中国儿童保健杂志 ›› 2019, Vol. 27 ›› Issue (10): 1054-1058.DOI: 10.11852/zgetbjzz2019-0274

• 科研论著 • 上一篇    下一篇

注意缺陷多动障碍患儿的功能损害特点研究

张小林1,2, 章依文1,2, 吴虹1,2, 马骏1,2, 姜艳蕊1,2, 喻珺纯1, 沈植旻1   

  1. 1 上海交通大学医学院附属上海儿童医学中心发育行为儿科,上海 200127;
    2 上海市环境与儿童健康重点实验室,上海 200127
  • 收稿日期:2019-03-11 发布日期:2019-10-10 出版日期:2019-10-10
  • 通讯作者: 章依文,E-mail:zhangyiwen@scmc.com.cn
  • 作者简介:张小林(1992-),女,在读研究生,主要从事多动症、儿童心理行为等领域的研究。

Research on the functional impairment in children with attention deficit hyperactivity disorder

ZHANG Xiao-lin1,2, ZHANG Yi-wen1,2, WU Hong1,2, MA Jun1,2, JIANG Yan-rui1,2, YU Jun-chun1, SHEN Zhi-min1   

  1. 1 Department of Developmental and Behavioral Pediatrics,Shanghai Children′s Medical Center Affiliated to Medical School of Shanghai Jiaotong University,Shanghai 200127,China;
    2 MOE-Shanghai Key Laboratory of Children′s Environmental Health,Shanghai 200127,China
  • Received:2019-03-11 Online:2019-10-10 Published:2019-10-10
  • Contact: ZHANG Yi-wen,E-mail:zhangyiwen@scmc.com.cn

摘要: 目的 评估注意缺陷多动障碍(ADHD)患儿的功能状态,研究不同性别、年龄段、智力水平ADHD患儿的功能损害差异。方法 2018年3月-2019年1月期间,收集疑似ADHD儿童1 718名,父母填写Weiss功能缺陷评定量表,同时专业医师按照DSM-5诊断标准对儿童进行诊断。符合诊断标准者纳入ADHD组,不满足诊断标准者纳入非ADHD组。结果 ADHD组1 011例,非ADHD组707例。在家庭、学习/学校、生活技能、自我观念、社会活动、冒险活动等维度及功能总分的功能损害方面,ADHD组均明显高于非ADHD组,两组差异均有统计学意义(Z=12.484、-15.629、-12.917、-9.435、-8.145、-11.026、-17.328,P<0.001)。在ADHD组中,男童在社会活动、冒险活动维度及总分的功能损害明显高于女童(Z=-3.322、-3.086、-2.350,P<0.05);年龄在9岁及以上组患儿在家庭、学习/学校、生活技能、自我观念、社会活动等维度及总分的功能损害,均明显高于低龄儿童(9岁以下)组(H=10.226、16.725、13.466、42.177、6.523、22.548,P<0.05);智力在中等至中下水平范围的两组(85~99,70~84)和智力低下组(<70)比智力在中等至中上水平范围的两组(100~114,115~129)在学习/学校维度有更严重的功能损害(H=54.528,P<0.05)。结论 ADHD儿童存在明显的功能缺陷,不同性别、年龄、智商水平的ADHD患儿的功能损害有不同的特点。

关键词: 注意缺陷多动障碍, 功能损害, 智商, 神经障碍性疾病

Abstract: Objective To assess the function in children with attention deficit hyperactivity disorder(ADHD),and to study functional impairment of ADHD children with different genders,ages,and intelligence quotient(IQ). Methods A total of 1 718 children with clinically suspected ADHD were investigated and interviewed from March 2018 to January 2019.Weiss Functional Impairment Rating Scale-Parent Report(WFIRS-P) was used to evaluate functioning of all children.ADHD group was diagnosed according to DSM-5 criteria for ADHD and children who did not meet the diagnostic criteria were assigned to non-ADHD group. Results Finally 1 011 children were in ADHD group,and 707 in non-ADHD group.ADHD children had significantly higher functional impairment than non-ADHD group in 6 dimensions,including family,school and learning,life skills,self-concept,social activities,risky activities and total score(Z=12.484,-15.629,-12.917,-9.435,-8.145,-11.026,-17.328,P<0.001).In ADHD group,boys had much severer deficits than girls in 2 dimensions of functioning such as social activities and risky activities and total score(Z=-3.322,-3.086,-2.350,P<0.05).Functional impairment of children over 9 years old were severer than children under 9 years old in family,school and learning,life skills,self-concept,social activities domains and total score(H=10.226,16.725,13.466,42.177,6.523,22.548,P<0.05).Three intelligent groups with IQ 85-99,70-84 and <70 had severer functional impairment in school and learning than other two groups with IQ 100-114 and 115-129(H=54.528,P<0.05). Conclusion ADHD children have significant functional impairment,and ADHD children with different gender,age and IQ levels show different patterns of functional impairments.

Key words: attention-deficit/hyperactivity disorder, functional, impairment, intelligence quotient, neurological disorders

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