• Clinical Psychopharmacology and Neuroscience
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• v.16 no.4
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• pp.407-414
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• 2018

Objective: Anxiety has been shown to influence functional impairment in patients with attention deficit hyperactivity disorder (ADHD). This study aimed to compare functional impairment in subjects with and without adult ADHD and to investigate the associations among trait anxiety, functional impairment, and ADHD symptom severity. Moreover, the effects of ADHD symptom subtypes on trait anxiety and functional impairment were also examined. Methods: The sample included 209 adults between the ages of 20 and 31 years. Fifty-one adults received a diagnosis of ADHD, and an additional age, sex-matched group of 51 adults comprised the adult control. Participants were assessed with Conners' Adult ADHD Rating Scales (CAARS), the Beck Depression Inventory (BDI), the Spielberg Trait Anxiety Inventory (STAI-T), and the Sheehan Disability Scale (SDS). The relationships among ADHD severity, anxiety, and functional impairment were investigated using Pearson's correlation analysis. Subtypes of ADHD symptoms that predicted anxiety and functional impairment were investigated using regression analyses. Results: Adult ADHD patients significantly differed from normal control subjects according to BDI, STAI-T, and SDS assessment. Significant positive correlations were noted between ADHD severity, anxiety, and functional impairment. Multiple linear regression analysis confirmed anxiety as a mediator between functional impairment and ADHD CAARS symptom subscales. Conclusion: Patients with adult ADHD showed higher levels of anxiety, depression, and functional impairment. Additionally, ADHD symptoms and anxiety impacted subject functional impairment. Our results suggest that anxiety may be a strong mediator between ADHD severity and functional impairment.

• 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.

• Clinical and Experimental Pediatrics
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• v.62 no.9
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• pp.360-366
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• 2019

Background: Attention deficit-hyperactivity disorder (ADHD) is one of the most common chronic behavioral disorders in school-aged children. Purpose: This study aimed to evaluate the effect of omega-3 supplementation as an alternative therapy for ADHD, which can be caused by vitamin and mineral deficiencies. Methods: This was a double-blinded clinical trial study. Sixty-six children with ADHD (aged 6-12 years) referred to our child and adolescent psychiatric educational and therapeutic clinic were selected based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria. Instruments including the Parent ADHD Rating Scale were used to assess ADHD at 0, 2, 4, and 8 weeks during the study. Results: The results showed no statistically significant difference between the methylphenidate with omega-3 group and methylphenidate with placebo group based on the Parents ADHD Rating Scale between week 0 ($P{\geq}0.96$) and week 8 ($P{\geq}0.75$). There were no significant intergroup differences between the Inattention ($P{\geq}0.48$) and hyperactivity/impulsivity ($P{\geq}0.80$) subscale scores on the Parents ADHD Rating Scale. The most common drug complications in the methylphenidate with placebo and methylphenidate with omega-3 groups were anorexia (27 [54%] vs. 41 [60.29%], respectively) and diarrhea (10 [20%] vs. 8 [11.76%], respectively), but the differences were not statistically significant (P>0.05). Conclusion: Our results demonstrate that a specific dose of omega-3 for 8 weeks had no effect on ADHD.

• The Journal of Pediatrics of Korean Medicine
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• v.33 no.2
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• pp.1-11
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• 2019

Objectives The objectives of this study is to investigate the characteristics of Attention-deficit/hyperactivity disorder (ADHD) pattern identification based on the survey of frequencies of symptoms and signs according to the pediatricians and psychiatrists in Korean Medicine. Methods Eleven pediatricians and fourteen psychiatrists participated in this study. 38 symptoms and signs of 4 ADHD pattern identifications (Kidney yin deficiency and liver yang ascendant hyperactivity 腎虛肝亢, Dual deficiencies in the heart and spleen 心脾兩虛, Phlegm-fire harassing the heart 痰火擾心, Spleen weakness and liver energy preponderance 脾虛肝旺) were used to evaluate the frequencies of ADHD. The differences in frequencies of symptoms and signs amongst ADHD pattern identifications, and the correlations between them were analyzed. Results There were significant differences in the frequencies of symptoms and signs between each pattern identification. Dual Deficiencies in the Heart and Spleen 心脾兩虛 is negatively related with hyperactivity and impulsivity, and positively related with inattention. Phlegm-fire Harassing the Heart 痰火擾心 is positively related with hyperactivity and impulsivity, and negatively related with inattention. Conclusions The results of the characteristics of ADHD pattern identifications from the survey analysis could be used in the clinical practices of ADHD as well as to improve the ADHD pattern identification questionnaire.

• Journal of the Korea Convergence Society
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• v.12 no.2
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• pp.113-120
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• 2021

The objective of this study is to identify the visual function impairment of children with each type of attention deficit hyperactivity disorder(ADHD). The subjects of this study were 49 children diagnosed with ADHD with visual function out of the normal range. The type of ADHD was investigated using the Korean-ADHD Rating Scale and visual function test. The attention deficit type(69.4%) of ADHD was the most common type among children with ADHD with vision problems. Although their overall naked-eye visual acuity was good, about 50% of the subjects showed problems with visual function. For those with the attention deficit type of ADHD, the myopia-related refractive error was high. For those with the hyperactivity type of ADHD, the astigmatism-related refractive error was higher. For those with vergence function disorder, convergence insufficiency was the most common. As there were differences in the visual impairment characteristics of children with different types of ADHD, it is necessary to approach a child's problem behavior through examination and screening for visual function disorders.

• Journal of Korean society of Dental Hygiene
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• v.21 no.3
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• pp.311-318
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• 2021

Objectives: The purpose of this study was to understand the level and patterns of college adjustment, major satisfaction, academic engagement, and attention deficit hyperactivity disorder (ADHD). This study examined the factors influencing adaptation to college life. Methods: This study was approved by the institutional review board of 00 university. We analyzed 166 survey data responses collected by distributing questionnaires from June 1 to July 2, 2020. Statistical product and service solutions version 23.0 was used for statistical analyses. The data were presented as frequencies and percentages or means and standard deviations, and pearson correlation analysis and multiple regression analysis were performed. Results: There was a significant difference in the average score of major satisfaction according to the type of college (university) and grades. For college adjustment, there was a significant difference in the average score according to major grades. Academic engagement showed a significant difference in the average score according to the college type and grade. Major satisfaction, college adjustment, and academic motivation showed significant positive correlations among the variables, whereas ADHD, major satisfaction, and college adjustment showed a significant negative correlation. Multiple regression analysis revealed that major satisfaction (p<0.001) and academic motivation (p<0.001) were factors affecting college adjustment (p<0.05). Conclusions: It is necessary to develop and apply specific and systematic adaptation programs to improve the understanding, control, and guidance methods for college students and to promote human relations, such as school life and social life.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.32 no.1
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• pp.28-34
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• 2021

Objectives: This study aimed to examine the effect of maternal adverse childhood experiences (ACEs) on the attention-deficit/hyperactivity disorder (ADHD) symptoms in the offspring and to examine the mediating role of antepartum health risk on the intergenerational transmission of maternal ACEs. Methods: The participants consisted of 461 mother-child dyads. Mothers completed the ACEs questionnaire and Diagnostic Predictive Scales. Multivariate logistic regression analysis was used to estimate the risk of ADHD symptoms in the offspring of mothers with ACEs and the mediating effect of antepartum health risks by path analysis. Results: In all, 35.4% (n=163) had at least one maternal ACE, and 11.1% (n=51) had three or more. Compared to the non-ADHD symptom group, the group of offspring with ADHD symptoms showed a significant association with maternal ACE score (p<0.001) and antepartum health risks (p<0.001). Multivariate analysis further showed a significant association between the sum of maternal ACEs [odds ratio (OR)=1.264, 95% confidence interval (CI)= 1.060-1.516, p=0.009], antepartum health risks (OR=1.236, 95% CI=1.036-1.475, p=0.019), and ADHD symptoms in the offspring. In the mediation model in which the mother's ACE score affected the offspring's ADHD symptoms, partial mediation through antepartum health risks was found to be significant (B=0.041, 95% CI=0.011-0.124). Conclusion: Maternal ACEs are significantly related to the incidence of ADHD symptoms in the offspring and antepartum health risks exert an indirect effect. These findings suggest that maternal ACEs have a negative impact on the offspring's brain development through intergenerational transmission, resulting in neurodevelopmental disorders such as ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.32 no.3
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• pp.118-125
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• 2021

Objectives: Childhood adversity is a risk factor for anxiety symptoms, but it affects anxiety symptoms in attention-deficit/hyperactivity disorder (ADHD). The current study aimed to examine the association between childhood adversity and anxiety symptoms in participants with and without ADHD. Methods: Data were obtained from a school-based epidemiological study of 1017 randomly selected children and adolescents. The ADHD and non-ADHD groups were divided using the Diagnostic Interview Schedule for Children Predictive Scale (DPS). The DPS was also used to assess comorbidities such as anxiety and mood disorders. The childhood adversities were assessed using the Early Trauma Inventory Self Report-Short Form, and the anxiety symptoms were assessed using the Screen for Child Anxiety Related Disorders. Linear and logistic regression models were used to investigate the association between childhood adversity and anxiety in the ADHD and non-ADHD groups with adjustments for age and sex. Results: This study found that the ADHD group did not show any significant association between anxiety symptoms and childhood adversities, whereas the non-ADHD group always showed a significant association. In a subgroup analysis of the non-ADHD group, the normal group without any psychiatric disorders assessed with DPS demonstrated a statistically significant association between childhood adversities and anxiety symptoms. These results were consistent with the association between childhood adversities and anxiety disorders assessed using DPS, as shown by logistic regression. Conclusion: The association between anxiety symptoms and childhood adversities statistically disappears in ADHD; ADHD may mask or block the association. Further longitudinal research is necessary to investigate this relationship.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.2
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• pp.99-111
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• 2021

Background: Attention deficit hyperactivity disorder (ADHD) is characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. It has a worldwide pooled prevalence of 5.29%. The characteristics of ADHD can increase the probability of dental treatment, while special behavior management can be required to allow proper treatment. In South Korea, the use of sedation in dental treatment has rapidly increased in recent decades. The present study aimed to investigate the trend and effects of sedation in patients with ADHD undergoing dental treatment in South Korea. Methods: The study used customized health information data provided by the Korean National Health Insurance Service. Among patients with the record of sedative use during the period from January 2007 to September 2019, those with International Classification of Diseases-10 codes for ADHD (F90, F91) were selected; the data of their overall insurance claims for dental treatment were then analyzed. The patients' age, gender, sedative use, and dental treatment were analyzed per year. The annual number of general anesthesia or sedation cases was also analyzed, and changes in the method of behavior management with increasing age were examined. Results: The study involved 7,654 patients with ADHD (6,270 males; 1,384 females). The total number of dental treatments was 137,778, while the number of sedation cases was 16,109, among which 13,052 involved male patients and 3,057 female patients. The number of general anesthesia cases was 631, among which 538 involved male patients and 93 female patients. The most frequently used sedation method in the dental treatment of patients with ADHD was N2O inhalation. The percentage of sedation cases was highest in patients aged 4 years, and it decreased with increasing age. Conclusion: In South Korea, both sedation and dental treatments were slightly more common in patients with ADHD than in the general population. With increasing age, the frequency of dental treatments and the percentage of sedation cases decreased.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.33 no.1
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• pp.2-15
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• 2022

Objectives: Children with attention-deficit/hyperactivity disorder (ADHD) tend to be noisy and violate rules with their disruptive behaviors, resulting in greater difficulties with off-task behaviors and being at risk for social refusal. The visual activity schedule (VAS) intervention program is a frequently used method to teach multiple skills involving on-task, use of schedules, transition behaviors, social initiation, independent play skills, classroom skills, and academic skills. The current systematic review aimed to examine the efficacy of using VAS intervention in reducing problem behaviors in children with ADHD between 5 and 12 years of age. Methods: Systematic searches were conducted using two electronic databases (PubMed and Scopus) to identify relevant studies published in English between 2010 and 2020. Four studies met the inclusion criteria: two studies examined the effect of schedule-based tasks and the use of an iPad on classroom skills, while the other two examined randomized clinical trials (RCTs) of psychosocial treatment for ADHD inattentive type and a cross-sectional study examined the impact of the group size on task behavior and work productivity in children with ADHD. Results: The findings indicate that the interventions used in all four studies could lead to increased satisfaction among participants and parents, as well as a reduction in problem behavior. In terms of the research indicators, the RCT had low quality, while the others were of high quality. Conclusion: A larger number of studies and the ADHD clinical population would help to increase the generalizability of future reviews of treatments in this context.