注意缺陷多动障碍儿童不同亚型的神经心理特征

Neuropsychological characteristics of different subtypes of attention deficit hyperactivity disorder

【目的】 分析注意缺陷多动障碍 (ADHD)儿童不同亚型的神经心理特征。 【方法】 将门诊儿童符合DSM IVADHD诊断标准者 172例分为注意缺陷为主型 (PI) 5 7例 ,多动 /冲动为主型 (HI) 2 1例和混合型 (CT) 94例 ,对三型儿童进行视觉 运动整合发育测验 (VMI)和联合型瑞文测验 (CRT ) ,并进行组间比较 ,将ADHD儿童的VMI测验结果和常模比较。 【结果】 随着年龄的增长 ,HI型比例下降 ,PI型比例上升 ,差异有显著性 ;HI型男童的构成比较大 ,PI型则女童的构成比较大。得到相同的VMI原始分的年龄 ,ADHD儿童大于常模组儿童 ;和常模组比较 ,原始分为 9分组差异有非常显著性 (P <0 .0 0 1) ,10～ 12分组差异有显著性 (P <0 .0 5 ) ;ADHD三型之间的VMI结果有差别 ,PI型最差、HI型和PI型之间差异有显著性 (P <0 .0 5 )。CRT结果PI型较差 ,但三型之间差异无显著性。 【结论】 ADHD的分型和年龄、性别有关 ;ADHD儿童的视觉运动整合能力较正常儿童差 ,VMI更能反映AD HD亚型中的注意力障碍问题 ;各亚型之间计划能力、一般智力没有明显的差异。

To analysis the neuropsychological characteristics of different subtypes of attention deficit hyperactivity disorder (ADHD). 172 outpatient children whose symptoms accorded with the standard of diagnoses were divide into 3 groups :PI(57 cases),HI(21 cases)and CT(94 cases).Then, the Developmental Test of Visual Motor Integration(VMI) and Combined Raven's Test (CRT) were carried out among the 3 groups. With the increase of age ,the percentage of HI decreased and PI increasd.There were notable differences.The percentage of boys was greater in HI while the percentage of girls was greater in PI.For the ADHD children,their primitive records of psychological age in VMI test fell behind the norm. Compared with the norm,there was very remarkable difference in the group whose primitive record is 9( P <0.001) and there were remarkable differences in the group whose primitive record is 10～12( P <0.05). What’s more,the VMI test results of 3 groups were varied. PI was the worst and there was great difference between HI and PI ( P <0.05). In the results CRT, HI was the worst. However there was no remarkable difference among 3 groups.[Conclusions] The classification of ADHD is related to age and sex. The visual motor integration ability of ADHD children is weaker than that of normal children, VMI can better reflect the problem of attention deficit in different subtypes of ADHD.