伴对立违抗性障碍的注意缺陷多动障碍儿童焦虑抑郁情绪分析

中国儿童保健杂志 ›› 2013, Vol. 21 ›› Issue (1): 65-67.

伴对立违抗性障碍的注意缺陷多动障碍儿童焦虑抑郁情绪分析

黄广文¹,苏林雁²,马敏¹,何满芬¹,谢高梅¹

1 湖南省妇幼保健院儿童保健科,湖南长沙 410008;
2 中南大学湘雅二医院精神卫生研究所,湖南长沙 410011

收稿日期:2012-06-25 发布日期:2013-01-06 出版日期:2013-01-06

Study of anxious and depressive emotion of attention deficit hyperactivity disorder with oppositional defiant disorder

HUANG Guang-wen¹,SU Lin-yan²,MA Min¹,HE Man-fen¹,XIE Gao-mei¹.

1 Department of Behavior and Developmental Pediatric,Hunan Provincial Maternal and Child Health Hospital,Changsha,Hunan 410008,China;
2 Mental Health Institute,the Second Xiangya Hospital,Central South University,Changsha,Hunan 410011,China

Received:2012-06-25 Online:2013-01-06 Published:2013-01-06

摘要/Abstract

摘要： 目的了解伴与不伴对立违抗性障碍(oppositional defiant disorder,ODD)的注意缺陷/多动障碍(attention deficit hyperactivity disorder,ADHD)情绪问题。方法对门诊就诊儿童以DSM-IV中ADHD和ODD诊断标准进行诊断,得到ADHD伴ODD者55例(占总数中59.14%),ADHD不伴ODD者38例(占总数中40.86%)。采用自行编制的家庭情况调查表,调查每一患儿情况。采用儿童焦虑性情绪障碍筛查表、儿童抑郁障碍自评量表评估儿童焦虑抑郁情绪。对两组儿童的焦虑抑郁情绪问题进行比较分析。结果 ADHD+ODD组在躯体/惊恐、广泛焦虑、分离焦虑、社交恐怖、学校恐怖及焦虑总分、抑郁总分得分均显著高于ADHD组(t=2.105~5.145,P<0.001~0.05)。结论伴ODD的ADHD儿童比单纯ADHD儿童存在更为明显的焦虑抑郁性情绪问题。应注重ADHD、ODD儿童情绪问题干预。

关键词: 对立违抗性障碍, 注意缺陷多动障碍, 焦虑, 抑郁, 儿童

Abstract: Objective To explore the emotional problem of attention deficit hyperactivity disorder (ADHD) with and without oppositional defiant disorder (ODD). Methods 55(59.14%) ADHD children with ODD,38(40.86%) ADHD children without ODD,93 children were evaluated with the Screen for Child Anxiety Related Emotional Disorders (SCARED) and Depression Self-rating Scale for Children (DSRSC),and 93 parents completed family information.Anxious and depressive emotion problems were compared with two groups. Result The ADHD with ODD group showed significantly higher somatization/panic,general anxiety,separated anxiety,socialization phobia,school phobia and anxiety total score,depression total score (t=2.105~5.145,P<0.001~0.05). Conclusions Children of ADHD with ODD have much more anxious and depressive emotion problems than simply ADHD.More attention should be paid to intervene the emotional problem of children with ADHD and ODD.

Key words: oppositional defiant disorder, attention deficit hyperactivity disorder, anxiety, depression, child

中图分类号:

R749.94

黄广文,苏林雁,马敏,何满芬,谢高梅. 伴对立违抗性障碍的注意缺陷多动障碍儿童焦虑抑郁情绪分析[J]. 中国儿童保健杂志, 2013, 21(1): 65-67.

HUANG Guang-wen,SU Lin-yan,MA Min,HE Man-fen,XIE Gao-mei.. Study of anxious and depressive emotion of attention deficit hyperactivity disorder with oppositional defiant disorder[J]. journal1, 2013, 21(1): 65-67.

参考文献

[1] Fergusson DM,Horwood LJ,Lynskey MT.Structure of DSM-Ⅲ-R criteria for disruptive childhood behaviors:confirmatory factor models[J].J Am Acad Child Adolesc Psychiatry,1994,33:1145-1157.
[2] 中华医学会精神科分会.中国精神障碍分类与诊断标准(CCMD-3)[M].济南:山东科学技术出版社,2001:154-155.
[3] 苏林雁,谢光荣,高雪屏,等.注意缺陷/多动障碍合并对立违抗障碍的临床和血清5-HT对照研究[J].中华精神科杂志,2001,34(4):230-233.
[4] 黄广文,苏林雁,任颖,等.伴与不伴对立违抗性障碍的ADHD儿童行为特征分析[J].中国临床心理学杂志,2004,12(4):388-390.
[5] 王凯,苏林雁,朱焱,等.儿童焦虑性情绪障碍筛查表的中国城市常模[J].中国临床心理学杂志,2002,10(4):270-272.
[6] 苏林雁,王凯,朱焱,等.儿童抑郁障碍自评量表的中国城市常模[J].中国心理卫生杂志,2003,17(8):547-554.
[7] 孙凌,苏林雁,刘永忠.对立违抗性障碍[J].国外医学:精神病学分册,2000,27(4):233-237.
[8] Harada Y,Yamazaki T,Saitoh K.Psychosocial problems in attention-deficit hyperactivity disorder with oppositional defiant disorder[J].Psychiatry Clin Neurosci,2002,56(4):365-369.
[9] 熊锦林,罗学荣,管冰清,等.伴与不伴对立违抗性障碍的注意缺陷多动障碍儿童自我意识分析[J].中国临床心理学杂志,2008,16(5):529-530.
[10] Kim HW,Cho SC,Kim BN,et al.Does oppositional defiant disorder have temperament and psychopathological profiles independent of attention deficit/hyperactivity disorder? [J].Compr Psychiatry,2010,51(4):412-418.
[11] Purper OD,Franc N.Emotional dysfunctions in attention deficit hyperactivity disorder[J].Arch Pediatr,2011,18(6):679-685.
[12] 耿耀国,苏林雁,李晏.注意缺陷多动障碍儿童焦虑抑郁情绪研究[J].实用儿科临床杂志,2006,21(13):843-844.
[13] Ellen B,Braaten,Biederman J,et al.Revisiting the association between attention deficit/hyperactivity disorder and anxiety disorders:A familial risk analysis[J].Niol Psychiatry,2003,53(6):93-99.
[14] Souza I,Pinheiroma,Mattos P.Anxiety disorders in an attention deficit /hyperactivity disorder clinical sample[J].A rq Neuropsiquiatr,2005,63 (2):407-409.
[15] Schatz DB,Rostain AL.ADHD with comorbid anxiety:a review of the current literature [J].J Atten Disord,2006,10(2):141-149.
[16] 苏林雁.注意缺陷多动障碍诊断的临床思考[J].实用儿科临床杂志,2010,25(12):871-874.
[17] 耿耀国,苏林雁,王洪.注意缺陷多动障碍儿童冲动行为与焦虑抑郁情绪的相关研究[J].中国学校卫生,2010,31(4):440-442.

【作者简介】黄广文(1970-),男,湖南人,副主任医师,医学硕士,主要研究方向为儿童行为与情绪障碍。