한국형 주의력결핍 과잉행동장애 약물치료 알고리듬 개발을 위한 예비연구

• Published in: Soa--chʻŏngsonyŏn chŏngsin ŭihak = Journal of child & adolescent psychiatry Vol. 22; no. 1; pp. 25 - 37
• Main Authors: 박재홍(Jae Hong Park), 김붕년(Bung-Nyun Kim), 김재원(Jae-Won Kim), 김지훈(Ji Hoon Kim), 손정우(Jung-Woo Son), 신동원(Dongwon Shin), 신윤미(Yun-Mi Shin), 양수진(Su-Jin Yang), 유한익(Hanik K. Yoo), 유희정(Hee Jeong Yoo), 이소영(Soyoung Irene Lee), 천근아(Keun-Ah Cheon), 홍현주(Hyun Ju Hong), 황준원(Jun-Won Hwang)
• Format: Journal Article
• Language: Korean
• Published: 대한소아청소년정신의학회 2011
• Subjects: ADHD; 주의력결핍 과잉행동장애; Comorbidity; 공존질환; Pharmacotherapy; 알고리듬; Algorithm; 약물치료
• ISSN: 1225-729X; 2233-9183

Objectives：This study was conducted to develop a Korean algorithm of pharmacological and non-pharmacological treatment strategies in attention-deficit hyperactivity disorder (ADHD) and its specific comorbid disorders (e.g. tic disorder, depressive disorder, anxiety disorder, bipolar disorder, and oppositional defiant disorder/conduct disorder). Methods：Based on a literature review and expert consensus, both paper- and web-based survey tools were developed with respect to a comprehensive range of questions. Most options were scored using a 9-point scale for rating the appropriateness of medical decisions. For the other options, the surveyed experts were asked to provide answers (e.g., duration of treatment, aver-age dosage) or check boxes to indicate their preferred answers. The survey was performed on-line in a self-administered manner. Ultimately, 49 Korean child & adolescent psychiatrists, who had been considered experts in the treatment of ADHD, vol untarily completed the questionnaire. In analyzing the responses to items rated using the 9-point scale, consensus on each option was defined as a non-random distribution of scores as determined by a chi-square test. We assigned a categorical rank (first line/preferred choice, second line/alternate choice, third line/usually inappropriate) to each option based on the 95% confidence interval around the mean rating score. Results：Specific medication strategies for key clinical situations in ADHD and its comorbid disorders were indicated and described. We organized the suggested algorithms of ADHD treatment mainly on the basis of the opinions of the Korean experts. The suggested algorithm was constructed according to the templates of the Texas Child & Adolescent medication algorithm Project (CMAP). Conclusion：We have proposed a Korean treatment algorithm for ADHD, both with and without comorbid disorders through expert consensus and a broad literature review. As the tools available for ADHD treatment evolve, this algorithm could be reorganized and modified as required to suit updated scientific and clinical research findings.