学前注意缺陷多动障碍患儿与正常儿童家庭功能的比较研究

Comparison of family functions of attention deficit hyperactivity disorder and normal preschool children

目的探讨福建省四个地市学前儿童注意缺陷多动障碍(ADHD)家庭功能缺陷的特征。方法采取随机抽样的方法抽取本省四市10所幼儿园,再从这些幼儿园中分层抽取小班、中班和大班的幼儿作为调查对象。由家长填写注意缺陷多动障碍SNAP-Ⅳ评定量表,评估阳性的幼儿作为研究组,再由家长填写家庭功能量表(FAD)。结果对1 076名幼儿进行了SNAP-Ⅳ评估,筛查出阳性的幼儿474名,阳性率为44%。对阳性的幼儿按照DSM-5的诊断标准进行诊断,共有63例幼儿符合ADHD的诊断标准。与年龄相匹配的63名正常儿童比较,学前ADHD组患儿家庭功能的沟通、角色、情感反应、情感介入、行为控制分量表和总的功能得分均低于正常对照组儿童,差异具有高度统计学意义(P<0.01),问题解决分量表得分差异无统计学意义;不同性别学前ADHD组儿童家庭功能的各分量表得分差异无统计学意义(P>0.05);小班、中班和大班ADHD儿童在家庭功能得分的比较中显示,沟通、行为控制和功能总分三个方面有高度统计学意义(P<0.01)。结论福建省学前ADHD患病情况不容忽视,且家庭功能存在缺陷。

Objective To explore the prevalence and family functions of attention deficit hyperactivity disorder(ADHD)with preschool children in four cities of Fujian province. Methods Totally 1 076 children from 10 kindergartens in four cities of Fujian province were screened randomly by their parents who finished questionnaire ADHD SNAP-Ⅳfirst,and then the children who had positive SNAP-Ⅳ were assessed family functions for by Family Assessment Device(FAD). Results There were 474 children screened positively from 1 076 children by SNAP-Ⅳ,and 63 children of them diagnosed by DSM-Ⅴcriteria for ADHD.The rate of positive SNAP-Ⅳscreening was 44%in four cities of Fujian.There were significantly lower scores of communication,roles,affective responsiveness,affective involvement and behavior control subscales,and scores of general function in FAD of preschool ADHD group than that of typically developed children(P<0.01),but there were no significantly differences of scores of subscale of problem-resolve in FAD between two groups.There was no significantly difference of scores of any subscale in FAD between boys and girls(P>0.05),but there were significantly differences of scores of communication,behavior control and general function in FAD among early stage,medium stage and later stage in preschool children(P<0.01). Conclusion We must face the facts of the high prevalence of preschool ADHD and their family faultiness in Fujian.