• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제13권1호
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• pp.139-152
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• 2002

연구 목적：ADHD 아동을 대상으로 DSM-Ⅳ 진단기준을 이용하여 세 아형으로 분류한 후, 임상적 특징과 신경심리학적 차이를 비교하고자 본 연구를 시행하였다. 방 법：연구는 1998년 7월부터 2001년 7월까지 주의력결핍 증상을 주소로 영남대학교 부속병원 정신과를 내원하여 ADHD로 진단된 6~15세 아동을 대상으로 하였고, 신경정신과적 공존질환이나 신경학적 이상이 있는 아동은 배제하여 총 404명으로부터 자료를 얻었다. DSM-Ⅳ 진단기준을 사용하여 아형으로 분류하였고, ADHD-C형이 234명(57.9%), ADHD-Ⅰ형이 156명(38.6%), ADHD-HI형이 14명(3.5%)이었다. 평균 연령은 9.63±2.49세였다. 약물치료 시작 전에, 정신병리평가, 지능 평가, 행동증상평가, 신경심리학적 실행기능에 대해 각각 평가를 하였다. 평가도구로는 정신병리를 평가하기 위해 한국아동인성검사(K-PIC)를, ADHD행동증상을 평가하기 위해 4종의 설문지형 평가도구인 한국판 주의력결핍장애 평가척도-가정판(ADDES-HV), ADD-H comprehensive teacher’s rating scale(ACTeRS), 한국형 소아기 집중력 문제척도(CAP)와 SNAP을 이용하였다. 지능은 K-ABC와 KEDI-WISC로 평가하였고, 주의력 및 실행기능검사는 Conner의 연속수행검사(CPT), 위스콘신분류검사(WCST), 정지신호검사(SST)를 사용하였다. 결 과：세 아형 별 비교에서 ADHD-C형이 가장 많았고 ADHD-Ⅰ, ADHD-HI 순 이었다. 아형간 남녀성별에 따른 유병율 차이는 보이지 않았다. 연령은 ADHD-Ⅰ형이 가장 높았다(p<.001). 정신병리평가에서 비행 과잉행동 정신증 점수는 ADHD-C형과 ADHD-HI형이 ADHD-Ⅰ형보다 높게 나타났고(p<.05), ADHD-C형에서 가족관계의 문제와 자폐증 점수가 ADHD-Ⅰ형보다 높게 나타났으며(p<.05), 자아탄력성 점수는 ADHD-Ⅰ형 보다 낮았다(p<.05). 불안, 우울, 신체화 증상은 세 아형간 차이를 보이지 않았다. 아형별 행동증상측정 결과 ADHD-C형이 ADHD-Ⅰ형보다 주의력결핍, 과잉행동, 충동성 점수가 더 높게 나타났다(p<.05). 단, 교사가 평가하는 ACTeRS에 의한 결과는 ADHD-HI형에서 주의력 결핍 증상과 과잉행동점수가 더 높았다(p<.05). 아형간 지능의 비교에서는 K-ABC를 이용한 평가에서 ADHD-HI 형이 순차처리항목과 계산능력에서 유의하게 높았고(p<.05), KEDI-WISC를 이용한 평가에서는 ADHD- HI형은 대상수가 소수여서 비교할 수 없었으며, ADHD-C형과 ADHD-Ⅰ형 사이에 유의한 차이는 보이지 않았다. CPT, WCST, SST를 이용한 신경심리학적 실행기능의 비교에서 아형간 계량적인 차이는 있었으나 통계적으로 유의한 차이는 보이지 않았다. 결 론：결론적으로 ADHD 세 아형은 임상적으로 뚜렷한 차이를 보였지만, 실행기능상 유의한 차이를 발견할 수 없었다. 향후 보다 잘 고안 된 연구와 발달중인 아동에 적절한 신경심리 평가 도구의 개발을 통해 결과를 보완해야 할 것으로 사료된다.

• Journal of Computing Science and Engineering
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• 제10권4호
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• pp.111-117
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• 2016

An accurate approach for diagnosis of attention deficit hyperactivity disorder (ADHD) is presented in this paper. The presented technique efficiently classifies three subtypes of ADHD (ADHD-C, ADHD-H, ADHD-I) and typically developing control (TDC) by using only structural magnetic resonance imaging (MRI). The research examines structural MRI of the hippocampus from the ADHD-200 database. Each available MRI has been processed by a region-of-interest (ROI) to build a set of features for further analysis. The presented ADHD diagnostic approach unifies feature selection and classification techniques. The feature selection technique based on the proposed binary-coded genetic algorithm searches for an optimal subset of features extracted from the hippocampus. The classification technique uses a chosen optimal subset of features for accurate classification of three subtypes of ADHD and TDC. In this study, the famous Extreme Learning Machine is used as a classification technique. Experimental results clearly indicate that the presented BCGA-ELM (binary-coded genetic algorithm coupled with Extreme Learning Machine) efficiently classifies TDC and three subtypes of ADHD and outperforms existing techniques.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제19권2호
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• pp.104-111
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• 2008

Objectives : The purpose of this study was to compare two subtypes of attention-deficit hyperactivity disorder (ADHD) and controls in their attention using ADHD diagnostic system (ADS), a kind of continuous performance test. Methods : Subjects of this study were 8 children with ADHD-predominantly inattentive type, 28 children with ADHD-combined type and 20 control children. Ages ranged from 5 to 14 years. The Korean Educational Development Institute version of the Wechsler Intelligence Scale for Children (KEDI-WISC) and the ADS were administered to all subjects to provide measures of intelligence and attention. Results : Significant differences were found in the ADS variables for the three groups. When compared with controls, the ADHD-predominantly inattentive type children scored significantly higher on the omission error at middle stage and later stage and ADHD-combined type children scored significantly higher on the omission error and reaction time at later stage. When compared with the other two groups, the ADHD-combined type children scored significantly higher on the commission error at all three stages. Conclusion : Our results suggest that the two subtypes of ADHD have different features in attention deficit. And there was a possibility that commission error is available variable to show cognitive characteristics of ADHD-combined type than any other ADS variables. Further studies are needed to evaluate this finding.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제21권2호
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• pp.72-79
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• 2010

Objectives : The purpose of this study was to examine the difference in functional impairment between children with attention-deficit hyperactivity disorder (ADHD) and normal controls, and to compare the functional impairment across ADHD subtypes. Methods : Children and adolescents with ADHD between the ages of 6 and 18 years were recruited for the study. Parents and teachers of the ADHD subjects completed the parents' and teachers' forms of the Children and Adolescents Functioning Impairment Scale (CAFIS), respectively. The results of these scales were compared to those of normal controls. Results : Subjects included 110 children with ADHD, predominantly inattentive type (ADHD-IA) ; 23 with ADHD, predominantly hyperactive-impulsive type (ADHD-HI) ; and 60 ADHD, combined type (ADHD-C). When compared to 41 normal controls, there were significant differences in CAFIS-parent and CAFIS-teacher scales for the ADHD group. Functional impairment in the family relationship as rated by the parents was higher in children with ADHD-C when compared to that of children with ADHD-IA. Conclusion : In comparison to normal children, children with ADHD have a higher level of impairment in several functional areas, and differences exist in functional impairment across ADHD subtypes. Further, ratings of functional impairment between parents and teachers were inconsistent. Thus, gathering information from the teachers is important when diagnosing or establishing treatment regimens for ADHD.

• 한국컴퓨터정보학회논문지
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• 제20권11호
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• pp.127-133
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• 2015

In this paper, we propose that college counselors be more knowledgable of adult ADHD symptoms and develop better understandings of subtypes of the disorder. The findings in this study show that college students with different subtypes of ADHD symptoms experience different types of psychological maladjustment as well as different levels of psychological distress. Specifically, combined-type trait group show the highest levels of each of subscale of SCL-90-R among the other groups (i.e., normal, predominant inattentive subtype, hyperactive-impulsive type). Furthermore, combined typed trait group show significantly higher levels of animosity and paranoid ideation than the others. Therefore, college counselors need to provide effective interventions addressing intense emotion and cognitive distortion among college students with ADHD combined symptoms.

• 생물정신의학
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• 제17권2호
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• pp.70-78
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• 2010

Objectives : This study investigated the differences of working memory among the subtypes of ADHD. Methods : Eighty-one children and adolescents with ADHD and thirty normal controls were recruited. Children with any cognitive disorders and low intelligence were excluded. In order to evaluate the verbal and visuospatial working memory, Digit span and Finger windows tasks were measured, respectively. Performances on these measures between children with ADHD and controls were compared. Further, performances among the groups of ADHD predominantly inattentive(ADHD-IA)(n=40), predominantly hyperactive-impulsive(ADHD-HI)(n= 10), and combined type(ADHD-C)(n=31), were compared. Results : Scores of Finger windows forward task were lower in the ADHD group as compared to the control group, whereas, the Digit span forward showed no difference. Both scores of Digit span backward and Finger windows backward task were lower in the ADHD group than the controls. Children with ADHD-IA performed poorer than children with ADHD-C on the Finger windows backward task. Conclusion : The results of this study showed that children with ADHD have deficits in spatial short-term memory and verbal and visuospatial working memory when compared to normal children. The deficits were evident in children with ADHD-IA subtype and in particular, performance on the visuospatial working memory task in this group was poorer than the ADHD-C group.

• Clinical Psychopharmacology and Neuroscience
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• 제16권4호
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• pp.407-414
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• 2018

Objective: Anxiety has been shown to influence functional impairment in patients with attention deficit hyperactivity disorder (ADHD). This study aimed to compare functional impairment in subjects with and without adult ADHD and to investigate the associations among trait anxiety, functional impairment, and ADHD symptom severity. Moreover, the effects of ADHD symptom subtypes on trait anxiety and functional impairment were also examined. Methods: The sample included 209 adults between the ages of 20 and 31 years. Fifty-one adults received a diagnosis of ADHD, and an additional age, sex-matched group of 51 adults comprised the adult control. Participants were assessed with Conners' Adult ADHD Rating Scales (CAARS), the Beck Depression Inventory (BDI), the Spielberg Trait Anxiety Inventory (STAI-T), and the Sheehan Disability Scale (SDS). The relationships among ADHD severity, anxiety, and functional impairment were investigated using Pearson's correlation analysis. Subtypes of ADHD symptoms that predicted anxiety and functional impairment were investigated using regression analyses. Results: Adult ADHD patients significantly differed from normal control subjects according to BDI, STAI-T, and SDS assessment. Significant positive correlations were noted between ADHD severity, anxiety, and functional impairment. Multiple linear regression analysis confirmed anxiety as a mediator between functional impairment and ADHD CAARS symptom subscales. Conclusion: Patients with adult ADHD showed higher levels of anxiety, depression, and functional impairment. Additionally, ADHD symptoms and anxiety impacted subject functional impairment. Our results suggest that anxiety may be a strong mediator between ADHD severity and functional impairment.

• 아동학회지
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• 제34권1호
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• pp.71-86
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• 2013

The purpose of this study was (1) to examine the level of learning disabilities reflected in the written expression and writing performance of at-risk children with ADHD, (2) to investigate the level of differences in writing learning disabilities and writing performance depending on ADHD subtypes, and (3) to explore the error types and contents in the written expression of at-risk children with ADHD. The participants in this study were 46 upper grade elementary school children. They were firstly screened by teacher nomination, and only participants with a K-ARS score of over 17 were then selected to be among the 46 children involved in this study. Two further tests were then carried out : K-LDES as an index of learning disabilities in written expression and BASA-writing as an index of writing performance. The results showed that the at-risk children with ADHD possibly had comorbid writing learning disabilities. They were significantly different in terms of the number of total syllables, errors and correct syllables that they produced, in comparison to normal children. But there were no differences as regards the level of learning disabilities in terms of written expression and writing performance based on ADHD subtypes. As regards the implications of these results for future research, we suggested that there is a need for the identification of comorbid writing learning disabilities in ADHD assessment.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제17권2호
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• pp.124-130
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• 2006

Objectives : The objective of this study was to evaluate the differences in patterns of temperament and character, as assessed by the Junior Temperament and Character Inventory (JTCI), between the children with attention-deficit/hyperactivity disorder (ADHD) and the control group in a community sample. In addition, we examined the potential differences on JTCI profiles according to the ADHD subtypes. Methods : Parents of 185 ADHD subjects (mean age $9.0{\pm}1.7$ years), as diagnosed by the DISC-IV, and 185 age- and gender-matched comparison children have completed the parent's version of the JTCI. Results : The ADHD group scored significantly higher in Novelty Seeking and lower in Persistence than the comparison group on JTCI. However, there were no significant differences in the temperament or character profiles by the ADHD subtypes. Conclusion : The results of this study suggest that the temperamental factors of higher Novelty Seeking and lower Persistence are related to ADHD. The temperament or character profiles in this study do not provide support for the distinctiveness of the ADHD subtypes.

• Genes and Genomics
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• 제40권12호
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• pp.1309-1317
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• 2018

It is well known that dopaminergic genes affect the development of attention deficit hyperactivity disorder (ADHD) in various populations. Many studies have shown that variable number tandem repeats (VNTRs) located within the 3′-untranslated region of DAT1 and in exon 3 of DRD4 are associated with ADHD development; however, these results were inconsistent. Therefore, we investigated the genetic association between two VNTRs and ADHD in Korean children. We determined the VNTRs using PCR. We examined genotype and allele frequency differences between the experimental and control groups, along with the odds ratios, using Chi square and exact tests. We observed a significant association between the children with ADHD and the control group in the 10R/10R genotype of DAT1 VNTRs (p=0.025). In addition, the 11R allele of DAT1 VNTRs showed a higher frequency in the control group than in the ADHD group (p=0.023). Also, the short repeat (without 11R) and long repeat alleles (including 11R) were associated with ADHD (p<0.05). The analysis of DRD4 VNTRs revealed that the 2R allele is associated with ADHD (p=0.025). A significant result was also observed in long and short repeats (p<0.05). Additionally, ADHD subtypes showed that the DRD4 VNTRs are associated with combined and hyperactive-impulsive subtype groups (p<0.05). Therefore, our results suggest that DAT1 VNTRs and DRD4 VNTRs play a role in the genetic etiology of ADHD in Korean children.