• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제22권4호
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• pp.246-252
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• 2011

Background : The objective of this study was to evaluate the diagnostic efficiency of the Comprehensive Attention Test (CAT) by comparing the results of the continuous performance test (CPT) and the CAT in children and adolescents with attention-deficit hyperactivity disorder (ADHD). Method : A total of 110 children and adolescents with ADHD (mean age : 11.2${\pm}$2.9 years, 76 boys) and 36 children and adolescents without ADHD (mean age : 12.0${\pm}$2.7 years, 25 boys) completed the CAT. We compared the specificity and sensitivity of the CPT and CAT at two different cut-off points via the McNemar test. The areas under the receiver operating characteristic curves (AUC) between the two groups were compared using Medcalc software. Results : The sensitivity and specificity of the CPT were .419 and .806, respectively. The sensitivity of the CAT was .827, which was significantly higher than that of the CPT (p<.001), and the specificity of CAT is .444, which was significantly lower than that of CPT (p<.001). The AUC of the CPT and CAT was .664 and .692, respectively, and there were no significant difference between the two groups on the paired comparison (p=.513). Conclusions : The results of this study suggest that the CAT has moderate specificity and high sensitivity. The CAT can be used as a useful tool to evaluate the neuropsychological function of children and adolescents with ADHD.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권2호
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• pp.99-111
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• 2021

Background: Attention deficit hyperactivity disorder (ADHD) is characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. It has a worldwide pooled prevalence of 5.29%. The characteristics of ADHD can increase the probability of dental treatment, while special behavior management can be required to allow proper treatment. In South Korea, the use of sedation in dental treatment has rapidly increased in recent decades. The present study aimed to investigate the trend and effects of sedation in patients with ADHD undergoing dental treatment in South Korea. Methods: The study used customized health information data provided by the Korean National Health Insurance Service. Among patients with the record of sedative use during the period from January 2007 to September 2019, those with International Classification of Diseases-10 codes for ADHD (F90, F91) were selected; the data of their overall insurance claims for dental treatment were then analyzed. The patients' age, gender, sedative use, and dental treatment were analyzed per year. The annual number of general anesthesia or sedation cases was also analyzed, and changes in the method of behavior management with increasing age were examined. Results: The study involved 7,654 patients with ADHD (6,270 males; 1,384 females). The total number of dental treatments was 137,778, while the number of sedation cases was 16,109, among which 13,052 involved male patients and 3,057 female patients. The number of general anesthesia cases was 631, among which 538 involved male patients and 93 female patients. The most frequently used sedation method in the dental treatment of patients with ADHD was N2O inhalation. The percentage of sedation cases was highest in patients aged 4 years, and it decreased with increasing age. Conclusion: In South Korea, both sedation and dental treatments were slightly more common in patients with ADHD than in the general population. With increasing age, the frequency of dental treatments and the percentage of sedation cases decreased.

• 재활치료과학
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• 제6권1호
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• pp.45-54
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• 2017

목적 : 본 연구는 주의력결핍 과잉행동장애(ADHD) 아동들의 집중력 향상과 충동성 조절에 상호작용식 메트로놈(IM) 훈련이 효과가 있는지 알아보고자 한다. 연구방법 : ADHD 아동 1명을 대상으로 2016년 5월부터 7월까지 개별 실험 연구(single-subject experimental research design) 중 ABA'디자인을 적용하여 실시하였다. 총 21회기로 기초선 3회기, 중재기 15회기, 추적기 3회기를 시행하였다. 중재는 IM 훈련이었으며 매 회기마다 IM의 SFA(Short Form Assessment)와 집중력 측정과제를 수행하였다. 또한 기초선, 중재기, 추적기 때 각 한번씩 IM의 LFA(Long Form Assessment)와 자기통제력 검사(SCRS) 평가를 진행하였다. 매회기 SFA와 집중력 측정과제의 결과를 시각적 그래프로 나타내었으며 LFA와 SCRS의 값은 표로 제시하였다. 결과 : 기초선과 비교하여 IM 훈련 중재 후에 대상자의 집중력은 향상되었으며 충동성은 감소하였다. 중재가 끝나고 한 달 후인 추적기에도 그 효과가 유지되거나 향상됨을 확인 할 수 있었다. 결론 : 본 연구는 IM이 ADHD 아동의 집중력 향상과 충동성 조절에 긍정적인 영향을 미친다는 것을 확인하였고 ADHD 아동의 중재방법으로써 임상적 근거를 제공하는데 의의가 있다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제29권3호
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• pp.144-148
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• 2018

Objectives: Previous studies have reported that internet addiction (IA) is associated with attention-deficit/hyperactivity disorder (ADHD) consistently. However, in terms of gender, there are controversial findings. We aimed to investigate the relation between IA and self-acknowledged ADHD traits among female college students in Japan. Methods: The study questionnaire consisted of questions about demographics, Adult ADHD Self-Report Scale-V1.1 Part A (ADHD screener) and Young's Internet Addiction Test (IAT). When four or more items are more frequent than the cut-off on ADHD screener, the subject was categorized into students with a positive ADHD screen. We defined students with total IAT score of 70 and higher as IA. Results: A total number of respondents was 369 (mean age: $19.0{\pm}0.7years$). Seventy-seven subjects were screened positive on ADHD screener (20.9%). Students with a positive ADHD screen scored significantly higher on the IAT ($54.2{\pm}14.2$ vs. $42.5{\pm}11.3$). The rates of IA in students with and without a positive ADHD screen were 18.2% and 1.0%, respectively. Conclusion: Results of this study demonstrated the relation between IA and self-evaluated ADHD traits among female college students in Japan. Appropriate education for students on how to use the internet properly will be necessary to prevent IA.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제29권2호
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• pp.62-72
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• 2018

Objectives: The molecular mechanisms underlying attention-deficit hyperactivity disorder (ADHD) remain unclear. Therefore, this study aimed to identify the genetic susceptibility loci for ADHD in Korean children with ADHD. We performed a case-control and a family-based genome-wide association study (GWAS), as well as genome-wide quantitative trait locus (QTL) analyses, for two symptom traits. Methods: A total of 135 subjects (71 cases and 64 controls), for the case-control analysis, and 54 subjects (27 probands and 27 unaffected siblings), for the family-based analysis, were included. Results: The genome-wide QTL analysis identified four single nucleotide polymorphisms (SNPs) (rs7684645 near APELA, rs12538843 near YAE1D1 and POU6F2, rs11074258 near MCTP2, and rs34396552 near CIDEA) that were significantly associated with the number of inattention symptoms in ADHD. These SNPs showed possible association with ADHD in the family-based GWAS, and with hyperactivity-impulsivity in genome-wide QTL analyses. Moreover, association signals in the family-based QTL analysis for the number of inattention symptoms were clustered near genes IL10, IL19, SCL5A9, and SKINTL. Conclusion: We have identified four QTLs with genome-wide significance and several promising candidates that could potentially be associated with ADHD (CXCR4, UPF1, SETD5, NALCN-AS1, ERC1, SOX2-OT, FGFR2, ANO4, and TBL1XR1). Further replication studies with larger sample sizes are needed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제26권3호
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• pp.183-189
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• 2015

Objectives : The aim of this study was to investigate Korean Wechsler Intelligence profiles and specific abilities related to attention problem of children with attention-deficit hyperactivity disorder (ADHD). Methods : The Korean Wechsler Intelligence Scale for Children-fourth edition (K-WISC-IV) and Advanced Test of Attention (ATA) were administered to 91 children and adolescents (age $8.5{\pm}2.6$ years, 73 boys) with ADHD. Pearson correlation and independent t-tests were used. Results : The means of Working Memory Index (WMI) and Processing Speed Index (PSI) showed a score of low average in K-WISC-IV. WMI scores for the K-WISC-IV showed clinically significant correlations with omission errors, commission errors, and response time variability on auditory ATA. PSI scores also showed significant correlations with response time and variability on visual ATA. In addition, significantly lower digit span backward scores were observed in hyperactive-impulsive/combined subtypes compared to inattentive subtype (t=3.60, p<.001). Conclusion : Children with ADHD showed significantly lower scores in WMI and PSI which were clinically correlated with ATA scores, and hyperactive-impulsive/combined subtypes showed poorer working memory functions in WMI. Follow-up studies are proposed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제5권1호
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• pp.102-107
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• 1994

갑상선호르몬 내성증후군(GRTH)과 주의력 결핍-과잉행동장애(ADHD)의 관계는 최근에 매우 연구가 활발히 진행되면서, ADHD환아에서 갑상선 검사를 기본검사로 시행할 것인가 여부가 또한 논란이 되고 있다. 저자는 ADHD 환아뿐 아니라 발달장애 환아에서도 GRTH가 발견될 수 있다는 사항에 주목하여 이들 환자들에서 갑상선 검사를 시행하여 이상 유무를 조사하고, 뚜렷한 이상소견을 보이는 환아들의 임상 양상을 밝혀 앞으로 이들의 가계 연구 및 유전자 연구의 시작을 해보고자 하였다. 총 51명에서 검사가 시행되었고, 이중 T3, T4가 모두 정상범위를 벗어나며, TSH가 정상 혹은 증가된 증례가 모두 11명이었다. 그들의 임상 특성과 진단등을 살펴보고, 앞으로의 방향에 대해 토의하였다.

• 동의신경정신과학회지
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• 제14권1호
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• pp.161-174
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• 2003

Attention deficit hyperactivity disorder(ADHD) is one of the most common childhood-onset psychiatric disorders. It is distinguished by symptoms of hyperactivity, inattention, and impulsivity. The etiology of ADHD is unknown, and the disorder may several different causes. The pharmacotherapy most widely used for ADHD occasionally gives rise to ill effects. The studys of ADHD were approached from the viewpoint of medicine and pedagogics, but it is rare from the viewpoint of the Korean Medicine. So, we searched for the studies on ADHD of Chinese Traditional Medicine(TCM) in last eight years(1995-2002). In TCM, ADHD was placed under the category of 'wind(風)-one of the five pathogenic factors', 'insomnia(失眠)', 'forgetfulness(健忘)' and 'restlessness(躁動)', etc. Jang and Bu(the internal organs; 臟腑) related with the differentiations of syndrome about ADHD were liver(肝), heart(心), spleen(脾), kidney(腎) and gallbladder(膽). Among them, liver(肝), kidney(腎) and spleen(脾) were important. The herbal medicines used in ADHD had the effects of spirit-calming(安神), orifices-opening(開竅), Eumyang-balance(陰陽平衡). And acupuncture therapy, ear-acupuncture therapy and dietary treatment, etc. were used in the treatment of ADHD. We expect that this review about ADHD in TCM help the clinical study of ADHD in Korean Medicine.

• 대한한방소아과학회지
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• 제20권2호
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• pp.147-175
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• 2006

Objective : This study is to investigate the method for assesment and diagnosis of ADHD, especially focusing on behavior rating scales. Methods : We searched the recent date of the publication and paper in ADHD. Results : For Assesment and Diagnosis of ADHD, various method such as interview with parents, child and teacher, behavior observation, behavior rating scales and neuropsychological test are used. The structured interview consists of the restrictive questions and response, and then have diagnostic algorithm, consequently can be used by untrained clinicians. Of the structured interview, standardization of K-SADS in Korean version is finished. Behavior rating scales, the form of parent, teacher and self-report questionnaires, are used as diagnosis and treatment evaluation of ADHD. Behavior rating scales consist of both ADHD-specific scales and broad-band scales designed to screen for various symptoms (including ADHD symptoms). ADHD-specific scales are useful in differential diagnosis, discrimination of subtype, treatment evaluation, However, broad-band scales are useful in preliminary examination. The neuropsychological tests can evaluate attention deficit and effect of attention deficit on cognitive function and academic performance. The neuropsychological tests also used in diagnosis and treatment evaluation of ADHD. Conclusion : For Assesment and Diagnosis of ADHD, various method are used, especially behavior rating scales are both useful and simple tool for diagnosis and treatment evaluation.

• 대한치과마취과학회지
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• 제12권2호
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• pp.111-114
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• 2012

Attention deficit hyperactivity disorder (ADHD) is characterized by inattention, impulsivity, and hyperactivity. Given high incidence of ADHD, many children with ADHD is likely to present for anesthesia. This case report suggests intramuscular premedication as an alternative method for anesthetic induction. A 9-year-old male patient with ADHD was transferred for dental treatment under general anesthesia. The patient refused to go into dental clinic office. Oral midazolam was given to the patient, however, he was resistant to take midazolam via oral route. Instead, we administer midazolam and ketamine via intramuscular route. After less than 10 miniutes, the patient became drowsy and was transferred to dental chair. Intravenous access and mask inhalation was possible. The patient received dental treatment under general anesthesia and recovered in a non-complicated way. In this case, intramuscular sedation with midazolam and ketamine was used as a premedication in highly uncoopearive patient refused to take oral sedative medication.