注意缺陷多动障碍共患对立违抗障碍儿童的家庭环境因素

Family environment factors in children with attention-deficit/hyperactivity disorder and comorbid oppositional defiant disorder

目的:探讨注意缺陷多动障碍(ADHD)共患对立违抗障碍(ODD)的儿童家庭环境特点及家庭危险因素。方法:选取符合DSM-5诊断的140例ADHD儿童(伴ODD亚组34例、不伴ODD亚组106例),正常对照儿童45例,由父母填写一般情况问卷和家庭环境量表中文版(FES-CV)。采取多重回归分析探讨ADHD、ADHD共患ODD的家庭相关因素。结果:多重回归分析显示,儿童月龄越低(β=-0.03,P<0.01)、家庭亲密度(β=-0.50,P<0.05)和组织性(β=-0.49,P<0.01)越低、矛盾性(β=0.30,P<0.05)越高,患ADHD的风险越大;儿童家庭矛盾性(β=0.21,P<0.05)和控制性(β=0.20,P<0.05)越高,ADHD儿童共患ODD的风险越大。结论:儿童月龄低、家庭亲密度和组织性低、矛盾性高是ADHD的危险因素。家庭矛盾性和控制性高是ADHD共患ODD的危险因素。

Objective: To investigate the characteristics of family environment of children with attention-deficit/hyperactivity disorder (ADHD) and comorbid oppositional defiant disorder (ODD),and to analyze the risk factors for ADHD and ODD. Methods: Totally 140 children with ADHD (34 cases in ADHD with ODD group,106 in ADHD without ODD group) meeting the diagnostic criteria of DSM -5 and the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL), and 45 normal children were selected. The general information questionnaire and Family Environment Scale-Chinese Version (FES-CV) were reported by parents. Results: M ultiple regression analysis showed that children age (β=- 0. 03,P < 0. 01),family cohesion (β=- 0. 50,P < 0. 05),and organization (β=- 0. 49,P < 0. 01) had negative association with ADHD diagnosis,while family conflict had positive association (β= 0. 30,P < 0. 01). Family conflict (β= 0. 21,P < 0. 05) and control (β= 0. 20,P < 0. 05) had positive association with comorbidity of ADHD and ODD. Conclusion: It suggests that younger age,lower family cohesion and organization may be risk factors for ADHD,and higher family conflict and control may be risk factors for comorbidity of ADHD and ODD.