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Introduction Using the National Health Insurance database in Korea, we examined the diagnostic and treatment incidence and comorbidity of attention-deficit hyperactivity disorder (ADHD). Methods During 2007–2011, we chose subjects aged 6–18 years, who had at least one medical claim containing an International Classification of Diseases, 10th Revision code for diagnosis of ADHD (F90.0) with no medication use in the previous 360 days. Then, we analyzed the data for 2008–2011 to determine the mean annual incidence and prevalence of newly diagnosed and medicated patients, as well as comorbidity. Results The average annual diagnostic incidence of ADHD was 0.357% (29,310.5/8,218,252), and the incidence of medication use for ADHD was 0.248% (20,340.3/8,218,252) during 2008–2011 with no significant annual difference. The transition rate from diagnosis to medication among newly diagnosed ADHD patients was 69%. The overall prevalence rate of ADHD diagnosis and medication during 2008–2011 was 0.799% (65,702/8,218,252) and 0.610% (50,127/8,218,252), respectively. Among newly diagnosed patients with ADHD, osmotic-controlled release oral delivery system methylphenidate was the most commonly used first medication, and depression was the most common comorbid psychiatric diagnosis. Discussion This is the first report of the nationwide data on the current diagnosis and pharmacotherapy of ADHD in the whole population aged 6–18 years. We need further investigation to find the factors of low diagnostic and treatment incidence compared with high prevalence of ADHD.

SummaryBackground It is uncertain whether folate is risk or preventive factor for allergic and respiratory diseases. Objective To determine the relationship between maternal or offspring folate status and subsequent development of allergic and respiratory diseases in early childhood. Methods In total, 917 mother-child pairs from a prospective birth cohort in South Korea were studied. Data regarding the children's allergic and respiratory outcomes were obtained from standardized questionnaires completed by the mothers at postnatal months 6, 12, and 24. Serum folate levels were measured in the mothers at mid- and late-pregnancy, and in their children at 24 months of age. Atopic biomarkers were measured in the cord blood (CB) and at 24 months after birth. Biomarkers and clinical outcomes were analyzed and compared between the mother-child pairs divided into two groups according to median serum folate status at mid- and late-pregnancy. Results Serum folate levels during mid-pregnancy were inversely associated with CB eosinophil count (adjusted odds ratio [OR] 0.72, 95% confidence interval [CI], 0.54–0.96) and positively associated with CB interleukin-10 levels (1.47, 1.11-1.94). Maternal folate level above the median value (≥9.5 ng/ml) during mid-pregnancy was associated with a decreased risk for the child of lower respiratory tract infections (LRTIs) at 6 months of age (adjusted OR 0.50, 95% CI 0.28-0.91) and atopic dermatitis (AD) at 24 months (adjusted OR 0.52, 95% CI 0.31–0.88), but not with LRTIs and AD at other ages. Conclusions A relatively high maternal serum folate level in mid-pregnancy was associated with a decreased risk of LRTIs and AD in early childhood. Pediatr Pulmonol. 2015; 50:155–163. © 2014 Wiley Periodicals, Inc.

Background: Bisphenol A (BPA) has been shown to affect brain and behavior in rodents and nonhuman primates, but there are few studies focusing on its relationship to human neurobehavior. We aimed to investigate the relationship between environmental exposure to BPA and childhood neurobehavior. Methods: Urinary BPA concentrations and behavioral and learning characteristics were assessed in a general population of 1,089 children, aged 8–11 years. The mainoutcomemeasuresweretheChildBehaviorChecklist(CBCL)andtheLearningDisabilityEvaluationScale(LDES). Results: Urinary levels of BPA were positively associated with the CBCL total problems score and negatively associated with the learning quotient from the LDES. The linear association with the CBCL anxiety/depression score and the quadratic association with the LDES listening score were significant after correction for multiple comparisons. Conclusions: Environmental exposure to BPA might be associated with childhood behavioral and learning development.Theresultssuggestpossiblenonmonotonicrelationships.Keywords: BisphenolA,childbehavior,childlearning, nonmonotonic dose–response. Bisphenol A (BPA) is a widespread industrial chemical. It is commonly used to synthesize polycarbonate plastics and epoxy resins, and these plastic polymers are extensively applied to the manufacture of various articles of daily use, including, for example, plastic food storage containers, polycarbonate beverage bottles, epoxy-lined food cans, baby formula bottles, and dental sealants, to name a few (Lakind & Naiman, 2011; Roy, Chakraborty & Chakraborty, 2009); thus increasing concerns have been raised over the past decade about the impact of environmental BPA on human health. Based on the chemical nature of BPA, an estrogenic compound, concerns have been directed largely

Introduction Although several studies have explored craving for certain drugs, there is limited data describing the relationship between alcohol and nicotine craving from a multidimensional perspective among individuals with comorbid nicotine dependence (ND) and alcohol dependence (AD). Methods We compared a group of male patients diagnosed with ND and AD (n = 160) to a group of male patients diagnosed with ND only (n = 235). Smoking- and drinking-related clinical features were measured, including craving levels and the Nicotine Dependence Syndrome Scale (NDSS), which is a multidimensional questionnaire measuring ND. Subsequently, we studied factors that influenced smoking and alcohol craving in the ND and AD group. Results Regarding the NDSS, the sum, priority and tolerance scores were significantly higher in the ND and AD group compared with the ND only group (P

Introduction Our objective was to identify the factors related to returning to smoking by analyzing data obtained from a smoking cessation clinic. Methods We analyzed data from 2,089 subjects (age 44.0 ± 12.9 years) who started a smoking cessation program between 16 July 2007 and 31 December 2008 in a community health center in the city of Ulsan. We analyzed demographic information and clinical variables using Kaplan–Meier survival analysis and calculated the hazard ratio for returning to smoking. Results Mean abstinence time differed according to the following factors: sex, past attempts to quit, employment status, type of health insurance, CO levels, results from Fagerstrom test for nicotine dependence (FTND), number of cigarettes smoked daily, use of a nicotine replacement, and number of contacts in the program. Using multivariate analysis, we identified negative relationships between treatment intensity and hazard ratio for the following: visits ≤4 (Exp(B) = 3.752, P

The Connor-Davidson Resilience Scale (CD-RISC) is a brief self-rating questionnaire for measuring resilience. The aims of the present study were to describe the development of a Korean version of the CD-RISC (K-CD-RISC) and to more firmly establish its psychometric properties in terms of reliability and validity. The participants consisted of a general population sample (n=194) and psychiatric outpatients (n=127) with non-psychotic mood or anxiety disorders. The K-CD-RISC score means (standard deviation) were 65.9 (13.6) in the general population and 50.4 (20.5) in the psychiatric outpatients. The mean score of the general population was significantly higher than that of the psychiatric outpatients. Exploratory factor analysis revealed five factors, and the obtained factor structure was verified through confirmatory factor analysis. In the general population, the Cronbach's α coefficient of the K-CD-RISC was found to be 0.92. Greater resilience was found to be associated with less perceived stress, anxiety and depression and with higher levels of positive affect and purpose in life. Taken together, our findings suggest that the K-CD-RISC has good psychometric properties and is a valid and reliable tool for assessing resilience.

Background: The present study assessed the association between blood lead and urinary cotinine levels and inattentive and hyperactive symptoms and neurocognitive performance in children. Methods: A total of 667 children (age range 8–11) were recruited from nine schools in five Korean cities. The teachers and parents completed the Korean version of the Attention-deficit/hyperactivity disorder Rating Scales (K-ARS), and the children performed neurocognitive tests. Blood lead and urinary cotinine levels were then measured. Results: The inattentive, hyperactive, and total scores of the teacher-rated K-ARS were positively associated with blood lead level, and the results of the continuous performance test (CPT), Stroop Color–Word Test, and Children’s Color Trails Test were inversely associated with urinary cotinine level when controlled for age, gender, father’s educational level, maternal IQ, child’s IQ, residential area, birth weight, and cotinine (for lead) or lead (for cotinine). The association between blood lead level and commission errors score on the CPT disappeared when the effect of urinary cotinine level was controlled. Conclusions: These findings indicate that environmental exposure to tobacco smoke in children is associated with poor neurocognitive performance, and low levels of lead are associated with inattention and hyperactivity symptoms.