• 대한한방소아과학회지
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• 제33권4호
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• pp.60-73
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• 2019

Objectives This study reviewed the effects of a combined treatment with Kampo and Western medicine for Developmental disability in Japan, and the provision of education programs in clinical care. Methods The search database includes J-STAGE. To narrow the search, the following key words were used: 'pervasive developmental disorders, Attention-Deficit/Hyperactivity Disorder, Learning Disorders or Learning Disabilities, Intellectual Disability, and Kampo'. The search was limited to the publication date from 2001 to 2019. Results 1. Japan analyzed five sections: The usage of the Kampo medicine ranges from 25.2% to 71.6%, and the Kampo medicine was highly used in large cities. 2. In Japan, the educational programs were provided for the caregiver and special educational programs were available for children with disabilities. 3. In Japan, there were 9 studies regarding developmental disability treating with herbal remedies. There were seven clinical trial reports, and two were published in a review or report form. 4. The results showed benefits of using Kampo for patients with lack of Yin in blood in treatment of developmental disorder. It is also important to control the liver qi and Yin in blood. 5. Seven papers reported no side effects or abnormal findings. They have reduced the use of antipsychotics. Conclusions These review studies in regards to the combined treatment of Kampo and Western medicines can be helpful to improve long term side effects of the antipsychotics used in developmental disorders.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제34권4호
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• pp.275-282
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• 2023

Objectives: This study aimed to identify the psychiatric comorbidity status of adult patients diagnosed with attention-deficit hyperactivity disorder (ADHD) and determine the impact of comorbidities on neuropsychological outcomes in ADHD. Methods: The study participants were 124 adult patients with ADHD. Clinical psychiatric assessments were performed by two board-certified psychiatrists in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. All participants were assessed using the Mini-International Neuropsychiatric Interview Plus version 5.0.0 to evaluate comorbidities. After screening, neuropsychological outcomes were assessed using the Comprehensive Attention Test (CAT) and the Korean version of the Wechsler Adult Intelligence Scale, Fourth Edition (K-WAIS-IV). Results: Mood disorders (38.7%) were the most common comorbidity of ADHD, followed by anxiety (18.5%) and substance use disorders (13.7%). The ADHD with comorbidities group showed worse results on the Perceptual Organization Index and Working Memory Index sections of the K-WAIS than the ADHD-alone group (p=0.015 and p=0.024, respectively). In addition, the presence of comorbidities was associated with worse performance on simple visual commission errors in the CAT tests (p=0.024). Conclusion: These findings suggest that psychiatric comorbidities are associated with poor neuropsychological outcomes in adult patients with ADHD, highlighting the need to identify comorbidities in these patients.

• Biomolecules & Therapeutics
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• 제20권1호
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• pp.125-131
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• 2012

Impulsiveness is an important component of many psychiatric disorders including Attention-deficit/hyperactivity disorder (ADHD). Although the neurobiological basis of ADHD is unresolved, behavioral tests in animal models have become indispensable tools for improving our understanding of this disorder. In the punishment/extinction paradigm, impulsivity is shown by subjects that persevere with responding despite punishment or unrewarded responses. Exploiting this principle, we developed a new behavioral test that would evaluate impulsivity in the most validated animal model of ADHD of the Spontaneously Hypertensive rat (SHR) as compared with the normotensive "control" strain, the Wistar Kyoto rat (WKY). In this paradigm we call the Electro-Foot Shock aversive water Drinking test (EFSDT), water-deprived rats should pass over an electrified quadrant of the EFSDT apparatus to drink water. We reasoned that impulsive animals show increased frequency to drink water even with the presentation of an aversive consequence (electro-shock). Through this assay, we showed that the SHR was more impulsive than the WKY as it demonstrated more "drinking attempts" and drinking frequency. Methylphenidate, the most widely used ADHD medication, significantly reduced drinking frequency of both SHR and WKY in the EFSDT. Thus, the present assay may be considered as another behavioral tool to measure impulsivity in animal disease models, especially in the context of ADHD.

• Journal of Medicine and Life Science
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• 제18권3호
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• pp.41-48
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• 2021

The prevalence of attention deficit hyperactivity disorder (ADHD), a developmental neuropsychiatric disorder, is high among children and adolescents. The pathogenesis of ADHD is mediated with genetic, biological, and environmental factors. Most therapeutic drugs for ADHD have so far targeted biological causes, primarily by regulating catecholaminergic neurotransmitters. However, ADHD drugs that are clinically treated have various problems in their addictiveness and drug stability; thus, it is recommended that efficacy and safety should be secured through simultaneous prescription of multiple drugs rather than a single drug treatment. Accordingly, it is necessary to develop drugs that newly target pathogenic mechanisms of ADHD. In this study, we attempt to confirm the possibility of developing new drugs by reviewing dopamine-related developmental mechanisms of neurons and their correlation with ADHD. Histone deacetylase inhibitors (HDACi) can regulate the concentration of intracellular dopamine in neurons by expressing vesicular monoamine transporter 2 and inducing the exocytosis of neurotransmitters to the synaptic cleft, thereby promoting the development of neurons and signal transmission. This cellular modulation of HDACi is expected to treat ADHD by regulating endogenous catecholamines such as dopamine. Although studies are still in the preclinical stage, HDAC inhibitors clearly have potential as a therapeutic agent with low addictiveness and high efficacy for ADHD treatment.

• 대한감각통합치료학회지
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• 제15권1호
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• pp.21-32
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• 2017

목적 : 지각운동프로그램이 주의력결핍과잉행동장애(Attention-Deficit/Hyperactivity Disorder; ADHD) 아동의 시각운동통합기술과 운동기술에 미치는 영향을 알아보고자 한다. 연구방법 : ADHD로 진단 받았으나 약물중재를 받고 있지 않는 8세 남아를 대상으로 실시하였다. 실험설계는 개별실험연구(single-subject research design) 중 A-B-A(follow up) 설계를 사용하였고, 기초선 A는 3회기, 중재기 B는 8회기, 추적기간 A는 3회기였다. 기초선기간과 추적기간에는 자유 놀이를 40분간 실시한 후 시각운동통합기술을 보기 위해 한국판시지각발달검사의 하위 항목인 따라 그리기와 운동기술을 보기 위해 줄넘기를 실시하였다. 중재기 B에는 지각운동프로그램을 40분간 제공한 후 한국판시지각발달검사의 하위 항목인 따라 그리기와 줄넘기를 실시하였다. 결과 : 시각운동통합기술을 측정하기 위한 따라 그리기 항목의 표준점수는 기초선 기간에는 평균 4.7점의 열등수준을 보였지만 중재기간에서는 평균 9.6점의 평균 수준을 유지하였으며, 추적기간에서는 7.7점의 평균이하의 수준을 보였다. 아동의 운동기술의 변화를 측정한 줄넘기에서는 기초선 기간에는 4.3회, 중재기간에서는 5.9회로 증가된 운동능력을 보였으나, 추적기간에서는 5회로 약간 감소하였다. 결론 : 지각운동프로그램이 ADHD 아동의 시각운동통합기술과 운동기술의 수행의 변화에 긍정적 효과가 있었다.

• 대한불안의학회지
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• 제15권2호
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• pp.101-108
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• 2019

Objective : This study aimed to investigate the associations of anxiety symptoms with behavior and attention in elementary school children with attention-deficit/hyperactivity disorder (ADHD). Methods : A total of 195 elementary school children with ADHD participated in the study. The Korean Version of ADHD Rating Scale (K-ARS) and Behavior Assessment System for Children(BASC-2) were used to measure the children's behavior. Anxiety and attention was assessed with State-Trait Anxiety Inventory for Children (STAIC) and ADHD Diagnostic System (ADS), respectively. Children with ADHD were categorized to two groups of ADHD with low anxiety (ADHD-LA) and ADHD with high anxiety (ADHD-HA) according to the total STAIC scores. Scores on K-ARS, BASC-2 and ADS were compared between two groups of ADHD-LA and ADHD-HA. Results : The Scores on K-ARS total and both subscales in ADHD-HA group were significantly higher than ADHD-LA group. Scores on the BASC-2 subscales including hyperactivity, aggression, conduct problem, anxiety, depression, somatization, withdrawal, attention problems were also significantly higher in ADHD-HA group compared to ADHD-LA group. In contrary, scores on ADS subscales were not significantly different between the both groups. Conclusion : Our study identified that the anxiety accompanied with ADHD was associated with the negative behavioral aspect in children with ADHD. However, the performances on attention task were not affected by the anxiety comorbid with ADHD. Future studies to reveal underlying mechanism are needed for further understanding the association with anxiety and ADHD.

• 디지털융복합연구
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• 제11권10호
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• pp.731-736
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• 2013

아동들의 주의력 결핍으로 인한 여러 가지 사회적 문제가 야기되고 있다. 주의력 결핍이 심각한 아동들을 위한 아동 친화적인 주의력 향상 방법이 제공될 필요성이 있다. 최근 아동들은 3D 게임을 매우 좋아하며 자발적인 참여를 하고 있다. 그러므로 아동들이 좋아하는 3D 게임을 이용하여 아동들의 주의력을 향상시키고자 3D 게임을 통한 주의력을 측정하는 방법에 대한 연구를 수행하였다. 기존 의학계에서 사용하는 주의력 측정 방법들을 고찰하고 게임내에서 주의력을 측정할 수 있는 변수들을 설정하였다. 누락 오류, 오경보 오류, 정반응 시간 평균, 정반응 시간 표준편차가 설정된 변수들인데, 일반아동과 주의력이 부족한 아동간에 대하여 시각 주의력에 대한 실험을 통해, 이들 변수들 간에 값의 차이가 있음을 알 수 있었다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제16권2호
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• pp.199-210
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• 2005

연구목표 : 주의력결핍과잉행동장애 (attention deficit hyperactivity disorder : 이하 ADHD)는 역학적 유전연구를 통해 강한 유전적 요인이 작용하는 질환으로 알려져 왔다. 최근에는 이에 근거하여 질환관련 취약유전자를 규명하려는 노력이 시작되었다. 본 연구는 소아정신과에 내원하여 ADHD 진단을 받은 아동과 정상 대조군을 대상으로, 도파민 운반체 유전자 제 1 형 (dopamine transporter gene type 1 ; 이하 DAT1)과 ADHD간의 연합 여부를 규명하는 것을 목적으로 하였다. 연구내용 : 본 연구의 대상이 된 ADHD 아동은 임상적인 면담과 K-SADS-PL을 통한 확진과정을 거쳐 진단되었으며, 모든 ADHD 아동을 대상으로 소아청소년 행동평가척도(Korean Child Behavior Checklist ; K-CBCL), 부모 및 교사용 코너스 척도, 듀폴 ADHD 임상척도 등 다양한 임상척도를 시행하여, 그 심각도를 평가하였다. 이러한 과정을 통해, 최종 진단된 85명의 ADHD 환아와 독립적으로 모집된 100명의 정상대조군을 대상으로 분자유전연구를 시행하였다. 각 대상으로부터 얻은 전혈 1ml로 유전자분석 (genotyping)이 시행되었고, DAT1 variable number of tandem repeat(VNTR)의 다형성을 확인하였다. 이를 통해, ADHD군과 정상군사이의 DAT1 대립유전자의 다형성 빈도차이를 분석하였고, 두 번째로, ADHD군내에서의 다형성 분포 및 유전형에 따른 임상척도, 신경심리변인과의 차이를 규명하였다. 연구결과 : 소아 환자군 및 대조군의 DAT1-VNTR 분석에서는 7, 9, 10, 11 repeat의 4가지 대립유전자가 발견되었다. 먼저 환자-대조군 모델을 적용하여, 각 대립유전자 빈도에 대하여 ADHD 환자군과 대조군 비교를 시행하였다. 그 결과, 9/10 genotype의 빈도가 환자군에서 대조군에 비해 유의하게 높은 빈도로 나타났다(p<0.05). 또한 9 repeat allele 존재여부에 따라 환아군을 나누고, 각 군에서의 주의력장애 진단시스템(attentional deficit diagnostic system ; ADS)의 결과를 비교한 결과, 9 repeat allele를 갖는 군에서 유의하게 높은 오경보 오류(commission error)점수를 보였다. 결론 : 본 연구에서는 첫째, 대조군-환자군 사이에서는 ADHD와 DAT1 9/10 genotype간에 유의한 연관관계를 보여주었다. 그리고 DAT1 9 repeat allele와 ADS결과에 대한 비교 분석에서 높은 충동성 (오경보오류)과 9 repeat allele이 연관되어 있다는 것이 확인되었다. 그러므로 본 연구 결과를 종합할 때, DAT1 9 repeat allele는 한국 아동 ADHD와 연관성이 있으며, 특히 충동성을 가진 ADHD와 유의한 연관관계를 나타낸다고 할 수 있을 것이다. 이러한 연구결과에 대해 향후 보다 큰 규모의 추시가 필요하리라 생각된다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제20권2호
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• pp.82-89
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• 2009

Objectives: Children with attention-deficit hyperactivity disorder(ADHD) often have difficulties in social behavior. The aim of this study was to evaluate the effectiveness of a short-term training program for improving social skills, self-perception and attention deficits. Methods: The subjects were nine children diagnosed with ADHD with(or without) other mental disorders using the Diagnostic Interview Schedule for Children(DISC-ADHD) module. Children were given eight sessions of a social skills training program. Parents of children simultaneously participated in their own training which was designed to support their children's generalization of skills. Assessments included child, parent and teacher ratings of social skills, self-perception and attention deficit at baseline and post-treatment. Results: Social skills training led to significant improvements in child-reported measures of self-esteem, in teacher reported measures of social skills, and in parent-reported measures of attention deficit. Conclusion: This study suggests that short-term social skills training programs for children with ADHD may improve their social skills, self-perception and attention deficits.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제30권1호
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• pp.2-8
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• 2019

Objectives: This study aimed to compare the quality of life reported by patients with attention-deficit/hyperactivity disorder (ADHD) to the patients' quality of life as reported by their caregivers. In addition, it aimed to examine how emotional problems, including depression and anxiety, and the severity of the symptoms affect the quality of life reported by the patients and their caregivers. Methods: The patients' quality of life and their degree of depression and anxiety were measured using the Pediatric Quality of Life Inventory (PedsQL) 4.0 Child Self-Report, the Children's Depression Inventory (CDI), and the Revised Children's Manifest Anxiety Scale, respectively. The caregivers' perception of the patients' quality of life and severity of the ADHD symptoms were measured using the PedsQL 4.0 Parent Proxy Report and the Conners' Parent Rating Scale (CPRS), respectively. A total of 66 participants completed the survey. The independent-samples t-test, Pearson's correlation analysis, and multiple regression analysis were conducted. Results: The mean score of the PedsQL 4.0 Child Self-Report was significantly higher than the mean score of the PedsQL 4.0 Parent Proxy Report. However, for school function, the PedsQL 4.0 Child Self-Report score was significantly lower than that of Parent Proxy Report. The correlation between the PedsQL 4.0 Child Self-Report and PedsQL 4.0 Parent Proxy Report scores was significant only for emotional function and social function. The multiple regression analysis showed that the PedsQL 4.0 Child Self-Report and PedsQL 4.0 Parent Proxy Report scores were significantly predicted by the CDI and CPRS scores, respectively. Conclusion: Our results demonstrate that there are clear differences between the quality of life reported by the patient themselves and that reported by their caregivers. In addition, the findings suggest that it is critical to treat the patients' accompanying depressive symptoms.