• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제30권2호
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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.

• 대한통합의학회지
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• 제10권3호
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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.

• 대한핵의학회지
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• 제37권4호
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• pp.235-244
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• 2003

목적: 주의력결핍 과잉행동장애 (Attention Deficit Hyperactivity disorder : 이하 ADHD)는 도파민계의 이상 기능으로 생기는 대표적 소아정신과 질환이다. Methylphenidate는 dopamine transporter(DAT)를 차단함으로써 ADHD 증상을 호전시키는 약물로 널리 알려져 있다. 따라서 본 연구에서는 ADHD 아동들을 대상으로 I-123 IPT SPECT를 이용하여 methylphenidate 투여 전후의 DAT density 양상을 비교해 보고자 한다. 대상 및 방법: 연구대상은 9명의 ADHD 아동과 7명의 정상 대조군이었다. ADHD 아동군과 정상 대조군에게 모두 약물 비노출 상태에서 $[^{123}I]IPT$를 정맥 주사후 2시간이 경과한 상태에서 SPECT를 촬영하였다. 이후 ADHD 아동군을 대상으로 methylphenidate 0.7mg/kg/d을 투여한 후 약 8주가 경과한 상태에서 $[^{123}I]IPT$ SPECT를 재촬영 하였다. Methylphenidate 투여 전과 후의 좌, 우측 기저 신경절 DAT 특이결합/비특이결합 비율을 구한 뒤 비교하였고, 약물 투여 후의 ADHD 증상 척도로 측정한 증상 호전도와 좌, 우측 기저 신경절 DAT 특이결합/비특이결합 비율 변화사이의 상관관계를 알아보았다. 결과: ADHD 아동군에서 약물 비노출 상태와 정상 대조군 사이의 좌, 우측 기저 신경절 DAT특이결합/비특이결합 비율을 비교한 결과 DAT 결합 비율이 정상 대조군에 비해서 유의하게 증가되었다. (Right : z=2.057, p=0.041 ; Left z=2.096, p=0.032). 또한 ADHD 아동들에게 methylphenidate 투여 전과 후 상태에서의 기저 신경절 DAT 특이결합/비특이결합 비율을 비교한 결과, methylphenidate 투여 후 상태가 methylphenidate 투여 전 상태에 비해 좌, 우측 DAT 결합비율이 유의하게 낮아진 것을 관찰할 수 있었다. (우측 : t=3.239, p=0.018 ; 좌측 : t=3.133, p=0.020). ADHD 증상의 호전도와 좌, 우측 기저 신경절 DAT 특이결합/비특이결합 비율 변하사이에는 유의한 상관관계를 보이지 않았다. 결론: 이러한 결과는 주의력결핍 과잉행동장애의 치료제인 methylphenidate가 작용하는 기전을 이용하여 주의력결핍 과잉행동장애의 병태생리와 연관된 도파민계 기능이상 가능성을 지지한다고 생각된다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제22권4호
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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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• 제20권1호
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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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• 제23권4호
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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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• 제22권4호
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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.

• 한국융합학회논문지
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• 제9권7호
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• pp.337-346
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• 2018

본 연구는 정신의료기관에 방문하여 치료를 받고 있는 인터넷 중독 임상군의 심리사회적 특성과 인터넷 중독과 관련된 영향요인을 규명하기 위해 2차 분석을 실시한 서술적 조사 연구이다. 연구대상자는 일 정신의료기관에 인터넷 중독으로 진단 및 치료를 받은 63명으로 전자의무기록을 확인하여 자료를 수집하였다. 전자의무기록에는 인터넷 중독 정도, 불안, 우울, 충동성, 주의력결핍과잉행동장애 정도, 사회연결망 정도를 측정하는 척도가 포함되어 있어 이를 이용하였다. 연구결과, 인터넷 중독 정도는 하루 인터넷 사용시간, 불안, 충동성, 주의력결핍과잉행동장애 증상과 유의한 상관관계가 있었으며, 인터넷 중독 정도의 영향요인은 주의력결핍과잉행동 증상, 하루 인터넷 사용시간, 충동성으로 나타났고, 총 설명력은 44%이었다. 본 연구 결과를 토대로 인터넷 중독 임상군이 겪고 있는 심리사회적 어려움을 치료에 반영하고, 주의력결핍과잉 행동장애 임상군에게 적절한 인터넷 사용 교육이 필요할 것으로 사료된다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제31권3호
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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.

• 동서간호학연구지
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• 제29권2호
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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.