Prenatal, Perinatal and Developmental Risk Factors of Attention-Deficit Hyperactivity Disorder

OBJECTIVES: The purpose of this study was to examine the prenatal, perinatal and developmental risk factors of attention-deficit hyperactivity disorder (ADHD), compared to unaffected siblings (SIB), and typically developing children (TC). METHODS: Subjects with ADHD, their SIB, and TC were recruited from the child psychiatry outpatient clinic of the Asan Medical Center Children's Hospital. The parents of the children completed questionnaires on perinatal and developmental risk factors. RESULTS: Fifty-eight subjects with ADHD (41 boys, 7.7+/-1.3 years), 21 SIB (8 boys, 8.2+/-1.8 years), and 22 TC (8 boys, 8.5+/-2.1 years) were included. The ADHD group showed higher rates of maternal stress during pregnancy than the SIB group (p=.002), and the ADHD group showed higher rates of familial psychiatric history than the TC (odds ratio, 8.76 ; 95% confidence interval, 1.69 to 45.45). CONCLUSION: These findings suggest that among perinatal and developmental factors, maternal stress during pregnancy contribute to the development of ADHD. Future prospective studies will be needed in order to determine the causal relationship between perinatal risk factors and development of ADHD.

Executive Function in Attention-Deficit/Hyperactivity Disorder : Relationship of Comprehensive Attention, Stoop Color-Word, Children's Color Trails, and Wisconsin Card Sorting Tests / 신경정신의학

OBJECTIVES: The objective of this study was to investigate the relationship of the Comprehensive Attention (CAT), Stoop Color-Word (STROOP), Children's Color Trails (CCTT), and Wisconsin Card Sorting Tests (WCST) in evaluating the executive function in attention-deficit/hyperactivity disorder (ADHD). METHODS: A total of 197 children and adolescents with ADHD (mean age 10.4+/-3.2 years, 173 boys) and 62 without ADHD (mean age 11.8+/-3.5 years, 48 boys) have completed the Swanson, Nolan, and Pelham-IV questionnaire (SNAP-IV), and also the CAT, STROOP, CCTT and WCST. RESULTS: The selective, sustained, divided attention and Flanker tests of the CAT significantly discriminated between the ADHD and non-ADHD groups. The results of the CCTT were significantly correlated with the results of the CAT only in the ADHD group. The results of the STROOP were associated with selective, sustained, divided attention and Flanker tests. The results of the WCST were significantly correlated with the scores of the Working Memory subtest of the CAT only in the non-ADHD group. CONCLUSION: The results of this study suggest that the CAT has strong discriminant validity and moderate concurrent validity. The CAT could be a tool for the evaluation of the executive function of ADHD.

The Relations hip Between Posts troke Depression and Functional Recovery of Rehabilitation Inpatients

BACKGROUND: To identify the prevalence and risk factors of poststroke depression(PSD) in patients admitted to department of rehabilitation medicine after stroke, to compare functional recovery of depressed patients and that of non-depressed patients, and to recognize the most useful depression scale that can predict functional recovery. METHOD: Of the hospitalized stroke patients in the department of Rehabilitation Medicine, 24 patients who were communicable were included in this study. To evaluate PSD, Beck depression inventory(BDI) and Korean form of Geriatric depression scale(KGDS) were used as self-rating scales. Hamilton depression scale(HAM-D) was used as an objective scale. Functional Independence measure(FIM) was measured at admission and discharge to evaluate functional recovery. RESULTS: In the 24 subjects, 17 patients(70.8%) and 9 patients(37.5%) were depressive by BDI and HAM-D. Of the 19 elderly patients, 16(84.2%) were depressive by KGDS. Factors such as age, level of education, religion, etiology or location of stroke were not significantly associated with PSD. And FIMscores were not significantly different in the depressed patients and non-depressed patients. The correlation coefficients of BDI, KGDS, HAM-D and FIMgain or efficiency were not statistically significant. CONCLUSION: The prevalence of PSDwas high in our study, but no association was found between PSD and functional recovery.