儿童注意缺陷多动障碍DSM-Ⅳ亚型的临床特征比较研究

Clinical Features of Subtypes of ADHD in DSM-Ⅳ

目的 :比较DSM -Ⅳ注意缺陷多动障碍 (AD/HD)以注意障碍为主型 (PI)、以多动 /冲动为主型 (HI)和混合型 (CT)的临床特征。方法 :将门诊儿童符合DSM -ⅣADHD诊断标准者 12 6例分为PI型 61例 ;HI型 9例、CT型 5 6例 ,比较三型合并障碍的诊断 ,父母、教师量表评分 ;韦氏儿童智力测验 (C-WISC)和注意测验。结果 :CT组合并品行障碍的发生率 ,父母、教师评定违纪行为和攻击性行为分量表、外向性行为问题及行为问题均显著高于PI组 ,WISC填图、划销测验净分低于PI组。教师评定学校情况PI组优于HI组和CT组。结论 :ADHD混合型的外向性行为问题、学业问题、注意力缺陷最严重 ,注意障碍为主型则在各方面损害较轻。

Objective:To explore the clinical features of subtyp es of ADHD in DSM-Ⅳ.Method:126 children fulfilled ADHD criteria of D S M-Ⅳ were further divided into 3 subtypes:predominantly inattentive(PI,61 cases) , predominantly hyperactive-impulsive(HI,9 cases)and combined type(CT,56 cases).C om orbid mental disorders were compared among the three groups.Parents and teacher s of children in each group completed CBCL(child behavior checklist)and TRF(teach er's report form).CWISC(Wechsler intelligence scale for children,Chinese versio n )and attention tests were also applied in each group.Results:Childr e n in CT group had more conduct disorder,more externalizing,delinquent and aggres sive behaviors rating by parents and teachers,and more inattentive than children in PI group.School performance of children in PI group was better than that of the other two groups evaluated by teachers.Conclusion:ADHD CT subty pe had highest rate of comorbid conduct disorder.They have more externalizing b ehavior,more academic problems and more inattentive.This subtype may be the mos t impaired subtype.