• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제5권1호
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• pp.102-107
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• 1994

갑상선호르몬 내성증후군(GRTH)과 주의력 결핍-과잉행동장애(ADHD)의 관계는 최근에 매우 연구가 활발히 진행되면서, ADHD환아에서 갑상선 검사를 기본검사로 시행할 것인가 여부가 또한 논란이 되고 있다. 저자는 ADHD 환아뿐 아니라 발달장애 환아에서도 GRTH가 발견될 수 있다는 사항에 주목하여 이들 환자들에서 갑상선 검사를 시행하여 이상 유무를 조사하고, 뚜렷한 이상소견을 보이는 환아들의 임상 양상을 밝혀 앞으로 이들의 가계 연구 및 유전자 연구의 시작을 해보고자 하였다. 총 51명에서 검사가 시행되었고, 이중 T3, T4가 모두 정상범위를 벗어나며, TSH가 정상 혹은 증가된 증례가 모두 11명이었다. 그들의 임상 특성과 진단등을 살펴보고, 앞으로의 방향에 대해 토의하였다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제29권4호
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• pp.150-160
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• 2018

Objectives: This study investigated the effect of social skills training (SST) on facial emotion recognition and discrimination in children with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Methods: Twenty-three children aged 7 to 10 years participated in our SST. They included 15 children diagnosed with ADHD and 8 with ASD. The participants' parents completed the Korean version of the Child Behavior Checklist (K-CBCL), the ADHD Rating Scale, and Conner's Scale at baseline and post-treatment. The participants completed the Korean Wechsler Intelligence Scale for Children-IV (K-WISC-IV) and the Advanced Test of Attention at baseline and the Penn Emotion Recognition and Discrimination Task at baseline and post-treatment. Results: No significant changes in facial emotion recognition and discrimination occurred in either group before and after SST. However, when controlling for the processing speed of K-WISC and the social subscale of K-CBCL, the ADHD group showed more improvement in total (p=0.049), female (p=0.039), sad (p=0.002), mild (p=0.015), female extreme (p=0.005), male mild (p=0.038), and Caucasian (p=0.004) facial expressions than did the ASD group. Conclusion: SST improved facial expression recognition for children with ADHD more effectively than it did for children with ASD, in whom additional training to help emotion recognition and discrimination is needed.

• Journal of Ginseng Research
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• 제35권2호
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• pp.226-234
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• 2011

We investigated the clinical effects of Korean red ginseng on attention deficit hyperactivity disorder (ADHD) in children. Eighteen subjects aged between 6 and 14 diagnosed with ADHD based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition diagnosis criteria were enrolled. Korean red ginseng (Panax ginseng) at 1,000 mg b.i.d. was administered to the subjects for 8 weeks. Eighteen children completed the questionnaire and clinical assessment by visiting the hospital at baseline, then in the first, fourth and eighth weeks. Clinical assessments were performed by using the ADHD Diagnostic System (ADS, a computerized attention assessment program), the abbreviated Conners' rating scale in addition to psychiatric interviews. After 8 weeks, significant differences were found in the omisssion errors of ADS ($78.56{\pm}43.33$ at baseline, $55.17{\pm}21.44$ at 8 weeks, p<0.023), Conners ADHD Rating Scale ($13.78{\pm}6.32$ at baseline, $9.50{\pm}4.80$ at 8 weeks, p<0.042) and Spielberger State Anxiety Scale ($30.94{\pm}6.25$ at baseline, $28.83{\pm}6.23$ at 8 weeks, p<0.024). In the Korean Personality Inventory for Children, a significant reduction of score was found in the physical development scale ($56.44{\pm}9.63$ at baseline, $50.94{\pm}8.91$ at 8 weeks, p<0.017) and social dysfunction scale ($56.33{\pm}6.82$ at baseline, $51.94{\pm}7.13$ at 8 weeks, p<0.025). These results suggest that Korean red ginseng may be effective in improving inattentiveness in ADHD children, but it remains uncertain if it improves the general severity of ADHD, depression, anxiety personality and behavioral changes.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제30권2호
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• pp.74-82
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• 2019

Objectives: The objective of this study was to investigate clinical and neuropsychological factors associated with treatment response and adverse events of atomoxetine in children with attention-deficit/hyperactivity disorder (ADHD) in Korea. Methods: Children with ADHD were recruited at the Department of Psychiatry of Asan Medical Center from April 2015 to April 2018. Diagnoses of ADHD and comorbid psychiatric disorders were confirmed with the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. The subjects were subsequently treated with atomoxetine for 12 weeks and illness severity was scored using the ADHD Rating Scale, Clinical Global Impression-Severity scale (CGI-S) and/or Improvement scale (CGI-I), at pre- and post-treatment. They also completed the Advanced Test of Attention (ATA), while their caregivers completed the Korean Personality Rating Scale for Children (KPRC) at pre- and post-treatment. Independent t-test, Fisher's exact test, ${\chi}^2$ test, mixed between-within analysis of variance and correlation analysis were used for statistical analysis. Results: Sixty-five children with ADHD (mean age: $7.9{\pm}1.4years$, 57 boys) were enrolled, of which, 33 (50.8%) were treatment responders. Scores on the social dysfunction subscale of the KPRC (p=0.021) and commission errors on the visual ATA (p=0.036) at baseline were higher in treatment non-responders than in responders; however, the statistical significances disappeared after adjusting for multiple comparisons. Mood changes were also observed in 13 subjects (20.0%), and three of them discontinued atomoxetine due to this. Additionally, atomoxetine-emergent mood change was observed more frequently in girls (p=0.006), while the intelligence quotient (p=0.040) was higher in those subjects with mood changes than in those without. Conclusion: The results of our study suggest that clinical and neuropsychological factors could be associated with treatment response or adverse events of atomoxetine in children with ADHD. Further long-term studies with larger samples are needed.

• 응용통계연구
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• 제25권3호
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• pp.389-401
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• 2012

This paper derives a benchmark dose(BMD) and its 95% lower confidence limit(BMDL) using a semi-parametric regression model for small lead based changes in attention-deficit hyperactivity disorder(ADHD) scores in the first wave of the Children's Health and Environment Research(CHEER) survey data, which have been regularly collected in South Korea since 2005. Ha et al. (2009) showed that the appearance of ADHD symptoms had a borderline trend of increasing with the blood lead concentration. Butdz-J${\o}$rgensen (EFSA, 2010a) derived the BMDL of lead corresponding to a benchmark region of 1 full intelligent quotient (IQ) score using the raw data in Lanphear et al. (2005, EHP). European Food Safety Authority (EFSA, 2010b) determined the BMDL of $1.2{\mu}g/dl$ as a reference point for the characterization of lead when assessing the risk of the intellectual deficit measured by IQ scores. Kim et al. (2011) indicated that an even lower BMDL could be obtained based on the ADHD score; however, the BMDLs depended heavily upon the model assumptions. We show in this paper that a semi-parametric approach resolves the model dependence of BMDLs.

• 디지털융복합연구
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• 제11권11호
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• pp.717-723
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• 2013

한국 초등학생의 10% 이상이 ADHD(Attention Deficit/Hyperactivity Disorder) 증상군으로 분류된다는 보고가 있다. ADHD와 같이 주의력이 심각하게 부족한 아동들은 주로 약물 치료에 의존하고 있다. 하지만, 약물치료는 여러가지 부작용이 따른다. 그러므로 아동들의 자발적인 참여를 유도하고 주의력을 향상시킬 수 있는 방법이 필요하다. 본 연구에서는 아동들이 좋아하는 게임을 이용하여 아동 친화적인 주의력 향상 모델을 따라 3D 체감형-기능성 게임을 개발하였다. 개발한 게임이 아동의 주의력을 향상시키는데 어떠한 효과가 있는지 확인하기 위해서는 주의력 측정 변인에 대해 연령별 변인 평균 및 표준편차를 알아야 한다. 실험을 통해 측정된 집단별 변인 평균은 향후 주의력 향상 효과성 실험 연구에 이용될 수 있다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제24권4호
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• pp.220-227
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• 2013

Objectives : This study aims to investigate the clinical characteristics and neuropsychological profiles of children with attention-deficit hyperactivity disorder (ADHD) and their siblings. Methods : Eighteen children (age $8.2{\pm}1.7$ years, 12 boys) with ADHD and their 18 siblings (age $7.8{\pm}1.6$ years, 8 boys) completed Continuous Performance (CPT), Stroop, Children's Trail Making, Rey-Kim Memory, and Kim's Frontal Executive Function tasks. The parents of these subjects underwent the Attention-Deficit/Hyperactivity Disorder Rating Scale (ARS), 10-item Parent General Behavior Inventory (P-GBI), and the Social Responsiveness Scale (SRS). Paired t-tests were used. Results : The inattention (p=.020), and hyperactivity-impulsivity (p=.001), scores of the ARS and the P-GBI score (p=.004) were significantly higher in children with ADHD than in their siblings. Deficits in social communication and motivation on SRS were higher in children with ADHD than in their siblings (p=.017 and p=.011, respectively). Z-scores of omission and commission errors as well as response time variability on visual CPT and omission errors on auditory CPT were in clinically significant range, and z-score of omission errors on auditory CPT was in borderline range in siblings. Omission (p=.018) and commission errors on Visual CPT (p=.007) were significantly higher in children with ADHD compared to their siblings. Recognition efficiency on Kim's Frontal Executive Function Task was lower in children with ADHD compared to their siblings, but in normal range in both groups. Stroop interference and figure fluency on Kims Frontal Executive Function Task were in borderline range in ADHD group, and figure fluency was in borderline range in siblings. Conclusion : Our results support a preliminary evidence for mild degree of attention deficit in ADHD siblings. Further studies are needed to examine the cognitive functions of siblings with ADHD in larger samples.

• 대한지역사회영양학회지
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• 제23권5호
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• pp.397-410
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• 2018

Objectives: An association between dietary patterns and mental health in children has been suggested in a series of studies, yet detailed analyses of dietary patterns and their effects on ADHD (attention deficit hyperactivity disorder) are limited. Methods: We included 4569 children who had dietary intake data as part of the CHEER (Children's Health and Environmental Research) study conducted nationwide from 2005 to 2010. We assessed ADHD (Attention Deficit Hyperactivity Disorder) by the DuPaul's ADHD Rating Scales and dietary intake by a semi-quantitative food frequency questionnaire. Using intake data, we constructed five dietary patterns: "Plant foods & fish," "Sweets," "Meat & fish," "Fruits & dairy products," and "Wheat based." Results: The overall proportion of ADHD was 12.3%. Boys (17.8%) showed a higher rate of ADHD than girls (6.5%). The total intake of calories (85 kcal) and plant fat (2g) in the ADHD group was significantly higher than that of the normal group. ADHD was significantly negatively associated with dietary habits such as having breakfast and meal frequency, and positively associated with eating speed, unbalanced diet, overeating, and rice consumption. Regarding dietary patterns, the "Sweets" category was relevant to high ADHD risk (OR 1.59, 95% CI: 1.18, 2.15 for Q5 vs. Q1) in a linear relationship. An inverse, non-linear association was found between "Fruits & dairy products" and ADHD (OR 0.55, 95% CI: 0.39, 0.76 for Q4 vs. Q1). Conclusions: Our study confirms both positive and negative associations between diet and ADHD in elementary school age children. Moreover, linear or nonlinear associations between diet and ADHD draw attention to the possible threshold role of nutrients. Further studies may consider characteristics of diet in more detail to develop better intervention or management in terms of diet and health.

• 정신신체의학
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• 제27권2호
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• pp.147-154
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• 2019

연구목적 우울증 환자들에게서는 부주의를 포함한 인지기능 저하는 흔히 동반된다. 우울증 환자들에게서 나타나는 부주의 증상은 주의력결핍/과잉행동장애(Attention Deficit/Hyperactivity Disorder, ADHD)에게서 나타나는 증상과 유사한 양상을 보인다. 부주의 증상의 원인에 따라 치료가 달라지므로 두 질환을 정확히 진단하는 것이 중요하다. 본 연구에서는 우울감을 주소로 내원한 환자들에서 ADHD 증상의 공존율과 증상 별 상관관계를 알아보고자 한다. 방 법 2015년 3월~2018년 7월까지 우울감을 주소로 순천향대학교 부속 서울병원 정신건강의학과 외래에 내원한 158명의 환자를 대상으로 하였다. 모든 대상자들은 사회인구학적 특성(연령, 성별, 학력, 직업), 한국판 역학연구센터 우울척도(The Center for epidemiological Studies-Depression Scale, CES-D), 성인 주의력결핍과잉 행동장애 자기보고척도(Adult Attention Deficit/Hyperactivity Disorder self-report scale-V 1.1, ASRS-V 1.1), 한국판 코너스 성인 ADHD 평정척도(Korean-Conners' Adult ADHD Rating Scale, K-CAARS)를 수행하였다. 우리는 우울증군과 비우울증군을 CES-D점수로 분류하였으며, 자료처리는 기술통계분석, 교차분석, t-tests, 피어슨 상관분석을 실시하였다. 결 과 성인 ADHD 증상 공존율은 우울증군에게서 36.7%로 높았다(p-value<0.001). K-CAARS에서 ADHD 증상 정도는 우울증군(Inattention=1.80, Hyperactivity=1.92, Impulsivity=1.56, Self-concept=2.06)이 비우울증군(Inattention=1.28, Hyperactivity=1.25, Impulsivity=1.09, Self-concept=1.42) 보다 높게 나타났다(p-value<0.001). 결 론 본 연구에서는 ADHD 증상이 우울군에서 공존한다는 것을 확인하였다. 우울감을 호소하는 환자의 증상을 평가할 때, ADHD 증상의 공존 여부와 ADHD 진단 가능성에 관심을 가지고 정확하게 진단하고 적절한 치료를 병행해 나가야 한다고 제안한다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제22권2호
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• pp.74-80
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• 2011

Attention-deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder with an onset of symptoms before 7 years of age, often starting as early as the preschool years. The off-label use of methylphenidate (MPH) for 3- to 6-year-old preschool children with ADHD is being more common, although MPH is not licensed for use in children younger than age 6 years, in most countries. Despite the limited data, the review of the literature suggests that MPH meets evidence based criteria as beneficial and safe for carefully diagnosed ADHD preschool children. Carefully monitored administration of evidence-based psychotropic medication in preschool children with ADHD may be indicated if psychosocial treatments are ineffective.