• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.30 no.2
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• pp.50-56
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• 2019

Most patients with Tourette's disorder experience an uncomfortable sensory phenomenon called the premonitory urge immediately before experiencing tics. It has been suggested that premonitory urges are associated with comorbidities such as obsessive compulsive disorder, anxiety disorders, and attention-deficit/hyperactivity disorder, although these associations have been inconsistent. Most patients experience tics as a result of the premonitory urges, and after the tics occur, most patients report that the premonitory urges are temporarily relieved. As a consequence, several studies have assessed the premonitory urge and its potential therapeutic utility. Based on the concept that the premonitory urge induces tics, behavioral treatments such as Exposure and Response Prevention and Habit Reversal Therapy have been developed. However, it is still unclear whether habituation, the main mechanism of these therapies, is directly related to their effectiveness. Moreover, the observed effects of pharmacological treatments on premonitory urges have been inconsistent.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.3
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• pp.257-266
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• 2022

Purpose : This systematic review examined evidence published 2000-2021 for occupational therapy interventions for adult Attention Deficit Hyperactivity Disorder (adult ADHD). Methods : In order to find out the studies on the effect occupational therapy intervention on individuals with adult ADHD, studies published from 2000 to February 2022 were searched on Google Academic Search. The keywords used were "adult ADHD" AND "Occupational therapy". A total of 785 studies were searched, and from these, 3 studies were selected based on the application of the selection and exclusion criteria. The included studies comprised of 1 Quasi-experimental design study(one group pre-post test) and 2 randomized controlled trials design studies. The included studies were analyzed in PICO(patients, intervention, comparison, outcomes). Results : As a result of analysing the subjects of the included studies, subjects diagnosed with adult ADHD or classified as high-risk group in Adult ADHD Self-Report Scale test, the number of subjects was 97, and the average age was about 33 years old. Occupational therapy intervention methods for adult ADHD include Tailored Intervention, Computerized Cognitive Training, and Cognitive-Functional Intervention. The Adult ADHD Self-Report Scale was the most used to check the symptoms of ADHD, and the COPM was used the most to measure the effects of occupational therapy interventions. The dependent variables of occupational therapy intervention were occupational performance, quality of life, executive function (behavioral regulation, metacognition), self-regulation function, stress management, and sustained attention. The effect of the intervention was statistically significant in 78.5% of the total. Conclusion : It is expected that the results of this study can be used as basic data for evidence-based practice for occupational therapists to apply adult ADHD interventions. In the field of occupational therapy in Korea, research on various interventions that can improve the occupational performance of adults ADHD should be conducted.

• The Korean Journal of Nuclear Medicine
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• v.37 no.4
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• pp.235-244
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• 2003

Purpose: Attention deficit hyperactivity disorder (ADHD) has been known as psychiatric disorder in childhood associated with dopamine dysregulation. In present study, we investigated changes in dopamine transporter (DAT) density of the basal ganglias using I-123 N-(3-iodopropen-2-yl) -2-carbomethoxy-3beta-(4-chlorophenyl) tropane [I-123 IPT] SPECT in children with ADHD before and after methylphenidate treatment. Materials and Method: Nine drug-naive children with ADHD and seven normal children were included in the study. We peformed brain SPECT two hours after the intravenous administration of I-123 IPT and made both quantitative and qualitative analyses using the obtained SPECT data, which were reconstructed for the assessment of soecific/nonspecific DAT binding ratios in the basal ganglia. All children with ADHD reperformed [123I]IPT SPECT after treatment with methylphenidate(0.7mg/kg/d) during about 8 weeks. SPECT data reconstructed for the assessment of specific/nonspecific DAT binding ratio of the basal ganglia were compared between before and after treatment methylphenidate. We investigated correlation between the change of ADHD symptom severity assessed with ADHD rating scale-IV and specific/nonspecific DAT binding ratio of basal ganglia. Results: Children with ADHD had a significantly greater specificinonspecific DAT binding ratio of the basal ganglia comparing to normal children(Right : z = 2.057, p = 0.041 : Left : z : 2.096, p = 0.032). Under treatment with methylphenidate in all children with ADHD, specificinonspecific DAT binding ratio of both basal ganglia decreased significantly greater than before treatment with methylphenidate (Right : t = 3.239, p = 0.018 ; Left : t = 3.133, p = 0.020). However, no significant correlation between the change of ADHD symptom severity scores and specific/nonspecific DAT binding ratio of the basal ganglia were found. Conclusions: These findings support the complex dysregulation of the dopaminergic neurotransmitter system in children with ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.22 no.4
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• pp.211-218
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• 2011

Objectives : Intellectual impairment in children with attention-deficit hyperactivity disorder (ADHD) is often associated with relatively severe cognitive dysfunction. This study was designed to investigate cognitive function using auditory and visual event-related potential P300 in children with ADHD with relatively higher and lower IQ. Methods : A total of 20 children aged 6-12 years with DSM-IV-TR diagnosis of ADHD-combined type were recruited. For 10 children with lower IQ (${\leq}$100) and 10 children with higher IQ (>100), auditory and visual P300 using oddball paradigm (target 0.2, standard 0.8, in probability) were employed. Results : No significant differences were found in P300 amplitude and latency between ADHD children with higher and lower IQ in both modalities. However, auditory P300 amplitude in the right parietal area (P8 electrode) was negatively correlated with verbal IQ in ADHD subjects (R=-.50, p<.05). Visual P300 amplitude in the left parietal area (P3 electrode) was positively correlated with performance IQ in ADHD subjects (R=.57, p<.01). Conclusion : This study suggests intellectual impairment, as evidenced by lower IQ, could not be associated with cognitive dysfunction reflected in event-related potential P300 in ADHD children. However, cognitive function reflected in intellectual subcomponents and P300 might be processed in a stimulus modality-specific and asymmetric pattern.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.20 no.1
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• pp.17-22
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• 2009

Objectives : A higher level of aggression has been reported for children with attention-deficit/hyperactivity disorder (ADHD) than for non-ADHD children. Aggression was shown to have a negative effect on the social functioning of children with ADHD. The ability to recognize facial emotion expression has also been related to aggression. In this study, we examined whether impulsivity and dysfunctional recognition of facial emotion expression could explain the aggressiveness of children with ADHD. Methods : 67 children with ADHD participated in this study. We measured the ability to recognize facial emotion expression by using the Emotion Recognition Test (ERT) and we measured aggression by the T score of the aggression subscale of the Child Behavior Checklist (CBCL). Impulsivity was measured by the ADHD diagnostic system (ADS). Results : The teacher rated level of aggression was related to the score of recognizing negative affect. After controlling for the effect of impulsivity, this relationship is not significant. Only the score of the visual commission errors ex plained the level of aggression of children with ADHD. Conclusion : Impulsivity seems to have a major role in explaining the aggression of children with ADHD. The clinical implication of this study is that effective intervention for controlling impulsivity may be expected to reduce the aggression 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.196-203
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• 2012

Objectives:We analyzed the usefulness of intelligence test in assessing attention-deficit hyperactivity disorder (ADHD). Methods:The medical records of 312 patients with ADHD who visited the child psychiatry department in one university hospital in Seoul, Korea, were reviewed. Demographic data and scores on the Korean Wechsler Intelligence Scale for Children-III (K-WISC-III) and Korean-Conners' Parent Rating Scale (K-CPRS) were analyzed. To assess the relationship with comorbidities, AD-HD subjects were classified as; externalizing disorders, internalizing disorders, tic disorders, and no comorbidities. Results:Verbal intelligence quotient (VIQ) was significantly higher than performance IQ (PIQ)($102.6{\pm}14.44$, $99.2{\pm}14.48$, p<.001). Using mean scatter method, subtest scores such as 'information, similarities, digit span and coding' were significantly lower than mean scores of sum of subtests of VIQ or PIQ (p<.05). Regarding comorbidities, children with externalizing disorders exhibited. Lower scores on 'information and vocabulary' than other groups (p=.008). Children with no comorbidities exhibited higher scores on 'similarities and object assembly' than children with externalizing/internalizing disorders (p=.001) and also on 'comprehension' than children with externalizing disorders (p=.006). For subtypes of ADHD, children with hyperactive-impulsive type had higher scores on 'comprehension' than children with inattentive and combined type (p=.004). Conclusion:These results suggested that intelligence test might provide useful information for assessing ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.22 no.4
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• pp.219-227
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• 2011

Objectives : This study examined maternal object relations, child's and mother's perception on rearing attitude, and children's self-esteem in children with attention-deficit hyperactivity disorder (ADHD) and their mothers. Methods : 64 children with ADHD and their mothers were included in the study group. In the control group, there were 85 children and their mothers. Mothers completed the following tests : Bell object relation inventory (BORI), maternal behavior research instrument (MBRI), Beck Depression Inventory (BDI), and Korean ADHD Rating Scale (K-ARS). Children completed Children's Report of Parental Behavior Inventory (CRPBI) and Rosenberg self-esteem scale. Results : Mothers of ADHD children displayed more rejecting and controlling parenting style than mothers in the control group. ADHD children showed lower self-esteem and perceived their parents as not affectionate, but rejecting and controlling. Mothers with ADHD children who belonged to object relations pathological group showed more rejecting rearing attitude and their children believed that they were more controlling, compared with children and mothers in other conditions. Among factors in mother's object relations, insecure attachment and ego-centricity impacted the rearing attitude. In turn, affective rearing attitude mainly influenced children's self-esteem. Conclusion : This study suggests that the approach focused on mother's object relations may help with the treatment of children with ADHD.

• Journal of the Korea Convergence Society
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• v.9 no.7
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• pp.337-346
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• 2018

The purpose of this study was to identify the characteristics and the attributes related to Internet use in patients with Internet addiction. This study is a descriptive secondary analysis study, at Internet addiction clinics used the data of 63 patients diagnosed with Internet addiction. Data were obtained from Internet addiction clinic Electronic Medical Records(EMR), there was included the Korean Internet addiction scale(K-scale), Beck Anxiety Inventory(BAI), Beck Depression Inventory(BDI), Barratt Impulsivity scale(BIS), Conners ADHD Rating Scale(CAARS), Lubben Social Network Scale(LSNS). K-scale had significantly correlations with Internet use time per day, anxiety, impulsivity, Attention deficit Hyperactivity Disorder(ADHD) symptom. In stepwise multiple regression, factors significantly affecting ADHD symptom (${\beta}=.37$), Internet use time per day(${\beta}=.29$), Impulsivity(${\beta}=.25$), which accounted for 44% of the variance. Results indicate that patients with Internet addiction had psychological difficulties and suggest that children with ADHD needed to intervention for appropriate internet use.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.31 no.3
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• pp.154-160
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• 2020

Objectives: It remains unclear whether methylphenidate (MPH) has yadverse effects on growth in children. This study aimed to investigate the association of MPH with serum biological markers of growth in children with attention-deficit/hyperactivity disorder (ADHD). Methods: The present study included 103 children with ADHD (64 drug-naive children, 39 MPH-treated children) and 112 control subjects. Children with ADHD were diagnosed on the basis of a semi-structured interview. Levels of biochemical markers of growth, including insulin-like growth factor-I, thyroid stimulating hormone (TSH), free T₄, calcium, phosphorus, alkaline phosphatase, vitamin D, hemoglobin, total protein, albumin, total cholesterol, and hematocrit were measured in these individuals. Results: Except in case of TSH, no intergroup differences were found in the levels of the growth markers. The levels of TSH were found to be lower in the MPH-treated boys with ADHD than in the drug-naive and control groups (p<0.05), although the levels of TSH in all the groups were within normal limits. Conclusion: In this cross-sectional study, no significant association was found between MPH and growth markers. This calls for the need to carry out prospective longitudinal research studies in the future that investigate the effect of MPH on the growth trajectory in children.

• Journal of East-West Nursing Research
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• v.29 no.2
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• pp.150-160
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• 2023

This study aimed to identify the actor and partner effects of parenting efficacy, spousal support on parenting stress and depression in couples with children with attention deficit hyperactivity disorder (ADHD). Methods: A cross-sectional survey design was used. Participants were 103 couples (103 husbands, 103 wives) with children with ADHD visiting child adolescent psychiatry clinic or community mental health center in Seoul, Gyeonggi-do, South Korea. Data were analyzed by SPSS 20.0 and AMOS 20.0 program. Results: The parenting efficacy of husbands and wives had direct actor effect (β=-.69, p=.004; β=-.60, p=.004) and partner effect (β=-.22, p=.007; β=-.18, p=.026) on their parenting stress. In addition, husbands and wives's parenting efficacy had a direct actor effect (β=-.25, p=.031; β=-.21, p=.025) on their depression and indirect actor effect (β=-.25, p=.004; β=-.34, p=.004) through parenting stress on their depression. However, parenting stress did not show a partner effect on depression. Husband and wife's parenting efficacy had a direct effect (β=.46, p=.004; β=.25, p=.009) on perceived spousal support. The effects of husbands and wives were the same in actor effect size (χ² differences=0.74, p=.390) and partner effect size (χ² differences=0.20, p=.652) of parenting efficacy on parenting stress. In addition, the effect sizes of husbands and wives were the same in actor effect size (χ² differences=0.93, p=.334) and partner effect size (χ² differences=0.15, p=.704) for parenting stress and depression. Conclusion: The results of this study may provide the foundation for developing a nursing intervention program that can maximize interaction between couples with ADHD children.