• Title/Summary/Keyword: 주의력 결핍과잉행동장애

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NEW DRUG THERAPY IN CHILD AND ADOLESCENT PSYCHIATRY-NEW LONG-ACTING PSYCHOSTIMULANTS (소아청소년 정신과 영역에서의 새로운 약물치료:새로운 장기작용형 중추신경자극제)

  • Choi, Sung-Ku
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.3-11
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    • 2003
  • Attention-deficit/Hyperactivity disorder(ADHD) is the most common psychiatric disorder of childhood and among the most prevalent chronic health conditions affecting school-aged children. Children with ADHD experience significant functional problems, such as school difficulties, academic underachievement, troublesome interpersonal relationships with family members and peers, and low self-esteem. The most widely used pharmacological treatments for ADHD are psychostimulants, such as methylphenidate and amphetamine salts. These medications provide clinical efficacy by increasing the availability of catecholamines, primarily dopamine, in the frontal lobe of the brain. immediate-release(IR) formulations of sychostimulants were among the most effective psychotrophic medications in the psychopharmacological treatment. However, there are some limitations of IR formulations:the short half-life and duration of efficacy, which result in the need for multiple daily dosing and the poor compliance. These limitations have led to the development of once-daily, extended-release(ER) formulations of methylphenidate and amphetamine salts. However, these ER formulations may not be as immediately helpful to ADHD children due to delayed onset of action and the acute tolerance which is the failure to sustain the efficacy with the same concentration of drug as the initial stage of medication. OROS-methylphenidate(Concerta$^{\circledR}$) given once a day produces an ascending-pattern plasma drug level generated by the osmotically released, timed drug-delivery system. These new formulations of the psychostimulants have been shown to be a useful alternative to old stimulant medications through the evidence by the clinical trials.

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Depression, Anxiety, Alexithymia, Stress Response in Caregivers of Attention Deficit Hyperactivity Disorder Patient (주의력결핍 과잉행동장애 환아 보호자의 우울, 불안, 감정표현불능, 스트레스반응)

  • Jeong, Jong-Hyun;Hong, Seung-Chul;Han, Jin-Hee;Lee, Sung-Pil
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.2
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    • pp.95-101
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    • 2005
  • Objectives : This study was designed to investigate depression, anxiety, alexithymia, stress res ponses in caregivers of patients with attention deficit hyperactivity disorder. Methods : The subjects were 38 attention deficit hyperactivity disorder patients caregivers(38 women, mean age $37.5{\pm}6.5$). Patients were diagnosed with DSM-IV ADHD criteria. Korean version of Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI), Toronto Alexithymia Scale(TAS) and Stress Response Inventory(SRI) were used for assessment. Results 1) The BDI scores of ADHD patients caregiver group were significantly higher than control group$(16.4{\pm}7.1\;vs.\;10.9{\pm}5.5)(p=0.011)$. 7 of the 38 caregivers(18.4%) and none of control group(0%) had BDI scores over 20 points(p=0.021). Calculated relative risk for ADHD in the presence of caregivers' depression was 1.516 overall(95% confidence interval, 1.234-1.862). 2) In ADHD patient's caregiver group, the scores of Stress Response Inventory were significantly higher than control group$(44.2{\pm}20.2\;vs.\;26.5{\pm}16.8)(p=0.006)$. 3) No significant differences were found in the score of STAI, SIAIS, SIAI-T, TAS between caregiver and control group. Conclusion : This study suggest that ADHD patients' caregivers are likely to have more depressive symptoms and higher stress response level than control group. We propose that physicians should consider integrated approaches for caregiver's psychopathology in the management of ADHD.

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ATTENTION DEFICIT-HYPERACTIVITY DISORDER: A CASE REPORT (주의력결핍-과잉행동장애 환아의 증례)

  • So, Jeong-Won;Ra, Ji-Young;Lee, Kwang-Hee;An, So-Youn;Kim, Yun-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.4
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    • pp.482-487
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    • 2010
  • Attention Deficit-Hyperactivity Disorder(ADHD) is the most common psychiatric disorder in school-age children which is increasing gradually. It is hard for ADHD children to focus on particular stimulus for a long time. ADHD children are characterized by hyperactivity which shows in behaviors like, talking too much, getting up from their seats without permission, running around, keep on moving their arms and legs. ADHD children have problems with impulse controlling that they tend to fall and get into an accident very often. Thus dentist's attention and care must increase when dental treatment is performed with ADHD children since behavior control, oral hygiene problems, and trauma might be expected. By using sedative drugs and psychological behavior control, chief complaint was resolved in a 8-years-old female diagnosed for ADHD.

Association between Atopic Dermatitis and Attention Deficit Hyperactivity Disorder Symptoms in Korean Children (소아.청소년에서 아토피 피부염과 주의력결핍과잉행동장애와의 관계)

  • Han, Doug-Hyun;Kim, Seong-Hyun;Chung, Un-Sun;Cho, Jeong-Hye;Park, June-Sung;Ahn, Jee-Young;Kim, Jae-Won
    • Korean Journal of Psychosomatic Medicine
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    • v.14 no.2
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    • pp.88-93
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    • 2006
  • Objective : The aim of this study was to examine the relationship between IgE-mediated atopic dermatitis and attention deficit hyperactivity disorder(ADHD) in Korean children. Method : This case-control study included 69 patients with atopic dermatitis and 42 normal students. Diagnoses of atopic dermatitis and assessments of its severity were made by the dermatologist. The MAST tests were administered to atopic dermatitis patients. The parents of all of the subjects completed the parent versions of the ADHD Rating Scale-IV(ARS). Results: Compared to the normal control group, the atopic dermatitis group scored significantly higher in the total, inattention, and hyperactivity/impulsivity profiles of the ARS(t=3.35, p<0.01 : t=6.41, p<0.01 ; t=3.93, p<0.01, respectively), The atopic dermatitis patients with ADHD hyperactivity/impulsivity subtype showed more severe symptoms of atopic dermatitis than those with ADHD inattentive subtype. The MAST-positive atopic dermatitis patients showed significantly increased incidence of ADHD symptoms than the MAST-negative counterparts. Conclusion : The results of this study suggest the possibility of an association between IgE-mediated atopic responsiveness and ADHD symptomatology.

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Major Lessons from the MTA in Treatment of Attention-Deficit Hyperactivity Disorder (주의력결핍 과잉행동장애 치료에서 MTA의 주요 교훈)

  • Hwang, Jun-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.21 no.1
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    • pp.3-10
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    • 2010
  • Objectives : The current review aimed to describe the major findings of the NIMH Collaborative Multisite Multimodal Treatment Study of Children with Attention-Deficit Hyperactivity Disorder (MTA) with regard to the treatment of children with attention-deficit hyperactivity disorder (ADHD). Methods : We performed a general review of the literature regarding the efficacy of the MTA's proposed treatments. Results : There is a large and still increasing body of evidence regarding the MTA's treatment outcomes. We present and discuss details of the findings at each follow-up point. Conclusion : Currently, findings regarding the MTA's treatments suggest children with combined-type ADHD exhibit significant impairment in adolescence, despite their initial symptom improvement. Further studies, using innovative treatment approaches and targeting specific areas of adolescent impairment, are needed in order to enhance ADHD treatment outcomes.

The Relationship Between Mother-Child Interaction Play Assessment of Children with Attention Deficit Hyperactivity Disorder and Delinquency-Oriented Behavior : Observational Study (주의력결핍 및 과잉행동장애 아동의 모-자녀 상호작용 놀이평가와 비행성향행동과의 관계 : 관찰연구)

  • Oh, Mi Kyoung
    • Korean Journal of Child Studies
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    • v.25 no.3
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    • pp.59-74
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    • 2004
  • The purpose of the this study was to examine the relationship between mother-child interaction play assessment of children with Attention Deficit Hyperactivity Disorder(ADHD) and delinquency through observational method. The subjects were 30children(normal: 15, ADHD: 15) between 4-6 elementary school grade. Instruments used Parent-Child Interaction Assessment(P-CIPA), Inventory of Delinquency-Oriented Behavior and Korea Children Behavior Check List(K-CBCL). Results showed that following : 1) ADHD affect the delinquency-oriented behavior; 2) there were significant differences in mother-child interaction play assessment between normal children group and ADHD children group; and 3) there was a significant relationship between parent-child interaction play assessment and delinquency.

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PSYCHOPHARMACOLOGY OF ADHD WITH COMORBID DISORDERS (주의력결핍 과잉행동장애와 공존질환의 약물치료)

  • Cho, In-Hee
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.36-52
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    • 2003
  • Attention deficit/hyperactivity disorder is one of the most comminly treated conditions in the child psychiatric units and results in substantial impairment in peer, family and academoc functioning. For 70% to 80% of children with a diagnosis of ADHD, stimulant tratment results in successful improvement of the core ADHD symptoms. However, children with ADHD have high level of comorbidity and may respond differently from children with ADHD without comorbidity. Therefore they may need specific treatment plan. We reviewed efficacy and safety of prescribed medication for treating children with ADHD, the relationship between ADHD and the comorbid conditions and treatment algorithm projects of ADHD with/without comorbid conditions performed Korean and American child psychiatrists. Our main objective is to increase the uniformity of treatment and improve the clinical outcomes of children with comorbid ADHD.

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A Study on the Attention, Intellectual Functioning and Behavior Characteristics of Girls with Attention-Deficit Hyperactivity Disorder (주의력결핍 과잉행동장애 여자 아동들의 주의력, 인지 기능 및 행동 특성에 대한 연구)

  • Kang, Il-Seon;Cho, A-Ra;Kim, Bong-Seog
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.20 no.1
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    • pp.10-16
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    • 2009
  • Objectives : The purpose of this study was to investigate the characteristics of attention, intellectual functioning and adaptation of girls with attention-deficit hyperactivity disorder (ADHD). Methods : The scores of the ADHD Diagnostic System (ADS), the Korean Wechsler Intelligence Scale for Children-III (K-WISC-III) and the Korean Personality Inventory for Children (KPI-C) were compared between 26 girls with ADHD and 26 boys with ADHD. Results : 1) There was no significant gender difference in the intellectual functioning, except for the picture completion subscale. 2) Compared to the boys, the girls responded more slowly on the ADS visual task. 3) The girls were rated higher by their parents for the depression and social relationship problems of the KPI-C. Conclusion : The results suggest that there are noticeable gender differences for the attention problems and social functioning of children with ADHD.

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GENERALIZED THYROID HORMONE RESISTANCE SYNDROME AND ATTENTION-DEFICIT/HYPERACTIVITY DISORDER (갑상선호르몬 내성 증후군과 주의력결핍-과잉행동 장애)

  • Ahn, Dong-Hyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.5 no.1
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    • pp.102-107
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    • 1994
  • Recently several studies showed a strong and specific association of Attention-Deficit Hyperactivity Disorder(ADHD) and generalized resistance to thyroid hormone(GRTH). The recommandation that all children with ADHD be screened for GRTH is an newer controversial issue in child psychiatric field. Author examined thyroid indices(T3, T4, TSH) and clinical characteristics in the 51 clinical populations with ADHD, developmental delay, and language disorders. The results are that 11 cases were out of the normal range of both T2 and T4 inspite of normal TSH. This finding is suggestive of the finding of GRTH cases. Therefore I suggest that child psychiatrist should pay attention to ADHD symptoms secondary to GRTH and that all children with familial ADHD and developmental delay(including launguage disorder) be screened for thyroid abnormalities.

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Off-label use of Psychotropic Medications in Preschool Children with Attention-deficit Hyperactivity Disorder (주의력결핍 과잉행동장애에서 허가 초과 약물 처방 : 학령전기 아동 중심으로)

  • Kim, Eui-Jung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.22 no.2
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    • pp.74-80
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    • 2011
  • Attention-deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder with an onset of symptoms before 7 years of age, often starting as early as the preschool years. The off-label use of methylphenidate (MPH) for 3- to 6-year-old preschool children with ADHD is being more common, although MPH is not licensed for use in children younger than age 6 years, in most countries. Despite the limited data, the review of the literature suggests that MPH meets evidence based criteria as beneficial and safe for carefully diagnosed ADHD preschool children. Carefully monitored administration of evidence-based psychotropic medication in preschool children with ADHD may be indicated if psychosocial treatments are ineffective.