注意缺陷多动障碍患儿的功能损害特点研究

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。

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

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.