Young Sook Kwack

Nationwide rate of attention-deficit hyperactivity disorder diagnosis and pharmacotherapy in Korea in 2008-2011.

Using the National Health Insurance database in Korea, we examined the diagnostic and treatment incidence and comorbidity of attention‐deficit hyperactivity disorder (ADHD).

A Multicenter Study Investigating Empathy and Burnout Characteristics in Medical Residents with Various Specialties

We assessed empathy in medical residents, including factors modifying empathy and the relationship between empathy and burnout. Participants (n = 317 residents, response rate = 42%) from 4 university hospitals completed a socio-demographic questionnaire, the Jefferson Scale of Empathy (Health Professional version, Korean edition), and the Maslach Burnout Inventory (MBI). Participants were classified by medical specialty: “people-oriented specialty” (POS group) or “technology-oriented specialty” (TOS group), with more women in the POS than in the TOS group, χ2 = 14.12, P < 0.001. Being female, married, and having children were factors related to higher empathy (gender, t = -2.129, P = 0.034; marriage, t = -2.078, P = 0.038; children, t = 2.86, P = 0.005). Within specialty group, POS residents showed higher empathy scores in the fourth as compared to the first year, F = 3.166, P = 0.026. Comparing POS and TOS groups by year, fourth year POS residents had significantly higher scores than did fourth year TOS residents, t = 3.349, P = 0.002. There were negative correlations between empathy scores and 2 MBI subscales, emotional exhaustion (EE) and depersonalization (DP). Additionally, first year POS residents had higher DP scores than did first year TOS residents, t = 2.183, P = 0.031. We suggest that factors important for empathy are type of medical specialty, marriage, siblings, and children. Burnout state may be related to decreasing empathy.

Factors that Affect the Adherence to ADHD Medications during a Treatment Continuation Period in Children and Adolescents: A Nationwide Retrospective Cohort Study Using Korean Health Insurance Data from 2007 to 2011

Objective Several factors, such as male gender, older age, type of insurance, comorbid conditions, and medication type, have been associated with attention-deficit/hyperactivity disorder (ADHD) medication adherence rates, but the results have been inconsistent. We analyzed data to answer several questions: 1) How old were patients who first refilled their treatment medications used primarily for ADHD, regardless of the medication type? 2) What socio-demographic factors are associated with medication adherence? 3) What medical conditions, such as medication type and comorbid diagnosis, influence adherence? Methods We analyzed National Health Insurance data, which comprised continuously enrolled Korean National Medical Insurance children (6–18 years) with at least 2 ADHD prescription claims (January 2008–December 2011). The persistence of use regarding the days of continuous therapy without a 30-day gap were measured continuously and dichotomously. Adherence, using a medication possession ratio (MPR), was measured dichotomously (80% cut-off). Results The cumulative incidence of index cases that initiated medication refills for ADHD treatment during the 4 year period was 0.85%. The patients who exhibited a MPR greater than 80 comprised approximately 66%. The medication type, high school age groups, physician speciality, treatment at a private clinic, and comorbid conditions were associated with medication adherence during continuous treatment using a multivariate analysis. Conclusion A better understanding of ADHD treatment patterns may lead to initiatives targeted at the improvement of treatment adherence and persistence. Other factors, including the severity, family history, costs, type of comorbidities, and switching patterns, will be analyzed in future studies.

Temperament and character profiles for children with ADHD with and without tic disorders

There is no research about whether ADHD with tic disorder that temperamental features that differ from the ADHD. This research aimed to identify temperament and character profiles for children with ADHD according to tic disorder by comparing them with a healthy control group. A discriminant analysis was conducted to identify whether temperament and character profiles can discriminate comorbidity. The sample consisted of three groups (N = 40 per group): ADHD alone, ADHD with tic disorder and age- and sex- matched healthy control. The parents of 120 children (mean age 8.57 ± 1.71 years) completed the Junior Temperament and Character Inventory (JTCI). The two ADHD groups showed higher novelty seeking and low persistence, self-directedness and cooperativeness than the control group. The ADHD alone group had lower scores for persistence and self-directedness than the other two groups. Temperament and character profiles were useful for discriminating ADHD from the control group. However, their discriminating power was relatively low for all three groups. Results indicated that differences in temperament and character in ADHD children were present according to comorbid tic disorders. JTCIs discriminating power for ADHD alone and ADHD with tic disorder was relatively lower than that of the combined ADHD group and the control group.

Effects of a Class-Based School Violence Prevention Program for Elementary School Students

Objectives: This study was conducted to investigate the effectiveness of a class-based school violence prevention program for elementary school student. Methods: 29 students were assigned to the school violence prevention program of 8 sessions, 28 students have been assigned to the control group. We assessed participants at baseline and post-intervention, through their self-report questionnaires such as Children’s Depression Inventory (CDI), Strengths and Difficulties Questionnaire and school violence experience, awareness about school violence, and coping ability to school violence. We compared the baseline and post-intervention result of each group and compared the posttest scores between the intervention group and the control group. Results: Comparing the intervention group and the control group, the post-intervention CDI total score and the awareness about school violence showed significant improvement in the intervention group. When compared according to gender, male students’ perception of school violence was improved, and female students showed significant differences in CDI scores. Conclusion: The CDI total scores and the perception of school violence were improved in the intervention group compared to the control group. And there are differential pattern of intervention effects according to gender. These findings have important implications to develop effective violence prevention programs.

PT551. Recognition and discrimination of facial emotion expression in Children with Attention-Deficit Hyperactivity Disorder and Autism Spectrum Disorder

Objectives:Impairment in facial emotion recognition and facial emotion discrimination is established findings in autism spectrum disorders(ASD). And children with attention-deficit hyperactivity disorder (ADHD) also experience significant difficulty in recognizing and discriminating facial emotion. this study aimed to investigate the differences in facial emotion recognition and emotion discrimination between children with ADHD and ASD children. Methods: 53 children, aged 7 to 11 years participated in this study. Among them, 42 children were diagnosed with ADHD and 11 children were diagnosed with ASD. We examined the ability to recognize facial emotion expression by using Penn Emotion Recognition Task (ER40) and we measured ability to discriminate facial emotional intensity by using Penn Emotion Discrimination Task(EDF40). Results: ADHD children were found to have better ability than ASD children in the recognition of happy and sad faces, but there was no significant difference in the recognition of angry, fear, and no emotion faces between two groups. Also, ADHD children recognized facial emotion expression better than ASD children when they shown female faces, but We found no significant difference between two groups when they shown male face. And ADHD children showed better ability than ASD children in the recognition of intense emotion expression but there was no significant difference in the recognition of mild emotional expression between two groups. We found no statistically significant difference in the discrimination of facial emotional intensity between the children with ADHD and ASD children. Conclusion: The results of our study suggested that children with ADHD have better ability in facial emotion recognition than children with ASD, yet have deficit in facial emotional intensity discrimination equal to children with ASD. PT552 Association of the GRIN2B rs2284411 polymorphism with methylphenidate response in attention-deficit/ hyperactivity disorder Johanna Inhyang Kim1, Kyungmin Kim1, Jae-Won Kim1, Soon-Beom Hong1, Bung-Nyun Kim1 1Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul,