일 지역사회에서 새로 진단받은 주의력결핍 과잉행동장애 소아청소년과 뇌전증 환아의 행동문제 비교 연구
A Study on the Comparison of Behavioral Problems in Community-dwelling Children and Adolescents with Newly Diagnosed ADHD and Children and Adolescent with Epilepsy
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초록
본 연구는 일 지역사회의 소아청소년을 대상으로 K-ARS, CAT, K-CBCL, 종합심리검사 및 면담을 시행하여 ADHD를 진단하였고, 새로 ADHD로 진단된 소아청소년의 행동문제를 뇌전증 환아와 비교하였다. 총 1,576명의 소아청소년의 7.8%인 124명이 ADHD로 진단되었고, 새로 진단된 ADHD 소아청소년의 52.4 %에서 임상 수준의 행동문제를 보였으며, K-CBCL의 모든 소척도에서 뇌전증 환아에 비해 높은 행동문제를 보였다. ADHD와 뇌전증 두 군간의 차이를 보였던 IQ를 보정했을 때에도 신체증상 외의 모든 K-CBCL 척도에서 ADHD 소아청소년은 유의미한 행동문제를 보였다. 이 결과는 진단되거나 치료받지 않은 ADHD 소아청소년에서 동반되는 여러 행동, 정서적 문제가 상당한 정도임을 나타내며 이로 인한 정신사회적 발달 저하 및 이차적인 기능의 손상을 예방하기 위해 ADHD의 조기평가 및 조기 치료개입이 절실하게 요구되는 바이다.
Abstract
Purpose: Attention-deficit/hyperactivity disorder (ADHD) is a common childhood illness, which frequently presents with various comorbid emotional, social, and behavioral problems. Yet, children with epilepsy also experience significant behavioral problems. In this study, we compared behavioral problems of 124 children and adolescents with newly diagnosed ADHD and 40 youths with epilepsy, aged 6~17 years. Methods: Among 1,576 urban community children and adolescents, the ADHD rating scale, the Comprehensive Attention Test, and a psychiatric interview were used to diagnose ADHD. In addition, we used the mother’s rating on the Korean Child Behavior Checklist (K-CBCL) to assess the presence of behavioral problems. Results: Compared to the epilepsy group, the ADHD group had lower IQ scores (100.29±13.47 vs. 108.61±15.04, p=0.007). In addition, the ADHD group had higher total K-CBCL scores (66.44± 10.32 vs. 50.68±8.97, p<0.001) as well as higher scores on all eight subscales of the K-CBCL than the epilepsy group. Sixty-five participants (52.4%) in the ADHD group showed significant behavioral problems (t score ≥64) compared to 7.5% of epilepsy group. After controlling for IQ, using an analysis of covariance, the ADHD group showed significantly higher total scores on the K-CBCL and all its subscales (p<0.001) than the epilepsy group, except on the somatic complaints subscale (p=0.275). Conclusion: Children with newly diagnosed ADHD suffer from various behavioral problems; therefore, the early assessment of and interventions for comorbid behavioral problems should be conducted for optimal management of childhood ADHD.
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