未成年犯共患不同亚型注意缺陷多动障碍的调查研究

Investigation of delinquent junior comorbidity with different attention deficit hyperactivity disorder subtypes

【目的】探讨男性未成年犯注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)的患病情况、亚型分布、行为障碍类型,为早期预防未成年人犯罪提供理论依据。【方法】取在押男性未成年犯76名,采用Vanderbilt ADHD家长评定量表进行调查,诊断为ADHD的未成年犯41例纳入未成年犯组。取神经心理科门诊男性、初诊患者,采用Vanderbilt ADHD评定量表进行评定,诊断为ADHD者38例纳入对照组。【结果】未成年犯ADHD的患病率高。未成年犯ADHD亚型分布与普通ADHD青少年不同,以多动冲动型和混合型为主。未成年犯组多动冲动型占51.22%,混合型占36.58%;而对照组注意缺陷型占39.47%,混合型占47.37%,两组亚型分布差异具有统计学意义(P<0.01)。对照组ADHD合并外化性行为障碍和内化性行为障碍,其在亚型之间分布有差异。而未成年犯组ADHD合并外化性行为障碍和混合性行为障碍,其在亚型之间分布无差异。【结论】未成年犯共患ADHD率高,诊断和治疗ADHD过程中,应对ADHD进行区别诊断和针对性治疗,对其预后和转归有着重要意义。

【Objective】 To explore the prevalence,different clinical subtype distribution and behavioral problems of delinquent junior with attention deficit hyperactivity disorder（ADHD） and to provide theoretical basis for early preventing delinquent junior. 【Methods】 Using Vanderbilt ADHD Parent Rating Scale,41 cases of delinquent junior males with ADHD were diagnosed,namely delinquent junior group.38 common adolescents males with ADHD who were diagnosed by Vanderbilt ADHD Rating Scale in the outpatient department were control group. 【Results】 The prevalence of ADHD in delinquent junior was obviously higher than common children.The main ADHD subtypes were predominantly hyperactivity-impulsive type and combine type in delinquent junior.This was different with common ADHD adolescents.There were 51.22% predominantly hyperactivity-impulsive type and 36.58% combine type in delinquent junior group.However,the control group had 39.47% predominantly inattentive type and 47.37% combine type.The delinquent junior with ADHD comobid externalizing disorders and co-existed externalizing disorders and internalizing disorders.Behavior problems distribution was not different in three clinical subtypes.But there was different in three clinical subtypes of common ADHD adolescents. 【Conclusions】 The prevalence of ADHD in delinquent junior is obviously higher than common adolescents.ADHD diagnosis and treatment should be differentiated individually.It has great significance on prognosis and outcome.