• Title/Summary/Keyword: 주의력 결핍/과잉운동 장애

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STUDY ON THE RELATIONSHIP BETWEEN THE ONTOGENETIC PROCESSES AND PSYCHOPATHOLOGY IN ATTENTION-DEFICIT HYPERACTIVITY DISORDER (주의력결핍 ${\cdot}$ 과잉운동장애의 Serotonin계의 개체발생적인 과정과 정신병리와의 상호관계에 관한 연구)

  • Jung, Yeoung;Shin, Sung-Woong;Whang, Joon-Won;Shin, Min-Sup;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.2
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    • pp.165-178
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    • 2001
  • In order to elucidate the biological etiology and the relationship between the ontogenesis of serotonin system and psychopathology in ADHD, plasma serotonin(5-hydroxytryptamine, 5-HT) and 5-hydroxyindoleacetic acid(5-HIAA) were measured and the correlation between the plasma levels of 5-HT and 5-HIAA and age were evaluated in 46 ADHD patients and 18 control subjects. The ADHD patients were composed of 16 combined type, 10 inattentive type, and 20 hyperactive-impulsive type and the control subjects were communication disorders. The results are summarized as follows:1) There was significant difference in plasma 5-HT levels among combined, inattentive and hyperactive-impulsive and control subjects(ANOVA F=4.33, df 3, 60, p<0.05), and post-hoc test using Scheffe method showed significant difference between the combined type and control group. But, post-hoc tests showed no significant differences between combined and inattentive, combined and hyperactive-impulsive, hyperactive-impulsive and inattentive, hyperactive-impulsive and control and inattentive and control groups. 2) There was no significant differences in plasma 5-HIAA levels among the combined, hyperactive- impulsive, inattentive and control groups(ANOVA F=2.08, df 3, 60, p>0.05). 3) Significant difference in 5-HT level was found between the whole ADHD group(N=46) and the control group(N=18)(T=3.10, df 62, p<0.05). But no significant difference in 5-HIAA level was found between the whole ADHD group and the control group(T=1.90, df 62, p>0.05). 4) Plasma 5-HT and 5-HIAA levels showed no significant correlation with TOVA findings(5-HT:omission pearson correlation 0.10, commision 0.23, reaction time 0.01, variability in attention 0.11, all p>0.05, 5-HIAA:omission 0.21, commision 0.15, reaction time 0.09, variability in attention 0.15, all p>0.05). 5) Plasma 5-HT and 5-HIAA levels showed no significant correlation with attention, hyperactivity and impulsivity based on DSM-IV criteria. 6) Plasma 5-HT and 5-HIAA levels showed no significant correlation with age both in ADHD and control group. These findings show that decreased plasma 5-HT level may play a role in the genesis of ADHD, but this finding has no significant correlation with the psychopathology of ADHD. And we could not find any significant differences in ontogenetic processes in 5-HT. Future studies should be focused on the drug effects, family history and prognosis based on the biochemical subtypes(high and low 5-HT group).

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CLINICAL CHARACTERISTICS OF CHILD & ADOLESCENT IMPATIENT WITH SEVERE ATTENTION DEFICIT/HYPERACTIVITY DISORDER AT A CENTER (일 병원에 심한 주의력결핍/과잉운동장애로 입원한 소아청소년의 임상특성)

  • Lee, Chang-Hun;Park, Sunny;Jhin, Hea-Kyung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.2
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    • pp.270-278
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    • 2005
  • Objectives : This study is to understand the clinical characteristics and course of inpatient severe ADHD. Methods : This study retrospectively investigated the chief complaints, history, demographics, neuropsychologic test, psychosocial status of 63 (male 58, female 5) inpatients from a single center with severe attention deficit/hyperactivity disorder(ADHD) during January 1, 1996 to October 31, 2002. Results : The patients with inpatient severe ADHD revealed a male to female ratio of 11.6 : 1 and the average age of onset was 5.3 years(63.6 months, SD 24.3 months) . Comorbidities were noted in 56/63 $(88.9\%)$ patients with the following frequencies : comorbid conduct disorder, 35$(55.6\%)$, mental retardation (MR), 24$(38.1\%)$, mood disorder, 5$(7.9\%)$, tic and Tourette's disorder, 4$(6.4\%)$, oppositional defiant disorder, 4$(5.0\%)$. Chief complaints for admission related to ADHD in 23$(36.5\%)$ patients while 37$(58.7\%)$ patients admitted due to symptoms associated to conduct disorder (CD). The mean onset age of comorbid delinquency was 9.0 years (108.2 months, SD28.8 months), and the average interval between onsets of ADHD and delinquency was 3.6 years (42.9 months, SD32.0 months). Patients who showed early delinquency tended to have an earlier onset of ADHD (p<0.05). Conclusion : The demographics, natural course, and psychosocial factors of hospitalized ADHD patients were similar to prior studies of ADHD in the general population. The onset of age was 5.3 years, and the onset of comorbid delinquency was 9.0 years. The earlier symptoms of ADHD manifested, the earlier delinquency appeared. Most patients were admitted due to chief complaints related to CD. Comorbidities, most of which were CD, were seen in $88.9\%$ of the patients.

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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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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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COMORBIDITY OF CHILD AND ADOLESCENT INPATIENTS (소아정신과 입원환자의 공존질병(Comorbidity))

  • Shin, Yun-O;Cho, Soo-Churl;Hong, Kang-E;Kim, Ja-Sung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.4 no.1
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    • pp.91-97
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    • 1993
  • The objective of this paper was to determine the degree of diagnostic overlap. In a pilot study of 56 inpatients(mean age 12) with DSM-III-R axis I and/or II disorders, the degree of psychiatric comorbidity was examined. 64.3% had two or more diagnoses. The samples were divided into the following 9 groups 1) attention deficit hyperactivity disorder 2) conduct disorder 3) oppositional defiant disorder 4) schizophrenia 5) mood disorders 6) tie disorders 7) elimination disorders 8) mental retardation 9) personality disorders Substantial overlap(especially tic disorders, elimination disorders, disruptive behavior disorders) occured among inpatients Patients had about 2 DSM-III-R axis I & II diagnoses. Additional research with increased sample size is necessary to clarify its relationship with other psychiatric diagnoses.

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Effects of Using Convergence Horseback Riding Program on the Emotion·Behavior Development, Anxiety, Depression and ADHD in Adolescent (융복합을 활용한 승마운동 프로그램이 청소년의 정서·행동 발달, 불안, 우울 및 ADHD에 미치는 영향)

  • Park, Yun-Jae;Jang, Hong-Young;Kim, Jong-Hyuck
    • Journal of the Korea Convergence Society
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    • v.7 no.6
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    • pp.287-295
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    • 2016
  • This study was conducted of students in their youth, who were having behavioral and emotional problems, anxiety, depression, and ADHD in their school. The participants took part in equestrian sports programs(equestrian program and apparatus program) twice a week, for 60 minutes each. To make progress in the study, mainly 4 scales are used as the standards of preliminary and post inspections : emotional and behavioral development scale, anxiety scale, depression scale, and ADHD scale. After conducting two-way ANOVA analysis, the conclusion was made as follows. The equestrian sports and horse riding exercise program which were used in this study did had an positive effect on emotional and behavioral scale, depression scale, anxiety scale, and ADHD scale. Moreover, it is determined that the equestrian sports had more positive effects than the equestrian sports which used apparatus. However, to precisely compare and contrast the effects of equestrian sports programs and apparatus programs, the follow-up studies need to limit the control group.

The Development of the Korean Form of Childhood Attention Problem(CAP) Scale: A Study on the Reliability and Validity (한국형 소아기 집중력 문제척도: 신뢰도 및 타당도 연구)

  • Seo, Wan-Seok;Lee, Jong-Bum;Park, Hyung-Bae;Suh, Hyea-Soo;Lee, Kwang-Hun;SaKong, Jeong-Kyu
    • Journal of Yeungnam Medical Science
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    • v.14 no.1
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    • pp.123-136
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    • 1997
  • The purpose of this study was to examine the reliability and validity of a Korean form of Childhood Attention Problem(CAP) scale. CAP were administered to 98 normal elementary school students as control group and 98 attention deficit hyperactivity disorder patients. Male students showed high scores than female students in both subscale and total scores, but not statistically significant. There were no significant difference in CAP scale between male students and female students in attention deficit hyperactivity disorder patients. In the reliability test, the test-retest reliability coefficient was highly satisfactory and that of inattention subscale was 0.83, impulsivity subscale was 0.70 and total score was 0.82. In the reliability test by internal consistency, the Cronbach $\alpha$ coefficient was highly satisfactory and that of inattention subscale was 0.91, overactivity subscale was 0.89(p<0.05). The concurrent validity between CAP scale and ADDES-BV scale was 0.85 in attention deficit hyperactivity disorder patient group and 0.73 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 CAP was 93.4%. In this point of view, CAP scale showed high reliability and validity in applying to Korean subjects and was proved to be the good and simple screening test tool for attention deficit hyperactivity disorder research and can help many young patient to treat early.

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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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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.