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A Preliminary Study on the Development of Korean Medication Algorithm for Attention-Deficit Hyperactivity Disorder

Other Title
한국형 주의력결핍 과잉행동장애 약물치료 알고리듬 개발을 위한 예비연구
Authors
박, 재홍; 김, 붕년; 김, 재원; 김, 지훈; 손, 정우; 신, 동원; 신, 윤미; 양, 수진; 유, 한익; 유, 희정; 이, 소영; 천, 근아; 홍, 현주; 황, 준원
Citation
Soa--chʿŏngsonyŏn chŏngsin ŭihak, 22(1):25-37, 2011
Journal Title
Soa--chʿŏngsonyŏn chŏngsin ŭihak; Journal of child & adolescent psychiatry; Journal of the Korean Academy of child and adolescent psychiatry; 소아 청소년 정신의학
ISSN
1225-729X2233-9183
Abstract
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.
Keywords
ADHDPharmacotherapyAlgorithmComorbidity
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Psychiatry & Behavioural Sciences
AJOU Authors
신, 윤미
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