深圳市小学儿童注意力缺陷多动障碍流行病学调查

An epidemiological survey of attention deficit hyperactivity disorder in school-age children in Shenzhen

摘要:

目的：调查深圳市小学儿童注意力缺陷多动障碍（ADHD）的患病情况和行为问题。方法：采用Conners行为量表对深圳市小学1~6年级10553名学生的家长、教师进行问卷调查，对经问卷调查为ADHD行为阳性的儿童进一步采用美国精神病学会的精神障碍诊断和统计手册第 4版（DSM-Ⅳ）进行诊断。结果家长问卷和教师问卷均填写完整、合格的为 8193份。纳入研究对象年龄为7~13岁。由家长问卷量表得到ADHD行为发生率为 7.60%，由教师问卷量表得到ADHD行为发生率为5.59%。依据DSM-Ⅳ诊断ADHD 442例，总患病率为 5.39%；7～13岁各年龄组间患病率差异有统计学意义（χ2=21.613，P<0.05），其中7～9岁各年龄组患病率较高，均在6%以上；男童患病率显著高于女童（6.65% vs 3.12%，P<0.05）。冲动多动问题（79.6%）、学习问题（60.6%）和品行问题（52.0%）是ADHD儿童较突出的行为问题，其中女童学习问题显著高于男童（83.5% vs 54.7%,P<0.01）。结论：深圳市小学儿童ADHD患病率为 5.39%，其中7~9岁儿童患病率较高；男童患病率显著高于女童；冲动多动问题、学习问题和品行问题是ADHD儿童常见的行为问题。

Abstract:

OBJECTIVE: To investigate the prevalence of attention deficit hyperactivity disorder (ADHD) and behavior problems among school-age children in Shenzhen City of Guangdong. METHODS: A total of 10553 students in Grades 1-6 from different primary schools in Shenzhen City were assessed by Conners Parent Symptom Questionnaire (PSQ) and Conners Teacher Rating Scale (TRS). Children showing abnormalities according to PSQ or TRS were further assessed according to the diagnostic standard for ADHD as laid out in the diagnostic and statistical manual for mental disorders- 4th edition (DSM-Ⅳ). RESULTS: A total of 8193 PSQ and TRS assessments were completed. The children were aged from 7 to 13 years. The total prevalence rate was 7.60% by PSQ and 5.59 % by TRS. Four hundred and forty-two children were diagnosed having ADHD by DSM-Ⅳ, with a prevalence rate of 5.39%. There were significant differences in the prevalence rate of ADHD among children aged 7 to 13 years (χ2=21.613, P<0.05). In children aged 7 to 9 years, the prevalence rate was higher (above 6%). The prevalence rate of ADHD in boys was significantly higher than in girls (6.65% vs 3.12%; P<0.05). Impulsion and hyperactivity (79.6%), learning (60.6%) and conduct disorders (52.0%) were the main behavioral problems in children with ADHD. The prevalence of learning disorders was higher in girls than in boys. Conclusions The prevalence rate of ADHD in children from primary schools in Shenzhen City is 5.39 %, and it is higher in children aged 7 to 9 years. Boys have a higher prevalence rates of ADHD than girls. Impulsion and hyperactivity, learning and conduct disorders are common problems in children with ADHD.