注意缺陷多动障碍儿童筛查中的医教结合初探  

Pilot study on screening for ADHD by partnership between medicine and education

作　　者：杨友[1] 钟向阳 张力[3] 罗晶[4] 鲍远军 孙璞 金星明[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心发育行为儿科,中国上海200127 [2]上海市闸北区教育学院,中国上海200070 [3]广西壮族自治区妇幼保健院儿童保健科,中国南宁530021 [4]四川省泸州市人民医院儿童保健科,中国泸州646000 [5]江西省九江市妇幼保健院儿童保健科,中国九江230032 [6]重庆市永川区妇幼保健院儿童保健科,中国重庆402160

出　　处：《教育生物学杂志》2016年第2期74-78,共5页Journal of Bio-education

基　　金：上海市科委2014年医学引导类基金(14411969200)

摘　　要：目的通过医教结合探索儿童注意缺陷多动障碍(attention-deficit hyperactivity disorder,ADHD)诊断中的不足,以提高临床诊断的正确性。方法选取上海市闸北区5所小学3年级学生作为研究对象,5所3年级学生的家长和班主任同时各填写SNAP-Ⅳ筛查问卷498份。结果以SNAP-Ⅳ得分值>1分为界,家长组总体阳性率比教师组高,单独注意缺陷和混合型差异有统计学意义(P<0.05)。进一步分析,18.27%的家长问卷阳性而教师问卷阴性(男46,女45),8.43%的教师问卷阳性而家长问卷阴性(男31,女11),19.28%家长问卷和教师问卷同时阳性(占阳性问卷的41.92%,男72,女24)。家长阳性教师阴性组与教师阳性家长阴性组及教师和家长均阳性组相比,注意缺陷分值差异有统计学意义(P<0.01);家长阳性教师阴性组与教师和家长均阳性组相比,多动冲动分值差异有统计学意义(P<0.01)。根据性别分组,仅教师和家长均阳性组的教师组在多动冲动领域显示有性别差异(P<0.01)。结论家长和教师提供的行为症状存在明显差异,同时家长和教师应当有不同的SNP-Ⅳ阳性率界值。临床诊断需要有教师报告,医教结合将使ADHD疾病诊断更加完善。Objective To improve the diagnosis of attention-deficit hyperactivity disorder（ ADHD） by adding the children＇s information from teachers in school. Methods A total of 498 students of grade three were selected in five primary schools in Zhabei district of Shanghai. Their parents and teachers were requested to answer the questionnaires of SNAP-Ⅳfor ADHD screening. Results At the cutoff 1,the overall positive rate of parent group was higher than that of teachers,and there was a significant difference between the attention deficit only and the mixed group（ P 0. 05）. Further,ninetyone（ 18. 27%） questionnaires were positive for parents only（ 46 boys,45 girls）. Forty-two（ 8. 43%） questionnaires were positive for teachers only（ 31 boys,11 girls）. Ninety-six（ 19. 28%） questionnaires were positive for both teachers and parents（ 72 boys,24 girls）. There were significant differences between parents and teachers in both attention deficit andhyperactivity on SNAP-Ⅳ questionnaire. There were significant sex differences in teachers subgroup for both teachers and parents positive group. Conclusion There is an obvious difference between parents and teachers to provide behavioral symptoms. At the same time,parents and teachers should have different positive cutoff of SNP-Ⅳ. We should have a faculty report. The combination of education and medicine will make the diagnosis of ADHD more perfect.

关 键 词：注意缺陷多动障碍 筛查 医教结合 

分 类 号：R749.94[医药卫生—神经病学与精神病学]