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背景:在儿童中,注意缺陷与多动障碍(attention deficit hyperactivity disorder,ADHD)是一种常见的精神障碍,可能会持续到成人期,并且往往与多种精神疾病的共病相关。目标:评估患有ADHD的学龄儿童焦虑、抑郁的共病情况,以及ADHD儿童的ADHD症状、焦虑症状和抑郁症状的严重程度与其父母相应症状严重程度的相关性。方法:本研究在上海新华医院进行,经过两阶段的筛选入组患有ADHD和未患有ADHD的7-10岁儿童。高年资的临床医师采用学龄期儿童情感障碍与精神分裂症检查表(Schedule for Affective Disorder and Schizophrenia for School-Aged Children,K-SADS-PL)诊断ADHD与其它符合DSM-IV诊断标准的疾病。每一个入组儿童的父亲或母亲完成三个自评量表:成人ADHD自评量表(ADHD Adult Self Report Scale,ASRS)、状态-特质焦虑问卷(State-Trait Anxiety Inventory,STAI)和Beck抑郁自评问卷(Beck Depression Inventory,BDI)。本研究共入组135名患有ADHD的儿童和65名未患有ADHD的儿童作对照组;94名患有ADHD的儿童的父母和63名未患ADHD的儿童的父母完成了针对家长的评估量表。结果:在135名ADHD儿童中,27%的儿童共病焦虑障碍,18%共病抑郁障碍,另外15%同时共病焦虑和抑郁障碍。ADHD儿童的母亲(不是父亲)与未患有的ADHD儿童母亲相比,有更严重的注意力缺陷症状、更严重的特质性焦虑症状以及更严重的抑郁症状。在ADHD儿童中,ADHD症状的严重程度与其父母的ADHD症状的严重程度之间无显著的相关性,但儿童的抑郁症状和焦虑症状与其父母的相应症状显著相关。结论:学龄期ADHD儿童常伴发焦虑、抑郁障碍。相较于未患有ADHD的儿童的父母,ADHD儿童的父母的自评ADHD症状更为常见。在患有ADHD的儿童父母中,母亲们自我报告的焦虑症状较父亲们更为严重。我们还需要开展随访研究来理清导致这一复杂的相互关系的遗传性、生物性和社会因素。
Background. In children, attention deficit hyperactivity disorder (ADHD) is a common mental disorder that may persist into adulthood and is often associated with comorbidity of multiple psychiatric disorders. OBJECTIVE: To assess the prevalence of anxiety and depression in school-age children with ADHD and the correlation between the severity of ADHD symptoms, anxiety and depressive symptoms in ADHD children and the severity of their parents’ corresponding symptoms. Methods: This study was conducted in Shanghai Xinhua Hospital. After two-stage screening, children aged 7-10 years with ADHD and without ADHD were enrolled. Senior clinicians diagnose ADHD and other DSM-IV diagnostic criteria using the Schedule for Affective Disorder and Schizophrenia for School-Aged Children (K-SADS-PL). Three self-rating scales were completed for each group of fathers or mothers: ADHD Adult Self Report Scale (ASRS), State-Trait Anxiety Inventory (STAI) and Beck Depression The Beck Depression Inventory (BDI). This study enrolled 135 children with ADHD and 65 children without ADHD as controls; parents of 94 children with ADHD and 63 parents of children without ADHD completed parent-assessment Scale. RESULTS: Out of 135 children with ADHD, 27% had comorbid anxiety disorder, 18% comorbid depression, and another 15% had comorbid anxiety and depressive disorder. Mothers of ADHD children (not fathers) have more severe attention deficit symptoms, more severe idiopathic anxiety symptoms, and more severe depressive symptoms than mothers who do not have ADHD children. There was no significant correlation between the severity of ADHD symptoms and the severity of their parents ’ADHD symptoms in children with ADHD, but the depressive and anxiety symptoms in children were significantly associated with their parents’ corresponding symptoms. Conclusion: ADHD children of school age often accompanied by anxiety and depression. ADHD children’s parents self-rated ADHD symptoms are more common than those who do not have ADHD. Among children with ADHD, mothers reported self-reported anxiety symptoms more severely than their fathers. We also need to conduct follow-up studies to sort out the genetic, biological and social factors that lead to this complex relationship.