• The Journal of Korean Medicine
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• v.31 no.1
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• pp.47-56
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• 2010

Objective: Many drug or non-drug therapies are reported to be effective in reducing the severity of attention deficit/hyperactivity disorder (ADHD). The aim of this study was to assess the effect of color and pattern on the severity of ADHD in young ADHD patients. Method: We randomly assigned 30 children into two groups and had them participate in 15-minute block play sessions once in a week. The experimental group used blocks with green (3G, Munsell color system) circle patterns on them, while the control group played with plain white blocks. We also provided a set of playing cards with the corresponding patterns. This trial continued for 4 weeks and 29 children (96.7%) completed. The primary outcome measurement was the ADHD rating scale-IV and was evaluated on every visit. Results: After the trial, ADHD score decreased in both groups but not significantly ($34.4{\pm}8.0$ to $30.0{\pm}4.3$; $34.0{\pm}6.0$ to $30.3{\pm}3.2$). However, there were significant differences in 4 items of ADHD rating scale between the two groups. These consisted of 3 inattention (Q3, Q7, Q15) and 1 hyperactivity-impulsivity (Q12) items and the reduction between the first and final visits was significant (p=0.0240, p=0.0498, p=0.0237 and p=0.0012 respectively). Conclusion: Repeated exposure to a green circle pattern might not influence the total score of ADHD rating scale but reduced 3 inattention items and 1 hyperactivity-impulsivity significantly in children with ADHD. Proper visual stimuli are partially helpful for pediatric ADHD.

• Clinical and Experimental Pediatrics
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• v.60 no.6
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• pp.189-195
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• 2017

Purpose: The purpose of this study was to investigate the effects of lamotrigine for the treatment of attention-deficit hyperactivity disorder (ADHD) symptoms in children with epilepsy. Methods: Pediatric patients newly diagnosed with epilepsy (n=90 [61 boys and 29 girls]; mean age, $9.1{\pm}3.4years$) were enrolled. All patients were evaluated with the Korean ADHD rating scale (K-ARS)-IV before treatment with lamotrigine and after doses had been administered. The mean interval of ADHD testing was approximately 12.3 months. The initial dosage of lamotrigine was 1 mg/kg/day (maximum 25 mg/day for the first 2 weeks), and increased by 1 mg/kg every 2 weeks until titrated up to 7 mg/kg/day (or maximum 200 mg/day). Results: The mean ADHD test score of the 90 subjects was $17.0{\pm}1.8$ at baseline. It was slightly reduced to $15.6{\pm}1.7$ after lamotrigine monotherapy (P>0.01). Prior to treatment, a total of 31 patients (34.4%) met the diagnostic criteria for ADHD according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, Of these 31 patients, 27 (87.1%) had significantly improved ADHD scores with lamotrigine monotherapy ($28.0{\pm}1.6$ reduced to $18.1{\pm}2.6$, P<0.001). Among these 27 patients, 25 (92.6%) showed normalized electroencephalogram (EEG) and 26 (96.3%) achieved total freedom from seizures within 12 months of the initiation of lamotrigine monotherapy. Conclusion: The results from our study show that lamotrigine had a positive effect in pediatric epilepsy patients by reducing ADHD symptoms, preventing seizures, and normalizing EEG. However, further research is required to determine whether lamotrigine is efficacious against ADHD symptoms independent of its effects on epileptic seizures.

• Child Health Nursing Research
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• v.17 no.2
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• pp.127-135
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• 2011

Purpose: The purpose of this study was to examine the relationship of mothers' recognition of Attention deficit hyperactivity disorder (ADHD), parenting stress and family support in mothers of children diagnosed with ADHD. Methods: The data were collected from December 24, 2009 to July 23, 2010. The participants were 141 mothers of children diagnosed with ADHD and who lived in D city. Descriptive statistics, t-test, ANOVA, Pearson correlation coefficients with SPSS 17.0 were used to analyze the data. To determine the most effective variable (mothers' recognition, parenting stress and family support) to predict parental stress, data were analyzed using canonical correlation with SAS 9.1 TS. Results: Canonical correlation analysis revealed that professional and teachers' roles of the 3 sub-domains of mothers' recognition were the most outstanding variables in predicting parenting stress. Parental distress/parent-child dysfunctional interaction of parenting stress was the most outstanding variable in predicting both mothers' recognition and family support. Spouse cooperation in family support was the most outstanding variable in predicting parenting stress. Conclusion: The results suggest that strengthening parents' recognition of ADHD and supporting interventions are important for reducing parenting stress. Professional and teachers' roles, parental distress/parent-child dysfunctional interaction and spouse cooperation should be included in the contents of structured programs.

• Child Health Nursing Research
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• v.17 no.2
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• pp.136-144
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• 2011

Purpose: The purpose of this study was to analyze teaching status and knowledge about children with Attention Deficit Hyperactivity Disorder (ADHD) in elementary school teachers. Methods: The participants of this study were 204 elementary school teachers in Busan. From July to September 2010, the researchers collected data by using self-report questionnaires consisted of questions about their teachers' characteristics and teaching status and KADDS (36 items) developed by Sciutto, Terjesen and Frank. Frequency, percentage, arithmetic mean, standard deviation, t-test and ANOVA were used to analyze the data using SPSS WIN 16.0 program. Results: Less than 50% of the participants had previous education on ADHD. According to this experience, there were significant differences in participants' knowledge about children with ADHD (t=4.703, p<.001). For the 36 items, participants had an average of $19.19{\pm}4.58$ points out of a possible 36. Moreover, lack of knowledge about teaching children with ADHD and communication problems with the parents of these children were considered to be the most disturbing factors. Conclusion: These results suggest that networks among teachers, parents and medical care professionals should be established. The results also indicate that educational programs for elementary school teachers should be developed in order to identify and teach children with ADHD appropriately.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.27 no.1
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• pp.48-55
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• 2016

Objectives: Children with attention-deficit hyperactivity disorder (ADHD) may have deficits in time perception, as assessed by the time estimation task and the time reproduction task, however its age-related trajectory is not yet determined. Therefore we examined the correlation between accuracy of time perception tasks and age, and the association between accuracy of estimation tasks and reproduction tasks. Methods: Sixty-three patients with ADHD, aged 8 to 18 years tested the tasks for five time durations (2, 4, 12, 45, and 60 seconds). Accuracy of tasks was assumed differences (absolute values) between raw results of tasks and original time durations. Spearman's correlation analysis was performed to determine correlation between accuracy of time perception tasks and age. Multivariate regression was used to determine the association of accuracy of estimation tasks with accuracy of reproduction tasks. Results: Age showed correlation with accuracy of estimation tasks, but not with that of reproduction tasks. We observed that the higher the accuracy in 12, 45, and 60 seconds duration time reproduction, the higher the accuracy in longer seconds duration time estimation. Conclusion: Age was correlated with time estimation accuracy whereas there was no impact on time reproduction accuracy. Association of each of the two time perception tasks, particularly in longer time duration, suggested specific impairments in time perception.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.27 no.1
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• pp.31-38
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• 2016

Pharmacotherapy is considered the first line therapy in attention-deficit hyperactivity disorder (ADHD). Many patients also choose complementary medicine such as dietary supplements. Omega-3 has shown some efficacy for improving ADHD symptoms in several studies. The goal of this review is to integrate the previous research findings on omega-3 and understand the issues worth considering in the treatment of ADHD. The terms "attention deficit disorder with hyperactivity", "omega-3", and "dietary supplements" were searched on PubMed, Cochrane, and Google scholar. The search was further limited to clinical trials, reviews, and meta-analyses. Trials that examined treatments for ADHD, used randomized design, and placebo-controlled trials were included. Eighteen clinical trials with a total of 1,141 participants were included in this review. Fifteen trials had parallel designs, comparing an omega-3/6 polyunsaturated fatty acid (PUFAs) or a combination of both to a placebo and three compared omega-3/6 PUFAs to a placebo and psycho-stimulants. Seven of the included trials showed significant improvements in groups receiving omega-3/6 PUFAs compared to placebo groups, however, 11 trials showed no significant differences. Evidence that PUFAs supplementation provides benefits for ADHD was yet limited. Mixed results were due to selection variability criteria, variability of supplementation, and short follow-up intervals.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.21 no.2
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• pp.72-79
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• 2010

Objectives : The purpose of this study was to examine the difference in functional impairment between children with attention-deficit hyperactivity disorder (ADHD) and normal controls, and to compare the functional impairment across ADHD subtypes. Methods : Children and adolescents with ADHD between the ages of 6 and 18 years were recruited for the study. Parents and teachers of the ADHD subjects completed the parents' and teachers' forms of the Children and Adolescents Functioning Impairment Scale (CAFIS), respectively. The results of these scales were compared to those of normal controls. Results : Subjects included 110 children with ADHD, predominantly inattentive type (ADHD-IA) ; 23 with ADHD, predominantly hyperactive-impulsive type (ADHD-HI) ; and 60 ADHD, combined type (ADHD-C). When compared to 41 normal controls, there were significant differences in CAFIS-parent and CAFIS-teacher scales for the ADHD group. Functional impairment in the family relationship as rated by the parents was higher in children with ADHD-C when compared to that of children with ADHD-IA. Conclusion : In comparison to normal children, children with ADHD have a higher level of impairment in several functional areas, and differences exist in functional impairment across ADHD subtypes. Further, ratings of functional impairment between parents and teachers were inconsistent. Thus, gathering information from the teachers is important when diagnosing or establishing treatment regimens for ADHD.

• Child Health Nursing Research
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• v.17 no.1
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• pp.39-47
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• 2011

Purpose: This study was done to determine whether a parenting education program using responsive teaching strategies is effective for parenting stress, maternal interactional behavior and behavioral problems in children at risk for Attention Deficit Hyperactivity Disorder (ADHD). Methods: Participants in this study were 17 elementary school children and their parents. The ADHD risk group was determined by scores on the Korean-ADHD Rating Scale. The parenting education program was developed based on Dr. Mahoney's responsive teaching curriculum. Mothers participated in the program once a week for 8 sessions. Treatment outcome was evaluated using the Korean version of the Child Behavior CheckList (K-CBCL), parenting stress, maternal interactional behavior, and child pivotal developmental behavior. Data were analyzed using Wilcoxon signed rank test, Mann-Whitney test, and regression analysis. Results: After the parenting education program, no significant difference in parenting stress (Z=-1.00, p=.320) was found, but there was a significant decrease in the child's internal behavior problems (Z=-2.05, p=.040), and also a significant improvement in maternal interactional behavior and a significant difference in child pivotal developmental behavior (Z=-2.67, p=.008). Conclusion: The results indicate that parenting education programs based on responsive teaching strategies are effective and that application of a program is recommended to prevent behavioral problems and improve maternal child interaction for children at risk for ADHD.

• Clinical Psychopharmacology and Neuroscience
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• v.16 no.4
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• pp.407-414
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• 2018

Objective: Anxiety has been shown to influence functional impairment in patients with attention deficit hyperactivity disorder (ADHD). This study aimed to compare functional impairment in subjects with and without adult ADHD and to investigate the associations among trait anxiety, functional impairment, and ADHD symptom severity. Moreover, the effects of ADHD symptom subtypes on trait anxiety and functional impairment were also examined. Methods: The sample included 209 adults between the ages of 20 and 31 years. Fifty-one adults received a diagnosis of ADHD, and an additional age, sex-matched group of 51 adults comprised the adult control. Participants were assessed with Conners' Adult ADHD Rating Scales (CAARS), the Beck Depression Inventory (BDI), the Spielberg Trait Anxiety Inventory (STAI-T), and the Sheehan Disability Scale (SDS). The relationships among ADHD severity, anxiety, and functional impairment were investigated using Pearson's correlation analysis. Subtypes of ADHD symptoms that predicted anxiety and functional impairment were investigated using regression analyses. Results: Adult ADHD patients significantly differed from normal control subjects according to BDI, STAI-T, and SDS assessment. Significant positive correlations were noted between ADHD severity, anxiety, and functional impairment. Multiple linear regression analysis confirmed anxiety as a mediator between functional impairment and ADHD CAARS symptom subscales. Conclusion: Patients with adult ADHD showed higher levels of anxiety, depression, and functional impairment. Additionally, ADHD symptoms and anxiety impacted subject functional impairment. Our results suggest that anxiety may be a strong mediator between ADHD severity and functional impairment.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.30 no.3
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• pp.121-126
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• 2019

Objectives: Awareness of attention-deficit/hyperactivity disorder (ADHD) in adults has significantly increased; however, clinical data specific to the Korean population are insufficient. Clinical experience of ADHD may differ based on whether psychiatrists have received pediatric psychiatry-specific training. In order to prepare a practice parameter for adult ADHD patients in Korea, we examined questionnaire data to observe how pediatric psychiatry training could affect clinical practice for adults with ADHD. Methods: A questionnaire about the diagnosis and treatment process was distributed to both general psychiatrists (GPsy) and child and adolescent psychiatrists (CAP) at the summer and winter workshop meetings of Korean Academy of Child and Adolescent Psychiatry. Results: In total, 142 psychiatrists participated in the survey (86 GPsy, 56 CAP). GPsy and CAP preferred pharmacotherapy (GPsy 82.40%, CAP 64.30%) as the primary treatment option and answered that the clinical psychiatric interview is the most necessary step in diagnostic assessment (GPsy 22.16%, CAP 19.00%). The GPsy responded with an optimal and average treatment duration that was shorter than that reported by CAP. Conclusion: Identification of the initial presenting symptom as the correct diagnosis and the optimal duration of pharmacotherapy differed between GPsy and CAP in practice, whereas concepts in diagnosis and treatment of ADHD in adults were similar for both groups. These results suggest the urgent need for the Continuing Medical Education program for psychiatrists treating adults with ADHD.