山东滨州市6～16岁少儿注意缺陷多动障碍现况调查

A Cross-Sectioual Study of Attention Deficit Hyperactiviey Disorder in 6～16 Year-old Children in Northern Shangdong Province

目的:比较少年(12～16岁)与学龄儿童(6～11岁)注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)患病情况及临床特点,为儿童ADHD的全面干预提供依据。方法:用分层整群抽样的方式,以学校为单位从鲁北4县市抽取4263名6～16岁儿童,采用问卷调查和专科访谈相结合的方法,按DSM-Ⅳ的ADHD诊断标准进行诊断,根据症状维度分布进一步区分为3种亚型:注意缺陷型(ADHD-I)、多动冲动型(ADHD-HI)和混合型(ADHD-C)。结果:(1)6～16岁少儿ADHD的总患病率为6.4%,ADHD-I型是主要类型,占63.7%;男童患病率高于女童(8.9%vs4.1%,P<0.001);少年患病率低于学龄儿童(5.3%vs.7.7%,P=0.002)。(2)不同年龄少儿ADHD亚型分布有差别,与学龄儿童组相比,少年组ADHD-HI和ADHD-C明显减少(9.5%vs.18.4%,9.5%vs.32.7%),ADHD-I明显增多(81.0%vs.49.0%)(P<0.001);少年ADHD患者的3项注意缺陷症状因子和6项多动-冲动症状因子患病率降低(P<0.001或0.01或0.05)。结论:注意力缺陷是少儿注意缺陷多动障碍的核心症状;注意缺陷多动障碍在较高年龄组的少年中患病率有降低趋势,多动-冲动症状改善更明显。

Objective： To compare the epidemiology and clinical characteristics of attention deficit hyperactivity disorder （ ADHD ） in adolescents （ 12- 16 years ） and school-age children （ 6 - 11 years ） to provide reference data for a comprehensive intervention to children ADHD. Methods： A population-based questionnaire study was conducted among subjects aged 6 - 16 years sampled from schools in Northern Shandong. Totally 4263 children （ adolescents 2358, school-age children 1905） were chosen by stratified-clustered-random sampling. The estimation of ADHD was investigated by asking the parents to complete ADHD questionnaires and subjects were followed up. The diagnosis for ADHD was made according to the Diagnostic and Statistical Manual of Mental Disorders （ DSM-Ⅳ） cliterca, which was divided into three kinds of subtypes in accordance with distribution of symptom dimensions. Results： The total prevalence of ADHD was 6.4% in this sample, which was predominated by the inattentive type （ ADHD-Ⅰ ） （63.7%） . The prevalence of ADHD was higher in males than in females （ 8.9% vs. 4. 1%, P 〈 0. 001 ）, and lower in adolescents than in school-age children （ 5.3% vs. 7. 7%, P = 0. 002 ） ~ Distribution of subtypes was different in ADHD children of different age. Compared with school-age children group, the hyperactive/impulsive type （ADHD-HI） and combined type （ADHD-C） were lower, and the inattentive type （ ADHD-Ⅰ ） was higher in adolescent group （ P 〈0. 001 ） . The prevalence of 3 symptomatic factors of inattention and 6 symptomatic factors of hyperactivity/impulsivity in adolescents ADHD was lower than that in school-age children ADHD. Conclusion： Inattention is central symptom for children ADHD. ADHD, symptom of hyperactivity/impulsivity especially in the elder groups have trends of lower prevalence rate.