注意缺陷多动障碍儿童冷执行功能特征

目的探讨注意缺陷多动障碍(ADHD)儿童冷执行功能(反应抑制、工作记忆)特征。方法对2013年9月至2015年9月深圳市儿童医院儿童保健科门诊初诊的92例ADHD男性患儿及21名对照组男性儿童,运用反应/不反应任务、Stroop色-字干扰测验进行反应抑制功能评估,运用木块记忆任务、N-back任务、背数及字母-数字任务进行工作记忆功能评估。将不符合正态分布的数据进行秩和检验,其余实验数据进行t检验进行统计分析;控制韦氏儿童智力量表第4版(WISC-Ⅳ)智商(FIQ)后,对相关指标进行协变量方差分析。结果两组儿童冷执行功能差异有统计学意义(P0.05),ADHD组在反应抑制(反应-反应任务及Stroop色-字干扰测验)及工作记忆(木块记忆任务、N-back任务、背数及字母-数字任务)的各项监测指标均较对照组差(P0.05)。结论 ADHD儿童在冷执行功能存在缺陷。     

注意缺陷多动障碍儿童冲动行为与执行功能的相关研究

研究注意缺陷多动障碍（ADHD）儿童冲动行为与其执行功能的相关关系。方法　对2005年1月至2007年7月在中南大学湘雅二医院精神卫生研究所、郑州市第九人民医院心理科、郑州市儿童医院保健部的187例ADHD儿童（均符合DSM-IV注意缺陷多动障碍的诊断标准）与126名对照组儿童分别进行Barratt冲动性量表中文版（BIS）和威斯康星（WCST）卡片分类测验。结果　ADHD冲动组、ADHD非冲动组和对照组组间WCST的评分差异无统计学意义（P > 0.05）,BIS的3个因子及冲动总分与WCST卡片分类测验的非持续性错误数呈显著的负相关（P < 0.05）。结论　ADHD儿童与对照组儿童的执行功能差异无统计学意义（P > 0.05）,但冲动行为越强烈,儿童出现随机错误的可能性越大。     

小脑功能与注意缺陷多动障碍

<正>注意缺陷多动障碍(attention-deficit/hyperactivity disorder,ADHD)是一种高患病率的异质性疾病,美国8～15岁儿童中ADHD的患病率为8.7%[1],世界范围内儿童患病率估计为8%～12%     

儿童血铅与注意缺陷多动障碍的相关性

目的研究儿童血铅水平与注意缺陷多动障碍(ADHD)的相关性。方法对100名儿童进行血铅水平测定,据其血铅水平分为血铅水平正常组(对照组)及血铅水平增高组(实验组)各50例,再对两组儿童分别进行Conners量表测查,研究Conners量表分值与血铅水平的相关性。结果血铅水平正常组Conners量表分值明显低于铅中毒组,两组比较有显著差异(P <0.01),且血铅水平与Conners量表分值呈显著正相关(P<0.01)。结论通过血铅水平的测定,可早发现、早诊断ADHD,有利于进行早期干预,从两改善其预后。     

注意缺陷多动障碍儿童父母养育方式调查

目的分析注意缺陷多动障碍(ADHD)儿童的行为特征及父母养育态度和行为特征,探讨其临床干预方式。方法采用Conners父母问卷(PSQ)和父母养育方式评价量表(EMBU),对146例6～15岁ADHD儿童及父母进行问卷调查分析。结果与常模对比,ADHD儿童在品行问题、学习问题、心身障碍、冲动-多动、焦虑和多动指数6个因子差异有统计学意义(P<0.01);ADHD家庭父亲在养育过程中的情感温暖、理解,惩罚、严厉,偏爱被试,拒绝、否认,过度保护5个因子差异有统计学意义(P<0.01);母亲在养育过程中情感温暖、理解,拒绝、否认,惩罚、严厉和偏爱被试4个因子差异有统计学意义(P<0.01)。结论 ADHD儿童的父母存在不恰当的养育态度和行为,提示对ADHD儿童应根据个体情况给予药物治疗、心理干预和父母不良教养方式纠正等临床综合治疗。     

注意缺陷多动障碍伴学习障碍患儿家庭环境因素对照研究

目的探讨注意缺陷多动障碍(ADHD)伴学习障碍(LD)儿童父母教养方式及家庭亲密度和适应性的特点。方法 2005年9月至12月采用两阶段流行病学调查方法对湖南省9495名儿童及其家长进行问卷调查,对符合DSM-Ⅳ诊断标准的ADHD伴LD患儿123例(ADHD伴LD组)和正常儿童142名(对照组),采用父母教养方式评价量表及家庭亲密度和适应性量表做进一步调查。结果 ADHD伴LD组父母惩罚、拒绝、过度干涉、过度保护及偏爱被试明显高于对照组,差异均有统计学意义(P0.05);而母亲的情感温暖低于对照组,差异均有统计学意义(P0.05)。ADHD伴LD组实际亲密度、理想亲密度、实际适应性和理想适应性均明显低于对照组,差异有统计学意义(P0.01)。结论 ADHD伴LD患儿父母养育方式存在诸多问题。对该类患儿避免不良的家庭教育方式,采取干预措施尤为重要。     

注意缺陷多动障碍与遗传

近10 a来,注意缺陷多动障碍(ADHD)分子遗传学的研究发展迅速。作为一种病因尚未明确的多基因遗传病,尽管候选基因关联研究和全基因组连锁分析方法在揭示ADHD易感基因和潜在的连锁区域方面已取得进步,但是研究结果并不一致,因而无法得出确切结论。     

多不饱和脂肪酸与注意缺陷多动障碍

注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)是儿童青少年期常见的心理行为障碍,其主要临床特征为注意力不集中、活动过度和行为冲动.ADHD的发病机制及病因至今不明,多数学者认同ADHD是生物-心理-社会因素共同作用形成的疾病模型.生物学因素包括生物化学、遗传学、免疫学、神经系统发育障碍、脑电生理、影像学等.近年来,人体营养状况与精神心理健康的关系愈来愈引起研究人员注意,也不断有学者报道儿童青少年营养状况与ADHD存在一定的相关性,其中多见多不饱和脂肪酸(polyunsaturated fatty acid,PUFA)与ADHD关系的研究,以及锌元素、镁元素在脂肪酸(fatty acid)与ADHD中的作用.本文在查阅相关文献基础上,仅就此方面做一综述.     

注意缺陷多动障碍共患学习障碍平衡功能研究

目的 探讨共患学习障碍(LD)是否增加注意缺陷多动障碍(ADHD)患儿平衡功能损害的程度.方法 1999年11月至2001年11月北京大学精神卫生研究所门诊就诊患儿,使用平衡功能测试仪对单纯ADHD组、ADHD共患LD组和正常对照组各30名的平衡功能进行比较.结果 单纯ADHD组在右侧单腿睁眼、闭眼状态下晃动速率均明显高于正常对照组,差异有统计学意义(P<0.05).在海绵垫平面睁眼、海绵垫平面闭眼、左侧单腿睁眼、闭眼状态下晃动速率高于正常对照组,但差异无统计学意义(P>0.05).ADHD共患LD组在固定平面睁眼、闭眼、左侧单腿睁眼、闭眼、右侧单腿睁眼、闭眼状态下的晃动速率明显高于正常对照组,差异有统计学意义(P<0.01或P<0.05).在海绵垫平面睁眼、海绵垫平面闭眼状态下晃动速率高于正常对照组,但差异无统计学意义(P>0.05).结论 单纯ADHD在感觉冲突情况下存在明显平衡功能缺陷.共患LD的ADHD患儿在基础状态下平衡功能即存在明显缺陷,其平衡功能受损广泛.提示在临床中对共患LD的患儿应重视开展平衡功能康复训练.     

学龄期注意缺陷多动障碍共患特定学习障碍儿童智力结构与临床特征分析

目的 探讨注意缺陷多动障碍（ADHD）共患特定学习障碍（SLD）儿童的智力结构及其他临床特征。方法 回顾性选择2018年10月至2019年4月在吉林大学第一医院发育行为儿科门诊明确诊断的学龄期ADHD儿童88例为研究对象,根据有无共患SLD分为单纯ADHD组（n=45）和ADHD共患SLD组（n=43）。分析比较两组患儿的智力结构及其他临床特征。结果 ADHD共患SLD组患儿言语智商（VIQ）、操作智商（PIQ）及总智商（FIQ）得分均显著低于单纯ADHD组（P < 0.05）,VIQ中的常识、类同、算数及背数得分显著低于单纯ADHD组（P < 0.05）,PIQ的填图、排列、积木及拼图得分显著低于单纯ADHD组（P < 0.05）;共患SLD的发生与FIQ、VIQ、PIQ及常识、类同、算数、背数、填图、排列、积木、拼图能力呈显著负相关（P < 0.05）。结论 ADHD共患SLD患儿FIQ、VIQ及PIQ表现差于单纯ADHD患儿,主要表现在大部分智力结构因子能力偏弱。需要进一步关注学龄期ADHD儿童共患SLD的管理与干预。     

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目的研究注意缺陷多动障碍(ADHD)儿童冲动行为与其执行功能的相关关系。方法对2005年1月至2007年7月在中南大学湘雅二医院精神卫生研究所、郑州市第九人民医院心理科、郑州市儿童医院保健部的187例ADHD儿童(均符合DSM-IV注意缺陷多动障碍的诊断标准)与126名对照组儿童分别进行Barratt冲动性量表中文版(BIS)和威斯康星(WCST)卡片分类测验。结果ADHD冲动组、ADHD非冲动组和对照组组间WCST的评分差异无统计学意义(P>0.05),BIS的3个因子及冲动总分与WCST卡片分类测验的非持续性错误数呈显著的负相关(P<0.05)。结论ADHD儿童与对照组儿童的执行功能差异无统计学意义(P>0.05),但冲动行为越强烈,儿童出现随机错误的可能性越大。     

The relationship between attention, executive functions and reading domain abilities in attention deficit hyperactivity disorder and reading disorder: a comparative study

BACKGROUND: Co-morbidity of attention deficit hyperactivity disorder (ADHD) and reading disorder (RD) is frequent. The objective of this investigation was to assess the potential uniqueness of co-morbid ADHD + RD and extend existing findings to the Hebrew language. METHOD: A parallel group design with post-hoc analysis of group differences was employed comparing four groups of children (19 ADHD, 17 RD, 27 ADHD + RD, and 23 controls) on reading measures, attention and executive functions (EF) as well as functions of phonemic awareness and rapid naming. Forward stepwise regressions were run in order to delineate significant relationships between phonemic awareness, rapid naming, attention and EF with outcome variables of reading. RESULTS: The co-morbid group shared the basic characteristic impairments in attention and executive functions with the pure ADHD group and in reading domain functions with the pure RD group. In addition, this group showed unique deficits in rapid naming and a more severe impairment in working memory. Forward stepwise regression pointed to associations between executive functions and word reading accuracy in children with ADHD, in contrast to associations between linguistic functions and word accuracy in non-ADHD. CONCLUSION: The combination of cognitive deficits in the subgroup of children with both ADHD and RD and the relationship between accuracy in word decoding and executive functions shown for the ADHD groups point to a distinct clinical profile of the co-morbid condition. Attention and EF should be considered in the diagnosis of RD and in the remediation protocol.     

注意缺陷多动障碍儿童共患对立违抗性障碍与父母养育方式的相关性北大核心CSCD

目的探讨注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童共患对立违抗性障碍(oppositional defiant disorder,ODD)与父母养育方式的相关关系。方法采用病例对照研究方法纳入482例ADHD儿童作为研究对象,其中未共患ODD(单纯ADHD组)322例,ADHD共患ODD(ADHD共患ODD组)160例,收集两组患儿一般人口学资料和父母养育方式量表评估得分情况。采用多因素logistic回归分析法探究父母养育方式与ADHD患儿共患ODD的关系。结果单纯ADHD组和ADHD共患ODD组父母养育方式得分(含拒绝因子、情感温暖因子、过度保护因子和偏爱因子)和一般人口学资料差异均无统计学意义(P>0.05)。在ADHD注意缺陷型患儿中,患儿年龄越大,父亲文化程度越低,共患ODD风险越大(P<0.05),而父母养育方式与共患ODD无显著关联(P>0.05)。结论ADHD患儿是否共患ODD与父母养育方式无明显相关性,临床工作中,应减少对ADHD共患ODD患儿父母都有养育方式不良的刻板印象,从多角度寻找共患ODD的原因,以提供合理的干预建议。     

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??Objective??To explore the characteristics of cold executive function??response inhibition and working memory?? in children with attention deficit hyperactivity disorder??ADHD??. Methods??Ninety-two boys with ADHD and twenty-one healthy control subjects received assessment of inhibition functions??go/no-go task and Stroop color-word test?? and working memory functions??Corsi block recall task??visual spatial N-back??digits span test and letter-number sequencing??. These children with ADHD were compared with healthy control subjects by t-test or Mann-Whitney rank. Then they were compared with healthy controls after controlling for FIQ by using analysis of covariance??ANCOVA??. Results??There were significant differences in all task between ADHD groups and healthy controls??P??0.05??. The differences of each test showed that children with ADHD performed worse than healthy controls in go /no-go??Stroop color-word test??Corsi block recall task??visual spatial N-back??digits span test and letter-number sequencing??P??0.05??. Conclusion??There are significant deficiencies in cold executive function in children with ADHD.     

Motor function and methylphenidate effect in children with attention deficit hyperactivity disorder

Aim: Hyperactivity, impulsivity and poor attention are the core problems of ADHD and central stimulant medication is the preferred treatment. Many children with ADHD also display motor problems. The present study investigated the presence of motor problems in subjects who showed positive response to central stimulants on ADHD symptoms, compared with non‐responders. Method: This is a retrospective study of 73 children diagnosed ADHD, aged 5–17 years, who had been assessed with parts of the ‘Motor Function Neurological Assessment’ (MFNU) and evaluated with regard to effect of central stimulant medication. The sample was divided into two subgroups based on the responses to methylphenidate: Medicine responders and Non medicine responders. Results: Stimulant responders showed significantly more motor problems than the non‐responders on all sub‐tests and on the total problem score of the MFNU. Motor problems were present both in younger (age 5–10 years) and older (11–17 years) stimulant responders. There were no gender differences in motor performance. Conclusion: Our findings indicate that the probability of positive effect of central stimulants on core problems of ADHD is higher when motor problems are present in addition to ADHD symptoms, than when motor problems are absent.     

热性惊厥与注意缺陷多动障碍关系探讨

目的 探讨热性惊厥（FC）与注意缺陷多动障碍（ADHD）的关系。方法 由小儿神经专科医师对172例FC进行5～10年远期随访,Conner’s简明症状问卷等方法对患儿进行测试。结果 有FC史小儿ADHD患病率为23.8%（41/72）,与无FC史的小儿ADHD患病率5.1%（14/273）相比,差异有非常显著性（P﹤0.01）。另外FC的发作次数﹤4次和≥4次,持续时间﹤30min和≥30min ADHD患病率相比均有非常显著差异（P<0.01）。结论 本资料提示FC多次、长时间发作可能是小儿ADHD发生原因之一,小儿反复性热性惊厥,有复发或癫痫危险因素宜用药物预防。     

Ferritin and hyperactivity ratings in attention deficit hyperactivity disorder

Background: Iron is a co‐factor of tyrosine hydroxylase which is a critical enzyme in dopamine synthesis. Dopamine has been implicated in the pathophysiology of attention deficit hyperactivity disorder (ADHD). Our objective was to investigate the association of ferritin level with parent and teacher ratings and cognitive measures after controlling for age, sex, ADHD subtype, comorbid conditions, hemoglobin, mean corpuscular volume and reticulocyte distribution width in a large sample. Methods: The study included 713 children and adolescents with ADHD (613 boys; age 7–15 years). Conners' Parent Rating Scale (CPRS) and Conners' Teacher Rating Scale (CTRS) were obtained. In a subgroup of patients we conducted Digit Span, Digit Symbol, Trail‐making Tests as measures of attention and executive functioning. Results: Multiple regression analysis indicated that CPRS Hyperactivity score was significantly associated with ferritin level (B =?0.12; t =?3.1; P < 0.01). Other CPRS and CTRS scores as well as cognitive measures were not associated with ferritin level. Conclusions: Although it is not possible to make an inference on causality in cross‐sectional studies, the results of this largest‐scale cross‐sectional field study to date suggest that lower ferritin level might be associated with parent‐reported hyperactivity after controlling for important confounding factors.     

Thyroid function in a population of children with attention deficit hyperactivity disorder

To determine the prevalence of thyroid hormone abnormalities and generalized resistance to thyroid hormone in a population of children with attention deficit hyperactivity disorder (ADHD) as compared to reference ranges determined from a control population and hence to determine if routine thyroid hormone screening in children with non-familial ADHD is indicated.

Method:

Children attending the State Child Development Centre in Perth, Western Australia with ADHD, as defined by the Diagnostic and Statistical Manual of Mental Disorders (fourth edition) provided the study population. The control population consisted of 353 normal children with a history of allergy in whom radioallergosorbent (RAST) testing was being performed.

Results:

The prevalence of thyroid hormone abnormalities in the study population was 2.3% (95% CI 0.6%, 5.7%). There were no cases of generalized resistance to thyroid hormone. The prevalence of thyroid hormone abnormalities in the general population of children and adolescents has been reported to vary between 1 and 3.7%.

Conclusion:

Routine thyroid hormone screening is not indicated in children with non-familial ADHD.     

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目的探讨中学生互联网过度使用(IOU)与注意缺陷多动障碍(ADHD)的关系。方法采用网络成瘾诊断问卷(YDQ)、长处和困难问卷父母版(SDQ)、注意缺陷多动障碍诊断量表父母版(ADHDDS-P)对64例互联网过度使用中学生和64名对照中学生进行评定和比较,并依据美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)中的ADHD诊断标准进行诊断性访谈。结果(1)IOU组符合DSM-Ⅳ中ADHD诊断标准的学生有14例,其中注意缺陷为主型5例,多动冲动为主型1例,混合型8例;对照组中符合ADHD诊断标准的学生有3例,均为混合型。(2)SDQIOU组多动注意不能、品行问题、情绪症状、困难总分等因子的得分均高于对照组,在亲社会行为因子上的得分显著低于对照组(P<0.01或P<0.05);(3)ADHDDS-PIOU组注意缺陷、多动/冲动因子得分和总分均显著高于对照组(P<0.01或P<0.05);(4)条件Logistic回归分析发现注意缺陷、多动注意不能是IOU的危险因素,亲社会行为是IOU的保护因素。结论互联网过度使用中学生存在着较多的注意缺陷多动障碍,其可能是造成中学生互联网过度使用的危险因素。