注意缺陷多动障碍与抽动障碍共病患儿家庭环境特征研究  

An investigation of family environment characteristics of children with comorbid attention deficit hyperactivity disorder and tic disorder

作　　者：匡桂芳[1] 傅平[1] 冀永娟[1] 夏颖[1] 吴爱勤[2] 

机构地区：[1]青岛市妇女儿童医疗保健中心,山东青岛266011 [2]苏州大学医学院第一附属医院,江苏苏州215006

出　　处：《中国妇幼健康研究》2011年第1期7-10,共4页Chinese Journal of Woman and Child Health Research

基　　金：青岛市科学技术局基金资助项目（08-2-1-6-nsh）

摘　　要：目的探讨注意缺陷多动障碍与抽动障碍共病患儿的家庭环境特征。方法采用自制的一般情况调查问卷及家庭环境量表中文版对注意缺陷多动障碍与抽动障碍共病组60例患儿、注意缺陷多动障碍组79例患儿、抽动障碍组60例患儿及正常对照组71名儿童分别进行评估。结果注意缺陷多动障碍与抽动障碍共病组不和睦家庭占16．7％，父亲文化程度为高中以下者占76．7％，父母对孩子有不合理期望的占41．7％，亲子缺乏交流的占35％，对孩子不良行为的态度采用惩罚的父亲占55．0％，母亲占48．3％。注意缺陷多动障碍与抽动障碍共病组与注意缺陷多动障碍组比较，家庭环境量表中文版中所有10个分量表得分均无明显差异（均P〉0．05）。注意缺陷多动障碍与抽动障碍共病组亲密度（7．17±2．12）、知识性（3．40±2．11）与组织性（5．55±2．01）得分低于抽动障碍组（分别为：7．90±1．67、4．72±2．04、6．50±1．87）。注意缺陷多动障碍与抽动障碍共病组道德宗教观得分低于正常对照组（分别为：5．30±1．50比5．87±1．25），独立性得分（5．53±1．31）高于正常对照组（5．06±1．47），矛盾性得分（4．32±2．58）高于正常对照组（2．68±1．82），知识性（3．40±2．11）、娱乐性（3．83±2．59）、组织性（5．55±2．01）得分低于正常对照组（分别为：5．13±1．85、5．34±2．14、6．80±1．75）。结论注意缺陷多动障碍与抽动障碍共病患儿的家庭环境特征与注意缺陷多动障碍患儿是相似的，均存在家庭功能缺陷，治疗应采取包括改善家庭环境在内的综合治疗措施。Objective To investigate family environment characteristics of children with comorbid attention deficit hyperactivity disorder （ADHD） and tic disorder （TD） （CAT）. Methods 60 children with CAT, 79 children with ADHD, 60 children with TD and 71 normal children were investigated using a self-designed general information questionnaire and Family Environment Scale-Chinese Version （FES- CV）. Results In CAT group, 16.7% of children lived in inharmonious family; the proportion of family in which father＇ s educational level below senior middle school was 76.7% ; 41.7% of parents having unreasonable expectation for their children; 35% children lacked communication with their parents; 55.0% of fathers and 48.3% of mothers punished the children for their ill behaviors. There were no significant differences in scores in all 10 subscales of FES-CV between CAT group and ADHD group （ all P 〉 0.05 ）. In CAT group, scores of children in cohesion, intellectual-cultural orientation and organization （7. 17 ±2. 12, 3.40 ± 2. 11 and 5.55 ± 2.01 respectively） in FES-CV were significantly lower than those in TD group （7.90 ± 1.67, 4.72 ± 2.04 and 6.50 ± 1.87 respectively）. The scores of children in family＇ s moral religious emphasis in CAT group were lower than those than N group （5.30 ± 1.5 vs 5.87 ± 1.25） , those in independence and conflict subscales were higher than those of children in N group （5.53 ± 1.31 vs 5.06 ± 1.47; 4.32 ± 2.58 vs 2.68 ± 1.82）, while those in intellectual-cultural orientation, entertainment and organization were all lower than those in N group （3.40 ±2. 11 vs 5. 13 ± 1. 85; 3. 83 ±2. 59 vs 5. 34 ±2. 14; 5. 55 ±2. 01 vs 6. 80 ± 1. 75）. Conclusion The characteristics of family environment of CAT children are similar to those of ADHD children. Both of them have deficits in family functions, so combined treatment should include improving the family environment of these children.

关 键 词：注意缺陷多动障碍 抽动障碍 共病 家庭环境 

分 类 号：R174[医药卫生—妇幼卫生保健]