家庭社会经济地位与学龄前儿童注意缺陷多动障碍的相关研究

Study on the associations between family socioeconomic status and attention deficit hyperactivity disorder symptoms in preschoolers

目的了解学龄前儿童注意缺陷多动障碍(ADHD)的流行情况,分析家庭社会经济地位与ADHD发生的关系,为儿童ADHD的防控和干预提供科学依据。方法采用方便整群抽样的原则,从农村地区的5所幼儿园和城市地区的2所幼儿园共抽取1 142名4～7岁的儿童,对其家长进行问卷调查。采用《ADHD评估量表(第4版)-学龄前儿童版》评估ADHD的症状水平。结果学龄前儿童ADHD症状阳性率为7.01%,男童检出率为7.38%,女童检出率为6.56%。农村地区检出率为7.99%,城市地区为6.67%。多因素分层回归显示,女童、父亲年龄较大者,家里儿童读物数量较多者,ADHD症状水平较低。此外,3岁后每年生活总花费较高者,其ADHD症状阳性率越高,这种趋势主要表现在城市儿童中,农村儿童则相反。结论家庭社会经济地位,特别是对学龄前儿童生活的投入与儿童ADHD密切相关,但是城乡差异和儿童年龄差异在其间起重要的调节作用。

Objective To know about the prevalence of attention deficit hyperactivity disorder（ADHD）in preschoolers,and to analyze the association between family socioeconomic status and ADHD symptoms in preschoolers.Methods A total of 1 142 children aged 4～7 and their parents were recruited from 7 kindergartens in rural and urban areas by convenient cluster sampling.ADHD symptoms were assessed by ADHD Rating ScaleⅣ-Preschool Version,and parents were requested to fill out the questionnaire.Univariate and multivariate Logistic regression analysis was applied to analyze the data.Results The overall prevalence of ADHD in preschoolers was 7.01%,and 7.38%for boys,6.56%for girls.The prevalence of ADHD in rural areas was 7.99%,while 6.67%in urban areas.Multivariate Logistic regression showed that girls and children whose father was older and with more book tended to have fewer ADHD symptoms.In addition,children with higher annual living cost after three years old showed more ADHD symptoms in preschool period.However,the association was only obvious in children from urban areas,and children in rural areas showed opposite results.Conclusions Family socioeconomic status,especially the living cost for children,have a significant association with ADHD symptoms in preschoolers.Furthermore,the differences on economic disparities between urban and rural areas and among children at different age stages,play an important mediating effect on the association between family socioeconomic status and ADHD symptoms.