• Childhood Kidney Diseases
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• v.18 no.2
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• pp.71-76
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• 2014

Purpose: Attention deficit hyperactivity disorder (ADHD) has been associated with impairments in frontal inhibitory function and the catecholaminergic system. ADHD is diagnosed in 3-5% of children. Children with ADHD seem develop various forms of urinary problems such as nocturnal enuresis, dysfunctional voiding, and diurnal incontinence. However, no data exist to confirm the presence of these problems in Korean children with ADHD. We investigated the clinical findings of voiding dysfunction in children with ADHD. Methods: Between October 2009 and March 2011, a total of 63 children (33 with ADHD, 30 with an upper respiratory infection, as a control group) were enrolled. ADHD was diagnosed using the diagnostic and statistical manual of mental disorders (DSM)-IV criteria. A comprehensive survey of voiding and defecation was administered. Results: The patient group included 28 boys and 5 girls; the control group comprised 20 boys and 10 girls. The mean age was $9.09{\pm}2.8$ years in the ADHD group and $8.58{\pm}3.1$ years in the control group. Children with ADHD had a statistically significantly higher incidence of urgency (P =0.017), urge incontinence (P =0.033), and constipation (P =0.045). There was no significant difference in the incidence of straining, intermittency, holding maneuvers, or nocturnal enuresis. Conclusion: Children with ADHD in Korea have significantly higher rates of urgency, urge incontinence, and constipation than those without ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.18 no.1
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• pp.10-15
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• 2007

Probably the three most important components to a comprehensive evaluation of patients with attention-deficit hyperactivity disorder (ADHD) are the clinical interview, the medical examination, and the completion and scoring or behavior rating scales. Teachers and other school personnel are often the first to recognize that a child or adolescent might have ADHD, and often play an important role in the help-seeking/referral process. A diagnostic evaluation for ADHD should include questions about ADHD symptoms, other problems including alcohol and drug use, family history of ADHD, prior evaluation and treatment for ADHD. Screening interview or rating scales as well as interviews should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with objective assessments of the ADHD symptoms, such as psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but they may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. Screening for intellectual ability and academic achievement skills is also important in determining the presence of comorbid developmental delay or loaming disabilities. The number and type of symptoms required for a diagnosis of ADHD vary depending on the specific subtype. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in daily functioning, and must not meet criteria for other mental disorders which might better account for the observed symptoms such as mental retardation, autism or other pervasive developmental disorders, mood disorders, anxiety disorders. This report aims to suggest a practice guideline of assessment and diagnosis for children and adolescents with ADHD in Korea.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.25 no.2
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• pp.65-72
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• 2014

Objectives : The objective of this study was to evaluate the treatment duration and adherence of osmotic-controlled release oral delivery system (OROS) methylphenidate for treatment of attention-deficit hyperactivity disorder (ADHD). Methods : A total of 843 children with ADHD were recruited : 213 children (25.3%) who had previously taken medications for ADHD and 630 drug-na$\ddot{i}$ve children (74.7%) were recruited. The dosage was adjusted according to the clinician's judgment. The primary efficacy endpoint of this study was treatment retention rate, which was estimated at Week 12 and Week 20 using the Kaplan-Meier curve. The Swanson, Nolan and Pelham-IV (SNAP-IV), Clinical Global Impression-Severity (CGI-S), Clinical Global Impression-Improvement, and the side effect rating scale were measured at every visit. Remission rates were presented based on SNAP-IV and CGI-S, respectively. Results : The treatment retention rate at 12 weeks and at 20 weeks was 76.2% and 66.8%, respectively. Divided according to 6-8, 9-11, 12-14 and 15-18 years of age, younger children tended to show a statistically higher treatment retention rate (p=.02). Based on SNAP-IV and CGI scores, children with better response to medication showed tendencies of statistically higher treatment retention rate. The most common adverse events included loss of appetite (7.1%) and insomnia (3.3%). There was no serious adverse event related to the treatment, such as death. Conclusion : The use of OROS methylphenidate for treatment of ADHD was safe and tolerable for children. In this study, lower age and better treatment response showed a statistically significant relationship with higher treatment adherence. Boys showed a trend of high treatment adherence. The treatment adherence at 20 weeks was satisfactory, however, the treatment adherence after 20 weeks showed a sharp decrease. Therefore, treatment persistence for six months after the beginning of ADHD treatment is important. In addition, the positive role of psycho-education for children and parents is necessary for increasing treatment adherence.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.24 no.4
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• pp.191-198
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• 2013

Objectives : The objective of this study is to find out the differences in psychopathology, temperament, and character factors between young adults with and without childhood attention-deficit hyperactivity disorder (ADHD) symptoms. Methods : The subjects consisted of 314 university students (male=72, female=242) in Gongju. They were divided into childhood ADHD group (N=54) and normal group (N=260) to the Wender-Utah Rating Scale. Participants were assessed using Korean Adult ADHD Scale, Beck Depression Inventory-II, Beck Anxiety Inventory, Kimberly Young's Internet Addiction Test, Barratt Impulsiveness Scale, Paranoia Scale, Korean-Schizotypal Ambivalence Scale, Lubben Social Network Scale, and Temperament and Character Inventory-Revised. Descriptive statistics, t-test, chi-square, spearman correlation, and stepwise multiple regression were applied to analyze the data. Results : Participants with childhood ADHD symptoms had high level of adult ADHD symptoms (p<.001), impulsiveness (p=.001), depression (p<.001), anxiety (p<.001), internet addiction (p<.001), paranoia tendency (p<.001) and low level of selfesteem (p<.001) compared to normal group. Self-directedness (p<.001) was lower, Harm avoidance (p=.001) and Self-transcendence (p=.029) were higher in the childhood ADHD group. In correlation and stepwise multiple regression, childhood ADHD symptoms were significantly associated with cooperativeness (r=-0.515 and ${\beta}$=-0.547, p<.001 respectively). Conclusion : This result showed that young adults with childhood ADHD symptoms had various forms of psychopathology and childhood ADHD symptoms were influenced by character such as cooperativeness. Therefore, more thorough evaluation regarding childhood ADHD symptoms is needed.

• The Journal of the Korea Contents Association
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• v.12 no.10
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• pp.330-339
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• 2012

The purpose of this study was to examine the relationship among children's ADHD symptoms, parenting stress and behavior regarding nurturing. The data were provided by 59 mothers of children with ADHD who is aged between 4 and 12. Mothers of children with ADHD were recruited through 3 departments of child psychiatry. The Korean version of Parenting Stress Index-Short Form, the Korean version of revised Maternal Behavior research Instrument(MBRI) and ADHD Rating Scale(K-ARS) was used to assess parenting stress, behavior regarding nurturing and ADHD symptoms respectively. Significant correlation was found between parental distress and warmth, rejection behavior. Parental distress is significant influence on behavior regarding nurturing through multiple regression analysis. Significant correlation was found between ADHD symptom and rejection behavior. ADHD symptom is significant influence on behavior regarding nurturing through multiple regression analysis. Behavior regarding nurturing is related to ADHD symptom, parental distress. Therefore, it is needed for not only treatment related to ADHD symptom but also interventions for behavior regarding nurturing for mothers of children with ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.85-92
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• 2002

Objectives：This study was conducted to compare the memory function among the attention deficit/hyperactivity disorder(ADHD), the learning disorder(LD) and the comorbidity disorder(ADHD+LD) groups. Methods：Thirty-four children(11 ADHD, 5 LD, 9 ADHD+LD, and 8 Psychiatric control) were individually assessed using the KEDI-WISC and Memoty Assessment Scale(MAS), and then the results of those test were analyzed. Results：In memory test, all of three group showed lower performances than control group. The comorbidity, the LD and the ADHD group showed lower scores in almost subtests of MAS respectively. The good performance in memory test was significantly correlated with the types of memory strategy and error response children used during testing. Discussion：The clinical utility of the memory test like MAS was discussed in terms of differential diagnosis for ADHD, LD and ADHD+LD children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.7 no.1
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• pp.44-51
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• 1996

Objective : The authors investigated family environemtn of ADHD referred to child psychiatric clinics. Method : Seventy two patients were grouped into pure ADHD and comorbid ADHD. Patient's lither and mother conducted the Korean Form of the Family Environment Scale(K-FES). And then, scores were compared with that of 77 normal controls. Results : Among subscales of K-FES, expressiveness, achievement orientation and organization were scored significantly lower in ADHD mothers' reporting than ADHD fathers' And only organization subscale was scored significantly lower in ADHD fathers' reporting than controls' In post hoc comparison, subscales of expressiveness, moral-religious emphasis and organization were significantly lower in mothers' reporting of pure ADHD and comorbid ADHD than of controls, and only organization subscale was significantly lower in fathers' reporting of comorbid ADHD than of controls. Conclusion : Parents of ADHD patients agreed that their families were not well organized, and each perceived somewhat differently on the family environment. Further study is needed to eludicate whether specific family environment causes ADHD or is caused by behavior of ADITD patients.

• The Korean Journal of Applied Statistics
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• v.29 no.7
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• pp.1295-1309
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• 2016

This paper is to reproduce the result of Kim et al. (2014) by deriving a benchmark dose lower bound (BMDL) of lead based on the 2005 cohort data set of Children's Health and Environmental Research (CHEER) data set. The ADHD rating scales in the 2005 cohort were not consistent along the three follow-ups since two different ADHD rating scales were used in the cohort. We first unified the ADHD rating scales in the 2005 cohort by deriving a conversion formula using a penalized linear spline. We then constructed two linear mixed models for the 2005 cohort which reflected the longitudinal characteristics of the data set. The first model introduced the random intercept and the random slope terms and the second model assumed the first order autoregressive structure of the error term. Using these two models, we derived the BMDLs of lead and reconfirmed the "regression to the mean" nature of the ADHD score discovered by Kim et al. (2014). We also noticed that there was a definite difference between the sampling distributions of the two cohorts. As a result, taking this difference into account, we were able to obtain the consistent result with Kim et al. (2014).

• The Korean Journal of Applied Statistics
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• v.31 no.1
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• pp.13-28
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• 2018

The ministry of Environment of Korea initiated two follow-up surveys in 2005 and 2006 to investigate environmental effect on children's health. These two cohorts, referred to as the 2005 Cohort and 2006 Cohort, were followed up three times every two years. This data set was referred to as the Children's Health and Environmental Research (CHEER) data set. This paper reproduces the existing research results of Kim et al. (Journal of the Korean Data and Information Science Society, 25, 987-998, 2014) and Lee et al. (The Korean Journal of Applied Statistics, 29, 1295-1310, 2016) and derive a benchmark dose lower limit (BMDL) for blood lead level for attention deficit hyperactivity disorder (ADHD) after pooling two cohort data sets. The different ADHD rating scales were unified by applying the conversion formula proposed by Lee et al. (2016). The random effect model and AR(1) model were built to reflect the longitudinal characteristics and regression to the mean phenomenon. Based on these models the BMDLs for blood lead levels were derived using the BMDL formula and the simulation. We obtained a hight level of BMDLs when we pooled two independent cohort data sets.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.7 no.2
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• pp.213-223
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• 1996

This study was performed to assess depression/anxiety of attention deficit hyperactivity disorder(ADHD) in children and adolescents and to use them as basic material for subdivied ADHD on phenomenological aspects. 51 hospitalized ADHD children and adolescents were assessed using the Korean form of the Kovacs' Children's Depression Inventory(CDI), Korean Form of the State-Trait Anxiety Inventory for Children(STAIC). Their data were compared to normal control of 50 mentally healthy children and adolescents in relation with the dermographic characteristic. The mean scores of CDI and STAIC-5(State) of ADHD group were statistically higher than those of the control group(p<0.01 or p<0.05). The mean scores of STAIC-T(Trait) of ADHD group were higher than those of the control group. These results suggest that the authors suggest that ADHD can be subdivide into pure ADHD, depressive ADHD and anxious ADHD by the comorbidity of the depression/anxiety.