孕期外源物暴露对儿童注意缺陷多动障碍的影响

目的 探讨注意缺陷多动障碍（ADHD）患儿与正常儿童在母孕期外源物暴露情况的差异,分析孕期外源物暴露与ADHD发病的相关性。方法 选择2015年1月至2016年10月在安徽省儿童医院就诊102例ADHD患儿为病例组,以同期在儿童保健门诊正常体检的105名非ADHD患儿为对照组,采用自编调查问卷收集两组儿童母亲在其孕期的外源物暴露情况。结果 两组儿童的母亲孕期经常接触二手烟、重金属、噪音、孕期患病情况和药物使用的差异有统计学意义（P< 0.05）,多因素分析显示孕期接触噪音、重金属和患病情况是ADHD发病的危险因素。结论 母孕期特定外源物的暴露是ADHD的危险因素,应采取相应措施,避免有害物对母孕期的伤害,降低ADHD发生。     

盐酸托莫西汀对注意缺陷多动障碍患儿的认知功能影响研究

目的探讨盐酸托莫西汀能否改善注意缺陷多动障碍(ADHD)患儿的认知功能。方法用Stroop测验、言语流畅性测验、威斯康辛卡片测验等神经心理学测量工具对符合美国《精神障碍诊断与统计手册(第4版)》(DSM—IV)诊断标准的56例ADHD患儿应用盐酸托莫西汀治疗前后进行认知功能评估。结果治疗后ADHD患儿威斯康辛卡片总错误数、持续错误数,Stroop任务中读彩色文字的错误数、读文字颜色的错误数和读彩色文字的时间,词汇流畅性测验中错误数和重复数以及工作记忆评估均较治疗前有明显改善(P<0.05或<0.01)。结论盐酸托莫西汀治疗剂量可以有效改善ADHD患儿执行功能、抑制功能、工作记忆以及语言功能。     

学龄期注意缺陷多动障碍儿童行为问题的研究

目的分析学龄期注意缺陷多动障碍（ Attention Deficit Hyperactivity Disorder, ADHD）儿童的行为问题。方法对82例ADHD儿童和82例正常组儿童进行对照研究,应用Conner’s儿童行为父母问卷及CBCL（ Children Behavior Check List）对所有受试者进行行为评定。结果Conner’s父母问卷和CBCL评定量表中,ADHD组在品行问题、学习问题、冲动-多动和多动指数、攻击性、多动因子得分和总分分别与对照组比较,差异均有统计学意义（P〈0．05）。结论学龄期ADHD儿童大多伴有行为问题,应重视早期干预和治疗。     

注意缺陷多动障碍患儿孕产及家庭危险因素分析

目的 探讨注意缺陷多动障碍（ADHD）患儿非遗传危险因素。方法 选择2014年1月至2017年5月在芜湖市第四人民医院就诊的ADHD患儿137例为ADHD组,同时期芜湖某小学按照年龄分层抽样选取400名健康儿童为对照组,采用自制问卷对两组儿童进行孕期、母亲、父亲及家庭因素调查。结果 ADHD组患儿难产、孕期情绪异常、母亲酗酒、母亲类似ADHD症状、高龄孕妇、父亲类似ADHD症状、夫妻关系紧张的比例均高于对照组,差异有统计学意义（P<0.05）。logistic回归分析显示,母亲酗酒、夫妻关系紧张、母亲ADHD病史、高龄孕妇、父亲ADHD病史和难产等是儿童ADHD发病的危险因素（P<0.05）。结论 孕产史和家庭环境中的某些因素与ADHD发病密切相关。     

儿童注意缺陷多动障碍的心理护理及干预

目的探讨注意缺陷多动障碍(ADHD)患儿注意障碍特点,为临床医护人员的治疗提供可靠依据。方法采用智力测验、注意力划销测验、行为评定等评估患儿。结果 ADHD患儿智力测试的智力多在正常水平或处于边缘智力水平,部分患儿表现为操作智商优于言语智商。结论了解ADHD患儿注意障碍特点,以便有针对性进行心理护理及干预。     

家长培训对注意缺陷多动障碍儿童干预的效果与分析

目的 探讨家长培训对注意缺陷多动障碍（ADHD）儿童的干预效果.方法 将100名ADHD儿童随机分为联合治疗组和药物治疗组,联合治疗组采用药物治疗合并家长培训,药物治疗组进行常规药物治疗,比较两组的干预效果.结果 干预前后,两组儿童的冲动-多动、焦虑、多动指数等得分均有降低,差异有统计学意义（P＜0.05）;干预后联合治疗组品行问题、学习问题、冲动-多动、焦虑、多动指数等得分均较对照组低,差异有统计学意义（P＜0.05）.结论 在药物治疗的基础上对ADHD儿童家长进行健康教育,能够在一定程度上改善儿童症状.     

儿童注意缺陷多动障碍的心理护理干预的临床观察

<正>注意缺陷多动障碍(ADHD)是学龄期儿童最常见的行为障碍之一,严重影响儿童的的身心健康及学业成绩。ADHD是一种早年发生、具有遗传特性的精神障碍性疾病,主要表现为注意力分散或不能维持注意、多动和冲动,对儿童认知行为功能有很大的负面影响[1]。其中注意力集中困难是这样儿童最突出的表现。患儿伴有不同程度的学习障碍,但智力正常或接近正常,如果未及时干预治疗,70%患儿的症状可持     

儿童注意缺陷与多动障碍与出生低体重儿的关联性研究

目的 了解儿童注意缺陷与多动障碍(ADHD)与出生低体重儿的关联性.方法 选取85例出生低体重儿与同期出生的正常体重儿进行Conners 评分以确定ADHD的发生率.结果 85例出生低体重儿检出ADHD 11例,明显高于正常体重儿,差异有统计学意义(P<0.05).结论 儿童注意缺陷与多动障碍(ADHD)与出生低体重儿具有关联性.     

不同亚型多动症儿童的智力研究

目的分析不同亚型多动症儿童的智力结构特点，为多动症的临床诊断和治疗提供参考。方法从儿童心理门诊抽取注意缺陷型、多动冲动型和混合型多动症儿童各30例，正常对照组60例，采用中国韦氏儿童智力量表（c—WISC）进行智力测验，对智测结果进行组间比较。量吉果多动症儿童韦氏总智商、言语智商、操作智商均低于正常儿童（P〈0．01），且智商变异性大，在各亚型中，混合型智商最低。结论多动症儿童智力受损是客观事实，不同亚型多动症智力结构和缺损程度存在差异，提示不同亚型多动症儿童认知机制不完全相同，应对多动症患儿进行区别诊断和针对性治疗。     

儿童注意缺陷多动障碍治疗药——Vyvanse

儿童注意缺陷多动障碍(attention-deficit hyperactivitydisorder,ADHD)又称注意力缺陷障碍多动综合征.主要临床表现为患儿的智力正常,注意力不能集中,注意短暂,活动过多,情绪不稳定,学习困难,成绩较差,6～14 岁儿童发病率较高.随着此类疾病的发病率逐年上升,ADHD儿童越来越受到世界各国心理学家、教育学家、儿童精神病学家以及广大教师、家长的广泛关注.     

An examination of differences in variables maintaining smoking behavior in adult smokers with and without attention-deficit/hyperactivity disorder

Individuals with attention-deficit/hyperactivity disorder (ADHD) smoke cigarettes at higher rates and have greater difficulty quitting than their non-diagnosed peers. This study examined differences between smokers with and without ADHD on a range of smoking-related variables. Twenty-two subjects with ADHD and 22 controls completed self-report measures of withdrawal symptoms, smoking motivation, sensory experience of smoking, and positive and negative affect. Compared to control smokers, smokers with ADHD reported greater craving and negative affect; perceived smoking as providing greater enhancement of concentration and alertness, as more calming, and as providing a greater decrease in irritability; found cigarette puffs to be more enjoyable and satisfying; and rated smoking as providing greater positive and negative reinforcement and greater cognitive enhancement. Women with ADHD reported the greatest effects of smoking on improving concentration and reducing irritability. Findings support the hypothesis that smokers with ADHD may experience smoking differently than smokers without the disorder, and that they may identify different motivations for smoking.     

托莫西汀联合脑电生物反馈治疗儿童注意缺陷多动障碍疗效观察

目的：研究托莫西汀联合脑电生物反馈治疗儿童注意缺陷多动障碍（ADHD）的疗效。方法：对46例ADHD惠儿给予托莫西汀与脑电生物反馈治疗4个月,于治疗前后详细记录患儿注意力商数与反应控制商数中视觉、听觉商数以及进行Conners儿童行为量表父母问卷并进行评估。结果：与治疗前比较,观察组注意力商数与反应控制商数中视觉、听觉商数较治疗前明显升高,差异有统计学意义（P〈0．05）;Conners量表评分较治疗前均明显下降,差异有统计学意义（P〈0．05）。与对照组比较,治疗后注意力商数与反应控制商数中视觉、听觉商数差异均无统计学意义（P〉0．05）;治疗后Conners量表评分在多动指数、学习问题、冲动一多动、品行问题等4个方面差异均无统计学意义（P〉0．05）,而在心身障碍、焦虑两个方面评分明显下降,差异有统计学意义（P〈0．05）。结论：托莫西汀联合脑电生物反馈治疗ADHD可以更好的改善患儿的注意缺陷、多动和冲动等核心症状。     

Dexmethylphenidate--Novartis/Celgene. Focalin,D-MPH,D-methylphenidate hydrochloride,D-methylphenidate,dexmethylphenidate, dexmethylphenidate hydrochloride

Celgene has developed a chirally pure form of methylphenidate (Ritalin), called dexmethylphenidate [d-methylphenidate, d-methylphenidate hydrochloride, d-MPH; Focalin]. The drug has been launched in the USA and is undergoing registration in Canada for the treatment of children with attention-deficit hyperactivity disorder (ADHD). Dexmethylphenidate is the single isomer version of racemic methylphenidate (Ritalin), which contains the active d isomer of Ritalin. Dexmethylphenidate acts via the inhibition of reuptake of norepinephrine and dopamine. Research is ongoing to further clarify the mode of therapeutic action in ADHD. Dexmethylphenidate was developed with the aim of reducing drug load, adverse events and drug interactions. Dexmethylphenidate provides effective management of attention-deficit hyperactivity disorder at half the dose of Ritalin. In April 2000, worldwide rights (excluding Canada) to dexmethylphenidate were granted to Novartis. Celgene has also granted Novartis rights to all related intellectual properties and patents. Novartis will fund all remaining development and marketing expenses required for regulatory approval and commercialisation of dexmethylphenidate. Crystaal Corporation, the marketing division of Biovail Corporation International, has exclusive Canadian marketing rights for all formulations of dexmethylphenidate. Novartis launched dexmethylphenidate (Focalin) in the USA during Q1 2002. It is available as a D-shaped tablet (2.5, 5 and 10 mg doses). Novartis had planned to use the tradename Ritadex, however the FDA recommended an alternative name due to potential prescribing errors with Ritalin. The finalized tradename to be used is Focalin. In July 2001, a new drug submission was filed with Canada's Therapeutic Products Programme for dexmethylphenidate in the treatment of attention-deficit disorder and attention-deficit hyperactivity disorder. Novartis is also developing an extended-release version of chirally pure dexmethylphenidate. Dexmethylphenidate has been found to be effective and well tolerated in clinical trials, involving a total of 684 children with ADHD and in 15 healthy adult volunteers. Dexmethylphenidate is a schedule II drug.     

Nicotinic receptor mechanisms and cognition in normal states and neuropsychiatric disorders

Cigarette smoking rates in the American population are approximately 23%, whereas rates of smoking in clinical and population studies of individuals with neuropsychiatric disorders are typically two- to four-fold higher. Studies conducted in a variety of neuropsychiatric populations [e.g. attention-deficit hyperactivity disorder (ADHD), Alzheimer's disease, schizophrenia] have collectively suggested that nicotine may be efficacious in remediating selected cognitive deficits associated with these disorders, thus providing a framework for understanding the specific vulnerability of these patients to smoking initiation and maintenance. However, the specific gain in cognitive performance produced by nicotine administration in healthy subjects with normal cognitive function is less clear. This article reviews our current understanding of central nicotinic acetylcholine receptor (nAChRs) systems in normal and neuropsychiatric disease states and, specifically, their role with respect to cognitive dysfunction and clinical symptoms in several specific neuropsychiatric populations, including ADHD, Alzheimer's disease, Parkinson's disease, Tourette's Disorder, schizophrenia and affective disorders. The potential benefits of nicotinic agents for therapeutic use in neuropsychiatric disorders is discussed, as well as directions for further research in this area.     

学习困难儿童认知特点的对照研究

目的探讨学习困难儿童的认知特点。方法采用配对研究方法,对86例学习困难儿童和86例正常儿童进行韦氏儿童智力量表、韦氏记忆量表、数字划消和瑞文标准推理测验等测定,并将结果进行对比分析。结果两组的语言智商、操作智商、总智商、经历定向、心智、再认、再生、理解、背数、长时记忆、短时记忆、记忆商、瑞文标准推论测验标准分比较差异有统计学意义（P〈0．05）。学习困难组的总分明显低于正常组,平均误差率显著高于正常组,差异有统计学意义（P〈0．01）。结论学习困难儿童智商低于正常儿童,记忆商数偏低,且存在注意力障碍。     

Application of Actigraphy in the Clinical Setting: Use in Children With Attention-Deficit Hyperactivity Disorder

Clinicians rely primarily on subjective behavioral questionnaires in assessing attention-deficit hyperactivity disorder (ADHD). The new mini-motion logger actigraph, which is a wrist-worn minicomputer, can add an objective element to this assessment and is especially useful in children due to its small size. We applied this technology as an outcome measure in evaluating drug therapy in two children with ADHD who were receiving methylphenidate and pemoline, respectively. We also assessed preliminary findings from an additional 13 children.     

Does a childhood history of externalizing problems predict smoking during pregnancy?

While the demographic characteristics of women who smoke during pregnancy are well established, less is known about psychiatric characteristics that may differentiate among persistent smokers, spontaneous quitters, and nonsmokers. The purpose of the present study was to test the hypothesis that a history of externalizing problems is related to persistent smoking during pregnancy. Participants included 93 pregnant women (mean age=28 years; 89% non-Hispanic White; 46% persistent smokers; and 16% spontaneous quitters). Externalizing problems, as evidenced by conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD), were assessed using diagnostic interviews. History of CD and ADHD varied by smoking status, with persistent smokers most likely to have a history of both disorders and exhibiting the highest levels of symptomatology. In multivariate analyses, a history of CD, but not ADHD symptoms, distinguished women who persisted in smoking during pregnancy from spontaneous quitters. Results suggest that a childhood history of conduct problems is a risk factor for maternal smoking during pregnancy and that psychiatric history is important to consider in developing more targeted cessation interventions.     

Understanding the Effects of Stimulant Medications on Cognition in Individuals with Attention-Deficit Hyperactivity Disorder: A Decade of Progress

The use of stimulant drugs for the treatment of children with attention-deficit hyperactivity disorder (ADHD) is one of the most widespread pharmacological interventions in child psychiatry and behavioral pediatrics. This treatment is well grounded on controlled studies showing efficacy of low oral doses of methylphenidate and amphetamine in reducing the behavioral symptoms of the disorder as reported by parents and teachers, both for the cognitive (inattention and impulsivity) and non-cognitive (hyperactivity) domains. Our main aim is to review the objectively measured cognitive effects that accompany the subjectively assessed clinical responses to stimulant medications. Recently, methods from the cognitive neurosciences have been used to provide information about brain processes that underlie the cognitive deficits of ADHD and the cognitive effects of stimulant medications. We will review some key findings from the recent literature, and then offer interpretations of the progress that has been made over the past decade in understanding the cognitive effects of stimulant medication on individuals with ADHD.