Probably the three most important components to a comprehensive evaluation of patients with attention-deficit hyperactivity disorder(ADHD) are the clinical interview, the medical examination, and the completion and scoring of behavior rating scales. Teachers and other school personnel are often the first to recognize that a child or adolescent might have ADHD, and often play an important role in the help-seeking/referral process. A diagnostic evaluation for ADHD should include questions about ADHD symptoms, other problems including alcohol and drug use, family history of ADHD, prior evaluation and treatment for ADHD. Screening interview 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 objective assessments of the ADHD symptoms, such as psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but they may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. Screening for intellectual ability and academic achievement skills is also important in determining the presence of comorbid developmental delay or learning disabilities. The number and type of symptoms required for a diagnosis of ADHD vary depending on the specific subtype. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in daily functioning, and must not meet 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, anxiety disorders. This report aims to suggest a practice guideline of assessment and diagnosis for children and adolescents with ADHD in Korea.
Adolescent ; Anxiety Disorders ; Autistic Disorder ; Child ; Diagnosis* ; Humans ; Intellectual Disability ; Korea ; Learning Disorders ; Mass Screening ; Mental Disorders ; Mood Disorders ; Psychological Tests ; Weights and Measures

OBJECTIVES: This study was conducted to investigate the prevalence of victims of bullying and the demographic characteristics of victims, and their related psychopathology, in a Korean nationwide sample of youths in middle and high school over a one month period. METHODS: During the autumn of 2009, students in the 7th to 12th grades at 23 secondary schools participated in a nationwide, cross-sectional study. The study subjects completed the Adolescent Mental Health and Problem Behavior Screening Questionnaire- II (AMPQ-II) and Symptom Checklist-90-Revision (SCL-90-R). Based on the data acquired, descriptive statistics, correlation coefficients and multiple logistic regression analysis were performed. RESULTS: Among the 3364 participants, 2272 (67.54%) completed the questionnaire. The prevalence of victimization was 28.9%. Male gender was positively associated with victimization, and grade level was negatively related to victimization. The AMPQ-II bullying score (Factor 4) was significantly (p<.001) and positively correlated to the AMPQ-II student total score (r= 0.50), Worry and thought (Factor 1 ; r=0.38), Mood and suicide (Factor 2 ; r=0.31), Academic and Internet-related problems (Factor 3 ; r=0.24), Rule violations (Factor 5 ; r=0.23), and AMPQ-II teacher total score (r=0.11). Somatization (r=0.23), Obsessive-compulsive behavior (r=0.24), Interpersonal sensitivity (r=0.30), Depression (r=0.33), Anxiety (r=0.26), Hostility (r=0.30), Phobic anxiety (r=0.22), Paranoid ideation (r=0.36), and Psychoticism (r=0.31) results from the SCL-90-R were also found to be positively related to the AMPQ-II bullying score, and remained significant after adjusting for age and gender. A total of 26% of the victims reported suicidal ideations as compared to 9% of non-victims over the month prior to the evaluation (chi2=119.595, df=1, p<.001). The multiple logistic regression analysis indicated that the AMPQ-II bullying score significantly increased the risk of suicidal ideation [Exp(b)=1.55, df=1, p<.001] after adjusting for age and gender. CONCLUSION: School bullying was highly prevalent among Korean middle and high school students. This study provided strong evidence that suicidal ideation and psychopathology were serious problems among the victims of bullying.
Adolescent ; Anxiety ; Bullying ; Crime Victims ; Cross-Sectional Studies ; Depression ; Hostility ; Humans ; Logistic Models ; Male ; Mass Screening ; Mental Health ; Prevalence ; Psychopathology ; Suicidal Ideation ; Suicide ; Surveys and Questionnaires

This practice parameter for non-pharmacological treatment for attention-deficit hyperactivity disorder(ADHD) review the domestic and international literature on the psychosocial treatment of children and adolescents with ADHD. This parameter include the parental training & education, cognitive behavior therapy(group or individual), social skill training, family therapy, play therapy(individual psychotherapy) and non-traditional therapy(art therapy, herbal therapy et al). Among them, there is some proven evidence only in parental training & education and cognitive behavior therapy. So, this parameter describes some details only in the field of parental training & education and cognitive behavior therapy. The efficacy or effectiveness, especially, cost-effectiveness of specific psychosocial treatment method for ADHD cannot be fairly assessed due to the scarcity of controlled clinical data. Based on the clinical expert consensus and limited evidence, we cautiously suggest the practice recommendations about the non-pharmacological psychosocial treatment for children and adolescents with ADHD.
Adolescent ; Child ; Cognitive Therapy ; Consensus ; Education ; Family Therapy ; Humans ; Parents ; Phytotherapy

The objective of this review is to propose the Korean practice guideline for pharmacological treatment of attentiondeficit hyperactivity disorder(ADHD). For making the guideline, the authors used the evidence-base approaches derived from a detailed review of literature including wide range of controlled clinical trials, studies of side effects of drugs, toxicological reports, and meta-analyses published in United States and Europe, as well as inside Korea. The review committee composed of experts in ADHD in Korea has reviewed the parameter. The practice parameter for pharmacological treatment describes the use of stimulants, atomoxetine, modafinil, bupropion, tricyclic antidepressants, and alpha-adrenergic agonists and their side effects. The recommendations of pharmacological treatment are proposed at the end of the article.
Adrenergic alpha-Agonists ; Advisory Committees ; Antidepressive Agents, Tricyclic ; Bupropion ; Europe ; Korea ; United States ; Atomoxetine Hydrochloride

OBJECTIVES: The purposes of this study were to develop a mental health screening questionnaire and the practical intervention programs or guidelines which can be used in middle and high schools by students and teachers. METHODS: The Adolescent Mental health & Problem behavior Screening Questionnaire II (AMPQ-II) was developed and was tested for reliability and validity using nationwide data from 2,180 middle and high school students and 2,145 teachers. RESULTS: The AMPQ-II was measured by both students and teachers. The correlation coefficient of the test-retest test was 0.567 and internal consistency was high (Cronbach's alpha=0.878). Five factors such as worry and thought, mood and suicide, academic and Internet-related problems, peer problems, and rule violations were proposed. We also developed a practical guideline and manuals which can be easily used by secondary school teachers to screen for and manage mental health problems at school. CONCLUSION: The AMPQ-II can be a useful and reliable tool to screen for mental health problems in middle and high schools in South Korea.
Adolescent ; Humans ; Mass Screening ; Mental Health ; Reproducibility of Results ; Republic of Korea ; Suicide ; Surveys and Questionnaires

OBJECTIVES: The purposes of this study were to develop a mental health screening questionnaire and the practical intervention programs or guidelines which can be used in middle and high schools by students and teachers. METHODS: The Adolescent Mental health & Problem behavior Screening Questionnaire II (AMPQ-II) was developed and was tested for reliability and validity using nationwide data from 2,180 middle and high school students and 2,145 teachers. RESULTS: The AMPQ-II was measured by both students and teachers. The correlation coefficient of the test-retest test was 0.567 and internal consistency was high (Cronbach's alpha=0.878). Five factors such as worry and thought, mood and suicide, academic and Internet-related problems, peer problems, and rule violations were proposed. We also developed a practical guideline and manuals which can be easily used by secondary school teachers to screen for and manage mental health problems at school. CONCLUSION: The AMPQ-II can be a useful and reliable tool to screen for mental health problems in middle and high schools in South Korea.
Adolescent ; Humans ; Mass Screening ; Mental Health ; Reproducibility of Results ; Republic of Korea ; Suicide ; Surveys and Questionnaires

PURPOSE: We evaluated various preoperative anterior segment parameters measured with a Pentacam rotating Scheimpflug camera and compared them with those of conventional methods. We also evaluated the effect of different parameters on corneal endothelial cells after cataract surgery. METHODS: Pentacam examination was performed in 88 eyes from 88 patients to evaluate central anterior chamber depth (ACD(pentacam)), nuclear density (Densitometry(pentacam)), anterior chamber volume (ACV), and lens thickness (LT(pentacam)). We compared values of ACD(pentacam) with those of ultrasound (ACD(sono)) and also compared Densitometry(pentacam) values with those of Lens Opacities Classification System (LOCS III) classification. We evaluated the effect of the following preoperative values measured with Pentacam on postoperative endothelial cell loss: pupil size measured both preoperatively and before capsulorrhexsis (Pupil(CCC)), amount of viscoelastics, and LT measured by ultrasound (LT(sono)). RESULTS: A significant concordance was found between the two grading methods of nuclear opacity: Densitometry(pentacam) and LOCS III classification (tau(b) = 0.414, p = 0.000). We also found a positive correlation between ACD(pentacam) and ACD(sono) (r = 0.823, p = 0.000) and between ACD(pentacam) and ACV (r = 0.650, p = 0.000). There were significant differences between the results of LT(pentacam) and LT(sono). The final regression model identified Densitometry(pentacam), viscoelastics and Pupil(CCC) as independent predictors of decreased postoperative corneal endothelial cell density (CD) at postoperative day 3, and Densitometry(pentacam), viscoelastics, and ACV as independent predictors of decreased CD two months postoperatively (p<0.05). CONCLUSIONS: Good agreement was found between all results obtained with the Pentacam and conventional methods except LT. Analyzing anterior chamber parameters preoperatively using Pentacam could be helpful to predict postoperative endothelial cell loss.
Adult ; Aged ; Aged, 80 and over ; Anterior Chamber/*pathology/ultrasonography ; Cataract/classification ; Cataract Extraction/*methods ; Corneal Endothelial Cell Loss/*diagnosis ; Female ; Humans ; Linear Models ; Male ; Middle Aged ; Photography/*instrumentation ; Predictive Value of Tests

OBJECTIVES: The current study was conducted in order to investigate teachers'recognition of school bullying using a nationwide database of adolescents in middle and high school in Korea. METHODS: Students in the 7th to 12th grades at 23 secondary schools participated in the current study during the fall of 2009. Subjects completed the self-report form of the Adolescent Mental Health and Problem Behavior Screening Questionnaire-II (AMPQ-II) and Symptom Checklist-90 Revised (SCL-90-R). In addition, relevant teachers used the teachers' rating scale of the AMPQ-II to report their students' status. Differences in the number of bullied students between teachers' recognition and students' report were explored. RESULTS: A total of 2270 subjects provided relevant responses to the questionnaire. While the one-month prevalence of victimization according to students' self-reports was 28.9%, the recognized prevalence by teachers was only 10.6%. For prediction of the presence of school bullying according to students' self reports on the AMPQ-II, item 7 of the teachers' report on the AMPQ-II showed a sensitivity of 16%, a specificity of 92%, a positive predictability of 44%, a negative predictability of 72%, a false positive rate of 8%, a false negative rate of 84%, and an accuracy of 69%, respectively. No significant differences in subscores of students' self reports of the AMPQ-II and SCL-90-R were observed between bullied students who were recognized by teachers and those who were not recognized. In stepwise discriminant analysis, classification of teachers' item 2 and item 7 on the AMPQ-II with respect to school bullying according to students' reports showed an accuracy of 63.4%. Using this model, 75.2% of non-victimized subjects were classified correctly, while only 35.2% of victimized subjects were classified correctly. CONCLUSION: Despite the high prevalence in Korea, teachers' recognition of school violence among their students remains low. Pre-professional and continuing education to improve teachers' understanding of school bullying and knowledge of effective classroom-based prevention activities should be encouraged.
Adolescent ; Bullying ; Crime Victims ; Education, Continuing ; Humans ; Korea ; Mass Screening ; Mental Health ; Prevalence ; Self Report ; Sensitivity and Specificity ; Violence ; Surveys and Questionnaires

This study was performed to investigate whether the spinal cholinergic and serotonergic analgesic systems mediate the relieving effect of electroacupuncture (EA) on oxaliplatin-induced neuropathic cold allodynia in rats. The cold allodynia induced by an oxaliplatin injection (6 mg/kg, i.p.) was evaluated by immersing the rat's tail into cold water (4℃) and measuring the withdrawal latency. EA stimulation (2 Hz, 0.3-ms pulse duration, 0.2~0.3 mA) at the acupoint ST36, GV3, or LI11 all showed a significant anti-allodynic effect, which was stronger at ST36. The analgesic effect of EA at ST36 was blocked by intraperitoneal injection of muscarinic acetylcholine receptor antagonist (atropine, 1 mg/kg), but not by nicotinic (mecamylamine, 2 mg/kg) receptor antagonist. Furthermore, intrathecal administration of M(2) (methoctramine, 10 µg) and M(3) (4-DAMP, 10 µg) receptor antagonist, but not M(1) (pirenzepine, 10 µg) receptor antagonist, blocked the effect. Also, spinal administration of 5-HT(3) (MDL-72222, 12 µg) receptor antagonist, but not 5-HT(1A) (NAN-190, 15 µg) or 5-HT(2A) (ketanserin, 30 µg) receptor antagonist, prevented the anti-allodynic effect of EA. These results suggest that EA may have a signifi cant analgesic action against oxaliplatin-induced neuropathic pain, which is mediated by spinal cholinergic (M(2), M(3)) and serotonergic (5-HT(3)) receptors.
Acetylcholine ; Acupuncture Points ; Animals ; Electroacupuncture* ; Hyperalgesia ; Injections, Intraperitoneal ; Neuralgia* ; Rats* ; Receptors, Muscarinic ; Serotonin ; Tail ; Water

Vertebral artery injuries associated with C1 lateral mass screw insertion rarely occur during C1-2 fusion. The posterior inferior cerebellar artery (PICA) is uncommonly located at the C1 lateral mass insertion position. A 71-year-old woman with atlanto-axial subluxation and cord compression underwent C1-2 fusion. Sixth nerve palsy and diplopia were detected postoperatively, and decreased consciousness occurred on postoperative day 4. Brain magnetic resonance image (MRI) and computed tomography (CT) revealed PICA infarction. In the preoperative CT angiography, the PICA originated between the C1 and C2 level. In the postoperative CT scan, the PICA was not visible. The patient was treated conservatively for two weeks and recovered. PICA originating between the C1 and C2 level comprises 1.1–1.3% of cases. Therefore, vertebral artery anomalies should be evaluated prior to C1-2 fusion to prevent vessel injuries.
Abducens Nerve Diseases ; Aged ; Angiography ; Arteries ; Brain ; Brain Infarction ; Consciousness ; Diplopia ; Female ; Humans ; Infarction ; Pica ; Tomography, X-Ray Computed ; Vertebral Artery