• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.5 no.1
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• pp.102-107
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• 1994

Recently several studies showed a strong and specific association of Attention-Deficit Hyperactivity Disorder(ADHD) and generalized resistance to thyroid hormone(GRTH). The recommandation that all children with ADHD be screened for GRTH is an newer controversial issue in child psychiatric field. Author examined thyroid indices(T3, T4, TSH) and clinical characteristics in the 51 clinical populations with ADHD, developmental delay, and language disorders. The results are that 11 cases were out of the normal range of both T2 and T4 inspite of normal TSH. This finding is suggestive of the finding of GRTH cases. Therefore I suggest that child psychiatrist should pay attention to ADHD symptoms secondary to GRTH and that all children with familial ADHD and developmental delay(including launguage disorder) be screened for thyroid abnormalities.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.29 no.4
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• pp.150-160
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• 2018

Objectives: This study investigated the effect of social skills training (SST) on facial emotion recognition and discrimination in children with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Methods: Twenty-three children aged 7 to 10 years participated in our SST. They included 15 children diagnosed with ADHD and 8 with ASD. The participants' parents completed the Korean version of the Child Behavior Checklist (K-CBCL), the ADHD Rating Scale, and Conner's Scale at baseline and post-treatment. The participants completed the Korean Wechsler Intelligence Scale for Children-IV (K-WISC-IV) and the Advanced Test of Attention at baseline and the Penn Emotion Recognition and Discrimination Task at baseline and post-treatment. Results: No significant changes in facial emotion recognition and discrimination occurred in either group before and after SST. However, when controlling for the processing speed of K-WISC and the social subscale of K-CBCL, the ADHD group showed more improvement in total (p=0.049), female (p=0.039), sad (p=0.002), mild (p=0.015), female extreme (p=0.005), male mild (p=0.038), and Caucasian (p=0.004) facial expressions than did the ASD group. Conclusion: SST improved facial expression recognition for children with ADHD more effectively than it did for children with ASD, in whom additional training to help emotion recognition and discrimination is needed.

• Journal of Ginseng Research
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• v.35 no.2
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• pp.226-234
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• 2011

We investigated the clinical effects of Korean red ginseng on attention deficit hyperactivity disorder (ADHD) in children. Eighteen subjects aged between 6 and 14 diagnosed with ADHD based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition diagnosis criteria were enrolled. Korean red ginseng (Panax ginseng) at 1,000 mg b.i.d. was administered to the subjects for 8 weeks. Eighteen children completed the questionnaire and clinical assessment by visiting the hospital at baseline, then in the first, fourth and eighth weeks. Clinical assessments were performed by using the ADHD Diagnostic System (ADS, a computerized attention assessment program), the abbreviated Conners' rating scale in addition to psychiatric interviews. After 8 weeks, significant differences were found in the omisssion errors of ADS ($78.56{\pm}43.33$ at baseline, $55.17{\pm}21.44$ at 8 weeks, p<0.023), Conners ADHD Rating Scale ($13.78{\pm}6.32$ at baseline, $9.50{\pm}4.80$ at 8 weeks, p<0.042) and Spielberger State Anxiety Scale ($30.94{\pm}6.25$ at baseline, $28.83{\pm}6.23$ at 8 weeks, p<0.024). In the Korean Personality Inventory for Children, a significant reduction of score was found in the physical development scale ($56.44{\pm}9.63$ at baseline, $50.94{\pm}8.91$ at 8 weeks, p<0.017) and social dysfunction scale ($56.33{\pm}6.82$ at baseline, $51.94{\pm}7.13$ at 8 weeks, p<0.025). These results suggest that Korean red ginseng may be effective in improving inattentiveness in ADHD children, but it remains uncertain if it improves the general severity of ADHD, depression, anxiety personality and behavioral changes.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.30 no.2
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• pp.74-82
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• 2019

Objectives: The objective of this study was to investigate clinical and neuropsychological factors associated with treatment response and adverse events of atomoxetine in children with attention-deficit/hyperactivity disorder (ADHD) in Korea. Methods: Children with ADHD were recruited at the Department of Psychiatry of Asan Medical Center from April 2015 to April 2018. Diagnoses of ADHD and comorbid psychiatric disorders were confirmed with the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. The subjects were subsequently treated with atomoxetine for 12 weeks and illness severity was scored using the ADHD Rating Scale, Clinical Global Impression-Severity scale (CGI-S) and/or Improvement scale (CGI-I), at pre- and post-treatment. They also completed the Advanced Test of Attention (ATA), while their caregivers completed the Korean Personality Rating Scale for Children (KPRC) at pre- and post-treatment. Independent t-test, Fisher's exact test, ${\chi}^2$ test, mixed between-within analysis of variance and correlation analysis were used for statistical analysis. Results: Sixty-five children with ADHD (mean age: $7.9{\pm}1.4years$, 57 boys) were enrolled, of which, 33 (50.8%) were treatment responders. Scores on the social dysfunction subscale of the KPRC (p=0.021) and commission errors on the visual ATA (p=0.036) at baseline were higher in treatment non-responders than in responders; however, the statistical significances disappeared after adjusting for multiple comparisons. Mood changes were also observed in 13 subjects (20.0%), and three of them discontinued atomoxetine due to this. Additionally, atomoxetine-emergent mood change was observed more frequently in girls (p=0.006), while the intelligence quotient (p=0.040) was higher in those subjects with mood changes than in those without. Conclusion: The results of our study suggest that clinical and neuropsychological factors could be associated with treatment response or adverse events of atomoxetine in children with ADHD. Further long-term studies with larger samples are needed.

• The Korean Journal of Applied Statistics
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• v.25 no.3
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• pp.389-401
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• 2012

This paper derives a benchmark dose(BMD) and its 95% lower confidence limit(BMDL) using a semi-parametric regression model for small lead based changes in attention-deficit hyperactivity disorder(ADHD) scores in the first wave of the Children's Health and Environment Research(CHEER) survey data, which have been regularly collected in South Korea since 2005. Ha et al. (2009) showed that the appearance of ADHD symptoms had a borderline trend of increasing with the blood lead concentration. Butdz-J${\o}$rgensen (EFSA, 2010a) derived the BMDL of lead corresponding to a benchmark region of 1 full intelligent quotient (IQ) score using the raw data in Lanphear et al. (2005, EHP). European Food Safety Authority (EFSA, 2010b) determined the BMDL of $1.2{\mu}g/dl$ as a reference point for the characterization of lead when assessing the risk of the intellectual deficit measured by IQ scores. Kim et al. (2011) indicated that an even lower BMDL could be obtained based on the ADHD score; however, the BMDLs depended heavily upon the model assumptions. We show in this paper that a semi-parametric approach resolves the model dependence of BMDLs.

• Journal of Digital Convergence
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• v.11 no.11
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• pp.717-723
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• 2013

It has been reported that more than 10 percent of Korean elementary students are classified into ADHD (Attention Deficit / Hyperactivity Disorder). Major treatment of ADHD is medication. However, medication brings various kinds of side effects. Therefore, we need a way to improve attention leve, and lead children to voluntarily participate in it. With this purpose, we tried to develop a 3D tangible game to improve the children's attention level. To measure the level of attention enhancement, firstly we measured both the group average and the standard deviation of the measurement variables from the raw data gathered during the game play time. The measured value can be effectively used to measure the level of attention improvement of the children who might need treatment.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.24 no.4
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• pp.220-227
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• 2013

Objectives : This study aims to investigate the clinical characteristics and neuropsychological profiles of children with attention-deficit hyperactivity disorder (ADHD) and their siblings. Methods : Eighteen children (age $8.2{\pm}1.7$ years, 12 boys) with ADHD and their 18 siblings (age $7.8{\pm}1.6$ years, 8 boys) completed Continuous Performance (CPT), Stroop, Children's Trail Making, Rey-Kim Memory, and Kim's Frontal Executive Function tasks. The parents of these subjects underwent the Attention-Deficit/Hyperactivity Disorder Rating Scale (ARS), 10-item Parent General Behavior Inventory (P-GBI), and the Social Responsiveness Scale (SRS). Paired t-tests were used. Results : The inattention (p=.020), and hyperactivity-impulsivity (p=.001), scores of the ARS and the P-GBI score (p=.004) were significantly higher in children with ADHD than in their siblings. Deficits in social communication and motivation on SRS were higher in children with ADHD than in their siblings (p=.017 and p=.011, respectively). Z-scores of omission and commission errors as well as response time variability on visual CPT and omission errors on auditory CPT were in clinically significant range, and z-score of omission errors on auditory CPT was in borderline range in siblings. Omission (p=.018) and commission errors on Visual CPT (p=.007) were significantly higher in children with ADHD compared to their siblings. Recognition efficiency on Kim's Frontal Executive Function Task was lower in children with ADHD compared to their siblings, but in normal range in both groups. Stroop interference and figure fluency on Kims Frontal Executive Function Task were in borderline range in ADHD group, and figure fluency was in borderline range in siblings. Conclusion : Our results support a preliminary evidence for mild degree of attention deficit in ADHD siblings. Further studies are needed to examine the cognitive functions of siblings with ADHD in larger samples.

• Korean Journal of Community Nutrition
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• v.23 no.5
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• pp.397-410
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• 2018

Objectives: An association between dietary patterns and mental health in children has been suggested in a series of studies, yet detailed analyses of dietary patterns and their effects on ADHD (attention deficit hyperactivity disorder) are limited. Methods: We included 4569 children who had dietary intake data as part of the CHEER (Children's Health and Environmental Research) study conducted nationwide from 2005 to 2010. We assessed ADHD (Attention Deficit Hyperactivity Disorder) by the DuPaul's ADHD Rating Scales and dietary intake by a semi-quantitative food frequency questionnaire. Using intake data, we constructed five dietary patterns: "Plant foods & fish," "Sweets," "Meat & fish," "Fruits & dairy products," and "Wheat based." Results: The overall proportion of ADHD was 12.3%. Boys (17.8%) showed a higher rate of ADHD than girls (6.5%). The total intake of calories (85 kcal) and plant fat (2g) in the ADHD group was significantly higher than that of the normal group. ADHD was significantly negatively associated with dietary habits such as having breakfast and meal frequency, and positively associated with eating speed, unbalanced diet, overeating, and rice consumption. Regarding dietary patterns, the "Sweets" category was relevant to high ADHD risk (OR 1.59, 95% CI: 1.18, 2.15 for Q5 vs. Q1) in a linear relationship. An inverse, non-linear association was found between "Fruits & dairy products" and ADHD (OR 0.55, 95% CI: 0.39, 0.76 for Q4 vs. Q1). Conclusions: Our study confirms both positive and negative associations between diet and ADHD in elementary school age children. Moreover, linear or nonlinear associations between diet and ADHD draw attention to the possible threshold role of nutrients. Further studies may consider characteristics of diet in more detail to develop better intervention or management in terms of diet and health.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.147-154
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• 2019

Objectives : Cognitive dysfunction, including inattention, is often observed in patients with depression. Inattentive symptoms in patients with depression is similar to those among attention deficit/hyperactivity disorder (ADHD) patients. It is important to diagnose the two diseases accurately, because the treatment varies depending on the cause of inattention. This study aimed to investigate the coexistence rate of ADHD and the correlation between ADHD symptoms and depression in patients with depression. Methods : Participants in this study were 158 outpatients presenting with depression, who visited the psychiatric department from March 2015 to July 2018. Participants divided into a depression and a non-depression group according to the Korean version of the Center for Epidemiological Studies-Depression Scale (CES-D) score and were administered the following : a sociodemographic variables form (age, sex, academic background, occupation), the self-reporting test for adult ADHD (Adult Attention Deficit/Hyperactivity Disorder self-report scale-V 1.1; ASRS V1.1), and the Korean version of the Connors adult ADHD rating scale (K-CAARS). Descriptive statistical analysis, crossover analysis, t-tests, and Pearson's correlation coefficient were conducted on the data. Results : The coexistence rate of adult ADHD symptom was as high as 36.7% in patients with depression (p<0.001). In K-CAARS, the depression group (Inattention=1.80, Hyperactivity=1.92, Impulsivity=1.56, Self-concept=2.06) showed higher average scores on ADHD symptoms than the non-depressive group (Inattention=1.28, Hyperactivity=1.25, Impulsivity=1.09, Self-concept=1.42, p<0.001). Conclusions : This study confirmed that ADHD symptoms coexist in the depression group. When evaluating the symptoms of patients who complain of depression, it is suggested that they should be accurately diagnosed and appropriately treated with interest to the coexistence of ADHD symptoms and the possibility for ADHD diagnosis.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.22 no.2
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• pp.74-80
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• 2011

Attention-deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder with an onset of symptoms before 7 years of age, often starting as early as the preschool years. The off-label use of methylphenidate (MPH) for 3- to 6-year-old preschool children with ADHD is being more common, although MPH is not licensed for use in children younger than age 6 years, in most countries. Despite the limited data, the review of the literature suggests that MPH meets evidence based criteria as beneficial and safe for carefully diagnosed ADHD preschool children. Carefully monitored administration of evidence-based psychotropic medication in preschool children with ADHD may be indicated if psychosocial treatments are ineffective.