소아청소년 간질 환자에서 ADHD 치료 실태에 대한 다기관 공동연구
Current Status of ADHD Treatment in Children with Epilepsy: A Retrospective, Multicenter, Cross Sectional Analysis in Korea
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초록
Purpose:The purpose of this study was to assess the current therapeutic status of attention deficit-hyperactivity disorder (ADHD) in children with epilepsy. Methods:A cross-sectional survey of 178 patients aged 4-20 years from ten pediatric neurology clinics in eight cities in South Korea from January 2005 to July 2010 was used to assess clinical characteristics of ADHD patients with epilepsy and risk factors associated with ADHD. Results:A total of 178 pediatric epileptic patients were recruited for this study. One hundred seventy-four subjects' (M:F=4:1, mean age: 12.2±3.3 yrs old) records were evaluated excluding four patients due to incomplete data. One hundred twenty- five of 174 patients (71.8%) had partial epilepsy and 45 had generalized epilepsy. Eighty of 112 patients showed ADHD combined type from the DSM IV. The mean prevalence rate of ADHD treatment among the epileptic patients was 1.9%. Over 45 % of patients showed complete or persistent symptoms without difficulties in school life with CNS stimulants. Adverse reactions were reported in 19.8% of patients who received ADHD medication, and 18 patients discontinued ADHD medication due to severe adverse effects such as aggravated seizures (5.6%) or ADHD symptoms (3.7%). About 60% of children with ADHD and epilepsy had psychiatric comorbid disorders. Conclusion:The results indicate that ADHD treatment in epilepsy patients is safe and effective. However, these data also show that ADHD in pediatric epilepsy patients in Korea is under-diagnosed and under-treated.
Abstract
Purpose:The purpose of this study was to assess the current therapeutic status of attention deficit-hyperactivity disorder (ADHD) in children with epilepsy. Methods:A cross-sectional survey of 178 patients aged 4-20 years from ten pediatric neurology clinics in eight cities in South Korea from January 2005 to July 2010 was used to assess clinical characteristics of ADHD patients with epilepsy and risk factors associated with ADHD. Results:A total of 178 pediatric epileptic patients were recruited for this study. One hundred seventy-four subjects' (M:F=4:1, mean age: 12.2±3.3 yrs old) records were evaluated excluding four patients due to incomplete data. One hundred twenty- five of 174 patients (71.8%) had partial epilepsy and 45 had generalized epilepsy. Eighty of 112 patients showed ADHD combined type from the DSM IV. The mean prevalence rate of ADHD treatment among the epileptic patients was 1.9%. Over 45 % of patients showed complete or persistent symptoms without difficulties in school life with CNS stimulants. Adverse reactions were reported in 19.8% of patients who received ADHD medication, and 18 patients discontinued ADHD medication due to severe adverse effects such as aggravated seizures (5.6%) or ADHD symptoms (3.7%). About 60% of children with ADHD and epilepsy had psychiatric comorbid disorders. Conclusion:The results indicate that ADHD treatment in epilepsy patients is safe and effective. However, these data also show that ADHD in pediatric epilepsy patients in Korea is under-diagnosed and under-treated.
참고문헌 (34)
- Reiff MI, "Children who have attentional disorders: diagnosis and evaluation", Pediatr Rev, 14, pp.455~465 (1993)
- Davis SM, "Epilepsy in children with attention-deficit", hyperactuvuty disorder, 2010, pp.42, 325~330
- Hamoda HM, "Association between attention-deficit", hyperactivity disorder and epilepsy in pediatric populations, 2009, pp.9, 1747~1754
- Barkley RA, "Issues in the diagnosis of attention- deficit", hyperactivity disorder in children, 2003, pp.25, 77~83
- Reilly CJ, "Attention deficit hyperactivity disorder (ADHD) in childhood epilepsy", Res Dev Disabil, 32, pp.883~893 (2011)
- Ottman R, "Comorbidities of epilepsy: Results from the Epilepsy Comorbidities and Health (EPIC) survey", Epilepsia, 52, pp.308~315 (2011)
- Liu ST, "Attentional processes and ADHD- related symptoms in pediatric patients with epilepsy", Epilepsy Res, 93, pp.53~65 (2011)
- Koneski JA, "Attention deficit and hyperactivity disorder in people with epilepsy: diagnosis and implications to the treatment", Arq Neuropsiquiatr, 68, pp.107~114 (2010)
- Parisi P, "Attention deficit hyperactivity disorder in children with epilepsy", Brain Dev, 32, pp.10~16 (2010)
- Schubert R, "Attention deficit disorder and epilepsy", Pediatr Neurol, 32, pp.1~10 (2005)
- McAfee AT, "The effect of pharmacotherapy for attention deficit hyperactivity disorder on risk of seizures in pediatric patients as assessed in an insurance claims database", Curr Drug Saf
- Still G, "Some abnormal psychical condition in children", Lancet, 20, pp.192~ (1902)
- Clements SD, "Minimal brain dysfunctions in the school-age child. Diagnosis and treatment", Arch Gen Psychiatry, 6, pp.185~197 (1962)
- American Psychiatric Association, "Diagnostic and Statistical manual of mental disorders. 3rd ed" (1980), American Psychiatric Press
- American Psychiatric Association, "Diagnostic and Statistical manual of mental disorders. 4th ed" (1994), American Psychiatric Press
- Plioplys S, "10-year research update review: psychiatric problems in children with epilepsy", J Am Acad Child Adolesc Psychiatry, 46, pp.1389~1402 (2007)
- Tian Y, "Attention networks in children with idiopathic generalized epilepsy", Epilepsy Behav, 19, pp.513~517 (2010)
- Posner MI, "The attention system of the human brain", Annu Rev Neurosci, pp.25~42 (1990)
- Coull JT, "The noradrenergic alpha2 agonist clonidine modulates behavioural and neuroanatomical correlates of human attentional orienting and alerting", Cereb Cortex, 11, pp.73~84 (2001)
- Corbetta M, "Voluntary orienting is dissociated from target detection in human posterior parietal cortex", Nat Neurosci, 3, pp.292~297 (2000)
- Bennett-Back O, "Attention- deficit hyperactivity disorder in children with benign epilepsy and their siblings", Pediatr Neurol, 44, pp.187~192 (2011)
- 변희정, "Psychiatric Comorbidity in Korean Children and Adolescents with Attention-Deficit Hyperactivity Disorder: Psychopathology According to Subtype", Yonsei Medical Journal, 47(1), pp.113~121 (2006), 연세대학교의과대학
- Hazell P, "Review of attention-deficit", hyperactivity disorder comorbid with oppositional defiant disorder, 2010, pp.18, 556~559
- Hazell P, "The overlap of attention deficit hyperactivity disorder with other common mental disorders", J Paediatr Child Health, 33, pp.131~137 (1997)
- Biederman J, "Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders", Am J Psychiatry, 148, pp.564~577 (1991)
- Wang HR, "Psychiatric manifestations and risk factors in children with seizure disordrs", J Korean Epilep Soc, 11, pp.40~49 (2007)
- 양수진, "학령기 주의력결핍 과잉행동장애의 임상적 평가와 공존 질환들", 신경정신의학, 47(5), pp.409~414 (2008), 대한신경정신의학회
- Bennett-Back O, "Attention- deficit hyperactivity disorder in children with benign epilepsy and their siblings", Pediatr Neurol, 44, pp.187~192 (2011)
- Keen DV, "ADHD and the paediatrician: a guide to management", Curr Pediatr, 15, pp.133~142 (2005)
- Yoo HK, "Effect of methylphenidate on the quality of life in children with epilepsy and attention deficit hyperactivity disorder: and open- label study using an osmotic-controlled release oral delivery system", Epileptic Disord, 11, pp.301~308 (2009)
- Schachar R, "Changes in family function and relationships in children who respond to methylphenidate", J Am Acad Child Adolesc Psychiatry, 26, pp.728~732 (1987)
- BlackmanJA, "Attention-deficit", hyperactivity disorder in preschoolers. Does it exist and should we treat it, 1999, pp.46, 1011~1025
- Depositario-Cabacar DF, "Treatment of epilepsy in children with developmental disabilities", Dev Disabil Res Rev, 16, pp.239~247 (2010)
- Torres AR, "Attention-deficit", hyperactivity disorder in pediatric patients with epilepsy: review of pharmacological treatment, 2008, pp.12, 217~233