Objectives: This study aimed to identify the psychiatric comorbidity status of adult patients diagnosed with attention-deficit hyperactivity disorder (ADHD) and determine the impact of comorbidities on neuropsychological outcomes in ADHD. Methods: The study participants were 124 adult patients with ADHD. Clinical psychiatric assessments were performed by two boardcertified psychiatrists in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. All participants were assessed using the Mini-International Neuropsychiatric Interview Plus version 5.0.0 to evaluate comorbidities. After screening, neuropsychological outcomes were assessed using the Comprehensive Attention Test (CAT) and the Korean version of the Wechsler Adult Intelligence Scale, Fourth Edition (K-WAIS-IV). Results: Mood disorders (38.7%) were the most common comorbidity of ADHD, followed by anxiety (18.5%) and substance use disorders (13.7%). The ADHD with comorbidities group showed worse results on the Perceptual Organization Index and Working Memory Index sections of the K-WAIS than the ADHD-alone group (p=0.015 and p=0.024, respectively). In addition, the presence of comorbidities was associated with worse performance on simple visual commission errors in the CAT tests (p=0.024). Conclusion These findings suggest that psychiatric comorbidities are associated with poor neuropsychological outcomes in adult patients with ADHD, highlighting the need to identify comorbidities in these patients.

Objectives: This study investigated the effectiveness of the intervention program for elementary school students with reading disorders. Methods: The intervention program focused on phonological awareness, phonics, and decoding training applied individually to 25 children with a reading disorder by the teachers in charge for four months. To measure the efficacy, this study evaluated the word reading accuracy, fluency, and the related cognitive functions, including phonemic awareness, phonics, and rapid automatized naming using the Computerized Comprehensive Learning Test-Reading before and after the program. Results: After the intervention, improvements were observed in the following: the reading fluency score and fluency percentile in the word attack test; reading accuracy rate, fluency score, and fluency percentile in the nonword decoding test; fluency score and fluency percentile in the rapid automatized naming tests; accuracy rate in the letter-sound matching test; accuracy rate in the nonword repetition test. On the other hand, there was no significant difference in the paragraph reading fluency test. According to the subtypes of reading disabilities, children with dyslexic or mixed types improved after the intervention. Conclusion Reading accuracy and fluency of school-aged children with reading disorders improved through the intervention program by the schoolteachers.

Objectives: This study investigated the effectiveness of the intervention program for elementary school students with reading disorders. Methods: The intervention program focused on phonological awareness, phonics, and decoding training applied individually to 25 children with a reading disorder by the teachers in charge for four months. To measure the efficacy, this study evaluated the word reading accuracy, fluency, and the related cognitive functions, including phonemic awareness, phonics, and rapid automatized naming using the Computerized Comprehensive Learning Test-Reading before and after the program. Results: After the intervention, improvements were observed in the following: the reading fluency score and fluency percentile in the word attack test; reading accuracy rate, fluency score, and fluency percentile in the nonword decoding test; fluency score and fluency percentile in the rapid automatized naming tests; accuracy rate in the letter-sound matching test; accuracy rate in the nonword repetition test. On the other hand, there was no significant difference in the paragraph reading fluency test. According to the subtypes of reading disabilities, children with dyslexic or mixed types improved after the intervention. Conclusion Reading accuracy and fluency of school-aged children with reading disorders improved through the intervention program by the schoolteachers.

Objectives: Adult attention-deficit/hyperactivity disorder (ADHD) is an important mental health problem that needs resolution, especially considering the high rates of ADHD continuation from childhood to adolescence/adulthood and the high prevalence of ADHD in adults. Adults with ADHD have lifelong negative impacts and require close monitoring with long-term follow-up. Hence, the establishment of a Korean practice parameter for adult ADHD is necessary to minimize discontinuation of treatment and enable information sharing among Korean mental health professionals. Methods: The Korean practice parameter was developed using an evidence-based approach consisting of expert consensus survey coupled with literature review. Results: According to the expert consensus survey, the most commonly used diagnostic methods were clinical psychiatric interview (20.66%) and self-report scales (19.25%) followed by attention (14.71%) and psychological tests (14.24%). Key evaluation instruments currently available in Korea are the World Health Organization Adult ADHD Self-Report Rating Scale, Korean Adult ADHD Rating Scale, Diagnostic Interview for ADHD in Adults, Barkley Deficits in Executive Functioning Scale for adults, Comprehensive Attention Test, Conners’ Continuous Performance Test, and the subtests of Wechsler Adult Intelligence Scale, Digit Span and Letter-Number Sequencing. Although pharmacotherapy is recommended as the first-line of treatment for adult ADHD, we recommend that it be followed by a multimodal and multidisciplinary approach including psychoeducation, pharmacotherapy, cognitive behavior therapy and coaching. Conclusion The Korean practice parameter introduces not only general information for the diagnosis and treatment of adult ADHD on a global scale, but also the process of diagnosis and treatment options tailored to the Korean population.

Objectives: Adult attention-deficit/hyperactivity disorder (ADHD) is an important mental health problem that needs resolution, especially considering the high rates of ADHD continuation from childhood to adolescence/adulthood and the high prevalence of ADHD in adults. Adults with ADHD have lifelong negative impacts and require close monitoring with long-term follow-up. Hence, the establishment of a Korean practice parameter for adult ADHD is necessary to minimize discontinuation of treatment and enable information sharing among Korean mental health professionals. Methods: The Korean practice parameter was developed using an evidence-based approach consisting of expert consensus survey coupled with literature review. Results: According to the expert consensus survey, the most commonly used diagnostic methods were clinical psychiatric interview (20.66%) and self-report scales (19.25%) followed by attention (14.71%) and psychological tests (14.24%). Key evaluation instruments currently available in Korea are the World Health Organization Adult ADHD Self-Report Rating Scale, Korean Adult ADHD Rating Scale, Diagnostic Interview for ADHD in Adults, Barkley Deficits in Executive Functioning Scale for adults, Comprehensive Attention Test, Conners’ Continuous Performance Test, and the subtests of Wechsler Adult Intelligence Scale, Digit Span and Letter-Number Sequencing. Although pharmacotherapy is recommended as the first-line of treatment for adult ADHD, we recommend that it be followed by a multimodal and multidisciplinary approach including psychoeducation, pharmacotherapy, cognitive behavior therapy and coaching. Conclusion The Korean practice parameter introduces not only general information for the diagnosis and treatment of adult ADHD on a global scale, but also the process of diagnosis and treatment options tailored to the Korean population.

OBJECTIVES: This study aimed to investigate the trajectory of change of diverse attention and working memory in Koreans from 4 to 40 years of age. METHODS: The data of 912 subjects from 4 to 15 years of age obtained from a previous standardization study of the computerized comprehensive attention test were merged with the newly obtained data of 150 subjects aged 16 to 40 years from this study. We evaluated the various kinds of attention, in which each subtest had five indicators. Working memory, with parameters such as number of correct responses and span, was also measured. RESULTS: Our findings indicated that attention developed as age increased, and it decreased or was maintained after a certain age. Selective and sustained attention developed rapidly in children and adolescents, until mid-teens or 20 s when it ceased development. Divided attention, however, developed up to approximately age 20. In addition, working memory developed until mid-teens or 20 s. CONCLUSION: We presented the standardized data on diverse kinds of attention and working memory in children, adolescents, and adults in Korea. We could recognize any patterns of change in attention and working memory with increasing age.
Adolescent ; Adult ; Child ; Humans ; Korea ; Memory, Short-Term ; Neuropsychological Tests

OBJECTIVES: Awareness of attention-deficit/hyperactivity disorder (ADHD) in adults has significantly increased; however, clinical data specific to the Korean population are insufficient. Clinical experience of ADHD may differ based on whether psychiatrists have received pediatric psychiatry-specific training. In order to prepare a practice parameter for adult ADHD patients in Korea, we examined questionnaire data to observe how pediatric psychiatry training could affect clinical practice for adults with ADHD. METHODS: A questionnaire about the diagnosis and treatment process was distributed to both general psychiatrists (GPsy) and child and adolescent psychiatrists (CAP) at the summer and winter workshop meetings of Korean Academy of Child and Adolescent Psychiatry. RESULTS: In total, 142 psychiatrists participated in the survey (86 GPsy, 56 CAP). GPsy and CAP preferred pharmacotherapy (GPsy 82.40%, CAP 64.30%) as the primary treatment option and answered that the clinical psychiatric interview is the most necessary step in diagnostic assessment (GPsy 22.16%, CAP 19.00%). The GPsy responded with an optimal and average treatment duration that was shorter than that reported by CAP. CONCLUSION: Identification of the initial presenting symptom as the correct diagnosis and the optimal duration of pharmacotherapy differed between GPsy and CAP in practice, whereas concepts in diagnosis and treatment of ADHD in adults were similar for both groups. These results suggest the urgent need for the Continuing Medical Education program for psychiatrists treating adults with ADHD.
Adolescent ; Adolescent Psychiatry ; Adult ; Attention Deficit Disorder with Hyperactivity ; Child ; Child Psychiatry ; Child ; Diagnosis ; Drug Therapy ; Education ; Education, Medical, Continuing ; Humans ; Korea ; Psychiatry

OBJECTIVES: This study was conducted to re-validate the clinical efficacy of the Korean Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Rating Scale (K-AARS), which is a self-report scale for ADHD in adults, and to determine the clinical utility and cut-off scores of K-AARS. METHODS: The participants were 135 drug naïve adults with ADHD and 144 healthy controls. To diagnose ADHD based on the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, two board-certified pediatric psychiatrists interviewed the participants and completed the Mini International Neuropsychiatric Interview. K-AARS was applied to all participants. K-AARS comprises six clinical subscales, one impairment subscale, and one driving behavior subscale. The receiver operating characteristic analysis was conducted to calculate the cut-off scores of K-AARS. RESULTS: All subscale scores, including six clinical subscale, impairment subscale, and driving behavior subscale scores, were found to be significant in distinguishing adults with ADHD from healthy controls. The sensitivity and specificity of the six clinical subscales were 63.0–77.0% and 66.7–79.9%, respectively. The combined total score of the six clinical subscales, had a sensitivity of 80.0% and specificity of 79.9%. CONCLUSION: The discriminative power of K-AARS for the diagnosis of ADHD in adults was excellent, and K-AARS and the empirical diagnosis of adults can be useful in diagnosing ADHD in adulthood.
Adult ; Attention Deficit Disorder with Hyperactivity ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Psychiatry ; ROC Curve ; Sensitivity and Specificity ; Treatment Outcome