脑电图在儿童注意缺陷多动障碍中的应用

注意缺陷多动障碍（attention deficit hyperactivity disorder，ADHD），又名儿童多动症，近年来发病率较高。临床上以注意力集中困难、多动或行为冲动、智力基本正常等表现为特征。现将我院1998年1月-2005年12月就诊的67例ADHD患儿的脑电图特点分析如下。     

注意缺陷多动障碍的定量脑电图研究进展

注意缺陷多动障碍是儿童期最常见的精神疾病之一,其临床表现为注意力不集中、多动和冲动,可严重影响患者的家庭生活、个人成就及社交关系,目前对该病仍缺乏客观指标进行诊断及评估疗效。脑电图检查可无创性地记录脑电活动,反映脑功能情况。该文就近年来定量脑电图在注意缺陷多动障碍方面的研究进展作一综述。     

儿童注意缺陷多动障碍脑电图特点与临床分析

儿童注意缺陷多动障碍 (ADHD)又称儿童多动症 ,是一种常见儿童行为障碍综合征。现将我院 1995年 2月～ 2 0 0 2年 5月 5 2例ADHD患儿脑电图 (EEG)特点与临床关系分析如下。资料与方法一、一般资料　采用美国DAM -Ⅱ诊断标准[1] ,确诊ADHD 5 2例 ,男 4 4例 ,女 8例 ;年龄 4～ 16岁 ,8～ 11岁 36例 ,占 6 9.2 %。二、临床表现　ADHD最常见和突出症状是注意力集中困难 ,活动多 ,情绪不稳定 ,冲动、任性及学习困难。 35例表现为注意力短暂、难以集中且分散 ;10例活动过度 ;4例学习困难 ;3例易哭闹、发怒、冲动、任性。三、检查方法　采…     

不同亚型注意力缺陷多动障碍儿童依恋特点的对照研究

目的探讨不同临床亚型注意力缺陷多动障碍(ADHD)儿童的依恋特点以及依恋与ADHD的关系。方法2006-05在济南和濮阳的5所小学2～4年级共2045人中用DSM-Ⅳ诊断标准进行筛查和诊断,对89例ADHD儿童与150例正常儿童实施儿童依恋量表测试,进行对照研究。结果ADHD组儿童的母亲依赖度、父亲依赖度、母亲亲近度、父亲亲近度及母子依恋和父子依恋总分均显著低于对照组(P<0.01),各临床亚型间,ADHD-C儿童母子依恋总分低于ADHD-H儿童,差异具有显著性(P<0.05);ADHD-I组儿童的父亲依赖度、父亲亲近度和父子依恋得分又显著低于母亲依赖度、母亲亲近度和母子依恋得分;父亲依赖度为ADHD的危险预示因子。结论ADHD儿童对父母依恋安全性低于正常儿童,且ADHD-C儿童的母亲安全性依恋最差;ADHD-I儿童的对父亲依恋安全性低于对母亲依恋安全性,父亲依赖度为ADHD的危险预示因子。     

儿童注意缺陷多动障碍脑电图特点与临床分析

注意缺陷多动性障碍(ADHD)，又名儿童多动症，是一种最为常见的儿童行为问题，临床上以注意力集中困难，多动或行为冲动但智力基本正常等表现为特征。现将我院1998～2003年在我科门诊就诊的ADHD患儿脑电图特点与临床特点分析报告如下。     

注意力测试仪在儿童注意缺陷多动障碍诊断中的应用

儿童注意缺陷／多动障碍（ａｔｔｅｎｔｉｏｎ ｄｅｆｉｃｉｔ ｈｙｐｅｒａｃｔｉｖｉｔｙ ｄｉｓｏｒｄｅｒ ,ＡＤＨＤ）,又称儿童多动症。患儿主要表现为注意力短暂,有多动或冲动的行为,并造成了学习困难等症状。近年ＡＤＨＤ越来越引起医学界、教育界的儿童心理卫生工作者的重视,被公认为是存在于儿童和青少年的主要心理障碍之一,学龄儿童患病率国内外报道在１．５％ ～ １０％[１］。但目前国内外对ＡＤＨＤ的诊断尚缺乏较客观的手段。为了提高诊断的客观性、准确性,我院引进ＮＪ２２－儿童注意力测试仪并应用于临床,取得了一…     

注意缺陷多动障碍儿童智力发育研究

目的研究注意缺陷多动障碍儿童的智力发育特点。方法采用韦氏儿童智力量表和注意力测试软件进行智力评估和注意力评定。结果研究组的智力水平、智力结构、注意力与对照组差异有显著性。结论注意缺陷多动障碍儿童智力发育不平衡，持续注意困难，视、听辨别能力低下。     

不同亚型注意力缺陷多动障碍患儿的临床特征分析

目的：研究不同亚型注意力缺陷多动障碍(ADHD)患儿的临床特征。方法：将符合美国《精神障碍诊断与统计手册(第4版)》ADHD诊断标准的175名患儿,分为注意缺陷型（ADHD-I,n=82）、多动-冲动型（ADHD-HI,n=24）和混合型（ADHD-C,n=69）,分别进行性别构成、危险因素、共患疾病、智力水平和Conners父母症状问卷的比较。结果：各亚型男女性别构成差异无统计学意义;ADHD-I组和ADHD-C组分娩异常的比率高于ADHD-HI组,ADHD-HI组和ADHD-C组家庭教育方式不当的比率高于ADHD-I组;3组言语智商、操作智商和总智商差异无统计学意义,ADHD-I组智力发展不平衡比率高于其他两组;ADHD-HI组和ADHD-C组对立违抗障碍、抽动障碍的共患率高于ADHD-I组,ADHD-I组和ADHD-C组学习困难的共患率高于ADHD-HI组;ADHD-HI组和ADHD-C组品行问题、冲动-多动、多动指数均高于ADHD-I组,而ADHD-I组学习问题最显著。结论：ADHD-C和ADHD-HI患儿对立违抗障碍和抽动障碍共患率较高,多动-冲动等破环性行为突出,ADHD-I患儿学习问题和智力发展不平衡显著。［中国当代儿科杂志,2010,12（9）：704-708］     

注意力缺陷多动障碍儿童下丘脑-垂体-肾上腺轴的功能研究

目的：通过研究注意力缺陷多动障碍（ADHD）儿童下丘脑-垂体-肾上腺轴（HPA）的功能状态,探讨HPA轴在ADHD发生中的作用。方法：128例6～14岁ADHD男童根据DSM-IV ADHD诊断和分型标准,其中注意缺陷为主型(ADHD-I)44例,多动-冲动为主型(ADHD-HI)32例,混合型(ADHD-C)52例,对照组为年龄匹配健康男童30名,于8∶00 am空腹采血。分别采用全自动微粒酶免疫分析法及电化学发光法检测血浆皮质醇及促肾上腺皮质激素（ACTH）,智力测验采用瑞文标准推理测验。结果：ADHD组IQ(84.5±11.3)低于对照组(94.6±12.4,P<0.01),ADHD 3个亚型组间比较差异有显著性(P<0.01),ADHD-I 和ADHD-C 两个亚组IQ水低于对照组(P<0.01), ADHD-HI组与对照组比较差异无显著性。ADHD组血浆皮质醇水平 (226.5±129.1 nmol/L)较对照组(384.5±141.4 nmol/L)明显降低(P<0.01),ADHD-HI组(154.4±71.6 nmol/L)下降程度较ADHD-I组(219.4±117.7 nmol/L)及ADHD-C组(258.3±136.4 nmol/L)为著(P<0.01),而ADHD各组血浆ACTH水平与对照组比较差异无显著性。结论：在非应激状态下ADHD儿童存在着HPA轴调节功能障碍,这可能系HPA轴低反应性所致。低血浆皮质醇对认知行为影响较小,而与注意缺陷、多动、冲动行为关系更为密切。［中国当代儿科杂志,2009,11（12）：992-995］     

注意缺陷多动障碍不同亚型注意力特征分析

目的 探讨注意缺陷多动障碍（ADHD）儿童不同亚型的注意力特征,为临床干预提供依据。方法 对 345 例 ADHD 儿童进行分型,使用整合视听持续性操作测试（IVA-CPT）进行注意力评估,比较不同亚型的视觉和听觉注意力特征。以 122 例正常儿童作为对照。结果 3 种亚型 ADHD 儿童综合注意力商数和综合控制力商数得分均明显低于正常儿童,差异有统计学意义（PPPP结论 ADHD 儿童注意功能低于正常儿童,且视觉注意功能受损重于听觉;不同亚型 ADHD 儿童在视觉和听觉注意力特征上的功能受损程度无差别。     

Clonidine poisoning in children: a recent experience

OBJECTIVES: To identify cases of clonidine poisoning presenting to a tertiary paediatric hospital and to investigate trends in presentation, outcome and prevention. Furthermore, any public health implications of the use of clonidine in children are to be explored. METHODS: Cases of clonidine poisoning presenting to Royal Children's Hospital were reviewed over the period from 1997 to 2001 (inclusive), with significant data obtained from coded medical records. RESULTS: Twenty-four cases of clonidine poisoning were identified over the 5-year period. Nine patients ingested their own medication, which was prescribed for attention-deficit hyperactivity disorder. Clonidine was prescribed for a child in 16 cases (67%). Impaired conscious state and bradycardia were the most common presenting features. Activated charcoal was given in 14 cases and volume expansion in six. There were 12 children (50%) who required admission to intensive care for monitoring, including three who received mechanical ventilation. The average length of stay was 25.7 h with no long-term complications. CONCLUSIONS: This is the largest series of clonidine poisoning in children recorded in Australia, with morbidity considerable. Emphasis needs to be placed on educating parents of clonidine's dangers in overdose to their own children as well as others.     

Personality differences in children and adolescents with attention-deficit/hyperactivity disorder, conduct disorder, and controls

BACKGROUND: Differences in personality profiles were examined between children who differed in their co-morbidity of externalizing disorders: attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD). METHODS: 11- and 17-year-old male and female twins from a community sample were categorized as ADHD only, CD only, co-morbid CD-ADHD, and controls (no ADHD or CD) based on threshold and subthreshold CD and ADHD diagnoses assessed with structured interviews. Multivariate analyses were used to identify patterns of personality that differentiate these four diagnostic groups. It was hypothesized that significant differences would be found in the pattern of personality variables between participants in the co-morbid group, compared to the other three groups, and that these differences would hold across developmental periods. RESULTS: As expected, the co-morbid group had a pattern of personality marked by higher Negative Emotionality and lower Constraint than the other diagnostic groups. This pattern was evidenced across gender and age cohort. CONCLUSIONS: An extreme personality profile may represent a liability toward the occurrence of ADHD and CD with more extreme profiles contributing to the occurrence of both disorders among boys and girls. Implications for treatment planning and theoretical development are discussed.     

Colour perception in ADHD

Attention-deficit/hyperactivity disorder (ADHD) is associated with unexplained impairments on speeded naming of coloured stimuli. These deficits may reflect hypofunctioning retinal dopaminergic mechanisms impairing particularly blue-yellow colour discrimination. Colour perception and rapid colour naming ability were investigated in 14 children with ADHD and 13 healthy peers matched for age, gender, and IQ, using the Farnsworth-Munsell 100 Hue Test (FMT) and the Stroop-Colour-Word test. Children with ADHD committed more errors on the FMT, particularly on discrimination of colours along the blue-yellow axis, and were slower on Stroop subtests involving colour naming. However, the latter deficit was accounted for similarly by blue-yellow and red-green discrimination abilities. Blue-yellow colour perception problems in ADHD contribute to but do not fully explain the observed slowed colour naming.