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

摘要:

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2 861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 2 861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1 304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。

Abstract:

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 2 861 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 2 861 ADHD children, 569 (19.89%) were classified as borderline, 846 (29.57%) as low average, 1 304 (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.