J Korean Acad Child Adolesc Psychiatry.
2011 Mar;22(1):25-37.
A Preliminary Study on the Development of Korean Medication Algorithm for Attention-Deficit Hyperactivity Disorder
- Affiliations
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- 1Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea. kbn1@snu.ac.kr
- 2Department of Psychiatry, School of Medicine, Pusan National University, Busan, Korea.
- 3Department of Neuropsychiatry, Chungbuk National University College of Medicine, Chongju, Korea.
- 4Department of Psychiatry, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea.
- 5Department of Psychiatry and Behavioral Sciences, School of Medicine, Ajou University, Suwon, Korea.
- 6Department of Psychiatry, Chonnam National University Hospital, Gwangju, Korea.
- 7Department of Psychiatry, College of Medicine University of Ulsan, Asan Medical Center, Seoul, Korea.
- 8Department of Psychiatry, Seoul National University College of Medicine, Bundang Hospital, Seongnam, Korea.
- 9Department of Psychiatry, Soonchunhyang University Medical School, Bucheon Hospital, Bucheon, Korea.
- 10Department of Psychiatry and Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Korea.
- 11Department of Psychiatry, Hallym University College of Medicine, Anyang, Korea.
- 12Department of Neuropsychiatry, Eulji University College of Medicine, Daejeon, Korea.
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, average 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, voluntarily 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.
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