儿童注意缺陷多动障碍认知功能不同干预模式效果分析

目的了解单独药物治疗、心理治疗以及药物联合心理治疗干预模式对注意缺陷多动障碍(Attention Deficit HyperactivityDisorder,ADHD)儿童认知功能的作用,探讨最佳干预模式。方法研究对象来源于2008年3月至2009年9月,在南昌大学第一附属医院心身医学科门诊及江西省心理康复中心心理门诊就诊的初诊患儿共102例,均明确诊断为ADHD。将患儿随机分为心理干预组(33例)、药物干预组(35例)及综合干预组(34例),分别应用心理治疗、药物治疗和药物联合心理治疗的方法进行干预,疗程3个月。干预前后使用持续注意测验、威斯康辛卡片分类测验、韦氏儿童智力量表、Conner’s儿童行为量表(父母版)对患儿的认知功能及精神症状进行评估。结果共85例患儿完成治疗;干预3个月后3组患儿持续注意测验、威斯康辛卡片分类测验各项指标以及C因子均较干预前改善(P值均<0.05);综合干预模式对患者认知功能改善效果最佳(P值均<0.05),心理治疗与药物治疗对认知功能改善作用差异无统计学意义(P>0.05);干预1.5月后药物干预组和综合干预组患者精神症状改善程度优于心理干预组(P<0.05),而干预3个月后综合干预组患者精神症状改善程度优于其他两组。结论综合干预模式对ADHD患者的认知功能及精神症状的改善效果优于单纯的心理治疗及药物治疗,是理想的ADHD干预模式。

Effects of cognitive function in children with attention deficit hyperactivity disorder by different intervention model

Objective To compare the effect of cognitive function in children with Attention Deficit Hyperactivity Disorder(ADHD) caused by three intervention models including single pharmacotherapy,psychotherapy and drugs combined psychological treatment,and to explore the best intervention model.Methods One hundred and two cases of ADHD children were divided into psychological intervention group,single medication group and comprehensive treatment group randomly,then respectively treated with psychotherapy,drugs and combination treatment for 3 months.The cognitive function and psychiatry symptoms were judged by the Continuous Performance Task(CPT),Wisconsin Card Sorting Test(WCST),Chinese Wechsler intelligence scale for children(C-WISC)and Conner’s parent Symptom Questionnaire(PSQ).Results Totally 85 patients completed the therapy.After treatment for 3 months,the Continuous Performance Task(CPT),Wisconsin Card Sorting Test(WCST) and Freedom From Distractibility of Chinese Wechsler intelligence scale for children(C-WISC)in three groups were improved after treatment(P<0.05).The comprehensive treatment had the best effect(P<0.05),and there was no significant difference between psychotherapy and drugs(P>0.05).Psychiatric symptoms in both the medication group and comprehensive treatment group were improved better than in the psychological treatment group after a month and a half(P<0.05),but after 3 months the therapeutic effect of the comprehensive group was better than the other two groups.Conclusion It is indicated by the results of study that comprehensive therapy can improve cognitive function and psychiatry symptoms in children with ADHD,superior to psychotherapy or drugs,and it is a ideal intervention mode of ADHD.