Study on family environment and development-related risk factors of children with attention deficit hyperactivity disorder

doi:10.11852/zgetbjzz2019-1491

Abstract

Abstract: Objective To explore the influence of family environment and developing-related factors on the children's attention deficit hyperactivity disorder (ADHD),so as to provide the basis for early prevention and treatment of ADHD. Methods Totally 132 ADHD children in Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine were enrolled in this study from 2014 to 2017. And 82 healthy children were selected as control group. The family environment,parental stress and early development two groups were analyzed and compared by multivariate Logistic regression. Results There were significant differences between two groups on maternal pregnancies (t=3. 540),pregnancy accidents (χ²=18. 678),birth accidents (χ²=6. 523),major diseases (χ²=5. 527),dependency (χ²=22. 760),primary dependants (χ²=11. 831),parenting style (χ²=10. 440),parental relationship (χ²=8. 198) and parental stress (t=5. 217) (P<0. 05). Logistic regression analysis revealed that the abnormal conditions during maternal pregnancy(OR=7. 233,95%CI:1. 640—31. 898),negative discipline (OR=3. 759,95%CI:1. 429—9. 887) and different parenting attitudes (OR=2. 860,95%CI:1. 041—7. 859) were risk factors for ADHD. Breastfeeding (OR=0. 128,95%CI:0. 032—0. 514),general parenting(OR=0. 026,95%CI:0. 003—0. 223) and easy parenting(OR=0. 021,95%CI:0. 002—0. 225) were protective factors of ADHD. Conclusion The perinatal abnormality,family education and family relationship are the influencing factors of ADHD,which should be paid more attention.

Key words: attention deficit hyperactivity disorder, development-related risk factors, family environment, perinatal period

摘要： 目的探讨家庭环境及发育因素对注意缺陷多动障碍(ADHD)发病的影响,为疾病的早期预防和治疗提供依据。方法对2014-2017年在上海交通大学医学院附属精神卫生中心儿少门诊就诊的132例ADHD儿童及82名健康对照儿童的家庭环境、父母压力、围生期及发育情况进行统计分析。结果 ADHD组和对照组在母孕次(t=3.540),孕期意外(χ²=18.678),出生意外(χ²=6.523),重大疾病(χ²=5.527),抚养情况(χ²=22.760),抚养人(χ²=11.831),管教方式(χ²=10.440),父母关系(χ²=8.198)及父母压力(t=5.217)方面的差异有统计学意义(P<0.05或P<0.01)。Logistic回归分析显示,母孕期异常(OR=7.233,95%CI:1.640~31.898)、管教方式不合理(OR=3.759,95%CI:1.429~9.887)、教养态度不一致(OR=2.860,95%CI:1.041~7.859)是发病的危险因素,母乳喂养(OR=0.128,95%CI:0.032~0.514)、养育情况属于一般(OR=0.026,95%CI:0.003~0.223)及好养型(OR=0.021,95%CI:0.002~0.225)是ADHD的保护因素。结论围生期异常、家庭教育、家庭关系等因素是影响ADHD发病的相关因素,应引起重视。

关键词: 注意缺陷多动障碍, 发育相关危险因素, 家庭环境, 围生期

CLC Number:

R749.94

LI Yan, DU Ya-song, JIANG Wen-qing, QIAN Yun, LIU Yue. Study on family environment and development-related risk factors of children with attention deficit hyperactivity disorder[J]. journal1, 2020, 28(5): 559-562.

李焱, 杜亚松, 江文庆, 钱昀, 刘乐. 注意缺陷多动障碍儿童发病家庭环境及发育相关危险因素的研究[J]. 中国儿童保健杂志, 2020, 28(5): 559-562.

References

[1] 李福轮,谢晴牧,赵乾龙,等.中国儿童注意缺陷多动障碍患病率的Meta分析[J].临床荟萃,2017,32(12):1079-1083.
[2] 杜亚松,曹阳,江文庆.注意缺陷多动障碍儿童的执行功能[J].中国儿童保健杂志,2019,27(5):465-468,472.
[3] Thapar A,Cooper M,Eyre O,et al.What have we lear nt about the causes of ADHD? [J].J Child Psychol Psychiatry,2013,54(1):3-16.
[4] 栾风焕,杜亚松.家庭功能对注意缺陷多动障碍儿童症状影响[J].中国儿童保健杂志,2017,25(12):1229-1232.
[5] Sagiv SK,Epstein JN,Bellinger DC,et al.Pre- and postnatal risk factors for ADHD in a nonclinical pediatric population[J].J Atten Disord,2013,17(1):47-57.
[6] Matte B,Anselmi L,Salum GA,et al.ADHD in DSM-5: a field trial in a large,representative sample of 18- to 19-year-old adults[J].Psychol Med, 2015,45(2):361-373.
[7] Francisco R,de la Peña,Lino R,et al.Validity and reliability of the kiddie schedule for affective disorders and schizophrenia present and lifetime version DSM-5 (K-SADS-PL-5) Spanish version [J].BMC Psychiatry,2018,18:193.
[8] Walg M,Hapfelmeier G,El-Wahsch D,et al.The faster internal clock in ADHD is related to lower processing speed: WISC-Ⅳ profile analyses and time estimation tasks facilitate the distinction between real ADHD and pseudo-ADHD [J].Eur Child Adolesc Psychiatry, 2017,26(10):1177-1186.
[9] Barroso NE,Hungerford GM,Garcia D,et al.Psychometric properties of the parenting stress index-short form (PSI-SF) in a high-risk sample of mothers and their infants[J].Psychol Assess,2016,28(10):1331-1335.
[10] Bonvicini C,Faraone SV.Scassellatic common and specific genes and peripheral biomarkers in children and adults with attention-deficit/hyperactivity disorder[J].World J Biol Psychiatry,2018,19(2):80-100.
[11] Cho YJ,Choi R,Park S,et al.Parental smoking and depression,and attention-deficit hyperactivity disorder in children and adolescents: Korean national health and nutrition examination survey 2005-2014[J].Asia Pac Psychiatry,2018,10(3):e12327.
[12] 刘康香,钟燕,蒋耀辉,等.注意缺陷多动障碍儿童危险因素的病例对照研究[J].实用预防医学,2011,18(5):797-799.
[13] Schermerhorn AC,D'Onofrio BM,Slutske WS,et al.Offspring ADHD as a risk factor for parental marital problems: controls for genetic and environmental confounds [J].Twin Res Hum Genet, 2012,15(6):700-713.
[14] 王峰,张珏春,杜亚松,等.注意缺陷多动障碍患儿父母婚姻冲突、严厉管教与亲子依恋的相关研究[J].中国儿童保健杂志,2017,25(7):660-663.
[15] 李焱,江文庆,杜亚松,等.不同亚型未服药注意缺陷多动障碍患儿的行为特征与父母压力的关系[J].中华实用儿科临床杂志,2013,28(16):1246-1249.
[16] 陈静,刘漪,杜亚松.中小班学龄前儿童父母亲职压力与儿童心理状况的影响因素研究[J].中国儿童保健杂志,2018,26(7):737-740.
[17] Piper BJ,Corbett SM.Executive function profile in the offspring of women that smoked during pregnancy [J].Nicotine Tob Res,2012,14(2):191-199.
[18] PiresTde O,da Silva CM,de Assis SG.Association between family environment and attention deficit hyperactivity disorder in children-mothers' and teachers' views [J].BMC Psychiatry,2013,27(13):215.
[19] Owens EB,Hinshaw SP.Perinatal problems and psychiatric comorbidity among children with ADHD [J].J Clin Child Adolesc Psychol,2013,42(6):762-768.
[20] Huang Y,Xu H,Au W,et al.Involvement of family environmental,behavioral,and social functional factors in children with attention-deficit/hyperactivity disorder [J].Psychol Res Behav Manag,2018,11:447-457.
[21] 刘欣,季忆婷,李生慧,等.小学生注意缺陷多动障碍的危险因素分析[J].上海交通大学学报:医学版,2016,36(8):1191-1195.