注意缺陷多动障碍儿童盐酸哌甲酯治疗后育儿压力的变化

目的:了解注意缺陷多动障碍儿童盐酸哌甲酯治疗后照料者的育儿压力变化。方法:对符合DSM-IV诊断标准的93例ADHD儿童使用盐酸哌甲酯治疗6周,使用ADHD症状分级父母评定量表、Conners父母评症状量表(PSQ)评估ADHD儿童症状,使用CGSQ评估儿童照料者的育儿压力。结果:盐酸哌甲酯治疗6周后ADHD儿童照料者的CGSQ总分(46.7±16.9 vs.40.6±13.6)及三个维度评分均下降(均P<0.05);多重线性回归分析显示,基线ADHD儿童PSQ总分及照料者对孩子的期待越高,照料者基线CGSQ总分越高(β=0.61、0.29,P<0.05)。经过治疗ADHD儿童的PSQ减分率、母亲年龄越大及儿童年级越低,照料者的CGSQ减分率越大(β=0.71、0.41、-0.31,P<0.05)。结论:盐酸哌甲酯治疗可减轻照料者的育儿压力,症状改善好、母亲年龄大及年级低的儿童照料者育儿压力减轻明显。

Changes of parenting stress in caregivers of children with attention-deficit/hyperactivity disorder after methylphenidate treatment

Objective:To explore the changes of parenting stress in caregivers of children with attention-deficit/hyperactivity disorder(ADHD) by methylphenidate hydrochloride treatment.Methods:Ninety-three children with ADHD who met the criteria of Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-IV) were treated with methylphenidate for 6 weeks.The Attention deficit hyperactivity disorder rating scale-IV home version(ADHD-RS-IV Home Version),Conners Parent Symptom Questionnaire(PSQ) were used to assess the symptoms of children with ADHD,and the Caregiver Strain Questionnaire(CGSQ) was used to assess the parenting stress of caregivers.Results:Compared with the baseline values,CGSQ total scores (46.7±16.9) vs.(40.6±13.6)] and the scores of three subscales of CGSQ were all decreased(Ps<0.05).Multiple linear regression showed that the higher baseline PSQ total score of children with ADHD and the parents’ expectation,the higher baseline CGSQ total score of caregivers(β=0.61,0.29,<0.05),and higher CGSQ reduction rate of caregivers at endpoint was associated with higher PSQ reduction rate,older mothers’ age and lower grade of children with ADHD(β=0.71,0.41,-0.31,P<0.05).Conclusion:Methylphenidate treatment could effectively reduce parenting stress of caregivers of ADHD children.Higher level of parenting stress reduction is related to greater improvement of symptoms,older mothers’ age and lower grade of children.