家庭治疗合并药物治疗与单纯药物治疗ADHD儿童的比较

目的:探索家庭治疗合并药物治疗对注意缺陷多动障碍(ADHD)儿童的行为及其家庭功能的影响。方法:将84例ADHD儿童分为综合组(43例)和药物组(41例),正常儿童41例为对照组,药物组接受常规的利他林治疗16周,综合组在药物治疗的基础上接受家庭治疗8次共16周。在入组时和家庭治疗结束后,分别采用Conners父母评定问卷(PSQ)、家庭功能量表(FAD)对3组儿童进行评定。结果:①治疗后,除了综合组的"心身障碍"及药物组的"心身障碍"和"情感反应"无明显改变,综合组和药物组的PSQ和FAD各因子分均显著下降,治疗前后的差异均有统计学意义[如综合组多动指数(1.02±0.42)vs.(0.68±0.23),药物组多动指数(1.10±0.45)vs.(0.69±0.22),P均<0.05];②治疗后在PSQ方面,3组组间的比较均无显著差异;③治疗后在FAD方面,3组组间的差异均有显著统计学意义[如综合组与药物组的"总的功能"(2.18±0.26)vs.(2.54±0.23),综合组与对照组的"总的功能"(2.18±0.26)vs.(1.65±0.28),药物组与对照组的"总的功能"(2.54±0.23)vs.(1.65±0.28),P均<0.05]。结论:家庭治疗结合药物治疗能有效改善ADHD儿童的症状及家庭功能,且对家庭功能的改善作用优于药物治疗。

Comparison of combined family therapy with drugs and simple medications in ADHD

Objective:To investigate the effects of combined family therapy with drugs on the behaviors of children with attention deficit hyperactivity disorder(ADHD) and family functioning.Methods:Eighty-four ADHD children were allocated to study group(n=43) and medication group(n=41) and another 41 normal children were recurited as control subjects.The medication group received stimulant Ritalin for 16 weeks,and the study group were given additional family therapy for 8 times on 16-week basis of drug therapy.All children in the three groups were assessed using Conners Parent Symptom Questionnaire(PSQ) and Family Assessment Device(FAD) before treatment and closure of family therapy.Results:Either in study group or medicaiton group except for psychosomatic factor and emotional reaction,the factor scores of PSQ and FAD were decreased significantly after stimulant intervention [e.g.,hyperactivity index for the study group and medication group:(1.02±0.42) vs(0.68±0.23);(1.10±0.45) vs(0.69±0.22),P<0.05].No significant difference was seen with PSQ,wherase the factor scores on FAD were significant different in the three groups after treatment(P>0.05;P<0.05) [e.g.,general functioning between study group and medication group:(2.18±0.26) vs(2.54±0.23);(2.18±0.26) vs.(1.65±0.28) for study group and controls;(2.54±0.23) vs(1.65±0.28) for medication group and controls].Conclusion:Combined family therapy with stimulant drugs is more effective on improvement of symptoms of ADHD children and family functioning,and is suprior to simple medicantion in this aspect.