• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.3
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• pp.190-196
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• 2015

Objectives : The aim of this study was to determine whether children with Tourette disorder (TD) have functional impairment and executive dysfunction in comparison to children with attention-deficit hyperactivity disorder (ADHD) and non-affected controls. Methods : From January 2006 to December 2013, 45 children and adolescents with TD and 50 children and adolescents with ADHD diagnosed at the Soonchunhyang University Bucheon Hospital and 50 non-affected controls were enrolled in this study. Functional impairment of the subjects was assessed using the Child and Adolescents Functioning Impairment Scale (CAFIS), parent and teacher versions. In addition, neuropsychological tests including Stroop color-word Test, Finger windows Test (FWT), and Digit span were administered. Outcomes were compared across the TD, ADHD, and non-affected controls. Results : No difference in CAFIS-parent and CAFIS-teacher results was observed between children with TD and non-affected controls, whereas, children with ADHD showed more impairments relative to non-affected controls in the CAFIS-parent. According to the Stroop color-word Test, FWT, and Digit span, executive function in children with TD did not differ from non-affected controls. Children with ADHD had poorer performance in measures of the Stroop color-word Test compared to children with TD. Conclusion : Children and adolescents with TD but not ADHD were not significantly different from non-affected controls on most measures of functional impairment and executive function. These findings suggest that an education program and intervention for children with TD would be important to reducing the stigma of TD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.3
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• pp.183-189
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• 2015

Objectives : The aim of this study was to investigate Korean Wechsler Intelligence profiles and specific abilities related to attention problem of children with attention-deficit hyperactivity disorder (ADHD). Methods : The Korean Wechsler Intelligence Scale for Children-fourth edition (K-WISC-IV) and Advanced Test of Attention (ATA) were administered to 91 children and adolescents (age $8.5{\pm}2.6$ years, 73 boys) with ADHD. Pearson correlation and independent t-tests were used. Results : The means of Working Memory Index (WMI) and Processing Speed Index (PSI) showed a score of low average in K-WISC-IV. WMI scores for the K-WISC-IV showed clinically significant correlations with omission errors, commission errors, and response time variability on auditory ATA. PSI scores also showed significant correlations with response time and variability on visual ATA. In addition, significantly lower digit span backward scores were observed in hyperactive-impulsive/combined subtypes compared to inattentive subtype (t=3.60, p<.001). Conclusion : Children with ADHD showed significantly lower scores in WMI and PSI which were clinically correlated with ATA scores, and hyperactive-impulsive/combined subtypes showed poorer working memory functions in WMI. Follow-up studies are proposed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.22 no.4
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• pp.246-252
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• 2011

Background : The objective of this study was to evaluate the diagnostic efficiency of the Comprehensive Attention Test (CAT) by comparing the results of the continuous performance test (CPT) and the CAT in children and adolescents with attention-deficit hyperactivity disorder (ADHD). Method : A total of 110 children and adolescents with ADHD (mean age : 11.2${\pm}$2.9 years, 76 boys) and 36 children and adolescents without ADHD (mean age : 12.0${\pm}$2.7 years, 25 boys) completed the CAT. We compared the specificity and sensitivity of the CPT and CAT at two different cut-off points via the McNemar test. The areas under the receiver operating characteristic curves (AUC) between the two groups were compared using Medcalc software. Results : The sensitivity and specificity of the CPT were .419 and .806, respectively. The sensitivity of the CAT was .827, which was significantly higher than that of the CPT (p<.001), and the specificity of CAT is .444, which was significantly lower than that of CPT (p<.001). The AUC of the CPT and CAT was .664 and .692, respectively, and there were no significant difference between the two groups on the paired comparison (p=.513). Conclusions : The results of this study suggest that the CAT has moderate specificity and high sensitivity. The CAT can be used as a useful tool to evaluate the neuropsychological function of children and adolescents with ADHD.

• 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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.29 no.3
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• pp.129-136
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• 2018

Objectives: This study aimed to evaluate the efficacy of the attention-deficit/hyperactivity disorder (ADHD)-After School Checklist (ASK) by comparing the results of the Comprehensive Attention Test (CAT) and Clinical Global Impression-Severity (CGI-S) Scale and then by calculating the area under the receiver operating characteristic (ROC) curve. Methods: We performed correlation analyses on the ASK and CAT results and then the ASK and CGI-S results. We created a ROC curve and evaluated performance on the ASK as a diagnostic tool. We then analyzed the test results of 1348 subjects (male 56.8%), including 1201 subjects in the general population and 147 ADHD subjects, aged 6-15 years, from kindergarten to middle school in Seoul and Gyeonggi province, South Korea. Results: According to the correlation analyses, ASK scores and the Attention Quotient (AQ) of CAT scores showed a significant correlation of -0.20--0.29 (p<0.05). The t-test between ADHD scores and CGI-S also showed a significant correlation (t=-2.55, p<0.05). The area under the ROC curve was calculated as 0.81, indicating good efficacy of the ASK, and the cut-off score was calculated as 15.5. Conclusion: The ASK can be used as a valid tool not only to evaluate functional impairment of ADHD children and adolescents but also to screen ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.29 no.3
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• pp.144-148
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• 2018

Objectives: Previous studies have reported that internet addiction (IA) is associated with attention-deficit/hyperactivity disorder (ADHD) consistently. However, in terms of gender, there are controversial findings. We aimed to investigate the relation between IA and self-acknowledged ADHD traits among female college students in Japan. Methods: The study questionnaire consisted of questions about demographics, Adult ADHD Self-Report Scale-V1.1 Part A (ADHD screener) and Young's Internet Addiction Test (IAT). When four or more items are more frequent than the cut-off on ADHD screener, the subject was categorized into students with a positive ADHD screen. We defined students with total IAT score of 70 and higher as IA. Results: A total number of respondents was 369 (mean age: $19.0{\pm}0.7years$). Seventy-seven subjects were screened positive on ADHD screener (20.9%). Students with a positive ADHD screen scored significantly higher on the IAT ($54.2{\pm}14.2$ vs. $42.5{\pm}11.3$). The rates of IA in students with and without a positive ADHD screen were 18.2% and 1.0%, respectively. Conclusion: Results of this study demonstrated the relation between IA and self-evaluated ADHD traits among female college students in Japan. Appropriate education for students on how to use the internet properly will be necessary to prevent IA.

• 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.

• 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.

• The Korean Journal of Physiology and Pharmacology
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• v.23 no.6
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• pp.483-491
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• 2019

Cordycepin exerts neuroprotective effects against excitotoxic neuronal death. However, its direct electrophysiological evidence in Alzheimer's disease (AD) remains unclear. This study aimed to explore the electrophysiological mechanisms underlying the protective effect of cordycepin against the excitotoxic neuronal insult in AD using whole-cell patch clamp techniques. ${\beta}$-Amyloid ($A{\beta}$) and ibotenic acid (IBO)-induced injury model in cultured hippocampal neurons was used for the purpose. The results revealed that cordycepin significantly delayed $A{\beta}$ + IBO-induced excessive neuronal membrane depolarization. It increased the onset time/latency, extended the duration, and reduced the slope in both slow and rapid depolarization. Additionally, cordycepin reversed the neuronal hyperactivity in $A{\beta}$ + IBO-induced evoked action potential (AP) firing, including increase in repetitive firing frequency, shortening of evoked AP latency, decrease in the amplitude of fast afterhyperpolarization, and increase in membrane depolarization. Further, the suppressive effect of cordycepin against $A{\beta}$ + IBO-induced excessive neuronal membrane depolarization and neuronal hyperactivity was blocked by DPCPX (8-cyclopentyl-1,3-dipropylxanthine, an adenosine $A_1$ receptor-specific blocker). Collectively, these results revealed the suppressive effect of cordycepin against the $A{\beta}$ + IBO-induced excitotoxic neuronal insult by attenuating excessive neuronal activity and membrane depolarization, and the mechanism through the activation of $A_1R$ is strongly recommended, thus highlighting the therapeutic potential of cordycepin in AD.

• 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.