门诊注意缺陷多动障碍儿童家庭环境因素分析

目的 探讨家庭环境因素在儿童注意缺陷多动障碍（ADHD）发病中的作用。方法 采用DSM-IV标准对门诊因注意力不集中、多动冲动表现或学习成绩下降而就诊的2296名儿童进行诊断，同时采用自行设计的问卷调查儿童的家庭环境情况，采用单因素分析和非条件多因素Logistic回归分析，研究可能导致ADHD发病的因素。结果 2296名儿童中，720名诊断为ADHD。ADHD儿童与非ADHD儿童的家庭环境因素比较差异存在统计学意义（P<0.05或P<0.01）。可能导致ADHD发病的危险因素包括父母婚姻不融洽、父母有吸烟史以及母亲孕期及产后常有情绪低落现象；儿童年龄大、女性、父亲文化程度高为ADHD发病的保护因素。结论 不良家庭环境对ADHD发病可能产生影响，在对ADHD进行防治时应充分考虑家庭环境因素的作用。

Analysis of family environment of children with attention deficit hyperactivity disorder in clinics

Objective To investigate the characteristics of family environment in children with attention deficit hyperactivity disorder (ADHD) in clinics, and analyse the risk factors for ADHD. Methods Two thousand two hundred and ninety-six children with inattention, hyperactivity or unfavourable school performance were subjected to diagnosis with DSM-Ⅳ criteria in clinics. The characteristics of family environment were investigated by self-prepared questionnaires. The risk factors for ADHD were explored by univariate analysis and noneonditioned multivariate Logistic regression analysis. Results Seven hundred and twenty children were diagnosed with ADHD. There were significant differences in family environment between children with ADHD and those without(P<0.05 or P<0.01). The risk factors for ADHD included discord between parents, parental smoking and maternal depression during pregnancy and after delivery, while older age, female, paternal higher educational background were protective factors for ADHD. Conclusion Unfavourable family environment may be associated with the prevalence of ADHD, and special attention should be paid to the family environment in the treatment of ADHD.