功能性遗粪症儿童心理发育特点的病例对照研究  

A Case-Control Study on the Psychological Characteristics of Children with Functional Encopresis

作　　者：衣明纪[1] 周晓彬[2] 王敬彩[1] 冉霓[1] 傅芃[1] 

机构地区：[1]青岛大学医学院附属医院儿童保健科,山东青岛266003 [2]青岛大学医学院流行病与卫生统计学教研室,山东青岛266021

出　　处：《实用儿科临床杂志》2008年第23期1836-1838,1847,共4页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨功能性遗粪症(FE)儿童的心理行为发育特点,为其心理干预提供理论依据。方法采用分层随机整群抽样法从青岛市城区抽取4044名4～5岁儿童。男2196名,女1848名。应用自制的儿童一般情况与遗粪症影响因素调查问卷、Achenbach儿童行为量表(CBCL)、3～7岁儿童气质量表与家庭环境量表-中文版(FES-CV)调查抽样儿童的家庭环境和生长发育状况,将调查发现的90例FE儿童作为病例组,其他儿童作为健康对照组,采用病例对照研究的方法探讨FE儿童的气质、行为和家庭环境特征。FE诊断依据中国精神疾病分类手册第3版(CCMD-3)标准。结果4～5岁儿童FE的患病率为2.23%(90/4044例),其中男童患病率为1.46%(32/2196例),女童患病率为3.14%(58/1848例)。FE儿童气质维度方面规律性、趋避性、适应度和坚持度的得分均高于健康对照组(Pa<0.05),注意分散度得分低于健康对照组(Pa<0.05);家庭环境特征方面病例组亲密度和组织性得分均低于健康对照组(Pa<0.05),而矛盾性得分高于健康对照组(P<0.01);FE儿童发生行为问题的风险较健康对照组大(OR=1.931)。FE是男童发生不成熟、分裂样、攻击和行为总分异常的危险因素(OR=2.96,3.94,8.26,3.22),是女童发生体诉、攻击性和多动的危险因素(OR=4.35,3.47,2.14);FE儿童患注意缺陷多动障碍(ADHD)的风险大于健康对照组(OR=2.650)。结论FE的实际患病率远远超过临床医师的估计。FE儿童有其气质特点,发生行为问题及患ADHD的风险较高。FE对儿童的行为发展和家庭环境造成不良影响,为改善FE儿童的生命质量,对其进行心理干预是必要的。Objective To explore the psychological characteristics of children with functional encopresis（ FE ） and provide theoretical basis for psychological intervention of FE. Methods A population - based questionnaire study was conducted among subjects 4 - 5 years old sampled from kindergartens in Qingdao and subjects were followed up. Four thousand and forty -four children aged 4 -5 years old（2 196 male, 1 848 female） were chosen by stratified- clustered -random sampling. Their family conditions, growth and development were investigated by questionnaires including self-made general condition and factors influencing encopresis questionnaire,Achenbach Child Behavior Checklist （CBCL） ,3 -7 years old children temperament questionnaire and family enviromnent scale - Chinese version（ FES - CV）. The temperamental and behavioral features,family environment of children with FE were analyzed. The diagnostic criteria of FE was based on CCMD -3. All statistical analyses were completed by SPSS 13.0 software. Results The morbidity rate in FE of children aged 4 - 5 years old was 2.23% （90/ 4 044）, of the total 1.46% （32/2 196） male,3.14% （58/1 848 ） female. The scores of rhythmicity, approach,adaptability, attention span and persistence,distractibility were significantly different from those of control group（Pa 〈 0. 05）. Children with FE lived in worse family environment. The cohesion and organization scores were lower than those of control group （Po 〈 0.05 ）. The conflict score was higher than that of control group （ P 〈 0. 01 ）. Children with FE had a higher risk of behavior problems （ OR = 1.931 ）. The abnormalities of immaturity, schizoid state, aggressiveness and the total score of behavior in male （ OR = 2.96,3.94,8.26,3.22 ） , somatic complaints, aggressiveness and restless behavior in female were more conmmn among children with FE（ OR =4.35,3.47,2.14）. The attention deficit hyperactivity disorder（ADHD） was far more common among children with FE than among normal ch

关 键 词：功能性遗粪症 心理 气质 行为 家庭环境 儿童 

分 类 号：R749.94[医药卫生—神经病学与精神病学]