• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제24권4호
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• pp.213-219
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• 2013

Objectives : It is known that adolescents with autism spectrum disorder (ASD) often concurrently exhibit attention-deficit hyperactivity disorder (ADHD). The objective of this study is to investigate how ADHD symptoms modify clinical characteristics in adolescents with ASD. Methods : Subjects were recruited from the Program for the Education Enrichment of Relational Skills program, which is a program for adolescents with ASD to promote and train social skills. The study participants and their parents completed the study questionnaires, such as the ADHD rating scale, Autism Diagnostic Observation Schedule, and Korean version of Child Behavior Checklist. Results : Adolescents with ASD and ADHD (N=19) were found to have more impaired sociality, less open communication with their parents, and more behavioral and emotional problems compared with adolescents with ASD, and without ADHD (N=28). Conclusion : Although further research is needed, the results of our study suggest that adolescents with ASD present different clinical characteristics when comorbid with ADHD.

• 대한불안의학회지
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• 제5권2호
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• pp.96-102
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• 2009

Objective : We investigated that ADHD categorical diagnosis and the dimensional tools for the evaluation of ADHD, widely used in the clinical field, such as the child behavior check list- Korean version (K-CBCL), Korean personality inventory for children (KPI-C), computerized Attention Diagnostic System (ADS). Method : The DSM-IV clinical diagnosis applied by child psychiatrist. K-CBCL, KPI-C, ADS are used. Ultimately, totally 161 ADHD children and 161 controls were evaluated. Subject group are consist of 202 boys (62.7%) and 120 girls (37.3%), and the mean age was $9.5{\pm}2.0$ years old. Results and Conclusion : Social problem, and attention problem in the K-CBCL, correct response time standard deviation in the computerized ADS were statistically significant different and attention problem in the K-CBCL, hyperactivity subscale in the KPI-C were significant trait, between subject group and control group. The ROC value of attention problem in the K-CBCL, hyperactivity subscale in the KPI-C, and ADS were .78, .93, .86. Finally, we found that K-CBCL, KPI-C, ADS were significant corelation with the ADHD categorical diagnosis.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제32권3호
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• pp.99-103
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• 2021

The purpose of this review is to examine the clinical use of functional near-infrared spectroscopy (fNIRS) in children and adolescents with psychiatric disorders. Many studies have been conducted using objective evaluation tools for psychiatric evaluation, such as predicting psychiatric symptoms and treatment responses. Compared to other tools, fNIRS has the advantage of being a noninvasive, inexpensive, and portable method and can be used with patients in the awake state. This study mainly focused on its use in patients with attention-deficit/hyperactivity disorder and autism spectrum disorder. We hope that research involving fNIRS will be actively conducted in various diseases in the future.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제31권2호
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• pp.80-87
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• 2020

Objectives: The prevalence of psychiatric disorders among young adults is different from that among younger or older age groups because of biological and environmental changes. The purpose of this study was to analyze the diagnostic distribution of psychiatric disorders in 19-30-year-old Koreans based on their age and gender using data from the Korean National Health Insurance Service (NHIS). Methods: From the 2011 medical claims sample data of NHIS of 1,375,842 people, we extracted the data of 221,038 people aged 19-30 years, including 106,232 (48.1%) men and 114,806 (51.9%) women. We evaluated the overall changes in the diagnostic distribution of psychiatric disorders over a 3-year period. Results: The diagnostic frequency in women was 13,627 (59.0%), which was significantly higher than that in men. "Other anxiety disorders" was the most common psychiatric disorder in both genders, followed by depressive episodes, somatoform disorders, "other neurotic disorders," and nonorganic sleep disorders. In men, attention-deficit/hyperactivity disorder or intellectual disabilities were not among the top 10 disorders. In women, no significant changes in major psychiatric disorders were seen over the 3-year period. Conclusion: These results reveal the trends of diagnostic distribution of mental illnesses depending on the development, particularly in young adulthood. It is necessary to identify whether such trends are due to biological or environmental factors, aging processes, or complex influences.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제1권1호
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• pp.27-39
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• 1990

주의력결핍 ${\cdot}$ 과잉운동장애는 학령전기 또는 학령기에서 가장 흔히 발견되는 질환들 중의 하나로서 학령기아동의 악 $3{\sim}20%$ 의 아동이 이 질환을 앓고 있는 것으로 평가되고 있다. 이 질환의 원인에 대하여는 유전적인 소인, 사회환경적인 요인등 여러주장들이 있어 왔으나, 임신 전후한 합병증이 많다는 연구, 신경학적인 검사에서 이상소견이 많이 발견된다는 보고, 납중독과의 관련설, 어머니의 술중독과 관련이 있다는 주장등은 환경적인 요인보다는 기질적인 요인이 작용하고 있을 가능성을 시사해준다 이에 본 연구는 '주의력결핍 ${\cdot}$ 과잉운동장애'와 관련있는 뇌의 부위를 연구하기 위하여 '단일광자방출전산화단층촬영'을 시행하여, 30.4%(14/46)에서 혈류의 감소가 있었음을 발견하였다. 이상소견이 발견된 뇌의 부위는 대뇌피질, 시상부, 실부회백질, 기저핵, 소뇌등 일정하지는 않았다. 정신병리와의 관계에서는 이상소견이 나타난 군에서 심한 장애를 보였으며, 특히 과잉운동. 언어 소운동부분에서의 차이가 뚜렸하였다. 이러한 결과에 기반을 두어 '주의력결핍과잉운동장애'는 크게 뇌의 혈류장애가 있는 군과 없는 군의 두군으로 대별할 수가 있으며, 향후의 연구에서는 보다 많은 대상군을 선정하여, 정확한 뇌의 부위를 발견하기 위한 노력을 기울여야 한다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제20권2호
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• pp.82-89
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• 2009

Objectives: Children with attention-deficit hyperactivity disorder(ADHD) often have difficulties in social behavior. The aim of this study was to evaluate the effectiveness of a short-term training program for improving social skills, self-perception and attention deficits. Methods: The subjects were nine children diagnosed with ADHD with(or without) other mental disorders using the Diagnostic Interview Schedule for Children(DISC-ADHD) module. Children were given eight sessions of a social skills training program. Parents of children simultaneously participated in their own training which was designed to support their children's generalization of skills. Assessments included child, parent and teacher ratings of social skills, self-perception and attention deficit at baseline and post-treatment. Results: Social skills training led to significant improvements in child-reported measures of self-esteem, in teacher reported measures of social skills, and in parent-reported measures of attention deficit. Conclusion: This study suggests that short-term social skills training programs for children with ADHD may improve their social skills, self-perception and attention deficits.

• 대한불안의학회지
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• 제15권2호
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• pp.101-108
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• 2019

Objective : This study aimed to investigate the associations of anxiety symptoms with behavior and attention in elementary school children with attention-deficit/hyperactivity disorder (ADHD). Methods : A total of 195 elementary school children with ADHD participated in the study. The Korean Version of ADHD Rating Scale (K-ARS) and Behavior Assessment System for Children(BASC-2) were used to measure the children's behavior. Anxiety and attention was assessed with State-Trait Anxiety Inventory for Children (STAIC) and ADHD Diagnostic System (ADS), respectively. Children with ADHD were categorized to two groups of ADHD with low anxiety (ADHD-LA) and ADHD with high anxiety (ADHD-HA) according to the total STAIC scores. Scores on K-ARS, BASC-2 and ADS were compared between two groups of ADHD-LA and ADHD-HA. Results : The Scores on K-ARS total and both subscales in ADHD-HA group were significantly higher than ADHD-LA group. Scores on the BASC-2 subscales including hyperactivity, aggression, conduct problem, anxiety, depression, somatization, withdrawal, attention problems were also significantly higher in ADHD-HA group compared to ADHD-LA group. In contrary, scores on ADS subscales were not significantly different between the both groups. Conclusion : Our study identified that the anxiety accompanied with ADHD was associated with the negative behavioral aspect in children with ADHD. However, the performances on attention task were not affected by the anxiety comorbid with ADHD. Future studies to reveal underlying mechanism are needed for further understanding the association with anxiety and ADHD.

• Environmental Analysis Health and Toxicology
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• 제25권4호
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• pp.259-262
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• 2010

In this review, we give an overview of psychiatric perspectives on environmental disease. The concept of genetic heritability and its meaning with regard to environmental risk factors will be discussed. Recent ideas of gene-environment interaction and neurodevelopmental disorder in psychiatry will also be introduced. This article discusses the environmental risk factors for attention deficit hyperactivity disorder (ADHD) and autism, the two major environmental diseases and neurodevelopmental disorders in psychiatry. Given that both ADHD and autism are complex conditions, the etiology is likely to involve multiple genes of moderate effect interacting with environmental factors. We will introduce recent environmental issues related to these two disorders.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제10권1호
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• pp.91-99
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• 1999

목 적：초기아동기에서부터 시작된 주의력결핍과잉행동장애와 아동기및 청소년시기에 발병한 기분장애, 조증은 서로 다른 질환군에 속해있다. 그러나 이들 질환의 증상이 서로 유사한 부분이 많고, 어른과 달리 소아, 청소년기 조증에서는 특징적으로 나타나는 비전형적인 증상들로 인해 두 질환을 감별하고 진단하는 데 많은 어려움이 있다. 본 연구에서는 이들 두 질환을 가지고 있는 아동과 청소년들의 일반적 특성과 임상양상 및 공존질환 등을 비교함으로써 각 질환의 특성을 파악하고 이들 질환사이의 관계를 규명하고자 하였다. 방 법：대상군은 고려대학교 구로병원 신경정신과와 서울대학병원 소아정신과로 내원하여 진단받은 35명의 주의력결핍과잉행동장애아와 19명의 조증환아로 선정하였다. 각각의 질환에서 특징적으로 보이는 증상들을 규명하고자 할 경우에는 서로의 질환을 동반하고 있지 않은 환아들로만 선정하여 각각 29명과 14명을 대상으로 하였다. 결 과：주의력결핍과잉행동장애와 소아, 청소년기에 발병한 기분장애의 조증 환자군을 비교한 결과, 발병연령(p<.01), 상태불안척도(p<.01), 출생시 체중(p<.01), 임신기간동안 입원 또는 사고경력(p<.05), 임신기간(p<.01), 주산기문제(p<.01), 학교에서의 문제행동(p<.01) 등에서 두 군사이에 의미있는 차이가 있었다. 두 질환의 증상들을 서로가 어느정도 공통적으로 가지고 있는 지를 비교해본 결과에서는 주의력결핍과잉행동장애 아동들이 물건을 잘 잃어버린다 항목에서 의미있게(p<.05)높았으며, 조증 증상항목의 과대사고(p<.01), 수면욕구의 감소(p<.05), 망상(p<.01), 환각(p<.05)항목에서 조증 환자들이 의미있게 높았다. 또한 이들 환자들의 공존질환들은 주의력결핍과잉행동장애 환아들에서 특히 주요우울증이 조증 환아들에서 보다 의미있게(p<.05)높게 나타났다. 가족력에서는 조증 환아들의 가족들에서 주의력결핍과잉행동장애 환자들의 가족들에서보다 기분장애가 의미있게(p<.05)높게 나타났다. 결 론：이들 두 질환들의 대상군들이 일반적 특성, 임상양상, 공존질환, 가족력 등에서 유의한 차이를 보이는 점에서 서로 독립적인 질환으로 생각되었으며, 향후 두 질환이 공존하는 환자군과 연령에 따라 보다 세분된 환자군 간의 다각적인 비교연구가 필요할 것으로 보인다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제1권1호
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• pp.77-88
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• 1990

주의력 결핍장애아동의 치료는 악물치료가 중요하지만 중복장애아동과 같은 원칙에서 인지-행동적, 교육적 접근과 상호보완이 필요하다. 치료의 첫단계는 진단을 확립하고, 아동, 부모, 교사에게 이장애의 특성을 설명해 주고 치료의 대책을 세운다. 약물치료는 주로 중추신경자극제-그중에서도 메칠페니데이트를 중심으로 논의하였고, 그외에 삼환계 항우울제, 클로니딘, 항정신병약물이 소개되었다. 약물치료이외의 방법들로는 정신요법, 인지행동요법, 교육적 방법과 부모및 가족상담의 원칙들을 논의하였다. 이들 전통적인 치료방법이외에 논란되고 있는 식이요법, 비타민요법, 저당분요법, 미네랄요법, 정제된 당분의 투여, 신경학적 조직의 이론에 근거한 운동요법들을 소개하고 설명하였다.