• Journal of Preventive Medicine and Public Health
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• v.53 no.1
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• pp.29-36
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• 2020

Objectives: Prenatal cadmium (Cd) exposure may be associated with attention-deficit/hyperactivity disorder (ADHD) in children. Therefore, the objective of this study was to examine the relationship between Cd exposure during gestation and ADHD at 6 years of age. Methods: As part of an ongoing cohort study (the Environment and Development of Children study), 479 mother-child pairs from Seoul, Korea were included for analysis between 2008 and 2011. The whole blood concentration of Cd was analyzed using atomic absorption spectrophotometry. The parents were surveyed about ADHD behaviors in their children at age 6. Multivariable linear regression models were used to investigate the relationship between prenatal exposure to Cd and ADHD at 6 years of age. Results: Increased prenatal Cd concentrations were associated with increased scores for ADHD for girls, but not for boys, at age 6. A 2-fold increase in the prenatal Cd level was significantly associated with a 22.3% (95% confidence interval, 11.6 to 34.1) increase in ADHD in girls at 6 years of age, as indicated by the linear regression model. Conclusions: Our results identified significant associations between prenatal Cd exposure and ADHD scores in 6-year-old girls.

• The Journal of Korean Academic Society of Nursing Education
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• v.20 no.3
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• pp.382-391
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• 2014

Purpose: The purpose of this study was to identify the predictors influencing on educational intervention for Attention Deficit Hyperactivity Disorder (ADHD) after analyzing the relationship among teachers' internal-external locus of control, leadership type and educational intervention for ADHD. Methods: A cross sectional study design was conducted with 255 teachers in three schools located in D, K and Y city. The data were analyzed by t-test, one-way ANOVA, Pearson correlation coefficients and multiple regression using SPSS 20.0. Results: Internal locus of control showed significantly positive correlations with educational intervention for ADHD. Efficient leadership type, harmony-oriented leadership type showed significant differences in inefficient leadership type on educational intervention for ADHD. Significant factors of the educational intervention were efficient leadership type, harmony-oriented leadership type, task-oriented leadership type and internal locus of control that were explained by 20.0% (F=12.5, p<.001) of educational intervention for ADHD. Conclusion: Based on the findings of this study, it is necessary to have teacher's efficient leadership type focused on ADHD symptoms. Teachers need to enhance their positive domain of internal-external locus of control towards students with ADHD to increase the effectiveness of their educational interventions for ADHD.

• Korean Journal of Biological Psychiatry
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• v.14 no.4
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• pp.256-261
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• 2007

Objectives : The aim of the present study was to examine whether anxiety and depression of children and mothers were associated with the children's medically unexplained somatic symptoms in attention-deficit/hyperactivity disorder(ADHD). Methods : 83 clinic-referred boys with ADHD and 52 boys without ADHD were included in this study. The frequency of the medically unexplained somatic symptoms, such as general-ache, headache, nausea, eye problems, skin problems, abdominal pain, vomiting was evaluated using the somatic symptom domain of the Child Behavior Checklist(CBCL). Children's anxiety and depression were evaluated using Kovacs Children's Depression Inventory(CDI) and Spielberger's State-Trait Anxiety Inventory(STAI) for children. Maternal anxiety and depression were measured by Spielberger's State-Trait Anxiety Inventory(STAI) and Beck's Depression Inventory(BDI). Stepwise linear regression analysis was used to examine the hypothesis. Results : Score of maternal state anxiety affects the T score of the somatic symptom domain in CBCL significantly(adjusted $R^2$=0.057 ; p=0.026). Conclusion : The frequency of medically unexplained somatic symptom of children perceived by mothers was associated with the high level of maternal state anxiety in ADHD. Frequent maternal report of the children's somatic symptom may be a warrant for the evaluation and management of the maternal state anxiety in ADHD.

• Anxiety and mood
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• v.7 no.2
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• pp.101-106
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• 2011

Objectives : The aim of this study was to investigate whether and how the symptoms of adult attention deficit hyperactivity disorder (ADHD) affect the stress and depressive symptoms in Korean soldiers. Methods : Data were collected on 131 subjects through self-report using the Korean Adult Attention-Deficit/Hyperactivity Disorder Scale (K-AADHDS), Center for Epidemiological Studies Depression Scale (CES-D), Korean Wender Utah Rating Scale (K-WURS), and the Brief Encounter Psychosocial Instrument (BEPSI-K). Student t-tests, Pearson Correlation, Logistic regression, and Path analysis were performed. Results : The scores related to adult ADHD symptoms on the K-AADHDS and K-WURS were correlated with stress scores on the BEPSI-K (r=0.529, p<0.001 and r=0.484, p<0.001) and with depressive symptoms on the CES-D (r=0.686, p<0.001 and r=0.628, p<0.001). Scores related to adult ADHD on the K-AADHDS were the most significant risk factors for stress (O.R=1.198, 95% CI=1.104-1.299), and depressive symptoms (O.R=1.306, p95% CI=1.112-1.534). Path analysis on depressive symptoms showed that adult ADHD symptoms affected stress and depressive symptoms. Conclusion : The results suggest that it may be important to consider the evaluation and treatment of adult ADHD in soldiers. Prospective studies with larger numbers of subjects are warranted to further explore the relevance of the present results.

• The Journal of Korean Academy of Sensory Integration
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• v.14 no.1
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• pp.1-8
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• 2016

Objective : The purpose of this study was to determine the reliability of Test of Playfulness (ToP) in Attention Deficit Hyperactivity Disorder (ADHD) children. Methods : Twenty ADHD children participated in this study. To determine inter-rater reliability, two raters was evaluated by Test of Playfulness scores and analyzed Kappa coefficient and total agreement and intraclass correlation coefficient (ICC). Results : Total agreement was the range of 75%~95% and the Kappa coefficients was the range of. 45~1.00. Analyzing inter-rater reliability by ICC showed very high reliability: Intrinsic motivation was .96, internal control was .98, suspension of reality was .90, framing was .98, total score was .99. Conclusion : A reliability of Test of Playflness of children with ADHD showed that high. On the basis of this study, it will provide availability for clinical evaluation of children with ADHD, and basic study on the play of children with ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.23 no.4
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• pp.181-187
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• 2012

Objectives:The objective of this study was to examine the perinatal and developmental risk factors of attention-deficit hyperactivity disorder (ADHD) diagnosed with a structured interview among Korean children. Methods:The current study included 924 children (6-15 years) recruited from schools in five Korean cities or a child psychiatry outpatient clinic of Seoul National University Children's Hospital. The parents of the children completed the structured diagnostic interview for attention-deficit hyperactivity disorder, as well as questionnaires on perinatal and developmental risk factors. Results:Preterm delivery, severe maternal stress during pregnancy, change in primary care taker during the first three years, postpartum depression, and delayed first sentence showed a significant association with ADHD diagnosis. Conclusion:These findings suggest that perinatal and developmental factors contribute to development of ADHD in Korean children. Conduct of future research using a prospective design is needed in order to identify the causal relationship between observed risk factors and development of ADHD.

• 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.

• 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.

• Korean Journal of Biological Psychiatry
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• v.26 no.2
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• pp.59-64
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• 2019

Objectives Internet gaming disorder (IGD) is associated with attention deficit/hyperactivity disorder (ADHD) or depression etc. We tried to examine the mediating effects of depression in the relationship between ADHD and IGD. Methods This study was conducted on 2000 people who participated in on-line survey among 14-39 year-old men and women in 2017. And we clarified the relationship among IGD, ADHD, and depression and tested the mediation model. The mean and standard deviation of the main variables were calculated and correlation analysis was performed to confirm the relationship among the main variables. In order to test the mediating effect of depression on the relationship between ADHD and IGD, the structural equation model was implemented using AMOS 21 (IBM). Results There were significant correlations among the variables; IGD, ADHD and depression. Depression had a mediating effect 0.23 (95% confidence interval : 0.17-0.28) in the relationship between IGD and ADHD. Conclusions This study showed that depression can mediate ADHD and IGD. Therefore, the evaluation and management of depression and ADHD should be included in the diagnosis and treatment of IGD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.2
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• pp.112-119
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• 2015

Objectives : The purpose of this study was to examine the prenatal, perinatal and developmental risk factors of attention-deficit hyperactivity disorder (ADHD), compared to unaffected siblings (SIB), and typically developing children (TC). Methods : Subjects with ADHD, their SIB, and TC were recruited from the child psychiatry outpatient clinic of the Asan Medical Center Children's Hospital. The parents of the children completed questionnaires on perinatal and developmental risk factors. Results : Fifty-eight subjects with ADHD (41 boys, $7.7{\pm}1.3years$), 21 SIB (8 boys, $8.2{\pm}1.8years$), and 22 TC (8 boys, $8.5{\pm}2.1years$) were included. The ADHD group showed higher rates of maternal stress during pregnancy than the SIB group (p=.002), and the ADHD group showed higher rates of familial psychiatric history than the TC (odds ratio, 8.76 ; 95% confidence interval, 1.69 to 45.45). Conclusion : These findings suggest that among perinatal and developmental factors, maternal stress during pregnancy contribute to the development of ADHD. Future prospective studies will be needed in order to determine the causal relationship between perinatal risk factors and development of ADHD.