• 대한통합의학회지
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• 제10권3호
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• pp.257-266
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• 2022

Purpose : This systematic review examined evidence published 2000-2021 for occupational therapy interventions for adult Attention Deficit Hyperactivity Disorder (adult ADHD). Methods : In order to find out the studies on the effect occupational therapy intervention on individuals with adult ADHD, studies published from 2000 to February 2022 were searched on Google Academic Search. The keywords used were "adult ADHD" AND "Occupational therapy". A total of 785 studies were searched, and from these, 3 studies were selected based on the application of the selection and exclusion criteria. The included studies comprised of 1 Quasi-experimental design study(one group pre-post test) and 2 randomized controlled trials design studies. The included studies were analyzed in PICO(patients, intervention, comparison, outcomes). Results : As a result of analysing the subjects of the included studies, subjects diagnosed with adult ADHD or classified as high-risk group in Adult ADHD Self-Report Scale test, the number of subjects was 97, and the average age was about 33 years old. Occupational therapy intervention methods for adult ADHD include Tailored Intervention, Computerized Cognitive Training, and Cognitive-Functional Intervention. The Adult ADHD Self-Report Scale was the most used to check the symptoms of ADHD, and the COPM was used the most to measure the effects of occupational therapy interventions. The dependent variables of occupational therapy intervention were occupational performance, quality of life, executive function (behavioral regulation, metacognition), self-regulation function, stress management, and sustained attention. The effect of the intervention was statistically significant in 78.5% of the total. Conclusion : It is expected that the results of this study can be used as basic data for evidence-based practice for occupational therapists to apply adult ADHD interventions. In the field of occupational therapy in Korea, research on various interventions that can improve the occupational performance of adults ADHD should be conducted.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제16권1호
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• pp.54-62
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• 2005

목적 : 이번 연구는 최근 주목을 받고 있는 dopamine beta hydroxylase 유전자의 Taq I 절단부위 다형성과 주의력결핍 과잉행동장애 발병 간에 어떤 관련성이 있는지를 알아보기 위한 연구이다. 방법 : 주의력결핍 과잉행동장애 아동 106명을 환자군으로 선정하고, 환자군과 성별, 연령별로 빈도짝짓기된 일반 아동 212명을 대조군으로 하는 환자-대조군 연구를 실시했다. 아울러 환자군과 부모를 대상으로 가족기반 연구를 병행했다. 결과 : 환자-대조군 연구에서는 환자군과 대조군 간의 유전자형이나 대립유전자 분포에 있어 유의한 차이를 발견하지 못했다. 그러나 가족기반 연구에서는 대립유전자 Al의 선택 전달이 관찰되었다. 결론 : 이번 연구를 통해 주의력결핍 과잉행동장애와 dopamine beta hydroxylase 유전자의 Taq I 절단부위 다형성 간의 관련성을 부분적으로 확인했으나 이를 뒷받침하기 위해 서는 추가적인 연구가 필요할 것이다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권2호
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• pp.58-69
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• 2017

Attention-deficit hyperactivity disorder (ADHD) is a highly prevalent, impairing, and comorbid disorder that persists into adulthood. ADHD should be diagnosed in the same manner as other common adult mental health disorders. The three most important components in the comprehensive evaluation of patients with ADHD are the clinical interview, medical examination, and completion and scoring of behavior rating scales. The diagnostic evaluation of ADHD should include questions about the symptoms, family history, prior evaluation and treatment of ADHD, as well as other problems including alcohol and drug use. Screening interviews or rating scales, as well as interviews, should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with the objective assessments of the ADHD symptoms, such as through psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. As comorbidity is the rule rather than the exception, clinicians should carefully screen for comorbid disorders as part of a comprehensive assessment of ADHD. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in his or her daily functioning, and must not meet the criteria for other mental disorders which might better account for the observed symptoms, such as mental retardation, autism or other pervasive developmental disorders, mood disorders and anxiety disorders. This report aims to suggest practice guidelines for the assessment and diagnosis of children, adolescents and adults with ADHD in Korea.

• 신경정신의학
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• 제53권3호
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• pp.154-161
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• 2014

Objectives This study was conducted in order to investigate characteristics of temperament, depression, anxiety, attention, and impulsivity in adult males with Attention Deficit/Hyperactivity Disorder (ADHD) and internet addiction tendency. Methods The survey participants were 181 (121 patients and 60 healthy control subjects) adult males older than 19 years of age in Chung-Ang University Hospital and Gongju National Hospital. Subjects were divided according to ADHD with internet addiction tendency (AI), pure adults with ADHD (AD), and healthy control subjects (HC). All groups completed the Adult ADHD Scale (AADHD), Wender-Utah ADHD Rating Scale (WUADHD), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), the Korean Version of Young Internet Addiction Scale (YIAS-K), Barratt Impulsiveness Scale (BIS) and Temperament Character Inventory-Revised Short version for identification of relationship between ADHD and internet addiction tendency. Results AI groups were found to have higher AADHD, WUADHD, BDI, YIAS-K, and Novelty Seeking scores, compared to the AD and HC groups. The Cooperativeness score of the AI group was significantly lower than that of the AD group and HC group. The BAI and BIS scores of the AI group and AD group were significantly higher than those of the HC group. The Self-Directedness scores of the AI group and AD group were decreased, compared to the HC group. YIAS-K scores were partially related to BDI scores in the AI group. Conclusion The results of this study indicate an association of higher score of BDI with internet addiction tendency in adult patients with ADHD. Management of temperament characteristics, depression, anxiety, attention, and impulsivity may be important for adults with ADHD and internet addiction tendency.

• 한국IT서비스학회:학술대회논문집
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• 한국IT서비스학회 2009년도 추계학술대회
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• pp.453-458
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• 2009

The purpose of this study was to detect early children with hyperactivity which is one of the symptoms of Attention Deficit - Hyperactivity Disorder (:ADHD). For this Purpose, This study used two methods; K-CBCL and observation of children`s behavior. K-CBCL was done online by parents at home. For observation of children's behavior, the school asked children to wear a 3 - axis accelerometer on their wrists. The data from K - CBCL and 3 - axis accelerometer were analyzed and clustered to separate hypersensitive children from ordinary children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권4호
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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.

• Journal of Medicine and Life Science
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• 제18권3호
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• pp.41-48
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• 2021

The prevalence of attention deficit hyperactivity disorder (ADHD), a developmental neuropsychiatric disorder, is high among children and adolescents. The pathogenesis of ADHD is mediated with genetic, biological, and environmental factors. Most therapeutic drugs for ADHD have so far targeted biological causes, primarily by regulating catecholaminergic neurotransmitters. However, ADHD drugs that are clinically treated have various problems in their addictiveness and drug stability; thus, it is recommended that efficacy and safety should be secured through simultaneous prescription of multiple drugs rather than a single drug treatment. Accordingly, it is necessary to develop drugs that newly target pathogenic mechanisms of ADHD. In this study, we attempt to confirm the possibility of developing new drugs by reviewing dopamine-related developmental mechanisms of neurons and their correlation with ADHD. Histone deacetylase inhibitors (HDACi) can regulate the concentration of intracellular dopamine in neurons by expressing vesicular monoamine transporter 2 and inducing the exocytosis of neurotransmitters to the synaptic cleft, thereby promoting the development of neurons and signal transmission. This cellular modulation of HDACi is expected to treat ADHD by regulating endogenous catecholamines such as dopamine. Although studies are still in the preclinical stage, HDAC inhibitors clearly have potential as a therapeutic agent with low addictiveness and high efficacy for ADHD treatment.

• 정신신체의학
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• 제19권2호
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• pp.74-82
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• 2011

연구목적: 본 연구의 목적은 소아 청소년 정신과 외래를 방문하는 주의력결핍 과잉행동장애(Attention-Deficit/Hyper-activity Disorder, ADHD) 아동의 주의력 결핍 정도와 심박 변이도(Heart Rate Variability, HRV)의 인자와의 관계를 비교하고 주의력 결핍 과잉행동의 검사 척도를 통한 증상의 정도와 부모 양육 스트레스 정도와의 연관성을 평가하고자 하였다. 방 법: 2007년 8월부터 2009년 7월까지 고려대학교 구로병원 정신건강의학과의 소아 클리닉을 방문하여 ADHD 진단을 받은 환자 중 이전에 약물 치료를 받은 기왕력이 없는 환자를 대상으로 하였다. ADHD 진단 및 평가에 주의력 장애 진단 시스템(ADHD diagnostic system, ADS)과 ADHD 평가 척도(ADHD rating scale, ARS)를 이용하였고, HRV 측정은 5분 동안 시행되는 것으로 평가하였다. 또한 부모의 양육 스트레스 정도를 측정하기 위하여 부모의 양육 스트레스 척도를 이용하였고 지능검사로는 한국판 아동용 웩슬러 지능검사가 이용되었다. Pearson 상관 분석을 통해 ARS 변수, ADS 변수와 HRV의 인자, 양육 스트레스 변수들 간의 상관관계에 대하여 알아보았다. 결 과: ADHD로 진단 받은 59명의 환자가 본 연구에 최종 참여하였다. HRV 인자 중 주파수 영역 분석법에서 저주파 스펙트럼은 ADS 변수 중 반응 시간 변산성(r=0.325, p<0.05)과 유의한 상관관계를 보였으나, 그 외 ADS 변수들과 ARS 변수들과는 유의한 상관 관계를 보이지 않았다. 부모 양육 스트레스에서는 ARS의 부주의 인자의 증상 정도가 심해질수록 부모-자녀의 역기능적 상호작용과 자녀의 기질과 관련된 척도가 유의하게 증가하였고 과활동성 인자의 증상 정도가 심해질수록 부모의 스트레스와 자녀의 기질과 관련된 척도가 유의하게 증가되었으며 그 외에는 유의한 차이를 보이지 않았다. 결 론: 본 연구에서는 ADHD 아동들에서의 임상적 변인과 HRV의 인자 사이에서 일부 연관성을 보여주었다. 따라서 차후 HRV가 임상적으로 ADHD 아동들에 있어서 치료를 받은 후 정신적 할당에 향상되었는지를 알아볼 수 있는 도구 중 하나가 될 가능성을 보여 주는 것이라 할 수 있겠고 이후 이에 따른 양육스트레스의 변화 또한 전향적인 연구가 필요할 것으로 생각된다.

• 한국학교보건학회지
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• 제17권2호
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• pp.35-46
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• 2004

Purpose: This study investigated the prevalence of middle school students with ADHD and the level of middle school teacher's knowledge, coping strategies, and educational intervention for ADHD. Methods: There were 185 teachers and 6,381 middle school students at the 6 middle schools in Pusan. The data was collected from December 20, 2003 to January 10, 2004. Results: 195 middle school students had ADHD (3.1%). The male students with ADHD made up 4.4% of the total students and the female students with ADHD totaled 1.3%. The mean score of middle school teacher's knowledge about ADHD was 21.86 of the score total 32. The teachers used a negative coping style less than an active and passive coping style. Of the educational interventions, the environmental intervention in the classroom was used more than the educational intervention activity. 61.1% of the teachers responded that they did not know very much about ADHD. 93.5% of the teachers had no educational experience with ADHD. 94.1% felt that they needed an education program about ADHD and over half of them intended to participate in an ADHD education program. Conclusion: Based on the results of this study, we concluded that the middle school teachers felt that they had insufficient knowledge about ADHD. They wanted the opportunity to increase their knowledge of ADHD. Therefore, it is necessary for educational programs about ADHD for teachers to be developed and made available to them.

• Clinical and Experimental Pediatrics
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• 제51권12호
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• pp.1324-1328
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• 2008

목 적: 주의력 결핍/과잉 운동 장애(ADHD)를 진단받은 환아를 대상으로 뇌파 결과의 차이 및 이에 따른 역학적 비교를 하고자 하였으며 뇌파의 차이에 따른 경련 발현의 차이를 비교해보고자 하였다. 또한 ADHD의 치료제로 사용되는 중추신경자극제의 사용과 경련 발현과의 연관성을 비교하고자 하였다. 방 법: 2001년 1월부터 2005년 12월까지 주의산만을 주소로 충북대학교병원 소아청소년과 및 소아정신과 외래를 내원한 환아를 대상으로 의무기록지 고찰을 통해 후향적으로 분석하였다. 결과: 이전 경련의 병력이 없는 환아중 주의산만을 주소로 본원 신경정신과를 방문한 환아를 대상으로 하였다. 대상 연령은 4세에서 17세 사이로 총 308명의 환아들 중 84명의 환아에서 뇌파를 시행하였으며 그중 남자가 72명(85.7%, 평균 연령 9.3세), 여자가 12명(14.3%, 평균 연령 8.0세)이었다. 정상뇌파소견을 보인 환아가 65명(77.4%), 이상뇌파소견을 보인 환아가 19명(22.6%)였으며 이중 경련증상을 보인 환아는 각각 1명(0.15%), 3명(15.7%)이었다. 중추신경자극제를 처방 받은 환자는 59명, 그렇지 않은 환자는 25명이었고 그중 경련증상을 보인경우는 각각 2명(3.4%), 2명(8.0%)로 나타났다. 결 론: ADHD 환아들은 임상에서는 표출되지 않으나 뇌파에서의 잠재적인 이상 소견 보일 수 있다. 본 연구에서는 이러한 뇌파의 이상 소견과 추후 경련 발현 여부와는 매우 높은 연관성을 보이고 있으며, ADHD의 치료로써 사용된 methylphenidate의 사용에 따른 경련 발현과의 통계적 유의성은 보이지 않았다. 따라서 ADHD 환아들에서 뇌파의 이상 소견이 보일 경우는 향후 경련 발현에 대한 보다 주의 깊은 추적 관찰과 함께 ADHD 환아들의 삶의 질 향상에 대한 적극적인 치료가 필요할 것으로 사료된다.