注意缺陷多动障碍儿童的智力现状及其影响因素

Intellectual status and factors influencing the intelligence in children with attention deficit and hyperactive disorder

目的了解6~16岁注意缺陷多动障碍(attention deficit and hyperactive disorder,ADHD)儿童的智力水平及其影响因素。方法采用回顾性研究方法收集2014年10月—2022年9月河南省儿童医院符合美国精神障碍诊断与统计手册第5版诊断标准的2861例ADHD儿童,采用韦氏儿童智力量表第4版测试ADHD儿童的智力水平。根据智商得分,总智商划分为临界(70~79分)、中下(80~89分)、中等(90~109分)、中上(110~119分)、优秀(≥120分)5个智力等级,并比较不同性别、不同年级、不同父母文化程度患儿智力水平的差异。结果2861例ADHD儿童中,总智商等级处于临界水平为569例(19.89%),中下为846例(29.57%),中等为1304例(45.58%),中上为111例(3.88%),优秀为31例(1.08%)。男童工作记忆、加工速度和总智商的得分低于女童(P<0.05);不同年级组间知觉推理、工作记忆、加工速度和总智商得分的比较差异具有统计学意义(P<0.05);ADHD儿童的言语理解、知觉推理、工作记忆、加工速度和总智商得分与父母文化程度相关(P<0.05)。结论ADHD儿童智力等级为中下和临界水平的比例较高,且其智商水平受到性别、年级和父母文化水平的影响。

Objective To study the intellectual level and the factors influencing the intelligence in children aged 6-16 years with attention deficit hyperactivity disorder(ADHD).Methods A retrospective study was conducted on 2861 children who were diagnosed with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition between October 2014 and September 2022 at Henan Children's Hospital.The Wechsler Intelligence Scale for Children-Fourth Edition was used to assess the intellectual levels of the ADHD children.Based on intelligence quotient(IQ)scores,the intellectual levels were classified into five categories:borderline(70-79),low average(80-89),average(90-109),high average(110-119),and superior(≥120).The intellectual levels among the children of different genders,grades,and parental education levels were compared.Results Among the 2861 ADHD children,569(19.89%)were classified as borderline,846(29.57%)as low average,1304(45.58%)as average,111(3.88%)as high average,and 31(1.08%)as superior.The boys had lower scores in working memory,processing speed,and overall IQ than the girls(P<0.05).There were significant differences in perceptual reasoning,working memory,processing speed,and overall IQ scores among different grade groups(P<0.05).The scores in language comprehension,perceptual reasoning,working memory,processing speed,and overall IQ were found to be associated with parental education level in ADHD children(P<0.05).Conclusions The proportion of ADHD children with low average and borderline intellectual levels is relatively high.The IQ level of ADHD children is influenced by gender,grade level and parental education level.