• 정신신체의학
• /
• 제27권2호
• /
• pp.147-154
• /
• 2019

연구목적 우울증 환자들에게서는 부주의를 포함한 인지기능 저하는 흔히 동반된다. 우울증 환자들에게서 나타나는 부주의 증상은 주의력결핍/과잉행동장애(Attention Deficit/Hyperactivity Disorder, ADHD)에게서 나타나는 증상과 유사한 양상을 보인다. 부주의 증상의 원인에 따라 치료가 달라지므로 두 질환을 정확히 진단하는 것이 중요하다. 본 연구에서는 우울감을 주소로 내원한 환자들에서 ADHD 증상의 공존율과 증상 별 상관관계를 알아보고자 한다. 방 법 2015년 3월~2018년 7월까지 우울감을 주소로 순천향대학교 부속 서울병원 정신건강의학과 외래에 내원한 158명의 환자를 대상으로 하였다. 모든 대상자들은 사회인구학적 특성(연령, 성별, 학력, 직업), 한국판 역학연구센터 우울척도(The Center for epidemiological Studies-Depression Scale, CES-D), 성인 주의력결핍과잉 행동장애 자기보고척도(Adult Attention Deficit/Hyperactivity Disorder self-report scale-V 1.1, ASRS-V 1.1), 한국판 코너스 성인 ADHD 평정척도(Korean-Conners' Adult ADHD Rating Scale, K-CAARS)를 수행하였다. 우리는 우울증군과 비우울증군을 CES-D점수로 분류하였으며, 자료처리는 기술통계분석, 교차분석, t-tests, 피어슨 상관분석을 실시하였다. 결 과 성인 ADHD 증상 공존율은 우울증군에게서 36.7%로 높았다(p-value<0.001). K-CAARS에서 ADHD 증상 정도는 우울증군(Inattention=1.80, Hyperactivity=1.92, Impulsivity=1.56, Self-concept=2.06)이 비우울증군(Inattention=1.28, Hyperactivity=1.25, Impulsivity=1.09, Self-concept=1.42) 보다 높게 나타났다(p-value<0.001). 결 론 본 연구에서는 ADHD 증상이 우울군에서 공존한다는 것을 확인하였다. 우울감을 호소하는 환자의 증상을 평가할 때, ADHD 증상의 공존 여부와 ADHD 진단 가능성에 관심을 가지고 정확하게 진단하고 적절한 치료를 병행해 나가야 한다고 제안한다.

• 대한한의학회지
• /
• 제31권1호
• /
• pp.47-56
• /
• 2010

Objective: Many drug or non-drug therapies are reported to be effective in reducing the severity of attention deficit/hyperactivity disorder (ADHD). The aim of this study was to assess the effect of color and pattern on the severity of ADHD in young ADHD patients. Method: We randomly assigned 30 children into two groups and had them participate in 15-minute block play sessions once in a week. The experimental group used blocks with green (3G, Munsell color system) circle patterns on them, while the control group played with plain white blocks. We also provided a set of playing cards with the corresponding patterns. This trial continued for 4 weeks and 29 children (96.7%) completed. The primary outcome measurement was the ADHD rating scale-IV and was evaluated on every visit. Results: After the trial, ADHD score decreased in both groups but not significantly ($34.4{\pm}8.0$ to $30.0{\pm}4.3$; $34.0{\pm}6.0$ to $30.3{\pm}3.2$). However, there were significant differences in 4 items of ADHD rating scale between the two groups. These consisted of 3 inattention (Q3, Q7, Q15) and 1 hyperactivity-impulsivity (Q12) items and the reduction between the first and final visits was significant (p=0.0240, p=0.0498, p=0.0237 and p=0.0012 respectively). Conclusion: Repeated exposure to a green circle pattern might not influence the total score of ADHD rating scale but reduced 3 inattention items and 1 hyperactivity-impulsivity significantly in children with ADHD. Proper visual stimuli are partially helpful for pediatric ADHD.

• Nutrition Research and Practice
• /
• 제5권3호
• /
• pp.236-245
• /
• 2011

This study investigated the correlation between consumption of sugar intake by fifth grade students in primary schools and development of Attention Deficit Hyperactivity Disorder (ADHD). A total of 107 students participated, and eight boys and one girl (8.4% of the total) categorized as high risk for ADHD according to diagnostic criteria. There were significant differences in the occupations and drinking habits of the respondents' fathers between the normal group and risk group. In a comparison of students' nutrition intake status with daily nutrition intake standards for Koreans, students consumed twice as much protein as the recommended level, whereas their calcium intake was only 60% of the recommended DRI (dietary reference intake). Regarding intake volume of vitamin C, the normal group posted 143.9% of the recommended DRI, whereas the risk group showed only 65.5% of the recommended DRI. In terms of simple sugar intake from snacks, students in the normal group consumed 58.4 g while the risk group consumed 50.2 g. These levels constituted 12.5% of their total daily volume of sugar intake from snacks, which is higher than the 10% standard recommended by the WHO. In conclusion, children who consumed less sugar from fruit snacks or whose vitamin C intake was less than RI was at increased risks for ADHD (P < 0.05). However, no significant association was observed between total volume of simple sugar intake from snacks and ADHD development.

• 동의신경정신과학회지
• /
• 제24권1호
• /
• pp.1-12
• /
• 2013

Objectives : The purpose of this study was to take around herbal medicine for Attention Deficit Hyperactivity Disorder in China. Methods : A journal search was performed using China National Knowledge Infrastructure (CNKI) from 2007 to 2012. Key words searched were 'ADHD'. Results : 25 studies were selected. Case control studies showed that herbal medicine treatment reported better results than the western medicine treatment group. 12 case reports reported a significant improvement in herbal medicine treatment for patients with ADHD. Frequently used herbal materials were Rhizome of Polygalae Radix and Rhizome of Acori Gramineri Rhizoma (16 times), Root of Glycyrrhiza uralensis Fisch (14 times), Root of Rehmanniae Radix et Rhizoma Preparata and Sclerotium of Poria cocos Wolf (12 times). Conclusions : There have been many studies regarding herbal medicine for Attention Deficit Hyperactivity Disorder in China, and these studies can be applied to the clinical practices in Korea.

• 대한한방소아과학회지
• /
• 제27권4호
• /
• pp.10-16
• /
• 2013

Objectives The purpose of this study was to investigate the acupuncture therapy about Attention Deficit Hyperactivity Disorder (ADHD) in China. Methods We searched for the studies on ADHD at China National Knowledge Infrastructure (CNKI, http://www.cnki.net) from 2011.1 to 2013.8. Results Selected 12 studies were divided into 7 case reports and 5 control studies. 7 case reports reported significant improvements with acupuncture therapy in ADHD. 5 control studies reported results that the acupuncture therapy groups were similar or better than western medicine treatment groups. Frequently used acupuncture points were EX-HN23 (7 times), GV20 ${\bullet}$ P6 ${\bullet}$ SP6 (6 times), G13 ${\bullet}$ EX-HN1 (5 times). Conclusions There have been reported many ADHD clinical studies in China and these studies can be applied to the clinical practices in Korea.

• Clinical and Experimental Pediatrics
• /
• 제64권9호
• /
• pp.489-493
• /
• 2021

Background: There is evidence of destructive effects of oxytocin use during labor on neurodevelopment. Purpose: This meta-analysis pooled all observational studies to determine the association between labor induction and the risk of attention-deficit/hyperactivity disorder (ADHD) among children. Methods: All observational studies (case-control and cohort) were reviewed until September 2020 after searches of the PubMed, Scopus, and Web of Science databases, the gray literature, and conference proceedings. The pooled odds ratios (ORs), relative ratios (RRs), and 95% confidence intervals (CI (swere calculated as random effect estimates of association among studies. Results: All observational studies were reviewed, including 4 cohort studies including 2,885,743 participants and 3 case-control studies including 51,135 participants (10,961 with ADHD and 40,174 in control groups) with a sample size of 2,936,878 participants. The pooled estimates of OR and RR did not indicate a significant association between labor induction and ADHD among children (OR, 1.13; 95% CI, 0.90-1.35) and (RR, 1.10; 95% CI, 0.96-1.24). Conclusions: The findings showed that labor induction is not associated with an increased risk of ADHD among children. However, more studies are needed to investigate the relationship between labor induction and ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제33권2호
• /
• pp.27-34
• /
• 2022

Stimulants, such as amphetamine and methylphenidate, are one of the most effective treatment modalities for attention deficit hyperactivity disorder (ADHD) and may cause various movement disorders. This review discusses various movement disorders related to stimulant use in the treatment of ADHD. We reviewed the current knowledge on various movement disorders that may be related to the therapeutic use of stimulants in patients with ADHD. Recent findings suggest that the use of stimulants and the onset/aggravation of tics are more likely to be coincidental. In rare cases, stimulants may cause stereotypies, chorea, and dyskinesia, in addition to tics. Some epidemiological studies have suggested that stimulants used for the treatment of ADHD may cause Parkinson's disease (PD) after adulthood. However, there is still a lack of evidence that the use of stimulants in patients with ADHD may cause PD, and related studies are only in the early stages. As stimulants are one of the most commonly used medications in children and adolescents, close observations and studies are necessary to assess the effects of stimulants on various movement disorders, including tic disorders and Parkinson's disease.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제28권1호
• /
• pp.25-30
• /
• 2017

Objectives: The study compared the intelligence test profiles of Tourette's Disorder (TD), attention-deficit hyperactivity disorder (ADHD), and TD with ADHD (TD+ADHD) groups. Methods: The Korean Wechsler Intelligence Scale for Children-third edition (K-WISC-III) and Korean Wechsler Intelligence Scale for Children-fourth edition (K-WISC-IV) were administered to 13 children and adolescents with TD, 17 children and adolescents with ADHD, and 15 children and adolescents with TD+ADHD. Each parameter was compared among the groups using the Kruskal-Wallis test. Results: The mean scores of the freedom from distractibility/working memory index (FD/WMI) and the digit span and arithmetic subtests of the TD+ADHD group were significantly lower than those of the TD group. Conclusion: According to the intelligence test results, the comorbid ADHD+TD group showed a significant decrease in working memory compared to the TD group. These findings are similar to those of previous research on cognitive functions and suggest that the TD+ADHD comorbid and TD alone groups exhibit different endophenotypes. The results also imply that WISC-III and WISC-IV, the most commonly used intelligence tests clinically, are effective in evaluating cognitive functions such as attention. Further research is required to confirm these results.

• 대한감각통합치료학회지
• /
• 제17권1호
• /
• pp.43-53
• /
• 2019

목적 : 본 연구는 주의력결핍과잉행동장애아동(Attention Deficit Hyperactivity disorder; ADHD)을 대상으로 국내에서 제공되는 중재 방법을 체계적으로 고찰하여 최신의 국내 치료 경향을 제시하고자 하였다. 연구방법 : 2004년 1월부터 2018년 12월까지 최근 15년간 국내 학회지에 게재된 연구를 대상으로 하였다. 누리미디어(DBpia), 스콜라(Scholar), 학술연구정보서비스(RISS), 한국학술정보(KISS)에서 '주의력결핍과잉행동', '아동', '중재'를 키워드로 검색하였다. 연구대상으로 선정된 연구는 총 14개로, 각 연구는 근거의 질적 수준과 방법론적 질적 수준으로 분석한 후 그 결과를 대상자, 중재, 대조, 결과의 순으로 제시하였다. 결과 : 분석 결과 근거기반 실행의 질적 수준은 수준 IV의 연구가 가장 많았고, 방법론적 질적 수준은 '보통'의 연구가 가장 많았다. 중재는 상호작용식 메트로놈 중재(Interactive metronome; IM)의 빈도가 가장 높았고, 측정된 평가도구는 상호작용식 메트로놈 전체형 검사(Long form assessment of IM), 아동 청소년 행동평가척도(Korean behavior child checklist; K-CBCL)의 사용이 높았다. 중재결과 ADHD아동의 집중력, 과잉행동, 과제 수행, 과다언어 사용, 그리고 타이밍 등에서 유의한 효과가 나타났다. 결론 : 국내 ADHD아동을 대상으로 다양한 중재방법이 제공되었고, 그 결과 ADHD증상에서 효과적인 결과가 나타났다. 따라서 본 연구결과는 임상에서 근거기반 실행을 위한 기초자료로 사용할 수 있다. 앞으로 ADHD아동을 대상으로 한 지속적인 연구가 이루어져야 할 것이다.

• Journal of Yeungnam Medical Science
• /
• 제17권2호
• /
• pp.108-122
• /
• 2000

Background: Models of attention deficit hyperactivity disorder(ADHD) that have proposed a hypodopaminergic state resulting in hypofunction of the prefrontal circuitry have assumed a unitary dopamine system, which largely ignores the distinct functional differences between mesocortical dopamine system and nigrostriatal dopamine system. Purpose: The author's goal was to develop a pathophysiological model for ADHD with greater explanotory power than dopaminergic hypofunction hypothesis in prefronal circuitry. Material and Methods: Published clinical findings on ADHD were integrated with data from genetic, pharmacological, neuroimaging studies in human and animals. Results: Molecular genetic studies suggest that three genes may increase the susceptibility to ADHD. The three candidate genes associated with ADHD are each involved in dopaminergic function, and this consistent with the neurobiologic studies implicating catecholamines in the etiology of ADHD. Pharmacological data also provide compelling support for dopamine and noradrenergic hypothesis of ADHD. Neuroimaging studies lend substantial support for the hypothesis that right-sided abnormalities of prefrontal-basal ganglia circuit would be found in ADHD. Conclusions: The present hypothesis takes advantage of the major differences between the two pertinent dopamine systems. Mesocortical dopamine system, which largely lacks inhibitory autoreceptors, is ideally positioned to regulate cortical inputs, thus improving the signal-to-noise ratio for biologically valued signals. In this circuit, therapeutic doses of stimulants are hypothesized to increase postsynaptic dopamine effects and enhance executive functions. By contrast, symptoms of hyperactivity/impulsivity in ADHD are hypothesized to be associated with relative overactivity of nigrostriatal circuit. This nigrostriatal circuit is tightly regulated by inhibitory autoreceptoors as well as by long distance feedback from the cortex, and slow diffusion of therapeutic doses of stimulant via oral administration is hypothesized to produce a net inhibition of dopaminergic neurotransmission and improves hyperactivity.