• 제목/요약/키워드: 주의력결핍

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주의력결핍 과잉행동장애 한국형 치료 권고안 개정안(III) - 약물치료 - (The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (III) - Pharmacological Treatment -)

  • 김효원;김은주;김지훈;박장호;반건호;이연정;정경운;신동원
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제28권2호
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    • pp.70-83
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    • 2017
  • The objective of this review is the revision of the Korean practice parameters for the pharmacological treatment of attention-deficit hyperactivity disorder (ADHD) based on the change in the diagnostic system from DSM-IV-TR to DSM-5 and psychopharmacological developments. For the evidence-based approach, the authors conducted a review of the literature, including controlled clinical trials, studies of the side effects of drugs, toxicology and meta-analyses from the United States and Europe, as well as recent research conducted in Korea. The review committee composed of Korean experts on ADHD reviewed the revised parameters. This revised version reveals how to use central nervous system psychostimulants, non-stimulants such as atomoxetine and alpha2 agonists, and other medication for ADHD, and how to manage the adverse effects of such medication. At the end of this revised version, the authors propose recommendations for the pharmacotherapy of ADHD.

주의력결핍 과잉행동장애 한국형 치료 권고안(IV) - 비약물적 치료 - (The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (IV) - Non-Pharmacologic Treatment -)

  • 신윤미;김의정;김윤신;방수영;이은하;이철순;장형윤;홍민하;신동원
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제28권2호
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    • pp.84-95
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    • 2017
  • Attention-deficit hyperactivity disorder (ADHD) is a neuropsychiatric disorder that begins in early childhood and can persist throughout adulthood. ADHD causes difficulties in various area of life, such as academic achievement, peer relationships, family functioning, employment and marriage. Although ADHD is known to respond well to medication, such treatment is more effective when combined with psychosocial (non-pharmacologic) therapy in terms of alleviating the core symptoms and improving appropriate functions. Psychosocial treatment interventions are divided into psychoeducation, behavioral parent training, school intervention, cognitive behavior therapy, social skill training, parent-child interaction therapy, play therapy, other treatments (coaching, complementary and alternative medicine), neurofeedback and Cogmed. Adult ADHD cognitive behavioral therapy is described separately. These practice parameters summarize the evidence for psychosocial treatment. Based on this evidence, specific recommendations are provided for psychosocial interventions.

주의력결핍 과잉행동장애 아동에서 감정인식능력 및 충동성이 공격성에 미치는 영향 (The Effect of Impulsivity and the Ability to Recognize Facial Emotion on the Aggressiveness of Children with Attention-Deficit Hyperactivity Disorder)

  • 배승민;신동원;이수정
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제20권1호
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    • pp.17-22
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    • 2009
  • Objectives : A higher level of aggression has been reported for children with attention-deficit/hyperactivity disorder (ADHD) than for non-ADHD children. Aggression was shown to have a negative effect on the social functioning of children with ADHD. The ability to recognize facial emotion expression has also been related to aggression. In this study, we examined whether impulsivity and dysfunctional recognition of facial emotion expression could explain the aggressiveness of children with ADHD. Methods : 67 children with ADHD participated in this study. We measured the ability to recognize facial emotion expression by using the Emotion Recognition Test (ERT) and we measured aggression by the T score of the aggression subscale of the Child Behavior Checklist (CBCL). Impulsivity was measured by the ADHD diagnostic system (ADS). Results : The teacher rated level of aggression was related to the score of recognizing negative affect. After controlling for the effect of impulsivity, this relationship is not significant. Only the score of the visual commission errors ex plained the level of aggression of children with ADHD. Conclusion : Impulsivity seems to have a major role in explaining the aggression of children with ADHD. The clinical implication of this study is that effective intervention for controlling impulsivity may be expected to reduce the aggression of children with ADHD.

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교사의 내·외통제성과 지도성 유형이 학령기 주의력결핍 과잉행동장애 학생의 교육적 중재에 미치는 영향 (Effects of teachers' internal-external control and leadership type on educational intervention for School-aged Attention Deficit Hyperactivity Disorder)

  • 조영경;박완주
    • 한국간호교육학회지
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    • 제20권3호
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    • pp.382-391
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    • 2014
  • Purpose: The purpose of this study was to identify the predictors influencing on educational intervention for Attention Deficit Hyperactivity Disorder (ADHD) after analyzing the relationship among teachers' internal-external locus of control, leadership type and educational intervention for ADHD. Methods: A cross sectional study design was conducted with 255 teachers in three schools located in D, K and Y city. The data were analyzed by t-test, one-way ANOVA, Pearson correlation coefficients and multiple regression using SPSS 20.0. Results: Internal locus of control showed significantly positive correlations with educational intervention for ADHD. Efficient leadership type, harmony-oriented leadership type showed significant differences in inefficient leadership type on educational intervention for ADHD. Significant factors of the educational intervention were efficient leadership type, harmony-oriented leadership type, task-oriented leadership type and internal locus of control that were explained by 20.0% (F=12.5, p<.001) of educational intervention for ADHD. Conclusion: Based on the findings of this study, it is necessary to have teacher's efficient leadership type focused on ADHD symptoms. Teachers need to enhance their positive domain of internal-external locus of control towards students with ADHD to increase the effectiveness of their educational interventions for ADHD.

야뇨증을 보이는 일반아동에서의 정서-행동 문제 (EMOTIONAL AND BEHAVIORAL PROBLEMS OF NOCTURNAL ENURESIS CHILDREN IN GENERAL POPULATION)

  • 이영식;김은영;나철;전창무
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제11권1호
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    • pp.42-50
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    • 2000
  • 연구 목적:현재 야뇨증에서 흔히 보이는 문제행동이 야뇨증의 원인인지, 결과인지, 아니면 공존하는 동반된 문제인지에 대한 의견이 분분하다. 저자들은 기존 연구의 대상이 대부분 임상환자였다는 점을 감안하여 비임상군을 연구대상으로 하여 야뇨증 아동에서 흔히 보이는 문제행동이 무엇인지를 알아보고 이를 통하여 야뇨증과 문제행동간의 관련성을 밝히고자 본 연구를 시행하였다. 방 법:충청북도 영동군 소재의 2개 초등학교 학생 1,421명중 야뇨증이 있는 72명을 환자군으로 하였고, 연령, 학년, 성별을 대비시킨 72명의 정상아동을 대조군으로 하여 수정된 아동행동조사표를 시행하였다. 결 과:야뇨증 아동에서 불안-공포 척도, 우울 척도, 주의력결핍-과잉활동 척도, 비행 척도의 점수가 의미있게 높게 나왔다. 주의력결핍-과잉활동 척도의 점수는 성별과 학년에 관계없이 항상 의미있게 높게 나왔으며 남자와 고학년에서는 비행 척도가 의미 있었고, 여자와 저학년에서는 불안-공포 척도가 의미 있었다. 결 론:야뇨증 아동에서 다양한 문제행동이 존재한다는 것을 알았고 야뇨증 환자의 치료시 이런 문제행동들에 좀더 주의를 기울이고, 더 많은 관심을 가져야 한다는 것을 알게 되었다.

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주의력결핍 과잉행동장애, 과거에도 있었을까? - 역사적 고찰을 중심으로 - (ADHD, New Developed or Newly Found : Historical Review)

  • 반건호;배재호;문수진;민정원
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제22권2호
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    • pp.57-66
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    • 2011
  • Introduction : Attention-deficit hyperactivity disorder (ADHD) was a newly coined term for a disease that existed prior to its naming in the mid 20th century. The issue about whether ADHD is a new disorder or merely a new name for an existing disorder is still controversial. The authors tried to find the clues to the answer for this question through reviewing historical documents for traces of ADHD. Contents : We could find literatures and medical records that contain possible ADHD symptoms. In particular, in 1845, Heinrich Hoffmann's 'fidgety Philip' or 'Johnny Look-in-the-air' nearly satisfies today's criteria for ADHD. Methylphenidate was approved as a promising chemical for inattention in 1957 before the establishment of the concept of ADHD. In 1968, ADHD was first officially introduced as "Hyperactivity Reaction of Childhood" by DSM-II. In 1980, DSM-III, 'Attention Deficit Disorder (ADD)' was adopted as an official diagnostic term and changed to 'ADHD' since the creation of DSM-III-R in 1987. Conclusion : As stated above, ADHD has existed since long ago and became familiar via an advanced diagnostic system and therapeutic options.

주의력결핍 과잉행동장애, 불안장애 아동의 실행기능 비교 (Comparison of Executive Function in Children with ADHD and Anxiety Disorder)

  • 박순말;신민섭
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제21권3호
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    • pp.147-152
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    • 2010
  • Objectives : The purpose of this study was to investigate the deficits in executive function in children with ADHD and anxiety disorder, and further, to characterize executive function deficits among the two groups. Methods : Subjects consisted of 60 children between the ages of 5 and 14 (16 Normal, 24 ADHD, 20 Anxiety Disorder). Neuropsychological tests (KEDI-WISC, CCTT, STROOP, WCST, ROCF) for assessing cognitive and executive function were individually administered to all subjects. Results : There were no significant differences in FSIQ or PIQ among the three groups. However, the ADHD group tended to score lower on the VIQ and subtest of similarity, vocabulary, and digit span tests. The three groups did not significantly differ with respect to CCTT test results. On the STROOP test, the ADHD group showed poor performance on the word, color, and color-word subtests. The three groups did not exhibit significant differences in WCST test results ; however, the anxiety group performed poorly belonging to below 25 percentile rank on perseverative response. On the ROCF test, the ADHD group performed poorly with respect to their organization score and in particular, regarding copy and immediate recall. The anxiety group also performed poorly with regard to organization ; however, this was limited only to immediate recall. Conclusion : Children with ADHD displayed poor inhibition and organizational abilities compared to children with anxiety and normal controls. Further, children with anxiety disorder exhibited low cognitive flexibility and voluntary problem-solving abilities compared to ADHD children and normal controls. Based on these results, we suggest that the characteristics of executive dysfunction in ADHD and anxiety disorder in children are different.

주의력결핍 과잉행동장애의 이환 여부에 따른 얼굴표정 정서 인식의 차이 (Difficulty in Facial Emotion Recognition in Children with ADHD)

  • 안나영;이주영;조선미;정영기;신윤미
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제24권2호
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    • pp.83-89
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    • 2013
  • Objectives : It is known that children with attention-deficit hyperactivity disorder (ADHD) experience significant difficulty in recognizing facial emotion, which involves processing of emotional facial expressions rather than speech, compared to children without ADHD. This objective of this study is to investigate the differences in facial emotion recognition between children with ADHD and normal children used as control. Methods : The children for our study were recruited from the Suwon Project, a cohort comprising a non-random convenience sample of 117 nine-year-old ethnic Koreans. The parents of the study participants completed study questionnaires such as the Korean version of Child Behavior Checklist, ADHD Rating Scale, Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. Facial Expression Recognition Test of the Emotion Recognition Test was used for the evaluation of facial emotion recognition and ADHD Rating Scale was used for the assessment of ADHD. Results : ADHD children (N=10) were found to have impaired recognition when it comes to Emotional Differentiation and Contextual Understanding compared with normal controls (N=24). We found no statistically significant difference in the recognition of positive facial emotions (happy and surprise) and negative facial emotions (anger, sadness, disgust and fear) between the children with ADHD and normal children. Conclusion : The results of our study suggested that facial emotion recognition may be closely associated with ADHD, after controlling for covariates, although more research is needed.

주의력결핍 과잉행동장애의 진단 보조도구로 뉴로가이드와 IVA + Plus의 유용성에 관한 예비연구 (A Preliminary Evaluation of NeuroGuide and IVA + Plus as Diagnostic Tools for Attention-Deficit Hyperactivity Disorder)

  • 양정인;김소율;김영성;이재원
    • 생물정신의학
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    • 제19권1호
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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.

한국인 주의력결핍 과잉행동장애와 세로토닌 1B 수용체 유전자 다형성의 관련성:가족기반 연구 및 환자-대조군 연구 (A Family-Based and Case-Control Association Study of the Serotonin 1B Receptor Gene Polymorphism in Korean Attention Deficit Hyperactivity Disorder)

  • 박태원;김붕년;임명호;유희정;강대희;정영철
    • 생물정신의학
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    • 제11권2호
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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.

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