宁波市中学生ADHD症状及相关睡眠紊乱调查

目的 了解浙江省宁波市中学生注意缺陷多动障碍(ADHD)现状及其睡眠紊乱情况。方法 于2015年5-6月采用分层随机整群抽样方法抽取宁波市中学生2 133人,采用自编一般情况调查表、中文版注意缺陷多动障碍评定量表-父母版(SNAP-IV)及失眠严重程度指数量表(ISI)对学生和家长进行现场问卷调查。结果 ADHD症状评分正常组、临界组、中度异常组和重度异常组的比例分别为87.2%(1 861/2 133)、9.3%(199/2 133)、2.5%(54/2 133)和0.9%(19/2 133),男性高于女性(Z=5.68,P < 0.01),低年级高于高年级(r_s=-2.02,P < 0.05);ADHD评分正常组、临界组、中度异常组和重度异常组失眠比例依次为20.63%(384/1 861)、31.66%(63/199)、37.04%(20/54)和42.11%(8/19),ADHD严重程度与失眠严重程度呈正相关(r_s=4.36,P < 0.01);各组上床、起床时间及睡眠时间差异均无统计学意义,ADHD症状临界组、中度异常组及重度异常组的ISI各单项评分及总分均高于正常组;注意缺陷评分、多动冲动评分及ADHD评分总分与ISI总分均呈正相关,以注意缺陷与ISI总分相关性最高。结论 ADHD症状高评分学生有较高的失眠发生率,提示对失眠症状的干预应作为ADHD的治疗目标之一。

Prevalence of attention deficit hyperactivity disorder and its relationship with sleep disorder among middle school students in Ningbo city

Objective To investigate the prevalence of attention deficit hyperactivity disorder(ADHD) and sleep disorder among middle school students in Ningbo city.Methods Stratified random cluster sampling was used to select 2 133 middle school students and their parents in Ningbo city for a self-administered questionnaire survey between May and June 2015 with a self-compiled questionnaire and Short Form,Parental Version of the Chinese Swanson,Nolan,and Pelham-IV(SNAP-IV);Insomnia Severity Index(ISI) was used to evaluate sleep status of the students.Results The proportions of the students with normal,critical,moderately abnormal,and severely abnormal SNAP-IV score for ADHD symptoms were 87.2%(1 861/2 133),9.3%(199/2 133),2.5%(54/2 133),and 0.9%(19/2 133),respectively;the boy students reported higher SNAP-IV score than the girl students(z=5.68,P < 0.01) and the students of low grade reported higher SNAP-IV score than the students of high grade (r_s=-2.02,P < 0.05).The proportions of self-reported insomnia were 20.63%(384/1 861),31.66%(63/199),37.04%(20/54),and 42.11%(8/19)for the students with normal,critical,moderately abnormal,and severely abnormal SNAP-IV score.The degree of ADHD was positively correlated to the severity of insomnia(H=4.36,P=0.00).There were no significant differences in the time of going to bed and getting up and the total sleep time among the students with different SNAP-IV score.The students with critical,moderately abnormal,and severely abnormal SNAP-IV score had higher total and domain ISI score than the students with normal SNAP-IV score.The scores of attention deficit and hyperactivity impulse score and overall ADHD score were positively correlated mildly with total ISI score.Conclusion The students with higher SNAP-IV score for ADHD symptoms had a higher incidence of insomnia and the result suggests that the intervention on insomnia could be adopted as one of measures for ADHD treatment.