注意缺陷多动障碍与儿童气质

目的 对注意缺陷多动障碍(ADHD)与儿童气质关系的分析,了解ADHD患儿的气质,为ADHD的诊断及治疗提供主要的参考.同时也为预防ADHD提供帮助.方法 ①病例组是45例已确诊为ADHD的患儿,对照组是45例正常儿童.②使用Conner's父母量表、行为方式问卷(BSQ)、小学儿童气质量表(MCTQ)分别评定两组儿童的多动指数、气质特性.③比较两组儿童的气质特性的差异,分析气质特性与ADHD的相关性.结果 ①9种气质特性中与ADHD显著相关的高活动性、高注意分散和低持久性,相关系数分别是0.531,0.387和0.494,P＜ 0.05.②ADHD组和对照组中有高活动性、高注意分散和低持久性等气质特性的儿童比例分别是42％和12％,P＜0.05.结论 与正常儿童比较,ADHD患儿有明显的不同的气质特性,而它的稳定性和可变性,决定了它是可改变的,故而改变家庭环境不良因素,可能会有利于ADHD的治疗及预防.     

注意缺陷多动障碍儿童气质特点研究

【目的】为了解注意缺陷多动障碍(attentiondeficithyperactivitydisorder,ADHD)儿童行为的异质表现和气质特点,为临床有效干预提供依据。【方法】选用两年来本院门诊采用美国精神障碍诊断和统计手册第3版修订本(DSM-Ⅲ-R)诊断标准,诊断为ADHD的115例儿童,其中男102例,女13例,平均年龄(8.6±1.8)岁。采用张劲松等修订的3~12岁儿童气质问卷。【结果】两年来门诊ADHD儿童以男性为主,占门诊ADHD儿童总人数的88.70%,女性仅占11.30%,二者差异有非常显著性(P<0.001)。ADHD儿童气质类型以难养型为主,结果有非常显著性(P<0.01)。难养型ADHD儿童活动水平、节律性、趋避性、适应性、反应强度、情绪本质、坚持性项目得分明显高于其它类型,差异有非常显著性(P<0.01)。【结论】活动多、注意力低下的儿童出现行为问题的频率较高,消极情绪和社交退缩明显的儿童,行为问题也多。建议尽早了解儿童的气质特点,给予积极的行为影响因素,会使ADHD儿童行为问题得到遏制。     

学龄前儿童注意缺陷多动障碍的药物治疗

药物治疗是矫正注意缺陷多动障碍(ADHD)的重要措施之一。既往药物治疗研究的主要对象是学龄儿童，对学龄前儿童关注较少。近年来进行的采用对照设计方法的试验结果表明，精神兴奋剂利他林治疗学龄前儿童ADHD有效，副作用轻微。建议对行为治疗效果欠佳或症状严重的3岁以上学龄前儿童给予利他林治疗，同时注意防止和正确处理用药过量。     

学龄前儿童注意缺陷多动障碍筛查量表的研究进展

注意缺陷多动障碍(ADHD)是一种常见的儿童行为问题,常在学龄期被诊断,但在学龄前期已经表现出较多的行为问题,因此,早期诊断注意ADHD成为一种趋势。本文对国内外关于学龄前儿童ADHD评估量表的研究进展进行了总结整理。     

邵东县儿童注意缺陷多动障碍流行病学调查

目的了解邵东县学龄儿童注意缺陷多动综合症的患病情况.方法应用Conners问卷对邵东县6～13岁学龄儿童进行调查. 结果总患病率为9.45%,其中男孩13.40%,女孩5.33%,两者有显著差异(P＜0.001).城乡之间与各年龄组之间的患病率差异无显著性.结论邵东县儿童注意缺陷多动障碍发病与全国水平基本一致,有必要加强家长对该病的认识以及早治疗.     

学龄前儿童注意缺陷多动障碍的药物治疗

药物治疗是矫正注意缺陷多动障碍 (ADHD)的重要措施之一。既往药物治疗研究的主要对象是学龄儿童 ,对学龄前儿童关注较少。近年来进行的采用对照设计方法的试验结果表明 ,精神兴奋剂利他林治疗学龄前儿童ADHD有效 ,副作用轻微。建议对行为治疗效果欠佳或症状严重的 3岁以上学龄前儿童给予利他林治疗 ,同时注意防止和正确处理用药过量     

学龄前注意缺陷多动障碍儿童智力特征的研究

目的探讨学龄前注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童的智力特征。方法从2007年6月至2010年5月在本院儿童发育行为中心确诊为注意缺陷多动障碍的4～6岁患儿中,随机选择43例纳入ADHD组,排除广泛性发育障碍、精神发育迟滞、神经系统疾病和重性精神病。同期在广州市某幼儿园随机选择32例正常儿童纳入对照组(排除注意缺陷多动障碍、学习障碍、品行障碍、精神发育迟滞,躯体、精神和神经系统疾病)(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象监护人的知情同意)。对两组儿童应用《中国-韦氏幼儿智力量表》(Chinese-WechslerYoung Children Scale of Intelligence,C-WYCSI),进行智力评估。结果 ADHD组儿童的总智商(full intelligence quotient,FIQ)、言语智商(verbal intelligence quotient,VIQ)、操作智商(performance intelligence quotient,PIQ)在正常范围内,但均较对照组明显偏低,两组比较,差异有显著意义(P0.05)。ADHD组在知识、图片词汇、算术、图片概括、领悟、动物下蛋、迷津、木块图案8项分测验的得分,亦较对照组明显低,两组比较,差异有显著意义(P0.05)。ADHD组|VIQ-PIQ|≥15分者为22例,对照组为3例,ADHD组言语智商与操作智商分离比例,较对照组明显高,差异有显著意义(P0.01)。因子分析中,ADHD组的言语理解因子、知觉组织因子、视觉刺激理解因子、同时加工、继时加工及行动计划得分,均较对照组明显低,差异有显著意义(P0.05)。结论学龄前注意缺陷多动障碍儿童的智力水平低于正常儿童,智力发展不平衡现象突出。     

注意缺陷多动障碍儿童及家庭情况研究

[目的] 探讨注意缺陷多动障碍(ADHD)儿童自身及其家庭特点，以了解其可能的环境病因。[方法] 按照美国精神病学会出版的《精神障碍诊断及统计手册》第4版(DSM-IV）ADHD诊断标准确定病例组儿童60名；按年龄、性别1：1匹配正常对照组儿童。采用自编问卷调查受试本人及家庭特征；应用SAS6．12统计软件进行t检验、X^2检验、Logistic比回归分析。[结果] ADHD偏食/挑食史、咬指甲、ADHD阳性家族史、父母关系、亲子关系、父母意见、父母养育方式、父母性格等12项指标均与对照组儿童有显著差别。Logistic回归分析结果显示：偏食、咬指甲、母性格及父子关系为显著危险因素，即儿童存在偏食及咬指甲，母性格不开朗及父子关系不亲密时，患ADHD的危险性较大。[结论] 儿童不良生活习惯及家庭环境可促使ADHD的发生。矫正儿童不良饮食习惯及行为，改变母亲恶劣性格及培养良好的父子关系可能减少ADHD的发病。     

注意缺陷多动障碍儿童及家庭情况研究

目的 探讨注意缺陷多动障碍(简称ADHD)儿童自身及其家庭特点，以了解其可能的环境病因。方法60名ADHD采用自编问卷调查受试本人及家庭特征；应用SAS56．12统计软件进行t-检验、χ^2检验、Logistic回归分析。结果 12项指标均与对照组儿童有显著差别。Logistic回归分析结果显示：偏食、咬指甲、母性格及父子关系为显著危险因素，即儿童存在偏食及咬指甲，母性格不开朗及父子关系不亲密时。患ADHD的危险性较大。结论 儿童不良生活习惯及家庭环境可促使ADHD的发生。矫正儿童不良饮食习惯及行为，改变母亲恶劣性格及培养良好的父子关系可能减少ADHD的发病。     

儿童注意缺陷/多动障碍及其分型的诊断研究

【目的】　探讨多动症量表和儿童注意力测试仪在儿童ADHD及其分型诊断中的应用价值。　【方法】　对380例拟诊为ADHD的 6 .5～ 11岁儿童分别采用Conners简明问卷和根据DSM IV标准制定的多动症量表 ,以及儿童注意力测试仪进行测查 ,对照量表与测试仪的阳性率 ,分析注意力测试仪的敏感性和特异性。　【结果】　ADHD各亚型发生率 ,注意障碍为主型占 5 7.1% ,多动 /冲动为主型占 7.1% ,混合型占 35 .8% ;注意力测试仪测试结果 ,注意力缺陷总阳性率为 78.4 % ,敏感性和特异性分别为 78.4 %和 88.3% ;不同亚型ADHD患儿的注意力缺陷的阳性率在统计学上差异无显著性 (χ2 =0 .78,P >0 .0 5 ) ,而不同严重度组别儿童的注意力测试缺陷的阳性率差异有非常显著性 (χ2 =2 2 .37,P <0 .0 1)。　【结论】　Conners量表仍不失为较好的筛查工具 ,而根据DSM IV制订的注意缺陷 /多动量表则便于亚型诊断 ,两者可互补使用 ;注意力测试仪只能作为ADHD诊断时的辅助依据 ,不能替代量表的作用。     

Dietary Patterns in Children with Attention Deficit/Hyperactivity Disorder (ADHD)

The role of diet in the behavior of children has been controversial, but the association of several nutritional factors with childhood behavioral disorders has been continually suggested. We conducted a case-control study to identify dietary patterns associated with attention deficit hyperactivity disorder (ADHD). The study included 192 elementary school students aged seven to 12 years. Three non-consecutive 24-h recall (HR) interviews were employed to assess dietary intake, and 32 predefined food groups were considered in a principal components analysis (PCA). PCA identified four major dietary patterns: the “traditional” pattern, the “seaweed-egg” pattern, the “traditional-healthy” pattern, and the “snack” pattern. The traditional-healthy pattern is characterized by a diet low in fat and high in carbohydrates as well as high intakes of fatty acids and minerals. The multivariate-adjusted odds ratio (OR) of ADHD for the highest tertile of the traditional-healthy pattern in comparison with the lowest tertile was 0.31 (95% CI: 0.12–0.79). The score of the snack pattern was positively associated with the risk of ADHD, but a significant association was observed only in the second tertile. A significant association between ADHD and the dietary pattern score was not found for the other two dietary patterns. In conclusion, the traditional-healthy dietary pattern was associated with lower odds having ADHD.     

Associations between Dietary Intake and Attention Deficit Hyperactivity Disorder (ADHD) Scores by Repeated Measurements in School-Age Children

Attention deficit hyperactivity disorder (ADHD) is a common psychiatric disorder in school-age children and adolescents. However, the reported associations between ADHD and single nutrient intake are inconsistent. The aim of the study was to investigate the relationships between dietary intake changes and the prevalence of ADHD over time with repeat measurements using data from the Children Health and Environment Research (CHEER). To assess changes over time, we used data obtained in 2006 and 2008 (Phases ₁ and ₂). In this study, there were 2899 children aged 8 years or older in Phase ₁ and 2120 children aged 9 years or older in Phase ₂ from Korea, and the ADHD scores and dietary intake of 1733 children in Phases ₁ and ₂ were used in the final analysis. The YN group refers to children whose disease had improved in Phase ₂, and the NY group refers to children diagnosed with ADHD in Phase ₂. A notable within-group result was the increase in vegetable protein (p = 0.03) in the YN group. A between-group comparison showed that significant changes in nutrient intake could be confirmed most in the NY group, and the YN group tended to have a lower nutrient intake than the NY group. In the correlation of changes in nutrient intake and three subtypes (combined, AD, and HD), the total fat (p = 0.048) and animal protein (p = 0.099) showed a positive correlation with the prevalence of AD. Vegetable iron (p = 0.061 and p = 0.044, respectively), zinc (p = 0.022 and p = 0.007, respectively), vegetable protein (p = 0.074), and calcium (p = 0.057) had inhibitory effects on ADHD and its subtype. In conclusion, management of dietary and nutritional status should be considered to ameliorate ADHD and its subtypes in school-age children, and these relationships require further exploration in other settings.     

少儿血铅水平对注意缺陷多动障碍的影响

目的探讨血铅水平与ADHD的关系。方法对32例ADHD和36例正常对照儿童进行血铅检测和对比。结果ADHD组儿童血铅水平较正常对照组高，且有显著性差异沪〈0．001）。结论低水平铅暴露可能是引起儿童ADHD的原因之一。     

少儿血铅水平对注意缺陷多动障碍的影响

目的探讨血铅水平与ADHD的关系。方法对32例ADHD和36例正常对照儿童进行血铅检测和对比。结果 ADHD组儿童血铅水平较正常对照组高,且有显著性差异(P<0.001)。结论低水平铅暴露可能是引起儿童ADHD的原因之一。     

Household Food Insecurity Is Associated with Symptoms of Emotional Dysregulation in Children with Attention Deficit Hyperactivity Disorder: The MADDY Study

The association of household food insecurity with symptoms of attention deficit hyperactivity disorder (ADHD) and emotional dysregulation in children was examined in this study. We utilized baseline data from 134 children aged 6–12 years who were enrolled in a clinical trial investigating multinutrient supplementation as a treatment for ADHD and emotional dysregulation. Household food security status was assessed using the 18-item US Household Food Security Survey Module. The symptoms of ADHD and emotional dysregulation disorders (oppositional defiant disorder (ODD) and disruptive mood dysregulation disorder (DMDD)) were assessed using the Child and Adolescent Symptom Inventory-5 and other comorbid emotional dysregulation symptoms were assessed using the Strengths and Difficulties Questionnaire (SDQ). Multiple linear regression determined associations between household food security status and symptoms of ADHD, ODD and DMDD, emotional symptoms and conduct problems. Household food insecurity was associated with more severe emotional symptoms (β = 2.30; 95% CI = 0.87–3.73; p = 0.002), conduct problems (β = 1.15; 95% CI = 0.01–2.30; p = 0.049) and total difficulties scores (β = 4.59; 95% CI = 1.82–7.37; p = 0.001) after adjusting for covariates (child’s sex, parent marital status, household income, parental anxiety and other parental psychopathology). In unadjusted analyses, household food insecurity was also associated with increased ODD (β = 0.58; 95% CI = 0.21–0.95; p = 0.003) and DMDD symptoms (β = 0.69; 95% CI = 0.20–1.19; p = 0.006), but these associations attenuated to non-significance after adjusting for all covariates. Household food insecurity was associated with more severe emotional dysregulation symptoms. Discussing and addressing food insecurity may be appropriate initial steps for youths with ADHD and emotional dysregulation.     

认知行为训练治疗儿童注意缺陷多动障碍的研究

目的：探讨认知行为训练对注意缺陷多动障碍（ADHD）儿童的治疗效果。方法：对34例ADHD儿童采用系统化的认知行为训练方案，3个月为1周期。治疗前后分别用Conners量表父母症状问卷（PSQ）和数字划销测验评估，做治疗前后的比较。结果：接受治疗的ADHD儿童在治疗后Conners量表PSQ总分明显降低（P＜0．01），数字划销测验失误率下降，治疗前后比较差异有显著性（P＜0．05），结论：认知行为训练能有效地治疗儿童注意缺陷多动障碍。     

Effects of Caffeine Consumption on Attention Deficit Hyperactivity Disorder (ADHD) Treatment: A Systematic Review of Animal Studies

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity. ADHD impairments arise from irregularities primarily in dopamine (DA) and norepinephrine (NE) circuits within the prefrontal cortex. Due to ADHD medication’s controversial side effects and high rates of diagnosis, alternative/complementary pharmacological therapeutic approaches for ADHD are needed. Although the number of publications that study the potential effects of caffeine consumption on ADHD treatment have been accumulating over the last years, and caffeine has recently been used in ADHD research in the context of animal models, an updated evidence-based systematic review on the effects of caffeine on ADHD-like symptoms in animal studies is lacking. To provide insight and value at the preclinical level, a systematic review based on PRISMA guidelines was performed for all publications available up to 1 September 2021. Caffeine treatment increases attention and improves learning, memory, and olfactory discrimination without altering blood pressure and body weight. These results are supported at the neuronal/molecular level. Nonetheless, the role of caffeine in modulating ADHD-like symptoms of hyperactivity and impulsivity is contradictory, raising discrepancies that require further clarification. Our results strengthen the hypothesis that the cognitive effects of caffeine found in animal models could be translated to human ADHD, particularly during adolescence.     

注意缺陷多动障碍儿童危险因素的病例对照研究

目的探讨儿童注意缺陷多动障碍（attention deficit hyperactivity disorder,ADHD）的危险因素。方法采用自制的一般情况调查表对来自湖南省儿童医院儿童保健门诊就诊的204例6~12岁儿童ADHD和199例6~12岁的正常儿童进行单因素分析和非条件多因素Logistic回归分析,研究可能导致ADHD发病的危险因素。结果单因素分析：两组儿童的性格类型、家庭类型、父亲文化程度、母亲职业、家庭收入、母亲孕期情绪、分娩情况、儿童既往病史和家族相关病史等特征比较差异有统计学意义。多因素分析：以是否患ADHD为因变量,以儿童性格类型、父母文化程度、父母职业等因素为自变量的多元Logistic回归分析发现儿童外向性格（OR=7.12）、父母体罚孩子（OR=6.27）、父母溺爱（OR=5.94）、家庭收入低（OR=2.99）、父母严厉管教（OR=2.27）为儿童患ADHD的危险因素,儿童无既往病史（OR=0.08）、核心家庭（OR=0.38）、父亲文化程度高（OR=0.64）、无家族病史（OR=0.36）为儿童ADHD的保护因素。结论父母的教育方式、文化程度、家庭类型和家庭经济收入等因素在ADHD的发病中可能产生重要影响,因此,医务人员在ADHD的防治过程中应充分考虑这些危险因素的作用。     

视听整合连续性训练治疗ADHD的疗效

目的探讨基于数字化的视听整合连续性训练治疗注意缺陷多动障碍(attention deficit/hyperactivity disorder,ADHD)的疗效。方法2017年12月-2019年5月共86例符合DSM-5的ADHD患者,分为研究组45例和对照组41例。对照组给予盐酸托莫西汀治疗,疗程3个月。研究组在上述药物治疗基础上给予基于数字化的视听整合连续性训练,2个疗程合计3个月。于治疗前、治疗3个月末,用SANP-Ⅳ量表评价临床疗效。结果两组患者治疗3个月末,SANP-Ⅳ评分均较治疗前显著下降(均显示P <0.05),研究组总分减分差值更大[(-1.23±0.26)vs.(-1.02±0.47)],差异有统计学意义(t=2.59,P <0.05)。研究组有效率高于对照组[88.89%(40/45)vs. 68.29%(28/41),(χ~2=5.499,P <0.05)],缓解率亦高于对照组[57.78%(26/45)vs. 36.59%(15/41),(χ~2=3.862,P<0.05)]。结论基于数字化的视听整合连续性训练联合托莫西汀,治疗ADHD疗效更佳。