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目的探讨儿童焦虑障碍诊断的稳定性及与症状变化之间的关系。方法 2012年10月—2014年10月采用整群抽样方法抽取河南信阳平桥区2所中心小学3~6年级5 233名7~13岁学生为调查对象,用长处和困难问卷(学生版)(SDQ)进行儿童焦虑障碍(anxiety disorders AD)的筛查,对阳性学生用儿童和青少年发育和健康状况评定量表(青少儿版)诊断,查出101例焦虑障碍患儿(AD),其中86例参与随访,对其进行儿童焦虑障碍自评量表测量,并分别于2013年10月、2014年10月进行诊断和量表测量,依据是否自愈分为自愈组和持续组,采用重复测量资料的方差分析症状与诊断变化之间的交互影响及焦虑症状不同时点的变化趋势。结果 73例患儿完成基础和2次随访诊断和量表测量;2次随访中分别有45、50例患儿自愈,自愈率为61.64%、68.49%,自愈与性别(随访1:男生23例,女生22例,P>0.05;随访2男生26例,女生24例,P=0.982)、年龄[随访1:(10.33±1.36)岁;随访2:(10.44±1.40)岁]无关联;症状部分,AD诊断与焦虑症状分趋势之间均有明显的交互作用(P>0.05),但持续组[基线:(30.05±13.43)分;随访1:(22.52±10.02)分;随访2:(22.62±7.38)分]和自愈组(基线:(27.40±11.62)分;随访1:(19.88±7.32)分;随访2:(17.61±5.54)分]之间的焦虑症状变化趋势差异无统计学意义(P=0.067)。结论儿童焦虑障碍诊断的稳定性低,缺乏临床效力。
Objective To investigate the relationship between the stability of children with anxiety disorder and the changes of symptoms. Methods From October 2012 to October 2014, a total of 5 233 students from 7 to 13 years of age from Grade 3 to Grade 6 at 2 Central Primary Schools in Pingqiao District of Xinyang, Henan Province, were selected as samples from October 2012 to October 2014. The questionnaires of the strengths and difficulties (Student Version) (SDQ) screening for anxiety disorders AD, and diagnosed positive children with children and adolescents’ development and health assessment scale (adolescent version), 101 children with anxiety disorder (AD) were identified Eighty-six patients were followed up and measured for children’s anxiety disorder self-rating scale. The diagnosis and scale measurement were performed in October 2013 and October 2014 respectively. According to whether they were self-healing or not, they were divided into self-healing group and continuous group. Repeated measures of analysis of variance analysis of symptoms and changes in the interaction between the impact and anxiety symptoms at different points in time trends. Results 73 cases of children completed basic and 2 follow-up diagnosis and scale measurement; 45,50 cases were self-healing in two follow-ups, the self-healing rate was 61.64%, 68.49% There were 23 males and 22 females, P> 0.05; 26 males and 26 females were followed up (P = 0.982) (P> 0.05), but the continuous group [baseline: (30.05 ± 13.43) points; follow-up 1: (22.52 ± 10.02) points; follow-up 2: (22.62 ± 7.38)] and self-healing group (baseline: (27.40 ± 11.62) points; follow-up 1: (19.88 ± 7.32) points; follow-up 2: (17.61 ± 5.54) points] The difference was not statistically significant (P = 0.067) .Conclusion The diagnosis of children with anxiety disorder is low stability, lack of clinical efficacy.