• Title/Summary/Keyword: 주의력결핍 과잉운동장애

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The Comorbidity of Attention Deficit Hyperactivity Disorder and the Effect of Methylphenidate on it (주의력 결핍 과잉 운동 장애 환자들의 약물치료 효과 및 Comorbidity에 관한 연구)

  • Lee, Jong-Bum;Park, Hyung-Bae
    • Journal of Yeungnam Medical Science
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    • v.10 no.1
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    • pp.166-178
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    • 1993
  • The objectives of this study were to evaluate the effect of methylphenidate on attention deficit hyperactivity disorder (ADHD) and the comorbidity of the disorder, using child attention problem checklist to 56 (male: 38, female: 18) patients from, March 992 to February 1993. The results were as follows: Among 56 subjects, ADHD alone were 20 (335.71%) subjects, and with one additional diagnosis were 31 (55.35%) subjects and with two additional diagnosis were 5 (8.93%) subjects. There was significant improvement on symptoms in the scores rated by teachers in 7th and 28th day after menthlphenidate administration compared to baseline score (P<0.05) and 28th day score showed significant improvement compared to 7th day score (P<0.05) and 28th day score showed significant improvement compared to 7th day score (P<0.05). There was significant improvement on symptoms in the scores rated by parents in 28th day after methylphenidate administration improvement compared with 7th day score. In single administration of methylphenidate in Sunday morning score compared to afternoon score (P<0.05). In the administration of significant improvement on symptoms compared with the Sunday morning rating score of parents (P<0.05) and the 28th day comparison was also showed significant improvement on symptoms in the scores rated by teachers compared with the scores rated by parents on symptoms (P<0.05). Among group comparison, all groups showed significant improvements (P<0.05) except conduct disorder & oppositional defiant group.

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The Study of Reliability and Validity of Attention Deficit Disorder Evaluation Scale-School Version(ADDES-SV) (주의력결핍 과잉운동장애 아동 평가척도의 교사 평가판에 대한 신뢰도 및 타당도 연구)

  • Bae, Jin-Woo;Cheung, Seung-Douk;Lee, Jong-Bum;Park, Hyung-Bae;Kim, Jin-Seung;Song, Chang-Jin
    • Journal of Yeungnam Medical Science
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    • v.14 no.2
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    • pp.415-429
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    • 1997
  • The purpose of this study was to examine the reliability and validity of attention deficit disorder evaluation scale-school version(ADDES-SV). Between October 1996 and November 1996, ADDES-SV was administered to 263 elementary school students in the second grade and between Jun 1996 and October 1996, 28 attention deficit hyperactivity disorder patients. In the reliability test, the test-retest reliability coefficient was significantly high and that of inattention was 0.88, that of impulsivity was 0.80, that of hyperactivity was 0.83 and total score was 0.83. In the reliability test by internal consistancy, the Cronbach $\alpha$ coefficient was significantly high and that of inattention was 0.98, that of impulsivity was 0.87, that of hyperactivity was 0.87(p<0.05). The half-sprit reliability coefficient by first-second half method showed high correlation and that of inattention was part 1: 0.96, part 2: 0.96 impulsivity was part 1: 0.95, part 2: 0.93, hyperactivity was part 1: 0.92, part 2: 0.94(p<0.05). Inter-rater reliability by pearson correlation coefficient was significantly high and that of inattention was 0.92, that of impulsivity was 0.87, that of hyperactivity was 0.89 and total score was 0.89. The concurrent validity between ADDES-SV and CAP scale was 0.85 in attention deficit hyperactivity disorder patient group and 0.79 in normal control group(p<0.05). In discriminant validity test between attention deficit hyperactivity disorder patient group and normal control group, the patient group showed higher score(p<0.05). The total discriminant capacity of the patient group in ADDES-SV was 94.6%. In this point of view, ADDES-SV scale showed high reliability and validity in applying to Korean subjects and was proved to be the useful screening test tool for attention deficit hyperactivity disorder research.

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THE COGNITIVE-BEHAVIORAL DIFFERENCES BETWEEN CHRONIC MOTOR TIC DISORDER AND TOURETTE'S DISORDER (만성 운동성 틱 장애와 뚜레뜨 장애의 인지-행동적 차이)

  • Shin, Min-Sup;Kim, Ja-Sung;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.4 no.1
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    • pp.133-141
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    • 1993
  • Present study investigated the differences in psychological tests responses between chronic motor tic disorder and tourette's disorder to clarify whether chronic motor tic and tourette's disorder constitute a single disorder on a continuum or not. Based on the diagnosis by child psychiatrists 29 chronic motor tic disorder and 10 tourette's disorder children between the age of 6 to 13 were selected, and the psychological tests responses of two diagnostic groups were compared. The results showed that tourette's disorder is more related to neulological problems than chronic motor tic disorder. Also it was found that children with tourette's disorder have more difficulties in social-emotional adjustment than children with chronic motor tic disorder. These results suggested that interactions among neurological factor, emotional factor and temperamental characristics might be more involved in tourette's disorder than in chronic motor tic disorder. The limitations of present study and the need for futher research on the comorbidity of tourette's disorder and ADHD were discussed.

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CLINICAL STUDY OF THE ABUSE IN PSYCHIATRICALLY HOSPITALIZED CHILDREN AND ADOLESCENTS (소아청소년 정신과병동 입원아동의 학대에 대한 임상 연구)

  • Lee, Soo-Kyung;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.145-157
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    • 1999
  • This study was performed by the children and adolescents who were abused or neglected physically, emotionally that were selected in child & adolescents psychiatric ward. We investigated the number of these case in admitted children & adolescents, and also observed characteristics of symptoms, developmental history, characteristics of abuse style, characteristics of abusers, family dynamics and psychopathology. We hypothesized that all kinds of abuse will influnced to emotional, behavioral problems, developmental courses on victims, interactive effects on family dynamics and psychopathology. That subjects were 22 persons of victims who be determined by clinical observation and clinical note. The results of the study were as follows:1) Demographic characteristics of victims:ratio of sex was 1:6.3(male:female), mean age was $11.1{\pm}2.5$. According to birth order, lst was 12(54.5%), 2nd was 5(23%), 3rd was 2(9%) and only child was 3(13.5%). 2) Characteristics of family:According to socioeconomic status, middle to high class was 3(13.5%), middle one was 9(41.% ), middle to low one was 9(41%), low one was 1(0.5%). according to number of family, under the 3 person was 3(13.5%), 4-5 was 17(77.5%), 6-7 was 2(9%). according to marital status of parents, divorce or seperation were 5(23%), remarriage 2(9%), severe marital discord was 19(86.5%). In father, antisocial behavior was 7(32%), alcohol dependence was 10(45.5%). In mother, alcohol abuse was 5(23%), depression was 17(77.3%), history of psychiatric management was 6(27%). 3) Characteristics of abuse:Physical abuse was 18(81.8%), physical and emotional abuse and neglect were 4(18.2%). according to onset of abuse, before 3 years was 15(54.5%), 3-6 years was 5(27.5%), schooler was 1(15%). Only father offender was 2(19%), only mother offender was 8(35.4%), both offender was 8(35.4%), accompaning with spouse abuse was 7(27%), and accompaning with other sibling abuse was 4(18.2%). 4) General characteristics and developmental history of victims:Unwanted baby was 12(54.5%), developmental delay before abuse was9(41%), comorbid developmental disorder was 15(68%). there were 6(27.5%) who didn‘t show definite sign of developmental delay before abuse. 5) Main diagnosis and comorbid diagnosis:According to main diagnosis, conduct disorder 6(27.3%), borderline child 5(23%), depression4(18%), attention deficit hyperactivity disorder(ADHD) 4(18%), pervasive developmental disorder not otherwise specified 2(9%), selective mutism 1(5%). According to comorbid diagnosis, ADHD, borderline intelligence, mental retardation, learning disorder, developmental language disorder, oppositional defiant disorder, chronic tic disorder, functional enuresis and encoporesis, anxiety disorder, dissociative disorder, personality disorder due to medical condition. 5) Course of treatment:A mean duration of admission was $2.4{\pm}1.5$ months. 11(15%) showed improvement of symtoms, however 11(50%) was not changed of symtoms.

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An Elementary School Children Screen Test for Attention Deficit Hyperactivity Disorder in Taegu City (대구지역 국민학교 어린이의 주의력 결핍 과잉 운동 장애 경향에 대한 선별 검사)

  • Park, Hyung-Bae;Kim, Jin-Sung;Jang, Sang-Ruyl;Park, Sung-Chan;Suh, Hye-Sao;Lee, Kwang-Hun;Kim, Young-Uck;Kim, Chang-Su
    • Journal of Yeungnam Medical Science
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    • v.12 no.1
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    • pp.56-74
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    • 1995
  • The authors applied ADDES-HV parent evaluation scale for the purpose of screening test to 538 2nd grade elementary school students from March 1994 to May. The results were as follows: There was no differences in scores of ADHD between schools. In comparing the male and female between three school students, male students showed signifieant high scores (p<0.05) than female students in the score of ADDES-HV subscale and total. There was no significant differences in ADDES-HV scale between male students and female students in both ADHD patients and normal controls. In reliability test for test and retest, the reliability coefficient was higher satisfatorily and that of inattention was 0.80, inpulsivity was 0.69, hyperactivity was 0.63 and the total score was 0.82. In reliability test by internal consistancy, the Cronbach ${\alpha}$ coefficient of patient group was 0.85(p<0.05) and that of normal control was 0.84(p<0.05). The Concurrent validity between ADDES-HV scale and DSM-III-R scale was 0.57(p<0.05) in ADHD patient group and 0.84(p<0.05) in normal control group. In discriminant validity test between ADHD patient group and normal control, the ADHD patient group showed higher score(p<0.05). The total disciminant capacity of the patient group in ADDES-HV scale was 94.44%. When we regard the cut off point as standard deviation 1.5, the male student was 80 score and the female student was 69 score. In this point of view, ADDES-HV scale was proved to be the useful screening test tool for ADHD research and showed higher reliability and validity in applying to Korean subjects.

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Effect of Interactive Metronome Training on Postural Control and Hand Writing Performance of Children With Attention Deficit Hyperactivity Disorder (ADHD): Single Subject Research (상호작용식 메트로놈(Interactive Metronome) 훈련이 주의력결핍 과잉행동장애 아동의 자세조절과 글씨쓰기 수행에 미치는 영향: 단일사례연구)

  • Park, Min-Kyoung;Kim, Hee
    • The Journal of Korean Academy of Sensory Integration
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    • v.16 no.1
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    • pp.14-24
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    • 2018
  • Objective : The purpose of this study was to identify the effect of Interactive Metronome (IM) training on postural control and hand writing performance of children with Attention Deficit Hyperactivity Disorder (ADHD). Methods : Participant was a third grade elementary school student diagnosed with ADHD. ABA design was used and a total of 30 sessions were held for 3 sessions every week for a total of 10 weeks. In the intervention period, IM training was conducted for 40~50 minutes before intervention for writing, and the writing task was carried out. We evaluated the handwriting legibility and speed. Before baseline A and within a month after A' phase, Clinical Observation of Motor and Postural Skills (COMPS) was evaluated to examine the changes in postural control of the student. Results : After the IM intervention, the postural control of the student improved in the score of slow movement, finger-nose touching, and asymmetrical tonic neck reflex. The handwriting legibility and speed has also tended to increase during the intervention period, but it has not significantly changed. Conclusion : This study could be used as an evidence that the IM training aimed at postural control and handwriting ability could enhance the ability to improve postural control and thereby provide fundamental knowledge for future studies.

Effect of Pharmacological Treatment for Attention-Deficit Hyperactivity Disorder on Motor Coordination: Open Label Study (주의력결핍 과잉행동장애 아동의 약물치료가 운동협응력에 미치는 효과: 개방연구)

  • Park, Kee Jeong;Kweon, Kukju;Lee, Saejeong;Lim, Yun Shin;Joung, Yoo Sook;Kim, Hyo-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.4
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    • pp.244-251
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    • 2017
  • Objectives: The objective of this study was to investigate the effect of pharmacological treatments for attention-deficit hyperactivity disorder (ADHD) on motor coordination, using the Developmental Coordination Disorder Questionnaire (DCDQ). Methods: The participants were recruited from April 2015 to November 2016 from the Department of Psychiatry of Asan Medical Center and were treated for 3 months with methylphenidate or atomoxetine. The illness severity at baseline and 3 months were scored using the ADHD Rating Scale (ARS), Clinical Global Impression-Severity Scale (CGI-S) and/or Clinical Global Impression-Improvement Scale (CGI-I). A total of 39 children with ADHD (age $8.0{\pm}1.4years$, 36 boys) completed the Advanced Test of Attention (ATA) and their parents completed the DCDQ at baseline and 3 months. The paired t-test, mixed between-within analysis of variance and correlation analysis were used. Results: The CGI-S (p<0.001), ARS (p<0.001), and fine motor/hand writing (p=0.005) on the DCDQ were significantly changed between pre-treatment and post-treatment. When the participants were divided into those who were suspected of having developmental coordination disorder (DCD) (n=23) and those who probably did not (n=16), the control during movement, fine motor/hand writing and general coordination scores on the DCDQ showed the main effects for group (p<0.001, p<0.001 and p<0.001, respectively). The fine motor/hand writing on the DCDQ has a significant main effect for time [F(1,37)=7.31, p=0.010, ${\eta}^2=0.405$] and the interaction effect between group and time was also significant [F(1,37)=4.63, p=0.038, ${\eta}^2=0.111$]. The baseline visual commission error on the ATA is significantly correlated with the changes in the DCDQ total scores (r=0.330, p=0.040). Conclusion: Our results provide preliminary evidence that pharmacological treatment for ADHD improves not only the core symptoms of ADHD, but also the motor coordination. Further studies are needed to confirm the effect of the pharmacological treatment for ADHD on the motor coordination.

Brain wave results in children with attention deficit hyperactivity disorder and treatment result with central nervous system stimulants (주의력결핍 과잉행동장애 환아에서 시행한 뇌파 결과 및 중추신경자극제 치료에 따른 결과)

  • Lim, Young Su;Sim, Ji Yun;Son, Jung-Woo;Kim, Won Seop
    • Clinical and Experimental Pediatrics
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    • v.51 no.12
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    • pp.1324-1328
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    • 2008
  • Purpose : Attention deficit hyperactivity disorder (ADHD) is a syndrome characterized by inattention, impulsive disruptive behavior, impaired concentration, and motor restlessness. This study examined the relationships among electroencephalographic (EEG) findings, stimulant use, and seizure occurrence in children with ADHD. Methods : We retrospectively studied 308 children with ADHD who visited the neuropsychiatric clinic of our hospital from January 2001 to December 2005. We retrospectively analyzed age distribution, etiology, abnormal EEG findings, and use of CNS stimulants. Among these children, brain waves was recorded in 84 patients. Results : Eighty-four children (72 males, 85.7%, 9.3 years mean age; 12 females, 14.3%, 8.0 years mean age) with ADHD had electroencephalograms (EEGs) performed at our institute. Nineteen patients (22.6%) demonstrated epileptiform abnormalities, and 65 (77.4%) demonstrated normal EEGs. Stimulant therapy was applied to 59 of 84 patients (70.2%). Seizures occurred in 1 of 65 patients with a normal EEG (incidence, 1.5%) and 3 of 19 treated patients with epileptiform EEGs (incidence, 15.7%). Conclusion : These data suggest that patients with normal EEGs have minor risk for seizure. In contrast, patients with epileptiform EEGs have higher risk for seizure than patients with normal EEGs.

Prevalence of Voiding Dysfunction and Constipation in Children with Attention Deficit Hyperactivity Disorder (주의력결핍 과잉운동장애 소아에서 배뇨장애와 변비의 유병률)

  • Kim, Joon Young;Lee, Eun Seob;Bang, Ji Seok;Oh, Yeon Joung;Lee, Yong Ju;Sung, Tae-Jung;Lee, Kon-Hee;Lee, Jung Won
    • Childhood Kidney Diseases
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    • v.18 no.2
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    • pp.71-76
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    • 2014
  • Purpose: Attention deficit hyperactivity disorder (ADHD) has been associated with impairments in frontal inhibitory function and the catecholaminergic system. ADHD is diagnosed in 3-5% of children. Children with ADHD seem develop various forms of urinary problems such as nocturnal enuresis, dysfunctional voiding, and diurnal incontinence. However, no data exist to confirm the presence of these problems in Korean children with ADHD. We investigated the clinical findings of voiding dysfunction in children with ADHD. Methods: Between October 2009 and March 2011, a total of 63 children (33 with ADHD, 30 with an upper respiratory infection, as a control group) were enrolled. ADHD was diagnosed using the diagnostic and statistical manual of mental disorders (DSM)-IV criteria. A comprehensive survey of voiding and defecation was administered. Results: The patient group included 28 boys and 5 girls; the control group comprised 20 boys and 10 girls. The mean age was $9.09{\pm}2.8$ years in the ADHD group and $8.58{\pm}3.1$ years in the control group. Children with ADHD had a statistically significantly higher incidence of urgency (P =0.017), urge incontinence (P =0.033), and constipation (P =0.045). There was no significant difference in the incidence of straining, intermittency, holding maneuvers, or nocturnal enuresis. Conclusion: Children with ADHD in Korea have significantly higher rates of urgency, urge incontinence, and constipation than those without ADHD.

Transcranial Magnetic Stimulation in Gilles de la Tourette Syndrome (뚜렛 증후군에서의 경두개 자기자극술)

  • Lee, Moon-Soo
    • Korean Journal of Psychosomatic Medicine
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    • v.18 no.1
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    • pp.3-10
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    • 2010
  • Gilles de la Tourette syndrome is a chronic motor and vocal tic disorder of childhood onset. Abnornmalities in basal ganglia-thalamo-cortical circuits may play an important role in the pathophysiology underlying the involuntary tics. It is often complicated by comorbid attention-deficit/hyperactivity disorder or obsessive-compulsive disorder. Transcranial magnetic stimulation(TMS) is a neurophysiologic technique with research ap-plication. As there is good evidence that this technique can modify cortical activity, repetitive TMS is also used for treatment to change the cortical excitability and therefore affect underlying interconnected cortical-sub-cortical loop. We reviewed the neurophysiologic parameters and the clinical applicability of TMS and rTMS.

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