• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.19 no.3
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• pp.147-155
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• 2008

Objectives: The purpose of this study was to evaluate the efficacy and tolerability of osmotic release oral system-methylphenidate (OROS-MPH) in children with attention-deficit hyperactivity disorder (ADHD) and comorbid psychiatric disorders. Methods: This was an 8-week open label study of OROS-MPH monotherapy. The subjects were 113 children with ADHD aged 6-12 years. Outcome measures were the Korean version of the parent ADHD Rating Scale (K-ARS), Korean version of the Conners Parent Rating Scale (K-CPRS), Clinical Global Impression-Severity and Clinical Global Impression-Improvement. Side effects were monitored using Barkley's Side Effect Rating Scale. We compared the change-over-time in the mean scores of the outcome measure according to the comorbidity of disruptive behavior disorder, depressive disorder, anxiety disorder, and tic disorder. Results: The mean K-ARS and K-CPRS scores were significantly decreased, regardless of the comorbidity. The mean doses of OROS-MPH and dropout rate did not differ significantly according to comorbidity. The OROS-MPH was well tolerated, regardless of the comorbidity. However, children with tic disorder reported a higher frequency of tics or nervous movements between the $2^{nd}\;and\;8^{th}$ week than those without tic disorder. Conclusion: The OROS-MPH is effective for decreasing the symptoms of ADHD, and it is well tolerated, even by patients with comorbid psychiatric disorders.

• The Journal of the Korea Contents Association
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• v.14 no.12
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• pp.854-862
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• 2014

Attention deficit hyperactivity disorder (ADHD) students' intellctual defects, learning problems, and poor academic achievements seem to be due to significantly lower intelligence compared to the normal students, but rather the characteristic of inability to pay attention at a given time can be seen as the more attributing reason. In this study, a comparison between the ADHD students and the normal students will be performed using a fMRI analysis in order to differentiate the brain function between the two groups during a working memory task performance and to assess the difference in the activated regions of the brain. Clinical survey examinations and fMRI measurements were performed for a group of 26 elementary students from the Incheon area. The stimulus of fMRI was a working memory. Cartography statistically analyzed parameters and the Statistical Package of Social Sciences using single-sample t-test, two-sample t-test, were analyzed by multiple regression analysis, the statistical significance level was p<0.05 in, respectively. The disproportionate developments could be seen in the ADHD students group such as the frontal cortex, parietal cortex, thalamus, and caudate nucleus, among others. In addition, as some students felt the increase in the difficulty of working memory task performance, the orbitofrontal cortex and the hippocampus were activated, which seems to be the result of an effort for looking for an answer. More types of ADHD students needs to be secured as research subjects, and more stimulations for fMRI experiments should be considered as it would be useful in the overall evaluation of brain function.

• The Journal of Korean Academy of Sensory Integration
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• v.18 no.1
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• pp.56-72
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• 2020

Objective : The purpose is to analyze the effects of parent training interventions in reducing the symptoms of Attention Deficit Hyperactivity Disorder (ADHD) and to provide a basis for the effects. Methods : We collected literature published in international academic journals from 2009 to 2019 through ProQuest and Scopus databases. The search key terms were (ADHD OR Attention Deficit Hyperactivity Disorder) AND (Parent OR Mother OR Father) AND (Training OR Program OR Therapy OR Intervention) AND (Randomized OR Randomised OR Randomly). The PEDro scale was used to evaluate the quality of the studies, and a meta-analysis was conducted through Comprehensive Meta-Analysis 3.0. Results : Of 628 studies that we reviewed, 20 were eligible for inclusion. of parental training interventions for children with ADHD appeared close to a medium effect size while parent-child interventions (0.639) appeared to have a medium to large effect size. Oppositional defiant behavior and conduct disorder (0.737) in children and children's emotions (0.679) appeared close to a large effect size. ADHD symptoms hyperactivity and impulsivity (0.590) and child behavior (0.521) appeared to be over a medium effect size. We chose a random-effects model since heterogeneity tests showed significant results. Conclusion : We were able to confirm the effects of parent training interventions on the symptoms of children with ADHD. This will be used as evidence to provide a clinical basis for occupational therapists. More research related to parental training interventions should be carried out to ensure better reporting in the future.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.6 no.1
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• pp.65-73
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• 1995

We conducted the comparative study of the effects of the parent training combined with medication and the medication only on 23 ADHD children with the age from 5 to 11(body 22, girl 1). Mothers of combined treatment group(parent training+medication) attended, the parent training program once a week for 8 consecutive weeks and booster session 1 month later. Children of both groups were assessed twice before and after treatment using the various using scales and TOVA to evaluate the treatment effects. The results of present study showed the greater effectiveness of the medication+parent training over the medication only in reducing the parenting stress of mothers as well as the inattention and behavioral problems of ADHD children. In medication only group while the scores of mother's rating did not change significantly after treatment, those of teacher's rating and TOVA tend to be decreased to normal range. These results suggested that methylphenidate is effective on improving attentional problems of ADHD children, but not on behaviral problems at home. These results mean that parent training is needed for reducing behavioral problems of ADHD children, negative interactions in mother-child relation, and parenting stress as well as maxmizing medication effect.

• Korean Journal of Biological Psychiatry
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• v.19 no.1
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• pp.45-52
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• 2012

Objectives : This study was designed to investigate the usability of IVA + Plus (Continuous Performance Test) and Neuro-Guide [Quantitative electroencephalography (EEG) normative database] as an auxiliary diagnostic tools for attention-deficit hyperactivity disorder (ADHD). Methods : The scores of IVA + Plus and resting EEG were obtained from 34 elementary school-aged children. Also, the Korean ADHD Rating Scale (K-ARS) and the Diagnostic Interview Schedule for Children version IV (DISC-IV) was done for the parent of them. From the result of the DISC-IV, we divided them into three groups, ADHD Not Otherwise Specified (NOS), and Normal Control (NC). Using NeuroGuide, the z-scores of relative power for delta (1-4 Hz), theta (4-8 Hz), alpha (8-12 Hz), and beta (12-25 Hz) were calculated. Then the correlation and variance analysis were done to investigate the differences between three groups. Results : The scores of IVA + Plus were negatively correlated with the K-ARS. IVA + Plus have successfully discriminated the ADHD from NC and NOS. The z-scores of relative power of delta and theta were positively correlated with the K-ARS. The z-scores of relative power of alpha and beta were negatively correlated with the K-ARS. Conclusions : The IVA + Plus and NeuroGuide QEEG test are expected to be used as the valuable tools for diagnosing ADHD accurately.

• Korean Journal of Biological Psychiatry
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• v.11 no.2
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• pp.146-154
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• 2004

Objective:Attention deficit hyperactivity disorder(ADHD) is the most common childhood psychiatric disorder, affecting 3-5% of school-aged children. Although the biological basis of ADHD is unknown, family studies provide strong evidence that ADHD has a genetic basis. Recent genetic studies have suggested associations between ADHD and serotonin 1B(5HT1B) receptor gene G861C polymorphism. The aim of this study is to test for the association between ADHD and 5HT1B receptor gene G861C polymorphism in Korean population. Method:We processed DNA extraction and genotyping. 106 Korean children with ADHD and their parents were analyzed using the transmission disequilibrium test(TDT) and haplotype-based haplotype relative risk (HHRR). And the ADHD children were compared with 212 age and gender matched normal controls. Results:There was no statistical difference of distributions between ADHD cases and controls. We did not observe any preferential transmission of alleles of 5HT1B receptor gene G861C polymorphism in ADHD. Conclusions:Though there is the possibility of failing to detect small genetic effects, our results show no evidence of an association between ADHD and 5HT1B receptor gene G861C polymorphism in the Korean population and indicate that it is unlikely that the 5HT1B receptor is implicated in the susceptibility to ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.139-152
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• 2002

Objectives：This study was conducted to compare the clinical and neuropsychological characteristics by DSM-IV subtypes of attention deficit hyperactivity disorder(ADHD) patients who did not have comorbid psychiatric disorders. Methods：5-15 year old children with ADHD were recruited at psychiatric outpatient clinic of Yeungnam University hospital and the patients with comorbidity or neurological abnormalities were excluded. Finally, total 404 children with ADHD were selected for this study. There were 234 subjects of ADHD-C(57.9%), 156 subjects of ADHD-I(38.6%) and 14 subjects of ADHD-HI(3.5%), who fulfilled the DSM-IV diagnostic criteria. The mean age of the total subjects was 9.63±2.49 years old. The psychopathology, IQ, behavioral problems, neuropsychological executive function were evaluated before pharmacological treatment. The measures were Korean Personality Inventory of Child(K-PIC) for psychopathology, 4 behavioral check lists(ADDES-HV, ACTeRS, CAP, SNAP) for behavioral symptoms of ADHD, K-ABC and KEDI-WISC for IQ and Conner's CPT, WCST, SST for neuropsychological executive functions. Results：1) The prevalence of subtypes was ADHD-C, ADHD-I, ADHD-HI in decreasing order. There was no sex difference of prevalence among three subtypes. The mean age of ADHD-I was older than other subtypes. 2) There was significant differences of psychopathology among subtypes, the ADHD-C and ADHD-HI had higher than the ADHD-I in the scores of delinquent, hyperactivity and psychosis；the ADHD-C had higher than the ADHD-I in the scores of family relation and autism, the scores of ego resilience were lower than the ADHD-I. However, there was no difference in anxiety, depression and somatization scores among them. 3) The results of behavioral symptom check lists, the ADHD-C had higher the score of inattention, hyperactivity and impulsivity than the ADHD-I. Meanwhile the results of ACTeRs, which rated by the teachers, were different. 4) There were significant differences of sequential processing scale and arithmetics among subtypes in IQ using K-ABC, but there was no significant difference between the ADHD-C and the ADHD-I after excluding the ADHD-HI due to small numbers. 5) There was numerical difference among subtypes but did not reach statistical significance in three neuropsychological executive function tests. Conclusion：In conclusion, our results revealed that there was significant difference in clinical features among three subtypes but, no significant difference in executive functions.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.1
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• pp.34-42
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• 1997

Enuresis is repeated involuntary or intentional voiding of urine into bed or clothes over age 5. Though it would be a self-remitting disorder, it could be serious problem in emotional and socio-adaptational aspects. The author reviewed the enuretic patients of Child & Adolescence psychiatric section in Chungnam National University Hospital during past 3 years. 46(4.9%) of 936 patients were diagnosed as enuresis in DSM-Ⅳ. The author evaluated their comorbidity by the data of diagnostic review made in two psychiatrists, and emotional aspects(self-concept, anxiety, depression) through the self-rating scales (Piers-Harris children’ self concept scales, RCMAS, state-trait anxiety inventory for children, child’s depresson inventory). Thirty(65.2%) of the 46 enuretic patients had additional diagnoses such as attention deficit hyperactive disorder, mental retardation, encopresis, oppositional defiant disorder, depression, anxiety disorder, autism, somatoform disorder, tic disorder, obsessive-compulsive disorder, sleep disorder, etc. Sixteen enuretic patients had at least one comorbid disorder. Eleven patients had two, and three patients had more than three. Fourteen of 46 enuretic patients were evaluated through self-rating scales of self-concept, anxiety and depression. But we couldn’t obtain meaningful results. Maybe it was due to the small sample size(N＝14) and the influence of the comorbid disorders. Finally, it was an impressive evidence that there exist many comorbid disorders in enuresis(esp. attention deifict/hyperactive disorder). In emotional aspects, the author thought that further evaluation should be needed for more meaningful results.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.16 no.1
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• pp.124-131
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• 2005

Childhood and adolescent onset-bipolar disorders have higher rate of comorbidity with anxiety disorders as well as attention deficit hyperactivity disorder and conduct disorder. Obsessive compulsive disorder, social phobia, panic disorder, and separational anxiety disorder are common comorbid anxiety disorders with bipolar disorders in child and adolescent. Prospective and reliable data on temporal and causal relationship between the onset of bipolar disorders and the onset of comorbid anxiety disorders are still in debate. The authors report 2 adolescent cases with antidepressant induced-manic episodes with preceding anxiety symptoms. The authors suggest careful prescription of antidepressants for anxiety disorders, even for those who do not have definite past history or family history of bipolar disorders. Further comprehensive and prospective studies are requested for the temporal relationship and pharmacological guideline for comorbid bipolar disorders and anxiety disorder in child and adolescent.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.1 no.1
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• pp.89-93
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• 1990

60 Attention-deficit hyperactive patients treated with stimulant drugs such as methylphenidate and pemoline were evaluated in regards to the therapeutic benefit and side effects of these drugs. The results were as follows : 1) Of the 60 subjects 34 showed considerable imporvement and only 8 showed little or no improvement. 2) Hyperactivity, inattention and impulsivity were improved markedly by stimulants These behavioral changes were accompanied by improved performance in classroom. 3) School age children tended to show more improvement than preschool children or adolescence. 4) Of the 60 subjects 25 showed no side effect and only 6 showed severe side effects, and common side effects were decreased appetite, insomnia and irritability or nervousness. It is the author's impression that despite of the therapeutic efficacy of these drugs when they were administered on a short-term basis, long-term outcome dose not seem to be altered by the administration of these agents.