儿童注意缺陷及破坏性行为障碍4年与8年随访比较

Natural prognosis of childhood attention deficit and disruptive behavior disorder: comparison between two follow-ups of 4-and 8-year

目的探讨注意缺陷与破坏性行为障碍(ADDBD)儿童的自愈率、其他精神障碍发生率随时间的变化状况。方法对2005年3—4月在河南省唐河县22所小学中诊断出的182例ADDBD儿童,分别于2009年(4年)、2013年(8年)后进行随访,依据精神障碍诊断与统计手册(第4版)进行ADDBD及其他精神障碍诊断。运用χ~2检验比较分析2次随访之间的差异。结果注意缺陷/多动障碍(ADHD)、对立违抗性障碍(ODD)自愈率均随时间而明显增高(ADHD:P=0.001,ODD:P=0.003);ADHD、ODD、ADHD+ODD儿童其他精神障碍总发生率2次随访差异无统计学意义(P>0.05);患者焦虑障碍、抑郁障碍、网络成瘾障碍及双相情感障碍发生率在2次随访间差异均无统计学意义(P>0.05)。结论 ADDBD的发展呈现随年龄逐渐减轻趋势,以ADHD、ODD表现明显;ADDBD预示着后来发生情感障碍的可能性高。

Objective To explore time variations in self-healing rate and the incidence of other psychiatric disorders among the children with attention deficit and disruptive behavior disorder （ADDBD）.Methods Two follow-up surveys at 4- and 8-year after the diagnosis of ADDBD were conducted among 182 child cases diagnosed during a study carried out between March and April 2005 in 22 primary schools in Tanghe county of Henan province.The clinical symptoms of ADDBD and other psychiatric disorders were assessed based on Diagnostic and Statistical Manual of Mental Disorders-IV （DSM-IV）.Results The self-healing rate of attention deficit hyperactivity disorder （ADHD） and oppositional defiant disorder （ODD） were both higher at the second follow-up in 2013 than those at the first-follow up in 2009 （P=0.001 and P=0.003）.There were no differences in the incidence rate of other psychiatric disorders among the children with ADHD,ODD,and ADHD comorbid with ODD （P〉0.05 for all） at the two follow-ups,so did the incidence rates of anxiety disorder,depression disorder,internet addiction disorder,and bipolar disorder （P〉0.05 for all）.Conclusion The clinical manifestations of children with ADDBD alleviate with the course of the diseases,especially for the children with ADHD and ODD.ADDBD may predict subsequent affective disorders among child cases.