧神益智), nourishing the heart and strengthening the spleen(養心健脾), tranquilzation(安神定志). removing heat-phlegm(淸熱化痰), inducing resuscitation and tranquilzation(開窮安神). The prescription was commonly used as Liuwei Dihuang Wan jiajian(六味地黃丸加減), Guipi Tang he Ganmai Dazao Tang jiajian(歸脾湯合甘麥大棗湯加減), Huanglian Wendan Tang jiawei(溫黃連溫膽湯加味). It should help primary care providers in their assessment of a common child health problem.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제24권4호
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• pp.199-206
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• 2013

Objectives : Attention-deficit hyperactivity disorder (ADHD) and Asperger's disorder (AD) in children are associated with attentional problems, impulsivity, hyperactivity, and difficulties with social interactions. Pharmacological treatment may alleviate symptoms of ADHD, but seldom solves difficulties with social interactions. Social skills training (SST) may assist in improving their social interactions. We examined the effects of SST on children's social competences, general behavior, and ADHD symptoms. Methods : Thirty four children, aged 7 to 12 years, participated in the cognitive behavioral SST program once a week at the outpatient division of child-adolescent psychiatry. SST was composed of 24 sessions (ninety minutes) for 6 months. Twenty-five children were diagnosed with ADHD, and 9 children were diagnosed with AD. Parents of the children rated Korea-Child Behavior Checklist (K-CBCL), Conner's rating scales, Korean-ADHD Rating Scale (K-ARS), Social Skill Rating System (SSRS), and Matson's Social Skill Rating Scale as an evaluation of the treatment effect, before the first session and after the final session of the training. Results : The ADHD group showed significantly increased scores of social and social competence of CBCL and SSRS. Further, scores of externalizing problems of CBCL, CRS, and ARS were significantly decreased. The Asperger's group showed significantly increased scores of social competence of CBCL, SSRS, and MESS. There was a significant difference of the improvement in CBCL's school and total behavior problem score, CRS between drug change group and no drug change group. Conclusion : The result of this study suggests that SST is effective in improving social skills for children with ADHD and AD. In addition, SST has shown its effectiveness in treating attentional problems for children with ADHD. To prove objective usefulness of SST, further studies with a more structured design and long-term duration along with a sufficient number of AD participants will be necessary.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제31권4호
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• pp.207-213
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• 2020

Objectives: Although aggressive behavior in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) has previously shown correlations with hyperactivity/impulsivity, few studies have examined its association with inattention or the effect of working memory on aggressive behavior. This study aimed to assess the relationship between inattention and aggressive behavior and the effect of working memory on the relationship between inattention and aggressive behavior in children and adolescents with ADHD. Methods: Thirty-one children and 26 adolescents with ADHD were retrospectively investigated. The subjects completed the Korean Wechsler Intelligence Scale for Children-Fourth Edition (K-WISC-IV), the Korean Child Behavior Checklist (K-CBCL), and the Korean Children's Depression Inventory (CDI). Results: Inattention was positively correlated with aggressive behavior in children and adolescents with ADHD and working memory showed an insignificant correlation. However, working memory had a significant moderating effect on aggressive behavior by interacting with inattention. The moderating effect of working memory manifested when the working memory index score on the K-WISC-IV was 73.5 points or higher, and it had a significant effect on aggressive behavior. Conclusion: This study shows that the severity of inattention and hyperactivity/impulsivity should be addressed to provide appropriate treatment to children and adolescents with ADHD who exhibit aggressive behavior.