Clinical Utility and Cut-Off Scores of the Korean Adult Attention-Deficit/Hyperactivity Disorder Rating Scale

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.

Association between Executive Functions and Time Perspectives in Patients with Adults Attention-Deficit/Hyperactivity Disorder / 신경정신의학

OBJECTIVES: This study examined the association between executive functions and time perspectives in patients with adult attention-deficit/hyperactivity disorder (ADHD). The executive function including self-management to time, self-organization/problem solving, self-restraint or inhibition, self-motivation, and self-regulation of emotion was analyzed. In addition, the time perspective, including past-negative, past-positive, present-hedonistic, present-fatalistic, future-negative, and future-positive, were investigated. The correlations between the executive functions and time perspectives were analyzed in an adult ADHD patient group. METHODS: Thirty-six participants were divided into 17 in the ADHD group and 19 in the Control group. The participants conduct psychological tests including Barkley Deficits in Executive Functioning Scale (BDEFS), ADHD Self-Report Scale, and the Swedish Zimbardo Time Perspective Inventory to confirm their executive functions, attention, and time perspectives. The participants were recruited at Samsung Medical Center from April 2017 to November 2018. The collected data was analyzed using a t-test and Pearson correlation analysis. RESULTS: The adult ADHD patients group showed significantly higher scores in the BDEFS and ADHD Self-Report Scale than the control group. In time perspective scores, the adult ADHD patients group was higher in the past-negative, present-hedonistic, present-fatalistic time perspectives than the control group. In addition, the adult ADHD patients group was lower in future-positive than the control group. In the adult ADHD patients group, the future-positive time perspectives were negatively correlated with the executive functions. CONCLUSION: These results suggest that the negative time perspective is related to the executive function deficits in an adult ADHD group, particularly in the self-management of time, self-organization/problem solving, and self-motivation.

The Relationship between Parental Attention Deficit Hyperactivity Disorder Characteristics, Executive Function and Parental Emotional Distress / 신경정신의학

OBJECTIVES: Attention deficit hyperactivity disorder (ADHD) is a disease of high heritability. Parents of children with ADHD have high parenting stress and low parenting efficacy. In this study, we assessed parents' characteristics including inattention, hyperactivity, impulsivity, executive function, anxiety/depression severity level, child's ADHD symptom severity, and parents' emotional distress level. The relationships between severity of ADHD symptoms in children, cognitive and emotional characteristics in parents, as well as parenting stress and parenting efficacy were evaluated. METHODS: 96 parents participated in the study. Each parent assessed their child's ADHD symptom severity, their own ADHD symptom severity, as well as executive function, depression, anxiety, parenting stress and parenting efficacy. Collected data was analyzed using multiple regression analysis. RESULTS: The mean ADHD Rating Scale score of 53 children was 22.91 (±9.63). Of these, 26 (49.0%) were taking medication. Eight (8.3%) of the 96 parents had psychiatric illnesses and 12 (12.5%) had the possibility of ADHD. Mothers showed significantly higher levels of parenting stress (p < 0.001), depression (p=0.006), and parenting efficacy (p < 0.001) compared with fathers. The children's ADHD symptoms, severity, and parental depression were related to high parenting stress. The ADHD symptoms of parents were associated with high parenting stress (p=0.032). Parental executive function was significantly associated with low parenting efficacy (p=0.015). CONCLUSION: Children's ADHD symptoms severity, parental depression and ADHD symptom severity were significantly associated with high parenting stress. Parental executive function was significantly associated with low parenting efficacy. In addition to treating the children with ADHD, evaluation and treatment of parents' symptoms is needed in order to reduce parenting stress and provide a stable parenting environment.

Characteristics Involved in Internet Addiction Tendency of Adult Males with Attention Deficit/Hyperactivity Disorder / 신경정신의학

OBJECTIVES: This study was conducted in order to investigate characteristics of temperament, depression, anxiety, attention, and impulsivity in adult males with Attention Deficit/Hyperactivity Disorder (ADHD) and internet addiction tendency. METHODS: The survey participants were 181 (121 patients and 60 healthy control subjects) adult males older than 19 years of age in Chung-Ang University Hospital and Gongju National Hospital. Subjects were divided according to ADHD with internet addiction tendency (AI), pure adults with ADHD (AD), and healthy control subjects (HC). All groups completed the Adult ADHD Scale (AADHD), Wender-Utah ADHD Rating Scale (WUADHD), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), the Korean Version of Young Internet Addiction Scale (YIAS-K), Barratt Impulsiveness Scale (BIS) and Temperament Character Inventory-Revised Short version for identification of relationship between ADHD and internet addiction tendency. RESULTS: AI groups were found to have higher AADHD, WUADHD, BDI, YIAS-K, and Novelty Seeking scores, compared to the AD and HC groups. The Cooperativeness score of the AI group was significantly lower than that of the AD group and HC group. The BAI and BIS scores of the AI group and AD group were significantly higher than those of the HC group. The Self-Directedness scores of the AI group and AD group were decreased, compared to the HC group. YIAS-K scores were partially related to BDI scores in the AI group. CONCLUSION: The results of this study indicate an association of higher score of BDI with internet addiction tendency in adult patients with ADHD. Management of temperament characteristics, depression, anxiety, attention, and impulsivity may be important for adults with ADHD and internet addiction tendency.

Treatment for Attention-Deficit/Hyperactivity Disorder in Adults

This review examined the treatment of attention-deficit/hyperactivity disorder (ADHD) in adults. It briefly addresses the issues about the cause of hospital visit, diagnosis, and impact of disease, specific to adults. The article focused on the evidence regarding the efficacy and tolerability of short- and long-acting stimulant medications, as well as the non-stimulant medications such as atomoxetine and bupropion in the treatment of the adult ADHD. Generally speaking, variability in diagnostic criteria, dosing parameters and response rates between the various studies were considerable. The aggregated literature shows that both the stimulants and non-stimulants had clinically significant beneficial effect on treating ADHD in adults. Special attention is given to the pharmacological treatment for patients with adult ADHD and various comorbidities. In summary, medications are effective and combined medication and psychosocial treatment is the most beneficial treatment option for most adult patients with ADHD.

Treatment for Attention-Deficit/Hyperactivity Disorder in Adults

This review examined the treatment of attention-deficit/hyperactivity disorder (ADHD) in adults. It briefly addresses the issues about the cause of hospital visit, diagnosis, and impact of disease, specific to adults. The article focused on the evidence regarding the efficacy and tolerability of short- and long-acting stimulant medications, as well as the non-stimulant medications such as atomoxetine and bupropion in the treatment of the adult ADHD. Generally speaking, variability in diagnostic criteria, dosing parameters and response rates between the various studies were considerable. The aggregated literature shows that both the stimulants and non-stimulants had clinically significant beneficial effect on treating ADHD in adults. Special attention is given to the pharmacological treatment for patients with adult ADHD and various comorbidities. In summary, medications are effective and combined medication and psychosocial treatment is the most beneficial treatment option for most adult patients with ADHD.

Clinical Features of Adult Attention-Deficit/Hyperactivity Disorder among Substance Abusers / 中国心理卫生杂志

Objective:To explore the clinical presentations and symptom distribution in adults with attention-deficit/hyperactivity disorder(ADHD) among non-alcohol substance use disorder population,and to prove the effectiveness of adult ADHD diagnosis.Methods:Thirty adults with ADHD and thirty non-ADHD controls were selected from Beijing Compulsory Detoxification Center,matched with sex,age,and education.Data collection included the following:(1)Self-report measures of developmental history,employment history,social history and ADHD clinical symptoms.(2)Psychiatric interview using structured assessments included the Clinical Diagonsitic Interview Scale(CDIS)for Diagnostic and Statistical Manual of Mental Disorders(DSM-IV).(3)Evaluation for cognitive function with the Wechsler Adult Intelligence Scale-Revised Chinese(WAIS-RC).Results:(1)The clinical core symptoms(such as attention deficit,restlessness,and impulsive symptoms)among adulthood ADHD were similar to childhood ADHD except for some hyperactivity symptoms.(2)The symptoms of attention deficit,restlessness and impulsiveness were more frequently in both of adulthood and childhood ADHD than non-ADHD controls(P