注意缺陷多动障碍儿童认知状况对照研究

目的探讨探讨注意缺陷多动障碍（attention—deficit hyperactivity disorder,ADHD）儿童的认知结构特点。方法对40例ADHD儿童（研究组）及与其人口学资料相匹配的107名健康儿童（对照组）采用GO／NOGO任务、字母版2-back工作记忆任务、韦氏记忆量表（WMS—C）中的数字广度及词汇流畅性测试比较两组间认知功能的差异。结果研究组在GO／NOGO任务的错误数、2-back工作记忆的反应时、WMS—C中的词汇流畅性方面均差于对照组（P〈0．05）。结论ADHD儿童存在认知功能的损伤,为今后ADHD儿童认知功能受损的神经机制研究提供证据。     

105例儿童注意缺陷多动障碍的临床资料分析

儿童注意缺陷多动障碍（ＡＤＨＤ）是一常见儿童行为异常问题。作者抽取符合ＣＣＭＤ—２—Ｒ中相应诊断标准的１０５例进行如下分析。１　临床资料１－１　资料　１０５例中男８４例,女２１例;年龄７～１２岁,平均（８－５±２－４）岁。病因与脑损伤有关者１７例（１６－１９％）。其中,早产４例、窒息５例、产伤２例、胆红素脑病１例、中毒性昏迷３例、高热惊厥２例。与遗传因素有关者３８例（３６－１９％）。其中,患神经症１５例、精神病３例、性格障碍１例、父幼时顽皮多动１９例。与家庭环境不良有关者３４例（３２－３８％）。…     

儿童注意缺陷多动障碍的研究进展

注意缺陷多动障碍（attention deficit hyperactivity disorder,ADHD）是与发育不相称的注意力不集中、冲动一多动为特征的行为障碍。是一种根据行为来界定的神经心理疾病,与学校和社会的成功、自我评价等高度相关。多起病于童年期,到青春期症状常缓解,但部分人一直持续到中年。ADHD是一种慢性疾病,可能影响患者生活的许多方面,     

注意缺陷多动障碍儿童听觉事件相关电位的正性波分析

作为反映认知功能的电生理指标,P3波是P300波群中被研究最多的正性成分.已有研究表明,P3波可成为注意缺陷-多动障碍(ADHD)的辅助诊断指标[1].而作为P300电位中的另一个正性成分P2波,国内研究者对其潜伏期尚有涉及,对P2波幅在ADHD疾病中的改变却极少报道.为此,我们对ADHD儿童P300中的正性成分P2、P3一并分析,报道如下.     

儿童注意缺陷多动障碍的非药物治疗

对目前儿童注意缺陷多动障碍非药物冶疗理论和方法进行综述，探讨各种心理行为干预措施的临床效果，为研究新的整合治疗方法提供理论依据。     

注意缺陷/多动障碍儿童临床特征与单胺类神经递质研究

目的：探讨注意缺陷/多动障碍（ADHD）儿童的临床特征及血清单胺类神经递质水平的变化。方法：对32例ADHD儿童（研究组）和46名正常儿童（对照组）测评Piers-Harris儿童自我意识量表（PHCSS）、儿童焦虑性情绪障碍筛查表（SCRED）、儿童冲动量表（BIS）等,对其中30例ADHD儿童及36名正常儿童测量血清5-羟色胺（5-HT）、多巴胺（DA）、肾上腺素等的含量。结果：研究组PHCSS评分低于对照组（P〈0.01）;研究组SCRED和BIS评分均高于对照组（P〈0.001）。研究组血清5-HT低于对照组（P=0.002）。血清5-HT水平与冲动总分（r=-0.273）呈负相关;血清DA水平与运动分呈正相关（r=0.541）。结论：ADHD儿童具有多动、冲动、自我意识低等临床特征。而血清5-HT水平降低可能与ADHD的冲动控制困难特征有关。     

注意缺陷多动障碍的共患病研究现状

注意缺陷多动障碍 (ａｔｔｅｎｔｉｏｎ ｄｅｆｉｃｉｔｈｙｐｅｒａｃｔｉｖｉｔｙｄｉｓｏｒｄｅｒ,ＡＤＨＤ)的共患病 ,是儿童精神科临床工作中常见的问题。据报道 ,在ＡＤＨＤ患儿中 ,6 %～ 92 %伴学习困难 ,30 %～ 5 0 %伴破坏性行为障碍 [包括对立违抗性障碍 (ＯＤＤ)和品行障碍 ],15 %～ 75 %伴心境障碍 ,8%～ 30 %伴焦虑障碍[1] 。共患病的存在明显影响其治疗和预后。近 2 0年来 ,国外学者在ＡＤＨＤ共患病的病因、临床表现和治疗方案等方面做了相当多的研究工作 ,而国内尚缺少这方面研究。为此 ,我们将国外文献加以概述 ,希望对国…     

注意缺陷多动障碍的治疗

注意缺陷多动障碍 (ADHD)的治疗近来有不少进展 ,现综述如下 :1　药物治疗1 1　中枢兴奋剂　包括哌醋甲酯 (MPH)、右旋苯丙胺 (DEX)和苯异妥因。兴奋剂可防止儿茶酚胺的重吸收 ,并促使其释放 ,故对ADHD患者的儿茶酚胺不足有补偿作用 ,有资料显示中枢兴奋剂可改善额叶的功能不良。中枢兴奋剂中MPH和DEX是治疗ADHD的首选 ,二者改善ADHD的核心症状的作用是相同的 ,而且MPH可改善短期记忆。最近的研究肯定了中枢兴奋剂对治疗儿童ADHD的作用。成人ADHD ,尤其是在童年期发病的 ,中枢兴奋剂仍是首选。无论对学龄或学前儿童还是青少…     

儿童注意缺陷多动障碍的几种诊断方法探讨

目的　探讨儿童注意缺陷多动障碍 (ADHD)的诊断方法。方法　对家长或教师认为“多动”的 6～ 1 1岁儿童 1 98例 ,采用美国《精神障碍诊断和统计手册》第 4版 (DSM Ⅳ )的标准、持续性注意测验 (CAT)、Conners父母症状问卷 (PSQ)和简明症状问卷 (ASQ)分别作诊断。结果　 4种方法诊断为ADHD的分别有 1 1 0例、1 0 5例、1 0 5例和 95例 ,相应占 55 6 %、53 0 %、53 0 %和 4 8 0 %。后三者分别与前者比较均无显著差异 ( χ2 值分别为 0 2 5、0 .2 5和 2 2 8,P均大于 0 0 5)。CAT、PSQ和ASQ与DSM Ⅳ诊断比较 ,分别有 96 2 %、95 3%和 95 8%为符合与基本符合。CAT的敏感性、特异性和准确性分别为 91 8%、95 5%和 93 4 % ,PSQ的三项相应为 90 9%、94 3%和 92 4 % ,ASQ的三项相应为 77 3%、88 6 %和 82 3%。结论　CAT和PSQ的敏感性、特异性和准确性分别相近或高于目前最常用的ASQ(CAT三项的 χ2 分别为 8 91、2 79和 1 1 4 7,PSQ三项的 χ2 分别为 7 6 4、1 82和 9 1 6 ,P均分别为小于 0 0 5、大于 0 0 5和小于 0 0 5)。对DSM Ⅳ诊断标准具有较客观的补充作用 ,值得试用以至推广应用     

Biogenetic temperament and character and attention deficit hyperactivity disorder in Korean children

BACKGROUND: The objective of this study was to evaluate the relationship between symptoms of attention deficit hyperactivity disorder (ADHD) and biogenetic temperament, as assessed by the Junior Temperament and Character Inventory (JTCI) in Korean elementary school children. SAMPLING AND METHODS: Five hundred and sixteen elementary school students (254 boys and 262 girls; age range 9-14 years, mean age 11.0 +/- 1.0 years) were studied. The Junior Temperament and Character Inventory, both the self-rating and parent rating scales, the DuPaul ADHD rating scale (ARS-IV) for parents and teachers and the Child Behavior Checklist have been completed by study subjects. Children with high ARS-IV scores (the upper 10th percentile, n = 52) were defined to have ADHD. Fifty-two age- and sex-matched non-ADHD control subjects were selected randomly from a pool of 464 subjects. RESULTS: Inattention and hyperactivity/impulsivity symptoms correlated positively with Novelty Seeking in both children and parent ratings. These symptoms correlated negatively with Persistence, Self-Directedness and Cooperativeness. Novelty Seeking also had significant correlations with attention problems, delinquent behavior, aggressive behavior, externalizing problems and social problems in the Child Behavior Checklist. The ADHD group (n = 52) had higher scores of Novelty Seeking and lower scores of Self-Directedness and Cooperativeness, compared with the control group. CONCLUSIONS: There were significant correlations between ADHD symptoms and Novelty Seeking. Current findings suggest that Novelty Seeking and ADHD share biogenetic backgrounds.     

Transferrin in korean children with attention deficit hyperactivity disorder

Objective

The aim of the present study was to investigate the relationship between iron, ferritin, transferrin, total iron binding capacity (TIBC), hemoglobin, mean corpuscular volume (MCV) mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) in children with ADHD.

Methods

MethodsaaThe sample consisted of 48 ADHD children and sex and age matched control children (a couple of 28 boys, 22 girls; age 6-8 years; mean±SD, 6.98±0.39). We diagnosed ADHD according to DSM-IV. ADHD symptoms were evaluated subjectively with Conners'' Parent Rating Scales, Dupaul Parent ADHD Rating Scales. Subjects with ADHD and control were evaluated the hematology test including the iron, transferrin, MCV etc. Paired t test were used to evaluate the relation of a lot of hematology findings between ADHD and control group.

Results

The serum iron, ferritin, transferrin, TIBC, hemoglobin, MCV, MCH, and MCHC of ADHD group were respectively 80.92±33.33 ug/dL, 35.81±16.59 ng/mL, 248.42±44.15 mg/dL, 351.69±102.13 ug/dL, 12.78±0.71 g/dL, 82.94±2.58 fL, 27.18±1.12 uug, 32.79±1.12%. Otherwise the serum iron, ferritin, transferrin, TIBC, hemoglobin, MCV, MCH, and MCHC of control group were respectively 82.04±28.14 ug/dL, 37.05±18.28 ng/mL, 266.27±25.40 mg/dL, 352.77±89.54 ug/dL, 12.77±0.70 g/dL, 81.81±2.96 fL, 26.69±0.99 uug, 32.66±0.96%. A significant difference were found in the transferrin(t=2.63, p=0.011), MCV (t=2.19, p=0.034), and MCH (t=2.18, p=0.034).

Conclusion

These results suggested that lower transferrin levels might be related with ADHD symptoms.     

注意缺陷多动障碍执行功能的研究进展

注意缺陷多动障碍(attention deficit hyperactivity disorder, ADHD)是儿童时期常见的中枢神经系统疾病,其主要表现为注意力不集中、多动及冲动.西方国家患病率为3%～5%之间,国内患病率为3%～10%.ADHD的症状可以造成儿童的学习、人际关系、社交等多个领域的功能明显缺损,部分儿童的症状还可以持续至成年而不愈,成为成人ADHD.     

Somatosensory functioning in children with attention deficit hyperactivity disorder

In older to test the hypothesis that attention deficit hyperactivity disorder (ADHD) is related to deficits in somatosensory processing, 49 ADHD male children and 49 matched controls were tested on a wide range of tactile tasks, and somatosensory evoked potentials (SEP) were also recorded. In addition, parents' and teachers' ratings on the children's typical responses to tactile stimuli were obtained. The results show that the ADHD children were less skilled on suprathreshold, but not on threshold tasks than were the controls. Further, a larger percentage of ADHD children were 'tactile defensive'. Finally, the ADHD children showed Iarger-than-normal amplitudes of late, but not early components of the SEP. These data suggest that some aspects of somatosensory processing by ADHD children are deficient.     

Executive dysfunctions in children with attention deficit hyperactivity disorder

One hundred and twenty-four male children ranging in age from seven to 12 years-old were selected. The sample was divided into two groups: (1) sixty-two with attention deficit hyperactivity disorder (ADHD) children; and (2) sixty-two normal matched controls (N-ADHD). Three tests were individually administered: (1) Wisconsin Card Sorting Test (WCST); (2) Verbal fluency and semantics (animals and fruits); and, (3) Picture Arrangement subtest of the WISC-R. For all the test scores, statistically significant differences were found between both ADHD and N-ADHD groups. Two separate factor analyses were performed, using the normal and ADHD groups. Four factors were found for the N-ADHD group, which accounted for 85.7% of the variance. The factor structure presented some similarities in both groups: Factor 2, 3 and 4 in the control group corresponded to factors 1, 2 and 3 in the ADHD group. Nonetheless, in the ADHD group Factor 1 (Abstraction and Flexibility Factor) was absent. Results are interpreted as supporting the hypothesis of executive dysfunction in children with ADHD.     

Response to methylphenidate in children with attention deficit hyperactivity disorder and manic symptoms in the multimodal treatment study of children with attention deficit hyperactivity disorder titration trial

OBJECTIVE: Recent reports raise concern that children with attention deficit hyperactivity disorder (ADHD) and some manic symptoms may worsen with stimulant treatment. This study examines the response to methylphenidate in such children. METHODS: Data from children participating in the 1-month methylphenidate titration trial of the Multimodal Treatment Study of Children with ADHD were reanalyzed by dividing the sample into children with and without some manic symptoms. Two "mania proxies" were constructed using items from the Diagnostic Interview Schedule for Children (DISC) or the Child Behavior Checklist (CBCL). Treatment response and side effects are compared between participants with and without proxies. RESULTS: Thirty-two (11%) and 29 (10%) participants fulfilled criteria for the CBCL mania proxy and DISC mania proxy, respectively. Presence or absence of either proxy did not predict a greater or lesser response or side effects. CONCLUSION: Findings suggest that children with ADHD and manic symptoms respond robustly to methylphenidate during the first month of treatment and that these children are not more likely to have an adverse response to methylphenidate. Further research is needed to explore how such children will respond during long-term treatment. Clinicians should not a priori avoid stimulants in children with ADHD and some manic symptoms.     

Venlafaxine in children and adolescents with attention deficit hyperactivity disorder

The primary purpose of this study was to describe tolerability and efficacy of venlafaxine in the treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD). A 6-week open trial of venlafaxine was conducted in 13 children and adolescents (mean age 9.9 +/- 2.5 years) with ADHD, and without comorbid depression. Venlafaxine was initiated at a dose of 18.75 mg/day and flexibly titrated to 56.25 mg/day. The Conners parent scale and Clinical Global Improvement (CGI) severity item were performed at baseline and at the end of the 6-week trial. All subjects completed the trial. Mean final dose of venlafaxine was 40.3 +/- 7.0. Venlafaxine was significantly effective in reducing the total score of the Conners parent scale from baseline to endpoint (P < 0.002, Z =-3.113) and the CGI severity item (P < 0.05). Transient side-effects such as somnolence (n = 2), stomachache (n = 2), and headache (n = 1) disappeared after second week of treatment. Also three subjects complained of sedation after raising the dose to 56.5 mg/day, therefore the dose was reduced to the previous level. These preliminary data suggest that venlafaxine may be an effective medication in the treatment of some children and adolescents with ADHD. Future double-blind controlled trials should be undertaken.     

Treatment of attention deficit hyperactivity disorder in children

Objective The present study investigated the predictive power of anxiety, IQ, severity of ADHD and parental depression on the outcome of treatment in children with ADHD. Method Fifty children with ADHD (ages 8–12) were randomized to a 10-week treatment of methylphenidate or to a treatment of methylphenidate combined with multimodal behavior therapy. Prior to treatment predictors were assessed. Outcome was assessed separately for parents and teachers on a composite measure of inattentive, hyperactive, oppositional- and conduct disorder symptoms. Results There was neither a significant difference between the two treatments at baseline nor did treatment condition predict outcome. Therefore the data were collapsed across the two treatments. A combination of anxiety and IQ predicted teacher-rated outcome, explaining 18% of the variance. Higher anxiety and higher IQ’s indicated better treatment outcome. There were no significant predictors of the parent-rated outcome. Conclusion This study showed a small but significant predictive effect of IQ and anxiety on treatment outcome in children with ADHD. Clinical implications This study supports the idea that for the treatment of ADHD children with comorbid anxiety and higher IQ respond better to the two most used treatments for ADHD.