论文部分内容阅读
目的比较美国《精神障碍诊断与统计手册》第4版(DSM-Ⅳ)注意缺陷多动障碍(ADHD)中以注意障碍为主型(ADHD-I)、以多动/冲动为主型(ADHD-HI)和混合型(ADHD-C)的临床特点。方法将1999年9月至2004年4月北京大学精神卫生研究所门诊就诊的符合DSM-Ⅳ中的ADHD诊断标准者748例分为ADHD-I型398例,ADHD-C亚型307例和ADHD-HI亚型43例,比较3个亚型的共患疾病,以及Rutter和Conners儿童行为问卷(父母问卷)中的行为问题。结果ADHD-C亚型对立违抗性障碍、品行障碍、双相障碍-躁狂发作的共患率显著高于ADHD-I和ADHD-HI亚型(P<0·01);ADHD-I学习困难的共患率显著高于其它两组亚型(P<0·001)。Rutter儿童行为问卷中ADHD-C亚型伴有的总行为问题和A行为问题明显多于ADHD-I与ADHD-HI亚型;ADHD-I亚型伴有的M行为问题多于ADHD-C与ADHD-HI亚型(P≤0·001)。Conners儿童行为问卷中ADHD-C和ADHD-HI亚型出现品行问题、冲动和多动、多动指数问题的比例均高于ADHD-I亚型(P≤0·001)。结论ADHD-C亚型的破坏性行为问题突出,而ADHD-I亚型的学习困难问题明显。
OBJECTIVE: To compare the prevalence of attention-deficit-predominant (ADHD-I) and hyperactivity / impulsivity-predominant (ADHD) in attention deficit hyperactivity disorder (ADHD) in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM- -HI) and mixed (ADHD-C) clinical features. Methods From July 1999 to April 2004, 748 ADDS-diagnosed ADHD diagnostic criteria from outpatient clinic of Peking University Mental Health Institute were divided into 398 cases of ADHD-I, 307 cases of ADHD-C subtype and ADHD -HI subtype in 43 patients, comparing co-morbidities in the three subtypes with behavioral problems in the Rutter and Conners Child Behavior Questionnaire (Parents Questionnaire). Results The comorbidity rate of ADHD-C subtypes was significantly higher than that of ADHD-I and ADHD-HI subtypes (P <0.01). The comorbidity rates of ADHD-C suboptimal oppositional conduct disorder, conduct disorder and bipolar disorder-manic episode were significantly higher than those of ADHD- The comorbidity rate was significantly higher than the other two subtypes (P <0.001). ADHD-C is associated with more general behavioral and behavioral problems in the Rutter Child Behavior Questionnaire than in ADHD-I and ADHD-HI subtypes; ADHD-I subtypes are associated with more M-behavior problems than ADHD-C and ADHD-HI subtype (P≤0.001). Conners Children’s Behavior Questionnaire ADHD-C and ADHD-HI subtype of conduct problems, impulsiveness and hyperactivity, hyperactive index problems were higher than the proportion of ADHD-I subtype (P≤0. 001). Conclusion The destructive behaviors of ADHD-C subtypes are prominent, while the learning difficulties of ADHD-I subtypes are obvious.