• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.17 no.2
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• pp.114-123
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• 2006

Objectives : The special class has been made, bringing rapid increase quantitatively. The authors carried out the child psychiatric interview and evaluation for 9 special-classed children in Asan city to find out clinical diagnosis and emotional/behavioral characteristics. Methods : The child psychiatrists evaluated special class children by DSM-IV and K-SADS-PL. Tools for the evaluation were Child Behavior Checklist- Korean version, Korean Personality Inventory for Children, Children's Depression Inventory, Abbreviated Conners Parent-Teacher Rating Scale-Revised, State-Trait Anxiety Inventory for Children, Vineland Social Maturity Scale, Wechsler Intelligence Scale for Children-III, and Childhood Autism Rating Scale. Results : Ultimately 53 children, consisting of 35 boys(67.9%) and 18 girls(32.1%), participated, and the average age was $10.5{\pm}1.3$ years old. Their measure of Vineland Social Maturity Scale was $78.7{\pm}20.0$, Childhood Autism Rating Scales was $25.4{\pm}9.0$, Child Depression Inventory was $22.2{\pm}5.2$, State-Trait Anxiety Inventory for Children was $35.2{\pm}8.2/36.5{\pm}6.2$, and Abbreviated Conners Parent-Teacher Rating Scale was $11.0{\pm}4.6$. In the clinical diagnosis evaluation, the prevalence rate of learning disorder was decreased compared to early research, ADHD had been newly appeared and depression disorder and anxiety disorder had been increased. Conclusion : This result suggests that a lot of children in a special class have complex emotional and behavioral problems in addition to educational problems.

• Clinical and Experimental Pediatrics
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• v.58 no.2
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• pp.64-68
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• 2015

Purpose: The purpose of this study was to investigate the importance of initial screening tests for depression and anxiety disorders in children with headache. In addition, this study evaluated whether the Children's Depression Inventory (CDI) and Revised Children's Manifest Anxiety Scale (RCMAS) are suitable for screening symptoms of depression and anxiety. Methods: A retrospective chart review was conducted of 720 children aged 7-17 years who had visited a pediatric neurology clinic for headaches and were referred to a pediatric psychiatric clinic for psychiatric symptoms from January 2010 to December 2011. All patients completed the CDI and RCMAS. Among them, charts of patients with clinically significant total scores (cutoff>15) for psychiatric symptoms, as defined by the CDI and RCMAS scoring scales, were reviewed. Results: Nineteen patients had headaches and clinically significant total scores for psychiatric symptoms. The mean age at headache diagnosis was 11.7 years, and 57% were male. Mean duration of headache was 11.5 months. Two point eight percent of the patients were diagnosed with psychiatric disorders including major depression (1.7%), generalized anxiety disorder (1.1%), and bipolar disorder (0.1%). Four patients (0.6%) were diagnosed with attention deficit/hyperactivity disorder (ADHD). Total mean CDI and RCMAS scores of patients referred to the psychiatric clinic were 18.8 and 22.2, respectively. There was no correlation between CDI or RCMAS total scores and headache frequency, duration, or severity. Conclusion: We recommend that all patients with headache should be screened for depression and anxiety by CDI and RCMAS scores.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.17 no.2
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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.

• 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.

• Journal of radiological science and technology
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• v.27 no.3
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• pp.31-41
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• 2004

Attention deficit hyperactivity disorder(ADHD)is one of the most common psychiatric disorders in childhood, especially school age children and persisting into adult. ADHD is affected 7.6% in our children, Korea. and persisting into $15{\sim}20%$ in adult. And it is characterized by hyperactivity, inattention and impulsivity. Brain imaging is one of way to diagnosis for ADHD. Brain imaging studies may be provide information two types - structural and functional imaging. Structural and functional images of the brain play an important role in management of neurologic and psyciatric disorders. Brain SPECT, with perfusion imaging radiopharmaceuticals is one of the appropriate test to diagnosis of neurologic and psychiatric diseases. Ther are a few studies about separated analysis between boys and girls ADHD SPECT brain images. Selection of Probability level(P-value) is very important to determind the abnormalities when analysis a data by SPM. SPM is a statistical method used for image analysis and determine statistical different between two groups-normal and ADHD. Commonly used P-value is P<0.05 in statistical analysis. The purpose of this study is to evaluation of blood flow clusters distribution, between boys and girls ADHD. The number of normal boys are 8(6-7y, average : $9.6{\pm}3.9y$) and 51(4-11y, average : $9.0{\pm}2.4$) ADHD patients, and normal girls are 4(6-12y, average : $9{\pm}2.4y$) and 13(2-13y, average $10{\pm}3.5y$) ADHD patiens. Blood flow tracer $^{99m}Tc-ethylcysteinate$ dimer(ECD) injected as rCBF agent and take blood flow images after 30 min. during sleeping by SPECT camera. The anatomical region of hyperperfusion of rCBF in boys ADHD group is posterior cingulate gyrus and hyperperfusion rate is 15.39-15.77% according to p-value. And girls ADHD group appears at posterior cerebellum, Lt. cerbral limbic lobe and Lt. Rt. cerebral temporal lobe. These areas hyperperfusion rate are 24.68-31.25%. Hypoperfusion areas in boys ADHD,s brain are Lt. cerebral insular gyrus, Lt. Rt. frontal lobe and mid-prefrontal lobe, these areas decresed blood flow as 15.21-15.64%. Girls ADHD decreased blood flow regions are Lt. cerebral insular gyrus, Lt. cerebral frontal and temporal lobe, Lt. Rt. lentiform nucleus and Lt. parietal lobe. And hypoperfusion rate is 30.57-30.85% in girls ADHD. The girls ADHD group's perfusion rate is more variable than boys. The studies about rCBF in ADHD, should be separate with boys and girls.

• Korean Journal of Childcare and Education
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• v.7 no.2
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• pp.137-158
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• 2011

This study is to investigate the effect of music therapy Program on Problem Behaviors and Social Skills Children with ADHD. The participants of the study were first and second graders in B elementary school in J city. They were observed in unsuitable behavioral patterns in school life by their homeroom teachers. Fifteen participants were divided into control and experimental group: The control group was eight and the experimental group was seven. Group music therapy was conducted two times a week for seven-week period. It took 35-40 minutes per therapy after school. Child Behavior Checklist-Korean, Social Skills Rating System, Social Acceptance were administered in pre- and post-stages. For the analysis of the data, Mann-Whitney U test was used. The findings from the research are summarized as follows: 1) The experimental group who was treated in music therapy showed a positive effect on problem behaviors. That is to say, the participants in the experimental group improved in emotional and cognitive stability while they significantly decreased attack behaviors; 2) The experimental group statistically showed significant improvement in their social behaviors compared to the control group. The music therapy group significantly increased social skills such as cooperation, self-assertion, and self-control. However, they did not improve responsibility as social skills in a significant manner; and 3) The experimental group showed higher degree of social acceptance than the control group. However, the result did not show a significant difference between the groups. In conclusion, the study proved positive effects of music therapy on ADHD children's uncarefulness, attack behaviors, and social skills for seven-week experimental period.

• The Journal of the Korea Contents Association
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• v.16 no.7
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• pp.291-299
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• 2016

This study aimed to evaluate the relationship of ADHD, depression, anxiety, self-esteem, impulsivity, suicide idea and quality of life as well as burnout of kindergarten teachers for the first time in Korea. Also, it examined the odds ratio with ADHD, depression, anxiety, self-esteem, impulsivity, suicide idea and quality of life between burnout group and the comparison group through logistic regression analysis. A set of questionnaires was provided to a total of 310 participants (80 with higher burnout risk and 230 without burnout risk) from April 2015 to July 2015. All of participants were evaluated using the Korean Adult Attention Deficit Hyperactivity Disorder Scales, Beck's Depression Inventory, Beck's Anxiety Inventory, Baratte' Impulsivity Scale, Rosenberg's Self-esteem Inventory and Qulity of Life Scale. The results of this study indicated that burnout risk group is related to ADHD and anxiety and impulsivity. For the treatment of burnout in kindergarten teachers, effective evaluation and treatment of ADHD and impulsivity, as well as anxiety, seem to be necessary.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.1
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• pp.25-50
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• 2001

Using Fourier transformation and wavelet analysis, we compared the auditory event-related potentials of the patients with attention deficit-hyperactivity disorders(abbr. ADHD, 13 boys) and normal control children(8 boys). Amplitudes of the event-related potentials which were calculated via Fourier transformation were compared between the groups and between conditions(non-target versus target) in each group. To the non-target stimuli, the patients with ADHD showed significantly greater amplitudes across almost all of the electrode sites and frequencies. To the target stimuli, the incidents which ADHD patients showed much higher amplitudes than normal controls significantly decreased, while those of the reverse results increased significantly. These results were consistent with the comparison results about negative difference wave(abbr. Nd wave) using Fourier transformation. In summary, it was proved that non-target stimulus which should be ignored elicited more robust electrical response from the patients with ADHD than normal children, but the target stimulus which reguired active processing did much less electrical activity in the patients. For the patients, they showed much inhibited electrical response to the target stimuli in some electrodes and frequency ranges. Normal children were more strongly stimulated by the target stimuli in almost all electrodes and frequency ranges than the patients, but less in prefrontal leads and frontal leads. Wavelet analysis results proved that early responses(0-300msec) to the nontarget stimuli of the patients were significantly greater than the normal controls in prefrontal, anterior frontal, some parts of temporal, and occipital lobes and that late response(300-370msec) were significantly lesser than normal children in parietal and central electrodes. Target stimuli elicited significantly higher electrical activity in both group than non-target stimuli did. Prefrontal and frontal lobes showed stronger responses in the patients than normal children irrespective of stimulus condition, but parietal and temporal lobes did higher activities in normal children than the patients only to the target stimuli. In conclusion, the patients with ADHD showed much greater responses to the stimuli which should be ignored, but failed to activated the necessary processes to the target stimuli. Also, we found that the frequency-dimension analysis and wavelet analysis were useful for the signal processing such as event related potentials.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.20 no.3
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• pp.129-139
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• 2009

Objectives : This study evaluated the effectiveness of school-based mental health screening and treatment linkage programs, focusing on attention-deficit hyperactivity disorder (ADHD) and adolescent depression. Methods : All 11,158 children and adolescents aged 8-14 years in Seoul received a school-based mental health screening, consisting of the Korean versions of the ADHD rating scale and the Child Behavior Checklist (CBCL), for ADHD, and the Center for Epidemiological Studies Depression Scale (CES-DS) and the Suicidal Ideation Questionnaire-Junior (SIQ-JR), for depression. The high-risk children's and adolescents' diagnoses were confirmed using the Diagnostic Interview Schedule for Children-IV (DISC-IV). Treatment linkage programs were managed by the Seoul Metropolitan Community Mental Health Center (Program 1), the Seoul Metropolitan Office of Education (Program 2), or the Dongjak District Office of Education (Program 3). We estimated and compared the referral rates of the three programs. Results : Program 1 screened and referred 22.9% of ADHD youths to mental health services, Program 2, 68.8%, and Program 3, 40.0%. Program 1 screened and referred 22.8% of depressed youths to mental health services, Program 2, 53.8%, and Program 3, 88.9%. Key elements for successful screening and referral programs were an effective school/community mental health center/Office of Education network, the parents' financial support and perception of their child's mental health status as being problematic, and the teachers' active engagement. Conclusion : This is the first study investigating the effectiveness of school-based mental health screenings' linkage to treatment for primary and middle school students in Korea. An effective network for community mental health and improvements in parents' and teachers' perceptions regarding mental health are needed for more successful treatment linkage.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.1
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• pp.115-124
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• 2001

Objective：The purpose of this study was to compare the clinical features of children with three subdiagnoses of tic disorder(transient tic disorder(TTD), chronic tic disorder(CTD) and Tourette’s disorder (TD)) and to exam the factors related with illness severity of them. Method：Subjects were 69 children who met DSM-IV criteria for tic disorder and 43 control children. All subjects were investigated demographic and clinical factors related to tic. The severity of tic was assessed with the Yale Global Tic Severity Scale(YGTSS) in tic disorder children. The Child Behavior Checklist(CBCL) was accomplished by parents of all subjects. Results：Children with TTD had not only shorter duration of tic symtoms but also milder tic severity and impairment than those with CTD and TD. They also had significantly lower scores on most CBCL subscales than children with CTD and TD, while they were similar with controls in all the CBCL subcale scores except aggressive behavior. Children with CTD and those with TD were similar to each other in clinical variables except number of tic symptom and scores on CBCL social problem subscale. The interference and intensity of motor tic symptoms and duration of tic symptoms were significant predictors of global impairment score on YGTSS, while the presence of comorbid ADHD was a preictor of the total behavior problem score of CBCL. Conclusion：These findings indicate that duration of tic symptoms and the presence of comorbid ADHD as well as the severity of tic symptoms strongly associated with the illness severity of children with tic disorder. These results also suggest that those clinical factors may be more important for assessing the severity of illness and determining the treatment strategy than the sub-diagnosis itself in children with tic disorder.