注意缺陷多动障碍患儿血清铁蛋白和血铅的变化

目的 测定不同亚型的注意力缺陷多动障碍(ADHD)患儿血清铁蛋白(SF)、Hb、血铅水平.探讨其在ADHD发病中的变化.方法 采用<美国精神病学会精神障碍分类法>(第4版)(DSM-Ⅳ)标准,并结合Conner's量表和视听整和连续执行测试法进行诊断,选择2008年8-12月本院儿科门诊确诊为ADHD的患儿53例.其中注意力缺陷型20例,混合型18例,多动-冲动型15例,同期选择来本院行体检的健康儿童18例作为健康对照组.抽取清晨空腹静脉血进行Hb、SF及血铅水平测定,应用SPSS 11.0软件对其进行统计学分析.结果 1.ADHD患儿各亚组SF水平均低于健康对照组,差异均有统计学意义(Pa ＜0.05),其中注意力缺陷型亚组SF水平下降明显,均低于混合型和多动-冲动型亚组(Pa ＜0.05).2.ADHD患儿各亚组间血铅水平无显著性差异;各亚组与健康对照组比较,血铅水平差异亦均无统计学意义(Pa ＞0.05).3.ADHD患儿各亚组间Hb水平无显著性差异;各亚组与健康对照组比较,Hb水平差异亦均无统计学意义(Pa ＞0.05).结论 ADHD尤其是注意力缺陷型患儿的发病可能与低水平SF有关,在诊治此类型患儿时应常规检测,并及早纠正.     

儿童注意缺陷多动障碍与肥胖的分布特点

目的 探讨注意缺陷多动障碍(ADHD)与肥胖的分布特点.方法 采用《精神障碍诊断和统计手册》第4版(DSM-Ⅳ)诊断标准确诊的ADHD患儿239例为ADHD组,常规体检儿童137例为健康对照组,2组均进行体格测量,根据WHO的儿童肥胖标准,评价正常、超重及肥胖,比较ADHD组与健康对照组及ADHD组各亚型间超重及肥胖率有无差异.结果 ADHD组超重+肥胖率[98例(41.0％)]与健康对照组[39例(28.5％)]比较差异有统计学意义(P ＜0.01);ADHD组超重率[41例(17.2％)]与健康对照组[22例(16.1％)]比较差异无统计学意义;ADHD组肥胖率[57例(23.8％)]与健康对照组比较[17例(12.4％)]差异有统计学意义(P ＜0.01):ADHD各亚型中,Ⅰ型(注意力缺陷型)超重+肥胖率与健康对照组比较差异有统计学意义(超重16例,肥胖19例,占40.3％);Ⅱ型(多动冲动型)超重+肥胖率与健康对照组比较差异无统计学意义(超重5例,肥胖8例,占36.1％);Ⅲ型(混合型)超重+肥胖率与健康对照组比较差异有统计学意义(超重20例,肥胖30例,占40.3％);3个亚型组间超重、肥胖率比较差异均无统计学意义(P均＞0.05);以超重、肥胖与否分组,超重+肥胖组ADHD发病率显著高于体质量正常组(P＜0.05).结论 肥胖症为ADHD的高危因素,二者内在发病机制可能有交叉.     

儿童癫痫共患注意缺陷多动障碍临床特征及相关因素分析

目的 探讨癫痫儿童注意缺陷多动障碍（ADHD）的临床特点,分析癫痫相关因素与ADHD之间的关系。方法　选取2015-09-01-2016-02-01就诊于中国医科大学附属盛京医院小儿神经科癫痫专业门诊的180例患儿为研究组,选择辽宁地区2所公立小学和1所公立初中的125例既往健康儿童作为对照组,详细收集基本资料并完成相关问卷调查和心理量表评估。结果　癫痫儿童ADHD共患率为28.89%,而对照组ADHD的发生率为7.2%,差异有统计学意义（P＜0.05）。癫痫相关因素中：性别、癫痫发作次数、口服单一抗癫痫药对共患ADHD无影响,而与癫痫首发年龄、发作是否控制、脑电图是否恢复正常、联合口服多种抗癫痫药物存在明显关联,差异有统计学意义（P＜0.05）。癫痫儿童的Conners行为评分普遍较高,品行问题、学习问题、多动和冲动等问题较单纯癫痫患儿显著,差异有统计学意义（P＜0.05）。结论　癫痫患儿中,ADHD发生率较高,癫痫首发年龄、是否控制、脑电图是否恢复正常、联合口服多种抗癫痫药物与癫痫儿童共患ADHD密切相关。癫痫儿童共患ADHD的品行问题、学习问题、多动-冲动方面表现较显著。     

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.     

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。     

癫(癎)患儿共患情绪与行为障碍及其对生活质量的影响

目的 观察癫癎患儿的抑郁、焦虑障碍、注意缺陷多动障碍(ADHD)症状的共患率,分析相关影响因素及其对患儿生活质量的影响.方法 对142例8～16岁不同类型癫癎患儿进行神经心理评估,对100例正在服药的患儿进行美国癫癎患者生活质量量表(QOLIE-31)问卷测试,观察共患情绪、行为障碍状况及影响因素.结果 (1)癫癎患儿情绪、行为障碍症状的共患率:142例癫癎患儿,共患一种或以上情绪、行为障碍者82例,占57.7%,其中抑郁、焦虑障碍及ADHD症状患病率分别为14.8%、44.4%及17.6%.(2)情绪、行为共患病的影响因素:共患病与性别、年龄及与癫癎疾病相关诸因素均无明显相关,共患病间存在相互影响.(3)共患病对癫痫患儿生活质量的影响:共患病组患儿总的生活质量及7个分项的分值均明显低于无共患病组(P<0.05).结论 癫癎儿童的抑郁、焦虑障碍及ADHD共患率颇高,与性别、年龄及癫癎疾病相关诸因素无明显相关,共患病间可互为影响因素,共患病是导致癫癎患儿生活质量低下的重要因素之一,故应对癫癎患儿进行全面的神经心理评估,在控制发作的同时治疗共患的情绪、行为障碍,以提高癫癎患儿的生活质量.     

原发性夜间遗尿症儿童神经心理学特征研究

目的 探讨原发性夜间遗尿症(PNE)患儿的神经心理学特征.方法 采用视听整合持续操作测试(IVA-CPT)和中国韦氏儿童智力量表(C-WLSC)对30例单纯PNE患儿(单纯PNE组)、22例PNE+注意缺陷障碍(ADHD)患儿(PNE+ADHD组)、30例单纯ADHD患儿(单纯ADHD组)以及30例健康儿童(对照组)进行对照研究.结果 IVA-CPT 单纯PNE组与对照组比较,综合控制商数和听觉反应控制商数、听觉谨慎商数、听觉一致性商数差异有统计学意义(P<0.05),综合注意商数、听觉注意力商数、听觉警醒商数和听觉注意集中商数差异有高度统计学意义(P<0.01);单纯PNE组与单纯ADHD组比较,综合控制商数、听觉反应控制商数、综合注意商数,听觉注意力商数差异有统计学意义(P<0.05);单纯PNE组与PNE+ADHD组比较,听觉反应控制商数和视觉速度商数差异有统计学意义(P<0.05),综合注意力商数、听觉注意力商数、视觉注意力商数、听觉警醒商数和视觉警腥商数差异有高度统计学意义(P<0.01).GMsc:单纯PNE组与对照组比较,数字广度、译码、知识与算术分测验量表分差异有统计学意义(P<0.05);单纯PNE组与单纯ADI-ID组比较,数字广度、译码、知识和算术分测验量表分差异有统计学意义(P<0.05);单纯PNE组与PNE+ADHD组比较,数字广度、译码和算术分测验量表分差异有统计学意义(P<0.05).结论 PNE患儿本身即存在注意力的损害,伴有ADHD时损伤更为严重.     

盐酸哌甲酯治疗癫患儿共患注意缺陷多动障碍的疗效及安全性

目的探讨癫患儿共患注意缺陷多动障碍(ADHD)的发生率,观察盐酸哌甲酯(MPH)治疗儿童癫共患ADHD的疗效及安全性。方法选取135例癫患儿,采用《美国精神疾病诊断与统计手册》4版标准编制的儿童ADHD临床诊断性会谈量表进行评估,筛选出癫共患ADHD患儿。在癫临床控制发作(>3个月)后,随机分为MPH组和对照组,MPH组在抗癫的基础上加用MPH,对照组则服用安慰剂,分别记录2组患儿注意力和多动行为变化情况、癫发作次数、药物不良反应。结果 135例癫患儿中,共检出56例共患ADHD患儿,共患率为41.48%。MPH组28例服药时间超过6个月,MPH组治疗后ADHD量表总分(15.4±0.4)分,与对照组比较差异有统计学意义(P<0.05)。MPH组1例用药2 d内出现癫发作次数增多,1例在服药3 d时出现失眠,家属自行停药。结论 ADHD在癫患儿中的发病率明显高于健康儿童发病率,在癫临床控制良好的情况下,MPH治疗ADHD是安全有效的。     

盐酸哌甲酯治疗儿童良性癫痫伴中央颞区棘波合并注意缺陷多动障碍的安全性研究

目的探讨盐酸哌甲酯治疗儿童良性癫痫伴中央颞区棘波(BECTS)合并注意缺陷多动障碍(ADHD)的安全性及对癫痫发作的影响。方法选取2007年4月至2008年10月广州市儿童医院神经内科确诊的40例BECTS合并ADHD患儿,经抗癫痫药物治疗临床无发作达6个月以上,加用盐酸哌甲酯,每6个月复查1次脑电图(EEG),评价患儿注意力和行为改善情况,记录癫痫发作次数、类型以及其他副反应,将患儿用药前后的癫痫发作情况进行自身对照研究。结果 40例中37例用药时间超过6个月,注意力、多动及对立违拗行为明显改善。4例发生副反应;2例用药1周内发作增多;1例用药1年后出现1次发作;1例用药2d内出现入睡困难,停药后发作及入睡困难停止。患儿服用盐酸哌甲酯前后癫痫发作及其他副反应出现情况差异无统计学意义(P0.05)。结论抗癫痫药控制临床发作的同时,在规范剂量范围内使用盐酸哌甲酯治疗BECTS合并ADHD具有安全性。     

注意缺陷多动障碍共患焦虑和抑郁情况及其行为特点的研究

评估注意缺陷多动障碍（ADHD）患儿共患焦虑和抑郁情况,同时探讨共患疾病对其行为的影响特点。方法　2007-2009年在中南大学湘雅二医院儿童精神卫生专科门诊收集105例ADHD患儿,年龄8～14岁,均符合DSM-IV诊断标准,但不存在对立违抗障碍、品行障碍和抽动障碍。于某学校选取66名同年龄段,无ADHD、对立违抗障碍、品行障碍和抽动障碍的学生作对照组。对所有研究对象采用ADHD诊断量表、Achenbach儿童行为量表（CBCL） 、儿童焦虑性情绪障碍筛查表（SCARED）、儿童抑郁障碍自评量表（DSRSC）进行评定,对照组儿童经SCARED、DSRSC评定后选择正常的43名作为正常对照组用于分析。结果　105例ADHD中39例（37.1%）共患焦虑,66名对照组中13例（19.7%）共患焦虑,两者间差异有统计学意义（χ2 = 5.829,P = 0.016）。ADHD共患抑郁者33例31.4%）,对照组10例（15.2%）,差异有统计学意义（χ2 = 5.704,P = 0.017）。ADHD同时共患焦虑与抑郁者16例（15.2%）,对照组中未发现共患焦虑与抑郁者。ADHD患儿CBCL社会能力得分均低于对照组,行为问题得分除躯体主诉外均显著高于正常对照组,差异有统计学意义（分别P = 0.000～0.010、P = 0.000～0.007）。ADHD单纯共患焦虑组CBCL躯体主诉得分显著高于单纯ADHD组,差异有统计学意义（P < 0.05）;ADHD单纯共患抑郁组CBCL焦虑/抑郁得分显著高于单纯ADHD组,差异有统计学意义（P < 0.05）;ADHD同时共患焦虑与抑郁组CBCL退缩、躯体主诉、焦虑/抑郁、思维问题、注意问题和内化性问题均显著高于单纯ADHD组,差异有统计学意义（P < 0.05）。结论　ADHD患儿有较高的抑郁和焦虑共患情况,同时共患抑郁与焦虑的ADHD患儿存在更多的行为问题,需要更多的精神卫生服务。     

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??Objective??To analyse clinical features of attention deficit hperactivity disorder??ADHD?? and its relationships with factors related to epilepsy. Methods??The clinical data of 180 children diagnosed with epilepsy in Pediatric Neurology Department of Shengjing Hospital between September 2015 and February 2016 were obtained and analyzed. 125 healthy children in the same district served as control. Results??The morbidity of attention deficit hyperactivity disorder in children with epilepsy was 28.89%. The morbidity was 7.2% in the controls. The difference was statistically significant ??P??0.05??. Among the risk factors of epilepsy?? the gender??seizure times and a single oral AEDS had no effect on the morbidity of ADHD. The morbidity was connected with an earlier onset age??GTCS??an unrecovered EEG and multiple AEDS of epilepsy. The difference was statistically significant ??P??0.05??. The children with epilepsy had a higher score by the evaluation of Conners Scale. The behavior??study and the impulsive-hyperactive behavior problems were more obvious among epilepsy children with attention deficit hyperactivity disorder??P??0.05??. Conclusion??The incidence of ADHD is high in children with epilepsy??and the initial onset age of epilepsy??the unrecovered EEG and various antiepileptic drugs are closely related with the prevalence of ADHD in children with epilepsy. In children with epilepsy and ADHD??the behavior problems??learning problems and hyperactivity-impulsive aspects are more significant.     

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??Abstract??Objective To study the methylphenidate hydrochloride controlled-release tablets??OROS-MPH??dose titration treatment for children with attention deficit hyperactivity disorder??ADHD??combining conduct disorder??CD??to achieve the best clinical efficacy. Methods According to the DSM-IV diagnostic criteria of attention deficit hyperactivity disorder??ADHD??combining conduct disorder??CD????120 cases of children were randomly divided into the original dose group and dose titration group.Two groups of children accepted the 24-week treatment of OROS-MPH??in which the original dose group were chosen to 18 mg/day?? dose titration group increased to 36 mg/day or 54 mg/day??respectively??in the fifth week and thirteenth week??and after the course of treatment??the following assessments were performed??SNAP-IV scale??Child Behavior Checklist??CBCL??and Treatment Emergent Symptom Scale??TESS??.Results ??1??The best response rate in the dose titration group was significantly higher than original dose group ??P??0.05??.??2??The SNAP-IV hyperactivity / impulsivity?? inattention and confrontation behavior items showed a significant difference between dose titration group and original dose group??P??0.05??.??3??In the CBCL behavior scales??dose titration group and the original dose group showed significant difference in the presence of adverse exchanges??forcedness??hyperactivity??aggression and discipline of the five dimensions??P??0.05??.??4??The incidence of side effects in both groups of children had no significant difference??P??0.05??.Conclusion With different doses of OROS-MPH for the treatment of children with ADHD and CD??effects differ more obviously-the higher dose??36 mg/day-54 mg/day??for the improvement of symptoms is better than lower dose??18 mg/day??.     

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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.     

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??Abstract??Objective??To study the GRPR polymorphisms in ADHD children and analyze the sequence of the second exon of GRPR. Methods??The DNA was taken from the periphery blood. The PCR of the second exon of 120 children with ADHD and 126 normal children was sequenced. We used Chi-square test to know difference of genotype and haplotype between ADHD and normal control group?? and among inattention?? hyperactivity and impulsivity compound group. Result??There were TT?? CC and TC polymorphisms in the second exon of GRPR in 661 and 450 sits. There was no difference between ADHD and normal control group??χ2 = 0.30??0.52??1.34??0.30??all P > 0.05??. There was no difference among inattention?? hyperactivity and impulsivity compound group??χ2 = 0.37??0.49??0.63??all P > 0.05??. Conclusion??The research has not proved the relationship between ADHD and the second exon of GRPR.     

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??Abstract??Objective??To investigate the working memory profiles in children with Attention Deficit Hyperactivity Disorder ??ADHD??. Methods??We investigated 39 children with ADHD ??DSM-IV???? including ADHD combined type??ADHD-C????n = 14????ADHD inattentive type ??ADHD-I?? ??n = 14?? and ADHD hyperactive/ impulsive type??ADHD-HI?? ??n = 11???? and 19 normal controls matched for age?? sex?? handedness?? and intelligence during a working memory task. Prefrontal brain activity was measured by concentration changes of oxygenated haemoglobin ??oxyHb??. Functional near-infrared spectroscopy ??NIRS?? was used to obtain the oxyHb. Results The results of working memory task?? ??1??ADHD children had more total errors ??3.51±3.025?? and comparison errors??2.41±2.149??than controls??P < 0.05??.??2??There was no significant difference in reaction time between ADHD and control group ??P??0.05??.??3??ADHD-C patients had more reaction errors??1.71±2.016??than ADHD-HI’s??P < 0.05?? ??on comparison errors??ADHD-HI children had more than ADHD-C’s??P < 0.05????and ADHD-I children also had more than ADHD-C’s??P < 0.05??.But there was no significant difference between ADHD-I and ADHD-HI group.??4?? ADHD-HI group had longer reaction time than ADHD-I’s ??P < 0.05??.The results of NIRS?? ??1?? There was no significant difference in concentration changes of oxygenated haemoglobin ??oxyHb?? between ADHD and control group when they performed working memory task.??2??Concentration levels of oxyHb in ADHD-C decreased in the left-down prefrontal cortex area during performing reaction commission than ADHD-I???-2.46±9.62 ??×10-4 vs.??10.47±14.18??×10-4 P < 0.05??.Conclusion??There are significant deficiencies in working memory in children with ADHD??ADHD subtypes differ in working memory profile.     

心理行为干预联合生物反馈对学龄前注意缺陷多动障碍患儿的疗效分析

目的 探讨心理行为干预联合生物反馈治疗对学龄前注意缺陷多动障碍（ADHD）患儿的疗效。方法 选择注意力缺陷型、多动-冲动型及复合型学龄前ADHD患儿各60例作为研究对象。按照干预措施前瞻性随机分为对照组、心理行为组、生物反馈组和综合组,治疗4个月后评估注意力集中时间及Conners父母量表（PSQ量表）的冲动-多动、多动指数评分。结果 治疗后心理行为组、生物反馈组和综合组中,三种类型患儿注意力集中时间均明显增加（P < 0.05）。对于三种类型的患儿,采用生物反馈及综合治疗均可降低冲动-多动评分（P < 0.05）;注意力缺陷型及复合型患儿采用心理行为及综合治疗可降低多动指数评分,多动-冲动型患儿采用心理行为、生物反馈及综合治疗均可降低多动指数评分（均P < 0.05）。结论 心理行为干预联合生物反馈治疗可提高ADHD患儿注意力集中水平,改善冲动-多动及多动的行为症状,不同ADHD类型患儿治疗效果略有不同。     

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目的比较美国《精神障碍诊断与统计手册》第4版(DSM-Ⅳ)注意缺陷多动障碍(ADHD)中以注意障碍为主型(ADHD-I)、以多动/冲动为主型(ADHD-HI)和混合型(ADHD-C)的临床特点。方法将1999年9月至2004年4月北京大学精神卫生研究所门诊就诊的符合DSM-Ⅳ中的ADHD诊断标准者748例分为ADHD-I型398例,ADHD-C亚型307例和ADHD-HI亚型43例,比较3个亚型的共患疾病,以及Rutter和Conners儿童行为问卷(父母问卷)中的行为问题。结果ADHD-C亚型对立违抗性障碍、品行障碍、双相障碍-躁狂发作的共患率显著高于ADHD-I和ADHD-HI亚型(P<0·01);ADHD-I学习困难的共患率显著高于其它两组亚型(P<0·001)。Rutter儿童行为问卷中ADHD-C亚型伴有的总行为问题和A行为问题明显多于ADHD-I与ADHD-HI亚型;ADHD-I亚型伴有的M行为问题多于ADHD-C与ADHD-HI亚型(P≤0·001)。Conners儿童行为问卷中ADHD-C和ADHD-HI亚型出现品行问题、冲动和多动、多动指数问题的比例均高于ADHD-I亚型(P≤0·001)。结论ADHD-C亚型的破坏性行为问题突出,而ADHD-I亚型的学习困难问题明显。     

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目的 探讨儿童注意缺陷、多动冲动等行为问题与睡眠障碍(SD)的关系.方法 2006年6月至2007年4月在长沙市5个行政辖区随机抽取1736名6～12岁儿童,对受试儿童的家长进行睡眠状况和注意缺陷多动障碍症状问卷调查.结果 1736名儿童中SD发生率为31.9%.SD组注意缺陷发生率为21.7%、多动冲动13.7%、白天嗜睡35.9%,均较非SD组13.0%、7.9%、24.7%高(P<0.01).行为问题与打鼾的频度有关,经常打鼾组的注意缺陷发生率为31.3%,高于从不打鼾组及偶尔打鼾组(分别为13.9%、16.2%,P<0.01);多动冲动的发生率为18.2%,亦高于从不打鼾组及偶尔打鼾组(分别为8.8%、9.9%,P<0.05).在SD的评分中,注意缺陷发生率高分组达19.2%～26.2%,明显高于其他低分组的10.9%～12.3%(P<0.01);多动冲动最高分组为16.2%,亦比低分组的5.7%～8.3%为高(P<0.01).SD、注意缺陷及多动冲动的发生率均存在性别差异,以男性为高(P<0.01).结论 儿童注意缺陷多动障碍等行为问题与SD相关,对出现注意缺陷多动障碍症状的儿童,有必要关注其睡眠状况.     

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??A case-control study on family environment factors in attention-deficit hyperactivity disorder with learning disabilities.????ZHANG Yue-bing*??LUO Xue-rong??LIU Xia??DING Jun??GUAN Bing-qing??YUAN Xiu-hong??YE Hai-sen??YANG Wei??NING Zhi-jun??WEI Zhen. *Mental Health Institute??Second Xiangya Hospital??Central South University??Changsha 410011??China
Abstract??Objective??To further explore the characteristics of family rearing pattern in ADHD with learning disabilities??LD??. Methods??From Sep. to Dec. 2005??a total of 9495 children and their parents were sampled at random in Hunan province using two-stage investigation. Those who were diagnosed with ADHD with LD and the normal control filled out Egna Minnen av Barndoms Uppfostran ??EMBU?? and family adaptability and cohesion scale ??FACESII—CV?? by themselves. Results??The parents’ punishments??rejection??excessive intervention??excessive protection and preference of ADHD with LD were lower than the normal children??P < 0.05??. The actual family cohesion??ideal family cohesion?? actual family adaptation??ideal family adaptation and affectionate warmth of ADHD with LD were lower than the normal children??P < 0.05 or P < 0.01??. Conclusion??There are some problems in the parental rearing pattern of ADHD with learning disabilities. It is important to avoid bad rearing pattern and find effective interventions.