• 제목/요약/키워드: Attention Deficit Disorder with Hyperactivity

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ADHD (주의력결핍 과잉행동장애) 생쥐 모델에서의 별아교세포 유래 신경전달물질 분석 (Analysis of Gliotransmitters in ADHD Mice)

  • 김가연;박재원;윤보은
    • 생명과학회지
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    • 제28권5호
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    • pp.597-604
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    • 2018
  • ADHD (Attention Deficit/Hyperactivity Disorder)은 4-17세의 아동 및 청소년의 약 10%가 겪는 흔한 신경 발달 장애이지만 그 핵심 기전이 알려져 있지 않은 가운데 관련한 여러 단백질들이 보고되어왔다. 이중 GIT1 (G-protein coupled-receptor kinase interacting protein-1)은 중추신경계에서 dendritic spine formation와 growth에 영향을 미치는 multifunctional adaptor protein으로, GIT1이 제거된 생쥐는 과잉행동, 주의력결핍 그리고 충동성을 보이는 ADHD 증상을 보이게 된다. 이 논문에서는 GIT1 유전자 변형 생쥐를 이용하여 genotype별로 신경교세포의 전달물질(gliotransmitter)을 비교 분석하는 실험을 진행하였다. 그 결과 주요 흥분성 전달물질인 glutamate는 HE (hetero)와 KO (knock-out)의 세포 내에서 WT (wildtype)보다 더 높은 농도로 존재했다. 한편, 억제성 신경전달물질인 GABA와 glycine의 경우 전반적으로 HE에서 가장 많은 함유량을 보였지만 소뇌 세포내의 경우, KO이 WT보다 많은 양을 함유한 것에 비해 대뇌 세포 내에서는 KO보다 WT의 억제성 전달물질 함유량이 높았다. 또한, glutamate와 GABA를 기준으로 흥분성/억제성 비율(excitation/inhibition ratio)을 보았을 때, 소뇌 세포 내/외 모두에서 KO이 가장 높은 수치를 보였고, 대뇌에서는 세포 내/외 모두 HE에서 가장 높은 수치를 보였다. 억제성 신경전달물질인 GABA가 KO의 대뇌 세포 외에서 가장 많은 것으로 보아 GIT1 결손을 보완하기 위해 억제성 물질을 더 많이 분비하거나 또는 과도하게 분비된 GABA를 재흡수하지 못하는 것이라 사료된다. 이는 ADHD 병리기전으로써 기능할 가능성을 제시하며 후속 연구를 통해 해당 기전에 대한 규명이 필요할 것으로 보인다.

소아(小兒) 틱장애에 대한 중의학적(中醫學的) 치료(治療) 동향(動向) -$1995{\sim}2002$년(年)까지 중의잡지(中醫雜誌)를 중심(中心)으로- (The treatment of tic disorder in traditional chinese medicine)

  • 신정애;김락형;김정연;장인수
    • 대한한방소아과학회지
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    • 제17권1호
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    • pp.141-155
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    • 2003
  • Method : Chronic motor tic or vocal tic disorders are characterized which have one of the two kinds of tics for more than a year. It is characterized chronic motor tic or vocal tic disorders that have one of the two kinds of tics for more than a year. But Tourette's disorder is a disease which has one or more motor tics and vocal tics for more than a year. Contemporary empirical studies have suggested the rate of comorbid attention-deficit hyperactivity disorder(ADHD) or obsessive compulsive disorder(OCD) in children with tic disorders be high. Objects : As society is confusing, tic disorders are increasing. Therefore, determining the treatment strategy in children with tic disorders is very important. So we studied the literatures of traditional chinese medicine about tic disorders and reported the results. Results : The principals for medical treatment were So-gan(疏肝), I-gi(理氣), Sik-pung(熄風), Gin-kyung(鎭痙), Chung-oel(淸熱) etc. Medicines treatment is used more than acupuncture treatment. The herbs are used Uncariae ramulus et Uncus(釣鉤藤), Paeoniae Radix Alba(白芍藥), Poria(白茯岺), Glycyrrhizae Radix(甘草), Bupleuri Radi.x(柴胡), Fossilia ossis Mastodi(龍骨) etc. in the order named. Acupuncture points were used Naegwan(PC6), Shinmuin(HT7), P'ungnyur4(ST40), Paek'oe. (GV20), Chung-wan(CV12), Samumgye(SP6), Kongson(SP4), T'aech'ung(LR3) and so on.

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주의력결핍 과잉행동장애와 우울장애 아동 집단의 부모 양육태도 (Parents' Rearing Attitude of Children with Attention-Deficit Hyperactivity Disorder and Depressive Disorder)

  • 김소연;황준원;김붕년;조수철;신민섭
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제19권3호
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    • pp.175-181
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    • 2008
  • Objectives: This study was conducted to compare the mothers' rearing attitude of ADHD children and that of children with depressive disorder. Methods: The participant consisted of 58 school-aged children diagnosed as ADHD, 14 children diagnosed as depressive disorder based on DSM-IV criteria. Normal control group consisted of 34 school-aged children who are free of any diagnosis of psychiatric disorders. Parental Acceptance-Rejection Questionnaire, Parenting Style Questionnaire, Children's Depression Inventory, Marital Satisfaction Scale, Beck's Depression Inventory were administered to all children and their mothers. Results: The parents of ADHD children showed more aggressive/hostile, neglecting/indifferent and less warm/affectionate parenting styles to their children than those of the depression and control groups. The depressive group perceived their parents as more rejecting than the control groups. Conclusion: The externalizing symptoms of ADHD might provoke parental distress and make it difficult for the parents to show positive rearing attitude toward their children. The depressive children might be more sensitive and perceptive to the negative sign of their parents' rearing attitude.

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Screening for depression and anxiety disorder in children with headache

  • Lee, Sang Mi;Yoon, Jung-Rim;Yi, Yoon Young;Eom, Soyong;Lee, Joon Soo;Kim, Heung Dong;Cheon, Keun-Ah;Kang, Hoon-Chul
    • Clinical and Experimental Pediatrics
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    • 제58권2호
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    • pp.64-68
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    • 2015
  • Purpose: The purpose of this study was to investigate the importance of initial screening tests for depression and anxiety disorders in children with headache. In addition, this study evaluated whether the Children's Depression Inventory (CDI) and Revised Children's Manifest Anxiety Scale (RCMAS) are suitable for screening symptoms of depression and anxiety. Methods: A retrospective chart review was conducted of 720 children aged 7-17 years who had visited a pediatric neurology clinic for headaches and were referred to a pediatric psychiatric clinic for psychiatric symptoms from January 2010 to December 2011. All patients completed the CDI and RCMAS. Among them, charts of patients with clinically significant total scores (cutoff>15) for psychiatric symptoms, as defined by the CDI and RCMAS scoring scales, were reviewed. Results: Nineteen patients had headaches and clinically significant total scores for psychiatric symptoms. The mean age at headache diagnosis was 11.7 years, and 57% were male. Mean duration of headache was 11.5 months. Two point eight percent of the patients were diagnosed with psychiatric disorders including major depression (1.7%), generalized anxiety disorder (1.1%), and bipolar disorder (0.1%). Four patients (0.6%) were diagnosed with attention deficit/hyperactivity disorder (ADHD). Total mean CDI and RCMAS scores of patients referred to the psychiatric clinic were 18.8 and 22.2, respectively. There was no correlation between CDI or RCMAS total scores and headache frequency, duration, or severity. Conclusion: We recommend that all patients with headache should be screened for depression and anxiety by CDI and RCMAS scores.

Preliminary Validation Study of the Korean Version of the DSM-5 Level 2 Cross-Cutting Symptom Measure: Depression and Irritability for Parents of Children Aged 6-17 Years

  • Shin, Min-Sup;Kim, Bung-Nyun;Jang, Mirae;Shin, Hanbyul;Seo, Gyujin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제33권3호
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    • pp.67-72
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    • 2022
  • Objectives: This study investigated the reliability and validity of the Korean version of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Level 2 Cross-Cutting Symptom Measure-Patient-Reported Outcomes Measurement Information System (PROMIS)-Depression and the Irritability for parents of children aged 6-17 years. Methods: Participants were 190 children diagnosed with depressive disorder (n=14), anxiety disorder (n=21), attention-deficit/hyperactivity disorder (ADHD; n=111), ADHD with anxious depression (n=13), and tic disorder with somatic symptoms (n=31). Patients were 8-15 years of age. The participants' mothers completed the Korean versions of the DSM-5 Level 2 Cross-Cutting Symptom Measure-PROMIS Depression and Irritability (Affective Reactivity Index, ARI), and the Korean Child Behavior Checklist (K-CBCL). Using these data, we calculated the reliability coefficient and examined the concurrent and discriminant validity of the PROMIS Depression and the Irritability (ARI) scales for assessing depression and irritability in children. Results: The reliability coefficient of the PROMIS Depression scale (Cronbach's α) was 0.93. The correlation coefficient with the K-CBCL DSM emotional problem score was 0.71. The PROMIS Depression scale significantly discriminated children with depressive disorders from those with other conditions. The reliability coefficient of the Irritability (ARI) scale was 0.91, suggesting its high reliability. Conclusion: Our results suggest that the Korean version of the DSM-5 Level 2 Cross-Cutting Symptom Measure for Depression and Irritability Scales for parents of children aged 6-17 years is reliable and valid and may be an efficient alternative to the K-CBCL.

주의력결핍 과잉행동장애 아동에서 학습동기증진프로그램 (The Learning Motivation Improvement Program in Children with Attention-Deficit Hyperactivity Disorder(ADHD))

  • 남궁선;안동현;이양희
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제18권1호
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    • pp.58-65
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    • 2007
  • Objectives : Motivational factor is a unique contributor to the typically poor academic performance of children with ADHD. However, few study has directly intervened learning motivation in children with ADHD. We conducted this study to explore the direct effects of the learning motivation improvement program applied to children with ADHD. Method The program was designed in order to increase an interest-inducing educational intervention, an academic skills integration, a basic learning activity (reading, writing, and math), and children's self-esteem. We conducted the program twice a week (total 10 sessions) and assessed learning motivation, teaming attitude, self-esteem, academic performance, and problem behaviors of participating children. Results : After the program, teachers reported improvement in teaming motivation. In addition, parents notified sisnificant reduction of problem behaviors. Children reported improvement in a few domains of teaming motivation and learning attitude. Conclusion : While loaming motivation is regarded as an important factor in education, there have been few studies considering this issue in both educational and psychiatric fields. The teaming motivation improvement would be needed in both field in order to reduce the deficits in academic performance in children with ADHD.

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외상 후 스트레스장애 아동의 정신병리와 부모의 우울불안 증상과의 관계 (The Relationship between Anxiety and Depression Symptoms of Children with Post-Traumatic Stress Disorder and Their Parents)

  • 박수빈;김소윤;권오향;배정훈;유희정
    • 대한불안의학회지
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    • 제9권1호
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    • pp.19-24
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    • 2013
  • Objectives: The objective of this study is to examine the association between the children's psychopathology and age, intellectual quotient, and parental psychopathology in children with post-traumatic stress disorder (PTSD). Methods: The emotional and behavioral problems of 35 children with PTSD (23 boys, 12 girls, mean age, $10.26{\pm}2.47$ years) were investigated by retrospective chart review. Their parents' anxiety and depression symptoms were also investigated. We examined the correlations between children's psychopathology and their parents' anxiety and depression symptoms, as well as their age and IQ. Results: There were positive correlations between maternal trait anxiety and depression, and children's emotional problems. State and trait anxiety of children with PTSD were positively correlated with age, and attention-deficit hyperactivity disorder symptoms were negatively correlated with age. Conclusion: Our results suggest that psychiatric manifestation of children who experienced trauma could differ according to the development stage, and the treatment of children with PTSD should involve parental education about the effect of maternal emotional states on children.

주의력결핍 과잉행동 장애의 원인(原因) 및 병기(病機)에 따른 한방음악치료의 기법(機法)에 관한 연구 (The Study on Treatment of Attention Deficit Hyperactivity Disorder by Oriental Medicine Music Therapy)

  • 이승현;김여진
    • 대한한방소아과학회지
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    • 제23권1호
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    • pp.115-126
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    • 2009
  • Objectives The purpose of this study is to introduce oriental medicine music therapy related to the treatment of ADHD. Methods This study observed ADHD from the oriental medical point of view and tried to treat this disease with the oriental medicine music therapy. Results ADHD is caused by excess of Yang energy, flaming-up of fire, blood deficiency of the heart and the spleen, deficiency of the kidney essence, and instability of emotions. The ADHD patients with the case of excess of Yang energy and flaming-up of fire, patients were played Fire-Gi rhythm as a treatment, and they listened to Metal-Gi music. Whereas, the ADHD patient with blood deficiency of the heart and the spleen, invigoration of vital energy music therapy can be used. Another case of ADHD patients with deficiency of the kidney, Water-Gi rhythm and replenishing vital essence music therapy can be used. According to the patients' seven modes of emotions, the proper music should be chosen. Conclusions Oriental medicine music therapy can be a new type of treatment for ADHD patients.

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뚜렛 증후군에서 보툴리눔 톡신의 임상 효과 : 증례보고 및 고찰 (The Clinical Effect of Botulinum Toxin in a Patient with Tourette's Syndrome: A Case Report and Review)

  • 현정근;이준형;이창민;임명호
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제24권2호
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    • pp.90-95
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    • 2013
  • Botulinum toxin, a neurotoxin, is known to be an inhibitor of cholinergic neuromuscular transmission. Recently, it was reported that the administration of botulinum toxin is effective for the treatment of focal neurological motor disorders such as cervical dystonia, blepharospasm, hemifacial spasm, spasmodic dysphonia, and writer's cramp. Several case studies reported that the botulinum toxin was administered for the treatment of motor tic or vocal tic. It was found that this toxin reduces the frequency and severity of the tic as well as the premonitory urge and symptoms. In our case study, a noticeable decrease of motor tic symptom was observed after an intramuscular injection of 300mg of botulinum toxin in an 18-year-old patient with Tourette's disorder who showed only a little improvement of motor tic and vocal tic symptoms after treatment with antipsychotic drugs for several years. This case is reported in our study and literature survey was undertaken for reviewing similar cases. In our study, an 18-year-old boy diagnosed with Tourette's disorder based on Diagnostic and Statistical Manual of Mental Disorders, fourth edition presented with the following scores : the Clinical Global Impression scale, Yale Global Tic Severity Scale (motor/vocal/severity), Premonitory Urge Score, Korean Attention-Deficit Hyperactivity Disorder Rating scale, and Kovac Depression scale which were performed prior to the treatment were 5, 21/5/50, 100, 17, and 18 points, respectively. Two weeks after the injection of botulinum toxin, the scores were 4, 17/5/40, 50, 16, and 19 points, respectively. Eight weeks after the injection of botulinum toxin, they had become 3, 15/5/30, 25, 16, and 20 points, respectively, which clearly indicates a noticeable decrease of motor tic symptom.

Development of the Korean Form of the Premonitory Urge for Tics Scale: A Reliability and Validity Study

  • Kim, Mira;Chung, Sang-Keun;Yang, Jong-Chul;Park, Jong-Il;Nam, Seok Hyun;Park, Tae Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제31권3호
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    • pp.146-153
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    • 2020
  • Objectives: This study aimed to evaluate the reliability and validity of the Korean Form of the Premonitory Urge for Tics Scale (K-PUTS). Methods: Thirty-eight patients with Tourette's disorder who visited Jeonbuk National University Hospital were assessed with the K-PUTS. Together with the PUTS, the Yale Global Tic Severity Scale (YGTSS), the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), the attention-deficit/hyperactivity disorder (ADHD) rating scale (ARS), and the Adult ADHD Self-Report Scale (ASRS) were implemented to evaluate concurrent and discriminant validity. Results: The internal consistency of items on the PUTS was high, with a Cronbach's α of 0.79. The test-retest reliability of the PUTS, which was administered at 2 weeks to 2 months intervals, showed high reliability with a Pearson correlation coefficient of 0.60. There was a significant positive correlation between the overall PUTS score and the YGTSS score, showing concurrent validity. There was no correlation between the PUTS, CY-BOCS, and ASRS scores, demonstrating the discriminant validity of the PUTS. Factor analysis for construct validity revealed three factors: "presumed functional relationship between the tic and the urge to tic," "the quality of the premonitory urge," and "just right phenomena." Conclusion: The results of this study indicate that the K-PUTS is a reliable and valid scale for rating premonitory urge of tics.