• Title/Summary/Keyword: Child with ADHD

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NEW ANTIDEPRESSANTS IN CHILD AND ADOLESCENT PSYCHIATRY (소아청소년정신과영역의 새로운 항우울제)

  • Lee, Soo-Jung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.12-25
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    • 2003
  • Objectives:As increasing number of new antidepressants have been being introduced in clinical practice, pharmacological understanding has been broadened. These changes mandate new information and theories to be incorporated into the treatment process of children with depressive disorders. In light of newly coming knowledge, this review intended to recapitulate the characteristics of new antidepressants and to consider the pivotal issues to develope guidelines for the treatment of depression in childhood and adolescence. Methods:Searching the Pub-Med online database for the articles with the key words of 'new', 'antidepressants' and 'children' ninety-seven headings of review articles were obtained. The author selected the articles of pertinent subjects in terms of either treatment guideline or psychopharmacology of new antidepressants. When required, articles about the clinical effectiveness of individual antidepressants were separatedly searched. In addition, the safety information of new antidepressants was acquired by browsing the official sites of the United States Food and Drugs Administration and Department of Health and Human Services. Results:1) For the clinical course, treatment phase, and treatment outcome, the reviews or treatment guidelines adopted the information from adult treatment guidelines. 2) Systematic and critical reviews unambiguously concluded that selective serotonin reuptake inhibitors(SSRIs) excelled tricyclic antidepressants( TCAs) for both efficacy and side effect profiles, and were recommend for the first-line choice for the treatment of children with depressive disorders. 3) New antidepressants generally lacked treatment experiences and randomized controlled clinical trials. 4) SSRIs and other new antidepressants, when used together, might result in pharmacokinetic and/or pharmacodynamic drug-to-drug interaction. 5) The difference of the clinical effectiveness of antidepressants between children and adults should be addressed from developmental aspects, which required further evidence. Conclusion:Treatment guidelines for the pharmacological treatment of childhood and adolescence depression could be constructed on the basis of clinical trial findings and practical experiences. Treatment guidelines are to best serve as the frame of reference for a clinician to make reasonable decisions for a particular therapeutic situation. In order to fulfill this role, guidelines should be updated as soon as new research data become available.

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STUDY ON THE RELATIONSHIP BETWEEN SEROTONIN SYSTEM AND PSYCHOPATHOLOGY IN TOURETTE'S DISORDER (Tourette씨병의 Serotonin계와 정신병리와의 상호관계에 관한 연구)

  • Cho, Soo-Churl;Shin, Yun-O;Suh, Yoo-Hun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.1
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    • pp.77-91
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    • 1996
  • In order to elucidate the biological etiology and the effects of comorbidity on biological variables in tic disorders, plasma serotonin (5-hydroxlfryptamine, 5-HT) and 5-hydroxy- indoleacetic acid (5-HIAA) we.e measured in 87 tic disorders and 30 control subjects. The 87 tic disorder were composed of 45 Tourette's disorder(TS), 22 chronic motor tic disorders (CMT) and 20 transient tic disorders (TTD). Among these patients,43 patients were pure tic disorder (PT), 28 subject also had attention deficit hyperactivity disorder (T+ADHD) and 16 subjects had obsessive compulsive disorders (T+ OCD) as comorbid disorders. The results are summarized as follows : 1) Plasma 5-HT levels showed significant positive correlations with plasma 5-HIAA levels (Pennon r=0.77, p<0.05). 2) Plasma 5-HT and 5-HIAA levels showed no significant correlation with age in tic disorders. 3) Plasma 5-HIAA and 5-HT levels showed no significant correlations with age in control subjects. 4) There was significant difference in plasma 5-HT levels among TS, CMT, TTD and control groups (ANOVA F=34.48, df=3, 113, p<0.01), and post-hoc test using Scheffe method showed significant differences between control and TS, control and CMT, control and ITD groups. But, post-hoc test showed no significant differences between TS and CMT, TS and TTD, CMT and TTD groups. 5) There was significant difference in plasma 5-HIAA levels among TS, CMT, TTD and control groups (ANOVA F=26.48, df=3, 113, p<0.01), and post-hoc test using Scheffe method showed significant differences between control and TS, control and CMT, control and TTD groups. But, post-hoc test showed no significant differences between TS and CMT, TS and TTD, CMT and TID groups.f) There was significant difference in plasma 5-HT and 5-HIAA levels among PT, T+ADHD, T+OCD and contol groups (ANOVA 5-HT, F=37.59, df=3, 113, p<0.01, 5-HIAA, F=27.37, df=3, 113, p<0.01), and post-hoc test using Scheffe method showed signiscant differences between control and PT, control and T+ADHD and control and T+OCB. But, post-hoc test showed no significant differences between PT and T+ADHD, PT and T+ OCD and T+ADHD and T+ OCD. These results show that decreased 5-HT and 5-HIAA levels may play a role in the genesis of tic disorders, but these findings have no significant correlations with the severity of tic disorders. And the comorbid disorders of tics may have minimal effects on the biochemical abnormalities. Future studies must be focused on the effects of serotonin agonists and antagonists on tic disorders and molecular biological methodology may enhance to elucidate the mechanisms of these abnormal findings.

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Relationship between Internet Game Addiction and Psychiatric Symptoms in a Child and Adolescent Psychiatric Clinic (일 대학병원 소아청소년 정신건강클리닉에 내원한 청소년에서 인터넷게임중독과 정신과적 증상의 관계)

  • Oh, Eun-Jeong;Choi, Sam-Wook;Lee, Hae-Kook;Park, Jang-Ho;Ahn, Joon-Ho;Choi, Ji-Eun;Bhang, Soo-Young
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.25 no.3
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    • pp.136-141
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    • 2014
  • Objectives : The aim of this study was to examine the relationship between internet game addiction and psychiatric symptoms. Methods : A total of 447 adolescents who were recruited from a child and adolescent psychiatric clinic of university hospital completed a self-report questionnaire consisting of Korean Internet Addiction Self-scale (K-scale), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Korean-Attention-Deficit Hyperactivity Disorder Rating Scale (K-ARS), and Adolescent Happiness Index (AHI). They were classified into three internet user groups, non-addicted group (below or equal to 94), potential risk group (95 to 107) and high risk group (above or equal to 108) according to K-scale total score. Results : Significant mean differences in BDI, BAI, K-ARS, and AHI scores were observed among the three groups. The BDI, BAI and K-ARS scores showed positive correlation with K-score. The AHI score showed negative correlation with K-score. Conclusion : Findings of this study suggest that depression, anxiety, inattention, hyperactivity/impulsivity, and happiness are associated with internet game addiction.

Agreement between Parents and Teachers on School Children's Emotional/Behavioral Problems (학령기 아동 정서.행동문제에 대한 부모-교사 평가 일치도)

  • Park, Hyo-In;Kim, Jin-Mi;Park, Yong-Chon;Kim, Seok-Hyeon;Ahn, Dong-Hyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.21 no.3
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    • pp.161-167
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    • 2010
  • Objectives: In assessing behavioral/emotional problems in school-aged children, the importance of multi-informant reporting has been well documented. However, in clinical settings obtaining multiple informants' opinions has proven difficult. For that reason, we researched the agreement and predictive validity of the Child Problem-Behavior Screening Questionnaire (CPSQ) in order to reveal how accurate parents' assessments reflected teachers'opinions. Methods: We conducted the first screening for second- and third-grade children from 3 elementary schools in Seoul from 2003 to 2007 using the CPSQ. There were 1178 children included in the analysis. We then administered the Korean version of the Child Behavior Checklist (K-CBCL) as a second screening tool and subsequently, the ADHD Diagnostic System (ADS) and the Korean Educational Development Institute version of the Wechsler Intelligence Scale for Children (KEDI-WISC) was administered by a psychiatrist. We examined each item on the CPSQ and the subscale's agreement between parent and teacher as well as the predictive validity of the CPSQ in children diagnosed with emotional/behavioral problems. Results: The agreement rates between parents and teachers appeared high for questions 18 (0.433), 1 (0.385), and 2 (0.325). Among the subscales, a relatively high correlation was found for externalizing problems, attention deficit hyperactivity disorder, and cognitive problems. For all diagnosed children, their parents revealed a higher sensitivity and lower specificity than teachers. Conclusion: From these results, we confirmed that the CPSQ can be useful for sorting out externalizing and cognitive problems. There is a need for further study, however, with a larger sample size.

STANDARDIZATION STUDY FOR THE KOREAN VERSION OF THE LURIA-NEBRASKA NEUROPSYCHOLOGICAL BATTERY FOR CHILDREN I : SCALE CONSTRUCTION, RELIABILITY & NORMS FOR THE KOREAN VERSION OF LNNB-C (한국판 아동용 Luria-Nebraska 신경심리 검사의 표준화 연구 I: 척도 제작, 신뢰도 및 뇌손상 진단을 위한 규준 산출)

  • Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.5 no.1
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    • pp.54-69
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    • 1994
  • The purpose of present study was to develop the Korean Version of Luria-Nebraska Neuropsychological Battery for Children(LNNB-C), to examine the reliability of it, and to establish the norms for determining the probability of brain damage. The normative group used to standardize the Korean version of LNNB-C was composed of 147 children between the age of 8 and 12(body 74, girl 73). The clinical group consisted of 19 brain damaged, 16 ADHD, and 16 psychiatric controls. The inter-scorer reliability was 96.3%, indicating that the stability of the scoring system for the Korean version of LNNB-C is good. The reliability coefficients(Cronbach's ${\alpha}$) of LNNB-C scales were ranged .51 to .91, which are similar to those of original LNNB-C. To establish the norms for detecting brain damage, the means and standard deviations for normative group were used to calculate T-scores for each scale. To determine a critical level that could successfully predict a normal child's average score at a given age, first the average score of normative group was calculated, and this score was then entered a regression equation with age to predict the average(baseline) acore. Finally, some issues on constructing the Korean version of LNNB-C and the cultural differences between Korean and American children in performing LNNB-C were discussed.

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BIO-PSYCHOSOCIAL STUDY OF EMOTIONAL BEHAVIORAL PROBLEMS IN KOREAN ELEMENTARY SCHOOL CHILDREN(II) -Quantitated Various EEG Elements of Basic Activity in ADHD and Emotional Behavioral Problem Children by Computerized Wave Form Recognition Method - (국민학교 아동의 정서행동문제에 대한 생물 ${\cdot}$ 정신사회학적 연구(II) -뇌파자동해석장치에 의한 주의력 결핍과잉운동장애 아동과 정서행동문제아동의 뇌파조사-)

  • Lee, Chung-Kyoon;Jang, Kyung-June;Park, Seong-Ho;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.40-54
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    • 1990
  • The author studied EEG differences among normal, children, children with emotional behavioral problems determined by Rutter's questionnaire and children with attention-deficit hyperactivity disorder according to DSM-III-R. The results are as follows ; There were no differences in incidence and pattern of abnormal EEG between normal control children and children with emotional behavioral problems. But children with attention-deficit hyperactivity disorder tend to show lower average amplitude, and less wave percentage time of alpha wave in occipital area than normal did, furdermore wave percentage time of alpha wave appeared more in left occipital area than in right occipital area, These results demonstrated that emotional behavioral problems in elementary school children may not be related to EEG abnormality, Where as children with attention deficit hyperactivity disorder showed underdeveloped alpha waves as compared with normal control children.

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The Cognitive Performance, Emotional and Behavioral Problems of the Children with ADHD Showing the Difference between Visual and Auditory Attention (시각 주의력과 청각 주의력의 차이를 보이는 주의력 결핍.과잉활동장애 아동의 인지기능과 정서 및 행동 문제)

  • Son, Jung Woo
    • Korean Journal of Biological Psychiatry
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    • v.13 no.2
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    • pp.70-81
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    • 2006
  • Objective : The purpose of this study was to investigate the differences of the cognitive performance, emotional and behavioral problems among the attention-deficit/hyperactivity disorder(ADHD) groups that show the difference between visual and auditory attention. Method : Using 'ADHD Diagnostic System(ADS)', visual attention and auditory attention of 98 children diagnosed as ADHD were measured. According to the omission and commission error of ADS, they were divided into three groups ; 1) the group whose each visual omission and commission error scores were higher than each auditory omission and commission error scores(VV group), 2) the group whose each auditory omission and commission error scores were higher than each visual omission and commission error scores(AA group), 3) the group that was the rest of VV and AA group(M group). And the results of both the subscales of Korean Educational Development Institute-Wechsler Intelligence Scale for Children(KEDI-WISC) and the subscales of Korean Child Behavior Checklist(K-CBCL) among three groups were compared. Finally, the correlation between the visual omission, visual commission, auditory omission, auditory commission error and the results of KEDI-WISC, K-CBCL were investigated. Results : The results were as follows ; 1) In 98 ADHD children, the number of VV group(N=56) was higher than that of AA (N=10) and M group (N=32). 2) All mean scores of the subscales of KEDI-WISC of VV group were higher than those of M and AA group. The score of verbal IQ(p=.039) of VV group was significantly higher than that of AA group and the scores of block design(p=.015), Kaufman's factor 2(p=.045), performance IQ(p=.004) were significantly higher than those of M group. The score of full IQ(p=.004) were significantly higher than that of M and AA group. 3) The mean scores of all K-CBCL subscales of VV group were higher than those of M and AA group, except the score of Somatic complaint subscale. The score of Social subscale(p=.041) of VV group was significantly higher than that of AA group. The score of Withdrawn subscale(p=.021) of AA group was significantly higher than that of VV group. 4) There were no significant correlation between the scores of visual omission/commission error and those of each subscale of KEDI-WISC. But, there were many significant correlations between the scores of auditory omission/commission error and those of each subscale of KEDI-WISC. 5) There were significant correlation between the score of the visual omission error and that of Thought problem subscale(r=.205, p=.043) of K-CBCL. There were significant correlation between the scores of the auditory omission error and those of Social subscale(r=-.319, p=.001), Social problems subscale(r=.206, p=.042), Thought problem subscale(r=.235, p=.021). Finally, there were significant correlation between the scores of auditory commission error and those of Social subscale(r=-.241, p=.017), Thought problem subscale(r=.235, p=.020). Conclusion : The ADHD children whose auditory attention ability were higher than visual attention ability had relatively better cognitive performance and less emotional/behavioral problems than the others. The more comprehensive experiment will be needed about the cognitive performance, emotion and behavior problems of the ADHD children showing the difference between visual and auditory attention.

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SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY FINDINGS IN ATTENTION DEFICIT- HYPERACTIVITY DISORDER (주의력결핍 ${\cdot}$ 과잉운동장애의 단일광자방출 전산화단층촬영 소견에 관한 연구)

  • Cho, Soo-Churl;Lee, Myung-Chul;Moon, Dae-Hyuk
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.27-39
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    • 1990
  • The neural mechanisms involved in attention deficit hyperactivity disorder are largely unknown. In order to investigate the neuroanatomical lesions of attention deficit hyperactivity disorders and their relationships with psychopathology, Single Photon Emission Computed Tomography(SPECT) using HMPAO was performed in 46 ADHDS and Yale Children's Inventory(YCI), Conners Parent Questionaire and DSM-III-R Questionaire for Disruptive Behavior Disorder were used to assess the psychopathology of ADHDS The results are summarized as follows; 1) 30.4% (14/46) of this series revealed decreased perfusion In SPECT. 2) Regions of hypoperfusion were seen in cerebral cortex(17.4%, 8/46), thalamus(13.0%, 6/46), deep gray matter(8.7%, 4/46), basal ganglia(6.5%, 3/46) and cerebellum(2.2%, 1/ 46). 3) The mean scores of the total YCI revealed significant difference between the two groups(SPECT abnormal versus normal group), and among the subscales, hyperactivity, language and fine-motor subscales showed significant differences between the two groups. Although the relationship between the abnormal findings and specific symptom clusters of ADHDS remains unclear, we can suggest that these abnormal findings could be associated with ADHD, and based on these findings, the ADHDS can be subclassified into two groups. This study can be said to reinforce the current conception of heterogeneity of ADHD.

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COGNITIVE CHARACTERISTICS OF CHILDREN WITH DYSLEXIA AND/OR ATTENTION DEFICIT/HYPERACTIVITY DISORDER (읽기 장애 아동과 주의력 결핍/과잉 활동장애 아동의 인지적 특성)

  • Kim, Seung-Tai;Kim, Ji-Hae
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.2
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    • pp.224-232
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    • 1996
  • The present study was conducted to investigate cognitive characteristics of children with dyslexia and/or attention deficit/hyperacidity disorder. Cognitive characteristics were evaluated by using KEDI-WISC, the Basic Achievement Test, TOVA, MFFT, and neuropsychological tests. ADHD group showed significantly lower level of performance in response time for correct responses and presented variability for correct responses in TOVA. Dyslexia and mixed group showed lower performance in Reading I and Reading II, Writing subtest in the Basic Achievement Test than those of ADHD group and in Information subtest of KEDI-WfSC. In order rd determine the diagnostic effectiveness of each psychological tests, discriminant analysis was conducted. In this analysis, 11 subtests of KEDI-WISC and 4 variables of TOVA, 4 subtests of the Basic Achievement Test, and MFFT, WCST were included as independent variables and each diagnostic roups were dependent variables. Discriminant analysis indicated that overall percentage of correct classification was 93.88%. The clinical implifications and limitations of the present study were listed and discussed.

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Social Behaviors, Psychosocial Adjustments, and Language Ability of Aggressive Victims, Passive Victims, and Bullies in Preschool Children (또래 괴롭힘 공격적 피해, 수동적 피해 및 가해 유아의 사회적 행동, 심리사회적 적응과 언어능력)

  • Shin, Yoo-Lim
    • Journal of the Korean Home Economics Association
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    • v.49 no.6
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    • pp.1-12
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    • 2011
  • This study investigated prevalence rates and differences in social behaviors, psychosocial adjustments, and language ability of preschool children who engaged in bully/victim subgroups: aggressive victims, passive victims, bullies, and non-involved. The participants were 297 preschool children and their teachers in Jeju City. The teachers measured children's peer victimization, social behaviors, and teacher-child relationships. Children's language ability and self-concept were also assessed by individual interview. There were significant differences in social behaviors, psychosocial adjustments, and language ability among the bully/victim subgroups. Aggressive victims included in a high risk group characterized by a high level of aggression, ADHD, peer rejection as well as conflicted relationships with teachers. Moreover, they had limited language ability. The findings highlight behavioral heterogeneity among the bully/victim subgroups in early childhood.