주의력결핍 과잉행동장애의 약물치료에 대한 일반 대중의 인식 = Public Perspectives on Pharmacological Treatment of Attention-Deficit Hyperactivity Disorder

다국어 초록 (Multilingual Abstract)

ObjectivezzThe aim of this study was to examine 1) public knowledge and perceptions about attention-deficit hyperactivity disorder (ADHD) and 2) factors influencing the public’s decisions to adhere to ADHD pharmacotherapy.
MethodszzIn this study, 396 participants responded to the internet survey regarding their experiences, beliefs and treatment preferences about ADHD.
Resultszz252 respondents (63.6%) were reluctant to pharmacological treatment of ADHD. The respondents chose the functional impairment of the brain as the main cause of ADHD were favorable to pharmacological treatment and scored significantly high on the ADHD Knowledge Questionnaire. On the other hand, the respondents who regarded ADHD as an overly active personality rather than a disease were skeptical to pharmacotherapy and scored significantly low. The respondents who were acquainted with someone who had been diagnosed with ADHD perceived themselves relatively well informed about ADHD. However, the subjective perception of the degree of knowledge of ADHD was not correlated with the objective score of the ADHD Knowledge Questionnaire.
ConclusionzzThe public is not well informed about ADHD and its treatments. Culturally appropriate psychoeducational strategies based on the media and the internet are needed. Providing biomedical conceptualization of ADHD to the public may aid with treatment decisions and promote adherence to pharmacological treatment.

국문 초록 (Abstract)

본 연구에서는 ADHD에 대한 대중의 인식과 그들이 ADHD의 약물 치료를 선택하는 데 영향을 미치는 인자를 파악하기 위하여 인터넷 설문 조사에 응답한 396명의 자료를 분석하였다.
응답자들이 ADHD에 관한 지식을 얻은 주요 경로는 신문, 방송과 같은 대중 매체와 인터넷으로 나타났다. 3분의 1 이상 (36.6%)의 응답자들이 ADHD의 주요 병인으로 ‘부모의 양육태도’를 선택하였다. ADHD를 진단 받더라도 약물을 사용을 하지 않겠다고 대답한 경우는 63.6%였다.
ADHD의 병인으로 ‘뇌기능장애’를 선택한 응답자들은 그 외의 병인을 선택한 경우에 비하여 약물요법에 호의적이었으며 ADHD에 관한 지식을 측정하는 문항에 대한 평균 점수가 유의하게 높았다. 반면에 ADHD는 질병이 아니라 과도하게 활동적인 성격이라고 대답한 응답자들은 약물요법에 비호의적이었으며 지식을 측정하는 문항에 대한 평균 점수가 유의하게 낮았다.
본인이나 주변의 인물 중에 ADHD를 진단 받은 인물이 있는 응답자는 본인이 ADHD에 대하여 비교적 잘 알고 있다고 생각하였다. 그러나 본인이 주관적으로 평가하는 ADHD에 대한 지식의 수준과 객관적으로 평가한 실제 지식의 수준은 상관 관계가 없는 것으로 나타났다.
ADHD 아동에게 적절한 진단과 치료를 받을 수 있는 기회를 제공하기 위해서는 대중을 대상으로 ADHD의 생물의학적 병인론을 바탕으로 한 교육이 필요하며 이를 위하여 대중매체와 인터넷을 활용하는 것이 효율적일 것이다

참고문헌 (Reference)

• 1 Broom A, "Virtually he@lthy: the impact of internet use on disease experience and the doctor-patient relationship" 15 : 325-345, 2005
• 2 Daley KC, "Update on attention-deficit/hyperactivity disorder" 16 : 217-226, 2004
• 3 Gustafsson P, "Treatment of ADHD with amphetamine: short-term effects on family interaction" 12 : 83-91, 2008
• 4 Cornell-Swanson L, "The use of stimulant medication for treatment of attention-deficit/hyperactivity disorder: a survey of school social workers’ knowledge, opinions/attitudes, and experience" 29 : 62-82, 2005
• 5 Frankenberger W, "The use of stimulant medication for treatment of attention-deficit/hyperactivity disorder: A survey of school psychologists’ knowledge, attitudes, and experience" 29 : 132-151, 2001
• 6 Diller LH, "The run on Ritalin. Attention deficit disorder and stimulant treatment in the 1990s" 26 : 12-18, 1996
• 7 Coghill D, "The impact of medications on quality of life in attention-deficit hyperactivity disorder: a systematic review" 24 : 843-866, 2010
• 8 Canino G, "The DSM-IV rates of child and adolescent disorders in Puerto Rico: prevalence, correlates, service use, and the effects of impairment" 61 : 85-93, 2004
• 9 Breggin PR, "Talking back to Ritalin: what doctors aren’t telling you about stimulants for children" Common Courage Press 1998
• 10 Powers RL, "Stimulant treatment in children with attention-deficit/hyperactivity disorder moderates adolescent academic outcome" 18 : 449-459, 2008
• 11 Bauermeister JJ, "Stimulant and psychosocial treatment of ADHD in Latino/Hispanic children" 42 : 851-855, 2003
• 12 Marcus SC, "Stimulant adherence and academic performance in urban youth with attention-deficit/hyperactivity disorder" 50 : 480-489, 2011
• 13 DeGrandpre RJ, "Ritalin nation: rapid-fire culture and the transformation of human consciousness" WW Norton & Company 2000
• 14 McLeod JD, "Public knowledge, beliefs, and treatment preferences concerning attention-deficit hyperactivity disorder" 58 : 626-631, 2007
• 15 McLeod JD, "Public attitudes toward the use of psychiatric medications for children" 45 : 53-67, 2004
• 16 Katusic SK, "Psychostimulant treatment and risk for substance abuse among young adults with a history of attention-deficit/hyperactivity disorder: a population-based, birth cohort study" 15 : 764-776, 2005
• 17 Jensen PS, "Psychoactive medication prescribing practices for U.S. children: gaps between research and clinical practice" 38 : 557-565, 1999
• 18 Pliszka S, "Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder" 46 : 894-921, 2007
• 19 Ahmed R, "Parents’ Perspectives About Factors Influencing Adherence to Pharmacotherapy for ADHD"
• 20 Olfson M, "National trends in the treatment of attention deficit hyperactivity disorder" 160 : 1071-1077, 2003
• 21 MTA Cooperative Group, "National Institute of Mental Health Multimodal Treatment Study of ADHD follow-up: changes in effectiveness and growth after the end of treatment" 113 : 762-769, 2004
• 22 MTA Cooperative Group, "National Institute of Mental Health Multimodal Treatment Study of ADHD follow-up: 24-month outcomes of treatment strategies for attention-deficit/hyperactivity disorder" 113 : 754-761, 2004
• 23 Peters K, "Mothers’ experiences of parenting a child with attention deficit hyperactivity disorder" 65 : 62-71, 2009
• 24 "Moderators and mediators of treatment response for children with attention-deficit/hyperactivity disorder: the Multimodal Treatment Study of children with Attention-deficit/hyperactivity disorder" 56 : 1088-1096, 1999
• 25 Schlesinger MJ, "Medical professionalism under managed care: the pros and cons of utilization review" 16 : 106-124, 1997
• 26 Summers JA, "Laypeople’s attitudes toward drug treatment for behavioral control depend on which disorder and which drug" 26 : 258-263, 1987
• 27 Bekle B, "Knowledge and attitudes about attention-deficit hyperactivity disorder (ADHD): a comparison between practicing teachers and undergraduate education students" 7 : 151-161, 2004
• 28 Sadock BJ, "Kaplan & Sadock’s synopsis of psychiatry: behavioral sciences/clinical psychiatry" Wolter Kluwer/Lippincott Williams & Wilkins 2007
• 29 Barkley RA, "International consensus statement on ADHD. January 2002" 5 : 89-111, 2002
• 30 Jerome L, "Graduating teachers’ knowledge and attitudes about attention-deficit hyperactivity disorder: a comparison with practicing teachers" 44 : 192-, 1999
• 31 Underhill C, "Getting a second opinion: health information and the Internet" 19 : 65-69, 2008
• 32 Bussing R, "Explanatory models of ADHD do they differ by ethnicity, child gender, or treatment status?" 6 : 233-242, 1998
• 33 Ghanizadeh A, "Educating and counseling of parents of children with attention-deficit hyperactivity disorder" 68 : 23-28, 2007
• 34 Goldman LS, "Diagnosis and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Council on Scientific Affairs, American Medical Association" 279 : 1100-1107, 1998
• 35 Olaniyan O, "Community perspectives of childhood behavioral problems and ADHD among African American parents" 7 : 226-231, 2007
• 36 Jensen PS, "Closing the evidence-based treatment gap for children’s mental health services: what we know versus what we do" 2 : 43-50, 2002
• 37 Kos JM, "Children with attention deficit hyperactivity disorder and their teachers: a review of the literature" 53 : 147-160, 2006
• 38 Berger I, "Attitudes toward attention-deficit hyperactivity disorder (ADHD) treatment: parents’ and children’s perspectives" 23 : 1036-1042, 2008
• 39 Mayes R, "ADHD and the rise in stimulant use among children" 16 : 151-166, 2008
• 40 Kim HJ, "A study on early child parent’s recognition of ADHD" Ewha Womans University 2008
• 41 Son JS, "A study of preschooler teachers’ recognition and the teaching realities on ADHD" Daegu Univerisy 2005
• 42 "A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD" 56 : 1073-1086, 1999