注意缺陷多动障碍自我意识和家庭环境情况的初步研究

目的评定注意缺陷多动障碍（ＡＤＨＤ）儿童的自我意识和家庭环境，并探讨二者与ＡＤＨＤ儿童的关系。方法应用Ｐｉｅｒｓ－Ｈａｒｒｉｓ儿童自我意识量表和家庭环境量表对７７例ＡＤＨＤ儿童进行评定。结果ＡＤＨＤ儿童自我意识低者占５３％，在行为、智力和学校、合群等方面低于正常儿童，家庭环境在亲密度、文化性等方面低于正常儿童家庭，而矛盾性高于正常家庭（Ｐ＜００１～００５）。结论ＡＤＨＤ儿童自我意识水平偏低，家庭环境较差。因此，对ＡＤＨＤ儿童药物治疗的同时，不可忽视心理治疗     

老年慢性精神分裂症的脑电地形图和多项诱发电位研究

为了解老年慢性精神分裂症患者与正常老人在脑电图（ＥＥＧ）、脑电地形图（ＢＥＡＭ）、视觉和听觉诱发电位（ＶＥＰ、ＡＥＰ）、脑干听觉反应（ＡＢＲ）和认知电位Ｐ３００（Ｐ３００）检测中的不同表现，对４０例正常老人及３４例老年慢性精神分裂症患者作６项电生理检测。结果发现，患者ＥＥＧ异常率达６６．７％，其ＢＥＡＭ趋向凹字形低密度带，ＶＥＰ（潜伏期Ｐ１、Ｐ２）、Ｐ３００（靶潜伏期Ｎ１—Ｐ２—Ｎ２—Ｐ３）均前移，ＡＥＰ（潜伏期Ｎ２、Ｐ３）延迟，ＡＥＰ、ＶＥＰ和Ｐ３００的Ｐ２、Ｐ３波幅均减低，均有显著性差异（Ｐ＜０．０５或Ｐ＜０．０１）。患者的ＡＢＲ于中央区左右侧不对称，绝对波幅波Ⅰ降低（Ｐ＜０．０１），这与本组对象ＣＴ结果吻合。采用多项诱发电位检测技术能较可靠反映精神分裂症患者脑的功能，可辅助患者的认知功能评定     

抑郁症临床症状与P_(300)的相关研究

作者用听觉识别法测定１９例抑郁症病人的事件相关电位Ｐ＿（３００），对其与临床症状进行相关分析，并与２８名正常人的Ｐ＿（３００）进行对照研究。结果显示：抑郁症病人的Ｎ＿１、Ｐ＿２、Ｎ＿２、Ｐ＿３的潜伏期较对照组明显延长，观察组与对照组的年龄、Ｎ＿１、Ｐ＿２、Ｎ＿２、Ｐ＿３的潜伏期与波帽的综合取值有显著差异，汉米尔顿抑郁量表（ＨＡＭＤ）总分与Ｐ＿３波幅呈显著负相关，ＨＡＭＤ总分与Ｐ＿３波帽、潜伏期及发病次数无关。研究结果提示Ｐ＿（３００）作为抑郁症病人认知受损指标有一定意义，但不是唯一的指标。     

阿尔茨海默病长潜时视觉和听觉诱发电位改变

目的探讨阿尔茨海默病（ＡＤ）患者的长潜时感觉性诱发电位的特点。方法应用丹麦电生理仪以及光和声刺激，对３９例ＡＤ患者和４０名正常老年人的视觉诱发电位（ＶＥＰ）和听觉诱发电位（ＡＥＰ）进行对照研究。结果部分ＡＤ患者ＶＥＰ形成双峰，ＡＥＰ趋向低而宽大。ＡＤ患者ＶＥＰ和ＡＥＰ的Ｐ３潜伏期在顶区均右侧（ＶＥＰ３７７±４４毫秒，ＡＥＰ３８８±２７毫秒）长于左侧（ＶＥＰ３７２±４４毫秒，ＡＥＰ３８１±２６毫秒），Ｐ＜０．０５。与对照组比较，ＡＤ患者ＡＥＰ主成分以及ＶＥＰ的Ｐ３潜伏期和ＡＥＰ、ＶＥＰ的Ｐ２、Ｐ３波幅均延迟和下降（Ｐ＜０．０５或＜０．０１）。结论提示ＶＥＰ和ＡＥＰ５０～５００毫秒长潜时成分可能是反映ＡＤ患者认知功能的一个客观指标     

注意缺陷多动障碍患儿局部脑血流灌注的研究

为探讨注意缺陷多动障碍（ＡＤＨＤ）局部脑血流（ｒＣＢＦ）特点及其可能的病理生理机制，应用单光子发射计算机断层扫描测定了１７例ＡＤＨＤ患儿和１１名正常儿童ｒＣＢＦ灌注情况。定性分析结果显示，ＡＤＨＤ患儿低ｒＣＢＦ灌注量的发生率（３５％）高于正常儿童（９％），低灌注部位涉及额叶、颞叶、枕叶和丘脑；半定量分析显示，左基底节灌注明显低于右侧（Ｐ＜０．０１），右侧扣带回和颞叶灌注低于左侧相应部位（Ｐ＜０．０５）。提示额叶－基底神经节环路在ＡＤＨＤ的病理生理机制中起重要作用。     

伴与不伴注意缺陷多动障碍的抽动秽语综合征患儿动态脑电图的对照研究

目的　探讨伴与不伴注意缺陷多动障碍（ＡＤＨＤ） 的抽动秽语综合征（ＴＳ） 患儿间脑电图的差异。方法　对８６ 例伴与不伴ＡＤＨＤ 的ＴＳ患儿进行２４ ｈ 动态脑电图（ＡＥＥＧ） 监测。结果　伴ＡＤＨＤ的ＴＳ组（４０ 例）ＡＥＥＧ异常率为７５％ ,单纯ＴＳ组（４６ 例） 异常率为３０％ ,２ 组差异有显著性（ Ｐ＜０－０５） ;ＡＥＥＧ异常的主要表现为慢波异常以及癫痫样波。伴ＡＤＨＤ的ＴＳ组的ＡＥＥＧ 局部异常多于广泛异常,且以额叶受累多见;而单纯ＴＳ组则广泛异常多于局部异常。结论　伴与不伴ＡＤＨＤ的ＴＳ患儿在脑电生理学上存在异质性     

伴与不伴注意缺陷多动障碍的抽动秽语综合征患儿动态脑电图的 …

目的 探讨与不伴注意缺陷多动障碍（ＡＤＨＤ）的抽动微语综合征（ＴＳ）患儿间脑电图的差异。方法 对８６例伴与不伴ＡＤＨＤ的ＴＳ患儿进行２４ｈ动态脑电图（ＡＥＥＧ）监测。结果 伴ＡＤＨＤ的ＴＳ组（４０例）ＡＥＥＧ异常率为７５％,单纯ＴＳ组（４６例）异常率为３０％,２组差异有显著性（Ｐ〈０．０５）;ＡＥＥＧ异常的主要表现为慢波异常以及癫痫样波,伴ＡＤＨＤ的ＴＳ组的ＡＥＥＧ局部异常多于广泛异常,且以额叶受     

朝鲜族、鄂伦春族醇代谢酶基因多态性与酒依赖的研究

目的了解醇脱氢酶（ＡＤＨ）和醛脱氢酶（ＡＬＤＨ）基因多态性与朝鲜族和鄂伦春族酒依赖发病的相互关系。方法采用耳血聚合酶链反应及等位基因特异性寡核苷酸杂交方法，检测ＡＤＨ和ＡＬＤＨ基因型在酒依赖患者（朝鲜族５５例，鄂伦春族３１例）与正常对照者（朝鲜族５０名，鄂伦春族３７名）人群中的分布频率。结果在酒依赖组与正常对照组之间，朝鲜族仅ＡＬＤＨ２基因频率的分布差异有非常显著性（Ｐ＜０．０１），而鄂伦春族的ＡＤＨ３基因频率分布和ＡＬＤＨ２基因频率分布的差异有非常显著性和显著性（Ｐ＜０．０１，Ｐ＜０．０５），两个民族的ＡＤＨ２基因频率分布差异均无显著性。结论提示朝鲜族酒依赖的发生与ＡＬＤＨ２基因有关，鄂伦春族则为ＡＬＤＨ２和ＡＤＨ３基因共同影响酒依赖的发生。     

脑干听觉诱发电位在阿尔茨海默病和老年精神分裂症患者中的应用

目的探讨阿尔茨海默病（ＡＤ）和老年精神分裂症（ＳＳ）脑干听觉诱发电位（ＢＡＥＰ）的特点。方法应用丹麦电生理仪及Ｃｌｉｃｋ短声刺激，测查３２例ＡＤ、３４例ＳＳ和４０名正常老年人（ＮＣ）的ＢＡＥＰ。结果ＡＤ组患者波形变异大，绝对潜伏期波Ⅲ、波Ⅳ和波Ⅵ明显延迟，主波绝对波幅波Ⅴ平均波幅分别低于ＳＳ组和ＮＣ组１８％和３４％，波Ⅱ、波Ⅳ、波Ⅴ、波Ⅵ和Ⅶ绝对波幅也显著低于ＳＳ组和ＮＣ组，与ＮＣ组间差异有显著性。ＳＳ组波Ⅲ、波Ⅵ绝对潜伏期较ＮＣ组延迟，绝对波幅波Ⅶ平均波幅低于ＮＣ组２０％。结论老年精神疾病ＢＡＥＰ异常表现在听神经至桥脑下段之间     

帕金森病病人的异常视网膜电图

目的探讨帕金森病（ＰＤ）病人视网膜的电生理改变，以期对ＰＤ诊断有所帮助。方法根据国际临床视觉电生理协会（ＩＳＣＥＶ）制定的标准化方案。对８２例帕金森病病人及４２名健康对照组进行视网膜电图（ｅｌｅｃｔｒｏｒｅｔｉｎｏｇｒａｍ，ＥＲＧ）检查。结果（１）ＰＤ组的ＥＲＧ的ｂ波波幅比对照组低（Ｐ＜０．０１），且波形不规则。（２）ＰＤ病人ＥＲＧ的ｂ波波幅和统一帕金森病量表（ＵＰＤＲＳ）评分呈负相关（Ｐ＜０．０１）。（３）ＰＤ病人常规服药后和停药１天相比ＥＲＧ的ｂ波波幅差异不明显（Ｐ＞０．５），但ＵＰＤＲＳ评分两组差异有显著性意义（Ｐ＜０．０１）。结论ＥＲＧ作为一种眼电生理检查，可客观地反映ＰＤ病人由于视网膜内多巴胺（ＤＡ）变化所致的视网膜电生理改变，且具有较好的稳定性，对ＰＤ的诊断有一定的意义。     

注意缺陷多动障碍核心症状对ADHD倾向儿童行为问题的影响

目的 探讨注意缺陷多动障碍（ADHD）核心症状对ADHD倾向儿童行为问题的影响,为早期识别ADHD患儿并进行有针对性的干预提供参考。方法 于2021年7月-8月,在广州市某小学筛选25名ADHD倾向儿童作为ADHD倾向组,纳入年龄、性别和年级相匹配的25名儿童作为正常组。采用中文版ADHD斯诺佩评估量表第4版（SNAP-IV）父母版评定ADHD核心症状,采用儿童困难问卷（QCD）和Conners父母症状问卷（PSQ）评定行为问题。采用Spearman相关分析考察ADHD核心症状与QCD和PSQ评分的相关性,采用分层线性回归分析探讨ADHD核心症状对行为问题的影响。结果 (1)组间差异显示,ADHD倾向组的注意缺陷和多动-冲动因子评分均高于正常组（t=7.771、6.726,P均<0.01）。(2)相关分析显示,注意缺陷因子评分与QCD总评分呈负相关（r=-0.440,P<0.05）,与PSQ的学习问题因子评分呈正相关（r=0.457,P<0.05）;多动-冲动因子评分与PSQ的焦虑因子评分呈负相关（r=-0.457,P<0.05）,与PSQ的冲动-多动因子评分呈...     

Identification of attention-deficit-hyperactivity disorder and conduct disorder in Mexican children by the scale for evaluation of deficit of attention and hyperactivity

The objective was weighing the usefulness of a Spanish-language Scale for the evaluation of deficit of attention and hyperactivity (EDAH) to identify children with attention deficit-hyperactivity disorder (AD-HD) and conduct disorder (CD) in a sample of school-aged children. We studied 132 children from a government-run public elementary school previously selected by teachers as having learning and attention disorders. We screened children of the sample with parents’ and teachers’ EDAH and Diagnostic and Statistical Manual of Mental Disorders-IV edition Text Revision (DSM-IV-TR) questionnaires, and performed an interdisciplinary clinical examination for the final diagnosis. We found 81 children with AD-HD and 51 children without AD-HD. AD-HD was classified as follows: AD-HD-combined (-C), n = 32; AD-HD-inattentive (-I), n = 17 and AD-HD-hyperactive (-H), n = 32. Cronbach's alpha calculation for the EDAH parents’ questionnaire was 0.76, and for teachers, 0.80. Sensitivity of the teachers’ EDAH questionnaire was 0.94, and specificity, 0.91. Sensitivity of the parents’ EDAH questionnaire was 0.91, while specificity was 0.87. The data of EDAH parents’ and teachers’ questionnaires have a concordance of 93.1% and 80%, respectively. The correlation of scores among parents’ and teachers’ EDAH scales was significant. The correlation between results from parents’ and teachers’ DSM-IV-TR and EDAH questionnaires was also significant. Our results partially support the use of EDAH questionnaires for AD-HD and CD screening in Spanish-speaking populations.     

注意缺陷多动障碍患儿的成人早期精神状况随访研究

Objective To investigate the psychiatric status in their young adulthood of children with attention deficit hyperactivity disorder (ADHD).Methods This was a prospedive study.The follow-up study of a cohort of clinic-referred ADHD children was conducted.At baseline, The consecutively referred children (n = 300) with DSM-Ⅳ ADHD, aged 7.5 - 17.0 years were assessed.At the 2.0 - 13.5-year follow-up, 116 ( 38.7% ) of them were reassessed ( aged 18.0 - 23.5 years ) using the structured psychiatric interviews to make DSM-Ⅳ diagnoses by trained clinicians, including the Conners Adult ADHD Diagnostic Interview for DSM-Ⅳ (CAADID), Structured Clinical Interview for DSM-Ⅳ Axis Ⅰ Disorders, Non-Patient Version ( SCID- Ⅰ/NP), and Structured Clinical Interview for DSM-Ⅳ Personality Disorders (SCID-Ⅱ).Results In the former 116 ADHD children, 50.9% (n =59) still met the ADHD criteria, in which 15.5% (n = 18) with pure ADHD, and 35.3% (n =41 ) fulfilled both ADHD and psychiatric/ personality disorders, 14.7% ( n = 17) met the criteria of psychiatric/personality disorders, but not ADHD,34.5% (n = 40) fulfilled none of the psychiatric/personality diagnoses at follow-up.Among 116 former ADHD children, 34.5% (n=40) had at least one DSM-Ⅳ axis Ⅰ disorders, in which 18.1% comorbid mood disorders, 10.3% anxiety disorders, 5.2% abuse disorders; and 32.8% (n=38) had at least one DSM-Ⅳ axis Ⅱ personality disorders, in which 5.2% type A personality disorders, 19.8% type B ( 17.2%anti-social personality disorders), 15.5% type C, and 6.0% others.Conclusion It indicates that ADHD youth be at high risk for a wide range of adverse psychiatric outcomes, and 2/3 of them have diagnoses of adult ADHD and/or psychiatric/personality disorders.     

注意缺陷多动障碍患儿的成人早期精神状况随访研究

Objective To investigate the psychiatric status in their young adulthood of children with attention deficit hyperactivity disorder (ADHD).Methods This was a prospedive study.The follow-up study of a cohort of clinic-referred ADHD children was conducted.At baseline, The consecutively referred children (n = 300) with DSM-Ⅳ ADHD, aged 7.5 - 17.0 years were assessed.At the 2.0 - 13.5-year follow-up, 116 ( 38.7% ) of them were reassessed ( aged 18.0 - 23.5 years ) using the structured psychiatric interviews to make DSM-Ⅳ diagnoses by trained clinicians, including the Conners Adult ADHD Diagnostic Interview for DSM-Ⅳ (CAADID), Structured Clinical Interview for DSM-Ⅳ Axis Ⅰ Disorders, Non-Patient Version ( SCID- Ⅰ/NP), and Structured Clinical Interview for DSM-Ⅳ Personality Disorders (SCID-Ⅱ).Results In the former 116 ADHD children, 50.9% (n =59) still met the ADHD criteria, in which 15.5% (n = 18) with pure ADHD, and 35.3% (n =41 ) fulfilled both ADHD and psychiatric/ personality disorders, 14.7% ( n = 17) met the criteria of psychiatric/personality disorders, but not ADHD,34.5% (n = 40) fulfilled none of the psychiatric/personality diagnoses at follow-up.Among 116 former ADHD children, 34.5% (n=40) had at least one DSM-Ⅳ axis Ⅰ disorders, in which 18.1% comorbid mood disorders, 10.3% anxiety disorders, 5.2% abuse disorders; and 32.8% (n=38) had at least one DSM-Ⅳ axis Ⅱ personality disorders, in which 5.2% type A personality disorders, 19.8% type B ( 17.2%anti-social personality disorders), 15.5% type C, and 6.0% others.Conclusion It indicates that ADHD youth be at high risk for a wide range of adverse psychiatric outcomes, and 2/3 of them have diagnoses of adult ADHD and/or psychiatric/personality disorders.     

The effects of continuous and partial reward on the vigilance task performance of adults with attentional deficits: a pilot investigation

The effects of reward schedule (100% and 30%) and extinction on attention (reaction time to auditory stimuli) and frustration levels (pressure exerted on a response key) of 15 adults with attentional disorders and 21 normal adults were examined using a continuous performance task. We predicted, that adults with attentional deficits would (a) perform similar to comparisons when rewarded on a continuous schedule, (b) exhibit higher levels of frustration when that continuous schedule was moved to an extinction schedule, and (c) experience more frustration than comparisons when rewarded on a partial schedule. Overall, adults with attentional deficits were slower to respond and their responses were more variable than typical comparisons across trials, similar to what is observed for children. Continuous reward resulted in poorer performance earlier in the reward phase and continued throughout an extinction phase. The frustration levels of adults with attentional deficits did not differ from comparisons across schedule conditions. Results are discussed in terms of the role of arousal in mediating responding to various schedules of reward.     

上海市闸北区5～15岁儿童注意缺陷多动障碍患病率及其影响因素的研究

目的了解上海市闸北区5~15岁儿童注意缺陷多动障碍（ADHD）的患病率特征及其影响因素。方法采用一般情况调查表和注意缺陷及多动症状调查表对上海市闸北区5~15岁儿童进行整群-分层抽样调查。共回收有效问卷9 900份,以美国精神障碍诊断和统计手册第4版ADHD的诊断标准对可疑患儿及其家长进行诊断性访谈,将ADHD患者分为注意缺陷为主型（ADHD-I）、多动-冲动为主型（ADHD-HI）和混合型（ADHD-C）,并分析ADHD的影响因素。结果 ADHD患病率为4.6%,其中ADHD-I型为2.4%,ADHD-HI型为0.4%,ADHD-C型为1.8%。男童患病率为6.6%,女童患病率为2.7%,男女患病率之比为2.41∶1。各年龄组ADHD各型的患病率存在差异,7~10岁组患病率最高（6.3%）。外地户籍儿童的患病率高于本市户籍儿童患病率。父母间的不同文化程度和人均月收入水平比较,其儿童的ADHD患病率差异有统计学意义。儿童月龄、性别及母亲低文化程度（初中及以下）是ADHD患病的影响因素。结论 ADHD-I型发病率高,7~10岁组患病率最高,儿童月龄、性别及母亲低文化程度影响ADHD患病率。     

利培酮治疗注意缺陷障碍对照观察

目的:观察小剂量利培酮治疗注意缺陷障碍(ADHD)的疗效和安全性,方法:前瞻性研究,以利他林作为对照,采用康纳多动症评定量表及不良反应症状量表(TESS)评定,观察4周,结果:利培酮有效率为77%,利他林为78%,未见锥体外系副反应,结论:利培酮与利他林的疗效相似,小剂量使用时安全有效.     

Attentional Capacities in Children with Autism: Is There a General Deficit in Shifting Focus?

Twenty-three children with autism and two control groups completed an attention battery comprising three versions of the continuous performance test (CPT), a digit cancellation task, the Wisconsin Card Sorting Test (WCST), and two novel, computerized tests of shifting attention (i.e., the Same–Different Computerized Task and the Computerized Matching Task). Children with autism could focus on a particular stimulus and sustain this focus as indicated by their performance on the digit cancellation task and the CPT. Their performance on the WCST suggested problems in some aspects of shifting attention (i.e., disengaging attention). The autism group performed as well as controls on the Same–Different Computerized Task, however, that required successive comparisons between stimuli. This implies that they could, in fact, shift their attention continuously. In addition, they did not differ from controls on the Computerized Matching Task, an analog of the WCST, suggesting that they do not have a general deficit in shifting attention.     

盐酸哌甲酯控释剂与速释剂对注意缺陷与多动障碍的疗效比较

目的比较盐酸哌甲酯控释剂（专注达）与速释剂（利他林）治疗儿童ADHD的疗效和安全性。方法上海心理咨询中心儿少部就诊ADHD患儿,按照患者意愿分别使用专注达与利他林治疗,随访2周、4周观察疗效（Conners量表和DSM—Ⅳ诊断标准）和安全性（血压、心律、主观不适等）。结果治疗两周后,专注达组Conners量表学习问题、多动指数两个指标与治疗前有显著改善（P〈0．01）,治疗四周后,两组在品行因子、学习问题因子、冲动-多动因子和多动指数上都显著好转（P〈0．05）;治疗四周后,两种药物均在注意缺陷分量表的得分显著好转（P〈0．05）,服用专注达和利他林组不良反应发生率没有显著差异（P〉0．05）。结论两种制剂疗效相当,使用安全。